In Remembrance – Joseph Herzog

Joseph Herzog, DVM

Dr. Joseph Herzog (Wisconsin ’97), 58, Kailua, Hawaii, died April 13 , 2020 of metastatic prostate cancer. Twelve years ago, Dr. Herzog moved to Oahu when his wife became a professor in Humanities and English UH West Oahu. He first worked at VCA Family and Oahu Veterinary Specialty Center, and then moved closer to home in Kailua at Makai Animal Hospital and part-time at Surf Paws Animal Hospital in Hawaii Kai.

Dr. Herzog was deeply involved in establishing, building, teaching in, and gaining AVMA accreditation for the first and only Veterinary Technician training program and associates degree in the state. In March 2020, the program dedicated the surgery suite in his honor.

He was active in the local veterinary community and volunteered at the Hawaii Humane Society. He served on the Board of the Hawaii Veterinary Medical Association as an Oahu Representative from 2018-2020, and Conference Committee member since 2017.

Dr. Joe always said he would see anything a client could bring through the door, and he treated beloved chickens, parrots, tortoises, and the occasional pot-bellied pig and pygmy goat in clinic. However, throughout his career he also treated bigger exotics. He served as the on-call veterinarian at the Santa Barbara Zoo and San Francisco Zoo, and he was the veterinarian of record for the Sea Life Park/Mauna Lani honu breeding and release program. He always enjoyed the challenge of a new animal and facing a new disease or injury.

Dr. Herzog is survived by his wife, Brenda Machosky, mother Rose Marie Farthing, father Ernest Herzog (Terry), brother Thomas Herzog (Jeff Kaufmann), and extended family in Illinois, New York and Virginia. He was predeceased by his beloved grandmother, Stella King, and step-father Howard Farthing. He is also survived by beloved dogs Bella, Potiki, and Fenway, and cats Huika and KoaKat.

Services will be announced at a later date. There is a memorial Facebook page that all are welcome to join: https://www.facebook.com/groups/1049974025388957/

Donations: Payable to UH Foundation with memo: Dr. Herzog Vet Tech Endowment, Account #206-2860-3, mailed to Donna Gutierrez, UH Foundation, 1314 S. King Street, Suite B, Honolulu, HI 96814, or online at: www.uhfoundation.org/HonoringDrHerzog

Submitted by Brenda Machosky

Becoming Antifragile

Author: Holly Sawyer, DVM, Human-Animal Bond Certified, works for GuardianVets, the only after-hours teletriage/telemedicine service to be endorsed by AAHA. The mission of GuardianVets is to keep the veterinary hospital in the center of the Human-Animal Bond while supporting the work-life balance of today’s veterinary professional.

If COVID-19 has taught us anything, it is that life can be wildly unpredictable. Veterinarians tend to be tidy, structured thinkers. That’s not to say we are all compulsive neat freaks. But our chosen profession demands that we master the art of pattern recognition. “Know your normal” becomes the mantra of every lecture and clinical rotation, and the aspiration of every new grad. So we gain expertise in “normal” and work hard to maintain it—in our patients and in our lives.

Duck and Pivot
The pandemic slammed us with a reality that was anything but “normal.” Overnight, we had to launch curbside care, rely on phone consultations and telemedicine, enact social distancing, and otherwise upend our historically stable profession. Let’s face it, a time-traveler from 1950 who walked into your clinic pre-COVID would have ogled at your pretty toys, but not the structure of the appointment, physical exam, or general administration of treatment. In a world of industry disrupters like Airbnb and Uber, consumer desire for choice and convenience is clearly king. In this moment of inertia within our profession, in which we are no longer the object at rest, but the object in motion, let us stay in motion. Just as the fighter in the boxing ring will fare better with quick feet and nimble reactions, we too can capitalize on the left hook that threw us off balance and now pivot into an upper cut that transfers all of that energy against the status quo.

Change Your Perspective, Change the World
What am I talking about here? You could call it a fundamental change in thinking, a mental model that embraces stressors and unpredictability as a catalyst toward improvement instead of detriment. I am talking about becoming Antifragile. This term, coined by risk analyst Nassim Taleb[1], has been applied to systems as varied as bacterial resistance and human psychology. To understand it, we must first look at the other end of the spectrum.

Fragile systems are brittle. They have very little margin for error because they maximize efficiency of time and resources to achieve optimal outcomes. Our modern, globalized society has steadily pushed us toward this ideal. We benefit from cheap food, medical advances, and technological gadgets that rely on tight tolerances of sourcing, shipping, supply, and demand. Enter COVID, and suddenly dairy farmers are dumping milk at huge economic loss because restaurants and schools are closed, while pig farmers face euthanizing pigs before they can be sold due to meat packing plant shutdowns. In our imperfect world, even small stressors can break a system, like a porcelain plate that shatters when dropped.

Resilient (or Robust) systems have built-in redundancies to survive stress. They are the plastic food containers that bounce on the floor. The system survives in its original form despite unpredictable events, but even resilient systems will reach a failure point. NASA’s Space Shuttle Program has learned that the hard way. Twice. Antifragile systems get better with stress and volatility. They are the Hydra of Greek mythology. Lop off one head, two grow in its place. Expose a population of staphylococcus to methicillin, and soon you will have a thriving infection of superbugs. Bad for us, great for them. Likewise, the saying, “What doesn’t kill you makes you stronger,” describes the mechanism by which we ourselves become antifragile. When we succeed in the face of overwhelming odds, we tend to achieve greater feats the next time around. The opposite viewpoint “Avoid all risk at all cost”—in turn makes for a very brittle population that fears unpredictability because it doesn’t know what it can overcome. [2]

Choose Your Own Adventure
Veterinary Medicine is at a pivot point in the boxing ring right now. Instead of resisting change, let us grow through it to become better than we were before. It will take energy, patience, creativity, and a willingness to fail small in order to succeed big. Happily, our clients are particularly forgiving of experimentation right now, especially when it is for their benefit. We can establish a new and better normal if we provide our clients the care they want, how they want, when they want it, while reclaiming some work-life balance for ourselves. Offer a digital patient portal, an easy pipeline for communication to bond the client to your clinic, so you remain at the forefront of healthcare decisions before entrepreneurs with far less training fill that space. Schedule differently, cross-train staff to new tasks, and leverage your RVTs and CVTs to legally fill needs previously provided by DVMs. Treat life as an adventure instead of a race to perfection, and don’t panic when you don’t recognize the pattern ahead. That which you fear may become a game-changing opportunity.

[1] Taleb, Nassim Nicholas. Antifragile: Things That Gain from Disorder. New York: Random House, 2012.
[2] Lukianoff, Greg, and Jonathan Haidt. The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure. New York: Penguin, 2018.

Veterinary Leadership Conference in 2020

We want you – Rising Leaders, Experienced Leaders, Presiding
Leaders – to attend the Veterinary Leadership Conference. This
conference, presented by your American Veterinary Medical
Association (AVMA) will help you develop, and expand your
leadership skills wherever you are in your Veterinary Career.
Continuing education (10 hours), Networking with colleagues, and
mentorship will be available in Chicago, Illinois January 9-12,
2020.

Also happening at this conference will be the Winter Session of
the AVMA House of Delegates (HOD). Interactive Sessions will
be available to breakdown Governance of the AVMA so that you
can discover ways to be involved, have your voice be heard, your
ideas shared and to make a difference in our profession.

Visit AVMA@Work to get more information about this conference and
ways that you can attend at reduced cost. Deadline for
Scholarships are October 31, 2019.


Both Carolyn Naun (Hawaii HOD Alternate Delegate) and myself
(Leianne Lee Loy – Delegate) will attend this yearly conference
and invite YOU to express, expand, gain more of your leadership
skills.

If you have any questions – please feel free to contact us via email
at contact@hawaiivetmed.org.

A Hui Hou and Aloha!
Leianne Lee Loy

Letter from the President – Oct 2019

Aleisha Swartz, DVM

Dear Friends,

I hope to see each of you soon at our annual conference at the Hilton Waikiki Beach on November 7-10, 2019. We are fortunate to host AVMA President John Howe and District 10 representative George Bishop at the conference this year. Dr. Howe’s areas of focus for his tenure as president are member needs, veterinary technicians and One Health. Please give them a warm welcome if you see them. Even if you are not attending the conference for CE be sure to join us for our annual meeting at noon on Saturday.

Mental health and wellbeing concerns for veterinary professionals have been in the national news recently. Awareness of the increased risk for burnout, substance abuse, depression and suicide ideation in our profession is hopefully a first step toward finding solutions for this crisis. The AVMA has many resources for veterinarians on personal and workplace wellness, and the HVMA has a wellness committee to assist members in need. 

In 1976, Dr. Bill Hettler, co-founder of the National Wellness Institute in the US, developed a model of wellness that included six dimensions of health: physical, emotional, intellectual, spiritual, occupational, and social. Since then others have added three more to create the nine dimensions of wellbeing: financial, creative and environmental. Each dimension is interconnected and collectively contributes to our overall wellbeing, and when one area is lacking, the others and overall wellbeing are affected. I encourage you to follow the links to read and learn more about these areas and take a self-assessment to identify areas where you might focus your self-care.

For this message I want to focus on the social dimension. One stated purpose of the HVMA is to promote the spirit of community among members of the veterinary profession. Our annual conference is a time to get together and catch up on what is happening with one another: the success and challenges of our friends and colleagues we may not see as often as we would like to. It is also a chance to make new friends and welcome new colleagues into our community. Brené Brown, best-selling author and published researcher writes the following in the introduction to her book Daring Greatly: “the surest thing I took away from my BSW, MSW, and Ph.D. in social work is this: Connection is why we’re here. We are hardwired to connect with others, it’s what gives purpose and meaning to our lives, and without it there is suffering.” This includes connection with colleagues in the workplace. In Dare to Lead she says this about her research: “Daring Leaders must care for and be connected to the people they lead. The data made clear that care and connection are irreducible requirements for wholehearted, productive relationships between leaders and team members.” She defines a leader as “anyone who takes responsibility for finding the potential in people and processes, and who has the courage to develop that potential.” As veterinarians, we are all leaders and we must strive to build connection in our work and social lives to build resiliency.

I hope you can all take a moment during the next month to talk story and build those connections with one another. By doing this we will be taking a step in the right direction to improve our well-being. Please reach out to a colleague, friend, or professional if you are suffering. We are here to help one another. And if you are interested in learning more so that you can help those at risk, visit the AVMA’s website on Question-Persuade-Refer (QPR) training. There is currently a pilot program that will provide training to learn how to identify and refer colleagues who are at risk.

Aloha,

Aleisha Swartz, DVM
President, Hawaii Veterinary Medical Association

Volunteers Needed for 2017 Hawaii Pet Expo

May 13th-14th at Blaisdell Exhibition Hall, corner of Ward Ave and King Street, Honolulu

Pet Expo is sponsored and organized by the HVMA. It has been an annual event for over 25 years and is FREE, and well received by the public, with an average of 10,000 people attending each year. The purpose of the Expo is to promote responsible pet ownership and strengthen the bond between people and their pets through educational displays, live animal demonstrations, and the latest in pet services and products. The HVMA is looking for veterinarians who will promote our profession in a positive manner and educate the public on the need for professional veterinary care. They are there to promote the HVMA and what we stand for, but can pass out business cards and information if asked for. We would like vets who are willing to volunteer their time to promote our profession and who are willing to interact with the public, to sign up.
1) HVMA Booth: This year we are doing away with the “Ask A Vet” booth, although vets manning the booth will be there to answer any kind of question. The HVMA booth will be similar to last year’s theme: Common Household Dangers.
2) Make and Take (Kiddie Craft ) Booth:  Assist kids and their parents with making finger puppets and other paper crafts, which they get to make and take home.  Keep booth clean and organized.
3) Greeters:  Pass out programs and poop bags at the door.  Help to direct traffic in and out of the Exhibition hall.  Smile and welcome people.  Collect canned goods and monetary donations for the Hawaii Food Bank.
4) Information Booth:  Help direct people to exhibits, answer questions, make announcements, box up food donations, make more poop bags, run errands, clean up pet messes that are reported or seen.
5) Show Marshalls:  The “Poop Patrol”.  Patrol Exhibition Hall and grounds outside, picking up pet messes.  Empty overflowing trash and cigarette bins outside hall and transfer to dumpster in back.  The good thing about show marshaling is that you get to walk around the hall and check out all the exhibits, although you are supposed to be working, not shopping during your shift!  We always need a lot of show marshals.

 

If volunteers sign up by the deadline, a t-shirt will be ordered for them. Sizes are M, L, and XL; please indicate shirt size when signing up. If you sign up vets are encouraged to wear lab coats or smocks to identify themselves as vet professionals, name tags will be provided. They may also wear the Pet Expo tshirt.
Volunteers are needed for Friday night to help set up. (No AC on Friday night, wear shorts!)
Saturday and Sunday the shifts are as follows: 9:30-12:00 am, 11:30 to 2:00 pm, and 1:30 to 4:00 pm. Only the first shift will be provided a small lunch.
Volunteers should sign up by calling Dr. Kam or staff at Ohana Vet Hospital at 845-1762, or fax at 848-1632.

Cats & Toxoplasmosis Information

Toxoplasmosis Facts

“Toxoplasma gondii is common, worldwide and everywhere and affects a variety of mammals and birds” – Companion Animal Parasite Council

  • Leading cause of toxoplasmosis in humans is through ingestion of undercooked meat. – CDC
  • Direct contact with cats is not considered to be a risk factor for toxoplasma infection in people, particularly when cats are kept indoors and fed a commercial diet. – CAPC
  • Toxoplasmosis is transmitted to humans from cats when humans accidentally swallow the parasite through contact with cat feces that contain Toxoplasma. CDC
  • Toxoplasmosis can be prevented if the following are done: clean the litterbox daily (the parasite takes 24 hours to become infective in cat feces), wash hands with soap and water after exposure to soil, sand, raw meat or unwashed vegetables, and ensure cats are kept indoors and eat only cat food. – CAPC
  • Only about 1% of cats are active hosts of toxoplasmosis able to shed the parasite. – CAPC
  • Infected cats shed for only about 1 to 3 weeks following infection. – CAPC
  • Because cats only shed the organism for a few days in their entire life, the chance of human exposure is small. – CFHC
  • Cats and dogs become infected with toxoplasma by ingestion of infected mammalian or avian tissues or ingestion of the parasite from articles contaminated by feline feces (e.g., soil, water, vegetation). – CAPC
  • About 19% (˜60 million) of the human population in the United States has already been exposed to (may be infected with) Toxoplasma. Of those who are infected, very few have symptoms because a healthy person’s immune system usually keeps the parasite from causing illness. – CDC
  • A 2013 study by VanWormer, et al. showed reduced prevalence of toxoplasmosis in cats who were fed and considered managed by humans as compared to wild felids and cats subsisting on wild prey.

Solutions to Consider

  • Keep cats indoors and prevent them from hunting and consuming undercooked meat, encourage cat owners to scoop litterboxes daily.
  • Support sterilization to reduce kitten births, since kittens and young cats are at greatest risk to become newly infected and shed the parasite.
  • Advocate for wildlife officials, conservationists, animal welfare advocates and veterinarians to work together to solve problems using the latest science combined with humane methods.

Resources/ References

  • Companion Animal Parasite Council (CAPC) – www.capcvet.org
  • Centers for Disease Control and Prevention (CDC) – www.cdc.gov
  • Cornell Feline Health Center (CFHC) – www.vet.cornell.edu/fhc/
  • VanWormer, E., P.A. Conrad, et al. (2013). “Toxoplasma gondii, Source to Sea: Higher Contribution of Domestic Felids to Terrestrial Parasite Loading Despite Lower Infection Prevalence.” EcoHealth 10, 277-289

HVMA Cats and Toxoplasmosis Information Sheet 12 28 16

Hawaiian Monk Seals and Toxoplasmosis

Hawaiian monk seals are listed as endangered under the U.S. Endangered Species Act and are protected by Federal and state law. This unique tropical pinniped is found exclusively within Hawaii’s waters, mostly throughout the low-lying atolls of the Northwestern Hawaiian Islands. However, monk seals have been recolonizing the main Hawaiian Islands over the past two decades. This subpopulation is estimated at 200-250 seals, and is growing. With that growth comes the recognition of new threats to the species such as fish hook ingestion, intentional killing, and now, an accumulating number of deaths from toxoplasmosis. This is not surprising, given the increasing geographic overlap between humans, cats, and Hawaiian monk seals.

A total of 8 monk seal mortalities (and 2 suspect mortalities) have been attributed to toxoplasmosis to-date. We arrived at this number by developing a case definition and retrospectively applying it to 306 cases of mortality from 1982-2015. To be classified as a protozoal-related mortality, we required: (a) pathological lesions consistent with protozoal disease and sufficient to cause mortality, and (b) confirmation of the organism in direct association with these pathologic lesions by immunohistochemistry. Supporting data such as serology and molecular analyses were provided when available. The results were recently published in the peer-reviewed journal, “Diseases of Aquatic Organisms.”

While 8 deaths may not sound like a large number, NOAA is growing increasingly concerned about the threat of toxoplasmosis for several reasons. First of all, the number of monk seal mortalities attributed to toxoplasmosis is an underestimate. More seals disappear each year than are found sick or dead. Even when carcasses are found, they may be too decomposed to definitively identify this infection as a cause of mortality. Vertical transmission to fetuses has been documented in monk seals, however failed pregnancies can be difficult to detect in wild animals. The outlook for treating sick seals is poor because of the rapid, severe, diffuse inflammatory response in the infected seal and because drug choices and delivery routes are far from optimal. Only two seals have been assessed prior to death, but both declined rapidly and could not be rehabilitated. Unlike threats such as fish hook ingestion or malnutrition, which can often be mitigated through rehabilitation, our options are severely restricted when it comes to treating seals for toxoplasmosis. Even if there were improvements in treatment modalities, most cases are simply found dead on the beaches. The population level impact of each mortality exceeds the loss of one seal because the future reproductive potential of that seal is also lost.

NOAA is one of a handful of Federal and state agencies that have met in 2016 to discuss the complex problem of cats in Hawaii and the threats (disease, predation) they pose to native wildlife. The group is still formalizing its mission, scope and membership, but for now, it is focused on compiling and disseminating the best available science on this issue. In time, subgroups will be developed to focus on specific topics. The group will seek participation from outside (non-agency) groups, including veterinarians – so stay tuned.

Through some of our ongoing research partnerships, we at NOAA are investigating the prevalence of exposure within the monk seal population using serology and molecular analyses. Evidence of previous exposure to T. gondii has been documented in a few apparently healthy monk seals as well, so we are very interested in this dichotomy. To address that, we are working with external partners and experts in this field to better understand the epidemiology of this pathogen in monk seals and the risk factors related to the host, pathogen and environment. I hope to be able to share the results of these studies with all of you in the years to come and I welcome your questions or dialogue on this topic.

Michelle Barbieri, DVM, MS

Wildlife Veterinary Medical Officer

Hawaiian Monk Seal Research Program

As the primary veterinarian for NOAA’s Hawaiian Monk Seal Research Program, Dr. Michelle Barbieri oversees wild monk seal disease surveillance, population health studies, vaccination, rehabilitation, and provides veterinary support to the program’s other research objectives.

References:

Honnold, S.P., Braun, R., Scott, D.P., Sreekumar, C. and Dubey, J.P., 2005. Toxoplasmosis in a Hawaiian monk seal (Monachus schauinslandi). Journal of Parasitology, 91(3), pp.695-697.

Barbieri, M.M., Kashinsky, L., Rotstein, D.S., Colegrove, K.M., Haman, K.H., Magargal, S.L., Sweeny, A.R., Kaufman, A.C., Grigg, M.E. and Littnan, C.L., 2016. Protozoal-related mortalities in endangered Hawaiian monk seals Neomonachus schauinslandi. Diseases of Aquatic Organisms, 121(2), pp.85-95.

2016 Member Updates

Welcome new members in 2016: Neal Villanueva, Rajdeep Singh Turna, Hui Nee Chin, Melanie Pearson, Krystina Keikionalani Cunningham, Edward Hsu, Ednee Yoshioka, Daniel McConnel, Heidi Choy, Chelsea Monroe, Caroline Olausen, Jamie Ota, Kristina Ramer, Karen Park, Renee Nagata, Lei Imaino-Hata, Clarence Carl Ducummon III.

Please congratulate our newest lifetime members: Richard Fujie, Patrick Ahana, Ted Cleghorn, Roger Kondo, Sharman Ellison, Tim Lau, Sterling Iwashita, and Thomas Lee.

Send us your updates to share with others! newsletter@hawaiivetmed.org