Suicide Prevention Training

Veterinary medicine is a community, and a community supports its members. For that reason, the AVMA is offering free training in suicide prevention to all veterinary professionals. QPR gatekeeper training — short for “question, persuade, refer” — teaches people without professional mental health backgrounds to recognize the signs that someone may be considering suicide, establish a dialogue and guide the person to seek professional help.

Veterinarians, veterinary students, technicians, assistants, practice managers and all other veterinary professionals are now eligible to take this free online training.

Access training resources here

Greater Good Charities Bring the Good Fix Program to Kauai

Submitted by Leilani Sim-Godbehere, DVM

Greater Good Charities will be offering a gift to our Kauai community through their Good Fix program. This is one of the charities that was instrumental in the Paws Across the Pacific program in Oct. 2020 when over 600 shelter animals were flown from the main Hawaiian islands to the U.S. mainland for adoption.

The Good Fix program will establish a humane mass trap-neuter-release program targeting the free-roaming cat overpopulation problem on Kauai. Some owned cats will also be included in the totals. Good Fix will work with local volunteers and will also deploy a team of specialized trappers throughout the island to maximize the number of cats sterilized. The program will encompass dual licensed HQHVSN (High Quality High Volume Spay Neuter) vets and MASH style experts to complete the work. The goal is to sterilize 15,000 cats over the year in 6 rounds. Sterilized cats will also be microchipped and FVRCP vaccinated. Dates are set for Oct 3-8 & 11-16, 2021; Jan 23-28, 2022; Jan 31-Feb 5, Mar 27-Apr 1 & Apr 4-9, 2022.

Besides public outreach, Greater Good Charities is inviting our veterinary community to learn more and participate in their program! Vets/techs interested in participating can contact the veterinary medical director of Greater Good Charities, Dr. Ruth Parkin, at ruthparkin@greatergood.org for an application. It is all volunteer work, but travel and accommodations for the medical team members who commit to an entire clinic session would be covered. Any non-medical persons interested in helping with trapping or other volunteer aspects can also contact Dr. Ruth Parkin. Participating vets will also be offered $150 vouchers to offset cost of dog spays for clients who might benefit from the financial support.

There is a plan in progress to address relocation of cats in certain wildlife/bird sensitive areas. It may become part of a “farm/barn-cat” program. The team is aware that this topic is high priority. The team is also aware of the Toxoplasma issues on island and will be including educational information on their community outreach to encourage the public about the importance of controlling overall free-roaming cat numbers.

Dr. Ruth Parkin and Dr. Julie Levy made a productive initial visit to Kauai on June 22 and 23,2021 for a site visit and to meet with local veterinarians and groups involved with animal welfare. They were delighted at the warm welcome they received and they look forward to working for the benefit of Kauai and hopefully our sister islands as well.

Legislative Update

New animal laws enacted in 2021:

Act 31 – Establishes the crime of sexual assault of an animal. Standard veterinary, animal husbandry, and conformation judging practices are exempt. Effective June 7, 2021.

Act 91 – Protects veterinarians from civil liability for rendering emergency aid to an animal, even if an owner is not available to consent to care. Requires veterinarians to report suspected animal cruelty or the injury or death of an animal as part of a staged fight. Protects veterinarians from civil liability for making such reports. Effective June 25, 2021.

Act 182 – Bans the unsupervised tethering of a dog under the age of six months. Bans tethering in a configuration that endangers the dog. Bans the use of tow or log chains to tether a dog. Effective July 6, 2021.

Act 5, Special Session – Requires dog and cat owners to have microchip identification implanted in their dogs and cats, and to register the microchip number and the owner’s contact information with a microchip registration company. Requires animal organizations to implant a microchip in all stray dogs and cats in their custody that do not have microchip identification. Effective January 1, 2022.

Panleukopenia Cases

Submitted by Kasey Carter, DVM

The Hawaii Cat Café (a Hawaiian Humane Society offsite adoption partner) closed to the public for two weeks starting Tuesday, July 27 due to a confirmed case of panleukopenia.  The Hawaii Cat Café has dedicated their space for the next two weeks to quarantine & monitor cats who were potentially exposed.  They are working closely with the Hawaiian Humane Society veterinary team to deliver diagnostics and care as needed.  Over thirty cats have been adopted from Hawaii Cat Café over the last two weeks – these adopters have been contacted to inform them of the panleukopenia exposure and have been offered a physical exam and vaccination through our Veterinary Services department.
 
To date, we have no additional confirmed cases in our cat population, which includes our other partners.  Our vaccine protocols include vaccination of all animals on intake, vaccination of kittens/puppies between 4-18 weeks every two weeks while in our care, and to vaccinate dogs and cats >18 weeks twice (if they are in our care at least 2 weeks).

If you have any questions or concerns or see any suspect/positive panleukopenia cases, please reach out directly to Dr. Carter at kcarter@hawaiianhumane.org

Thank you!

Specialty/ER Service Interruption

The Hawaii Board of Veterinary Medicine has recently reinterpreted Hawaii’s veterinary practice law and begun rejecting the practice of veterinary sponsorship. This practice previously allowed many out-of-state specialists to share their services with our clients on a short-term or intermittent basis. All of us have benefited from referring our clients to visiting dermatologists, radiologists, surgeons, as well as our few emergency care centers that operate 24/7. This interruption in veterinary sponsorship has limited service hours at emergency clinics and worsened the backlog of surgery cases in Hawaii.

If your clients are being affected, please encourage them to file a complaint with the DCCA and Board of Veterinary Medicine to insist that they must immediately return to honoring the practice of veterinary sponsorship in Hawaii as clearly allowed by HRS 471(2)-5.

Suicide Prevention and Mental Health

Delve into the latest research on suicide and its causes in this conversation on veterinary mental health with experts from the AVMA and the Association of American Veterinary Medical Colleges (AAVMC). Learn strategies to promote mental health, prevent suicide, and intervene in a mental health crisis. Come away knowing individual and community risk and protective factors, get guidance on mental health crisis warning signs, and learn how to get help for someone in crisis – vital steps in building healthy communities and supporting our colleagues and peers. A culture of caring offers help and hope to its members—and we all can play a role in building that community.
View webinar here

AVMA Update – April 2021

Aloha Colleagues!

Before I share with you the many programs the American Veterinary Medical Association has available for all members, I did want to take this opportunity to send a huge virtual Mahalo to you for your support of my candidacy for the AVMA Board of Directors District X Representative. Although I was not chosen, I am grateful to have been on the ballot – Mahalo!

We, Carolyn Naun (alternate delegate) and I (Delegate and State Advocacy Committee Member), will continue to represent Hawaii proudly at the House of Delegate meetings. If there are any questions or concerns, please feel free to contact us.

Aloha,
Leianne K. Lee Loy


Highlights from the AVMA:

AVMA Virtual Convention July 29 – August 1, 2021: Registration is open!
Check out “Convention at First Glance” to discover the over 300 hours of
continuing education. avmaconvention.org

VLC (Veterinary Leadership Conference) January 7-9, 2022 avma.org/vlc
(NOTE: Please click here for highlights of the AVMA House of Delegates Winter Session including the Veterinary Information Forum that took place during the VLC.) This is a great conference to develop, improve and perfect your leadership skills.

COVID-19 resource center: www.avma.org/Coronavirus
More information about veterinarians’ ability provide vaccines
E-book: COVID-19: Meeting the Challenge

AVMA Axon online platform – digital education https://axon.avma.org
Certificate Programs, Webinars, My Veterinary Life Podcasts Series

AVMA Trust Retirement Plan avmalifeplans.com/ARP
For questions, or to schedule a personal consultation, email AVMATrustRetirementPlan@transamerica.com or call
312-596-5336.

AVMA, VetSuccess Partnership
• Veterinary Industry Tracker
• To learn more about the AVMA’s economics resources, visit
avma.org/VeterinaryEconomics

Diversity, Equity, and Inclusion: avma.org/diversity

Telehealth
AVMA Guidelines for the Use of Telehealth in Veterinary Practice
2021 AAHA/AVMA Telehealth Guidelines for Small-Animal Practice

Veterinarians as COVID-19 Vaccinators

Submitted by the American Veterinary Medical Association

The AVMA has been working hard for the past few months, as veterinarians have been increasingly discussed as needing to be among those able to assist in efforts to vaccinate people against COVID, to have veterinarians specifically included in the declarations under the federal Public Readiness and Emergency Preparedness Act (PREP Act), which authorizes the HHS Secretary to issue emergency public health declarations and provides limited immunity from liability to those covered under the act.

As of March 12, 2021, veterinarians and veterinary students are included in the PREP Act:

· It allows veterinarians who are licensed to practice under the law of any state to administer COVID vaccines in any jurisdiction in association with a COVID vaccination effort by a state, local, tribal, or territorial authority or by an institution in which the COVID vaccine is administered.

·        This also applies to veterinarians who have held an active license or certification under the law of any state within the last five years which is inactive, expired or lapsed, as well as veterinary students with appropriate training in administering vaccines. The intent is to include recently retired veterinarians who may want to help.

·        Today’s amendment preempts any state law that would otherwise prohibit veterinarians or veterinary students who are a “qualified person” under the PREP Act from prescribing, dispensing, or administering COVID vaccines or other covered COVID countermeasures.

·        Veterinarians and veterinary students will be afforded liability protections in accordance with the PREP Act and the terms of the amendment. However, specific conditions must be met in order for the authorization to administer the vaccines and the liability protections to apply. These liability protections apply from March 11, 2021, through October 1, 2024.

·        In order for the authorization and liability protections to apply, veterinarians and veterinary students must be participating in association with a COVID vaccination effort by a state, local, tribal, or territorial authority, or by an institution in which the COVID vaccine is administered. Additional specific requirements also must be met, such as having basic certification in CPR, completing the CDC COVID vaccination modules, an observation period, etc. There is a separate section of the declaration that applies to those in the uniformed services and for federal employees, contractors and volunteers when authorized to administer COVID vaccine.

·        While the liability outlined in the PREP Act is broad, it does not apply to willful misconduct, and the federal government does not provide a legal defense in the event that you are sued. Your state may have separate liability protections, along with separate requirements to qualify, and may or may not provide a legal defense. Veterinary malpractice will not likely respond to claims arising from a veterinarian intentionally vaccinating people against COVID.

More information on vaccination volunteer requirements

Sign up for Hawaii’s volunteer Medical Reserve Corps here

PREP Fact Sheet that Includes Veterinarians as Qualified Health Professionals

Federal Requirements for the Veterinarian-Client-Patient Relationship

The following guidance information has been provided by the AVMA

THE BASICS

The federal government regulates veterinary medicine and animal drugs very differently than it does human health care and drugs intended for human use. This is, in part, because veterinarians are key to maintaining a healthy, safe, and wholesome food supply and because they also play an important role in overseeing the judicious use of antimicrobials in animals. One important difference between human and veterinary medicine is that the U.S. Food and Drug Administration (FDA) has authority under the federal Food, Drug and Cosmetic Act (FDCA) over the use of animal drugs and human drugs by veterinarians, and the authority to define how a veterinarian-client-patient relationship (VCPR) is established for certain uses of animal and human drugs. [1]

For these uses, FDA has authority to require the keeping of veterinary medical records and to access them at any reasonable time to verify and copy them. [2] Use of animal and human drugs by veterinarians that violates the federal VCPR parameters set forth in the FDCA and its implementing regulations results in the drug being statutorily deemed unsafe for the use and, if in animal feed, the feed is statutorily deemed adulterated. [3] The USDA, which regulates veterinary biological products, also has promulgated rules defining a VCPR using the same language as the FDA. [4]

APPLICATION OF THE FEDERAL VCPR

The federal VCPR applies to any use of an FDA-approved human drug in animals, including over-the-counter (OTC) human drugs. [5] It applies to any use of an FDA-approved animal drug in any manner that differs from its approved labeling (Extra Label Drug Use [6]), such as a different frequency of administration, different dose, different medical indication for its use, different route of administration, or use in a different species. [7] It also applies to the use of compounded drugs by veterinarians [8] and a veterinarian’s authorization of a veterinary feed directive (VFD). [9] All of these are very common occurrences in the day-to-day practice of veterinary medicine.

Establishing the federal VCPR requires a physical examination of the animal or timely and medically appropriate visits to the premises where animals are kept. The FDA does not allow the VCPR to be established through electronic means. [10] FDA does allow the VCPR to be maintained electronically through telemedicine. [11] Veterinarians must comply with the federal VCPR in each of the circumstances in which it applies, irrespective of whether state law defines it differently.

The federal VCPR also applies in two important, but more limited, circumstances under USDA authorities. Veterinarians who manufacture biological products for use in their patients must do so within the context of the federal VCPR. [12] Veterinarians also must have established a federal VCPR when using prescription platform product biologics, which are a new category of biotechnology vaccines. [13]

CONFLICTING STATE AND FEDERAL VCPR DEFINITIONS AND TELEMEDICINE

• Conflicting state and federal VCPR definitions (e.g., states allowing the VCPR to be established electronically) would cause significant confusion. The FDA and USDA have used the same regulatory definition to avoid such confusion.
• Veterinarians must comply with the federal VCPR requirements where they apply, regardless whether state laws are more lax. Activities where the federal VCPR applies are extremely common in day-to-day veterinary practice.
• State law and regulations relating to the establishment of a VCPR that conflict with federal law would also cause telemedicine encounters to be frustrating for many veterinary clients. A veterinarian who has not already established a VCPR that complies with federal requirements (i.e., by conducting an in-person examination/visit) could not even recommend the use of an FDA-approved human OTC product for an animal without violating federal law.
• There are many valuable uses of telemedicine within the parameters of a federal VCPR.

  1. 21 USC 360b; 21 CFR Part 530
  2. 21 CFR 530.5
  3. 21 USC 360b(a)(1), (2), (4) & (5); 21 USC 342(a)
  4. 9 CFR 107.1(a)(1)
  5. 21 USC 360b(a)(5); 21 CFR 530.2; 21 CFR 530.3(a)
  6. https://www.fda.gov/animal-veterinary/resources-you/ins-and-outs-extra-label-drug-use-animals-resource-veterinarians
  7. 21 USC 360b(a)(4); 21 CFR 530.2; 21 CFR 530.3(a)
  8. https://www.fda.gov/animal-veterinary/resources-you/ins-and-outs-extra-label-drug-use-animals-resource-veterinarians#compounding; FDA Draft Guidance for Industry #256
  9. 21 CFR 558.6(b)
  10. FDA letter to the American Veterinary Medical Association, April 6, 2017 – “Therefore, for the purposes of the federal definition, a VCPR cannot be established solely through telemedicine (e.g., photos, videos, or other electronic means that do not involve examination of the animal(s) or timely visits to the premises).”; During the pandemic FDA announced they will temporarily suspend enforcement of the federal VCPR physical exam and premises visit requirements. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/cvm-gfi-269-enforcement-policy-regarding-federal-vcpr-requirements-facilitate-veterinary. In this announcement FDA reiterated that under normal circumstances – “Given that the Federal VCPR definition requires animal examination and/or medically appropriate and timely visits to the premises where the animal(s) are kept, the Federal VCPR definition cannot be met solely through telemedicine.”
  11. Id. “The regulations do not specifically address the use of telemedicine to maintain an established VCPR. However, based upon the language of the VCPR definition provided above, nothing would prohibit the use of telemedicine (e.g., use of photos, videos, or other electronic means that may be considered virtual) to allow the veterinarian to keep informed and able to make medical judgments regarding the health of the animal(s) and the need for medical treatment between periodic examinations of the animal(s) and/or timely visits to the premises where the animal(s) are being kept.”
  12. 9 CFR 107.1(a)
  13. USDA Veterinary Services Memorandum 800.214

Leianne Lee Loy Running for AVMA Board of Directors Representing Hawaii’s District

Message from Leianne K. Lee Loy, current AVMA Hawaii Delegate and candidate for AVMA Board of Directors Representing District X:

Aloha Colleagues!

I ask for your support and vote to be the next member of the AVMA Board
of Directors. You will be receiving an email from the AVMA with a ballot,
my biography and “Seeking Statement”. You will have from March 1-31st to
vote.

I share with you a platform for which I bring my diverse perspective:
a) Diversity, Equity and Inclusion – educating and advocating for our Veterinary Community.
b) Quality of life for the Veterinary Community – raising a family and caring for our elderly family members while working.
c) Retaining and Maintaining AVMA membership throughout your veterinary Career.
d) Support of “support staff” – veterinary nurses/technicians building a career that brings satisfaction.
e) Critique of the AVMA during COVID 19 – how well did we support the Veterinary Community? There are 500,000 Americans who lost their lives to
COVID19; how were animals/veterinarians affected by those lives lost? As the AVMA reviews their response to this pandemic, strategic plans can be made to prepare for future health emergencies.

An email message will be sent to all eligible voters, providing instructions
and a link to a secure voting website. The email is sent from the address
AVMAelection@avma.org. Please vote!

More information available here:
www.fb.com/VoteLeianneForAVMABoard
www.instagram.com/leianneleeloyforavmaboard