NC State CVM: The Oath

Oath

The Special Edition | Spring/Summer 2017

TEACH • HEAL • DISCOVER

Healthy Animals, Healthy Economy page 1

Animal Care is Big Business page 3

Ms. Faux page 5

Fighting Antibiotic Resistant Bacteria page 10

Paying it Forward page 21

Veterinary Medicine's Masked Heroes page 13

FROM THE DEAN

Healthy Animals, Healthy Economy Four CVM Deans: (from left to right) Warwick A. Arden (2004-09), Terrence Curtin (1979-92), Oscar J. Fletcher (1992-04) and D. Paul Lunn (2012-)

In a few weeks, the NC State College of Veterinary Medicine’s class of 2017 will graduate — and many of them will stay right here in North Carolina.

Our 32nd class will add to the large number of CVM alumni already working in the state.

A 2016 study commissioned by the College showed that 36 percent of North Carolina DVMs graduated from NC State. Along with our faculty, they make up 41 percent of the North Carolina Veterinary Medical Association.

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The veterinary profession has a strong economic impact on the state — and the CVM is a big part of that impact. The same study determined that the veterinary services field has a $1 billion impact in North Carolina, creating jobs for over 14,000 people. The study predicts that over the next decade there will be a 26 percent growth in the industry in North Carolina.

According to most recent available figures, there are 3,508 veterinarians in North Carolina, and 36% of them are NC State graduates; 41% of the membership of the North Carolina Veterinary Medical Association graduated from the CVM.

THE VETERINARY SERVICES FIELD IS A $1 BILLION INDUSTRY IN NORTH CAROLINA, EMPLOYING SOME 14,330 PEOPLE. an emphasis on educating the next generation of veterinary professionals, providing compassionate patient care through the NC State Veterinary Hospital and expanding our impact on biomedical research — the core activities of our college.

We also take a closer look at donors’ critical role in making our work possible through scholarships, facilities, medical equipment and endowed professorships.

CVM alumni work in the various facets of veterinary medicine.

While most of our DVM graduates are devoted to companion animal medicine, a critical group supports the 50,000 farms in North Carolina. Those farms add $57 billion to North Carolina’s economy. Without access to adequate veterinary care, the state’s agriculture industry would fail.

This edition of The Oath examines the study’s results in more detail, focusing on the College of Veterinary Medicine’s clear, strong and vital economic impact. -- the core activities that bring meaning to the phrase “teach, heal, discover” on the cover of this magazine. We present this information as “proof of performance” in our quest to set and achieve aspirational goals.

The CVM’s impact on veterinary medicine in our state will continue to grow in the future, as we continue to train a high proportion of North Carolina’s future veterinarians. This gives us a unique opportunity to impact our community and achieve our mission — improving both animal and human health.

D. Paul Lunn Dean, College of Veterinary Medicine NC State University

This issue also presents a snapshot of our progress in achieving the goals of our new five-year strategic plan, with 2

ECONOMIC IMPACT

Animal Care is Big Business Our growing impact on North Carolina's economy North Carolinians love their pets, according to a recent study by Economic Modeling Specialists International (Emsi). Both pet ownership and spending on pets is growing in the state, as well as nationally. When adding in the state's thriving agriculture industry, spending on animals in North Carolina tops $58 billion. NC State College of Veterinary Medicine is a key contributor to that number. Our hospital, research, education and veterinary services provided by alumni resulted in more than $174 million in added state income in the 2015-2016 fiscal year, the study found. Some of the high points are detailed College of Veterinary here. For an in-depth narrative, visit: Economic Impact cvm.ncsu.edu/impactreport

Medicine

A study of five key areas over the 2015-16 fiscal year

$5.5 MM in Student Spending

There are more than 3,500 veterinarians in the state. veterinarians veterinary technicians researchers support staff

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36% are CVM alumni

26%

Expected N.C. job growth over the next 10 years

Veterinary services are responsible for $1 billion in sales in North Carolina.

65%

Estimated North Carolina households with one or more pets

$174.2 Million in added income to North Carolina

$8.9 MM in Research Activities

$32.5 MM

in Veterinary Hospital Spending

$37.7 MM

in Day-to-Day CVM Operations

$89.6 MM

in DVM Alumni Impact

The economic impact is equivalent to supporting 3,345 jobs in veterinary services

North Carolina is home to more than 50,000 farms..

The veterinary profession plays a critical role in assuring the health of the $57 billion agriculture industry in the state.

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REAL PURPOSE

Ms. Faux: Everything about her looks real... and nothing is One of the most popular horses on campus never makes a sound. You can’t ride her, and she won’t trot or jump or gallop. You can’t bathe her, though she’s always impeccably groomed. You can’t feed her; she won’t eat. But you can take her apart and put her back together again — over and over. Her name is Ms. Faux.

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She is one of the stars of the Simulation Lab at the NC State College of Veterinary Medicine. She used to live in a large classroom — sometimes in the hallway — in the Veterinary Health and Wellness Center, not far from where her living, breathing equine brethren are housed. Now, she has moved into the barn at the Teaching Animal Unit, even closer to real horses.

Stare into her eyes and you half-expect her to blink. Her hide feels remarkably real, but her body is an epoxy/fiberglass blend over a steel frame. Inside Ms. Faux is a five-section GI tract, an anatomically correct colon, three sets of interchangeable ovaries, a spleen and kidneys, all made from combinations of latex, silicone, vinyl or plastic. Her neck can be injected with needles and colic can be simulated.

Semester after semester Ms. Faux and dozens of her fellow SimLab models provide students something they both need and want — to practice, practice, practice. And then practice some more.

“This is where you make your mistakes without judgment,” said Abi Taylor, general practice clinical assistant professor and director of the Simulation Lab. “It can take you 30 times or 130 times to get it. That’s OK. That’s why you’re here.”

Taking the fear out of surgery SimLabs and highly realistic animal models are recent innovations in teaching veterinary medicine, prevalent in Europe and gaining in popularity in the United States. CVM’s SimLab launched in the fall of 2015. Under the guidance of Taylor and Gail Druley, SimLab's manager and research technician, it has quickly grown to include everything from large-scale complex “high-fidelity” animal models — Ms. Faux, a new cow, a Belgian Malinois with simulated blood on the way — to smaller, less realistic yet just-as important “low fidelity” models.

Gail Druley, SimLab's manager and research technician, demonstrates a needle injection on the neck of Ms. Faux.

Many of those models are DIY, designed and crafted by Taylor and Druley and cover everything from halter placement to hand tie suturing, ear and eye exams and spaying. There are models that even help students identify different sizes of organs or to learn, as all veterinarians must, to “see” with your hands during many surgeries.

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“It all revolves around having a safe space where students can practice without the faculty peering over them — unless they want assistance,” said Taylor.

some take a little longer. I love the ones where it takes a little longer because then when it goes off, when they get it, it’s like you hear the angels sing.”

“I notice that during surgery or even when practicing surgery, students are doing fine and as soon as we start giving feedback you see them instantly shake and start to make mistakes.”

Almost all of Taylor’s model ideas come from what she’s teaching and what she notices students need more practice with. She is committed to the goal of growing and perfecting CVM’s SimLab’s offerings.

The formal aspect of the SimLab comes in week-long classes during “selectives,” held each semester between the end of classes and a holiday break, where students sign up for an intensive class focusing on a particular specialized field or skill.

But the power of SimLab comes during the rest of the year.

Though most popular with first and second years, the lab is open to all CVM students for drop-in sessions or to check out a particular model to practice on at home. Druley’s cell phone number is on the whiteboard outside of the SimLab room. All a student needs to do is text or call.

A variety of informal skill self-tests are available at the SimLab at any given time. During the week, a first-year student could be in the room practicing suturing while another tries out an anesthesia machine or perfects venipunctures on the lifelike veins of model horse heads.

There’s also the basics. Several models are geared toward finetuning motor skills and discovering the proper way to handle instruments. The benefit of a particular flick of a wrist or an effective rotation of a hand holding a scalpel is difficult to teach via textbooks. In the SimLab, mastering finger placements and grips and posture is part of your growth as a veterinarian before you cut into fake flesh and sew it up.

During selective sessions, students often watch videos narrated by Taylor, who then stops at various parts and goes over the steps in person, walking around the room and stopping to assist students as needed. It’s like watching Julia Child on TV go over the proper way to cook a roast and at the same time having her in your kitchen to make sure you don’t overdo it on the salt.

“It’s amazing seeing the light bulbs go off in their heads and watching as they become comfortable with the skills they’re doing,” said Druley.

Druley has spent nearly 30 years at the CVM, notably at the Teaching Animal Unit, and has 20 years of private practice experience. “For some, the skills learning happens quickly and 7

Despite Taylor’s vast veterinary experience, she deeply understands the importance of repeated practice. When she took a 10-week maternity leave a few years back, she found herself at home practicing suturing.

ALMOST ALL OF TAYLOR’S MODEL IDEAS COME FROM WHAT SHE’S TEACHING AND WHAT SHE NOTICES STUDENTS NEED MORE PRACTICE WITH. SHE IS COMMITTED TO THE GOAL OF GROWING AND PERFECTING CVM’S SIMLAB’S OFFERINGS.

Feeling nervous about surgery is normal, said Taylor. Those emotions don’t need to consume you and after SimLab they most likely won’t.

Amanda Hanley, a first-year student with a small animal focus, devotes an hour each week to SimLab, between 8 a.m. and 9 a.m. on Fridays before classes begin.

“I think what I enjoy about it is that it’s a low-stakes type of thing,” said Hanley. “Because it’s not a live animal and because you’re not poking for blood, it calms your nerves. You can actually focus on how to do something rather than worrying about being with a real patient and thinking you’re going to hurt them or mess up.”

Second-year student Abby Crownshaw sees similar benefits.

She’s spent hours practicing on one of the spay simulation boxes, plastic boxes covered with “skin,” with a balloon standing in for a uterus and different colors of rubber bands for different arteries and ligaments.

“When I got to my spay I was like, ‘OK, I got this. I know what I’m supposed to be doing. I’ve practiced these techniques.

I know how to move my hands. I know how to control my instruments. I know how everything should feel. I know what I’m doing.”

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During a SimLab selective, students work on a simulated spay with small plastic shoeboxes covered in a fabric designed to feel like skin.

Firm and bold The life-size Ms Faux is a dramatic teaching tool for the SimLab, but mastering the basics is the heart of SimLab. Which is why, during an early morning session in late November, a group of 20 students were staring intently at a small plastic shoebox that is a simulated spay.

There was even some work to get to that point. Students practice placing towels on their surgery space. They go over the different types of towel clamps and review names of instruments before they get their hands on them.

And when they do pick up a scalpel, that’s only the beginning.

Various tips and tricks of the trade are rapidly imparted to students as they begin watching the training video. Then, after pausing the video, Taylor’s warm yet firm voice comes through loud and clear.

“OK, you ready to spay?” she says from the front of the room.

The students make a cut they’re told should be firm and bold.

The step-by-step video, narrated by Taylor, plays at the front of the room as she stops at multiple points to check on all of the students.

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Afterward, the students cut through a fabric designed to feel just like skin. Some students appear confident, others are nervous. Taylor and Druley have seen all these reactions before and know just what to say and do to help. No student is embarrassed; no one is shamed. Everyone is comfortable.

“We have some good 5-centimeter incisions here and we have some … overly enthusiastic 5 centimeters here,” says Taylor.

Many students enter the CVM eager to not only learn about the best surgery techniques — they want to feel like surgeons right away. The SimLab gives them that experience. But, more importantly, it helps them develop into the skilled surgeons they know they can be.

“Let’s take a five-minute break,” says Taylor after the class finishes the initial incisions into their spay boxes. “And then we’ll remove the uterus.” ~ Jordan Bartel/NC State Veterinary Medicine

DISCOVERY SPOTLIGHT

Fighting Antibiotic-Resistant Bacteria in Food Animals Treating large farm animals on and off campus takes up most of Derek Foster’s week. But the assistant professor of ruminant health management at the NC State College of Veterinary Medicine also researches the most effective drug therapies for animals so important to the state’s agriculture economy.

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Foster’s heavily collaborative research centers on antibiotic He has worked with Mark Papich, professor of clinical use in food animals with two big goals: understanding pharmacology, to find ways to measure drug concentrations how to maximize the effectiveness of drugs veterinarians directly at the site of infections. Accurate measurements of commonly use and taking a closer look at the development how much antibiotic is getting into bacteria-infested airways of antimicrobial resistance in is particularly important when bacteria that could also impact treating common infections “With our training in microbiology, humans. that lead to conditions such as pharmacology, disease and animal pneumonia.

“Veterinarians are key to health, we can provide a unique integrating the very disparate “In an attempt to use antibiotics perspective to translate research fields that contribute to this in a more judicious way, can findings into clinically useful research area,” said Foster, we figure out if there are a member of the CVM’s better dosing regimens?” recommendations.” department of population said Foster. “Can we measure health and pathobiology. “With our training in microbiology, drug concentrations where the bacteria actually are to try to pharmacology, disease and animal health, we can provide a predict which drug is going to be the most effective in treating unique perspective to translate research findings into clinically disease?” useful recommendations.”

Foster, who holds a degree in animal science from NC State and earned a doctorate of veterinary medicine from the CVM in 2004, has made such research a priority since joining the faculty of his alma mater.

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FOSTER’S OVERARCHING RESEARCH INTEREST IS BALANCING HOW TO BE SELECTIVE WITH DRUGS TO LESSEN RISKS TO PUBLIC HEALTH WHILE NOT ALTERING VETERINARIANS’ ABILITY TO EFFECTIVELY TREAT ANIMALS.

Foster has also teamed with Papich, Timo Prange, clinical assistant professor of equine surgery, and Megan Jacob, microbiologist and director of the CVM’s diagnostic laboratories, in researching antimicrobial resistance development in bacteria — especially Salmonella and E. coli, which sometimes have devastating effects on human health.

“There may be opportunities in drug formulation that could allow drugs to target certain areas of the body that are prone to infection while decreasing the amount of drug that moves into the intestine and leads to the unintended consequences of resistant bacteria.”

Responsible drug practices and antimicrobial resistance research are CVM priorities. The CVM includes faculty considered experts on such matters who shape the international conversation on approaches on drug use and antimicrobial resistance, said Foster.

A part of the national Food Animal Drug Residue Avoidance Databank (FARAD), a research group working to prevent drug residue in food animals, is housed on campus. In October a multi-day meeting of the World Health Organization’s advisory group on antimicrobial resistance was held on campus.

And in January, Foster was instrumental in bringing a Food Armor Foundation outreach specialist to campus to train students on a new and innovative plan for responsible drug use with farm animals.

The group worked together to find ways to measure drugs in the gastrointestinal tracts of cattle. Prange helped Foster, Papich and Jacob develop a surgical technique that implants a sampling device into the GI tract of cattle in order to continuously measure how much drug is present up to two weeks after dosing.

The research team has grown in the areas of infectious disease and microbiomes research. CVM faculty members Cristina Lanzas, Casey Theriot and Benjamin Callahan, have “dramatically” expanded the team’s broad picture of the function of antimicrobial resistance in large populations of animals. Another addition to the team: Sophia Kathariou, an expert in food borne bacterial pathogens in the food science and microbiology department at NC State’s College of Agriculture and Life Sciences.

Continued research is needed as the rate of antimicrobial resistance development in both human and veterinary medicine has increased to a point where some bacteria have been difficult to treat, said Foster, who noted that proposed solutions to antibiotic resistance mostly feature broad bans on how animals are treated with these drugs. These restrictions have significant downsides in that they may prevent rapid and effective treatment in ill animals and ultimately be counterproductive.

Foster’s overarching research interest is balancing how to be selective with drugs to lessen risks to public health while not altering veterinarians’ ability to effectively treat animals.

“My goal isn’t to say we shouldn’t be using antibiotics,” said Foster. “But I want to be able to say that when we do treat animals with them, we should do it in a prudent way.” ~ Jordan Bartel/NC State Veterinary Medicine

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HEALING EXPERIENCE

Veterinary Medicine's Masked Heroes

E

33,585 Pet Visits

422,508 Diagnostic Lab Procedures Performed

It’s a little after 9 a.m. on a Friday, and the soft tissue and oncologic surgery service rounds room is quiet. It’s not usually like this, but scribblings on the office space’s glass wall reveal why. There’s a list of surgeries, about seven deep, written with green erasable marker. The names of lead surgeons are assigned on top of each. You can just barely make out the word “chimp.” At the end of the day, these will be erased.

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Top

Bell

Soon, there will be a new list, likely just as long. Montana DiVita, a fourth-year veterinary medicine student, is waiting in the office space in the Veterinary Hospital. She doesn’t want to be sitting here. She’s eager to head down the hall, don shoes, hair covers and a mask to complement her scrubs and white coat, and then walk into an operating room or two.

The OR is where DiVita and her fellow soft tissue rotation students most want to be — and are most wanted. In operating room 5, Kyle Mathews, professor of soft tissue and oncologic surgery, is working on Danny Boy, a 5-year-old golden retriever. Mathews is focused on one of the dog’s leg sticking out from under a sheet. He’s fixing an arteriovenous (AV) fistula, an abnormal connection between an artery and a vein.

1,399 Equine Patients

p Patient Names

la

Max

He is joined, as usual, by a resident, an intern and many fourthyear students.

About 20 feet away in operating room 8, the day’s other lead surgeon, Valery Scharf, clinical assistant professor of soft tissue and oncologic surgery, is tackling another case: Moose, a 7-year-old Labrador retriever.

Moose requires a partial mandibulectomy to remove the large tumor in his jaw before it spreads.

Over a few hours, half of Moose’s lower jaw will be removed

by Scharf. She, too, is joined by a resident and an intern. As Scharf works, between the loud whizzes of a surgical drill and a

VALERY SCHARF'S TYPICAL DAY: MULTIPLE SERIOUS SURGERIES, NERVES, TEACHING, BLOOD AND ULTIMATELY THE GRATIFICATION OF SAVING THE LIFE OF SOMEONE’S PET.

bone saw, she talks them through the surgery step by step as they assist.

The fourth-year students walk back and forth between OR 5 and OR 8, often observing quietly and shuffling around the 14

rooms to find the best angles to watch. Some ask questions.

Some find it better to watch silently.

require coordination with the medical oncology and radiation oncology services.

Sometimes the surgeries are so intense and complicated, silence is the only reasonable reaction.

“We get oncologic cases, acute cases and everything in between,” says Mathews. “And then we see emergencies in the middle of the night that aren’t going to make it until the morning unless we step in.”

“This,” says Scharf as she works on Moose, “has the potential to cure this dog.”

It’s all amazing to watch — sometimes tense, often powerful solely for the mastery of a delicate scalpel movement.

For Scharf, who later will suture a pacemaker on the beating heart of a 10-year-old Staffordshire bull terrier, this is a typical day: multiple serious surgeries, nerves, teaching, blood and ultimately the gratification of saving the life of someone’s pet.

It’s the typical day-to-day experience for everyone on the service’s team as well.

On this day, after Mathews finishes with the AV fistula surgery, he’ll perform abdominal exploratory surgery on a visiting chimpanzee. After that, he’ll surgically remove fungus from a dog’s nasal cavity. He successfully performed a similar fungal surgery the day before.

And while the prognosis for Moose, Scharf’s first patient of the day, is good once the tumor is removed — months later, he is still doing well, she says — the other day Mathews had a case where there was little they could do to rid a dog of a particularly large and invasive facial tumor.

Led by four surgeons — Mathews, Scharf, Marije Risselada and Christopher Adin — the soft tissue and oncologic surgery service sees small animal patients with a wide variety of conditions. Many of its cases, about 60 percent or so, according to Mathews, involve cancer surgery.

Scharf said the service sees at least one case a day that involves some form of cancer.

But during the week, the group can also tackle cases involving pain management, respiratory conditions, reconstructive and plastic surgery, head and neck issues and gastrointestinal diseases.

The soft tissue and oncologic surgery service works closely with other Veterinary Hospital specialists including anesthesia and emergency care.

The service often works hand-in-hand with other Veterinary Hospital specialists, including those in critical care and internal medicine. Cancer treatments require detailed and individualized plans, usually involving chemotherapy or radiation or both.

Many cases require 24-hour postoperative monitoring. These 15

For the team, the surgeries are often challenging and stressinducing and rewarding. Even during 2 a.m. emergency calls, the team’s surgeons enjoy the adrenaline rush.

“If we have a day where we have surgery after surgery and they’re intense but they go well, your students are enthusiastic, your residents are learning and your clients are happy — that’s the kind of day that’s so fulfilling,” says Scharf. “And there are so many of those.”

At any given time, the team of about 10 fits into the rounds room, a shared work space near the operating rooms. Along with the surgeons, the soft tissue and oncologic surgery service team usually includes one surgical intern and four-tofive fourth-year CVM students, here for a few weeks as part of a clinical rotation in the hospital. The service has a total of five residents, though just one surgery resident is with the service

AT THE END OF EACH DAY, THE TEAM TRIES TO MEET TO GO OVER THE DAY’S EXPERIENCES. THAT’S PART OF THE LEARNING EXPERIENCE, ESPECIALLY FOR FOURTH-YEAR STUDENTS.

at a time. The service has one clinical technician and is looking for a second.

In between surgeries, the group sits in this room to pour over research and perform consultations for other services and also for referring vets. At the end of each day, the team tries to meet to go over the day’s experiences. That’s part of the learning experience, especially for fourth-year students.

When the team returns from this morning’s surgeries, they are drawn immediately to their chairs and their open laptops spread across a central table.

Breaks like this one don’t last too long. The big surgery of the day is a procedure that would normally be one of the least remarkable — the exploratory abdominal surgery. But when that’s being performed on a chimpanzee, lunch is put on the backburner in order to watch.

The chimp was transported to the CVM by the North Carolina Zoo and Mathews is the lead surgeon on this one as well. This is the kind of day where if you want to see Mathews, you’ll have to see him in an operating room.

The oncological cases are memorable and complicated. But they are the types of cases that are often the most rewarding for Mathews. To be a surgeon is to be given the opportunity to cure and that is a powerful motivator.

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“For me personally it’s challenging and that’s what I like,” says Mathews, who arrived at the Veterinary Hospital in 1997 following four years as a clinical instructor at the University of California-Davis. There’s a lot of different things you get to work on.

You never get bored. You never stop learning at a facility like this where you are surrounded by experts in every veterinary speciality.”

As Scharf puts it, soft tissue and oncologic surgeons often get the chance to be heroes in the eyes of pet owners. At 34, she is the youngest surgeon on the team, joining the Veterinary Hospital in the summer of 2014. In veterinary school at Texas A&M University, she initially pursued an interest in large animals; she liked cows and loved being outdoors. But she also loved anatomy and dissection; surgery was always high on her interest list and she received encouraging feedback from clinical residents and instructors.

By her fourth year in veterinary school, she knew soft tissue and oncologic surgery were for her.

“You have a dog that comes in and is bleeding and on death’s door and you’re able to give the owners the good news — that we fixed it and your pet is going to be OK,” says Scharf.

Additionally, many of the service’s patients recover in the intensive care unit. An understanding of critical care medicine and the ability to coordinate care with the experts on the hospital’s critical care service are essential."

For DiVita and her fellow fourth-years, the surgeries make a strong impact — and the students are frequently active participants to various degrees. It’s vital to watch complicated cases and be a part of them. It’s vital to revel in a successful cases and feel the emotional crush when nothing can be done.

Fourth-year students have a limited role in surgeries, especially the most serious cases, but there’s always something to retract or suture or flush out with water. During their rotation, Scharf aims to guide fourth-years’ understanding of diseases that require surgery, mastering how to find out what they need to know about their patients and thoroughly knowing the available treatment options. The soft tissue surgeons want fourthyears on rotation to walk away from their time with a service

“But it’s also showing that it’s their responsibility in terms of patient care to follow up. It’s one thing to do the procedure in the OR, but if you also can’t take care of your patient outside of the OR you’re not going to be a good surgeon," says Scharf.

Scharf, who considers Mathews a mentor, actively sought positions in academia because she enjoyed teaching. That’s a big part of the surgeons’ jobs as well.

The fundamental lesson for residents and interns is getting a strong grasp on procedure. But they gain much more than technical expertise.

“I really want them to look at the whole patient and that means understanding the diagnostics leading up to the surgery,” says Scharf.

“But it’s also showing that it’s their responsibility in terms of patient care to follow up. That’s a huge part of it. It’s one thing to do the procedure in the OR, but if you also can’t take care of your patient outside of the OR you’re not going to be a good surgeon.

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Kyle Mathews conducts surgery with assists from fourth-years and residents.

knowing the best ways talk to their clients in the real world after they graduate.

And the rotation with the soft tissue and oncological service helps hone patient communication skills as well. During the visit Friday, DiVita received a call from a owner asking for an update on a pet.

“Of course that part is difficult, we have cancer cases,” she says. “It’s tough and always will be. But for me, I think about how I would want my own pet’s condition explained to me.”

After the short break in the rounds room, DiVita makes her way again to an operating room. Scharf is here with Jezzabelle, the 10-year-old Staffordshire bull terrier who needs to have her spleen removed and a pacemaker put in.

At the same time the pacemaker is successfully implanted, Mathews oversees the nasal operation in another room. That involves using a polymer-based substance made specially at the hospital’s pharmacy that gels after injection into dog’s nasal cavity.

Once again, the chairs in the service’s office space are empty.

The laptops are open but silent. The operating rooms are full.

And it’s not yet 2 p.m. ~ Jordan Bartel/NC State Veterinary Medicine

VETERINARY HOSPITAL

Adding it Up 3,475

Surgical Procedures Performed

180,415

Pharmacy Prescriptions Written

4,641

Cancer Patients

3,101

Patients for Ophthalmic Services

2,030

Cardiac/Heart Disease Patients

7,746

Emergency and Internal Medicine Patients Source: NC State Veterinary Hospital Clinical Services Statistcal Report 2016. Numbers include both large and small animal visits.

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Everyday Heroes In ways both big and small, throughout the year the work of CVM faculty, staff and students make an extraordinary impact on veterinary medicine.

280 Research Publications Distributed

100 Students Enrolled in the Class of 2020 19

10,000 Visitors at the CVM open house

8,626 Attended Continuing Education events

35 Medals Awarded at the Dog Olympics 20

SUPPORTING CARE

Paying It Forward for Fritz and Softy The Greenwalds of Efland, N.C., know their horses. In fact, Olive Greenwald -- wife of Lew -- and their daughter Emily enjoyed riding their horses, Fritz and Softy, competitively for a number of years. Fritz was Olive’s dressage and trail horse, and Softy was Emily’s equitation horse.

Things went well, but competitive athletes occasionally must deal with injuries and wear and tear, and that’s also true of equine athletes. And so it came to pass that in 1998, Fritz needed surgery on his hock (a leg joint, for those of you unfamiliar with horse anatomy). The Greenwalds brought him to the NC State Veterinary Hospital, where he underwent successful treatment, allowing Olive and Fritz to compete together for another five years.

In time, both Fritz and Softy passed away, though, and the Greenwalds wanted to do something appropriate to memorialize their long-time competitive partners.

Remembering their experience with NC State, they decided to endow the Fritz and Softy Equine Scholarship at the College of Veterinary Medicine (CVM) in 2008. While the annual scholarship award can be given to any CVM student, the intention was primarily to fund students specializing in some aspect of equine medicine.

That’s where Zoie Randall, CVM class of 2019, comes in.

Zoie grew up in Mooresville, N.C., where she started riding horses, “since I was 7 years old.” Not only did she ride from an early age, she spent lots of time with horses in need of rehabilitation, working in externships and a variety of similar roles as she got older. In addition, her mother, a small animal veterinarian herself, is a 1987 graduate of the CVM. It was only natural that Zoie would develop an interest in caring for competitive horses. She got her undergraduate degree from NC State in animal science with an eye on one day becoming 21

a vet herself specializing in equine sports medicine, treating patients just like Fritz and Softy. Given that history, it seems almost preordained that Zoie Randall would one day be the recipient of the Fritz and Softy Equine Scholarship.

That didn’t make it any less exciting or welcome, though.

When asked how she reacted when she learned about the scholarship being awarded to her, Zoie says, “I was so thankful! ... every dollar helps! It is so nice to see that the university and alumni realize the debt students have to endure to start their dream career and are willing to help!”

Donor Giving by Source 2012-2016 Individual contributions from private citizens are the number one source of donations to the CVM in support of its work, followed by charitable foundations.

Here is a comprehensive breakdown of donation sources for the last five fiscal years:

56%

Private Individuals

34%

Foundations

5%

Alumni

3%

Corporations

1.5%

Other Organizations

0.5%

Faculty/Staff/NC State Parents

Even though NC State CVM students enjoy a low-cost tuition in comparison with other top vet schools, and also graduate with lower debt levels, not having to worry quite so much about living expenses and paying off student loans allows students like Zoie to focus more on their studies and less on current and future financial pressures.

Furthermore, as Zoie points out, studying at NC State allows her to take advantage of world class faculty and resources. For example, she has already had the chance to gain experience learning how to help equine injuries heal faster through stem cell therapy.

“There are so many opportunities here,” she says, “and the faculty are always so supportive and helpful.”

When asked what thoughts she’d like to express to her benefactors, the Greenwalds, she says, “THANK YOU THANK YOU THANK YOU!! I really appreciate your generosity and I hope to pass along the favor to another student one day.”

The Greenwalds can rest assured that Fritz and Softy’s legacy is paying new dividends every day for the future of equine medicine. ~Steve Volstad/NC State Veterinary Medicine 22

NC State Veterinary Medicine NC Veterinary Medical Foundation 1060 William Moore Drive • Raleigh, NC 27607 Give Now: Use the giving envelope enclosed, (checks payable to “NCVMF”), or give online at cvm.ncsu.edu/giving.

Contact Us: Giving Office: 919-513-6660 cvmfoundation@ncsu.edu The Oath is published by the NC State Veterinary Medicine Communications and Marketing office.

Contact us at CVMCommunications@ncsu.edu This magazine was printed for a total cost of $4,500, or $1.33 per copy. No state funds were used.

Rising Hero Class of 2020 member Ty Smith has long had a passion for animal care, but the CVM's Allen Cannedy helped motivate him to continue his education at NC State.

"Seeing him as a veterinarian I felt like I could become a veterinarian, because I guess the field isn't predominately people who look like me."

Read more about Ty at cvm.ncsu.edu/tysmith

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