Keystone Veterinarian Summer 2023

treats a wide variety of orthopedic, soft tissue, oncologic and neurologic conditions From common injuries to more complicated procedures, VRC incorporates the most advanced equipment and techniques to deliver successful patient outcomes.

Since we opened our doors in 2019, we have experienced consistent growth due to your confidence in us for the care of your patients. For that, we profoundly thank you

Our clients come from all walks of life and many from miles away. But what they all have in common is a beloved pet with oral cancer or significant dental and anesthetic needs. We are honored to help, and our consistent 5-star online reviews show our commitment to concierge-level care and service.

We’d like to introduce you to the VDS Chadds Ford clinical team, including our newest members: Dr. Kelly Saverino, Dr. Becca Feuer, and Dr. Melanie Jarrett.

We welcome your call should you wish to consult about a challenging case, or, if you make a referral for care, please know we promise your clients and patients an exceptional experience.

VDS is the only referral practice in the nation dedicated to advanced dentistry and oral surgery for pets where a full-time board-certified veterinary dentist and a board-certified veterinary anesthesiologist are on staff to ensure the safest and most comfortable experience… and the best possible outcome.

John Lewis, VMD DAVDC, FF-OMFS

Becca Feuer, VMD Dentistry Resident

Marissa Berman, DVM (Residency Trained in Dentistry)

Kelly Saverino, DVM DAVDC

Melanie Jarrett, DVM DACVAA

Subscriptions:

The Keystone Veterinarian is mailed to PVMA Members at no charge as a member benefit. Subscriptions are available to non-members for $30/year or $10 for a single issue. Please contact Editor@PaVMA.org if you’re interested in receiving the Keystone Veterinarian magazine.

Notice to Readers:

Neither this publication, Hoffmann Publishing, nor PVMA assumes responsibility for material contained in articles and advertisements published, nor does publication necessarily constitute endorsement or approval of the advertiser, product, service or author viewpoint by the Keystone Veterinarian, its editors and publishers or the Pennsylvania Veterinary Medical Association. In addition, neither this publication nor PVMA guarantees the accuracy, reliability or completeness of any facts, views, opinions, recommendations, information or statements contained within this publication.

Reproduction in whole or in part is prohibited without the permission of the Pennsylvania Veterinary Medical Association.

The Pennsylvania Veterinary Medical Association is dedicated to ensuring the vitality of the veterinary profession by promoting excellence in veterinary medicine, advancing animal health and welfare, and protecting and enhancing human health.

8574 Paxton Street, Hummelstown, PA 17036

717.220.1437 | Info@PaVMA.org | PaVMA.org

EXECUTIVE

President: Dawn Fiedorczyk, VMD

President-Elect: Thomas Munkittrick, MS, DVM

Vice President: Rhett Proctor, VMD

Secretary/Treasurer: William Croushore, DVM

Board Chair: Marisa Brunetti, VMD

BOARD OF TRUSTEES

Western Region Trustee: Andrea Honigmann, DVM

North Central Region Co-Trustees: Jody Kull, DVM, & Andrea Carr, DVM

South Central Region Trustee: Gary Brummel, DVM

Metro Philadelphia Region Trustee: Marisa Brunetti, VMD

Equine Veterinarian At-Large: James Holt, VMD

Production Animal Veterinarian At-Large: Robert Cloninger, VMD

Academic Veterinarian At-Large: Alessandro Lamacchia, VMD

Certified Veterinary Technician At-Large: Ashley Elliott, CVT

AVMA Delegate: Tina Dougherty, VMD

AVMA Alternate Delegate: Kate Boatright, VMD

Student At-Large: Roxy Ackerman

Lettich-Snyder, CVT

Message from the President

Dear PVMA Members,

The function of a community is not to fix your weaknesses but to amplify everyone’s strengths.

— Simon Sinek

The veterinary community continues to evolve and flex to meet every changing demand of our world. With a pet population that continues to grow, veterinarians, credentialed veterinary technicians, and other team members are in short supply. Socioeconomic forces, focus on work-life balance, geographic location, and other influences have unfortunately moved many veterinarians from large animal and food animal sectors. This has left producers, small farms, and equine owners to struggling to find veterinary care. Statistics and projections by experts paint a dismal picture that these issues will be remedied quickly.

Great attention is being given to how we can matriculate more veterinarians and how we can recruit more credentialed veterinary technicians and other support staff. While these endeavors are key for volume, it is also vital that we take every effort to retain these individuals within the field of veterinary medicine. It is particularly vital to retain practitioners and trained team members in areas of greatest need. In some cases, veterinarians, credentialed veterinary technicians (CVTs, RVTs, LVTs) and other members of the team are transitioning to other jobs or sectors of veterinary medicine from which they were initially trained.

PVMA is addressing one of the veterinary community’s concerns by investigating and nurturing the need for credentialed veterinary technicians (CVTs). The entire veterinary team, through all sectors of our profession, varies in size, duties and responsibilities. While veterinarians dictate the medicine and care of the animals, CVTs, veterinary assistants, and other support staff members are often the glue that holds much of our community together. They make sure the processes happen. With the ever-increasing deficits of veterinarians, credentialed veterinary technicians are needed more than ever to support our community.

Empowering our CVTs and support staff to utilize their skills, grow, and continue to learn is vital for them to prosper. Supporting them so that they can enjoy their work and feel fulfilled in what they do will have a positive outcome on the overall team and the ability for veterinarians to continue to care for our evergrowing patient and client numbers. While some states are exploring advanced degrees and revisiting the verbiage of their practice acts for their certified and non-certified veterinary technicians, PVMA has also been involved in looking into these things as well as focus groups on exploring the possibilities of a mid-level practitioner role for credentialed veterinary technicians.

The saying “work smarter, not harder” is a term that I share quite frequently. This comes to mind with this topic because many veterinarians cannot possibly work more hours. We will not be able to meet the needs of our pets, herds, pharmaceutical needs, food supplies, public health, etc., without thinking outside the box and exploring different options to meet the needs we are faced with.

Dawn Fiedorczyk, VMD President, Pennsylvania Veterinary Medical Association

Message from the President

continued from page 5

Work-life balance also remains an ongoing challenge and factor that burdens our profession. The past couple of years have changed the way many individuals view the family unit, the concept of work-life balance, and even an individual’s value system. We are naïve to believe that everyone seeks the same benefits and goals in life. While we can unite in our love of animals and science, we often differ in what fills our hearts and fuels us to wake up each day. Attention to quality of life and values will continue to shape our professional and business choices for years to come. While life continues to try to return to some type of normalcy, many of us find that it still remains different.

Continued evaluation of both our personal and professional value systems is needed for development and growth. While mental health is slowly becoming less stigmatized, it still remains a topic of contention. Embracing the importance of mental health alongside that of physical health, however, provides more balance individually and within the community.

The veterinary profession is represented by a diverse population of individuals who have embarked on a profession that offers an equally endless number of opportunities. Appreciating, accepting, and including these diversities is important as we continue to navigate our changing community. As June ends Pride month and having recently celebrated Juneteenth, we are reminded that many of our colleagues need our continued support and alliance as they struggle to ensure their basic human rights.

While my presidency will soon come to an end, I reflect upon all of the things that I wanted to see accomplished and all of the things that we have done. One year is not enough to change the world, but I am thankful for where we are now. Although cliché, the PVMA cannot continue without your support and your voice. Whether you would like to volunteer for one of our committees, consider a position on the board of trustees, donate to our philanthropic organization, Animal Cares PA, or make your voice heard through our membership survey — please take part any way that you can. The PVMA is dedicated to being an advocate for our profession. We cannot continue this endeavor without your help, your voice, your support.

HereÊareÊourÊcurrentÊlistingsÊinÊPennsylvania

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PracticeÊOwnershipÊOffers...Ê

· Opportunity to create and live the lifestyle you desire

· Have the capability to control your schedule

· Finances flowing to pay off student debt more quickly

· Control of your medicine & how your prac�ce is operated

· Unlimited income potential versus a limited salary

David McCormick, MS, CVA 888.881.7084 • midatlantic@simmonsinc.com• www.simmonsinc.com

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www.simmonsinc.comÊÊ

The Confidentiality Agreement link is on the bottom of the home page. You can also register for the SimmonsÊPracticeÊWatch when we have a new listing, a notice is sent to the Practice Watch list first.

Search and Rescue: Augmenting My Passion and My Profession

By Jennifer Lettich-Synder, CVT, co-authored by Tracy Siek

It’s a cold dark December night, and you are all snug and warm in your bed about to doze off into a deep restful sleep.

“Whaaaa Whaaaa.” Your Active 911 alert jostles you out of your peaceful slumber. Knowing you must be at work in the morning you get up, get dressed and pull on your boots. Your dog’s tail wags and wags as you grab your Search and Rescue (SAR) pack and head out the door. You drive into the night and finally arrive on scene. You sign in, your task area is assigned and out you go into the wilderness. It’s dark, cold, and wet as you trudge through the briars, traversing over logs and through the swamp. Your K-9 partner zigs and zags as he covers the assigned search area, bounding over falling trees and splashing through creeks.

You see your dog’s head whip to the right as he takes off sprinting through the woods. He comes bounding back and jumps on you, his way of telling you he found someone.

All the years of blood, sweat, and tears come down to this moment. The lost time with family, the missed engagements, the holidays that are cut short; all the sacrifices that come with being a First Responder. THIS is where your training pays off.

You take off running through the woods hoping for the best but being prepared for the worst. You hear the lost subject’s muffled, hallowed cry for help. The missing individual is half undressed, suffering from hypothermia, barley coherent. As you quickly call in your location to Incident Command, your flankers start administering first aid. The rest of the recovery team arrives, you pack the subject into a Stoke’s Basket and start the trek out of the woods. The ambulance arrives and your missing subject is whisked away to the hospital.

You head back to incident command, sign out and head home, tired but with a full heart knowing that someone’s brother, son, or father will live to see another day.

Each call-out has a different scenario, the missing person varies, and the way the dogs work and react can change, but in the end we all wish for the same outcome, bringing home the missing.

As a veterinary technician we take an oath: “I solemnly dedicate myself to aiding animals and society by providing excellent care and services for animals, by alleviating animal suffering, and by promoting public

health. I accept my obligations to practice my profession conscientiously and with sensitivity, adhering to the profession’s Code of Ethics, and furthering my knowledge and competence through a commitment to lifelong learning.”

I take my role as a veterinary professional in the field of SAR very seriously. As a veterinary professional, my role in SAR is twofold: not only do I give back to my community by participating in the search and rescue aspect to bring loved ones home, but I use my skills to build up my team by teaching them the value of being prepared and having the knowledge to act accordingly in emergency situations. It’s not just jumping to help with a broken nail at training or bandaging up a torn paw. It’s giving members of the SAR community the knowledge and confidence to come to the aid of their K-9 friend and partner through teaching and education.

As a veterinary technician, I make it my solemn duty to educate my teammates and the SAR community so they are better prepared for any emergency that may arise where veterinary care is not readily available. I coordinate and teach canine CPR and first aid classes. I cover such topics as bloat, canine nutrition, emergency wound treatment, and dehydration. I also possess the skills necessary to read a dog’s behavior and body language in order to pick up on medical issues, which can cause career-ending injuries if undiagnosed.

Understanding canine behavior is very important when observing the dog work. A head turn, a change in direction or something more subtle such as the flick of an ear or a lip lick can tell a story as to where scent has travelled, giving us a depiction of where the missing has gone.

Veterinary medicine has constant change and interaction, therefore, continuing education and helping others in the field become successful is a common goal of many. This same idea is shared in search and rescue. The more successful, well-trained veterinary team members that are out there, the better the profession. The more well-trained SAR personnel there are, the better response time and success of bringing the missing person home.

Both roles involve integrity, selflessness, motivation, and dedication.

I find a huge fulfillment when helping others. Being a veterinary technician as well as being an active member in my community with Search and Rescue, specifically working with canines, is a perfect place for me.

About the Author: Jennifer Lettich-Snyder, CVT, CCRP, K-9 Captain of Pennsylvania Canine Search and Rescue, and K-9 Handler for other SAR organizations, has been involved in veterinary medicine for 20 years and has been a First Responder for 25 years, SAR for 7 years. K-9 Charlotte is a Redbone Mix and is Certified in Trailing and Land Human Remains Detection, working towards Water Certification. K-9 Penelope is a Bloodhound in Certified Trailing. K-9 Dingo is a Pug Mix working on Land and Water Human Remains Detection. Professionally, Lettich-Snyder is a CVT at Anthracite Animal Clinic and Sunbury Animal Hospital.

Co-Author: Tracy Siek has been involved in SAR as a K-9 Handler for 7 years. K-9 Bentley is a 10-year-young rescue who is certified for Live Find through NASAR (National Association for Search and Rescue) as well as Human Remain Detection through AWDA (American Working Dog Association), NASAR and PSARC (Pennsylvania Search and Rescue Council). K-9 Zophie is a two-year-old Border Collie mix who is certified for Live Find through NASAR. Zophie is currently working towards her Human Remain Detection certification.

Some Knock-Knock Jokes Just Aren’t Funny

What to Do When the DEA Comes Knocking

Key Takeaway: It’s essential for practices to be proactive with their controlled substance security. Completing a gap analysis and tightening up recordkeeping are strong first steps for improving security of controlled drugs.

Ominous Voice: “Knock-knock”

You: “Who’s there?”

If the DEA comes knocking, are you ready? Can you confidently answer their questions and explain your controlled substance security, and recordkeeping, and how it complies with federal and state regulations? If not, then that needs to be a priority because the DEA doesn’t plan their visits at your convenience, and DEA fines are more than $15,000 per violation.

Ominous Voice: “The DEA”

You: “$#!+*%^?#!!!!”

There is no question that controlled substance regulations are difficult to understand exactly what is sufficient and what isn’t. Controlled Substance Acts are written with minimum expectations, but there is also the expectation that controlled drugs are maintained in a manner that provides sufficient security and tracking. What counts as sufficient you ask? Well, that is the million-dollar question, and the answer depends somewhat on all the nuances of each individual practice. There is no one right answer that will fit all practices. Therefore, it’s important to evaluate your current processes and identify potential gaps. The following tips will get you started in the right direction.

The Gap Analysis

No, this isn’t analyzing the gap in your door that the DEA is knocking on. This is analyzing the gap between your current controlled substance practices and a completely secure system. To do this, go through all aspects of the controlled substance lifecycle from ordering through administration or wasting and try to come up with ways that someone could divert drug and be unlikely to get caught. Be honest with yourself on how

reliably the double checks in your current policy are actually occurring. What happens when your practice management system goes down? Could someone that knows the workarounds divert some drug without raising any suspicion? Document all the diversion opportunities you find, then start brainstorming what can be done to close the identified gaps.

Recordkeeping

According to Title 21 CFR, Part 1301.91 “A healthcare organization and its employees are mandated to report any incident of drug diversion within the organization.” To be able to report, you must be able to identify the drug diversion. That’s where a strong recordkeeping system comes into play. Cleaning up your recordkeeping will likely help close some of the gaps you identified as well. Recordkeeping can be through electronic logging and documentation, automated dispensing cabinets, paper and pen, or a combination of multiple methods. The method used is only as good as the consistency with which it is done per practice policy. If everyone is finding a loophole and documenting as they see fit, no system will be sufficient. Therefore, the best system is the one that is most likely to be used consistently by everyone in your practice.

With recordkeeping, you need to consider the variety of records required. While you do need to log doses, there are also many other records that are either required or potentially beneficial to address gaps. These include, but aren’t limited to, waste logs, inventory records, discrepancy resolution, med pickups by clients, and documentation of drug receipt. Given the variety of records and variation within each type, such as logging doses in hospital versus on ambulatory calls, it’s important to have a policy or SOP in place that clearly documents the expectations for all things controlled substance related.

When Your Logs Don’t Match Reality

If you are regularly verifying actual quantity on hand compared to expected quantity in your logs, you will have discrepancies. That doesn’t necessarily mean anything was done wrong. However, there needs to be a plan in place for how discrepancies are handled. Solid dosage forms such as tablets, capsules and patches shouldn’t be off because they are being dispensed by a defined unit. However, multi-dose liquids are frequently off (over or under) from the expected quantity. Reasons for this include manufacturer overage, hub loss, leaky vials, and incorrect volume removed. Here are my top tips for handling each of these.

August 17 – 20, 2023 Hershey Lodge | Hershey, PA

1. Overfill: Use all the drug in the vial even if your log goes negative. Either create a log entry to adjust your quantity up or go to negative values. Using the drug is often easier than trying to appropriately destroy (and document destruction) of the overfill.

• Continuing Education Tracks for:

• Companion Animal

• Equine

• Large/Production Animal

• CVT/VTS

• Practice Management

• 20+ Hours of PA-Approved Continuing Education (CE) Credits

• Peer Networking and Activities

• Access to the Whova App, Offering Exhibitor and Attendee Interaction

2. Hub loss: Determine a hub loss amount per stick for your practice. It will vary slightly based on if you are using hubless syringes and needle size. However, I have found that either 0.04 or 0.05 ml per stick is a good average based on the norm of using a variety of syringe types and sizes. When your on-hand amount is less than expected, count the number of sticks and multiply by the hub loss factor. That will determine if hub loss can reasonably account for the missing volume.

• Discounted Hersheypark tickets

3. Leaky vials: These are challenging to address for drugs where the vial is stuck many times during its in-use life. There are needleless vial adaptors available that can decrease the number of sticks. It also may be beneficial to retrain staff on using the smallest reasonable needle size for drawing up the dose and inserting the needle at a 45-degree angle.

4. Incorrect volume removed: Consider retraining staff to ensure everyone is aware of appropriate technique for reading syringes (hold at eye level, don’t angle, etc.) and ensure that the syringes being used facilitate reading to the desired volume. For example, if the dose is logged as 0.78ml but a 5ml syringe is used, the volume is unlikely to be completely accurate due to syringe marking limitations.

There is a lot to consider with controlled substance security and regulatory compliance. However, it’s important to take a proactive approach to establishing your program and preparing for the day the DEA comes a knockin’.

About the Author: Dr. Lauren Forsythe is a Clinical Assistant Professor of Pharmacy at the University of Illinois Veterinary Teaching Hospital. She is also a diplomat of the International College of Veterinary Pharmacists. Dr. Forsythe graduated from the University of Findlay, College of Pharmacy in 2015 and completed her veterinary pharmacy residency at Purdue’s Veterinary Teaching Hospital. Contact: lforsythe7040@gmail.com

Need more controlled substance help? Dr. Forsythe will be presenting 3 hours on DEA compliance at the Keystone Veterinary Conference in August.

By Jon Detweiler

Watching a professional sports team clinch a national title is awe-inspiring. We cheer and celebrate the collective success of teamwork at the very pinnacle of perfection. Yet on Monday morning, we return to our veterinary practices and struggle to keep the wheels on the bus. We work to keep the staff from fighting, the clients from melting down, and the leadership united. Veterinary leadership teams can be coached and trained, no different than a professional sports team, to be a cohesive, high-functioning team that serves to raise the capacity of the entire hospital staff and drives successful outcomes. Overcoming our dysfunctions and building a strong foundation can set any veterinary team on the road to a championship title.

In his New York Times Best Selling Book, The Five Dysfunctions of a Team, Patrick Lencioni describes a hierarchy of broken behaviors that can cripple a team (figure 1). Lencioni’s methodology begins with absence of trust, which typically stems from an unwillingness to be vulnerable and results in team members who won’t ask for help. Absence of trust creates space for the next dysfunction, fear of conflict. Here, team members cannot engage in the debate of ideas, leading to disingenuous acceptance rather than productive growth. The third dysfunction is lack of commitment, wherein team members fail to engage and ultimately do not commit to the team’s strategic goals. Avoidance of accountability is next and leads to team members not calling out counterproductive behaviors, which further erodes the team. Finally, Lencioni describes how an inattention to results leads to individuals placing their own objectives above that of the collective team. Many teams, if not all, experience some of these dysfunctions at one point or another.

Inattention to Results

If we revisit the champion sports team comparison, we will see parallels in these dysfunctions that would unquestionably lead to failure. Consider a quarterback who doesn’t trust his receiver to run the correct play or a catcher who won’t talk to his pitcher about a run of bad throws or a point guard who doesn’t commit to daily practice and maybe even a striker who is more concerned with his personal scoring record than that of the team. Examples in that context make it obvious that these behaviors are not part of a winning team’s strategy.

Avoidance of Accountability

Lack of Commitment

Fear of Conflict

Using Lencioni’s approach, we can use the inverse of these dysfunctions to strengthen and reorient our team for success. Demonstrate trust in the team, encourage productive discourse around ideas and thoughts, show commitment through action, display radically transparent accountability through the ownership of mistakes and finally, always stay focused on the strategic goals of the practice. Over 85% of teams surveyed revealed that lack of trust is the number one perceived dysfunction, therefore we can conclude that building trust is the most likely starting point.

Absence of Trust

Developing trust requires selfreflection, when we consider our own vulnerability, we see the team differently. Vulnerabilitybased trust normalizes phrases such as “I’m sorry,” “I messed up,” “I need help,” or “You’re better at this than me.” Building trust is an active process that is demonstrated through action. Ralph Waldo Emerson said, “What you do speaks so loudly I cannot hear what you are saying.” Let your actions send clear and consistent messages. Commit yourself to daily practices that build trust, always give others the benefit of the doubt, enthusiastically seek the counsel of others as you work to improve yourself, and participate in your peers’ journeys while

Patrick Lencioni’s “The Five Dysfunctions of a Team”

celebrating their achievements. Recognize that success is dependent on everyone. Remove I/me/my from your vernacular and replace those words with we/together/ us. Persevere because trust takes time to build. It demands repeated, real-life experiences to forge and requires a consistent example of credibility and integrity.

Albert Einstein said, “In the middle of every difficulty lies opportunity.” Recognizing our potential dysfunctions provides a roadmap for development. Our veterinary leadership teams, as well as our technical teams, customer service teams, and professional teams, are all best served when they train and practice team building daily. Leadership should set an unmistakable example for those that they lead while using every chance possible to demonstrate trust, encourage open discussions, solidify commitment, improve accountability, and focus on the mission. Developing these cohesive behaviors is crucial to building a strong team and a positive practice culture. When teams win, it is not an accident. Teams win because of hard work and dedication. Make a commitment to your team today and help them win that championship title.

About the Author: Jon Detweiler is a seasoned veterinary hospital administrator and leadership consultant in southeastern Pennsylvania. He is a dynamic speaker who presents at national events and has authored a variety of management-oriented articles for veterinary journals and publications. Detwiler has focused on process building/ efficiency, leadership development, and employee performance across several industries including veterinary, public safety, emergency preparedness, and mass event management. His undergraduate degree is in Emergency Management from Hahnemann University, and he has completed executive certificate work through Cornell University with a focus on Change Management. He is a proud “Terv” dad and he enjoys cooking, hunting and traveling with his wife. He can be reached at jdetweiler@vbb.vet.

“Not finance. Not strategy. Not technology. It is teamwork that remains theultimate competitive advantage, both because it is so powerful and so rare.”

— Patrick Lencioni

Jon Detweiler will be presenting at the Keystone Veterinary Conference in August.

As of the time of the writing of this update, there are several legislative updates that are of concern to the veterinary profession in Pennsylvania.

Issue 1: Scope of Practice in Large Animal Medicine

The ad hoc committee on the scope of practice of veterinary technicians has been discussing the feasibility of allowing credentialed veterinary technicians (CVT, LVT, RVT) to perform pregnancy determination in cattle either manually or by ultrasound under the indirect supervision of a veterinarian. There have been inquiries from the legislature in Harrisburg about this as a means to alleviate the shortage of rural veterinarians, including discussion about both state board regulation and opening the practice act. The committee is not in favor of either of these options for obvious reasons.

On the other hand, we have received informal communication from the professional licensure committee of the PA House that regulatory or practice act changes are likely unnecessary since the language of the current practice act seems to already allow this, under the indirect supervision of a veterinarian. In addition, credentialed veterinary technicians already can legally perform diagnostic imaging under the practice act. This discussion is ongoing as we try to determine the appropriate path to take.

Issue 2: Pending State Legislation

Victoria’s Law is reappearing in the legislature. This bill seeks to enact a statewide ban on the sale of dogs and cats in pet shops. The PVMA has been on record in the past and continues to be against this legislation. We believe the bill may get out of committee in the House

Legislative Update

By Bill Croushore, DVM, PVMA Secretary/Treasurer

this time; however, it is unlikely to gain traction in the Senate, for now. It is likely that this bill will continue to show up every session. PVMA’s position on Victoria’s Law can be found on our website, PAVMA.org under advocacy.

There has also been a bill introduced that would raise the dog license fees that fund enforcement of the Dog Law. PVMA is in support of this fee raise since it has been several decades since the fees were raised.

One more bill of concern to veterinarians is the “Protecting our Pets” bill introduced by Rep. Schlossberg. This bill seeks to regulate the pet insurance industry. Currently, there is no regulation of the pet insurance industry in Pennsylvania; this would be a first step in building a regulatory framework. PVMA has not taken a position on this legislation yet.

Issue 3: Xylazine as a Controlled Substance

Finally, there has been a flurry of activity surrounding the Shapiro administration’s executive rule to schedule xylazine as a Class III controlled substance. The administration wants this to be able to prosecute illegal possession of xylazine since it is being used to cut illegal fentanyl. It is believed that xylazine is contributing to overdose deaths when used in conjunction with opioids. In addition, the county district attorneys are wanting authority to prosecute illegal possession of xylazine, which they do not have if it isn’t a controlled substance.

The problem for veterinarians is, if xylazine is scheduled as a Class III controlled substance, it is very likely manufacturers and distributors will quit selling to practices in Pennsylvania because of the regulatory burden. Nationally, xylazine is a $4 million drug in revenue in a $7 billion

animal health market. It is also a low margin drug for the manufacturers, and it wouldn’t take much to lose it.

With great help from our lobbyist, Patty Mackavage of Duane Morris Government Strategies, we have been working overtime to preserve the availability of xylazine in Pennsylvania. We assembled a team of veterinarians from Penn Vet, AABP, AAEP, and the AVMA to help PVMA lobby for exemptions for the veterinary community and our clients, and we were successful. As of Saturday, June 3, the final rule was published that exempts legal prescription xylazine from being scheduled as a controlled substance, while still allowing illicit bulk xylazine to be scheduled.

Since this is a temporary emergency rule, we still have some work to do. We would like to see legislation in the Commonwealth to make this permanent, and there is a bill likely to be introduced. This is similar to efforts in both Tennessee and Louisiana at least, and the bill is modeled after the federal bill, “Combatting Illicit Xylazine Act” (CIXA). The precedent for this is a law passed nearly 30 years ago that controlled anabolic steroids while exempting veterinary formulations. There is momentum in both the US House and Senate to make this law. CIXA needs to happen to prevent xylazine from being scheduled at the federal level, which if that happens, xylazine will certainly cease to be available because of the regulatory burden. The PVMA continues to support the AVMA in their efforts to get CIXA passed at the federal level.

If there are any questions about legislative or regulatory matters, or if you are interested in assisting the PVMA in our efforts, please reach out to Dr. Jim Holt or myself.

Because Disasters Don’t Just Happen to People

By Sarah Speed Gabel, Esq.

Have you ever considered what would happen to a veterinary clinic if there were a major natural disaster? Perhaps you’ve faced one, or at least an instance when you and your staff were unable to get to work because of a power outage or flooding.

There is nothing more terrifying than being responsible for lives and facing an emergency. We know that the human-animal bond is strong and only becomes stronger when endangered.

Pennsylvania’s number one industry is agriculture. We are home to a nationally recognized cradle of horse breeding, and an estimated 70% of our households contain pets. We have seen what happens when disaster strikes and there isn’t a plan for the animals — it makes national news.

Fortunately, Pennsylvania is prepared, and you can be too. The Pennsylvania Animal Response Team is embedded in the Pennsylvania Emergency Management Agency and charged with overseeing 50 active all-volunteer county animal response teams (CARTs) that provide statewide coverage to respond to emergencies involving animals.

In our day-to-day work, we respond to house fires, floods, and vehicle accidents, providing temporary shelter and transportation with our partners in emergency response and the animal sheltering community. We also assist with planning at the county and local level, helping officials and business owners create and practice their emergency plans and provide training to responders and residents alike in preparing for an emergency.

Many of our teams have veterinarians as members, and we rely heavily on their expertise in safely removing animals from drains or as we use our specialized equipment to lift a large animal. Our teams are available with equipment and trained volunteers to support veterinarians in tricky situations where an animal is stuck or they just need support or access to special equipment

to get an animal up and moving.

At our core, our mission is large scale disasters and we have answered that call many times over the years, including running the mega animal shelter at West Chester University in response to the ice storms of 2014, opening six emergency shelters in response to Hurricane Irene, assisting the Bureau of Dog Law Enforcement in the removal of more than 250 chihuahuas off a property, and most recently, assisting Philadelphia Animal Care and Control and the Brandywine SPCA in setting up a temporary shelter to quarantine dogs during a canine influenza outbreak.

While we work and train to respond to every conceivable emergency, there are always those that no one could predict. The recent derailment of a train just over the border recently tested our readiness. I am proud to report that our skills and preparedness served us well as our Washington County CART team swiftly responded to move the residents of an animal sanctuary threatened by pollution to a safer location within hours.

The Pennsylvania Animal Response Team is ready to set up temporary animal shelters of any size and scale anywhere within the Commonwealth when disaster strikes. Recently, we created our own 16-hour emergency response for animals course and we have added a basic large animal handling course to our offerings as well. Our classes are designed to provide a crash course on emergency response within PA to anyone interested in volunteering or just learning more about how to be prepared.

There are a wealth of resources on our website (www. PaAnimalResponse.org) on emergency planning for your home, business, and community. We would love to grow our ranks of veterinary partners, so please get in touch.

About the Author: Sarah Speed Gabel has served as the Executive Director for the Pennsylvania Animal Response Team for the last five years after serving nearly 10 years on the Board of Directors.

Ticks of Pennsylvania

Ticks of Pennsylvania

Ticks and tickborne diseases are widespread in Pennsylvania and throughout much of the United States. These diseases cause a variety of ailments in multiple veterinary species, including dogs, horses, and cattle. Spring and summer is tick season, so it is a good time to brush up on tick identification and review what tickborne diseases are present in your area.

Ticks and tickborne diseases are widespread in Pennsylvania and throughout much of the United States. These diseases cause a variety of ailments in multiple veterinary species, including dogs, horses, and cattle. Spring and summer is tick season, so it is a good time to brush up on tick identification and review what tickborne diseases are present in your area.

Different life stages and sexes of ticks may look different!

Nymph

Male

Female

The blacklegged tick, also called the deer tick, is the most common species of tick in Pennsylvania. 1 Often found in forested areas, this is the only species in the Eastern United States that can transmit the bacteria which causes Lyme disease.

The blacklegged tick, also called the deer tick, is the most common species of tick in Pennsylvania. 1 Often found in forested areas, this is the only species in the Eastern United States that can transmit the bacteria which causes Lyme disease.

Blacklegged ticks can carry the pathogens that cause Lyme disease

anaplasmosis in dogs and horses (and people too).

The American dog tick is a common species of tick throughout the entire Eastern United States. It is especially prevalent in pastures and prairies with tall grasses.

The American dog tick is a common species of tick throughout the entire Eastern United States. It is especially prevalent in pastures and prairies with tall grasses.

–American dog ticks can carry the pathogens that cause rocky mountain spotted fever in dogs (and people), as well as bovine anaplasmosis in cattle.

Both males and females have white, weblike markings on their back.

Both males and females have white, weblike markings on their back.

Blacklegged ticks can carry the pathogens that cause Lyme disease and anaplasmosis in dogs and horses (and people too).

American dog ticks can carry the pathogens that cause rocky mountain spotted fever in dogs (and people), as well as bovine anaplasmosis in cattle.

Female ticks are red on half of their body.

Female ticks are red on half of their body.

Different life stages and sexes of ticks may look different!

Both males and females have white, weblike markings on their back.

o n

Male

a r T i c kA m b l y o m m a a m e r i c a n u m

The lone star tick is an aggressive biter that was historically found throughout the Southern United States. However, in recent years the range of this tick has been expanding northward, and it can now be found in Pennsylvania. 3

kThe bite of this tick can transmit tularemia in dogs and cats.

kThe bite of this tick can transmit tularemia in dogs and cats. 2

Female

s –

The palps are important for Identification

s

i

The palps (sensory organs on the front of the tick, like their “antennae”) have points that extend outward.

References:

1 Pak, D , Jacobs, S B , & Sakamoto, J M ( 2019 ) A 117year retrospective analysis of Pennsylvania tick community dynamics Parasites & Vectors , 12 ( 1 ), 189 https : //doi org/ 10 1186 /s 1307101934516

2 Machtinger, E . & Springer, H . R . ( 2019 ) . Protecting Companion Animals Against Ticks in Pennsylvania . Penn State Extension . https : //extension . psu . edu/protectingcompanionanimalsagainstticksinpennsylvania

3 Pennsylvania Department of Environmental Protection . (n . d . ) . Tick Surveillance and Testing . Commonwealth of Pennsylvania . https : //www dep pa gov/Business/ProgramIntegration/VectorManagement/Ticks/Pages/default aspx

4 Animal and Plant Health Inspection Service (n d ) The Asian Longhorned Tick : What You Need to Know and What You Can Do United States Department of Agriculture https : //www aphis usda gov/aphis/maps/animalhealth/asianlonghornedtick

5 Oakes, V J , Yabsley , M J , Schwartz, D , LeRoith , T , Bissett, C , Broaddus, C , Schlater , J L , Todd, S M , Boes , K M , Brookhart, M , & Lahmers , K K ( 2019 ) Theileria orientalis Ikeda Genotype in Cattle, Virginia, USA Emerging Infectious Diseases , 25 ( 9 ), 1653 –1659 https : //doi org/ 10 3201 /eid 2509 190088

Female Male Male Female Nymph Nymph Female T i c k I d e n t i f i c a t i o n O n ly Insect Identificatio n Laboratory Depa rtment of Entomology 501 Ag. Science & Industries Building University Park, PA, 16802 https://ento.psu.edu/about/contact/ instructions -f or -i nsect -i dent ificationrequests N e e d A s s i s t a n c e I d e n t i f y i n g a T i c k ? T i c k & P a t h o g e n I d e n t i f i c a t i o n Tick Research Lab of

Pennsylvania

Managing Difficult Clients

By Leanne Rios, CVT

One of the veterinarians I work with shared a story with me about a difficult client interaction that has affected how she handles cases now. The client had been verbally abusive to her and the staff. There was a lack of medical care compliance. She had told me that she should have put her foot down much sooner. The situation had been delicate due to the owner’s mental challenges and, of course, compassion for the animal. Eventually, she did end up firing the client. She has learned over the years and from this experience what she will tolerate and what she will no longer accept when it comes to client behavior.

While I like to think that we have many good clients that are compliant, listen to our suggestions, and do as we recommend for the wellbeing of their pets, there are a select few that make it more than difficult for us to do our jobs. This often makes me think of the unfortunate saying, ‘one bad apple spoils the bunch.’

We can understand to a certain point when clients may be upset and misdirect their anger toward us. Financial concerns are a common example of this, such as when a client says to ‘do whatever it takes,’ not understanding the cost of the care their pet receives. Another common situation is when a client acts on raw emotion from an upsetting development with their pet’s health. In both cases, veterinary team members must watch how we react so that the situation is not made worse.

I have heard and seen people who accuse veterinary teams of ‘playing with puppies and kittens all day,’ ‘being in it for the money,’ or in the extreme case, not caring about a client’s pet. To combat these thoughts and the distressing situations we can face in the clinic, I spoke to my co-workers to gain some perspective on how they would handle such difficult situations in the hopes their insight and wisdom would guide me in these trying times.

One common piece of advice I was given was that if an incorrigible client is causing a scene at your practice, try to take them into a room to offer privacy so other clients are not involved in the situation. Most of the time people just want to be heard. It is best to let them rant and listen to what they are saying without interrupting.

Once the client is finished, depending on the situation, remember to keep calm and prioritize empathy in your response. Statements such as, ‘I hear what you are saying’ and ‘I understand your frustration’ can help to demonstrate this. Offer to explain the facts of the case and try to explain why certain treatments are necessary for their pet. Of course, if the client is being verbally abusive, end the conversation for the time being to prevent further escalation. You could offer the client a chance to arrange a follow-up meeting either by phone or inperson for another day once tempers cool down. If you are a technician, receptionist, or assistant, this may involve getting a doctor or your practice manager involved in the situation.

If you are a practice manager or doctor, consider offering the client your work email so that they may contact you should they choose to discuss the situation further. Sometimes a situation works out—the client feels that they have been heard and their pet often gets the continued care they need. On the other hand, even if you do everything right, including breaking down the invoice and reviewing the necessary treatments and diagnostics, and the client really cannot be reasoned with, then the best outcome for the veterinary clinic may be to terminate the veterinary-client-patient relationship. This should be done by clinic leadership.

It is important to remember that if the situation did escalate to this point, it is not a reflection on anybody in the practice. It is a reflection on the client. We are in this profession to be advocates for our patients by being their voice and activist in their time of need. We should take strength from that knowledge to help us through these challenging times. I hope that one day, the stigma around veterinary medicine will change and more clients will truly see beyond the curtain that our worth is far greater for what we do, and all that we are able to accomplish with our knowledge and skills rather than just see dollar signs and us as playmates for their ‘puppy’ and/or ‘kitten.’

About the Author: Leanne Rios, CVT, has had a passion for animals for a long time. She is a graduate of the Veterinary Technician Institute in Pittsburgh and has been a Certified Veterinary Technician in small animal practice for three years.

Is this sign costing you paying clients?

By Aimee St. Arnaud, Practice Owner

A long-time client rushes into your clinic carrying her dog, Rose. Even though you are fully booked, you take Rose in and diagnose pyometra. It’s the end of a very long day but you offer to do the surgery. The client takes one look at the “Payment Due When Services Rendered” sign and says, “I can’t afford that right now. We’ve been coming to you since Rose’s first puppy exam. There must be something you can do?”

When she fails to qualify for Care Credit, the only alternative you can offer is euthanasia. The client walks out of the clinic.

You don’t hear from her again until she posts on Facebook calling you out for refusing to treat her suffering dog just because she couldn’t come up with funds right then.

You don’t read the comments. You are well acquainted with the “money-hungry-vet” posts on social media. All the years of trust and goodwill of you fitting her in and offering to stay late to do the surgery went out the window because of a cash flow and financing gap.

It’s not just low-income pet owners

Does this sound familiar? As a partner in two practices myself, I hear all the time from my own team and practices who are seeing more existing clients who used to be able to pay for services now putting off routine treatments and refusing procedures for unexpected illnesses or injuries. Suddenly, it isn’t

just low-income families asking you for help but established clients who previously accepted your treatment recommendations without question. We shouldn’t be surprised based on the percentages of Americans living paycheck to paycheck. According to a 2022 Bi-Partisan Policy Center study, “Americans are critically unprepared for financial emergencies,” with a third of respondents reporting difficulty coming up with $400 for an emergency expense.1

These are not people who cannot pay. These are people who cannot pay all at once.

Working with your clients

At Open Door, we believe you should be able to serve your clients without having to give discounts or free services. Our recommendations are based on what’s working in our own practices.

We think it’s time to take down that “Payment Due at Time of Service” sign, replacing it with wording about financing options to spread the cost of care over time. You may have tried payment plans in the past and felt they were a nightmare, but hear me out.

In Open Door practices, a quick discussion about goals for the visit is held to connect clients with payment options tailored to their individual needs. That may be third party financing like CareCredit®, Scratchpay® or Sunbit®; however, approval odds

for these options may be limited for up to 40% of Americans. According to a 2019 Bureau of Consumer Financial Protection report, four in ten US adults have credit scores under 620, are unscorable, or credit invisible. This signals that only 60% of US adults may qualify for traditional financing options used by veterinary practices, as approval is dependent on credit scores. We offer VetBilling®, a program that allows us to decide if we can offer financing, how much to offer, and the repayment schedule, taking into account everything we know about the client. VetBilling® takes it from there, handling all the “nightmare” parts like collections and freeing us to focus on caring for our patients. For surgeries, dentals, and preventative care plans with a year’s worth of prevention, we offer payment over four months to increase compliance. When people aren’t focused solely on the stress of cost of the care, they can better see the value of services.

And here’s the best part — a 94% successful repayment rate! Our team authored a research paper in Frontiers in Veterinary Medicine where 6 years of veterinary payment plan data was analyzed.2

The time has come

The idea of externally managed pay-over-time plans for veterinary care is long overdue. We can finance our car, our house, and our phone. Millennials and Gen Z expect these options, and Millennials are the largest pet owning population.3 By the way, 70% of them are living paycheck to paycheck.4 I encourage you to give pay-over-time options a try. I’m convinced you’ll find more of your clients saying yes to your treatment recommendations and that your practice can see an increase in revenue. One practice in upstate NY saw a 30% increase in dental revenue when offering pay-over-time options. You will also feel less pressure to give deep discounts and free services that cut dangerously into your profit margin. Finally, I‘m convinced that your clinic morale will increase when your staff members feel empowered to offer solutions.

References

1. Orbe A, Snyderman R, Sprick E, and Akabas S. New BPC survey underscores Americans’ financial fragility, demand for workplace and policy innovation. Bipartisan Policy Center. Published April 12, 2022. https://bipartisanpolicy.org/blog/new-bpc-survey-underscoresamericans-financial-fragility-demand-for-workplace-and-policyinnovation/

2. Cammisa HJ and Hill S. Payment options: An analysis of 6 years of payment plan data and potential implications for for-profit clinics, nonprofit veterinary providers, and funders to access to care initiatives. Front Vet Sci 2022:9. https://doi.org/10.3389/fvets.2022.895532

3. Megna M. Pet ownership statistics 2023. Forbes Advisor. Updated April 10, 2023. https://www.forbes.com/advisor/pet-insurance/petownership-statistics/

4. Books KJ. Nearly three-quarters US millennials live paycheck to paycheck, survey shows. CBS News. Published April 28, 2023. https:// www.cbsnews.com/news/millennials-paycheck-to-paycheck-financialstatus/

About the Author: Aimee St. Arnaud is a business partner in two full-service veterinary clinics (Community Pet Care Clinic in Ohio and Open Door Veterinary Care in North Carolina) that focus on removing barriers to care and increasing access to veterinary services while still maintaining a net positive revenue between 5-20%. She has created a non-profit mentorship training called Open Door Veterinary Collective for clinics that want to replicate their business model. This includes how to successfully use pay-over-time options, embracing spectrum of care, utilizing staff to their fullest skill levels in your schedule, and operational efficiencies. She would love to hear from readers and continue this important conversation. For those considering payment options, a limited number of free consultations are available. Aimee can be reached at aimee@opendoorveterinarycare.com.

I’m convinced you’ll find more of your clients saying yes to your treatment recommendations and that your practice can see an increase in revenue. A practice in upstate NY saw a 30% increase in dental revenue when offering pay over time options!

What is the Animal Health and Diagnostic Commission?

By Jim Holt, VMD

As the laboratory system has come up for another 5-year accreditation, I am reminded of how far we have come. Many veterinarians are unaware of the existence of the Animal Health and Diagnostic Commission (AHDC) which was formed in 1986 by legislative act. This was created partially in response to the need to bolster the veterinary laboratory system for national accreditation. At that time, the laboratories were about to lose their nationally accredited status, preventing them from participation in testing for international trade. What currently exists is a unique three-laboratory system: one is in Harrisburg, one at Penn State University, and one located at the New Bolton Center, University of Pennsylvania School of Veterinary Medicine.

It is a rarity to have more than one laboratory located in a state. The PA laboratory system helps support a vibrant agriculture community, including a large export market.

The AHDC meets six times annually and is directed by the PA Secretary of Agriculture. It has legislative representatives from the House and Senate as well as representatives from various experts of animal industries such as the Department of Health, USDA APHIS, USDA Wildlife Services, Pennsylvania Game Commission, and the USDA Farm Service. Many agriculture groups and stakeholders are present, which helps to keep open communication between industry and government. A broad range of issues arises in conversations, such as the ever-changing environment and the recent Avian Influenza outbreak. Additionally, proactive discussions about big picture ideas such as One Health and Antimicrobial Resistance take place.

Animal agriculture is the prime focus of the AHDC; however, its organization reflects the multiple stakeholders involved in the production of quality products for our ever-growing population as well as other agriculture businesses. The AHDC helps agriculture remain the largest contributor to the economy of the Commonwealth.

Vet Humor

I had a client bring in their cat they told me was constipated. There was no stool in the litter box. The cat was thin so I could palpate the abdomen very easily, and there was no large amount of stool in the cat. Then I looked at the other records, and said to them that they have dogs. They replied yes. I asked if the dogs had access to the cat box. They thought about this for a minute or two, then I thought both of them were going to vomit in the exam room. It was a man and his son. I guess they never changed a diaper or looked at poop.

My Top 3 “Funny Moments” from providing In-home pet euthanasia services:

After Gracie the Shih Tzu had passed away, I wrapped her in my fluffy blanket to carry her out to my car and the client exclaimed “Don’t cover her head – she won’t be able to breathe.”

Another client called her elderly Springer Spaniel to us by saying, “Pepper, come over here and meet your executioner.”

I recently answered my phone and the caller asked, “Do you come out and euthanize people in their homes?”

Quite shocked, I replied, “No, I’m so sorry, but I only euthanize pets, not people.”

We had a mother and daughter come into our hospital with their guinea pig. They brought the pet in for an emergency visit as they were deeply concerned that the pig had a worm or other foreign object protruding from his anus. They stated that every time they attempted to remove it, it would retreat back into the body. The owner relayed that she had even taken a pair of tweezers and at one point got ahold of the object but once again, was unable to pull it out.

After a 20 second exam, our veterinarian explained to the owner that the guinea pig was in fact male, and that the culprit was a penis. While we all felt it was hilarious, including the owner, who was also quite embarrassed, we cringed at the thought of her trying to pull off this poor guy’s penis with tweezers.

Thankfully, he was not injured in the attempt at removal, but we feel confident he’ll be looking at his owner quite a bit differently for a while!

~ Kathryn Reilly, BSc, BVSc, DLAS, ExMBA, of Farewell

After discussing recommendations for a patient, the owner asked, “Is this going to cost me an arm and a leg?” My mouth started talking before I thought about it and said, “No, we had to stop accepting them as we ran out of storage.” The next 15 seconds of silence took forever.

Client comes in with her dog that keeps scratching and proudly stated that they stay all natural, even the children aren’t vaccinated, and they don’t use chemicals.

After exam, I said, “I have good news and bad news. The bad news is your dog has fleas. The good news is they are all natural!”

She took home a year’s worth of flea/tick medication, got the dog vaccinated, scheduled the needed boosters, and got a lot of spray for the house and car.

~ Debra Nahay, DVM, of Northeast Animal Hospital

~ Paula Coleman, Practice Manager of Aardvark Animal Hospital

~ Melanie Goble, DVM, of Renewed Strength Veterinary Services

~ Melanie Goble, DVM, of Renewed Strength Veterinary Services

&Tick Wet Lab

The results are in!

3 Amazing Keynote Panelists

+ 21 Speakers

+ 1 Wet Lab

+ 6 Classrooms

+ 13 CE credit hours

+ 28 Exhibitors

+ 251 veterinary professionals = Spring Clinic 2023

PVMA’s Spring Clinic held in scenic Happy Valley, State College, featured a 2-hour continuing education Keynote Panel Case Discussion with Andrea Carr, DVM, John Anastasio, DVM, DACVECC, and Stephanie LeNoir, LVT, VTS (ECC), “on emergency stabilization and case management that a General Practitioner can perform to assist ER care of the patient. General session lectures included Small Animal, Production/Large Animal, Technician, and CVPM/Professional Development. As always, there was a full exhibitor showcase for our veterinary professionals to engage with and learn about innovative products, professional services, career opportunities, and more. PVMA appreciates all who participated in this inspiring conference.

Outpatient Tech Anthem

By Courtney Lieb, CVT

OPT OPT yeah you know me, I take this job seriously, If you arrive to your appointment late, Then you are just going to have to wait. I discharge surgery pets to go home, Don’t ever leave them alone. Be sure to keep an eye, On your pet’s incision and restrict exercise. Surgery recheck is in 7-10 days, To make sure everything looks okay.

I booster pets vaccines, As well as squeeze butts clean. I perform toenail trims on animals big and small, We love them and treat them all!

OPT OPT, yeah that’s me.

PVMA Members: share your artistic talents!

Submit artwork, poems, or links of musical recordings to PVMA | Keystone Veterinarian Magazine (pavma.org).

All content is subject to review for consideration of publication.

The first veterinary poem I wrote while I was employed at a small animal clinic (hired post internship!). The inspiration and humor from this poem dates back to when I was outpatient technician on Thursday and Friday afternoons. I was surgical assistant and

anesthetist

for

surgical

procedures those mornings, and would instruct clients on

how

to

care

for

their pets at discharge time. Outpatient appointments not only included surgical discharges, but also vaccine boosters, nail trims, expressing anal glands, etc. I was in charge of all outpatient appointments at that time. I absolutely enjoyed and looked forward to each appointment. I wanted to come up with a song/anthem to designate the outpatient technician position. It did not take long before my official version of an outpatient technician anthem was created. This anthem sparked my inspiration to continue writing veterinary-themed poems.

PVMA in Action

PVMA

partnered with Valley Central Veterinary and Referral Emergency Center (VCVREC) for the Annual Lehigh Valley Spring Symposium.

This one-day event held in April featured six speakers presenting on topics of oncology, communication, triage, industry news, and team approach to patient care. A special thank you to VCVREC’s Becky Remaly and PVMA’s Corinne Tolan for collaborating on this continuing education program.

Alison Marusak volunteers at the registration desk

Presenters Dr. Kristin Fisher, Dr. Craig Clifford, Dr. Christine Mullin, Dr. Philip Bergman, Dr. Angela Gifford (missing Dr. Tara Fetzer)

PVMA’s Dr. Andrea Carr makes announcements

VCVREC owners Ronald Hodges, DVM, PC, DACVIM, and Carlos Hodges, DVM, MS, PC, welcome attendees to the Spring Symposium.

Shana Adams

Carlee Arndt

Brittany Babcock

Paulette Baecker

Annie Banaszak

Dalen Banicky

Bethany Bankovich

Dr. Barrie Barr

Pamela Bensinger

Ellen Boise

Danika Boltz

Madison Bowden

Lisa Butler

Brooke Campbell/ Tomasetti

Tina Capparell

Alicia Carr

Kelly Cloak

Robert Zachary

Cochran

WELCOME NEW MEMBERS

Tanya Conrad

Dr. Helen Crabtree

Allison Crowell

Dr. Margaret Cumming

Rose Dolin

Charlotte Dudis

Lauren Faust

Leah Rita Feeley

Lisa Filer

Dr. Kelly Fishman

Ali Frankenfield

Catherine Galleher

Denielle Genzel

Dr. Meg Gobeli

Jeanne Jones

Dr. Aminata Kalley

Dr. Joseph Keller

Kayla Keller

Dr. Steven Kelly

Heidi Kennedy

Dr. Rena Kennedy

Rachel Kline

Dr. Michelle Lanica

Sophia LaRocca

Dr. Sondra Lavigne

Grace Lewis

Trishel Lewis

Erin Lighting

Hannah Listopad

Tricia MacArthur

Lauren Mack

Allysa May

Faith McElravy

Sarah Medina

Clara Meyers

Taylor Miller

Dr. Allison Milne

Kiana MiVille

Dr. Jennifer Mulvaney

Kathryn Parker

Dr. Richard Perkins

Dr. Sara Pfeiffer

Meghan Pilewski

Kate Reedenmeyer

Dr. Karen Riebsame

Dr. James Robertson

Dr. Michael Rommel

Dr. James Rowe

Isabelle Schlehr

Nora Schwartz

Brandy Sickles

Shelby Simon

Sonya Sinclair

Tiffany Sipe

Dr. Katie Slivko

Faith Smith

JoAnna Stanford

Dr. Mary Stearns

Alison Steibe

Megan Summerall

IN MEMORIAM

Lauren Summers

Vivian Tran

Dr. Ralph Urmson

Jessica Vamos

Kristin Vancalmthout

Genesis Vasquez

Daniel Vogel

Samantha Wagner

Dr. Tracy White

Bradford Widenmeyer

Shannon Wilson

Jordyn Wolf

Janet Young

Jennifer Yurkon

With heavy hearts, we announce the death of VMD Park W. Haverstick (Newmanstown, Pennsylvania), who passed away on May 25, 2023 at the age of 74. Family and friends are welcome to leave their condolences on this memorial page and share them with the family.

He was loved and cherished by many people, including : his wife Brenda Bolcar Haverstick; his children, Rebecca Haverstick (Adam Schwartz), Park Haverstick II (Danielle Haverstick) of Myerstown, PA, Anne Haverstick Frederick of Myerstown, PA and Donald Haverstick (Rachael Haverstick) of Lititz, PA.; his grandchildren, Willa, Louisa Schwartz, Dylan, Wyatt Haverstick, Max, Cru, Finn Frederick, Elaina, Natalie and Maci Haverstick; his parents, Kathryn Zwally Haverstick and Dr. Donald Haverstick; and his siblings, Jean Meisner of Myerstown, PA, Paul Haverstick of Waterbury, VT and Dr. Jane Fuhrman of Myerstown, PA.. He was also cherished by his wife and children, and he loved his family and friends, but it is his 10 grandchildren that were the light of his life.

A celebration of life was held on Thursday, June 8th 2023 from 4:00 PM to 7:00 PM at 116 Springhaven Rd, Newmanstown, PA 17072.

In lieu of flowers, donations can be made to Susquehannock Fly Fishers, Inc (susqff.org) – where Park was a dedicated member for many years –PO Box 872, Lebanon, PA 17042.

Park W. Haverstick, VMD

India Imperatore, VMD

India Imperatore of New London, PA, passed away on Tuesday, September 6, 2022, suddenly at her home, “the farm” where she lived for over 30 years.

Born on April 18, 1956, in Englewood, NJ, to the late Helen Emma Imperatore (Turner) and Arthur E. Imperatore, Sr., India spent her early years in Bergen County. At a young age, she found a love for animals, the water, music, and knowledge. She majored in Classical Languages at New York University and spent her early twenties traveling, rebuilding a sailboat and riding horses. India attended veterinary school at the University of Pennsylvania, where she graduated in 1991 and earned her V.M.D. She loved animals of all shapes and sizes, but particularly horses. She started a private practice and worked at Delaware Park Racetrack and Fair Hill Training Center for fifteen years.

India married Harry Thompson in 1992 and had two children: Emma (29) and Olivia (27). After the two divorced, India left the racetrack and used her knowledge and horsemanship skills to help treat horses and animals for friends, acquaintances and her daughters.

India spent her later years exploring alternative medicine and modalities, meditating, reading, gardening, volunteering, doing conservation and political work. She particularly enjoyed attending retreats at the Omega Center in Rhinebeck, NY, planting trees with One Tree in Tampa, FL, and made tireless efforts as a volunteer, including: Project Cure in West Grove, PA; being an oyster citizen/scientist doing conservation work with the Billion Oyster Project restoring reefs to the NY Harbor through public education and research; researching water quality for the City Island Yacht Club (NY) on their eDNA project; and doing political work in her community of Chester County, PA. She traveled often, particularly to visit family and friends in the areas surrounding NY Waterway in Weehawken, NJ, and to visit her daughters in Texas and Florida. The farm was her sanctuary and the place she held closest to her heart. She poured her energy and time into it, constantly working on projects, both indoors and out.

She was an incredibly kind, honest and sentimental being. She was fearless. India worked every day to be a better person for herself, her children, and the world around her. She loved reminiscing over photographs of her life and loved ones, and often kept notes and mantras in sight and in her pockets. She had a quirky sense of humor and immense wisdom. She was a grounding source for her daughters, who she loved dearly and proudly.

India is survived by her two children, Emma and Olivia; her two brothers, Armand Pohan (Nancy Reiger) and Arthur Imperatore Jr.; nieces and nephews, Andrew Pohan, Alicia Pohan (Matthew Riker), Amanda Pohan (Jason Kachadourian), Arthur Imperatore III, Alexander Imperatore, and Augusta Imperatore.

She is predeceased by her beloved parents, Helen and Arthur; her sister-in-law, Peggy Pohan; and nephew, Justin Imperatore.

In lieu of flowers, please consider planting a tree in her memory through the link provided. Additionally, donations can be made to Billion Oyster Project (https://www.billionoysterproject.org/donate), The Blueprint (https://secure.actblue.com/donate/tbpembed), or St. Jude Hospital for Children (https://www.stjude.org/donate/).

VETERINARIANS

East End Veterinary Medical Centre | Full Time / Pittsburgh, Pennsylvania

Associate Vet opening at our practice in Pittsburgh, PA. Enjoy a great work/ life balance. Our office is collaborative hosting weekly and monthly meetings, but our culture is what we’re most proud of. East End Veterinary Medical Centre is a professional practice with a tight knit team and because of this we have experienced growth every year. 4-Vet practice with plans of expansion. Wellness, surgery (including ortho if you want), diagnostics and treatment, and dental services. Dog and cat exclusive. No on call. Closed on most national holidays. Limited ER. Competitive salary and bonus program. Excellent benefits and incentives. Please call Kelli Dowhaniuk at 818-309-3709 and/ or email Kelli.Dowhaniuk@nva.com.

Halfmoon Valley Animal Hospital | Full Time / Port Matilda, Pennsylvania

Small animal veterinarian wanted for full or part time position 15 minutes from PSU. We are a 6-doctor (4-Dr. equivalent), 8-technician practice located in a beautiful country setting, but only minutes from all that the university has to offer. We are a well-respected, rapidly growing hospital, that strives to offer top quality medicine and surgery, while still emphasizing the importance of family and life away from our jobs. No evenings/weekends. Two 24-hour care facilities nearby. Excellent benefits package. All levels of experience are encouraged to apply. Buy in/buy out potential. Please email halfmoonvalleyah@ comcast.net.

Huntingdon Valley Veterinary Hospital | Full-Time / Huntingdon Valley, PA

LIFE-CHANGING CAREERS START HERE!

Outstanding Non-Corporate Veterinary Hospital looking for exceptional associates that are seeking life-changing careers. Excellent medicine with unparalleled mentoring, compassionate and uplifting team environment. We are offering an exceptional compensation program and a fantastic work-life balance. Accepting applications for a limited time. Contact us today at Huntingdon Valley Veterinary Hospital. Call or email Doreen Belz, DVM 215-379-2947 hungtingdonvalleyvet@ outlook.com.

Animal Emergency Center | Full or Part Time / Watsontown, Pennsylvania

We are looking to hire an additional FT ER Veterinarian. We will also consider PT and have relief needs. AEC is an AAHA accredited facility servicing the Northumberland County community’s needs for after hours and weekend ER for 20+ years. We have top notch equipment and staff as well as a manageable caseload and workflow so you can enjoy your time at work. Please email for more information, we would love to talk to you about this opportunity! Please email heather.kelly@ cvpco.com.

Rockhill Veterinary Associates | Full Time / Sellersville, Pennsylvania

We are an AAHA accredited hospital with a 63-year legacy of high-quality veterinary care in the community of Sellersville, PA. We are located in beautiful Bucks County and our renovated barn setting is warm and welcoming. The hospital is well-equipped with digital radiography, ultrasound, full ldexx in-house lab, cold laser, and many other diagnostic tools. The amazing staff seeks to provide the best possible medical, surgical, and dental care. We are seeking an Associate Vet with opportunity for advancement! Apply directly at //cvpco. com/careers or email lynsey.dolce@cvpco. com.

Shippensburg Animal Hospital | Full Time / Shippensburg, Pennsylvania

Hiring a Small Animal Lead Veterinarian to serve as the clinical leader of the hospital and to own the ongoing evaluation and management of clinical practices as well as the delivery of patient care. Shippensburg Animal Hospital has been proudly serving our community for over 50 years across our 3 hospitals. We offer our small animal patients a comprehensive pharmacy, Idexx laboratory, digital radiography, cold laser therapy, orthopedics, and ultrasound all in-house. Generous Comp/Benefits/PTO + Flexible Schedule. Apply directly at //cvpco. com/careers or email lynsey.dolce@cvpco. com.

Covenant Veterinary Care | Full or Part Time / Marietta, Pennsylvania

Seeking associate small animal veterinarian (full or part-time). Located in the historic river town of Marietta, PA, Covenant Veterinary Care offers house call and clinic visits plus general surgery, general

dentistry, in-house diagnostics and digital X-ray in our recently renovated building. Our two veterinarians and dedicated staff promote a professional and collegial culture dedicated to supporting the bond in partnership with owners and their pets. Applicants for full-time employment can expect competitive compensation based on the ProSal model along with benefits. Part-time compensation to be negotiated. Interested parties please email cvcmgt167@gmail.com.

Wellsboro Small Animal Hospital | Full or Part Time / Middlebury Center, Pennsylvania

The Wellsboro Small Animal Hospital is currently expanding capabilities by adding on a CT suite and is looking to hire a small animal general practitioner, internist, or emergency veterinarian. Flexible work schedule with 3- or 4-day work week options if desired, along with competitive salary. Benefits include 100% employer paid health/dental/vision insurance, 4% match 401(k), CE allowance, professional licensing dues, malpractice insurance, VIN & professional membership, competitive vacation time and more. Located in Middlebury Center, PA. The region offers a wonderful opportunity for those who enjoy the outdoors. Send resume to mgmtwsah@ptd.net. Call Dr. J. Salevsky at 570-376-2800 or email with any questions.

Donovan Veterinary Clinic | Full Time / Ligonier, PA

Donovan Veterinary Clinic is seeking a full-time or part-time mixed animal veterinarian. Situated in the beautiful Laurel Highlands, this privately owned, two-doctor practice is supported by our skilled and friendly staff. We are a busy, progressive practice seeking a dedicated team member. Benefits include employer paid health/dental/vision insurance, 3% match 401(k), CE stipend, professional licensing dues, malpractice insurance, professional memberships, paid vacation/ sick time. Come join our team today! Please call Terry at 724.238.9645 and/or email dvc@lhtot.com.

The Cat Hospital of Maine | Full-Time / Manchester, ME

Are you looking to ramp up OR to wind down your small animal career? The Cat Hospital of Manchester, Maine (bordering Augusta) is a spacious and welcoming feline

(and exotics) clinic, in a tranquil state, where starry nights are no strangers. Our ideal candidate likes 4-season living, and can perform basic surgery, dentistry, and ultrasonography. We offer the usual dues and perks: 4 weeks’ vacation + many 5-day weekends. Full-time pays $120,000 annually with extra offered/negotiable for special interests, experience and productivity (e.g. board certified, exotics, ER, integrative, ortho and/or acupuncture). Please contact our Practice Manager, Buffy Kilbreth, via email at cathospitalleadership@gmail. com or at 207-623-1228.

Cove Mountain Animal Hospital | FullTime / Duncannon, PA

Cove Mountain Animal Hospital is a fullservice veterinary hospital. We are a busy, rapidly growing clientele facility and eager to add an additional doctor to our team with future ownership options. Our stateof-the-art veterinary hospital is equipped with digital radiology, ultrasound, dental x-ray, and full in-house laboratory. We offer many services, which include orthopedics, soft-tissue surgery, laser therapy, dental treatments, and more. The hours of operation are Monday –Friday. We look forward to your drive and ability to work well with a team. We are offering full- and part-time positions. Experience preferred but new graduates are encouraged to apply. Please call Tanya Conrad at 717-8345534 and/or email Covemountainah@ gmail.com.

Buckingham Animal Hospital | Full Time / Doylestown, Pennsylvania

Seeking full-time veterinarian in beautiful Central Bucks County for Buckingham Animal Hospital, a privately-owned five-doctor practice. Veterinarians are supported by our highly trained and friendly staff within our well-equipped, bright and spacious stand-alone building. We are seeking a kind team member with excellent interpersonal and communication skills – sense of humor is a bonus! The owner is a 2003 Penn Vet graduate with experience mentoring new veterinarians. Generous salary and benefits. Schedule averages 35-40 hours/week, no after-hours emergencies. Close to the charming towns of Doylestown and New Hope and driving distance to Philadelphia and NYC. Please email Brad Kube, VMD, at buckah1950@ gmail.com.

Mt. Nittany Veterinary Hospital | Full Time / State College, Pennsylvania

Mt. Nittany Veterinary Hospital (MNVH) in State College, PA– Seeking Your Innovative Leadership as a Managing DVM! Working at MNVH offers growth opportunities, a collaborative environment, a positive culture, and a generous array of benefits that just aren’t found together anywhere else. If you’re curious, motivated, and want to be part of MNVH’s longstanding success, then take a look at this opportunity. Please call Kelli Dowhaniuk at 818-309-3709 and/ or email Kelli.Dowhaniuk@nva.com.

TECHNICIANS

Animal Health Care Center of Hershey | Full or Part Time / Hershey, Pennsylvania

A 5-doctor small animal hospital is searching for a full or part time certified/ experienced technician or assistant who has the skills, knowledge, and initiative to join our team. The schedule varies between the hours of 6:30am-6:30pm and alternating Saturday mornings and holidays. Overtime may occur. No late night or overnight shifts. Aside from technical aspects we are looking for someone who will fit our team core values of being a reliable team player, a hard worker, is kind and respectful and keeps a positive attitude. Comprehensive benefit package for full time and salary dependent on experience. Please submit a resume with a cover letter to Stephanie at ahccmanager@gmail.com.

Leighow Veterinary Hospital | Full-Time or Part-Time / Danville, PA

Leighow Veterinary Hospital is a fullservice small animal hospital located in Danville, PA. We are committed to high quality care utilizing the latest advances in veterinary technology. We are seeking part/full time veterinary technicians who have great client communication skills and are compassionate and enthusiastic about patient care. Job duties include restraint, venipuncture/catheter placement, anesthetic induction and monitoring, radiographs, in-house laboratory tests. The right candidate has a degree from an accredited veterinary technician program or 2 years’ experience in the field and excellent communication skills, compassion, enthusiasm, self-motivated. Competitive salary based on experience and credentials,

health insurance, 401(k) plan, paid time off and employee discounts. Please email leighowveterinary@gmail.com.

PracTICES/EQUIPMENT FOR SALE

Various Locations in Pennsylvania

PetSmart Veterinary Services is offering independent ownership opportunities to qualified veterinarians in Pennsylvania. Locations span between eastern PA (outside Philadelphia) and western PA (Erie). We offer low start-up costs, certain back-office support (recruiting, marketing, technology, and operations), and existing pet owner traffic through our retail store. Most of our hospitals have been recently remodeled or refreshed. This is a great opportunity. Call Juliet Diiorio at 312-6223737 for more information!

Western Pennsylvania

BUYING OR SELLING A PRACTICE – Buying or selling a veterinary practice? Confused about corporate consolidators? Count on the experience of Total Practice Solutions Group – Great Lakes. Contact TPSG Great Lakes (www.tpsgsales.com) at 440-9334522 – Dr. Kurt Liljeberg (kurt@tpsgsales. com) or Bret Halishak (bret@tpsgsales. com).

East of Pittsburgh

PRACTICE FOR SALE (PA-6050) – Small animal practice east of Pittsburgh grossing over $550K. Nice, well-equipped practice. Practice and real estate offered at $499K. Call for more information. Contact TPSG Great Lakes (www.tpsgsales.com) at 440933-4522 – Dr. Kurt Liljeberg (kurt@ tpsgsales.com) or Bret Halishak (bret@ tpsgsales.com).

East Side of Pittsburgh

PRACTICE FOR SALE (PA-9120) – Small animal practice on east side of Pittsburgh grossing $815K. Two exam rooms and digital x-ray. PRICE REDUCED – Practice and real estate now offered at $780K. Buyer should make income of over $200,000 after paying for all practice expenses and mortgage. Call for more information.

Interested in placing a classified ad? Visit PaVMA.org/Classified-Ads for information on all classified ad placement opportunities.

classified ads continued from page 33

Contact TPSG Great Lakes (www.tpsgsales. com) at 440-933-4522 – Dr. Kurt Liljeberg (kurt@tpsgsales.com) or Bret Halishak (bret@tpsgsales.com).

Southeast of Erie PRACTICE FOR SALE (PA-9340) – Small animal practice southeast of Erie grossing $723K. Well-equipped with Idexx VetLab and LaserCyte, CR x-ray, digital dental, and ultrasound. Practice is offered at $550K and real estate is offered at $375K. Call for more information. Contact TPSG Great Lakes (www.tpsgsales.com) at 440-9334522 – Dr. Kurt Liljeberg (kurt@tpsgsales. com) or Bret Halishak (bret@tpsgsales. com).

Harrisburg Area

Busy and growing, small animal practice with nice, freestanding real estate, in a good location with easy access. Well maintained 2000 sq. ft. facility. Both practice and real estate are for sale. (PA919). For more information, 888.881.7084 or MidAtlantic@ Simmonsinc.com.

North-Central Pennsylvania

Small animal practice with a location that allows the owner to live in PA or NY. The practice is located on one of the main roads in the region and serves a broad range of the surrounding communities. The practice and real estate are for sale. Seller financing may be an option depending on the buyer. (PA805). For more information, 888.881.7084 or MidAtlantic@ Simmonsinc.com.

Northwest Pennsylvania

Reduced purchase price! Solo small animal practice with a stable and committed team. Sits on a 2-acre lot that has plenty of space for future expansion. The owner is ready to retire so the practice and real estate are both for sale. (PA123) For more information, 888.881.7084 or MidAtlantic@Simmonsinc.com.

Northwest Pennsylvania

Healthy and growing 1-2 doctor small animal practice. Housed in a free-standing 3,700 sq. ft. facility that is well-equipped and well-maintained. Plenty of room for future expansion. Both practice and real estate are for sale. Staff expected to stay. (PA111) For more information, 888.881.7084 or MidAtlantic@ Simmonsinc.com.

Southeast Pennsylvania

Solo small animal practice north of Philadelphia, housed in a free-standing, 2,000 sq. ft. building. Located just off one of the main roads, which provides easy access. Both practice and real estate are for sale. The owner will help with the transition. (PA204) For more information, 888.881.7084 or MidAtlantic@ Simmonsinc.com.

Southeast Pennsylvania

Solo small animal practice southwest of Philadelphia, housed in 1,300 sq. ft. building with room for future expansion. Both practice and real estate are for sale. Staff is expected to stay. The owner will help with the transition. (PA242) For more information, 888.881.7084 or MidAtlantic@Simmonsinc.com.

East Central Pennsylvania

Small animal practice located near I-78 which provides easy access to Harrisburg, Allentown and more. housed in a freestanding, 3,500 sq. ft. building with 3 exam rooms, a treatment area, a surgical suite and more. Both practice and real estate are for sale. The owner will help with the transition and may stay part time. (PA241) For more information, 888.881.7084 or MidAtlantic@Simmonsinc.com.

Northeastern Pennsylvania

Solo small animal practice that is located in northeastern PA, in the Scranton-WilkesBarre area. It has an easy work schedule and NO after-hours calls. The practice is very well-equipped and organized for efficient work-flow. It has an attractive, free-standing, 2,400 square foot facility that has two exam rooms and all of the usual amenities including extra storage areas for future growth (or personal use!) The owner is ready to retire so both the practice and the real estate are for sale. 100% financing is expected for the buyer. (PA311) For more information, 888.881.7084 or MidAtlantic@ Simmonsinc.com.

Relief Veterinarians

David J. Henzler, DVM, PhD

Dauphin, Lebanon, Berks, Schuylkill, Lancaster, Lehigh, and York Counties RELIEF VETERINARIAN with 15 years of clinical practice experience, including 3.5 years as a full-time 24-hour emergency

doctor. PhD in Veterinary Science. Serving small animal and exotic practices in Dauphin, Lebanon, Berks, Schuylkill, Lancaster, Lehigh, and York counties. Available to cover vacations, illness, maternity, and other needs. Energetic with a professional appearance and excellent communication skills. Integrous, dependable, and detailed. “I treat your practice like my own!” Call 717.341.4357 or email henzlerdvmphd@aol.com.

Erin K Murphy, DVM

Berks, Lancaster, Lebanon, Lehigh, and Schuylkill Counties

Outgoing, energetic, and professional veterinarian in search of small animal practices where I can utilize my 24 years of clinical experience. I enjoy surgery, internal medicine, dermatology, wellness visits, and participating with the human-animal bond. Excellent communication skills, active listener, compassionate, and empathetic. Email ekhj07@gmail.com.

Jacqueline Burke, VMD

Berks, Bucks, Chester, Delaware, Lackawanna, Lancaster, Monroe, Montgomery, and Philadelphia Counties 1987 Penn honors grad seeks relief work within 30-60 minutes of the QuakertownPottstown area. Fast and proficient in surgery. Very dependable, professional appearance and manner. See website at jacquelineburkevmd.com. Call 610-7541155 or email at jacquib1018@gmail.com.

Michael Reese, VMD, MS

Berks, Bucks, Chester, Delaware, Lancaster, Lehigh, Montgomery, and Philadelphia Counties

Small animal veterinarian practicing in Philadelphia and the surrounding region. 13 years’ experience working in hospitals in Philadelphia and the surrounding suburbs. I am knowledgeable, efficient, and personable, and I enjoy and highly value client education. I am also flexible and readily able to adapt to various hospitals’ protocols and procedures. Please let me know if I can be of help in providing shortor long-term relief services to your practice. Thank you! Email reeseveterinary@gmail. com.