AVMA Update Jan 2019

American Veterinary Medical Association (AVMA) Winter Session and The Veterinary Leadership Conference (VLC)

Aloha to you all and a belated Happy New Year!

The House of Delegates convened for the Winter Session in combination with the Veterinary Leadership Conference in Chicago, Illinois, January 10-13.  This years theme was Evolution of Leadership – Learn, Grow, Lead, Evolve your Leadership Journey. The purpose of the VLC was to provide veterinary professionals, at all stages of their career, personal and professional leadership that benefits the individual attendee and the Veterinary Profession.  The conference included:

a) AVMA governance meetings

b) Continuing Education Sessions focused on leadership development

c) Network opportunities

At this conference, Rising Leaders are interacting with Experienced Leaders to expand leadership skills and gives everyone the tools to create a roadmap for our leadership journey.

Here is a summary of our AVMA House of Delegates Winter Session:

Membership

AVMA membership is strong with the association’s official membership at more than 93,400. AVMA retained a higher percentage of members to start the year. Three out of every four veterinarians are members of the AVMA.

Health Insurance is returning!

Beginning in July, members and their employees in the AVMA LIFE Trust, or a related entity, may be able to offer health insurance as an ‘association of employers.’ This means veterinarians who are employers – including those who are self-employed – might be eligible to purchase group health insurance for themselves, their families, and their employees through the AVMA family. The program is expected to build over time.

For more information and to sign up for the latest updates,  go to: AVMALife.org or call 800-621-6360.

Enhancing the utilization of veterinary technicians

During the House of Delegates business meeting, the HOD’s Veterinary Information Forum was committed to the topic of enhancing the utilization of veterinary technicians. Prior to the forum, AVMA members were asked to provide their input on the topic to their House representatives, and more than 400 comments were received.

The value of veterinary technicians is certain and that efforts need to be made across the profession to increase technician use and boost job satisfaction. Members of the House of Delegate recommends that the AVMA Board of Directors convene a task force to design a plan to improve veterinary technician utilization and that a progress report be shared with the HOD within a year.

Governance: House of Delegate Actions

HOD members also acted on several resolutions and bylaws amendments, including:

  • Model Veterinary Practice Act: Refer to the AVMA Board of Directors
    • Consideration of a revised version that incorporates input from HOD deliberations conducted during the meeting.
  • Membership Dues Increase: Approved
    • A resolution submitted by the AVMA Board of Directors to increase annual membership dues $30 in 2020, and, if necessary, up to $10 in 2021 and 2022 for regular and affiliate memberships. Reduced dues memberships will be made equal to 50% of the annual dues of regular members.
  • Bylaw amendment expanding the composition of the AVMA Council on Veterinary Services to include a credentialed veterinary technician.  Approved.
  • Bylaw amendment changing the name of the AVMA Council on Public Health and Regulatory Veterinary Medicine to the AVMA Council on Public Health. Approved
  • Bylaw amendment removing a statement of responsibility of the AVMA Council on Research. Approved.
  • Bylaw amendment removing a statement of responsibility of the AVMA Council on Biologic and Therapeutic Agents. Approved
  • Bylaw amendment that replaces the AVMA Judicial Council with an ad hoc hearing panel to adjudicate complaints of unethical conduct by AVMA members. Approved
  • Bylaw amendment related to the maintenance of House status for House of Delegates member organizations. Approved
  • Bylaw amendment expanding eligibility of membership on the AVMA Council on Public Health (formerly known as the AVMA Council on Public Health and Regulatory Veterinary Medicine). Approved

Keynote speaker Drew Dudley: Day One Leadership.

Leadership is more than money, power and influence.  Drew’s message is to focus on the “everyday leadership.” We have all changed someone’s life — usually without even realizing it. Let us celebrate leadership as the everyday act of improving each other’s lives.  Create those moments that have powerful impacts and growth and that can be life changing for you and your organization. To learn more about Drew’s message refer to his Ted Talk on Leadership or enjoy his book: This is Day One, A Practical Guide to Leadership That Matters.

Future VLC Meeting

January 9-12, 2020

VLC benefits veterinary professionals at all career stages to take on new challenges and leadership roles that benefit both the individual attendee and the veterinary profession. The benefits of attending the combined VLC and House of Delegates winter session are:

  • Evolve your leadership skills – Gain new insights, expand your personal tool set, and learn from those who’ve come before you.
  • Connect with a diverse network of leaders from across the veterinary profession.
  • Deepen your understanding of how the AVMA works and discover exciting opportunities to get involved!
  • Earn up to 8 hours of continuing education credit.

Please feel free to contact your AVMA Hawaii Alternate Delegate – Carolyn Naun, or myself – Leianne Lee Loy if you would like to learn more about this meeting (avma_delegate@hawaiivetmed.org).

AVMA Convention: A Monumental Experience

Save the date: August 2-6, 2019 in Washington D.C.

Aloha!

Leianne K. Lee Loy

Hawaii Delegate for AVMA

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.

Submitted by:
Jenee S. Odani, DVM, DACVP
Associate Specialist: Veterinary Extension
Pre-Veterinary Medicine Program Advisor
College of Tropical Agriculture and Human Resources/HNFAS
University of Hawaii

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.

Message from the President Jan 2019

Aloha HVMA members,

January is a time to reflect back on the accomplishments of the past and look forward to the goals of the future. Thanks to the hard work of the conference committee we had another highly successful annual meeting in November with internationally recognized speakers in internal medicine, exotics, dentistry, Fear Free practice, disaster planning and more. We are already beginning to plan for next year’s event so please let us know if there are any speakers or topics you would like to see in the future. At our annual meeting we elected new officers to the board and also updated our by-laws. More information on these can be found on the Member Resources page of our website.

As we move into 2019 we look forward to serving members and the community in many ways including disaster planning with HI-EMA, legislative advocacy, keeping you informed on topics of importance to veterinary medicine in addition to opportunities to participate in community outreach. Our website’s About us page has been updated with our purposes as stated in our charter with the state. Please take a moment to read about who we are.

Membership renewal season has begun and we encourage you to renew early. Please see here for all the benefits of membership.

Finally, we want to share our gratitude to Eric Ako for his many years of service to the HVMA as the Executive Vice President. Please be sure to thank him when you see him, as this organization would not be where it is today without his tireless efforts. We are very fortunate that Jill Yoshicedo has agreed to take the reins as EVP, and know she will continue to add value to your membership and advocate on behalf of veterinarians in Hawaii. We also say aloha to Cordell Chang after many years of service as the HVMA representative to the AVMA.

Save the date for the 66th Annual Conference: November 7-10, 2019!

Aloha on behalf of the HVMA board,

Aleisha Swartz

2018-2020 Officer Nomination Slate

HVMA Board
President-Elect: Alfred Mina
Vice Pres: Tim Falls
Secretary: Jenee Odani
Treasurer: Brenda Smith
Executive Vice President: Jill Yoshicedo
Maui County Delegate (1): Leo Murakami

Hawaii County Delegates (2): Jacob Head, open

AVMA House of Delegates

Hawaii Delegate: Leianne Lee Loy

Hawaii Alternate Delegate: Carolyn Naun

We will be holding elections during the annual business meeting on Saturday, November 10 at 12:15pm at the Hilton Waikiki Beach Hotel, 3rd floor, Prince Jonah Room. Installation of officers will be held on Sunday, November 11 at 12:15pm at the same location. You do not need to be a conference attendee to attend these meetings. Please join us!

Hawaii Rabies Quarantine Changes

Rule amendments to Chapter 4-29, HAR recently received final approval from the Governor and will become effective on August 31, 2018. A summary of the more significant changes follows. The complete Chapter 4-29, HAR with amendments is located on the Hawaii Department of Agriculture’s website at: http://hdoa.hawaii.gov/ under the Administrative Rules tab. The Animal Quarantine information page (access by clicking on the Animal Quarantine tab) has been updated and new checklists added to assist with preparing a dog or cat for the 5 Day or Less program and Direct Airport Release.

Exact Changes Made:

A. Section 4-29-2 Definitions
The definition “Service Animal” is added and the definitions of “Service Dog” and “User” are amended to reflect the definition of service animals under current Federal ADA language.

The definition “Eligibility Date” or “Eligible Date” is added for clarification of terminology and means the date determined by the State that an animal may qualify for five day or less quarantine by meeting all the specified requirements.

“Qualification date” is added for clarification and means the date determined by the state that an animal may be released from quarantine by meeting all the specified requirements under Chapter 4-29, HAR.
The definition “Safeguard” is added and means to confine and handle animals so that the animals shall not come into physical contact with any other animal, or cause a potential human exposure, at any time. The location and method of confinement and handling shall be approved by the state.

“Veterinary Hospital” is added for clarification and means an office or building designated for the sole purpose of providing veterinary examinations, diagnostics, and medical and surgical treatments of animals operated by a veterinarian licensed to practice in Hawaii.

B. Section 4-29-8.1 Other requirements
Changes are made to: Reduce the minimum time required from the most recently administered rabies vaccine before arrival in Hawaii from 90 days to 30 days;

Modify the minimum time required from a successful OIE-RVA test by reducing the period from the test before arrival in Hawaii from 120 to 30 days; and

Another amendment is added that owners are required to register their pet’s microchip number with the local county humane society or local animal welfare organization. Other changes are made throughout the section for clarification.

C. Section 4-29-8.3 Movement of dogs and cats requiring urgent diagnostic, medical or surgical procedures not available in Hawaii
A new subsection (b) is made to establish requirements for the importation of cloned animals derived from donor tissue originating in Hawaii into the state without quarantine. This provision allows application of advances in science and technology to qualify as a low risk category for import. Requirements for the cloning facility, veterinary management, brood stock, clone animal preparation, transportation and procedures are included.

J. Section 4-29-11 State animal quarantine station
Changes add that admission to the station may be denied to anyone that is not listed as an owner, co-owner, registered handler or authorized visitor on the record of an animal quarantined in the quarantine station. This change will increase biosecurity and minimize the potential of introducing diseases into the station.

An amendment is added to clarify that station veterinarians are authorized to refer an animal to a veterinary facility for diagnostics and treatment not available at the Station with or without prior owner authorization or approval. This is for situations when owners are not available and/or referral is in the best interest of the animal.

K. Section 4-29-17 Fees at the animal quarantine station.
Changes are made to fees for Five-day or less quarantine, Direct airport release, Neighbor Island Inspection Permit (NIIP) and Re-entry fee with direct airport release and ground transportation on Oahu are made. The total new fees for Five­day or less quarantine being $244 (currently $224); Direct airport release total fee of $185 (currently $165); NIIP fee of $165 (currently $145), and Reentry fee with direct airport release of $98 (currently $78).

L. Throughout Chapter 4-29, HAR, the term “service dog” is changed to “service animal” to reflect current Federal ADA language.

Read full press release here

 

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).

The Use of Drugs in Food Animal Species

Christie Balcomb, BVSc, DACVIM
YourVet Maui
1476 S. Kihei Rd, Kihei, HI 96753
(808) 879-5777
Email: Christie@yourvetmaui.com

The use of medications in food-producing animals can have some challenges, as current demographics seem to be shifting for more people to have livestock as pets and other food-producing animals that are treated more as companion animals than in the past. Livestock are being kept as pets in more urban settings and will likely be seen by veterinarians that treat solely companion animals. Some owners are more willing to pursue medical and surgical treatment for these animals such as backyard chickens or pet goats. However, the Federal Drug Administration (FDA) designates “food animals” as any species that are raised and used for food production or consumption by humans. The species considered to be Major food animal species include: Cattle, Swine, Chickens and Turkeys. Minor species include sheep, goats, camelids, aquaculture species and honeybees, and rabbits. There are several important regulatory distinctions made between Major and Minor food animal species.

“Food-producing animals” are animal species or classes that are used to create a food or food by-product that does not require slaughter, such as milk (also used to make cheese and butter), eggs and honey.1

It is important to note that the FDA does not recognize the owner’s intended purpose of the animal, such as companion miniature pigs versus commercial pig breeds, and all fall under the classification as a Major food animal species. So, even if the animal is considered by the owner as a pet, rather than a production animal, the government regulations and restrictions still apply. Unfortunately, veterinarians cannot always guarantee the outcome and disposition of an animal for the rest of its life.

Extralabel drug use (ELDU) is allowed under the American Medicinal Drug Use Clarification Act (AMDUCA) of 1994, as long as certain requirements are met, including the existence of a valid Veterinary Client Patient Relationship (VCPR). 2-4

Extralabel use is defined as the use or intended use of a drug that is not in accordance with the approved labeling in regards to:

  1. Species
  2. Indication
  3. Dose rate
  4. Dose frequency
  5. Route of administration

For ELDU in Food Animal Species, the following requirements must be met:

  1. There is no approved animal drug labeled for use for that species, indication, dose rate and concentration. [An approved human drug must not be used in extralabel fashion if an approved animal drug exists that can be used in an extralabel fashion]
  2. There must be a diagnosis based on evaluation of the condition suspected
  3. Establish an appropriately extended withdrawal time prior to sale or consumption of milk, eggs, meat or edible products
  4. Maintain records to identify the treated individual
  5. Take precautions to ensure that the established extended withdrawal times are met to prevent any violative residues are found in products to enter the food chain

As clinicians, we are often faced with challenges, as many of the species that we treat are not listed on the label of many veterinary medications, and thus we need to use drugs in an extralabel fashion.  As such, we are also very dependent on scientific data and utilizing the Food Animal Residue Avoidance Database (FARAD) is an essential tool to ensure that we are following the appropriate requirements of ELDU as defined by AMDUCA.

FARAD is a USDA-funded university-based consortium that is overseen and operated by faculty and staff within the Colleges of Veterinary Medicine at the University of California-Davis, the University of Florida, Kansas State University, North Carolina State University and Virginia-Maryland College of Veterinary Medicine. FARAD is a great resource for veterinary practitioners to provide guidance and advice to avoid violative residues in animal products intended for human consumption. The program provides a hotline for requests, as well as online submission of withdrawal times, and a wealth of information on the use of medications in both major and minor use species.  It is highly recommended for any extralabel drug use in a food animal or food-producing animal species to submit a request for appropriate withdrawals to avoid violative residues. For example, the labeled dose rate of procaine penicillin is considered now to be subtherapeutic, and thus it is common for clinicians to use much higher dose rates or frequency of administration, and thus the withdrawal times can extremely prolonged compared to what is listed on the label.5 Current updates on prohibited and restricted drugs used in food animals can be found on their website: http://www.farad.org/prohibited-and-restricted-drugs.html.

The purpose behind many of the major and minor designations and regulations is to protect public health and food safety. Drugs and drug classes that have been prohibited for use in these species have been found to cause potential disease or harm to humans through exposure, or do not have an acceptable analytical method established. Other restricted drugs include classes of antimicrobials that are considered important for human health, and extralabel use of these medications may put the public at risk if antimicrobial resistance develops. In the next few years, it is likely that these regulations will grow to include other antimicrobial classes, or restrict their use further in an attempt to slow the tide of antimicrobial resistance in bacteria.

Violations of these regulations could end up with a consequence of drug residues in food products, which may have health implications for the humans consuming these products. Any products sold to the product could be considered a liability issue due to sale of an adulterated product into the human food chain.6 For those food animals considered as pets, administration of a prohibited antimicrobial may result in transmission of bacteria with resistance to that microbial to the rest of the flock or to the owners, themselves. Other options of antimicrobials with similar spectrum of activity may be available to use in ELDU, rather than these prohibited drugs.

In conclusion, as veterinarians that may practice on both companion and production animals, it can be challenging to adhere to FDA regulations for certain medications, such as the prohibition of any ELDU of fluoroquinolone antibiotics in any food animal species. It can also be uncomfortable to mention the term “food animal” species to a client who has a sanctuary for farm animals that will not be entering the food chain, and some clients may be offended. However, as part of the ELDU requirements, keeping records with some acknowledgement of withdrawal times for food products must be written. It may be more palatable to clients if there is a written statement about the FDA requirements based on species, but understanding that this animal is considered a pet. Finally, FARAD can be an extremely useful resource in case of determining withdrawal periods in case of historical administration, or pre-emptive research to provide the best estimate based on scientific literature. The FARAD digest publications have useful summaries of ELDU in backyard poultry, small ruminants and other species.6-10 FARAD is not a regulatory or governing body, but a program to help support veterinarians maintain public health and food safety.

FARAD Contact Info
Website: www.farad.org
Hotline: 1-888-873-2723

Please also feel free to contact Extension Veterinarian Jenee Odani to discuss any issues: jsodani@hawaii.edu or (808) 956-3847.

Drug or drug class Special considerations
Antiviral drugs – adamantane and neuraminidase inhibitors Prohibited ELDU in all poultry
Cephalosporins Except for cephapirin, any ELDU in MAJOR species (cattle, swine, chickens, turkeys) is prohibited. ELDU in MINOR use species is permitted.
Chloramphenicol Any use is prohibited in food animals
Clenbuterol Any use is prohibited in food animals
Diethylsilbesterol (DES) Any use is prohibited in food animals
Fluoroquinolones ELDU is prohibited in all food animal species (MAJOR and MINOR)
Gentian Violet Any use is prohibited in food animals
Glycopeptides Any use is prohibited in food animals (e.g. vancomycin)
Indexed drugs 11 Some use permitted in MINOR species
Medicated feeds Any ELDU prohibited – Veterinary Feed Directive 2017
Nitrofurans Any use is prohibited in food animals (e.g. topical use of nitrofurazone)
Nitroimidazoles Any use is prohibited in food animals (e.g. metronidazole)
Phenylbutazone Prohibited in dairy cattle >20 months
Sulfonamides * Use in milking sheep and goats is discouraged; Prohibited in dairy cattle >20 months, except for approved labeled use
Table adapted from FARAD http://www.farad.org/prohibited-and-restricted-drugs.html, updated 7/16/2018

 

References:

  1. FARAD. Available at www.farad.org. Accessed on 9/30/2018.
  2. US FDA. Animal Medicinal Drug Use and Clarification Act (AMDUCA) 1994. Available at: https://www.fda.gov/animalveterinary/guidancecomplianceenforcement/actsrulesregulations/ucm085377.htm. Accessed on 9/30/2018
  3. Extralabel drug use in animals. 21 CFR 530.
  4. AVMA. VCPR. Available at: https://www.avma.org/KB/Resources/Reference/Pages/VCPR.aspx. Accessed 9/30/2018.
  5. DeDonder KD, Gehring R, Baynes RE et al. Effects of new sampling protocols on procaine penicillin G withdrawal intervals for cattle. JAVMA 2013, 243:10, 1408-1412.
  6. Marmulak T, Tell LA, Gehring R et al. Egg residue considerations during treatment of backyard poultry. JAVMA 2015, 247:12, 1388-1395
  7. Webb A, Baynes RE, Craigmill AL et al. Drugs approved for small ruminants. JAVMA 2004, 2224:4; 520-523
  8. Baynes RE, Payne M, Martin-Jimenez T et al. Extralabel use of ivermectin and moxidectin in food animals. JAVMA 2000, 217:5, 668-671
  9. Riveiere JE, Tell LA, Baynes RE et al. Guide to FARAD resources: historical and future perspectives. JAVMA 2017, 250: 10, 1131-1139
  10. Davis JL, Smith GW, Baynes RE et al. Update on drugs prohibited from extralabel use in food animals. JAVMA 2009, 235:5, 528-534
  11. US FDA. Index of legally marketed unapproved new animal drugs for minor species. https://www.fda.gov/AnimalVeterinary/DevelopmentApprovalProcess/MinorUseMinorSpecies/ucm125452.htm. Accessed 9/30/2018.

 

Meet a Member: Ben Okimoto, DVM

Dr. Ben Okimoto served as the Honolulu Zoo Veterinarian for over 30 years. He graduated from Kansas State College of Veterinary Medicine in 1980. As well as caring for the health of the Zoo’s animals and promoting the Zoo’s mission of educating and inspiring Hawaii’s keiki, he mentored many young aspiring veterinarians along the way. With his permission, we have reprinted his memoir of his time at the Honolulu Zoo, originally published for Honolulu Zoo Society members.

March 24, 1988: My “Start Date” at the Honolulu Zoo 30 years and 3 months ago resulted from my selection as Zoo Veterinarian by Jerry Marr (Zoo Director), Walter Ozawa (Parks Department Director) and Dr. Allen Miyahara (UH Veterinarian). At that time I had no idea it would last for 3 decades.

I remind the zoo keepers that I have worked here longer than many of them have been alive. I am so grateful to all who have worked at the zoo for all their support for all these years. And I mean all the zoo staff, from the vet staff, the animal staff, commissary staff, grounds and maintenance staff, administrative staff, the Honolulu Zoological Society, Service Systems staff, the Front Office/ticket booth staff, and even the Security staff. They have all assisted and supported me in caring for the zoo animals, and I especially appreciate their support for those times when my efforts were insufficient or inadequate.

I was hired as an entry level Zoo Veterinarian to work under the guidance of Dr. Patrick Leadbeater. The City brought in Dr. Amy Shima from the San Diego Zoo for a couple of weeks to train me and to assess our zoo hospital. The City then sent me on an orientation/training trip for two and a half months to mainland zoos. I spent most of my time at the St. Louis Zoo and the Brookfield Zoo in Chicago, but I was also able to visit the zoos in Cincinnati, Lincoln Park in Chicago, Milwaukee, Indianapolis, and the International Crane Trust. Later I spent a couple of weeks with Dr. Shima at the San Diego Zoo. All this exposure was very opportune training for me as I assumed the lead role of Honolulu Zoo Veterinarian in 1989.

Our zoo vet hospital at that time was a quaint small house on zoo grounds that I believe Paul Breese said was built in 1953. At one time that eventual zoo hospital was the home for the zoo curator and later zoo veterinarian. That veterinarian was Dr. Calvin Lum. Many years ago one of Dr. Lum’s son, Jory, was hired as a zoo keeper. Jory visited the clinic and pointed out to me that the surgery room used to be his bedroom. The other identical house built on zoo grounds originally was the home for the Zoo Director. When the curator’s home was converted to the hospital, the director’s home was converted to become the zoo keeper meeting and locker/shower facility. It is currently being used by the staff of Service Systems.

We were very lucky that in 2004 the City and the Zoo Society, along with individual benefactors (Mark Bogart) were able to fund the construction of a new zoo hospital. I based the floor plan on the design of the Miami Metro Zoo’s hospital, and the whole project including the buildings and equipment cost around $4 million. We moved into the new hospital in late 2005.

Since that time we have cared for many of the zoo animals in the new hospital. We have even assisted outside agencies in caring for non-zoo animals: Hawaiian bats, Hawaiian Monk Seals, Yellow Belly Sea Snakes, Brush Tailed Rock Wallabies, and several others.

There have been other non-zoo animals that we did not care for but had to interact with, most notably “Tyke” the elephant. There was also the live Cobra found at the airport, the live Cougar that was confiscated from a home in Hawaii Kai, and the live Fishing Bat found at the wharf, among others.

Thirty years is a long time to care for an animal. Inevitably and sadly it means that you will outlive many of the animals that you care for. This is felt most strongly by the primary zoo keepers who provide daily care for the years that they work at the zoo. But medical care providers can also develop associations, relationships, and even bond with individual zoo animals.

I would like to tell you about some of the zoo animals that I will never forget.

The reptile keepers will have to forgive me for saying that it can be difficult to “bond” with a reptile. But some reptiles have such a strong presence that they had an aura about them. “Goliath” our male alligator was such an animal. He didn’t move much and he often just lay on the grass or floated in the pond. But as you approached him, all he had to do was open his eyes and look at you and you immediately became aware that he wasn’t a floating log, he was a living dinosaur.

Some birds can live for a long time. “Abby” our Abyssinian Ground Hornbill is in his forties. I think “Abby” is intelligent enough to recognize individual people. He will frequently come up to the exhibit fence when people are nearby, but he seems to actually interact with you the more often and the longer you “know” him. Recently he was brought up to the hospital when he was soaked and very disheveled. He was stressed and not very responsive, but after a while he reacted to me when I called him over to stand in front of a heat lamp.

Many years ago we had a female Crested Celebes Macaque named “Gabby”. She was very responsive and friendly, often turning her back up to the fence to have her back scratched. Every year I had to dart her to sedate her for her annual examination. This would stress her in the beginning of the procedure but she would eventually just place her hind end up against the fence, like saying “go ahead, get it over with already”. All the primates recognize me as the person who darts them, but “Gabby” was different. She was the only primate in my 30 years here who would forgive me. Always within a couple of days of darting she would be friendly to me again and would present her back for scratching.

“Pandji” was the greatest tiger I have known. He was our male Sumatran tiger who had a medical condition with his esophagus. One of my veterinary technicians at that time actually helped to hand raise him when he was a cub at the Henry Doorly Zoo in Omaha. His benign disposition was a great help to us when we were treating him here because at one time he was unconscious for over two days. One of my colleagues, the late Dr. Phil Kau, inserted a jugular catheter into his neck vein and we had him on an IV drip continually, until he woke up. We had to quickly remove the catheter and exit his sleeping quarters. Although he was aware of our presence inside his sleeping quarters, “Pandji” made no aggressive moves towards us. Later it became evident that he had developed a severe problem with his esophagus. Dr. Kau and I diagnosed it as a stricture in his esophagus, deep in his chest, at about the level of his heart. There was nothing else that we could do for him. Another colleague, Dr. Jim Scoggin, referred a human Gastroenterologist, Dr. Bill Hartman to assist us. Dr. Hartman brought down all his own equipment, all his staff, and they treated him surgically, as best they could with human equipment. “Pandji” did okay for about a month, and then he got sick again. Dr. Hartman came down and worked on him again, and again, and again, for several months. As he modified his procedure (there were very few references in the literature to treat this condition) “Pandji” lasted longer before he needed treatment again. Eventually Dr. Hartman’s treatment lasted a year and we would only need to call him in whenever we did “Pandji’s” annual exam. Dr. Hartman saved “Pandji’s” life when veterinarians could do no more for him. Throughout this time of multiple immobilizations “Pandji” was compliant, cooperative, and dignified.

“Apollo” was the greatest lion I have known. Where “Pandji” was compliant and quiet, “Apollo” could be feisty, angry, and very dangerous. “Apollo” was the only animal in my 30 years that I was afraid of. There were several other animals who were also dangerous and worthy of great respect, but unlike other animals, “Apollo” was not dangerous because he was afraid or anxious or stressed. He was dangerous because he meant to be. When he needed to be darted for sedation he was not afraid. He wouldn’t try to run away, no, he would charge me. He would jump up on the fence, roar loudly and bite the chain link, crimping the links with his canine teeth like the fence was made out of plastic. When a full grown male lion does that 2 feet away from your face and you are standing there alone, besides putting your faith in the almighty you put your faith in the chain link fence. As “Apollo” got older and slowly came down with big cat old age problems like cataracts and kidney problems, his attitude, persona, and reaction times slowly changed. He became like a feisty old man in a nursing home, diminished from his youth, but still having regal character inside him.

“Kruger” was the greatest rhino I have known. He was also the biggest rhino I have known, albeit that was because he was overweight. But as huge as he was, and with his massive horn, he was still quiet and gentle. As he got older, we determined that he was having kidney problems. We could not reverse his kidney problems and we were limited as to what we could do to treat him. One of the medications we gave him was supplemental IV fluids. We did not have a containment chute big enough to restrain him. But “Kruger” was so calm and gentle that he would allow me to stick large needles into his ear veins to give the IV fluids. And so without any physical restraint he would line up next to a fence, let me insert the needles, and just stand there for the fluids to flow in, so long as someone kept feeding him apples and produce. We did this multiple times. One time we had at least two IV lines flowing and he stood there for a couple of hours to allow several liters of fluid to go in, all the while happily munching away on apples. “Kruger” also liked to get scratched, he had a soft spot at the base of his neck.

“Kihei Iki” and “Kihei Ha ehu ehu” were two of the most unique animals I have ever cared for. They were two Hawaiian Hoary Bats that we were able to keep alive for 3 and 5 years respectively. As federally listed endangered species, no one can keep Hawaiian bats. But if they are found injured and deemed non-releasable then they were turned over to us for care. I have developed a tremendous interest and respect for all bats, but especially for our Hawaiian Hoary Bat (‘Ope’ape’a). At a bat conservation field workshop in Arizona they cautioned us to always handle hoary bats with leather gloves because they will bite hard. But I have found that Hawaiian Hoary bats are much more gentle and calm. They quickly acclimated to captivity and I could daily feed them mealworms with my bare hands. They also liked to be stroked on top of their heads and would doze off after eating. I was pleased to give testimony in support of Senator Sam Slom’s bill to name the ‘Ope’ape’a as the Official State Land Mammal for Hawaii.

As much as these animals have meant to me, and as much as I have come to respect the people that work here, there was something more that kept me working here. That was my belief in the zoo itself. Soon after I started working here I pondered why the zoo continued to exist, what was its justification. I concluded that its purpose was for conservation education for the children of Hawaii. That was the justification, and because of that the zoo existed, and because of that it justified keeping these exotic animals in captivity, and because of that it justified me being here to take care of them.

Meet Your Board: Eric Ako, Executive Vice President

Dr. Eric Ako has served as the HVMA Executive Vice President since 1987. Over the past 30 years, Eric has grown the HVMA annual conference into a wonderful resource attracting well-known speakers and attendees from all over the world. In serving Hawaii’s local VMA chapter, he has advocated for legislation benefiting and strengthening the veterinary profession and our ability to care for Hawaii’s animals and protect human health.

Eric Ako also opened The Pet Doctor veterinary clinic in Kahala in 1987, where he has treated companion animals with a special interest in avian medicine. Seeing the needs of the smaller outer islands, he extended his veterinary services to Lanai, and offers regular veterinary care including spay/neuter surgeries to Lanai residents several times a month. He also serves as the veterinarian for the Lanai Cat Sanctuary.