Timely Topics

The Starving Veterinarian

Submitted by Kelly Foster, DVM

We often talk about wellbeing in terms of data and programs, but sometimes a single piece of writing says it more plainly than any survey can. “The Starving Veterinarian,” a poem by Dr. Ashley Hill, a small animal vet in northern Colorado, came out of an ordinary early-morning emergency call and grew into something many of us will recognize. The title carries a double meaning — the literal skipped meals of a doctor rushing out the door, and the slower emotional and financial depletion that builds underneath a demanding calling. Hill names the things we tend to carry quietly: compassion fatigue, the strain of caring for patients whose families don’t always see the pressures behind the work, and the cost of giving your whole self to a profession that gives back unevenly. We’re sharing it here not as a downer, but because naming these experiences is often the first step toward tending to them — and because you deserve to feel seen in this work.

The Starving Veterinarian

By Dr. Ashley Hill

I awake with a groan, what a way to start,
Not the alarm clock but my phone, another bleeding heart.

I skip breakfast and grab some fruit,
The fastest thing to eat en route.

I think to myself, “don’t despair,
I’ll eat when I get there.”

Instead of gratitude,
I am met with attitude,
At just 5 minutes passed 8,
I’m greeted with “You’re late. How could you make us wait?”

Personally I’m impressed,
I didn’t get to eat, but I did get dressed.

You were so worried, but don’t dismay,
Thanks to us, your pet will be okay.

But “Oh, by the way…”
“I won’t be able to pay today.”

And as I stitch up this doggy,
My cereal sits getting soggy.

I throw the sad attempt away,
“Maybe I’ll just go out today.”
I see patients back to back,
There’s just no time for a snack.

The way things are going I have a hunch,
I’ll once again work through lunch.

“I’ll just go and grab something, it’s not that far…”

Then in walks a dog, hit by a car.
My techs order pizza and take shifts,
I might get some if I’m swift,
They bring out a piece as I take out a mass,
Ask if I want any, “For now, I’ll pass.”
Maybe I can just have a granola bar,
No time, a cat needs CPR.

I step out for a moment just to feel the sun,
“Sorry,” they say “we’ve got another one.”

I’m feeling weak and looking pale,
As I bandage this broken nail.

I finally get home, but the day’s not done,
A text on the phone, “Can you see another one?”

“At least I’ll be thinner”
I chuckle, half-way through prepping dinner.

With a sigh I turned off the stove,
And off to another emergency I drove.

When I get home so late at night,
I find I’m tired, and have lost my appetite.

There’s pain in my heart and in my head,
I should probably just go to bed.

But as my eyelids fall,
Another call,
“Please, my dog is very sick, I think it’s time.”

I just want rest, is that such a crime?
“I’m sorry, but it’s late and I have needs too.”
“Please doc, it’s not me, my pet really needs you.”

A long pause, I’m such an oaf,
Damn my allegiance to this oath.
“But she can’t get up, could you come to us?”

By now you know me, it should be obvious.
And out of bed I crawl,
In the middle of the night out to a house call,
I walk through the door, and on the floor,
I saw a sweet creature, barely a dog anymore.

“She hasn’t eaten, I can’t remember when she’s last had a
meal.”
I knelt by this angel, “Dear sweet girl, I know how you feel.”
I helped this dog pass peacefully,
And celebrate this life tearfully.

And as I push away the pain,
I go to bed and think, I would do it all again.
As a vet I am starving, for days I am hungry,
But please, go on how I’m “only in it for the money”.
It is not my fault your animal is sick,
But it is your fault, when I stay passed my shift.
It’s not my fault that you can’t pay.
But it is your fault why I’m so tired today.
Please don’t blame me for your issues,
I have also had my fair share of abuse.

Just because I’m not as open,
Does not discount that I, too, am broken,
I am affected for days,
In so many ways, and (so you’re aware), I am not okay.
But I’ll get up tomorrow, and keep it up,
Maybe not for you, but at least for your pup.
Weeks later, in the middle of my shift,
I receive an unexpected gift.
A basket of treats, and a hand written card.
“I appreciate what you do, don’t work too hard!”
And with the words that I read,
My soul had been fed.
I take a moment off my feet,
To finally get a small bit of it to eat,
“Geez, you look tired, are you okay?”

I smile and nod. I am tired. “It’s just been a long day.”

Why Routine Testing for FeLV/FIV in Animal Shelters Is No Longer Recommended

Submitted by Lisa Labrecque, DVM

Feline Leukemia Virus (FeLV) and Feline Immunodeficiency Virus (FIV) affect cats of all ages worldwide. The percentage of cats that are infected with these viruses varies according to geographic region, the environment, and the lifestyle of the cat, but estimates tend to be quite low, with 2-4% of cats infected in the U.S.^1,2 and a similar percentage here in Hawaii.

There has been much debate over the past few years in the animal welfare community about whether to routinely test cats for FeLV and FIV. For many years, shelters have felt an obligation to test all cats for FeLV and FIV prior to adoption. The hope was that testing would ensure that shelters were placing healthy cats up for adoption and that the viruses might be eradicated through shelter testing efforts. However, new information about the tests and the diseases has led to the recommendation that shelters discontinue routine testing of cats for FeLV and FIV.³

New research has shown that a negative or positive result at one point in time is not definitive by itself. The diseases have an overall low prevalence in our cat population, and the available tests are not 100% accurate.⁴

Furthermore, we now know that cats may experience a variability of infection, so we can no longer make conclusions about the results of a single test. For cats that test negative, we can only conclude that they are negative at the time they were tested. It takes at least 30 days from the time of infection with FeLV to test positive, and it can take up to 60 days for a cat infected with FIV to develop enough antibodies to cause a positive result. Therefore, if a cat was infected just prior to intake at the shelter, they would test negative but could have the disease.

A negative test can also give adopters a false sense of security. The concept of incubation periods and exposure can be difficult to convey during adoption when people are already overloaded with information and excitement about their new pet. Although chances are that a cat testing negative is truly negative (due to low prevalence of the disease), some cats may have been exposed prior to intake and could develop FeLV or FIV after adoption.

On the other hand, a positive test in a healthy cat who is at low-risk for infection is more likely to be a false-positive than a positive result in a sick cat or one at higher risk. In typical cat populations where there is low prevalence of disease, a majority of positive results will be false positives.⁴ For example, if there is 2% disease prevalence in a population, and a test with 98% sensitivity is used to test 1,000 cats, there will 39 positive tests:
19 true positives (0.02 x .98 = 0.096, 0.0196 x 1,000)
20 false positives (0.02 x 1,000)
Note that there will be slightly more false positives than true positives. Compare this to the same testing performed in a population with 4% disease prevalence:
39 true positives (0.04 x .98 = 0.0392, 0.0392 x 1,000)
20 false positives (0.02 x 1,000)
In this population with higher disease prevalence, there are many more true positives than false, making the test that much more reliable.

Positive FIV test results may also be caused by circulating maternal antibodies that can be present in a kitten up to 6 months of age. And some cats who are exposed to FeLV can contain the virus early on; if this occurs, they no longer shed the virus and cannot infect other cats but may still test positive.²

At the Hawaiian Humane Society, we no longer test healthy cats or kittens. We still test sick cats, those who have clinical signs consistent with infection, and at-risk cats. Based on our newer understanding of the variability of disease, we believe that FeLV/FIV testing is best done in collaboration with a cat’s primary care veterinarian where they receive comprehensive care and recommendations based on their lifestyle.

1. Cornell Feline Health Center, Cornell University, College of Veterinary Medicine, “Testing for FeLV and FIV”
2. 2020 American Association of Feline Practitioners’ Feline Retrovirus Testing and Management Guidelines
3. Shelter Medicine Program, University of Wisconsin-Madison, School of Veterinary Medicine, “Why are some shelters no longer testing all cats for FeLV and FIV?”
4. Journal of Veterinary Internal Medicine, Performance of 4 Point‐of‐Care Screening Tests for Feline Leukemia Virus and Feline Immunodeficiency Virus.

New World Screwworm Updates

Effective August 3, 2026: Mexico will require USDA-accredited veterinarians to issue New World screwworm inspection documents for pet dogs and pet birds traveling to Mexico. Pet cats will continue to travel to Mexico with no documents needed prior to travel.

Pet Dogs

Pet dogs will be required to travel with a NWS Inspection Certificate for Pet Dogs Moving (Exporting) from the United States to Mexico that is issued and signed by a USDA-Accredited Veterinarian within 5 days of arrival in Mexico. This form does NOT require APHIS endorsement.

Pet Birds

Pet birds may travel to Mexico beginning August 3, 2026 and will be required to travel with a NWS Inspection Addendum for Pet Birds Moving (Exporting) from the United States to Mexico that is issued and signed by a USDA-accredited veterinarian within 5 days of arrival in Mexico. This addendum does NOT require APHIS endorsement; however, it will be required IN ADDITION TO the “Veterinary Health Certificate for Export of Pet Birds from the United States of America to Mexico”, which must be issued by a USDA-accredited veterinarian AND endorsed by APHIS prior to travel.

Pet Cats

Pet cats will continue to travel to Mexico with no documents needed prior to travel.

Please refer to the relevant sections of the APHIS Pet Travel to Mexico webpage for more details.

APHIS’ NWS notice regarding NWS restrictions to Mexico has been updated accordingly:

Due to the detection of New World screwworm (NWS, Cochliomyia hominivorax) in the United States, Mexico continues to prohibit exports of the following species from all U.S. states:

Cattle (slaughter and reproduction)
Wild ruminants (non-bovine)
Equine (slaughter, breeding/work, and sport/exhibition/transit)
Sheep and goats (slaughter and reproduction)
Swine (reproduction)
Ferrets (commercial and pets)
Songbirds/ornamental birds/raptors (commercial and pets)
All zoological species as listed under the “Zoological Animals” and “Other Animals” section of the IREGs Mexico page

ADDITIONAL GUIDANCE
As of November 22, 2024, Mexico is considered to be affected with screwworm. All dogs (including U.S.-origin dogs returning to the United States after traveling to Mexico) must meet APHIS requirements for screwworm freedom certification upon entry (re-entry) into the United States. Additional information can be found on the APHIS Dog Import Website.

ASPCA has developed guidance for Animal Transport here.

Canine Distemper in Hawaii

Submitted by Erika Sox, DVM, DACVIM

While we enjoy a low prevalence of Canine distemper virus in Hawaii, we do occasionally see cases here and it is important to remain vigilant to protect pets that may be vulnerable to infection.

Canine distemper is a highly contagious and often fatal viral disease of domestic dogs. Young puppies and unvaccinated adult dogs in high density housing are at highest risk. Acutely affected dogs commonly exhibit clinical signs of fever, lethargy and inappetence, respiratory signs (nasal discharge, coughing and labored breathing due to pneumonia), ocular signs (uveitis, KCS), and GI signs (anorexia, vomiting, diarrhea with or without blood). In severe cases, these may be followed by central neurologic signs such as clonic muscle tremors and seizures. Neurologic signs can take up to 3 months to develop and sometimes do so without other preceding clinical signs. ^{1, 2}

Diagnosis is made by recognition of compatible clinical signs, along with confirmation through testing, ideally with quantitative RT-PCR which can distinguish between natural and vaccine-derived distemper. Testing is readily available through commercial veterinary labs but take several days to return, making clinical suspicion and proper handling of suspect cases imperative while awaiting results. Distemper should be considered in any febrile dog exhibiting symptoms of the GI, respiratory and neurological systems, especially if unvaccinated or incompletely vaccinated. ^{1, 2}

Distemper is shed in all body secretions of acutely infected animals and can be spread by both direct contact and via respiratory droplets. Isolation of both clinically ill and unvaccinated exposed dogs requires designated airspace and is crucial to preventing spread. The virus is fragile in the environment and readily killed with most cleaning agents but can survive at least several hours. Staff handling affected animals should wear appropriate PPE and practice proper hygiene protocols. Detailed isolation and clearance protocols are available online. ¹

There is no specific treatment or cure for Distemper virus. Treatment is generally supportive in nature and may include IV fluid therapy, anti-emetics, nutritional support, antibiotics for secondary infections, and anti-convulsant medications. ^{1, 2}

Vaccination is highly effective in preventing disease and is considered core for all puppies and dogs worldwide. Initial vaccination should be administered at 6 to 8 weeks of age and repeated every 2 to 4 weeks until 16 weeks of age, followed by a 1-year booster and then boosters every 3 years. ³

Pet Expo May 2-3, 2026

Dear Colleagues, Staff, and Friends,
It’s that time again when the HVMA celebrates National Pet Week (May 3-9) with the sponsorship of the Hawaii Pet Expo on May 2 and 3, 2026. The association has hosted this FREE community event for the last 34 years. This event continues to draw large crowds ( over 10,000 in the weekend) and is one of the few events that welcome the attendance of pets.

This year the HVMA booth will contain exhibits on topics such as pet myths, heat stroke, and other veterinary issues. We will once again have our snack bar and “Ask-A-Vet” area. This year we will need 5 volunteers (vets and/or staff) to effectively man the booth. We also need volunteers to man our Make-N-Take It booth, Foodbank/Info booth, Pet Snack Bar, Photo and Fundraiser booths, show marshals, and greeters.

The Hawaii Pet Expo would not have been such a success all these years, without the volunteerism of veterinarians, staff, family, and friends. Volunteers work a 2 hour shift and receive an Expo t-shirt. Lunch will be included for those who participate in the 9 a.m. to 12 p.m. shift. We can never have too many volunteers! Please sign-up and also help to promote the event by posting the Expo fliers and discussing the event with your clients. Your association delegates will also call you to remind you.

Sincerely,
Lissa Kam, DVM
Chairperson
Hawaii Pet Expo

JOB DESCRIPTIONS

HVMA BOOTH

Ask-A-Vet
Answer questions and encourage public to enjoy the educational displays in the booth

GREETERS
Pass out programs, poop bags
Aid in helping attendees with strollers, wheelchairs, etc. through turnstiles
Smile

FOODBANK & INFO BOOTH
Be able to answer questions, direct venders and public to booth area
Lost and found center
Be able to find security, expo organizers
Collection and packing of food donations
Collection of monetary donations
Coordinate volunteers (show where shirts are and their work areas)

MAKE & TAKE CRAFT BOOTH
Help kids and adult with crafts
Encourage participation

SHOW MARSHALS
Walk around exhibition hall and outside to clean-up spills and accidents (take poop to outside dumpster)
Mop areas where there has been accidents
Make sure exhibition hall doors are closed
Remind pet owners to keep dogs leashed or secured and have cats, birds and pocket pets in carriers for the safety of all pets involved
Assist exhibitors with removal of trash and put in outside dumpster
All cleaning supplies provided (poop bags, disinfectants, mops)

SNACK BAR
Help pet owners create snacks for pets

PHOTO BOOTH
Help public take their photos with props

FUNDRAISER BOOTH
Sell fundraiser merchandise
Help purchasers decorate tote bags

AVMA News – January 2026

Greetings from your AVMA delegates! We recently returned from the January House of Delegates meeting in Chicago, where we reviewed and approved several small updates to the AVMA Bylaws.

We also spent time discussing two resolutions. The first focused on the importance of early socialization and training in animals. While there was broad support for the intent, it was noted that the language was written broadly enough to include wildlife, zoo animals, and other species for which human socialization may not be appropriate. Because of this, the resolution was referred back to the AVMA Board of Directors for refinement, and we expect a revised version—with clearer species-specific guidance—to return to the House in the future.

The second resolution addressed castration in camelid species, an area where the AVMA had not previously had a formal policy. Although policies already exist for other small ruminants and pigs, this prompted an important discussion about anesthesia and pain management. Your Hawaii delegates proposed strengthening the language to strongly recommend anesthesia and pain management for camelid castration. While this amendment did not pass—largely due to concerns about keeping wording consistent across species—we continue to stand behind the recommendation. Camelids are typically castrated later in life, often between 18 and 24 months of age, which raises additional animal welfare considerations. Our plan is to return this summer with a proposal to strengthen the language across all applicable species, improving consistency while still allowing veterinarians appropriate clinical discretion.

We also had two topics for the Veterinary Information Forum. One focused on educational standards for veterinary technicians; no formal action was taken at this time. The second addressed the role of allied organizations within the House of Delegates. In addition to state delegations, the House includes representatives from allied veterinary organizations that bring valuable expertise from specialized areas of practice. These voices are especially important when we’re discussing niche topics, like the aforementioned camelid medicine. There is some concern that changes in membership numbers could affect continued representation for certain groups, so a task force has been created to explore ways to ensure these perspectives remain part of the conversation. The National Association of Federal Veterinarians has been particularly engaged in this discussion, as federal veterinary positions may be impacted by ongoing workforce reductions.

Our next House of Delegates meeting will take place July 9–10, 2026, in Anaheim, California, alongside the AVMA Annual Convention. We’re hoping to bring forward our proposed resolutions at that time. Before then, we’ll be reaching out through a future newsletter to gather your input—so please keep an eye out. If you have experience or insights you’d like to share, we would truly welcome your involvement.

As always, thank you for allowing us to represent Hawaii and keep you connected to what’s happening at the national level.

Carolyn Naun, DVM
AVMA Hawaii Delegate
cnaun@armsofaloha.com

Jenee Odani, DVM, DACVP
AVMA Hawaii Alternate Delegate

The Starving Veterinarian

Pet Dogs

Pet Birds

Pet Cats

Animal Disease

Animal Movement

JOB DESCRIPTIONS