Keystone Veterinarian Volume lll

keystone

veterinarian

OFFICIAL PUBLICATION OF THE PENNSYLVANIA VETERINARY MEDICAL ASSOCIATION

VOLUME III, 2012

www.pavma.org

pvma

pennsylvania veterinary medical association

advancing animal welfare and human health while ensuring the vitality of the profession

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pvma

pennsylvania veterinary medical association

pennsylvania veterinary medical association

8574 paxton street hummelstown, pa 17036

advancing animal welfare and human health while ensuring the vitality of the profession

phone: 888.550.7862 fax: 717.220.1461 email: pvma@pavma.org website: www.pavma.org

what’s featured 14

The Ongoing Debate Over Feral Cats (Part 2)

18

5th 3 Rivers Veterinary Symposium

in this issue

2012 EXECUTIVE COMMITTEE Robert P. Lavan, DVM, ACPVM President Kenton Rexford, VMD President-Elect Sherrill Davison, VMD, Vice President

7

Pennsylvania Task Force 1 In Need of Veterinary Services

7

Leptospirosis Survey Available Until October 30

9

Letter to the Editor: Another Perspective on the Stem Cell Therapy Debate

16

Protecting the Reputation of Your Practice Online

20

Marcellus Shale and Hydraulic Fracturing (Hydrofracturing): Hope, Hype, Health, Hysteria, and Questions

22

2012 PVMA Building Campaign

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2013 Winter Seminar Vacation to Antigua

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PVMA Welcomes Its 2013 Slate of Officers

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PVMA Member Awards Received During the 6th Keystone Veterinary Conference

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Federal Trade Commission Hosted Workshop on Pet Medications—Comment Period Still Open

Ronald M. Kraft, DVM Secretary-Treasurer E. Mark Fox, VMD Immediate Past President Mary A. Bryant, VMD AVMA Delegate Charlene Miller Wandzilak Executive Director

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ON THE COVER: The photo on the cover of this issue of keystone veterinarian is from Isel Pollock, the 6TH grade winner of PVMA's 2012 Digital Photography Contest. Congratulations, Isel!

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Quarterly Columns 6 Observations

by Heather Berst, VMD

“Client Education is the Key to Getting More Pets Through the Door”

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The President’s Two Cents

"The Votes Are in in Pennsylvania!”

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From Where I Sit

“Healthcare Reform: Understanding the Moving Target”

by Robert Lavan, MS, MPVM, DVM, DACVPM

by Charlene Wandzilak

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Practice Pearls

"Practice Owners: Coasting to a Crisis?”

by David McCormick, MS, and Sherry Everhart, BS, RVT

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Foundation Cornerstone

34

Member News

38

What’s Happening

40

The Grand Finale

"3rd Annual Bark in the Park 5k Run & 1 Mile Dog Walk" "Dr. Kimberley Galligher Takes Over Phoenixville Veterinary Hospital" “Events and Education”

Advertising Index 37 AVMA-PLIT 17

Burzenski & Company, PC

9

DoveLewis Emergency Animal Hospital

3, 11

Drexel University College of Medicine

IRC Highmark 21

Nate Lynch & Associates, LLC

4

On-Hold Specialists

35

Pfizer Animal Health

5

PNC Bank

RC pvmaAssure Insurance Agency, Inc. 17

ScoDen, LLC

37

Simmons Veterinary Practice Sales & Appraisals

25

TransFirst Health Services

7 VetCor

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IFC

Wharton Executive Education, University of Pennsylvania

36

Classifieds

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keystone

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2012 Board of Trustees (A= Alternate Trustee, T=Trustee)

District I Adam Hoover, VMD, Trustee Karen Martin, VMD, Alternate

District II Lloyd Reitz, Jr., DVM, Trustee Stacia McMahon Gilbert, DVM, Alternate

District III Robert Bishop, DVM, Trustee Mary-Lynn McBride, DVM, Alternate

District IV Henry Croft, Jr., VMD, Trustee John Showalter, DVM, Trustee Michael Q. Bailey, DVM, DACVR, Alternate

District V Bill Croushore, DVM, Trustee Dan Zawisza, VMD, Alternate

District VI Andrea Honigmann, DVM, Trustee John Simms, VMD, Trustee Trent Lartz, DVM, Alternate Jeff Steed, DVM, Alternate

District VII Christina Dougherty, VMD, Trustee Jim Holt, VMD, Trustee Casey Lynch Kurtz, VMD, Trustee Theodore Robinson, VMD, Trustee Kimberley Hershhorn Galligher, VMD, Alternate Kim Kovath, VMD, Alternate Steven Prier, VMD, Alternate Tom Garg, VMD, Alternate

Editor: Heather Berst, VMD Staff Editor & Graphic Designer: Lori Raver Staff Editor: Charlene Wandzilak Editorial Correspondence Letters to the Editor should be sent to PVMA, Attn: Lori Raver, 8574 Paxton Street, Hummelstown, PA 17036, fax 717.220.1461, or by email at lraver@pavma.org.

Advertising keystone veterinarian is published quarterly by the Pennsylvania Veterinary Medical Association. Inquiries about display advertising should be directed to Lori Raver at the address and phone number listed above. Advertising information is also available on our website, www.pavma.org. Contracts and insertion orders should be sent to the address listed above by the appropriate submission deadline.

Submission Deadlines All articles, classifieds, and display advertisements must be received by the deadlines listed to be considered for inclusion in the respective issue: Volume IV, 2012—November 1, 2012 Subscriptions keystone veterinarian is mailed to all PVMA members at no charge as a member benefit. Subscriptions are available to non-members for $30 a year or $10 for a single issue.

Notice to Readers Neither this publication nor PVMA assume responsibility for material contained in articles and advertisements published, nor does publication necessarily constitute endorsement or approval of the advertiser, product, service, or author viewpoint by the keystone veterinarian, its editors and publishers, or the Pennsylvania Veterinary Medical Association. In addition, neither this publication nor PVMA guarantee the accuracy, reliability, or completeness of any facts, views, opinions, recommendations, information or statements contained within this publication.

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

Copyright 2012: Pennsylvania Veterinary Medical Association.

District VIII Mike Barnett, DVM, MBA, Trustee Ferdinand Visintainer, VMD, Trustee Susan Ackermann, DVM, Alternate

AVMA Alternate Delegate Mike Topper, DVM, PhD, DACVP

Academic Veterinarian At-Large Colin Harvey, BVSc, ACVS

Veterinary Student At-Large Lauren A. Aldinger (V’12)

Production Animal Practice Veterinarian At-Large Darcie Stolz, VMD

Equine Veterinarian At-Large

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Veterinary Technician At-Large Joy Ellwanger, CVT

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observations

Client Education is the Key to Getting More Pets Through the Door

By Heather Berst, VMD, Editor

I

dreaded visiting one particular veterinary hospital when I started my employment with Hill’s. Why? I could never find a parking spot in the lot! It was a very busy practice. Then, about two years ago, I visited the veterinary hospital and guess what? I got a parking spot in the front row. Where have all the clients gone?

We know that dogs and cats are visiting the veterinarian less frequently. The Banfield Pet Hospital 2011 State of Pet Health Report is eye opening. This report found that there is an increase in preventable diseases in our pets.

Diseases such as diabetes, dental disease, heartworm disease, flea infestations, and obesity are on the rise. We need to address these preventable diseases in the pet population.

Is there a solution? Yes! Studies show that 58% of pet owners would take their pet to the veterinarian more often if they knew the visits could prevent problems later and 57% of pet owners would take their pets to the veterinarian more frequently if the pets could live a longer life. Consequently, the American Veterinary Medical Association (AVMA) launched the Partners for Healthy Pets program at the AVMA Convention in San Diego in August to deal with these issues. I was very proud to see that the PVMA was an associate member of this partnership.

The Partners for Healthy Pets is a non-profit committee of the AVMF that was created to ensure that pets receive the regular healthcare they deserve. Last year, the AVMA and AAHA released guidelines for canine and feline preventative care. These can be found at the website, www.partnersforhealthypets.org. The Partners for Healthy Pets website contains a toolbox for practices to implement these preventative guidelines.

I attended the AVMA convention this year, and was fortunate to attend the symposium on the partnership. I was interested to learn the dental profession went through a similar change many years ago. Historically, dentists had spent most of their time filling cavities and performing treatment procedures. Then, the entire profession decided to work towards preventive dental care for humans. Now, who doesn’t visit the dentist twice a year? (Or at least feel guilty if you don’t). That should be our goal in veterinary medicine. Pet owners need to realize the value of bringing their pets in annually or biannually to prevent disease.

The Partners for Healthy Pets website has fantastic tools. There is a survey tool that can be utilized to survey the clients and staff at your hospital to obtain their perspectives on preventive healthcare. There is also a training manual to implement the guidelines, presentations to give to staff at veterinary hospitals, webinars, and internet marketing information, communication information, and tips to make a feline friendly practice. I think that every small animal practice in Pennsylvania needs to visit the website and take a look at some of the tools.

So, back to the practice I mentioned in the beginning. I went there recently, and the parking lot is starting to fill up again. Hopefully, if they embrace the tools available to them on the Partners for Healthy Pets website, they will be just as busy as ever in the near future! l

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Boehringer Ingelheim Vetmedica Leptospirosis Survey Available Until October 31

t

he Pennsylvania Veterinary Medical Association is working with Boehringer Ingelheim Vetmedica, Inc. (BIVI), to conduct a survey to acquire information about canine leptospirosis regionally within Pennsylvania.

The survey itself takes about 15 minutes and is completed online, asking for information on your lepto cases including diagnosis and treatment details. Someone in your clinic would need to review the records prior to starting the summary in order to provide accurate details.

Once the research is gathered, we will work with BIVI to provide you with the survey results for our state so you can share them with your staff and your clients.

Survey respondents will be entered into a random drawing to win either a New iPad (16 GB - one first place prize) or a tray of DuramuneÂŽ Max 5/4L (five second place prizes), to be given away in October (again, this may vary).

If you’d like to participate or to find out more, please visit www.surveymonkey.com/s/PennsylvaniaLeptoSurvey or contact Charlene Wandzilak at cwandzilak@pavma.org. The survey must be completed by October 31, 2012, to be eligible to win. l

Pennsylvania Task Force 1 In Need of Veterinary Services Pennsylvania Task Force 1 (PA-TF1) is one of 28 certified, operational and deployable federal assets of the National Urban Search and Rescue System established by the Federal Emergency Management Agency (FEMA). If mobilized, the task force is able to reach any location in the United States within 6 hours. Personnel respond generally from within 150 miles of Philadelphia including Pennsylvania, New Jersey, Delaware and Maryland.

The task force is currently seeking a partnership with willing veterinarians for pre-deployment exams for K-9 members of the force. Veterinarians would be required to go to PA-TF1 headquarters upon notification of deployment and to conduct basic pre-deployment medical evaluations of the dogs and sign a Fit For Deployment certification. Deployments generally only happen once or twice a year and the screenings are not time consuming.

If you are interested in learning more about this opportunity, please contact Ken Pagurek, PA-TF1 Program Manager at 215.437.2166. l

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the two cents thepresident’s president’s two cents

The Votes Are in in Pennsylvania!

By Robert Lavan, DVM, MS, MPVM, DACVPM, President

T

his issue's column is a collection of thoughts on various topics. The first of which is that the race for President of the United States is heating up but here at PVMA, we already know the election results.

Congratulations to Dr. Jim Holt who was elected as our next Vice President. The PVMA Executive Committee for 2013 will be: • President—Dr. Kenton Rexford • President-Elect—Dr. Sherrill Davison • Vice President—Dr. Jim Holt • Secretary/Treasurer—Dr Ron Kraft • Immediate Past President—Dr. Bob Lavan We just finished the third of our 2012 CE events, the 6th Keystone Veterinary Conference. It was very well attended with over 800 registrants and should be considered a big success. Attendance exceeded 2011's meeting by over 100 participants. I want to congratulate the PVMA management team for a terrific effort and a wonderful conference. I also want to congratulate Dr. Lisa Murphy and the Scientific Program Committee for putting together a wonderful program. On the last day, I had lunch with a New York veterinarian who drove down to our meeting from Ithaca because of the variety and quality of the speakers and topics. If you missed this meeting, you missed a great CE opportunity. Fortunately, it will be back next year August 15-18, so save the date!

I will be asking the large group of PVMA Past Presidents who are active members to join an advisory group for the current president. As an organization, we are blessed with many men and women who have served as PVMA leaders and who continue to donate their time for the organization and participate in our CE meetings. I would like to organize a more formal process to enable future PVMA officers to get quick access to this wealth of experience.

Our insurance agency, pvmaAssure, exists for the benefit of our members and is not beholden to anyone other than PVMA members. Dollars spent here benefit you and your organization. I hope you will consider asking for an insurance quote to see if pvmaAssure can provide an insurance program tailored for the needs of your hospital and staff. You won’t get better service and may be able to reduce your insurance costs.

I wanted to congratulate our Executive Director, Charlene Wandzilak, for her award from the American Society of Veterinary Medical Association Executives. She recently received the Distinguished Service Award for her volunteer work on their behalf. This award is well-deserved.

Finally, get out to vote in the upcoming election. The phrase “vote early and vote often” is variously attributed to gangster Al Capone and Chicago ex-mayor Richard J. Daley and is one way of assuring an election outcome. The other is to stay active in the process and work to help your candidate get elected. Remember, If you don’t vote, don’t complain about the outcome! l

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Letter to the Editor

Another Perspective on the Stem Cell Therapy Debate

By Mike Hutchinson, DVM

I

am writing this letter as a response to comments that I read in the editorial section of the Volume I, 2012, edition of keystone veterinarian, in which the legitimacy of claims made by proponents of stem cell therapy was brought into question. Most notably, the author of those comments made the implication that stem cell therapy might be turning into “the 21st century snake oil.” Out of a passion for this profession, I would like to address those questions, because I am wholly of the mind that adipose-derived stem cell therapy is an effective and well-researched procedure that will not be fading away any time in the near future.

To provide the reader with some background, since 2008 I have performed over 400 stem cell treatments using adipose-derived stem cells (approximately 75 with Vet Stem technology and the remainder with MediVet-America in-house technology). I give RACE-approved talks on stem cell science, techniques and case studies in the US and abroad. I have spoken with and visited several active stem cell researchers from private companies as well as veterinary and human universities from around the globe, and I continue to do this on a frequent basis. In addition, I guest host a weekly webinar primarily for veterinarians in North America discussing adipose-derived stem cell therapy along with suggested protocols and current outcomes for compassionate use of this technology. As I continue to put much of my time and effort into researching this new branch of medicine, I am amazed by both its capacity to help animals today as well as its enormous potential for the future.

evidence that stem cell therapy may accelerate the oncologic process in patients with a pre-existing neoplastic condition. I must respond with this question: Is it the author’s implication that the FDA should oversee all other surgical procedures that we perform on a daily basis in our clinics? If they do not, does that put into question any claims that we make after performing a surgery? Furthermore, evidence that stem cell therapy may accelerate the oncologic process must be taken into serious consideration and, as such, is listed as a current contraindication. However, the current stem cell companies provide information on over 10,000 cases that have been treated to date with no adverse side effects, but instead positive benefits described by pet owners and their veterinarians alike. This evidence is anecdotal, but isn’t that the criteria we use every single day in our practices to judge our treatment outcomes? We took an oath to first do no harm; a search for adverse side effects of utilizing first generation, autologous adipose-derived stem cells in Google yields no such examples.

Finally, the author states a concern that clients are being sold a treatment modality on a premise that has not yet been proven and says that a client is more likely to spend thousands of dollars if they hear a claim that their pet will be made new again. In this case, I would agree continued on page 38

The first comment with which I would like to contend is a proposal by the author of the original article that improvement in patients of this therapy is not due to the ability of stem cells to differentiate into other cell lines. It is important to point out that the International Stem Cell Association has defined a stem cell using four criteria, one of which is that they have the ability to differentiate into either adipose, cartilage (chondrocytes) or bone (osteocytes). Coincidentally, we have since learned that the adipose-derived stem cells can trans-differentiate across germ layer lines. They are in the mesoderm lineage (Mesenchymal Stem Cells or MSCs), but can cross into the ecto and endoderm lines. When injected into a degenerative joint microenvironment, adipose-derived stem cells have already been shown to differentiate into cartilage in humans, rats, goats, rabbits, and mini-pig models.

While the dog and cat studies are not yet finished, there is no reason to think that their results will be any different. In either case, it will not be long until we find out.

However, it should be noted that cell differentiation is not widely regarded as the major function of these cells. At this point in time, many researchers believe that the MSC’s most useful function is their stimulatory effect on cells in a paracrine manner. The stem cells have the ability to secrete chemokines that apparently “cross-talk” with distressor signals from the damaged tissue. They also secrete proangiogenic factors such as vascular endothelial growth factor (VEGF), which in turn accelerate the proliferation of endothelial cells. This explains many of the benefits already seen with stem cell therapies in vivo.

Secondly, the author of the original article asserts that a lack of Federal Drug Administration (FDA) oversight of these procedures should bring into question claims made by stem cell companies and cites WWW.PAVMA.ORG

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from where I sit

Healthcare Re form Understanding the Moving Target

By Charlene Wandzilak, Executive Director

a

s we all watch political campaign debates and advertisements on TV and we anxiously await the Presidential election to get here in November, healthcare reform is a hot topic among candidates and healthcare insurance carriers, but more importantly, to employers and individuals. The issue for many brings feelings of apprehension and confusion. Rightfully so; it is confusing. It changes the health insurance landscape tremendously, and it's unknown what true impact it will have. As your advocate and resource, PVMA and our exclusively owned insurance agency, pvmaAssure, are here to help navigate through the moving parts of healthcare reform and make sure you understand how it impacts you as an employer, employee, or individual.

President Obama signed the Patient Protection and Affordable Care Act (ACA) into law in 2010. Better known as healthcare reform, the new law ushered in many changes that will take place over the next decade. Most Americans will be touched in some way by the landmark legislation which was recently upheld on June 28, 2012, by the Supreme Court of the United States when it was challenged for numerous reasons.

Most significantly, the Affordable Care Act will expand health insurance options for the more than 32 million Americans who currently lack coverage. Nearly all Americans will be required to obtain health insurance, with federal subsidies available for those who qualify by income. In addition, through the state-based insurance exchanges that will become available in 2014, consumers will be better able to understand, compare and purchase coverage.

What exactly will happen is unknown at this time because healthcare reform is a moving target. Here are the changes that will take place that you should be aware of for 2013 and 2014:

For Employers • Insurance coverage will continue to cover dependents to the age of 26.

• As of September 23, 2012, group health plans and health insurance issuers are required to distribute an easyto-understand Summary of Benefits and Coverage (SBC) and a uniform glossary of terms to all employees insured under the health plan. As an employer, this means that you are responsible to make sure your employees covered by your health plan receive this information. As insurers, it requires that all insurance carriers make sure you receive it to distribute. Insurance brokers, like pvmaAssure Insurance Agency, will be available to ensure that you understand these duties and help you with educating your staff how to utilize their benefits and understand their coverages.

• In 2013, all employers regardless of the number of employees must report the value of the health insurance paid by the employer on the employees’ w-2.

• In 2014, employers much notify employees of the existence of the insurance exchange.

For Employees/Individuals • In 2013, there is a $2,500 Flexible Spending Account (FSA) maximum • In 2013, the penalty increases from 10% to 20% for non-qualified medical expenses paid through a Health Savings Account(HSA) • In 2013, there is an increase in the Medicare Part A (hospital insurance) tax rate on wages by 0.9% (from 1.45% to 2.35%) on earnings over $200,000 for individual taxpayers and $250,000 for married couples filing jointly and impose a 3.8% tax on unearned income for higher-income taxpayers • In 2014, there will be no pre-existing condition exclusions • In 2014, you will have access to an insurance exchange

What It Means For Insurance Carriers • Medical Loss Ratio will apply – The carrier must use 85% (80% for small groups) of the premium collected to pay an actual claim. 15-20% can go toward profits and administrative costs. If they do not use 85% of the premium, they are required to issue a refund to the client. In the case of a group health plan, if the employee has continued on page 39 10

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practice pearls

Practice Owners …

Coasting to a Crisis?

By Sherry Everhart BS, RVT, and David McCormick, MS, Simmons Mid-Atlantic, Boalsburg, Pennsylvania

i

ncreasingly, baby boomer-aged veterinarians are beginning to consider retirement. For practice owners, this brings up the need to exit from ownership, the timing and the question, can I afford to retire?

Having been one of the most entrepreneurial generations in history, baby boomer business owners are now fast approaching 50 and older and are beginning to think about the right time to exit the workforce.

Recent studies predict that over the next 10 years, one out of every two privately owned businesses will change hands. These same studies also show, however, that 75% of small business owners have no actual strategic exit plans in place. Regrettably, for too many veterinary business owners, this means that they don’t see that a major crisis looms in their immediate future. By not preparing, too many practice owners will learn that, when the time comes to exit, their practice may have little to no saleable value.

Over the past several years, veterinary practice appraisers have been recognizing an unfortunate increase in the number of practices that have exceptionally low profits, and therefore, low value. Beyond the No Lo issue, many of these affected practices share some commonalities and operational habits that lead us to descriptively classify them as a group that is “coasting in neutral.”

Flat or declining practice revenues and the likely decreased profits inevitably equates to a decrease in practice value. It can sneak up on the practice if you are not paying attention—especially for a practice that is coasting in neutral.

• • •

•

To better understand what coasting means and the devastating effect it can have, it is important to see how it can develop. In almost all affected cases, there is a loosely similar set of owner and practice characteristics:

• the practice is 20 years or more old the owner is approaching retirement age and has owned and operated the practice from its beginning the practice real estate is owned by the practice owner the owner has enjoyed practicing but the stress of management is beginning to increase and he or she is looking forward to retirement financially, the owner is enjoying increases in cash flows from the practice

If any of this resonates with you, please keep reading!

The Set-Up for Coasting In Neutral Veterinary practices experience a life cycle phases much like a person, i.e., a growth phase, a maturation phase, and then an aging phase. Because the demands on cash flow appear to play a formative role in the eventual development of the coasting in neutral practice, it is useful to examine these demands during each of these phases.

Practice Growth Phase The growth phase involves the initial start-up, acquisition or significant remodel plus the associated debt.

Debt repayment extracts a large portion of available cash flows. During this phase, owners are attentive to maintaining profitability in order to maintain sufficient cash to satisfy both debt payments and personal needs at home. Therefore, maintaining practice growth is essential and increasing revenues typically result in increased take home dollars.

Practice Maturation Phase For many practices, this is the period of time when perhaps the significant debts are paid off and there is more cash flow available for other purposes. The practice is still growing and with the growth there are additional expansion projects. Once again, debt obligations are assumed and the cash flow will again be tighter. The practice owner is attentive to its profitability and to fostering continued practice growth but there is less stress than during the initial growth phase because there is more reliability in the practice, the team and the client base. continued on page 13

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Practice Pearls continued from page 12

Practice Aging Phase In this phase, growth and expansion projects are no longer needed or even desired. Cash flow available to the owner is often at a high level in large part because all debt obligations have now been satisfied. Additionally, other non-veterinary demands on cash flow have generally decreased. At this stage practice owners are generally experiencing a level of financial comfort they have only glimpsed previously. The owners are often gradually becoming tired of the demands of practice in general and especially managing staff. The thrill and pleasure of practice and practice ownership is waning.

After two to three decades of active clinical productivity, practice management, people management, etc., the owner is now at one of the major decision points of his or her professional life. Unknowingly, they have arrived at the beginning of the coasting in neutral stage. How they proceed in the Practice Aging Phase will have a significant far-reaching effect on their practice’s value.

Coasting in Neutral Having arrived at this point in their practice life, the owner will make one of two general choices. One choice, the preferable choice, is to continue to “work” the practice as they have in the past – focusing on managing the practice for profitability, utilizing the team efficiency, providing a good service and experience for the client, and by focusing on practicing medicine (as opposed to selling products). By doing so, their practice will probably maintain its value.

• Decreased hours in the practice from elements outside of your control. Often the owner or their spouse develops an illness or a physical condition that reduces their ability to maintain work hours. Many baby boomer business owners also still have living parents who are declining in health that can result in additional constraints on their time that can be invested in the business.

• Life is good. Frequently when the owner earns a comfortable living he/she finds it easier to no longer work as hard. Not only have the practice debt obligations been retired, but often so have personal debt obligations such as home mortgage, tuition, and other personal loans. Having filled their homes and raised their families, baby boomers are also at an age when they are inclined to spend less dollars accumulating ‘stuff’. Even though the practice profits may be declining, the owner isn’t aware of it because there is less going out to service other debts and obligations.

• Owners have ignored their competition.

After having been in practice so long and being well-established, these practice owners frequently have a loyal and stable client base that provides steady, although not growing, revenues. They have not needed to rely on initiatives to differentiate their services. The competition during this time though, may have not only caught up, they may have steamed ahead.

The net result of these, and a myriad of other justifying reasons (plus issues related to the economy), is flat or decreased revenues and likely lower levels of profitability.

Inevitable Outcome of Coasting Flat or declining practice revenues and the likely decreased profits inevitably equates to a decrease in practice value. It can sneak up on the practice if you are not paying attention – especially for a practice that is coasting in neutral. For many of these owners, their hard work has provided a steady income and a comfortable lifestyle for them and their families. Why wouldn’t it have significant value?

Exacerbating this situation, many studies show that baby boomers, while hardworking, are a generation of poor savers. As a result, many baby boomer business owners in general and thus many practice owners are planning on the sale of their practice as the funding source for the majority of their retirement. The impact of a low practice value as the outcome of coasting can be devastating.

Back in Gear???

Practice owners who suspect they may fall in the general pattern of the coasting phenomena are encouraged to get out of the coasting mode and become active in the details of your practice again. Consider the following: 1. Build a strong, innovative management team dedicated to practice growth. As discussed above, a practice owner may face significant life challenges that impact his or her ability to continue spending large amounts of time in the practice in later years. Transferring marketing, stratcontinued on page 31

Alternatively, others will, without any knowledge or recognition, gradually slip into a coasting mode, a neutral mode where the focus on actively managing the practice begins to decline. The reasons are varied and are frequently very legitimate which is why awareness is even more important. The reasons can include: • The owner needs (and probably has earned) a little time off. Baby boomer business owners were a generation that devoted long hours into building their practices and often at the expense of personal and family time. As they grow older, many of them are transitioning to spending a greater portion of their time with family and recreational activities. In order to provide the additional time off and easier days in the practice, some owners will overhire additional support staff which can be a further drain on profits.

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9/27/2012 4:52:23 PM

The Ongoing Debate Over Feral Cats

By Bryan Langlois, DVM, Medical Director of the Humane League of Lancaster County, Lancaster, Pennsylvania

PART 2 OF A 2-PART SERIES:

o

k. Now that we've had time to digest the various viewpoints and issues surrounding the feral cat issue (and if you are like me downing a bottle of TUMS while doing it) which appeared in Volume II of keystone veterinarian, let us look at the less controversial issue of running a successful trap/neuter/ release (TNR) program. This article will focus more on the pure medicine and surgery aspect. I will start though by looking at what makes a program really successful.

Perhaps the one thing that is overlooked by most people when starting up a TNR program is that of the commitment involved, both in time and in resources of money, volunteers, and equipment. To do TNR clinics of 50-plus cats is not an easy feat, requires the coordination of multiple different groups, and especially good coordination of your veterinary team. A space big enough to properly house these animals in the cages/traps throughout the entire process is also required.

The ideal set up is a building that can be separated into four main areas. Those are: incoming, where the cats are first brought in and paperwork signed; induction, ideally a room that has no exits aside from a closeable door so cats cannot escape as they are induced; surgery prep/surgery room, where the animals are prepped and the surgery takes place; and recovery, where the cats are monitored by someone as they wake up and is the place where the caretakers come to pick up the cats at the end of the day.

Many people who want to do clinics think all they need is a veterinarian and possibly a technician to get the cats done, but this could not be further from the truth. The only reason the program we run at the Humane League is as successful as it is is because of the dedication 14

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and teamwork of about six to seven people who work with me. Bringing a feral through the entire spay/neuter process has many steps, and staff and volunteers are needed at each step for this process to move efficiently. The magic ratio of technicians to veterinarians appears to be 3:1. This allows enough people to be able to take care of two to three cats at once and keeps the veterinarian working at the surgery table constantly. Many of the veterinarians that help out in these clinics are volunteering their time, and the last thing they want to be doing is standing around waiting for another cat to work on. Having too few technicians and assistants means the gears of progress are going to grind along painfully slowly and discourage many veterinarians and other volunteers from helping out in the future. Keep this in mind when a program is being conceived.

There are a few—sometimes debatable—topics that come up when TNR programs are being done. The most common ones are: whether to test every cat for FeLV/FIV, pregnancy terminations, and how far to go on medical treatment of feral cats with issues. The current thinking on the FeLV/FIV issue is that it should not be mandatory for all cats.

The main reason for this is the cost that is undertaken testing each cat.

Many feel, myself included, that the money is better focused towards the cost of the actual surgery and rabies vaccine. If one has the money to allow for the testing of every cat that comes through the program, then there is nothing wrong with that. However, it is important to have it clearly described and delineated in the waiver the caretaker will sign (see later in the article) what the policy is for cats that test positive for either virus. Having this decided before anything happens saves a lot of stress and heartache/headaches later when a cat is under anesthesia, tests positive, and now an argument ensues as to what to do. Often this is the exact situation where the caretaker cannot be gotWWW.PAVMA.ORG

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ten a hold of either. I do feel, however, that the option of testing cats should be made available to the caretaker (with the caretaker absorbing the cost) as it is always good to know and to identify potential pockets of infected cats. Finally, I feel it is vital to have a few tests available to test cats that come in looking very sickly. It helps make medical management decisions easier for those cats.

Perhaps there is no greater emotional aspect of doing TNR than terminating pregnancies.

Anyone who has done these clinics with any regularity know that come the months of April through June it can be nothing but pregnancy terminations on every female cat that comes in (many of which appear to be very close to term). This is perhaps the hardest thing for all of us that work in the field have to come to terms with. While never an easy thing to do, I feel it is necessary in these clinics to perform this procedure. There are already so many feral cats out there that allowing these kittens to be born to add to that population would be completely defeating the purpose. The proper thing to do with any kittens young enough in a TNR program is to “harvest” them and work to get them tamed and adopted. There is currently a movement out there among the No-Kill Nation folks that pregnancies should not be terminated at all and that any pregnant feral cat should be put into a foster home situation, allowed to have the kittens, and when the kittens are 8-10 weeks old be taken and placed for adoption. While this idea has the best of intentions, I feel it is not practical in today’s world, and would expose many a caretaker to severe risk of injury in having to deal with a feral cat. In many situations, foster programs are stretched to their limit as it is, and adding this to the list of animals needing fostering would hurt the chances of other animals, not to mention provide unnecessary and perhaps unethical stress on a feral cat.

There are some caretakers who know their cat is pregnant and prefer to let her have the kittens and then bring them all in through the program. That is an acceptable option to me, although getting the mother and kittens in at the right time post-queening for follow-up is crucial. In addition, there may be veterinarians or other volunteers who do not believe in terminating pregnancies. This is ok as well, and I do not force anyone to be part of it who does not want to. They still can participate in other surgeries and be a valuable addition to the team. It is important that everyone agree at the start if any pregnancies will be terminated Now we come to what to do with the ill or injured feral cat. I have seen these handled in all ways from immediate euthanasia to all out efforts to save or heal them. I think the WWW.PAVMA.ORG

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correct action sits in between the two. The three main health issues I have seen with feral cats presented to the TNR are upper respiratory infection (URI), abscesses, and poor body condition score. It has been my experience that most of these can be adequately treated.

URI is something that will always be seen in the feral cat population. In an ideal world, we would not put an animal that is suffering from an URI under anesthesia and do a surgery such as a spay or neuter. Everyone knows though that the feral cat presents challenges and situations that never fall in the “ideal” range. In my experience, most feral cats that have a mild case of URI can be safely anesthetized and have a quick spay or neuter procedure done. These cats are monitored very closely under anesthesia and are given a shot of Covenia to help control the bacterial infection aspect of the URI. They also are often given a bolus of sub-cutaneous (SQ) fluids to help them with hydration issues.

Often times, the caretakers can keep an eye on the cat and let us know if there are further issues. There are those feral cats that are so ill with URI it is not advisable to even risk anesthesia. If possible, these cats are tested for FeLV/FIV first to rule out these infections. If they are positive, the cat is euthanized. If they are negative, we try to work with the caretakers of these cats to see if they can provide the cat with some oral medication (usually doxycycline liquid or crushed enrofloxacin tablets) in food. If they can, we send them with this medication and instructions to keep the cat confined. It is then brought in after a few weeks for surgery when the infection has cleared. Most caretakers are agreeable to this solution and do not mind paying the cost of the medication. If the cat is so wild and feral that it cannot be medicated or confined easily, then the ethical choice is euthanasia.

that these cats need for medication. Again, if the wounds are accompanied by other signs of illness, the cat should ideally be tested for FeLV/FIV is possible. Cats that have very extensive wounding to the point that the wounds would prevent adequate function outdoors or inhibit their defensive mechanisms in any way should either be confined by the caretaker in an indoor area until healed or should be considered for euthanasia. It is not ethical in my opinion to put a severely injured cat back outside where it will not be able to fend for itself.

Finally, I do see quite a few cats that come in

I am firm believer that all cats get a rabies vaccine as part of the service. This is a vital public health issue and will help prevent the spread of rabies through this population if an outbreak were to occur.

Cats that have wounds or abscesses when presented again need to be evaluated on a case by case basis. I have found that most wounds and even deep abscesses can be treated quite successfully while the cat is under anesthesia. The wounds can be clipped, cleaned, and flushed if need be. Drains cannot be used unless the cat is tame enough to allow follow-up care with the veterinary team or the caretaker’s local veterinarian.

Often a shot of Covenia and Metacam is all

with poor body condition. All ferals are going to look scruffy and rough from living the outdoor life, but the cats I am referring to are the ones with a body condition score of 0-1/5.

A thorough physical should be done on these cats when they are anesthetized including particular attention to the oral cavity and abdominal areas. Often we find cats with either some resorptive lesions on their teeth or outright tooth root abscesses that can be dealt with when the cat is under anesthesia. Again, providing proper pain control and antibiotics to the cat (usually in the form of a long-acting opioid like buprenorphine, metacam injection, and covenia) will cover these cats for medication. When looking at the abdomen, it is important to feel for any large masses or other signs of a possible obstruction. If one is found, then the cat should ideally be tested for FeLV/FIV first, and—if negative and the cat isn't "off the wall" feral—a possible surgical exploration should be undertaken to see if a simple surgical procedure can remedy the situation. Finally, the role of intestinal parasites must not be overlooked and often these cats benefit greatly from a broad spectrum worming that includes praziquantel in some form. Again, each case must be handled individually and the veterinarian must use his/her best judgment when making a decision.

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Protecting the Reputation of Your Practice Online Provided courtesy of the Veterinary News Network

W

e are all very proud of our hospitals and seeing a negative review online can cause a real sense of offense and even panic.

Here is a case study of a recent situation where the Veterinary News Network helped a member hospital dealing with some negativity online.

This review was posted on Yelp on May 25 of this year: We used their clinic/pet hotel when leaving to go out of town for a few days. When we came back our dogs neck was full of blood. We took

know he was by the door) they yelled at our dog and said "bad dog, you are a BAD DOG" (because my dog was jumping up and down and being loud) My husband opened the door and said "do not call him that, he is 8 months old and does not realize what he is doing."

He could not believe that the vet of all people called him a bad dog! We actually boarded our dog there when we were out of town and used their clinic when needed, NEVER AGAIN! There is nothing in this review that can be automatically flagged as being abusive, vulgar or against Yelp’s terms of service. So … what is the proper way for this clinic to respond? See below for their very professional and courteous reply: I am the Hospital Director at ABC Animal Hospital and can confidently say that we are very proud of the care our boarding guests receive - so I was deeply saddened to see your review of our hospital. I'm sure I would feel shocked as well if I found blood on my pet after picking him up from boarding and my assumption would be the same as yours … that someone did not care for my pet in the manner I expected.

him home and tried to figure out why and realized that the thick rope they used (made us take our leash back and they used theirs) cut his neck! They would not take responsibility when we called back (after we noticed it right after we got home) We dropped him back off 10min. after we picked him up to let them see his neck. They said they didn't know why his neck was bloody. They took him back to a room and my husband followed them (they didn't

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I see that your posting came about a month after your pet's boarding visit and your immediate return to have our doctors examine your pet. Has something else happened that I'm not aware of? I talked with the doctor and staff involved and reviewed our official Medical Record. I understand that there was a small sore on your pet's ear tip that caused blood to splatter on his neck when he flapped his ears, and that no cut was found on his neck or elsewhere. Ear lesions are notoriously bad about bleeding, especially when the pet shakes his head.

I was relieved to see that there was not a neck wound or signs of injury other than the sore on his ear. If this sore has not healed, we would be very happy to see your pup again to see if we

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can do something beyond what we originally recommended. Of course, this recheck exam will be at no charge and can be done at either our location or our main hospital at, whichever is more convenient and comfortable for you.

We are sorry that you feel you had an unpleasant boarding. Please feel free to call me directly at xxx-xxx-xxxx so we can discuss your pet's progress. Also, if I have misunderstood your concerns, I would welcome any further clarification.

There are several important things to recognize here. First, this clinic was actively listening and engaging when online reviews were found. Second, they did not let a negative review get the better of them. They did their research, responded to the concern and, most importantly, made a bid to take the discussion offline. Third, their effort was genuine, empathetic and geared towards showing other readers how professionally they handle complaints. Finally, they handled this situation just as if the person had come into their clinic to make the complaint.

Don’t let the modern technology make you do something you wouldn’t normally do.

Handling complaints online is no different than handling them face to face.

The good news? After the reply, this review was removed and is no longer showing up in search engine results!

Realize that you are not in this fight alone.

The Veterinary News Network can provide assistance in dealing with review sites to understanding how best to “listen” in this new world of emerging and social media. We are happy to review your proposed replies or even help craft the reply if necessary. We also have a complete series of articles written by Dr. Humphries about handling complaints and online reputation management. VNN has partnered with PVMA and we encourage your practice to join us. Learn more at www.

MyVNN.com. l

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3 Rivers Veterinary Symposium Returns to Pittsburgh November 3-4, 2012 William Penn Omni Hotel, Pittsburgh, Pennsylvania

12 HOURS APPROVED CE CREDIT

j

oin PVMA in Pittsburgh for the 5th 3 Rivers Veterinary Symposium and earn up to 12 hours of continuing education credit.

Remember, Pennsylvania license renewal is November 30 – make sure you have all of the necessary credits. The symposium will feature 10 educational tracks over 2 days, including:

Speakers and Topics Companion Animal Internal Medicine Gary Oswald, DVM, DACVIM Tampa Bay Veterinary Specialists and Emergency Care Center, Tampa, Florida • Gastrointestinal Diagnostics: Tests You Can Perform in Your Practice • Treatments that Work for Inflammatory Bowel Disorders, Alimentary Lymphoma, Hepatitis, and Pancreatitis—Parts 1 & 2 • Urinary Diagnostics: Facts and Fiction About What Blood and Urine Can Really Tell Me • Treatments That Work for Chronic Renal Disease • Treatments That Work for Lower Urinary Disorders—FLUTD, Incontinence, Stones, and Transitional Cell Tumors

SPONSORED BY 18

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Companion Animal Toxicology

Companion Animal Endocrinology

Camille DeClementi, VMD, DABT, DABVT Senior Director and Toxicologist, ASPCA Animal Poison Control Center, Pittsburgh, Pennsylvania • Managing Common Plant Intoxications • Managing Common Animal Medication Intoxications • Managing Common Human Medication Intoxications • Managing Common Yard and Garden Hazards • Managing Common Kitchen and Bathroom Hazards • Managing Common Garage and Basement Hazards

Michael Schaer, DVM, DACVIM, DACVECC Professor, Department of Small Animal Clinical Sciences, College of Medicine, University of Florida, Gainesville, Florida • The Atypical Cushing Dog • Diabetic Phenomena • The Atypical Addison’s Dog • Clinical Pearls

Companion Animal Critical Care Kenneth Drobatz, DVM, MS Professor and Chief, Section of Critical Care and Director of Emergency Services, Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania • Recognition and Treatment of Shock • Initial Approach to the Acute Abdomen • Approach to Respiratory Distress • Global Approach to the Trauma Patient

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Companion Animal Emergency Medicine Tony Johnson, DVM Clinical Assistant Professor, Emergency Critical Care, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana • ER Management of Acute Heart Failure • The Critical Kidney: Management of Acute Kidney Injury • Acute Feline Hepatic Failure • Lipid Rescue • Top Ten Pitfalls of ER Medicine • ER and ICU Nutrition

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Veterinary Technician Equine Surgery James Schumacher, DVM, MS, DACVS Professor of Equine Medicine and Surgery, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee • Methods of Skin Grafting That You Can Perform in Your Practice • Diseases of the Sinuses of the Horse and Surgery of the Sinuses Performed with the Horse Standing

Equine Medicine John Schumacher, DVM, MS, DACVIM JT Vaughan Teaching Hospital, College of Veterinary Medicine, Auburn University, Auburn, Alabama • Examination and Localization of Pain the Horse’s Foot • Causes and Treatment of Hematuria in the Horse

Bovine Misty Edmondson, DVM, MS, DACT Assistant Professor, College of Veterinary Medicine, Auburn University, Auburn, Alabama • Trichomoniasis in Beef Cattle • Managing Musculoskeletal Injuries in Ruminants • Urolithiasis in Ruminants • Penile & Preputial Conditions in Bulls • Ecbolics & Tocolytics in Bovine Reproduction • Antimicrobial Therapy in Bovine Reproduction

Practice Management Karyn Gavzer, CVPM Veterinary Practice Management Consultant, KG Marketing & Training, Inc., Springboro, Ohio • How to Go and Grow in a Slow Economy • 5 Things Every Practice Needs to do on Social Media • Pricing, Fees and the Value Proposition • New Standards in Client Care • How to Build a Lean Mean Marketing Machine for Your Practice SPONSORED BY

Sandra Sargent, DVM, DACVD—Dermatology Christine Rutter, DVM—Critical Care Dianna Ovbey, DVM—Anesthesiology Shelly Chesmer, CVT—Critical Care Pittsburgh Veterinary Specialty and Emergency Center, Pittsburgh, Pennsylvania LECTURES TO BE DETERMINED (updates will be posted on PVMA’s website, www.pavma.org)

Hotel Reservations

A block of discounted rooms is available at the Omni William Penn Hotel for 3 Rivers Veterinary Symposium attendees. To make your online reservation, please visit www.pavma.org. Room reservations are guaranteed on a first-come, first-served basis until October 5, 2012, after which rooms may be reserved on a space and rate availability basis only.

The discounted rates are: • $169 – single/double occupancy • $189 – triple occupancy • $199 – quadruple occupancy

What Does Your Registration Include?

• • •

•

•

Top notch continuing education (up to 12 hours available) Admission to the exhibit hall Reception in exhibit hall on Saturday evening (complimentary hors d’oeuvres and drink provided) Continental breakfast, refreshment breaks, and lunch on Saturday and Sunday Lecture notes provided online

Exhibitor Appreciation Reception Saturday, November 3, 2012 . 4:30–5:30pm

Plan to attend our complimentary reception on Saturday evening to enjoy great food, the company of colleagues, and the opportunity to visit with exhibitors. One complimentary drink ticket will be provided to each attendee. The exhibiting companies continue to support PVMA and the veterinary profession and we encourage you to take the time to show your appreciation. Participate in our exhibitor bingo game for the chance to win great prizes!

How to Register

Register online at www.pavma.org or scan the code at the right with your mobile device. Prefer to register by mail? Complete the registration form on page 23 and fax to 717.220.1461 or mail to PVMA at 8574 Paxton Street, Hummelstown, PA 17036.

Questions?

Contact Christine Gacono, Director of Education & Events Email: cgacono@pavma.org Phone: 888.550.786 Fax: 717.220.1461 l

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Marcellus Shale and Hydraulic Fracturing (Hydrofracturing) Hope, Hype, Health, Hysteria, and Questions

By David Wolfgang, DVM, DABVP-Dairy, Extension Veterinarian, Penn State University, University Park, Pennsylvania

t

he pros and cons of Marcellus Shale and hydraulic fracturing (HF) (fracing/fracking) are some of the most controversial topics in Pennsylvania. This broad topic can generate discussion and strongly held opinions in all corners of the state.

While much activity has already taken place and updated regulations are in place, many people continue to question whether the economic benefits will outweigh suspected or projected health effects for animals, people and the environment. Veterinarians may well be asked for input as their neighbors or communities may soon be or may already be faced with the prospect of wells in their backyard. First it would be impossible in just a few pages to address all the issues surrounding Marcellus Shale and HF. Second, this topic is so diverse and wide ranging that no one person can be an expert in all facets. Readers can find the testimony or reports from experts and advocates with divergent opinions that range from very safe and positive for society to very unhealthy and negative long-term. In this short piece I cannot

answer all questions and concerns. I will try to summarize some of the potential health concerns that Pennsylvania's veterinary profession may want to consider as they seek to provide advice to their clientele regarding Marcellus Shale and HF. Images on this page illustrate (a) areas in the country where major gas pockets exist and (b) schematic of the vertical horizontal, and fracturing aspects of this form of unconventional gas recovery.

The following is some background information, so that everyone understands why HF is necessary. Early petroleum and gas wells such as those started in Titusville, PA, in the late 1880’s tapped pools or pockets of gas/petroleum via vertical wells. These would be called conventional wells. The gas or liquid that accumulated in an underground vault could be pumped out or at times vented to the surface under pressure (picture old movie of oil gusher coming in after drilling). Some wells that produced slowly or appeared to have run dry could be made more productive by expanding the pocket underground. In the very earliest wells, ‘shooting’ the well might involve dynamite. In the late 1940’s, petroleum engineers introduced the principle of fracturing the semi-porous rock as a way of increasing yield. Fracturing required the application by injection under pressure a mixture of water, sand, and a small amount of chemicals (e.g., salts, solvents, anti- microbials/algae, and emollients) into the rock formation. The fracturing of the rock underground could greatly increase the yield and the longevity of a well.1 In the 1980’s, technology was developed that allowed petroleum engineers in Texas to begin to retrieve natural gas from more dense shale formations. Here, both the technology to run the drill bore more horizontally to tap into deeper shale formations as well as the ability to hydraulically fracture these shales was introduced. These dense shales have to be fractured to create spaces/gaps for the gas to accumulate and flow into the well. The best known of these shales in the MidAtlantic states is the Marcellus formation followed by a deeper yet untapped formation, the Utica Shale. A very good summary of the very broad natural gas industry along with worldwide implications can be found in the special report in The Economist.1 So what are the major veterinary public health concerns? These can be divided in general terms into immediate and longer term questions.

Some of the major immediate concerns: potential acute ingestion of high salt, high osmotic pressure HF fluids, and water and air pollution related to mud and high volumes of truck traffic and the occasional accident. The longer term questions are what impacts do or can frack chemicals have on animal and human health perhaps over the next 25-50 years.

One immediate concern is the impact tapping the Marcellus Shale reserves can have on water resources. It takes one million to several million gallons of fresh water to HF a well. In Pennsylvania, the Department of Conservation and Natural Resources (DCNR), the Fish and Boat Commission (FBC), the Department of Agriculture (PDA), and the Department of Health (DOH) all have a vested interest in the quantity and quality of fresh water. By regulation, the volume of water continued on page 21

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Fracking continued from page 20

withdrawn from a source stream is controlled based on flow, seasonality, ground water, and drought/rainfall conditions. Fresh water is trucked to a site and the mix necessary to fracture the well is created.

The HF water mixture has generated most of the public and veterinary health concerns.

Each company and site may have small variations in the mix necessary to HF the well. However, most of the HF fluids overall are similar. The particular mixture used on a specific well is based on the geology of the formation underground. In general, the fluid used for injection is about 99.5% water and sand with the remaining 0.5% as added salts and chemicals. The 0.5% seems small but when multiplied over millions of gallons the potential for contamination issues increases.

This 0.5% has drawn lots of public health interest. In some press articles it has been stated that the chemicals used were secret or unknown. That is not exactly correct. Under federal OSHA regulations, the chemicals used on each site must be listed and that information is available. Each site must have a MSDS sheet and safety information on those MSDS sheets. This is exactly the same sort of information that veterinarians must

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maintain on chemicals used in their hospitals.

What is guarded as proprietary information is the individual concentration recipe that each company uses per site. (e.g., it would be possible to learn if product X was added to the frack water, what may not be readily available to the general public would be if product X was 0.001% or 0.005 %.) The Pennsylvania State University (PSU) Extension fact sheet5 provides a very nice summary and a more complete explanation of how HF fits into the development of the MS formation.

Several preliminary studies on the impacts of HF on water supplies in PA have been conducted. The study conducted for the PA legislature is cited below. 3 This study looked as several hundred rural water wells or systems in both the MS areas and other PA rural areas. Water quality was analyzed both before and after drilling. Please review the cited article for detailed information, but in the vast majority of cases, HF had no, minimal or no significant impact on water quality. The EPA is sponsoring a national study to review water concerns related to HF. This study is being conducted in the states of CO, TX, ND, and two sites in PA. This study and its results should be available for scientific and public review early in 2013.

In the process of drilling a well site the bed rock is disturbed and often ground water close to a well might contain higher levels of minerals for a short time. Deep wells occasionally go through underground pockets of water (old ocean water) that have high brine content.

This can contaminate ground water but this is rare. Abnormal levels from these sources usually return to normal in a few weeks. Occasionally, methane is found naturally but closer to the surface. This low level methane can be in ground water in the same geographic areas.

Methane is not toxic but at high levels in water it can present a safety hazard in enclosed areas. Venting can eliminate this risk. The newer technology MS gas wells are several thousand feet deep, far below ground water levels, and they have at least a triple casing.

It is very unlikely that leaking frack water or methane directly from new wells presents a veterinary health hazard.

To date, short-term human and veterinary health concerns from HF fluids have been sporadic, poorly defined, and difficult to document. While no significant health events have been documented that does not mean that some individuals do have strongly held opinions regarding the safety of these procedures. 2 There is legitimate concern that continued on page 39

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2012 PVMA Building Fund

a

s the Pennsylvania Veterinary Medical Association (PVMA) celebrates its 2-year anniversary of building ownership, we are proud to officially introduce its official home to the veterinary community in our Commonwealth. Purchased in September 2010, the 5,624 square foot building is an investment in real estate as well as the future of the association. Serving as the PVMA headquarters, the building provides ample space for the current management team as well as room to grow.

Located in Hummelstown, Pennsylvania, the building is located within easy reach of our state capitol, Harrisburg. Renovated just before purchase, the building consists of two floors with overnight accommodations possible on the second floor. In addition to spacious offices for members of our management team, the large common areas allow for in-house committee and board meetings and member functions which

were not previously possible. Future plans also include renovation of the garage area into a state-of-the-art conference room to provide continuing education programs and offer additional space for our association’s business meetings.

Our choice to invest in a property was part of a long-range plan to better serve our members in ways that were not possible before. Our increased space and resources will allow us to branch out in our endeavors and create an increased value of membership. The decision was weighed carefully by the Building Acquisition Taskforce, Executive Committee, and Board of Trustees, and the decision was made to go forward only when a property was found which would serve the association’s needs for years to come. Our building offers a permanent home for our organization and a presence in the community for veterinary medicine.

Our Fund PVMA invites our members, corporate partners, and friends to help us retire our building debt so that the association can move forward with a solid financial base and increased capacity to serve our members. We have set a goal of $300,000 and the building fund campaign will run until December 31, 2013.

Levels of donations have been set starting at just $50 and pledges can be made monthly, quarterly, or semi-annually. All donors will be recognized on a permanent display in the PVMA office. Those generous donors who pledge $2,500 or more will have the opportunity of choosing a room in the office to be named after them.

If every PVMA member would donate just $150, we would easily reach our goal of $300,000. We hope that we can count on your support of PVMA and our efforts to establish a permanent home and long-term success for our association. Thank you in advance for your consideration and your commitment to PVMA!

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Naming Opportunities • Main Foyer Naming Opportunity —$2,500 • Reception Area Naming Opportunity —$5,000 • Small Conference Room Naming Opportunity—$5,000

RECEPTION

SMALL CONFERENCE ROOM

MAIN FOYER

LARGE CONFERENCE ROOM

• Large Conference Room Naming Opportunity—$7,500 If you would like to make a donation to the PVMA Building Fund, please complete the form on this page and return to PVMA at 8574 Paxton Street, Hummelstown, PA 17036 or by fax to 717.220.1461. l

Pennsylvania Veterinary Medical Association

2012 PVMA Building Fund You may also donate to the PVMA Building Fund online at www.pavma.org

Name

pvma

Payment: q I have enclosed a check payable to the PVMA Building Fund in the amount of

Business (if applicable)

Address

City

State Zip

Phone Number

$

q

I would like to pay by credit card: q Visa q MasterCard q Discover

Credit Card Number

Email Address

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PVMA, c/o 2012 Building Fund Campaign, 8574 Paxton Street, Hummelstown, PA 17036 Thank you for your investment in PVMA.

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a u g i t n A

2013 PVMA Winter Seminar Vacation to

FEBRUARY 9-16, 2013 St. James Club Resort 26 hours of approved CE credit in a luxury location when winter is coldest at home Speakers include: Randall Thomas, DVM, DACVD Andrew Rosenfeld, DVM, DABVP John Godbold, Jr., DVM For full information, download the brochure at www.pavma.org or scan the code at the right with your mobile device.

Questions?

Contact Dr. Ted Robinson at 215.357.6820 or fandr@voicenet.com.

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PVMA Welcomes Its 2013 Slate of Officers t

he ballots were counted during the Keystone Veterinary Conference in August, and the winners are in. Beginning January 1, 2013, the veterinarians on these pages will be the new leadership of PVMA. We congratulate our new officers. Our newly elected Trustees will be featured in Volume 4.

2013 President Kenton Rexford, VMD, Glenshaw, PA Kenton D. Rexford, VMD, is a native of western Pennsylvania. He attended the Pennsylvania State University where he earned a Bachelor of Science Degree in Animal Bioscience in 1990. He received his veterinary degree from the University of Pennsylvania, School of Veterinary Medicine in 1994. Dr. Rexford worked as a mixed animal practitioner for 18 months. He then practiced small animal medicine full-time while concurrently working part-time as an emergency veterinarian.

He found that he enjoyed emergency medicine and surgery and accepted a full-time position with the Veterinary Emergency Clinic (VEC) in 1998. The VEC is now part of Pittsburgh Veterinary Specialty and Emergency Center (PVSEC). Dr. Rexford is a partner at PVSEC and has been a member of PVMA since 1995. When he is not working, he enjoys snowboarding and whitewater kayaking. Dr. Rexford is the proud owner of Rogan, a Dogue de Bordeaux.

2013 President-Elect Sherrill Davison, VMD, MS, MBA, DACPV, Kennett Square, PA Sherrill Davison, VMD, MS, MBA, DACPV, received a Bachelor of Arts in Biology from the University of Pennsylvania in 1979, a veterinary degree from the University of Pennsylvania in 1983, a Master of Science degree from the University of Pennsylvania in 1988, and a Master of Business Administration from the Wharton School in 2004.

She is currently Resident Director of the New Bolton Center Pennsylvania Animal Diagnostic Laboratory System, Director of the Laboratory of Avian Medicine and Pathology, and an Associate Professor of Avian Medicine and Pathology, University of Pennsylvania. Prior to her Associate Professorship, she held the positions of Assistant Professor, Lecturer and Resident at the Veterinary School’s Laboratory of Avian Medicine and Pathology. Prior to her work at the university, she was a practitioner in a small animal hospital. Dr. Davison also holds a specialty certificate as a Diplomate of the American College of Poultry Veterinarians.

Dr. Davison is active in the American Association of Avian Pathologists and holds or has held the following positions: Chair and member of the Respiratory Diseases Committee, Chair of the Respiratory Disease Symposium, Education Committee and the Preceptorship Committee.

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tion of Avian Pathologists Avian Diseases Journal. She has also served the American College of Poultry Veterinarians in the following capacities: Member and Chair of the Examination Review Committee and past Secretary/Treasurer. Dr. Davison is a member of the United States Animal Health Association Salmonella Enteritidis Committee and the Transmissible Diseases of Poultry and Other Avian Species Committee, and chaired the Subcommittee on Laryngotracheitis. She has served the Pennsylvania Poultry Federation and PennAg Industries in the following capacities: Advisor to the Meat and Egg Councils; Poultry Health Committee Advisor on Avian Influenza; Committee on Disposal Methods for Avian Influenza Infected Flocks; Poultry Health Committee on Research for Avian Influenza; Pennsylvania Egg Quality Assurance Program Executive Committee. Dr. Davison has also served in the following capacities: Salmonella Enteritidis Advisory Committee; and chair of the Subcommittee on Salmonella Enteritidis Field Studies. She currently is PVMA Vice-President and is a member of the Legislative and Regulatory Affairs Committee.

2013 Vice President Jim Holt, VMD, Glenmoore, PA Jim Holt, VMD, showed an interest in animals beginning at an early age and has been an avid horse rider since he was 9-years-old.

While riding hunters and jumpers, the highlight of his riding career was when he rode in a Grand Prix at age 16. Dr. Holt attended the University of Pennsylvania and graduated in 1991. Upon completion of his education, he was hired on at Morgantown Veterinary Clinic, a mixed equine/bovine practice that serviced northern Chester, Lancaster, and Berks Counties. In 1993, Dr. Holt decided to open his own mixed practice called Brandywine Veterinary Services which he still owns today. Currently, he works three days per week as the veterinarian for New Holland Sales Stables in New Holland, PA, working predominantly with cows and horses. The rest of Dr. Holt’s time is spent in a more typical mixed equine/bovine practice doing prepurchase exams, treating equine lameness, offering second opinions, overseeing imports and exports, and dealing with animal welfare issues as they relate to how animals are treated at sales and equine rescue facilities. Dr. Holt has served as the Trustee for the Brandywine Veterinary Medical Association and currently serves as a District VII Trustee. He has also served as the Equine Chair on the Scientific Program Committee and is a member of the Coalition for the Care, Custody, and Welfare of the Unwanted Horse.

Secretary-Treasurer Ron Kraft, DVM, Norristown, PA Dr. Ron Kraft grew up in central New Jersey and is a 1974 graduate of Purdue University, School of Veterinary Medicine.

After earning his veterinary degree, Dr. Kraft practiced in Mendham, NJ. In 1975, he joined Trooper Veterinary Hospital in Norristown, PA, first as an associate and then as a partner. In 1993, Dr. Michael continued on page 27 WWW.PAVMA.ORG

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Slate of Officers continued from page 26

Herman joined the partnership at Trooper Veterinary Hospital (www.

TrooperVet.com). The hospital has grown to include six doctors, a staff of over 30, and has been AAHA-certified for the last 21 years. Ron and Mike built a brand new facility in 2004, more than doubling the size of the old hospital. Ron and his wife of 42 years, Linda (Lucas) Kraft are both Penn State alums and avid Penn State football fans. They are the proud parents of Leonard, their 13-year-old yellow Lab, a wonderful SPCA find. Dr. Kraft knows what his clients go through as he lives with a senior pet and all the medical problems senior canines endure. For over 30 years, he has given back to the profession by serving on PVMA committees, as a PVMA Trustee, and currently as Secretary-Treasurer.

He shared the Veterinarian of the Year Award in 1985 and received the Distinguished Veterinary Service Award in 2011. In addition to veterinary medicine and PVMA activities, he enjoys skiing, boating, golfing, biking, fine dining, and spending time at his vacation homes in the Pocono Mountains and Jackson Hole, Wyoming.

Delegate to the American Veterinary Medical Association Mary Bryant, VMD, West Chester, PA Dr. Mary Bryant is a 1995 graduate of the University of Pennsylvania, School of Veterinary Medicine and spent eight years in small animal private practice in Wilmington, DE, until joining Merial in January 2004. After spending seven years at Merial as a Senior Technical Services Veterinarian, she was promoted to the Northeast Regional Director of Field Veterinary Services. Currently, she also has the role of being the Director of Professional Affairs, the liaison between all professional veterinary organizations and Merial.

Dr. Bryant is now actively involved in the Pennsylvania Veterinary Medical Association, having served as PVMA President in 2007. She has returned to the AVMA House of Delegates, this time as the Delegate from Pennsylvania. Since 2002, Dr. Bryant has been an Adjunct Assistant Professor at the University of Pennsylvania, School of Veterinary Medicine, where she coordinates and teaches a career development course to third year veterinary students. She is also the Chair of the PVMA’s Student Liaison Committee for the University of Pennsylvania, School of Veterinary Medicine.

Dr. Bryant participates in sprint triathlons and is an avid bird watcher.

She resides in West Chester, PA, with her husband, Michael, a neurobiologist and co-founder of Melior Discovery, a biotechnology company located in Exton, PA. She has three furry children: Rhys, Sam, and Oliver. l

PVMA Has Fact Sheets!

Ever wish you had a resource to give to clients to help them understand everyday dangers for their pets? Or maybe one to explain the dangers of internet pharmacies, safe travel with pets, and more. Well, PVMA is here to help. We offer client-oriented fact sheets on our website at www.pavma.org/petowners.aspx. Download them and print copies for your clients or provide them with the link.

Our list of fact sheets is constantly expanding, so check back often! Have a topic you'd like to see covered? Send an email to lraver@pavma.org.

Since joining Merial, Dr. Bryant has been honored as a recipient of Merial’s Circle of Excellence Award for 2004, 2005, 2006, and 2007 and is also a two time winner of the Vital Circle Award (2006 and 2009), a prestigious award that recognizes leadership among her peers.

She also is the 2004 co-recipient of the Team of Two Award along with District Manager Doug Beatty for teamwork; the 2004 Liberty Team Award, a leadership award from her sales district; and in 2005, received the Vital Difference Award given to her by Merial’s National Accounts Team for her work on Merial University.

Dr. Bryant began contributing to the profession as a veterinary student on a national level when she was elected the National President of the Student American Veterinary Medical Association during her senior year, Penn’s first student to fill this role. This experience led to further involvement in the veterinary profession on a national level. From 1997-2003, Dr. Bryant served as the youngest woman delegate on the AVMA’s House of Delegates representing the state of Delaware.

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PVMA Members Were Honored During the Annual Hall of Fame Dinner

e

ach year during Keystone Veterinary Conference, PVMA honors some of its most outstanding members with awards for their service. Nominated by their peers, PVMA wass proud to honor these individuals for their extraordinary contributions at our Hall of Fame Dinner held on Friday, August 17, 2012.

Dr. A. Wayne Mountan Memorial Media Awards Lee Pickett, VMD The 2012 recipient of the Dr. A. Wayne Mountan Memorial Media Award is Dr. Lee Pickett in recognition of her excellence in communicating the importance of veterinary care and pet responsibility through her regular contributions to The Reading Eagle.

Dr. Pickett has written the weekly newspaper column “Ask the Vet’s Pets” for 10 years to educate animal lovers and encourage them Dr. Robert Lavan present Dr. Lee Pickett with to visit their veterinarians the Dr. A. Wayne Mountan Memorial Media regularly. Joining her Award. are pets Daisy Dog and Christopher Cat, along with occasional ferret, rabbit and other guest columnists. Dr. Pickett, the medical director of Bernville Veterinary Clinic, practices companion animal medicine and acupuncture, and writes magazine articles on pet health care.

The Wodan Animal Hero Award Quentin The 2012 recipient of the Wodan Animal Hero Award is Quentin in recognition of the companionship, concern, good cheer, and therapy he provides to children and adults in the community and at home. He’s owned by Dr. Michael and Sonja Haught of Lancaster, along with son, Jack.

Dr. Robert Lavan presents the Haught family and Quentin with the Wodan Animal Hero Award.

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Jack, is seven years old and has a high functioning autism diagnosis. When the family applied for a service dog, Jack was having a lot of trouble with anxiety, particularly in organized crowds like sporting events, church services, school

keystone veterinarian

6th Keystone Veterinary Conference Facts August 16-19, 2012

Hershey Lodge, Hershey, Pennsylvania

Who Was There?

• • • • • • • •

467 veterinarians 270 certified veterinary technicians and assistants 12 practice managers 13 students 28 office staff 11 shelter personnel 60 exhibitors 13 sponsors

Did you know?

• KVC offered 188 hours of continuing education over four days • Veterinarians and certified veterinary technicians could earn up to 26 hours of continuing education during KVC • 18 states were represented by attendees at KVC; some came from as far as Arizona, Colorado, Missouri, Texas, Idaho, and Vermont!

• 45 speakers participated in KVC

performances, and even events like the PVMA Hall of Fame dinner.

Jack has overcome this fear through his own brave efforts and the support of his family and his dog. The service Quentin provides to Jack is called “snuggle” where Quentin is in a downed position and Jack snuggles into Quentin’s side and often puts his head on top of Jack. This is very calming to Jack and the unconditional love and support Quentin gives him is an important stabilizer in his day-to-day life.

Public Service Award of Merit John Lee, VMD The Public Service Award of Merit is presented annually to a member of the Pennsylvania Veterinary Medical Association for an outstanding act or achievement outside the veterinary profession. The 2012 recipient of the Public Service Award of Merit is Dr. John Lee in recognition of his instrumental role in the creation of continued on page 29

Dr. John Lee, pictured with his wife, Janey, received the Public Service Award of Merit.

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PVMA Awards continued from page 28

Safety and Inspection Service (FSIS), Field Operations in 1991, serving as a public health veterinarian. He has also received numerous awards.

The Barn at Spring Brook Farm and his regular, continued involvement as a board member and willing volunteer.

Animal Welfare Advocacy Award Ernest Hovingh, DVM, PhD

In April, he received the Founder’s Award from The Barn at Spring Brook Farm, a facility recently constructed to encourage animal therapy for children with disabilities. He has been Vice-Chairman of the Board since the group’s founding. Dr. Lee is also an avid participant in trips to the southwest with Native American Veterinary Services (NAVS), and this fall’s trip will be his eighth year of participation.

Veterinarian of the Year Heather Berst, VMD

Dr. Heather Berst received the Veterinarian of the Year Award.

The Veterinarian of the Year Award is presented annually to a member of the Pennsylvania Veterinary Medical Association for an outstanding achievement in veterinary medicine within the past year. This year’s recipient is Dr. Heather Berst in recognition of her outstanding work in and dedication to the veterinary profession in many ways, including her work with Hill’s Pet Nutrition as well as her roles within PVMA, Pennsylvania Veterinary Foundation (PVF), and The Dean’s Alumni Council at The University of Pennsylvania, School of Veterinary Medicine.

Dr. Berst is an enthusiastic volunteer with any task including active leadership in the planning of PVF’s annual Bark in the Park 5k Run fundraiser, co-sponsoring dinner meetings, and events with PVMA to educate veterinarians on pet nutrition and why PVMA is important.

She also dedicates time and energy to the Dean’s Alumni Council at Penn and works tirelessly to promote the school.

Distinguished Veterinary Service Award Craig Shultz, DVM

Dr. Robert Lavan presents Dr. Craig Shultz with the Distinguished Veterinary Service Award.

The Distinguished Veterinary Service Award is presented annually to a member of the Pennsylvania Veterinary Medical Association for an outstanding act or achievement to the veterinary profession over a period of years.

The 2012 recipient of the Distinguished Veterinary Service Award is Dr. Craig Shultz in recognition of his many years in veterinary medicine, his dedication to PVMA, and most notably his roles as State Veterinar-

ian and with the USDA. Dr. Shultz was appointed as Director of the Bureau of Animal Health and Diagnostic Services in September 2008. He was in private large animal veterinary practice in Columbia County from 1976 to 1991. He joined the United States Department of Agriculture (USDA), Food WWW.PAVMA.ORG

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Dr. Ernest Hovingh received the Animal Welfare Advocacy Award.

The Animal Welfare Advocacy Award recognizes a PVMA member who has demonstrated outstanding compassion and/or developed programs for the welfare of animals. The 2012 recipient of the Animal Welfare Advocacy Award is Dr. Ernest Hovingh in recognition of his influential role in ensuring the welfare of dairy cattle as a trainer with the Farmers Assuring Responsible Management program, an auditor with the Professional Animal Auditor Certification Organization, and an extension veterinarian within the agricultural community.

Dr. Hovingh is an extension veterinarian with Penn State College of Agricultural Sciences. His program areas include Johne’s disease control, lameness, milking parlor management, on-farm epidemiology, and animal wellbeing. He is a member of many professional associations and he has been widely published.

Veterinary Industry Partner of the Year Award Dan Pitrovich, Merial, Ltd. The Veterinary Industry Partner Award is presented to a Veterinary Industry Partner member to recognize his or her steadfast commitment to ensuring the vitality of the Pennsylvania Veterinary Medical Association and the veterinary Christine Gacono and Charlene Wandzilak profession. The 2012 represent Dan Pitrovich with the Industry Partner cipient of the Veterinary Award.

Industry Partner Award is Dan Pitrovich from Merial, Ltd., in recognition of our appreciation for his years of commitment to the Pennsylvania Veterinary Medical Association and the veterinary profession as a whole.

Dan is currently Senior Sales Development Representative. During his time with Merial, Ltd., and has received numerous awards. Dan has been an avid partner of PVMA, ensuring that Merial is supportive of PVMA’s continuing education efforts.

Veterinary Technician of the Year Award Kristine Rigler, CVT During the Hall of Fame Dinner, the Pennsylvania Veterinary Technicians Association (PVTA) also presented awards including the Veterinary Technician of the Year. This award is presented annually for outstanding achievement in veterinary technology. The 2012 recipient of the Veterinary Technician of the Year Award is Kristine Rigler, CVT, in recognition of her committed efforts to continually improve her continued on page 30 keystone veterinarian

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PVMA Awards continued from page 29

knowledge and expertise in her field and for being a champion for the veterinary profession.

Jamie DeFazio presents Kristine Rigler with the PVTA Veterinary Technician of the Year Award.

Kristine is currently the Head of the Surgical Nursing Department at Valley Central Veterinary Referral Center in Whitehall. She is an active member of the National Veterinary Technicians Association (NAVTA), the Pennsylvania Veterinary Technicians Association (PVTA), Lehigh Valley Veterinary Medical Association (LVVMA), and the Veterinary Wound Management Society (VWMS). She is currently in pursuit of her VTS in surgery and will be sitting for the

written exam in October.

PVTA Veterinary Technology Scholarship Carly Kammerer The Veterinary Technology Scholarship of the Pennsylvania Veterinary Technicians Association is awarded annually to assist a student during their education to become a certified veterinary technician. Criteria for the scholarship is based on cumulative GPA, academic achievements, plans for the future, and financial need.

Carly Kammerer received the PVTA Veterinary Technology Scholarship.

public partnership to serve as a unifying network of organizations, businesses, federal, state, county and local government agencies, and individuals that support the prevention, preparedness, response, and recovery for emergencies affecting animals. Because disaster response needs to happen at a local level, PASART builds County Animal Response Teams (CARTs) across the state. County coordinators are selected to lead the development of county teams consisting of volunteers who will respond to emergencies at the local level.

Mark Zebrowski The second recipient of a 2012 President’s Award is Mark Zebrowski in recognition of his generous and enthusiastic willingness to volunteer with PVMA and his dedication to spreading awareness of the importance of veterinary medicine through his therapy dog work.

In 2009, Mark’s then four English black Labradors—Elliott, Artemus, Ignatius, and Oliver—received the Wodan Dr. Robert Lavan presents Mark Zebrowski with his President's Award.

Animal Hero Award for their therapy work. Now adding Sebastian to the mix, the five continue to visit more and more people at hospitals, nursing homes, care centers, even the Pennsylvania Farm Show. There is no way to even guess at the number of patients they have visited with over the years, but it’s likely in the thousands. They have been with patients as they have transitioned to the next life and with newborns whose lives have just begun. Mark and his dogs have truly touched the lives of those in need.

PVTA selected Carly Kammerer as this year's scholarship recipient in recognition of her excellent academic performance and sincere drive toward a specialized career serving animals as a certified veterinary technician.

Mike Rader

President's Awards Pennsylvania State Animal Response Team The first recipient of a 2012 President’s Award is the Pennsylvania State Animal Response Team (PaSART)in recognition of their continuing effort to safeguard animals across the Commonwealth through disaster preparedness, disaster response, and creating public awareness throughout the state.

Dr. Robert Lavan presents Joel Hersh with a President's Award on behalf of PaSART.

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Mike Rader received his President's Award during the Friends of Veterinary Medicine Reception in May.

The third recipient of a 2012 President’s Award is Mike Rader, Executive Director for the Senate Agriculture and Rural Affairs Committee. In a relatively short time, Mike Rader impressed our association by his leadership, willingness to partner and learn about issues, and his desire to ensure that legislation which is reviewed and passed by his Chairman’s Committee is reasonable and the best interest of animals and stakeholders.

PVMA honored Mr. Rader in recognition of the important and much appreciated role he plays in the advancement of veterinary medicine, public health, food safety, and animal welfare within our great Commonwealth. continued on page 31

The Pennsylvania State Animal Response Team (PaSART) was created through a private-

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PVMA Awards continued from page 30

The Richard H. Detwiler Cornerstone Service Awards of the Pennsylvania Veterinary Foundation During the Hall of Fame Dinner, the Pennsylvania Veterinary Foundation (PVF) also took time to award its Richard H. Detwiler Cornerstone Service Awards. These awards are presented to volunteers who have made outstanding contributions and shown dedicated commitment to the mission and goals of PVF.

Dr. Ted and Leni Robinsion

Dr. Larry Gerson presents Leni and Dr. Ted Robinson with their Cornerstone Award.

The first recipients of The Richard H. Detwiler Cornerstone Service Award are Dr. Ted and Leni Robinson in recognition of their continuous dedication with Native American Veterinary Services (NAVS) and their promotion of the Pennsylvania Veterinary Foundation in the veterinary

Practice Pearls continued from page 13

egizing, and personnel management duties to competent individuals will allow the practice to continue to grow and still can free up a business owner significant amounts of time.

2. Your practice should always be evolving. Always have an eye on your competition and advances in the profession. Most businesses require a steady investment into keeping technologies, therapies, and equipment current in order to continually improve the quality of their services. This is true for veterinary practices as well. Accordingly, your pricing model needs to keep current as well.

3. Be attentive to general business trends and how they can impact your practice. Many of the top business trends for 2012 are considered abstract concepts for many older veterinary business owners. These include use of internet video, social media, mobile friendly websites, and reputation management as communication tools, especially for new clients. If you don’t recognize these terms, be assured your competition does.

If you suspect that your practice may be coasting or that you may have profitability issues, then it is time to have your practice valued. While it is

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community and beyond. NAVS, started in 2001 by Dr. Robinson, provides veterinary services to animals owned by Native Americans living on reservations who have little or no access to veterinary care. Both Dr. Robinson and Leni have been instrumental in coordinating the trips, assisting on the reservations, promoting PVF and NAVS by manning the booths at veterinary meetings throughout the year, and selling handmade Native American jewelry.

Dr. Charles Newton The second recipient of The Richard H. Detwiler Cornerstone Service Award is Dr. Charles Newton in recognition of his unwavering supporting role as Chair of the Scholarship Committee and his dedication to the Pennsylvania Veterinary Foundation as a member of the Board of Trustees. As a long-standing member of the faculty and Professor of Dr. Charles Newton Orthopedic Surgery, Deputy Associate Dean at the University of Pennsylvania, School of Veterinary Medicine at the time of his retirement in 2011, Dr. Newton provided a keen perspective into the needs of veterinary students when evaluating scholarship applications, developing scholarship criteria, and selecting worthy recipients.

Congratulations to all the 2012 recipients, and be sure to nominate your own outstanding colleagues next year. l

good to have a value for financial planning and exit planning purposes, the valuation process will help diagnose the financial diseases that may be plaguing your practice. This gives you time to make change well in advance of your exit from ownership.

Deciding the time to exit and sell your practice is one of the most important financial and personal decisions in most owners’ lifetimes.

Given the number of practices expected to be available on the market in the next ten years, practice owners should stop the coasting and start focusing on improving profitability, building a strong management team, and improving profits. This will not only maximize your practice’s attractiveness and its value at the time of sale, it will also improve each year between now and when you do exit.

A wise veterinarian once commented, “The savvy practice owner will work their very hardest at two stages of their practice life: the first five years after the initiate the practice and the last five years as they prepare for its eventual sale.” l David McCormick and Sherry Everhart are veterinary practice appraisers and practice management consultants at Simmons Mid-Atlantic.

They can be reached at 888.881.7084 and by email at DMcCormick@ TMcCG.com and SEverhart@TMcCG.com.

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Feral Cats continued from page 15

It is important to make sure that there is some sort of sign in sheet or waiver that the caretakers sign and agree to when the cat is brought in. This ensures that the caretakers are completely aware of what is going on and what will be done to the cats. At a minimum, what should be offered for the price of the service is the surgery, a rabies vaccine, some form of injectable pain medication, and a small tipping of the left ear. Believe it or not, I find the thing that seems to upset people the most is the ear tip. Most will feel it is some sort of mutilation of the cat and is not necessary. It is, in fact, very necessary as it is helps to identify those cats that have already been altered. It is also a manner to weed out people who may be trying to sneak their own cats through the program for a cheaper fee. The process of properly ear tipping will be discussed later. This form should also provide choices for other services that can be provided for a small fee. These can include FVRCP vaccination, flea treatment/worming, and FeLV/FIV testing.

merely place the opening of the squeeze cage up against the opening of the trap or carrier. It will take a few practice tries to figure out how best to do this while not letting the cat escape through the temporary opening between the two. Cover the squeeze cage with a towel or sheet and take the cover or sheet off the trap/carrier if there was one.

Cats will feel more secure in a darker place, so some may just walk right into the cage. Sometimes banging on the trap/carrier lightly will get them to run across into the cage. There will inevitably be one or two “escapees” who then have fun darting all over the room trying to escape. Having a net or a good pair of “cat nappers” is essential to try and get the cat quickly and with as little trauma to it and yourself. A trick when netting a cat is that once you have it, if you lift the net up off the ground, the cat will stop struggling as much. Use a gloved hand or towel to try and grab the cat only as a last resort. While those gloves and towels may look nice and thick, I can guarantee a cat can easily bite through them. A rabies/catch pole should never be used on a cat!

It serves no purpose and can cause serious injury to a cat.

There are many different injectable anesthetic agents out there, and the best anesthesia, as we all know, is the one “you are most comfortable with.” That being said, I personally use a combination of Telazol/ Butorphanol/Dexdomitor. Another combination that works well and is much less expensive is Ketamine/Dexdomitor/Butorphanol. Both of these combinations provide a smooth induction and recovery as well as about 30 minutes of solid anesthesia time.

These services would vary depending on what the particular clinic is able to offer. Caretakers must understand the items on the document as well as what they mean when they initial/sign it at the time of drop off. On the reverse side of this sheet should be an area for all of the medical information pertaining to what was done to the cat, places for the animal’s identification information, sex, age, color, physical exam findings, surgical report and findings, and the services performed. We have found having this all on one sheet cuts down greatly on confusion and paperwork.

To keep track of the cat as it goes through the various aspects of the clinic, we have found that using disposable, write-on, white ID collars works very well. As it comes in, each cat gets a number starting with 1. That number is put on the sign-in/medical sheet, collar, and carrier or trap that it arrived in. This way everything is easily tracked through the process.

The next step in the process is inducing the cat with anesthesia for the procedure. Obviously, most ferals will not be amenable to a physical exam pre-op, and this is something we as veterinarians just have to accept. The best and least stressful manner to work with the cats during this process is to take away the human handling element. The best thing that works is to invest in a couple of “squeeze cages”. These cages look like basic wire cages but have a mechanism in them that allows you to push the cat up against one side to easily inject it. If the cat is in a trap, a special tool that looks like an elongated wooden comb can also be used to do this. To get the cat into the squeeze cage, 32

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Once anesthetized, a technician can then take the cat out of the squeeze cage and begin to prepare it for surgery. The cat should be placed on a towel, sheet, or fleece that should then accompany it through the entire process. The technicians I work with at the Humane League are amazing in their speed of preparation for surgery (which is crucial in large scale clinics). A technician should also give the cat a visual exam, observing for any signs of injury or illness. If found, these should be brought to the attention of the veterinarian. All cats should have their ears checked and cleaned/treated for mites if necessary.

Any other desired treatments, such as vaccinations, testing, flea treatment, etc., should be given at this time. The ear tip should be given as this time as well. We use a simple hemostat to clip a small portion—no greater than about 1cm—on the left ear tip. A scalpel is then used to remove the tip of ear distal to the hemostat. The hemostat then stays on during the duration of the surgery allowing proper hemostasis to occur. Other methods have been to tip the ear with an electro-cautery unit or tip it and use some styptic powder on the wound. Again, it is whatever works for your situation. The cat is then routinely prepped for surgery with one minor exception. If the clinic is being conducted during the colder months of the year, it is wise to limit the amount of hair shaved on the abdomen of females to as little as needed to perform the surgery safely. These will help keep these animals warmer in the post-op period and when released.

The cat is then moved to the surgery table and a routine castration or ovariohysterectomy is performed along with anything else the cat may need surgically done. Remember, it is important to always keep the veterinarian working at the surgery table, and an ideal set up is a veterinarian situated between two tables so he or she can rotate from table to table doing surgery. This is why it is ideal to have three technicians per veterinarian as mentioned earlier. The cat should ideally have a small mask placed over its face and secured with an IV line tubing or a cat muzzle. Oxygen from an anesthetic machine can be administered through this mask at a low rate throughout the surgery, and allows the ability to start gas anesthesia quickly if need be during the surgery.

These masks can be quickly disinfected between cats.

Anesthetic events such as apnea, cardiac arrest, or reaction to anesthetic drugs do happen in feral cat surgeries. My policy has always

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foundation cornerstone

3rd Annual

Bark in the Park 5k Run & 1 Mile Dog Walk Sunday, October 28, 2012 City Island (Riverview Pavilion), Harrisburg, PA TO BENEFIT

Join us with or without your dog to take part in our annual 5k Run and 1 Mile Dog walk in the capitol city. Get pledges to bring with you to benefit PVF, and then have fun on your run!

Want to get in on the fun but don't want to run? Be a sponsor! Visit www.pavetfoundation.org to help sponsor this charity event.

Event Schedule 7:00am Registration 8:30am 5k Run 9:00am 1 Mile Dog Walk 9:30am Costume Contest

Collecting Pledges You can help raise even more money for The Last Chance Fund (TLC) by getting pledges from your friends, family, and co-workers. Make sure your name is on all pledge forms and checks to ensure you are given credit for your work! The more pledges you get, the prizes you can receive and the more homeless animals you can help.

Registration Brochures for runners containing pledge forms, brochures for sponsors, and online runner registration is available at www.pavetfoundation.org or scan the code at the right with your smartphone.

Pre-Registration by October 15 $25 per person (includes t-shirt) $10 per child age 11 or under (includes t-shirt)

Onsite Registration $35 per person $15 per child age 11 or under WWW.PAVMA.ORG

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Costume Contest Have even more fun on race day when you and/or your dog dress up in costume and participate in our costume contest! Prizes in several categories will be awarded to individuals, dogs, individuals with dogs, and groups. Prizes will be provided for all contest winners. More extensive details about the contest will be available here by September 1.

Who Has TLC Helped?

Proceeds from Bark in the Park go directly to aid The Last Chance Fund (TLC) which provides veterinary care for unowned companion animals like Spike. At 5-months old, a good Samaritan found Spike injured along the side of the road.

He rushed the dog to the Animal Hospital of Willow Street and surrendered him. Apparently hit by a car, Spike had a broken leg which required two pins to fix. A very happy dog, Spike was able to walk on his own the very next day and was adopted into a new home during his recovery time at Willow Street.

Questions?

Contact Christine Gacono at cgacono@pavma.org or 888.550.7862. keystone veterinarian

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member news

Welcome New Members p VMA welcomes the following new members and thanks them for joining PVMA! (July 17— September 25, 2012)

2012 Graduate Members

Dr. Carrie Kean, Kinzua Veterinary Clinic, Warren, PA Dr. Erin DeSantis, Clearfield, PA

Academic Active

Dr. Mary Kennett, Pennsylvania State University, University Park, PA

Active

Dr. Elizabeth Keehner, Macungie, PA Dr. Teresita Hernandez, Macungie Animal Hospital, Macungie, PA Dr. Nancy Soares, Macungie Animal Hospital, Macungie, PA Dr. John Yaswinski, Nazareth Veterinary Center PC, Nazareth, PA Douglas Caucci, Orson Corners Vet Clinic, Lakewood, PA Dr. Albert Blumbergs, Pet Vet Express Mobile Veterinary Services, Mount Joy, PA Dr. Matthew Stachmus, Pleasant Valley Animal Hospital, Altoona, PA Dr. Cynthia Graves, TaoVET, Malvern, PA Dr. Mary Malloy, CARES, Philadelphia, PA Dr. Joy Redmond, Covance, Denver, PA Dr. Brian Gilpin, Shenandoah Veterinary Hospital, Martinsburg, WV Dr. Andrew Silverstone, Animal Care Clinic of Holland Road, Virginia Beach, VA Dr. John Coniglario, Animal Hospital of Gilbertsville, Gilbertsville, PA Dr. Jeffrey Kovacs, Shippensburg, PA Dr. Suzanne Middaugh, Dillsburg, PA Dr. Michele Pietrzak, Pittsburgh, PA Dr. Nancy Resciniti, Mountain Top, PA Dr. Donald Schruda, Malvern, PA

Brie Messier, Mid-Atlantic Veterinary Specialists, Malvern, PA Amanda Weister, Dover, PA Marty Mikosz, MBA, West Chester Veterinary Medical Center, West Chester, PA

Student

Wanxin Liu, Philadelphia, PA Elena Martinez de Andino, Richmond, VA Mariss Dick, Philadelphia, PA Jolie Hunsinger, Catawissa, PA Abby Meltzer, Philadelphia, PA Megan Murray, Philadelphia, PA Emily Ehmann, Bryn Mawr, PA Elizabeth Stiles, Philadelphia, PA Melanie Lang, Philadelphia, PA Samantha Mangel, Philadelphia, PA Jennifer Murphy, Philadelphia, PA Lynn Pavlovic, Harrisburg, PA Angela Smith, Philadelphia, PA Brooke Jaffe Zwerling, Elkins Park, PA Emily Brenner, Philadelphia, PA Sondra Calhoun, Philadelphia, PA Caroline Childs, Philadelphia, PA Jennifer Driskell, Philadelphia, PA Kelly Giffear, Sewell, NJ Killian Lenahen, Fort Washington, PA Klaudia Polak, Philadelphia, PA Rebecca Samley, Philadelphia, PA Meghan Shapiro, Philadelphia, PA Brian Sposato, Nutley, NJ

n July 31, 2012, Dr. Richard Wolstenholme transitioned the ownership of the Phoenixville Animal Hospital to Dr. Kimberley Galligher, owner of Willistown Veterinary Services. Dr. Galligher as she has been working for Phoenixville Animal Hospital since the fall of 2009 on a part-time basis. Dr. Wolstenholme’s goal in this transition was to ensure that the clients he has come to know and service over the last 32-years would be afforded the same level of personalized care along with access to a highlevel of veterinary medicine they have had thus far.

Government

Dr. Thomas Alexander, Pennsylvania Department of Agriculture, Harrisburg, PA

Industry Partner

Mark Zebrowski, Schwenksville, PA

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Life members have been PVMA members for at least 25 years and no longer actively practice veterinary medicine.

Dr. Charles Newton, Hayward, WI Dr. Midge Leitch, Cochranville, PA Dr. Robert Whitlock, Kennett Square, PA l

o

Dr. Kara Osterbur, Pittsburgh, PA Dr. Megan Mackalonis, Wilkes Barre, PA Dr. Katherine Borland, Pittsburgh, PA

Rhonda Kromer, Wright Veterinary Medical Center, PC, Bethlehem, PA Joy Mueller, Back Mountain Veterinary Hospital, Dallas, PA Joanne Bolte, Greener Pastures Veterinary Service, Saegertown, PA Karen Seger, PVSEC, Butler, PA Amy Peters, Pittsburgh, PA Lisa Brzezicki, Newtown Veterinary Hospital, Newtown, PA Allyn Clay, York, PA Michelle Hyde, Charles M. Hyde Veterinarian, Point Marion, PA

Life

Dr. Kimberley Galligher Takes Over Phoenixville Animal Hospital

Active-Recent Graduate

Practice Manager

Janelle Defulio, Barrington, NJ Caitlin Gormley, Drexel Hill, PA Casey Murphy, Philadelphia, PA Krista Rieckert, Philadelphia, PA Morgan Taylor, Philadelphia, PA Alyssa Leone, Voorhees, NJ Marisa Palmer, Philadelphia, PA Kristen Endres, Newark, DE Elizabeth Miller, Philadelphia, PA Corinne Buirkle, Philadelphia, PA Nicole D'Addezio, Wyomissing, PA Kathryn Feldman, Philadelphia, PA Alexandra Stevens Mariel Hosier, West Deptford, NJ Caitlin Russell, Philadelphia, PA Jessica Abu-Hijleh, Boothwyn, PA Leigh Davis, Philadelphia, PA Lauren Glowzenski, Philadelphia, PA Julie Merkt, Philadelphia, PA Alexandra Pinamonti, Harrisburg, PA Sarah Schoenhut, Philadelphia, PA Matthew Terzi, Philadelphia, PA Katie Carlson, Philadelphia, PA

As many of you are aware, some updates to the hospital are long overdue and Dr. Galligher has plans to ensure that those needs are addressed both from an appearance and a medical standpoint. Facade and lobby renovations are anticipated to be completed by the Spring of 2013 and the addition of a new digital x-ray and dental unit along with a practice management software system will ensure that the level of medicine Phoenixville Animal Hospital offers is comparable or exceeds that of other veterinary practices in the area.

Dr. Wolstenholme and the rest of the Phoenixville Animal Hospital team are excited about this new transition and PVMA congratulates Dr. Galligher and wishes her the best of luck in her new endeavor. l

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Feral Cats continued from page 32

been not to resuscitate a cat if cardiac arrest has occurred. This is because with feral cats the amount of care that would be needed afterward to properly diagnose, treat, and monitor that cat in the post arrest phase would be practically impossible to carry out. We cannot adequately screen these cats pre-op, and while we do our best to ensure a safe a surgery as possible, having the reactions and deaths occur is something that has to be accepted.

Once the surgery is completed the cat should be moved from the surgery table, have the hemostat removed from the left ear and the ear tip checked for any bleeding, have any further medications given per the veterinarian's instructions, be wrapped up in its towel or fleece, and placed back into its carrier or trap. The cat should then be moved to a recovery area where one or two technicians or volunteers that are properly trained can monitor the cats for any problems during recovery.

It is also important to remember to remove the identification collar from the cat before placing it back in its carrier or trap. I personally do not have any problem with a cat being recovered in a trap if it is only overnight and the cat is released the next morning. There are some groups and caretakers that insist on holding a feral cat for a few days post-op to make sure they are doing alright, especially if they were pregnant. This can be done, but the needs of the cat have to be taken into account such as proper room to move around, eat, drink, urinate, and defecate normally and in a way that will not get them soiled or wet. Keeping a cat in a trap for an extended period of time can lead to a lot of muscle cramping and other problems. The cat can then be picked up by its caretaker when awake and basic post-operative care instructions can be given. It is important to stress that the cats should remain confined overnight to let the effects of the anesthesia wear off so that once outside, ferals vulnerable to predators. The cat is then released to the caretaker with any other instructions.

cat clinic your first time. It will not go well and everyone will end up discouraged and angry. Start as small, with 5-10 cats. That is what we at the Humane League have done and now we can easily get 100-120 cats done in a clinic with a few veterinarians and the outstanding technician team I have. Starting small allows for working out a proper system and the kinks that come with it so that everyone is happy and things can move more smoothly. Then, gradually increase your numbers. Also, make sure everyone involved has the chance to give their input and ideas. Often other people will have great ideas and suggestions that you may never have considered.

I hope this 2-part series on feral cats and TNR clinics has been both helpful and thought provoking. If anyone has any questions about the topic or the clinics, please do not hesitate to contact me at blanglois@humaneleague.com or 717.393.6551, ext 241. l

The final area to consider is cost charged to the caretaker. I think this can basically be based on how much money it costs to operate the clinic. If you have volunteers and are only paying for your supplies, then the costs can be lower per cat. If you are paying your veterinarian and technicians (and there is nothing wrong with having to do this) then your costs per cat are will be higher.

The average cost per cat for a surgery, rabies vaccine, and ear tip seems to be in the $45–$60 range. At the Humane League, we can do it for $10 a cat, but that is only because of generous monetary donations, grants, and the volunteers who help us at no cost. Whatever your price is, I am firm believer that all cats should receive a rabies vaccine as part of the service. This is a vital public health issue and will help prevent the spread of rabies through this population if an outbreak ever were to occur.

My final bit of advice on doing these clinics is to always start small. Do not attempt to do a 100 WWW.PAVMA.ORG

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Classified Ads Veterinarians ASSOCIATE VETERINARIAN needed for full or part-time in well-established practice. New graduates are welcome to apply. The practice includes 2 busy offices—1 is a new 11,000 sq ft hospital with up-to-date equipment and good support staff. Practice is strictly small animal, primarily dog/cat. Focus is preventive and general medicine, general and orthopedic surgery. We offer a competitive salary and good benefits package.

Located in beautiful north central PA. Many recreational and cultural opportunities are available.

Please send or fax resume to: Adrian Carlin, VMD. 12043 Route 287, Middlebury Center, PA 16935, fax 570.376.2936, or email to: wsahvmc@ptd.net.

DO YOU like weekends off and no on call time?

Busy, Four Doctor, small animal practice seeking a friendly, energetic, well rounded veterinarian who wants to practice quality medicine and surgery.

Potential to earn $100,000 plus per year, 401K, health insurance and many other benefits. New graduates welcome. Ultrasound experience a plus.

Call Dr. Beth Crombie at 570.523.3640 or email lvh@dejazzd.com.

ASSOCIATE VETERINARIAN wanted for wellequipped small animal practice in southwestern Pennsylvania. Full-time, Monday through Friday hours. Well-established practice with a growing client base. Mail resume to Fayette Veterinary Hospital, PO Box 295 Fayette City, PA 15438.

ASSOCIATE VETERINARIAN part or full-time for 2 doctor small animal practice in Erie PA. Excellent team and technology. After hours emergencies referred to emergency clinic. Positive attitude, excellent communication skills, and dedication to customer service required. Strong interest in surgery a plus. Resume and letter of interest to Scott Johns VMD, Fairview Veterinary Hospital, 7733 W Ridge Rd. Fairview, PA 16415, or FairviewVet@verizon.net.

THE VETERINARY REFERRAL Center in Malvern, PA, is seeking four (4) experienced internshiptrained Emergency Veterinarians, as well as two (2) residency-trained Critical Care Veterinarians. Several years of post-internship experience working in a specialty hospital with board-certified critical care specialists is strongly preferred. VRC Emergency offers a highly competitive compensation package with an excellent benefits program. Please email a resume and cover letter to the attention of Dr. Dietrich Franczuszki, President and Chief Medical Officer at info@vetreferral.com or mail to his attention at: 340 Lancaster Avenue, Malvern, PA 19355.

RELIEF VETERINARIAN needed: CPVETS, and emergency service located in State College, PA, is looking for a part-time relief veterinarian who is available for occasional weekend shifts. We are a relatively new, but now established, hospital that serves much of central Pennsylvania. Some experience required. We prefer applicants to have at least one year in private or emergency practice.

You can learn more about our practice by visiting our 36

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website at www.cpvets.net. Resumes can be emailed to cpvet@yahoo.com, faxed to 814.237.4646, or mailed to 1522 Martin St., State College, PA 16803.

EXPERIENCED FULL or part-time associate needed to join single doctor small animal practice in Hanover, PA. Well-equipped hospital, great clients and experienced staff. Excellent work ethic, medical skills, and communication skills necessary.

Good schedule. No emergencies. Generous salary and benefits package. Fax resume to 717.633.3604 or call 717.633.3603.

Veterinary Technician FULL-TIME VETERINARY technician: An experienced and dedicated full-time certified veterinary technician needed to join our great team. Visit www. leesportanimalhospital.com and Facebook. Interested?

Fax cover letter and resume to 610.926.3860.

relief services. Contact 610.721.6634 or kimvmd@ hotmail.com for more information.

EXPERIENCED VETERINARIAN, 1987 Penn grad seeks part-time employment within 30-45 minutes of the Pottstown/Quakertown area. Special interests in surgery, diagnostic imaging, exotics. Professional, reliable, neat appearance. Call Jacqueline Burke, VMD at 610.754.1155 or email jacquib@dejazzd.com.

LOOKING FOR relief: Veterinarian needed for Tuesday and or Thursday evenings. Approximate hours are 4 hour weekly with opportunity for further relief (vacations) Contact: Providence Veterinary Hospital, Chester, PA. 215.620.2407.

MJ POTTER, UP 97. Experience in small animal internal medicine, critical care, oncology, and general surgery. Available for long or short term relief in Delaware, Chester, Lancaster, and surrounding counties. 610.357.5275 or drmjpotter@hotmail.com.

Practice Consultant PRACTICE SALES and appraisals—Why pay 8-10% in commissions to help you sell your practice? Our company has the knowledge and experience to produce significant savings for you. Call to inquire about our rates. No obligation. Practice valuations starting at $2500. Ark Business Consulting. Alan Glassman, VMD; David Cherst, CPA, MBA. 610.283.3476.

Relief Veterinarians SAFI CHAND, DVM. Compassionate, productive small animal veterinarian, strong interpersonal, medical and surgical skills, >5 year experience in referral/ER,exotics, available weekends, weekdays and nights. 413.636.9209; safi_c2000@yahoo.ca.

EXPERIENCED, SURGICALLY-COMPETENT veterinarian available for relief employment. York, Adams, Lancaster, Dauphin, Cumberland, and Franklin Counties. Allan Hill, VMD, 717.723.6559.

BONNIE J. MILLER DVM. Veterinarian with 25+ years experience in small animal, pocket pets, avian, reptile and exotics. Licensed in MD and PA. APHIS certified and have a current DEA certification.

Proficient in surgery as well. York, Lancaster, Gettysburg, Harrisburg, and surrounding areas in PA. Northern Baltimore County and some parts of Hartford and Frederick Counties. 717.739.8400.

DONALD W. STREMME, VMD. Experienced veterinarian (35+ years) available for small animal and exotic (birds, pocket pets, reptiles) relief work in Philadelphia area and South Jersey. Will consider other areas where licensed, too. Licensed (including DEA and USDA-APHS) in PA, NJ, NY, FL and CA. Email to CCACDWS@aol.com.

KATHRYN WEST, DVM, UF ‘94. Small animal and exotic/non-traditional pet work, including sx.

Central and SE PA. kswdvm@comcast.net.

DR. KIMBERLEY HERSHHORN GALLIGHER, Willistown Veterinary Services, is available for

keystone veterinarian

WILLIAM KEER, DVM, Wisconsin ‘99 Providing veterinary relief services and improving colleagues’ quality of life in eastern Pennsylvania. Please contact me via email at bkeer@ptd.net or phone at 484.560.4338 for more information.

THE VISITING VET! Experienced relief veterinarian available for quality coverage in Chester County, Northern Delaware, southern Lancaster County and southern New Jersey. Small animal and pocket pets. Soft tissue surgery and emergency coverage. Licensed three states and DEA current certificate. One day or regular short-term part-time. References available. Contact: Sandra Fargher, VMD '91, at 610.299.8593 or sandraatmillrd@aol.com.

HOW DO you spell relief? Jerry Godfry, DVM! I have been a veterinarian for 38 years and have owned my own practice in Chester County for the past 30 years. I have sold my practice recently and I am currently available to work as a relief veterinarian in Philadelphia and the surrounding areas. I am an experienced, reliable doctor that would fit your needs. My experience ranges from cats and dogs to birds and reptiles. I am licensed and accredited in PA as well as federally accredited. I work well with new staff and am able to work a busy schedule. Available for day and evening shifts in addition to Saturdays and some holidays. Will travel 45-1 hour if needed.

Please contact if interested. 610.506.6494.

To Purchase LOOKING TO BUY: Two older veterinary books in decent condiition: Color Atlas of Small Animal Dermatology by Barbara A. Kummel, DVM—printed

by Mosby Co., 1990 copyright; and Small Animal Dermatology by Muller & Kirk, printed by W.B. Saunders, 1969 copyright. Not interested in newer editions.

724.872.8644. Ask for Dr. Hope, Jackie or Joyce.

For Sale SMALL ANIMAL solo practice for sale in SW Pennsylvania. Owner retiring. Established 35 years.

10 minutes West of Airport and half hour to downtown continued on page 38 WWW.PAVMA.ORG

9/27/2012 4:53:17 PM

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what’s happening

Events & Education

november 2012

october 2012

5TH 3 Rivers Veterinary Symposium, Omni William Penn Hotel, Pittsburgh, PA

October 28, 2012

PVMA will be returning to Pittsburgh for the 5TH 3 Rivers Veterinary Symposium. 12 hours of continuing education credit will be available in a variety of tracks including companion animal, bovine, and more.

Full details on program, hotel, and registration are available at www.pavma.org.

3rd Annual Bark in the Park 5k Run & 1 Mile Dog Walk, City Island (Riverview Pavilion), Harrisburg, PA Help raise money for the Pennsylvania Veterinary Foundation's The Last Chance Fund (TLC) by participating in our 3rd Annual Bark in the Park 5k Run & 1 Mile Dog Walk. The Last Chance Fund raises funds for the veterinary care of abused or neglected unowned companion animals. Register for the race individually or as a team and then begin collecting pledges. You can also register on race day. There will also be a costume contest for dogs and their owners with prizes. Get full details and register online at www.pavetfoundation.org.

Letter to the Editor continued from page 9

with the author by cautioning against these types of claims as well.

However, I must offer to any readers this retort: Do you know of any anti-inflammatory/immune-modulator treatment for osteoarthritis that provides relief for pain (based on the Glasgow scale), improves range of motion and flexibility (goniometric measurements) and does so for over one year on average? And if you did, would you use it?

Dr. Glenn McGee, a noted bioethicist, made this valuable comment pertaining to efficacy of stem cell therapy: “Your questions as to efficacy (and whether there is *any* efficacy are legitimate questions to which more than 200 authors have provided answers in more than 50 published articles in the more than 10 stem cell-germane peerreviewed ISI-ranked journals that are thriving under an avalanche of data — more every year. There is so much evidence that I think maybe, just maybe, we should have another “thread” in the blog to discuss the problem of “evidence blindness” among those who discuss MSCs. How could you possibly be unaware, if you know how to type pubmed. org, of the volume of articles chronicling study and positive effects from MSC use in clinical trials? There aren’t enough slots to publish all the articles that get approved by peer reviewers in the decent stem cell journals and subspecialty journals that document efficacy.”

The research base concerning the subject of adipose-derived stem and stromal cell therapy is already vast, and growing very quickly. Along with the current use of this technology in osteoarthritis, ligament, bone and tendon injuries, I have personal knowledge of research into stem cells as a possible treatment for IBD, chronic pancreatitis in cats, atopy, peri-anal fistulas, degenerative myelopathy, IVDD, osteoarthritis (cartilage repair studies), cardiomyopathies, chronic renal disease, chronic active hepatopathies and SARDS. As I mentioned earlier, these stem cells hold great potential as future therapies for a multitude of diseases.

I must conclude by posing one extremely important question for my colleagues to ponder: How do you design a randomized, double blind clinical trial on an autologous therapy? It is simply impossible to devise a clinical trial to test the effectiveness of this therapy in the conventional manner while having the therapy remain “autologous.”

Therefore, if you attach the label of “unproven” to this therapy, you must consider the consequences of that statement. If you are waiting to hear 38

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November 3-4, 2012

february 2013 February 9-16, 2013 St. James Club Resort, Antigua Just when winter is the coldest, PVMA is heading to Antigua for the 2013 Winter Seminar Vacation. 26 hours of continuing education credit will be available in a from three speakers. The resort also boasts endless amenities and Full details on the program, resort, and travel arrangements are available in a downloadable brochure at www.pavma.org. l

the results of those conventional studies before you start using these modalities in your practices, then you will never use them. Regenerative medicine is a new paradigm. It is paramount that we begin to shift our way of performing studies and use the individuals as the control. Our current technologies allow us to perform detailed tests on an animal before, during and after therapy and are more than adequate to determine if the patient has improved, worsened or stayed the same. There are billions of dollars being spent on these treatments around the globe and for good reason. This therapy using adipose-derived stromal cells is providing relief for many different ailments; trust that it is here to stay. While private companies do not customarily publish their study results until they have a product that is ready to launch into the marketplace, there are other areas where an abundance of knowledge can be found on this topic. (Pubmed. org and clinicaltrials.gov are two such places.) With some personal research, I am confident you will find that this new branch of medicine is much more than a “21st century snake oil.” I urge any and all readers to look into the published studies and find out for yourselves. l

Classifieds continued from page36 Pittsburgh. Hours can be expanded. Includes land, building, and equipment on busiest road in Beaver County. Serious inquiries to 724.375.6312.

FOR SALE: Veterinary real estate commercial and residential real estate in Lancaster County, PA. This property has been a veterianry hospital for 39 years.

Excellent location, one acre lot, three stall barn, fenced half acre. Real estate under $275,000. Equipment for sale separately. Email eah70@windstream.net or call 717.733.1078.

IN-HOUSE ABAXIS lab equipment HMII, HM%, VS2, Idexx U/A analyzer, and istat for sale. Also Ettinger's Internal Medicine, first edition (2 book set). Please contact me for details at eggzoticdvm@gmail.com.

PRACTICES FOR SALE: Gulf County, FL: SA Gross Income ^38%;York County, ME: SA. 3,500sf w/RE; Hillsborough County, NH: SA. 1,750sf w/RE; Piedmont Area, NC: SA 4,000sf w/RE; Buncombe County, NC: Feline. 3,000sf w/RE; Shelby County, TN: SA. 1,500sf w/RE; Houston, TX: SA 3-exam rooms w/RE. PS Broker, Inc., 1.800.636.4740, www.psbroker.com. l

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Federal Trade Commission Hosted Workshop on Pet Medications—Comment Period Still Open

t

he Federal Trade Commission (FTC) hosted a workshop focused on pet medications in Washington, DC on October 2. The AVMA has been actively engaged with the FTC on this issue and participated in the workshop.

The AVMA also submitted official comments to the FTC’s Federal Register Notice requesting public input on questions they posed related to veterinary medicine and prescription writing. The comment period, originally slated to close Friday, September 14, has been extended to Thursday, November 1. We encourage you to take advantage of the extended comment period and submit your thoughts to the FTC at https://ftcpublic.commentworks.com/ftc/petmedsworkshop.

Healthcare Reform continuued from page 10

paid part of the premium, that same percentage of the refund must be paid back to the employee.

• The premium increase oversight will apply – this means that carriers will have to justify any premium increases in their book of business that exceed 10%.

My column covers only the tip of the iceberg and brings you the most relevant and current points of interest that will impact you soon. If you are interested in learning more, Highmark Blue Shield has an excellent website dedicated to healthcare reform—www.highmarkonhealthcarereform.com. I encourage you to take a look at it so you can understand all the intricacies better or if you are suffering from insomnia!

If you would like to learn a more condensed version of what you need to know about healthcare, reform, and what resources we can provide through pvmaAssure, I encourage you to join us for one of our webinars:

Fracking continued from page 21

since the frack water does contain chemicals (albeit at low levels) and salts at levels if ingested or if contaminating ground water they could cause either acute or chronic animal or fish disease. Each gas well has systems in place to capture the frack water as it escapes back up the well along with the gas. The largest volume (15-20%) comes back up the well shortly after the well is HF. Small amounts of frack water dribble back up the well over the life of the well. At this time, most companies in PA have developed resources to recycle the frack water and re-use it in other wells. Long-term contaminated waste water that is not recycled will have to be decontaminated or disposed of in a safe and approved manner. Monitoring wells and the returning frack water over the next 25-50 years will be an important responsibility for veterinary, public health, and environmental officials. Hopefully the various public, veterinary, and natural resource agencies will cooperate and

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The workshop was open to the public. The meeting took place at the FTC’s Conference Center in Washington, DC. While there was no opportunity to publicly comment during the workshop, questions and comments were accepted throughout the workshop via Twitter using the hashtag #FTCpets. For additional information, please contact the conference organizer, Stephanie Wilkinson, in the FTC’s Office of Policy Planning at petmedsworkshop@ftc.gov or 202.326.2084.

PVMA submitted comments to the FTC which can be found on our homepage at www.pavma.org and had representatives present at the workshop to gather more information for our membership. l

October 24, 2012 2:00–3:00pm—Register at https://cc.readytalk.com/r/v7p0f3zt5ohd 8:00–9:00pm—Register at https://cc.readytalk.com/r/wkf9sq6q6eky

October 25, 2012 12:00–1:00 p.m—Register at https://cc.readytalk.com/r/ji8to7feybyq So does healthcare reform fix all of our healthcare woes? Many involved in the insurance industry are concerned that the new law falls short of solving the pressing problem of continuously rising medical care costs. More programs are needed to control costs while improving the quality of care and the safety of American patients. Whether or not this is true and what healthcare reform will ultimately look like remain to be seen. Time will tell. One thing is for certain, the complexities of the issue require each of us to have a resource and advocate in our corner to help us navigate through it. PVMA and pvmaAssure plans to be this for the veterinary profession here in Pennsylvania. l

coordinate monitoring efforts, as the MS issues cross human, animal, natural environments, and economic boundaries.

Again, this short piece cannot do justice to the complexity of the MS issue. If readers choose to visit just one site for additional information, I strongly suggest they follow the link to the PSU Marcellus Shale website, www.marcellus.psu.edu.5 Abundant links can be found to a wide variety of resources on Marcellus Shale. l References 1. “An Unconventional Bonanza”, The Economist (economist.com/special reports), July 14, 2012, 3-18 2. Bamberger, M and R. E. Oswald, Impacts on Human and Animal Health, New Solutions, vol. 22(1), 51-77, 2012 3. http://extension.psu.edu/naturalgas/publications 4. http://www.iogawv.com/Resources/Docs/Marcellus-drinking- water-2011.pdf 5. http://www.marcellus.psu.edu/

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the grand finale

Laughter Is the Best Medicine Rules For Cats • • • • • • • • • • • • • • • • • • •

All rules can be broken when you feel like it.

Don't worry about vet bills, someone else will pay.

Know where the sock drawer is for naps.

Help with jigsaw puzzles.

Sniff every stranger.

Be astonishingly mysterious.

When in doubt, chase something.

Don't play in plastic bags.

Ignore your mistakes.

When in doubt, let your tail do the talking.

Never sleep alone.

Curtains are for climbing only.

All chairs belong to the cat of the house.

Baths are for dogs.

Feeding time is when YOU want to be fed.

Go absolutely berserk for no apparent reason.

Scratching humans and furniture is a no-no.

Try to keep that mouse alive for your human.

Make the world your playground.

• Whenever you miss the sandbox, cover it up. Dragging a sock over it helps.

• If you can't get your way, lay across the keyboard until you do.

• When you are hungry, meow loudly so they feed you just to shut you up.

• Always find a good patch of sun to nap in.

• Nap often.

• When in trouble, just purr and look cute.

• Life is hard, and then you nap.

• Curiosity never killed anything except maybe a few hours.

• When in doubt, cop an attitude.

• Variety is the spice of life. One day, ignore people; the next day, annoy them.

• Climb your way to the top. That's why the curtains are there.

• Make your mark in the world, or at least spray in every corner.

• Always give generously; a bird or rodent left on the bed tell them "I care."

FUNNY ANIMAL PHOTOS

final words of wisdom The only way to keep your health is to eat what you don't want, drink what you don't like, and do what you'd rather not.

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—MARK TWAIN keystone veterinarian

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