Богдан Маліцький/stock.adobe.com

 readers and happy Friday! We are officially less than a month away from our final conference of the year: Fetch Long Beach. From December 6-8, 2024, veterinary professionals, industry leaders, and the 

 team will head to Long Beach, California for a weekend full of learning, networking, and fun! There is still time to sign up, so register 

 today. If you cannot make it, you can follow along with all the highlights, covered sessions, and video interviews on the dedicated 

, formerly known as Proposed Initiative 145, which will introduce a new midlevel practitioner (MLP) position in veterinary medicine, despite multiple organizations speaking out against it. The new position will be master level trained and would be allowed to diagnose, treat, and perform surgery on veterinary patients. 

Andrea Pace, CVT, VTS (ECC), reviewed the importance of using Kirby’s Rule of 20, a list of 20 essential parameters that should be assessed every day in critically ill animals at your practice.

 continues to cover the 2024 New York Vet, we have compiled a list of all our current coverage in one article. From interviews with faculty, to covering sessions, you can find it all 

 and hosted by Adam Christman, DVM, MBA; Anne Chauvet, DVM, DACVIM, CHT-V shared with listeners her path to becoming a veterinary neurologist, and tips and tricks she learned along the way.

 that for the first time since 2015, it updated its Feline Heartworm Guidelines for veterinarians and addressed persistent undermanagement and underdiagnosis of heartworm diseases in cats.

Articles

Wrap up: Colorado voters approve midlevel practitioner proposal, and other veterinary news

is highlighting some notable practice managers. These outstanding professionals are working to promote the profession, provide service to their communities, and make a difference in the lives of patients and clients. Click on each headline to read more about them.

Celebrating our Veterinary Heroes: Practice manager Malik Mitchell

Malik Mitchell, center director for Heart + Paw Callowhill in Philadelphia, Pennsylvania, was inspired to pursue this career thanks to the wonderful leaders before him. In an interview with 

, he said he strives every day to become the practice managers they were and to continuously improve to be better for the staff, clients, and patients that walk through the doors of Heart + Paw.

In 2023, Mitchell was selected as the practice manager winner in 

’s third annual Veterinary Heroes recognition program. His nominator said Mitchell is also dedicated to making the hospital’s community a better place. “Malik is constantly looking for new ways to engage his neighborhood and the surrounding area,” the nominator wrote. “Seeing a desperate need for walk-in, nonemergency veterinary appointments in his hospital’s Philadelphia neighborhood, Malik partnered with his team to pioneer walk-in hours to provide the best care possible for as many pets as possible."

“Malik is also dedicated to being a role model within the community as we as an industry work to be more accessible to people of color.” The nominator added that Mitchell also fosters a positive work environment, ensuring that all team members feel “valued and heard and that their contributions are recognized.”

VMHA announces 2024 Practice Manager of the Year

The Veterinary Hospital Manager Association (VHMA) announced this past July that Joshua Blakemore, CVPM, RVT, FFCP, was named its 2024 Practice Manager of the Year (PMOY). Blakemore was selected as the award recipient for helping fellow technicians in Vermont overcome hurdles. According to a news release, the VHMA uses the PMOY to honor a practice manager who uses their experience, expertise, and knowledge to help make their practice a better place as well as improve business operations.

“[Blakemore’s] initiative in advocating for an apprenticeship program and licensure reciprocity in Vermont for technicians, assisting the local community during a natural disaster, and developing staff training programs for his hospital earned him this distinction above over 70 other nominations,” Christine Shupe, CAE, VHMA executive director, said in the release.

Each year the VHMA asks practice owners, collages, or veterinary management professionals themselves to nominate a professional they feel has made their practice a better place. The range of the transformation can be anywhere between financial, cultural, marketing, practice organization, and more.

The CVPM credential is awarded to 28 practice managers

More than 2 dozen veterinary management professionals earned the Certified Veterinary Practice Manager (CVPM) credential this past spring through the Veterinary Hospital Managers Association (VHMA). The CVPM credential is recognized and respected by practice leaders and others in the veterinary industry, according to the association

The association's voluntary CVPM credential is recognized as a sign of professional achievement and excellence and is awarded to those who demonstrate the knowledge and experience necessary to manage the ever-changing operations of today's veterinary practices successfully. Applicants are tested rigorously on relevant management knowledge in human resources, law and ethics, marketing, organization of the practice, and finance.

The CVPM exam is offered electronically across North America to registered candidates.

Before sitting for the exam, applicants meet practice management experience requirements and must demonstrate that they have earned sufficient formal education and continuing education credits.

These professionals are working to promote the profession, provide service to their communities, and make a difference in the lives of patients and clients

3 must-reads on outstanding practice managers

Officials with the FDA have approved the first generic florfenicol drug (Paqflor; Phibro Animal Health) for controlling mortality in certain species of freshwater-reared fish. This newly approved therapy contains the same active ingredient as the approved brand name drug product Aquaflor (Merck Animal Health), which was first approved on October 24, 2005, and contains no inactive ingredients that may significantly affect the bioavailability of florfenicol, according to the FDA.

Over the past several decades, the FDA has implemented policies to help ensure that medically important antimicrobials approved for use in animals, including fish, are used in a manner that is consistent with principles of antimicrobial stewardship, according to an agency news release. All medically important antimicrobials for animals require the oversight of a licensed veterinarian because the FDA believes that, given their specialized training and experience, veterinarians play a critical role in antimicrobial stewardship and can help reduce the risks of antimicrobial resistance.

As florfenicol products, both Paqflor and Aquaflor are classified as veterinary feed directive drugs and are only available by or on the order of a licensed veterinarian.

 Paqflor is marketed under the same conditions of approval as Aquaflor, and the labeling for Paqflor contains the same language dictating how it can be used.

Earlier this year, the FDA approved 2 new indications for Aquaflor. According to Merck, the supplemental approval increased the maximum daily dosage for freshwater-reared finfish—other than freshwater-reared warmwater finfish—for 10-15 mg/kg body weight and changed the conditions for use to allow florfenicol in recirculating aquaculture systems.

Those approvals allows for control of mortality caused by furunculosis associated with 

 in freshwater-reared salmonids and for control of mortality caused by coldwater disease associated with 

 at a maximum dose rate of 15 mg/kg. Additionally, the drug can be used for control of mortality caused by columnaris disease in all freshwater-reared finfish, including freshwater-reared salmonids.

“This new dose rate allows producers of trout and other freshwater-reared salmonids increased flexibility in managing these 3 important bacterial diseases,” Tim Kniffen, DVM, technical services manager, Merck Animal Health, said in a news release.

 “We are pleased to be able to continue to offer our customers solutions-focused products that meet the ever-changing needs of their businesses."

Environmental assessments prepared for Aquaflor found no significant environmental impacts were expected from the approved uses of the drug, according to the FDA. The federal agency established acute and chronic water quality benchmarks to protect freshwater aquatic life and included these on the labeling of Aquaflor for use by permitting authorities.

In determining approval for Paqflor, officials with the FDA also assessed the safety of edible products from fish treated with this generic drug. They determined that, when used according to the labeling, any residues of florfenicol that remain in the edible tissues of treated fish are at a concentration that meet the agency’s standard of reasonable certainty of no harm to people eating the fish.

FDA approves first generic florfenicol for controlling mortality in freshwater-reared fish. News release. FDA. November 14, 2024. Accessed November 14, 2024. 

https://www.fda.gov/animal-veterinary/cvm-updates/fda-approves-first-generic-florfenicol-controlling-mortality-freshwater-reared-fish?utm_medium=email&utm_source=govdelivery

FDA grants Merck Animal Health approval for 2 new Aquaflor indications. News release. Merck Animal Health. March 14, 2024. Accessed November 14, 2024. 

https://www.merck-animal-health-usa.com/newsroom/fda-grants-merck-animal-health-approval-for-two-new-aquaflor-indications

The Phibro Animal Health product is the first of its kind for controlling mortality in some aquatic species

FDA approves generic florfenicol drug for certain freshwater fish

Andrea Pace, CVT, VTS (ECC), discusses the importance of using Kirby’s Rule of 20

Insights on Kirby’s Rule of 20

Kirby’s Rule of 20 is a list of 20 essential parameters that should be assessed daily in all critically ill animals.

 In fact, many of these parameters should be evaluated multiple times a day.

 at the Fetch dvm360 Conference in Atlantic City, New Jersey, Andrea Pace, CVT, VTS (ECC), talked about her lecture on Kirby’s Rule of 20, explaining that although the rule is not widely used, it provides an excellent framework for ensuring comprehensive patient evaluations in hospital settings.

I am a huge advocate for reasonable and… informed triages. I feel like a lot of places, sometimes it gets a little bit thrown by the wayside and it's just like, ‘Oh, they're here, and let's look at them.’ So I wanted to make sure people are really taking a close look at our patients and making sure we're really assessing everything we can in a timely fashion, but also being aware of some of the limitations and urgencies that may exist in our triages. And Kirby's Rule of 20 is something I feel like is not used as much as it could be, but it's a great backdrop for making sure we are taking a look at all our patients and being able to focus on all of their issues in the hospital.

. February 6, 2013. Accessed November 14, 2024. 

https://www.dvm360.com/view/checklist-rule-20-pdf

Linklater A. Monitoring the critically ill small animal using the Rule of 20. Merck Veterinary Manual. November 2020. Accessed November 14, 2024. 

https://www.merckvetmanual.com/emergency-medicine-and-critical-care/monitoring-the-critically-ill-small-animal/monitoring-the-critically-ill-small-animal-using-the-rule-of-20

Videos

Last week, the New York Vet conference took place in New York City, New York, and gathered industry leaders and exhibitors to discuss advancements in veterinary medicine, emerging treatments, and new approaches to patient care. Attendees, and the dvm360 staff, were able to attend sessions and engage in clinical and business sessions, panel discussions, and more. In case you missed this year’s New York Vet conference, here is what dvm360 covered during the conference.

, Andrew Rosenberg, DVM, DACVD, shared the 4 distinct skin reaction patterns that can alert veterinary professionals of allergies in cats.

Zenrelia, a Janus kinases (JAK) inhibitor that recently received FDA approval, is taking the veterinary industry by storm. Rosenberg 

 to attendees what atopic dermatitis can look like in the clinic, explained exactly what JAK inhibitors are and how they work, plus reviewed the findings of a head-to-head study on Zenrelia and Apoquel.

Jörg M. Steiner, DrMedVet, PhD, DACVIM (SAIM), DECVIM-CA, AGAF, 

 with attendees during his lecture at the conference the pros and cons surrounding the multiple methods for diagnosing patients with dysbiosis well as the intestinal microbiome.

 with Rosenberg, he explains the unique challenges of diagnosing and treating allergies in cats, as their symptoms often present as mixed reaction patterns, and their selective eating complicates food trials.

During her lecture at the New York Vet Show, Ann Hohenhaus, DVM, DACVIM (Oncology, SAIM), took attendees into a 

 into the essential components of a diagnostic investigation of canine patients with canine mast cell tumors, including the use of fine-needle aspiration and diagnostic imaging methods.

Diagnosing skin disease in feline patients can be challenging, as cats often hide discomfort and may overgroom rather than scratch, leading to overlooked signs like hair loss from self-biting or licking. During his lecture, 

Unique Considerations in Feline Dermatologic Disease

, at the 2024 New York Vet Show, Rosenberg, outlined common skin reaction patterns in cats and provided diagnostic guidance for veterinary professionals.

, Rosenberg explains the effectiveness of JAK inhibitors like Apoquel and Zenrelia in treating allergy symptoms in animals. Although JAK inhibitors are valuable for symptom management, Rosenberg emphasizes allergy testing and immunotherapy as the best options for long-term management. He explained that he uses JAK inhibitors initially to control symptoms until immunotherapy takes effect and for managing occasional flare-ups.

Because veterinary technicians can play a crucial role in hospice care and the euthanasia process, it is important to use them to the best of their abilities. In her lecture during New York Vet, Jamie Rauscher, LVT, hospital manager of Animal Hospital of Towne Lake, and president of the National Association of Veterinary Technicians in America broke down a 

 professionals can use to implement effective hospice and a palliative care plan.

Check out all that dvm360 covered at this year’s conference

New York Vet conference 2024 recap

5 mm Pinfenon (S) tablets. (Photo courtesy of Scarecrow Incorporated)

Scarecrow Incorporated, a Tokyo-based company involved in the research, development, and distribution of supplements for animals, has received the world’s first patent for Pinfenon (S) —an animal supplement found to lower levels of atrial natriuretic peptide (ANP) in dogs.

 ANP is a biomarker for heart health, and high levels of it are associated with cardiac disorders such as mitral regurgitation, a type of heart valve disease frequently observed in small dog breeds, particularly in Japan. The hormone ANP is released by the heart in response to heart strain and is often elevated in dogs with heart conditions.

The patent for Pinfenon (S) was obtained following demonstration of its effectiveness in easing heart strain and lowering ANP levels. Before obtaining the patent for Pinfenon (S), a clinical trial was carried out in 27 dogs with mitral regurgitation across 15 hospitals in Japan. Pinfenon (S) was administered alongside the patients’ regular heart medication for 30 days. Blood tests were taken both at the start of the trial and after 30 days, and the dogs' difficulty with breathing was also monitored.

The study results revealed a notable reduction in ANP as a cardiac biomarker when compared to ANP levels before the 30-day administration of the supplement (

 Significant improvements in breathing difficulties were also noted.

According to the company, valvular heart diseases are the leading cause of death in elderly dogs. Additionally, almost 8 million dogs suffer from heart disease, accounting for 10% of all canines in the US, and as many as 75% of older dogs are affected by some form of heart disease.

“According to the guidelines by the American College of Veterinary Internal Medicine (ACVIM), mitral regurgitation is classified as stages A to D depending on the extent of progression with state A indicating mild disease and stage D indicating severe disease. While drug therapy is started at the diagnosis of stage B2 or C, most animals are subject to follow-up observation at an earlier stage. Many owners are concerned about the lack of treatment despite the diagnosis of a cardiac disorder, and as a result, many owners look for something they can do for their dogs,” wrote the organization in a statement.

“The Pinfenon series can be said to be a means to provide help in such situations. These products are able to be introduced from the early stage of the disease, such as stage A and stage B1, and we hope that the use of Pinfenon (S) from a young age will not only provide support for the dogs’ hearts but also help the dogs remain energetic throughout their lives,” they continued.

The primary component of Pinfenon (S) is an extract from the bark of the French maritime pine, a natural and water-soluble substance that is safe and has high physiological activity, according to Scarecrow Incorporated.

The supplement also contains fermented sesame extract, yeast extract, indigestible dextrin, cellulose, sucrose ester, and lactose.

World’s first patent acquired for animal supplement “Pinfenon” (S) (R). News release. Scarecrow Incorporated. November 12, 2024. Accessed November 14, 2024. 

https://prnmedia.prnewswire.com/news-releases/worlds-first-patent-acquired-for-animal-supplement-pinfenon-s-r-302301995.html

Heart disease in dogs. CVCA Cardiac Care for Pets. Accessed November 14, 2024. 

https://www.cvcavets.com/canine-heart-diseases/#:~:text=Nearly%208%20million%20dogs%20suffer,About%20Heart%20Diseases%20in%20Dogs

The role of the new supplement in providing support for canine cardiac disorder. Scarecrow Incorporated. Accessed November 14, 2024. 

https://cdn.kyodonewsprwire.jp/prwfile/release/M103184/202410238652/_prw_PA1fl_9I6EwxLq.pdf

What is Pinfenon? Scarecrow Corporation. Accessed November 14, 2024. 

https://pet-medical.info/en/pinfenon/index.html

Pinfenon (S) has been found to decrease levels of atrial natriuretic peptide in dogs, helping to reduce heart strain