Advocate Issue 4 2019 by FVMA

F V M A ADVOCATE ISSUE 4 | 2019

CARE AND MONITORING OF THE CRITICAL PATIENT

TAMI LIND, BS, RVT, VTS(ECC)

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INCORPORATING BEHAVIOR STRATEGIES INTO PATIENT CARE: PRACTICAL SOLUTIONS FOR DAILY SITUATIONS

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CHRISTOPHER L. PACHEL, DVM, DACVB, CABC

THE

ANNUAL

GULF-ATLANTIC VETERINARY CONFERENCE

DE CE MBE R 5 - 8, 2 019 BOCA RATON RESORT & CLUB, A WALDORF ASTORIA RESORT

A SCIENTIFIC PROGRAM TO ENRICH EVERY MEMBER OF THE SMALL ANIMAL VETERINARY CARE TEAM Details on pages 14-19

President's Message 7207 Monetary Drive Orlando, Florida 32809 Phone – 407.851.3862 Toll Free – 800.992.3862 Fax – 407.240.3710 info@fvma.org | www.fvma.org

OFFICERS

Dr. Michael Epperson President Dr. Mary Smart President-elect Dr. Donald H. Morgan Treasurer Dr. Marc A. Presnell Past President Mr. Philip J. Hinkle Executive Director

DISTRICT REPRESENTATIVES Dr. Scott Richardson District 1–Big Bend Dr. Thomas E. Hester 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. Barbara Lewis 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

As we get ready to head into the fall season, the FVMA continues to work hard on behalf of its membership. While attending the AVMA Annual Convention in Washington D.C., myself — as well as 170 or more veterinarians — made a quick trip to Capitol Hill. We were capable of securing meetings with the offices of many of our elected officials. We were able to hold meetings discussing important legislative issues affecting veterinary medicine nationwide. Our delegates were able to secure appointments with the offices of Florida Senators Marco Rubio and Rick Scott, along with Representatives Charlie Christ and John Rutherford. I would like to personally thank Representative Dr. Ted Yoho who took time out of his busy schedule to not only attend the AVMA House of Delegates meeting but to also speak directly to the Florida delegation. We are very appreciative of his time and support of veterinary medicine in the state of Florida. I cannot begin to emphasize how important participation in state and local legislation is for veterinary medicine. Decisions today will shape the practice of tomorrow. We believe participation in Legislative Action Days helps inform and educate our elected official on matters that are important to the profession. Legislative Action Days 2020 will take place on January 22-23, 2020, at the Hotel Duval in Tallahassee, Florida due to Florida Legislative Session starting early this upcoming year — so save the dates now so you can join us in advocating for the veterinary profession! In August, I represented the FVMA at the UF College of Veterinary Medicine’s First-Year Leadership Experience in High Springs, Florida. The incoming first-year class attends FLE, along with secondyear student facilitators; UF CVM faculty, clinicians and staff; and representatives from sponsored organizations. Some of the program goals included exercises that touched on leadership, teamwork, professional development, relationship building and fostering a sense of community — all while having fun. The students were all eager to get started. Based on my experience with the incoming freshman class, I believe the future of veterinary medicine is bright. The FVMA continues to maintain a wonderful relationship with the UF CVM, and we are thankful to be a part of this experience. The FVMA believes offering educational opportunities to membership is just one way we can better serve the entire veterinary care team. We continue to offer world-class educational opportunities through the continuing education (CE) we offer at our conferences and symposiums, including our hands-on wet labs. With that being said and the end of the year approaching, we invite you to attend the 7th Annual Gulf-Atlantic Veterinary Conference on December 5-8, 2019, at the Boca Raton & Resort in Boca Raton, Florida. If you have not yet obtained your needed CE or would like to take advantage of this unique educational experience, I highly recommend you attend TGAVC 2019. Registration is now open, and there are many great educational opportunities being offered this year, including more than 300 CE hours offered total, 11 hands-on wet labs, a Suicide Prevention Certification workshop, and the Florida Laws and Rules & Dispensing Legend Drugs courses. Other exciting things coming up include the 15th Annual Promoting Excellence Symposium hosted by the FAEP in less than a month (October 10-13, 2019), which will be held at the Sanibel Harbour Marriott Resort & Spa in Fort Myers, Florida. It is sure to be a great opportunity for the equine practitioner, providing them with world-class, equine-exclusive continuing education. Your Executive Board will be meeting in September to discuss important issues regarding the FVMA, veterinary medicine in Florida, and possible legislative issues and bills during the 2020 Florida Legislative Session that will impact veterinary medicine. In closing, we have tremendous energy within the Association on a local and state level. We will use the momentum of today to get us closer to where we want to be tomorrow. Thank you for allowing me to represent the members of the FVMA. We will continue to work hard on your behalf and be the voice for veterinary medicine in Florida. Michael Epperson, DVM

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

In Remembrance Kenneth Garber, DVM Dr. Kenneth Garber, 72, passed away on July 27. He was a retired veterinarian, FVMA retired member and equestrian enthusiast. He resided in Wellington, Florida, where he moved to after his retirement with his wife Selma Garber and their pets. Dr. Garber received his DVM from the University of Bologna in Italy, where he spent many years practicing veterinary medicine.

He learned to speak Italian fluently and continued to visit the country throughout his life even after he returned to the U.S. When he returned to the U.S., he opened a veterinary practice just outside of Philadelphia. He ran the practice for more than 20 years until he moved to Wellington, Florida in the winter of 1999 to retire. He became an FVMA retired member in 2000. Dr. Garber loved to go boating and sailing. A celebration of life was held on August 4 at the Annapolis Maritime Museum in Eastport, Maryland, just off the Chesapeake Bay where Dr. Garber and his wife spent their summers.

William H. Jernigan, DVM Dr. William H. “Bill” Jernigan, 87, passed away on September 7. Born and raised in Florida, he established Sebring Animal Hospital after he graduated from Auburn University in 1963, making him one of the early veterinarians to practice in the area. His practice began as a mixed animal medicine practice but transitioned to a strictly small animal practice after the facility moved to its current location, which is where it’s been since 1970. Dr. Jernigan has been a member of the FVMA since he graduated in 1963. He was known for being a mentor to students who had

a passion for animals and a desire to pursue veterinary medicine. Dr. Jernigan stayed active in the management of his practice, never officially retiring. His son Dr. William Lawrence Jernigan has been the owner of Sebring Animal Hospital since 1996, working there since 1982 and helping provide quality health care for pets in Highlands County. He was very active in the First United Methodist Church in Sebring, where he sang in the choir for more than 50 years. He was an active member of the Sebring Rotary Club, joining the club in 1963, and was a past board member of the local Salvation Army. Dr. Jernigan was also a veteran of the United States Air Force, a member of the Grand Guard of the University of Florida and a lifetime member of the University of Florida Alumni Association where he did his undergraduate studies.

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MEMBER SPOTLIGHT UF CVM Clerkship Through MDAS Extended 4 More Years The Miami-Dade County Commission passed a resolution to extend the UF CVM Shelter Animal Sterilization and Population Management Clerkship, housed at Miami-Dade Animal Services (MDAS), for a four-year term. In its third year, the program provides students a hands-on experience in a community animal shelter setting. Having been continued on a year-to-year basis, the overwhelming reviews and success of the program prompted the Miami-Dade County Commission to pass the resolution and noted how UF’s commitment to the program provides a great public service to the county. The clerkship provides students with the opportunity to enhance their clinical and surgical skills by training in high-volume spay/neuter surgery technique and advanced surgical procedures, including limb amputation, wound repair, hernia repair and tumor removal. It allows students to help animals in need and better understand the dynamics — along with the issues — shelter medicine deals with. A maximum of five students can participate in the clerkship, which is offered in two-week periods, and the participating students are housed in an apartment near the shelter.

Two UF students perform a spay-neuter procedure on a cat at Miami-Dade Animal Services. Photo courtesy of Dr. Simone Guerios

Simone Guerios, DVM, Ph.D., who is a clinical assistant professor of shelter medicine at UF and the clerkship supervisor for MDAS, said the students learn how to aid in the medical care of pets with critical conditions, giving them the possibility of survival and quality of life. “One of the biggest successes of our shelter is the achievement of a 90 percent live-release rate for the past four years,” Guerios said in a press release. “The collaboration we have with UF has been instrumental in maintaining this impressive rate, as well as by contributing to the training of future shelter medicine veterinarians in high standards of care and animal welfare to practice in their future professional careers.” MDAS Director Alex Muñoz said that the experience provides students with exposure to working in animal shelter medicine firsthand, helping shelter staff manage a population of up to 600 animals a day sometimes. MDAS is the only open-admission shelter in the county, averaging an intake of about 30,000 animals per year. Dr. Maria Serrano looks on while Dr. Simone Guerios performs a procedure on an animal at Miami-Dade Animal Services. Drs. Serrano and Guerios, both veterinarians for Miami-Dade and UF, work closely with UF veterinary students during their clerkships at the shelter. Photo courtesy of Dr. Simone Guerios

4 | FVMA ADVOCATE

FVMA Member Joins Advisory Panel for Boykin Spaniel, Inc. Lesley Hack, DVM, who is the owner of Boca Veterinary Clinic in Boca Raton, Florida, joined the newly formed Veterinary Advisory Panel for Boykin Spaniel Rescue, Inc. Dr. Hack has been receiving praise from leaders of the national breed rescue organization for her work on reviewing complex cases presented to the panel. Her and the panel’s recent consulting has helped two serious and complex cases start on the road to recovery, including one of the dogs being almost well enough to be adopted. "We are so proud to have Dr. Hack on our team," says Boykin Spaniel Rescue Inc.'s Director of Operations and Marketing Lynne Brown. "Knowing that she is available to provide input for our complex cases and incredible care for the dogs we bring to her practice is invaluable to us." In addition to providing her time in a consultative capacity, Dr. Hack is also involved in the local community, giving back after hurricanes, floods and other tragedies. Dr. Hack has been a member of the FVMA since 2013.

Dr. Lesley Hack with Ruthie. Photo courtesy of Dr. Lesley Hack

US Rep. Ted Yoho Receives AVMA Advocacy Award Since 1997 ∙ Preserving practice identities ∙ Helping practices grow ∙ Respecting clinical independence ∙ Adding career paths & benefits U.S. Rep. Dr. Ted Yoho Photo courtesy of U.S. Congress website

∙ Earning a caring reputation

FVMA member and U.S. Rep. Dr. Ted Yoho (R-FL) was recognized by the American Veterinary Medical Association (AVMA) for his work to help advance the AVMA's legislative agenda. Rep. Yoho was presented with the AVMA Advocacy Award for his contributions as an advocate for the veterinary profession. The award is given once a year to an individual who has played an instrumental role in advocacy efforts for the profession.

Over 300 locations in 29 states -

Rep. Yoho is one of three veterinarians in the U.S. Congress. He is a member of the House Agriculture Committee and co-chair of the Congressional Veterinary Medicine Caucus. At the AVMA Annual Convention in August, Rep. Yoho addressed AVMA members at the AVMA House of Delegates meeting and at the first-ever Advocacy in Action workshop about the importance of veterinary advocacy.

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Rep. Yoho has been an FVMA member since 1996, and he has been very active in Florida equine veterinary medicine for years. He is also an active member of the Florida Veterinary Corps.

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6 | FVMA ADVOCATE

Celebrating

OUR VETERINARY TECHNICIANS THE FVMA SALUTES VETERINARY TECHNICIANS DURING NATIONAL VETERINARY TECHNICIAN WEEK OCTOBER 13-19, 2019 Veterinary technicians play a vital role in veterinary medicine, and we celebrate their hard work, passion and commitment to excellence. As the voice of veterinary medicine in Florida, we are honored to serve them and all of our 5,600 members and the nearly 80 percent of veterinary practices we represent across the state. To further recognize the outstanding contributions of veterinary care teams in our industry and to support both team member career development, we invite all Florida veterinary technicians and veterinary team members to join our veterinary team member affiliate membership programs to better serve these distinguished professionals. Operating under the umbrella of the FVMA, these organizations extend the reach and mission of our association by offering affiliate membership and exclusive benefits to eligible individuals. These benefits include: • Career networking opportunities with thousands of veterinary colleagues. • A dedicated staff of FVMA professionals committed to your success (available Monday - Friday from 8 a.m. - 6 p.m.). • Discounts on world-class CE and conference registration. • Updates on the latest news and issues impacting veterinary medicine. • Legislative and regulatory advocacy. • Membership card, certificate, pin and much more! We encourage eligible team members to join us and add their voices to strengthen our profession and their careers. On behalf of the FVMA membership team, Executive Board, staff and all those who benefit from their veterinary technicians’

dedication to their careers and the animals they care for, we extend our sincerest gratitude and wish everyone a wonderful and successful year. If you know a certified veterinary technician or animal care technician who has done a truly outstanding job this year and gone above and beyond to support their practice and care for clients, consider nominating them for the FVMA’s CVT of the Year or Team Member of the Year awards, to be handed out at our annual conference in March 2020. For more information about affiliate membership and for applications for each, please visit www.fvma.org, or email us at info@fvma.org. We also can be reached by phone at 407.851.3862 or toll-free at 800.992.3862.

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Care and Monitoring

of the Critical Patient

Tami Lind, BS, RVT, VTS(ECC) Purdue University, West Lafayette, Indiana Technicians will be asked at some point in their career to monitor a critical patient. These patients require a high level of care, concentration and critical thinking skills. Technicians must be comfortable with monitoring these patients and using their brain to problem solve and alert the clinician when patient parameters change. One of the most critical patients is a patient on the critical care ventilator. Most general practices, and some specialty facilities, do not have critical care ventilators, but the process of caring for a ventilator patient can be translated to any critical patient. Everything that a technician has learned in school is used on these patients. Critical patients are usually obtunded or heavily sedated. Multiple monitoring devices should be used to keep an eye on the patient’s vitals, hydration status, ventilation status and organ function. Documentation is also critical. Every change in a patient’s status should be documented, and vitals should be taken on the patient frequently.

hard to see, so I would suggest going to other veins first. If placing a central line in a jugular vein, a radiograph must be performed to make sure that the catheter is placed in the cranial vena cava right above the right atrium. An arterial catheter should be placed in these patients. These can be placed in the dorsal pedal, femoral or coccygeal artery. Use caution in placing a catheter in the femoral artery because this can be hard to secure to the patient. An arterial blood sample can be used to assess patient ventilation and oxygenation. Arterial catheters can also be used to more accurately assess blood pressure. Sometimes, especially in these critical patients, you are

The patient’s airway should be assessed first. Ventilator patients should be intubated for as long as possible. Sedated patients have decreased ventilator drive and are at risk for regurgitation and aspiration. These patients are usually on multiple medications to help decrease their respiratory drive so the machine can breathe for them. Sterile technique should be used to place the endotracheal tube to make sure that there are minimal bacteria that enter the airway. One of the major complications of a mechanically ventilated patient is hospital-acquired pneumonia due to bacteria being introduced by the endotracheal tube. A pulse oximeter should be placed on the patient to make sure that the patient is appropriately perfusing its organs. Capnography should also be used to make sure the patient is ventilating appropriately. A normal ETCO2 reading is 35-45 mmHg. Suctioning and humidifying of the endotracheal tube should be performed every four hours, or as needed, to prevent mucous secretions from clogging the endotracheal tube. Hopefully, the patient has already had venous access. If not, a peripheral catheter most likely will not be enough for these patients. Triple or quadruple lumen central lines should be placed. These will help with the multiple medications that these patients are on, as well as possibly be used for intravenous nutrition and blood sampling. These can be placed in the jugular, saphenous, medial and ombobracheal veins. Ombobracheal veins are very 8 | FVMA ADVOCATE

Eye and ear protection are very important when mechanically ventilating a patient. Photo courtesy of Tami Lind

unable to place an arterial catheter because their blood pressure is so low. With these patients, you must wait until you can feel the artery before you can place a catheter. A multiparameter unit should be placed on the patient to assess heart rhythm, ETCO2 , invasive blood pressure, oxygenation and temperature. The ECG clips should be placed on “sticky” pads to ensure that the metal clips do not cause skin damage. There are multiple brands of these to choose from, so choose what is best for your practice. A urinary catheter should be placed in these critical patients. Technicians should use a long-term urinary catheter, such as a foley, and place with sterile technique. A collection bag should be placed on the catheter to ensure that we can measure the amount of urine that the kidneys are producing.

Proper padding under the patient is important to prevent pressure sores. Photo courtesy of Tami Lind

The patient should also be placed on a properly cushioned area. When it comes to critical patients, it is easier on everyone if the patient is placed on an elevated table. This way, you can get around the patient on all four sides. These patients are prone to pressure sores, especially when they start losing muscle mass due to inactivity. Once the patient is hooked up to all monitoring devices, there are multiple areas of the patient to consider. The patient’s airway, mouth, eyes, ears, urinary system and gastrointestinal system must be cared for. The technician must also perform physical therapy.

Airway care

If the patient has an endotracheal tube, it must be properly cared for to make sure that the patient does not acquire hospital-born pneumonia. The endotracheal tube must be replaced every 24 hours with sterile technique. In a recumbent patient, you must inflate the cuff to ensure that the lungs inflate appropriately. One complication of the cuff being inflated, or over inflated, could cause tissue necrosis of the trachea. It is suggested to deflate the cuff and reposition the endotracheal tube every four hours to prevent tissue necrosis. These patients also need humidification of their airway. This can decrease mucous viscosity and tracheal inflammation. To do this, technicians can instill a small amount of sterile water into the endotracheal tube and then suctioning the endotracheal tube after. Suctioning of endotracheal tube is necessary to prevent mucous buildup and occlusion of the airway. This should be performed every four hours or on an as-needed basis.

Oral care

Patients that are recumbent and have endotracheal tubes or tracheal tubes in are at an increased risk of ulcers in their oral cavity. To prevent this, the whole mouth must be kept moist. The technician must suction out all mucous and debris. Use a different suction catheter than the one used for the tracheal tube. This will prevent bacteria from being introduced into the lungs. A glycerin solution can then be used to prevent drying out the tongue. The tongue can also be covered with a glycerin-soaked gauze. Do not wrap the tongue as this can cause ranulas to form.

A monitor should always be hooked up to keep an eye on all vitals of your patient. Photo courtesy of Tami Lind

The pulse oximeter probe should also be taken off the tongue and moved to a different area to prevent necrosis. This procedure should be done every four hours.

Eye care

Critical patients that are recumbent are at an increased risk of eye ulcers because they cannot blink. Artificial tears should be placed on the eyes every two hours. Goggles can also be used to seal off the eye from the environment. Most clinics do not have goggles so trying to keep the eyes closed with tape could also be used. Technicians should check for ulcers in the eyes at least once a day.

Urinary care

Urinary catheters should be cleaned every eight hours to prevent infection. This includes the flushing of the prepuce with a dilute chlorhexidine solution and wiping the lines associated with the urinary catheter. The urinary bag should be emptied every four hours to assess kidney function. A technician should calculate how much fluid is going into the patient and how much fluid is coming out of the patient to assess kidney function and hydration status. Patients are at a higher risk of acquiring urinary catheter infections so keeping the catheter clean will help keep the infections at bay.

Gastrointestinal/Nutritional care

Critical patients need nutrition. This can be delivered via central line by parenteral nutrition or via nasogastric or nasoesophageal

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tube by liquid diets. Do not place nonsterile nutrition through the central line. This can cause infections in the blood stream and create more complications for the patient. Most likely, these patients will have diarrhea. Technicians must keep the patient clean and dry. Keep a close eye on the color of the fecal material. Black or bloody stool can indicate a more serious complication and will need more attention.

Physical therapy

Physical therapy is very important in critically ill patients. These patients lose muscle mass quickly and can acquire pressure sores and ulcers. Passive range of motion and rotating of the hips should be done every four hours. Patients can get out of the hospital quicker the sooner physical therapy is started. Critical ventilator patients can be very time consuming, and technicians will have to think and troubleshoot their way through many organ systems of these patients. There are multiple drug calculations and every part of nursing care that technicians have ever learned about. When a critical patient walks out the door, it can be a very rewarding experience for the whole team.

References

Battaglia, Andrea M., and Andrea M. Steele. Small Animal Emergency and Critical Care for Veterinary Technicians. 3rd ed., Elsevier, 2016. Silverstein, Deborah C., and Kate Hopper. Small Animal Critical Care Medicine. St. Louis, MO: Saunders/Elsevier, 2009

Tami Lind, BS, RVT, VTS(ECC) Tami Lind is the current ICU and ER supervisor at Purdue University. She has been at Purdue University for eight years. She went to veterinary technology school at Purdue and graduated in 2010 with her bachelorâ&#x20AC;&#x2122;s degree in veterinary technology and has never left! She started as a veterinary technician in the ICU, and she has been the supervisor at Purdue since 2012. She received her VTS in ECC in October 2016. She enjoys teaching new veterinary technicians and veterinary students, and she tries to prepare them for their career ahead.

FVMA Sponsors UF CVM's Annual First-Year Leadership Experience

Members of the Class of 2023 during the First-Year Leadership Experience, part of orientation for incoming veterinary students, at Camp Kulaqua on August 13-14. Photo courtesy of Alex Avelino

FVMA President Dr. Michael Epperson chatting with one of the new freshmen students during the StrengthsQuest training which encourages embracing our natural strengths. Photo courtesy of Chani Rue

The Florida Veterinary Medical Association sponsored the UF College of Veterinary Medicine’s annual First-Year Leadership Experience (FLE) for UF CVM students at Camp Kulaqua on August 13-14, 2019. FLE provides a learning experience for students to promote teambuilding and camaraderie as they begin their journey in veterinary medicine.

the importance of professionalism and inclusion in our CVM community.”

The program for FLE 2019 touched on important topics for veterinary students, including discussions on leadership, professional development, relationship building, veterinary school expectations, and academic and professional conduct standards. UF CVM faculty participated as small group facilitators and in large group discussions, and will serve as great mentors as they guide the students along their journey through veterinary school. FVMA provided lunch for the veterinary students, along with T-shirts for them to wear during activities throughout the two days.

“We are so thankful to the FVMA for supporting this important event that helps our new students learn more about the profession and college community that they are now a member of,” Dr. House said.

The students enjoyed and valued the involvement of both the FVMA and UF CVM in providing two days of educational fun to help prepare them for their next four years of veterinary school.

UF CVM Director of Student Affairs Dr. Amanda House chaired the event along with the help of several UF CVM faculty and staff. This year, FLE included a StrengthsQuest training with UF Division of Student Affairs Director of Engagement Jaime Gresley and a workshop on understanding unconscious bias presented by Dr. Kate Ratliff, who is an assistant professor in the UF Department of Psychology.

Class of 2022 FLE FaciliGators celebrate the end of a successful First-Year Leadership Experience. Photo courtesy of Alex Avelino

A total of 119 students participated this year with 26 student facilitators, 16 faculty and staff facilitators, 14 Office of Student Involvement staff and UF CVM Associate Dean Dr. Juan Samper. FVMA President Dr. Michael Epperson, FVMA past president Dr. Richard Carpenter and his wife Buttons Carpenter attended the event on behalf of the FVMA. “FLE has been a special part of CVM orientation for many years and is an opportunity for students to get to know each other, build relationships with some of our faculty and staff, and learn more about themselves with a focus on their individual strengths,” Dr. Amanda House said. “The event highlights resources and WWW.FVMA.ORG |

The “Yelling Yetties” participate in UF RecSports team-building activities. Photo courtesy of Chani Rue

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NOMINA T

CAL L

NS IO

R FO

Nominations Deadline

FOR THE 2020 FVMA ANNUAL AWARDS

FVMA SERVICE AWARDS NOMINATIONS DEADLINE IS NOVEMBER 22, 2019

Nominations are now open for the 2020 FVMA Annual Awards! The Florida Veterinary Medical Association invites you to nominate deserving candidates for the 2020 FVMA Annual Awards! Awards in several categories will be determined by a special committee in early December 2019. Award recipients will be publicly honored at an awards presentation ceremony on March 13, 2020, during the 91st FVMA Annual Conference in Orlando, Florida. This is an important program for our Association, giving us the opportunity to honor outstanding members and individuals who serve our profession with distinction and contribute to the advancement of veterinary medicine in the state of Florida. We invite you to participate in this valuable program to recognize peers, colleagues and friends of the profession for their achievements and contributions. The Annual Awards also highlight exceptional service by Florida citizens who have dedicated their time, talent and services to the enhancement and protection of the veterinary profession. Awards include a “Citizen of the Year” and nominated pets can be inducted into the “Pet Hall of Fame” with a Pet Hero Award. Nomination forms and listings of past award recipients are available at www.fvma.org. Members of the FVMA are encouraged to nominate deserving colleagues and friends of veterinary medicine for an award. Members may also call the FVMA toll-free at 800.992.3862 for assistance in nominating a deserving colleague or friend for an award.

12 | FVMA ADVOCATE

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

2020 Award Categories • • • • • • • •

Distinguished Service Veterinarian of the Year Lifetime Achievement Gold Star CVT of the Year Team Member of the Year Citizen of the Year Pet Hero

SUBMIT YOUR NOMINATIONS BY NOVEMBER 22, 2019

SERVICE AWARD CATEGORIES & ELIGIBILITY CRITERIA DISTINGUISHED SERVICE AWARD

The Distinguished Service Award is awarded for exceptional achievements and contributions by a member toward the advancement of veterinary medicine and the profession. To qualify, a member must have been dedicated to veterinary medicine and given time and energy beyond reasonable expectations. To be eligible for this award, a nominee must have been an active member of the Association for at least the past 15 years.

VETERINARIAN OF THE YEAR AWARD

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

LIFETIME ACHIEVEMENT AWARD

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

• LEADERSHIP – Assumes a leadership role in creating and maintaining an efficient and highly motivated animal health care services delivery team among all employees. • EDUCATION – Regularly strives to further develop his/ her knowledge and skills by participating in continuing education seminar; formal study at a junior college or university; or by undertaking self-directed study through journals, online programs, etc.

CITIZEN OF THE YEAR

The Citizen of the Year Award is awarded to any non-veterinarian who has made an outstanding contribution to the advancement of the Association and veterinary medicine.

PET HALL OF FAME

One inductee to the Pet Hall Of Fame will be selected for one of the following categories. 1. HERO – Pets who have unselfishly saved or preserved human life (non-professional). 2. COMPANION – Pets who have provided a benefit and contributed to the quality of life of their human companions. 3. PROFESSIONAL – Specialty trained as a physically challenged person’s assistance animal or used in law enforcement.

TEAM MEMBER OF THE YEAR

GOLD STAR AWARD

The Gold Star Award is awarded to members who have contributed much of their time and energy to the Association and/or a local association for the advancement of veterinary medicine and the profession. To be eligible for this award, the nominee must have been an active member of the Association for at least the past three years.

CERTIFIED VETERINARY TECHNICIAN OF THE YEAR

This award recognizes the many outstanding contributions made by Certified Veterinary Technicians (CVT) to the overall success of the veterinary practice operated or staffed by an FVMA member veterinarian. To be eligible for nomination of this award, the individual must be a full-time employee of an FVMA member practice for a minimum of three years and demonstrates the following: • CARING – Provides animal health care services in a compassionate and clinically appropriate manner. • COMMITMENT – Works in support of the employing veterinarian to achieve a high level of client satisfaction and established annual performance goals of the veterinary practice.

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The Team Member of the Year Award recognizes the many outstanding contributions made by veterinary care team members to the overall success of the veterinary practice operated or staffed by an FVMA member veterinarian. To be eligible for nomination for this award, the individual must be a full-time employee of an FVMA member practice for a minimum of three years and demonstrates the following: • CARING – Provides animal health care services in a compassionate and clinically appropriate manner. • COMMITMENT – Works in support of the employing veterinarian to achieve a high level of client satisfaction and established annual performance goals of the veterinary practice. • LEADERSHIP – Assumes a leadership role in creating and maintaining an efficient and highly motivated animal health care services delivery team among all employees • EDUCATION – Regularly strives to further develop his/her knowledge and skills by participating in continuing education seminar; formal study at a junior college or university; or by undertaking self-directed study through journals, online programs, etc.

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THE

ANNUAL

LECTURES

CUTTING-EDGE

GULF-ATLANTIC VETERINARY CONFERENCE

HANDS-ON WET LABS

DECEMBER

5-8, 2019

BOCA RATON, FLORIDA

DYNAMIC

EXHIBIT HALL

A SCIENTIFIC PROGRAM TO ENRICH EVERY MEMBER

2019

TGAVC

Experience the Difference

NETWORKING

REGISTRATION IS OPEN! WWW.TGAVC.ORG

OF THE SMALL ANIMAL VETERINARY CARE TEAM

Engaging, Hands-on Wet

Thursday, December 5 | 8:00 a.m. - 12:00 p.m.

Jason Arble, DVM, MSc, DACVR, MRCVS

With Conf. Reg. Fee: Vets $475 | Wet Lab Only Fee: Vets $675

ADVANCED SMALL ANIMAL ABDOMINAL ULTRASOUND

With Conf. Reg. Fee: Vets $425 | Wet Lab Only Fee: Vets $625

Friday, December 6 | 8:00 a.m. - 5:00 p.m.

Thursday, December 5 | 1:30 - 5:30 p.m.

Jason Arble, DVM, MSc, DACVR, MRCVS

With Conf. Reg. Fee: Vets $475 | Wet Lab Only Fee: Vets $675 DV

Jan Bellows, DVM, DAVDC, DABVP

With Conf. Reg. Fee: Vets $425 | Wet Lab Only Fee: Vets $625

ADVANCED DENTAL TECHNIQUES

Thursday, December 5 | 8:00 a.m. - 5:00 p.m.

Jan Bellows, DVM, DAVDC, DABVP

CANINE EXTRACTION TECHNIQUES

BASIC SMALL ANIMAL ABDOMINAL ULTRASOUND

VETERINARY POINT-OF-CARE ULTRASOUND FOR EVERYDAY PRACTICE

FELINE EXTRACTION TECHNIQUES

ULTRASOUND DV

DENTISTRY

Saturday, December 7 | 8:00 a.m. - 5:00 p.m. SÃ¸ren Boysen, DVM, DACVECC Serge Chalhoub, BSc, DVM, DACVIM (SAIM)

Friday, December 6 | 8:00 a.m. - 12:00 p.m.

Jan Bellows, DVM, DAVDC, DABVP

With Conf. Reg. Fee: Vets $475 | Wet Lab Only Fee: Vets $675

I CI A N

DENTAL RADIOLOGY POSITIONING AND TECHNIQUES

TE C

With Conf. Reg. Fee: Vets $425 | Wet Lab Only Fee: Vets $625

FEATURED SPEAKERS

Friday, December 6 | 1:30 - 5:30 p.m.

RICK ALLEMAN

DVM, Ph.D., DABVP, DACVP

JAN BELL

DVM, DAVD

Denise S. Rollings, CVT, VTS (Dentistry)

I CI A N

DENTAL NERVE BLOCKS, CLEANING, PROBING & CHARTING

TE C

With Conf. Reg. Fee: Techs $95 | Wet Lab Only Fee: Techs $150

CLARA S.S. GOH

BVSc, MS, DACVS-SA

RANDY HALL

CEO

RALPH HARVEY

DVM, MS, DACVAA

PETER HELMER

KEITH A.

DVM, DABVP (AVIAN PRACTICE)

DVM, MS, M

STUART WALTON

PETER W

Saturday, December 7 | 8:00 a.m. - 12:00 p.m. Denise S. Rollings, CVT, VTS (Dentistry)

With Conf. Reg. Fee: Techs $95 | Wet Lab Only Fee: Techs $150

HOWARD B. SEIM III JENNIFER STOKES

DVM, DACVS

DVM, DACVIM (SAIM)

ROBERT SWINGER

DVM, DACVO

BVSc (hons), BScAgr (hons), DVM, MBA MANZCVS (SAIM), DACVIM (SAIM)

INFO@FVMA.ORG | PHONE: 800.992.3862/ 407.851.3862 | FAX: 407.240.3710 | WWW.TGAVC.ORG

t Labs

Special CE Offerings  Dispensing Legend Drugs

Saturday, December 7, 2019 | 7-7:50 a.m. Edwin Bayó, Esq.  Suicide Prevention Certification

SURGERY DV

OPHTHALMIC SURGERY

 Florida Laws & Rules Governing the

Thursday, December 5 | 10:00 a.m. - 5:00 p.m. Robert Swinger, DVM, DACVO

With Conf. Reg. Fee: Vets $450 | Wet Lab Only Fee: Vets $650

NOSE TO TAIL SURGERIES IN THE DOG

Saturday, December 7, 2019 | 1:10-3 p.m. Philip Richmond, DVM, CHC-BCS, CCFP Kelly Brady, LMHC, AP

Practice of Veterinary Medicine Sunday, December 8, 2019 | 7-8:50 a.m. Edwin Bayó, Esq.

MORE THAN 300 CE HOURS

Thursday, December 5 | 8:00 a.m. - 5:00 p.m. Howard B. Seim III, DVM, DACVS Clara S.S. Goh, BVSc, MS, DACVS- SA

• Maximum of 31 CE hours for veterinarians • Maximum of 20 CE hours for veterinarian technicians

NOSE TO TAIL SURGERIES IN THE CAT

With Conf. Reg. Fee: Vets $695 | Wet Lab Only Fee: Vets $895 M

WET LABS SELL OUT FAST... RESERVE YOUR SEAT EARLY!

Friday, December 6 | 8:00 a.m. - 5:00 p.m.

Howard B. Seim III, DVM, DACVS Clara S.S. Goh, BVSc, MS, DACVS- SA

With Conf. Reg. Fee: Vets $695 | Wet Lab Only Fee: Vets $895

LOWS

DC, DABVP

. HNILICA

MBA, DACVD

WEINSTEIN

DISTINGUISHED SPEAKERS MICHAEL S. CANFIELD AMARA ESTRADA

DVM, DACVD

DVM, DACVIM (CARDIOLOGY)

TERRY O'NEIL

CPA, CVA

JON M. FLETCHER

DVM, DACVIM

LAURA GARRETT

DVM, DACVIM (ONCOLOGY)

GARRET PACHTINGER SHEILAH ROBERTSON MICHAEL SCHAER

VMD, DACVECC

BVMS (HONS), Ph.D., DACVAA, DVM, DACVIM (SAIM), DECVAA, DACAW, DECAWBM DACVECC (WSEL), CVA, MRCVS

JACQUELINE WHITTEMORE

DVM, Ph.D., DACVIM (SAIM)

@TGAVCONFERENCE |

• • • • • • • • • • • • •

DR. HEIDI ALLESPACH DR. JASON ARBLE ED BAYÓ, ESQ. DR. SØREN BOYSEN DR. KELLY BRADY DR. JEN BRANDT MEGAN BRASHEAR,

BS, RVT, VTS (ECC)

• • • • • • •

DR. CHERIE BUISSON DR. DYLAN BUSS DR. SUSAN CARASTRO DR. SERGE CHALHOUB DR. PAIGE EVANS MONIQUE FEYRECILDE, BA, LVT, VTS (BEHAVIOR) • DR. KATHLEEN GELATTNICHOLSON • DR. SHANNON HOLMES

TGAVCONFERENCE |

TAMI LIND, BS, RVT, VTS (ECC) DR. ROXANE MACLELLAN KARA MAGNEHEIM, CVT, BAS DR. JESSICA MARTINEZ DR. LISA MASON DR. ELIZABETH McMORRAN REBECCA NEGRETTI,

CVT, VTS (ECC)

• CORT NORTON, CVT • JEANNE PERRONE, CVT, VTS (DENTISTRY)

• DR. PHILIP RICHMOND • DENISE ROLLINGS, CVT, VTS (DENTISTRY)

• DR. LAYLA SHAIKH • DR. RITA WEHRMAN

@FLORIDA_VMA

Enjoy first-rate amenities at the BOCA RATON RESORT & CLUB, A WALDORF ASTORIA RESORT 501 EAST CAMINO REAL, BOCA RATON, FLORIDA 33432 | PH: 888.557.6375 | www.bocaresort.com

The VENUE

Boca Raton Resort & Club, A Waldorf Astoria Resort

A blend of old-world charm with modern luxury. Enjoy endless amenities, including 13 on-site restaurants, a private marina, a half-mile of private beach and an award-winning spa. A block of rooms has been reserved at the Boca Raton Resort & Club, A Waldorf Astoria Resort, in Boca Raton, Florida for the Gulf-Atlantic Veterinary Conference. Special extended stay arrangements have been made for the group rate to remain in effect for three days preand post-conference, subject to availability. RESORT FEE AND TAXES: Additional daily resort charge of $10 per room (reduced from $40) per night, plus applicable state and local tax of 13 percent, will be posted to all guestrooms. Resort fee includes:

• Internet access in guestrooms and public spaces • Private beach services including chairs and beach towels • Mizner’s Quest Discover Tour • Access to two full-service fitness centers • Unlimited driving range usage and golf club storage

• 10 percent off tennis • Local, 800 & domestic long-distance phone calls • Bellman gratuities for arrival and departure • Complimentary in-room coffee & tea • Designated resort shuttle transportation including bungalows and beach club

TGAVC SPECIAL ROOM RATES ROOM TYPE DISCOUNT RATE BUNGALOW ROOM $199 BUNGALOW SUITE $250 CLOISTER ROOM $230 TOWER ROOM $245 BEACH CLUB STANDARD ROOM $275 YACHT CLUB ROOM $345 Additional room types and rates available

RESERVE YOUR ROOM TODAY! DISCOUNTED ROOM RATES AVAILABLE UNTIL OCTOBER 31, 2019 OR UNTIL ROOM BLOCK IS SOLD OUT. Call 888.557.6375 and mention the group code "ATGAVC".

2019

TGAVC

THE 7TH ANNUAL GULF-ATLANTIC VETERINARY CONFERENCE

BEACH CLUB

TOWER CLOISTER

Address:

 Dr.  Mr.

CE Proceedings

Exhibit Hall access Holiday Mingle All coffee breaks

Signature

TOTAL WET LAB FEE $

Veterinary Point-of-care Ultrasound ..................................... Dental Nerve Blocks, Cleaning, Probing & Charting (Techs)..... Suicide Prevention Certification....................................

SATURDAY WET LABS & WORKSHOP

Advanced Small Animal Abdominal Ultrasound............ Advanced Dental Techniques......................................... Dental Radiology Positioning & Techniques (Techs)............ Nose to Tail Surgeries in the Cat.. ........................................

FRIDAY WET LABS

TGAVC, 7207 Monetary Drive, Orlando, FL 32809 |

 Mastercard

www.tgavc.org; info@fvma.org |

$675.00 $150.00 N/A

$675.00 $625.00 $150.00 $895.00

$675.00 $625.00 $650.00 $625.00 $895.00

DOES NOT INCLUDE ACCESS TO CE

Holiday Mingle Exhibit Hall access

All coffee breaks

407.240.3710

TOTAL SPECIAL EVENT/GUEST FEE $

Holiday Mingle .................... FREE for registered attendees

____ x 1 Ticket for $35.00 ____ x 4 Tickets for $100.00 = $ ____ (Four tickets must be purchased at the same time to qualify for discount.)

Thurs., Dec. 5: Fishing Tournament ......................$195.00 Sat., Dec. 7: FVMA Foundation Reverse Raffle (Win $2,500)

SPECIAL EVENTS

(Children’s Registration does not include lunch)

Friday lunch Saturday lunch

Discover

Fax:

ZIP:

Spouse & Guest Registration................................ $120.00 Spouse/Guest Registration includes:

800.992.3862; 407.851.3862 |

$475.00 $95.00 No charge

$475.00 $425.00 $95.00 $695.00

$475.00 $425.00 $450.00 $425.00 $695.00

 American Express

State:

TGAVC

With Conf. Reg. Fees Wet Lab Only Fees

Expiration Date

Basic Small Animal Abdominal Ultrasound................ Feline Extraction Techniques ........................................... Ophthalmic Surgery ......................................................... Canine Extraction Techniques........................................ Nose to Tail Surgeries in the Dog ........................................

THURSDAY WET LABS

WET LABS & WORKSHOP

Cancellation Policy: Cancellation deadline for a full refund of registration fees minus a $50 administrative charge is October 31, 2019. Cancellations should be received in writing and acknowledged by the FVMA by the above date to be eligible for a refund. Cancellations after that date and no-shows are non-refundable.

 Friday lunch Saturday lunch

Registration fees includes:

Currently enrolled in an AVMA-accredited school

Veterinary Technician Student

$95.00

Veterinary Technician Veterinary Assistant Practice Manager Administrative Staff

$95.00

$195.00 $195.00 $195.00 $195.00

$150.00 $150.00 $150.00 $150.00

Veterinary Student

Currently enrolled in an AVMA-accredited school

$655.00 $455.00 $455.00 $555.00 $125.00

$575.00 $375.00 $375.00 $475.00 $125.00

Veterinarian Recent Graduate (2019) First-year Graduate (2018) Second-year Graduate (2017)

After Oct. 31

By Oct. 31

(Includes Conference Proceedings on Key Card)

Name as It Appears on Card

Credit Card Number

Method of Payment  Check/Money Order  Charge My Credit Card Below $

 Visa

Phone:

Business/Clinic/School:

PAYMENT INFORMATION

City:

Name:

 Ms.  Mrs.

Email:

DEADLINE TO PRE-REGISTER & SAVE: OCTOBER 31, 2019

MAILING INFORMATION

DECEMBER 5-8, 2019 | BOCA RATON, FL

REGISTRATION FORM

2019 ADV4REG19

Incorporating Behavior Strategies into Patient Care: Practical Solutions for Daily Situations Christopher L. Pachel, DVM, DACVB, CABC Animal Behavior Clinic, Portland, Oregon

because, just as a conversation of words evolves as it continues, the signals that an animal displays will change over the course of an exam, an appointment or a hospital stay — and that is valuable information to consider! The signals that we give with our own body language can also affect the “conversation” and have the potential to be misinterpreted by other species. For example, direct approach with sustained eye contact may indicate focus, attentiveness or interest when we are speaking to another person; however, approaching a dog or cat in the same manner may be perceived as an overt threat and may elicit a very different reaction from what was intended.

Use of a commercially available "lick-mat" provides proactive, positive conditioning through routine procedures during Lance's puppy exams. Photo courtesy of Theresa DePorter

Even before we put our hands on a dog or cat for a physical exam, we can use body language cues to understand their level of comfort, arousal, fear, etc. For example, twitching of the tail in a cat is a sign of increased arousal, especially in combination with dilated pupils. On the other hand, resting in a sternal position with hips in lateral recumbency, with the tail stretched out behind, is an indication of a relaxed demeanor in that moment for both dogs and cats. For dogs, a tail position held over the horizontal of the back or stiff posture/movement may indicate an increase in arousal, whereas a crouched posture while avoiding eye contact is more likely to indicate fear or anxiety. It is important for patient comfort, as well as for staff safety, that we remain aware of those body language signals and treat them as “words” in a conversation. That analogy is especially relevant

20 | FVMA ADVOCATE

Most problems encountered during exams of intolerant animals are fear based, even in patients that may not appear especially fearful at the time of the interaction. It is common for a dog or cat whose lower-level “warnings” have been ignored to escalate to more forward or offensive patterns. And if those higher-level behaviors provide an immediate sense of increased safety for the animal, those behaviors are more likely to be displayed during future visits and may increase in intensity as well. For these reasons, it is important to factor the animal’s emotional state into our approach and our procedures to reduce the risk of creating or exacerbating fear-based problems for the patients that are entrusted into our care. Strategies for reducing patient stress begin even before the patient enters the exam room and may include things such as managing the traffic flow within the reception area, providing visual barriers to block line of sight of other animals, providing elevated locations for placing cat carriers up and off the floor, or allowing clients to check in by phone from the parking lot to avoid bringing stressed animals into the clinic before staff members may be ready for them. Speaking with a calm, quiet voice and allowing the animal to “warm up” to social interaction can be helpful for animals that may be on the fearful or stressed end of the spectrum. It may be possible to use food reinforcement in an intentional way to help the animal acclimate to the clinic environment more quickly, although this isn’t possible for all patients or situations. Keep in mind that even in situations in which using food reinforcement

isn’t practical, such as prior to anesthesia or sedation, it may be an option to have a dog lick from a cup of frozen broth or other flavored liquid, which may allow for the same positive reinforcement benefit without compromising patient care. Providing for patient comfort can also be done by ensuring secure footing on all exam surfaces, making specific carrier recommendations to owners of cats and small dogs to allow for comfortable transport and low-stress access to the patient, and by making a point to create positive emotional experiences for our patients before we start to see signs of stress. Not only is this proactive approach helpful during individual appointments, it is also recommended in relation to the life stage of the patient by creating those positive expectations for puppies and kittens as a baseline for all future experiences. Some patients will benefit from a more intentional incorporation of classical and operant training strategies into treatment routines in such a way that leverages food and other reinforcers to improve patient comfort and facilitate “procedures” such as stepping on the scale in the lobby. Options range from providing a “treat trail” that the animal can explore at their own pace as they step into position on the scale to using “stationing” or specifically trained movement patterns (i.e. leveraging a “hand touch” to guide the movement of the animal without leash or physical pressure) to move the animal into the desired position. These more-involved strategies may take a bit more time to train up front, but the longterm benefits are likely to outweigh the initial time investment. We can also improve safety and patient comfort by using tools such as body wraps, head collars, proactive leash handling and effective use of basket muzzles (which are generally preferred over other muzzle types). That is not to say that because an animal is muzzled or towel-wrapped for safety, that we can then disregard their communication signals or overall comfort. Rather, these tools should be used in combination with other techniques for reducing patient stress as much as is possible within that interaction.

Specific positioning of reinforcement allows for "stationing" of a patient, as is done here for a standing exam of Phoebe. Photo courtesy of Christopher Pachel

Continued awareness of the impact of the physical environment — from the examination room to the treatment and hospitalization areas of the clinic — can also reduce patient stress. Minimizing offensive odors, reducing unnecessary noise, allowing for visual separation between patients of different species and using environmental treatments, such as pheromones or calming music, can provide measurable benefit. Practicing techniques (such as towel wrapping of cats), manipulating animals through physical position changes (standing to lateral, etc.) and using low-stress restraint methods are incredibly helpful when it comes to facilitating procedures such as venipuncture, radiographs or transport through the clinic. Practitioners working with nonhuman primates or large marine mammals are likely already aware of the power of

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training “cooperative care” techniques in which the animal is an active participant in their own care — the same opportunities are available to other practitioners for their companion animal patients too! Taking a behavior-focused approach to patient care can also positively impact the go-home recommendations that are provided to clients. By collecting a detailed history and troubleshooting potential complications prior to creating treatment plans, we can greatly reduce the potential for treatment failure after a patient is discharged from the clinic. For example, asking pointed questions such as “Does your home have stairs that your dog needs to navigate?” or “Will your dog eliminate when on leash?” can identify obstacles for post-orthopedic procedure patients or for those with limited mobility for other reasons. Developing a plan that is specific for the individual patient can be accomplished quickly and efficiently with just a bit of pre-planning. History information will also allow you to identify strategies that may be of benefit for patients, especially when procedures have a flexible or elective timeline. Teaching a patient to eliminate on

THE FVMA |

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@FLORIDA_VMA | 21

leash, trialing situational medication options prior to surgery, improving confinement or separation tolerance, practicing polite greetings without jumping up, and auditioning puzzle toys for mental enrichment can all help to prevent specific problems during the recovery period. The strategies introduced here are just a small fraction of what is currently available to practitioners for improving the quality of care that we provide to our patients. Rather than rushing out and attempting to implement all these techniques, it may be helpful to focus on three or four that seem most accessible or the most practical for your location or skill set. Implement those to the best of your ability and then evaluate how well they are working for you prior to setting your sights on the next strategies for implementation. The sky is the limit, and your patients and clients will thank you for your efforts!

protecting your practice Even if it seems unlikely, allegations of harassment, discrimination and wrongful termination can happen in your practice and are costly to defend. Our Employment Practices Liability program helps you get the legal protection and support you deserve.

800-228-7548, option 4

avmaplit.com

22 | FVMA ADVOCATE

Christopher Pachel DVM, DACVB, CABC Christopher Pachel, DVM, DACVB, CABC received his veterinary degree from the University of Minnesota in 2002, and he worked as a general practitioner in the Minneapolis-St. Paul, Minnesota area prior to the start of his residency program. He operated a house-call behavior practice in the Minneapolis-St. Paul area from 2005 until 2010. In 2010, he also became board certified by the American College of Veterinary Behaviorists. He is currently the owner of the Animal Behavior Clinic in Portland, Oregon; lectures regularly throughout the U.S. and Canada; and has taught courses in veterinary behavior at multiple veterinary schools in the U.S. He has published research on feline water consumption preferences, wrote a book chapter on inter-cat aggression for the May 2014 issue of “Veterinary Clinics of North America: Small Animal Practice,” and is co-author of a book chapter on pet selection for animal-assisted therapy.”

Wellness & Well-being

RESOURCES FOR THE VETERINARY PROFESSION Samantha Rosenthal, director of communications & public relations In the last few years, there has been a growing interest and concern for the wellness and well-being of veterinary professionals. The 2017 Merck Veterinary Wellbeing Study reported that veterinarians experience slightly lower levels of well-being than the general public, and about 1 in 20 veterinarians suffer from serious psychological distress. A recent study (January 2019) by the CDC, in conjunction with the AVMA, reported female veterinarians are 3.5 times more likely to die from suicide compared to the general population, while male veterinarians are 2.1 times as likely to compared to the general population. Organizations like the FVMA and AVMA have started providing resources, programs and educational opportunities to raise awareness about the issue to not just the general public but within the profession itself – ultimately, to erase the stigma and normalize the idea of getting help when life starts to become difficult for practitioners. The FVMA created the Professional Wellness and Well-being Committee to provide Florida veterinarians with resources and support for chemical dependency, psychiatric illness, eating disorders, anger management, professional burnout and compassion fatigue. The goal of the committee is to provide veterinarians with better resources that address issues like worklife balance, job satisfaction, how to deal with work and life struggles, and create awareness and prevention of suicide within the profession. The FVMA has recognized that the health, wellness and well-being of its members are an essential component to guaranteeing they have happy personal and professional lives. Oftentimes, we hesitate to reach out for help — sometimes not even knowing where to look and what resources and tools are established to provide guidance to those who are struggling. The FVMA has compiled a list of resources, assessments, tools and support groups that can help provide support, encouragement and assistance to those learning to manage the stressors brought on by the profession and regain balance to their lives.

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SELF-ASSESSMENTS

Self-assessments provide an opportunity to examine the positive and negative personal and work-related experiences that impact our lives. While they aren’t diagnostic tests, they’re tools designed to provide introspection about yourself, your environment, your workplace and how you manage these many aspects. Below are examples of some self-assessments that we encourage members to take that can help them assess things like burnout, compassion stress, and other psychological and emotional factors that play a part in mental well-being. These can help identify areas you may want to focus more time on for finding self-care options.

• AVMA’s

Wellbeing

Assessment

for

Veterinarians:

https://myvetlife.avma.org/rising-professional/your-wellbeing/ wellbeing-self-assessment

• Professional Quality of Life Measure (self-evaluation for risk of compassion fatigue, STS and burnout): https://proqol.org/ ProQol_Test.html

• SAMHSA-HRSA Center for Integrated Health Solutions’ AUDIT-C: https://www.integration.samhsa.gov/images/res/tool_auditc.pdf

• SAMHSA-HRSA Center for Integrated Health Solutions’ Patient Stress Questionnaire: https://www.integration.samhsa. gov/Patient_Stress_Questionnaire.pdf

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WORK & COMPASSION FATIGUE

While compassion fatigue and burnout are similar, they’re not the same things. Compassion fatigue is comprised of two components: secondary traumatic stress AND burnout. You can experience secondary traumatic stress and burnout each on their own, but to experience compassion fatigue both components need to be present. Dr. Charles Figley first introduced this concept when he wrote his book in 1995 “Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized.” Compassion fatigue is a result of the unique relationship that veterinarians have with a patient, which allows them to express empathy with a patient that is ill, dying or experiencing a traumatic event. It is also a result of when a veterinarian sees a client go through the trauma of losing a cherished pet or when clients are faced with difficult decisions that result in euthanasia. Sometimes known as “vicarious trauma” or “secondary traumatic stress,” veterinarians are more at-risk for compassion fatigue because they experience secondary traumatic stress as part of caring for patients and clients. Using the ProQOL self-assessment or consulting with a mental health professional can be helpful for those experiencing compassion

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@FLORIDA_VMA | 21 23 @FLORIDA_VMA

fatigue. Knowing the signs that you or someone you know are experiencing compassion fatigue can be helpful and allow you or that individual to take the first steps toward recovery. Symptoms of compassion fatigue include, but are not limited to: • Feelings of apathy. • Isolation. • Struggling to find joy in activities you once found enjoyable. • Mental and physical exhaustion and/or tiredness. • Chronic physical ailments or sickness. • Poor self-care, including hygiene habits. • Recurring nightmares or flashbacks to general or specific traumatic experiences with a patient or situation. • Alcohol abuse, substance abuse and/or the misuse of prescribed medications. Connecting with colleagues and being able to share your experiences has shown to help relieve stress and provide social support. Some other personal approaches to tackling compassion fatigue can include, but are not limited to: • Building resilience through proper sleep, nutrition and regular physical activity. • Provide moments throughout your day and week for alone time. • Engaging in activities that provide relaxation and mindfulness, like meditation. • Connect with your colleagues through online discussion boards and forums to share stories, ideas and show support for those experiencing compassion fatigue as well. • Journaling or other forms of stress-free writing every day for 15 minutes. Below are some additional resources and materials that can help you learn more about compassion fatigue, its signs and ideas for coping strategies: • Burnout and compassion fatigue in veterinary medicine: www.youtube.com/watch?v=Rqb3n4JGX8c • Compassion Fatigue Awareness Project: www. compassionfatigue.com

• Rekindle Solutions: http://rekindlesolutions.com/ • "When Helping Hurts: Compassion Fatigue in the Veterinary Profession" by Dr. Kathleen Ayl (Book is available on Amazon • AVMA's Professional Development Webinar - Staying Afloat: Professional Stress and Well-being (https://www.avma.org/ ProfessionalDevelopment/Career/Pages/webinar-stress-well-being.aspx) • Dr. Dani McVety-Leinen’s article in The Advocate – “Being Un-Offendable in Veterinary Medicine”: https://issuu.com/ fvma_faep/docs/advocate_issue_2_2019_web_version/14

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STRESS MANAGEMENT

Veterinarians deal with stress daily due to the nature of the profession. From diagnosing critically ill patients to managing your personal budget to pay off student debt and achieve future financial goals, it is important for veterinarians to take time every day to relieve stress that results from everyday life stresses. The AVMA compiled a Stress Management Checklist that provides basic stress-relief measures, which can be used to ensure you’re taking time to deal with stressors in your life in a positive way.

24 | FVMA ADVOCATE

The checklist says some ways to manage stress include: ;; Exercise regularly ;; Get sufficient sleep ;; Plan for and follow a balanced diet ;; Drink alcohol in moderation ;; Maintain a healthy weight ;; Balance work and play ;; Delegate tasks appropriately. Don't try to do everything yourself ;; Spend quality time with friends and family ;; Resolve conflict in a timely and respectful manner ;; Take psychological health seriously. Seek professional assistance if bothered by feelings of depression or other signs of mental illness ;; And last but not least, never underestimate the health benefits of playing with your pet Information above provided by the AVMA (https://www.avma.org/

ProfessionalDevelopment/PeerAndWellness/Pages/wellness-checklist.aspx)

It is important to learn how to deal with stress because too much stress can have negative effects on overall physical health and well-being. Ways to deal with stress can include yoga, meditation, breathing exercises, practicing mindfulness, taking time to perform affirmations and/or putting time aside to be alone before you begin your workday. There are apps for smartphones that you can download to use to help relieve stress, practice mindfulness and help you manage your stress.

YOGA APPS

 Pocket Yoga ($2.99)  Daily Yoga (free with in-app purchases)  Yoga for Beginners | Mind+Body (free)  Yoga Studio: Mind & Body (free with in-app purchases)  Simply Yoga - Fitness Trainer (free)  Yoga | Down Dog (free)  5 Minute Yoga Workouts (free with in-app purchases)

MEDIATION & MINDFULNESS APPS

Insight Timer (free with in-app purchases) Stop, Breathe &Think (free or $10/month) The Mindfulness App (free with in-app purchases) Headspace: Meditation & Sleep (free with in-app purchases) Calm (free with in-app purchases) Simple Habit (free with in-app purchases) Breethe: Meditation & Sleep (free with in-app purchases) Oak - Meditation & Breathing (free with in-app purchases) 10% Happier: Meditation (free with in-app purchases) Pocket Meditation Timer (free)

OTHER APPS TO DOWNLOAD TO HELP MANAGE STRESS

Breathe2Relax (free) iBreathe – Relax and Breathe (free with in-app purchases) Sanvello: Stress & Anxiety Help (free with in-app purchases) Relax Melodies: Sleep Sounds (free with in-app purchases) Happify: for Stress & Worry (free with in-app purchases) Shine - Self-Care & Meditation (free with in-app purchases) Personal Zen (free with in-app purchases) MindShift CBT - Anxiety Canada (free with in-app purchases) Colorfy: Coloring Art Game (free with in-app purchases) Rootd - Panic Attack Relief (free with in-app purchases)

Other stress reduction techniques that have shown to help decrease stress levels include physical exercise or engaging in fun leisure activities with family and friends. Pick the relaxation and stress management techniques that help you best manage and cope with stress. In the end, the most important thing is learning how to recognize the symptoms of stress and finding the best methods to relieve stress during tense situations.



 COUNSELORS IN FLORIDA If you would like to talk to a professional to seek further help, below is a list of counselors in Florida who specialize in working with health professionals that deal with issues like compassion fatigue, burnout and stress management. • Gerald A Kurtz, Ph.D. – Hialeah area – 305.343.4441 • Alexis Polles, MD – Fernandina Beach area – 904.447.5433 • Quinn and Truett – Lakeland area – 863.683.9600 • Karin E Courchaine, Ph.D. – Marion County area – 352.874.9914 • Lynne Spinney – St. Petersburg area – 727.493.0347 • Michael Whalen – St. Petersburg area – 727.493.0347 • Tom Antonek, Ph.D. – Ocala/Port Richey area – 813.358.2053 • Kelly Brady, LMHC, AP – Tampa area – 813.335.2060 • Deborah Troupe, LMHC – Jacksonville area – 904.568.9008

WORK-LIFE BALANCE

The demands of the veterinary profession can be challenging. Balancing the demands of your personal and professional lives can sometimes be tricky but finding that balance for yourself provides you with the opportunity to enjoy your career while also taking needed personal time for yourself. The first step is always prioritizing your wellness and well-being first, which also helps work toward increased levels of work satisfaction. Some ways to improve work-life balance include adjusting how you spend your time at work including your case load. Being able to have a conversation with your boss when work demands can feel overwhelming is important and should be encouraged. Keep in mind that wellness is a combination of many factors that come from different aspects of our lives. The AVMA lists nine dimensions of well-being which are: Occupational

Social

Financial

Intellectual

Emotional

Creative

Spiritual

Physical

Environmental

Information provided above by the AVMA (https://www.avma.org/ ProfessionalDevelopment/PeerAndWellness/Pages/self-care.aspx)

The FVMA and its Professional Wellness Committee continues to work to provide Florida veterinarians with resources and support for those who might be struggling or affected by wellness and well-being issues, including suicide. The FVMA reminds its members there is hope — together we can find the strength to overcome.

If you or someone you know is suicidal or in an emotional distress, contact the National Suicide Prevention Lifeline at 1.800.273.8255 (TALK). Trained crisis workers are available to talk 24 hours a day, seven days a week. Your confidential and toll-free call goes to the nearest crisis center in the Lifeline national network. The Crisis Text Line is also available 24 hours a day, seven days a week. Text HOME to 741741 from anywhere in the U.S. at any time and a live, trained crisis counselor receives your text and responds on a secure online platform. You can also call 211 to speak with a live, trained service professional in your local area. All calls are confidential, and 211 is accessible 24 hours a day, seven days a week.

The 2014-2015 class of AVMA Future Leaders produced a podcast series “Wellness Podcasts.” The podcasts were created to help guide veterinarians in improving their own wellness, along with helping their employees. An overarching theme is finding the work-life balance that is right for you, which ultimately will help veterinary professionals find everyday happiness in their career and within themselves. The podcast series can be found at this link: https://www.avma.org/

mindful BE

ProfessionalDevelopment/PeerAndWellness/Pages/wellness-podcasts.aspx

SUPPORT GROUPS & ORGANIZATIONS FOR VETERINARY PROFESSIONALS

Not One More Vet (https://www.nomv.org) Vets4Vets® (https://vinfoundation.org/resources/vets4vets/) Veterinary Support Personnel Network (https://www.vin.com/vspn/) MightyVet (https://mightyvet.org/) AVMA Member Discussions: Work-Life Balance & Wellbeing (visit avma.org for access) University of Tennessee Veterinary Social Work program – Any veterinarian can contact a veterinary social worker at the University of Tennessee, Knoxville School of Veterinary Social Work. Call 865.755.8839 or email vetsocialwork@utk.edu. Florida Professionals Resource Network (PRN) (www.flprn.org) WWW.FVMA.ORG |

THE FVMA |

@FLORIDAVMA |

@FLORIDA_VMA | 25

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 wanted to ask a question regarding video recording with audio in the workplace. My employer has installed a security system with video and audio recording, and I wanted to know if it is legal to have the audio recording? She has posted signs alerting people that they are being recorded with audio. She wants us to sign a sheet acknowledging this information, but the sheet says a licensed contractor had to install the camera and I don't know if that's the case. My only issue is the audio part. I'm very uncomfortable with private information (i.e. social security number, personal information, etc.) being recorded. What are my rights? A: The law prohibits secretly or surreptitiously making recordings.

That is why when you call a business, you may get a recorded message that alerts you that phone calls may be recorded for “training purposes.” Giving that oral notice, posting written notice or having the employees sign an acknowledgement makes the recording no longer surreptitious. You have the same right anyone else has: to be notified that audio/ video recordings are being taken and then decide to proceed accordingly. Callers can hang up or prospective clients have the right not to do business there. You may have the right not to work there anymore if you choose, assuming you’re not bound by an employment contract.

QUESTION:

I am a 2017 graduate and got my license in January 2018. My renewal date will be the two-year mark in 2020. I am wondering if I need 30 CE credits or if it works different for a new graduate? A: Florida Rule Chapter 61G18-12.002 Continuing Education

Requirements for Active Status License Renewal at section (5) states "A licensed veterinarian shall not be required to complete a continuing education requirement prior to the first renewal of his license, but it shall be required prior to any subsequent renewal." You, therefore, do not need 30 CE credits for renewal in 2020. You will for any subsequent renewals.

QUESTION:

Exactly what is my proper response to a case of suspected animal abuse? Does client-doctor confidentiality take precedence or has Florida HB 7125 passed? What are any recommendations you have?

26 | FVMA ADVOCATE

A: HB 7125 was passed and signed into law by Governor Ron

DeSantis. It goes into effect October 1, 2019. Until then, F.A.C. 474.2165 Ownership and control of veterinary medical records; or copies of records to be furnished without the 2019 amendment (reproduced below) remains in effect. As of October 1, 2019, veterinarians can report suspected animal abuse, etc. 474.2165 F.A.C. will be amended to read at s. (4)(d): In any criminal action or situation where a veterinarian suspects a criminal violation. If a criminal violation is suspected, a veterinarian may, without notice to or authorization from the client, report the violation to a law enforcement officer, an animal control officer who is certified pursuant to s. 828.27 (4)(a), or an agent appointed under 818.828.03. However, if a suspected violation occurs at a commercial food-producing animal operation on land classified as agricultural under s. 193.461, the veterinarian must provide notice to the client or the client’s legal representative before reporting the suspected violation to an officer or agent under this paragraph. The report may not include written medical records except upon the issuance of an order from a court of competent jurisdiction.

QUESTION:

We have a new client who is a veterinarian from Colombia but is not yet licensed in the U.S. She has two French bulldogs that are pregnant and due this week. We are doing scheduled C-sections. Can I allow her to scrub in and assist without any problems? She would only be helping with the closure after the puppies have been removed. She is a new graduate with some equine experience. Her plan is to take the Boards next year. A: The rule on delegable tasks does not specifically prohibit

delegating any task other than what's cited in the following rule, as long as it's performed under the “immediate supervision” of a licensed veterinarian. 61G18-17.005 Tasks Requiring Immediate Supervision. (1) All tasks which may be delegated to a veterinary aide, nurse, laboratory technician, intern, or other employee of a licensed veterinarian shall be performed only under the “immediate supervision” of a licensed veterinarian as that phrase is defined in subsection 474.202(5), F.S., with the exception of the following tasks which may be performed without the licensed veterinarian on the premises: (a) The administration of medication and treatment, excluding vaccinations, as directed by the licensed veterinarian; and (b) The obtaining of samples and the performance of those diagnostic tests, including radiographs, directed by the licensed veterinarian.

(2) The administration of anesthesia and tranquilization by a veterinary aide, nurse, laboratory technician, intern, or other employee of a licensed veterinarian requires “immediate supervision” as that phrase is defined in subsection 474.202(5), F.S. (3) The administration of any vaccination by a veterinary aide, nurse, technician, intern or other employee of a licensed veterinarian which is not specifically prohibited by Rule 61G18-17.006, F.A.C., requires “immediate supervision” as that phrase is defined in subsection 474.202(5), F.S. Technically speaking, the only tasks that can't be delegated are vaccinations for the four diseases listed in rule 61G18-17.006. 61G18-17.006 Diseases which Only a Veterinarian May Immunize or Treat. For the purpose of implementing the exemption provisions of Section 474.203(5)(a), F.S., the Board recognizes that the following diseases are communicable to humans and are of public health significance, and that only a veterinarian may immunize or treat an animal for these diseases: (1) Brucellosis. (2) Tuberculosis. (3) Rabies. (4) Equine Encephalomyelitis A veterinarian can be disciplined for “delegating professional responsibilities to a person when the licensee delegating such responsibilities knows or has reason to know that such person is not qualified by training, experience, or licensure to perform them.”

(e) United States Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services. (f) Any AVMA accredited school of veterinary medicine. (3) Upon specific request, continuing education courses shall be approved by the Board whenever the courses provide additional current information with respect to the practice of veterinary medicine. Such requests shall include the following: (a) A detailed course outline or syllabus; (b) A current curriculum vitae of each speaker or lecturer; (c) The procedure to be used for recording attendance; and (d) The number of continuing education hours for which the course sponsor requests approval. (4) Beginning on May 31, 2006, each provider, unless exempted by rule, shall be registered with the Board. The fee for such registration shall be $200 and such registration must be renewed by May 31 of every other even numbered year. (5) Course approval shall expire four (4) years from the date of approval. Continuing education providers shall reapply for approval of any course that has expired by complying with Rule 61G1816.0035, F.A.C. Rulemaking Authority 474.206, 474.211 FS. Law Implemented 474.211 FS. History–New 12-10-81, Amended 8-15-84, 5-7-85, Formerly 21X16.03, Amended 10-14-86, 3-26-90, Formerly 21X-16.003, Amended 8-18-94, 2-6-95, 7-4-95, 12-30-97, 7-13-04, 3-7-06, 2-25-14, 1-31-16.

QUESTION:

Do my USDA-APHIS National Veterinary Accreditation Program Training courses that I completed online in May 2019 count toward my CE credits? I have completed three, one-hour courses.

I have been operating out of the same location since June 2000, and I am about to move into a new hospital that I have built. It will hold the same name, same doctors and same everything other than it will be at a new location, which is a quarter of a mile west on the same street. What might I need to legally do as far as licenses, permits, etc.?

A: Yes, USDA courses are approved CE in the state of Florida. Below

A: The two most important things:

QUESTION:

is the relevant rule:

61G18-16.003 Continuing Education Standards. (1) The continuing education requirements outlined in Rules 61G18-16.001 and 61G18-16.002, F.A.C., may be complied with by attendance at approved scientific veterinary medical meetings. A licensed veterinarian shall receive credit for no more than five (5) hours of continuing professional education in business, practice management courses or stress and impairment seminars during any biennium period. (2) Approved courses are deemed scientific if continuing education courses are provided by: (a) National, State and International veterinary association meetings and Board meetings; (b) Board Certified Specialties recognized by the AVMA; (c) University of Florida, College of Veterinary Medicine sponsored courses, including clinical grand rounds, veterinary resident’s seminars and Board specialty review sessions; (d) The Registry of Approved Continuing Education Courses (RACE); and

WWW.FVMA.ORG |

1. Apply for a new premise permit. You can do it online or use the printed form. 2. Apply to DEA for a change of address. If you Googles “DEA change of address,” they will get the link to do this online.

If the county/city has an occupational license, they need to update that or get a new one.

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

THE FVMA |

@FLORIDAVMA |

@FLORIDA_VMA | 27

CLASSIFIED ADVERTISEMENTS VETERINARIANS WANTED

VETERINARIAN WANTED – CLEARWATER, FL: Come explore the Gulf Coast! Animal Health Care Clinic in Clearwater, FL is looking for a veterinarian to join our community-based practice. We are a busy, multidoctor hospital that provides quality veterinary care for dogs and cats. Our inviting facility has undergone changes and improvements throughout the years in keeping with the many ongoing advancements in veterinary medicine. The caring support staff are dedicated to our patients, clients, and community. Get to know us better here! Clearwater is a wonderful place to live and work. Located in the Tampa Bay area, it is known for sunny weather and beaches. The downtown city also offers plenty of amenities, including plenty of restaurants, shops, and live entertainment to explore. If you enjoy living the beach life, then this Gulf Coast gem is for you! We are a family of practices with a long history and reputation that separates us from others - check us out! We support our veterinarians with superior salary, benefits including health and dental, 401(k), CE allowance, vacation, dues, liability coverage, outstanding practice teams, and a family friendly atmosphere. If interested, please email Katie Hanson at katherinehanson@vetcor.com. (4/19; ID#46409) VETERINARIAN WANTED – ST. AUGUSTINE, FL: Come join our team! Jackson Veterinary Hospital in St. Augustine, FL is seeking an associate veterinarian to join our growing practice. We are a multi-doctor, fullservice hospital that focuses on combining high-quality veterinary care with exceptional client service for companion animals. Our facility includes a full in-house lab, digital x-ray, digital dental x-ray, and ultrasound, along with a fully equipped surgical suite. We also offer Chinese herbal medicine and acupuncture. We work closely with a local emergency clinic for after hour appointment referrals. Get to know us better here! This is an ideal opportunity for experienced veterinarians and new graduates alike, as our collaborative team offers a wide range of experience and areas of interest, creating a healthy work/life balance and a family-like environment. St. Augustine, known as the oldest city in the United States and founded in 1565, allows for a “small-town” feel with all the amenities of a large city nearby and an abundance of historical locations to experience. It is a great place to live and work. The downtown district offers an amazing assortment of fine shopping, dining, and events to attend. You can also enjoy a multitude of outdoor activities including close range to beaches, parks, hiking trails. St. Augustine is also within a two hour drive to the major Central Florida amusement parks. This area has something unique to offer everyone! We are a family of practices with a long history and reputation that separates us from others - see what all the buzz is about! We support our veterinarians with superior salary, benefits including health and dental, 401(k), CE allowance, vacation, dues, liability coverage, outstanding practice teams, and a family friendly atmosphere. If interested, please email Katie Hanson at katherinehanson@vetcor.com.(4/19; ID#46409) VETERINARIAN WANTED – SUNRISE, FL: Scarbrough Animal Hospital, a well-established, family owned, high quality, small animal practice in Sunrise, Florida is seeking an associate veterinarian. Scarbrough Animal Hospital is a three-doctor practice with highly motivated support staff. Our veterinarians provide general medicine and surgery to companion animal patients. We have expanded and modernized our services to better serve our patients and clients. While our hospital has experienced continual growth through the years, recent growth has been exceptional. The ideal applicant would be a motivated, outgoing, energetic individual with excellent client and communication skills proficient in diagnostics and internal medicine. A basic knowledge of surgical skills is preferred; however our current Doctor has a high level of surgical experience and is willing to teach. Additional benefits would be that the candidate would require minimum to no supervision and capable of directing support staff. Three year’s experience in private practice is preferred. Base pay can reach up to $130K along with a high percentage production bonus. Bilingual is a plus! Live and work near the beach and enjoy the numerous activities that our area has to offer. Please contact Alix Rairden my email for more information alix222@gmail.com. (4/19; ID#4566) VETERINARIAN WANTED – BRADENTON, FL: Moving/Sign-on Bonus. People are our most important asset: veterinarians, staff & clients celebrating their love of pets. We are searching diligently for the exceptional, energetic, compassionate, team-oriented SA associate with excellent communication skills to come grow with us! All experience

28 | FVMA ADVOCATE

levels considered. Established in 1947 and growing! Our new 7,000 sq-ft facility houses our fast-paced hospital with a practice of excellence philosophy. Digital radiology, digital dental radiology, separate surgical and dental suites, ultrasound, radio surgery, high-speed dental equipment, therapy laser, acupuncture, herbal medicine, video otoscope, chemistry, CBC, pulse oximetery, ekg, blood pressure monitors, CO2, patient warming. Base plus production pay; health insurance; retirement plan; stipend for CE, license, and dues; vacation; health savings account. Contact Jeff Logas, Bradenton Veterinary Hospital, 1324 17th Ave W, Bradenton, FL 34205 Jeffrey.Logas@BradentonVeterinary.com 941.746.2252 (4/19; ID#10809) VETERINARIAN WANTED - COCOA, FL: Full time veterinarian needed in our 3 doctor small animal / exotic animal hospital in Cocoa, FL - we are in an excellent location just east of Orlando, just west of Cocoa Beach, just north of Vero Beach , and just south of Daytona Beach. We opened our free-standing facility in April 2007 and have state of the art diagnostic, surgical, and dental capabilities. Our hours of operation are 7:30-5:30 M-F and Sat 8-12. No after hour emergency work required. Salary negotiable. Please come see us! Feel free to call, text, or email for more detail - Dr. Sarah Guttery 321-636-2230, sguttery@cfl.rr.com. (4/19; ID#19114) VETERINARIAN WANTED – VOLUSIA COUNTY, FL: Volusia County is seeking a Veterinarian to lead our spay/neuter program and oversee the county's medical examination and treatment of animals. To apply go to www.volusia.org --> "Career Opportunities" (4/19; ID#46432) VETERINARIAN WANTED – TAMPA BAY, FL: Tampa Bay Downs Thoroughbred Race Track is actively seeking an experienced Veterinarian to join our team for the 2019-20 meet. We are looking for a candidate to fill a Veterinarian position examining thoroughbreds both pre and post race. The ideal candidates must be experienced with racetrack procedures including both morning and afternoon responsibilities and be able to move seamlessly between positions. The successful candidates must licensed by the State of Florida or able to gain licensing no later than November 15, 2019. To apply call 813-855-4401 ext 1368 or email at employment@tampabaydowns.com(4/19; ID#46184) VETERINARIAN WANTED – JACKSONVILLE, FL: Miramar Animal Hospital is a fast-paced, two doctor practice in the San Marco area of Jacksonville, FL. Our hospital focuses on providing thorough and progressive veterinary care to the tight-knit community in which we stand. We offer a full range of modern and traditional solutions for dogs and cats. Aside from general wellness exams, our practice offers in-house laboratory, radiology, and ultrasonography, acupuncture and laser therapy, and routine dentistry and surgical procedures. We are looking for a motivated individual who is interested in practicing high quality veterinary medicine while developing long-term relationships with our clients and their pets. Miramar Animal Hospital is a growing clinic. We are willing to fill this newly created position with a new graduate who will be provided an opportunity for mentorship and personal growth or someone with experience. For more information please contact (904) 737-0403. (4/19; ID#28285) VETERINARIAN WANTED – KEY LARGO, FL: The Island Hammock Pet Hospital is looking for the right candidate with several years of experience to help us continue to grow and achieve our goals of providing exemplary medicine to our patients and outstanding service to our clients. We are a new, fast growing, three doctor companion animal practice located in Key Largo, Florida. We offer a strong compensation package, an experienced staff and a rewarding work environment. We operate a new, AAHA accredited, state of the art facility and utilize efficient business practices. You can learn more about us at www.IHPH.net. The fabulous Florida Keys offers some of the best fishing and SCUBA diving available in North America. Island life is a laid back, semi-rural lifestyle. All of the advantages of a large metropolitan area are within a 45 minute drive. If you love the water and sun, the Florida Keys is a great place to live. To learn more about the position, please send your resume to careers@IHPH.net. (4,5,6/19; ID#10524) VETERINARIAN WANTED – CAPE CORAL, FL: Full-time/Part-time veterinarian needed for our modern, fully equipped Affordable Pet Hospital in Cape Coral FL. Were are state of the art practice with in house full blood work capabilities, Digital x rays, Laser and Ultrasound machines. New graduates are welcome. Our clients expect the best and we are looking for that special someone with the right attitude for client satisfaction. Competitive salary. Please email resumes to management at lorena@petcoral.com.(4/19; ID#46509)

VETERINARIAN WANTED – VERO BEACH, FL: The Humane Society of Vero Beach & Indian River County is seeking enthusiastic additions to its veterinary team. Under new leadership, the HSVB is embarking to quickly grow its programs and services to provide high-quality care to its shelter pets and to help its community keep pets in homes for the long-haul. Competitive salary (DOE), Medical, dental, vision, 403B, and short-term disability included. $2000 provided annually for CE. View Florida & Georgia Practices for Sale the job description at hsvb.org. (4/19; ID#46450) VETERINARIAN WANTEDSolo - ORLANDO, FL:Gross $200,000/yr. annual FL: Jacksonville: dr, SA prx. $518K+. No salary regardless of experience. For more information please contact after-hours ER. RE Included. (FL43J) Dr. Adkins at 407-529-5651 (4/19; ID#28095)

GA: NEW! Hinesville: Solo dr, SA prx. $930K+ Gross. RELIEFincome VETERINARIANS $196K personal to new owner. (GA34H)

Florida & Georgia Practices for Sale FL: Jacksonville: Solo dr, SA prx. Gross $518K+. No after-hours ER. RE Included. (FL43J) GA: NEW! Hinesville: Solo dr, SA prx. $930K+ Gross. $196K personal income to new owner. (GA34H)

RELIEF VETERINARIAN: "Got to get away? "VetRxRelief , 37 years GA:small South Central GA: $959K+ gross, up 5% in 2019, experience animal Veterinarian.Please call 321-508-3879 or Vetgator@gmail.com. (3-4/19;Nice ID #2187) 1.5 doctor practice. facility & equipment. (GA14F)

GA: South Central GA: $959K+ gross, up 5% in 2019, 1.5 doctor practice. Nice facility & equipment. (GA14F)

FL: SOLD! South Central FL: Congratulations to Dr. PRACTICES FOR SALE OR LEASE Jeff Saunders on the sale of his practice, Saunders RENT Veterinary TO OWN Services. PRACTICE – ST. CLOUD, FL: St. Cloud 192 (FL28A)

FL: SOLD! South Central FL: Congratulations to Dr. Jeff Saunders on the sale of his practice, Saunders Veterinary Services. (FL28A)

practice & equipment- rent to own. Dr. Larry Adkins 407-529-5651 DrLarryAdkins@gmail.com FL: SOLD! West ofhttp://lowcostanimalhospitals.com/ Amelia Island: Congratulations to (4/19; IDDr. #28095) Kimberly Carter on the sale of her practice, Nassau PRACTICE FOR SALE – WAUCHULA, FL: Practice For Sale:(FL65Y) Central Florida Veterinary Hospital to Dr. BethAnne Frost. – 80% Small solo. 2400 sq ft with adjacent 3000 sq ft conference center. Digital radiography, in house North blood chemistry, Accuvet surgery laser, all the toys. FL: SOLD! of Orlando: Congratulations to Dr. Grossing over Greer $900,000 lastof3 his yearspractice, and will go over $1m in AH 2019.to Kent onannually the sale River Oaks Owner retiring to health and Berrios. family. Work steady and plentiful in busy Dr. Anadue Ortiz & Jose (FL10L) rural practice. Can be expanded. Serious inquiries only. Owner will finance qualified buyer and assist in transition. 863-773-9215 or 863-781-9215. 1610 Frederica Road, Saint Simons Island, GA 31522 (4/19; ID #28130)

Toll Free: (800) 333-1984 | www.simmonsinc.com Email: southeast@simmonsinc.com EQUIPMENTS FOR SALE Licensed in Florida, Georgia, North Carolina, EQUIPMENT FOR SALE SOUTH FLORIDA: Excellent new condition: and South Carolina Real Estatelike Broker

stainless dental tub, new fixtures; 2 gas anesthesia. Bank of 5 cages. Burton surgery floor lamp. Iris Ramirez DVM 239-454-7387. (4/19; ID #29259)

FL: SOLD! West of Amelia Island: Congratulations to Dr. Kimberly Carter on the sale of her practice, Nassau Veterinary Hospital to Dr. BethAnne Frost. (FL65Y) FL: SOLD! North of Orlando: Congratulations to Dr. Kent Greer on the sale of his practice, River Oaks AH to Dr. Ana Ortiz & Jose Berrios. (FL10L) 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, and South Carolina Real Estate Broker

PS BROKER FloridaFlorida & Georgia Practices for Sale Practice Listings! Jacksonville: dr,ofSA prx. Gross No New–FL: Central Florida– Solo North Tampa– Well$518K+. established, after-hours ER. in RE2018. Included. (FL43J) 1.25 Dr., $860K gross In-house lab, digital x-ray, dental x-ray, 4400 sq. ft. free standing hospital w/ 3 exam rooms, Prx and RE available a turnkey operation. GA: NEW!inHinesville: Solo dr, SA prx. $930K+ Gross.

Veterinary Practice Real Estate Brokers, Licensed Nationwide Sales — Buyers Representation — Certiﬁed Valuation Analyst Florida & Georgia Practices for Sale

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FL: Jacksonville: Solo dr, SA prx. Gross $518K+. No practices nationwide. after-hours ER. RE Included. (FL43J)

Florida Practices For Sale

$196K personal income to new owner. (GA34H)

GA: NEW! Hinesville: Solo dr, SA prx. $930K+ Gross. $196K personal income to new owner. (GA34H)

1.5 doctor practice. Nice facility & equipment. (GA14F)

GA: South Central GA: in $959K+ gross, up 5% in 2019, animal practice a great Gulf coast 1.5 doctor practice. Nice facility$147k & equipment. (GA14F) location! $858k gross/ net in most

West Central Florida– Well established solo Dr. Practice grossing just over $600K. RE available...3600 ft. w/ GA: South Central GA: $959K+sq. gross, up3exam 5% inrooms, 2019, in-house lab, digital X-ray and more. Sold SE Coastal Fl.– Solo Dr. Practice grossing $822K, 6100 sq ft FL: Congratulations to Dr. office FL: and SOLD! boardingSouth space.Central Well equipped with experienced staff. JeffinSaunders the sale of his practice, Saunders Located an upscaleon beach community.

Hernando County: Thriving solo small

Veterinary Services. (FL28A)

recentSouth year.Central Appx.FL: 2600sq. ft. facility. FL: SOLD! Congratulations to Dr. This practice still has room to grow! FL94 Jeff Saunders on the sale of his practice, Saunders Veterinary Services. (FL28A)

Veterinary Hospital to Dr. BethAnne Frost. (FL65Y)

FL: SOLD! West of Amelia Island: Congratulations to practice onon the thesale southeast coast! Dr. Kimberly Carter of her practice, Nassau +/-$450k gross, +/-$110k net can be Veterinary Hospital to Dr. BethAnne Frost. (FL65Y)

Dr. Ana Ortiz & Jose Berrios. (FL10L)

FL: SOLD! of Orlando: to Dr. GreatNorth opportunity in a Congratulations vibrant, aﬄuent Kent Greer on the sale of his practice, River Oaks AH to community! FL95 Dr. Ana Ortiz & Jose Berrios. (FL10L)

Greater Orlando area– Solo Dr. has worked only part time. FL: SOLD! West of Amelia Island: Nice 2700 sq.ft. freestanding office on a newCongratulations major 6 lane. to Great Dr. opportunity Start-up/Jump-Start. Priced to sell.Nassau Kimberlyfor Carter on the sale of her practice, Central-East Coast– Just minutes from the beach!! Solo Dr. with high fromNorth a $1.025mm gross. Congratulations In-house lab, 2100 FL: net SOLD! of Orlando: to sq. Dr. ft. office Kent on major 4 lane. Established almost 40 years. Greer on the sale of hisforpractice, River Oaks AH to Are Corporate Groups contacting you about buying your Practice? If so, let us help make sure you get your best deal!!!

1610 Road, Simons Island, GA 31522 Contact Dr.Frederica Richard Alker forSaint further practice information. Toll Free: (800) 333-1984 | www.simmonsinc.com Email: southeast@simmonsinc.com 850.814.9962 or Richard@tpsgsales.com Licensed in Florida, Georgia, North Carolina, Showcase Properties of Central Florida, Broker and South Carolina Real Estate Broker

WWW.FVMA.ORG |

Palm Beach County: Solo small animal expected. Appx. 1150sq. ft. facility.

1610 Frederica Road, Saint Simons Island, GA 31522 PS BROKER has listings available Nationwide! Toll Free: (800) 333-1984 | www.simmonsinc.com Email: southeast@simmonsinc.com psbroker.com 800.636.4740 Licensed in| Florida, Georgia, North Carolina, | info@psbroker.com and South Carolina Real Estate Broker

THE FVMA |

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@FLORIDA_VMA | 29

ANNUAL OCALA

EQUINE CONFERENCE

JANUARY 24-26, 2020 | OCALA, FLORIDA

SAVE THE DATE | JANUARY 24-26, 2020 REGISTRATION OPENS NOVEMBER 1, 2019 The Ocala Equine Conference offers the highest quality continuing education in equine veterinary medicine to enhance scientific and clinical knowledge for the diagnosis, treatment and care of the horse. This is an exciting opportunity for equine veterinarians to gather in “The Horse Capital of the World” for a world-class program of wet lab and lectures presented by acclaimed equine medicine experts.

ULTRASOUND WET LAB

Friday, January 24, 2020 8:00 a.m. - 4:30 p.m. Peterson & Smith Reproduction Center

FEATURED SPEAKERS • Dr. Aric Adams • Edwin Bayó, Esq. • Dr. David Freeman

• Dr. Amy Grice • Dr. Tim Lynch • Dr. Margo Macpherson

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