The recommended duty hours for veterinary students completing their clinical rotations have been decreased in the Student American Veterinary Medical Association’s (SAVMA) “Duty Hour Guidelines.” The change comes as a recognition of the importance of students’ wellbeing.

The document changed its recommended duty hours for veterinary students from no more than 80 hours a week to a limit of 60 hours a week, including all on-call responsibilities, required class time, and any clinical work done at home. Previously, the guidelines suggested students not be on site for more than 24 consecutive hours at a time. The revised document now states continuous onsite duty should not surpass 16 hours.

“If continuous duty on-site spans a 24 hour period, a minimum consecutive fourteen hour break should be provided between duty shifts. Students may remain on duty for up to 6 additional hours (past 16 hours) to participate in didactic activities, transfer of patients, conduct outpatient clinics, and maintain continuity of medical and surgical care,” reads the newly revised guidelines.

First established in 2011, the Duty Hour Guidelines had been last updated in 2019. Its most recent revision was approved on June 23, 2024, by the SAVMA House of Delegates HOD, with the executive board also voting on the new guidelines on August 1, 2024.

 In conjunction with their vote, the SAVMA released a statement in which they spoke about burnout among the medical profession and highlighted related challenges veterinary students may face.

The Medscape Physician Lifestyle report, which contains insights from more than 13,000 physicians in the United States describing different aspects of their personal and professional lives indicated that physicians who work 71 hours or more are 21% more likely to experience burnout than those who work 31 to 40 hours weekly, according to the SAVMA statement.

 The SAVMA also cited a Merck study that revealed that most veterinarians experience low to medium levels of burnout, with exhaustion being the primary form.

“As early career individuals in similar teaching environments, veterinary students are not immune to these challenges... Many confounding factors have been reported by students to affect their wellbeing in the clinic, from the inability to consume a decent meal or properly take care of bodily functions, the lack of appropriate rest periods between shifts, the inability to follow through with mental health or other medical appointments due to fear of repercussions, wrote the SAVMA in their statement, citing a rotation stress questionnaire that revealed the primary source of stress for veterinary students are a heavy workload and long working hours.

Additional revisions to the guidelines include

Adequate time for rest being defined as 10 hours free of duty between scheduled duty time, including duties at home

Recommending that a minimum break of 30 minutes for meals should be provided within the 8-hour period when students work 8 consecutive hours of work

Stating that travel time for an externship should not exceed 10 hours per day, with time being allotted based on the distance of the externship from the student’s residence.

Including that it is the student's responsibility to track their duty hours and notify supervising faculty if the duty hour guidelines are surpassed.

In a memo, Megan Gulsby, SAVMA wellbeing officer, talked about how these amendments to the guidelines more effectively address student wellness in clinical training environments despite the varying needs and constraints of different veterinary schools. She stated that her goal with these amendments is to advocate for student needs, highlight the importance of assessing students' wellbeing, and initiate discussions with veterinary schools and the American Association of Veterinary Medical Colleges (AAVMC) about improving scheduling and clinical rotations, according to a news release.

SAVMA HOD updates duty hours guidelines. News release. American Veterinary Medical Association. August 5, 2024. Accessed August 5, 2024. 

https://www.avma.org/news/savma-hod-updates-duty-hours-guidelines

SAVMA Duty Hour Guidelines. Student American Veterinary Medical Association. Accessed August 5, 2024. 

https://www.avma.org/sites/default/files/2024-08/SAVMA-Duty-Hour-Guidelines-240624.pdf

SAVMA Statement on Veterinary Student Duty Hours. Student American Veterinary Medical Association. Accessed August 5, 2024. 

https://www.avma.org/sites/default/files/2024-08/SAVMA-Statement-on-Veterinary-Student-Duty-Hours-240624.pdf

Articles

The SAVMA updated its guidelines for clinical students, reducing the number of recommended rotation hours, increasing suggested breaks, and more

Clinical duty hour guidelines for veterinary students are revised in recognition of student wellness 

Craig A Clifford DVM, MS, DACVIM (Oncology) explains how general practitioners 

Interview with veterinary oncology Dr Craig Clifford

Phenotyping has proven to be a useful tool when it comes to canine lymphoma patients. During his upcoming lecture at Fetch Kansas City, Craig Clifford, DVM, MS, DACVIM (Oncology), explains the importance of phenotyping for suspected canine lymphoma patients, and how general practitioners can utilize this testing before they refer patients to a veterinary oncologist. 

Registration for our Fetch Kansas City conference is still open! Sign up 

 today to be able to hear more on phenotyping canine lymphoma from Clifford as well as attend sessions from our other amazing faculty. 

Craig A Clifford DVM, MS, DACVIM (Oncology): 

The vast majority of oncologists now will actually use a T cell (T) specific protocol or a B cell (B) specific protocol, and where that comes from was, for many years, we had our one size fits all. Protocol, B's did well, T's didn't, and it was the definition of insanity. We kept doing the same thing, hoping for a better outcome for T. And finally, over the course of time, we've learned that there are certain drugs that do better for T and certain drugs do better for B. So we go ahead and we do.

That brings up the other question is, like, how should we run the test, and who should do it. And to me, in my area in Pennsylvania, I have my primary cares run the test because it's something that they can do. It's not a specialist test, it's a veterinary test. For me, having that information at the consult already condenses down my console, so I can be very specific as to how the dog is going to do and what protocol we're using. So I actually encourage my primary cares in the area to be doing phenotyping within their practice, not having me do it.

Craig A Clifford DVM, MS, DACVIM (Oncology), gives an inside look into his upcoming Fetch Kansas City lecture on canine lymphoma

Phenotyping for canine lymphoma

Robin A Saar, RVT, VTS (Nutrition) discusses the GI barrier and how to rebuild it in an interview with dvm360 at the 2024 AVMA Convention.

Rebuilding the GI barrier

Robin A Saar, RVT, VTS (Nutrition) recently coauthored the 

textbook with Sarah Dodd, BVSc, MSc, PhD, DECVCN. A senior scientific communication technician, she also presented several continuing education sessions at the 

2024 American Veterinary Medical Association Convention

 and how it can be rebuilt. Methods include alternative therapies such as fecal microbiota transplant.

The following is a transcript of the video:

: So, if we're looking to try to rebuild our GI barrier, it really is important, of course, that we have good nutrition. We want to look at highly digestible nutrients. We want those nutrients to be a proper balance for that species, so if it's a carnivore or an omnivore. We want to make sure they're coming from the proper proportions, including for the life stage of that pet. We also can start thinking about alternative therapies. We call them alternative therapies, but they really are becoming now more common therapies that we know can help rebalance.

Fecal microbiota transplant, or FMT, is taking feces from a normal, healthy, functioning adult animal, and putting that into a same species animal that is having a dysfunction, [such as] a GI upset or disease. In other sense, the goal of that [therapy] is to put in normal, functioning bacteria and other microbes, and the chemicals or metabolites they make, to help rebuild that barrier back to normal. That will work by feeding the enterocytes, the colonocytes that are there… so that they can produce mucus and help rebuild that barrier.

Robin A Saar, RVT, VTS (Nutrition) discussed nutrients and fecal microbiota transplant in an interview at the 2024 AVMA Convention in Austin, Texas.

 has shown evidence of multidirectional mammalian interspecies transmission of the highly pathogenic avian influenza (H5N1). Specifically, the study revealed cattle-to-cat and cattle-to-raccoon transmission.

Investigators conducted a clinic epidemiological investigation across 9 farms in Texas, New Mexico, Kansas, and Ohio that reported morbidity events between February 11, 2024, and March 19, 2024. A diagnostic investigation was carried out on samples collected from the 9 farms, with investigators utilizing whole genome sequencing of characterized viral strains as well as modeling and epidemiological data. They concluded that cattle from the Ohio farm had been infected by cows in Texas after the Texas cattle were transported to the Ohio farm.

The study also revealed H5N1 was transmitted to other mammals including cats and a raccoon. Mortality events were also reported in great-tailed grackles and pigeons. Oropharyngeal swabs from great-tailed grackles and rock pigeons, along with lung and brain tissues from a cat found dead on one of the farms in Texas, tested positive for H5N1.

Moreover, a comparable epidemiological situation involving the deaths of both domestic and wild mammals was noted in 4 farms located in Ohio, New Mexico, and Texas. On the Ohio farm, 6 domestic cats died following the disease outbreak in the dairy cows. Additionally, cats found deceased on 2 farms, as well as a raccoon found dead on one of the farms in New Mexico, also tested positive for the virus.

“This is one of the first times that we are seeing evidence of efficient and sustained mammalian-to-mammalian transmission of highly pathogenic avian influenza H5N1,” Diego Diel, associate professor of virology in the Department of Population Medicine and Diagnostic Sciences and director of the virology laboratory at the Animal Health Diagnostic Center (AHDC) in the College of Veterinary Medicine at Cornell University in Ithaca, New York, and co-corresponding author of the study, said in a news release.

The cats and raccoon likely acquired the virus after consuming raw milk from infected cows, according to the study.

The investigators theorized that the wild birds became infected through environmental contamination or aerosols generated during milking or cleaning activities in the milking parlors, according to a release.

 However, the exact cause of this infection is unclear.

Additional viral sequence analysis gathered from 1 farm in Texas and 1 farm in Kansas—approximately 280 km apart from each other—indicate a connection and potential 2-way virus dispersal between these 2 farms. Further phylogenetic analysis including other H5N1 B3.13 sequences identified 2 additional H5N1 sequences from blackbirds that clustered with viral sequences from the 2 farms. Additionally, the blackbirds were collected 8 km to 12 km away from the farm in Texas. “Together these results suggest both 268 long- and close-range lateral spread and transmission of HPAIV between farms,” wrote the authors of the study.

Although whole genome sequencing of the virus did not show any mutations that would increase the transmissibility of H5N1 in humans, Diel addressed the underlying implications and concerns of the study’s recent findings. “The concern is that potential mutations could arise that could lead adaptation to mammals, spillover into humans and potential efficient transmission in humans in the future,” he said in a news release.

The study, funded by the Animal Health Diagnostic Center at Cornell University in New York, the Ohio Animal Disease and Diagnostic Laboratory, the Texas A&M Veterinary Medical Diagnostic Laboratory, and the United States Department of Agriculture,

 demonstrated a high tropism of the virus for the mammary gland, with high infectious viral loads present in the milk of affected animals. Still, milk supply remains safe, as pasteurization destroys the virus.

H5N1 infections have led to the deaths of more than 100 million domestic birds and thousands of wild birds in the country. Moreover, 11 human cases of avian influenza have been reported in the US to date, with the 

 case dating back to April 2022. Four cases were associated with cattle farms, while 7 were connected to poultry farms, including a recent 

 in Colorado. The recent patients were infected with the same strain identified in the study as being present in dairy cows. This prompts researchers to believe the virus likely came from dairy farms in the same county where the patients were located.

Recently, the US Centers for Disease Control and Prevention announced a $5 million initiative to provide seasonal flu vaccines to livestock workers. The announcement came amid concern that a new variant of H5N1 might develop in farm workers, who are at increased risk of contracting the virus, which could put the public health in jeopardy.

State-level public health officials will distribute seasonal flu vaccines to workers at local events and in areas where they frequently congregate, but it will not be mandatory, according to a news release.

“Preventing seasonal influenza in these workers, many of whom are also potentially exposed to H5N1 viruses, may also reduce the risk of new versions of the influenza A virus emerging,” said Nirav Shah, principal deputy director of the CDC, in a news release.

Caserta LC, Frye EA, Butt SL, et al. Spillover of highly pathogenic avian influenza H5N1 virus to dairy cattle. 

. Published online July 25, 2024. doi:10.1038/s41586-024-07849-4

Ramanujan K. Study confirms mamal-to-mammal avian flu spread. 

. July 24, 2024. Accessed August 1, 2024. https://news.cornell.edu/stories/2024/07/study-confirms-mammal-mammal-avian-flu-spread

Christensen J. To prevent supercharged flu virus, CDC pushes seasonal flu vaccines to farmworkers at risk of coinfection with bird flu. 

. July 30, 2024. Accessed August 1, 2024. https://www.cnn.com/2024/07/30/health/cdc-worry-new-virus-emerge-bird-flu-seasonal-flu-vaccines/index.html

Researchers found evidence that H5N1 can be transmitted from cows to other mammals, including cats and raccoons

New study finds cows can transmit avian flu to other mammals 

ELIAS Animal health, a clinical-stage firm specializing in pet cancer treatments, has announced plans to begin a new trial to investigate its adoptive T cell therapy—ELIAS Cancer Immunotherapy (ECI). The study will explore the effectiveness of ECI paired with a new adjuvant for preserving limbs in large-breed dogs with appendicular osteosarcoma. The study will be carried out by Jeffrey Bryan, PhD, DVM, and Megan Mickelson, DVM, at the University of Missouri (MU).

The Canine Osteosarcoma Limb-Sparing Clinical Trial (ECIP-OSA-01), which will receive a grant from the Morris Animal Foundation, will evaluate the safety and effectiveness of the combined treatment approach in dogs of large breeds who have received a new diagnosis of appendicular osteosarcoma and who have not received prior treatment for this cancer. The treatment will involve limb-sparing surgery to excise the primary tumor, followed by ECI immunotherapy in combination with the new adjuvant. Additionally, patients will be required to complete a 7-11 week treatment protocol at the MU Veterinary School of Medicine, in Columbia, Missouri, and return for regular follow-up appointments. Moreover, each patient will be monitored for a year following their diagnosis, according to ELIAS.

"For dogs with appendicular osteosarcoma, amputation of the affected limb followed by chemotherapy is the typical standard of care. However, in certain cases, amputation may not be appropriate," Noe Reyes, DVM, ELIAS chief medical officer, explained in a news release.

 "In this study, we're evaluating a new approach where the dog is treated with the limb-sparing surgery followed by ECI immunotherapy."

Eligible breeds encompass large to giant-sized dogs, including

Moreover, to be eligible, tumors must be located in the distal radius or mid-ulnar area, with no more than one-third of the radius affected. Patients must also be free of metastatic disease at diagnosis. Additionally, pet owners or caregivers must be able and willing to attend all treatment and follow-up appointments at the Veterinary Health Center at the MU.

"Personalized immunotherapy is the greatest advance in cancer in the 21st century," Bryan said in the release.

 "Successfully combining it with limb-sparing surgery would be a vertical step in osteosarcoma."

According to the company, ECI has shown encouraging results in prior studies on canine osteosarcoma. Earlier this year, the United States Department of Agriculture (USDA) Center for Veterinary Biologics concluded that data from the company's ECI-OSA-04 pivotal study, which assessed the combined safety and efficacy of ECI, showed a reasonable expectation of efficacy.

 The upcoming study seeks to investigate new treatment options that may offer options that could avoid amputation and improve the quality of life for dogs diagnosed with osteosarcoma, according to ELIAS.

ELIAS Animal Health to conduct limb-sparing canine osteosarcoma clinical study with grant from Morris Animal Foundation. News release. ELIAS Animal Health. July 31, 2024. Accessed August 1, 2024. 

https://prnmedia.prnewswire.com/news-releases/elias-animal-health-to-conduct-limb-sparing-canine-osteosarcoma-clinical-study-with-grant-from-morris-animal-foundation-302210521.html

Canine Osteosarcoma Limb-Sparing Clinical Trial (ECIP-OSA-01). ELIAS Animal Health. Accessed August 1, 2024. 

https://eliasanimalhealth.com/clinical-trials/canine-osteosarcoma-limb-sparing/

USDA agrees clinical trial data for the ELIAS Cancer Immunotherapy (ECI®) demonstrates reasonable expectation of efficacy for the treatment of bone cancer in dogs. News release. ELIAS Animal Health. January 17, 2024. Accessed August 1, 2024. 

https://eliasanimalhealth.com/press-releases/usda-agrees-eci-demonstrates-reasonable-expectation-efficacy-canine-cancer/

ELIAS Animal health will combine its adoptive T cell therapy with a new adjuvant in an upcoming study

Study on limb-sparing canine osteosarcoma treatment is underway

Happy Friday dvm360 readers! We hope everyone had an amazing week and are ready for a much-earned weekend. With the countdown to Fetch Kansas City continuing to dwindle down, registration remains open! You can 

 today to secure a spot among our amazing attendees and fantastic faculty for a weekend full of learning and fun. Learn from experts on topics ranging from large animal medicine to hospital design, and more!

As you register for Kansas City, here are this week’s article highlights:

 earlier this week that it has approved a 3-year expiration date expansion for Vetoquinol’s Clevor, a ropinirole ophthalmic solution, when it is stored within its original package.

 featuring veterinary and pet facilities opening across the United States is now available! This recent version including a veterinary dental clinic in New Jersey, a new CityVet location in Oklahoma, and the nation’s first dog hygiene and wellness franchise in South Carolina. 

 of The Vet Blast Podcast, Baran Schultz, owner of Schutlz Technology, shared some insights and innovations of technological advances in veterinary medicine and how they are keeping staff, patients, and clients safe and healthy.

Vicki J. Pollard, AIA, NCARB, CVT, AAA, an architect from Animal Arts, 

 in a recent article the essential components and design considerations for a well-functioning pack prep area in veterinary hospitals.

 with Jill Clark, DVM, Clark shares the differences between empathy and sympathy to help attendees in her lecture understand the place each of these feelings has in the clinic, and how it can help them connect with clients.

Dechra Limited announced that it purchased Akston Biosciences Corporation’s long-acting veterinary insulin program, giving the company ownership of the intellectual property and rights for the development, manufacturing, and worldwide commercialization of the canine and feline candidate therapies