In this issue: Canine Lyme Disease Accounts Receivable And More …

issue 15.02 | March-April

magazine of the new york state veterinary medical society issue 15.02 | March-April

magazine of the new york state veterinary medical society

ISSN 2333-3375 • USPS 407-350 100 Great Oaks Blvd., Suite 127, Albany NY 12203 Tel. (800) 876-9867 • Fax (518) 869-7868 • Email [email protected] • Web www.nysvms.org

Connections is published bimonthly by the New York State Veterinary Medical Society Inc., 100 Great Oaks Blvd., Suite 127, Albany NY 12203. Subscriptions are $1/year to members as part of their annual dues, $25/year to subscribers and $50/year to nonmember veterinarians in New York State. Opinions expressed in articles and editorials of Connections are those of the authors and are not necessarily those of the New York State Veterinary Medical Society Inc. Second-class postage paid at Albany, N.Y. Postmaster: Send address changes to: NYSVMS, 100 Great Oaks Blvd., Suite 127, Albany NY 12203.

Communications Education/Conference Executive Director Specialist Specialist NYSVMS Legal Counsel Membership Assistant Jennifer J. Mauer, CAE Stacey Allen Dory Fisk, CMP Barbara J. Ahern, Esq. Jennifer Hill

NYSVMS officers Regional Officers President Capital District Long Island Dean M. Snyder, DVM Mark E. Will, DVM Surinder S. Wadyal, DVM President-elect Catskill Mountain New York City Susan E. Wylegala, DVM David C. Leahy, DVM Allan P. Bregman, DVM Past President Central New York Northern New York Christopher Brockett, DVM Victoria Bentley, DVM Jessica Scillieri Smith, DVM Treasurer Finger Lakes Southern Tier Lawrence W. Bartholf, DVM Robert Hamilton, DVM Joshua H. Clay, VMD AVMA Delegate Genesee Valley Westchester/Rockland Walter K. McCarthy, DVM Andy Fleming, DVM Robert J. Weiner, VMD Hudson Valley Western New York James C. Zgoda, DVM Jeanne Best, DVM

2 New York State Veterinary Medical Society Table of contents Departments

5 President’s Message 2015 Legislative Agenda

A voice for the profession and for 6 Legal humane treatment of animals page 12 8 Practice Manager

10 Case Study

23 Classified Ads

24 In Memoriam

Association

17 Behavioral Myths: What You

Need to Know to be an Accurate

Source of Information

19 Canine Lyme Disease: What are

the hot topics in 2015 for the

New York State Veterinarian?

Want to learn more? Visit Connections online in the Knowledge Center: www.NYSVMS.org

New York State Veterinary Medical Society 3 Save the Date NEW YORK STATE

VETERINARY CONFERENCE New York State SPRING 15 Spring Veterinary MAY 15-17 • RYE BROOK, NY Conference

May 15-17, 2015 The New York State Veterinary Medical Society and Hilton Westchester | Rye Brook, NY the Cornell University College of Veterinary Medicine will host the second annual Spring Conference at Hosted by the Westchester Hilton, in Rye Brook, N.Y. Earn more New York State than 20 continuing education credit hours, attend Veterinary Medical Society lectures from the nation’s premiere speakers, mingle & Cornell University College of Veterinary Medicine with veterinarians from the tri-state area and check out the Exhibit Hall, featuring vendors devoted to all aspects of veterinary practice. NYS-VC Spring is one conference you will not want to miss!

For more information, call 607.253.3200 or 518.869.7867

Featured Speaker: Alexander de Lahunta, DVM, Ph.D. More to come… 4 New York State Veterinary Medical Society NYSVMS Update President’s Message

harmful legislation and promote • Your perception of quality legislation. It was YOUR laws that protect and promote services and positive outcomes involvement that helped us the practice and profession. is considered overrated bring dentistry into the scope of by others. practice of veterinary medicine. Ours is the only organization in New York State that speaks • You do not know your state No matter whether you for veterinarians; educates legislator or Congressman or have a deeper interest in the legislators on veterinary medicine; they do not know you. legislative process and have joined the GRLN or are simply and protects and promotes • You are just beginning a member of NYSVMS, there the practice and profession. or ending your professional are four critical habits you can In 2012, the NYSVMS resurrected career. develop to help ensure your its most effective and During the workshop, Burridge voice is heard. According to popular advocacy program: focused on the message, Mr. Burridge, these include: the GRLN Workshop and “he who shows up wins.” Legislative Reception. • Voting Educating lawmakers about issues • Communicating with elected During that initial seminar, the critical to veterinary medicine officials NYSVMS invited Craig Burridge, is essential to a successful Dean M. Snyder, DVM CAE, executive director of the advocacy campaign. These days, • Supporting the NYSVMS and Pharmacists Society of the State veterinarians have a multitude communicating with staff s I write this, of New York to speak. Burridge of ways to reach lawmakers and members the NYSVMS is stressed the importance of including the Internet, Facebook, • Donating money to the gearing up for its “having a seat at the table Twitter, email, traditional letters, annual Grassroots otherwise you’ll end up being just Political Education Committee faxes, telephone calls, and (PEC) Legislative Network another entrée on the menu.” in-person visits to legislators’ A(GRLN) Workshop and Legislative As Mr. Burridge explained, district and Albany offices. The NYSVMS PEC helps the Reception. NYSVMS members you need advocacy if… Society educate lawmakers will meet with New York State Senators, Assembly members and legislative staffers to discuss the issues most critical to the “ If you want to become involved, but veterinary medicine profession. don’t know how, call the NYSVMS office Since its inception 125 years ago, the NYSVMS has served at (800) 876-9867 to get started.” as the advocate for the veterinary medical profession • You ask yourself whether You can see actual proof of the about the issues critical to in New York State. Like water what you do runs the risk of success of these contacts in our rushing over a dam after a the practice and profession becoming obsolete. efforts last year to have dentistry and a healthy PEC is one of springtime thaw, there is added to the scope of veterinary • Someone or something else the key essential components never ending river of proposed medicine. When special interest controls what you get paid, to grassroots legislative legislation impacting veterinary groups rallied to derail the bills, what professional services advocacy. Look for more medicine flows from Albany the NYSVMS put out a call to you provide and what you information on the PEC in the throughout New York State. members to reach out to their can do within your profession next issue of Connections. legislators; and these calls and Thankfully, NYSVMS helps and practice. you navigate these raging letters were received in droves. For now, do not hesitate waters and avoid hitting • You cannot identify at least Our Legislative Representative, to become involved in your rocks by providing you with 100 consumers of your services Tom Gosdeck, Esq., heard from organization. We are here to a life jacket, raft and extra willing to take a bullet or go to countless legislators that they help protect the profession and rowing power. Our legislative the wall to ensure you remain were hearing your voices and your livelihood, with you we will representatives, Government their provider. you were having an impact. be even stronger. If you want to become involved, but don’t know Relations Committee and • You are disenchanted It was our members’ involvement how, call the NYSVMS office at Grassroots Legislative Network with what you do and want that help pass that crucial (800) 876-9867 to get started. (GRLN) help shield you from a change. •

New York State Veterinary Medical Society 5 Legal You Asked, We Answered

Member Question: Is a licensed and under the general supervision Veterinarians (NASPVHV 51) adopted a working rule permitting veterinary technician able to of a licensed veterinarian. or on a computerized version the use of a signature stamp on the currently being used by many rabies vaccination certificate in lieu give a rabies vaccination? There is a more stringent rule “paperless” practices. Either of an original signature, provided NYSVMS Legal Counsel: for rabies vaccinations because version of that form must be the signature stamp is under the A licensed veterinary technician rabies vaccinations for animals signed by a licensed veterinarian. control of the veterinarian at all (LVT) can give a rabies vaccination, are a public health mandate If it is signed by an LVT in place times, and only used with their but must be working under the intended to protect both the of the veterinarian, it will not be knowledge and consent. The direct supervision of a licensed animals and the humans with recognized as a valid vaccination signature stamp, like an original veterinarian; the statement of whom they come into contact. certification by the Department signature, is the veterinarian’s vaccination must be certified The more stringent rule for rabies of Agriculture and Markets. certification that the vaccination by the licensed veterinarian. vaccinations is based on the information on the certificate is By their signature on the rabies The general rule for vaccinations requirement in the Agriculture correct. A stamp with the name, vaccination certificate, the in New York State Education and Markets Law that requires address and telephone number veterinarian certifies that the Department regulations is that an a licensed veterinarian to certify of the practice but without the vaccination was properly done, LVT can prepare and administer to the rabies vaccination. This signature of the veterinarian who and that the information on medication on medical orders certification is provided by the performed the vaccination will the animal and the vaccine is of a supervising veterinarian; rabies vaccination certification, not be considered valid by the correct. As an accommodation to they also provide that an LVT either on the pre-printed form Department of Agriculture and veterinarians, the Department performing this function must be developed by the National Markets. Although an LVT working of Agriculture and Markets has actingAVMA_PLIT_print_ad_8.5x5.5 pursuant to the wBleeds_PRO.pdf direction 1 Association1/16/2015 10:35:52 of AM Public Health

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For a coverage comparison of your entire insurance portfolio to the PLIT Program, 6 call 800-228-PLITNew York S tate(7548) V eterinaryor visit avmaplit.com Medical Society under the supervision of the Medicine, direct supervision veterinarian will sometimes sign requires the veterinarian to be on the veterinarian’s name with the same premises as the person their own initials (indicating under supervision. That means that the veterinarian’s name the LVT may not give a rabies was signed by another person), vaccination unless the licensed this practice is not endorsed by veterinarian supervising the the Department of Agriculture vaccination is on the premises at and Markets, and they may the time the vaccination is given. require the veterinarian to testify This rule for rabies vaccinations under oath to the accuracy applies if the vaccination is given of the information on the in a private practice setting, rabies vaccination certificate during a county-sponsored rabies if it is signed by an LVT. clinic, or to animals in a shelter or The Department of Agriculture humane society. At one time the and Markets, the Department Department of Agriculture and of Health (which has jurisdiction Markets and the Department over rabies clinics) and the of Health considered whether Education Department have the rules for rabies clinics or for now agreed that for the shelters should be different, but veterinarian’s certification to be ultimately decided that this one validly given when an LVT, not rule must apply in all settings. the veterinarian, is the one giving Member Question: the vaccination, the veterinarian A compounding pharmacy has can provide us with medications AVMA tried, in 2013, for must exercise direct supervision reached out to us and claims for office use. Is this true? Congressional approval of over the LVT. As defined by the that because they hold a DEA a limited exception to the Practice Guidelines adopted NYSVMS Legal Counsel: Manufacturer License they compounding rules that by the Board for Veterinary New York State has not enacted would apply to veterinarians any state law or regulation that only, but that item was taken permits practitioners/prescribers out of a bill on compounding to order compounded drugs for before it was brought up for office use. Absent any state law, a vote. Absent any change in federal law applies. Federal law the federal law, NYSVMS has and DEA regulations only permit looked at the possibility of practitioners/prescribers to order changing New York State law compounded drugs for a specific to allow for ordering and use of patient, for a specific use, over compounded medications “for a very limited time period. office use” by veterinarians. While it may not seem, from a NYSVMS has been discussing practitioner standpoint, that there with the NYS Education should be a difference between Department, which regulates the ordering of a general-purpose medicine, veterinary medicine drug and one compounded for You Should See and pharmacy, the possibility a specific purpose, they are of providing a limited exception treated differently under the law. that would allow veterinarians This New Website There is more enforcement of the to purchase and keep “for rules that apply specifically to office use” small amounts Introducing: www.veterinaryfinancialadvisors.com compounded medications since of compounded drugs. The Designed specifically for veterinary practices, our new website is the problems with the human Executive Secretary of the Board steroid drug compounded by filled with reference material and veterinary-specific financial insight. for Pharmacy has said that state the New England Compounding law must be changed to allow for Take a look today and see why Burzenski & Company Center (Framingham, Mass.) in such an exception; it cannot be has become an expert in providing accounting and financial services 2012 that was contaminated done by regulation or guidelines, to the veterinary industry. and resulted in fungal meningitis and NYSVMS is pursuing and death in many patients. this change in the law. This is not the only incidence • of problems with compounded Barbara Ahern, Esq., Gary I. Glassman, CPA medications, but its severity NYSVMS Legal Counsel [email protected] has resulted in the enhanced ����������������������������� 203.468.8133 enforcement that we see today.

www.veterinaryfinancialadvisors.comNew York State Veterinary Medical Society 7

������������������������������� Practice Manager Preventive Maintenance for Your Accounts Receivable

anaging their animal. On top of that, sidestepped, ignored or you’ll tell You don’t forget those calls, do accounts the practice may have had a the client, “When you get to it… you? So what happens now… receivable, long-term relationship with just send me something, or my After months without getting for many, is the family. Potentially even for office will send you a statement.” paid, the office manager as exciting generations. So, the uneasiness Weeks go by, months can go probably will bring it to your Mas getting a root canal. On a of discussing costs starts to by and, yes, even years, and attention and want to know, daily basis, you wear many set in. Veterinarians who do no payment is received. At this “What should we do?” Your hats, and collections and farm visits understand the point there is no communication accountant may ask, “What billing is that last hat that you importance of maintaining the and what oftentimes makes is going on with your accounts want to wear. Especially if it herd for milk production. For it worse, is that the client receivable?” Does any of this has already been a long day. Equine Veterinarians with a high now has moved onto another sound remotely familiar to you? You’ll look for other priorities in profile client, know that this is veterinarian. How dare they, you I met with a veterinarian who most cases than dealing with the client’s livelihood in front ask? You are now out what is clients who owe you money… of them. You start to feel the wanted to expand his practice owed plus any ongoing revenue! but couldn’t because of what right? Let’s set the stage… pressure or they may pressure Now that emergency call that you for time. At this point for was on the books! Another You just met with the client, and you made during the middle of many, talking about the client’s was trying to remodel the perhaps helped them through the night on a holiday, just sits financial responsibility is now family cabin but couldn’t until a very difficult procedure with there and festers, doesn’t it? more funds were available. When Selling or Buying a Veterinary Practice

CALL ON TOTAL PRACTICE SOLUTIONS GROUP Veterinary Practice Sales & Appraisals Practice Sales Practice Valuations Associate Buy-Ins Buyer Representation Seller Representation Financial Assistance

Dr. Kurt Dr. Bill Dr. John Dr. George Liljeberg www.tpsgsales.com Crank Bryk Sikora

Kurt D. Liljeberg, DVM Bill Crank, DVM John Bryk, DVM George R. Sikora, DVM Western NY Representative Eastern NY Representative Eastern NY Representative Eastern NY Representative Toll Free: 800.380.6872 Toll Free: 877.487.7765 Toll Free: 877.487.7765 Toll Free: 877.487.7765 8E-mail: [email protected] E-mail: [email protected] E-mail: [email protected] York State VE-mail:eterinary [email protected] Medical Society Granted, most veterinarians in that you now are assuming do not go into practice just for that the office manager is the money. However, when doing a great job in managing you do not get paid for services this aspect of the business. In rendered, does it affect how most cases, this is the farthest you operate on a daily basis? thing from the truth. It’s not More importantly, does it affect that they don’t want to do a how you do business with your good job here. It’s because in good paying clients? Of course most cases, the office manager it does! This fact is openly or person assigned to it, is also overlooked in many cases. The wearing many hats. And the small percentage of clients who collection hat is the last hat do not pay or become very slow- they put on because of the pays are far outweighed by the reasons listed above. They’re vast majority who clients who do no different. Yes, the billing pay you on time. So why is there goes out monthly and maybe this aspect of your practice. The cannot, there are third party hesitancy when dealing with a someone might call the client discussion regarding someone’s vendors that can do it all day small portion of the practice? after 90 days on the books financial responsibility is simply every day for you.) It’s simply called… avoiding or realistically, when they get an extension of your bedside • Do you turn accounts over conflict! No one wants conflict. to it. So what is the proper manner. Preventative health for collections before the way to handle your A/R? care helps the animal. And a It is very important that you account reaches 120 day preventative maintenance know you are not alone in your Your approach should be no past due. Sixty to 90 days approach to receivables enables handling of your accounts different than how you already is ideal, why? Because the you to provide more health receivable, if you’re handling teach your clients every day client is now gone and you care service to everyone! It’s it as outlined above. It’s the when it comes to preventative have lost your leverage after a win-win situation. So the main reason most hire an health care for their animal. 90 days. If you’re afraid of bottom line is that it comes office manager to handle the As a profession, veterinarian alienating the client, wait down to a positive mindset. responsibility. The fallacy here lies do a good job of discussing until six months or more and I tell people that collections/ then turn the account over receivables doesn’t have to be for collections and you’ll really a four letter word. But when have a hornet’s nest on your you sit down and really think hands. Early intervention about, it is… being “FAIR.” If can take advantage of a you’re fair with your client at day softer approach to help you one then you can expect them maintain the relationship. to be fair with you, 60 to 90 Salvaging write offs didn’t days after service is rendered. work 20 years ago and will Veterinary Practice Sales & Appraisals So long as you have discussed not work in today’s economy. their financial responsibilities Don’t be afraid to outsource from day one. PLEASE BE FAIR! early. Contact us TODAY if you are: • Communication is king! Don’t Key Points be afraid to communicate to • Does my office use a client SELLING a practice your client on all levels. information form that also • BUYING a practice outlines my office policies for Tim Olesky, Division Vice every client to eliminate any President of TekCollect, MERGING multiple practices gray areas, including financial Incorporated. TekCollect responsibilities, payment provides comprehensive expectations? cash flow management, SEEKING an associate or collections and customer • Does my office send out retention solutions. partnership buy-in or buy-out monthly statements that TekCollect’s technologically also reinforce the office’s advanced approach payment terms? generates the highest For more information, call: • Does someone from my office recovery ratios in the call on accounts that are marketplace. For more 800-567-1264 more than 30 days past due information, visit on a regular basis? Meaning www.tekcollect.com. Nate Lynch is a Certified Valuation Analyst. during the day, evenings and Or contact by phone at on weekends. (If they or you (518) 761-0028 © 2015

Newwww.natelynch.com York State Veterinary Medical Society 9 Case Study

IndustrLargey Extremity Tumors Resulting In Difficult Closure

ot only are large VSRC for a large (12.7 x 9.2 x 7.2 the elbow joint. The remainder Pre-surgical planning for wound tumors involving cm), ulcerated mass located of her physical exam was normal closure involved either a full- the extremities on her right forelimb at the and no co-morbidities were thickness mesh graft or axial difficult to excise, flexor surface of the elbow identified. Cytological exam pattern flap based on the the resulting joint (Figure 1). The mass had revealed large mononuclear cells thoracodorsal artery and vein. Nlarger skin defect poses a real been growing for over one year, with occasional small lymphocytes The affected limb and potential challenge to close. Familiarity and just prior to presentation, and rare non-degenerative donor sites were prepared for with various options and careful it began to ulcerate and neutrophils, consistent with surgery. The mass was excised surgical planning can make a big was causing lameness. mild chronic inflammation. along with a 2 cm wide peripheral margin of normal tissue and as difference between amputation Physical exam revealed a Surgery deep a margin as permissible. and limb preservation. large, hairless, broad-based Pre-anesthetic blood evaluation An isthmus of normal skin lesion, extending around the Patient Information and three-view thoracic (approximately 3 cm width) was limb, involving the cranial, “Zoe” is an 11-year-old, 23.6 kg, radiographs were normal. left along the medial surface, craniomedial and lateral margins female spayed English Springer Images of the right elbow did not which helps minimize lymphatic surfaces of the elbow joint. The Spaniel, who presented to reveal any osseous involvement. edema in the distal extremity. mass was limiting flexion of

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Located in the Hudson Valley, Joe Stephenson is the only dedicated veterinary broker actually in New York State. Backed by the most experienced and innovative appraisers and brokers in the country, Joe brings that expertise right to SIMMONS your doorstep! Veterinary Practice Sales and Appraisals Joe Stephenson Joe Stephenson, MA 41 Main Street #941 Associate Broker New Paltz, NY 12561 41 Main Street P. 845-943-4998 New Paltz, New York E. [email protected] 800-474-4775 845-943-4998 [email protected] www.simmonsinc.com 10 New York State Veterinary Medical Society The resulting skin defect was layer, absorbable bandage be mature enough to discontinue approximately 14 x 11 x 2 cm. material is also sterile. A splint bandaging after approximately is incorporated into the tertiary four to six weeks. Hair will A full-thickness mesh graft was layer because movement continue to grow from the graft’s chosen over a thoracodorsal of the graft interferes with follicles so always try to place based axial pattern flap because revascularization. The first the graft in alignment with the of utility, conformity, and ease bandage change takes place surrounding hair direction to of harvesting and application. 4-5 days after the procedure. maximize cosmetic appearance. A section of full thickness skin During this time the graft with dimensions slightly larger becomes viable through Summary than the skin defect at the two processes, plasmatic Full-thickness mesh grafts tumor site was harvested from imbibition and vascular offer much utility when closing the ipsilateral, lateral thoraco- inosculation. Plasmatic a large surgical defect on an abdominal region. The graft imbibition is the “drinking” extremity. They are versatile, was prepared by removing the of plasma, erythrocytes and robust, and, when managed underlying fat to the level of polymorphonuclear cells from correctly, can result in 90-100 the hair follicles. Multiple small the recipient bed via capillary percent “take” (Figure 4). staggered fenestrations parallel action. Vascular inosculation is to the lines of tension were made This tumor was histologically the budding and anastomosis in the graft. Meshing allows for characterized as a nerve sheath of vessels from the recipient drainage, which minimizes lifting tumor with a low mitotic index, bed into the graft. When of the graft off the recipient absent vascular invasion, and changing the bandage, the bed, helps with expansion, completely excised. Given its patient is usually sedated conformity, and adherence to biological behavior, there is and care is taken to prevent irregular surfaces. Small gauge a very low risk of metastasis dislodging the graft from the monofilament sutures (4-0/5- however recurrence is likely. recipient site. A healthy viable 0 nylon) are place around the graft should have a contused “Zoe” is no longer carrying a periphery of the graft (Figure 2). (port wine) appearance, due to 1.8 kg tumor burden, she has A few “anchoring” sutures can the absorption of hemoglobin normal range of motion in her also be placed at strategic points products and sluggish blood elbow joint, her lameness has (concave or convex surfaces) in flow in the graft. Unhealthy resolved, and she is enjoying all the middle of the graft. Care is grafts have a white or black of her normal summer activities taken to avoiding any tension appearance. If areas of the including swimming. across the graft surface and • graft have questionable at the graft-recipient skin Joseph C. Glennon, viability, they are left in place interface. After the graft is VMD, Diplomate ACVS until they further define anchored in place, the donor Surgeon, Veterinary themselves. The bandage site is closed primarily (Figure 3). Specialties Referral Center and splint are replaced, Aftercare again using sterile dressing, Adjunct Associate Professor of Surgery, Selling? Buying? Maintaining sterile technique, and it is changed in another Albany Medical College You only have one chance to the graft is covered with a four to five days. Sutures are get it right! sterile non-adherent pad removed in 10-14 days and Consultant, Rensselaer coated with a thin layer of the limb re-bandaged for an Polytechnic Institute Dept. antibiotic ointment. This primary additional 10-14 days. In most Biomedical Engineering cases, the granulation tissue layer helps retain moisture, Course Instructor, Kyon that grows into the graft promoting epithelialization Veterinary Surgical Products and preventing dehydration. fenestrations will be completely The secondary intermediate epithelialized and the graft will Figure 1: Large ulcerated neoplasia located at the flexor surface IMMONS of the right elbow joint. S Figure 2: Full-thickness mesh graft Veterinary Practice Sales and Appraisals Have an interesting case you would like to share? used to close a large skin defect. Joe Stephenson, MA Contact Stephanie Quirini at Figure 3: Several sutures are Associate Broker placed at strategic locations to 41 Main Street (800) 876-9867 or by email at [email protected]. anchor it to the recipient bed. New Paltz, New York Figure 4: Full-thickness mesh graft one month post-op. Hair is 800-474-4775 845-943-4998 starting to grow in the graft. [email protected] www.simmonsinc.com New York State Veterinary Medical Society 11 Feature

2015 Legislative Agenda A voice for the profession and for humane treatment of animals

elebrating its 125th the best interest of our members, tightening the FDA oversight of compounded medications for anniversary, the animals, animal owners and compounding pharmacies. their personal pets in order to society as a whole. Working have small supplies available mission of the Subsequently, compounding together with the Legislature for immediate use in clinical New York State pharmacies were unable to supply and New York State agencies, patients. Presently this is Veterinary Medical veterinarians with compounded our joint efforts ensure that the the only way available for CSociety has remained consistent medications for “office use;” highest quality of veterinary veterinarians to uphold the throughout its storied history: to compounding pharmacies were care will be available to New oath of veterinary medicine and protect, promote and advance required to compound York State consumers. not allow animals to suffer. the science and profession of medications for specific patients veterinary medicine in New York The need to have compounded Compounding only. This left a large void in State. The NYSVMS works to veterinarians’ ability to quickly medications available for ensure that New Yorkers have Medications treat animals with compounded immediate use is great in access to the highest caliber In October 2012, national medications, as a time lag is veterinary medicine, and NYSVMS veterinary care available in headlines reported a meningitis required before medications believes this is our number one the most cost effective way. outbreak that was traced back are compounded and sent to legislative priority for 2015. to contaminated compounded The NYSVMS is the acknowledged the patient. Unfortunately, this Position statement: NYSVMS injectable medication made by and respected voice for the system ensures that animals will draft legislation allowing a “compounding pharmacy” profession, concerned with will suffer before compounded compounded medications be located in Massachusetts. In upholding ethical and proper medications are available. available for “office use” in 2013, the federal government standards in the treatment of Furthermore, veterinarians a veterinary practice setting. all animals. The NYSVMS acts in passed H.R. 3204, the Drug Quality and Security Act, have resorted to prescribing

12 New York State Veterinary Medical Society Real-Time Reporting animals in order to expand the NYSED and the Board veterinarian may work with of Controlled the products and services for Veterinary Medicine to all animal species, NYSED they offer to the public. ensure this law is enforced. has been concerned that Substance practices limited to “single When these services are The law specifically provides Prescriptions species” are viewed by the limited to grooming, there that floating teeth on horses, Legislation was enacted in general public as “specialists” is no problem. However, a non-invasive procedure August 2013 mandating real- and NYSED has been holding when they start offering often performed safely by time reporting of controlled species-specific practices to vaccinations and other unlicensed individuals, is substances by prescribers and “specialist” standards where medications for animals, not considered part of the dispensers. Veterinarians are no standard ever existed. with no licensed veterinarian practice of animal dentistry. often both the prescriber and to examine the animal, However, more extensive Currently, there are 22 the filler of the prescription, make a qualified diagnosis, procedures, especially those AVMA-recognized veterinary which is especially true in and determine the best requiring sedation, must be specialty organizations emergency cases in rural areas treatment, they are engaging performed by veterinarians, comprising 40 distinct where no other source of the in the illegal practice of and NYSVMS is committed medical specialties, with pharmaceutical is available veterinary medicine. NYSVMS to seeing this requirement poultry as the only species- nights/weekends. Proponents is committed to working followed. Unlicensed specific credential. Board have concurred that veterinary with the Legislature and individuals, even those just certification only exists for 22 prescriptions are not a ready NYSED to enforce the floating equine teeth, cannot veterinary medical disciplines source of drugs for human laws on the practice of be permitted to use the term such as internal medicine, abuse, requiring real-time, veterinary medicine and “equine dentist” or “equine surgery, dermatology and daily tracking. The state’s shut down the ability for dentistry,” which misleads cardiology, to name a few. veterinarians are now faced these lay businesses to the horse-owning public. with burdensome reporting engage in illegal practice Since no national requirements, even if they do of the profession. Small animal groomers, credentialing entities not prescribe any regulated similarly, should not be exist to even award board It is also illegal practice for drugs during a reporting period. offering or performing dental certification in a single a licensed veterinarian to procedures on companion species, veterinarians Position statement: NYSVMS work for a non-veterinary animals unless they are cannot meet this new rule urges a veterinary exemption business and sell medications licensed veterinarians or imposed by NYSED. Further, for the requirements of or vaccinate animals veterinary technicians. veterinarians are denied online, real-time reporting without first examining NYSVMS will use all available the ability to name their of these substances as them and without keeping avenues to ensure that practice in a way that will an alternative to growing records on their medical dental procedures on inform the public about the numbers of veterinarians treatment, rules that apply companion animals are type of animals that will be simply not stocking these to the practice of veterinary performed only by licensed treated there. In addition, it substances for dispensing medicine in any setting. veterinary personnel, and places new graduates and in their hospitals, a result Illegal practice does not that groomers are not new practice owners at a that may leave an animal in provide any benefit to misleading the public by disadvantage when they pain until a regular pharmacy animals who may receive offering to perform dental enter a marketplace where opens in an area convenient medications they do not services on animals. hundreds of other practices to the animal’s owner. having species-specific need, or even medications Position statement: NYSVMS names were approved by Protecting Your that are wrong for them. The will continue to work with NYSED up until 2013. Profession—Curbing illegal practice of veterinary the New York State Education medicine is a threat to the Department to enforce the The NYSVMS is working with Unlicensed Practice veterinary profession, and The NYSVMS commits to new law restricting the the NYSED to develop a NYSVMS strongly supports practice of animal dentistry policy on naming veterinary working with the Legislature, all measures that will allow Board for Veterinary Medicine to licensed veterinarians. practices to allow practices for increased enforcement to indicate, in the practice and New York State Education of unlicensed practice. • Naming Veterinary Practices Department (NYSED) to help name, whether they limit NYSED has a long-established promulgate and implement • Dentistry their veterinary care to a policy that any professional single species of animal, laws and/or regulations to In 2014, legislation was practice claiming to be a without claiming specialty address the following: enacted to amend the “specialty” must be owned or diplomat status. NYSVMS veterinary practice act and • Illegal veterinary practice by by a veterinarian who is urges NYSED to adopt clarify that the practice of non-veterinarians board-certified in that a policy that benefits dentistry on animals was part medical specialty. Last year, veterinary consumers and Some animal shelters, pet of the practice of veterinary NYSED extended this rule to a is not overly restrictive to stores and farm supply medicine. The NYSVMS practice name that is species- veterinary businesses. stores have begun offering commits to working with additional services for specific. While a licensed

New York State Veterinary Medical Society 13 Position statement: NYSVMS NYSVMS believes we must the cat from using its claws to the general public. This will continue to work undertake all reasonable efforts destructively or when its clawing disrupts the need for animal with the New York State to ensure that more animals presents an above normal owners to establish strong and Education Department to are professionally vaccinated health risk for its owner(s). viable relationships with local develop a more realistic against rabies. NYSVMS is Scientific data indicates cats who veterinarians for critical care at policy for the naming of committed to working with the possess destructive scratching all stages of their pet’s life. Legislature and Executive Office behavior are more likely to be veterinary practices. NYSVMS is concerned that these to develop a program that will euthanized, abandoned or services are provided in facilities better ensure universal licensure relinquished into the shelter Public Health failing to meet the minimum Rabies remains a significant of dogs, but will not sacrifice system. Despite the common standards for cleanliness and threat to humans and a major rabies control in this effort. argument that declawing can quality veterinary care. These public health expense. The cause behavior changes in cats, activities flourish largely without control of rabies in animals is Declawing of Cats numerous scientific studies regulation by any state agency an effective buffer to human Veterinarians take the issue of showed no increase in behavior at the same time that the exposure of this deadly disease. onychectomy (declawing) very changes post-procedure. State Education Department An important aspect of the seriously as it’s considered a NYSVMS position mirrors the enforces Standards of Practice rabies control program is current surgical procedure. They strive position of the American for New York State licensed law mandating veterinary to educate pet owners of all Veterinary Medical Association. veterinarians. We encourage control of the rabies vaccine and available alternatives prior Position statement: The the Legislature to mandate that rabies vaccinations. A number to discussing declawing. The NYSVMS strongly encourages any facility in which animals of proposals have been made NYSVMS strongly encourages client education prior to are treated for any medical allowing unlicensed individuals client education prior to consideration of declawing, condition meet the standards to administer rabies vaccines in a consideration of declawing, and believes the decision of care recently imposed by variety of special circumstances. and believes the decision should be made by the the NYSED. An animal does not should be made by the We have seen rabies vaccine owners in consultation with know the corporate structure owners in consultation with clinics conducted in tractor their veterinarian. Medical of its caregiver, but all animals their veterinarian. Medical supply store parking lots and decisions should be left to are entitled to the minimum decisions should be left to retail drugstores in a number of the sound discretion of fully standards mandated by NYSED. the sound discretion of fully states. It is circumstances like trained, licensed and state trained, licensed and state As we work to ensure that these that pose a significant supervised professionals supervised professionals veterinary facilities maintain public health threat. operating within appropriate operating within appropriate pace with the technology of a standards of practice. Position statement: NYSVMS standards of practice. new era, and the state works joins the New York State to ensure better treatment It is the veterinarian’s obligation Department of Health, the Highest Quality of animals in pet shops and to consult with cat owners New York State Department Care for Animals breeding facilities, it is time regarding normal scratching of Agriculture and Markets, An increasing number of not- behavior of cats, the surgical the National Association for-profit entities, originally procedure itself, and potential of State Public Health formed to provide services to risks to the patient. Declawing Veterinarians, and virtually abandoned and neglected of domestic cats should be all experts in the field of animals, are expanding their considered only after attempts public health in affirming scope of services and illegally have been made to prevent that proposals to allow offering veterinary services a non-veterinarian to administer rabies vaccine are poorly reasoned and represent a serious threat to New York State’s efforts to control the spread of rabies.

14 New York State Veterinary Medical Society that we provide a reasonable lack of trained personnel Today in New York State, we on lay corporate practice measure of oversight to protect or other similar reasons. face lay corporate intrusion into were allowed to lapse. The the animals in not-for-profit veterinary practice. Although NYSVMS adds the voice of the Position Statement: shelters and animal rescue practice acquisition by lay veterinarian to this issue. NYSVMS is making universal facilities. It is time to end the corporations is not permitted microchipping of companion horror stories of death, disease under New York State law, animals a priority in their Animal Guardianship and mass euthanization at these various shell “management One of the cornerstones of practice. The NYSVMS facilities by imposing minimum contracts” have served to shield veterinary medicine is the high would like to see shelter standards for their operation. these transactions from the standard of practice provided by animals reunited with their enforcement of our current laws. veterinarians. This is evidenced Only after New York State owners, and this technology NYSVMS is concerned about by the relatively low incidence establishes animal care is the best method to this trend, as it establishes a of disciplinary charges filed standards that can be legally achieve that goal. NYSVMS separate category of veterinary against licensed veterinarians enforced by localities will urges the enactment practitioner (the lay corporation) by the State Education senseless animal death, disease of legislation requiring that may not possess any Department. With the relatively and mass euthanasia at these municipal shelters to scan veterinary knowledge, and is modest income enjoyed by the facilities cease occurring. all animals they accept effectively removed from the state’s licensed veterinarians, for microchips and make Position statement: While oversight and control of NYSED. affordable veterinary care efforts to reunite these not-for-profit facilities Ultimately, in these cases, an remains universally available animals with their owners. maintain they provide a important layer of protection is to New York consumers. public service, there is no lost to the consumer. In all cases, Position statement: This effective oversight of their Corporate Practice New York State law currently the ultimate treatment plan longstanding balance is activities and consequently restricts the practice of is the sole responsibility of the being challenged by those little public protection. veterinary medicine (and many licensed veterinarian treating who seek to be appointed Consistent with this other professions) to licensed each animal, rather than non- the “legal guardian” of a commitment, NYSVMS urges veterinarians, professional veterinary business managers. companion animal, whether the Legislature to provide service corporations and The vertical integration of owned by themselves or a reasonable measure of professional limited liability laboratory services, pet foods, others, for the purpose oversight to the growing companies. This system assures supplies and ancillary care under of bringing suit against number of not-for-profit that professional liability the same corporate umbrella anyone who has, in their shelters and animal rescue accrues to the individual license exposes the public to marketing opinion, caused distress facilities. These facilities holder. The public interest is practices that might be seen to the animal. We disagree begin with the highest best served when individual as unprofessional conduct with animal advocates goals and intentions practitioners are responsible if conducted by individual who believe appointment but, as news accounts for veterinary decision-making practitioners. There is now no of animal guardians would increasingly demonstrate, and thus subject to license mechanism for state oversight improve the treatment of often fail to meet their suspension or revocation for for practices conducted and animals. Proposals allowing lofty goals whether due to improper veterinary treatment. controlled by lay corporations. for the appointment of lack of sufficient funds, third party guardians for Position statement: We animals, with its potential believe the risks to the of costly court-ordered public will increase if this punitive damage awards, consolidation of practice should be defeated. continues. The New York State Board of Regents has While the state’s veterinary voiced their concerns about practitioners have long been the erosion of state control at the vanguard of initiatives that would occur if the ban that protect the health and well being of the state’s companion and production animals, they view such initiatives with skepticism. The long-accepted and traditional

New York State Veterinary Medical Society 15 treatments, or long-accepted report it is often the final means pass a federal mandate requiring who reasonably, and in good animal husbandry practices, of preventing the euthanization veterinarians to provide a written faith, reports suspected may be found by a third party or surrender of a dog that has copy of every prescription for cases of food production to be offensive. As a result, a resisted behavioral modification. a companion animal, whether animal abuse to the proper person may seek appointment The AVMA has undertaken a or not the client needs or even authorities. The current as the guardian of the animal review of the medical, social and wants it. This will place undue law does not apply to these to seek monetary damages humane aspects of this issue and regulatory and administrative animals even though they from the animal’s owner, has modified its formal position burdens on veterinarians are also subject to injury veterinarian or other third party. as the national leader on and small businesses. through abuse, neglect and cruel treatment. It’s not inconceivable that such veterinary issues. Both the AVMA Position statement: The accepted practices as declawing and NYSVMS discourage the AVMA and NYSVMS oppose Funding for cats, ear cropping of certain practice except when medically this legislation at the breeds of dogs, neutering, necessary and as a last resort for Federal level, and NYSVMS Licensure Boards euthanasia, raising animals animals in cases where numerous is committed to working In recent years, NYSVMS has for food production and even prior attempts at socialization alongside the AVMA to joined other licensed professions dog training could be found to have failed, and the likely fight this legislation. to urge the Legislature and constitute the level of animal alternative is surrender of the Executive Office to increase cruelty that would allow for the animal, and likely euthanization Liability for funding for the Office of appointment of such a guardian. in cases where an animal’s owner Reporting Abuse the Professions through a surcharge on license fees. literally must decide between a As in virtually every other Implementation of the concept This was designed to ensure beloved animal and keeping an segment of society, NYSVMS of “guardianship” could also that the State Boards had apartment or co-op. The NYSVMS and its members are sensitive affect the way in which the sufficient resources to fulfill also opposes regular kennel to liability issues. The small state’s SPCAs and animal their mission. Recently, these devocalizations as unnecessary. number of professional liability control officers deal with funds have been re-directed claims brought against its injured, dangerous or otherwise Position statement: NYSVMS to unrelated purposes and not practitioners demonstrates unadoptable animals, if faced urges the Legislature to made available to Board staff the profession’s long history of with potential litigation from work carefully to balance to perform their duties. We urge providing quality veterinary care. the animal’s guardian. the interests of these the State Education Department animals with the urge to NYSVMS strongly encourages Animal owners in New York State to ensure that the funds made ban this procedure. Medical the Legislature and Executive have long known that both the available to the Boards are decisions should be left to Office to continue progress professionalism exhibited by the available for the purpose of the sound discretion of fully made regarding the disclosure state’s veterinarians, and the serving licensed professionals. trained, licensed and state of treatment records under regulatory oversight of the Board supervised professionals certain limited circumstances. Throughout its history, NYSVMS for Veterinary Medicine, have operating within appropriate has demonstrated it will act been sufficient incentives for A 2003 Law provides for limited standards of practice. as necessary to ensure the outstanding care for the state’s immunity from liability for a NYSVMS believes that this health of the animal population companion and production veterinarian who reasonably, and decision should be made on a of our state. It will zealously animals. Veterinarians should in good faith, reports suspected case-by-case basis and only protect and defend the proper be entitled to rely upon an cases of companion animal in appropriate cases at the scope of practice of veterinary adherence to the accepted abuse to proper authorities. In request of animal owners, medicine, while meeting its standards of practice within their addition to the obvious benefit following a full review of the professional mandate to scope of practice of veterinary derived by the animals subjected animal’s medical history. alleviate animal suffering. medicine to shield and protect to this abuse, there are greater them from such litigation. societal benefits as well. NYSVMS We thank you for your The Fairness to strongly supported enactment of support of our Legislative Devocalization Pet Owners Act this long-standing priority issue. Program during 2014 A number of proposals to ban (H.R. 4023/S.2756) As the number of well intended and look forward to a the devocalization of dogs have Veterinarians all wish to provide animal refuge facilities, found mutually successful 2015. been given consideration on our pets the best care and to have inhumane conditions, We stand ready to work the basis that such procedure is services possible. It is also clear continues to grow throughout in partnership with the defacto cruel to the dog involved. that financial decisions are the state, it is imperative that Legislature to achieve Upon surveying its members, necessary when contemplating licensed veterinarians have the our goals for humane NYSVMS has determined that those services and prescribing protections that will foster the treatment of animals devocalization appears to be a those medications to provide reporting of these conditions. and the advancement of veterinary medicine. very infrequent procedure, for some of that care. That is why Position statement: NYSVMS • which very few veterinarians flexibility to choose where pet encourages your careful References for all sides of the have experience. At the same owners fill their prescriptions is consideration of its proposal debate are available upon request time, veterinarians in urban an important option. However, to extend immunity from areas, particularly New York City, some in Congress are working to liability to a veterinarian

16 New York State Veterinary Medical Society Want to learn more? Association Visit Connections online. Behavioral Myths: What You Need to Know to be an Accurate Source of Information

n this age of technology, Fact or Fiction? there are countless FICTION: Puppies should stay Register now for NYS-VC Spring: forums where one can home until they have completed www.vet.cornell.edu/nysvc find discussions related their full vaccination series. to pet behavior. Much of In FACT, by the time a puppy sounds as part of their world. not really want their dogs to this freely available information receives her last vaccination, her I As this sensitive period ends, be afraid of them! Veterinary has not been vetted and it sensitive period for socialization puppies often exhibit more team members should be may not be scientifically sound. will probably have ended. What caution, which can transition prepared to offer clients viable Sometimes, misinformation can does that mean? Dogs are most into fear or even aggression. alternatives to risky procedures, be dangerous to the health of flexible and most able to easily and to explain the reasoning people and pets. It behooves accept novel stimuli between The biggest risk to a puppy’s for these recommendations. the veterinary team to be the the ages of four weeks and 14 life is not a communicable go-to source for scientifically weeks. During that time period, disease, but rather the Fact or fiction? sound information regarding puppies tend to accept new development of a behavior FICTION: Some breeds behavior. Let’s start by dispelling people, animals, sights and problem. Many undesirable are too stubborn or some popular misconceptions. behaviors can be prevented aggressive to respond to through early education of “treat based” training. people and their pups. In FACT, all animals deserve Of course, there must be some humane handling in all aspects safety guidelines associated of their lives including their with socializing young puppies. training. There are many reasons Puppies should visit locations that an individual animal may not where healthy puppies and dogs respond to a particular training FREE Borrower-Lender Matching Site visit. Before recommending a routine. The problem may lie in Best Rates Available puppy socialization class, be the animal’s ability to perceive sure that all puppies have had the presented cue. For instance, Over $210,000,000 both an initial vaccination and there may be a sensory or an examination by a veterinarian in loan requests processed! cognitive deficit. The animal may to assure that there are no be distressed or anxious, in which signs of illness. Better still, why case learning cannot occur. There not run your own classes?  Acquisitions may be a flaw in the manner of Fact or Fiction? training, with an inappropriate  Start Ups delivery of reinforcers, selection FICTION: Confrontational of reinforcers, or application of training techniques do no harm.  Construction cues. Instead of stubborn, think In FACT, confrontational training insufficiently motivated or easily  Refinancing techniques actually may distracted. Help clients find a contribute to the development trainer who is patient, creative of aggressive and fear-based and willing to think outside behaviors. While some correction the box rather than one that based maneuvers and gadgets encourages confrontations. may at first glance seem Keep in mind that when it glamorous and impressive, comes to training “aggressive punishment based training dogs:” most of our canine strategies are typically designed www.veterinaryloans.com patients exhibit aggressive 877.288.VETS (8387) to instill fear. Your clients do New York State Veterinary Medical Society 17 Dr. Lindell will be featured at NYS-VC Spring Conference on Friday morning, May 15. She there be so very many chew will cover a host of behavioral topics in the Licensed Veterinary Technician track. toys on the market? There 8–8:50 a.m. • History Taking for Behavior Patients is no suggestion that dogs indulge in these pleasurable 9–9:50 a.m. • Preventing Behavior Problems–Introduce Behavioral Well-Care to Everyday Practice activities in order to gain seek 10:20–11:10 a.m. • Behavioral Myths–What You Need to Know to status or dominance in their be an Accurate Source of Information for Your Clients relationships. Remember KISS! 11:20 a.m.–12:10 p.m. • Feline Housesoiling–Don’t Blame the Cat Fact or Fiction? For more information and to register for the conference, visit www.vet.cornell.edu/nysvc. FICTION: Pets that destroy things or urinate inside Bio when alone are spiteful. Ellen Lindell, VMD, DACVB, attended and graduated from Franklin & Marshall College in In FACT, pets that exhibit Lancaster, Pa. She then received her doctorate in veterinary medicine from the University of undesirable behaviors when they Pennsylvania School of Veterinary Medicine. After practicing general medicine and surgery are left alone, and exclusively for several years, Dr. Lindell began a residency program in veterinary behavior at Cornell when left alone, are usually University College of Veterinary Medicine. She successfully fulfilled the requirements for board- suffering from separation certification and is now a Diplomate of the American College of Veterinary Behaviorists. related distress. They are not Though most of her time is spent practicing behavioral medicine, Dr. Lindell loves to teach. spiteful but rather anxious and She serves as a behavior consultant on the Veterinary Information Network (VIN) and need help. They should never regularly lectures to veterinarians at both regional and national conferences. Dr. Lindell has be punished so please explain been an invited speaker at meetings of paraprofessionals, breeders and pet owners. to your clients that it is not appropriate to return home only In between practicing and lecturing, Dr. Lindell enjoys writing about behavior. For many to scold or worse, rub a pet’s years, she wrote a popular Q & A column in the Cornell University publication, Catwatch. She nose in the “mess”. Schedule a has written chapters for several veterinary textbooks as well as public interest books. behavior consult for them. Help your clients rebuild good feelings and repair that damaged bond.

behavior because they are It is a FACT that punishment Fact or Fiction? afraid. Training is about routinely increases fear. Many FICTION: Puppies communicating not dominating. dogs initially exhibit defensive are a clean slate. aggression when frightened, In FACT, it is FICTION that In FACT, a puppy’s behavior then learn to exhibit offensive aggressive dogs are trying is influenced by his genetic aggression to resolve conflict. to dominate their owners. makeup, his early environment, and yes, to a degree, his For years it was suggested Fact or Fiction? present environment. But that young dogs needed FICTION: Most behavior when problematic behaviors to be suppressed lest they problems are rooted in dogs develop, don’t blame the climb a proverbial ladder trying to be “dominant.” owner. Owners cannot be and try to dominate the In FACT, behaviors that are held entirely responsible for household. This way of thinking often considered problematic the behavior of their future contributed to the persistence are perfectly normal behaviors dog. The veterinary team can of confrontational training for dogs. Quite simply, dogs pull, offer appropriate preventative methods designed to squelch jump, and chew things because services and counseling to behaviors. Instead of being these behaviors produce their help each puppy live up to his humanely taught which own rewards. By pulling on the potential and his owner’s goals. appropriate behaviors to exhibit, leash, a dog can get somewhere dogs faced punishment for faster. Rather than waiting far Fact or Fiction? exhibiting normal but socially away on the floor to be petted, FICTION: Gentle handling unacceptable behaviors. a small dog will quickly learn and attention to behavior As behavioral science has that jumping up provides an takes too much time. advanced, it has become immediate pet. As for chewing In FACT an hour of prevention apparent that most dogs our possessions: Dogs explore may be worth a lifetime of cure. aggressively threaten their their environments with their Yes, it takes time to attend owners not because they are mouths, and apparently take to behavior and welfare. The trying to dominate but because pleasure in chewing. If that results are priceless. they are anxious or fearful. were not the case, would • Ellen Lindell, VMD, DACVB

18 New York State Veterinary Medical Society Want to learn more? Visit Connections online. Association Canine Lyme Disease: What are the hot topics in 2015 for the New York State Veterinarian?

yme disease, Ixodes non-contentious. Screening disease and other tick-borne 1. Positive results may results in ticks and its causative non-clinical dogs and cats for diseases based on the results excessive antibiotic usage by tick-borne agent infectious disease is common of their dog’s test. This will veterinarians who chose to Borrelia burgdorferi place in veterinary medicine also enable the veterinarian treat non-clinical dogs. (Bb) all are on the rise. as part of our preventative to educate the client in 2. In non-Lyme endemic areas LIn August 2013 the Center for medicine or wellness package general on human risk for the likelihood of a positive Disease Control increased their that we offer our clients and tick-borne disease. being false is increased estimate of the number of new is considered standard of 4. To identify emerging diseases and therefore the testing is human cases of Lyme disease care. Other examples include in the practice area and to inaccurate and unnecessary. from 30,000 to at least 300,000 heartworm disease, other assess the practice’s success annually, and there is no doubt tick-borne diseases and fecal These issues will be discussed at preventing tick-borne during our presentation but that Bb is the most common examinations. The reasons for disease and to enable pathogen we deal with in our screening every dog in Lyme are unlikely to present a huge changes in the practice debate since most Lyme experts canine patients in the U.S. at endemic or Lyme emerging protocols. For instance if large and specifically in New areas are as follows: including those on our panel are many positives are being seen in favor for screening non-clinical York State. These organisms are 1. To enable treatment of then the veterinarian might complex and they often present dogs for tick-borne diseases non-clinical dogs. want to assess the practices’ annually. The pros and cons of a challenge to the veterinary tick control usage and or a. The treatment of the usage of the common tests practitioner in terms of the best initiate vaccinations. way to prevent, diagnose and proteinuric but otherwise used today in New York State will treat these infections. Therefore apparently non-clinical 5. To allow the veterinarian be presented including in-house it is my absolute pleasure to dogs to try and catch and the client assess and reference lab C6 based present the current areas of Lyme nephritis early the success of their tick- testing (SNAP 4DX PLUS, and the controversy among Lyme experts is in consensus and borne disease prevention quantitative C6 test) by IDEXX in the Northeast as a preamble non-controversial. This strategy and to provide Laboratories, the multiplex test to the presentation we will make can only be achieved positive re-enforcement for run at the Cornell diagnostic at the New York State Spring via the screening the compliance of clients laboratory and the aquplex4 Veterinary Conference in May. of all apparently employing the strategy test run by Antech laboratories. The areas we will focus on at non-clinical dogs successfully. A. The treatment of that presentation, and that I b. The treatment of The reasons sometimes apparently non-clinical dogs will focus on in this piece pertain non-proteinuric non- presented for not screening This is a tremendously important to diagnosing Bb infection, the clinical dogs is not in every dog every year in a and commonly asked question utility in treating infected dogs consensus and will be practice are as follows: and one to which none of the that appear to be non-clinical discussed later in this for the disease, and should we review as well as during or should we not vaccinate dogs our panel discussion. for Lyme disease in Lyme endemic 2. To serve as a marker for tick areas as part of our tick-borne exposure, for failed tick disease prevention strategy. control, and for a higher Register now for NYS-VC Spring: Screening for Bb likelihood of other tick- infection. Should we borne disease serving as co- www.vet.cornell.edu/nysvc test, and with what? infections in the same dog. Compared to other issues 3. To enable the veterinarian surrounding canine Lyme disease to educate the client as to I believe that this one is relatively their family’s risk for Lyme

New York State Veterinary Medical Society 19 experts on the panel will have will represent a large portion a completely evidence-based of our presentation. answer to. This is because the 1. The major arguments in definitive study that would favor of the usage of Lyme involve taking a very large vaccines are as follows: number of Lyme positive dogs, There are currently four treating half and not treating extremely effective and reliable half and seeing which dogs had vaccines on the market that a higher chance of becoming have all gone through rigorous ill down the road has not been USDA approval. All have been done, for practical reasons. critically assessed for safety In lieu of definitive data there and efficacy, including many will be opinions expressed studies published in peer including different definitions reviewed journals. They are of our pledge to “do no harm.” safe and clean and nothing Lyme positive apparently non- like the first generation of clinical dogs will be broken Lyme vaccines that spurred up into two main groups. complaints of reactivity and 1. Proteinuric Lyme positive raised safety concerns. In fact dogs. In this case there is little given the recent correction in debate and the consensus the Centers for Disease Control is to treat aggressively, and Prevention (CDC) human long term with doxycycline Lyme data there is a race to and other components of market for new human vaccines standard care for proteinuria, in final trial stages that work while monitoring blood in an identical fashion to the work, blood pressure and canine vaccines. The canine proteinuria via urine protein vaccines are extremely safe, to creatinine ratios. and in conjunction with tick removal and tick control 2. Non-proteinuric Lyme positive prevent Borrelia burgdorferi dogs. A lively debate will infection, therefore clearly ensue regarding this group preventing clinical Lyme disease between the opinion that NEW! including Lyme nephritis. The these dogs should definitively anecdotal evidence for this fact It’s a soft chew. not be treated and the is overwhelming, but it has also Kills both fleas and ticks. opinion that some of these been shown prospectively in It’s prescription only. dogs at least may benefit multiple controlled studies in from treatment. The possible experimental infection and in value of the quantitative the field. These studies will be C6 assay will be presented presented demonstrating the regarding this group including benefit of a comprehensive supportive data from dogs Lyme disease prevention and people. These data package with in Lyme endemic show that the usage of the areas should include tick quantitative c6 in monitoring removal, tick control and therapy in people can be vaccination. No vaccines, tremendously valuable. Data though, are completely without correlating the quantitative risk. But when weighing the c6 concentrations with risks versus the benefits of Lyme circulating immune complexes vaccines the evidence strongly in dogs will be shown as well. supports the vaccination B. Should vaccination of Lyme positive and Lyme negative dogs in Lyme endemic be a part of the Lyme NexGardTM (afoxolaner) is the protection you areas as a part of the entire prevention package in asked for, and patients will beg for. Lyme endemic areas? package and the is NO evidence NexGard is FDA-approved to kill fleas, prevent flea infestations, and kill the for any unusual deleterious This is obviously another American dog tick. NexGard is available only with a veterinarian’s prescription, and effects of Lyme vaccination. features anti-diversion technology monitored by Pinkerton® Consulting & Investigations. highly debated issue which

IMPORTANT SAFETY INFORMATION: For use in dogs only. The most common adverse reaction is vomiting. Other adverse reactions ®FRONTLINE is a registered trademark, and TMNexGard and FRONTLINE VET LABS are trademarks, of Merial. reported are dry/flaky skin, diarrhea, lethargy, and anorexia. The ®PINKERTON is a registered trademark of Pinkerton Service Corporation. ©2014 Merial Limited, Duluth, GA. safe use of NexGard in pregnant, breeding, or lactating dogs has not 20 All rights reserved. NEX14TRADEADNew (01/14).York Statebeen V eterinaryevaluated. Use with caution Medical in dogs with a Shistoryociety of seizures.

xng218646_NYVMA-8.5x11_rsg.indd 1 2/24/14 12:28 PM 2. The major arguments against Join us at NYS-VC Spring and hear Drs. Meryl Littman, Richard Goldstein, Bettina Wagner, vaccination are as follows: and Mary Labato, leading experts and study group members of the JVIM consensus statement, talk on the diagnosis, treatment and prevention of canine Lyme disease. a. A perception of reactivity demonstrated in Lyme The Lyme Consensus Team Debate will be held Sunday, May 17, 8:30 – 10:20 a.m. vaccines in the literature For more information, and to register for the conference, visit www.vet.cornell.edu/nysvc. from the late 1990s and early 2000s. Speaker Bios b. A lack of efficacy when Lyme vaccines are Richard Goldstein, DVM, DACVIM (SAIM), DECVIM-CA used in the field and assessed alone and Dr. Goldstein graduated from the Koret School of Veterinary Medicine, The Hebrew University not part of the entire of Jerusalem, Israel in 1993. He completed an internship at the same institution. Thereafter, preventative package. he completed a residency in Small Animal Internal Medicine at the University of California, Davis, in 1998. After two years in private specialty practice in California, he joined the faculty c. A lack of proof that at Cornell University, College of Veterinary Medicine from 2001-2011 and served as associate vaccines actually prevent professor between 2006-2011. In November 2011 he joined The Animal Medical Center in Lyme nephritis since this New York City as the Chief of the Division of Medicine. He is board certified in Small Animal disorder is so rare and Internal Medicine by the American College of Veterinary Internal Medicine as well as the almost impossible to study. European College of Veterinary Internal Medicine—Companion Animals. Dr. Goldstein has According to those who hold earned numerous awards including the Norden Distinguished Teaching Award in 2004. this view, the concept of do no harm in this case dictates Mary Labato, DVM, DACVIM concentrating on tick control and Graduate of Tufts’ first veterinary class in 1983, Dr. Labato is a veterinary internist at the Foster not adding in the vaccine. Clinical Hospital for Small Animals. Specializing in all areas of internal medicine, with a primary interest signs are rare and easily treated, in disorders of the kidneys and bladder, she is also board certified by the American College of and although Lyme nephritis can Veterinary Internal Medicine. She attended Smith College in Northhampton, Mass. before be fatal it is very rare and may entering Tufts’ then-nascent veterinary school. She spent a short time in private practice not justify vaccinating millions of before returning to the school for a residency and, ultimately, a clinical faculty position. Dr. dogs in Lyme endemic areas. On Labato lectures in small animal medicine about the disorders of urination, as well as on the other side of the argument drugs that influence the kidneys and bladder such as high blood pressure medication and is the notion that once infected diuretics. She was a winner of the Cummings School’s Alumna of the Year award in 2001. with Lyme, always infected, so every possible effort needs to NEW! Meryl P. Littman, AB, VMD, DACVIM It’s a soft chew. be put in to prevention. And although Lyme nephritis is rare, Kills both fleas and ticks. Dr. Littman received her V.M.D. and Interned at the University of Pennsylvania. After several years it is completely preventable. If in private practice in Boston, she returned to Penn for Residency in Small Animal Internal Medicine It’s prescription only. the dogs never get infected and and has remained on their faculty since 1979. As an Associate Professor in the Clinician-Educator preventing that in every possible track, most of her time is spent seeing clinical cases and teaching. Her research interests include dog is completely worth it. • infectious diseases (especially tick-borne), renal and urologic diseases (especially protein-losing Richard E. Goldstein, nephropathy), hypertension, and the genetic diseases of soft-coated Wheaten Terriers (SCWT, DVM, Diplomate ACVIM including inflammatory bowel disease, protein-losing enteropathy/nephropathy, Addison’s and ECVIM-CA disease, and juvenile renal disease). Currently she is doing genome-wide-association studies for PLE/PLN with the SCWT DNA Bank and updating the SCWT Open Registry which lists almost The Animal Medical 1000 affected dogs. She was Chair of the ACVIM Lyme Consensus Statement in 2006. She served Center NY, NY as Chief of the Section of Medicine and Chair of the Intern Program at Penn for many years. References for all sides of the debate are available upon request Bettina Wagner, DVM Dr. Bettina Wagner, is an Associate Professor of Immunology and the Director of Serology/Immunology at the Animal Health Diagnostic Center (AHDC) at College of Veterinary Medicine, Cornell University. She earned her veterinary degree at the University of Veterinary Medicine in Hannover, Germany. She has about 20 years of research experience in equine immunology. Dr. Wagner’s research focuses on neonatal immunity with the goal to develop novel preventive strategies for allergic diseases and equine herpes virus type 1. Dr. Wagner developed the Lyme Multiplex Assay that is available NexGardTM (afoxolaner) is the protection you at the AHDC to aid with the diagnosis and treatment of Lyme disease in dogs and horses. asked for, and patients will beg for.

NexGard is FDA-approved to kill fleas, prevent flea infestations, and kill the American dog tick. NexGard is available only with a veterinarian’s prescription, and features anti-diversion technology monitored by Pinkerton® Consulting & Investigations.

IMPORTANT SAFETY INFORMATION: For use in dogs only. The most common adverse reaction is vomiting. Other adverse reactions ®FRONTLINE is a registered trademark, and TMNexGard and FRONTLINE VET LABS are trademarks, of Merial. reported are dry/flaky skin, diarrhea, lethargy, and anorexia. The ®PINKERTON is a registered trademark of Pinkerton Service Corporation. ©2014 Merial Limited, Duluth, GA. safe use of NexGard in pregnant, breeding, or lactating dogs has not All rights reserved. NEX14TRADEAD (01/14). been evaluated. Use with caution in dogs with a history of seizures. New York State Veterinary Medical Society 21

xng218646_NYVMA-8.5x11_rsg.indd 1 2/24/14 12:28 PM PURPLE PARTY Silent Auction & WineWall

NEW YORK STATE

VETERINARY CONFERENCE SPRING 15

MAY 15-17 • RYE BROOK, NY Fundraiser to Benefit Cornell Veterinary Student Scholarships and the NYSVMS Political Education Committee (V-PEC) Saturday, May 16, 2015, 5-7p.m. New York State Spring Veterinary Conference | Hilton Westchester, Rye Brook, NY

Funds raised during the Silent Auction benefit The Silent Auction will once again feature the NYSVMS legislative advocacy through the popular wine wall. Donate a bottle of wine valued Veterinary Political Education Committee and at more than $25 dollars to the Wine Wall. Attendees will purchase a ticket to receive a gift-wrapped the NYSVMS Scholarship, awarded annually to a surprise bottle. Nearly half the bottles won in veterinary student at Cornell. Established in 1994 2013–2014 were valued between $50 and $100! as a permanently-endowed scholarship, it provides Popular Donation Items Include: gift baskets, wine tuition assistance to New York State residents who and beer baskets, overnight stays, artwork, jewelry, are third or fourth-year students and show interest in sporting event tickets, electronics and historical organized veterinary medicine. veterinary objects.

Contact NYSVMS headquarters and let us know what YOU CAN DONATE!

I wish to donate an item to the Silent Auction _____ and/or Wine Wall _____

Donor Name: ______

Organization Name: ______

Mailing Address: ______City: ______State: _____ Zip: ______

Phone: ______Fax: ______Email: ______

How will you deliver item: Directly to conference Ship to NYSVMS Other ______

Describe the item you are donating (please be as descriptive as possible): ______

______

Approximate Retail Value: $______

Please fax this form to (518) 869-7868 or email the form to Dory Fisk, [email protected]

22 FORM DONATION NYSVMS, 100 Great Oaks Blvd., Suite 127, Albany, NY 12203 New York State Veterinary Medical Society PURPLE PARTY Classified ads Silent Auction Positions, For Sale and More …

& WineWall Veterinarian Wanted and surgery preferred; love of practice builder. 35 years of clinical call G.R. Sikora, DVM or J.P. Bryk, medicine and chocolate required! experience. Many references. DVM, B.R. Crank, DVM toll free Westchester/Rockland Located in lower Westchester at (877) 487-7765 or go to www. FT/PT veterinarian sought to join NEW YORK STATE County. Come play with us! Call Practice for Sale TotalPracticeSolutionsGroup.com progressive SA practice located 40 (914) 949-2190 or (914) 949-4684. NY 165. Great Western NY practice VETERINARY CONFERENCE NY-Long Island suburbs. Small SPRING 15 minutes north of NYC. Excellent in a charming, well-laid out facility. MAY 15-17 • RYE BROOK, NY animal practice, current owner opportunity for new graduate or Motivated seller means great Relief Veterinarians does integrative practice with for internship trained/experienced Available cash flow for new buyer! Grossing Fundraiser to Benefit veterinarian to take next step. conventional medicine and surgery Experienced SA relief veterinarian around 540K. Asking $568,350 Salary commensurate with ability, as well as eastern acupuncture available for Western, Central for practice and real estate. For experience. Submit cover letter/ and herbal medicine. Grossing Cornell Veterinary Student Scholarships and the and Southern NY. Practicing detail, see: http://simmonsinc. resume to Rick Germano, DVM, $450K. Call Bill at (419) 945-2408 quality medicine and soft tissue com/states/ny/. Contact Joe at [email protected]. Email [email protected] NYSVMS Political Education Committee (V-PEC) surgery. Compassionate with Stephenson from Simmons NY: (800) FT/PT SA veterinarian wanted. excellent client communication 474-4775, [email protected]. NY-Upper NY State, mixed animal practice with RE & 3 bedroom ranch AAHA accredited for over 40 years, skills and a familiarity with several NY 171. Putnam County practice for Saturday, May 16, 2015, 5-7p.m. house, grossing over $900,000 and VFAP accredited. Currently medical record systems. Contact: sale. One doctor. Grossing $508K. New York State Spring Veterinary Conference | Hilton Westchester, Rye Brook, NY have 5 DVMs, 5 LVTs and great Dr. Melissa Mandzak, (585) 402- Asking $750K for practice and PS Broker Inc. Onondaga County, support staff. Competitive salary, 4323 or [email protected]. real estate. For more details go to N.Y.: ER, 2,400sf w/3-exam rooms. CE allowance, medical/dental/vision Per-diem work & steady P/T in http://simmonsinc.com/states/ NY7. York County, Maine: 2,000sf insurance, 401K, membership dues, SA, +/-3.6 acres, w/apartment. Funds raised during the Silent Auction benefit The Silent Auction will once again feature the NYC and surrounding metro areas. ny/ or contact Joe Stephenson more. Email resume to Amerling@ ME5. Westmoreland County, Pa.: popular wine wall. Donate a bottle of wine valued Available most Mondays, Tuesdays, from Simmons New York at (800) NYSVMS legislative advocacy through the MillerClarkAnimalHospital.com. 4,300sf SA, +/-4.7 acres, w/rental at more than $25 dollars to the Wine Wall. Attendees Wednesdays, Thursdays, and 474-4775/[email protected]. Veterinary Political Education Committee and income. PA5. Orleans County, will purchase a ticket to receive a gift-wrapped Progressive SA clinic seeking a fun Fridays. Contact Dr. Tobias Jungreis Need help Selling, Buying, or the , awarded annually to a Vt.: 4,400sf, 1-1/2 doctor SA, +/-3 NYSVMS Scholarship and outgoing FT clinician to join (917) 378-8447 or (516) 295-1098. Appraising your Veterinary surprise bottle. Nearly half the bottles won in acres, w/apartment. VT3. (800) veterinary student at Cornell. Established in 1994 our staff. Experience in medicine Excellent people skills. Good practice? For a free consultation 2013–2014 were valued between $50 and $100! 636-4740 www.psbroker.com as a permanently-endowed scholarship, it provides • Popular Donation Items Include: gift baskets, wine tuition assistance to New York State residents who and beer baskets, overnight stays, artwork, jewelry, are third or fourth-year students and show interest in sporting event tickets, electronics and historical organized veterinary medicine. veterinary objects.

Contact NYSVMS headquarters and let us know what YOU CAN DONATE!

I wish to donate an item to the Silent Auction _____ and/or Wine Wall _____

Donor Name: ______

Organization Name: ______

Mailing Address: ______City: ______State: _____ Zip: ______

Phone: ______Fax: ______Email: ______

How will you deliver item: Directly to conference Ship to NYSVMS Other ______

Describe the item you are donating (please be as descriptive as possible): ______

______

Approximate Retail Value: $______

Please fax this form to (518) 869-7868 or email the form to Dory Fisk, [email protected]

DONATION FORM DONATION NYSVMS, 100 Great Oaks Blvd., Suite 127, Albany, NY 12203 New York State Veterinary Medical Society 23 Periodical

100 Great Oaks Blvd., Suite 127 Albany NY 12203

In Memoriam Colleague Who Will Be Missed the late George and Emily Coroner and as a Steuben County Commissioner of Agriculture Davidsen, he later moved to legislator and vice chairman. He and Markets for the State of Greenwich, N.Y., and graduated also chaired the Legislature’s New York, a position he held from high school there in 1953. Agriculture, Industry and until his retirement in 1999. Planning Committee, which He attended the New York Don was predeceased by his wife, designed and directed the State College of Agriculture Elizabeth Warner and his brother, construction of its new 10 million at Cornell University and Roger. In 2005, he married dollar county office building received the degree of Doctor Valarie Smith who survives. of which he was very proud. of Veterinary Medicine in 1959. In addition, Don is survived A street in front of the office After graduation, Don joined the by his brother George (Nancy) “Davidsen Way” bears his name. U.S. Air Force where he attained Davidsen; three children Karen He was elected to the Steuben the rank of Captain while serving (John) Polechetti, Kristine (Bruce) Dr. Donald R. County Hall of Fame in 2002. In in Alabama and Aviano, Italy. MacKellar, Richard (Loriann) 1986, Don was elected to the Davidsen ’59 After returning to the states in Davidsen; eight grandchildren, Dr. Donald R. Davidsen passed New York State Assembly. While 1964, he opened a large animal AJ, Christa, and Mia Polechetti, away unexpectedly at Rochester in the assembly he served as practice in Canisteo where he Daniel, James and Michael General Hospital on Saturday, the ranking minority member practiced until 1987. During this Dineen, and Matthew and Aleah Jan. 10, 2015, with his wife of both the Assembly Health time, Don served as a member Davidsen; as well as seven step- and children by his side. Born and Agriculture Committees. of the Canisteo Central School children; 11 step-grandchildren; in Flushing, N.Y., in 1936 to In 1995 Don was appointed Board, as a Steuben County and one step-great grandson. • 24 New York State Veterinary Medical Society