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Bond Vet Offers New Mental Health Program for Veterinary Professionals "Paving the Path to Wellness"

Rowan University held a beam signing ceremony as construction of New Jersey’s first veterinary school reaches the halfway point

Shreiber School of Veterinary Medicine celebrates 50% completion

The Veterinary Cooperative announced a strategic alliance with Fear Free to promote low-stress veterinary care and mental health support for veterinary professionals

New partnership supports veterinary mental wellbeing 

Videos

Andrew Findlaytor, DVM, shares why clinics should use relief veterinarians

Integrating relief medicine into practices

Researchers made the discovery in tissue from 2 cats that had died in 2008, and say it provides new understanding of the disease

Study shows transfer of feline coronavirus between domestic, wild cats

PetVivo Holdings, Inc is partnering with Orthobiologic Innovations to organize clinical trials for its Spryng with OsteoCushion Technology

Two organizations partner to develop research on veterinary device for osteoarthitis

Learning more about the Veterinary Innovation Summit and Veterinary Innovation Council from Jennifer Wesler, DVM, DACVO

Insights on the Veterinary Innovation Summit 

Wrap up: Fetch Coastal is officially moving to National Harbor, and other news 

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Janine Malloy is a workflow expert with 25 years of experience in veterinary medicine and practice management, including general practice, specialty, emergency, university, and corporate environments. Fluent in multiple languages, she excels in understanding and responding to the evolving needs of veterinary businesses, identifying areas for improvement, and addressing inefficiencies. She is also a passionate advocate for veterinary work-life balance and a member of Not One More Vet, an organization dedicated to transforming veterinary practices for a brighter future.

Veterinary practices could be leaking revenue, adding up to significant losses. Technology can stop the leaks. 

Five silent revenue drains and ways to plug them 

Peter Weinstein, DVM, MBA, spoke alongside Kelley Detweiler, an expert on Drug Enforcement Administration (DEA) regulatory compliance, about best practices for maintaining controlled substance logbooks during a session at the Fetch dvm360 Conference in Kansas City, Missouri. In addition to general logbook compliance, the presentation covered how to handle and reconcile discrepancies, and the DEA’s position on hub loss and substance waste.

Weinstein and Detweiler began their presentation with a brief section about frequently asked questions (FAQs), addressing some common misconceptions. They explained that, according to Title 21 of the Code of Federal Regulations, logbooks are not required to be bound, but they must be maintained in a manner that does not allow any log sheets to be loose or falling out of order. They also must be secured in consistent chronological order for the current 2-year period, according to Detweiler. Logbooks should also be stored close to where DEA-compliant controlled substances are being used, they are not required to be locked up, and they should never leave the premises.

Perhaps the strongest point of emphasis throughout the pair’s discussion regarding DEA-compliant logbooks was the significance of the entries consistently balancing out to 0. The DEA does not want variances. Similarly, it is their recommendation to never leave blanks in logbooks. If a practice is documenting waste, rather than leaving a field blank as in indication that there was no waste, filling in a "0" as a record that there was no confirmed waste was advised.

“[DEA]-compliant logs should tell the story of the controlled substance usage from the point of acquisition to the point of administration, dispensing, or disposition,” Weinstein said during their session at the Fetch dvm360 conference. “Disposition could be wasting, and/or expiration.”

For more information, Weinstein and Detweiler debunked myths and misconceptions surrounding DEA regulation in a 

According to DEA regulations, a full inventory of all controlled substances must be conducted biennially at a minimum following the date when the initial DEA inventory was conducted. Though, Weinstein compares waiting until the last minute to complete biennial inventory to getting taxes together each year on April 14, knowing they are due on April 15.

The speakers discussed conducting controlled substance reconciliations on logbooks, which is the process of comparing the actual amount of physical inventory "on-hand" against the amount of inventory that should be on-hand according to the logbooks, Detweiler noted. They compared to a checkbook of every drug from a specific category. If a practice is not reconciling their controlled substance logs on a regular basis, there would be no way to identify discrepancies or to identify if their logs are consistent with their inventory. Weinstein recommended that reconciliation logs be conducted by an authorized user and a witness, preferably on camera for an extra layer of security.

“So, the more you do a reconciliation, the more likely you are to balance out,” Weinstein said. “Don’t you hate it at the end of the day, when you’re balancing out the drawer, and there’s a penny off? Well, how about if that penny is 1 cc of fentanyl… what do you do to resolve [that]?”

In their session, the pair also recommended that reconciliations be conducted, at minimum, weekly. Although the DEA does not set forth a specific frequency for conducting reconciliations, the more often you reconcile the better. Frequency should be determined based on the size of the practice and volume of controlled substance use. If it's a large practice with higher controlled substance usage, reconciliations should be conducted daily or, if possible, at the end of each shift. In general, the more controlled substances a practice uses, the more often they should reconcile.

Detweiler stressed the urgency of recognizing discrepancies. “Because remember, if something doesn’t jibe, you have 24 hours to make notification to the DEA,” she said. “And that registrant who’s holding the bag needs to know immediately, because it affects their entire license and livelihood.”

What is an acceptable amount of hub loss?

“So, the DEA recognizes that hub loss exists,” Detweiler said during the session. “However, they do not specify a certain amount of hub loss that is allowed, they do not provide how it should be calculated, and they will check how you are accounting for hub loss for things that do not balance out to 0 in your logs.” She explained that, with different substances, often depending on the viscosity, and with different needle gauges, hub loss will vary. Her advice for determining acceptable hub loss is to establish a consistent formula for calculating it. “The DEA wants to know that you’re not predetermining amounts, and that you have a formula,” she said.

She recommended multiplying the number of pokes by whatever amount was determined for hub loss on a specific container or bottle for liquid controlled substances. If the resulting number from your calculations is within 10% of where it’s supposed to be, in most cases that would be considered typical hub loss. Practices should always determine hub loss amounts according to a specific container, and should be prepared to explain those calculations to the DEA with a well-documented formula for how that calculations was determined.

“So, basically, [number of] pokes [multiplied by predetermined amount],” Detweiler clarified. “[If the result is] within 10%, over or under of where you should be, you’re most likely good. If it’s not within 10%, it should be investigated for potential significant loss.”

Concluding their presentation, Weinstein and Detweiler stressed the importance of documenting waste, even if that means writing “0.” Additionally, Detweiler encouraged the audience to add side comments, because there's no such thing as over-documenting. They also recommended including the date and initials next to any corrections or cross-outs so that everyone knows who to ask if they have questions. Some additional tips for success include:

Properly account for document, and don’t predetermine, hub loss

Ensure proper documentation of any discrepancies and make sure the DEA registrant receives a copy of it as soon as possible

“So, we know that this is not a lot of fun, but it’s really, very important,” Weinstein said, wrapping up the session. “It’s very important for you and your practice, it’s important for your team, it’s important for the profession, and it’s important for the community in which you work.”

Weinstein P., Detweiler K. Oh My Log! Championing Logbook Success. Presented at: Fetch dvm360 Conference; August 23-25, 2024; Kansas City, MO.

Record-keeping for DEA-compliant controlled substances was discussed in a session at the Fetch dvm360 Conference in Kansas City

Conference

Practice Management

Best practices for logbooks

Stokes Pharmacy and Bova Group (Bova) announced an exclusive partnership to offer a United States mad oral treatment for feline infectious peritonitis (FIP). The medication will treat the now once-fatal virus through a compounded preparation supported by Bova’s drug formula that has been used in clinical research studies globally.

“Made possible by our Bova partnership, Stokes Pharmacy will compound and sell the only oral formula identical to the Bova formula used in clinical studies across the globe. Our tablets were tested by Bova to meet their exact specifications. We are thrilled to bring this long-awaited treatment to the US and put FIP treatment back in the hands of the veterinarians," Michael Tursi, Stokes' president, in a news release.

 the drug formula created by Bova is used by Bova Aus and Bova UK, with exports to other countries with import permissions currently in place. There was previously no legal access to FIP oral treatment available in the US for veterinarians, according to the company. Because of this, pet owners have relied on options outside of a pharmacy or FDA-registered manufacturer to get treatment for their sick pets. Recognizing this gap in veterinary medicine, Bova vetted leaders within the industry to find the right partner to help bring their formula to the US market and created this partnership with Stokes Pharmacy.

“The introduction of FIP products to Australia and subsequently to the UK has led us on a transformative path. Collaborating with feline specialists around the world has propelled the progression of knowledge and comprehension of FIP. At Bova, we have been fortunate enough to support multiple clinical trials around the world on our unique formulation. This has helped give veterinarians confidence in using our formula and bringing the treatment of this fatal disease back under their control,” said Nick Bova, Bova’s managing director.

There are so many black-market options available out there and their quality is so varied. We wanted a partner who took quality and science as seriously as we do at Bova. Stokes Pharmacy is an impressive organization that prioritizes quality and science. Now, together, we can finally help save cats' lives across the USA who are impacted by this terrible disease," he continued.

“The FDA’s Center for Veterinary Medicine has alerted veterinarians that, while compounded GS-441524 is not legal, the agency does not intend to enforce new animal drug approval requirements for products compounded from GS-441524, when prescribed by a veterinarian for a specific cat patient for the treatment of Feline Infectious Peritonitis under the conditions listed in 

Guidance for Industry (GFI) #256 Compounding Animal Drugs from Bulk Drug Substances

. GS-441524 has been nominated by Stokes Pharmacy to be included on the list of animal drug bulk substances regarding GFI #256 office use and now has a place on the GFI under review list. Because of this, the compounded medication 50 mg tablets are eligible to be sold in hospitals for office sale in every state except Arkansas, Maine, Massachusetts, New Mexico, New York, Oregon, Rhode Island, and West Virginia. However, according to the release, veterinarians who work in a state that does not allow GS-441524 for office use can prescribe the drug in the name of the patient.

“The FDA is aware of social media posts suggesting that compounded GS-441524 will be “legally” available in the United States starting June 1. The agency reminds compounding pharmacies, veterinarians and pet owners that animal drugs compounded from bulk drug substances are unapproved drugs and are not, in fact, legal. However, in GFI #256, the FDA has described certain conditions where the agency does not intend to take enforcement actions for compounded products for use in animals,” FDA shared, in an organizational release.

Compounded GS-441524 is now available by veterinary prescription for veterinary offices and individual patients in permitted states.

US-made compounded oral treatment for feline infectious peritonitis now available. News release. Stokes Pharmacy. May 20, 2024. Accessed June 14, 2024.

FDA announces position on use of compounded GS-441524 to treat FIP. News release. May 10, 2024. Accessed June 14, 2024. 

https://www.fda.gov/animal-veterinary/cvm-updates/fda-announces-position-use-compounded-gs-441524-treat-fip#:~:text=The%20FDA%20is%20aware%20of,not%2C%20in%20fact%2C%20legal

The compounded treatment became available by veterinary prescription of individual patients in all states on June 1, 2024

Clinical

Compounded oral FIP treatment is now available 

Three veterinary hospitals have been named grand prize winners in dvm360’s 2024 Hospital Design 360 Competition. These newly built or recently renovated facilities were each named Hospital of the Year, in 3 structure size categories, and 7 more hospitals are receiving merit awards. All winners are being recognized for the quality and uniqueness of their layouts, décor, and amenities as well as spaces that serve staff, clients and patients well.

The 3 grand prize winners will be presented with their awards Sunday, August 25, 2024, with a celebratory luncheon during the 

, Missouri. Selected by a panel of judges, the 2024 Hospital of the Year honorees are as follows:

: Blue Cross Animal Clinic in Albuquerque, New Mexico

: Habitat Veterinary Hospital in Boise, Idaho

: The Vet Vision Center in Lambertville, New Jersey

“With the highest number of submissions this year, these 3 winners did a fantastic job showcasing their outstanding veterinary hospital designs, setting a new benchmark for excellence in our profession,” Adam Christman, DVM, MBA, chief veterinary officer for dvm360, said. “Their arduous work, dedication and passion for innovation are celebrated in each of these outstanding hospitals.”

The celebratory event in Kansas City will also feature a panel discussion with the winning practice owners, as well as an architect and design expert. These scheduled speakers include Christman; Ashlee Andrews, DVM, owner, Blue Cross Animal Clinic; Sohaila Maleki, chief visionary officer and founding partner, Habitat Veterinary Hospital; Reed Linenberger, DVM, chief financial officer and partner, Habitat Veterinary Hospital; Shelby Reinstein, DVM, MS, DACVO, owner and founder, The Vet Vision Center; and Becky Gasser, NCARB, director of design and partner, BDA Architecture, PC.

In an interview with dvm360, Maleki and Linenberger spoke about the significance of Habitat Veterinary Hospital’s being selected a grand prize winner. “It means a lot, actually, because we put so much thought and energy and all the things that we've learned through the years together to create this beautiful space. To be recognized for that is really, really special to us,” Maleki said.

“I think it also helps us in our grand vision… veterinary medicine is changing a lot, and we feel very appreciated that [dvm360 is] recognizing us as a smaller hospital,” Linenberger added.

Although the competition brings attention to the winning hospitals, Reinstein said the program also helps bring awareness to designers and the work they do for hospitals. “Veterinary medicine is coming into a new age, where it matters what your hospital looks like. It matters what it does. All of it matters,” she said.

In addition to the grand prize winners, the competition judges recognized the following Merit Award recipients:

Partners Animal Hospital West Loop in Chicago, Illinois

Red Barn Animal Hospital in Gilberts, Illinois

All Creatures Great and Small in Downers Grove, Illinois

dvm360’s John Hydrusko, vice president, sales, MJH Life Sciences, congratulated all of the competition winners in a statement. “We are honored to add these incredible clinics into our Hospital Design winner's circle. Creating a beautiful workspace for employees, the clients and pets they service is a true testament to exceptional veterinary care,” he said.

Abi Bautista-Alejandre, assistant editor, contributed to this article.

Grand prize winners were named Hospital of the Year in 3 size categories, and 7 additional facilities receive the Merit Award 

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dvm360 announces 2024 Hospital Design 360 Competition winners

Companion Animal End-of-Life Doulas (CADs) are professionally trained individuals meant to provide nonmedicinal, nonjudgmental emotional support and comfort to a dying animal and their caregivers. Ken Gorczyca, DVM, CHPV, CPEV, an in-home euthanasia practitioner in San Francisco, California, and veterinary facilitator for the University of Vermont (UVM) Companion Animal End-of-Life Doula Training Program, recently spoke at the 2024 American Veterinary Medical Association Convention in Austin, Texas, about the emerging role of CADs. He shared core principles, methods, and strategies for CADs, and how to integrate them into existing veterinary practices, citing real-life examples from current CADs.

“I really believe that many of us in the veterinary profession, especially end-of-life practitioners, already are playing the role of death doula,” Gorczyca said during his presentation.

 “I don’t think we knew that term.”

The practice can be traced back to Ancient Greece, where the word “doula” was used to describe women who assisted throughout pregnancy and childbirth.2 Doulas, not to be confused with obstetricians or midwives whom they often work alongside, are not medical professionals, but are meant to provide guidance and emotional support.

 Today, the term has extended to apply to those professionally trained to provide similar emotional support at the end of life. In recent years, they’ve become increasingly more common in the veterinary field, according to Gorczyca.

CADs accept that birth, death, and grief are natural and expected in life. Their goal is to serve the family, and the animal, as companions, focused on calming, soothing, comforting, and supporting, rather than trying to cure or treat the animal. Among other things, CADs can educate and empower clients in their decision making, support animal comfort and home safety, provide advice regarding care plans, make referrals to additional support services, aid in grieving, and even serve as a stand-in during euthanasia if the owner cannot, or does not want to, be present. In a nonmedicinal support role, CADs should respect the boundaries of veterinary medical professionals, refrain from engaging in clinical tasks, and avoid medical advice or influence.

“The veterinary community and the pet doula work actually do merge at the end of life,” Gorczyca said, regarding why veterinary practices should consider implementing CADs.

Ken Gorczyca, DVM, CHPV, CPEV, shared insight into the increase of death doulas in the veterinary field, at the 2024 AVMA Convention.

Janine Malloy

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