NAVC Institute Course Catalog 2014 by NAVC

May 18-23, 2014 â&#x20AC;˘ Orlando, FL

Cardiology Neurology for Neurophobes Ophthalmology: Surgery & Medicine BETTER CARE THROUGH PRECISION NAVC.com/Institute | NAVC Institute 2014

Summer camp for clinical minds

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Orthopedics: Stifle Repair Small Animal Endoscopy Small Animal Ultrasound Soft Tissue Surgery 1

Its just about that time again. Time to roll up your sleeves, put on your thinking caps and get down to the intense, invigorating and hands-on learning that happens every year at the NAVC Institute. There’s a reason so many of your peers love this veterinary training course. The multi-day, in-residence approach allows you to focus your full attention on developing the critical skills and techniques you need right now. Under the guidance of board-certified veterinary professionals, you’ll learn and perform procedures you can put into practice immediately. Because we keep the classes small, you’ll enjoy plenty of one-on-one interaction with your instructors and fellow classmates. And in many cases, you get to reconnect and learn alongside colleagues you haven’t seen all year. In the words of one loyal attendee, the NAVC Institute is “like summer camp for veterinary professionals!”

And at this summer camp, the skills you learn will benefit your patients, your clients, your practice and your bottom line for seasons to come.

We hope you’ll join us for another year of “totalimmersion” education at the NAVC Institute.

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All About The NAVC Institute GETTING THERE

MEAL PLAN

You have two options for getting from the Orlando International Airport to the Caribe Royale: taxicab (approximately $50.00 USD) or Mears Transportation. You’ll receive a Mears coupon with your final registration confirmation number, and you can buy tickets at the Mears Transportation desk at the Orlando International Airport or online at mearstransportation.com or by calling +1.407.423.5566.

Your NAVC Institute registration fee includes meals for the entire program. Please note there’s no evening meal planned for Wednesday, May 21st. All meals are served in the Grand Sierra D Ballroom and are for badged attendees only. If you wish to have your family or guests join you for any meal, you may purchase meal tickets at the NAVC Institute Registration Desk.

HOME AWAY FROM HOME Your NAVC Institute registration fee includes a one-bedroom suite at the Caribe Royale All-Suites Hotel and Convention Center, located at 8101 World Center Drive in Orlando. Your suite has a separate living room, a bathroom, two televisions, a minirefrigerator and a microwave. Please indicate your choice of a King bed or two Queen-size beds during the registration process and we’ll make your hotel reservation for you. If you’re attending a 5-Day course, check in on Sunday, May 18th and check out on Friday, May 23rd. If you’re attending a 3-Day course, check in on Sunday, May 18th and check out on Wednesday, May 21st. If you wish to arrive earlier or stay later than these dates, you’re responsible for hotel charges.

PACKING LIST You’ll be notified if special attire is recommended for your particular course. Scrubs or easily-laundered outerwear are recommended. Closed-Toed Shoes are absolutely required in Hands-on Laboratory sessions. Light Clothing: Orlando weather in May is warm and humid, with outside temperatures usually in the mid- to high-80s. Sweaters or Jackets: Convention center rooms are kept quite cold, so bring along a cover up.

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Vegetarian choices will be available at every meal. Please note any special food restrictions or allergies by answering the question in the Online Registration Process or by completing the printed Lodging Form. We’ll do our best to accommodate all dietary needs.

BE PREPARED! For textbook and supplementary material recommendations, please refer to the course descriptions. You’ll receive a selfassessment exam with your final course packet. This optional exam is a tool you can use to determine your knowledge base prior to attending the course.

ARRIVAL Check in at the Caribe Royale is 3:00 pm. The NAVC Institute Registration Desk in the Convention Center will be open from 2:00 to 8:00 pm on Sunday, May 18th. Join us at our informal Welcome Reception on Sunday evening from 6:00 to 8:00 pm in the Grand Sierra D Ballroom in the Convention Center at the Grand Caribe Convention Center. We’re serving light hors d’oeuvres and drinks and presenting a short introductory welcome and orientation program beginning at 7:00 pm.

HOW MANY CE CREDITS WILL I EARN AT THE NAVC INSTITUTE? Each 5-Day NAVC Institute course provides 34 CE credit hours. Each 3-Day NAVC Institute course provides 22 CE credit hours. (RACE approval pending) 3

EXHIBITORS Do you want to showcase your solutions to an engaged audience of ambitious veterinary professionals? Sign up for a tabletop booth at the NAVC Institute. Many of our Hands-足on Laboratory sponsors display their equipment in our exhibit area. Spaces are limited.

Sharpen your skills. Perfect your techniques. Catch up with your colleagues at the learning event you look forward to all year.

Want to sponsor a course, a coffee break or a document bag insert? Please contact Sondra Reynolds for more information or to register your booth. Sondra Reynolds

Advertising Sales Manager +1.352.244.3711 SReynolds@NAVC.com

Summer camp for clinical minds

NAVC.com/Institute | NAVC Institute 2014

Summer camp for clinical minds

NAVC.com/Institute | NAVC Institute 2014

Caribe Royale Orlando All-Suite Resort & Convention Center HOTEL HIGHLIGHTS Here among more than 53 lush, tropical acres, youâ&#x20AC;&#x2122;ll stay in one of the 1,218 spacious, well-appointed one-bedroom suites. Our sessions are held in the expansive state-of-the-art meeting and event facilities, with unmatched hospitality and service and a wealth of desirable dining options and hotel amenities. All this just minutes from the areaâ&#x20AC;&#x2122;s world famous theme parks and attractions.

The Caribe Royale is an all-suite hotel. The Standard Suite is one bedroom with two queen-sized beds that connects to a living room with a full-sized sleeper sofa.

Self-parking & Fitness Center are complimentary. No resort fees. Internet access is free in the dining room and exhibit area only, with a low $4.99/24-hour access fee elsewhere. 6

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Table of Contents Cardiology..............................................................8 Neurology for Neurophobes..............................10 Ophthalmology: Surgery & Medicine...............12 Orthopedics: Stifle Repair..................................14 Small Animal Endoscopy....................................16 Small Animal Ultrasound....................................18 Soft Tissue Surgery..............................................20

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CARDIOLOGY

COURSE LEADER Clarke Atkins, DVM, DACVIM

Cardiology without Intimidation 34 CE credit hours (RACE approval pending)

Clarke Atkins, DVM, the former Jane Lewis Seaks Distinguished Professor of Companion Animal Medicine at North Carolina State University and 2004 Norden Award for teaching excellence recipient, is boardcertified by the ACVIM (Medicine & Cardiology). His research involves canine and feline heartworm disease and treatment of cardiovascular disease in dogs, cats and horses. He has authored over 150 publications and has provided well over 1,000 hours of continuing education in the U.S. and many countries around the world.

Additional Instructors: Marisa Ames, DVM Clifford “Kip” Berry, DVM, DACVR Teresa DeFrancesco, DVM, DACVIM, DACVECC Robert Prosek, DVM, MS, DACVIM Rebecca Stepien, DVM, DACVIM

In this session, you’ll gain an understanding of all the important cardiovascular diseases of dogs and cats, including pathogenesis, recognition/diagnosis and management. The instructors are excellent teachers, who teach using positive reinforcement. Furthermore, lectures are interactive, encouraging voluntary audience participation. Specifically, you’ll develop the ability to recognize abnormal heart sounds and determine the most likely causes and their importance. We’ll demonstrate recorded heart sounds using infrared technology to transmit the sounds to your headset. You’ll learn radiology, electrocardiography and echocardiography during lectures and labs. We’ll round out the diagnostic sessions with the newest information on biomarkers and genetics of heart disease. Following our lectures on pathogenesis and treatment of heart failure, we’ll describe and discuss all the important cardiovascular diseases of dogs and cats. Finally, we’ll use clinical cases to underscore important diagnostic and therapeutic aspects of each disease.

Learning Objectives: • Recognize heart sounds, knowing the genesis and importance of what you’re hearing. • Understand what electrocardiography can and cannot be expected to tell you about a patient. • Interpret and manage arrhythmias. • Confidently assess echo reports and echocardiographic views to diagnose cardiovascular diseases. • Develop a strong foundation for interpreting thoracic radiographs while recognizing their shortcomings. • Understand the most important congenital and acquired cardiac and vascular diseases in dogs and cats. • Learn the best accepted therapeutic approach to each and the reasons for each. • Cement diagnostic and therapeutic knowledge with interactive case discussions chosen to highlight the lessons learned. SUPPLEMENTAL MATERIALS: 1. Ware W, Cardiovascular Disease in Small Animal Medicine, Manson Publishing, 2007. Ettinger, Feldman - Textbook of Veterinary Internal Medicine - 7th edition, Elsevier, 2010. 2. Fox, Sisson and Moise - Small Animal Cardiology - 2nd edition, WB Saunders, 1999. 3. Fuentes and Swift - Manual of Small Animal Cardiorespiratory Medicine and Surgery, published by BSAVA (www.bsava.com), available through Iowa State Press. Out of Print, available in some places.

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TUESDAY, MAY 20

WEDNESDAY, MAY 21

THURSDAY, MAY 22

FRIDAY, MAY 23

BREAKFAST 7:00 – 8:00 AM 8:00 – 9:00 am

Heart Sounds and Physical ECHO Introduction Examination Lecture (All)

Congenital Heart Disease I

Pathogenesis of Heart Failure and Its Treatment

Feline Heart Disease I

DeFrancesco

Atkins

Stepien

Congenital Heart Disease II

Cardiovascular Pharmacology

Feline Heart Disease II

Estrada

Atkins

Stepien

Differentiating Cardiac From Respiratory Disease

Cardiovascular Pharmacology

Systemic Hypertension in Dog & Cat

Atkins

Ames, Atkins

Stepien

ECGs in the ER: Unknowns

Case Discussions Focusing Canine Heart on Physical Exam Disease I Mitral Findings-Radiology Disease

Case Discussions Cat and Dog

Ames, Atkins

Atkins

Lab Atkins

Stepien

Heart Sounds and Physical ECHO Laboratory I 9:00 – (Group A) 10:00 am Examination Lecture Atkins

Ames, DeFrancesco, Prosek, Stepien

Lab

ECG Unknowns I (Group B)

Atkins

BREAK 10:00 – 10:30 AM ECHO Laboratory II (Group A)

Radiology I 10:30 – 11:30 am

Ames, DeFrancesco, Prosek, Stepien

ECG Unknowns II (Group B) Berry

11:30 am – Radiology II 12:30 pm

Berry

Ames

LUNCH 12:30 – 1:30 PM 1:30 – 2:30 pm

ECG Unknowns I (Group A)

Radiology III

Heartworm Disease - Canine Heart Dog Disease II Dilated Cardiomyopathy

Atkins

COURSE CONCLUDED (34 CE credit hours)

ECHO Laboratory I (Group B) 2:30 – 3:30 pm

Berry

Ames, DeFrancesco, Prosek, Stepien Atkins

Radiology VI

ECG Unknowns II (Group A)

Stepien

Heartworm Disease - Canine Heart Cat Disease III ARVC

Atkins

ECHO Laboratory II (Group B) Ames, DeFrancesco, Prosek, Stepien Atkins

Berry

Ames

BREAK 3:30 – 4:00 PM 4:00 – 5:00 pm

Arrhythmias - Rx

Radiology Lab (Group A)

RECEPTION 3:30–5:00 PM

Berry

Electrocardiography: Obtaining and interpreting ECGs (Group B) Ames

5:00 – 6:00 pm

DeFrancesco

Canine Heart Disease IV Miscellaneous (Endocarditis, Pericardial Disease) Stepien

Electrocardiography: Obtaining Biomarkers & and interpreting ECGs (Group A) Genetic Testing

Case Discussions Dog

Ames

Radiology Lab (Group B) Berry

DeFrancesco

Stepien

DINNER 6:00 – 7:30 PM * There will also be an optional Radiology Lab continuation with question/answer session on Monday from 7:30 – 8:30 PM.

Hands-on Lab

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Lecture/Discussion NAVC.com/Institute | NAVC Institute 2014

CARDIOLOGY

MONDAY, MAY 19

Neurology for Neurophobes

COURSE LEADER Peter J. Dickinson, BVSc, PhD, DACVIM

Neurology for Neurophobes 34 CE credit hours (RACE approval pending)

Dr. Dickinson received his Veterinary degree from the University of Liverpool in 1989. He spent 1 year in mixed general practice before completing a 2 year internship at the University of Glasgow. He completed a PhD and post-doctoral research training in developmental neuroscience in Glasgow followed by a neurology/neurosurgery residency at UC Davis. He has been a board certified neurologist since 2000 and on the faculty at UC Davis since 2003. He is currently Professor Neurology/ Neurosurgery and Director of the Petersen Brain Tumor Laboratory. He has lectured extensively both nationally and internationally and teaches basic neurosciences and clinical neurology within the Veterinary Medical Teaching Hospital.

Additional Instructors: Natasha Olby, VetMB, PhD, DACVIM Simon R. Platt, BVM&S, MRCVS, DACVIM, DECVN

The overarching goal of this course is to help you overcome the all-too common fear of neurological case management. You’ll receive both theoretical and practical training allowing you to complete and interpret neurological examinations and be comfortable formulating a diagnostic plan for animals with neurological problems. Learning will be based around essential neuroanatomical and functional principles to provide a basis for lifelong learning. Using case-based material, we’ll address and reinforce the management of common neurological conditions. At the end of the course, you’ll achieve a knowledge level where you both enjoy and enhance the management of neurological patients in your practice.

Learning Objectives: • Conduct neurological exams and lesion localization in your practice. • Establish appropriate neurological case management protocols. • Perform basic neurodiagnostic procedures (e.g., CSF sampling and analysis). • Know how to conduct and interpret vertebral column radiography and imaging. • Set a solid foundation for lifelong advancement in veterinary neurology.

SUPPLEMENTAL MATERIALS: 1. BSAVA Manual of Canine and Feline Neurology 4th Edition, 2013, British Small Animal Veterinary Association. 2. Handbook of Veterinary Neurology 5th Edition, 2010, Elsevier.

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TUESDAY, MAY 20

WEDNESDAY, MAY 21

THURSDAY, MAY 22

FRIDAY, MAY 23

BREAKFAST 7:00 – 8:00 AM 8:00 – 9:00 am

Overview of the Nervous System “The Big Picture”

Extrinsic Spinal Chord Diseases

The Vestibular Animal: A Common Presentation

Seizures: Understanding the Basics Makes It Easy

Neuromuscular Diseases: More Common Than You Think

Dickinson

Olby

Platt

Olby

Platt

Intrinsic Spinal Cord Diseases

Inflammation, Infection, Infraction: Common Brain Conditions

Seizures: A Practical Approach to Treatment

Flaccid Limbs and Weak Dogs

Platt

Olby

Dickinson

Critical Skills: The 9:00 – 10:00 am Neurological Examination Made Easy Platt

BREAK 10:00 – 10:30 AM You Have to Know 10:30 – 11:30 am Where It Is! Spinal Cord Basics

Dickinson

11:30 am– Disc Disease: What 12:30 pm You Do Is Important

Olby

Spinal Cord Trauma: What You Can Do and What’s In the Future

Tremors and Abnormal Movements

Seizures: Real Cases, Neurophobe No Real Solutions More: Cases Solved

Olby

Platt

You Have To Know Where It Is! Brain Basics

Brain Tumors and Cancer in the Neurologic Patient: Realistic Options

Brain Trauma: They Survive If You Don’t Make It Worse!

Neurophile Graduation: Key Points Reviewed

Platt

Dickinson

Platt

Dickinson

COURSE CONCLUDED (34 CE credit hours)

LUNCH 12:30 – 1:30 PM 1:30 – 2:30 pm

Hands-on Secrets to the Neurological Exam: Spinal Cord

Hands-on Secrets to the Neurological Exam: Brain Part I

Things You Can Do In Practice: CSF, Joints and Radiographs Part I

Abnormal Vision: Refer to Opthalmologist or Neurologist?

Dickinson, Olby, Platt

Dickinson

2:30 – 3:30 pm

Handson Secrets to the Neurological Exam: Spinal Cord

Hands-on Secrets to the Neurological Exam: Brain Part II

Things You Can Do In Practice: CSF, Joints and Radiographs Part II

Feline Neurology: An Overview of Why Cats are Different!

Dickinson, Olby, Platt

Platt

BREAK 3:30 – 4:00 PM 4:00 – 5:00 pm

Spinal Radiographs: Tips for Why, When and How

Common Cranial RECEPTION Nerve Abnormalities: 3:30–5:00 PM Tips for Smart Decision Making

Infectious Disease Testing, Genetic Testing: What Do I Do with this Result?

Olby

Dickinson

5:00 – 6:00 pm

Practical Approach to Spinal Cord Disorders: Case Discussion

Brain FUN for Neurophobes: Case Discussions

Is it Neurological? Harder Than You Think! Prize Contest

Olby

Platt

Dickinson

DINNER 6:00 – 7:30 PM Hands-on Lab

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Lecture/Discussion NAVC.com/Institute | NAVC Institute 2014

Neurology for Neurophobes

MONDAY, MAY 19

OPHTHALMOLOGY: Surgery & Medicine

COURSE LEADER Caryn Plummer, DVM, DACVO

Practical Approaches to Clinical Ophthalmology 34 CE credit hours (RACE approval pending)

Dr. Plummer graduated from the University of Florida College of Veterinary Medicine in 2002 and then completed a rotating internship in small animal medicine and surgery at Michigan State University in 2003. She pursued specialty training in comparative ophthalmology at the University of Florida and following completion of the residency, became a diplomate of the American College of Veterinary Ophthalmologists in 2006. She is currently on faculty at the University of Florida. She lives with her husband, 3 elderly kitties and Maevis the French bulldog in Gainesville, FL. Free time is spent out of doors (hiking, scuba) or reading.

Additional Instructors: Gil Ben-Shlomo, DVM, PhD, DEVCO, DACVO

This course is designed to refresh primary care practitioners on the basics of clinical veterinary ophthalmology and provide you with updates on the latest treatment options for a variety of ophthalmic conditions. The format is a mixture of lectures and discussions about the most common diseases and disorders that may affect the periocular and ocular structures, combined with hands-on laboratories in which you can practice examination and diagnostic techniques as well as surgical approaches to orbital, adnexal and corneal conditions. You’re invited to submit images of your own ophthalmology cases for discussion.

Learning Objectives: • Perform (or improve familiarity/comfort with) a thorough ophthalmic examination (techniques, equipment and indications – what to do and when to do it). • Diagnose and treat common ophthalmic disorders. • Understand the potential implications of systemic disease on ocular health and vice-versa. • Understand the indications for and approaches to adnexal, orbital and corneal surgeries (including, but not limited to, blepharoplasty, cherry eye repair, keratectomies, conjunctival grafts and enucleations).

Brad Holmberg, DVM, PhD, DAVCO Bianca Martins, DVM

SUPPLEMENTAL MATERIALS: 1. Veterinary Ophthalmic Surgery, edited by Kirk N. Gelatt and Janice P. Gelatt. Elsevier Saunders, 2011. 2. Online video clips of surgical procedures available at www.gelattonline.com. 3. Essentials of Veterinary Ophthalmology, 2nd edition, edited by Kirk N. Gelatt. Wiley Blackwell, 2008.

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TUESDAY, MAY 20

WEDNESDAY, MAY 21

THURSDAY, MAY 22

FRIDAY, MAY 23

BREAKFAST 7:00 – 8:00 AM 8:00 – 9:00 am

The Ophthalmic Examination and Diagnostics

Diagnostic Procedures (Cadavers)

Eyelid and Adnexal Surgeries (Pig Eyes)

Plummer

Ben-Shlomo, Holmberg, Martins, Plummer

Cherry Eye Repair (Cadavers)

Eyelid and Adnexal Surgeries (Pig Eyes) (continued)

Ben-Shlomo, Holmberg, Martins, Plummer

The Ophthalmic 9:00 – 10:00 am Examination and Diagnostics (continued) Plummer

Cornea

OMSD

Holmberg

Plummer

Cornea (continued)

Posterior Segment

Holmberg

Ben-Shlomo

Cornea (continued)

Ocular Emergencies

Holmberg

Ben-Shlomo

Corneal Procedures (Pig Eyes)

Review of Attendees Cases/Q & A

Ben-Shlomo, Holmberg, Martins, Plummer

Plummer

Corneal Procedures (Pig Eyes) (continued)

COURSE CONCLUDED (34 CE credit hours)

BREAK 10:00 – 10:30 AM Examination 10:30 – 11:30 am Techniques (Live Animals) Ben-Shlomo, Holmberg, Martins, Plummer

Orbital Blocks, Proptosis Reduction, Orbital Surgery (Cadavers)

Eyelid and Adnexal Surgeries (Pig Eyes) (continued)

Ben-Shlomo, Holmberg, Martins, Plummer

Enucleation 11:30 am– Examination 12:30 pm Techniques (Live (Cadavers) Animals) (continued) Ben-Shlomo, Holmberg, Martins, Plummer

Uveal Disease

Ben-Shlomo, Holmberg, Martins, Plummer

Ben-Shlomo

LUNCH 12:30 – 1:30 PM 1:30 – 2:30 pm

2:30 – 3:30 pm

Conjunctival and Lacrimal Disorders

Eyelid

Glaucoma

Ben-Shlomo

Plummer

Conjunctival and Lacrimal Disorders (continued)

Eyelid (continued)

Glaucoma (continued)

Ben-Shlomo

Plummer

Ben-Shlomo, Holmberg, Martins, Plummer

Corneal Procedures (Pig Eyes) (continued) Ben-Shlomo, Holmberg, Martins, Plummer

BREAK 3:30 – 4:00 PM RECEPTION 3:30–5:00 PM

4:00 – 5:00 pm

Orbit

Lens Disorders

Participant’s Choice

Holmberg

ALL

5:00 – 6:00 pm

Interactive Case Presentations

Ben-Shlomo, Holmberg, Martins, Plummer

DINNER 6:00 – 7:30 PM Hands-on Lab

Summer camp for clinical minds

Lecture/Discussion NAVC.com/Institute | NAVC Institute 2014

OPHTHALMOLOGY: Surgery & Medicine

MONDAY, MAY 19

ORTHOPEDICS: Stifle Repair

COURSE LEADER Don Hulse, DVM, DACVS, DECVS

Management of Stifle Injuries in the Dog & Cat 34 CE credit hours (RACE approval pending)

Dr. Hulse graduated from Texas A&M in 1970 and completed his surgical training at Kansas State University in 1973. Commencing in 1970 and continuing until his appointment as a Professor of Orthopedic Surgery at Texas A&M University in 1984, Dr. Hulse served as a clinician in general practice and as a Staff Surgeon at Louisiana State University and Oklahoma State University. He successfully fulfilled the requirements for admission into the American College of Veterinary Surgeons in 1977. He is a recognized leader in veterinary orthopedics and is frequently invited to speak at National and International Veterinary conferences. He has developed techniques commonly used for treatment of bone and joint disorders in dogs and is a co-author of Small Animal Arthroscopy. His clinical research interests focus on minimally invasive surgery for joint disorders and for fracture treatment.

Additional Instructors:

Within a lecture/laboratory combined experience, you’ll receive in-depth exposure to common stifle problems you may experience in daily practice. You’ll learn and practice procedures in “saw bones” and cadavers, and we’ll stress exposure technique and identification of normal and pathologic intra-articular structures in lecture, with multiple practice opportunities. We’ll also address diagnosis and management of cranial cruciate ligament injury in large breeds of dogs as well as toy breeds of dogs and cats. Over two consecutive days, you’ll learn and perform techniques using novel knotless stabilization products positioned at the quasi isomteric femoral and tibial sites. In addition, you’ll have a chance to discuss and practice mechanical altering stabilization procedures, such as the CORA based leveling osteotomy that are useful in active large breeds of dogs as well as dogs with deranged stifles or excessive slope. You’ll follow techniques to achieve excellent visualization of the medial and lateral meniscus, identify and treat meniscal tears. A single day of lecture and practice is devoted to feline cases, focusing on surgical procedures for cranial cruciate ligament injury, patella luxation and deranged stifles. Finally, we’ll cover novel techniques for non-surgical management for osteoarthritis in the dog and cat. The end of each day is devoted to interactive Case Discussions, so we encourage you to bring cases from your practices.

Learning Objectives: • Understand surgical approaches to the canine and feline stifle. • Identify intra-articular structures and isometric points. • Apply novel knotless anchor systems.

Caleb Hudson, DVM

• Measure the tibial plateau slope and position of the CORA.

Sandra Hudson, BS, MBA, CCRP

• Perform a CORA-based leveling osteotomy.

Sharon Kerwin, DVM, MS, DACVS

• Confidently manage stifle surgery cases (peri-operative and post-operative).

Laura Peycke, DVM, MS, DACVS-SA, DACVS Brian Saunders, DVM, PhD

• Explore options for non-surgical management of OA in dogs and cats. SUPPLEMENTAL MATERIALS: 1. Course Notes will be provided prior to the course for study.

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TUESDAY, MAY 20

WEDNESDAY, MAY 21

THURSDAY, MAY 22

FRIDAY, MAY 23

BREAKFAST 7:00 – 8:00 AM 8:00 – 9:00 am

Applied Surgical Anatomy of the Stifle: Primary and Secondary Restraints (CrCl CaCl, MCL, LCL, Lateral/Medial Meniscus)

Lab 4 - Cadaver 2 Stifle Left: Identification of Intra-articular Structures; Application of Corkscrew or SwiveLock

Lab 8 - Cadaver 4 Stifle Left; Surical Approach; Block Recession, Tibial Crest Transposition, Medial Release

Joint Stabilization with Mechanic Stabilization Techniques: TTA

Review of Lecture/ Lab Stifle

C. Hudson

C. Hudson, Hulse, Peycke

Primary and 9:00 – 10:00 am Secondary Restraint Injury: Mechanism and Pathology Hulse

Kerwin

Lab 5 - Cadaver 2 Stifle Right: Lab 8 - Cadaver 4 Identification of Intra-articular Stifle Left Structures; Application of 5.5 (continued) SwiveLock with 2 Strands (4 Arms) 2mm Fiberwire

Joint Stabilization with Mechanic Stabilization Techniques: TPLO

Alternative Uses of Athrex Stabilization Products: Tarsus/ Shoulder/Elbow

C. Hudson, Hulse, Peycke

Saunders

Hulse

C. Hudson, Hulse, Peycke

BREAK 10:00 – 10:30 AM Signalment, History, 10:30 – 11:30 am Clinical Findings, Imaging of Primary and Secondary Restraint Injury Peycke

11:30 am– Isometric Sites, 12:30 pm Application of Arthrex Stabilization Products Hulse

Lab 6 - Cadaver 3 Stifle Left: Surgical Approach and Identification of MCL and CaCLL; Application of Swivelock and Pushlock for Stabilization

Lab 9 - Cadaver 4 Stifle Right: Patella Stabilization Methods Coupled with CrCl Stabilization

Joint Stabilization with Management of Mechanic Stabilization Stifle OA: NonTechniques: CORA Surgical Methods based Leveling Osteotomy (CBLO)

C. Hudson, Hulse, Peycke

Hulse

Lab 7 - Cadaver 3 Stifle Right: Repeat Lab 6

Lab 10 - Feline Cadaver Stifle, Planning of CBLO Feline Stifle Joint: Patella Luxation Stabilization Coupled with CrCl Stabilization with a 3.5mm SwiveLock Loaded with Labral Tape

Management of Stifle OA: NonSurgical Methods

C. Hudson, Hulse, Peycke

Hulse, Kerwin, Saunders

Saunders

COURSE CONCLUDED (34 CE credit hours)

Saunders

LUNCH 12:30 – 1:30 PM 1:30 – 2:30 pm

2:30 – 3:30 pm

Lab 1: Application of Corkscrew Anchor and SwiveLock to Simulated Saw Bones

Peri-Operative & Post-Operative Care: Rehabilitation Methods; Outcome

Peri-Operative, PostOperative Care & Rehabilitation of the Feline Stifle

Lab 11 - Sawbones: CBLO Appilication

C. Hudson, Hulse, Peycke

C. Hudson, S. Hudson, Hulse

C. Hudson, S. Hudson

Hulse, Kerwin, Saunders

Lab 2 - Cadaver 1 Stifle Left: Surgical Approach and Identification of Intra-articular Structures; Application of Corkscrew

Patella Luxation: Clinical Findings, Imaging; Stabilization Methods

Summary of the Day; Lab 12 - Cadaver 5 What We Learned; Stifle Left: CBLO Common Laboratory Errors: Discussion

C. Hudson, Hulse, Peycke

Peycke

C. Hudson, Hulse, Peycke

Hulse, Kerwin, Saunders

BREAK 3:30 – 4:00 PM 4:00 – 5:00 pm

Lab 3 - Cadaver 1 Stifle Patella Luxation with RECEPTION Right: Identification of CrCL Injury 3:30–5:00 PM Intra-articular Structures; Application of a Swivelock

Lab 12 - Cadaver 5 Stifle Left: CBLO (continued)

C. Hudson, Hulse, Peycke

Hulse, Kerwin, Saunders

5:00 – 6:00 pm

Summary of the Day; Feline Stifle Joint: Patella Luxation; What We Learned; Common Laboratory Ligament Injury Errors: Discussion

Summary of the Day; What We Learned; Common Laboratory Errors: Discussion

C. Hudson, Hulse, Peycke

Hulse, Kerwin, Saunders

Hulse

C. Hudson

DINNER 6:00 – 7:30 PM Hands-on Lab

Summer camp for clinical minds

Lecture/Discussion NAVC.com/Institute | NAVC Institute 2014

ORTHOPEDICS: Stifle Repair

MONDAY, MAY 19

SMALL ANIMAL ENDOSCOPY

COURSE LEADER David C. Twedt, DVM, DACVIM

An Introduction to Small Animal Endoscopy (3 days) 22 CE credit hours (RACE approval pending)

Dr. Twedt is a professor in small animal internal medicine and directs the Endoscopy Teaching Center at Colorado State University. He has lectured both nationally and internationally on all areas of small animal endoscopy and has published many papers and chapters on endoscopy. Dr. David C. Twedt graduated from Iowa State University and entered an internship and medicine residency at The Animal Medical Center in New York City with an interest in gastroenterology. Dr. Twedt then joined the staff of the Animal Medical Center and was also a research associate at the Liver Research Center of Albert Einstein Medical School. Dr. Twedt is currently a Diplomate of the ACVIM, Professor in the Department of Clinical Sciences at Colorado State University and Director of the Veterinary Endoscopy Teaching Center.

This course provides the basics on the most common endoscopies performed in practice, including GI endoscopy, cystoscopy, rhinoscopy, bronchoscopy and otoscopy. During our daily Hands-on Laboratories, you’ll learn the indications for using endoscopy, what you can diagnose with endoscopy and how to perform various procedures. We’ll cover endoscopy of the esophagus, stomach and intestine, cystoscopy using a rigid endoscope in female dogs, evaluating the respiratory system using endoscopy and ear cleaning and evaluation of the middle ear using otoscopy.

Learning Objectives: • Perform GI endoscopy of the esophagus, stomach and intestine. • Perform cystoscopy using a rigid endoscope in female dogs. • Evaluate the respiratory system using endoscopy. • Perform otoscopy for diagnosis, ear cleaning and evaluation of the middle ear.

Additional Instructors: Rod Rosychuk, DVM, DACVIM Todd Tams, DVM, DACVIM

SUPPLEMENTAL MATERIALS: 1. Small Animal Endoscopy; Tams TR and Rawlings CA eds. Elsevier 3rd edition.

Summer camp for clinical minds

NAVC.com/Institute | NAVC Institute 2014

TUESDAY, MAY 20

WEDNESDAY, MAY 21

SMALL ANIMAL ENDOSCOPY

MONDAY, MAY 19

BREAKFAST 7:00 – 8:00 AM 8:00 – 9:00 am

Overview of GI Endoscopy: Endoscopy of the Esophagus

Multipurpose Rigid Endoscopy Cystoscopy

Introduction to Otoscopy

Tams

Rosychuk

Multipurpose Rigid Endoscopy: Upper Respiratory

Advanced Otoscopy

Twedt

Rosychuk

Endoscopy of the 9:00 – 10:00 am Stomach

Tams

BREAK 10:00 – 10:30 AM Endoscopy of the 10:30 – 11:30 am Intestine

Twedt

11:30 am– Endoscopic 12:30 pm Procedures

Twedt

Lower Respiratory Endoscopy

Otoscopy Lab

Twedt

Rosychuk

Multipurpose Rigid Endoscopy and Bronchoscopy Teaching Model Technique Lab

Otoscopy Lab

Tams, Twedt

Rosychuk

LUNCH 12:30 – 1:30 PM 1:30 – 2:30 pm

GI Endoscopy

Cystoscopy, Rhinoscopy and Bronchoscopy Lab

Otoscopy Lab

Tams, Twedt

Rosychuk

2:30 – 3:30 pm

GI Endoscopy

Cystoscopy, Rhinoscopy and Bronchoscopy Lab

Endoscopy Wrap-Up Questions/Answers Equipment

Tams, Twedt

Rosychuk, Tams, Twedt

Tams, Twedt

BREAK 3:30 – 4:00 PM 4:00 – 5:00 pm

GI Endoscopy

Cystoscopy, Rhinoscopy and Bronchoscopy Lab

Tams, Twedt

5:00 – 6:00 pm

Interactive Evening Session GI Cases: What’s Your Diagnosis?

Interactive Evening Session Cases: What’s Your Diagnosis?

Tams, Twedt

RECEPTION 3:30–5:00 PM

COURSE CONCLUDED (22 CE credit hours)

DINNER 6:00 – 7:30 PM Hands-on Lab

Summer camp for clinical minds

Lecture/Discussion NAVC.com/Institute | NAVC Institute 2014

Small Animal Ultrasound

COURSE LEADER Clifford “Kip” R. Berry, DVM, DACVR

Small Animal Abdominal Ultrasound 34 CE credit hours (RACE approval pending)

Dr. Berry’s research interests are broad, with over 70 scientific publications. He is known for his interest in physiological imaging, thoracic imaging and diagnostic ultrasound and is co-editor of the Textbook of Veterinary Nuclear Medicine. Dr. Berry is a professor of diagnostic imaging at the University of Florida. His passion is for teaching and clinical research related to multiple imaging modalities within veterinary medicine. He has taught and been course coordinator for several different courses at the NAVC Institute. He has won a number of teaching awards including the most recent teacher of the year award from the graduating senior class (2013) specifically for his devotion to the teaching of clinical ultrasound in small animals.

Imagine spending an entire week learning all you want to know about abdominal ultrasound, with training by internationally-renowned, ACVR boarded radiologists with a passion for teaching. Designed for beginners through advanced learners, this course provides a solid foundation for exploring and mastering the fundamentals of abdominal diagnostic ultrasound in dogs and cats. We’ll present didactic material in a friendly and engaging atmosphere to encourage your interaction. Our small group setting means you’ll receive unparalleled hands-on scanning time of focused objectives as well as tailored instruction addressing your specific needs and goals.

Learning Objectives: • Develop the technical ability to perform a complete abdominal ultrasound examination. • Obtain the best images possible by demonstrating competency of ultrasound instrumentation. • Appreciate the appearance of normal organs, variations in normal anatomy, and the importance of anatomic landmarks in diagnostic ultrasound. • Demonstrate a working knowledge of the various disease processes amenable to diagnostic abdominal ultrasound and appreciate important limitations.

Additional Instructors: George Henry, DVM, DACVR Martha Moon Larson, DVM, MS, DACVR

Course notes for Small Animal Abdominal Ultrasound will only be available in digital format.

Nate Nelson, DVM, MS, DACVR Matthew Winter, DVM, DACVR Dan VanderHart, DVM, DACVR

SUPPLEMENTAL MATERIALS: 1. Nyland and Mattoon, Small Animal Veterinary Diagnostic Ultrasound, 3rd edition, Elsevier-Saunders, Spring, 2014. 2. Penninck and D’Anjou, Atlas of Small Animal Ultrasound, Wiley Blackwell, 2008.

Summer camp for clinical minds

NAVC.com/Institute | NAVC Institute 2014

TUESDAY, MAY 20

WEDNESDAY, MAY 21

THURSDAY, MAY 22

FRIDAY, MAY 23

BREAKFAST 7:00 – 8:00 AM 8:00 – 9:00 am

Lab 2 - Video Cases (Group A) - Lecture

Introduction Berry

Lab 3 - Video Cases (Group B) - Lecture

Important Ultrasound Principles Henry

How to Scan: 9:00 – 10:00 am Techniques for Image Optimization

Lab 5 - Adrenals & Lab 6 - Video Cases Pancreas (Group A) - (Group B) - Lecture Lecture Moon Larson

Nelson

Henry

Lab 2 - Ultrasound (Group B)

Lab 3 - Ultrasound (Group A)

Henry, Moon Larson, VanderHart, Winter

Lab 5 - Ultrasound (Group B) Henry, Nelson, Winter, VanderHart

VanderHart

Lab 6 - Cats (Group A)

Biopsy Station Nelson

Berry

Henry, Moon Larson, VanderHart, Winter

Lab 5 - Adrenals & Pancreas (Group B) Lecture

Neck, Thorax and Emergency Ultrasound

BREAK 10:00 – 10:30 AM Lab 1 - Video Cases 10:30 – 11:30 am (Group A) - Lecture

Lab 2 - Video Cases (Group B) - Lecture

Lab 4 - Video Cases (Group A) - Lecture

Nelson

Winter

Lab 2 - Ultrasound (Group A)

Lab 4 - Ultrasound (Group B)

Moon Larson Moon Larson

11:30 am – Lab 1 - Ultrasound 12:30 pm (Group B)

Lab 5 - Ultrasound (Group A) Henry, Nelson, Winter, VanderHart

Biopsy Station Berry, Henry, VanderHart, Winter

Berry, Henry, VanderHart, Winter

VanderHart

Reporting Ultrasound Findings: What to Remember and How to Keep the Momentum Going

Berry

COURSE CONCLUDED (34 CE credit hours)

LUNCH 12:30 – 1:30 PM 1:30 – 2:30 pm

Lab 1 - Video Cases (Group B) - Lecture

Lab 3 - Video Cases (Group A) - Lecture

Lab 4 - Video Cases (Group B) - Lecture

Lab 6 - Video Cases (Group A) - Lecture

Moon Larson

Henry

Winter

VanderHart

2:30 – 3:30 pm

Lab 1 - Ultrasound (Group A)

Lab 3 - Ultrasound (Group B)

Lab 4 - Ultrasound (Group A)

Lab 6 - Cats (Group B)

Berry, Henry, VanderHart, Winter

Henry, Larson, Nelson, Winter

BREAK 3:30 – 4:00 PM 4:00 – 5:00 pm

Liver/GB/Biliary

Portosystemic Shunts RECEPTION 3:30–5:00 PM

Lymph Nodes, Great Vessles, Peritoneum, Retroperitoneum

VanderHart

Winter

Nelson

5:00 – 6:00 pm

Urogenital Ultrasound

Gastrointestinal Tract

Differences Between the Dog and Cat

VanderHart

Winter

DINNER 6:00 – 7:30 PM Hands-on Lab

Summer camp for clinical minds

Lecture/Discussion NAVC.com/Institute | NAVC Institute 2014

Small Animal Ultrasound

MONDAY, MAY 19

Soft Tissue Surgery

COURSE LEADER Howard B. Seim III, DVM, DACVS

Practical Techniques in Soft Tissue Surgery 34 CE credit hours (RACE approval pending) Through this course, you’ll advance your understanding of the technical aspects of a variety of practical soft tissue surgery procedures. Some theory is included in the lectures, but our emphasis is on explaining how to perform each procedure.

Dr. Seim graduated from Washington State University, completed an internship in Saskatoon, Saskatchewan Canada and a two year surgical residency at the Animal Medical Center in New York City. He obtained Diplomate status in the American College of Veterinary Surgeons in 1983. He is currently on the surgical staff at Colorado State University. He was Chief of the Small Animal Surgery section at CSU from 1992 to 2002. He was recipient of the Merck AGVET Award for Creative Teaching, the CSU Award for Instructional Innovation and selected as the North American Veterinary Conference’s Small Animal Speaker of the Year in 2009. Dr. Seim is founder of VideoVet, a Veterinary Surgery Continuing Education video series. www.videovet.org.

Additional Instructors: Brad Case, DVM, MS Clara Goh, BVSc, MS, DACVS Daniel Smeak, DVM, DACVS

We’ll cover topics representing surgical conditions frequently seen in veterinary practice. Examples include the 10-minute gastropexy, rapid splenectomy, perineal hernia repair, salivary gland resection, surgery of the canine and feline urethra, surgery of the external and middle ear, anal sacculectomy, managing feline ear polyps and more. An entire day is also dedicated to ‘Feline Surgery Techniques.’ To help illustrate each technique, we’ll frequently use video of clinical case material. This course is recommended for veterinarians interested in providing a higher level of surgical treatment for their patients. The hands-on practical lab will give you the opportunity to practice techniques discussed in lecture. If you have been thinking of incorporating more surgery into your practice, this course is a must.

Learning Objectives: • Update your knowledge of common surgical techniques and procedures. • Review regional anatomy associated with each surgical technique. • Increase your confidence levels in performing a variety of soft tissue surgery procedures. • Realize that many soft tissue surgery procedures can be successfully performed in your veterinary practice.

SUPPLEMENTAL MATERIALS: 1. Title: Veterinary Small Animal Surgery, Edition and Year: 2011, Author: Karen M. Tobias, Publisher: Elsevier, Email: www.us.elsevierhealth/com. 2. Title: VideoVet - Soft Tissue Surgery Video Series, Edition and Year: - 2013, Author: Howard B Seim III, Publisher: VideoVet, Email: www.videovet.org.

Summer camp for clinical minds

NAVC.com/Institute | NAVC Institute 2014

TUESDAY, MAY 20

WEDNESDAY, MAY 21

THURSDAY, MAY 22

FRIDAY, MAY 23

BREAKFAST 7:00 – 8:00 AM 8:00 – 9:00 am

Salivary Mucocele

Laryngeal Tie-Back

Nasal and Auricular Squamous Cell CA Ventral Bulla Osteotomy

Forelimb Amputation Miller’s Knot, Double Half Hitch “Strangulation” Knot, Instrument and Suture Handling (Group A)

Case

Seim

Smeak

Vulvarplasty, Cystotomy, Partial Cystectomy Technique

Perineal Intestinal Urethrostomy, Dorsal Anastomosis Approach

Soft Tissue Surgery Cases (Group B)

Goh

Case

Seim

Urethrotomy and 9:00 – 10:00 am Urethrostomy

Goh

Case, Goh, Smeak

BREAK 10:00 – 10:30 AM Anal Sacculectomy, 10:30 – 11:30 am Chest Drain Placement and Tracheostomy Seim

11:30 am – Skin Flaps and 12:30 pm Tension-relieving Sutures

Smeak

Total Ear Canal Ablation, Lateral Bulla Osteotomy

E-tube Placement, Chest Drain Placement, Subtotal Colectomy

Gastropexy Technique, Rapid Splenectomy

Miller’s Knot, Double Half Hitch “Strangulation” Knot, Instrument and Suture Handling (Group B)

Smeak

Case

Smeak

Case, Goh, Smeak

Visceral Organ Biopsy

Nasal and Auricular Squamous Cell CA Ventral Bulla Osteotomy

Serosal Patch and Diaphragmatic Hernia

Soft Tissue Surgery Cases (Group A)

Seim

Case, Goh, Seim, Smeak

Seim

LUNCH 12:30 – 1:30 PM 1:30 – 2:30 pm

2:30 – 3:30 pm

Salivary Mucocele Urethrostomy/ Otomy

Laryngeal Tie-back

PU Dorsal Approach

Forelimb Amputation COURSE CONCLUDED (34 CE credit hours)

Case, Goh, Seim, Smeak

Chest Drain-Finger Trap Anal Sacculectomy Tracheostomy

Vulvarplasty Cystotomy and Urethra Palpation

E-tube Placement, Chest Drain Placement, Subtotal Colectomy

Gastropexy Technique, Rapid Splenectomy

Case, Goh, Seim, Smeak

BREAK 3:30 – 4:00 PM RECEPTION 3:30–5:00 PM

4:00 – 5:00 pm

Skin Flaps

Bladder Wall Resection

Intestinal Anastomosis Serosal Patch

Case, Goh, Seim, Smeak

5:00 – 6:00 pm

Tension-relieving Sutures

Visceral Organ Biopsy

Diaphragmatic Hernia

Case, Goh, Seim, Smeak

DINNER 6:00 – 7:30 PM

Summer camp for clinical minds

NAVC.com/Institute | NAVC Institute 2014

Soft Tissue Surgery

MONDAY, MAY 19

MAY 18-23, 2014. PLEASE PRINT.

_____________________________________________________________________________________________________________________________________________________ Last Name First Name ❏ DVM ❏ VMD ❏ Other _________________________________ _____________________________________________________________________________________________________________________________________________________ Practice Name (if mailing to place of business) _____________________________________________________________________________________________________________________________________________________ Street Address Apartment/Suite Number _____________________________________________________________________________________________________________________________________________________ City State/Province ZIP/Postal Code _____________________________________________________________________________________________________________________________________________________ Country Business Telephone Number _____________________________________________________________________________________________________________________________________________________ FAX Number Alternate Telephone Number _____________________________________________________________________________________________________________________________________________________ Email Address (Please provide your email address in order to receive course information and updates.)

COURSES FOR VETERINARIANS

PERF

Through March 30, 2014

After March 30, 2014

❏ Cardiology

$3,900

$4,100

❏ Neurology for Neurophobes

$3,400

$3,600

❏ Ophthalmology: Surgery & Medicine

$3,600

$3,800

❏ Orthopedics: Stifle Repair

$3,700

$3,900

❏ Small Animal Endoscopy (3-day)**

$2,900

$3,100

❏ Small Animal Ultrasound

$4,200

$4,400

❏ Soft Tissue Surgery

$3,900

$4,100

Rates are in U.S. dollars.

**Fee for 3-day course includes 3 nights lodging.

Fee includes: registration, course notes, lodging for 3 or 5 nights (based on selected course) at the Caribe Royale Orlando All-Suite Hotel, meals from Monday breakfast through Friday (or Wednesday) lunch, several Hands-on Laboratories and one complimentary transferable registration to the NAVC Conference 2015, January 17–21. Each 5-day course, provides 34 CE credit hours, 3-day course provides 22 CE credit hours (RACE approval pending).

FOOD ALLERGIES: Please diclose any food allergies here: _______________________________________________________ COURSE NOTES: You will be provided with both a printed* and a digital copy of the course notes. If you do not wish to receive a printed version, please check here. ❏ *Course notes for Small Animal Abdominal Ultrasound will only be available in digital format.

PAYMENT INFORMATION ❏ Check (payable to NAVC; must be payable in U.S. funds drawn on a US Bank) ❏ Credit Card (check one) ❏ Visa ❏ MasterCard ❏ American Express ❏ Discover Account #________________________________________________

Exp Date ____/____

_________________________________________________________ Cardholder’s Name (as it appears on card)_

_______________________________________________________ Cardholder’s Signature

CANCELLATION POLICY ancellations before April 1, 2014 are subject to a $200 cancellation fee. No refund for cancellations after April 1, 2014. All courses at C the NAVC Institute are subject to cancellation. Registrants will be reimbursed fully for registration fees and will have the opportunity to transfer to a new course based on availability.

3 WAYS TO REGISTER 1. Online: NAVC.com | 2. FAX: +1.352.375.4145 | 3. Mail: The NAVC Institute, 5003 SW 41st Blvd, Gainesville, FL 32608-4930 Questions? Contact info@NAVC.com or +1.352.375.5672

Registration Form

NAVC Institute 2014 Registration Form

You will be required to pay for additional room nights if arriving before Sunday, May 18 or spending the night on Friday, May 23. Registrants in the 3-Day course must pay for additional room nights if staying over on Wednesday, May 21. You only need to complete this form if you are staying additional nights or if you have special requests.

__________________________________________________________________________________________________________________________________ Last Name First Name __________________________________________________________________________________________________________________________________ Arrival Date Departure Date: Check One: ❏ One King-Size Bed ❏ Two Queen-Size Beds __________________________________________________________________________________________________________________________________ Street Address Apartment/Suite Number __________________________________________________________________________________________________________________________________ City State/Province __________________________________________________________________________________________________________________________________ ZIP/Postal CodeCountry __________________________________________________________________________________________________________________________________ Business Telephone Number Alternate Telephone Number __________________________________________________________________________________________________________________________________ FAX Number Email Address

CREDIT CARD (check one) ❏ American Express

❏ Discover

❏ MasterCard

❏ Visa

Account #_______________________________________________________

Exp Date ____/____

________________________________________________________________________________________________________________ Cardholder’s Name (as it appears on card) ________________________________________________________________________________________________________________ Cardholder’s Signature Date

Please note any special requests (ie, handicap requirements, feather-free bedding, etc) on the line below. Every attempt will be made to honor your request. Special Requests: _________________________________________________________________________________________________________________

PLEASE MAIL FORM TO: The NAVC Institute, 5003 SW 41st Blvd, Gainesville, FL 32608-4930 OR FAX TO: +1.352.375.4145 QUESTIONS? Call: +1.352.375.5672 | Email: info@NAVC.com | Visit: NAVC.com

PERF

LODGING Form

NAVC Institute 2014 Lodging Form

NAVC Institute 5003 SW 41st Boulevard Gainesville, FL 32608-4930

NAVC Institute 2014

NONPROFIT ORGANIZATION U.S. Postage

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