Timely Topics

Letter from the President – Nov 2020

I write this with a bit of sadness knowing we are missing our usual opportunity to see friends and colleagues at the annual meeting. This year has brought challenges like no other in our lifetimes and our connection to one another has helped us all adapt and find ways to continue our very important work. I hope you can all join us at our virtual meeting Saturday 11/14, and that we can resume in person gatherings in the not too distant future.

The HVMA Executive Board continues to advocate for members and the animals and people of Hawaii. We have continued our meetings virtually and uninterrupted during this time. Your membership dues are essential in maintaining our ability to continue as an organization so please renew if you have not already done so.

Our involvement as a supporting agency to the state and counties during emergencies has also continued. As flights outside the state were reduced in March the opportunities for adoption placement outside the state became extremely limited. Shelters across Hawaii have relied on out of state transport for adoption placement when local opportunities are exhausted. The lack of flights put our local shelters at risk of being beyond their capacity and reducing their ability to help other animals in need. Greater Good Charities responded to a request for assistance to transport pets to the continental US. They have coordinated an unprecedented flight of dogs and cats to animal welfare organizations in the pacific northwest. Many of the pets have adoptive homes already before they even land! This is an effort we have supported closely working with HI-EMA, GGC, Wings of Rescue and shelters from Kauai, Oahu, Lanai, Maui, and Hawaii Island. This has also provided the opportunity for further disaster planning, collaboration and training for the state, our association and local animal welfare organizations.

It has been an honor to serve as the HVMA President the last two years and I will continue to support the association as I move on to the role of Past President. Please do not hesitate to reach out if there is anything the HVMA can do to support your work as veterinarians in Hawaii.

Aloha,
Aleisha Swartz

What to do when marine wildlife need help?

Submitted by Michelle Barbieri, DVM

There are lots of ways that you can help Hawaii’s marine wildlife, both as an individual and if your clinic gets calls or inquiries. It may be completely normal for an animal (such as a green sea turtle or Hawaiian monk seal) to rest on the beach, but those sightings are informative even if the animal is safe and healthy. You can encourage clients to report sightings or concerns by calling the state-wide Marine Animal Stranding and Reporting Hotline at (888) 256-9840. This menu-based hotline will divert calls to the island- and wildlife-specific point of contact, and if the call comes in after hours, it will be checked first thing the next day, so always leave contact information for follow up questions. This is the best go-to contact number to keep at the front desk of your clinic or stored in your phone.

Many species (especially sea turtles and marine mammals) are protected by law. That means that even if you are a licensed, practicing, and well-intentioned veterinarian, conducting medical procedures on them requires specialized permits and expertise, so it should always be done by appropriately trained and permitted stranding response personnel. If your clinic gets a call about a marine animal in need, it is best to refer them directly to the Stranding Hotline for assistance. Please do not attempt to treat an animal yourself.

It is also important to give wildlife a safe distance, avoid approaching, touching, or otherwise disturbing them because rest is important to their biology, and they can be a danger to your safety. You can also help by advising clients to keep pet cats indoors, which will reduce the risk of disease spread, namely toxoplasmosis.

Between Jan-July 2020, 18 monk seal pups were born in the main Hawaiian Islands: 5 on Oʻahu, 11 on Molokaʻi, and 1 each on Kaua‘i and Hawaiʻi Island. Encountering female seals that are nursing their pups is a situation in which it is important to be especially cautious, as these seals in particular can be aggressive.

The Fishing Around Seals and Turtles program provides guidelines on how to fish safely around these animals and what to do if a fisherman accidentally hooks one while fishing. Again, if someone contacts you about an entangled or hooked animal please refer them to the stranding hotline.

If you suspect illegal or suspicious activity, it can be reported to: (a) the Hawaii DLNR Division of Conservation and Resources (DOCARE) hotline at (808) 643-DLNR, or preferably on the DLNRTip App for your mobile device; or (b) NOAA Office of Law Enforcement Hotline (800) 853-1964. The Stranding Hotline links to DOCARE as well.

For additional information contact: RespectWildlife@noaa.gov
For immediate assistance or to report marine wildlife emergencies call: 1-888-256-9840
If you are interested in having electronic materials with this information that you can print and post at your clinic, please contact Dr. Michelle Barbieri.

Microchip Regulation Update

On July 1, 2020, the City and County of Honolulu implemented mandatory microchip identification for cats and dogs over the age of four months. This replaces the City and County of Honolulu’s dog license tag requirement, but does not replace the requirement that cats allowed outdoors have visible identification. Any dog or cat without a microchip who is impounded by Hawaiian Humane Society or taken into custody by an animal rescue nonprofit must have a microchip implanted before release. The microchipping obligation does not apply to private individuals returning lost pets or to veterinary clinics, but we hope you will urge your clients to comply with the law. Clients with a new pet who is already microchipped should be informed that they have 30 days to update the pet’s microchip with their owner information.

In addition, the Hawaiian Humane Society will no longer be updating their microchip registry. Instead, they are recommending that veterinarians help pet owners register their information with the microchip manufacturer or with a free online database such as FoundAnimals.org. Pet owners who have microchips implanted by your clinic also have a legal obligation to register their contact information with an online registry within 30 days. Please do not send microchip information to the Hawaiian Humane Society at this time.

Another provision of the new law requires that any intact dog impounded as stray three times in a 12-month period must be spayed/neutered before the dog can be returned to its owner unless a licensed veterinarian finds the dog is medically unfit for sterilization.

Questions or comments may be directed to the Hawaiian Humane Society at info@hawaiianhumane.org or 356-2200.

Update from Hawaiian Humane Society

July 1 marked the implementation of the most significant overhaul of Oahu’s animal welfare ordinance in 25 years. It made changes in three major areas:

Stray animal handling
Pet identification
Routinely stray dogs

The pet identification provisions are expected to affect the greatest number of pet owners.

FAQs

What law has changed?
Revised Ordinance of Honolulu Chapter 7: Animals and Fowl

How did the rules change regarding stray animal holding?
Hawaiian Humane now has legal custody of any stray dog or cat with microchip identification after five days in its care, down from nine. Dogs wearing a current county license tag still must be held for a minimum of nine days. The kenneling fee for stray animals has increased to $10 per day from $2.50. There is still no kenneling charge for animals reclaimed within 24 hours. This is not a legal requirement, but Hawaiian Humane is urging pet owners who travel, particularly if they will not have email or cell phone access, to list their pet sitter or veterinarian as a secondary contact on their microchip registration in the event that their animal gets lost while they are away.

What are the new rules for pet identification?
All dogs and cats are now required to have microchip identification. Pet cats allowed outdoors are still required to have visible identification. That is highly recommended for dogs, as well, but not legally required.

What if you have a current dog license?
Owner information can still be updated with the City and County of Honolulu. No new dog licenses are being sold and licenses can no longer be renewed.

What about microchip registration?
Clinics that wish to upload microchip information should do so with the manufacturer’s database, not Hawaiian Humane. Hawaiian Humane is no longer maintaining a separate microchip database for Oahu and pet owners are no longer legally required to register their microchips with Hawaiian Humane. Under the new ordinance, pet owners who have microchips implanted have 30 days to register their contact information with the microchip manufacturer or a free online database. Similarly, they have 30 days to update any changes to their contact information or to transfer ownership of a pet.

What does the new law say about routine strays, or “frequent fliers”?
Any dog brought to Hawaiian Humane as stray three times in a 12-month period must be spayed/neutered before the dog can be returned to its owner, unless medically contraindicated. Sterilization services will be offered at the Community Spay/Neuter Center, but owners may request that Hawaiian Humane transfer a dog falling under this requirement to a private veterinary clinic upon confirmation of a spay/neuter appointment.

What do we do if someone brings us a lost pet?
Hawaiian Humane remains the official pet lost and found for Oahu. If you need help identifying the owner of a microchipped pet, call the admissions team at 356-2285.

Letter from the President – April 2020

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

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

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

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

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

Aloha,
Aleisha Swartz

Becoming Antifragile

Author: Holly Sawyer, DVM, Human-Animal Bond Certified, works for GuardianVets, the only after-hours teletriage/telemedicine service to be endorsed by AAHA. The mission of GuardianVets is to keep the veterinary hospital in the center of the Human-Animal Bond while supporting the work-life balance of today’s veterinary professional.

If COVID-19 has taught us anything, it is that life can be wildly unpredictable. Veterinarians tend to be tidy, structured thinkers. That’s not to say we are all compulsive neat freaks. But our chosen profession demands that we master the art of pattern recognition. “Know your normal” becomes the mantra of every lecture and clinical rotation, and the aspiration of every new grad. So we gain expertise in “normal” and work hard to maintain it—in our patients and in our lives.

Duck and Pivot
The pandemic slammed us with a reality that was anything but “normal.” Overnight, we had to launch curbside care, rely on phone consultations and telemedicine, enact social distancing, and otherwise upend our historically stable profession. Let’s face it, a time-traveler from 1950 who walked into your clinic pre-COVID would have ogled at your pretty toys, but not the structure of the appointment, physical exam, or general administration of treatment. In a world of industry disrupters like Airbnb and Uber, consumer desire for choice and convenience is clearly king. In this moment of inertia within our profession, in which we are no longer the object at rest, but the object in motion, let us stay in motion. Just as the fighter in the boxing ring will fare better with quick feet and nimble reactions, we too can capitalize on the left hook that threw us off balance and now pivot into an upper cut that transfers all of that energy against the status quo.

Change Your Perspective, Change the World
What am I talking about here? You could call it a fundamental change in thinking, a mental model that embraces stressors and unpredictability as a catalyst toward improvement instead of detriment. I am talking about becoming Antifragile. This term, coined by risk analyst Nassim Taleb[1], has been applied to systems as varied as bacterial resistance and human psychology. To understand it, we must first look at the other end of the spectrum.

Fragile systems are brittle. They have very little margin for error because they maximize efficiency of time and resources to achieve optimal outcomes. Our modern, globalized society has steadily pushed us toward this ideal. We benefit from cheap food, medical advances, and technological gadgets that rely on tight tolerances of sourcing, shipping, supply, and demand. Enter COVID, and suddenly dairy farmers are dumping milk at huge economic loss because restaurants and schools are closed, while pig farmers face euthanizing pigs before they can be sold due to meat packing plant shutdowns. In our imperfect world, even small stressors can break a system, like a porcelain plate that shatters when dropped.

Resilient (or Robust) systems have built-in redundancies to survive stress. They are the plastic food containers that bounce on the floor. The system survives in its original form despite unpredictable events, but even resilient systems will reach a failure point. NASA’s Space Shuttle Program has learned that the hard way. Twice. Antifragile systems get better with stress and volatility. They are the Hydra of Greek mythology. Lop off one head, two grow in its place. Expose a population of staphylococcus to methicillin, and soon you will have a thriving infection of superbugs. Bad for us, great for them. Likewise, the saying, “What doesn’t kill you makes you stronger,” describes the mechanism by which we ourselves become antifragile. When we succeed in the face of overwhelming odds, we tend to achieve greater feats the next time around. The opposite viewpoint “Avoid all risk at all cost”—in turn makes for a very brittle population that fears unpredictability because it doesn’t know what it can overcome. [2]

Choose Your Own Adventure
Veterinary Medicine is at a pivot point in the boxing ring right now. Instead of resisting change, let us grow through it to become better than we were before. It will take energy, patience, creativity, and a willingness to fail small in order to succeed big. Happily, our clients are particularly forgiving of experimentation right now, especially when it is for their benefit. We can establish a new and better normal if we provide our clients the care they want, how they want, when they want it, while reclaiming some work-life balance for ourselves. Offer a digital patient portal, an easy pipeline for communication to bond the client to your clinic, so you remain at the forefront of healthcare decisions before entrepreneurs with far less training fill that space. Schedule differently, cross-train staff to new tasks, and leverage your RVTs and CVTs to legally fill needs previously provided by DVMs. Treat life as an adventure instead of a race to perfection, and don’t panic when you don’t recognize the pattern ahead. That which you fear may become a game-changing opportunity.

[1] Taleb, Nassim Nicholas. Antifragile: Things That Gain from Disorder. New York: Random House, 2012.
[2] Lukianoff, Greg, and Jonathan Haidt. The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure. New York: Penguin, 2018.

COVID-19 and Your Pet

Updated April 5, 2020

How to Best Protect Your Pet

Stay home and follow social distancing orders from authorities. Studies show COVID-19 is often spread by those who are not yet showing symptoms of disease. Consider yourself infected and take the proper precautions to protect your community.
DO NOT take your pet to a veterinary clinic for wellness visits, vaccinations, or elective procedures (such as spay/neuter) that may be safely delayed for a few months.
If you are concerned with your pet’s health issue, CALL YOUR VET. Many vets are practicing telemedicine with established and new clients and patients, and will be able to make a tentative diagnosis and prescribe medication over the phone or after an online consult.
If you are diagnosed with COVID-19 but do not need to be hospitalized, you can still safely care for your pet. Practice good hygiene practices by washing your hands before and after interacting with your pet, not kissing or sharing food with your pet, and avoiding close contact (hugging, sleeping together). If possible, wear a facemask to reduce your spread of virus particles.

Make a Plan for Your Pet

You should identify a family member or friend who can care for your pets if you need to be hospitalized.
Have an appropriate carrier/crate for each pet, and enough food, medication, and supplies for at least two weeks.
Ensure all medications are documented with dosages and administering directions. Including the prescription from your veterinarian is ideal.
Pets should have identification: Collar with ID tag and microchip.

COVID-19 and Pets

Infectious disease experts and multiple international and domestic human and animal health organizations agree there is no evidence at this point to indicate that pets become ill with COVID-19 or that they spread it to other animals, including people.
If you are not ill with COVID-19, you can interact with your pet as you normally would, including walking, feeding, and playing. You should continue to practice good hygiene during those interactions (e.g., wash hands before and after interacting with your pet; ensure your pet is kept well-groomed; regularly clean your pet’s food and water bowls, bedding material, and toys).
Out of an abundance of caution, it is recommended that those ill with COVID-19 limit contact with animals until more information is known about the virus. Have another member of your household take care of walking, feeding, and playing with your pet. If you have a service animal or must care for your pet, wear a cloth facemask; don’t share food, kiss, or hug them; and wash your hands before and after any contact with them.

CDC Recommends Cloth Facemasks

CDC recommends wearing cloth face coverings in public settings to slow the spread of the virus and help people who may have the virus and not know it from transmitting it to others. Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.

Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.

The cloth face coverings recommended are NOT surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.

CDC: How to Protect Yourself
CDC: Info on Cloth Masks

General information about COVID-19:

The betacoronavirus that causes COVID-19 is SARS-CoV-2 (formerly 2019-nCoV).
Person-to-person and community spread has been reported in numerous countries, including the United States.
Transmission primarily occurs when there is contact with an infected person’s bodily secretions, such as saliva or mucus droplets in a cough or sneeze. Transmission via touching a contaminated surface or object (i.e., a fomite) and then touching the mouth, nose, or possibly eyes is also possible, but appears to be a secondary route. Smooth (non-porous) surfaces (e.g., countertops, door knobs) transmit viruses better than porous materials (e.g., paper money, pet fur) because porous, especially fibrous, materials absorb and trap the pathogen (virus), making it harder to contract through simple touch.
There are currently no antiviral drugs recommended or licensed by FDA to treat COVID-19, and there is no immunization available.
Cases of COVID-19 and community spread are being reported in most states.
The best way to avoid becoming ill is to avoid exposure to the virus. Taking typical preventive actions is key.

Have Any Pets Been Infected with COVID-19?

On April 5th, the USDA National Veterinary Services Laboratories has confirmed the presence of SARS-CoV-2 in one tiger at a zoo in New York. Read full USDA article.

While two dogs (Hong Kong) and two cats (one in Belgium and one in Hong Kong) living with people diagnosed with COVID-19 have also been reported to have been infected with SARS-CoV-2, other dogs and cats also living with infected people remain uninfected. To date the CDC has not received any reports of pets or livestock becoming sick with COVID-19 in the United States. Infectious disease experts and multiple international and domestic human and animal health organizations continue to agree there is no evidence at this point to indicate that, under natural conditions, pets spread COVID-19 to people. To date, all animal cases have had no or mild symptoms that resolved with supportive care.

Because the situation is ever-evolving, public and animal health officials may decide to test certain animals out of an abundance of caution. The decision to test will be made collaboratively between local, state, and federal animal and public health officials. After the decision is made to test, state animal health officials will designate a state-appointed veterinarian, USDA-accredited veterinarian, or foreign animal disease diagnostician to collect the sample using appropriate personal protective equipment (PPE) and sample collection methods.

Again, current expert understanding is that COVID-19 is primarily transmitted person-to-person. This supports a recommendation against testing of pets for SARS-CoV-2, except by official order. If dogs or cats present with respiratory signs, veterinarians should test for more common respiratory pathogens.

Pets in homes with owners with COVID-19: Although there have not been reports of pets becoming sick with COVID-19, out of an abundance of caution, it is recommended that those ill with COVID-19 limit contact with animals until more information is known about the virus. If you are ill with COVID-19 have another member of your household take care of walking, feeding, and playing with your pet. If you have a service animal or you must care for your pet, then wear a cloth facemask; don’t share food, kiss, or hug them; and wash your hands before and after any contact with your pet or service animal. You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home. Additional guidance on managing pets in homes where people are sick with COVID-19 is available from the CDC.

Keeping pets safe: For responsible pet owners, preparing in advance is key. Make sure you have an emergency kit prepared, with at least two weeks’ worth of your pet’s food and any needed medications. Usually we think about emergency kits like this in terms of what might be needed for an evacuation, but it’s also good to have one prepared in the case of quarantine or self-isolation when you cannot leave your home.

While we are recommending these as good practices, it is important to remember that, to date, there have not been any reports of pets or other animals becoming ill with SARS-CoV-2, and there is currently no evidence that pets can spread COVID-19 to other animals, including people.

Should any animal showing signs of respiratory illness be tested?

USDA and CDC do not recommend routine testing of animals for this virus. Because the situation is ever-evolving, public and animal health officials may decide to test certain animals out of an abundance of caution. The decision to test will be made collaboratively between local, state or federal public and animal health officials.

Should I avoid contact with pets or other animals if I am sick from coronavirus (COVID-19)?

You should restrict contact with pets and other animals while you are sick with COVID-19, just like you would with other people. Although there have not been reports of pets becoming sick with COVID-19 in the United States, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus. When possible, have another member of your household care for your animals while you are sick. If you are sick with COVID-19, avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets. More information is available on how to keep people and animals safe at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/animals.html.

What should I do if I think my animal has the virus?

Call your veterinary clinic with any questions about your animal’s health. In order to ensure the veterinary clinic is prepared for the household animal, the owner should call ahead and arrange the hospital or clinic visit. Make sure to tell your veterinarian if your animal was exposed a person sick with COVID-19, and if your animal is showing any signs of illness. Veterinarians who believe an animal should be tested will contact state animal health officials, who will work with public and animal health authorities to decide whether samples should be collected and tested.