Paycheck Protection Program Update from AVMA

The AVMA Advocacy team worked very hard to influence and improve the Paycheck Protection Program. The Small Business Administration recently released data on the loans and the uptake by the veterinary profession has been significant. About 56% of veterinary practices took PPP loans totaling an estimated $2.1 Billion, with over 80% of the loans being less than $150,000.  Over 200,000 jobs in veterinary practices have been protected. A blog posting with data and an infographic can be found at https://www.avma.org/blog/covid-19-loans-are-supporting-veterinary-teams-and-patients.

Congress is working on additional legislation that will impact the PPP, which could include retroactive changes.  It is expected to pass before Congress leaves for their August recess.  AVMA is actively seeking measures to ensure favorable tax treatment of PPP loan proceeds, and for a streamlined forgiveness process for loans below $150,000, which would include the vast majority of veterinary PPP loans. We have a Congressional Advocacy Network Action Alert out on the tax treatment of PPP funds that can be found at https://avmacan.avma.org/avma/app/onestep-write-a-letter?0&engagementId=508320.

2020 HVMA Conference Cancelled

Dear HVMA Members,

Thank you so much for your positive feedback and support for our annual conference. We sincerely want to meet your expectations and provide the same quality CE and warm fellowship that we have in the past. We regret that we have decided to cancel our 2020 Annual Conference (November 12th-15th) due to multiple factors relating to the COVID-19 pandemic, including limited capacity in our exhibit hall and lecture rooms to accommodate physical distancing requirements, increased risk of spreading SARS-CoV-2 in an indoor convention involving many people from outside of Hawaii, and the unknowns of the COVID-19 situation in the fall.

HVMA will hold our Annual Business Meeting virtually on November 14, 2020, and will also be offering monthly CE webinars starting in July 2020. We will be planning to hold our next full in-person Annual Conference during November 11-14, 2021 in Honolulu, Hawaii.

Please let us know if you have any suggestions for virtual CE topics or other ways the HVMA can support you. May you, your veterinary teams, and your families stay well and safe during these challenging times.

Aloha,
Your HVMA Board

In Remembrance – Dr. Jessica Massengale

Jessica Massengale, DVM

Dr. Jessica Claire Lee Massengale, 34, of Kaneohe, Hawaii, died peacefully on Thursday, July 9, 2020. She was born in Huntington, West Virginia, on May 18, 1986 to Roger and Debra Massengale and baptized as a child at First United Methodist Church, Paintsville, Kentucky.

A life-long learner, Jessi received her high school diploma in 2004 from Virginia Episcopal School in Lynchburg, Virginia, graduated in 2008 from Midway College with her Bachelor Degree in Equine Therapy and earned her Doctorate of Veterinary Medicine in 2014 from Auburn University. She was a dedicated and beloved doctor of animals at Haiku Veterinarian Clinic in Kaneohe. She loved all things pertaining to horses and rode on Equestrian teams for both Virginia Episcopal School and Midway College. She had an adventuresome spirit, was learning to kayak, and especially enjoyed hiking with her dogs.

In addition to her parents, she is survived by her sister, Sarah Anne and brother-in-law Mårten Waern, Stockholm, Sweden; maternal grandmother, Clara Marcum, Ashland, Kentucky; paternal grandmother, Norma Jean Massengale, Wayne County, Kentucky; aunts, Catherine (Fred) Waits, Shelbyville, Kentucky; Linda (John) Lash, Athens, Georgia; uncle, Scott Massengale, Wayne County, Kentucky; and many cousins. Her family, a host of friends, colleagues, clients, and her faithful dog companions, Bodhi and Marley, will miss her.

Memorial contributions may be made to your local animal shelter, pet charity, or allow an animal to adopt you in Jessi’s memory.

Letter from the President – April 2020

Aleisha Swartz, DVM
HVMA President

I hope this finds you, your ohana, staff and colleagues in good health. I don’t think any of us would have predicted the rapid changes that have occurred across the planet since the January newsletter. Normal as we knew it and our regular daily operations feel like a bit of a distant memory right now. But thankfully in every dark cloud there are many silver linings.

Veterinarians, like other public health stewards, are trained problem solvers and we have been working hard to solve our problems, from those at home to in our businesses and in our communities. I have been amazed seeing the innovation and effort by Hawaii veterinarians as they work to protect their teams, ensure care for animals in need and service to the people of Hawaii and beyond.

The HVMA has been working hard on behalf of members and the animals and citizens of Hawaii during the pandemic. We have proactively and successfully advocated for more flexible use of telemedicine during this challenging time to maintain care for animals while keeping people safe. We have set up a Facebook group for Hawaii veterinarians to keep in touch and share with one another and have hosted weekly virtual meetings where we discuss the current knowledge about SARS CoV-2, its impact on animals and practices. We responded to a request for assistance from HI-EMA and City and County of Honolulu to support pet owners during this emergency. During this time, we have spent many hours each week participating in HI-EMA and Honolulu Department of Emergency Management calls to ensure animal needs are met. The HVMA was able to secure a grant from Greater Good of 22 pallets of dog and cat food and 4 pallets of litter to be used for COVID-related emergency sheltering or for pet owners in need due to financial hardship so many are currently facing. The shipping to Hawaii was graciously donated by a local business and The Salvation Army was instrumental in coordinating the food delivery from California. It has been delivered to animal shelters and human food service distribution partners on Kauai, Oahu, Maui and Hawaii Island. We will continue to seek support for pet owners in financial distress so that they can continue to care for their family members during this challenging time. We know the importance of the human-animal bond is perhaps more important than ever during this time of social distancing.

I encourage you to reach out to us if there is anything, we can do to support your work and businesses. More than at any other time it is essential that we are caring for ourselves and doing what we can to stay healthy. Get lots of sleep, eat good food, enjoy the beautiful outdoors when you can and make time for self-care. We cannot care for others if we do not first care for ourselves. If you have been contemplating taking up meditation for a long time now and need a reason this is a good one. Just sitting quietly and breathing for a brief time can work wonders to help manage the stressful times a little bit better. Take care of your families and colleagues as well. Be kind to one another and give thanks to all of those working so hard to keep us safe. I feel so fortunate to be in a state that has done so much to protect its citizens. I also feel so fortunate to be surrounded by peers in a profession that is critical to preventing and solving this and the next zoonotic outbreak. The importance and need for veterinarians is greater now than ever.

On behalf of the board I wish you health and well-being in the rest of 2020 and beyond. I hope to hear more from you on what we can do to support you as a Hawaii veterinarian.

Aloha,
Aleisha Swartz

New Board Members Wanted!

2020 is an election year and we are looking for anyone interested in bringing new ideas and energy to our organization. The positions open for nominations include Pres-Elect, VP, Secretary, Treasurer, Executive VP, Oahu Reps and Kauai Rep. Please don’t be shy and contact the nominating committee for more info!

SARS-CoV-2 Animal Testing

Routine testing of animals for COVID-19 is NOT recommended by the American Veterinary Medical Association (AVMA), American Association of Veterinary Laboratory Diagnosticians (AAVLD), National Association of State Public Health Veterinarians (NASPHV), or the National Assembly of State Animal Health Officials. Nor is it recommended by key federal agencies, including the CDC and USDA.

Current expert understanding is that SARS-CoV-2 is primarily transmitted person-to-person. There is currently no evidence that animals can transmit this virus to people. In rare instances, people have spread the virus to certain animals.

Veterinarians are strongly encouraged to rule out more common causes for clinical signs in animals before considering testing for SARS-CoV-2. The CDC, USDA, and other federal partners have created guidance, including a table of epidemiological risk factors and clinical features for SARS-CoV-2 in animals to help guide decisions regarding animal testing.

The decision to test an animal should be made collaboratively between the attending veterinarian and local, state, and/or federal public health and animal health officials after careful consideration of this guidance as provided.

AVMA-AAVLD-NASPHV-NASAHO Joint Statement on Animal Testing

Hawaii State Dept of Ag Guidelines on Animal Testing


Labs with SARS-CoV-2 PCR Animal Tests

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.

Panleukopenia Cases on Oahu

In recent weeks, several veterinary practices on O’ahu have reported seeing a number of feline panleukopenia cases. Below is a link to a summary on Feline Panleukopenia provided on the AVMA website for review. Veterinarians who have had patients suspected of dying from panleukopenia can contact Dr. Aleisha Swartz for information on further confirmatory testing including necropsy and PCR at president@hawaiivetmed.org.

AVMA article on feline panleukopenia.

Article on sanitation procedures.

Legislative Update – Jan 2020

HVMA has introduced HB 2528 and SB 2985 in the 2020 legislative session. These bills modify Hawaii’s veterinary practice act to 1) provide immunity in the absence of gross negligence to veterinarians who provide emergency care to an animal, and 2) clarify that the duty of a veterinarian includes reporting to law enforcement any cases of animal injury or death where there is reasonable cause to believe that it relates to dog fighting or animal abuse, while granting veterinarians immunity from any civil liability for such reporting. These additions to our veterinary practice act would put Hawaii in line with much of the rest of the United States. A big mahalo to Representative Hashem and Senator Baker for sponsoring the introduction of these bills to the legislature. Please thank them, particularly if you are from their districts!

1/28 Update: First round of SUPPORT testimony needed on this measure by Thursday 1/30! Submit online testimony here. Contact us if you have questions or comments on this measure, or if you are able to go down to the capitol and testify in person.