PetVet November December 2018

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VOL. 1 ED. 3 • NOVEMBER / DECEMBER 2018

A Practical Guide for Pet Health Professionals

10 TODDLER MUST-HAVE

ITEMS FOR EVERY

WORKING MOM

SANCHEZ –EMDEN URI PALS PLACE A SAFE HAVEN FOR PEOPLE & THEIR PETS

PHOTO BY MAIGRE STUDIOS

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November / DECEMBER 2018

CONTENTS 6

Veterinarian Life Advice

7

PetVet Advisory Board

14

The 5 Stages of Surviving Bad Reviews

16

URI PAL S Place

A SAFE HAVEN

8

12

A Practical Guide for Pet Health Professionals

Inspired By Tragedy: Dr. Michael Brown

for People and Their Pets

Five Expert Tips to Protect Your Clinic from Infectious Diseases

20 10 Must-Have TODDLER Items for

Every Working Mom

24

22 All About Insulin 30 PetVet 10: Ten Things to Do

This Month

ON THE COVER WWW. PET VETMAGAZINE .COM

REVOLUTIONIZING THE HISPANO–AMERICAN PET COMMUNITY

VOL. 1 ED. 3 • NOVEMBER / DECEMBER 2018

A Practical Guide for Pet Health Professionals

10 TODDLER MUST-HAVE

PHOTO BY MAIGRE STUDIOS

ITEMS FOR EVERY

WORKING MOM

SANCHEZ –EMDEN URI PALS PLACE A SAFE HAVEN FOR PEOPLE & THEIR PETS

PetVetMag

@PetVet_Magazine

Copyright November 2018. PetVet Magazine is published bimonthly by Barkleigh Productions, Inc, 970 West Trindle Road, Mechanicsburg PA 17055. Postmaster: Send change of address to Pet Vet Magazine c/o Barkleigh Productions, Inc., 970 West Trindle Road, Mechanicsburg PA 17055. No part of this publication may be reproduced without written permission of the publisher. Editorial offices: 970 West Trindle Road, Mechanicsburg PA 17055. (717) 691–3388 FAX (717) 691–3381 Email: info@barkleigh.com

Dr. Marta Sanchez-Emden Photo by Maigre Studios

PETVET MAGAZINE

5

VETERINARIAN LIFE ADVICE

Your Motivation Starts Here LIFE ADVICE FROM THE COOLEST VETERINARY PROFESSIONALS WE KNOW

CONTACT Inquiries: info@barkleigh.com (717) 691-3388 Editorial: rebecca@barkleigh.com (717) 691-3388 (ext. 225) Advertising: james@barkleigh.com (717) 691-3388 (ext. 224)

STAFF Publisher Barkleigh Productions, Inc. President Todd Shelly Vice President Gwen Shelly Chief Operations Officer Adam Lohr Executive Editor Rebecca Shipman Art Director Laura Pennington Senior Graphic Designer Jenn Barraclough Junior Designer Jenny Thomas Web Master Luke Dumberth Director of Marketing & Client Relations James Severs Administrative / Marketing Assistant Karin Grottola

“Even the smallest things can make a big difference to another living thing and you will feel good when you do it!”

Kathryn Primm, DVM, Applebrook Animal Hospital Ooltewah, TN

6

PETVET MAGAZINE

Marketing Coordinator Alyx Robertson Social Media / Pr Coordinator Chelsey Hall

ADVISORY BOARD

Meet our EDITORIAL

ADVISORY BOARD!

PetVet’s advisory board is here to help ensure quality content to motivate & educate Veterinarians and their staff.

Jenifer Chatfield DVM, DACZM

Alberto Fernandez DVM, DACVECC

“People should be so lucky as to get to be a veterinarian. The broad-based education empowers us to be successful in multiple fields and affords us the opportunity to choose how we spend our professional time.”

Julie Legred CVT

"The human race will not be possible without the animal kingdom. It is our duty to take care of those that provide to us and to me it is an honor to do so."

Lisa Powell DVM, DACVECC “I have worked in many areas of veterinary medicine and veterinary technology over the last thirty five years, and it is amazing how far our profession has grown and paved the way for the betterment of animals' lives and happiness, as well as improving public health issues. It is an honor for me to be a part of this advisory board to offer additional education and opportunities to grow in our profession.”

Jill Richardson-López DVM, MBA “Do something every day to make an animal’s life better.”

“I have had the privilege of working with a variety of animals in my career and my passion has allowed me to be involved in teaching veterinary students, interns, residents and other veterinarians. I continue to enjoy going to work A Practical every day to help critically ill dogs and cats, and Guide for love the client interactions as well. I am proud Pet Health to be a part of this advisory board to help teach Professionals and spread my love for this profession to others in the veterinary community.”

S Q UA R E LO G O

A LT E R N AT E L O

CONNECT WITH

PETVETMAG PETVET_MAGAZINE

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808285 C0 M0 Y0 K60 PETVET MAGAZINE

A Practical Guide f

BEBA

H E A D E7R F O

CLIENT SERVICES

THE

5

Stages of

SURVIVING

BAD REVIEWS

Dr. Kathryn Primm

We all know it…the sinking feeling we get when we see the alert, a single star and a nasty diatribe about how awful you are. Rejection leads your brain through a sequence of emotions much like the stages of grief. Emotional pain brings these coping strategies to life for everyone.

E

lisabeth Kubler Ross introduced the world to her concept of the five stages of grief in her book, On Death and Dying, way back in 1969. Her stages were denial, anger, bargaining, depression and acceptance. Since then, people have debated her ideas and presented all kinds of steps and stages of their own.

But think for a moment, does it matter whether she got it “right”? No. What matters is understanding how your brain copes with seeing a negative review about yourself and your business. Can we not only survive a bad review, but convert it to a teachable moment? The five–stages model works really well to answer that question.

1 8

Denial “It can’t be true.” The first time I saw a bad review, I was aghast. The review was completely unfair

and untrue! Yes, in some cases reviews are completely false or even rest on mistaken identity, but most reviews, like myths and legends, contain a grain of truth. Find that truth and use it to drive improvement.

Find something that justifies the opinion. Perhaps it is just a misconception that you can correct! For example, my animal hospital got a review saying that we were ridiculously overpriced, stating that their dog’s annual visit cost them $400—I wish! I know that amount is not accurate because we have bundled our annual offerings at a standard price. So I posted a public reply that explained the mistake and invited that reviewer to contact us privately so we could fix it. We never heard from her, of course, but we have demonstrated integrity by offering restitution.

If there is truth in the criticism, use it to improve your practice. Suppose someone complained that your

PETVET MAGAZINE

PETVET MAGAZINE

9

DEPRESSION A bad review will go away, as everything does. Your good reviews will soon scroll it off the page. receptionist was rude. Whether or not it was true (everyone has bad days), take the opportunity to remind your team to smile when they answer the phone. Provide refresher training with this exercise: Make yourself invisible to the others (use another room, a screen, blindfolds), then speak to them. Let them vote on whether you were smiling. You will be amazed at how easily your message is understood. Follow up by rewarding smiles with praise or goodies. Trust me; if you start handing out chocolate to every smiling face,

those Pavlovian employees will soon smile all the time!

2

Anger Critical evaluation is bound to arouse your anger; wait for it. We all take pride in our work. Your team is your family, and anyone attacking them can bring out your beast and not your best. The adage, “Don’t get mad, get even” has it wrong. It is OK to get mad, but then you have to get better. Most of your clients will appreciate it. To those that never complain and always take

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your advice, send thank–you cards just for being a wonderful pet parent. You will find your anger dissipates as you write details of how terrific each good client is and you imagine their pleasure when they read it.

3

Bargaining Like grief, criticism is so painful that we are tempted to answer back in self–defense or appeasement.

Neither response is appropriate in a public forum. Answer, of course (you want to show that you care about your service and your business), but just make a single statement in your defense, like, “I’m sorry we remember this incident differently.” Then offer a private exchange: “Please contact us personally so we can make sure you have been treated fairly and received our standard exemplary service. We take pride in our mission and strive to give top–notch care for pets and their people.”

Don’t get into a back–and–forth on social media. Just don’t do it, no matter how wrong they are. Those with justifiable complaints will contact you to right the wrong. Those complaining with ill intent won’t, thankfully—you do not want them for clients.

Remember, no matter how much you want to try to bargain with a critique, it’s always a mistake to let yourself be dragged into the fray. Mark Twain warned, “Never argue with a fool. Onlookers may not be able to tell the difference.”

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10

PETVET MAGAZINE

Depression Having failed to erase a bad review through anger or bargaining, we may feel helplessly discouraged, defeated and disheartened. But it’s a mistake to give up. A bad review will go away, as everything does. Your good

reviews will soon scroll it off the page.

Let’s face it, if you only have 5-star reviews, won’t people feel skeptical that you are buying them?

Let the discomfort of feeling helpless and hopeless prompt you to seek good reviews. Put a note on your invoices asking people to share their experiences on Google. With a sign or a wall of pet photos (people love to show off their pets), remind people to check you out on Facebook where they are automatically asked to review you.

The last stage of dealing with bad reviews is…

5

Acceptance Eventually, you remember that you are not a loser and realize that the angry mobs will dissipate (if they really formed, it is very hard to rally people for long, even if there’s a little buzz). People may jump on the negativity bandwagon at first, but soon their attention is pulled elsewhere. It will blow over, I promise.

Accept that you cannot be the right fit for every client. No one can. Legitimate concerns need to be resolved. Others need to be cautiously curtailed. Remember, rational people will see through ridiculous claims, and those rational souls are the demographic that you want. As for the others… well, we have a saying, “You can take your crazy somewhere else because we are all stocked up!”  Kathryn Primm, DVM is the owner and founder of Applebrook Animal Hospital in Ooltewah, Tennessee. She also enjoys writing, speaking to and engaging veterinary professionals and pet lovers.

She has written and contributed content to many outlets, including magazines like Woman’s Day, Prevention and Health as well as Veterinary Economics, dvm360, Firstline, Vetted and dvm360.com. Her regular "Ask A Vet" column is featured

on iheartdogs.com and iheartcats.com, reaching more than 3 million viewers. Dr. Primm was also the nation's first Fear Free Certified Professional and is the Module Chair for a second level of certification for Fear Free.

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11

Why It Matters to Me

A

pril 2011 began like most every spring in Alabama. As the month unfolded, the National Weather Service began to voice concerns for the central and northern regions of the state regarding the possibility of tornadoes near the end of the month. The early morning of the 27th provided just a preview of the disaster that awaited the small community of Arab during the course of the day.

T H EN

Tr a G e d y Dr. Michael Brown NOW

By: Dr. Jill Richardson–López

12

PETVET MAGAZINE

“I remember standing just outside my basement door watching the powerful swirls of wind and hoping beyond all hope the weather prognosticator’s predictions were wrong. It was such an odd day, never allowing us to relax or even breathe a sigh of relief. It was one storm after another. After the loss of power, I drove the few miles to my farm where I retrieved a diesel–powered generator and restored television and computer service to our home. During the course of that day, two to three dozen neighbors sought shelter in our basement. People were literally hanging on every word concerning the weather. It was a day that just seemed to go on forever. It would be nine long days before electrical repairs would be made. Needless to say, we grilled up all the frozen foods from the neighborhood—we ate well,” says Dr. Michael Brown.

Arab Veterinary Hospital was readied via a generator to receive injured pets and livestock. It was in the midst of this that the community learned of the tragic deaths of the Hallmark family (five total). This family had ties in many directions in this small community of about 8,000 folks.

The tornadoes killed 238 people that day, making it the deadliest tornado outbreak on record in Alabama. Marshall County, where Arab is located, experienced 14 confirmed tornado tracks, making it the highest ever recorded nationwide in one day.

According to meteorological reports, the afternoon tornado reached a span of 1.25 miles with estimated peak winds of 210 mph as it traveled 47 miles.

Sadly, the deaths included Shane Hallmark, his parents Phillip and Ann, his young nephew Jayden, and his wife Jennifer. Shane and Jennifer’s six–year–old daughter Ari was injured badly but survived. Shane’s first job had been as a young jack–of–many–trades at both the veterinary hospital and the farm. This was a family that meant a great deal to so many people in Arab.

Four years later, a piece of commercial property

IT WORKS came on the market, and with it came a great opportunity. During the two–year renovation of the existing building, Dr. Brown was able to add a basement at the south end, building it to specifications sufficient to withstand a Category 5 storm.

The shelter is located inside Thompson Hall and bears the name “Hallmark Safe House” and is just under 1,000 square feet. It will accommodate about 30 people seated, along with as many pets.

The shelter has a designated storm manager and is equipped with telephone, television, internet, a restroom and a small work surface.

Being pet–friendly is such an important feature because it allows the hospital to honor and care for an entire family. While there are several other shelters in the community, AVH is the only one open to pets.

PETVET MAGAZINE

IT MATTERS “My family joined the community in mourning their loss, and it was during this time and the days to follow as I surveyed the damage, I was determined to find a way to offer a safe haven during bad weather, particularly to people with pets,” concludes Dr. Brown. 

13

Industry News

URI PAL S Place

A SAFE HAVEN

Pets are the silent victims of domestic violence. And now they will be protected for

for People & Their Pets

the first time.

By Steve Dale

T

his fall, a seven–story domestic violence shelter designed for ALL domestic violence survivors, including family members with four legs, called PALS (People and Animals Living Safely) Place will open in Brooklyn.

There will be 30 apartments, all pet friendly—the first facility of its kind in the U.S. Dr. Kurt Venator, chief medical officer at Purina, calls it “a game changer and a life saver.”

He’s referring to both human and animal lives.

“If we stayed much longer, Downey would have been abused for sure, and our lives—all our lives—were at risk,” says Brenda.

The family had two cats, and when the first cat was abused, she relinquished her to an animal shelter. But when he threatened their second cat, she just couldn’t bring herself to further break up her family. But what was she to do? It seems she had nowhere to go with her other cat.

“When I was accepted into Urban Resource Institute (URI), I jumped up and down like a little kid. I knew if Downy could be safe, we all could be safe,” Brenda exclaimed.

PALS Place will be a part of Urban Resource Institute (URI), the largest provider of domestic violence services in America. Currently, URI does make some space for people and pets available in their existing facilities.

14

OVER

of domestic violence

victims report that

THEIR PETS WERE EITHER threatened, harmed or killed

by their abuser.

“While it’s great that we provide pet friendly spaces, far more than most cities; there’s clearly an overwhelming need and our goal is to move toward meeting that demand,” says Nathaniel M. Fields, president and CEO of URI and Center Against Domestic Violence.

No one knows how many pets actually die as a result of domestic violence, but we do know that over seventy percent of domestic violence victims report that their pets were either threatened, harmed or killed by their abuser.

“Today we understand that veterinary professionals can be on the front lines for all of this,” says veterinary forensics pioneer, Dr. Melinda Merck, author of Veterinary Forensics: Animal Cruelty Investigations, 2nd Edition and co–author of Veterinary Forensic Investigation of Animal Cruelty: A Guide for Veterinarians and Law Enforcement.

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Photo of Dr. Kurt Venator and Nathaniel M. Fields

Arguably, getting involved and speaking out for animals is consistent with the veterinary oath.

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Photo of Domestic Violence Survivor, Hope Dawson

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“Of course, there may be physical signs of animal abuse,” says Merck.

“But think about hidden injuries, like rib fractures. Another sign not always thought about may manifest in behavior issues,” she says.

“It’s very important for veterinarians to think about the possibility of domestic violence,” adds Merck. “I am sure we could identify it, as at least a possibility, more often if we simply thought about it. Sometimes domestic violence is suspected but veterinarians may not want to get involved.”

Arguably, getting involved and speaking out for animals is consistent with the veterinary oath.

HABRI (Human Animal Bond Research Initiative), Purina, Bayer Corporation, Pet Partners (the nation’s largest nonprofit registering handlers of animal–assisted interventions), Noah’s Animal House and URI have formed a coalition to support the passage of the Pet and Women Safety (PAWS) Act (H.R. 909, S.322), a bill that is adamant about removing a roadblock that is essential to the safety of these survivors with pets by enabling them to live healthy, safe lives, together with the entire family.

Noah’s Animal House and URI are part of the just three percent of domestic violence shelters across the country who are working to keep both pets and their owners away from the dangers of domestic abuse. Together, these two incredible organizations have saved more than 1,500 pets from abusive conditions, so that no domestic violence survivor is forced to choose between staying in an abusive relationship and leaving their pet with their abuser or an animal shelter.

“When fleeing domestic violence, victims often leave with the clothes they’re wearing and little more,” says Fields. “Having a family pet—especially when there are children—brings something with them which offers continuity and stability.”

“And let’s not ignore pets’ ability to help us to feel better, and even to heal,” Venator adds.

PALS Place won’t only be a building that allows pets—the building itself is being created with pets in mind. “We’ll offer more than just cute boxes filled with toys, pet food, pet treats, a dog and/or cat crate, cat litter, litter boxes, leashes and collars to all of the dogs and cats. From the ground up, everything is in consideration of pets and people living better together, from the flooring to the consulting of our experts on color palates,” describes Venator.

Survivors of domestic violence tell it best. “I never would have imagined that this would happen to me, and I just thought it would get better,” says Hope Dawson. “But it didn’t. When I made the decision to go, there was no question about taking Coco. But we had nowhere to go. We lived out of my car, when finally, I had to give up Coco, just hoping we could get her back. When URI called, I said ‘Did you create this program just for me? Is this really true or a dream?’”

It was true, Dawson was able to reunite her two children with Coco. “That’s exactly what was necessary for our healing to begin—for all of us, including Coco,” she says. “Of course, it’s important and right to keep the family together. Coco is definitely a part of our family.”  Steve Dale, CABC (certified animal behavior consultant) is host of three pet radio shows, two nationally syndicated and on WGN Radio, Chicago. His many TV appearances include Animal Planet shows, National Geographic Explorer and The Oprah Winfrey Show.

Steve authored and contributed to many pet books, including “Decoding Your Dog” (authored by American College of Veterinary Behaviorists). He’s currently a contributor on syndicated “HouseSmarts” TV. He’s a Board member of the Winn Feline Foundation and Human Animal Bond Association. He speaks about animal behavior at conferences and meetings around the world. His blog is www.stevedale.tv)

“From the ground up, everything is in consideration of pets and people living better together, from the flooring to the consulting of our experts on color palates.” – Dr. Kurt Venator

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17

Best Practices

5 EXPERT TIPS TO YOUR CLIENTS FROM

By Jason Stull, VMD, MPVM, PhD Diplomate ACVPM and Michelle Evason, BSc, DVM, DACVIM

Infectious diseases, like canine influenza and leptospirosis are on the rise, nationwide. These tips can help your clinic remain outbreak-free and reduce disease spread in the pet and human communities.

Be aware: Have infectious disease on your diagnostic radar. An index of suspicion and diagnostic screening are keys to determining what disease(s) are at play for sick patients. Identifying the disease–causing pathogen will help you tailor treatment and prevention, reducing on-going transmission to animals (and people) in your clinic and the community. For example, knowing the upper respiratory signs of a canine patient is due to canine influenza allows you to ensure the dog is kept away from other dogs for at least three weeks (the infectious period); a canine patient with a sudden onset of kidney and/or liver disease should prompt checking for leptospirosis ASAP. Wash your hands. Frequent and effective hand hygiene (using alcohol–based hand sanitizer or soap and water) can make a huge difference in disease prevention for your patients, staff and you.

Teamwork and Communication: Involve the whole hospital in risk reduction. Make sure everyone (i.e. front-end staff to DVMs) knows the clinic procedures to follow to stop the introduction and spread of disease in your hospital. For example, when scheduling an appointment for a patient with an acute 18

onset of cough and concern of suspected infectious disease (such as canine influenza), have a staff member (wearing appropriate protective equipment) meet the client and patient outside of the clinic for evaluation. Allowing the patient to enter the hospital, contaminate the lobby and exam room, and interact with other dogs or people is a recipe for disaster.

Prevention: Don't put all your eggs in one basket. Never rely on a single method for disease and outbreak prevention. Vaccinations are an important tool to prevent the spread of disease, but the rest of your ID prevention toolkit can be just as important.

Ensure you (and your whole clinic staff) follow disinfection practices and establish and follow other infection control protocols to protect against all types of infectious diseases.

Plan for it: Develop Standard Operating Procedures (SOPs). Make a plan before there is an outbreak. Train your whole team on infectious disease prevention and management. Consider getting your facility certified in Infectious Disease Management, through the Heroes for Healthy Pets program. This free program can be assessed at Heroes4HealthyPets.com 

PETVET MAGAZINE

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LIFESTYLE

10

M U S T- H A V E

TODDLER ITEMS FOR EVERY

WORKING MOM

By Dr. Justine Lee, DACVECC, DABT; CEO, VETgirl, LLC.

A

s someone in my mid40s, I never thought I'd get to be a mother. I'm loving it, despite never having thought of myself as a "toddler" person. It's changed me for the better—for the most part—in making me a more relaxed, laid back person. What's bad about it though? I'm no longer the hyper–efficient veterinarian that I used to be!

So, I wanted to share a few tips on how to be a more efficient veterinarian and mother. Find out what you really need to help you survive those toddler years. Here are the top 10 things that I found necessary to help me survive my toddler years as a busy working mom!

P.S. Wine, Netflix subscription, an uber–supportive spouse, a moms' group, and a good reserve of babysitters or nanny not included in the list...

20

1. Bathtub Letters & Numbers These were the best gift I ever got for tub time. They keep my kid occupied during bath time, and it lets us practice how to say certain letters. They stick to the tub, your forehead and walls for lots of entertainment and bath time giggles.

2. Amazon Prime Now

One weekend night, my husband was out ice fishing and I was all alone with a sick toddler…and we ran out of Children's Tylenol. Seriously? I almost ran down the block to Walgreens, but I couldn't leave the kid alone. And then I remembered: Amazon Prime NOW! I'd never used it. Does it work? Within 2 hours, 4 bottles of Children's Tylenol and Children’s Motrin (plus 1 pint of Ben & Jerry's) arrived, delivered to my door. Reasonable prices. Plus, easy to tip. And I wanted to weep with joy. Amazon Prime Now, you had me at "Hello."

PETVET MAGAZINE

3. A Library Card Support your local library!

Mine has a story time twice a week, great toys to play with, and an incredible selection of board books to read and return.

4. Crayola Color Wonder Markers Save your walls. These markers only work on special paper, which saves the rest of your books, magazines, journals, etc. Worth the gift!

5. Silicone Bibs These are great to catch all the food that your toddler doesn’t throw on the floor to your dog and cat.

(To the “I’m–on–really–expensive– hypoallergenic–food” cat, at that.)

6. Litter-Robot: The Automatic Kitty Litter Box You’re probably wondering what this has to do with having a toddler. Well, I have no time to do anything anymore, and the last thing I need is to stress out about having to scoop litter. I’m actually surprised how much this $500 splurge improved my QOL dramatically (along with my Roomba). Apparently one of my anal retentive stressors was making the house not reek of cat feces and kitty litter. And this thing has brought me so much joy. No scooping, ever. I dump the box every 7–10 days. And I can neurotically look at my app for the Open Air to make sure my cat doesn’t have FLUTD.

9. Boogie Wipes I hate the idea of paying money for saline-infused wipes just for boogers, but these really are so soft. And, as you will soon discover, toddlers snot constantly!

7. Magna–Tiles OK, the textbook answer is that these “tactile, colorful translucent Magna-Tiles” are easy to use and let you create 3-D shapes that help with “patterning, shape recognition, building and motor skills.”

The real reason? You can step on them in the middle of the night and they don’t drive you to a 4-out-of-4 Colorado Pain scale like stepping on a Lego!

8. Gerber ‘Lil Crunchies (aka, I–love–these–like–crack– cocaine–crunchies) I mean, what’s in these things? My kid purposely digs into the diaper bag and pantry closet to get these things out. I think they may contain some weird, addictive ingredient that this toxicologist hasn’t identified yet.

PETVET MAGAZINE

10. Cooking shears to cut up toddler–sized food!

My husband makes fun of me for using scissors to cut up everything in the kitchen. I use these to cut noodles, PB&J sandwiches, blackberries, etc. into non– choking–sized-–bites for kids. Obviously, keep all sharp and dangerous things out of your kid’s reach.  What hints or items are a MUST HAVE in your toddler house? Share!

Dr. Justine Lee is a board-certified veterinary specialist in both emergency critical care (DACVECC) and toxicology (DABT).

She is the founder and CEO of VETgirl, a subscription-based podcast and webinar service offering RACE-approved, online veterinary continuing education. Dr. Lee has been published in numerous veterinary journals, is the author of two humorous pet reference books, has published several veterinary textbooks along with book chapters, and has been aired on radio and television to promote preventative medicine, animal health, and the overall wellbeing of pets. Dr. Lee lectures throughout the world on emergency and critical care, and recently was honored with “Speaker of the Year”, and has been featured on NBC Weekend Today, Rachael Ray, WCCO, MPR, and various other TV and radio engagements. More information can be found at www.drjustinelee.com and www. vetgirlontherun.com.

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Business Trends

ALL ABOUT

INSULIN

By Nyssa Reine–Salz, DVM, DACVIM

I

nsulin is a hormone produced by beta cells of the pancreatic islets of Langerhans.(1) Insulin helps regulate blood glucose. Diabetes Mellitus is the scientific term to describe partial or complete lack of insulin, which results in alteration of blood glucose.

Diabetes in dogs is typically similar to Type 1 diabetes seen in people. It results from an inability to produce insulin, most commonly related to immune mediated destruction of the pancreas. Dogs with diabetes require lifelong insulin treatment.

Diabetes in cats more closely resembles Type 2 diabetes in people. A combination of insulin therapy, dietary management and lifestyle changes are utilized to manage diabetes in cats, and can even result in a remission of signs in cats, though often temporary.(2) Most types of insulin used in cats have been associated with remission.(2,3) Several types of insulin are commercially available for diabetes maintenance. Just like with people, there isn’t an insulin product that is effective in managing every patient, and individual response to insulin therapy can be unpredictable.

The concentration of insulin in insulin products manufactured for people is 100 IU/ml, which is abbreviated as U100. The concentration of insulin in veterinary insulin products is 40 IU/ml, which is abbreviated as U40. There are specific syringes manufactured to be used

22

with the specific concentration of insulin and it is imperative that these guidelines be followed to avoid errors of administration.

The advantage of the use of U40 insulin in dogs and cats is that because of the lower concentration, the physical unit is larger; making it easier to see the small doses they typically receive. Human insulins are also divided by their expected duration and onset of action. The common categories are rapid acting, intermediate acting and long acting. These terms are applied to insulin used for dogs and cats, but the true response is varied from patient to patient.

Insulins FDA Approved for use in Dogs and Cats Porcine Lente Insulin is categorized as an intermediate acting insulin and is a U40 insulin.(1,4) The product was first launched in the US under the brand name, Vetsulin® in 2004. In Canada and other countries, this product is sold under the brand name Caninsulin®. It is a suspension of two different insulin products—an aqueous portion, which acts more quickly, and a crystalline portion for sustained activity. This unique property necessitates the labeling recommendation of vigorous mixing to assure the proper ratio of the two products.

The labeled starting dose for dogs is 0.50 U/kg a day;

PETVET MAGAZINE

however, only approximately 1/3 of canine patients can be regulated on single daily doses. Many endocrinologists recommend a starting dose of 0.25-0.5 IU/kg, based on an increased likelihood of patient response.(4) Most cats are managed well on Vetsulin at 1–2 units/cat twice a day.(4) Vetsulin is a veterinary prescription product sold through the veterinary channel.

Vetsulin should only be administered with U40 syringes.

Insulin FDA Approved for Use in Cats Only Protamine Zinc Insulin (PZI) is a long acting insulin sold under the brand Prozinc® and is FDA approved for use in cats. PZI insulin is a 40 IU/ml insulin.

(1,5) It is used at a starting dose of 0.20.07IU/kg SC every 12 hours for cats.

(1,5) Prozinc® is a veterinary prescription product sold through the veterinary channel. Prozinc® should only be administered with U40 syringes. Prozinc® is not typically recommended for the management of diabetes in dogs and its use is extra label.

Human Insulins Extra Label Neutral Protamine Hagedorn (NPH) is an intermediate acting insulin sold under the brands, Novolin® N or Humulin N. This insulin is a U100 insulin that is manufactured for human diabetes management but is used off label in dogs. The starting dose is 0.3 to 0.4 U/kg twice a day in dogs.(1) The duration of action in cats is often insufficient, so its use is not typically recommend. NPH is available through most human pharmacies.

Insulin Detemir is a long acting insulin sold under the brand Levemir®.

It is a U100 insulin that is manufactured for human diabetes management. The starting dose of insulin Detemir in dogs is 0.1 Units/kg SC q12h.(1) Canine insulin

receptors appear to be 4X more sensitive than human receptors to insulin Detemir, and therefore may be hard to dose in small dogs.(1,6) Unlike less potent insulin products , it is recommended that blood glucose be measured within the first few days of therapy to assure hypoglycemia is not present. Detemir is available through most human pharmacies.

Insulin Glargine Insulin Glargine is a long acting insulin sold under the brand Lantus®.

It is a U100 insulin that is manufactured for human diabetes management but is often used extra label in cats and less commonly in dogs. Starting dose for both dogs and cats is 0.25-0.5 IU/ kg twice daily.(7,8) Glargine is available through most human pharmacies. References: 1.

Plumb’s Veterinary Formulary,8th Edition:” Insulin: Regular (Crystalline Zinc), Lispro, Isophane (NPH), Protamine Zinc (PZI), Porcine Zinc (Lente), Glargine, Detemir, January 2015, PharmaVet Inc. 2.

Scott-Moncrieff, J Catharine: What influences diabetic remission in cats (CVC highlight).

Journals: Vet Med. 2014 November; 109(11):344-345.

3.

Gostelow, Ruth et al: Systematic review of feline diabetic remission: Separating fact from opinion. Vet J. 2014 November; 202(2):208-21.

4.

Vetsulin, Product Insert

Hess RS, Drobatz KJ. Glargine insulin for treatment of naturally-occurring diabetes mellitus in dogs. JAVMA. 2013;243(8):1154-1161.

8.

Nyssa Reine–Salz is a graduate of the University of Florida, College of Veterinary Medicine. She completed an internship in Small Animal Internal Medicine and Surgery and a residency in Small Animal Internal Medicine at the AMC in New York, New York. After achieving Board Certification in Internal Medicine, Dr. Reine–Salz was on staff at the Animal Medical Center with a focus on nephrology and endocrinology until 2009. Dr. ReineSalz has worked for Merck Animal Health as an Internal Medicine Consultant with an emphasis on diabetic support since 2012.

ProZinc, Product Insert Ford, S., et al. (2010). Evaluation of Detemir Insulin in Diabetic Dogs Managed with Home Blood Glucose Monitoring. Proceedings: ACVIM. Accessed via Veterinary Information Network; vin.com.

5.

6.

Roomp K, Rand JS. Management of diabetic cats with long-acting insulin.

Vet Clin North Am Small Anim Pract.

2013;43(2):251-266.

7.

PETVET MAGAZINE

23

PetVet Profile

REVOLUTIONIZING THE HISPANO–AMERICAN PET COMMUNITY

By Steve Dale

Photos by Maigre Studio

T

he U.S. now has more Spanish speaking citizens than Spain (according to the Instituto Cervantes and the U.S. Census Bureau). And people who speak Spanish as a first language may have a pet, and likely love that pet very much. While some may have resources for everything pet–related, others may not.

Dr. Marta Sanchez–Emden is founder and director of the Animal Health and Rehab Center in South Miami, which includes two veterinary hospitals and an animal rehabilitation center. She holds a certificate in Veterinary Acupuncture (International Veterinary Acupuncture Society, 2002) and in Canine Rehabilitation (University of Tennessee, 2003).

Sanchez–Emden strongly believes that veterinary medicine should be paying more attention to the growing Hispano–American community, and the potential client base.

“Hispano–American owners like to think they are bringing their non–human babies to, not only a good doctor, but to a nice,

24

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caring and friendly person that will treat them as family,” she says. “And do not make assumptions. If an owner comes in knowing little or no English, make sure you communicate the findings, diagnostic and treatment options clearly and properly by writing them, or with the help of a bilingual person.

That owner with broken English may be a newly arrived professional with a doctorate degree, just like yours.”

Communication is a big deal for Sanchez–Emden who is a regular on Telemundo’s/NBC’s morning show and is the host of Spanish Language podcast, which she began earlier in the year for Merck Animal Health. Sanchez–Emden started doing TV about ten years ago when local news channels first approached her. Sanchez–Emden fell in love with doing TV, and TV fell in love with her. She’s also appeared on Univision, PBS Spanish, Cisneros Studios and others, in both English and Spanish.

“Getting trusted information about your pets can be challenging, especially if English is your second language,” she says. “The human–animal bond is the same no matter who you are.”

While it’s true that no two veterinary professionals share the same story —Sanchez–Emden’s might one day be a book; from her achievement of being an international fencing competitor to treating zoo animals with laser therapy.

Sanchez–Emden was born in Spain, but moved to Puerto Rico when she was about a year old, and grew up in San Juan. She always had pets as a kid, and a special affinity to them from as early as she can remember.

Sanchez–Emden recalls this story from when she was about three years old, and was scolded by her mom. “I was feeding one cat and the cat didn’t instantly eat the Purina Cat Chow,” she

TELEVISION CHAMPION MIAMI ZOO

IN PUERTO RICO, SHE WAS A CHAMPION FENCER AND BECAME A PART OF THE NATIONAL TEAM.

begins to laugh. “I wanted to show the cat, this stuff is very good. So, I demonstrated and ate some. And that is when my mom walked into the room.”

In Puerto Rico, she was a champion fencer and became a part of the National Team. Still, her commitment to become a veterinarian never wavered. She was then accepted to Tuskegee University College

of Veterinary Medicine. “There was no fencing there, and if there was, I wouldn’t have had time anyway,” she says.

Veterinary school is already extremely challenging, but to her surprise, she discovered that she was pregnant during her first year. “Veterinary school was already hard and being pregnant during it was extremely challenging,”

says Sanchez–Emden. “Studying while nauseated, making sure to eat healthy and exercise was an extra commitment that I had to make.”

Gabriel was born at the beginning of the second semester in her second year.

“And that’s when things got really complicated,” says Sanchez–Emden, “I had block exams one day after I was

All Things Dog...and More!

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27

TELEVISION CHAMPION MIAMI ZOO

ALWAYS UP FOR A CHALLENGE, SHE THOUGHT SHE MIGHT BE ABLE TO USE HER EXPERTISE AND EXPERIENCE WITH A LASER TO BENEFIT SOMEWHAT LARGER CLIENTS.

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PETVET MAGAZINE

released from the hospital.”

She went on to graduate Cum Laude and took the “Veterinary Oath” on stage with her classmates while holding baby Gabriel.

Sanchez–Emden later met the love of her life, Brian Emden, who was a pharmaceutical rep and he called on her clinic. They had a son, Andre, in 2007.

“Brian and I had an instant connection,” she says and laughs, “He is my husband, my best friend, father to my sons, and my business partner.” Brian is administrator at both of her practices.

Always up for a challenge, she thought she might be able to use her expertise and experience with a laser to benefit somewhat larger clients. And the Miami Zoo accepted her offer. “I wanted to do acupuncture for Maude (the Asian elephant), but figured out pretty quickly the needles won’t penetrate the skin. So, I did laser therapy and I feel so good that it really did help her.”

Sadly, Maude—who painted Christmas ornaments as a hobby—later passed away as a result of an unrelated

HER FIRST SON IS AN ENGINEERING STUDENT AT MIAMI FLORIDA INTERNATIONAL UNIVERSITY AND HER TEN-YEAR-OLD CONTINUES TO BE “HER LITTLE FENCER.”

obstruction. The zoo gifted a painted ornament to Sanchez–Emden, which she cherishes. She also treated giraffes and a koala at the zoo, among other species.

Sanchez–Emden agrees, if trainers at the zoo can allow her to safely treat an elephant, with the elephant and other species volunteering, we all need to do better with dogs and cats—the veterinary professional and the pet owner.

Three years ago, Sanchez–Emden decided to introduce her then seven-yearold son to fencing. However, she couldn’t be just another mom watching on the sidelines—she got the bug to fence again.

Instantly, she once again found her passion of the sword. Now, she’s competing around the world, participating in the Pan American Games in St. Thomas and the Fencing World Cup in Slovenia last year, and will soon be in Livorno, Italy for the 2018 Fencing World Cup. Sanchez–Emden is 51 years old, and says, “I’m having the best time in my life.” Her first son is an engineering student at Miami Florida International

University and her ten–year–old continues to be “her little fencer.” Her animal family includes her rescue street dog, named Guarapo (which means sugar cane juice—because he is so sweet), and

her cats are Nicolas and Pop Tart.

Sanchez–Emden believes in following your dreams, and if you do—they might just come true—with more than a little bit of hard work and perseverance. 

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29

PETVET TEN

1

2 Peanut Butter MONTH

November is

November is also

PET DIABETES

Did you know that some types of peanut butter contain xylitol, a sweetener that can cause hypoglycemia and liver damage in dogs? Be sure to educate yourself and your clients. Check out this article to learn more: http://aspcapro. org/sites/pro/files/xylitol.pdf

Get free social media messaging from the Pet Diabetes Alliance and post on your social channels to educate your local community: https://usa.petdiabetesmonth.com/ petcare-alliance-professionals.aspx

3

BRING

PEACE

4

PETVET top 10

Ten things to do this month see how many you can do! and give your bedroom a ZEN makeover with the help of Amazon.com Tibetan Singing Bowl Sets from $12, Himalayan Salt Glow Lamp from $13.99, a buckwheat filled Zafu Cushion starting at $19.99 and Essential oils packs of 10 starting at $15.95.

THE HOLIDAYS ARE A TIME

WE GIVE THANKS

FIND YOUR

for all the wonderful things in our lives. It is also a time that we come together to help those that are less fortunate. Giving back to your community is easy with Volunteermatch. com. You can choose from several categories and find a volunteer opportunity that is right for you.

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5

PETVET MAGAZINE

INNER PEACE and start each day with meditation using these three simple steps: sit cross–legged in a quiet area, close your eyes and clear your mind of all thoughts for at least ten minutes. Check out these 20 scientific reasons why you should start meditating today: https://www. psychologytoday.com/us/blog/feeling-it/201309/20scientific-reasons-start-meditating-today

6

7

PLANNING TO TRAVEL during the holidays?

Make traveling with your pets easier by visiting bringfido.com to locate pet friendly accommodations and attractions.

8

$

Do you miss your

$

Cerebral college days but not ready to add to your student loan debt? Check out these free, self-paced online courses from MIT: https://www.class-central. com/university/mit Courses range from The Secret of Life to Global History of Architecture.

MANAGING

YOUR MONEY — especially while financing your education —might seem daunting. But understanding a few basics of finance can make it all much less complicated. Learn Financial Basics with this free course offered by Zoetis: https://vetvance.com/course/1011

10

9

DID YOU KNOW THE

THE SPORT OF

BOWLING

was played as early as the fifth century? Organize a clinic outing at your local bowling alley for an exciting team–building activity.

Award the team member

Graph your daily moods

with the most strikes and share fun photos on your

to learn more about

clinic’s social channels.

yourself. Get anonymous support when you need it and give support when you feel like it. It is free

SHARE YOUR ACCOMPLISHMENTS WITH US:

with the Moodtracker Social Diary app.

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