Veterinary Palliative Medicine

Veterinary Palliative Medicine is growing globally.

Co-Founders of the World Veterinary Palliative Medicine Organization (WVPMO), Dr Lynn Hendrix and Dr Caroline Ficker discovered soon after meeting that they shared a vision for the future of veterinary medicine.  Not only that, they saw how it could change the lives of veterinarians, their patients and the people who love them.

As palliative care awareness grew in veterinary medicine and became a hot topic at veterinary conferences, they saw the need to bring more education on the subject, formalise the field, and usher palliative medicine into the mainstream. The WVPMO’s mission is to elevate palliative medicine to the forefront of veterinary education, improve the lives of animals across the globe, and support clients by promoting and advancing veterinary medicine centered on quality of life. Dr Hendrix states, “We really also want to improve the lives of our colleagues, which in the US are suffering from increased levels of depression, anxiety and suicide.”

Dr Hendrix and Dr Ficker have noticed a rise in interest in veterinary palliative medicine in recent years. Dr Ficker says “We believe we can help every veterinarian around the world enhance their skills, educate their clients, and help animals live better.  We also believe that in helping animals and their people live better, the veterinarian can also.”

They are working to provide webinars and interactive workshops. In addition to education, they want to build a community of veterinarians who are looking for an evidence based approach to provide the best standard of care for end of life veterinary patients and their caregivers.

The World Veterinary Palliative Medicine Organization is a non-profit Corporation, 5013c pending. The WVPMO is open to licensed veterinarians around the globe. You can join by visiting wvpmo.org.

If you would like more information about the WVPMO, please contact Dr Lynn Hendrix at President@wvpmo.org or Dr Caroline Ficker at President-elect@wvpmo.org .

AVMA Update Spring 2019

Aloha HVMA members! These are some highlights from the AVMA.

AVMA Convention 2019

A monumental experience awaits you in Washington, D.C. and we can’t wait to see you there! This year’s event will take place August 2-6 and the CE and events schedule is now available for you to search. Start planning an itinerary that will earn you more than 40 hours of CE and still leave plenty of time for networking, fun events, and sightseeing . Choose from nearly 900 education sessions over the course of the five-day conference. There are hands-on labs, interactive workshops, panels, lectures, and poster presentations. Register at AVMA.org.

Axon: Next-generation digital education

AVMA Axon™ is an online learning tool that you can incorporate into your daily life. Veterinarians, veterinary technicians, practice managers, or other team members, can find CE with information you need – about the newest studies, techniques, and trends – along with actionable ways to apply it to your daily life and work. Examples of topics:
Agile Pioneers
Career Development
Financial Health
Leadership
One Health
Policy and Practice
Wellbeing, Diversity, Inclusion
Advocacy

AVMA Axon™ is a resource for the entire veterinary community. As an AVMA member, all of the current offerings are free. Start exploring today at axon.avma.org.

AVMA establishes veterinary technician task force

Veterinary technicians are important members of the veterinary health care team. Their skills and expertise help both the patient and the practice. Improving veterinary technician utilization would only enhance that level of service and increase job satisfaction. At the AVMA Board of Directors spring meeting April 12-13, the Board voted to approve a task force which will develop a plan to improve vet tech use while recognizing the importance of financial and career sustainability, effective task delegation, and the wellbeing of both the veterinary technician and the practice.

The task force comes after the AVMA House of Delegates discussed technician utilization and ways to enhance it during its January meeting. It was clear during the discussion that the value of veterinary technicians is important and that efforts need to be made across the profession to increase technician use. The consensus among House members led them to recommend that the AVMA Board convene a task force to design a plan to improve veterinary technician utilization and that a progress report be
shared with the House Of Delegates within a year.

Guiding the profession: Policy actions

AVMA councils and committees reviewed more than 40 AVMA policies prior to the Board meeting that were subsequently submitted for reaffirmation, revision and approval. Highlights include the Board voting to:
– Reaffirm the AVMA Policy on Transport, Sale Yard Practices and Humane Slaughter of Hoofstock and Poultry
– Approve the revised Policy on Animal Abuse and Neglect
– Approve the revised Policy on Veterinary End-of-Life Care
– Refer the revised Policy on Judicious Therapeutic Use of Antimicrobials to the AVMA House of Delegates with a recommendation to approve
– Refer the revised Joint American Association of Bovine Practitioners-AVMA Judicious Therapeutic Use of Antimicrobials in Cattle Policy to the House of Delegates with a recommendation to approve
– Refer the revised Model Veterinary Practice Act to the House of Delegates with a recommendation to approve

Carolyn Naun and I are your AVMA House of Delegates. Please feel free to contact us if you have any questions, comments or topics of discussion.

Aloha,
Leianne K. Lee Loy, DVM

Meet a Member – Nicole Roybal

Nicole Roybal, DVM, DACVO, is a 2007 graduate of Colorado State University and completed a rotating internship and residency at Veterinary Specialty Hospital of San Diego where she remained for 5 years as staff ophthalmologist before deciding it was time to return home to Hawaii. She grew up in Kaneohe, attended Kamehameha Schools and is honored and excited to join the local veterinary community.

She recently opened Pacific Animal Eye Care with her husband Jason Roybal. As a brand-new, family-owned and operated ophthalmology specialty practice located in Kaneohe, they are dedicated to providing excellent service as well as high-quality medicine. They offer advanced diagnostic modalities such as slit lamp biomicroscopy, indirect ophthalmoscopy, gonioscopy, rebound tonometry, ocular ultrasound exams, and electroretinography. Surgical services include phacoemulsification for cataracts, cryosurgery for abnormal cilia and neoplastic lesions, as well as a full array of microsurgical instrumentation for eyelid, corneal and intraocular procedures.

She welcomes consultations at info@pacificanimaleyecare.com or (808)445-6778. For more info, please see www.pacificanimaleyecare.com.



Meet Your Board – Joe Herzog

Joe Herzog, DVM with Potiki

The three main academic routes at Stanford University send a student to law, business or medical school. While at Stanford as an undergraduate, Joe Herzog was on the path to medical school. An epiphany crossed that path and convinced him to be a doctor of many species rather than one.

Veterinary school at the University of Wisconsin–Madison introduced Joe to the animals of America’s Dairyland. Not wanting to spend a lifetime in rubber boots, eating cheese curds, Joe became a small animal emergency vet. As an ER vet, he was willing to see any animal that could be brought into the emergency clinic, including exotics.

A desire to see “all creatures, great and small” led Joe to a part-time gig at the Santa Barbara Zoo and then the San Francisco Zoo. It was there that his patients really qualified as exotic. His largest patient was an African elephant that weighed approximately 3000 kg. His smallest was a 5g Jackson’s chameleon.

An odd, memorable case from Joe’s internship involved a female mixed-breed dog that had been hit by a car. She came in with inspiratory dyspnea and no breath sounds in the caudal thorax. Dogs like that often have a pneumothorax, which requires expedient thoracocentesis. The chest tap easily yielded 12 mL of watery tan fluid. There were a few different things he expected from a chest tap; tan watery fluid was not one of them. Quickly to radiology to reveal: pregnancy and diaphragmatic hernia!

Joe moved to Oahu in 2007, when spouse Brenda Machosky became a Professor of English at UH-West Oahu. He no longer stays up all night to take ER cases. But, to spice-up the routine cases of skin, ears, ears and skin, Joe teaches an online Medical Terminology course at Windward Community College. He taught Pharmacology and Large Animal Clinical Procedures in the Vet. Tech. Training Program for several years prior.

As a cancer patient himself for the past 5 years, Joe has special regard for his cancer patients and their owners. He has surgically removed cancerous growths from some of our affected Green Sea Turtles. He monitors the healthy young sea turtles at the Mauna Lani Hotel and prepares them for their annual release every 4th of July, which is Turtle Independence Day.

Music and biking provide a welcome distraction from the work world. Joe sings with the Windward Choral Society. He also sang in the chorus for the Hawaii Opera Theatre production of Romeo and Juliet last year. He bikes 100 miles on a Sunday in late September with the Honolulu Century Ride. Now working part-time at Surf Paws Animal Hospital in Hawaii Kai, he relishes the opportunities to treat multiple species, and still avoids cheese curds.

Joe Herzog, DVM

A Message from Jed Rogers

Past HVMA President Jed Rogers shares a memoir of his time with HVMA and what he’s been up to since then.

Greetings fellow HVMA members,

I enjoy keeping in touch with HVMA through newsletters, emails, and trips to Hawaii. In a recent email exchange with Jill, she asked me to share some of what I’ve been up to since I moved back to the mainland.

After six great years in Hawaii and a lot of memorable experiences with family, friends, and colleagues at VCA Kaneohe Animal Hospital and beyond, I had the opportunity to move to Denver, a city I had visited before but didn’t know very well. The opportunity was a veterinary technology company, and although the ideas and technology were solid, we were a little too far ahead of the industry’s comfort zone. From there, I went back to VCA for four years to help guide a recently purchased hospital. Once I had that practice stabilized and growing, I decided it was time to forge out on my own. So I opened Firehouse Animal Hospital in central Denver in 2004. We grew quickly, so my business partner and I raised money from a private equity firm and bought 7 other hospitals, merging 2 of the smaller ones into two of the bigger ones. We built 4 facilities in 6 years, and all of the hospitals were doing well, but when the financial crisis hit in 2008, our financial partners wanted out. So in 2010, we sold the practice group to VCA.

For the next year and a half, I focused on doing consulting for two shelters: Denver Dumb Friends League, and Hawaiian Humane Society, which enabled me to come back to Hawaii frequently.

In late 2011, I started another group of Firehouse practices in the Austin, TX area, with a veterinarian partner, John Faught. After the Denver experience, I had decided to not take private investments anymore, and not to acquire hospitals, but to start them from scratch instead. That means slower growth but a lot more independence for us as business owners and as practitioners.

While we were getting the first Firehouse hospital open in Austin, I was approached about taking a position at ASPCA in New York City overseeing all of the organization’s veterinary operations. In late 2012 I accepted that position. So from the end of 2012 to the end of 2016, I traveled back and forth between Denver and NYC to oversee a group of 400 employees (including 100 veterinarians) in four groups: Animal Hospital, Spay/Neuter Operations, Poison Control Center, and Humane Alliance (spay / neuter training). As the only veterinary representative in the senior leadership of the organization, it was a truly unique experience.

By the end of 2016, Firehouse needed me full time again, so I returned and have been focused on that ever since. We are now up to 5 hospitals, with a 6th in development and hopefully a few more on the way. Our goal is to create an independent group of hospitals that benefits from some economies of scale but is able to focus on patient care and client experience delivered the way we like. My business partner and I used to say that there were 100 little things that make Firehouse what it is, and he had the great idea to actually write them down here: https://firehouse.vet/100-little-things/

Along the way, I have had personal ups and downs too. In 2013, I lost my wife Maia to breast cancer. She was diagnosed in 2002 and went through an 11-year journey. My kids (born in Hawaii) are my joy. My daughter Caitlin graduates from Colby College this year, and my son Eddy is a sophomore at the University of Denver. I recently married a college friend, Susanna Nemes, and we are now a blended family with 4 kids (all in college) and 6 cats.

I cherished my time in Hawaii. You all know just how unique it is. Where else could a haole learn to make a mean spam musubi? I’ve had the opportunity to travel around the country and the world, and there’s no place better! Hope to see all of you again sometime soon.

Jed Rogers, DVM

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.

Other AVMA Opportunities

Volunteer with AVMA

Volunteers are now invited to serve on AVMA’s Council on Education (COE). The deadline for receipt of applications for the COE is February 15, 2019. More information on the COE and the Member Application is available here.

AVMA Fellowship Program

Shape public policy while enhancing your knowledge of the political process! The AVMA is now accepting applications for the next AVMA Fellowship Program, which runs from the end of August 2019 through August 2020. The deadline for applications is February 8, 2019. All AVMA member veterinarians are eligible to apply. Please visit AVMA’s website for more info.

AVMA Veterinary Leadership Conference Report

Every year, the HVMA sponsors one of its members to attend the Veterinary Leadership Conference in Chicago alongside the AVMA House of Delegates Meeting. In 2019, Dr. Jenee Odani represented the HVMA. Read her experience below.

This was my first time attending the AVMA Veterinary Leadership Conference in Chicago (held this year: Jan 10-13, 2019). There were three learning tracks: Rising Leaders, Experienced Leaders, and Presiding Leaders. I could identify with some issues in each track and I was grateful that we could register for sessions in any of the tracks. The sessions I attended included leadership and personal development, veterinary debt initiatives, virtual care, and mentoring. My favorite session was conducted by GetMotiVETed, which taught me tricks on how to be more productive with my time and reinforced my belief that we are in the GREATEST profession of all! I enjoyed conversations with seasoned veterinary leaders as well as students and recent graduates. With new perspective and knowledge, I am more excited about the future of our profession and the rewarding ways that we can contribute to its growth. It was a great experience and I strongly urge anyone interested in learning more about organized veterinary medicine to consider attending next year!

Jenee S. Odani
HVMA Secretary

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.

Meet a Board Member: Brenda Smith, Treasurer

Dr Brenda Smith grew up ‘on the mainland’.  Living in Louisville, Kentucky for most of her childhood, she developed a passion for horses and became very involved in Pony Club and dressage and eventing.  The seeds for a career in Veterinary medicine were planted early. Moving to Texas in high school, she remained through school, graduating from Texas A&M College of Veterinary Medicine in 1995.

The next 11 years were spent in Oregon and Washington, working first at mixed animal and then small animal clinics and the Southwest Washington Humane Society. An interest in alternative medicine led to certification in acupuncture through IVAS in 2001 and several Chinese herbal courses in the following years. She got immersed in volunteer work as well, supporting and serving on the board of the Feral Cat Coalition of Oregon as well as participating in international spay/neuter projects.  Spare time was spent exploring. The hiking and trail-riding and rafting are amazing in the Pacific Northwest.

Dr Smith moved to Maui in 2006, then Oahu in 2010. Moving to Oahu, she began Cherished Pet, a home euthanasia service, as well as doing relief work. Horses and rafts were replaced with surfboards and sailing gear! Volunteer work continued as well, both internationally doing spay/neuter projects and locally with the Polynesian Voyaging Society. Sailing on canoes (Faafaite and Hikianalia) from Auckland to Papeete to Hilo was a huge adventure!

The volunteer work was so rewarding, that in 2013 Dr Smith moved to American Samoa to work on a large scale spay/neuter and dog overpopulation project.  After two years and 5000 surgeries, the island dog population was much healthier. The island is beautiful, both above and underwater. Hiking and diving and outrigger paddling were spare time activities.

Last year, Dr Smith and her partner Tim moved back to Oahu and she resumed doing relief work and home euthanasia. She is currently working at Kailua Animal Clinic at their new Feline Wellness Center, paddling recreationally with Lanikai Canoe Club, and generally enjoying life biking and beach walking around Kailua. Her two cats have moved from Washington to Hawaii to American Samoa and then back. They have now been joined by four entertaining backyard hens.