PetVet October November 2019 by Barkleigh Productions

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VOL. 2 ED. 5 â&#x20AC;¢ OCTOBER / NOVEMBER 2019

CELEBRATING

VETERINARY TECHNICIANS

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IT’S NOT JUST A BOWL MERCK It could spread a disease worse than Bordetella

Compare the risks Highly contagious Unresponsive to antibiotic treatment Primary cause of pneumonia Vaccine recommended in AAHA* guidelines

Bordetella

Canine Influenza (CIV)

YES NO NO YES

YES YES YES YES

Recommend vaccination for CIV in addition to Bordetella.

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CONTENTS

A Practical Guide for Pet Health Professionals

6 PetVet Advisory Board 8 Celebrating Veterinary Technicians 12 The Veterinarian’s Role in Positive Reinforcement Training

14 Not Just Scratching the Surface: The Perception and Reality of Ringworm Transmission

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VOL. 2 ED. 5 • OCTOBER / NOVEMBER 2019

@PetVet_Magazine CELEBRATING

VETERINARY TECHNICIANS

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Copyright October 2019. 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

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OCTOBER / NOVEMBER 2019 20 3 Strategies for Managing Stress and Finding Joy as a Veterinarian

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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

Courtney Campbell DVM “My passions ultimately drove me towards becoming a veterinarian, but when I was growing up I briefly flirted with the idea of becoming a magician. As a veterinarian, the ability to save lives, keep animals healthy, and strengthen the human–animal bond makes me realize there’s nothing more magical than that.”

Alberto Fernandez DVM, DACVECC "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

“People should be so lucky as to get to be a veterinarian. The broadbased 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 “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 every day to help critically ill dogs and cats, and love the client interactions as well. I am proud to be a part of this advisory board to help teach and spread my love for this profession to others in the veterinary community.”

Jill López DVM, MBA

A Practical Guide for Pet Health Professionals

“Do something every day to make an animal’s life better.”

“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.”

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WHY IT MATTERS

VETERINARY TECHNICIANS By Mary Mould

t is important to honor veterinary technicians and bring awareness of their importance in veterinary medicine. Veterinarians would not be able to run their hospital effectively if veterinary technicians were not there to hold it all together. They are highly educated and skilled and are an integral part in handling the animals and educating owners, but many don’t realize what a veterinary technician does every day. They don’t just hold animals during an exam. Veterinary technicians have a great desire to work with animals and that is why education is so vital for this career. You will see veterinary technicians in hospitals, specialty clinics, research labs, animal shelters, zoos and wild life centers. The education required to become a veterinary technician is not easy. It is actually rather hard and requires a lot of hands–on and willingness to put all effort in to be able to take care of the animals and do no harm.

TECHNICIAN EDUCATION A licensed veterinary technician, or RVT, LVT, or 8

CVT, earns an associate degree in a veterinary technology accredited program. The program must be an accredited AVMA school and the program must meet CVTEA accreditation. Many technicians go on and further their education and earn a Bachelor of Science in veterinary technology. There are also veterinary technician specialties. The NAVTA Committee on Veterinary Technicians Specialties (CVTS) was formed in 1994 and is recognized by the American Veterinary Medical Association. The CVTS provides guidelines to veterinary technician organizations to facilitate the formation of a specialty organization. Academies develop advanced pathways, which a candidate must follow and complete in order to be awarded the designation of VTS (Veterinary Technician Specialist) in their specific discipline. When you look at the amount of education a veterinary technician is required to become licensed or can further their education, this is quite a commitment they make to the animal profession.

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N THE DAY

IN THE DAY OF A TECHNICIAN Following are the day–to–day duties of Shannon Patsko, RVT, from the Poland Veterinary Centre in Poland, Ohio.

Photo by Poland Veterinary Centre

“A normal day for me is usually crazy with me running around the clinic, performing all types of job duties. Some may think it is impossible to perform or complete all my duties in one day, but I do. In the morning, I admit patients for surgery and perform pre–anesthetic physical examinations, obtain lab work, calculate doses of medications and fluids, and administer medications according to protocol. This is all done before we start seeing patients for the day. I check patients in for exams and assist in physical assessments, administer vaccines and educate clients with the latest information available in veterinary medicine. My daily responsibilities include, operating laboratory equipment to evaluate chemistry panels and CBC, interpreting urinalyses, intestinal parasite exams, cytology exams, blood smears and radiographs. I also assist our veterinarians in surgery. Typical procedures include, gastropexy, orthopedic surgeries, exploratory laparotomy and cystotomy. When I’m not assisting, I monitor our patients under anesthesia, operate monitoring equipment and maintain normal parameters of vitals. Then there are those times where an emergency comes in and now I’m in triage mode. Yes, veterinary technicians make decisions on this, too. We assess the animal’s condition, take vitals and then discuss the evaluation with the veterinarian for treatment. One of my favorite aspects of my job is dentistry. I regularly complete oral assessment, treatment and prevention; scale, polish, probe, chart and obtain intraoral radiographs. I administer local nerve blocks, prepare periodontal equipment and assist the veterinarian in surgical extractions.”

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OF A TE

VETERINARY TECHNICIAN CHALLENGES As you can see, veterinary technicians are nurses, laboratory technicians, anesthetists, surgical assistants, radiologists, dental assistants, educators, and most of all, an advocate for the patients. One big challenge is salary or wage. Their salary is lower than many other comparable jobs in medicine. This career requires devotion and compassion, and veterinary technicians realize they will not get paid that well for everything they do. But they are there every day as an advocate for the animal and devoting hard work to assure the animal lives a long life. However, with all this hard work, there are many other challenges to being a veterinary technician. Many times, they are preparing emotionally for a euthanasia that is scheduled to come in. Sometimes the patients live a long time, and for others, their lives are cut short due to disease or other unforeseen circumstances. There is a lot of grief that a technician feels for their patients. It does not matter how many years one has been a veterinary technician, the grief is always the same and can become overwhelming. Not only is their concern for the pet, but also for the owner. They explain to the owner what is going on, step–by–step, to make an unbearable moment as comfortable as possible. A veterinary technician’s compassion is remarkable.

www.rememberapet.org

The future is very promising for veterinary technicians. One student from the San Juan College Veterinary Technician Distance Program has taken the program to become licensed so she can further her education to perform Physical Therapy for animals. There are technicians working in Mobile Veterinary Clinics, reaching those areas that may not have access to veterinary care. The future is inspiring as to what these technicians, or “Angels for Animals,” can bring to the veterinary profession and care for the animals. 

October is National Veterinary Technician Month! Mary Mould, ME.d, RVT, Associate Professor, San Juan College, Veterinary Technology Program, has been teaching online in veterinary technology programs for over 20 years. She earned her bachelor’s degree in veterinary technology and a master’s in education. Mary especially enjoys clinical laboratory and radiology. Outside of work, Mary enjoys her two Cavalier King Charles, gardening, and spending time with her family.

BUSINESS TRENDS

The Veterinarian's

ROLE IN POSITIVE

REINFORCEMENT

TRAINING By Steve Dale

ast night when taking our dogs for a walk, we passed another couple walking their two dogs. Casually chatting, the dog owner with his older Beagle said, “Cooper gets this way when he wants to dominate me.” This guy would do anything for Cooper. If his dog looks at him cross–eyed, he’s on his way to his veterinarian—and he is by all accounts as kind and gentle as pet parents can be. In this instance, I was able to easily convince him that our dogs don’t wake up in the morning scheming to dominate us. But many people feel this way. A big part of the problem is dog trainers who continue to train dogs using assertive and aversive methods, and clients assume these trainers are correct when, decidedly, they are not. Unknowingly, sometimes veterinarians even recommend these trainers—giving them additional, albeit unfortunate, legitimacy. Common sense—it seems—would dictate positive reinforcement works best. Would you rather work with

someone who praises you when you are right, or merely admonishes when you are wrong? Some say that simple statement doesn’t apply because our dogs are like wolves who require us to demonstrate we’re the pack leaders. However, our dogs are not wolves. Sure, they’re related to wolves, and evolved from a wolf species, but actually dogs evolved with us. So, if common sense doesn’t win the day, how about science? For me, the most compelling study I’ve seen is when veterinary behaviorist Dr. Theresa DePorter, based in Bloomfield Hills, MI, investigated a local dog trainer who used aversive training methods in his puppy classes. After one year, 38 percent of the puppy class grads were rehomed, surrendered or euthanized. It gets worse. After two years, 60 percent of the dogs were rehomed, surrendered or euthanized. DePorter then convinced that same trainer to offer positive reinforcement classes, and instructed him on how to conduct the classes. The five weekly, in–hospital

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94%

OF THE DOGS IN

THE positive reinforcement class remained in homes,

puppy socialization classes were for pups ages seven to twelve weeks. This wasn’t a typical tiny study of a handful of dogs; she followed 519 puppies for a year. And one year later, 94 percent of dogs in the positive reinforcement class remained in homes, compared to aversive training, which over a third of puppies were re-homed, surrendered or euthanized a year later. Still not convinced? While only a few studies have analyzed training, a 2008 survey on the methods used on 303 Belgian military working dogs (MWD), handlers revealed the use of harsh training methods was not as effective as positive reinforcement—and may even present a welfare issue. Pulling on the leash and hanging dogs by their collars were the most commonly used aversive stimuli. The team's performance was influenced by the training method and by the dogs’ concentration: (1) low–performance dogs received more aversive stimuli than high–performance dogs; (2) a dog's distraction influenced the performance; distracted dogs performed less well. What’s more, positive reinforcement seemed to positively impact the relationship and bond with the handler, which for MWD and their handlers, can mean the difference between life and death. In his blog for Psychology Today, Dr. Marc Beckoff nails it when he writes,

compared to aversive training,

which over

1/3 of puppies

were re-homed, surrendered or euthanized a year later.

“Research has shown many dog owners do not reach out to professionals for advice on dog training methodology. Even if they do reach out to dog trainers, the profession is unregulated, and many trainers are still using and promoting outdated methods. In addition, cultural factors such as family history or celebrity trainers influence how owners interact with their dogs. The evidence on negative welfare and behavioral consequences of training dogs using aversive tools and methods is relatively recent, and it may take time for the general public to become aware of the risks.” Very few truly educated dog trainers support the notion of aversive training. Still, as Beckoff says, since the profession is unregulated, how does the public know? No wonder some cities in the U.S. are now looking at following what many nations have done, and that is to ban the use of shock or e–collars, prong and choke collars. There’s lots of other documentation of studies that support my contention that positive reinforcement is not only a more effective way to teach our pets, but it’s also what they deserve. After all, our dogs are supposed to be our best friends. It’s imperative veterinary professionals support puppy classes for all the reasons that socialization and early training are exceedingly important. But first, it’s important to audit a trainer’s

class so it’s fully understood who you are recommending. One way to have absolute control is to offer puppy classes in your clinic, taught by a professional trainer and/ or a veterinary nurse. Also, clients (and the puppies themselves) will become bonded to the practice. And, you can impart messages that most trainers do, beginning with, “Anytime you note a change in your dog’s behavior—the problem may be medical. First, contact your veterinarian.” Steve Dale, CABC (Certified Animal Behavior Consultant) is the author of a popular blog, www. stevedalepetworld.com. He is the host of two national radio shows, and is heard on WGN Radio, Chicago. His many TV appearances include Oprah to National Geographic Explorer, and is a contributor on syndicated “HouseSmarts TV.” Steve edited “Decoding Your Dog,” authored by American College of Veterinary Behaviorists, and has contributed to many books and publications. Steve speaks around the world at animal behavior and veterinary conferences and serves on the Boards of the Winn Feline Foundation and Human Animal Bond Association. His many awards and honors include the AVMA Humane Award, and he was inducted into the Dog Writer’s Association Hall of Fame.

INDUSTRY N EWS

NOT JUST

SCRATCHING THE SURFACE

THE PERCEPTION AND REALITY OF RINGWORM TRANSMISSION

raced back to the 15th century, ringworm has a long and evolving history of how it’s treated and perceived. As suggested by its name, this highly contagious fungal infection, characterized by a distinct circular rash in humans, was at one time believed to be caused by parasitic worms. In the coming centuries, ringworm was understood to be a fungal infection, but the name stuck and belief in the ways it can be (or not be) transmitted also remained stuck. Ringworm can be transmitted from animals to humans (and from humans to animals) by direct contact with contaminated sources—this is without debate—but can ringworm also be transmitted through the air?

A Very Brief History of Ringworm Perception and Treatment While little was known about ringworm at the time, in the 1800s, its spread among humans was generally attributed to poor hygiene and diet. In the April 1912 publication of Popular Science Monthly, an explanation of “immigration law as it stands since the legislation of 1907” noted the required mandatory exclusion of immigrants with “loathsome or dangerous diseases,” including ringworm. Up until the mid–twentieth century, treatment for

by Annette Uda

ringworm was something akin to “slash and burn,” with hair removed and caustic chemicals applied to destroy the fungus. In 20th century London, children with the fungal infection were relegated to “ringworm schools” and treated with x–rays. How ringworm was spread and treated was more closely and accurately examined during the Second World War when members of the military began contracting ringworm and other fungal diseases, particularly in tropical locations, and during the 1950s when the toxicity of contemporary ringworm treatment was called into question. But what do medieval names, immigration laws, London ringworm schools, x–rays and military movements have to do with ringworm in dogs and cats? In short, how ringworm is spread in animal care environments remains a subject of debate and knowledge should always be evolving. As indicated by the name of this fungus, nothing about ringworm is a straight line.

What Causes Ringworm in Pets? Ringworm is caused by pathogenic fungi known as dermatophytes. Among the dermatophytes that cause ringworm, the Microsporum canis fungus is responsible for 98 percent of the ringworm cases in cats and 70

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percent of ringworm in dogs (followed by Microsporum gypseum at 20 percent and Trichophyton mentagrophytes at 10 percent). In addition to dogs, cats and humans, ringworm can occur in all domesticated species of animals. The fungus feeds on the dead keratin in upper layers of skin, hair and nails. The tell–tale patchy hair loss in animals is the result of easily broken, weakened and brittle hair shafts. As the fungal spores multiply, the infection can spread. Ringworm can typically remain viable for up to 18 months. Generally speaking, ringworm is more common in cats than in dogs, but geographic location can also play a role. As the fungus thrives in a warm, damp environment, not surprisingly, ringworm is reportedly more common

in the southern part of the United States. Since Hurricane Harvey hit the Houston, TX area in 2017, the Houston Humane Society notes an increase of ringworm that shows no signs of abating. Ringworm flourishing is attributed to the area’s typical warmth and humidity. Not every pet or person exposed to ringworm spores will experience an infection. A variety of factors play a role, including age, health, suppressed or compromised immune system and nutrition, as well as the number of spores present to establish the infection during the circumstances of the exposure.

How Is Ringworm Transmitted? Ringworm is transmitted by direct contact with the fungus, whether from

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an infected animal or person (including an asymptomatic carrier), a contaminated fomite or surface. The spores of the ringworm fungus are remarkably hardy; able to remain viable for longer than 18 months given the right environment. Direct contact transmission of ringworm, as just described, is without debate, but is there another mode of transmission? Can ringworm be aerosolized? And, if so, can it still cause infection? Arnold Plotnick, MS, DVM, ACVIM, a board–certified veterinary internist, feline specialist and the owner of Manhattan Cat Specialists describes the potential for aerosolized ringworm fungus: “Spores are small and may also be carried on air currents and on dust particles. Once the spores reach the coat,

Microsporum canis fungus is responsible for 98% of the ringworm cases in cats and 70% of ringworm in dogs. if they survive the cat’s natural defense mechanisms (for example, grooming and sunbathing), they adhere to and invade cells called keratinocytes on the hair shaft and skin (and occasionally, the nails) and they germinate, initiating the infection…” Microsporum canis, the dermatophyte responsible for 98 percent of the ringworm cases in cats and 70 percent of ringworm in dogs, is between two and three microns in size. That is, as suggested by its name, microscopic. In an animal care environment, fungus spores that are continuously shed create a high pathogen load, depending on the number of infected animals. As further described by Dr. Plotnick, “Ringworm spores can persist in the environment for a long time, perhaps 18 to 24 months. The spores are microscopic and can be spread easily by air currents and contaminated dust, and through heating ducts and vents.” The premise that ringworm spores can be aerosolized finds notable support in a 2003 study: “Environmental Detection of Microsporum Canis Arthrospores in the Households of Infected Cats and Dogs,” published in the Journal of Feline Medicine and Surgery. The researchers, collecting air samples using a Sas super–100 air sampler found, “In this study, infected cats appeared to be a striking source of contamination in their environment, and also provoke a massive airborne presence of viable fungal elements.”

In the 2014 clinical review, “Feline Dermatophytosis: Aspects Pertinent to Disease Management in Single and Multiple Cat Situations,” also published in the Journal of Feline Medicine and Surgery, the author acknowledges, “The question of airborne transmission of spores inevitably arises, both in private homes and in shelters,” and cites the above–referenced 2003 article. However, in contrast to that earlier study, Dr. Plotnick describes, “In a field study conducted by the author, airborne transmission of spores was monitored in a dedicated treatment facility. Contact plates placed over forced air heating vents on random sample days were never found to be culture positive, even though at times more than 20 cats were present in the facility. However, furnace filters during this time period were always culture positive, indicating that infected hairs and spores were drawn into air vents and trapped in the furnace filter and not being blown throughout the facility.” Can the 2003 study and 2014 be reconciled? It may come down to air sampling methodology. In short, a school of thought holds that putting plates in front of an air supply vent is not a valid air sampling strategy. Impaction of spores on the plate requires a velocity faster than what is simply needed to spread spores within a room, which may explain why spores were not collected in the 2014 study.

Ringworm Transmission Reality Evolution Despite increasing discussion of ringworm fungus aerosolization, there is no doubt the common perception that it is not aerosolized is firmly entrenched but, as documented above, the premise that it can be aerosolized is not without support. Bearing in mind the previously discussed 2003 study and the uncertainty in the sampling methods of the 2014 study, here is the minimum of what is known: The ringworm spore is no greater than three microns, an easily aerosolized size, and the spores can remain viable for at least a year and a half. Google “ringworm” and virtually every article kicks off with some variation of “ringworm is a fungus, not a worm.” A 15th century understanding of this fungal infection commonly persists because of perception without knowledge. For some, there is no debate as to how ringworm is—and isn’t—transmitted. But when the health of animals and the humans who care for them is at stake, the goal should be to never stop learning and evolving to safely prevent the spread of disease. Additional studies may help further understand the transmission of ringworm. Annette Uda is the founder of PetAirapy, the animal care industry’s leading manufacturer of studybacked UVGI surface and air sanitation equipment. Annette has a passion for animal health and educating animal care providers on reliable, non-toxic ways to create clean, healthy environments for animal clients and staff that are protected from airborne pathogens, infectious disease, and noxious VOCs. To learn more about her company, visit petairapy.com.

PETVET MAGAZINE

Beyond The Stethoscope

By Angela Demaree, DVM Making an impact in today’s fast-paced world and social media abyss is simpler than you think.

PETVET MAGAZINE

t can be hard to figure out where we fit in and how we can make a positive impact with so much noise and distraction in the world today. The ability to connect easily and effortlessly with people around the globe is so wonderful and exciting; however, isn’t it also true that we sometimes put our personal relationships aside to keep up with the day–to–day demands of the internet? We know through research that personal connections improve mental health and wellbeing. Study after study finds benefit and an improved sense of wellbeing when you feel truly connected to friends, family and community.1,2 Researchers have also found that when you are looking at your phone instead of being fully focused and present for your conversations, the inverse is true.3 Your friends and family may even feel that they aren’t important. In today’s fast–paced environment, people are increasingly seeking out more value and less internet access. In fact, coffee shops are popping up that are purposefully NOT providing Wi–Fi to their customers!4 Crazy, right? Or is it an important part of our future and learning to manage this new era of information overload? Take a look at fast–growing businesses that

are considered disrupters in their industry. What often sets them apart is that they provide a sense of connection and add value for their customer. The wave of the future is focused, considerate and individualized customer service. Instead of asking, “How can we squeeze the margins and make more profit?” We should be asking, “How can we improve customer service to make each and every one of our clients feel valued?” Improved customer service leads to an improved client experience, which often translates into revenue. Customers and clients who feel valued are often shocked by our simple actions of gratitude and thoughtfulness in today’s age of cold technological distance. And they will share your thoughtful actions freely with friends and family, in–person, on social media, at local coffee shops and in line at the grocery store. As someone who has struggled to fit in throughout my career, I think a lot about impact and service to others. When my vet school class was asked to take some version of the Myers-Briggs personality test, I remember at the end the professor asked, “Who’s letters didn’t I call?” I raised my hand

and looked around; I was the only one. Rather than struggling to fit in, it’s important to take a moment to realize that it doesn’t matter, because quite simply, you belong here. Each and every one of us has a unique and important purpose in this world to fulfill and it’s important to remember that we don’t need to fit in, because we belong here. Sometimes the most impactful thing we can do is to take a moment to ask ourselves a few simple questions: What organizations, either personal or professional, do you participate in that add value to your life through providing a sense of community, belonging and support? What’s one action you can take today to improve someone else’s sense of belonging? Who can you surprise today with a simple sign of appreciation? I challenge myself with these questions every day in order to be fully focused and present for others, and hopefully make a positive impact in the world. Today, I am extending that challenge to you and look forward to cheering you on as you make your positive impact on the world.

Angela Demaree, DVM, MPH, CHPC, currently serves as the Chief Operating Officer for Pinpoint Pharma, a 21st century veterinary compounding pharmacy. Angela is a Major in the U.S. Army Reserves, a Certified High Performance CoachTM and the host of Beyond the Stethoscope, the podcast for veterinarians and busy professionals who want actionable, implementable solutions surrounding work-life balance, accomplishing your goals and living your dreams. She spends her free time with her horse, Tommy and teaching her Quaker parrot the Purdue Fight Song. You can connect with Angela on Instagram, Twitter and LinkedIn @DemareeDVM.

REFERENCES 1. LISA F. BERKMAN, S. LEONARD SYME, SOCIAL NETWORKS, HOST RESISTANCE, AND MORTALITY: A NINE-YEAR FOLLOW-UP STUDY OF ALAMEDA COUNTY RESIDENTS, American Journal of Epidemiology, Volume 109, Issue 2, February 1979, Pages 186–204, https:// doi.org/10.1093/oxfordjournals.aje.a112674 2. Brummett, B. H., Mark, D. B., Siegler, I. C., Williams, R. B., Babyak, M. A., Clapp-Channing, N. E., & Barefoot, J. C. (2005). Perceived Social Support as a Predictor of Mortality in Coronary Patients: Effects of Smoking, Sedentary Behavior, and Depressive Symptoms. Psychosomatic Medicine,67(1), 40-45. doi:10.1097/01.psy.0000149257.74854.b7 3. Braff, D. (2017, March 9). Your smartphone may be ruining your relationships, even when it’s off. Chicago Tribune. Retrieved November 9, 2018, from https://www.chicagotribune.com/lifestyles/sc-phonerelationship-family-0307-20170309-story.html 4. Mele, C. (2017, May 9). Coffee Shops Skip Wi-Fi to Encourage Customers to Actually Talk. New York Times. Retrieved November 9, 2018, from https:// www.nytimes.com/2017/05/09/technology/coffeeshop-wifi-access.html?_r=0 PETVET MAGAZINE

BEST PRACTICES

hether you are a new grad, or a seasoned veteran of the veterinary profession, the feeling of stress is often hanging around. For some of us, it’s a nagging weight we carry day in and day out. For others, it comes in waves of the highest highs (a life saved by your expert intervention) and the lowest lows (a life lost despite your best efforts). Many of us believe this is just the way it is…that the emotional roller coaster is just “part of the job”…that the sleepless nights, overworking and the endless pursuit of work/life balance just comes with the territory. What if that weren’t true? If it’s not true, then we would find that our emotional health is not tied to our professional outcomes; that our quality of sleep is not dictated by the activities of the day; and that work/life balance is not a myth, but a reality. I like those options much better! I believe the real causes of stress in our profession come down to just a handful of things which can be greatly altered using these three strategies for managing stress, and finding joy.

Strategy 1: Ease In By the time you graduate from veterinary school, you have spent years and years focused on that one goal. But, before you began the long academic journey to become veterinarian, you were more than just a person working toward becoming a veterinarian! You had interests, hobbies, activities and talents that contributed to who you were. But as is true for many—as the academic pressures rose, and the

By Cari Wise, DVM

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At first, because you have been focused on vet med for so long, this is going to seem a little strange. But think back, maybe way back, to the days before the pursuit of veterinary medicine consumed your life. How did you spend your free time? demands on your time increased—you let all that “extra stuff” fall away. But here’s the deal… it’s all the “extra stuff” that makes life fulfilling and fun. Without it you are no more than your job. And although you serve in a profession that does highly impactful work, it is not the essence of your being. You are more than just a veterinarian. So, if you’re new to the profession, please think twice before going all–in. I’m not saying you should not enjoy your new career and give 100% when you are at work, but I am recommending you let work be work, and embrace the other areas of your life when you are not on the job. At first, because you have been focused on vet med for so long, this is going to seem a little strange. But think back, maybe way back, to the days before the pursuit of veterinary medicine consumed your life. How did you spend your free time? What hobbies or activities did you participate in that you have since given up? Consider intentionally scheduling 30 minutes in your week to do one of those non–vet things that you used to enjoy. Just 30 minutes, and do it even if you don’t feel like it, and see what happens. You’ll likely find as you prioritize time to focus on other things, the pressures of your new veterinary career will not seem as heavy.

career was associated with a dream you had for your future. The future is now. Are you living that dream? It is possible that your dream shifted a bit as you completed your studies and entered the profession. But if you are finding yourself becoming unhappy with your work, you might want to dust off that old dream and compare it to your current reality…there could be a “fit issue”. Fit issues come in two main forms. The first has to do with misaligned practice area, which can include geographic location. The second has to do with misaligned practice focus, which includes the species you want to see and practice areas which interest you the most. If you’ve taken a job in a geographic area away from friends and family with

whom you are close and with whom you wish to “do life”, you’ll want to intentionally build in time to stay connected. Thankfully, social media and web–based video communication is easier than ever. Just stay aware of how the distance may be impacting you, and don’t be afraid to make a change to remedy the geographic misalignment by moving closer if needed. Likewise, if you’ve taken a job in a small animal clinic where they only serve cats and dogs and your passion is pocket pets, for example, it is worth asking hospital leadership if you can expand the practice to include those additional species. If your species and areas of interest can’t be pursued where you work now, you might also need to consider a change in order to find satisfaction in your

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career. Having the opportunity to focus on your special interests can go a long way toward creating job-related joy.

Strategy 3: Be Simply Human Somewhere along the way, many of you will begin to forget that eventually some cases will not turn out well, and accidents will happen. Thankfully, these things typically happen infrequently, but when they do occur, you might be tempted to turn toward self–blame. Please hear this, poor case outcomes and accidents do not mean you are a bad veterinarian. You are simply human, not super human, after all! The reality is, that despite your very best efforts, mistakes and accidents will happen—and some cases will not respond to treatment as anticipated.

In addition, some clients will simply refuse to take your medical advice. None of these things devalue you as a veterinarian! Resist the urge to take it personally. There are very few things that you can control, and medical outcomes, as well as the actions of others, are simply not controllable. When you really recognize this as true, you can allow yourself to stop wasting time worrying. Worrying will not benefit your patients (or you) in any way. Chronic worry can actually negatively impact your physical health. Worry is a colossal waste of energy and a serious stealer of joy. Instead, remind yourself you are simply human, and allow the outcomes to be what they are, without making them mean anything more.

When you make the best decisions you can for your patients based on the information have and the permissions you are given, approach your cases with good intent and provide good customer service, then you’ve done your job. Now go out and enjoy your life!  Dr. Cari Wise is a graduate of the University of Missouri, College of Veterinary Medicine and Founder/CEO of Joyful DVM LLC and the Vet Life Academy membership. She provides veterinary life coaching, courses and consulting to help veterinary professionals transform their lives and love their careers.

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3 Amazing veterinary professionals who ARE Breaking the Gender mold By Jill López DVM, MBA

he world is changing in many ways, and one of the changes is acceptance of non–traditional gender roles. These days it is common place to learn about real people and celebrities identifying themselves proudly as LGBTQ or even gender–fluid. We understand now that gender and sexuality can be viewed as a spectrum. There was a time, not so long ago, that LGBTQ veterinary professionals had to keep their sexuality a secret from their co-workers and managers. There may be some areas that are still resistant to change, despite both federal and state laws protecting workers. The following are three amazing LGBTQ veterinary professionals who are helping to break down barriers with their powerful visibility, and are showing the world that they are able to be who they truly are and achieve whatever they wish to do.

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sidney MICHELSON

Life lessons for the next generation

Biggest issue facing those transitioning

We spend a lot of time with our coworkers, and being part of the LGBTQ community is often a big part of who we are and how we interact with the world. Give your co–workers a chance. If they are not part of the community, then they likely just don't understand. I've had much better experiences when I've been open to questions. If we're not willing to help educate, then people are going to go do the research themselves (and we all know the hazards of resorting to Google for info), or they are just going to not bother to try to understand and continue with their narrow–minded beliefs.

I started transitioning from female to male at a time when there was not a whole lot of information on being trans, and most of what I could find was not positive. I found a few things about being trans–gendered online, but what I quickly found out was that to truly succeed, you have to pass and you pretty

How to support LGBTQ team members With the current state of things, we see far more negative press about our community than positive. We have to be very careful with who we come out to and who knows we are out. Please understand that we are not likely to come out to you right off the bat. We need to assess situations as our lives really do depend on who knows. Some of us may never come out. Please be respectful of that.

much have to be stealth. It's difficult to have a mentor or be a mentor when you have to hide a big part of who you are.

What you need to know about me I'm a good tech. My gender identity does not play a part in the quality of care I provide patients. I'm in this field for the same reason you are—for the love of animals and medicine.

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terminology Ace or Asexual: The lack of a sexual attraction or desire for other people. Bisexual: A person attracted to more than one gender.

Cisgender: A term used to describe a person whose gender identity aligns with the sex assigned to them at birth. Gay: A person who is emotionally, romantically or sexually attracted to members of the same gender.

Gender-fluid: A person who does not identify with a single fixed gender; of or relating to a person having or expressing a fluid or unfixed gender identity.

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michelle RABORN, RVT How the profession is working TO support LGBTQ Over the last twenty years our profession has come a long way—from support groups to active LGBTQ communities in veterinary medicine. PRIDE VMC is doing some great things and there are also several Facebook groups.

The biggest issue I face professionally Working in the south; acceptance is my biggest problem.

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I am a forty–three–year–old veterinary professional who identifies as a lesbian. I have been in the field for more than 25 years. I am in a loving relationship and engaged to a wonderful woman who is a veterinarian. We have three fur babies; two dogs and a cat, and are working on starting our own family.

LGBTQ: An acronym for “lesbian, gay, bisexual, trans-gender and queer.” Non-binary: An adjective describing a person who does not identify exclusively as a man or a woman.

Pansexual: Describes someone who has the potential for emotional, romantic or sexual attraction to people of any gender.

Queer: A term people often use to express fluid identities and orientations. Often used interchangeably with "LGBTQ."

Transgender: An umbrella term for people whose gender identity and/or expression is different from cultural expectations based on the sex they were assigned at birth.

max ROBINSON Life lessons The biggest life lesson I can share for the next generation is to learn your history, and listen to those who came before you, both inside the LGBTQ community and inside our own veterinary medicine community. Our vet med community is blessed with being able to scribe what has happened—things we’ve learned, things that didn’t go well, and things that did go well. The LGBTQ community doesn’t have that hardly. Our history was passed down by survivors of the AIDS crisis, people who were at Stonewall, and our beloved drag queens. Listen to them and their stories, you will be able to expound upon what they’ve learned. It’ll make your life a whole lot easier if you learn where you’ve come from.

How can the profession support LGBTQ better? This profession, like many others, can better help and support the

LGBTQ community by being more outgoing with providing health care to us. Mainly aimed at my trans brothers and sisters. Transgender people have a lot of medical issues they face. Amongst the LGBTQ community, they’re at the top of the table for suicide and mental health issues like depression. They have medical costs for their gender reassignment surgeries and hormone replacement therapies. As we all know, medicine and treatments costs money. Tools and access to more and better health care would do wonders.

People in my state have major issues with this kind of thing. It’s the one thing I have to be mindful of no matter what I do, even out in public. I’ve even worked with people who may not be homophobic but they have said homophobic things, which then challenges my authority. If they think they are better than me because of one thing about me, then why should I be listened to about how to work a case? It’s a challenge with a really hard balance, and even bigger fear.

The biggest issue I face

I love my job with an unwavering passion. I have been a technician for eight years. I have a wonderful support system with my church family and my partner of over eight years. I love my fat cat, Ser Jorah. I have a passion for body modification, and if I could, I would tattoo myself all over. Also, draining abscesses and pulling out cuterebra larvae are my forte.

The biggest issue I face professionally is actually being a gay man. Especially working and living in Mississippi. I always have to be mindful of myself. Am I acting too gay? Am I being too flamboyant? Will a client belittle me and refuse my services because of me being gay? It’s the scariest part of my job. PETVET MAGAZINE

What you need to know about me

PetVet Profile

Kara Burns

FOR PE T By Steve Dale

ara Burns, MS, MEd, LVT, VTS (Nutrition) currently has two loves. One of those loves is her wife, Dr. Ellen Lowery, and the other is veterinary nutrition. That’s right, nutrition. “I realized the importance of nutrition as I witnessed the difference proper nutrition makes in our patients,” she says. “Many veterinary professionals don’t talk about the topic, and it’s been my mission to change that.” Indeed, Burns is a force to be reckoned with. She speaks around the world and consults practices. Her passion is palpable when you listen to her. Burns is all about passion. “Passion is what makes life worth living, and I admire people who have it. I think everyone has a passion for something,

they just need to find it. I think technicians tend to be very passionate, otherwise they wouldn’t have pursued this career.” It’s a career in which Burns, past president of NAVTA and editor–in–chief of Today’s Veterinary Nurse, has irrefutably achieved success. At 54, veterinary technology wasn’t Burns’ first career. In college Burns excelled in field hockey and women’s softball, as well as in her majors of Education and Psychology at the University of Maine. A self– admitted perfectionist, Burns has always been about living her best life. Her job out of graduate school was a psychologist in the emergency department of Maine Medical Center in Portland. She also worked extra shifts answering poison control questions, and many of

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those questions were about pets. A combination of factors led her to veterinary medicine. She grew up with many pets in the home, and it’s a career that, deep inside, she always wanted to pursue. Simultaneously, there was a certain frustration with what she was doing. “I was dealing with emergencies, psychotic breaks and people on the verge of suicide, and there were not enough resources to help individuals in need. And that was difficult,” expressed Burns. So, Burns took a leap of faith —leaving a “decent income” for a five–dollar–an–hour job in the early 1990’s as a vet assistant. Five years later, she passed the Veterinary Technician National Exam. “Oh, I loved it from the start,” she says. And then along the way, a veterinarian she worked for noted her passion in nutrition and let her run with it. And run with it she did. Burns is a founder of the veterinary technician specialty and the Academy of Veterinary Nutrition Technicians. In 2004, she was transferred to Topeka by Hills Pet Nutrition as a veterinary technician specialist, and moved half way across the country to Kansas. Burns admitted that she did have second thoughts. “Oh absolutely, I mean, moving to Topeka from the state I love. But there was an almighty plan.” It turned out, that move changed her life in two ways. This is about the time that Burns, who was once reluctant about public speaking, launched her speaking career. The other was meeting the love of her life, and it was what Burns today says was love at first sight. Burns isn’t typically all too effusive about her emotions. But her

In 2004, she was transferred to Topeka

Hills Pet Nutrition as a veterinary technician specialist, and moved half way across the country to Kansas.

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“I never thought about coming out because I was always out; I was never in,” she laughed. “I’m lucky because I believe

the veterinary profession is more accepting than others. I think it’s that we’re all pretty empathetic.”

face lights up when you mention Ellen. Today, Lowery is a professor at Kansas State University, Olathe. Burns says, “I never thought about coming out because I was always out; I was never in,” she laughed. “I’m lucky because I believe the veterinary profession is more accepting than others. I think it’s that we’re all pretty empathetic.” Burns though realizes that being “out” isn’t so easy in many practices. She’s on the Board and is Treasurer of the Pride Veterinary Medical Community (formerly the Lesbian and Gay Veterinary Medical Association). Pride VMC offers support to the LGBTQ+ community. “Receiving support from colleagues in the same place you are at is enormously helpful,” she says. “What do you say to co–workers? Do you come out? And what do you say to clients, even in

making casual conversation?” Burns is all about change when it’s the right thing to do. And that also refers to the change from veterinary technician to veterinary nurse. “It’s not just a name change, veterinary nurse provides a better understanding to pet owners regarding our role on the team and the training that credentialed technicians receive.” She adds that the days of hiring well–intentioned but under–qualified animal lovers who have little or no formal veterinary education and calling them technicians has to stop. And the profession needs standardized credentialing. Having a background in psychology, Burns is qualified more than most to comment on the depression and suicide rate within the profession. “I don’t know that we can solve this on our own,” she says. “I think we would

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benefit by professional psychological intervention within the profession, beginning with the veterinary schools—and that is starting to happen. Admitting the problem and openly discussing it is a very good start. Mental health is as important as physical well–being; they go hand in hand, but there remains a stigma to mental health. The focus has been on veterinarians, when the entire team is impacted. We’ve been talking about it, and now we’re beginning to offer resources.” Lowery and Burns have three children, ranging in age from 18 to 30 years old, and two granddaughters. They now live in their recently–built dream home, shared with an assortment of critters, starting with Fribble, a French Bulldog (who Burns says “is the best dog ever, ever”), an Australian Shepherd/Border

They now live in their recently– built dream home, shared with an

assortment of critters. Collie–mix named Brees; two domestic shorthair cats, Oreo and Baby; a Snowshoe named O’Malley and Ollie the Persian (“the best cat ever”). Also, there is a guinea pig named Nugget, Bella the Meyer’s parrot and Loki the green–cheeked Conure. Their six finches are new and, to date, unnamed (although, as a group, they answer to the ‘Minions’). And finally, the two lovebirds Juno and Sookie—though some suggest Kara and Ellen might have been as suitable.

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PETVET TOP 10 1 THE 3RD WEEK IN OCTOBER IS

These days, everyone

NATIONAL

TECHNICIAN WEEK

Ten things

Show your veterinary team how much you love and appreciate them by doing something special for them. We suggest a gift card for a massage or their favorite lunch spot.

has a podcast. BUT IF YOU ARE Looking for

something that makes you laugh until your side hurts while actually learning something about veterinary medicine, then you definitely want to tune in to Vet Candy with Dr. Jason Chatfield and his twin vet sister, Dr. Jen Chatfield on iTunes, Google Play, and more!

Are you losing your mind trying to make

healthy lunches for your kids? Get some great tips and lots of inspiration with nutritionist Caitlin Kiarie, and follow her @ momntotnutrition on Facebook or Instagram.

November is Pet Diabetes Month! That means that your friends at Purina, Zoetis and Merck Animal Health have some great freebies for your clients. Check out the goodies at usa.petdiabetesmonth.com

Time to pull out your old

coverallS & shoulder sleeves The Veterinary Medicine Loan Repayment Program will pay up to $25,000 each year towards qualified educational loans of eligible veterinarians who agree to serve in a NIFAdesignated veterinarian shortage situation for a period of three years. The catch is, you must apply before October 7th through November 11th. For more information, visit https://nifa.usda.gov

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to do this month See how many you can do!

Looking for a fun way to team-

Try an Escape Room party. build at your clinic?

NOVEMBER 11TH

IS VETERANS DAY

6 Did you know that the American Veterinary Medical Foundation has a scholarship program for military veterans that pursue an education in veterinary medicine? You can show your support by donating to this worthy cause at avmf.org

Escape Rooms are a live action, team-based game where players work together to solve clues or accomplish tasks within a limited amount of time.

8 9 The best way to start

your day is with A

great breakfast, but who has time in the morning when you are rushing around? Try Overnight Oats with this simple recipe: Combine 1 part oats to 1 part milk to 1/8 part chia seeds in a clean mason jar. Stick it in the refrigerator overnight and in the morning pop open, add some fresh berries and honey, and you have a tasty, delicious and easy breakfast that you will love!

Get some vet pride! The PRIDE Veterinary Medical Community strives to foster acceptance & inclusivity for people of all sexual orientations, gender identities and gender presentations within the veterinary medical profession.Â Learn more or sign up at pridevmc.org

Be thankful!

10 PETVET MAGAZINE

Thanksgiving is on the horizon and that likely means a big feast and lots of discount shopping in your future. But, donâ&#x20AC;&#x2122;t forget the real reason for the season this year. Make a list of what you are thankful for and keep it on hand to read through when you have a bad day.

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