Vesticular Stomatitis in Missouri

First Vesicular Stomatitis Virus Case Confirmed in Missouri Horse

(Information known at press time: August, 2020. Watch for the Executive Report for timely updates.) In July, Missouri State Veterinarian Dr. Steve Strubberg announced the state’s first case of Vesicular Stomatitis in a horse in Newton County. The announcement follows a positive confirmation from the United States Department of Agriculture’s National Veterinary Services Laboratory (NVSL), making Missouri the seventh state to confirm the virus this year. As a result, the Missouri Department of Agriculture is urging horse owners to monitor their livestock closely and call their veterinarian if symptoms arise. All susceptible animals on the affected premises have been quarantined. The quarantine will continue for at least 14 days after the onset of lesions in the last affected animal. The Department has begun epidemiological work to trace back any possible sources of transmission; however, flies and midges are known to be vectors of the virus. As a preventative measure, Missouri has required a veterinary examination, Certificate of Veterinary Inspection (CVI) and an Entry Permit for hooved animals entering the state from affected areas.

Vesicular Stomatitis is a contagious, non-fatal virus that primarily affects horses and cattle by causing a fever and vesicular lesions in the mouth, on ears, near the coronary band of hooves or on teats. Horses infected with Vesicular Stomatitis may be treated with antiinflammatory medication to minimize swelling and kept on soft feeds to ensure they continue eating and drinking. The virus occasionally affects other hooved livestock, including sheep, goats and swine. The virus has been confirmed in Arizona, Kansas, Nebraska, New Mexico, Oklahoma and Texas this year in both horses and cattle. Veterinarians Accredited veterinarians will play a critical role in the rapid diagnosis of Vesicular Stomatitis in horses. Veterinarians can assist in collecting samples and submitting them for testing to the NVSL in Ames, Iowa. Although flies and other insects are the primary vectors for the virus, the Department encourages veterinarians to follow proper biosecurity measures as they travel to prevent spread between farms. Because of the confirmed case in Missouri, other states and Canada are likely to increase restrictions on livestock imports. Animal health officials strongly encourage all livestock owners and veterinarians to call the animal health authority in the destination location for the most current import requirements prior to travel. Horse and Livestock Owners All horse and livestock owners should enhance their existing biosecurity measures, including insect control programs, reducing contact between horses, and isolation protocols for horses returning to a farm. Owners should also clean and disinfect communal waterers, feed bunks, trailers and other livestock equipment regularly. Hosts of Exhibitions, Trail Rides and Markets The Department strongly recommends hosts of exhibitions, trail rides and markets require CVIs issued within 48 hours of arrival and a veterinary inspection upon arrival. If any horses or livestock exhibit suspicious symptoms consistent with Vesicular Stomatitis, the State Veterinarian recommends sending the animal home for isolation and testing. If adopted, these heightened recommendations may help keep horses and livestock healthy, and provide for continuity of farm and business operations. For official guidelines related to exhibitions, trail rides and markets, visit https://agriculture.mo.gov/. Vesicular Stomatitis is a reportable disease. Individuals or veterinarians who suspect or have concerns about the virus should contact the Department at (573) 751-3377. To learn more about Vesicular Stomatitis, go to https://agriculture.mo.gov/. To view USDA’s latest situation report on the spread of the virus in 2020, visit USDA APHIS online.

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Rapid Support: What you need. When you need it. • Essential Business Template • Wellbeing: Taking care of yourself • Apply for Payroll Protection: How and Where • What does practice look like in hot spots? • Practice tips in the COVID-19 environment • Defining essential service in Missouri, what it means to your practice • Tool for creating a menu of services in the pandemic Thank you so much for the correspondence and helpful links for information on how we can deal with the pandemic this past month…We do open every MVMA email and follow many of your suggested recommendations… Thanks to your guidance we were able to be prepared and apply promptly for the Care’s Act Payroll Protection Program Loan the day it came online. Kathryn Kovar D.V.M. Nicholas Pisoni D.V.M. Binder Animal Hospital 24 14 MVMA QUARTERLY - SPRING 2019 A high profile event transpired in recent weeks when Stray Rescue in St. Louis, accused Veterinary Specialty Services, and the St. Louis Animal Control, of acting improperly in euthanizing a dog after a biting incident. Through efforts of Stray Rescue, a torrent of social media activity was unleashed against VSS and Animal Control. The vicious cyberbullying against VSS raised to the level of death threats in some instances. After conversations with VSS, MVMA was satisfied that proper actions were taken when the private practice notified animal control immediately after their technician was bitten by the animal. Given the level of social media attacks after the incident, MVMA leadership issued the following email to MVMA members: Missouri Veterinary Medical Association Members: We are sharing this information with you to help you understand the issues involved in a cyberbullying event taking place in St. Louis Monday night February 11th, and today, Tuesday February 12th, regarding Veterinary Specialty Services, Stray Rescue, and the St. Louis County Public Health Department. We have been in contact today with VSS, and have offered them our assistance in whatever way we can. It is important we share the following with our MVMA members so you may know all the facts, and in turn, explain them to your own clients. We have been in contact with the GSLVMA, VSS, and The Social DVM, and have had a well-rounded discussion of our MVMA Board of Governors regarding the handling of this issue. We have also passed along resources available through the AVMA. Dr. Gorse of VSS has thanked us and our members for our solidarity with them. We wish VSS the best of luck in this unfortunate situation and have asked them to let us know of anything we can do for them. This communication to our members then carried the following statements by VSS and Animal Control. VSS gave MVMA the following information: Veterinary Specialty Services was providing care to an extremely critical stray that had been brought in to us by a local rescue group. The patient became aggressive during hospitalization, and, despite appropriate protective measures, a technician was bitten. We immediately notified the local rescue group, and per Missouri statue, filed a bite report with the St. Louis County. Following the report, St. Louis Animal Care and Control took custody of the patient from VSS. The St. Louis County Health Department made the difficult decision to euthanize the patient per Missouri law. Everyone is saddened by this outcome. Despite a veterinary/client relationship of over 20 years, the rescue group has engaged in a major cyber-bullying campaign vilifying VSS and Animal Care and Control for following the regulations of St. Louis County and the State of Missouri. The technician who is injured will physically be fine. We are all “hanging in there” and greatly appreciate the incredible support we have been receiving from the veterinary community, near and far. Animal Control, under the City of St. Louis Department of Health, subsequently released this statement regarding the incident: St. Louis County Interim Health CoDirector Spring Schmidt’s Statement on Faust On February 11, St. Louis County Animal Care and Control took in Faust, a 6 year-old female pitbull from Veterinary Specialty Services, after VSS reported that she bit one of its staff. Missouri law and St. Louis County ordinance require all dogs who have bitten a human and broken skin to be quarantined for rabies observation for a minimum of 10 days unless signs of neurological defects indicate rabies and in that case, the animal should be euthanized. Rabies observation consists of looking for neurological defects or issues. VSS had already observed serious signs of MVMA Stands Up, On Behalf of Its Members, Against Cyberbullying 12 MVMA QUARTERLY - SPRING 2018 Two plus years ago, then MVMA President-Elect Dr. Cliff Miller had ap pealed to Orscheln Farm & Home, headquartered in Moberly Missouri, to discontinue their new policy of offering in store veterinary services through a 3rd party vendor. Orscheln sent a letter confirming their decision to continue these services in December of 2016. On behalf of the MVMA, Dr. Miller had appealed to Orscheln to discontinue the services in defer ence to their relationship with local veterinarians, especially in small towns and rural areas. Due to ongoing conversations and relationships with Orscheln executives Dr. Miller, currently MVMA Board Chair, received a follow-up letter from the company on January 22, 2018, announcing they have now discontinued these in store veterinary services. The letter states: “We value our relationship with the local veterinarians … and would certainly welcome the opportunity to work with them to strengthen our relationship with pet owners…”. Dr. Miller worked diligently on this issue on MVMA’s behalf and is excited for Missouri’s veterinarians to hear this news. He lauds Orscheln for the turn around and urges Missouri’s veterinarians to consider strengthening this relationship, especially in light of other competing companies who continue to undermine local veterinarians with in store veterinary services. Working for Our Members The week following the MVMA Convention was a tumultuous one. The Missouri Bureau of Narcotics and Dangerous Drugs issued a notice that stated all veterinarians who dispense and prescribe must have their own individual DEA number. This would have entailed thousands of dollars in license fees for clinics. As requested by the BNDD, the MVMA sent all members a notice of this change on Wednesday January 24, 2018. On Friday, January 26 MVMA was able to send the following email alert to all members: We are pleased to announce that we have been notified by the Bureau of Narcotics and Dangerous Drugs that the decision regarding all veterinarians needing DEA licenses has been rescinded. All requirements and enforcement will revert to the status prior to the announcement made earlier this week, including allowing multiple veterinarians to use one DEA license in their clinic. This is the result of swift and effective reaction by your MVMA leadership team, invaluable input from our legal counsel Sean Edwards, highly responsive and valuable input from AVMA, as well as the individual efforts of our members. Thank you to all involved. We hope all members help us in communicating the power of organized veterinary medicine. As a profession small in number it is important to stand united. The first and most basic way for a veterinarian to help is to be an MVMA member. This DEA license issue dramatically demonstrates how quickly things can change, and how much they could cost, if MVMA did not exist. Thank you for your membership. Please help us spread the word about this issue, and perhaps in the process recruit a colleague to MVMA membership. MVMA Pressure Leads to DEA License Decision Reversal 12 MVMA QUARTERLY - SUMMER 2019 MVMA Successful In Securing Emergency Rules on Compounded Drugs From Pharmacy and Veterinary Boards A fter over a year of hard work and collaboration with the Missouri Board of Pharmacy and the Misso uri Veterinary Medical Board, the MVMA is happy to announce that each of those boards have issued emergency rules that enable M issouri veterinarians to stock (with limitations) compounded drugs to be used in emergencies, until patient-specific prescriptions can be ordered and filled. These rules are in effect as of March 31, 2019, until January 8, 2020, when the rules re quire approval by the legislature to make them permanent. The Missouri Board of Pharmacy rule sets out requirements that allow pharmacies to provide these non-patient specific drugs to Missouri veterinarians for emergency use. The Missouri Veterinary Medical Board rule governs the quantity allowed, and the rules for dispensing these drugs. The new veterinary rule states: “A veterinarian may dispense no more than a seven- (7) day supply per patient from an office stock compounded preparation provided by a licensed pharmacy. A patientspecific prescription must be issued to continue treatment beyond seven (7) days and comply with all other requirements under this rule.” Although no specific stock quantity per clinic is designated, the MVMA strongly recommend s every clinic take into account the con ventional demand within their practice, the storage requirements, and the expiration dates for each compounded drug they store and stock, and to be prepared to justify these quantities if the clinic is audited. You should expe ct unusual scrutiny as you practice under these new rules, and should avoid any perception of using the new rules to skirt the strictly enforced rule that requires a patient-specific prescription outside of the emergency nature of the new rule. Also, please remember that compounded dr ug use in food producing animals continues to be illegal and nothing in these new emergency rules change that federal mandate. MVMA will work diligently to encourage the legislature to make the rules permanent by January. Working for Our Members For more information, visit stokes503B.com Did you hear the one about the veterinarian who thought ordering a compounded medication from a 503A pharmacy was the same as from a 503B pharmacy? Facebook comments from our members... environment • Tools for Curbside service • Now animals may be at risk of COVID-19, The Facts • A Missouri Veterinarians Guide to testing and treating COVID-19 in Animals • Protective Equipment and Drug Shortage Strategies • Current State of the Profession in Missouri. Survey: what are your colleagues doing? • COVID-19 Member Resource Page, and much more…