Cannabis Info from AVMA

AVMA submitted comments to the FDA regarding critical veterinary issues related to cannabis products, and the importance of addressing them. The AVMA submitted the comments following a public hearing held by the agency in late spring to gather stakeholder input while considering regulatory frameworks for hemp derivatives—including CBD—used for therapeutic purposes and as food additives.

“Veterinarians have a strong interest in, and enthusiastically support, exploring the therapeutic potential of cannabis-derived and cannabis-related products,” according to the AVMA comments. “But we want to be sure we can have continued confidence in the efficacy, quality, and safety of products used to treat our patients.”

The AVMA’s concerns stem largely from the widespread marketing of cannabis-derived products, including hemp products, with health claims that haven’t received the required FDA evaluation and approval. “The FDA should establish a clear and efficient process for approval of cannabis-derived and -related therapeutic products, and then conduct consistent enforcement against manufacturers and distributors who are noncompliant,” the AVMA said in their comments. Read full AVMA article here.

In addition to advocating for practitioners, the AVMA provides several resources regarding cannabis:

Extortion Scam Targeting DEA Registrants

DEA is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel. In an attempt to create the illusion that these criminals are DEA employees, they have masked their telephone number on caller id with a phone number for a legitimate DEA office.  For example, these criminals have used the phone numbers for DEA’s Office of Congressional and Public Affairs and DEA’s 800 number which is used to provide direct support to DEA registrants.

Impersonating a federal agent is a violation of federal law. Registrants should be aware that no DEA agent will ever contact members of the public by telephone to demand money or any other form of payment or threaten to suspend a registrant’s DEA registration.

If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through “Extortion Scam Online Reporting” posted on the DEA Diversion Control Division’s website, www.DEADiversion.usdoj.gov.

HVTA Update

  • Our goal is to get as many eligible techs grandfathered in as RVTs as possible. So far only 3 have done it! This is the YEAR to get them studying. That way they can take the VTNE in 2020 and beat the 2021 cut-off. Study sessions are on the HVTA website and on the Events tab of our FB Page.
  • We have a FAQ page for anyone who might have questions about grandfathering.
  • Last, we have Clinic/Facility Membership that allows clinics and hospitals to show support for HVTA, post jobs, and we put their clinic name/logo into our newsletter.

Submitted by Sam (Craddock) Geiling, RVT, President, Hawaii Veterinary Technician Association

Rat Lungworm Disease Workshop

The University of Hawai`i at Hilo invites the public to the 6th International Scientific Workshop on Angiostrongylus cantonensis and Angiostrongyliasis (rat lungworm disease), held January 5-8, 2020, at the Hilo Hawaiian Hotel. Dr. Richard Malik (PhD, DVM) of the University of Sydney’s Centre for Veterinary Education will be leading discussion sessions for veterinarians on detection, treatment, and prevention of rat lungworm disease in domestic animals, wildlife, and livestock. There is no fee, but all attendees must register by September 1st at https://hilo.hawaii.edu/conferences/rat-lung-worm-2020/. Case study presentations are also welcome; abstracts due September 1st. For additional information, contact rlwlab@hawaii.edu.

Conference Registration Open

Registration is open for our 66th Annual HVMA Conference, which will be held from November 7-10, 2019 at the Hilton Waikiki Beach Hotel. We are again offering over 80 hours of RACE-approved CE (up to 27 credits for vets and 16 credits for vet techs) and bringing in world-renowned speakers covering a variety of topics including cardiology, oncology, sports medicine, equine medicine, soft tissue surgery, infectious disease, exotics, essential oils, wellness, the opioid crisis, and emergency & critical care.

Our wet lab offerings include orthopedic labs by Brian Beale and Don Hulse, a small diameter endoscopy lab by Carrie Palm and Sean Hulsebosch, dental radiograph positioning and interpretation labs by Kevin Stepaniuk, and a laser lab by Yukiko Kuwahara.

During the conference, we will hold our annual HVMA Hui on Saturday November 9 at 12:00pm during lunch. You do not need to be a conference attendee to come to the meeting. During the meeting, we will provide an update on what the HVMA has been doing this past year as well as overview any important legislative and island news. If you are interested in sharing anything during this time, please email us.

Also on Saturday November 9 from 6-8pm we will be hosting our annual social cocktail party. Tickets to this event are $60 or complimentary with full conference registration.

Register online for early bird pricing by September 15th. Remember to log in to your HVMA online account to register at the reduced member rates. If you have forgotten to renew your membership for 2019, it’s not too late! We hope you and your staff can join us!

Pesticides Rules Change

§4-66-54 of the Hawaii Administrative Rules is being updated by the Hawaii Department of Agriculture Pesticides branch to mandate that “every retailer that sells or distributes pesticide products to the public shall prominently post within ten feet of any pesticide product display or sales area, a warning sign that includes:

  1. Information regarding the proper handling, storage, and disposal of all pesticides sold;
  2. Emergency telephone numbers to call in case of poisoning from the pesticides; and
  3. A statement that use of any pesticide product in a manner inconsistent with its label is prohibited by law.

The warning sign shall be no less than seventeen inches by twenty two inches and contain lettering of sufficient size, no less than sixteen point bold type, which will enable the sign to be read from a distance of six feet under all lighting conditions normally encountered during business hours.”

The rules have not yet been signed as law by the governor but are expected to be signed some time in the May-June timeframe. These rules will affect
retailers that sell pesticides in any form (flea collars, topical medicine, etc.).

Sample signage wording below:

  1. For the proper handling, storage, and disposal of a pesticide product as required by Federal and State law, please refer to its label.
  2. In case of pesticide poisoning, please call the National Poison Control Center at 1-800-222-1222.
  3. It is a violation of Federal and State law to use any pesticide product in a manner inconsistent with its label.

[Pesticide product signage as required by Hawaii Administrative Rules(HAR) 4-66-54(d).]

For more information, please see the Department of Agriculture website.

Honolulu Street Dog Coalition

The Street Dog Coalition is a Colorado-based nonprofit founded by veterinarian Jon Geller whose mission is to provide free veterinary care and related services to pets of people affected by homelessness. Dr. Geller began providing care through street clinics in Ft. Collins in 2015 and has since expanded to mentor and provide supplies to licensed, volunteer veterinarians willing to lead clinics in their communities. The Street Dog Coalition partnered with the AVMA in July for a clinic at the Denver convention in July, read more about it here.

The Honolulu Street Dog Coalition clinics are led by Aleisha Swartz, DVM, and have started providing veterinary care such as vaccinations, parasite control and treatment of minor medical concerns at the new Punawai Rest Stop in Iwilei. The facility was built by the City and County of Honolulu and is a pet-friendly hygiene center where people can do laundry, take showers, receive mail and access social services.

The number of pets belonging to people affected by homelessness is unknown but is estimated to be approximately 10%. For the first time the 2019 Hawaii Homeless Point in Time Count survey asked people if they had pets; this information should be available in the spring.

If you are interested in more information on how to support this effort, volunteering at the Honolulu Clinics, or starting a clinic on a neighbor island, contact Aleisha at honolulu@thestreetdogcoalition.org. Support staff are welcome to volunteer. For more information about The Street Dog Coalition visit their website.

Rat Lungworm Disease in Hawaii

In November and December 2018, two young dogs in the Honolulu area were diagnosed with Rat Lungworm Disease, caused by Angiostrongylus cantonensis. Both puppies presented with spinal hyperesthesia, hindlimb weakness, and proprioceptive ataxia. One dog had peripheral eosinophilia; all other hematology and serum biochemistry tests were unremarkable. Plain radiographs and computed tomography scans (with/without) contrast were performed but did not reveal a cause for the neurologic signs. Cerebrospinal fluid analysis in both patients revealed eosinophilic pleocytosis and real-time PCR testing for Angiostrongylus cantonensis on CSF was positive in both dogs, confirming a diagnosis of neural angiostrongylisias; PCR testing for other canine neural pathogens was negative.

Both dogs responded rapidly to treatment with corticosteroids and recovered clinically within 2 weeks. Neither dog was observed ingesting a snail or slug, but both dogs had environmental access to them. Dr. Richard Malik (University of Sydney) spoke on this topic in May 2018 and recommends treating with corticosteroids (up to 6 weeks), +/- anthelmintics (if early infection when the larvae are still small and not yet in the CNS), and pain medication or other symptomatic care as needed. He also recommends antibiotics to address the issue of translocated bacteria carried by migrating larvae.

If you have any suspected cases or have questions regarding diagnosing, treating, or preventing rat lungworm infection in dogs or other animals, please call Dr. Jenee Odani (Extension Veterinarian) at 808-956-3847 or email jsodani@hawaii.edu. She is especially interested in conducting post mortem testing on suspected cases.

Hawaii Veterinary Emergency Response

HVMA is working with the Hawaii Emergency Management Agency (HI-EMA) to support local and state disaster preparedness pertaining to animals. Would you be interested in volunteering in the event of an emergency? Would you be interested in being part of the working group developing a set of guidelines for animal care and treatment and considering the formation of a Veterinary Medical Reserve Corps or Companion Animal Response Team? Please help us gauge member interest by taking our survey below.

Feline Fix by Five Campaign

Why the change in recommended age of sterilization of cats?

Philip A. Bushby, DVM, MS, DACVS

In June of 2017, the AVMA formally endorsed the consensus document put forth by the Veterinary Task Force on Feline Sterilization for Age of Spay and Neuter Surgery, which recommends cats not intended for breeding be gonadectomized by five months of age. This joined endorsements from other veterinary medical and cat breeding associations including the
American Association of Feline Practitioners, Association of Shelter Veterinarians, American Animal Hospital Association, Winn Foundation, Catalyst Council, Cat Fancier’s Association and The International Cat Association. Feline Fix by Five (FFF) is a campaign promoted by the
Marian’s Dream Foundation to share this recommendation that has garnered such broad support. FFF was born out of awareness that cats can be reproductively active by 4 to 5 months of age, yet most veterinarians recommend spay/neuter of cats at 6 months of age or older. The
result of this mismatch between age at which cats can become pregnant and the recommended age of sterilization is demonstrated any time one walks into a local animal shelter.

Animal shelters are generally overrun with kittens, the vast majority of which are the result of unplanned and unexpected pregnancies of young cats. A survey conducted in the State of Massachusetts revealed surprising results. While many people believe that pet-overpopulation is the result of pets that are left intact for their entire life, the opposite is true. Cats that were eventually spayed accounted for 87% of all litters born. [1]

Cat owners who are unsure of when to have their cat sterilized or simply wait until 6 months of age or later are faced with the dilemma of what to do with an unexpected litter of kittens. Too often those kittens are relinquished to local shelters and too often those kittens are euthanized. The problem was not that the owners refused to spay or neuter their pet; it was that they didn’t have it done in time.

Esther Mechler of the Marian’s Dream Foundation, who initiated the FFF campaign, has stated that “the number of births prevented – simply by changing the recommended age for spay/neuter of cats from 6 months to between 4 and 5 months – could reduce the numbers of shelter intakes enough to balance the number of potential adopters with available cats and
kittens. We could end the overpopulation of cats by this one simple change.” [2]

As a profession, we need to recognize that there is, at present, no scientifically sound basis for waiting until 6 months of age or older to sterilize cats and no contraindications for spay/neuter at 4 to 5 months of age. Anesthetic concerns about juvenile surgery voiced in the 60s and 70s
are no longer valid. There are many anesthetic drugs and protocols in use today that are safe in cats as young as 6 weeks of age. Old fears that castration of juvenile male cats would predispose to urinary obstruction were disproven in the 90’s. [3]

There are numerous known health benefits for spay/neuter in cats, in addition to the population management benefits, and there is “no evidence to suggest that pediatric gonadectomy by 5 months of age is linked to any
increased risk of disease.” [4] A survey conducted in 2000 of veterinarians who were, at that time, spaying and neutering cats under 5 months of age, confirmed that the surgeries were easier, faster, and had fewer complications than spay/neuter of cats at 6 months of age or older. [5]

So, what should the practicing veterinarian do to make this change? Simply add one more appointment to your standard kitten wellness protocols. Make no changes in current vaccination and parasite control recommendations except add an appointment for spay/neuter two to three weeks after the last kitten vaccination. Owner compliance will be increased,
surgeries will be easier, and, in time, local shelters will not be overrun with kittens.

For more information on Feline Fix by Five go to http://www.felinefixbyfive

For more information on the AVMA’s position on spay neuter go to
http://www.avma.org/spayneuter

1. Manning MM & Rowan AN, Companion animal demographics and sterilization status: Results from a survey in four Massachusetts towns. Anthrozoos 5 (3).
2. Esther Mechler, Personal Communication, October 25, 2017.
3. Stubbs WP Scrugges SL, et al BMS. Prepubertal gonadectomy in the domestic feline: Effects on skeletal, physical and behavioral development. Vet Surg. 1993;22.
4. Dale S. When to Spay/Neuter Cats? Vet Consensus Says Fix by Five Months. Vet Pract News. 2016.
5. Land TDVM, Wall SDVM. Survey of the Coalition of Spay/Neuter Veterinarians. J Am Vet Med Assoc. 2000;216(5).