Antimicrobial Stewardship
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EXECUTIVE COMMITTEE
President: Thomas Munkittrick, MS, DVM
President-Elect: Rhett Proctor, VMD
Vice President: Andrea Honigmann, DVM
Past-President: Dawn Fiedorczyk, VMD
Secretary/Treasurer: William Croushore, DVM
BOARD OF TRUSTEES
Western Region Trustee: Erin Johnson, DVM
Metro Philadelphia Region Trustee: Marisa Brunetti, VMD
North Central Region Trustee: Andrea Carr, DVM
South Central Region Trustee: Gary Brummel, DVM
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: Christian Nase
Message from the President
Thomas Munkittrick, MS, DVM President, Pennsylvania Veterinary Medical Association
PVMA Members,
The Pennsylvania Veterinary Medical Association (PVMA) was incorporated in 1885. Our association has survived many ups and downs through the years. I have been a PVMA member since 1995 and became more active in the early 2000s. My first role was the liaison to the state board. I attended many board meetings and reported back to the PVMA staff to update the members. I was elected vice president in 2008, president-elect in 2009, and president in 2010. During my presidency, the board decided to purchase our home office in Hummelstown. Our vision was to secure a home base for our members and employees. This was an exciting time for all!
With the onset of the COVID-19 pandemic, the building became vacant. PVMA employees worked from home and never returned. Most employees resigned from PVMA. Our building was vacant yet significant expenses such as the mortgage, utilities, taxes, and maintenance remained (50K per year) for an empty office. In the fall of 2023, the Board of Trustees (BOT) entertained selling the building and an appraisal was performed. In January of 2024, the Executive Committee and BOT unanimously voted to sell the property. A competitive offer was accepted, and on April 30, 2024, the property was officially sold.
The PVMA has been in the restructuring phase since the pandemic. We have reorganized our management and are balancing the checkbook. In 2010, our vision and decisions were clearly different than in 2024. Purchasing our home base in 2010 seemed to insure our future home. Selling the building 2024 is certainly a bittersweet moment.
PVMA is here to help our members improve the quality of veterinary medicine in the state of Pennsylvania. I challenge our new veterinarians to engage and volunteer. We need to unravel our past and embrace our future. See you at Keystone!
Thomas W. Munkittrick PVMA President
Antimicrobial Stewardship Deciding when, where, how, and for how long
By Erica Tramuta-Drobnis, VMD, MPH, CPH
The veterinary community should strive to embrace a One Health approach that considers both individual patients and the animal population as a whole. Veterinarians must be conscious of their possible contribution to the emergence of antimicrobial resistance (AMR) when prescribing antimicrobials. When reaching for antimicrobials, we must choose carefully, wisely, and with appropriate stewardship, reserving key human critical antimicrobials for use only when necessary. When deciding what medication to select for a patient, it is paramount to understand the drugs themselves, their mechanism of action, their role in human and animal medicine, their ability to contribute to AMR, and when to use them and when not to. This permits us to better protect animal and human health. Judicious antimicrobial use supports One Health and is globally responsible.
Antimicrobial Prescribing: The Six Moments
If you are looking for a way to conceptualize how to select an antimicrobial for your patients, consider the WSAVA’s Six Moments of Veterinary Antimicrobial Prescribing concept.1 It provides a great way to determine if antimicrobials are warranted while ensuring we practice proper antimicrobial stewardship.
1. Diagnosis. Ensure you take into account the signalment, clinical history, and physical exam findings in conjunction with diagnostics, e.g., cytology C/S, to reach an appropriate definitive or presumptive diagnosis.
2. Treatment. Always ask yourself if antimicrobial therapy is necessary. This step is huge but many falter here. By never even reaching for medications that are not warranted and not guided by evidence-based medicine and professional guidelines (see box 1, page 10) we can improve antimicrobial stewardship greatly.
Consider some of the shifts we have seen in recent years for recommended treatments for common presentations in general practice, such as utilizing therapeutic diets and probiotics over metronidazole for acute diarrhea or watchful waiting approach.2-6
3. Guidelines. Review guidelines already available by ACVIM/ WSAVA, developed by experts, based on clinical evidence and research-backed on when to reach for antimicrobials, which medication to use, what dose, frequency, and more.
4. Antimicrobial selection. Given the current medical condition, ask yourself what, if any, antimicrobial is appropriate. We need continued on page 8 >
Antimicrobial Stewardship
Figure 1: Examples of antimicrobial classifications based on level of human importance and what should be used as first-, second-line, and as a last resort.
to not only consider the cost (sadly), size of the patient, and side effects, but we also must consider previous antimicrobial exposures, drug reactions, efficacy at the target locale, available products for species and size, route of administration, drug interactions, and potential for AMR.
Additionally, the public health rating for critically important antimicrobials must be considered (see box 2, page 11). This is a key component that is often forgotten. Only under absolute necessity should we be reaching for critically important human antimicrobials for veterinary patients.
5. Dosage regimen. A lot goes into this, even though we may consider this only for a passing glance. We need to consider the drug dose, route, frequency, duration, and formulation. These factors should be combined with considerations for owner and patient compliance to determine the best medication for the individual situation. Is the owner an 80-year-old who uses a walker and cannot easily bend to administer meds, or is it a spry twenty-year-old? Does the owner work 12-hour shifts and cannot give meds TID? Will the patient be cooperative? For animals who won’t take meds in pill pockets, food, or another mode of delivery, can the owner safely get meds into them more than once a day?
6. Advice to the owner. Finally, we have a duty to educate the owner about side effects, when to expect treatment improvement (or failure) and advise how to recognize failure or success. Further, we need to ensure appropriate reevaluation and schedule accordingly, ensuring owners understand the value and need for rechecks. Finally, we may want to discuss preventative measures for the future and resolve any other underlying triggers or concerns.
Watchful waiting
Gone are the days when we simply reach for antimicrobials because clients expect it. It is no longer acceptable for a client to dictate how we treat our pets merely because they want to go home with something in hand. We have an obligation to educate owners as to the underlying cause of clinical signs and why or, more likely, why we are not sending the pet home with an antimicrobial.
Watchful waiting is defined as the vigilant monitoring of a patient’s condition where we anticipate a spontaneous cure without the use of an antimicrobial. We give the owner
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recommendations for supportive care, advise on when it is time to intervene further, and provide appropriate explanations as to why these medications are not necessary.9
The time has come when watchful waiting is becoming the standard for certain conditions (e.g., acute diarrhea and stable upper respiratory tract disease in cats). We may provide supportive care, such as nutritional support, SQ fluids, nasal drops, probiotics, or other medical therapies. Still, we are no longer reaching immediately for the antimicrobial. Evidence continues to show that antimicrobials do not change the clinical course in several conditions, and they can cause ill effects, such as damaging the GI tract and increasing the risk of AMR.2-11
Preventing AMR
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When considering antimicrobials and the importance of preserving them for human use, we need to ensure we reach for the smallest gun with the widest reach for the condition of concern. We also need to make certain we consider antibiotic selection and how critical a particular medication is in the human field. Are you reaching for a medication of critical importance? If so, are you justified, or is there a better first choice out there?12,13
Consider whether the drug is classified as an important, highly important, and critically (most) important antimicrobial (see Figure 1). Our goal is to use the least important clinically appropriate antimicrobial at the correct dose, for the right duration, and the proper dosing frequency. We need to start with first-line medications to preserve those critically important drugs for when they are absolutely warranted. Ideally, we want to reserve the highly/critically important medications as a last resort, preferably based on culture and sensitivity results.
Client and staff education
It is crucial for veterinarians to exercise caution when prescribing antimicrobials, but the responsibility does not stop there. Providing education to both staff and clients regarding the rationale behind drug selection, the criteria for utilizing (or not) antimicrobial drugs, and the advantages and disadvantages of their usage helps to enhance understanding of the therapy’s objectives, potential adverse effects, projected treatment length, and other relevant information.
Antimicrobial Stewardship
continued from page 9
BOX 1. ANTIMICROBIAL USE AND STEWARDSHIP RESOURCES
Numerous resources can be greatly beneficial to the small animal veterinarian. These references should be reviewed periodically, as they are updated and to ensure you remain familiar with the recommendations and maintain proper antimicrobial stewardship.
2023 WSAVA list of essential medicines for cats and dogs, https://wsava.org/ wp-content/uploads/2023/11/2023essential-medicines-for-cats-anddogs.pdf
2022 AAFP/AAHA Antimicrobial Stewardship Guidelines: https://www. aaha.org/resources/2022-aafpaahaantimicrobial-stewardship-guidelines/
University of Minnesota’s Pocket Guide: Antimicrobial Prescribing for Common Small Animal Disease: https://arsi.umn. edu/sites/arsi.umn.edu/files/2020-01/ antimicrobial_prescribing_pocket_ guide_10Jan2020_v2_Final.pdf
International Society for Companion Animal Infectious Disease (ISCAID) guidelines: https://www.iscaid.org/ guidelines
o Respiratory Tract Disease in Dogs and Cats
o Bacterial Urinary Tract Infections in Dogs and Cats
o Canine Superficial Bacterial Folliculitis
ACVIM Consensus Statement on Therapeutic Antimicrobial Use in Animals and Antimicrobial Resistance: https:// doi.org/10.1111/jvim.12562
The Ohio State University College of Veterinary Medicine’s Antimicrobial Use Guidelines: https://ohiostate. pressbooks.pub/osuvmcabxuse/
Choose wisely; let stewardship be your guide
Antimicrobial stewardship is no longer just a buzzword. As a profession, veterinary medicine provides a great service to the One Health community. By protecting our animals, we help to preserve the environment, the human-animal bond, and global health. We take an oath to do no harm. Not only does that include not intentionally causing grievance to an individual patient, but that extends to the global animal community and, in turn, humans. We can minimize our impact on AMR by reaching for antimicrobials only when medically necessary and their use is supported by scientific evidence. By wisely choosing when selecting specific medications, we leave less of a negative imprint. By practicing proper antimicrobial stewardship, we preserve the health and well-being of our patients and the world they live in.
About the Author: Erica Tramuta-Drobnis, VMD, veterinarian, CPH, is the CEO and Founder of ELTD One Health Consulting, LLC. Dr. Tramuta-Drobnis works as a public health professional, emergency veterinarian, freelance writer, consultant, and researcher. She is passionate about One Health issues and believes that pet health, food safety, agricultural health, and more can address the interconnection of human, animal, and environmental health. Veterinarians are primed to be at the forefront of One Health initiatives, and she is passionate about issues from antimicrobial resistance to infectious disease control, vaccination health, and wildlife conservation. In her free time, Erica enjoys cooperative care training, sudoku, Tai Chi (black sash), reading, and spending time with her husband (an internist), and her dog, Jazzy. Erica can be contacted at eltdonehealthconsultingllc@gmail.com.
References
1. World Small Animal Veterinary Association (WSAVA). Six Moments of Veterinary Antimicrobial Prescribing. https://wsava.org/wp-content/uploads/2024/05/FECAVA_6MOMENTS_A3_05-2023_ENG_ SCREEN.pdf
2. Shmalberg J, Montalbano C, Morelli G, Buckley GJ. A Randomized Double Blinded Placebo-Controlled Clinical Trial of a Probiotic or Metronidazole for Acute Canine Diarrhea. Frontiers in Veterinary Science. 2019;6. Accessed September 10, 2022. https://www.frontiersin.org/articles/10.3389/fvets.2019.00163
3. Rudinsky AJ, Parker VJ, Winston J, et al. Randomized controlled trial demonstrates nutritional management is superior to metronidazole for treatment of acute colitis in dogs. J Am Vet Med Assoc. 2022;260(S3):S23-S32. doi:10.2460/javma.22.08.0349
4. Garcia JL. What are the best practices for antibiotic use in feline upper respiratory tract disease? DVM 360. Published August 7, 2017. Accessed April 22, 2024. https://www.dvm360.com/view/what-are-bestpractices-antibiotic-use-feline-upper-respiratory-tract-disease
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5. Lappin MR, Blondeau J, Boothe D, et al. Antimicrobial use Guidelines for Treatment of Respiratory Tract Disease in Dogs and Cats: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases. J Vet Intern Med. 2017;31(2):279-294. doi:10.1111/ jvim.14627
6. WSAVA Global Veterinary Council. Key Documents on Responsible Antimicrobial Use and AMR Prevention. WSAVA. Accessed February 28, 2024. https://wsava.org/global-guidelines/keydocuments-on-responsible-antimicrobial-use-and-amr-prevention/
7. Frey E, Costin M, Granick J, Kornya M, Weese JS. 2022 AAFP/AAHA Antimicrobial Stewardship Guidelines. Published online 2022. https://www.aaha.org/globalassets/02-guidelines/2022antimicrobial/2022-aafp_aaha-antimicrobial-stewardship-guidelines.pdf
8. Stavroulaki EM, Suchodolski JS, Xenoulis PG. Effects of antimicrobials on the gastrointestinal microbiota of dogs and cats. The Veterinary Journal. 2023;291:105929. doi:10.1016/j. tvjl.2022.105929
9. Shi N, Li N, Duan X, Niu H. Interaction between the gut microbiome and mucosal immune system. Military Medical Research. 2017;4(1):14. doi:10.1186/s40779-017-0122-9
10. Weese J s., Giguère S, Guardabassi L, et al. ACVIM Consensus Statement on Therapeutic Antimicrobial Use in Animals and Antimicrobial Resistance. Journal of Veterinary Internal Medicine. 2015;29(2):487-498. doi:10.1111/jvim.12562
11. Brookshire WC, Shivley JM. Improving Patient Outcomes Through Antibiotic Stewardship. Today’s Veterinary Practice. Published February 15, 2021. Accessed November 1, 2021. https:// todaysveterinarypractice.com/improving-patient-outcomes-through-antibiotic-stewardship/
12. The WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR). Critically Important Antimicrobials for Human Medicine : 6th Revision. WHO; 2018:1-52. Accessed April 21, 2024. https://www.who.int/publications-detail-redirect/9789241515528
13. Victoria State Government, Department of Energy, Environment and Climate Action. Antiobiotic use in Dogs and Cats. Stop, Think, Shoose wisely. Published online 2024. Accessed May 29, 2024. https://drive.google.com/file/d/1tpgHtE7-W8TFhBHwS9QMtUgeZvZlc98s/view?usp=embed_ facebook
Box 2.
Public Health Classification of Antimicrobials
WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR), Critically Important Antimicrobials for Human Medicine: 6th Revision. https:// www.who.int/publications-detailredirect/9789241515528
World Animal Health Organisation, OIE List of Antimicrobial Agents of Veterinary Importance https://www.woah.org/ app/uploads/2021/06/a-oie-listantimicrobials-june2021.pdf
Current Challenges and Solutions for the Rural Veterinary Workforce
Rural (large/mixed) veterinarians have a critical role in ensuring the health and welfare of animals in our communities. They are at the forefront of the humananimal interface by monitoring diseases in large commercial farms, treating animals in small backyard farms, and educating new hobby livestock owners. Their presence and success are a matter of food safety and food security, both locally, nationally, and internationally.
The rural veterinary workforce is decreasing at an alarming rate. According to the Farm Journal Foundation, food animal veterinarians are 5% of the current veterinary workforce, a decrease of 35% in fifty years. Approximately 50% of practicing rural veterinarians are within five years of retirement.1 Less than 5% of veterinary graduates nationally enter livestock practice and of those, about 50% leave rural veterinary practice within five years.
By Jody A. Kull, DVM
large animal veterinary medicine can be physically challenging at times and can involve long hours on the road and responding to emergency calls. This could impact a veterinarian’s work-life balance. The debt-to-income ratio for rural veterinarians can be larger than those in an urban practice. Rural practice ownership is profitable, but attaining ownership can be difficult with high educational debt. This presents financial constraints for those in rural veterinary practice.
Addressing Rural Veterinary Workforce Shortages
Rural areas often face unique challenges in recruiting and retaining veterinary professionals. Rural areas can feel geographically isolating, with a perceived lack of social amenities. As a new veterinary professional in a rural community, this isolation can be difficult to overcome. The type of work in
The rural veterinary workforce shortage issue continues to grow, but so does its awareness. Multiple organizations, universities, and states are working together to create tangible and effective solutions to recruit and retain veterinarians. The Farm Journal Foundation, with a grant from the Zoetis Foundation, has helped to propel the issue to Washington and gain the attention of policymakers. Discussions focus around supporting and
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modifying current loan repayment programs, providing business and early career support, and recruiting and exposing students to livestock medicine.
The Veterinary Medical Loan Repayment Program (VMLRP), first passed in 2003, is a USDA NIFA grant program. USDA will apply $25,000 to veterinary educational debt per year for a three-year service contract. This grant award is taxed and included in the total award amount, while the similar rural human medicine program is not. The Rural Veterinary Workforce Act, supported by the AVMA, has been introduced many times to relieve the tax burden associated with the grant and allow approximately 39% more funds for new awardees. Contact your US representatives to request support for tax relief of the VMLRP.
The Veterinary Services Grant Program (VSGP) is facilitated by USDA NIFA for rural practice enhancements. This grant can be up to $125,000 for practice support and equipment purchases. In 2024, USDA NIFA has partnered with LifeStock International to assist in the application process for both programs.
Improving Support for Rural Practitioners
There are opportunities within the livestock industry for recent graduates to gain business knowledge and support. American Association of Bovine Practitioners (AABP) has a Recent Graduate Conference for early career veterinarians that provides networking opportunities, practical medicine tips, and business/financial management for new/prospective owners. Additionally, Texas Tech University hosts a Professional Skills Bootcamp for the Recent Graduate Rural Practitioner that focuses on additional networking and support for rural veterinarians. The AABP Building Excellence in Rural Veterinary Practice Workshop is a year-long program for early career veterinarians with multiple seminars and workshops. Small cohorts work together with industry experts for individualized and personalized hands-on business support and education. Dr. Brian Reed, Agricultural Veterinary Associates and treasurer of AABP, is an integral part of the program.
Some states have their own rural veterinary support programs. The Veterinary Training Program for Rural Kansas (VTPRK) has been extremely successful over 15 years. This program includes
David McCormick, MS, CVA
Sherry Everhart CVT, CMA
Dagmar Sachs, CEPA
Current Challenges and Solutions for the Rural Veterinary Workforce
continued from page 13
a $25,000 loan each year in veterinary school in exchange for a four-year commitment of service. The 8-year commitment includes business classes, a food animal practical skills training, continuing education meetings, state-wide agricultural tours, personalized mentoring, and a capstone presentation. Maine has a program for recipients of a VMLRP, providing an additional three years of loan repayment for continued rural veterinary service. Many states are in the development stages of their own program, including Kentucky, South Dakota, Oklahoma, and Nebraska to match the success stories from Kansas, Maine, and other states not listed. The Pennsylvania Department of Agriculture is discussing ideas for similar rural veterinary support programs. Contact your state and US representatives to discuss this topic more.
Interdisciplinary Approach
Rural veterinary retention and success is not possible without involving the community. Veterinarians need to raise awareness of the importance of veterinary care and promote positive relationships and engagement within the community. Groups such as state Farm Bureaus, nutritionist groups, supply stores, small business associations, lending organizations, cattleman
groups, and others must collaborate to provide small business support and resources. Together, they can promote and support outreach efforts like educational workshops, public health campaigns, and community event participation.
The Pennsylvania Center for Dairy Excellence (CDE) continues to grow its veterinary outreach. Focused on supporting all aspects of the dairy industry, the CDE is celebrating its 20th anniversary in 2024. Producer grants are available to promote direct veterinary involvement in the farm management team. The CDE also has resources about mental health, risk management, financial planning, and animal welfare. The Animal Care booklet created in 2022 provides guidelines to meet the requirements of the FARM program. Their weekly and monthly email updates are relevant for any veterinarian to stay informed on important topics in the dairy industry. CDE is currently providing weekly industry calls with updates about HPAI.
With less than 2% of the nation’s population living on farms, it is unrealistic to expect our future rural veterinarians to come from a rural background. Exposing students to livestock and rural communities should be included in all levels of education, including grade school. The Farm Journal Foundation created educational toolkits for undergraduate, veterinary student, and early career veterinarians in 2023. The web-based modules are
designed as interactive cases structured around current students and veterinarians and include videos, worksheets, veterinarian examples, and a variety of resources to address the barriers to entry and success of rural veterinarians. Each module can be integrated into classrooms, 4-H/FFA clubs, and workshops as independent study and group discussions and complement additional resources.
While the rural veterinary workforce faces significant challenges, the future of rural veterinary medicine can be strong. Each rural veterinarian contributes approximately $340,000 in economic impact to their county and creates 4-5 additional jobs.1 USDA has identified 711 counties in the US with a shortage of rural veterinarians. Filling these shortage areas would create an additional $242.2 million in economic impact in rural America. Contact state and US legislators to talk about rural veterinary support. With innovative solutions and open conversations between the many stakeholders involved, the challenges can be addressed to ensure that rural communities have access to quality veterinary care. By investing
in the success of rural veterinary professionals, strengthening support networks, and recruiting new students, a sustainable workforce can be built to safeguard the future of our food supply and protect human health.
References:
1. Neill C L. Tackling veterinary debt: Addressing the persistent shortage of food animal veterinarians and its impact on rural communities. Farm Journal Foundation, 2023.
About the Author: Dr Kull owned Valley Mobile Veterinary Service, a mobile food animal veterinary business serving Montour and surrounding counties. She focused on producer, student, and community education. In 2023, after 19 years in clinical practice, Dr Kull joined the Department of Veterinary & Biomedical Sciences at Penn State University as an Assistant Teaching Professor. She enjoys teaching and advising preveterinary students. She has been a Veterinary Ambassador for the Farm Journal Foundation since 2022.
Updates on Highly Pathogenic Avian Influenza
During the 2024 AVMA House of Delegates session, experts from numerous agencies involved in the response to the HPAI outbreak provided updates on the status of the outbreak in poultry, dairy cattle, other mammals, and humans.
Information was provided by representatives from the US Department of Agriculture (USDA), Food and Drug Administration (FDA), Centers for Disease Control (CDC), American Association of Bovine Practitioners (AABP), American Association Avian Pathologists (AAAP), National Animal Health Laboratory Network (NAHLN), National Association of Public Health Veterinarians (NAPHV), and National Assembly of State Animal Health Officials (NASAHO).
As of June 20, 2024, key points include:
• Cases in dairy cattle are confirmed on 116 premises across 12 states.
• Introduction of the H5N1 virus to dairy cattle appears to be through a single contact between cattle
By Kate Boatright, VMD
and an infected wild bird. The virus has since spread laterally among cattle.
• Transmission of the virus is multifactorial and includes animal movement, shared equipment and workers between farms, and other mammals.
• Lactating cattle are the most affected with morbidity around 10% and mortality (including from culling) less than 2%.
• Other mammals, including cats, have been infected. Cats are present on over 80% of affected farms and on more than 50 farms cats have been found sick or dead.
• Small animal veterinarians should remain vigilant, especially with regard to sick cats that have contact with livestock. Information on handling recommendations can be found at https://www.cdc.gov/ bird-flu/hcp/animals/index.html
• Testing for HPAI in affected cattle is free for producers and financial assistance is available for affected farms. Prevention and monitoring programs are also available, and there may be financial incentives for participating.
• Beef in the food chain and pasteurized milk supplies are safe.
• Public Health Risk is low. There have been three confirmed human cases, all of whom had direct contact with infected cattle. No human-to-human transmission has occurred.
This is a rapidly evolving situation. Resources for veterinarians and producers include the following:
https://www.aphis.usda.gov/ livestock-poultry-disease/avian/avianinfluenza/hpai-detections/livestock
https://www.cdc.gov/bird-flu/ spotlights/h5n1-response-06072024. html
Biting Back: How veterinary teams can teach about tick-borne diseases
By Emily Struckhoff, MS, and Malu Tejada, MD MPH - Penn State Extension
Ticks are common throughout Pennsylvania. They can be found on many animals, including dogs, cats, cattle, and horses, and veterinary clinics across the state often deal with these pests and the pathogens they carry. However, ticks are not just an animal health issue. The same ticks that can cause disease in animals can also cause disease in their human owners. Because of this, veterinarians are in a unique position to help educate their clients about the most effective ways to prevent tickborne diseases.
Tick-borne diseases: A One Health issue
One Health is the concept that the health of humans, animals, and the environment are all connected.1 Ticks and tickborne diseases are considered a One Health issue due to the interconnectedness between ticks, the pathogens they spread, the host animals they bite, and the environment. Ticks spread disease by picking up pathogens, such as bacteria and viruses, from an animal host. These pathogen-carrying ticks then
transmit that pathogen to the next human or animal they bite, which may result in this host becoming infected with a tickborne disease. The health of humans and animals, therefore, is closely connected to the presence of ticks and the environment in which they all live.
Which diseases affect both humans and animals?
Several species of ticks in Pennsylvania can transmit different disease-causing pathogens. Many of these tick species bite both humans and animals, and some tick-borne pathogens can cause disease in multiple animal species (Table 1). For example, Lyme disease, the most common tick-borne disease in the United States, can affect humans, dogs, and horses.2 If a client has pets or livestock that are often bitten by ticks, that client is likely at higher risk of tick bites and tick-borne diseases. Similarly, if a client is often being bitten by ticks, their animals may also be at risk.
Biting Back: How Veterinary Teams Can Teach About Tick-borne Diseases
continued from page 17
Table 1. Diseases that affect both human and animals in the United States, and the species in which they can cause disease.2,3,4
Lyme Disease
Anaplasmosis
Rocky Mountain Spotted Fever
Tularemia
Blacklegged tick (Ixodes scapularis)
Blacklegged tick (Ixodes scapularis)
American dog tick (Dermacentor variabilis)
American dog tick (Dermacentor variabilis) and Lone Star tick (Amblyomma americanum)
Borrelia burgdorferi
Anaplasma phagocytophilum
Rickettsia rickettsii
Francisella tularensis
*Cats can be seropositive for the bacteria that causes Lyme disease, but no cases of naturally occurring clinical Lyme disease have been identified in cats.2
How to talk to clients about tick-borne disease
Veterinarians and veterinary technicians are a trusted source of information for their clients and are uniquely positioned to raise awareness and educate about tick-borne disease risk in both humans and animals. In fact, several strategies for reducing tick-borne disease risk in animals are also applicable to humans. Here is some advice about reducing tick-borne disease risk you can provide to your clients:5,6
Use tick bite prevention tools
The best way to prevent tick-borne diseases is by preventing tick bites in the first place. There are many options available for tick bite prevention. For humans, wearing long pants and long-sleeved shirts, using an insect repellent, and treating clothing with permethrin are all effective ways to reduce the risk of tick bites. Alternatively, many tick bite prevention options are available depending on the animal. Clients should consult with their veterinarian about what options are best for their pets or livestock. You can also remind clients that preventative methods should be used only on the species for which they are labeled (e.g., dog treatments should not be used on cats).
Know when and where the risk for ticks is highest
While ticks can be encountered throughout the year, clients should be especially careful and take all protective measures during the spring, early summer, and fall in forested areas and tall grasses.
Do a tick check
After being outdoors, there are several steps clients can take to protect both themselves and their pets from tick bites. The first step is to do a tick check. Ticks can attach anywhere, but they prefer places that feel more covered or where skin is thinner. For both humans and animals, this includes areas around the ears, under the legs, and under long hair or fur. Doing a tick check can not only reduce tick-borne disease risk, but it can also prevent ticks from “hitchhiking” on a pet into the house.
Safely remove attached ticks
Removing tick from dog. Image by Penn State Extension
If any attached ticks are found, clients should remove them as soon as possible with a pair of fine-tipped tweezers. After removing an attached tick, clients should be on the lookout over the next few weeks for potential symptoms of a tickborne disease and reach out to their veterinarian or doctor with questions.
Ticks can spread disease-causing pathogens to both humans and animals. Veterinarians, vet techs, and other veterinary professionals play an important role not just in disease diagnosis and treatment, but also in client education about the risks these arthropods pose to both their animals and themselves. The One
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Other Resources
Ticks and Tick-borne Disease: https://extension.psu.edu/ticks-and-tickborne-disease
Protecting Companion Animals Against Ticks in Pennsylvania: https://extension.psu.edu/protecting-companion-animalsagainst-ticks-in-pennsylvania
Protecting Livestock Against Ticks in Pennsylvania: https://extension.psu.edu/protecting-livestock-against-ticksin-pennsylvania
References
1. One health basics. cdc.gov. Updated September 28, 2023. Accessed April 16, 2024. https://www.cdc.gov/onehealth/basics/index.html#:~:text=One%20 Health%20is%20a%20collaborative,plants%2C%20and%20their%20shared%20 environment
2. Vogt N. Lyme borreliosis in animals. Merck Veterinary Manual. Updated March 2021. Accessed April 16, 2024. https://www.merckvetmanual. com/generalized-conditions/lyme-borreliosis/lyme-borreliosis-inanimals?query=lyme%20disease
3. Springer A, Glass A, Probst J, Strube C. Tick-borne zoonoses and commonly used diagnostic methods in human and veterinary medicine. Parasitology Research. 2021;120(12):4075-4090.
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4. Foley J. Tularemia in animals. Merck Veterinary Manual. Updated July 2020. Accessed April 16, 2024. https://www.merckvetmanual.com/generalizedconditions/tularemia/tularemia-in-animals?query=tularemia
5. Preventing tick bites. cdc.gov. Updated July 1, 2020. Accessed April 16, 2024. https://www.cdc.gov/ticks/avoid/on_people.html
6. Preventing ticks on your pets. cdc.gov. Updated January 10, 2019. Accessed April 16, 2024. https://www.cdc.gov/ticks/avoid/on_pets.html
About the Authors: Emily Struckhoff, MS, and Malu Tejada, MD MPH - Penn State Extension, is a Vector-borne Disease Program Specialist at Penn State Extension. She received her B.S. in Biology from Saint Louis University and M.S. in Entomology from the University of Illinois Urbana-Champaign. At Penn State, Emily develops and delivers programming about vectors, such as ticks and mosquitoes, throughout Pennsylvania.
Malu Tejada is a statewide multilingual Extension Educator for the Penn State Extension Food, Families, and Communities unit. Malu received her medical degree from the University of Geneva, Switzerland, and her master's in public health from the London School of Hygiene and Tropical Medicine, UK. She enjoys developing meaningful relationships with communities and organizations, and she contributes as the human health expert to the Penn State Extension Vector-borne Disease team.
Rabies Monitoring How Can You Help?
By: Len Donato, VMD, DABVP (Avian Practice)
Veterinarians are important ambassadors for the prevention of rabies. Each day in small animal practice we vaccinate dogs and cats to help prevent this infectious and zoonotic disease. Can we do more? What else can we do to help?
The answer lies in getting involved with rabies monitoring, Identification of rabies suspects and proper reporting help Pennsylvania residents and local communities understand the disease impact. Each month a report is generated by state officials of the number of rabies cases by county and by affected species. This is the tip of the iceberg of actual rabid animals in Pennsylvania. As veterinarians, we can help by assisting in the identification of rabid animals. In my small animal hospital, we work with local authorities to prepare samples to test for rabies. With some planning this can be a relatively simple process for you and your hospital as well.
Work with your township police department/ animal control officer
Residents usually call the police when there is an odd animal encounter, such as a bat found in a house or a raccoon attacking a dog. Public awareness of rabies has increased over the years, so even if the resident kills the animal before the police arrive, many times they will still call the authorities. Establishing a relationship with local law enforcement increases the likelihood that they will bring you potential rabies suspects instead of immediately disposing of them.
You may decide to donate these services or charge some nominal fee to the township, but an understanding, written or oral, should be in place so proper procedures occur each time a rabies suspect is presented to you.
The typical responsibilities of the local authorities include:
1. Bring rabies suspect to you, usually already deceased.
2. Fill out appropriate documentation for testing.
3. Transport or ship to local testing facility.
4. Inform exposed individuals and your facility of results.
You will need to take certain precautions and have the proper equipment (see box 1) to prepare the sample for transport. Create protocols and train staff to follow them. These protocols should include everything that happens while the specimen is in your clinic, including who handles the specimen upon arrival to arranging a time for local authorities to pick up the sample for transport or shipping.
BOX 1. EQUIPMENT NEEDED FOR SAMPLE PREPARATION
1. PPE
a. Mask and protective eye wear/face shield
b. Gloves
c. Gown
2. Wet table
3. Instruments for incising skin, muscle, and spine
4. Styrofoam cooler + ice packs
5. Two bags for prepared specimen and one bag for accompanying documentation
6. Bag for animal disposal
Procedure to prepare sample for transport/ shipment
After cephalectomy, the head is allowed to drain into the wet table or tub. The head is placed in two sealed bags to prevent cerebrospinal fluid and other fluids containing the rabies virus from uncontrolled leaking. A bat or very small creature should be sent whole to the lab using the same bag technique. Ice packs are placed in the cooler with the specimen. The documentation is also placed in a sealed bag and travels in the
cooler or is firmly attached to the outside of the cooler. If there will be a delay in transport or lab availability, do not freeze the specimen unless directed to do so by the lab. Occasionally timing can be challenging, like a holiday or extended weekend. Check with the lab for instructions. An updated list of labs is available at https://www.health.pa.gov/topics/Labs/Pages/ Laboratories.aspx
Taking part in disease monitoring helps control the spread of rabies and educates the public about the disease. We, as veterinarians, are leaders in helping control infectious and zoonotic diseases. Working with local authorities and state labs can make preparation and submission of samples for rabies fairly straightforward. I have been helping with the preparation of rabies samples my entire career and I’m happy to play a role in monitoring this disease.
References:
1. Pennsylvania Department of Health:Rabies. Available at https://www.health.pa.gov/topics/disease/Pages/Rabies.aspx. Accessed May 4, 2024
2. Pennsylvania Department of Health:Labs.Available at https://www.health.pa.gov/topics/Labs/Pages/Laboratories. aspx. Accessed May 4, 2024
3. Pennsylvania Department of Agriculture: Reported Rabies Cases. Available at https://prdagriculture.pwpca.pa.gov/ Animals/AHDServices/diseases/Pages/Rabies.aspx Accessed May 4, 2024
About the Author: Dr. Len Donato graduated from the University of Pennsylvania Veterinary School in 1996. He became boarded in avian medicine in 2008. He is the owner of Radnor Veterinary Hospital and Department Head of the ZECAMS program at Penn Vet. He treats dogs, cats, birds, reptiles, ferrets, rabbits, guinea pigs, rodents, amphibians, hedgehogs, sugar gliders and other non-traditional pets. Dr. Donato’s areas of interest include orthopedics, CT imaging, and wildlife & exotic pet medicine and surgery. Email: LD@radnorvet.com.
HONEY BEES HAVE THE ANSWERS!
By Tiffany Ayres, CVPM
Picture of a brood frame (baby bee frame) showing worker bees and the queen of the colony - the queen has the orange elongated abdomen located on the right side/middle section of the photo. The worker bees will hover over the capped brood to ensure their temperature remains at a constant temperature (between 92-97 degrees fahrenheit); while other worker bees will follow the queen around taking care of her needs.
For decades, people have found the honey bee a marvel of nature. Perhaps because this tiny insect gathers droplets of nectar and through constant attentiveness can turn this watery substance into the sweet ambrosia we know as honey. Or maybe it is due to the diligence the honey bee exhibits while performing the task of pollinating numerous flowers, bushes, trees, and grasses, covering their hairy bodies with pollen. Or possibly it is none of these feats that allow us to experience 1/3 of the foods we currently enjoy due to these pollination efforts, but something entirely different.
No matter what the reason, the honey bee continues to captivate audiences around the world–and for good reason. For one hundred and thirty million years, the honey bee has lived and worked alongside their nest mates. They have mastered the skills of COMMUNICATION and TEAMWORK. The honey bee makes living and working with others
appear easy, while humankind continues to struggle with both skillsets of communication and team work.
Beekeepers quickly recognize the united nature of the honey bee. A simple example and test of their skill may be conducted by placing a water source for the honey bee to drink. Once one bee locates this refreshment, the message is quickly communicated to others. Within a few minutes, the water dish becomes the newest hangout for the honey bees to visit and quench their thirst. This efficient communication is performed consistently and constantly to ensure the well-being of the colony. As soon as a bee returns to their colony, they receive status reports on the queen’s health, brood (baby bees health, age, numbers), food quantity and quality for both adult bees and baby bees, as well as numerous other updates. By receiving this timely status report, each individual bee can adapt to the
needs of the colony by making shifts in their tasks to work towards their colony’s sustainability.
Teaming efforts are seen in countless behaviors, whether it is through the collective measures honey bees take using their body heat to overwhelm a larger insect threat, the clustering behavior to heat the colony to survive the winter, festooning behavior performed by house bees to create wax comb, or the efficiency of team work exhibited by receiver bees; we can learn much from studying the successful strategies constantly exercised by the honey bee. The HONEYBEE CONCEPT is a program developed to do just that.
The HoneyBee Concept was developed by Employee Operations Manager Tiffany Ayres who worked in the Veterinary Management field for more than two decades helping train facility teams to work cohesively. Beekeeping was a hobby she started to give back and support the environment, but quickly discovered the honey bees had lessons to offer. Through observation and study, Tiffany recognized the synchronized harmony honey bee colonies exhibited, seamlessly working together to accomplish their tasks to support the colony. Each honey bee working independently yet working with others within their colony without fail, not much different than a team of employees working for a business. The HoneyBee Concept Program reviews and interprets the successful methodologies used by the honey bee and simplifies the discovery into six (6) components developed to easily be incorporated into our own organizations for communication and teamwork enhancement. It is quite incredible to witness the impact these slight adjustments accomplish.
We often seek improvements in our own systems by incorporating methods used by other successful businesses, why not turn to a social organism that has been successful for thousands of years. Though a bit unconventional, this non-traditional “little” expert has the answers if we are willing to listen and learn.
For more information on the HoneyBee Concept programs please visit www.keystobee.com or directly email saybees. apiary@gmail.com.
Take care of our pollinators for everyone’s Well-BEEing.
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Veterinary practice involves a wide variety of legal issues. Tucker Arensberg attorneys have experience working with veterinarians in all of the legal aspects of their practice.
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To learn more visit www.tuckerlaw.com, follow us on LinkedIn , or call 412-566-1212.
About the Author: Tiffany Ayres, CVPM, has worked in the veterinary field for more than twenty-five years in an array of leadership positions. With her broad view of the veterinary industry, Tiffany offers a wide scope of knowledge and the ability to adjust her approach to the needs of the recipients. In 2023, she developed Keys to Bee, Inc. and achieved her Masters in Beekeeping. Now she captures the attention of audiences by utilizing the fascination of the honeybee to successfully deliver organizational sustainability messages.
Enhancing Public Health Through Employee Benefits Programs for Veterinarians
It can be easy to overlook, but public health is intricately linked to the well-being of both humans and animals, and veterinarians play a crucial role in safeguarding this health ecosystem. Promoting positive human-animal relationships, preventing zoonotic diseases, and maintaining safe living environments are direct ways that veterinarians play a role. As educated experts, it’s also important to be strong ambassadors and leaders of positive public health practices.
“Veterinary public health is all the veterinary applications that impact the social, mental, and physical well-being of humans.
- Dr. Satesh Bidaisee”1
The demanding nature of veterinary practice, coupled with unique occupational challenges, can impact veterinarians' ability to provide optimal care and fulfill their important public health role. You know how difficult your day-to-day job can be – and how outside factors can add stress and impact your ability to be effective. Strong employee benefits programs tailored to the needs of veterinarians and their team members not only support physical and mental well-being, but also contribute significantly to public health outcomes.
Here are 4 key areas that robust employee benefits programs should include:
Access to Healthcare:
Comprehensive health insurance coverage provided through employee benefits programs ensures that veterinarians have access to essential medical care for themselves and their families. By maintaining a healthy workforce, these programs indirectly contribute to public health by ensuring
that veterinarians are physically capable of providing quality veterinary services. Access to healthcare also promotes early detection and management of health conditions among veterinarians, enabling them to continue their crucial role in safeguarding both animal and human health.
Promoting Preventive Care for Animals:
Employee benefits programs that offer discounted or free veterinary services for employees' pets promote preventive care for companion animals. Veterinarians supported by these robust benefits programs can contribute to the overall well-being of communities through mitigation of zoonotic diseases, as well as all the positive mental benefits that come with pet ownership. Regular veterinary check-ups, vaccinations, and preventive treatments not only improve the health and well-being of individual animals but also contribute to broader public health goals. I’m sure I have been ‘preaching to the choir’ on this point – but have you considered offering these services or pet insurance programs for your staff?
Supporting Continuing Education and Professional Development:
Continuing education is vital for veterinarians to stay updated on the latest advancements in veterinary medicine and public health. Employee benefits programs that allocate resources for professional development enable veterinarians to enhance their knowledge and skills, ultimately benefiting public health outcomes. By staying informed on emerging health threats and best practices, veterinarians can effectively contribute to disease surveillance, outbreak response, and preventive measures.
Addressing Mental Health Challenges:
Veterinary medicine can be emotionally demanding, leading to high levels of stress, anxiety, and burnout among practitioners and team members. Strong employee benefits programs that prioritize mental health support play a crucial role in addressing these challenges. Access to counseling services, mental health resources, and peer support networks can help veterinarians cope with the pressures of their profession, reducing the risk of mental health disorders and improving overall well-being. By supporting the mental health of veterinary professionals with an employee assistance program, you can help ensure a resilient workforce capable of providing compassionate and effective care to animals and communities.
Employee benefits programs tailored to the needs of veterinary professionals play a crucial role in enhancing public health outcomes. By supporting access to healthcare, promoting preventive care for animals, facilitating continuing education, and addressing mental health challenges, the benefits you offer can contribute to the well-being of both your staff and the communities they serve. And as an added bonus, quality employee benefits packages can attract the best candidates for
your employment needs – and help you keep those employees around!
If you need help bolstering your benefits package, Alera Group’s Small Business Unit can help! We’d love to have a discussion with you about how to help your business stand out during the hiring process -- while at the same time providing resources to enhance your employees’ well-being and forwarding public health goals. As a preferred partner of PVMA, we’re familiar with the needs of your industry, and our team is well equipped to assist you. Whether you’re interested in health insurance plans, voluntary products, offering pet insurance or employee assistance programs – we can’t wait to hear how we can help you!
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1 St. Georges University. (2022, August 10). Explaining Veterinary Public Health: How Animal Care Affects Humans. Veterinary School Blog. https://www.sgu. edu/blog/veterinary/explaining-veterinary-public-health/
Bridging the Gaps: The Vital Role of the Food Animal Veterinarian in One Health
By Sierra R. Guynn, PhD, DVM, DACVPM
One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals (livestock and wildlife) and ecosystems (including plants).1 The intricate interconnections between these three entities form a central intersection of One Health, which strengthens or deteriorates as a function of what the three components are experiencing.
Domesticated animals raised for food have profound effects on humans and the environment. Per the US Department of Labor, less than 1% of employed individuals in the US work in the raising or harvesting of animal products. However, the vast majority of Americans ingest food animal products their entire lives, with little to no knowledge of the process. As our population increases, efficiency is paramount to provide adequate food animal products for the country. Often, efficiency requires concentration of the animals for at least part of their lives, which in turn intensifies the negative effects on the environment.
The food animal veterinarian is at the crossroads of One Health. We facilitate producers’ efforts to ensure that safe and wholesome food animal products are on American dinner tables for generations and also understand that we cannot neglect the environments in which those generations will live.
Antimicrobial Resistance (AMR)
According to the Centers for Disease Control and Prevention, 2.8 million antimicrobial-resistant infections occur in the US a year, at a national cost of more than $4.6 billion. AMR is a multifactorial problem with causes rooted in both human and veterinary medicine. Unfortunately, the use of antibiotics in food animals is often assessed unfairly. While it is true that 80% of antibiotics sold in the US are for food animal use, this is a function of animal size. Pound for pound, humans and companion animals use ten times the amount of antibiotics used in food animal production.
The US food animal veterinary sector has made several positive changes to reduce antibiotics used in food animals by removing medically important antibiotics as growth promotants and from over-the-counter sales. However, continued research is necessary to examine the effects of antibiotics excreted in animal waste affecting AMR in soil and wildlife.
We also need to increase our client education to aggressively promote preventative medicine and management strategies that will reduce the need for antibiotics. I am cognizant of the challenges though, as I have heard “Can’t you just give him a shot?” more times than I can count. However, there are many examples of these same preventative measures increasing production and reproductive efficiency, thereby
increasing returns for the producers and reducing impact on the environment. Additionally, food animal veterinarians need to continue to consult with industry and academic partners to research and develop non-antibiotic options available to increase the health and immunity of food animals, such as feed additives and immunomodulators.
Food Safety
Food animal veterinarians and producers have done an extraordinary job in the US providing wholesome meat and milk with programs such as Beef (and Pork) Quality Assurance and the FARM program for dairies. In 2022, antibiotic residues in all USDA regulated meat/eggs were ~0.3% and in milk were less than 0.01%. Unfortunately, per the CDC, three of five of the most common enteric food borne illnesses causing hospitalizations in the US are bacteria that regularly inhabit the gastrointestinal tract of food animals. The implementation of extensive measures at processing plants to prevent contamination continues to be improved; however, it is reasonable to consider measures to reduce the load of pathogens pre-processing. Pre-processed animals are at the feedlot, finishing house, or broiler house where the veterinarian can liaison between research experts and producers to apply new technologies and products; for example, prebiotics, probiotics, and modulation of microbiomes.
US Economy and Food Security
According to the USDA, beef, dairy, poultry, pork, and eggs are in the top 10 largest sources of cash receipts from US-produced farm commodities. Beyond providing the major nutritional proteins for humans and our pets, food animal agricultural byproducts augment health and well-being for everyone.
Disease outbreaks could greatly impact both economic and food security. It is estimated that a foot-and-mouth disease outbreak in the US could cost $200 billion dollars to our beef, dairy, and pork industries. In 2021, African swine fever (ASF) was identified in swine in Haiti and the Dominican Republic. The cost estimation of an ASF outbreak in the US is $80 billion, and Haiti is less than 1000 miles from US shores.
Beyond the economic devastation and long-term detrimental effects to exports, any foreign animal disease (FAD) has the potential to severely restrict the availability of affordable protein in the US. In 2022, per the USDA, greater than 12% of people experienced food insecurity. And food insecurity is a direct cause of many chronic diseases, poor mental health, and poor performance at work/school which ultimately costs the US economy more.
Food animal veterinarians play a critical role in protecting the US food supply from FAD, we are “the first responders” on farms and growing operations. We need to be cognizant of clinical signs, involved in developing farm biosecurity protocols, aware of changing situations, and responsible for educating our producers (and the backyard operations) on the need for vigilance.
Food Animal Veterinarian's Role
Our clients are providing an invaluable service to every person in the US. Our foremost role as their veterinarian is to support them to improve the health and welfare of their animals. However, according to our veterinary oath we also need to protect public health. This requires us to educate ourselves and our clients about proper biosecurity measures for their operations, judicious use of antibiotics, and appropriate preventative medicine and reproductive techniques to improve efficiency. By increasing efficiency and embracing new technologies, we can hopefully mitigate the effects of large-scale production on the environment, an essential piece of the One Health puzzle. Food animal veterinarians can assist producers to navigate the new information and technologies being provided by researchers, industry, public health agencies, and government programs to ensure that together we conserve animal resources in the US.
References
1. One Health High-Level Expert Panel (OHHLEP); Adisasmito WB, Almuhairi S, Behravesh CB, Bilivogui P, Bukachi SA, Casas N, Cediel Becerra N, Charron DF, Chaudhary A, Ciacci Zanella JR, Cunningham AA, Dar O, Debnath N, Dungu B, Farag E, Gao GF, Hayman DTS, Khaitsa M, Koopmans MPG, Machalaba C, Mackenzie JS, Markotter W, Mettenleiter TC, Morand S, Smolenskiy V, Zhou L. One Health: A new definition for a sustainable and healthy future. PLoS Pathog. 2022 Jun 23;18(6):e1010537. doi: 10.1371/journal.ppat.1010537. PMID: 35737670; PMCID: PMC9223325.
About the Author: Dr. Sierra Guynn earned a DVM at the Virginia Maryland Regional School of Veterinary Medicine in 2006, after completing her PhD in comparative physiology at Creighton University School of Medicine in 2002. She went into large animal private practice in Maryland (1 yr) and Texas (5 yr). In 2012, Sierra went back to the VA/MD College of Vet Med as a Clinical Assistant Professor in the food animal section. In 2022, she became a Diplomate of the American College of Veterinary Preventative Medicine. Her research interests include Cryptosporidium parvum in dairy calves, Theileriosis in cattle, preventative ruminant medicine, and the role of food animals in One Health.
Inclusive, ambitious research to meet the needs of a changing planet
Collaborative research communities supported by the Environmental Innovations Initiative are addressing issues related to climate action, stewardship of nature, and societal resilience.
Reprinted with permission from the University of Pennsylvania’s Penn Today. Originally published on December 7, 2023 with the byline “By Katherine Unger Baillie, MA, MES"
What do farmers need from academics to build a livelihood that’s sustainable, from both an economic and an environmental standpoint? How can anthropologists, wildlife ecologists, and veterinarians work in sync to identify—and solve—critical public and environmental health challenges? Answering these questions and many others related to the environment requires interdisciplinary collaboration. To build teams, Penn’s Environmental Innovations Initiative (EII) has a funding mechanism that encourages cross-school, crossdepartmental collaborations called “research communities.” This year, two research communities led by Penn’s School of Veterinary Medicine received funding from the Initiative.
“We established the research communities to be something like research projects, but more open, collaborative, and publicfacing,” says Kathleen Morrison, faculty co-lead of EII and the Sally and Alvin V. Shoemaker Professor in the School of Arts & Sciences’ Department of Anthropology. “All of them address issues related to our mission of climate action, stewardship of nature, and societal resilience, but every group approaches the challenge of the climate emergency in a different way.”
Thomas Parsons, the Marie A. Moore Professor of Animal Welfare and Ethics and professor of swine production medicine at Penn Vet, co-leads one research community that received funding for a second time this year, the Penn Regenerative Ag Alliance, together with Mark Alan Hughes of the Kleinman Center for Energy Policy. The team includes additional faculty from Penn Vet and the Kleinman Center, as well as the School of Engineering and Applied Science, the School of Arts & Sciences, and Penn Global.
And a second research community born of the Vet School, newly supported this year, is One Health@Penn, led by Penn Vet’s Jenni Punt, associate dean for One Health and a professor of immunology. Punt collaborated on the proposal with Penn Vet’s Julie C. Ellis, and Brittany Watson, as well as Hillary Nelson of the University’s Master of Public Health program.
“The timing of the research communities program was extraordinarily wonderful for us,” says Punt. “It allowed us to take ideas that we thought, ‘Oh it would be nice to do this,’ and move them toward becoming operational.”
Agriculture and the environment in harmony
Regenerative agriculture distinguishes itself by practices that don’t just avoid degradation of the environment, but in fact improve soil and ecosystem health.
When the Penn Regenerative Ag Alliance first received Initiative support in 2022, it coincided with the launch of the Penn Vet Center for Stewardship Agriculture and Food Security. The two entities, with overlapping membership, share a goal of building connections across campus around how agriculture can be part of the solution to climate change and environmental harms.
Over the last year, Parsons and Hughes have gathered experts in soil health, such as Zhengxia Dou, from Penn Vet, and Alain Plante, from Penn Arts & Sciences, to turn attention to how farms can reinvigorate degenerated soils. In work with Ellen Neises and her colleagues at Penn’s Weitzman School of Design, they’re also exploring the use of riparian buffers on farms, areas along streams or other waterways that are planted with trees, shrubs, and other plants to protect water quality and provide wildlife habitat.
They’re working with Penn Engineering’s Peter Psarras at the Clean Energy Conversions Lab to consider the role of farms in carbon capture, as well as Engineering’s Cherie Kagan and Rahul Mangharam, to collaborate on technological applications for regenerative agriculture. And they’ve engaged Tom Daniels and Nicholas Pevzner of Weitzman in discussions about how the renewable energy industry poses both a challenge and an opportunity to traditional farms.
Faculty and staff reported on ag-related work and its intersections at a public workshop held during Energy Week this past spring, featuring a keynote, faculty presentations, and student posters. “We created a lot of opportunity for interaction,” Parsons says. “All these different schools bring unique perspectives and expertise, so our aim is to try to synthesize those perspectives and have an impact.”
In the coming year, the alliance plans for a second workshop and other events, such as a monthly seminar series and podcast miniseries. They’re also working on opportunities to get researchers and students out into the field to see agricultural challenges and opportunities firsthand.
Working toward One Health solutions
Most in the veterinary field understand the One Health concept: that the health and well-being of humans, animals, and the environment are intrinsically connected. Yet this approach to scholarship has been slower to catch on in arenas outside veterinary medicine.
In the case of the One Health@Penn research community, support from the Initiative helped strengthen and formalize efforts that Punt and others at Penn had already begun to put in motion. Since joining the faculty in 2018, Punt has worked with Penn Vet dean Andrew Hoffman to develop a variety of cross-disciplinary connections, including rolling out new dualdegree educational programs and building on the strengths of existing ones, like the robust VMD-Ph.D. program. Working with Ellis, a wildlife ecologist and co-director of the Wildlife Futures Program at Penn Vet, Punt also helped organize a crossUniversity group that calls itself One Health in Action (OHiA) and includes Nelson from Penn Medicine as well as a variety of scholars across Penn Vet, including Stephen Cole; Erick Gagne; postdoc Sabrina Greening; Lisa Murphy; Laurel Redding; Caroline Sobotyk; Brittany Watson; and Elizabeth Woodward, who hail from diverse fields.
Within that group, a key goal emerged: to work toward creating a National Science Foundation–funded fellowship program for training scientists in interdisciplinary, One Health ways of thinking.
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This year, two research communities led by Penn’s School of Veterinary Medicine received funding from the Environmental Innovations Initiative. (Image: iStock/microgen)
Inclusive, ambitious research to meet the needs of a changing planet
continued from page 29
“As veterinarians, we are inherently interdisciplinary because not only do we need to understand the health of multiple species, but we always need to tend to the humans involved when we treat our animals,” Punt says. “We also need to be humble and know where our scholarly limits are and when we need to cross over and talk to wildlife ecologists, designers, architects, psychologists, and anthropologists.”
Since receiving EII support, which was matched by funding from the Vet School by the dean, the One Health@Penn team has been laying the foundation for those types of perspectiveshifting conversations.
At the inaugural talk of the OHiA seminar series, held during Earth Week at Penn in April and supported by the research community, veterinary epidemiologist Craig Stephen spoke about how a reframing of One Health may be necessary to meaningfully address planetary health. Another speaker visited campus this fall as part of the series. The community has also convened a monthly One Health Research in Progress Series, focused on climate change and health for the 2023–24 year and featuring faculty from all 12 schools at Penn.
To “train the trainers” in climate change science, the research community is offering stipends to Nelson, Woodward, and Gagne to complete the Certificate in Climate Change program offered by Penn’s College of Liberal and Professional Studies. These faculty will also create a Climate and One Health course, with assistance from two dual-degree students from Penn Vet, targeted for the 2024–25 academic year.
“Elizabeth, Erick, and Hillary are very creative as well as rigorous thinkers,” Punt says. “They want to make this course hands-on, really interdisciplinary, and involve real problem-solving.”
‘Spreading its wings’
Through EII, all of the research communities have had opportunities to not only develop and meet with their own groups, but also forge connections across communities, and even outside Penn. Representatives from the Regenerative Ag Alliance and One Health@Penn groups have engaged in efforts to build new graduate certificates in environment- and climate-related fields, and have met with teams from other higher-ed institutions to discuss similar cross-disciplinary research efforts.
Part of EII’s mission is to “catalyze solutions to significant realworld challenges,” and the research communities are a key part of achieving that goal.
“There’s a lot of foundational work to figure out what teams are out there, what people are doing, and to figure out what problems are out there that our expertise can help in solving,” Punt says.
“This is Penn Vet spreading its wings. It’s important in a visionary way.”
Jenni Punt (center), a professor of immunology at Penn Vet, is leading the One Health@Penn research community.
(Image: Eric Sucar)
Members of an EII research community and others joined together at the Regenerative Ag Alliance Workshop, held in the Kleinman Energy Forum during Penn’s Energy Week in March. (Image: Ashley Hinton/Penn Vet)
Thomas Parsons (right), the Marie A. Moore Professor of Animal Welfare and Ethics and professor of swine production medicine at Penn Vet, co-leads the research community, the Penn Regenerative Ag Alliance, with Mark Alan Hughes of the Kleinman Center for Energy Policy. (Image: Penn Vet)
Legislative and Regulatory Affairs Committee Update
By Dr. William Croushore
2024 is shaping up to be a busy year on the legislative and regulatory front. So far, the Legislative and Regulatory Affairs Committee (LRAC) has been involved in several initiatives. With the help of our lobbyist, Patty Mackavage, PVMA continues to maintain a strong presence in Harrisburg. Collaboration with the AVMA, AABP, AAEP and PennVet has greatly contributed to the successes realized so far in 2024.
Xylazine
Most notably, HB 1661, amends The Controlled Substance, Drug, Device and Cosmetic Act, providing for the scheduling of xylazine as a class III-controlled substance and, as of the writing of this update, has passed both chambers and awaits Governor Shapiro’s signature. Governor Shapiro is expected to sign it into law. PVMA along with collaboration from AVMA, AABP, AAEP and PennVet, was instrumental in the development of this legislation.
There is, however, a very important exemption for veterinarians in this bill; approved veterinary formulations will not be considered a controlled substance under this law. This exemption was critical to ensure that manufacturers continue to distribute veterinary approved xylazine to practitioners in Pennsylvania. Due to the regulatory burden of distributing a controlled substance, the availability of xylazine would have been seriously jeopardized without this exemption. Once signed into law, however, it will still allow for vigorous prosecution of illicit use. HB 1661 mirrors Governor Shapiro’s executive rule issued in the spring of 2023 scheduling xylazine as a class III-controlled substance with the same veterinary exemption. Special thanks to Rep. Carl Metzgar for introducing HB 1661 and shepherding its passage.
Media Relations
LRAC was involved in media relations surrounding the recent arrest of two individuals stemming from two separate judgements by the State Board of Veterinary Medicine of practicing veterinary medicine without a license. The unsealed court dockets showed that the two individuals were arrested and jailed for 30 days for failure to comply with subpoenas issued while enforcing a cease-and-desist order resulting from these judgements.
Pet Health Insurance
Dr. Tom Munkittrick testified last year before a PA House committee on HB 660, which would regulate pet health insurance. That bill was introduced by Rep. Michael Schlossberg and is currently working its way through the PA senate as of the writing of this update.
New Committee Members
We welcome the following members to LRAC: Dr. Andrea Carr and Dr. Darren Statler. This committee is vital to protecting the practice of veterinary medicine and animal welfare in Pennsylvania. If you are a PVMA member who would like to join this essential committee, please contact: membership@pavma. org.
A Grain of Truth: How Possum Hypnosis Kept Me Out of Jail
By Todd A. Jackson, DVM, DACLAM
This series of articles depicts funny, tragic, terrifying, or otherwise memorable anecdotes and stories from veterinary careers. Some of them might be mine. Some might belong to other people. I’m not telling. In all cases, the names have been changed to protect the innocent and the comically guilty. Some are completely true, but at minimum, every story has at least a grain of truth. For those of you who haven’t been in the veterinary field long enough to remember when the best available drug to treat arthritis in dogs was aspirin (available in 5 grain tablets), a grain is an obsolescent unit of mass based upon the mass of a single ideal seed. In the Apothecaries' system, it is equal to 64.79891 milligrams. So, maybe not much, but there is some truth in there!
Important Definitions:
Possum — Didelphis virginiana, an omnivorous, tick, trash, and roadkill eating, North American marsupial with an opposable thumb on the hindlimb, a forked penis in males, and 2 vaginas in females. (Really, I’m not making that up!)
Opossum — also Didelphis virginiana — same thing, but Irish.
Back in my residency days, I walked outside at the end of a latespring day and saw a friend of mine, Laurie Hayes, staring into a trash can alongside a campus police officer. Now usually I’m one to mind my own business, but it was clear that something interesting was going on. I walked over to Laurie and asked her, “What’s up?”
It was one of those oldfashioned trash cans found in parks and college campuses that were made from cement with a metal top to keep out rainwater and an aluminum insert to hold the trash. A small, juvenile opossum (or “possum” for the less fancy folk in the audience) had smelled discarded food in the trash can. It had been able to climb up the cement sides of the can, but after jumping into the trash and enjoying a meal of a spoiled ham sandwich, the aluminum insert was too slick to let the poor thing climb back out. It would jump up and scratch at the sides of the can, trying to get a foothold while sliding back down to the bottom over and over again. You could tell it had been at it for a while because it was obviously tired. Laurie and the officer had both tried to reach in and help it, but it tried to bite them any time they got close.
Enter our hero — me. I saw my chance to rescue a poor, innocent, woodland creature and said, “Don’t worry! I’ll get it out of there.” The officer stepped in front of me and warned me to stand back, or I could be injured. The possum was obviously highly dangerous by the way it had been snarling, hissing, and biting at anybody that came near. I proudly explained to the officer that I was a veterinarian and knew how to safely rescue the possum without getting hurt. The officer agreed to let me try, but still seemed worried about my safety.
I had my lab coat with me and tossed it down on top of the little furball. While it was distracted and trying to push the lab coat off of its head, I reached down and grabbed it by the base of the tail, lifting it out the trash can.
Keystone readers, you must understand that while I’m explaining the next set of events in “normal time,” all that occurred next happened almost instantaneously. There wasn’t time to think. Actions and reactions from both me and my feral patient were all reflexes, snap decisions, and actual snapping. Our actions proceeded only from instinct, not coherent and logical thought processes. The actual time elapsed was only seconds.
Of course, while lifting it up out of the trash by the base of its tail, the possum reached upwards in a J shape to bite me in the wrist. I know there was no malice there. From the wild animal’s perspective, it had just been caught by a predator and feared being eaten. (I hear that possum is delicious — “the other yellow meat,” but I have never tried it myself.) The possum had no way of knowing that I was helping it rather than turning it into my evening meal.
I fully expected this to happen and was prepared to protect myself. While lifting it out of the trash can, as it reached up to bite me, I gave it a quick and decisive shake. I was careful not to shake hard enough to cause any injury while still shaking hard enough to prevent being bitten. I mimicked the same motion that our family chihuahua does with her chew toys after ripping them out of my hand when I press the squeakers inside. The possum reacted exactly as expected, going completely limp and closing his eyes — playing possum.
At this very moment, I was actually quite proud of myself and my veterinary reflexes, honed from years of having patients try to bite me while giving injections, trimming nails, and cleaning ears. I could see how everything was going to work itself out–my patient safely rescued, no blood shed from either one of us, and all it had cost me was the need to throw my lab coat in the laundry when I got home. Life was good. I was clearly an excellent veterinarian.
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A Grain of Truth: How Possum Hypnosis Kept Me Out of Jail
continued from page 33
Then I heard it. The police officer shouted in a voice loud enough to knock me backwards a few inches — “WHAT DID YOU DO!?!?!?!”
The officer had suddenly grown 2 inches taller by standing up straighter. The look on his face went from one of concern that I could be injured to one of anger/frustration/ consternation. Somehow, unbeknownst to me, I had transformed into a heinous criminal who must be ejected from society. The officer’s right hand hovered just above his firearm, ready to draw if I made any sudden moves. It was absurd. I was only armed with a “passed out” juvenile possum, not any kind of weapon that made me dangerous.
Nothing was happening except that I was getting more nervous. I needed to stall for time. I started counting more slowly: “7... 6……. 5….…... 4………....”
At that moment, I saw the possum open one eye, and without moving its head or any other part of its body, glance around furiously to see if the coast was clear. I quickly said, “3, 2, 1.”
I regained my balance and tried to figure out what had caused the sudden change in the officer’s demeanor just as I was about to complete my mission of mercy. Then it hit me… The officer had no idea that possums play possum. From the officer’s point of view, he had just witnessed the wild animal equivalent of “shaken baby syndrome.” He had watched me give the possum a quick shake and thought that I had killed the poor thing. I was about to be arrested.
Now once or twice in my life when I’ve suddenly realized that I’m in deep trouble, when I didn’t see it coming and therefore didn’t figure out an escape plan, my brain has come up with an on the spot, creative, and pathetically stupid way for me to act. This was one of those times. I looked over at the officer and said, “Sir, he’s not injured. He’s just hypnotized. Back in veterinary school, we took a class in animal hypnosis to help us in situations like this.”
Now that part was true. In freshman year, we took an animal behavior class, and one lecture focused on animal hypnosis. I’m still waiting for that lecture to become useful, perhaps for some ferret that’s addicted to smoking and wants help learning to quit? Maybe an overweight schnauzer that has tried everything else for weight loss but isn’t yet ready to go on Ozempic? Either way, I am NOT advocating lying to police officers. Lying to police officers is a real crime (unlike rescuing juvenile possums). I was not lying about my animal hypnosis training, even if it only lasted 50 minutes back in 1987.
Of course, the officer didn’t buy it. He kept his hand hovering over his 9 mm semi-automatic, apparently ready to gun me down if I made any sudden moves. I was very careful to move very slowly while gently placing the possum on the ground and stepping back. I explained to the officer that I was going to count backwards from 10, and when I was finished, the possum would awaken from his trance and be perfectly fine. Despite the officer’s skepticism, I started counting, “10, 9, 8…”
Right on cue, it jumped up and ran off as if nothing ever happened. My friend Laurie said “wow!” The officer stood there with his mouth open, completely stunned. I smugly reiterated that animal hypnosis is useful in those emergency situations when an animal is about to injure itself or a person and you don’t have a sedative handy. Sedatives obviously work better, but you can’t have them with you, ready to inject all the time. The police officer thanked me for my help, and we all went on our merry ways. I was relieved to have not been shot or placed in handcuffs and thought to myself that I am one very lucky animal doctor. Case closed.
Unfortunately, the case wasn’t closed. My friend Laurie was so amazed by my prowess as an animal hypnotist that she went and talked to the faculty of my residency program. She told them all about how I have this amazing power, every bit as good as how Crocodile Dundee was able to calm the bull in the middle of the road by waggling his pinky and thumb at it. She demanded that they have me teach a class in animal hypnosis so that everyone can learn that skill. I walked into rounds the next morning only to see all the faculty frowning at me. They demanded to know why I told a tall tale to a police officer, pretending that a possum playing possum is equivalent to a Las Vegas show with a pocket watch as a pendulum. I explained what happened, but still lost a little credibility with my mentors. I had learned that not everyone in the world knows that when trapped, possums play possum. I also learned that when trapped, my brain may panic and spew BS like a dairy bull with crypto.
About the Author: Dr. Jackson is a board-certified specialist in laboratory animal medicine and serves as the Director of the Animal Resource Program and a Research Professor in the Office of the Senior Vice President for Research and the Department of Veterinary and Biomedical Sciences at Penn State’s University Park campus. He can be reached via e-mail at taj5330@psu.edu.
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Paw Prints Veterinary Clinic | Full Time / Morgantown, West Virginia
Join Our Expansion! We currently built a brand-new facility and therefore, looking to add more doctors to our GP small animal hospital in Westover, West Virginia. Paw Prints Veterinary Clinic’s new (additional building) opened in the Summer of 2022. We are currently an eight-doctor practice. We have the capacity to do bone plating, TTA, and TPLO surgeries. Our new facility will be equipped with a CT scanner. We have Storz laparoscopic and arthroscopic equipment. This is an excellent opportunity for a new grad or experienced Veterinarian. Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli.Dowhaniuk@nva.com.
Dover Area Animal Hospital | Full Time / Dover, Pennsylvania
Dover Area Animal Hospital in South Central PA located Northwest of York is seeking an Associate Veterinarian. We are currently a 7-doctor practice with a recently expanded and upgraded hospital. We are a high-volume busy clinic with experienced veterinarians who are willing to teach and mentor new graduates. Our hospital includes surgical and cold laser, digital X-ray, ultrasound, paperless records, and boarding and grooming facilities. You can expect a diverse medical and surgical caseload in a laid-back atmosphere. We are offering competitive salaries and flexible work hours with a full benefits package and a potential sign-on bonus (minimum $10,000). Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli.Dowhaniuk@nva.com.
Confederate Woods Veterinary Hospital | Full Time / Gettysburg, Pennsylvania
Confederate Woods Veterinary Hospital in Gettysburg, PA, is an AAHA-accredited hospital seeking a veterinarian. We
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Companion Animal Hospital | Full Time / Mount Joy, Pennsylvania Veterinarian opening in Mount Joy, Pennsylvania. No Emergency or oncall. Companion Animal Hospital was founded in 1995, and it has continued to grow and serve the community ever since. We are a staff of 8 doctors, 15 veterinary technicians as well as qualified receptionists and veterinary assistants. We provide a broad range of veterinary services including wellness care, acupuncture, in-house laboratory, digital radiology, nutritional counseling, orthopedic surgery including tplo., reproductive health and services, and a canine rehabilitation program. We see dogs, cats, pocket pets, chickens, and potbellied pigs and work with the local wildlife rescue. Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli.Dowhaniuk@nva.com.
North Versailles Veterinary Care | Full Time / North Versailles, Pennsylvania North Versailles Veterinary Care located in North Versailles, Pennsylvania is a fullservice animal hospital that welcomes both emergency treatment cases as well as pet patients in need of routine medical, surgical, and dental care. We are looking for an enthusiastic and passionate Veterinarian to help us continue to grow. Relief, PT, FT, and Managing opportunities available. North Versailles Veterinary Care stays on top of the latest advances in veterinarian technology and above all, remembers that all animals and pets need to be treated with loving care in every check-up, procedure, or surgery.
All levels of experience are welcome to apply! Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli.Dowhaniuk@nva.com.
Keystone Veterinary Care | Full Time / State College, Pennsylvania
Imagine a veterinary hospital with a team that practices progressive medicine, cultivates a growth mindset, encourages constant learning, and celebrates small victories. Imagine that veterinary hospital is located in a beautiful area flush with outdoor activities and amenities, while still maintaining a small-town, close-knit feeling. Now, imagine that a veterinary hospital is looking for a passionate and dedicated veterinarian. Keystone Veterinary Care has a part- or full-time position for an experienced veterinarian with at least 1 year’s experience in practice. We are also open to mentoring new graduates with guidance and support from our talented team and formal mentorship program. Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli.Dowhaniuk@nva.com.
The Animal Hospital on the Golden Strip | Full Time / Williamsport, Pennsylvania
We are looking for another veterinarian to be a part of our well-established small animal practice. We treat dogs, cats, and some exotics. We feel we do many things well but if we had to highlight a few it would be the ability of being very capable. Our technician team is out of this world and makes our doctors’ lives very manageable throughout the day. We also handle end-of-life care impeccably and care deeply about our community. Enjoy 4-day work weeks with no on-call. We serve the Lycoming and surrounding counties. Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli. Dowhaniuk@nva.com.
Best Friends Animal Hospital | Full Time / Chambersburg, Pennsylvania
Best Friends Animal Hospital is seeking a compassionate veterinarian to join our progressive small animal practice. At Best Friends Animal Hospital, we are committed to supporting learning and growth as well as providing mentorship. The ideal candidate for this role would be able to perform surgery, evaluate
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Chambersburg Animal Hospital | Full Time / Chambersburg, Pennsylvania
Chambersburg Animal Hospital is a fullservice companion pet hospital providing comprehensive medical, surgical, and dental care for dogs, cats, and pocket pets. We are located conveniently off Routes 81 and 30 in Chambersburg, Pennsylvania, and have been serving the community for over 70 years. We are looking for a full-time Veterinarian who has an interest in dentistry and surgery. Our hospital includes 6 exam rooms, a large surgery suite, a dental suite, laser surgery, ultrasound, a complete pharmacy, and more. Limited evening and weekend hours and no emergency hours. Please call Kelli Dowhaniuk at 818-3093709 and/or email Kelli.Dowhaniuk@ nva.com.
Blair Animal Hospital |Full Time / Hollidaysburg, Pennsylvania
Our hospital in beautiful central Pennsylvania is looking to add another part to full-time veterinarian to our team. We are currently comprised of two fulltime veterinarians and one part-time veterinarian, along with an amazing support staff. Blair Animal Hospital is a cat and dog-exclusive hospital, but our clientele and team would be happy to open our doors to exotics and/or pocket pets if there is an interest in this area. We look forward to mentoring a new graduate or learning from an experienced applicant who is looking to work within a team to care for our patients. Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli.Dowhaniuk@nva.com.
Camboro Veterinary Hospital | Full Time / Edinboro, Pennsylvania
Managing Veterinarian / Medical Director opening at Camboro Veterinary Hospital
located near Erie, PA. We are looking for an experienced Veterinarian who is a good communicator, and a team player who enjoys collaboration and contributing to the growth of our team through sharing knowledge and teaching. This is both a clinical and non-clinical position some of which involves surgery, and dentistry, providing excellent medical leadership, creating an environment of teamwork, managing associate veterinarians, and assuring regulatory compliance relating to the practice of veterinary medicine. We are a team of 3 FT and 2 PT veterinarians. Progressive clinic with lots to offer. Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli.Dowhaniuk@nva.com.
Butler Veterinary Associates, Inc., and Emergency Center | Full Time / Butler, Pennsylvania
Butler Veterinary Associates is looking to hire an Associate DVM. We are a large group practice that provides general practice as well as emergency services in the Butler/North Pittsburgh area. We get many challenging cases to keep your diagnostic, medical, and surgical skills sharp. All this in a strong team-based environment. We see ourselves as a step between most general practices and board-certified specialists in what we can offer clients diagnostically, medically, and surgically. If you want to be a part of a dynamic team reach out today! Excellent mentorship for new grads. Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli.Dowhaniuk@nva.com.
Pittsburgh Premier Veterinary Care & Rehabilitation | Full Time / Pittsburgh, Pennsylvania
Pittsburgh Premier Veterinary Care & Rehabilitation is a 2-doctor practice looking for another Associate Veterinarian. Our hospital includes 5 exam rooms, a surgery suite, a dental area, a radiology suite (including ultrasound), and an open treatment room concept. Rehabilitation equipment includes an underwater treadmill, dry treadmill, companion animal laser, and therapeutic ultrasound. We offer urgent care type appointments as well as sick and well visits. Patients consist mainly of canines and felines, but some exotic
animals are seen at doctors’ discretion. No weekends or on-call. All levels of experience are welcome to apply! Please call Kelli Dowhaniuk at 818-309-3709 and/or email Kelli.dowhaniuk@nva.com.
Marcho Farms Inc. | Full or Part Time / Souderton, Pennsylvania
Seeking a veterinarian to manage calf health for an integrated veal calf producer in Pennsylvania and New York. Must have a valid veterinary license to operate in PA and NY. Must be able to work independently. Hours are flexible. The position involves regular visits to veal farms with additional visits to diagnose, treat, and manage disease as necessary, as well as management of calf health protocols. Please call Sonia Arnold at 610-698-4847 and/or email sarnold@marchofarms.com.
Wellsboro Small Animal Hospital | Full Time / Middlebury Center, Pennsylvania
We are seeking a small animal general practitioner to join our team located in Middlebury Center, PA. New graduates are welcome. Mentorship is happily provided. We are a 3-doctor practice with an off-site board-certified radiologist and cardiologist. Offered services include routine/sick care, surgery (soft tissue/ orthopedic), dental care/surgery, digital radiography, cardiac and abdominal ultrasonography, and computed tomography. We will soon have in-house computed tomography. Flexible work schedule with competitive salary and benefits. Send inquiries or resumes to Dr. J. Salevsky at 570-376-2800 and/or email mgmtwsah@ptd.net.
Crescent Ridge Veterinary Hospital | Full or Part Time / Zelienople, Pennsylvania Crescent Ridge Veterinary Hospital is a veterinarian-owned, full-service practice in Zelienople, Pennsylvania that is looking to grow. We are seeking a dedicated and compassionate Associate Veterinarian to join our team. This is a full-time or part-time, on-site role at Crescent Ridge Veterinary Hospital. The Associate Veterinarian will be responsible for providing exceptional medical and surgical care to patients, conducting physical exams, and developing treatment plans. The Associate Veterinarian will also be responsible for excellent client communication and
education, and consultation with other members of the veterinary team. This position offers the opportunity to work in a supportive environment. Please call Chelsea at 724-740-8399 and/or email crvhofficemanager@gmail.com.
Londonderry Animal Hospital | Full or Part Time / Middletown, Pennsylvania
Seeking an independent, compassionate Veterinarian to join our team! Why Londonderry Animal Hospital in Middletown, PA? We’re focused on making sure our hospital has the right tools to allow our doctors and medical staff the ability to provide excellent service and care! We are proud to offer additional growth opportunities for Associate DVMs through our partnership with Veterinary Practice Partners (VPP). VPP has 100 veterinarian owners who co-own their practices across 150 + locations.
Requirements: State Veterinary Board License must be in good standing for the state where they intend to be hired, before their start date. Please call Laura Auker at 423.306.2150 and/or email lauker@vetpartners.com.
Tri-County Veterinary Services | Full or Part Time / Loysville, Pennsylvania
Located west of Harrisburg, we are a privately owned, 3-doctor practice seeking 1 or 2 PT/FT small animal or mixed animal associates who are looking to develop their skills and have some freedom to achieve their life objectives. We seek associates who wish to practice excellent and compassionate medicine. The small animal portion of our fullservice hospital treats primarily dogs and cats with some doctors treating small mammals as well. After-hours emergencies are referred. We also operate a separate spay/neuter clinic. Veterinarians with any level of experience are considered. Generous salary, benefits, C.E., and sign-on bonus. Please contact or forward your resume to Dr. McMillen at docandmrs@pa.net.
West Lancaster Animal Hospital | Full or Part Time / Lancaster, Pennsylvania
West Lancaster Animal Hospital in Lancaster, PA seeks a team-focused veterinarian to join our well-established, AAHA-accredited small animal practice in
Lancaster, PA. Our modern hospital boasts advanced diagnostic features, dedicated leadership, and more. The priority of our committed and well-educated support staff, which includes multiple CVTs, is providing fantastic veterinary care to pets in our community. This position has leadership potential for an experienced veterinarian looking to lead a devoted and hardworking team! Benefits include a superior salary and $40,000 sign-on bonus, medical benefits (including health, dental, and vision), 401(k), employee assistance program (EAP), CE PTO and allowance, vacation, dues, liability coverage, and so much more. Please call/ text Alexis at 302.316.5545 and/or email adelledonne@vetcor.com.
Oley Valley Animal Clinic | Full Time / Oley, Pennsylvania
Oley Valley Animal Clinic is looking for a Managing Veterinarian to join their team! Oley Valley Animal Clinic is a wellestablished, small animal veterinary hospital providing comprehensive medical, surgical, and dental care. Our mission is to provide the Oley Valley and surrounding communities with advanced, compassionate, and comprehensive care. We aim to embody our core values of efficiency, compassion, responsibility, dependability, and professionalism in everything we do. The ideal candidate places a high priority on fostering client relationships and will thrive in a busy, multi-doctor practice, has a love of people and collaboration, and enjoys a progressive medical approach. Please reach out to Arianna Dobroski at arianna.dobroski@nva.com.
Larkin Veterinary Center |Full-Time/ West Lawn, Pennsylvania
Are you interested in leading others? Larkin Veterinary Center is looking to add a Managing Veterinarian to their team! Larkin Veterinary Center is built on the belief that patient care and comfort come first, whether a dog, cat, or exotic pet. We pride ourselves on preventative care through routine vaccinations, twice-yearly exam recommendations, and preventative diagnostic testing. Our dental program is top-notch with digital dental X-rays for every patient, and all our surgeries receive full, advanced monitoring. Please reach out to Arianna Dobroski at arianna.dobroski@nva.com.
Technicians
A & M Animal Clinic | Part Time / Watsontown, Pennsylvania
Certified Veterinary Technician/ Veterinary Assistant Wanted for A & M Animal Clinic at Hazel Twp, Pa. Join an experienced mentor who’s dedicated to nurturing your growth. Perfect for anyone seeking flexibility and guidance. Assist with surgeries and provide compassionate care to our loyal clientele. Fair pricing ensures accessibility for all pet parents. Enjoy flexible hours tailored to your schedule. Don’t miss this opportunity to jumpstart your career with mentorship and community-focused care. Apply now to become an integral part of our team! Please send resumes to Dr. Abdelmalek at samyzaki93@yahoo. com or call (570) 454-2466.
Practice Managers
Limerick Veterinary Hospital | Full Time / Limerick, Pennsylvania
Limerick Animal Hospital, Limerick, Pennsylvania, is seeking a Veterinary Practice Manager who can partner with the practice department leads by ensuring quality, modern, and compassionate care for our clients and pets. Our ideal candidate is a leader who is team-focused, self-motivated, has strong organizational skills, is task and detail-oriented, and can prioritize and delegate efficiently. Works well under pressure and maintains compassion and empathy for clients, patients, and staff they serve. Candidates should be familiar with all aspects of business management including human resources, financial, operations, marketing, facility, and client services. Candidates possessing CVPM certification, veterinary experience, or have an associate degree in business management is a plus. Health, vision, and dental insurance. Paid time off, 401K, and employee pet discount. Salary range – $60,000 – $75,000. Please email Shirley Lockhart, MBA, at slockhart@ lockhartvetconsulting.com.
Practices/Equipment For Sale
Maine
Suburban general veterinary practice for sale in Maine. 2700 sqft small animal wellness practice on 21-acre property, incl. renovated 2400 sqft house, 960 sqft garage w/ apartment, & greenhouse. Real estate available. 2 exam rooms, crematory. Digital records & imaging. $700K+ collections, 1600+ clients. Near ER & specialty care. Zoned for mixed/ equine use. Please contact Rohit rohit@omni-pg.com or 234-353-3268.
Western Pennsylvania Consolidators? Count on the experience of Total Practice Solutions Group – Great Lakes. Contact TPSG Great Lakes BUYING OR SELLING A PRACTICE – Buying or selling a veterinary practice? Email or call (www.tpsgsales.com) at 440-933-4522Dr. 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 $769K. 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 440-933-4522 - Dr. Kurt Liljeberg (kurt@tpsgsales.com) or Bret Halishak (bret@tpsgsales.com).
Relief Veterinarians
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 humananimal bond. Excellent communication skills, active listener, compassionate, and empathetic. Email ekhj07@gmail.com.
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.
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 Quakertown-Pottstown area. Fast and proficient in surgery. Very dependable, professional appearance and manner. See website at jacquelineburkevmd. com. Call 215-892-8315 or email at jacquib1018@gmail.com.
Michael Reese, VMD, MS
Lancaster, York, Dauphin, Lebanon, Berks, and Chester Counties
Small animal veterinarian practicing in Lancaster County and the surrounding region. 15 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 relief services to your practice. Thank you! Email reeseveterinary@gmail.com.
