Industry veterans reflect on insights they would share with their younger selves

Transcription

1 January/February, 2014 Vol. 6, Issue 1 Promoting Excellence in Animal Health Sales Industry veterans reflect on insights they would share with their younger selves Inside: Making an Impact» p.8 Back to Basics Marketing» p.20 Alphabet Soup» p.68

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3 January/February 2014 Dental page 26»» Publisher s letter: Chris Kelly Wisdom...Pass it on»» Industry insights: Kirk Augustine Wisdom at Work»» distribution Making an Impact Henry Schein Animal Health s Mike Stone says DSRs are well-positioned to help their customers increase business in 2014»» Inside sales: Todd Brodersen Far Beyond February The dental conversation shouldn t be reserved to just one month out of the year»» Sales: Pat Malone The Engaged Clinic How to provide value to those involved in a clinic s decision-making process»» Sales: Brian Sullivan The Grinch Inside the mind of the negotiating buyer»» Sponsored Content Pet-Side Fructosamine testing: Essential for managing diabetic patients pg5 pg6 pg8 pg12 pg14 pg16 pg18»» Marketing: Pam Foster Back to Basics Marketing Help practices pass the top 5 marketing tests»» Finance: Fritz Wood, CPA, CFP What s Your Lever? Dissecting the veterinary business»» dental Dispelling Dental Myths Twelve basic steps for quality dental care How customers can skyrocket their feline dental practice Equipping the veterinary dental practice Digital Radiography: Today s Standard of Dental Care More veterinarians understand the need to deliver good dental care. But, are they following through with the right technology? pg20 pg22 pg26 pg28 pg30 pg32 pg36 Veterinary Advantage magazine (ISSN ) is published bi-monthly, PO Box , Marietta, GA Copyright 2014 All rights reserved. Subscriptions: $49.00 per year for individuals; issues are sent free of charge to dealer representatives. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Veterinary Advantage, PO Box , Marietta, GA Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors. Periodicals Postage Paid at Marietta, GA and at additional mailing offices. Veterinary advantage ««January/February

4 January/February Cover feature: Mark Thill Words of Wisdom Industry veterans reflect on insights they would share with their younger selves Dennis Cloud, DVM: The value of the team Dan Segna, DVM: Get involved Bud Dorris: Tools for success Rick Sain: Disciplined goal-setter Dave Manley: Rely on others»» Trends The Supplement Sale Laura Thill With a basic understanding of supplements, reps can engage their customers in the market. Taking Control of Flea and Tick Laura Thill Flea and tick prevention begins with education»» Equine Tools for Success Laura Thill Investing in the right tools has been key to growth for Tennessee Equine Hospital»» Sales meeting Biological Indicators Are your customers doing everything they can to prevent surgical infections?»» ALphabet Soup: Dawn Singleton-Olson Alphabet Soup Sorting out the veterinary industry s associations, boards, conferences, and more»» COMMUNITY REP SPOTLIGHT: Lead from the Front MWI s Bob Weinschenk reflects on the traits needed to succeed in the animal health industry»» ATS Time Savers Ten ways to increase effective time management 4 January/February 2014»» Veterinary advantage pg40 pg41 pg42 pg44 pg46 pg48 pg50 pg54 pg62 pg64 pg68 pg78 pg80»» News pg82 What s the Scoop pg84»» New product spotlight pg86»» Editor s note: Mark Thill Pearls of Wisdom pg90 Editor Mark Thill mthill@vet-advantage.com Managing Editor Graham Garrison ggarrison@vet-advantage.com Senior Editor Laura Thill lthill@vet-advantage.com Contributing Editor Jennifer Ryan jryan@vet-advantage.com Art Director Brent Cashman bcashman@vet-advantage.com Vice President of Sales & Marketing Rick Boggess rboggess@vet-advantage.com Senior Account Executive Kim Long klong@vet-advantage.com Account Executive Doreen Carpenter dcarpenter@vet-advantage.com Executive Vice President of Business Development Kirk A. Augustine kaugustine@vet-advantage.com Vice President Industry Relations Lorne Elder lelder@vet-advantage.com Sales & Marketing Coordinator Paige Kelly pkelly@vet-advantage.com Circulation Laura Gantert lgantert@vet-advantage.com President & Publisher Chris Kelly ckelly@vet-advantage.com Photography by Sarah Jean Condon Corporate Headquarters 3628 Blakeford Club Dr. Marietta, GA phone fax 2014 editorial board Kim Allen, Henry Schein Animal Health Scott Handler, DVM, Patterson Veterinary Jeannie Jeffery, Henry Schein Animal Health Jackie King, AVDA Karen Miller, Midwest Veterinary Supply Clay Cass, Merritt Veterinary Supplies John Ryan, MWI Veterinary Supply Michael Stone, Henry Schein Animal Health Mark Ziller, Animal Health International

5 Publisher s Letter ««Wisdom Pass it on I have been very blessed in my life with people who ve shared their expertise and experiences with me, both personally and professionally. Family, coaches, teachers, friends and colleagues have all been influential for different reasons. Early in my professional career, George Blowers a legend in the healthcare business was a mentor for our growing sales company, which represented healthcare manufacturers selling products through distribution. George suggested that since we had over 400 DSRs on the East Coast selling our products, we should publish a regular newsletter to keep them updated on our products, reimbursement and key selling points. Reluctantly, my business partner and I agreed, knowing it would be time-consuming. Three months later, we realized George s idea was a game changer. Our phones were ringing, sales were up, and we had effectively increased our presence with our key constituents in a unique and meaningful way. This newsletter would eventually morph into Repertoire Magazine, a must-read publication for DSRs in healthcare. It would ultimately lead me to launch Vet-Advantage as well. When we started five years ago, I remember being blown away by the quality of people who agreed to hear our story and provide guidance. There are three of them in this issue whom I would like to mention, the first being Mike Stone. A friend of mine at Henry Schein Medical recommended Mike as a resource when I told him I was considering a start-up in the animal health business in 2008, and Mike has been a great sounding board ever since. If you have ever met Mike s brother John, you ll quickly realize that knowledge and willingness to share is a family trait. Mike has been an editorial board member since our inception, and we re thrilled he finally agreed to an interview we could share with the industry. It begins on page 8. Todd Brodersen was another person recommended as a go-to guy in terms of animal health knowledge, and he s always been willing to share it as well. We quickly hit it off in our start-up phase, and Todd has been a regular contributor to Vet-Advantage ever since, concentrating primarily on inside sales. Todd s last column is in this issue, as he heads off into a new position which will have him traveling the globe. He has been an asset to the magazine and a good friend. We all wish him the best in his new position. Bob Weinschenk is another friend who has been very generous with his time and expertise. He is retiring (see page 78) and the industry will miss his passion, leadership and wonderful demeanor. When I was getting started in the business, Bob and I found out we lived very close to each other, and the local Starbucks became our early morning watering hole. The end result of those meetings made Vet-Advantage a better product, and I am thankful for that and Bob s friendship. Last, I would like to call attention to our cover story, Words of Wisdom. As you can tell, I believe there is no better gift than knowledge offered by people who have been there, done that, and I would like to recognize everyone who agreed to contribute to this story. whether you re paying it back or paying it forward, we are thankful for the gift. Chris Kelly When we started five years ago, I remember being blown away by the quality of people who agreed to hear our story and provide guidance. Veterinary advantage ««January/February

6 »» Industry Insights Wisdom at Work By Kirk Augustine Were you excited to chunk the 2013 calendar in favor of a fresh one for 2014? Do you have a promising direction or plan? Do you feel a bit wiser from the challenges learned over the last year? The Words of Wisdom article in this issue features successful distributor and veterinarian journeymen who strove to learn what it takes for success in this industry, and offer their insights to younger versions of themselves. So much of our success depends on our ability to turn our best and worst experiences into knowledge, and then apply it. The analytical tools we have today can be overwhelming for those who struggle to turn information into action through presenting facts, findings, or asking a dialogue-producing set of questions. The personal relationship remains critical to long-term business success, as each person interviewed in this article emphasizes. Companies are the platforms whereby people do business with people! Networking is still best done face-toface, as Dave Manley relates. Our industry pendulum seems to be swinging again; pivoting on age-old business issues surrounding the value of distribution, the true cost of servicing veterinary Companies are the platforms whereby people do business with people! product customers, and the expanding channel sources now made possible by the Internet business platforms. Too frequently, fear of loss continues to drive poor decision-making, whether that is from a DVM, DSR, manufacturer rep, or management. We must remain earnest in first remembering our business is animal health; the prevention, treatment, and optimization of the health of animals in homes or on production farms resulting in less risk to the animals and to human populations. Without this focus, the business marketing and sales models fail to produce revenues to satisfy customers, shareholders, stakeholders and employees. Balancing too-much with too-little remains a significant challenge. Such a statement first takes my mind to inventory management collaboration with customers. DSRs are well-positioned to routinely help establish minimums and maximums for SKUs (QOH; ROP; EOQ values) and advise practices to move inventory management to a team function, where 0 quantity on hand is not an acceptable reorder point (See Dr. Dennis Cloud s team comments in the Words of Wisdom article). The too-much with too-little paradigm is also relevant to the amount of time you spend with individual practices and the various decision makers within the practice. In previous columns I have exposed the challenges of the vet technician becoming more influential, which Bud Dorris also relates in this issue. This year will produce more expansion to product offerings and label indications in some of the major categories. It also promises an expansion in some solid, businessbuilding segments that deserve attention and targeting. The savvy DSR must work smarter and more strategically within each account to maintain success and grow a territory. Thank you for your support, feedback and ideas. Best wishes for a successful 2014! 6 January/February 2014»» Veterinary advantage

7 Smart Dispense Technology, Single Glove Delivery SINGLE GLOVE DELIVERY: Quick Dispensing No Tugging No Wasted Gloves Look for the seal on Sempermed Products. GLOVES ARE PACKED FLAT: Faster Donning Fewer Wrinkles No Clumping MORE GLOVES PER BOX: Greater Efficiencies Less Packaging Waste Less Storage Space Out-of-the-box thinking. Every. Single. Pull. If it matters to you, it matters to us. That s why we re taking extra steps in our packing process to improve your hand protection experience. Our new Smart Dispense Technology, Single Glove Delivery packaging assures efficient dispensing and easy donning, so you can quickly get to the job at hand. We are people protection. Try it for free. us at GloveInfo@SempermedUSA.com or call Learn more at SmartDispenseGloves.com Follow us on Twitter SempermedUSA.com/Blog Connect on LinkedIn th Street North Clearwater, Florida Phone: / Fax:

8 »» Distribution Making an Impact Henry Schein Animal Health s Mike Stone says DSRs are well-positioned to help their customers increase business in 2014 The flip side of challenge is opportunity. Veterinary practices and the sales reps who serve them will face plenty of both in 2014, says Mike Stone, vice president of sales, Henry Schein Animal Health. Among the challenges that veterinary practices will face: Staff turnover. Competition from big-box stores and online competitors. Demonstrating to clients the value of the practice s services. Getting everyone in the practice from the front desk to the veterinarian on the same page insofar as their communications with clients. Promoting the concept of pet wellness. Providing alternative ways for clients to finance their pets care. Distributor reps can also help their customers understand their clients needs and use technology , the Internet, social media to make their practices more accessible and convenient for clients. Sales reps can help with all, says Stone, who spoke with Vet-Advantage Publisher Chris Kelly recently about the year ahead. Following is an edited version of the interview. Veterinary Advantage: Is the message about wellness and prevention starting to resonate with pet owners? Mike Stone: It s starting to, but there s a lot more work to be done. It can t be one and done. From an industry standpoint, the challenge is getting the general public to understand the value of the veterinarian and preventive medicine. Historically, too many people associate the wellness check with vaccinations, and that s only a small piece of it. Veterinary Advantage: The veterinary profession continues to ask, Do veterinary practices rely too much on the sale of products to remain profitable? How should they answer? Stone: The percent of revenue and profit generated by pharmacy continues to subsidize a great deal of overhead in many practices. But if they eliminated their pharmacies, what would they have to charge for a visit or vaccinations? Fewer people would be able to afford veterinary care for their pets. Mike Stone Veterinary Advantage: How can veterinary practices address this dilemma? 8 January/February 2014»» Veterinary advantage

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10 »» Distribution Stone: Many practices are addressing the perception that online retailers and big box stores have better prices headon with their clients. I ve seen comparison charts of popular Heartworm preventatives and Flea and Tick products comparing prices in the waiting areas of many veterinarians. Other practices are having the discussion during the exam, and having their front desk staff remind their clients of the valuable manufacturer product guarantees, promotions and offers from the manufactures that are exclusive to their practice. The other important thing practices can do is make it convenient for their clients to order drugs online, from their practice s website. Partnering with online pharmacies, such as MyVetDirect, allows the veterinarian to better manage prescriptions and generate additional revenue, and makes it easy for clients to get medications for their pets. There clearly is a gap between what pet owners hear and what veterinarians think they re communicating. Pet owners come to their veterinarians for recommendations. They are a trusted resource and I feel that is an excellent opportunity for them to make sure animals get the care they need. Veterinary Advantage: How can distributors help their customers face some of these challenges? Stone: We can help with staff training, and we can help our customers improve their communication and messaging skills, including providing clear recommendations to their clients. There clearly is a gap between what pet owners hear and what veterinarians think they re communicating. Pet owners come to their veterinarians for recommendations. They are a trusted resource and I feel that is an excellent opportunity for them to make sure animals get the care they need. One of the biggest gaps is in the area of weight management and education. A nutritional recommendation from a veterinarian is huge. Whether you re talking about a prescription diet or even just a high-quality diet, practices can be competitive pricewise [with big-box stores and Internet sellers], and they can make it convenient for the client to buy products from the practice. That frequent interaction with the hospital is good for the pet, and strengthens the bond between the client and his or her veterinarian. Veterinary Advantage: How do the skills necessary for sales success today differ from those of, say, five years ago? Stone: In the past, hunting down hard-to-source items was what made a good rep. Today, sales reps have to have business acumen, so they can help their customers prosper and operate more efficiently. They need to help practices not only understand products, but also how to use those products efficiently to improve patient care. They need to show their customers how to get the entire staff onboard to support those products and procedures. And they need to practice greater time management skills, so they can handle the increasing needs of customers and vendor partners. Distributor reps can also help their customers understand their clients needs and use technology , the Internet, social media to make their practices more accessible and convenient for clients. Veterinary Advantage: Are the dynamics of the distributor-manufacturer relationship different today than in the past? How can they work more effectively together? Stone: The dynamics are similar to the past, though today s marketplace is more competitive. Certainly, with regard to capital equipment, the sale cycle is different, and the lifetime of the product is longer. The distributor rep sees the client more frequently than the capital-equipment manufacturer, so that distributor is in a good position to qualify the customer s need for equipment. The rep needs to be proactive, and look for opportunities to help his or her customers expand services or improve their medical care. Veterinary Advantage: What about ride-withs? Do they differ from those of, say, five or 10 years ago? Stone: The most successful reps ride with their manufacturer partners one or two days a week. But those calls are more targeted than in the past. They may visit one, two, three hospitals in a given day. These calls are a tremendous opportunity for our sales force to improve their knowledge of the manufacturer s products. And they provide an opportunity to help the doctor with recommendations. Sometimes, the veterinarian might prefer one product, and the front-desk staff another. That confuses the client and hurts sales. A distributor and manufacturer, working together in lunch-and-learns, can help the veterinarian decide on which products to recommend, and get everyone on staff on the same page. 10 January/February 2014»» Veterinary advantage

11 SCIENCE & SUCCESS VETORYL Capsules are a key part of the veterinary pharmaceutical portfolio I offer my customers. Laura and Tim, the local Dechra Territory Managers, host and conduct Lunch and Learn sessions with me and educate the entire hospital team about VETORYL and Canine Cushing s disease. In addition, Dechra offers great educational pieces I can share with my doctors. Their diagnostic and treatment algorithms make great references for the hospitals to post in their pharmacies and the client brochures help pet owners better understand Cushing s and the use of VETORYL to manage it. When my customers realize how committed Dechra and I both are to bringing them a quality FDA-approved veterinary medication they frequently replace their old human drug prescribing behavior with VETORYL. Russ Smolke, Midwest Rep We ll provide the science and support. You provide the success and customer satisfaction. VETORYL CAPSULES (trilostane): 10mg, 30mg, 60mg and 120mg Capsules to treat all sizes of dogs Proven safety, efficacy and quality Veterinary Technical Support available ( ) RACE approved CE dinner meetings Lunch and Learn in-clinic presentations Online RACE approved CE To schedule a lunch and learn or ride along contact your Dechra representative. Contact information for Dechra representatives can be found at Partnering with Dechra to bring VETORYL CAPSULES (trilostane) to your veterinary customers is easy. Dechra s sales representatives and our veterinary technical team will help you deliver the science and support your customers are looking for when diagnosing and managing Canine Cushing s syndrome. Successful management of Cushing s with the only FDA approved drug for the treatment of canine hyperadrenocorticism is not only good medicine, it is good business for you and your customers. VETORYL is a trademark of Dechra LTD. 2012, Dechra Ltd. NADA , Approved by FDA As with all drugs, side effects may occur. In field studies, the most common side effects reported were poor/reduced appetite, vomiting, lethargy, diarrhea, and weakness. Occasionally, more serious side effects, including severe depression, hemorrhagic diarrhea, collapse, hypoadrenocortical crisis, or adrenal necrosis/rupture may occur, and may result in death. VETORYL Capsules are not for use in dogs with primary hepatic or renal disease, or in pregnant dogs. Refer to the prescribing information for complete details or visit

12 »» Inside Sales Far Beyond February The dental conversation shouldn t be reserved to just one month out of the year For flea and tick season, it makes sense. We focus on flea and tick because it has a definitive timeframe in much of the United States based on the parasite load and weather patterns. By Todd Brodersen Todd Brodersen began his animal health industry career in His experience includes executive level positions in inside sales, sales-force development and marketing management. Todd now operates Same Page Consulting (Omaha, NE). His unique Business Builder program was developed for U.S. distribution companies. Business Builder methods are customer-oriented, generate incremental revenue and successfully support distributor growth. Todd uses sales and operations data, metrics, and analytics resulting in optimized deployments of resources that support best practices in sales, marketing, distribution, and procurement. For more information contact Todd at Todd.Brodersen@yahoo.com or visit However, dental care doesn t have those elements. Dogs and cats have bad teeth, bad breath, and need attention all year. Are we doing a disservice to our customers by allowing them to focus a concentrated effort on this category for only one month out of the year? How do we help our customers understand the importance of prevention and maintenance versus treatments? We do a fine job of letting them know what s in stock, what s on special, and what they should be focusing on right now. How do we get them to continue focus on things that can build their practice and increase their business? Dental procedures are often viewed as treatments by the pet owners. It would be interesting to know what a pet owner thought about dental as prevention of bad breath, gum disease, and health conditions as serious has heart disease. Pet owners readily accept that vaccinations will protect their pets from bad things like rabies, distemper, and kennel cough. Why have we as a profession not inspired our customers and their clients to look at dental in the same light? There are many well run practices that have already figured out what I am trying to convey in this article. Think about it. How do you assist your customers in being prepared for dental month while teaching them to continue the focus far beyond the month of February? The best medicine The answer is prevention. Preventative medicine is a topic that I have written about in a few of my recent articles. We have established that pet owners see vaccinations as necessary, Ask questions that will spark conversation, and become genuinely interested in using the resources at your disposal for the advantage of your customers 12 January/February 2014»» Veterinary advantage

13 Dental: C.E.T toothpaste Greenies C.E.T. Hextra Chews Dental Scaler/Polisher Prophy Cups Tips Business Builder Categories/Products Anti-Infective: Parasite Control: Vaccines: Amoxicillin Heartgard Duramune Max Cephalexin Frontline/Frontline Plus Nobivac Canine Clavamox Interceptor Vanguard Puppy Plus Azithromycin Seresto Pure Vax Vectra Collaborative Communication keeps the Customer + ISR + OSR on the same page: Be knowledgeable of the challenges your customers face. Be prepared to assist with those topics as well as servicing their immediate needs. Incorporate the help of your outside reps in order to be most effective with your recommendations and assistance. Have a discussion with your outside counterpart and determine what you have other than products that you can use to assist your customers with delivering the prevention message. and they understand vaccinations protect their pets, or prevent them from contracting diseases. Flea and tick products are also a type of prevention. Heartworm medications prevent an infestation of heartworm and protect the pet, while flea products often prevent a parasite infestation to the pet and home. Many times an antibiotic is prescribed for pets who are about to undergo a dental or have just received a dental in order to prevent infection. Prevention is the best medicine for a healthy pet and dental exams should be part of a wellness program within the practice. Wellness programs are all about prevention. Have a discussion with your outside counterpart and determine what you have other than products that you can use to assist your customers with delivering the prevention message. Together you can help your practices become more proactive with their approach to preventative medicine. Client education is a key component when you are discussing the types of activities with a customer. Offer suggestions and refer them to resources that can help them to deliver these messages. This consultative approach and general interest in the success of their practice will result in a stronger relationship between you and your customer. The more they rely on you, the more recommendations you can make, and that results in more business. This sort of relationship is tough for the competition to combat. Know what topics are relevant right now for the industry and your customers. Apply that knowledge to the recommendations that you make on products. Expand your reach in the practice by offering tips or information that can help them to grow their business. Become more of a partner, and less of a supplier. Ask questions that will spark conversation and become genuinely interested in using the resources at your disposal for the advantage of your customers. Make every effort to work in tandem with your outside rep to create the most consistent messaging possible. Sharing your thoughts, observations, and conversational notes about the practice can only bring more success to you, your outside partner, and the practice. Veterinary advantage ««January/February

14 »» Sales The Engaged Clinic How to provide value to those involved in a clinic s decision-making process A recent article on employee engagement began: With so much being written about the lack of employee engagement it is a wonder that the business community accomplishes anything. While the lack of employee engagement is an issue, there are many organizations where employees are fully engaged and those businesses are thriving. It caused me to think about clinic engagement and the different levels of clinics I see across a distributor rep s territory. By Patrick T. Malone Patrick T Malone is a Leadership Expert and Senior Partner at The PAR Group, an international training and development firm based in Atlanta, Ga. He is the coauthor of the business book Cracking the Code to Leadership and may be reached at patrick.malone@thepargroup.com Struggling clinics consistently point to the economy and competition from other clinics, OTC products, Wal-Mart, PetMed Express and manufacturers as the problem. On the other hand, thriving clinics continue to grow at double digit rates, compete effectively for their pharmacy and OTC business and partner with suppliers to best serve their clients. Their starting points are different, and their attitudes negative or positive illuminate a sharp contrast in their approach. When you ask your clinics about their objectives, you may get a blank stare, primarily because no one ever asked them. So ask, but give them time to think it over. Once established, an annual follow-up to insure their goals haven t changed is appropriate. You cannot help your clinics reach their objectives until you know exactly what those objectives are. Connect presentations to their goals Why would I (the clinic owner) be interested in anything that isn t helping me get where I want to go? This is where Decision Goals have the greatest impact. Consider this conversation piece: You cannot help your clinics reach their objectives until you know exactly what those objectives are. My first advice to distributor reps is to start with the mindset that it s possible to influence clinic engagement in your territory. Then, consider these strategies to create more engaged clinics while increasing the number of clinics that consider you as a trusted advisor, as opposed to just another distributor rep. Identify the decision-makers goals What are their aspirations? Objectives? Realistically, not every clinic owner is interested in growing the business. Some owners may be reaching retirement age and would like to maximize the valuation of their business. They may be looking for ways to increase their profitability. There are a wide variety of potential objectives, so don t assume, or if you do, at least verify your assumptions. I m convinced that adopting a competitive flea and tick strategy will protect your top line revenue while enhancing the overall valuation of the clinic. Let me run some numbers for you, and then you can decide if this approach is right for your situation. To accomplish this on your calls, remember these three criteria: 14 January/February 2014»» Veterinary advantage

15 A. Start with a confident statement about your idea, product or service that contains a benefit important to your listener. B. Transition to neutral. It is safe for the listener to be invited initially to simply look and/or listen. C. Acknowledge the listener as the decision-maker, and that as such you are okay with a well-informed yes or a well-informed no. Again, it makes the conversation safe for your listener. This type of opening also positions you different than your competitors, and moves you toward the trusted advisor status and away from being just another distributor rep. Approaching the practice manager or buyer The primary responsibility of practice managers and buyers is to take routine tasks off the DVMs and the practice owners. However, they also have a secondary role of shielding the decision-makers from sales reps whose only interest is selling something. Further compounding this situation is their goals may differ from the decisionmakers. While the practice owner may want to maximize the clinic s value so he/she can retire comfortably, the buyer s goal may be to minimize his/her own workload. So, a benefit to the owner may be a burden to the buyer. That is, unless you are creative enough to reposition your idea, product or service to improve the buyer s life, or not further complicate it. The same three criteria above come into play, repositioned to the buyer s point of view, which then opens the door to the clinic owner. And you have become even more valuable because you ve helped everyone get what they want, while getting what you want. These strategies hinge on your confidence in your knowledge, skill, ability to think outside the box and create solutions that are flexible enough to provide value to all involved in the decision-making process. It isn t easy, but the value of a territory filled with engaged clinics will pay dividends for years to come for you and your organization. And you will have transitioned from just another distributor rep to a trusted advisor and invaluable asset. Powerful Visit us at WVC booth 632 Dependable Trusted A powerful and dependable electrosurgical unit from Bovie, the name you trust. The Aaron 1250-V expands your veterinarians surgical repertoire, without expanding their budget! The compact unit offers up to 120 watts of surgical power with five (5) modes of energy delivery. Save your veterinarian time and money during surgical procedures with the Aaron 1250-V. Contact your Bovie representative for a demo. Learn more about the Aaron 1250-V on our SoundByte from Vet Advantage Bovie Medical Corporation 5115 Ulmerton Road Clearwater, FL U.S. Phone Fax sales@boviemed.com Veterinary advantage ««January/February

16 »» Sales The Grinch Inside the mind of the negotiating buyer Last month, a large company inquired about doing a Negotiation Skills Seminar for their national meeting. This is one of my favorite sessions to deliver, because if the skills are used, it leads to higher sales margins and quicker deals. As I began questioning the key decision-maker for the meeting, I quickly learned this would not be an audience of salespeople or business owners, but rather a room full of buyers and purchasing agents. In other words, the students I would teach are the very people who you negotiate with every day. You know the ones who try to suck every last nickel out of your pocket and send you home to your starving family. By Brian Sullivan Sales Coach and Business Consultant Brian Sullivan,CSP is the author of the book, 20 Days to the TOP How the PRECISE Selling Formula Will Make You Your Company s Top Sales Performer in 20 Days or Less. Sign up for his free weekly motivation and sales tip by going to Fun stuff that will keep you focused on getting to the top! I had a decision to make. Do I reveal the secrets I share with you, so that they can then take even more nickels out of your pocket? But then it hit me. I felt like the Grinch who had suddenly found the true meaning of Christmas. Perhaps sales isn t about winning, stealing higher margins, and dominating the greedy buyer. Perhaps it s about much more than that. Maybe it s really about putting two people in a room who are looking for much more than winning the short-term deal. Maybe it s about teaching salespeople and buyers how to respect each other, care for each other, be honest with each other with hopes of developing a long-term friendship/partnership that makes them both look good. After my warm and fuzzy revelation, I got to work preparing the meeting. My objective was to teach the buyer how to find the best long-term partners and how to weed out those unworthy of their business. In the process, I would teach them how to get as much as possible out of you, but warned them the best salespeople will not be bullied just as the best buyers will not be bullied. In the end, I believe the best negotiator, with the best long-term intentions, should win, but only slightly more than the other party. In short, it s a WIN/ win situation. And for the purposes of this article, I want you to be the person that regularly WINS (capital letters). The following is what I taught the audience, so you know what to expect when they come at you with these techniques. And let s be clear, just as you have a goal to sell as much product at the highest margin, they too are being paid to get the best product at the lowest cost. And this is how I teach them to do it: In the end, I believe the best negotiator, with the best longterm intentions, should win, but only slightly more than the other party. 16 January/February 2014»» Veterinary advantage

17 Buyer negotiation tips 1. Prepare: Make a list of what s important to you regarding suppliers, then do your homework to find companies who match your wants. Call at least three people to learn about that supplier and get real world opinion. If prices are listed on websites, write them down. While the lowest price isn t always the best option, it s the only thing to consider when all suppliers look, sound, act and smell the same. 2. Aim low: Think about what would be a GREAT deal for you. Don t ever make the first offer because there is a chance the unconfident salesperson will assume all you care about is price. As a result, they ll often slash their margins without you having to do anything. And don t accept the first offer. Again, the unconfident salesperson will often let their urgency to get the order cause them to lower their price even more. 3. Always ask for something: There is a better than 90-percent chance you ll get more than you originally thought if you just ask. Don t stop there. If you get a no, ask FIVE times. If after five times the salesperson isn t budging, chances are they have gone as far as they can. 4. Ask the right person: Great salespeople who come prepared and have the answers you need are extremely valuable. Because of this, they ll usually have the authority to make selling decisions. This means you are negotiating with the right person. But when they tell you they need to get approval, they re often telling you they either lack the knowledge or skill to get the deal done, or the confidence to negotiate. In this case, ask to be introduced to the leader who can help get your answers. 5. Be willing to walk: There are many companies who want your business. While it s often hard to find, the best long-term partner will be the one who fully understands your needs and helps you find solutions that make your life easier. Remember, acquisition price is only one part of the equation. The cheapest price often comes with the worst service. If you know they re going to start low, ask for tons, go over your head (if you re unprepared), and possibly walk, what should you do? The answer is simple. Prepare, Aim high, Always ask more, Get to the right decision-makers and Be willing to walk. And the bonus lesson: 6. DON T BE A JERK! Because the prepared salesperson who has a great attitude, delivers Five Star service, is smart and confident, and is a high-level communicator will also be willing to walk! And because they are so good, they know there are more than enough nice prospects to do long-term business with. Sales negotiation take-away Now that you know what is in the minds of your prospects and current customers, use the information to better prepare for your negotiations. If you know they re going to start low, ask for tons, go over your head (if you re unprepared), and possibly walk, what should you do? The answer is simple. Prepare, Aim high, Always ask more, Get to the right decision-makers and Be willing to walk. You ll find better long-term customers, higher margins and some extra post Holiday Grinch green to put in your wallet in Veterinary advantage ««January/February

18 »» Sponsored by IDEXX: Building Your Lab Business Pet-Side Fructosamine testing: Essential for managing diabetic patients The 2010 AAHA Diabetes Management Guidelines for Dogs and Cats 1 spells out the challenge most practices face every day: Diabetes mellitus (DM) is a treatable condition that requires a committed effort by veterinarian and client. Treatment of DM is a combination of art and science, due in part to the many factors that affect the diabetic state and the animal s response. Each animal needs individualized, frequent reassessment, and treatment may be modified based on response. You can help solve this challenge for your customers. You see, practitioners know that the foundation of successful diabetes management is an accurate diagnosis with ongoing monitoring based on patient history, clinical signs and in-house lab test results. The question for you is: how do your customers arrive at an accurate diagnosis and how do they efficiently monitor patient responses to treatment? Laboratory testing is the key. Michelle Frye, DVM, SM, explains: A complete laboratory assessment is necessary to thoroughly evaluate these patients and includes a complete blood count (CBC), biochemical profile (including electrolytes), complete urinalysis and urine culture. Fructosamine (FRU) testing is highly recommended for obtaining a more complete and reliable clinical assessment of the diabetic patient. Ideally, this is done inhouse for quick answers. In addition, she said, A fructosamine assay may be beneficial for determining if the origin of hyperglycemia is from stress in some patients (particularly cats), and is highly recommended for ongoing monitoring of both the canine and feline diabetic patient. [It] provides key complementary information about glucose control. In short, fructosamine (FRU) testing is highly recommended along with blood glucose curves and assessment of clinical response to provide a more complete and reliable clinical assessment of the diabetic patient. Ideally, this testing is done in-house for quick answers. If a practice isn t currently using the FRU test, you ll be doing them a great favor by bringing it up. How to discuss FRU testing with your customers When visiting a practice, ask about the approach their team follows for diagnosing, treating and monitoring diabetic patients, and then inquire about FRU testing. Check-off (qualify): Doctor, can you please walk me through how you diagnose and monitor diabetes in your practice? Confidence: If YES, confirm and support benefits. If NO, assert the benefits with confidence. I m sure you ll help more patients by doing in-house FRU testing to differentiate diabetes from stress and also to monitor response to treatment. Invitation to neutral: Let s look at how FRU testing provides answers for a more complete and reliable clinical assessment of your diabetic patients. Seek alignment/understanding as the dialogue continues: Can you help me understand How often do you diagnose and treat diabetic patients? Have you considered running FRU tests in-house to manage their conditions? Are you aware that in-office FRU testing will help you accurately, quickly and efficiently differentiate and manage the diabetic patient? With FRU testing at their fingertips, practices can enhance the way they manage diabetes in their canine and feline patients. Visit idexx.com/diabetes to learn more. 18 January/February 2014»» Veterinary advantage 1.

19 SNAP test results just got a whole new look. Now your customers can electrify SNAP protocols with the new SNAP Pro Mobile Device. Find out how at idexx.com/snappro. The SNAP Pro Mobile Device will be available to ship early in the fi rst quarter of Preordering is available now IDEXX Laboratories, Inc. All rights reserved All /TM marks are owned by IDEXX Laboratories, Inc. or its affi liates in the United States and/or other countries. The IDEXX Privacy Policy is available at idexx.com.

20 »» Marketing Back to Basics Marketing Help practices pass the top 5 marketing tests Your customers have a big challenge, and they need your help. Today s veterinary practice marketing options and must do s make it hard for busy owners and practice managers to know where to start or how to keep up. Therefore, many practices overlook basic marketing fundamentals that are critical to success. By Pam Foster Pam Foster, Managing Editor, Community Content & Media for the NAVC, is a Certified SEO Copywriter and the co-author of Wildly Profitable Marketing for the Pet Industry a complete, easy to follow roadmap for veterinary practices. She specializes in helping practices and other veterinary organizations thrive through strategic marketing content, online and offline. When using the more consultative approach with your customers, you can help them succeed by walking them through five top marketing essentials. By showing them these tests and emphasizing their importance, you ll make a massive difference in your customers marketing results. Let s get started. Marketing Test No. 1: WHERE ARE YOU and HOW DO I REACH YOU? When pet owners move to a new town or adopt a new pet, they look online for veterinary care in their town, right? They search by town, ZIP code and/or neighborhood name. They re hoping to find a local practice so they can call for an appointment. The only way for a practice to be found by these clients is to list the practice location information everywhere. The web industry refers to this as local NAP: Name, Address and Phone number. 1 Every veterinary practice As part of pre-planning for practice calls, review the practice s website and ask yourself, Where s their location information? should post a consistent NAP listing on their own website and on local business directory sites, review sites and Google. It s surprising how many veterinary websites don t do this easy step! How you can help. As part of preplanning for practice calls, review the practice s website and ask yourself, Where s their location information? If you see that the local NAP is missing or incomplete, show your customers the following How-To sheet during the sales call, explaining that if they make these simple adjustments, they ll have much better results. 20 January/February 2014»» Veterinary advantage

21 Does Your Veterinary Website Pass the WHERE ARE YOU? Test? Use this quick, easy test to make sure local clients can find your practice when they re searching online. Your physical address and phone number are on EVERY page of the practice website. The best place for this information is on the masthead of every page, right at the top where it can be seen in seconds (don t make clients hunt for the basics). Here s an example (right): Veterinary phrases and your town name are used on EVERY page of the practice website. Include phrases such as, veterinarians in [my town] in headlines and other content plus Page Title tags and Meta Description tags. Ask your web developer to do this ASAP if you can t do it yourself. The practice website provides driving directions and a map. By providing directions and a map (or a link to Google Maps) on Contact Us, About Us and even your Home page, clients can easily get to your practice without having to call and tie up your phone line. The website is properly listed in Google Places for Business. When you see local map-based practice listings in Google search results, you can assume those practices verified their websites on Google Places for Business. Using this free service, you can set up a complete profile with your address and phone number plus descriptive veterinary services in [my town] information, service categories, photos, videos and more all helping more pet owners find you online (see the example below). To get started, visit The practice has a Google+ account. You can improve your Google search engine rankings with a combination of Google Places for Business and Google+ the place to establish a community of circles that include pet owners, local media, local pet businesses that may refer you and so on. It s also where people can post reviews of your practice (Google+ reviews are favored over Yelp reviews!). To get started, visit Your practice s Name, Address and Phone number are consistently listed in online directories. Be sure to claim your practice s listings on Internet Yellow Pages, CitySearch, the local Chamber of Commerce website and perhaps a local pet services directory if available. If you follow this Where Are You? test and make the necessary adjustments, you can expect to see some nice improvements fairly quickly. Next month we ll cover Marketing Test #2: THE MOBILE-FRIENDLY PRACTICE. 1. Search Engine Land Veterinary advantage ««January/February

22 »» Finance What s Your Lever? Dissecting the veterinary business Now is a good time to examine the basics of veterinary business, and determine where you might have the biggest impact on your customers bottom line. The math of veterinary business is straightforward (see graphic): Gross Income Expense = Profit By Fritz Wood, CPA, CFP A recent study by IDEXX of hundreds of practices in the U.S. showed that about 20 percent of inhouse diagnostic tests never showed up on an invoice, and about 10 percent of reference lab work was never invoiced. Gross Income = The greatest opportunity to grow the bottom line (Profit) is by growing the top line (Gross Income). While you can and should provide guidance on inventory management (see articles published last year), your greatest opportunity to exert influence is in helping practices grow gross income (aka gross revenue, or revenue). There is generally far less opportunity to grow profit through reducing practice expenses. Rare is the practice with expenses spinning wildly out of control. Rare is the practice that saves its way to prosperity. Since increasing the top line (gross income) is the key to a healthier practice and greater profit, that s where the overwhelming majority of your time, energy, and efforts should be focused. What exactly constitutes gross income? In a small animal practice gross income is defined as: Average Charge per Transaction (aka Average Transaction Charge, Average Client Transaction, Average Transaction Fee, etc.) X Number of Transactions In terms of trends, the Average Charge per Transaction has consistently grown through the years, though largely and in many cases, exclusively as a result of fee increases. Practices wholly reliant upon fee increases to sustain growth (or mitigate decline) are in harm s way. That is not a sustainable strategy. Meanwhile, the number of transactions has been flat or declining for many years. The reasons for this are myriad and well-known. 22 January/February 2014»» Veterinary advantage

23 I don t like riding in the car because I get [SUPPRESSED IMMUNE RESPONSE. ABNORMAL RESPIRATORY RATE. SKIN DISORDER. METABOLIC CHANGES. OLFACTORY OVERLOAD. ] stressed. Start a new dialogue about behavior then start new Zylkene. Because your patients aren t just stressed out. They re stressed within. Your clients may not realize behavior problems aren t just stress-related, they re health-related too. You re the lifeline for answers and new Zylkene is your first line: The only veterinary nutraceutical with alpha-casozepine, a safe and natural ingredient derived from casein, a milk protein with calming properties Clinically proven for behavioral problem management without drowsiness or sedation Indicated for situational stress or chronic anxiety in dogs or cats Palatable, once-daily formulation in three sizes Learn more at vetoquinolusa.com/zylkene or call Relax, you ve got Zylkene is a registered trademark of Vétoquinol Vétoquinol 11/2013

24 »» Finance profits could more than double if practices simply charged for all products conveyed and services rendered. Fee capture plugging the holes in the bottom of the bucket is well-worth your time, energy and investigative efforts. Now then, what items impact the Average Charge per Transaction? 1. Charging for all products and services delivered 2. Charging fair and reasonable professional fees 3. Performing more services and/or delivering more products for each patient 4. Improving compliance Next, dissect the factors influencing the other side of the equation the number of transactions: 1. Leverage and delegation 2. Number of new clients 3. Client loyalty/retention 4. Practice hours of operation 5. Improved compliance Do your customers charge for all they do? Evidence suggests veterinary practices do not always charge for everything they do. Failing to capture charges can only happen for one of two reasons: either 1.) accidentally, or 2.) on purpose. If a product or service is given away on purpose, that s commonly known as a discount. The next issue will delve further into professional fees, but suffice it to say that discounts often do not make business sense. Alternatively, if a practice gives away a product or service accidentally, that s commonly known as an internal control weakness. The practice wanted and intended to charge for the product or service, but somehow, it simply fell between the cracks. Fortunately, there are plenty of tactics that can be implemented in a practice (in the exam rooms, in the lab, pharmacy, surgery, anesthesia, radiology, hospital ward, treatment area, etc.) that mitigate that risk. Most practitioners wrongly assume that we charge for what we do we re careful and don t make mistakes things don t fall through the cracks in my practice. A recent study by IDEXX of hundreds of practices in the U.S. showed that about 20 percent of in-house diagnostic tests never showed up on an invoice, and about 10 percent of reference lab work was never invoiced. Lab work is especially egregious since the practice has lost both time (doctor and staff) and money (the cost of the re-agent, snap test, or reference lab). How does this happen? Human error is to blame. Eliminate error through automation I strongly recommend practices eliminate the possibility of human error via automation. If the practice management information system has two-way communication with the in-house lab and the reference lab, missed lab charges disappear and profits increase. Does this two-way communication (integration) exist in the practices you call on? If not, you have an obligation to talk about what they re missing. They re doing the work and incurring the expense they need and deserve to get paid for it! Another benefit of integration is that the lab results are deposited directly into the patient medical record. Two of my colleagues (Mark Opperman, CVPM and Cynthia Wutchiett, CPA) have estimated that profits could more than double if practices simply charged for all products conveyed and services rendered. Fee capture plugging the holes in the bottom of the bucket is well-worth your time, energy and investigative efforts. In the next issue, we ll continue working through the list of levers you might engage to effect significant positive change in your practices this year. 24 January/February 2014»» Veterinary advantage

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26 »» Dental Dispelling Dental Myths By Mary L. Berg, BS, RVT, RLATG, VTS (Dentistry) Approximately 80 percent of adult dogs and 70 percent of adult cats have some form of oral disease. Calculus and gingivitis are the most common conditions diagnosed by veterinarians in all ages of animals. and missing, it should also indicate the locations and severity of dental disease indicators, such as periodontal pockets, mobility, furcation involvement, gingival recession and loss of attachment. These basic indices will help the veterinarian determine the stage of periodontal disease in the patient. This chart becomes part of the patient history and can be used to track changes in the oral health of the patient throughout its life. It is vital that veterinary professionals stop looking at dental care as a necessary evil, but instead, embrace the idea of taking the practice of dental cleaning up a notch! One way they can do so is to dispel the myths and misconceptions surrounding dental procedures, including dental cleaning. Vet-Advantage readers can help. Here are just a few of those myths. Charting Hospitals record all vaccines, blood work and other healthrelated issues in their medical charts. Is oral health less important? A complete oral examination and chart should be completed on every patient that presents for a dental procedure. Not only should the chart include the teeth present Scaler tips In many hospitals, technicians use only one scaler tip for the entire procedure. It s true that this tip is often called the universal tip, and it can be used above and below the gumline. But it s not very effective in either case. The use of two different tips a beaver tail and a periodontal tip will be more efficacious. The beaver tail is a board tip that is extremely effective for removing gross calculus deposits on the crowns of the teeth. Each type of scaler has different areas of efficacy on the tip, but usually, it is the last 3 mm of the tip. The technician should NEVER put the tip straight down on the tooth, as this will cause thermal damage to the tooth. The handpiece should be held lightly, as the hand is only a guide to the dental scaler. The technician should proceed with long, broad strokes, and should avoid taking the tip off and on the tooth repeatedly, as this can cause concussive injury to the pulp of the tooth. Once the gross calculus is removed from the crowns of the tooth, the periodontal tip should be used to go below the gumline to remove debris from the sulcus and the pockets around the tooth. The advantage of using a periodontal tip 26 January/February 2014»» Veterinary advantage

27 over a curette is that the ultrasonic action bursts the cell walls of the bacteria, and the water flushes the bacteria and debris from the pocket. The technician should always follow the power scaler with a curette to ensure that all the calculus is removed from the pocket. It s not advised to use only the perio tip for the entire dental procedure, as the tip is not designed to remove gross calculus deposits and will add time to the procedure and wear to the instrument. The practice should check the tips often, using the tip guide received at the time of purchase, as the tips do lose efficacy over time. Polishing The teeth must be polished after scaling to smooth out the microetches created when scaling. Many practices believe it s acceptable to use either coarse or medium grit pumice for polishing. The problem with that approach is, coarse or medium grit pumice creates additional etches on the enamel. Compare pumice to sandpaper: When a very smooth surface is the goal, fine or extra fine sandpaper is used. The same should be true for dental pumice. Practices should make sure to request fine or flour pumice when ordering. (Practices can make their own pumice Compare pumice to sandpaper: When a very smooth surface is the goal, fine or extra fine sandpaper is used. The same should be true for dental pumice. paste by ordering flour pumice and glycerin, and mixing the two into a thick, cookie dough consistency.) Last spring, the American Animal Hospital Association published the 2013 AAHA Dental Care Guidelines for Dogs and Cats ( I recommend reading these guidelines and following them to help ensure that patients get the best dental care possible. Mary L. Berg, BS, RLATG, RVT, VTS (Dentistry), is the founder of Beyond the Crown Veterinary Education, a consulting company providing onsite dental training for the entire staff. She worked in research for more than 13 years, specializing in products aimed at improving the oral health of companion animals. She served as the practice manager and dental specialist at Gentle Care Animal Hospital, Lawrence, Kan., for more than seven years. She has authored or co-authored over 60 publications, and has been a speaker and wet lab instructor at numerous conferences. She can be reached at (785) or mlberg1@aol.com Veterinary advantage ««January/February

28 »» Dental Twelve basic steps for quality dental care When you proactively look for and treat dental problems, everyone is a winner, says Tony Woodward, DVM, Dipl. AVDC. The pet benefits because they feel better, act better, and relate better to their owner. The owner benefits because their pet acts better, their breath is not offensive, and so the human-animal bond is strengthened. The practice benefits from owners that are bonded more closely to their pets and improved financial security. There are no losers in this equation. Woodward offers a 12-step cleaning procedure as the foundation from which proper diagnosis and treatment flow. Step 1: Patient history and physical exam. Many times, clues in the patient s history can lead to a specific dental lesion. Further, some systemic diseases can have implications for oral health. Other items worthy of note include the presence of oral/facial enlargements, draining tracts, lymph node enlargement, altered eating behaviors, etc. Step 2: Initial oral survey. Prior to anesthesia in a cooperative patient, or immediately after anesthetic induction, the veterinarian should give the entire oral cavity a once over to get an idea of what the case might entail. Some things to look for: odor, pain on manipulation, missing teeth, occlusal abnormalities, etc. Step 3: Supragingival calculus removal. Removal of calculus above the gum line may be the most visible part of the procedure to the owner, but it is the least important part for the patient s dental health, because much of potential disease lies below the gum. Supragingival calculus removal usually is accomplished with a combination of power equipment (e.g., rotary instrument, sonic scaler, ultrasonic scaler, hydraulic scaler) followed by hand scaling with scalers and curettes. It s important to note that this is the only step that can be done though poorly without the patient being anesthetized. So-called anesthesia-free dentistry is really only substandard tooth grooming. Step 4: Subgingival cleaning. This is the most important part of the procedure for the patient. The veterinarian removes calculus, plaque and toxins from the root surfaces, allowing normal re-attachment of periodontal structures to the root. Subgingival scaling involves a combination of power equipment and hand instruments, and may involve three steps: 1) subgingival planing (calculus removal), 2) root planing (smoothing rough surfaces) and 3) subgingival curettage (soft tissue debridement of the inside of the gingival pocket). The use of ultrasonic equipment has gained popularity for subgingival scaling. Despite claims to the contrary, it s not possible to effectively clean under the gum line in a non-anesthetized patient. Step 5: Polishing. Polishing of the tooth surfaces removes small defects and irregularities that occur during the cleaning process. Smoothing the surfaces with a prophy angle and fluoridated prophy paste decreases plaque retention and slows the formation of calculus. 28 January/February 2014»» Veterinary advantage

29 U-40 insulin syringes available for diabetes mellitus in both dogs and cats Step 6: Sulcus irrigation/lavage. The use of an air-water handpiece or curved tip syringe allows the veterinarian to direct irrigant gently into the gingival sulcus, effectively removing loose calculus and polishing materials. Step 7: Fluoride application. This strengthens the enamel and helps decrease sensitivity associated with exposed dentin and/or root surfaces. Step 8: Complete charting. Full-page dental charts become particularly useful as serial charts are accumulated during the life of the patient. Changes in dental health can be tracked by referring to earlier charts of the same patient. Step 9: Radiographs. Eighty percent of clinically relevant dental anatomy cannot be seen by the naked eye, and so cannot be visualized without the use of dental radiographs. Dental radiographs cannot be obtained on non-anesthetized patients. Failing to obtain dental radiographs means that many (if not most) patients will be left in pain. Step 11: Home care. At some point during the dental cleaning process, the veterinarian should go over home care options with the owner. Home care modalities include brushing, rinses, gels, chews, dental-specific diets and periodontal vaccines. Step 12: Schedule the next appointment. The practice should let the client know the next time he or she should bring in the pet, and make sure the reminder system is in place and working. Step 10: Treatment plan. Most patients will require some additional treatment beyond the basic cleaning. The treatment plan should include needed medication, and the veterinarian should make sure to charge appropriately for his or her professional time and materials. To view the complete 12-Step Cleaning Procedure by Tony Woodward, DVM, go to downloads/12step_cleaning.pdf. Veterinary advantage ««January/February

30 »» Dental How customers can skyrocket their feline dental practice If your customers are going to get serious about veterinary dentistry, they better get serious about dental X-rays. That s the line in the sand, says Jan Bellows, DVM, DAVDC, DABVP, who practices at All Pets Dental, Weston, Fla. Veterinarians who are not equipped to take X-rays are not equipped to do advanced dental work on their patients. Bellows, who is president of the American Veterinary Dental College, gave a presentation entitled Skyrocket your feline dental practice at the 2013 American Association of Feline Practitioners Conference. Why don t cats visit more often? It s no secret that cat owners don t take their pets to the veterinarian as often as dog owners. The Bayer Veterinary Care Usage Study III: Feline Findings, released in January 2013, showed that fewer than 50 percent of cats visited the veterinarian in 2011, and that the number of cat visits dropped 14 percent from 2001 to Bellows believes there are three primary reasons for this. First, cats appear to their owners more self-sufficient than dogs, hence, perhaps not in need of veterinary care. Second, more dog-owners tend to pay for their pets than cat-owners, who often find or are given their pets. That being the case, the dog has greater perceived value, and the owner is more likely to take greater care (and money) to see they are healthy. And third, closely related to the first, is that cats tend to hide their disease better than dogs. In any of these three cases, the result most often is the emergence of oral-health-related problems. A proper examination calls for a tooth-by-tooth evaluation (30 teeth in cats, 42 in dogs), says Bellows. To do it right, the veterinarian needs to use intraoral digital X-rays, because 60 percent of cats (and dogs ) tooth structure is subgingival, that is, below the gum line. 30 January/February 2014»» Veterinary advantage

31 The most common feline pathologies are: Tooth resorption, or FORLS (sometimes incorrectly identified as cavities, because it can appear as a hole in the tooth). Half of all cats over 3 years old will have at least one tooth resorption, according to Bellows. These lesions are painful and, fortunately, treatable. Stomatitis, a severe oral disease in which the cat becomes allergic to plaque around its teeth. The allergic response appears as marked inflammation at the area where the tooth meets the gum line. Often, full-mouth extractions result in a cure. Feline oral cancer. Fractured teeth. The enamel in the cat s tooth tends to be much thinner than that in the dog s tooth, making it important to repair chips or extract the tooth as soon as possible. Tooth-by-tooth evaluation A proper examination calls for a tooth-by-tooth evaluation (30 teeth in cats, 42 in dogs), says Bellows. To do it right, the veterinarian needs to use intraoral digital X- rays, because 60 percent of cats (and dogs ) tooth structure is subgingival, that is, below the gum line. Without radiography, the dentist may be able to probe for pathology, but can t see the whole picture, such as abscesses or internal root structure. Nor can the veterinarian do a proper tooth-by-tooth exam without anesthesia. In fact, the American Veterinary Dental College and the American Animal Hospital Association do not condone non-anesthetic dental cleanings, says Bellows. Some new products on the market are improving the quality of dental exams, he adds. One is a diagnostic test strip that can be used as an exam room indicator of gingival health and periodontal status. It should be used in every exam, and during follow-up exams, to make sure plaque is under control, he says. (The test strip is referred to the 2013 AAHA Dental Care Guidelines for Dogs and Cats. ) Another example: new sealants that can protect against periodontal disease under the gumline. Veterinarians, clients and sales reps alike should make themselves aware of the Veterinary Oral Health Council, an entity of the America Veterinary Dental College, which awards its Seal of Acceptance to products that successfully meet pre-set criteria for effectiveness in controlling plaque and tartar deposition in dogs and cats, says Bellows. For more information, go to Veterinary advantage ««January/February

32 »» Dental Equipping the veterinary dental practice By Stephen Juriga, DVM, DAVDC Veterinary dental services have become an essential component of preventative healthcare in small animal practice. Veterinarians who provide comprehensive dental services that restore oral health routinely receive client feedback on their patients improved comfort and overall health. Providing a high level of dental services calls for proper room design, lighting, anesthesia, monitoring and patient support, and the necessary equipment intraoral dental radiography, air-driven dental delivery system, ultrasonic scaler, polisher, hand instruments and dental materials/supplies. Dedicated space Dentistry requires a dedicated space ranging from 8 x 10 ft. to (ideally) 12 x 15 ft. The dental operatory should be separate from the general surgery room, because of the aerosolized bacteria released during dental procedures. It should also be separate from the general treatment room, whose high traffic makes it less than ideal, especially when taking radiographs. Many new hospitals dedicate the same square footage to their dental operatory as their surgery operatory. The following items should be incorporated in the dental operatory: Peninsula table(s) with a knee space, adjustable seating and grate for drainage. Ceiling or floor-mounted lighting designed to illuminate the oral cavity with minimal shadowing. Headlamp lighting and/or fiber optics. Magnification dependent on the clinician. Cabinetry for convenient storage of instruments and materials. Instrument table within 3 feet of the procedural table to organize and access specific packs/instruments. Dental delivery system, dental radiography and anesthesia delivery system. Multiple grounded 110-volt receptacles (3 fourplug grounded outlets) to power the dental delivery system, monitoring equipment, thermal support system, radiography, ultrasonic scaler, and other equipment. Anesthesia with intubation is necessary to properly assess and treat the companion animal dental patient. Hospitals should set procedure-specific anesthetic protocols, and use regional nerve blocks, intravenous fluid therapy, thermal support and patient monitoring to provide patient safety and rapid recovery. Moreover, patients should be observed during recovery as well as an additional 60 minutes in a central area of the hospital. Equipment Equipment for performing dental procedures includes: Anesthetic delivery system, active scavenger, patient monitoring, thermal support systems and intravenous fluid infusion system. 32 January/February 2014»» Veterinary advantage

33 Equipment to expose and process intraoral dental radiographic system or intraoral films. A high- and low-speed dental delivery system for air and water. Equipment for sterilizing instruments. Low- and high-speed handpieces. Various sizes of burs. Powered scaler (ultrasonic, subsonic or piezoelectric). Suction (recommended). Fiber optic light source (recommended). Instruments Instruments required for a dental prophylaxis or minor periodontal therapy include: Dental chart to record oral pathology, treatment and follow-up. Periodontal probe and dental explorer. Retraction aids (mouth speculum, or Minnesota retractor). Tartar forceps. Ultrasonic scaler and polishing unit(s). Hand scaler(s), to be used supragingivally. Hand curette(s), to be used subgingivally. Sharpening supplies (India stone, mechanical or manufacturer). Instruments used for extraction therapy or periodontal surgery include: Local anesthetic drug(s) Bupivacaine or Lidocaine. Scalpel handle and blades (#11, 15 or 15 C). Periosteal elevator(s) for efficient and precise flap creation. Luxators (a knife-like instrument used between the tooth and alveolar socket to cut the periodontal ligament or elevate an individual root segment). Size #2, 3, 4, & 5. Elevators (more blunt instrument used between tooth segments to elevate tooth and roots). Wing tipped elevators (sharp, knife-like instruments that conform to the conical shape of the tooth root to aid in extraction therapy). Spoon or Miller Curette, used to debride the alveolus. Root pick, in the event of a root fracture. Extraction forceps. Thumb forceps (1 x 2 teeth). Iris, LaGrange or Metzenbaum scissors and mosquito hemostats. Needle holder of preference. Suture material Vicryl Rapide or Monocryl in a 4-0 and 5-0 size on a reverse cutting needle. Other materials include: Gauze, local or topical antimicrobial agent, hemostatic agent, sealant, and bone augmentation material. Materials Prior to beginning any oral procedure, the patient s oral cavity should be irrigated with a 0.12% Chlorhexidine solution to reduce aerosolized bacteria and bacteremia. The technician and veterinarian should use protective aids/devices (dosimeter, mask, eye protection, gloves and smock). Other materials needed include: Antiseptic rinse. Prophy paste/pumice. Prophy angle and cups. (disposable) Sealant. Needles and syringes. Intraoral digital system or radiographic film. Measures to prevent hypothermia (e.g., circulating water blanket, hot air blanket, conductive blanket, towels, blankets). Gauze and sponges. Antimicrobial agent for local application. Suture material (4-0 and smaller) Bone augmentation material. Hemostatic agents. Local anesthetic drugs. Minimum protective devices to be used during dental procedures include: Cap. Hair bonnet. Mask. Goggles, surgical spectacles or face shield. Smock. Gloves. Earplugs. Dosimeter. Protection from radiation (e.g., lead shield). Veterinary advantage ««January/February

34 »» Dental Undisturbed plaque will mineralize and result in calculus, which is a hard substance that appears yellow or brown on the tooth surface. If untreated, plaque and calculus commonly will lead to bad breath, red gums (gingivitis), oral pain, infection, and loss of teeth. Mouth gags should be used with caution. Studies have shown that mouth gags can produce excessive forces, and if used for extended time can result in a masticatory myositis or reduction of blood flow in the maxillary artery, which could result in cerebral ischemia, deafness and blindness. Client education and home oral hygiene A post-anesthetic/dental release form is helpful to direct the pet s immediate and long-term care. This document should discuss the procedure, recovery from anesthesia, feeding recommendations, limitations in activity, and expectations regarding pain or healing over the next several days to weeks. Medications should be listed on the document as well as the patient s re-examination appointments. Digital photographs and radiographic images are an important part of this dental release or discharge document, and should be presented at dismissal by the veterinarian or dental technician involved in the procedure. This document should illustrate the degree of periodontal disease (calculus, tartar or oral pathology), treatment(s) performed, and direct the home oral hygiene therapy needed to maintain oral health. The dental practice should consider taking before-and-after photographs of all procedures performed: Use a lip retractor so both arcades are visible and parallel to the axis of the photograph. The camera should be set on Macro, without flash and dental light directed away. Use an SD card per patient (labeled A, B, C ). Radiographic images are exported from the digital radiographic system to the SD card and inserted into a Microsoft Word document to illustrate the procedure and/or treatment(s) performed on each patient. Ideally, a pet s teeth should receive some form of daily mechanical cleansing (brushing or dietary texture). Brushing or tartar-specific diets have been shown to remove the daily accumulation of plaque from the teeth when it is still soft. Undisturbed plaque will mineralize and result in calculus, which is a hard substance that appears yellow or brown on the tooth surface. If untreated, plaque and calculus commonly will lead to bad breath, red gums (gingivitis), oral pain, infection, and loss of teeth. Chemical plaque control can be offered only in conjunction with a mechanical plaque control. I recommend that veterinarians become familiar with the approved products from the Veterinary Oral Health Council at Resource List: 1. Holmstrom SE, Bellows J, Juriga S, Knutson K, Niemiec BA, Perrone J AAHA Dental Guidelines for Dogs and Cats, J AM Anim Hosp Assoc 2013;49: (Available at: 2. Bellows J, Small Animal Dental Equipment, Materials and Techniques, Blackwell Publishing 2004 Stephen Juriga, DVM, Diplomate AVDC, is the owner of River Heights Veterinary Hospital, a five-doctor, AAHA practice in Oswego, Ill., and a co-author of the 2013 AAHA Dental Care Guidelines for Dogs and Cats. He graduated from the University of Illinois in 1987, and returned there to complete a dental residency from , under board-certified dentist and surgeon Dr. Sandra Manfra. In 2007, he became a Diplomate of the American Veterinary Dental College and received the Robert Wiggs Outstanding Candidate Award. He gave a presentation on Equipping Your Dental Practice at the 2013 Veterinary Dental Forum in October in New Orleans, La. and shared his proceedings notes with Veterinary Advantage. 34 January/February 2014»» Veterinary advantage

35 GOOD TASTE MEANS BEING A LITTLE CHEW-Z. C.E.T. VEGGIEDENT Tartar Control Chews for Dogs are a great-tasting way to promote oral health that s free of wheat gluten and animal protein. In fact, a recent study showed that VEGGIEDENT Chews help effectively reduce calculus, plaque, and halitosis. 1 They even help freshen breath when used once daily. The unique mechanical action and exclusive shape help keep dogs teeth clean and healthy. By now, it s E-Z to guess what that exclusive shape might be. So recommend VEGGIEDENT Chews to your veterinary customers. They make at-home pet dental care tasty for their patients and simple for their clients. Talk to your customers about the benefits of VEGGIEDENT Chews today!.e.t C. HOME DENTAL CARE OVER 25 YEARS C.E.T. VeggieDent Tartar Control Chews Great tasting chews for dogs that help prevent plaque and calculus and freshen breath. Reference: 1. Clarke DE, Kelman M, Perkins N. Effectiveness of a vegetable dental chew on periodontal disease parameters in toy breed dogs. J Vet Dent. 2011;28(4): Virbac Corporation. All Rights Reserved. C.E.T. and VEGGIEDENT are registered trademarks of Virbac Corporation in the US. 1/

36 »» Dental Digital Radiography: Today s Standard of Dental Care More veterinarians understand the need to deliver good dental care. But, are they following through with the right technology? By Laura Thill Digital radiography is changing the face of veteri nary oral care, according to experts. Yet, it appears there s room for improvement. The standard of care in veterinary practice today is to incorporate dental radiography into every professional dental treatment, says Daniel T. Carmichael, DVM, FAVD, Diplomate AVDC. Digital radiography has, for the most part, replaced film-based technology, he adds. However, while both the American Veterinary Dental College (AVDC) and the American Animal Hospital Association (AAHA) have identified dental X-rays as a necessary part of a professional dental treatment, many practices have yet to adopt digital radiography, he points out. I would estimate that the majority of veterinary practices have not yet adopted dental radiography into their practices, Carmichael says, noting that this goes for some of the large corporate entities as well. Not only are these practices delivering sub-standard dental care, but they are also missing out on a profitable source of practice income. Many practice management experts have identified dental radiography as one of the most profitable investments a veterinary practice can make, with a rapid return on investment. He estimates it takes less than 6-12 months to recoup costs. Veterinary dental specialist Brett Beckman, DVM, FAVD, DAVDC, DAAPM, agrees that digital radiography has become a standard of care for veterinary dental care. The technology enables veterinarians to diagnose periodontal disease much more thoroughly, he points out. But, he, too, sees a gap between the availability of digital radiography and the number of veterinarians who have adopted the technology for dental care. 36 January/February 2014»» Veterinary advantage

37 On one hand, more veterinarians today are taking courses in dental extractions, he points out. We are getting to the point where more veterinarians understand that the majority of their work includes surgical extractions, which [requires] digital radiography, he says. The problem, he adds, is that some veterinarians have the technology, but haven t taken courses in surgical extraction. Or, some veterinarians are trained to perform surgical extractions, but have yet to add digital radiography. Beckman, who provides veterinary dental webinars, courses, continuing education and lectures, notes that veterinarians interested in providing oral healthcare (e.g., such as those attending his courses and lectures) are getting on board with digital radiography. Whereas about 10 percent of veterinarians attending his lectures/courses had the technology 10 years ago, roughly percent do today. The cost of doing business With increasingly advanced technology comes a cost, and one might wonder how much veterinarians are willing to pay for equipment, such as digital radiography, as well as how much their clients are willing to pay for the service. While the cost of digital radiography has been relatively stable over the last several years, the fact is, it can cost as much as $10,000 or $12,000 for a practice to add it (including the software and a generator). But, this is the only investment in general veterinary medicine that, if used properly, has the greatest return on investment, says Beckman. Even if a veterinarian doesn t charge for the actual X-rays, [he or she] can pay for the unit in six months, simply by doing procedures that are based on digital radiography/images. It may cost a practice not to add digital radiography, he adds, noting that having the technology enables the practice to provide better patient care, which in turn leads to increased client trust and greater revenue. A famous veterinarian/practice management guru, Marty Becker, once said, Think less of the cost to the client if they accept your recommendations, and think more about the cost to the patient if they don t, says Carmichael. Sure, new technology comes with a price tag, but in the dental world it is not prohibitive. Not only that, periodontal disease can adversely impact an animal s overall health, he continues. It is well known that the consequences of periodontal disease go way past bad breath, he says, noting that it can cause painful oral infections and the spread of bacteria to vital body organs. It is also known that the best treatment for periodontal disease is prevention, he adds. A client s investment in preventive care helps ensure a healthier life for his or her pet, as well as helps avoid more costly treatments down the road, he points out. As veterinarians, we are obligated It may cost a practice not to add digital radiography, he adds, noting that having the technology enables the practice to provide better patient care, which in turn leads to increased client trust and greater revenue. to offer the very best in care, and charge what we need to cover the costs and make a fair profit. But, no matter how well intentioned clients are, their decisions often depend on how much they can afford. The ability of pet-owners to afford proper dental care ranges and is based on economics, says Carmichael. Pet insurance doesn t always cover the full cost of advanced dental procedures, he points out. And, when clients can afford dental care for their pets, they likely won t do so if they aren t properly educated on the benefits of the investment, he notes. Eighty percent of the practice base of a general veterinary practice won t be able to afford the cost of the procedure, says Beckman. That said, 20 percent of clients likely can afford high-end services and will follow through on their veterinarian s recommendations, he points out. We need to keep in mind that nearly every patient the veterinarian examines will have something wrong with its mouth usually periodontal disease, Beckman Veterinary advantage ««January/February

38 »» Dental Digital radiography can cost as much as $10,000 or $12,000 for a practice to add, but if used properly, can have a great return on investment. Even if a veterinarian doesn t charge for the actual X-rays, [he or she] can pay for the unit in six months, simply by doing procedures that are based on digital radiography/ images, says Brett Beckman, DVM, FAVD, DAVDC, DAAPM. It may cost a practice not to add digital radiography, he adds, noting that having the technology enables the practice to provide better patient care, which in turn leads to increased client trust and greater revenue. continues. If percent of patients have periodontal disease, veterinarians should be talking to all clients about oral care and prevention, knowing that roughly 20 percent will follow through. Distributor sales reps should remind their customers that this 20 percent of clients [account for] 80 percent of the revenue for the practice. These clients are the consumers of any high-end service that the practice offers. Working with customers When distributor sales reps are educated about dental technology and products, they can better service their veterinarian customers particularly those who resist change in the industry. There are many innovations in the veterinary dental market, says Carmichael. Some are true innovations and others do not stand up to the test of scientific scrutiny. When veterinarians don t trust new technology, they might be reluctant to adopt it, he explains. The key is [for sales reps] to be able to sort out for the veterinarian what new technologies are true breakthroughs vs. [those] that may not be effective. In Beckman s experience, one of veterinarians biggest complaints is that no one teaches them how to use digital radiography. Sales reps not only should be aware of and knowledgeable about the products they carry, but they should be able to make recommendations for training, he notes. He recommends sales reps approach their customers with several probing questions, such as the following: Doctor, does your practice have digital radiography? If so, are you taking digital dental radiographs, including full-mouth X-rays? Are you aware that digital radiography is a standard of care one that ensures better patient care and additional revenue for your practice? In addition, reps should offer their customers a copy of the AAHA dental guidelines. Adding digital radiography is an investment, he says. Veterinarians need the equipment and training, as well as technicians to run the digital equipment. It s the reps job to help [their customers] determine what they need to do to set up what lectures and seminars [to attend], and what training and education they require. This is an investment for sales reps as well, Beckman continues. They too must attend lectures and seminars in order to understand how the equipment works and direct their customers to the right educational sources, he explains. Particularly as more distributors are helping their veterinarian customers add digital radiography, sales reps must be smarter when it comes to offering this service, he adds. If veterinarians know what they should be doing to provide proper dental care, and they are offering these services with enough enthusiasm, there will be a steady market and a high demand for service, says Carmichael. An educated sales force that can be trusted to provide advice on the necessary tools and products, and that can deliver them, will do well, he adds. Editor s note: Readers can view Brett Beckman s website at Vet-Advantage would also like to thank Crosstex for its direction with this piece. 38 January/February 2014»» Veterinary advantage

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40 They say youth is wasted on the young. We hope not. Vet-Advantage spoke to a few seasoned professionals veterinarians, and distributor and manufacturer sales professionals about the most valuable lessons they learned over the years. Then we asked them to imagine sitting across the table from their younger selves and imparting some of that experience. Here s what they said. Industry veterans reflect on insights they would share with their younger selves By Mark Thill 40 January/February 2014»» Veterinary advantage

41 Dennis Cloud, DVM: The value of the team Dennis Cloud, DVM learned one of the most valuable lessons of his professional life when he was still a young man. Cloud, a native of St. Louis, Mo., and owner of Rock Road Animal Hospital there, had just graduated from the University of Missouri College of Veterinary Medicine. One of his professors approached him about an opening with the U.S. Public Health Service at Colorado State University. If Cloud took the position, he would be fulfilling his military obligation. He followed up, and got the job. It was an eye-opener. In Colorado, Cloud was engaged in the Collaborative Radiological Health Laboratory, which was studying the effects on dogs of long-term, low levels of radiation. We took care of 2,000 beagles, he says. He learned a lot about beagles, and he learned a lot about canine reproduction. All very valuable. But he learned something else the value of a team. In Colorado, he was surrounded by capable staffers and colleagues. It was the very first time in veterinary medicine where I witnessed that the team was just as important as the veterinarian, he says. It was a lesson he took with him into private practice, during a career in which he opened and sold several hospitals. You have to have that great team, he says. That was true 40 years ago, and it s true today. And I ve always had that team other doctors I ve worked with, receptionists, technicians. Were Cloud to be sitting with his younger self, he d have a few more things to share. First and foremost, he would say that what happens in the exam room is what defines a veterinarian and his or her practice. You have to be medically sharp; that s essential, he says. Even more important, though, is showing clients that you care about them and their pets. That s where it starts and ends. Words of Wisdom Balance Work/life balance is important too. At his busiest, Cloud who, with his wife, Sharon, have six children would work roughly from 8 a.m. till 3 p.m., come home till about 5:30 p.m., then go back to the hospital till 9 p.m. The routine allowed him to have dinner with his family. Did I miss some things [at home]? he asks rhetorically. Yes. But I was able to maintain some balance, because of the associates I had. He would probably also tell his younger self the value of getting involved in the veterinary community. Cloud is a member of the American Animal Hospital Association, You have to have that great team. That was true 40 years ago, and it s true today. Dennis Cloud American Veterinary Medical Association, and the American Association of Feline Practitioners. He lectures on practice management, risk assessment and management, canine and feline pediatrics and senior care. He serves on the Veterinary Economics Hospital Design judging panel and advisory board, and also serves on the Missouri University College of Veterinary Medicine Strategic Advisory Board, The Partnership for Preventative Pet Health Care Advisory Board, and the advisory council of the Missouri Veterinary Medical Association. He has also served on Pfizer and IDEXX advisory boards. He is also a co-host with Dr. Caroline Gilje on KTRS 550 AM Animal Advice radio show sponsored by Purina on Saturday mornings. Cloud looks ahead at a new model for the profession he loves. It s something he has thought about for a couple of decades now. Veterinary advantage ««January/February

42 Words of Wisdom Clients love one-doctor practices, he says. They want to see that doctor; they don t like going to a five-doctor practice and seeing a different person every time. The problem is, that model lacks some efficiency. In the new model of veterinary care, clusters of veterinarians in small practices would pool their money and invest in a central, 24/7 hospital. The model would be similar to human medicine. Clients would continue to see their veterinarian at the local hospital. But if a surgical procedure or advanced treatment were required, that veterinarian would schedule it for the central facility. You d have the best of both worlds, he says. You d have your one-or-two-doctor practice, but you wouldn t be duplicating all the facilities. If a client knows that I will be doing the surgery, and that I ll be going in [to the central hospital] every day to check on their dog, they wouldn t have any problem with that. Dan Segna, DVM: Get involved Sometime in junior high in Southern California, Dan Segna, DVM, decided that being a veterinarian such as the veterinarian who called on his family s commercial poultry ranch was a more attractive option than owning and operating an egg ranch. His career in veterinary medicine has taken many turns since then, but he has never looked back on his decision to pursue the profession. Segna is assistant executive director of the California Veterinary Medicine Association. Make sure the other veterinarians you work with have the same practice philosophy as you from a clinical and business perspective. Dan Segna A graduate of the UC Davis (California) School of Veterinary Medicine, Segna practiced veterinary medicine in private practice for many years, first in Thousand Oaks, Calif., and then near Sacramento, where he eventually owned two practices. In the early 1990s, he became involved with the California Veterinary Medical Association. He was part of a group looking at computer-based technology, and began writing databases for the association. In 1994, he became the association s director of computer information services. It was a half-day-a-week job, which did not interfere with his practice schedule. Later, he helped the association create and maintain an online presence. By the mid-2000s, he was working several days a week for CVMA, involved in membership and various programs, such as one involving feral cat spay/neuter. Then, in 2008, as he was planning to sell his practice, CVMA asked him to become its full-time assistant executive director. The planets were aligned, and I made the jump, he says. Were Segna to have a sit-down with his younger self, here are some of the things he d share: Make sure the other veterinarians you work with have the same practice philosophy as you from a clinical and business perspective. Take care of yourself first. Veterinary medicine is a stressful job, and practitioners can be prone to burnout. Make sure you have a support system, and make time for yourself. Keep learning new things. My practice was primarily cats and dogs, but I had an exotic animal component too, Segna says. It was a constant challenge, which I enjoyed. Learn and implement new technologies, whether they are clinical or diagnostic, or business-oriented. Get involved in organized veterinary medicine, as it exposes individual practitioners to larger outside issues that may affect their practices and profession. Associations are able to accomplish a lot of things 42 January/February 2014»» Veterinary advantage

43 Iams Veterinary Formula Diets Prescribed for New Year s resolutions and dental health. Weight Loss/Mobility Plus Joint Plus Glucose & Weight Control Plus Our breakthrough diets utilize a total body approach for healthy weight loss. Plus, they contain ingredients that address associated indications your patients may be experiencing, along with nutritional components for overall health and well-being. L-Carnitine contributes to the oxidation of fat Animal-based protein supports lean muscle mass Glucosamine and Chondroitin Sulfate building blocks for cartilage to promote joint health Patented Carbohydrate blends helps optimize blood glucose and insulin response Prebiotic FOS contributes to GI health Targeted fatty acid ratio promotes healthy skin and coat; helps manage inflammation at the cellular level Sodium Hexametaphosphate (HMP) tartar build-up reducing agent for dental health* *HMP can be found in all Iams Veterinary Formula dry dog formulas with the exception of Renal Plus. SPECIAL LIMITED-TIME OFFER Receive an additional item FREE with the purchase of these Iams Veterinary Formula diets or biscuits: Weight Loss/Mobility Plus, Weight Loss Rewards Plus, Joint Plus, or Glucose & Weight Control Plus. Buy 3, Get 1 Free: Purchase 3 of any item, receive 1 of the same item free! in which you order. There is no limit to the number of qualifying orders during the designated promotion time frame. All orders must be placed by 2/28/14. This offer cannot be combined with any other offer. Offer is good while supplies last and is subject to change or cancellation without prior notification. Available through MWI and Henry Schein 2014 P&G

44 Words of Wisdom that individuals can t do on their own, especially in the area of legislation and regulations. You become part of the discussion, helping determine the future of the profession. As a side benefit some of my best friends have come through people I ve met in my association work. Nothing wrong with idealism Segna would encourage veterinary school graduates to hold on to their idealism. True, life has a way of straightening things out, but there s nothing wrong with aiming for the best. Here s what else he would share with young grads: Find a good mentor at the beginning of your career. Have confidence in what you know. Young grads know a lot coming out of school, he says. During those first two or three years out, you really learn the practice of veterinary medicine; it s when you put into practice what you learned in school. Take chances early in your career. A veterinary degree opens the door to a lot of opportunities; this is a good time to figure out which ones you want to pursue. Stay positive. Early in Segna s career, an older veterinarian advised him to hold on to all the Thank- You notes he would no doubt receive from clients. Then, when he encountered the occasional disgruntled client, he could pull out those Thank-Yous and get back on track. Finally, seriously consider practice ownership. Many of the recent graduates I talk to say that they are not interested in practice ownership, he says. Most of the practice owners I talk to are happy with their decision to become an owner. I certainly enjoyed owning a practice most days. As an owner, you take on more responsibility, but you also have more control over your professional and personal life, and you re like to receive higher compensation than you would as an associate veterinarian. Bud Dorris: Tools for success In his 53-year career, Bud Dorris implemented several tools for success: Integrity, honesty, hard work, awareness of the customer s time, and a willingness to ask for the order. He retired in 2013 as national accounts manager from PRN Pharmacal, following a career that took him from veterinary pharmaceutical sales, to human pharmaceutical sales, back to veterinary sales, to veterinary distribution, and back again to veterinary pharmaceutical sales. Were Dorris to have a discussion with his younger self along the lines of, If I only knew then what I know now, here are some of the things he would share, first from a manager s standpoint, and then from a salesperson s standpoint. Manager s standpoint To his younger manager self, Dorris would share the following: Ask your salespeople for their opinions and desires about marketing and sales programs, including promotions. It s an approach that worked well for Dorris when he was a regional manager at Bristol Myers. Impress upon the sales force the importance of being quiet after handing literature to the veterinarian. A lot of guys keep talking, he says. Better to let the doctor lead the discussion at that point. Maintain a sense of balance in your life. Dorris was 100 percent dedicated to meeting sales goals. But it s just as important to be dedicated to vacation time, family time and spirituality. I was kind of one-sided until I got older, he admits. Be proud of the company you work for, and share that pride with your customers. That was easy for Dorris to do, as his company PRN became employee-owned 10 years before his retirement. It was the greatest part of my career, he says. What s more, veterinarian customers liked the idea of employee ownership. 44 January/February 2014»» Veterinary advantage

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46 Words of Wisdom Don t be intimidated by management. Share your thoughts and ideas with them, even if you re a young rep. Bud Dorris Salesperson s standpoint To his younger sales rep self, Dorris would share this: Don t be intimidated by management. Share your thoughts and ideas with them, even if you re a young rep. Let them know things you think might help the company s sales, he says. Pay attention to the technicians and others in the office. When I started, technicians weren t as important [in buying decisions] as they are today, he says. The doctor did all the buying. If he had to do it over again, he would get to know the technicians earlier, and better. Don t neglect your personal finances. Salespeople are on the road four or five days a week, he says. They either let somebody else organize their finances, or they do it themselves haphazardly. You re better off doing it in an orderly and logical way. Search for an employee-owned company for which to work. At PRN Pharmacal, Dorris found a culture high in honesty, integrity and intelligence, as embodied by its chairman, Everett Mealman. There are a few things of which Dorris is as absolutely sure of today as he was when he got into the business 53 years ago, namely: Operate your territory in an orderly fashion, follow up on promises and answer questions as fully as possible. It s OK to tell customers you don t know the answer, but will get back to them, he says. But it s a lot better if you have the answer. When presenting a product to veterinarians or technicians, be aware of their time and know your products. Remember that in the back of their minds, they re thinking of the next surgery. When in the presence of your customers, remember that you represent your company to them. Rick Sain: Disciplined goal-setter Rick Sain retired from Butler Schein (now Henry Schein) Animal Health in years after he began his career in veterinary sales with Memphis, Tenn.-based Curts and Morgan, which was owned by his Uncle Al. His first year in the business was inauspicious he swept floors and washed windows; after awhile, he was promoted to shipping clerk. He finally got his chance to go into the field in 1963, following some product training and a week on the road with a veteran rep. Had he the opportunity to do it all over again, he would. But he might do some fine-tuning. For example, during his first seven or eight years in the business, he would have skipped the time he spent as a visiting salesman and immediately begun work as a disciplined, sales-oriented rep. If I could tell my younger self anything, it would be, Start earlier being a disciplined goal-setter, a disciplined salesperson. Sain eventually did become that disciplined goal-setter. He grew to be regimented in his call cycle, and meticulous in his note-taking. I could look back at an order I wrote six months before, and tell you where I was, what was said in my conversation with the doctor, he says. Then, when he returned six months later, he d know to say, Doctor, when I was here six months ago, we talked 46 January/February 2014»» Veterinary advantage

47 Because your waiting room is filled with variety... so is our glove line. From the makers of Sensi-Touch Your day can turn into a real zoo. Choose from a variety of premium surgical and exam gloves that provide tactile sensitivity, long-wearing comfort, allergy protection and fit your unique needs. Extra protection, powder-free latex, latex-free, chemotherapy approved and more, our product line is as versatile as you are. To see all of our species of gloves, visit For samples, visit Original Perry Style 42 Latex, Powdered Surgical Gloves Micro-Touch Nitrile Synthetic, Nitrile, Powder-Free Exam Gloves GAMMEX Non-Latex Sensitive Non-Latex Surgical Gloves and are trademarks owned by Ansell Limited or one of its affiliates Ansell Limited. All Rights Reserved. about digital X-ray. Are you ready to [move forward]? Value to customers always Throughout his career, Sain strove to provide value to his customers. Yes, my goal was to get an order, he says. But I was so much more than an order-taker. I brought information. I never reached in my billfold and paid for an office call, but I paid my doctors with information and service. I took care of their problems. When I walked out the door, [the doctor] felt good, and I did too. If I ever wasted his time, it was a bad visit. Sain is as sure today as he was decades ago of the value of consistency, hard work and dependability. I was professional in my approach and my appearance. I wore a coat and tie on every call. I respected the doctor and his time. And he knew the meaning and value of work. I told the 25 or so people I trained [through the years] that the secret to success is so simple, many people miss it. You start work early, you quit late, and you work through lunch some days. When you do that, you ll be successful. He tried to convey another thing to those he trained: The joy he took in his work for 50 years. The veterinarians I called on became my family and friends on the road. That s how I was able to enjoy my profession 50 years. He recalls his wife, Barbara, telling him as he left the house in the morning, You re the luckiest person I know, because you re happy to be going to work, he says. I told her, that s because I was going to see my friends. Yes, my goal was to get an order. But I was so much more than an ordertaker. I brought information. I never reached in my billfold and paid for an office call, but I paid my doctors with information and service. Rick Sain Veterinary advantage ««January/February

48 Words of Wisdom Dave Manley: Rely on others Dave Manley retired in December 2012 following a full and varied career. With a master s degree in educational counseling, he planned to teach high school science and do some coaching, most likely football. He did, in fact, work briefly as a guidance counselor. But events primarily, the Vietnam conflict took him in another direction. He got drafted, went through Officer Candidate School, and ultimately was assigned to psychological operations, or PSYOPS, at Fort Bragg, N.C. After completing his military service, he took a position as an area personnel manager in New Jersey for American Hospital Supply Corp. (now Cardinal Health), a national distributor and manufacturer, primarily servicing hospitals. He served in various HR and sales positions for American s distribution and manufacturing businesses before taking early retirement from the company in I would tell my 30-year-old self to practice personal networking. For four years, he owned an independent rep and specialty distribution business in Upstate New York. Then, in 1994, he joined Welch Allyn, which was creating a surgical camera business. Three years later, he was offered the opportunity to work in special markets for Welch Allyn, spending half his time handling veterinary responsibilities and the other half working with U.S. government contract sales. Later, he became involved solely with the veterinary market. As I look back over the years, with all those varied experiences, I can t tell you how many hundreds of people I met along the way who impressed me, he says. I think I didn t network enough, in the business sense, to my advantage. Today, people network through social media outlets, and that s well and good. But I would tell my 30-year-old self to practice personal networking, he says. The phone call to a close business associate who has moved on to a different area is important. When you re 30, you feel, I can get this done by myself, he says. Better to learn early on how to rely on others. Another lesson learned? Confidence. When you re unsure of yourself, you question yourself when you re really doing the right thing. So I would say, be a little more confident in your ability to make good decisions, stick by them, and support them. It wasn t until I was 26 or 27 that I had confidence in myself, and felt comfortable in my skin. Listen closely That said, Manley is just as sure today as he was 30 years ago of five things: The importance of being a good listener. Perhaps it was his background in counseling that taught him this lesson early on. In the military, it grew on me, he says. You have to listen, because if you don t hear what s being said, you ll pay the consequences. Dave Manley Second, and closely related, is another lesson Manley learned in the service, acting as the administrative officer to a colonel. It is the importance of clarity. The lesson I learned was, never be evasive when responding to a request for information. If you don t know the answer, research it, get the facts, and be direct in your response. Make a clear recommendation. Family first is the third thing of which Manley has always been certain. It s such a payoff when you get older, he says. It s just fun to be involved in your family s lives. Fourth, a good company gives its people ample opportunities to excel. It s a lesson Manley learned first in the military, then at American. They gave a lot of responsibility to very young people who had a lot of talent, and who were able to figure things out and get the job done. Finally, Manley is as sure today as he was 30 years ago of the importance of mentoring. I learned that at a fairly early age, he says. I was mentored, and took that very, very personally, he says. Later, when he had the opportunity, he mentored young people himself. 48 January/February 2014»» Veterinary advantage

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50 »» Trends The Supplement Sale With a basic understanding of supplements, reps can engage their customers in the market. By Laura Thill Not everyone is sold on supplements. The industry is self-regulated and there s a lack of clinical evidence backing the efficacy of supplements. Yet, they re high in demand by pet owners, who are eager to purchase inexpensive products from their local retailers. So, it comes down to this: Are your veterinarian customers thumbing their nose at an undefined science? Or, are they providing credible recommendations based on their patients needs? The market is growing and it s split between the veterinarian clinics and over-the-counter products, says Adrian Bayley, president, North American Compendiums, Inc. (Port Huron, Mich.). Now is the time for veterinarians to get involved, and distributor sales reps must demonstrate to veterinarians that they are a credible source. The market is growing and it s split between the veterinarian clinics and over-the-counter products. The FDA and most veterinarians consider supplements both nutritional and therapeutic low-risk, notes Bayley. However, some products contain outlandish claims, he points out. There is a lack of scientific trials, which would be very expensive, [particularly since] there are no patents on these products. Veterinarians [tend to] focus on the efficacy of supplements, Bayley continues. They question whether pet owners really know what they re getting when they purchase supplements. Not only that, you can give the same supplement to two different pets, and they ll respond differently, he adds. There s no magic 50 January/February 2014»» Veterinary advantage

51 What are supplements and are they safe? Supplements are products intended to support maintenance of normal biological structure and function in animals, according to the National Animal Supplement Council. They can be dietary (vitamins) or therapeutic (e.g., glucosamine, chrondroiton sulfate and MSM for joint care; omega-3 and omega-6 fatty acids for skin and coat care; or calming supplements with herbal sedatives to address anxiety). When used appropriately and according to a veterinarian s direction, supplements generally are considered safe. Issues arise, however, when pet owners sidestep the veterinarian and seek out inexpensive products at local retail stores. For instance, pet owners can unwittingly overdose their pets on nutritional supplements, particularly when their diet already is rich in vitamins. Excess vitamin A can lead to damaged blood vessels, dehydration and joint pain in dogs, according to WebMD. Too much vitamin D can cause a dog to stop eating or lead to bone damage or muscular atrophy. And, an overdose of calcium can cause skeletal problems. Cats, too, can develop health problems following overdoses of nutritional supplements. An overdose of vitamin A-enriched foods, such as raw liver, and vitamin A supplements, such as cod liver oil, By educating clients on risks and symptoms of vitamin overdose, and making appropriate recommendations, veterinarians can strengthen their doctor-client relationship. can lead to lethargy, loss of appetite, weight loss, lameness, rough hair coat, constipation, abnormal sitting posture and skin allergy, according to PetMD. Similarly, too much calcium and vitamin D can also pose health risks. For this reason, it s important for veterinarians to stay involved in their clients decisions to give their pets supplements. By educating clients on risks and symptoms of vitamin overdose, and making appropriate recommendations, veterinarians can strengthen their doctor-client relationship. It s good value to the client and good business for the practice. Innovative joint support in a once-daily chew Undenatured Collagen Type II Supports healthy joints and flexibility The most abundant protein in cartilage Supports your mobility and rehabilitation programs The advanced step in joint management programs OMEGA Vétoquinol

52 »» Trends Now is the time for veterinarians to get involved, and distributor sales reps must demonstrate to veterinarians that they are a credible source. National Animal Supplement Council The National Animal Supplement Council (NASC) formed in 2002 in response to a lack of legal category for dietary supplements for animals and concern that certain regulatory bodies might remove these products from the marketplace. The Dietary Supplement Health and Education Act (DSHEA), passed in 1994, provides strict guidelines for the labeling and marketing of human dietary supplements, including preventing manufacturers from making overt claims about their products. However, DSHEA does not apply to similar products for animals. NASC s goal is to work cooperatively with the regulatory agencies to create a framework that is fair, reasonable, responsible and consistent for animal supplements, according to the organization. Today, its membership is comprised of over 125 U.S and international companies committed to providing health supplements and nutritional supplements of the highest quality for companion animals, primarily dogs, cats and horses. Only independently audited NASC member companies operating under the stringent guidelines of NASC for manufacturing, labeling and adverse event reporting, and demonstrating responsible participation are permitted to use the NASC Quality Seal. For more information, visit bullet. But, even if a supplement has a placebo effect, who s to say that s not a good thing? That said, if the veterinarians aren t offering supplements, pet owners can just as easily purchase them from PetSmart or Walmart. And, while they likely won t put their pet at risk, without veterinarian guidance, pet owners may overdose their pet on vitamins or give them less effective, off-brand products. Are reps ready? Distributor sales reps can play a role in keeping their veterinarian customers informed. Distributors can reach out to their manufacturer partners, who have promotional material regarding labels, trials and trial results, notes Bayley. Many manufacturers have done some good research, offer good products and provide thorough information, he says. And while it s not practical for all distributor sales reps to call every manufacturer about their product labels, there are compendiums, such as the one on the Vet-Advantage website ( listing product information and directions for use. In addition, the best way to learn about supplements is for distributor reps to ride along with the manufacturer reps [on their sales calls], he points out. Working with reputable manufacturers whom distributors can depend on to use top quality ingredients and do regular quality assurance testing is key, Bayley continues. Particularly since some of these materials come from foreign countries, many of which have fewer regulations than the United States, it s important to ensure that what s on the label is actually in the bottle, he explains. When a product is less expensive, we have to ask why, he says. Does it offer the same quality assurance? Sometimes, a cheaper product is not such a good [choice]. If I call four distributors, I ll probably find they 52 January/February 2014»» Veterinary advantage

53 all work with reputable manufacturers that offer similar pricing. Armed with credible products and promotional/informational materials, sales reps can initiate a discussion with their veterinarian customers. They can begin by asking several probing questions, such as: Doctor, are you aware that we offer a range of supplements? Are you also aware that we only supply good-quality products, which undergo quality assurance testing periodically? We supply you with other pharmaceuticals and can easily address your need for supplements as well. May I leave you some fliers and information sheets on some supplements I believe you might be interested in? Why supplements? Some veterinarians may be skeptical about the efficacy of supplements. But, there s no denying, many of their clients want them for their pets: For the most part, supplements are considered safe for pets. Clients are looking to purchase them, whether from their veterinarian or local retailers. Supplements represent business for the veterinary practice. For involved veterinarians, this is an opportunity to offer clients their expertise and recommendations. For clients, working closely with their veterinarian is a value-added proposition. Reps can remind their customers that they can help ensure their clients and patients are getting high-value products, while building the relationship. For instance, the veterinarian might say to his or her client, Try this supplement and bring your pet back in two months. At that time, we will see how it is responding to the therapy. Clients are eager to take advantage of cheaper options from Walmart or big-box pet stores. Veterinarians, however, can offer the benefit of their expertise. For instance, they can help clients avoid giving their pets products that might impact other medicines they are taking. The market is growing, says Bayley. Now is the time for veterinarians to get on board. Veterinary advantage ««January/February

54 »» Trends Taking Control of Flea and Tick Flea and tick prevention begins with education By Laura Thill Flea and tick products today are readily available, and many agree they work better than ever before. Why, then, do these parasites continue to present a problem for dogs, cats and their owners? Flea and tick control continues to be a nationwide problem for several reasons, according to experts: Climate change has led to a greater prevalence of parasites, as well as the movement of parasites to more areas of the country. As more wildlife migrates to suburban and urban areas, they bring with them more fleas and ticks. A lack of information leaves some pet owners in the dark when it comes to the importance of yearround prevention, as well as proper technique in applying products. There will always be fleas, says Michael Murray, DVM, MS, Dipl, ACVIM, technical marketing director for U.S.A. Pet Parasiticides, Merial Limited. Feral cats, possum, raccoons even the neighbor s pets are a source of infestations, he points out. A flea-infested feral cat sleeping under your deck each night can leave behind hundreds of flea eggs, he says. And when those eggs have developed into new, hungry fleas, a pet owner s dog can pick them up in seconds during a romp in the backyard. This same urban wildlife, as well as deer and birds, can also leave behind ticks. Products that kill both fleas and ticks are really targeting very different parasites that have one thing in common feeding on blood. Preventives are a form of insurance, note experts. However, it s a policy that some pet owners don t feel compelled to invest in. According to a 2012 Gallup study, It would be great if veterinarians could predict the weather for pet owners. But, they can t, and, if pet owners wait until they see fleas on their pet, it s probably too late. Michael Murray, DVM, MS, Dipl, ACVIM, technical marketing director for U.S.A. Pet Parasiticides, Merial Limited 54 January/February 2014»» Veterinary advantage

55 roughly half of pet owners treat all year long, while about one third of pet owners treat in-season flea and tick problems, and one of every six pet owners have the attitude that they ll only treat flea and tick when they see a problem, says Doug Yoder, director of marketing analytics and insights, Bayer Healthcare. There are many factors contributing to this, he points out: Pet owners try to save money by not purchasing flea and tick preventives, they have the preventives but get busy and forget to apply them, or they don t apply them correctly. Indeed, about 17 percent of pet owners have scaled back on flea and tick protection, notes Paris Revoir, DVM, national training manager at Bayer Healthcare and the former owner of PetWorks Veterinary Hospital, citing a recent PetCareRx study printed in the Fountain Agricounsel newsletter. At the same time, about 300,000 cases of human Lyme disease are reported annually in the United States. When talking to pet owners in the Northeast, it s rare to find pets or their owners that haven t been impacted in some way by Lyme, he says. The perfect storm Year-round flea and tick control is especially important given that egg development is weather dependent, says Murray. And weather is unpredictable. Last summer, we had some high humidity and relatively cool temperatures, he recalls. This was ideal for the development and survival of flea larvae. Then, later in the summer it warmed up, and suddenly the fleas Pet owners were polled on flea and tick preventives: Roughly half of pet owners treat all year long One third treat in-season flea and tick problems, One of every six pet owners have the attitude that they ll only treat flea and tick when they see a problem were everywhere. Pet owners not only were battling the fleas that developed outdoors, but also the infestations in their home from the egg-laying fleas on their pets. It would be great if veterinarians could predict the weather for pet owners, he continues. But, they can t, and, if pet owners wait until they see fleas on their pet, it s probably too late. Those fleas have been laying eggs, which likely are in the pet owner s house by now! More than just a nuisance, in some cases this can be quite dangerous. A couple of years ago, there was a winter freeze in the South, he says. People turned up the heat, and the warm indoor temperatures caused flea eggs in their homes to quickly develop into hungry fleas looking for a blood meal. Some dogs were infested with hundreds of fleas and required blood transfusions. MeloxiMed TM (meloxicam) Injection 5 mg/ml solution for injection non-steroidal anti-inflammatory drug for use in dogs and cats only. anada approved by fda ndc benefits MeloxiMed TM can be administered intravenously or subcutaneously. One injection provides about 24 hours of pain and inflammation relief in dogs A single injection in cats provides pain & inflammation relief for about 15 hours. list no. unit PacKage case size 1mel x 10 ml 300 (30 x 10) indications dogs: For the control of pain and inflammation associated with osteoarthritis. cats: For the control of postoperative pain and inflammation associated with orthopedic surgery, ovariohysterectomy & castration when administered prior to surgery. caution: Federal law restricts this drug to use by or on the order of licensed veterinarian. Warning: Repeated use of meloxicam in cats has been associated with acute renal failure and death. Do not administer additional injectable or oral meloxicam to cats. See Contraindications, Warnings, and Precautions for detailed information. Veterinary advantage ««January/February

56 »» Trends Weather watch Year-round flea and tick control is especially important given that egg development is weather dependent Similarly, tick development also is weather dependent, notes Murray. Because ticks spend the majority of their time off a host, they are very susceptible to temperature and moisture, he says. Cooler, wet summers tend to be followed by a bigger tick season in the fall. And, all it takes is one tick to spread a serious infectious disease, he adds. The rep s role Veterinarians know that fleas and ticks present a yearround problem, necessitating continuous treatment. Sales reps can help their veterinarian customers inform and educate their clients. Distributor sales reps should have an open-ended discussion with their veterinarian [customers], says Revoir. Reps should find out what the veterinarian s overall strategy is with regard to flea and tick control. And, while lunch-and-learns are a great means for reps to present new products and solutions, the staff can only retain so much information, he says. For this reason, brochures and written instructions can be very helpful, particularly when reps highlight key information for their customers. Veterinarians love to teach, and sales reps can help put them in a teaching mode, says Revoir. [When I was a veterinary practice owner], I would set the box of flea and tick control on the examination table after having the flea and tick discussion and say to my clients, This is what I recommend medically for your pet. Pet owners are more likely to say Yes to a product if their veterinarian makes it clear he or she supports its use, he adds. At the same time, veterinarians are always looking to control their inventory, he points out. Offering too many products or letting clients make the choice can confuse clients something sales reps should keep in mind when presenting solutions to their customers. Veterinarians are looking for truly unique products that provide good efficacy and value for their clients, adds Yoder. Veterinarians and their clients have more choices than ever before, experts point out, including collars that provide up to eight months of protection and better tasting oral preventives. By asking a couple of probing questions, distributor sales reps can zero in on the needs of their customers and their clients: Doctor, can you tell me about the types of flea and tick problems you see at your practice? What do you feel is important to you and your clients in the way of a flea and tick solution? Veterinarians, in turn, can ask their clients some probing questions as well: Do you ever see deer, feral cats or other wildlife in your yard? Do you take your dog to a dog park? Where else do you take your pet? Questions such as these can help veterinarians better understand their patients risk for flea and tick issues, notes Murray, adding that this is a much better approach than trying to convince clients to use a product simply because the veterinarian has it on his or her shelf. Once veterinarians understand their patients risks for flea and tick, rather than telling clients what not to do, they can educate them about protecting their pets. Rather than veterinarians telling clients, Don t take your dog to the dog park, they can say, Let s see how we can protect your dog, he says. Veterinarians should make this a collaborative effort with the pet owners. After all, if pet owners voluntarily bring their pets to the veterinarian, they are interested in learning how to ensure the health of their pet, he points out. When pet owners feel more involved in the decisionmaking process, it follows they will be more likely to comply. 56 January/February 2014»» Veterinary advantage

57 Killer protection with killer new offers. The FRONTLINE Plus Premium Pack is fi lled with added value your clients can get only through you. NEW Inside for your clients: 3 or 6 doses of FRONTLINE Plus SATISFACTION PLUS GUARANTEE TM* Money-saving coupon Pet Health Guide A PIN code for a free 5 x7 Snapfish Soft Cover Photo Book ** * The guarantee offers your choice of a refund, product replacement, or a FREE in-home inspection and treatment, if necessary. Please see full details at ** Pet owner pays for shipping & handling. FRONTLINE is a registered trademark, and SATISFACTION PLUS GUARANTEE is a trademark, of Merial Merial Limited, Duluth, GA. All rights reserved. FLE13PLTRADE3 (1/14).

58 »» Trends Flea Control The time to begin flea control is before the problem emerges. Chances are, no one will notice the first few fleas their pet brings in this spring. But, within a month, their home can become something of a flea factory, and their pet undoubtedly will be miserable. Dogs and cats (as well as coyotes, raccoons and possum) are prime targets for one species of flea in particular, Ctenocephalides felis, the cat flea. Once the cat flea jumps on its victim, it immediately feeds on its blood and remains there for its entire life at least two or three months. Within 24 hours of landing on a cat or dog, fleas begin laying their eggs as many as 40 or 50 per flea each day. The smooth eggs fall off the dog or cat and stick in grooves of hardwood floors, mats, carpets, beds and more. The eggs hatch into larvae, which thrive in warm areas with moisture, such as carpets. In the following seven to 21 days, the larvae, which feed on flea droppings, spin their cocoons. Within two or three weeks (up to 150 days in colder temperatures), a new flea emerges and lands on the dog or cat, and the cycle begins again. At the very least, fleas create an annoyance to dogs and cats, who scratch at them. Some pets are better than others at removing the pests, which latch onto their hair follicles. Sometimes, they present more than just an annoyance. Many pets develop an allergy to flea bites, and when cats and dogs ingest fleas during grooming, they may be infected with tapeworms. And, puppies, kittens or smaller breeds risk developing anemia due to loss of blood. Clearly the time to attack this problem is before it occurs. How flea products work Modern flea products work by killing adult fleas and preventing new infestations by killing fleas before they lay eggs or killing the eggs. For these products to be effective, they need to be used according to their labels and all dogs and cats in the household must be treated. Flea products should be used year-round, because although people tend to think of them as a spring-summer problem, some of the worst flea problems can occur in the autumn and winter. Relatively cool and damp summers can create ideal conditions for flea development, followed by a fall flea surge. These fleas can leave eggs behind in the home, and when the winter cold arrives and pet owners turn on the heat or humidifier, a flea infestation can surge within the home. Pet owners sometimes complain that the flea product they have purchased from the veterinarian does not work because the pet keeps becoming infested with fleas. This does not mean the product isn t working. Typically this occurs because the pet may be acquiring fleas from a flea development hotspot outdoors, or there may be a flea hotspot in the home. Even after a flea product is used, the eggs, larvae and pupae in the home continue to develop. It can take several weeks for this flea biomass to run its course. In that time, pet owners may see even more fleas on their pet than when they first treated it, because of a surge of developing fleas in the home. It will help pet owners if the veterinary staff establishes proper expectations for results using flea control products. An elaborate discussion of flea biology is not necessary, but there will be fewer complaints if the pet owner understands that pets can acquire new fleas in seconds, and that these fleas may take a few hours to be completely killed. That said, they will be killed typically before they have a chance to lay eggs if the pets are treated according to the product label. Veterinarians should remind their clients to keep their pets on a flea product, even after indoor fleas have fully disappeared. One romp through an area trespassed by an infested possum or raccoon, and a dog or cat easily can bring home another round of fleas. How to sell Distributor reps can ask what flea products the veterinary practice s clients prefer. How does the clinic ensure that pet owners get the product they need? Do they discuss flea control with the pet owner, or wait until the pet owner asks for a product? By working closely with the manufacturer, reps can supply their customers with tools, such as literature and videos, to keep clients informed on the importance of flea prevention. Editor s note: Vet-Advantage would like to acknowledge the contribution of Merial (Duluth, Ga.). 58 January/February 2014»» Veterinary advantage

59 Chew love. It s easy to see how the Real-Beef Chewable supports your recommendation for year-round heartworm disease prevention. HEARTGARD Plus (ivermectin/pyrantel) is: The only heartworm preventive that comes in the Real-Beef Chewable The heartworm preventive dogs love to take 1,2 The #1 most requested heartworm preventive 3 Backed by the Plus Customer Satisfaction Guarantee 4 IMPORTANT SAFETY INFORMATION: HEARTGARD (ivermectin) is well tolerated. All dogs should be tested for heartworm infection before starting a preventive program. Following the use of HEARTGARD, digestive and neurological side effects have rarely been reported. For more information, please visit HEARTGARD and the Dog & Hand logo are registered trademarks of Merial. All other marks are the property of their respective owners Merial Limited, Duluth, GA. All rights reserved. HGD13TRTRADEAD3 (03/13). 1 Of dogs showing a preference in three studies, dogs preferred HEARTGARD Chewables over INTERCEPTOR (milbemycin oxime) Flavor Tabs by a margin of 37 to 1; data on file at Merial. 2 Of dogs showing a preference in two studies, all dogs preferred HEARTGARD Plus Chewables to TRIFEXIS TM (spinosad + milbemycin oxime) beef-flavored chewable tablets; Executive Summary VS-USA and VS-USA Opinion Research Corporation, Heartworm Prevention Medication Study, Data on file at Merial. 4 Ask your Merial Sales Representative for full guarantee details.

60 »» Trends Tick Control Ticks can present a year-round problem for pets, and a year-round opportunity for reps to help their veterinarian customers. Several species of ticks are native to the United States, and more than one species may gravitate to any one region or climate. Ticks feed on many animals, including deer, small rodents, opossums, raccoons and birds. As the habitat and number of wildlife have expanded, so has the geographic distribution of ticks. Ticks generally thrive in warmer weather, but one winter thaw can lead to a new surge when pet owners least expect it. For instance, the black-legged tick, which can infect dogs and people with Lyme disease, will be active and searching for a host on which to feed once the ambient temperature rises above freezing. No matter what time of year they emerge, however, ticks are known to transmit diseases that are life threatening to both pets and humans. Lyme disease tends to be the best known of these diseases, but ehrlichiosis, Rocky Mountain spotted fever and anaplasmosis are among other common ticktransmitted diseases. Virtually every area in the country is at risk for at least one of the tick-transmitted diseases. How it works Ticks feed on animals, including dogs and cats, for only a few days. Ticks are found in more places than ever today, and pets can be exposed not only in wooded areas but in their yard, neighborhood and parks as well. So, tick control is highly important, especially since one tick alone can transmit a serious disease. Commercial products containing DEET are toxic to animals; therefore pet-owners should stick with solutions specifically designed for pet use. Tick control products are available in topically applied liquids, collars and recently, in an oral product. The important thing is whether a product effectively kills ticks and, if so, for how long. While some products are appropriate for both dogs and cats, others may be toxic for one or the other, and reps need to be aware of the varying implications of the products they carry. Because ticks can thrive all year long, controlling ticks is a continuous challenge for pet owners. Typically, spring, summer and fall are the heavy tick seasons. Ticks decrease their activity as temperatures soar in the summer, but re-emerge as the weather cools off. Therefore, the Companion Animal Parasite Council recommends administering year-round tick prevention to dogs and cats, particularly in areas in which Lyme disease is endemic. How to sell Distributor reps can work with the manufacturer to acquire a greater understanding of the tick risk for each area or practice they work with. In addition, they must work with their customers to learn how pervasive the tick problem is for their patients. If two clinics in the same area are experiencing different degrees of tick problems, reps may need to explore this further to ensure that one clinic is not overlooking something. It is not unheard of for veterinarians to underestimate the reality of the threat of ticks. Reps should ask their customers what their practice recommends for tick control. In some cases, vets may be hearing from their clients that a product is not working well. This is a function of the number of ticks on a dog, rather than an ineffective product. If a tick product kills 95 percent of ticks, and the dog is infested with 100 ticks, a pet owner will notice five engorged ticks. Also, some clients may not realize it takes longer to kill ticks than it does to kill fleas. Reps can remind their customers that even the best products can take some time to eradicate a tick problem. Preventing the issue, rather than trying to end it once it develops, is always the best approach. Editor s note: Vet-Advantage would like to acknowledge the contribution of Merial (Duluth, Ga.). 60 January/February 2014»» Veterinary advantage

61 Includes Designed to make application precise and neat. See side of package for details. Applicator Patent Pending ACTIVE INGREDIENTS: Etofenprox (CAS # ) 30.0% (S)-Methoprene (CAS # ) 3.6% Piperonyl Butoxide (CAS # )* 5.0% OTHER INGREDIENTS: 61.4% Total 100.0% *(butyl carbityl) (6-propylpiperonyl) ether and related compounds See side/back panels for additional Precautionary Statements EPA Reg. No EPA Est. No TX-1 Product code: RM# NET CONTENTS: 0.90 fl oz total (Three 0.30 fl oz/9.0 cc tubes) For Use Only on Extra-Large Dogs/Puppies 81 lbs. and over Includes Fleas Ticks Mosquitoes Flea Eggs Designed to make Flea Larvae application ion precise and neat. See side of package for details. icator Patent Pending ACTIVE INGREDIENTS: (S)-Methoprene (CAS # ) 3.6% Etofenprox (CAS # ) 40.0% OTHER INGREDIENTS: 56.4% Total 100.0% Contains a Coat Conditioner KEEP OUT OF REACH OF CHILDREN DO See NOT side/back USE panels for additional Precautionary Statements ON CATS EPA Reg. No EPA Est. No TX-1 Product code: RM# Month Supply NET CONTENTS: NTS: fl oz total (Three fl oz/1.8 cc tubes) For Use Only on Cats and Kittens 5 lbs. & over Fleas Flea Larvae Flea Eggs Deer Ticks Mosquitoes THE BIGGER THEY ARE, THE HARDER THEY FALL IN LOVE WITH THE SMALL PRICE. EVEN YOUR CLIENTS WITH BIG DOGS PAY JUST $10 A MONTH FOR FLEA AND TICK PROTECTION. At a suggested retail price of just $29.99* for 3 months, for every size dog, Ovitrol X-Tend TM Flea & Tick Spot On for Dogs is a powerful solution for veterinary management of fleas, ticks and mosquitoes. It s a great way to build loyalty with clients faced with the super-sized costs of owning a big breed or multiple pets. Now, you can get savings you ll love on Ovitrol X-Tend TM Flea & Tick Spot On for Dogs or Cats with a SPECIAL OFFER. Simply call or visit us at Ovitrolxtend.com or vpl.com. Ovitrol Flea & Tick Spot On KEEP OUT OF REACH OF CHILDREN CAUTION 3 Month Supply 10 weeks of age or older X-LARGE for Dogs Ovitrol STARTS KILLING FLEAS & TICKS WITHIN 15 MINUTES KILLS KILLS & REPELS T N Flea & Tick Spot On & 12 weeks of age or older LARGE for Cats STARTS KILLING FLEAS WITHIN 15 MINUTES KILLS Ovitrol X-Tend TM Spot On products are available for dogs and cats of all sizes, all for the same low price. Each box contains 3 doses and 1 X-Tender TM Applicator. *Every package of Ovitrol X-Tend TM Flea & Tick Spot On product (every animal size) sold to clinics for a suggested DVM price of $14.99 each, with suggested retail price of $29.99 to clinic clients Veterinary Products Laboratories. Ovitrol, Spot On, Vet-Kem and the Vet-Kem design are registered trademarks of Wellmark International. All other trademarks are the property of their respective owners TM

62 »» Equine Tools for Success Investing in the right tools has been key to growth for Tennessee Equine Hospital. By Laura Thill There are no secrets to success as far as equine practice owner Monty McInturff, DVM, is concerned. Anyone can have the tools [to grow their business], he points out. They just can t be afraid to invest in those tools. Advice well taken, considering the advancement of his practice, Tennessee Equine Hospital (Thompson s Station, Tenn.), since it opened in his father s cow barn in After graduating with his DVM in 1989 and taking advantage of an internship in Birmingham, Ala., Mc- Inturff returned to his hometown, Thompson s Station, and opened an ambulatory equine practice in Within a year, he merged with another practitioner, followed by the addition of Matthew Povlovich, DVM, in By 1998, the group had opened a small facility. In 2007, McInturff and co-owner Povlovich changed the brand to Tennessee Equine Hospital in preparation for their expansion to a 25,000-square-foot facility on a five-acre site, which opened its doors in Today, Tennessee Equine Hospital continues to operate there, but has since added 11 doctors, four administrative staff members and eight technical staff members, bringing its total staff to 23. Customers His patients may be horses, but, in McInturff s opinion, it s a people business. The horses don t choose their doctors, he says. People do. So, we must maintain great relationships with and provide value to the horse owners and trainers. Our customers must see us as information leaders. Today, 50 percent of our gross revenue is from hospital care and 50 percent is from ambulatory care, says McInturff. We have seven ambulatory trucks, a chiropractor, an acupuncturist, an internal medicine specialist and a board-certified surgeon. In fact, adding a board surgeon has helped him and his partner take the practice to the next level, he points out. We have a surgery suite, bone scan capacity and large internal medicine wing. We also have an indoor arena where we can watch lameness cases. We have a great relationship, he says of his partnership with Povlovich one that revolves around strong communication and regular meetings. Once we align our goals and vision, we can move forward, he notes, adding that, despite his growth as a practice owner, I m also a practice manager. Indeed, his willingness to step into a practice management role has enabled McInturff to adjust to the changing climate in the veterinary industry and grow his business steadily. Key to his ability to run his practice has been the robust veterinary practice management software system he 62 January/February 2014»» Veterinary advantage

63 established years ago. This [system] has been huge, he says. It s been a great help with managing inventory control, invoices, cash flow and patient scheduling. This is one thing we ve done well. Working with customers His patients may be horses, but, in McInturff s opinion, it s a people business. The horses don t choose their doctors, he says. People do. So, we must maintain great relationships with and provide value to the horse owners and trainers. Our customers must see us as information leaders. He strongly encourages his staff to follow his lead by providing a good source of information and value to our customers, he adds. We look for reps who are available and in touch with the needs of the practice. We aren t interested when reps are just throwing products in our face. Monty McInturff, DVM One way the doctors and staff at Tennessee Equine Hospital ensure their customers receive great value is by providing a blend of service and products, notes McInturff. Our customers need both, and at a fair price, he says. And, by fair, he means for both the customer and the practice. Undercharging for services can threaten the health of the business, he points out. At the same time, overcharging customers can drive them away. We charge fairly for our services and products, which enables us to provide high-quality care for our patients. And, that s what keeps our customers coming back. A culture of we When clients bring their horse to Tennessee Equine Hospital, they can count on much more than the care of a great veterinarian. They can count on a team of doctors and staff, all of whom are available to care for the patient. We have built Clinical concerns Perhaps one of the biggest clinical issues Monty McInturff, DVM, and his colleagues and staff at Tennessee Equine Hospital, treat is lameness. Looking ahead, he anticipates the availability of improved medical solutions to address this condition. We are just scratching the surface with regard to regenerative therapy, he notes. [Researchers] should be looking more closely at developing such tools as PRP and stem cell treatment, rather than focusing only on pain management. Other medical concerns on McInturff s radar include keeping horse owners and trainers on track with their horses wellness exams particularly with regard to de-worming and vaccinations; colic; and upper and lower respiratory disease. It can be particularly difficult to keep horse owners on schedule with de-worming and vaccinations, he points out. We try to educate our customers on the value of vaccinations and healthcare prevention vs. treating diseases. In addition, the practice has a rigid reminder system in place. We also stress product quality and product guarantees to our customers something that can t be ensured when they purchase products from farm stores, he says. a culture of we at our hospital, says McInturff. We really stress this approach to our customers. In fact, they present this approach to their sales reps, as well. We like our distributor sales reps to know everyone on our team and become a part of our culture, McInturff says. We look for reps who are available and in touch with the needs of the practice. We aren t interested when reps are just throwing products in our face. But, when they take time to know us, we appreciate that. And, the folks at Tennessee Equine Hospital try to make it easy for their distributor sales reps to accomplish just that. We invite our reps to parties and luncheons, McInturff says. We [value] sales reps we can count on. Editor s note: For more information about Tennessee Equine Hospital, visit Veterinary advantage ««January/February

64 »» Sales Meeting Biological Indicators Are your customers doing everything they can to prevent surgical infections? Veterinarians rely on their office sterilizers to ensure their surgical instruments are infection-free and safe to use. But, how do they know their sterilizers are doing their job? Indeed, non-sterile devices can cause surgical infections, so knowing the sterilizer is working properly is extremely important. Biological indicators devices used to test the ability of a sterilizer to kill a large number of live bacterial spores are the only type of sterilization monitor that prove the sterilizer has been able to deliver the lethality needed to kill a large number of microorganisms, according to experts. How they work With regard to biological indicators, the term kill is measured by the sterilizer s ability to eliminate any growth of the spores that are resistant to the specific sterilization process, including steam, ethylene oxide gas or hydrogen peroxide. Self-contained biological indicators are the most commonly used design. They are comprised of a spore carrier with an ampoule of growth media contained within a protective package for placement within the sterilizer during the sterilization cycle. Following sterilization, the biological indicators are incubated at a temperature and time conducive for growth of the spores before the final result is read. If the sterilization process can kill the population of spores in the biological indicator, it provides a level of sterility assurance that the process was also able to kill any microorganisms on the surgical instruments. In recent years, improvements in biological indicator technology have led to a reduction in the incubation time required for readout. Whereas traditional spore strip biological indicators have a seven-day readout, standard self-contained biological indicators may be read after 24 or 48 hours. Rapid readout technologies provide biological indicator results in one to four hours, depending on the type of sterilization method that is being monitored. (Results are available in as little as one hour for steam processes, four hours for ethylene oxide systems and 24 hours for hydrogen peroxide systems.) Biological indicators should be used at least daily, each day the sterilizer is used. In practices where a large number of loads are processed daily, more frequent use should be considered to reduce the risk of using a non-sterile instrument on a patient. For large sterilizers, biological indicators should be used within a test pack configuration. 64 January/February 2014»» Veterinary advantage

65 Protect Your Patient. Protect Your Business. If your instruments are not sterile, your procedure is not sterile. MODEL 5 XL 3M Steri-Vac Sterilizers and Accessories In today s veterinary care environment, you require speed, accuracy, credibility and efficiency in all phases of the sterilization process. 3M stands ready to put our leadership, sterilization products, services and educational tools to work for you. As a worldwide leader in sterilization assurance, 3M s comprehensive product line is backed by excellence in innovation, experience and service. Animal Health 3M, All rights reserved.

66 »» Sales Meeting Distributor sales reps can initiate a discussion about biological indicators with their veterinarian customers and gain a better understanding of their needs by asking a few probing questions, such as the following: Doctor, how does your staff routinely monitor your sterilizers to ensure they are effectively sterilizing your surgical instruments? Are you aware that self-contained biological indicators can save time and money compared to mail-away spore strips, which require a longer incubation time? Did you know that biological indicators are the only method of sterilization monitoring that proves the actual lethality of your sterilizers? Working with customers Typically, biological indicators are packaged units of per box and two to four boxes per case. Most biological indicators have an month shelf life and require special storage conditions to avoid extremes in temperature or relative humidity, which can affect the viability of the spores. Product design (self-contained vs. spore strip) and readout time can impact the cost of the product, as can the test pack configuration. (Sometimes the biological indicator is in a test pack configuration that simulates the challenge of the packaged instruments.) Your customers might respond that their current sterilizers are regularly maintained and work very well. Sales reps can explain that, while regular sterilizer maintenance is important, there are a number of factors that can impact the effectiveness of sterilizers, including how it is loaded and what types of instruments are processed. In addition, staff procedures can also affect the sterilizer efficacy. Sterility assurance monitoring with biological indicators is a method to detect sterilizer issues, not only between Some veterinarians believe that mail-away spore strips are easier and less expensive to purchase. However, that s not necessarily true. maintenance checks but also with regard to variations in staff, procedures, packaging and the type of instruments being sterilized. Some veterinarians believe that mail-away spore strips are easier and less expensive to purchase. However, that s not necessarily true. Some veterinarians might be surprised by the total cost of spore strips, including shipping costs, lab and documentation costs. Also, self-contained biological indicators reportedly are simple to use and provide a faster result than spore strips, reducing the veterinarian s risk of using non-sterile devices or of accidental contamination, which can occur with handling and lead to a false result. Finally, some veterinarians might not be aware that AAHA Standards for Accreditation include the use of biological indicators for sterilizer monitoring for all types of sterilization processes. When monitoring is not performed, the veterinary surgical facility is not in compliance with the AAHA guideline. In the end, biological indicators provide the veterinary practice with an assurance that its sterilizers are working properly and that its surgical patients are in safe hands. Editor s note: Vet-Advantage would like to thank 3M for its assistance with this article. 66 January/February 2014»» Veterinary advantage

67 PLATINUM GOLD SILVER BRONZE SponSorS SponSorS platinum GOld Silver bronze SponSorS platinum GOld Silver bronze SponSorS platinum GOld Silver bronze SponSorS platinum GOld Silver bronze platinum GOld Silver bronze SponSorS onsors platinum GOld Silver bronze S platinum GOld Silver bronze SponSorS platinum GOld Silver bronze SponSorS platinum GOld Silver bronze

68 »» Alphabet Soup Alphabet Soup Sorting out the veterinary industry s associations, boards, conferences, and more Since the FDA approved our new NSAID and it passed our QA, we ll be rolling it out ASAP at the WVC, so be sure your OSRs stop by our booth in Aisle D. Did you get all of that? As a veterinary sales representative, you are likely bombarded with acronyms on a regular basis. The alphabet soup of the veterinary industry fills a very large bowl! From professional organizations to conferences to state and regional associations, it can get a bit overwhelming to keep track of all of those letters in their various combinations. This reference guide will help you sort them all out, with web addresses to help you quickly access more information. Industry Associations: Name Abbreviation Web Address Notes Association for Assessment and Accreditation of Laboratory Animal Care American Association of Bovine Practitioners American Association of Equine Practitioners American Association of Equine Veterinary Technicians American Association of Feline Practitioners By Dawn Singleton-Olson Industry Associations: There are numerous associations and organizations dedicated to every aspect of veterinary medicine, as you ll see from the following list. Specialty Boards and Colleges: There are a number of veterinary specialty organizations for the many branches of veterinary medicine, each with its own requirements for certification. Conferences: Each year, there are many state, regional and national veterinary conferences held around the country, offering educational and networking opportunities in the industry. The list includes some of the largest and most popular conferences. State Veterinary Medical Associations: Each of the 50 states and Puerto Rico has its own veterinary medical association, each with unique policies and procedures. Many hold annual meetings, and these dates can be found on each state association s website. AAALAC aaalac.org AAALAC is a private nonprofit organization that promotes the humane treatment of animals in science through a voluntary accreditation program. AABP aabp.org The AABP is an international association of veterinarians serving society as leaders in cattle health, welfare and productivity. AAEP aaep.org The AAEP's mission is to improve the health and welfare of the horse, to further the professional development of its members, and to provide resources and leadership for the benefit of the equine industry. AAEVT aaevt.org The American Association of Equine Veterinary Technicians and Assistants (AAEVT) is a sister organization to the AAEP and is a separate professional non-profit organization. Membership in the AAEVT is open to all veterinary technicians, assistants, and support staff with an equine interest AND those employed in the veterinary health care industry worldwide. Student membership is available for those currently enrolled in an AVMA/CVMA accredited program of veterinary technology. The AAEVT offers equine oriented CE courses focusing on all aspects of equine practice. AAFP catvets.com The AAFP is for practitioners striving for excellence in feline medicine and surgery. American Animal Hospital Association AAHA healthypet.com AAHA is an international association of more than 42,000 veterinary care providers who treat companion animals. AAHA is the only organization that accredits animal hospitals throughout the U.S. and Canada. Approximately 3200 veterinary hospitals voluntarily participate in the AAHA hospital evaluation program. 68 January/February 2014»» Veterinary advantage

69 American Association of Human- Animal Bond Veterinarians American Association for Laboratory Animal Science American Association of Public Health Veterinarians American Association of Swine Practitioners American Association of Small Ruminant Practitioners AAHABV aahabv.org The American Association of Human-Animal Bond Veterinarians provides education, resources, and support to enhance the ability of veterinarians to create a positive and ethical relationship between people, animals, and their environment. AALAS aalas.org The American Association for Laboratory Animal Science is a nonprofit membership association dedicated to the exchange of information and expertise in the care and use of laboratory animals. Since 1950, the AALAS has been dedicated to the humane care and treatment of laboratory animals and the quality research that leads to scientific gains that benefit people and animals. AAPHV no site The mission of the Association is to promote the science and art of public health, epidemiology, and preventive medicine by providing an expert forum for the discussion of public health issues of importance to the veterinary profession and the development of professional recommendations and public health resolutions. AASP aasp.org The AASP has approximately 1,300 members involved in practice, industry and academia in more than 40 countries. AASRP aasrp.org The American Association of Small Ruminant Practitioners (AASRP) was founded in 1968 to further the programs and studies of those working with small ruminants sheep, goats, camelids, elk, deer and other related species. Association of Avian Veterinarians AAV aav.org The Association of Avian Veterinarians is an international professional organization of practitioners advancing and promoting avian medicine, stewardship, and conservation through education of its members, the veterinary community and those they serve. American Association of Veterinary Anatomists American Academy on Veterinary Disaster Medicine American Association of Veterinary Immunologists American Academy of Veterinary Acupuncture American Association of Veterinary Medical Colleges American Academy of Veterinary Nutrition American Association of Veterinary Parasitologists American Academy of Veterinary Pharmacology and Therapeutics American Association of Veterinary State Boards American Association of Wildlife Veterinarians American Association of Zoo Veterinarians AAVA vetanatomists.org The AAVA is a non-profit membership organization dedicated to the advancement of veterinary anatomical science. AAVDM no site The American Academy on Veterinary Disaster Medicine, Inc. is an organization dedicated to providing a forum for the sharing of factual information on natural and man-made disasters that threaten the wellbeing of animals and the environment. AAVI theaavi.org The American Association of Veterinary Immunologists is dedicated to the development, promotion, and dissemination of knowledge in veterinary immunology. This includes immunology of livestock and poultry, companion animals, fish and marine mammals. AAVA aava.org The AAVA's mission is to improve animal health care by the advancement of veterinary acupuncture, Traditional Chinese Veterinary Medicine and Traditional Asian Medicine through education, research and leadership. AAVMC aavmc.org The Association of American Veterinary Medical Colleges coordinates the affairs of the 28 U.S. Veterinary Medical Colleges, four Canadian Colleges of Veterinary Medicine, Departments of Veterinary Science and Comparative Medicine, animal medical centers, and three international veterinary schools. AAVN aavn.org The AAVN is an international association of veterinarians and animal scientists with a common interest in animal nutrition as it relates to animal health. AAVP aavp.org AAVP is a scientific and educational organization with approximately 450 members. Members of AAVP are teachers, students, scientists, veterinarians and others interested in parasites of companion, food-producing, and other domesticated animals and wildlife, some of which are transmissible to humans. AAVPT aavpt.org The purpose of the AAVPT is promotion of the science of veterinary pharmacology and therapeutics. AAVSB aavsb.org AAVSB is the single entity that reports national examination scores to the jurisdiction(s) where a veterinarian desires to be licensed. AAVSB is permitted to report these scores to the veterinary boards only; no other parties can receive scores. AAVSB membership includes 57 jurisdictions. It also serves as a resource to the public for information about veterinary medical regulation. AAWV aawv.net The AAWV was formed to enhance the contribution of veterinary medicine to the welfare of the wildlife resource. AAZA The mission of the American Association of Zoo Veterinarians is to optimize the health, welfare, and conservation of wildlife through education, scientific study, collaboration and advocacy. American Boarding Kennel Association ABKA no site ABKA is the non-profit trade association for the pet boarding industry in the United States and around the world. ABKA members offer a variety of services including pet boarding, grooming, training, transportation, shipping, pet supplies, day care and food sales. Veterinary advantage ««January/February

70 »» Alphabet Soup American College of Laboratory Animal Medicine American Canine Sports Medicine Association American College of Veterinary Theriogenologists American College of Veterinary Pharmacists American College of Veterinary Pathologists Association of Exotic Mammal Veterinarians ACLAM aclam.org The American College of Laboratory Animal Medicine is an organization of board certified veterinary medical specialists who are experts in the humane, proper and safe care and use of laboratory animals. ACSMA acsma.org The ACSMA is an association of veterinarians, physical therapists, trainers, and other professionals devoted to addressing the medical and surgical problems encountered in the canine athlete and the working breeds. Their expertise addresses virtually all conditions that affect a variety of sporting breed dogs. ACT theriogenology.org The Society for Theriogenology is an organization of veterinarians dedicated to animal reproduction, whose mission is to promote standards of excellence in reproductive medicine, to provide outreach and education to veterinarians, and to foster continual improvements in theriogenology. ACVP vetmeds.org The American College of Veterinary Pharmacists was established to support the efforts of independent pharmacists to develop and strengthen services they provide to veterinarians assisting them in meeting the needs of their patients. The college provides educational materials and programs, serves as an information resource and provides networking opportunities and specialty services. ACVP acvp.org The American College of Veterinary Pathologists is an international organization for those specializing in veterinary and comparative pathology. The College was incorporated in 1949 to further scientific progress in veterinary pathology; to establish standards of training, experience, and examinations for qualification as specialists in veterinary pathology; and to further the recognition of such qualified specialists by certification and other means. AEMV aemv.org AEMV was established in 2000 by veterinarians interested in advancing the veterinary care of ferrets, rabbits, guinea pigs, hamsters, rats, mice, and other exotic companion mammals. American Humane Association AHA americanhumane.org American Humane Association's mission as a network of individuals and organizations, is to prevent cruelty, abuse, neglect, and exploitation of children and animals and to assure that their interests and well-being are fully, effectively, and humanely guaranteed by an aware and caring society. Animal Health Institute AHI ahi.org Animal Health Institute is the U.S. trade association that represents manufacturers of animal health care products the pharmaceuticals, vaccines and feed additives used to produce a safe supply of meat, milk, poultry and eggs, and the veterinary medicines that help pets live longer, healthier lives. American Heartworm Society AHS heartwormsociety.org The AHS mission is to lead the veterinary profession and the public in the understanding of heartworm disease. American Holistic Veterinary Medical Association American Pet Products Manufacturers Association American Pre-Veterinary Medical Association Association of Reptilian and Amphibian Veterinarians AHVMA ahvma.org The American Holistic Veterinary Medical Association explores and supports alternative and complementary approaches to veterinary healthcare, and is dedicated to integrating all aspects of animal wellness in a socially and environmentally responsible manner. APPMA americanpetproducts.org American Pet Products Manufacturers Association is the leading not-forprofit trade association serving pet product manufacturers and importers. Founded in 1958, APPMA's membership has grown to nearly 700 pet product manufacturers and importers representing both large corporations and growing business enterprises. APVMA apvma.org American Pre-Veterinary Medical Association is a college-level national chapter organization dedicated to promote and stimulate interest in the field of veterinary medicine and provide its member clubs with sources of information regarding sister clubs and the field of veterinary medicine. ARAV arav.org Association of Reptilian & Amphibian Veterinarians is a non-profit international organization of veterinarians and herpetologists founded in Their goal is to improve reptilian and amphibian veterinary care and husbandry through education, exchange of ideas and research. The Association of Reptilian and Amphibian Veterinarians (ARAV) promotes conservation and humane treatment of all reptilian and amphibian species through education, captive breeding and reptilian and amphibian habitat preservation. 70 January/February 2014»» Veterinary advantage

71 American Society of Animal Science ASAS asas.org American Society of Animal Science is a professional organization for animal scientists designed to help members provide effective leadership through research, extension, teaching and service for the dynamic and rapidly changing livestock and meat industries. American Society of Laboratory Animal Practitioners American Society for the Prevention of Cruelty to Animals ASLAP aslap.org American Society of Laboratory Animal Practitioners promotes the acquisition and dissemination of knowledge, ideas, and information among veterinarians and veterinary students having an interest in laboratory animal practice. The Society does so for the benefit of laboratory animals, other animals, and society in general. ASPCA aspca.org The American Society for the Prevention of Cruelty to Animals mission is to promote humane principles, prevent cruelty, and alleviate fear, pain, and suffering in animals. Association of Shelter Veterinarians ASV sheltervet.org Incorporated in January 2002, this association membership includes over 300 veterinarians, students and shelter employees and seeks to improve the health and wellbeing of animals in shelters through the advancement of shelter medicine. American Society of Veterinary Ophthalmology Academy of Veterinary Allergy and Clinical Immunology American Veterinary Chiropractic Association ASVO American Society of Veterinary Ophthalmology provides an opportunity for veterinarians to carry on advanced studies by the dissemination of new information in ophthalmology and encourages ophthalmologic training in veterinary colleges. AVACI Academy of Veterinary Allergy and Clinical Immunology is an association of veterinarians with a special interest in clinical allergy and applied immunology in small and large animals. The purpose of the Academy is to promote research of allergic diseases and other related diseases of animals and to disseminate information concerning this research. AVCA animalchiropractic.org American Veterinary Chiropractic Association is a professional membership group promoting animal chiropractic to professionals and the public, and acting as the certifying agency for doctors who have undergone postgraduate animal chiropractic training. Association for Veterinary Clinical Pharmacology and Therapeutics AVCPT avcpt.org The Association for Veterinary Clinical Pharmacology and Therapeutics was founded in 1976 to foster interest in and disseminate knowledge of veterinary pharmacology and therapeutics. Academy of Veterinary Dentistry AVD avdonline.org The Academy of Veterinary Dentistry was formed to recognize those individuals who dedicate a significant part of their professional activities to the practice of, instruction of, or research in Veterinary Dentistry. The Academy is dedicated to the continued improvement of practice standards and knowledge in Veterinary Dentistry. American Veterinary Dental Society AVDS avds-online.org The American Veterinary Dental Society was founded in 1976 for the purpose of creating a forum for advancing the knowledge, education, and awareness of veterinary dentistry among veterinarians, students, and the public. American Veterinary Exhibitors' Association AVEA theavea.org The American Veterinary Exhibitors' Association's mission is to improve the effectiveness of all conventions, meetings, and exhibitions for the veterinary industry. Academy of Veterinary Homeopathy AVH theavh.org Founded in 1995, the Academy of Veterinary Homeopathy is comprised of veterinarians who share the common desire to restore true health to their patients through the use of homeopathic treatment. Members of the Academy are dedicated to understanding and preserving the principles of Classical Homeopathy. Association of Veterinary Hematology and Transfusion Medicine American Academy of Veterinary Informatics AVHTM avhtm.org AVHTM is an organization dedicated to scientific advancement and education in veterinary hematology and transfusion medicine. Their website includes links to veterinary blood banks, and to organizations related to transfusion medicine. AVI avinformatics.org AVI was formed to expand the use of the computer as a tool in veterinary medicine. This includes serving as an educational resource, promoting the use of information technology and electronic communications, and developing and promoting standards in veterinary information management. Veterinary advantage ««January/February

72 »» Alphabet Soup American Veterinary Medical Association American Veterinary Medical Foundation American Veterinary Medical Law Association American Veterinary Society of Animal Behavior Association of Veterinary Technician Educators Association of Zoo Veterinary Technicians AVMA avma.org The American Veterinary Medical Association established in 1863, is a notfor-profit association representing more than 80,000 veterinarians working in private and corporate practice, government, industry, academia, and uniformed services. Structured to work for its members, the AVMA acts as a collective voice for its membership and for the profession. AVMF avmf.org AVMF is the charitable arm of the AVMA, dedicated to embracing and advancing the well-being and medical care of animals. Charitable contributions and support to the Foundation help veterinarians help animals. Initiatives include: Humane Outreach-Animal Welfare, Education and Public Awareness, Research Support, Student Enhancement, and Support of American Veterinary Medical Association and its Initiatives. The AVMF, a two-time, four-star rated nonprofit by Charity Navigator, has awarded more than $50 million in grants since it began in AVMLA avmla.org A national association of attorneys, veterinarians, and other individuals and organizations with an interest in veterinary medical law and how it pertains to the veterinary profession and allied fields. AVSAB avsabonline.org AVSAB's mission is to promote the understanding of applied animal behavior through collaborative, scientific efforts that foster compassionate and respectful interactions with animals. AVTE avte.net The mission of AVTE is to promote quality education in veterinary technology. AZVT azvt.org The Association of Zoo Veterinary Technicians is dedicated to all aspects of quality veterinary care in the field of zoo animal medicine. Their commitment is: To promote and improve professional standards among zoo veterinary technicians; to maintain a cooperative working relationship with other zoo professionals; to provide a forum for the presentation and exchange of information, challenges, and methodology encountered in the field of zoo veterinary technology through a quarterly newsletter and annual conferences; to encourage the recognition of the importance of the veterinary technician s role in zoo veterinary medicine, scientific study, and conservation; to educate the public, increasing the appreciation of the bond between human beings and all life on earth. U.S. Food and Drug Administration FDA fda.gov The Food and Drug Administration (FDA or USFDA) is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments. The FDA is responsible for protecting and promoting public health through the regulation and supervision of food safety, tobacco products, dietary supplements, prescription and over-the-counter pharmaceutical drugs (medications), vaccines, biopharmaceuticals, blood transfusions, medical devices, electromagnetic radiation emitting devices (ERED), and veterinary products. Humane Society of the United States HSUS humanesociety.org The Humane Society of the United States is the nation s largest animal protection organization. Since 1954, The HSUS has been fighting for the protection of all animals through advocacy, education, and hands-on programs. International Association for Aquatic Animal Medicine IAAAM iaaam.org The International Association for Aquatic Animal Medicine is an organization of individuals who are professionally interested in and devote a significant amount of time to the practice of aquatic animal medicine, teaching and research in aquatic animal medicine, or the husbandry and management of aquatic animals. International Renal Interest Society IRIS iris-kidney.com The IRIS site, sponsored by Novartis, was created to help veterinary practitioners better diagnose, understand, and treat renal disease in cats and dogs. International Union of Veterinary Cyclists International Veterinary Acupuncture Society IUVC iuvc.org The International Union of Veterinary Cyclists was founded to bring veterinary professionals together in beautiful cycling destinations for some world-class continuing education. IVAS ivas.org IVAS is a non-profit organization dedicated to promoting excellence in the practice of veterinary acupuncture as an integral part of the total veterinary health care delivery system. The Society endeavors to establish uniformly high standards of veterinary acupuncture practice through its educational programs and accreditation examination and process. IVAS seeks to integrate veterinary acupuncture and the practice of western veterinary science, while also noting that the science of veterinary acupuncture does not overlook related treatment modalities. 72 January/February 2014»» Veterinary advantage

73 International Veterinary Information Service Journal of the American Veterinary Association IVIS ivis.org A not-for-profit organization established to provide up-to-date, clinically relevant information to veterinarians, veterinary students, and animal health professionals world wide. JAVMA avma.org/news/javmanews Published twice monthly, this peer-reviewed, general scientific journal provides reports of clinical research, feature articles, and regular columns of interest to veterinarians in private and public practice. National Animal Poison Control Center NAPCC napcc.aspca.org National resource for any animal poison-related emergency, available 24 hours a day, 365 days a year at North American Veterinary College Administrators North American Veterinary Technicians Association NAVCA navca.org The NAVCA Conference takes place at a different Veterinary College every year. Representatives meet to share information and communicate on various aspects of College, Hospital, and Business Office management. They represent 31 Veterinary Colleges and Schools in the North America. NAVTA vetmed.tamu.edu/navca The mission of NAVTA is to represent and promote the profession of veterinary technology. NAVTA provides direction, education, support and coordination for its members and works with other allied professional organizations for the competent care and humane treatment of animals. National Mastitis Council NMC nmconline.org The NMC is a not-for-profit professional organization devoted to reducing mastitis and enhancing milk quality. The NMC promotes research and provides information to the dairy industry relative to udder health, milking management, and milk quality. National Board of Veterinary Medical Examiners NBVME nbvme.org The NBVME provides standardized examinations for use by state and provincial licensing boards as part of their licensure procedure for veterinarians. Orthopedic Foundation for Animals OFA offa.org The mission of the Orthopedic Foundation for Animals is to collate and disseminate information concerning orthopedic and genetic diseases of animals; to advise, encourage and establish control programs to lower the incidence of orthopedic and genetic diseases; to encourage and finance research in orthopedic and genetic disease in animals; to receive funds and make grants to carry out these objectives. Society for Tropical Veterinary Medicine Student Veterinary Emergency and Critical Care Society STVM soctropvetmed.org The Society for Tropical Veterinary Medicine is a nonprofit organization whose purpose is the advancement of tropical veterinary medicine, hygiene and related disciplines. The activities of the Society focus scientific interest on strategies to deal with established and changing patterns of diseases affecting animals in the tropics. SVECCS sveccs.org The primary objective of National SVECCS is to advance the specialty area of veterinary medicine and increase the competence of those who practice in this field by establishing requirements for certification in the field, encouraging continuing professional education, promoting research, and enhancing the dissemination of new knowledge of veterinary medicine through didactic teaching and postgraduate programs. Society of Veterinary Hospital Pharmacists SVHP svhp.org The purpose of the Society is the furtherance of interests and promotion of education for veterinary hospital pharmacy. Society for Veterinary Medical Ethics SVME svme.org The Society for Veterinary Medical Ethics was founded in 1994 by a group of veterinarians, biomedical researchers, and academics to promote discussion and debate about ethical issues arising in and relevant to veterinary practice. United States Animal Health Association USAHA usaha.org USAHA, the nation's animal health forum for over a century, is a sciencebased, non-profit, voluntary organization. Its members are state and federal animal health officials, national allied organizations, regional representatives, and individual members. USAHA works with state and federal governments, universities, veterinarians, livestock producers, national livestock and poultry organizations, research scientists, the extension service and several foreign countries to control livestock diseases in the United States. Veterinary Cancer Society VCS vetcancersociety.org VCS was formed in 1976 by veterinarians who wanted to establish a professional organization dedicated to veterinary oncology. VCS is a nonprofit organization with over 800 members including specialists in medical, surgical, and radiation oncology, internists, pathologists, pharmacologists and general practitioners worldwide. Veterinary Emergency & Critical Care Society VECCS veccs.org The Objective of the Veterinary Emergency & Critical Care Society is to raise the level of patient care for seriously ill or injured animals through quality education and communication programs. Veterinary advantage ««January/February

74 »» Alphabet Soup Veterinary Hospital Managers Association VHMA vhma.org The mission of the Veterinary Hospital Managers Association is to enhance and serve professionals in veterinary management through superior education, certification, and networking. Veterinary Information Network VIN vin.com The Veterinary Information Network, founded in 1990 by veterinarians Dr. Duncan Ferguson and Dr. Paul D. Pion, is the first and largest online service for veterinary professionals. It can be defined as a multi-specialist veterinary facility, with boarded consultants and a fully-staffed library / trained librarians. Veterinary Specialists in Private Practice Veterinary Wound Management Society VSIPP vsipp.com The mission of VSIPP is to provide veterinary specialists in private practice a forum for networking, motivation and communication that will result in a better understanding of the challenges they face in large group practices while serving the human-animal bond. VWMS vwms.net The Veterinary Wound Management Society's mission is to advance the art and science of animal wound management thus promoting excellence in the field. Wildlife Disease Association WDA wildlifedisease.org Founded in 1951, the WDA is an international, nonprofit organization with members actively engaged in research, teaching, and service activities related to wildlife. World Small Animal Veterinary Association WSAVA Each year an Annual WSAVA World Congress is held in a different part of the world, hosted by a member association under the auspices of WSAVA. The Congress attracts large numbers of vets and veterinary nurses/technicians from many countries. They are able to learn from top international speakers on all aspects of small animal practice. Proceedings from the Congress are available to veterinary schools, libraries and individuals, and provide a valuable source of the most up to date knowledge. World Veterinary Association WVA worldvet.org Founded in 1863, the World Veterinary Association works closely with the International Office of Epizootics (OIE), the Food and Agriculture Organization of the United Nations (FAO), and the World Health Organization (WHO). Association for Women Veterinarians AWV womenveterinarians.org AWV advocates for women and promotes leadership in the veterinary profession. International Sled Dog Veterinary Medical Association ISDVMA isdvma.org ISDVMA actively promotes and encourages the welfare of the sled dog athlete. Specialty Boards and Colleges: American Board of Veterinary Practitioners American Board of Veterinary Toxicology The American College of Veterinary Anesthesia and Analgesia American College of Veterinary Clinical Pharmacology American College of Veterinary Dermatology American College of Veterinary Emergency and Critical Care ABVP abvp.com The American Board of Veterinary Practitioners advances the quality of veterinary medicine through certification of veterinarians who demonstrate excellence in species-oriented clinical practice. ABVT abvt.org The American Board of Veterinary Toxicology is a group of specially trained veterinarians that strive to inform and educate the public, private practice veterinarians and veterinary medical students about toxicologic hazards to pets, livestock and wildlife. ACVA acva.org The American College of Veterinary Anesthesia and Analgesia was founded in 1975 to promote the advancement of veterinary anesthesiology and to assist the veterinary profession in providing exceptional service to all animals. ACVCP acvcp.org The American College of Veterinary Clinical Pharmacology is a specialty board recognized by the American Veterinary Medical Association. The primary objectives of the College are to advance the discipline of veterinary clinical pharmacology as a clinical specialty and assure the competence of those who practice in this field. ACVD acvd.org The ACVD is the official specialty organization accredited by the American Veterinary Medical Association in 1982 and charged with maintenance of high standards of postgraduate training in veterinary dermatology. The purpose of the ACVD is to advance and promote excellence in veterinary dermatology, oversee postgraduate training in veterinary dermatology, sponsor research, and organize scientific and educational programs for both veterinary dermatologists and general practitioners. ACVECC acvecc.org The objectives of the ACVECC are: To promote advancement and high standards of practice for those individuals involved in veterinary emergency and critical care medicine and to establish requirements and foster development of residency and alternative training programs for post-doctoral education and experience prerequisite to certification in the specialty of Veterinary Emergency and Critical Care Medicine. 74 January/February 2014»» Veterinary advantage

75 American College of Veterinary Internal Medicine American College of Veterinary Microbiologists ACVIM acvim.org The ACVIM is the international certifying organization for veterinary specialists in cardiology, large animal internal medicine, neurology, oncology, and small animal internal medicine. ACVM acvm.us The American College of Veterinary Microbiologists is the specialty organization recognized by the American Veterinary Medical Association for Certification of veterinarians with special expertise in microbiology. American College of Veterinary Nutrition ACVN acvn.org The primary objective of the ACVN is to advance the specialty area of veterinary nutrition, and to increase the competence of those who practice in this field by establishing requirements for certification in veterinary nutrition, encouraging continuing professional education, promoting research, and enhancing the dissemination of new knowledge of veterinary nutrition through didactic teaching and postgraduate programs. American College of Veterinary Ophthalmologists American College of Veterinary Preventive Medicine American College of Veterinary Radiology American College of Veterinary Surgeons American College of Zoological Medicine ACVO acvo.org The American College of Veterinary Ophthalmologists promotes excellence in veterinary ophthalmology through advanced training, certification, research and education. ACVPM acvpm.org The ACVPM challenges fellow veterinarians engaged in public practice to improve the strength and breadth of their knowledge in veterinary preventive medicine by pursuing board certification. This experience will enhance personal skills, expand professional expertise, strengthen the specialty of Veterinary Preventive Medicine and ultimately favorably affect the health of mankind and the animal kingdom. ACVR acvr.com The American College of Veterinary Radiology was founded in 1961 to determine competence of voluntary candidates in veterinary radiology and to encourage the development of teaching personnel and training facilities in veterinary radiology. ACVS acvs.org The goal of the ACVS Foundation is to inspire and support scientific and educational achievements that will improve surgical healthcare of animals. The Foundation supports innovative proposals from veterinary students, surgical residents and ACVS Diplomates (young investigators, university faculty members and specialists-in-practice). ACZM aczm.org ACZM is an international specialty organization recognized by the American Veterinary Medical Association (AVMA) for certification of veterinarians with special expertise in zoological medicine. ACZM is responsible for establishing training requirements, evaluating and accrediting training programs, and examining and certifying veterinarians in the veterinary specialty of zoological medicine. American Veterinary Dental College AVDC avdc.org AVDC is the clinical specialist organization for veterinary dentists, recognized by the American Board of Veterinary Specialties of the American Veterinary Medical Association. Conferences: Atlantic Coast Veterinary Conference ACVC acvc.org Conference of Research Workers in CRWAD Animal Diseases Central Veterinary Conference CVC thecvc.com Music City Veterinary Conference MCVC tvmanet.org Mid-South Regional Veterinary MSRVC Conference Midwest Veterinary Conference MVC mvcinfo.org North American Veterinary Conference NAVC navc.com New England Veterinary Conference NEVC Pacific Veterinary Conference PVC pacvet.net North American Veterinary NAVDF navdf.org Dermatology Forum Southeast Veterinary Conference SCAV scav.org Southern Veterinary Conference SVC thesvconline.com Southwest Veterinary Symposium SWVS swvs.org Gulf-Atlantic Veterinary Conference TGAVC tgavc.org Western Veterinary Conference WVC wvc.org Wild West Veterinary Conference WWVC wildwestvc.com Veterinary advantage ««January/February

76 »» Alphabet Soup State Veterinary Medical Associations: Alaska VMA AKVMA akvma.org Alabama VMA ALVMA alvma.com Arkansas VMA ARVMA arkvetmed.org Arizona VMA AZVMA azvma.org Puerto Rico VMA CMVPR cmvpr.org Connecticut VMA CTVMA ctvet.org California VMA CVMA cvma.net Colorado VMA CVMA colovma.com District of Columbia VMA DCVMA Delaware VMA DEVMA devma.org East Tennessee VMA ETVMA etvma.com El Paso VMA EVPMA Florida VMA FVMA fvma.org Georgia VMA GVMA gvma.net Hawaii VMA HVMA hawaiivma.org Indiana VMA INVMA invma.org Illinois State VMA ISVMA isvma.org Idaho VMA IVMA ivma.org Iowa VMA IVMA iowavma.org Kansas VMA KSVMA ksvma.org Kentucky VMA KVMA kvma.org Louisiana VMA LVMA lvma.org Massachusetts VMA MAVMA massvet.org Maryland VMA MDVMA mdvma.org Maine VMA MEVMA mainevetmed.org Missouri VMA MOVMA movma.org Memphis/Shelby County VMA MSCVMA mscvma.org Montana VMA MTVMA mtvma.org Michigan VMA MVMA michvma.org Minnesota VMA MVMA mvma.org Mississippi VMA MVMA msvet.org North Carolina VMA NCVMA ncvma.org North Dakota VMA NDVMA ndvma.com New Hampshire VMA NHVMA nhvma.com New Jersey VMA NJVMA njvma.org New Mexico VMA NMVMA nmvma.org Nebraska VMA NVMA nvma.org Nevada VMA NVMA nevadavma.org New York State Veterinary Medical Society NYSVMS nysvms.org Oklahoma VMA OKVMA okvma.org Ohio VMA OVMA ohiovma.org Oregon VMA OVMA oregonvma.org Pennsylvania VMA PAVMA pavma.org Rhode Island VMA RIVMA rivma.org Southern Arizona VMA SAVMA savma.net South Caroline Association of Veterinarians SCAV scav.org Southern California VMA SCVMA scvma.org South Dakota VMA SDVMA sdvetmed.org Southeastern Michigan VMA SEMVMA semvma.com Tennessee VMA TVMA tvmanet.org Texas VMA TVMA tvma.org Utah VMA UVMA uvma.org Vermont VMA VVMA vtvets.org Virginia VMA VVMA vvma.org Washington State VMA WSVMA wsvma.org Wisconsin VMA WVMA wvma.org West Virginia VMA WVVMA wvvma.org Wyoming VMA WYVMA wyvma.org 76 January/February 2014»» Veterinary advantage

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78 COMMUNITY Rep Spotlight Lead from the Front MWI s Bob Weinschenk reflects on the traits needed to succeed in the animal health industry The motto of the guided missile destroyer the USS James E. Williams Lead from the Front has special meaning for Bob Weinschenk, who announced his retirement as senior regional sales manager from MWI Veterinary Supply in August 2013 after close to 45 years in the industry. Weinschenk a Vietnam veteran knew James Elliott Williams, a sailor in the United States Navy during the 1950s and 1960s, and the most highly decorated enlisted man in the history of the U.S. Navy. In fact, Weinschenk was invited to attend the commission ceremony for the destroyer in But the motto also has meaning Bob Weinschenk for Weinschenk as it relates to his experience as a veterinary products salesman, first on the manufacturing side, and then on distribution. It was insightful, thoughtful, firm and decisive leadership on the part of MWI s executive team that brought the company from $195 million in sales in 2000, when Weinschenk joined the company, to more than $2 billion today. It s a testimony to leadership, to manage that growth without the wheels coming off, he says. Lessons learned in Vietnam Born in 1946, Weinschenk was raised in Noblesville, Ind., which was, at the time, a farming town north of Indianapolis. His father, Ed, worked for years as a retail merchant for the now-defunct Morris Five and Dime. After that, he opened his own women s clothing store, named Mr. Ed s. When Ed s wife, Dorothy, wasn t taking care of the kids, she worked with her husband in the store. Two years into college, young Weinschenk joined the Navy Reserve, figuring that after he got out, he could finish his education on the GI Bill. After his first year in the Navy, he reported to Treasure Island Naval Base in the San Francisco Bay, where he received his orders to serve on a river patrol boat in Vietnam. He went on active duty in July Working the heavily armed river patrol boats, or PBRs, in the rivers and canals of South Vietnam, Weinschenk learned some valuable lessons, which he was able to call up during his career in veterinary sales: Trust. With only four people on your patrol boat, you had to trust them; your life depended on it, he says. Teamwork. We always patrolled with two boats. It was imperative you always knew what the other boat was going to do, and that they knew what you were going to do. And we operated with SEALs and helicopter gunship support, so we needed to work with them too. Leadership. Anyone with military experience can understand the importance of chain of command. He also learned the importance of training. When it came time to go to Vietnam, you were ready, he says. It was a lesson that proved to be valuable as he made the transition from manufacturer sales, with a limited number of products to represent, to distribution, with thousands of products. Leadership model Weinschenk returned from Vietnam in October 1968, and went back to school. But after one semester, he went to work as a distribution manager for Pitman-Moore, an 78 January/February 2014»» Veterinary advantage

79 animal health manufacturer. From Pitman-Moore, he went to ER Squibb, which was later acquired by Solvay Veterinary. In 1989, he was recruited by Ciba-Geigy (now Novartis) to help launch that company s animal health business. He was there roughly 10 years. He was at Ciba-Geigy when the company made the decision to sign agency agreements with distributors. It was a foreign concept to distribution, he says. In fact, most distributors initially rejected the idea (though one was eager to sign a contract before Weinschenk even left the room). Ultimately, the model worked well for the manufacturer and its agents, he says. When MWI looked to expand its presence east of the Mississippi, a friend recommended Weinschenk. MWI had a distribution center in Atlanta, but no sales presence. The opportunity intrigued him. Though he had never worked for a distributor, he had built relationships with distributors during his 10 years at Ciba Geigy. Upon meeting MWI executives Jim Cleary, Herb Ingersoll and Jeff Danielson, Weinschenk was immediately drawn to the company. I saw it was different management, different leadership, he recalls. I had just gone through an entrepreneurial opportunity with Ciba Geigy, he says, referring to setting up the distribution network. I never thought I would have that same opportunity again. But here I was, extended the opportunity with MWI to expand east of the Mississippi. So, he found himself as MWI s first sales manager in the eastern part of the country. Despite the word manager in his title, initially, he didn t have any salespeople reporting to him. My first job was to go out and set up accounts in Georgia, he says. Making the transition from manufacturing to distribution with many more products to represent and many more points of contact, including manufacturers and customers wasn t easy, but his experience with first-class training in the military helped. You need training on what you feel is the most important thing you re providing to the veterinary clinic, he says. It s constant training, every day. Organizational skills are also a must. A great career path His career in animal health has been rewarding. If you have the integrity, the work ethic and honesty, you can have an outstanding career in animal health, he says. But it has not been without its challenges, including: 1) consolidation of manufacturers and distributors; 2) the rise of the Internet, and the potential threat it poses to veterinarians pharmacy business; and 3) the rise of buying groups. But buying groups are only a threat only if the distributor hasn t adequately established his or her value to customers, he says. That s where I feel one of the biggest challenges going out five or 10 years will be instilling that value among customers. We re getting challenged with accessibility, that is, getting to the decision-makers. If reps haven t created that value, they will get locked out. Animal health is a great career path, says Weinschenk, who, with his wife, Mary, plans to build a lake house in Tennessee and enjoy each other s company, as well as If you have the integrity, the work ethic and honesty, you can have an outstanding career in animal health. that of their three daughters and grandchildren. You re working with some of the best professionals out there, not just in the clinics, but industry too. There are a lot of well-managed companies, with a lot of good people. It s a testimony to the animal health business. Throughout his years in the business, he hired about 75 people, and did so in the spirit of the man who had hired him years earlier at Pitman-Moore Fred Harris. Harris knew Weinschenk had not finished college. But he saw me for what I was and gave me that opportunity, he says. Weinschenk tried to share that legacy among the people he interviewed and hired. To young reps, he offers a couple of words of advice: First, don t burn any bridges. With consolidation, you never know who you ll end up working for in the future, he says. Second, get a college degree. Coming home from Vietnam in 1968, Weinschenk wasn t prepared to sit still and get his degree. I m blessed, in that it didn t affect me. Still, he advises others to graduate. COMMUNITY Veterinary advantage ««January/February

80 Time Savers Ten ways to increase effective time management If you are like most salespeople, time always seems to be in short supply. Many salespeople tell us they don t have enough time with their customers, or to attend a professional development seminar or even read a book on sales effectiveness. For those time-crunched people who are looking for some quick suggestions for making the most of their time, here are 10 ways to increase effective time management: 1. Don t rush. Take the time to do it right. If you can t get everything done, at least get the most important things done right. 2. If in doubt, ask. Don t spend time guessing what s required. Ask! Asking is faster and gets you to the end result quicker. 3. Write it down. Writing things down ensures you have the right information to follow-up on the commitments you make. 4. Plan your day. The old adage is, plan your work and work your plan. Plans guide you through the day, help you to avoid distractions and keep you on course. 5. Keep files trim. The more stuff you accumulate; the harder it is to find anything. When in doubt, throw it out. Purge all files on a regular basis. 6. Don t be a perfectionist. It is said, If it s worth doing, it s worth doing well. But well does not mean perfectly; it means it is sufficient to fulfill the purpose intended. 7. Handle paper only once. When possible, that is. As you pick up each piece of paper, scrap it, delegate it, do it, file it, or schedule a time to do it later. The same thing applies to Don t procrastinate. Procrastination is putting off until later what is best done now. Putting things off wastes time, causes stress and helps make life unpleasant for yourself and others. 9. Say No more often. Make sure the request fits your goals before you agree. Remember, every time you say yes to something, you are saying no to something else that could be done instead. 10. Practice Pareto s Principle. This rule suggests that 80 percent of your results are achieved by 20 percent of the things you do. Focus on the priorities. For more information on training in this area or other sales training curriculum, visit: or contact Mike Biggins at mike.biggins@ats-solutions.net. Are you new to the Animal Health industry? Are you looking for a way to accelerate your new employees along the learning curve for the Animal Health Industry? Then you are a candidate for the next session of Introduction to the Animal Health Industry Open enrollment courses are offered at ATS s Kansas City Training Facility. February 25 26, 2014 April 15 16, 2014 To enroll contact: ATS animal health training solutions ATTN: Leah Byers NW Ambassador Drive, Suite 601 Kansas City, MO Phone: January/February 2014»» Veterinary advantage

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82 COMMUNITY News Henry Schein, Supplier Partners provide support for victims of Typhoon Haiyan Henry Schein, Inc. announced that it will donate $150,000 in support of relief efforts for victims of the disastrous Typhoon that struck the Philippines. Henry Schein is working with its suppliers and non-governmental organization (NGO) partners AmeriCares, Direct Relief, Heart to Heart International and MedShare to provide essential health care supplies for the ongoing relief efforts, and funds raised through the Henry Schein Cares Foundation will be donated to organizations also providing urgent care to victims. Mulroy Consulting Group formed to serve the animal health industry Mulroy Consulting Group LLC was launched to provide services to animal health manufacturers and distributors worldwide. Services include but are not limited to new product introductions; optimal sales and marketing channel identification, contracting and management; distribution training and development; sourcing new products; new product development; business development and identifying / developing collaborative ventures in the industry. Its principle, Martin Mulroy, served most recently as Chief Commercial Officer for Abaxis Inc., ultimately responsible for all sales, marketing, business development, and clinical services, as well as administrative / customer and technical service functions of the Animal Health business in North America, including its wholly owned subsidiary, Abaxis Veterinary Reference Laboratories (AVRL). The company is in the process of contracting with various affiliates with extensive animal health industry expertise so as to broaden the consulting services it is now offering worldwide. Boehringer Ingelheim announces equine research award recipients Boehringer Ingelheim Vetmedica, Inc. (BIVI), has selected five equine researchers as recipients of its 2013 Advancement of Equine Research Awards. Each researcher will receive a grant of $15,000 to study the diagnosis, pathogenesis, transmission, control and/or prevention of equine infectious diseases during The following researchers received awards: Noah Cohen, VMD, MPH, PhD, DACVIM, professor at Texas A&M University, for Is Diversity of the fecal microbiome associated with risk of Rhodoccocus equi foal pneumonia? ; Nicola Pusterla, DVM, PhD, DACVIM, professor at the University of California, Davis, for Investigation of the presence of novel viruses in nasal secretions of horses with infectious upper respiratory tract disease ; David Horohov, PhD, professor at the University of Kentucky, for Subisotypic differences in the immunoglobulin G response to Lawsonia intracellularis in vaccinated, seropositive and clinically affected horses ; Ramiro E. Toribio, DVM, PhD, DACVIM, associate professor at The Ohio State University, for Dynamics of the equine fecal microbiome in response to antibiotics ; Ashely G. Boye, DVM, DACVIM, assistant professor of medicine at the University of Pennsylvania, for Determining optimal sampling site for strangles carriers using loop-mediated isothermal (LAMP) PCR. Virbac names Michael Albo Director of Communications Virbac Corporation announced that Michael Albo has been named Director of Communications, effective December 2, In his new role, Albo will be responsible for managing and directing internal and exter- Michael Albo nal communications for Virbac. He will be the liaison to media personnel for general inquiries, new products or research finding, and in the event, crisis management. He will also work in cooperation with key stakeholders to keep the flow of pertinent information open. In addition, Albo will ensure all communications from Virbac are precise and succinct both traditionally and digitally. Albo has devoted his entire career to a variety of positions in the sales and marketing industry. He most recently served as Director of Sales and Marketing at Nestle-Purina, leading the PurinaCare Pet Health Insurance and Partners in Wellness product lines. He was instrumental in launching the brands in a web environment, through an e-commerce site. Prior to that, Albo owned and operated a successful marketing agency, Catalyst Marketing Studios. 82 January/February 2014»» Veterinary advantage

83 CAUTION: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Description: NEXGARD (afoxolaner) is available in four sizes of beef-flavored, soft chewables for oral administration to dogs and puppies according to their weight. Each chewable is formulated to provide a minimum afoxolaner dosage of 1.14 mg/lb (2.5 mg/kg). Afoxolaner has the chemical composition 1-Naphthalenecarboxamide, 4-[5- [3-chloro-5-(trifluoromethyl)-phenyl]-4, 5-dihydro-5- (trifluoromethyl)-3-isoxazolyl]-n-[2-oxo-2-[(2,2,2-trifluoroethyl)amino]ethyl. Indications: NEXGARD kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis), and the treatment and control of American Dog tick (Dermacentor variabilis) infestations in dogs and puppies 8 weeks of age and older, weighing 4 pounds of body weight or greater, for one month. Dosage and Administration: NEXGARD is given orally once a month, at the minimum dosage of 1.14 mg/lb (2.5 mg/kg). Dosing Schedule: Body Afoxolaner Per Chewables Weight Chewable (mg) Administered 4.0 to 10.0 lbs One 10.1 to 24.0 lbs One 24.1 to 60.0 lbs. 68 One 60.1 to lbs. 136 One Over lbs. Administer the appropriate combination of chewables NEXGARD can be administered with or without food. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes to ensure that part of the dose is not lost or refused. If it is suspected that any of the dose has been lost or if vomiting occurs within two hours of administration, redose with another full dose. If a dose is missed, administer NEXGARD and resume a monthly dosing schedule. Flea Treatment and Prevention: Treatment with NEXGARD may begin at any time of the year. In areas where fleas are common year-round, monthly treatment with NEXGARD should continue the entire year without interruption. To minimize the likelihood of flea reinfestation, it is important to treat all animals within a household with an approved flea control product. Tick Treatment and Control: Treatment with NEXGARD may begin at any time of the year (see Effectiveness). Contraindications: There are no known contraindications for the use of NEXGARD. Warnings: Not for use in humans. Keep this and all drugs out of the reach of children. In case of accidental ingestion, contact a physician immediately. Precautions: The safe use of NEXGARD in breeding, pregnant or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures (see Adverse Reactions). Adverse Reactions: In a well-controlled US field study, which included a total of 333 households and 615 treated dogs (415 administered afoxolaner; 200 administered active control), no serious adverse reactions were observed with NEXGARD. Over the 90-day study period, all observations of potential adverse reactions were recorded. The most frequent reactions reported at an incidence of > 1% within any of the three months of observations are presented in the following table. The most frequently reported adverse reaction was vomiting. The occurrence of vomiting was generally self-limiting and of short duration and tended to decrease with subsequent doses in both groups. Five treated dogs experienced anorexia during the study, and two of those dogs experienced anorexia with the first dose but not subsequent doses. Table 1: Dogs With Adverse Reactions. Treatment Group Afoxolaner Oral active control N 1 % (n=415) N 2 % (n=200) Vomiting (with and without blood) Dry/Flaky Skin Diarrhea (with and without blood) Lethargy Anorexia Number of dogs in the afoxolaner treatment group with the identified abnormality. 2 Number of dogs in the control group with the identified abnormality. In the US field study, one dog with a history of seizures experienced a seizure on the same day after receiving the first dose and on the same day after receiving the second dose of NEXGARD. This dog experienced a third seizure one week after receiving the third dose. The dog remained enrolled and completed the study. Another dog with a history of seizures had a seizure 19 days after the third dose of NEXGARD. The dog remained enrolled and completed the study. A third dog with a history of seizures received NEXGARD and experienced no seizures throughout the study. To report suspected adverse events, for technical assistance or to obtain a copy of the MSDS, contact Merial at or For additional information about adverse drug experience reporting for animal drugs, contact FDA at FDA-VETS or online at Mode of Action: Afoxolaner is a member of the isoxazoline family, shown to bind at a binding site to inhibit insect and acarine ligand-gated chloride channels, in particular those gated by the neurotransmitter gamma-aminobutyric acid (GABA), thereby blocking pre- and post-synaptic transfer of chloride ions across cell membranes. Prolonged afoxolaner-induced hyperexcitation results in uncontrolled activity of the central nervous system and death of insects and acarines. The selective toxicity of afoxolaner between insects and acarines and mammals may be inferred by the differential sensitivity of the insects and acarines GABA receptors versus mammalian GABA receptors. Effectiveness: In a well-controlled laboratory study, NEXGARD demonstrated 100% effectiveness against adult fleas 24 hours post-infestation for 35 days, and was 93% effective at 12 hours post-infestation through Day 21, and on Day 35. On Day 28, NEXGARD was 81.1% effective 12 hours postinfestation. Dogs in both the treated and control groups that were infested with fleas on Day -1 generated flea eggs at 12- and 24-hours post-treatment (0-11 eggs and 1-17 eggs in the NEXGARD treated dogs, and 4-90 eggs and eggs in the control dogs, at 12- and 24-hours, respectively). At subsequent evaluations post-infestation, fleas from dogs in the treated group were essentially unable to produce any eggs (0-1 eggs) while fleas from dogs in the control group continued to produce eggs (1-141 eggs). In a 90-day US field study conducted in households with existing flea infestations of varying severity, the effectiveness of NEXGARD against fleas on the Day 30, 60 and 90 visits compared with baseline was 98.0%, 99.7%, and 99.9%, respectively. Collectively, the data from the two studies (one laboratory and one field) demonstrate that NEXGARD kills fleas before they can lay eggs, thus preventing subsequent flea infestations after the start of treatment of existing flea infestations. In well-controlled laboratory studies, NEXGARD demonstrated >97% effectiveness against Dermacentor variabilis 48 hours post-infestation for 30 days. Animal Safety: In a margin of safety study, NEXGARD was administered orally to 8- to 9-week-old Beagle puppies at 1, 3, and 5 times the maximum exposure dose (6.3 mg/kg) for three treatments every 28 days, followed by three treatments every 14 days, for a total of six treatments. Dogs in the control group were sham-dosed. There were no clinically-relevant effects related to treatment on physical examination, body weight, food consumption, clinical pathology (hematology, clinical chemistries, or coagulation tests), gross pathology, histopathology or organ weights. Vomiting occurred throughout the study, with a similar incidence in the treated and control groups, including one dog in the 5x group that vomited four hours after treatment. In a well-controlled field study, NEXGARD was used concomitantly with other medications, such as vaccines, anthelmintics, antibiotics (including topicals), steroids, NSAIDS, anesthetics, and antihistamines. No adverse reactions were observed from the concomitant use of NEXGARD with other medications. Storage Information: Store at or below 30 C (86 F) with excursions permitted up to 40 C (104 F). How Supplied: NEXGARD is available in four sizes of beef-flavored soft chewables: 11.3, 28.3, 68 or 136 mg afoxolaner. Each chewable size is available in color-coded packages of 3 or 6 beef-flavored chewables. NADA , Approved by FDA Marketed by: Frontline Vet Labs, a Division of Merial Limited. Duluth, GA USA Made in Brazil Rev. 7/2013 NEXGARD and FRONTLINE VET LABS are trademarks of Merial Merial. All rights reserved. Veterinary advantage ««January/February

84 COMMUNITY News Putney promotes Shannon Lancaster and Jason Dobrinick; named Portland s 2013 Business of the Year Putney, Inc., has promoted Shannon Lancaster to Director of Financial Planning and Analysis, and Jason Dobrinick to Manager of Inside Sales. In his new role, Lancaster will strengthen Putney s commercial operations by enhancing the reporting and forecasting capabilities while also providing the financial insight required to support the company s rapid growth. Dobrinick will now oversee Putney s inside sales team and is responsible for the team achieving its annual sales objectives. Putney also has been named Portland s 2013 Business of the Year in recognition of the company s contribution to Portland s economic growth, according to a release. This is the fifth major award that the company has won in the last six months. Previous recognition of Putney s growth includes being named to the Inc list and the Deloitte Technology Fast 500. Putney has also been recognized for its excellent workplace culture in 2013 by being named the number one best place to work in Maine and appearing in Fortune magazine, listed as the Tenth Best Small/ Medium Workplace in the United States. Kinn announces sponsorship of American Humane Association Kinn Inc., has announced its sponsorship of American Humane Association, in which Kinn will make a series of donations to support their mission. As a company centered around providing consumers with better tools to not only care for their pets, but develop deeper connections and relationships with them, we are thrilled to sponsor American Humane Association, explained Alex McKinnon, founder and CEO of Kinn, Inc. American Humane Association represents a very important cause that is near and dear to our hearts and we are committed to helping their efforts in any way we can. NAVTA names Julie Legred Executive Director The North American Veterinary Community (NAVC) has announced that Julie Legred, CVT, is the new Executive Director of the National Association of Veterinary Technicians in America (NAVTA). She s also the Senior Manager, Veterinary Technician Programs for NAVC, overseeing all Veterinary Technician initiatives within the NAVC. Ms. Legred has been serving as the Interim Executive Director for NAVTA for the last year and has been involved with NAVTA in other roles for many years. She has served as the association s President, twice. Happy New Year from your friends at Iams! As you know, it is our goal to help you and your customers grow your diet businesses. To help you accomplish this, we have a number of programs currently in place, and some new programs coming as well. These programs remain available to our partners at Henry Schein Animal Health and MWI. Current Program Tools/Resources: Buy 3, Get 1 Free: Purchase 3 of any item, receive 1 of the same item free! This runs from January 1 February 28, Receive an additional item FREE with the purchase of three of the same Iams Veterinary Formula diets or biscuits: Weight Loss/Mobility Plus, Weight Loss Rewards Plus, Joint Plus, or Glucose & Weight Control Plus Product Training: Dental training with $10 incentive SoundByte: A SoundByte on Dental is available in this magazine, and will be added to the app as well by mid-february. Future Programs Product Training: An online training course through Vet-Advantage will cover Home Delivery. Henry Schein and MWI reps will receive cash incentives for taking the training and passing the quiz. Available February 15th March 15th. 84 January/February 2014»» Veterinary advantage

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86 New Product Spotlight Wahl Clipper launches new and improved Bravura Clipper with Lithium Ion Power Wahl Clipper Corporation announced the launch of the new professional Wahl Bravura Li+ Cord/Cordless Clipper, available in three new brilliant colors - Pink, Purple and Gunmetal. The Bravura Li+ is designed for long running times of 90 minutes with quick recharges of 45 minutes and operates at full speed until depleted. The Bravura Li+ can be charged thousands of times without any noticeable loss in battery capacity ensuring high performance and long service life. Not only is this powerful cord/cordless rotary motor clipper exceptionally quiet with virtually no vibration, it is also lightweight, durable and maintenance free with 5,500 SPM s. The new advanced Lithium Ion technology is revolutionary and sophisticated offering higher performance, longer effective usage times and absolute consistent reliability. The Lithium Ion batteries have a no memory effect allowing for full battery capacity to be obtained without constant recharging and discharging of the unit. Medical Illumination introduces SYSTEM TWO LED Series Medical Illumination International introduced a new line of surgery lighting the SYSTEM TWO LED series. Incorporating the superior characteristics of LED light sources, this new series represents the pinnacle of the well-established SYSTEM TWO product line with over 120,000 lux output, 4,300º Kelvin color temperature, electrical usage about ½ of comparable halogen-based lights, and with virtually cold light output. 50,000 hour rated LED life means that bulb replacement becomes a thing of the past. Additionally, the SYSTEM TWO LED series provides the unique feature of all primary functions being able to be performed in the sterile field, by use of our celebrated all-inclusive sterilizable handle. The on/off switch, five stage dimming, and positioning of the light head can all be achieved in this manner, along with the capability of utilizing disposable handle covers. The SYSTEM TWO LED series represents a major step forward in green technology, by dramatically lowering energy consumption, producing less heat, and eliminating bulb replacement. Available in Solo, Duo or Trio ceiling mount models and in various combinations that may include High Definition video monitors or video cameras. Sold through veterinary equipment distributors, worldwide. Sogeval Laboratories releases SAMeLQ 225 Snap Tablets Sogeval Laboratories announced the release of SAMeLQ 225 Snap Tablets, an innovative nutritional supplement for liver support in canines and felines. Ingredients in SAMeLQ 225 Snap Tablets include S-Adenosyl Methionine, Glycyrrhizinate Ammonium (extract from Licorice Root) and Quercetin. S-Adenosyl Methionine (SAMe) is an antioxidant, anti-inflammatory and analgesic used in animals and humans. Glycyrrhizinate Ammonium (Licorice Root) has been clinically shown to prevent damages to liver cells and promote liver regeneration. Furthermore, Licorice Root extract is an anti-inflammatory compound that also stimulates the immune system. Quercetin is a powerful antioxidant that complements the benefits of S-Adenosyl Methionine. Together, these ingredients, along with additional N-Acetyl-Cysteine, Taurine, B vitamins, Zinc and Vitamin E, offer a new approach to liver support. Palatable SAMeLQ 225 Snap Tablets allow for precise dosage for all bodyweights and are designed to protect the delicate SAMe molecule from the environment, allowing for delivery of the full dose to the animal. FDA approves new label indications for Bayer s Advantage Multi (imidacloprid + moxidectin) in the U.S. Bayer HealthCare LLC Animal Health division announced that the U.S. Food and Drug Administration (FDA) has approved Advantage Multi for Dogs for the treatment of circulating 86 january/february 2014»» Veterinary advantage

87 New Product Spotlight microfilaria, the first life stage of heartworm, making it the only FDA-approved product labeled for microfilaria treatment. Advantage Multi for Dogs was also approved by the FDA for the treatment and control of sarcoptic mange, which can result in intense itching in dogs and, in turn, cause hair loss, reddened skin, body sores and scabs. Bayer also announced that the FDA has approved the use of Advantage Multi for Cats (0.4 ml size only) to prevent heartworm disease, kill adult fleas and treat flea infestations in ferrets, making it the first-ever heartworm and flea product labeled for use on ferrets. Vetoquinol releases Zylkene When pets communicate their stress through changes in behavior, their owners may not realize behavior problems can trigger health-related troubles, too. Now veterinarians can start a new dialogue about behavior and start new Zylkene. The only veterinary nutraceutical with alphacasozepine, a safe, natural ingredient clinically proven for behavioral problem management without drowsiness or sedation. This palatable, once-daily formation is ideal for situational stress and chronic anxiety in dogs and cats. Package Insert for Dogs Approved by FDA, ANADA NDC MeloxiMed Injection (meloxicam) 5 mg/ml Solution for Injection Non-steroidal anti-inflammatory drug for use in dogs and cats only. Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian. WARNING : Repeated use of meloxicam in cats has been associated with acute renal failure and death. Do not administer additional injectable or oral meloxicam to cats. See Contraindications, Warnings, and Precautions for detailed information. Description: Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam class. Each ml of this sterile product for injection contains meloxicam 5.0 mg, alcohol 15%, glycofurol 10%, poloxamer 188 5%, sodium chloride 0.6%, glycine 0.5% and meglumine 0.3%, in water for injection, ph adjusted with sodium hydroxide and hydrochloric acid. CH3 S OH O N N N H S CH3 O O meloxicam Indications: Dogs: MeloxiMed (meloxicam) Injection 5 mg/ml Solution for Injection is indicated in dogs for the control of pain and inflammation associated with osteoarthritis. Dosage and Administration: Carefully consider the potential benefits and risk of MeloxiMed Injection and other treatment options before deciding to use Meloxicam Injection. Use the lowest effective dose for the shortest duration consistent with individual response. Dogs: MeloxiMed Injection 5 mg/ml Solution for Injection should be administered initially as a single dose at 0.09 mg/lb (0.2 mg/kg) body weight intravenously (IV) or subcutaneously (SQ), followed, after 24 hours, by Meloxicam Oral Suspension at the daily dose of mg/lb (0.1 mg/kg) body weight, either mixed with food or placed directly in the mouth. Contraindications: Dogs with known hypersensitivity to meloxicam should not receive Meloxicam Injection 5 mg/ml Solution for Injection. Warnings: Not for use in humans. Keep this and all medications out of reach of children. Consult a physician in case of accidental ingestion by humans. For IV or SQ injectable use in dogs. All dogs should undergo a thorough history and physical examination before administering any NSAID. Appropriate laboratory testing to establish hematological and serum biochemical baseline data is recommended prior to, and periodically during use of any NSAID in dogs. Owner should be advised to observe their dogs for signs of potential drug toxicity. Precautions: The safe use of MeloxiMed Injection 5 mg/ml Solution for Injection in dogs younger than 6 months of age, dogs used for breeding, or in pregnant or lactating bitches has not been evaluated. Meloxicam is not recommended for use in dogs with bleeding disorders, as safety has not been established in dogs with these disorders. Safety has not been established for intramuscular (IM) administration in dogs. When administering MeloxiMed Injection 5 mg/ml Solution for Injection, use a syringe of appropriate size to ensure precise dosing. As a class, cyclo-oxygenase inhibitory NSAIDs may be associated with gastrointestinal, renal and hepatic toxicity. Sensitivity to drug associated adverse events varies with the individual patient. Dogs that have experienced adverse reactions from one NSAID may experience adverse reactions from another NSAID. Patients at greatest risk for renal toxicity are those that are dehydrated, on concomitant diuretic therapy, or those with existing renal, cardiovascular, and/or hepatic dysfunction. Concurrent administration of potentially nephrotoxic drugs should be carefully approached. NSAIDs may inhibit the prostaglandins that maintain normal homeostatic function. Such anti-prostaglandin effects may result in clinically significant disease in patients with underlying or pre-existing disease that has not been previously diagnosed. Since NSAIDs possess the potential to induce gastrointestinal ulceration and/or perforations, concomitant use with other anti-inflammatory drugs, such as NSAIDs or corticosteroids, should be avoided. If additional pain medication is needed after the administration of the total daily dose of Meloxicam Oral Suspension, a non-nsaid or non-corticosteroid class of analgesia should be considered. The use of another NSAID is not recommended. Consider appropriate washout times when switching from corticosteroid use or from one NSAID to another in dogs. The use of concomitantly protein-bound drugs with MeloxiMed Injection 5 mg/ml Solution for Injection has not been studied in dogs. Commonly used protein-bound drugs include cardiac, anticonvulsant and behavioral medications. The influence of concomitant drugs that may inhibit metabolism of MeloxiMed Injection 5 mg/ml Solution for Injection has not been evaluated. Drug compatibility should be monitored in patients requiring adjunctive therapy. The effect of cyclooxygenase inhibition and the potential for thromboembolic occurrence or a hypercoagulable state has not been studied. Adverse Reactions: Dogs: A field study involving 224 dogs was conducted. Based on the results of this study, GI abnormalities (vomiting, soft stools, diarrhea, and inappetance) were the most common adverse reactions associated with the administration of meloxicam. The following table lists adverse reactions and the numbers of dogs that experienced them during the study. Dogs may have experienced more than one episode of the adverse reaction during the study. Adverse Reactions Observed During Field Study Clinical Observation Meloxicam Placebo (n =109) (n = 115) Vomiting Diarrhea/Soft Stool Inappetance 3 0 Bloody Stool 1 0 In foreign suspected adverse drug reaction (SADR) reporting, adverse reactions related to meloxicam administration included: auto-immune hemolytic anemia (1 dog), thrombocytopenia (1 dog), polyarthritis (1 dog), nursing puppy lethargy (1 dog), and pyoderma (1 dog). Post-Approval Experience (Rev. 2009): The following adverse reactions are based on post-approval adverse drug event reporting. The categories are listed in decreasing order of frequency by body system. Gastrointestinal: vomiting, diarrhea, melena, gastrointestinal ulceration Urinary: azotemia, elevated creatinine, renal failure Neurological/Behavioral: lethargy, depression Hepatic: elevated liver enzymes Dermatologic: pruritus Death has been reported as an outcome of the adverse events listed above. Acute renal failure and death have been associated with the use of meloxicam in cats. To report suspected adverse reactions or for technical assistance call For a complete listing of adverse reactions for meloxicam reported to the CVM see: Information For Dog Owners: Meloxicam, like other NSAIDs, is not free from adverse reactions. Owners should be advised of the potential for adverse reactions and be informed of the clinical signs associated with NSAID intolerance. Adverse reactions may include vomiting, diarrhea, lethargy, decreased appetite and behavioral changes. Dog owners should be advised when their pet has received a meloxicam injection. Dog owners should contact their veterinarian immediately if possible adverse reactions are observed, and dog owners should be advised to discontinue Meloxicam Injection therapy. Clinical Pharmacology: Meloxicam has nearly 100% bioavailability when administered orally or after subcutaneous injection in dogs. The terminal elimination half life after a single dose is estimated to be approximately 24 hrs (+/-30%) in dogs regardless of route of administration. Drug bioavailability, volume of distribution, and total systemic clearance remain constant up to 5 times the recommended dose for use in dogs. However, there is some evidence of enhanced drug accumulation and terminal elimination half-life prolongation when dogs are dosed for 45 days or longer. Peak drug concentrations of mcg/ml can be expected to occur within 2.5 hours following a 0.2 mg/kg subcutaneous injection in dogs. Based upon intravenous administration in Beagle dogs, the meloxicam volume of distribution in dogs (Vdλ) is approximately 0.32 L/kg and the total systemic clearance is 0.01 L/hr/kg. The drug is 97% bound to canine plasma proteins. Effectiveness: Dogs: The effectiveness of MeloxiMed Injection 5 mg/ml Solution for Injection was demonstrated in a field study involving a total of 224 dogs representing various breeds, all diagnosed with osteoarthritis. This placebo-controlled, masked study was conducted for 14 days. Dogs received a subcutaneous injection of 0.2 mg/kg MeloxiMed Injection 5 mg/ml Solution for Injection on day 1. The dogs were maintained on 0.1 mg/kg oral meloxicam from days 2 through 14. Variables evaluated by veterinarians included lameness, weight-bearing, pain on palpation, and overall improvement. Variables assessed by owners included mobility, ability to rise, limping, and overall improvement. In this field study, dogs showed clinical improvement with statistical significance after 14 days of meloxicam treatment for all variables. Animal Safety: Dogs: 3 Day Target Animal Safety Study -In a three day safety study, MeloxiMed Injection 5 mg/ml Solution for Injection was administered intravenously to Beagle dogs at 1, 3, and 5 times the recommended dose (0.2, 0.6 and 1.0 mg/kg) for three consecutive days. Vomiting occurred in 1 of 6 dogs in the 5X group. Fecal occult blood was detected in 3 of 6 dogs in the 5X group. No clinically significant hematologic changes were seen, but serum chemistry changes were observed. Serum alkaline phosphatase (ALP) was significantly increased in one 1X dog and two of the 5X dogs. One dog in the 5X group had a steadily increasing GGT over 4 days, although the values remained within the reference range. Decreases in total protein and albumin occurred in 2 of 6 dogs in the 3X group and 3 of 6 dogs in the 5X group. Increases in blood urea nitrogen (BUN) occurred in 3 of 6 dogs in the 1X group, 2 of 6 dogs in the 3X group and 2 of 6 dogs in the 5X group. Increased creatinine occurred in 2 dogs in the 5X group. Increased urine protein excretion was noted in 2 of 6 dogs in the control group, 2 of 6 dogs in the 1X group, 2 of 6 dogs in the 3X group, and 5 of 6 dogs in the 5X group. Two dogs in the 5X group developed acute renal failure by Day 4. Bicarbonate levels were at or above normal levels in 1 of the 3X dogs and 2 of the 5X dogs. Histological examination revealed gastrointestinal lesions ranging from superficial mucosal hemorrhages and congestion to erosions. Mesenteric lymphadenopathy was identified in 2 of 6 dogs in the 1X group, 4 of 6 dogs in the 3X group, and 5 of 6 dogs in the 5X group. Renal changes ranged from dilated medullary and cortical tubules and inflammation of the interstitium, to necrosis of the tip of the papilla in 2 of 6 dogs in the 1X group, 2 of 6 dogs in the 3X group, and 4 of 6 dogs in the 5X group. Injection Site Tolerance - MeloxiMed Injection 5 mg/ml Solution for Injection was administered once subcutaneously to Beagle dogs at the recommended dose of 0.2 mg/kg and was well-tolerated by the dogs. Pain upon injection was observed in one of eight dogs treated with meloxicam. No pain or inflammation was observed post-injection. Long term use of MeloxiMed Injection 5 mg/ml Solution for Injection in dogs has not been evaluated. Effect on Buccal Mucosal Bleeding Time (BMBT) - MeloxiMed Injection 5 mg/ml Solution for Injection (0.2 mg/kg) and placebo (0.4 ml/kg) were administered as single intravenous injections to 8 female and 16 male Beagle dogs. There was no statistically significant difference (p>0.05) in the average BMBT between the two groups. Storage Information: Store at controlled room temperature, F (20-25 C). Protect from light. How Supplied: MeloxiMed Injection 5 mg/ml Solution for Injection: 10 ml vial Manufactured For: Bimeda, Inc. Le Sueur, MN Manufactured By: Intas Pharmaceuticals Limited, Plot No : 457, 458, Village Matoda, Bavla Road, Ta.- Sanand, Dist.- Ahmedabad India MEL001 Rev. 04/13 Package Insert for Cats Approved by FDA, ANADA NDC MeloxiMed Injection (meloxicam) 5 mg/ml Solution for Injection Non-steroidal anti-inflammatory drug for use in dogs and cats only. Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian. WARNING: Repeated use of meloxicam in cats has been associated with acute renal failure and death. Do not administer additional injectable or oral meloxicam to cats. See Contraindications, Warnings, and Precautions for detailed information. Description: Meloxicam is a non-steroidal anti-inflammatory drug (NSAID) of the oxicam class. Each ml of this sterile product for injection contains meloxicam 5.0 mg, alcohol 15%, glycofurol 10%, poloxamer 188 5%, sodium chloride 0.6%, glycine 0.5% and meglumine 0.3%, in water for injection, ph adjusted with sodium hydroxide and hydrochloric acid. CH 3 S OH O N N N H S CH 3 O O meloxicam Indications: Cats: For the control of postoperative pain and inflammation associated with orthopedic surgery, ovariohysterectomy and castration when administered prior to surgery. Dosage and Administration: Carefully consider the potential benefits and risk of MeloxiMed (meloxicam) Injection and other treatment options before deciding to use Meloxicam Injection. Use the lowest effective dose for the shortest duration consistent with individual response. Cats: Administer a single, one time subcutaneous dose of MeloxiMed Injection 5 mg/ml Solution for Injection to cats at a dose of 0.14 mg/lb (0.3 mg/kg) body weight. Use of additional meloxicam or other NSAIDs is contraindicated. (See Contraindications). To ensure accuracy of dosing, the use of a 1 ml graduated syringe is recommended. Contraindication: Cats with known hypersensitivity to meloxicam should not receive MeloxiMed Injection 5 mg/ml Solution for Injection. Additional doses of meloxicam or other NSAIDs in cats are contraindicated, as no safe dosage for repeated NSAID administration has been established (See Animal Safety). Do not use meloxicam in cats with pre-existing renal dysfunction. Warnings: Not for use in humans. Keep this and all medications out of reach of children. Consult a physician in case of accidental ingestion by humans. For subcutaneous (SQ) injectable use in cats. Do not use IV in cats. Do not administer a second dose of meloxicam. Do not follow the single, one-time dose of meloxicam with any other NSAID. Do not administer Meloxicam Oral Suspension following the single, one-time injectable dose of meloxicam When administering any NSAID, appropriate laboratory testing to establish hematological and serum biochemical baseline data is recommended prior to use in dogs and cats. All cats should undergo a thorough history and physical examination before administering meloxicam. Do not repeat the single, one-time dose of meloxicam in cats. Owner should be advised to observe their cats for signs of potential drug toxicity. Precautions: The safe use of MeloxiMed Injection 5 mg/ml Solution for Injection in cats younger than 4 months of age, cats used for breeding, or in pregnant or lactating queens has not been evaluated. Meloxicam is not recommended for use in cats with bleeding disorders, as safety has not been established in cats with these disorders. Safety has not been established for intravenous (IV) or intramuscular (IM) use in cats. When administering MeloxiMed Injection 5 mg/ml Solution for Injection, use a syringe of appropriate size to ensure precise dosing. As a class, cyclo-oxygenase inhibitory NSAIDs may be associated with gastrointestinal, renal and hepatic toxicity. Sensitivity to drug-associated adverse events varies with the individual patient. Cats that have experienced adverse reactions from one NSAID may experience adverse reactions from another NSAID. NSAIDs may inhibit the prostaglandins that maintain normal homeostatic function. Such anti-prostaglandin effects may result in clinically significant disease in patients with underlying or pre-existing disease that has not been previously diagnosed. Patients at greatest risk for adverse events are those that are dehydrated, on concomitant diuretic therapy, or those with existing renal, cardiovascular, and /or hepatic dysfunction. Concurrent administration of potentially nephrotoxic drugs should be carefully approached and monitored. Anesthetic drugs may affect renal perfusion; approach concomitant use of anesthetics and NSAIDs cautiously. Appropriate monitoring procedures should be employed during all surgical procedures. The use of perioperative parenteral fluids is recommended to decrease potential renal complications when using NSAIDs. If additional pain medication is needed after the single one-time dose of meloxicam, a non-nsaid class of analgesic may be necessary. In one study 1, one cat in each NSAID treatment group had increased intraoperative hemorrhage. Since NSAIDs possess the potential to induce gastrointestinal ulceration and/or gastrointestinal perforations, concomitant use of meloxicam with other anti-inflammatory drugs, such as NSAIDs or corticosteroids, should be avoided. Consider appropriate washout times when switching from corticosteroid use to meloxicam in cats. As a single use product in cats, meloxicam should not be followed by additional NSAIDs or corticosteroids. The use of concomitantly protein-bound drugs with MeloxiMed Injection 5 mg/ml Solution for Injection has not been studied in cats. Commonly used protein-bound drugs include cardiac, anticonvulsant and behavioral medications. The influence of concomitant drugs that may inhibit metabolism of MeloxiMed Injection 5 mg/ml Solution for Injection has not been evaluated. Drug compatibility should be monitored in patients requiring adjunctive therapy. The effect of cyclo-oxygenase inhibition and the potential for thromboembolic occurrence or a hypercoagulable state has not been studied. Adverse Reactions: Cats: A field study involving 138 cats was conducted. Of the 72 cats receiving MeloxiMed Injection 5 mg/ml Solution for Injection, six cats (8.3%) experienced post-treatment elevated serum blood urea nitrogen (BUN) levels. The pre-treatment values were in the normal range. Of the 66 cats in the butorphanol treatment group, no cats experienced post-treatment elevated serum blood urea nitrogen levels. Nine cats (12.5%) receiving MeloxiMed Injection 5 mg/ml Solution for Injection had post-treatment anemia. Pre-treatment, these cats all had hematocrit and hemoglobin values in the normal range. Four cats (6.1%) in the butorphanol treatment group had post-treatment anemia. All but one cat, who had a mild anemia pre-treatment (hematocrit=21% and hemoglobin=7.0 g/dl) had normal pretreatment values. Twenty-four hours after the injection with MeloxiMed Injection 5 mg/ml Solution for Injection, one cat experienced pain upon palpation of the injection site. Foreign Experience: Repeated use in cats has been associated with acute renal failure and death. In studies used for the foreign approval of MeloxiMed Injection 5 mg/ml Solution for Injection in cats, lethargy, vomiting, inappetance, and transient pain immediately after injection were noted. Diarrhea and fecal occult blood have also been reported. Post-Approval Experience (Rev. 2009): The following adverse reactions are based on post-approval adverse drug event reporting. The categories are listed in decreasing order of frequency by body system: Urinary: azotemia, elevated creatinine, elevated phosphorus, renal failure Gastrointestinal: anorexia, vomiting, diarrhea Neurologic/Behavioral: lethargy, depression Hematologic: anemia Death has been reported as an outcome of the adverse events listed above. Acute renal failure and death have been associated with the use of meloxicam in cats. To report suspected adverse reactions or for technical assistance call For a complete listing of adverse reactions for meloxicam reported to the CVM see: ProductSafetyInformation/ ucm htm Information For Cat Owners: Meloxicam, like other NSAIDs, is not free from adverse reactions. Owners should be advised of the potential for adverse reactions and be informed of the clinical signs associated with NSAID intolerance. Adverse reactions may include vomiting, diarrhea, lethargy, decreased appetite and behavioral changes. Cat owners should be advised when their pet has received a meloxicam injection. Cat owners should contact their veterinarian immediately if possible adverse reactions are observed. Clinical Pharmacology: Meloxicam has nearly 100% bioavailability after subcutaneous injection in cats. The terminal elimination half life after a single dose is estimated to be approximately 15 hrs (+/-10%) in cats. Peak drug concentrations of 1.1 mcg/ml can be expected to occur within 1.5 hours following a 0.3 mg/kg subcutaneous injection in cats. The volume of distribution (Vdλ) in cats is approximately 0.27 L/kg, with an estimated total systemic clearance of L/hr/kg. The drug is 97% bound to feline plasma proteins. Effectiveness: Cats: The effectiveness of MeloxiMed Injection 5 mg/ml Solution for Injection was demonstrated in a masked field study involving a total of 138 cats representing various breeds. This study used butorphanol as an active control. Cats received either a single subcutaneous injection of 0.3 mg/kg MeloxiMed Injection 5 mg/ml Solution for Injection or 0.4 mg/kg butorphanol prior to onychectomy, either alone or in conjunction with surgical neutering. All cats were premedicated with acepromazine, induced with propofol and maintained on isoflurane. Pain assessment variables evaluated by veterinarians included additional pain intervention therapy, gait/lameness score, analgesia score, sedation score, general impression score, recovery score, and visual analog scale score. Additionally, a cumulative pain score, which was the summation of the analgesia, sedation, heart rate and respiratory rate scores was evaluated. A palpometer was used to quantify the pain threshold. A substantial number of cats required additional intervention in the 0-24 hour post-surgical period, with the majority of these interventions taking place within the first hour. Therefore, the percentage of cats in each group that received one or more interventions was designated as the primary assessment variable. Approximately half of the cats in each group received a pain intervention as a result of the first (time 0) post-surgical evaluation, i.e., extubation. At this point, the need to provide a pain intervention was not statistically significant between the two groups (p=0.7215). However, the median number of interventions was one per cat in the meloxicam group and two per cat in the butorphanol group and this difference was statistically significant (p=0.0021). The statistical evaluation supports the conclusion that the meloxicam test article is noninferior to the butorphanol active control. Forty-eight of the 72 cats in the meloxicam group received one or more interventions (66.7%), and 47 of 66 cats in the butorphanol group received one or more interventions (71.2%). The number of interventions administered to the meloxicam group was less than the butorphanol group at 1, 3, 5, 8, 12, and 24 hours post-surgery. Cats receiving MeloxiMed Injection 5 mg/ml Solution for Injection showed improvement in the pain assessment variables. Animal Safety: Cats: 3 Day Target Animal Safety Study - In a three day safety study, subcutaneous MeloxiMed Injection 5 mg/ml Solution for Injection administration to healthy cats at up to 1.5 mg/kg (5X the recommended dose) resulted in vomiting in three cats (1 of 6 control cats and 2 of 6 cats in 5X) and loose stools in four cats (2 of 6 control cats and 2 of 6 cats in 5X). Fecal occult blood was detected in ten of the twenty four cats, including two cats in the control group. This was not a dose-related event. Clinically significant hematologic changes seen included increased PT and APTT in two cats (1 of 6 control cats and 1 of 6 cats in 5X), and elevated white blood cell counts in cats having renal or GI tract lesions. Serum chemistry changes observed included decreased total protein in four of 24 cats (1 of 6 cats in 1X, 2 of 6 cats in 3X and 1 of 6 cats in 5X), concomitant increases in blood urea nitrogen (BUN) and creatinine values in 2 of 6 cats in 5X. Histological examination revealed gastrointestinal lesions ranging from inflammatory cell infiltration of the mucosa of the GI tract to erosions. Mesenteric lymphadenopathy was identified in 1 of 6 cats in 1X. Renal changes ranged from dilated medullary (2 of 6 cats in 1X, 1 of 6 cats in 3X, and 1 of 6 cats in 5X) and cortical (3 of 6 cats in 1X, 1 of 6 cats in 3X, and 3 of 6 cats in 5X) tubules and inflammation (2 of 6 cats in 1X, 2 of 6 cats in 3X, and 2 of 6 cats in 5X) or fibrosis (2 of 6 cats in 3X and 2 of 6 cats in 5X) of the interstitium to necrosis of the tip of the papilla (5 of 6 cats in 5X). Subsequent oral dosing - In a nine day study with three treatment groups, Meloxicam Injection 5 mg/ml Solution for Injection was given as a single subcutaneous injection using doses of 0 mg/kg (saline injection), 0.3 mg/kg and 0.6 mg/kg on Day 0. Meloxicam Oral Suspension, 1.5 mg/ml or saline was then administered orally once-daily at the same respective dose (0.3 or 0.6 mg/kg) for eight consecutive days. Clinical adverse reactions included vomiting, diarrhea, lethargy, and decreased food consumption in the treated groups, and one day of diarrhea in one control cat. The gross necropsy report includes observation of reddened GI mucosa in 3 of 4 cats in the 0.3 mg/kg group and 1 of 4 cats in the 0.6 mg/kg group. All saline-treated cats were normal. By Day 9, one cat in both the 0.3 mg/kg group and the 0.6 mg/kg group died and another cat in the 0.3 mg/kg group was moribund. The cause of death for these cats could not be determined, although the pathologist reported pyloric/duodenal ulceration in the cats in 0.6 mg/kg group. The safety studies demonstrate a narrow margin of safety. Injection Site Tolerance - Histopathology of the injection sites revealed hemorrhage and inflammation, myofiber atrophy, panniculitis, fibrin deposition, and fibroblast proliferation. These findings were present in cats in all groups, with the 3X cats having the most present. No safe repeat dose has been established in cats. Storage Information: Store at controlled room temperature, F (20-25 C). Protect from light. How Supplied: MeloxiMed Injection 5 mg/ml Solution for Injection: 10 ml vial. Reference: 1 Slingsby L.S., A.E. Waterman-Pearson. Comparison between meloxicam and carprofen for postoperative analgesia after feline ovariohysterectomy. Jour of Small Anim Pract (2002)43: Manufactured For: Bimeda, Inc., Le Sueur, MN Manufactured By: Intas Pharmaceuticals Limited, Plot No : 457, 458, Village Matoda, Bavla Road, Ta.- Sanand, Dist.- Ahmedabad India. 1MEL001 Rev. 04/ Veterinary advantage ««January/February

88 88 January/February 2014»» Veterinary advantage

89 chewables CAUTION: Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: For use in dogs to prevent canine heartworm disease by eliminating the tissue stage of heartworm larvae (Dirofilaria immitis) for a month (30 days) after infection and for the treatment and control of ascarids (Toxocara canis, Toxascaris leonina) and hookworms (Ancylostoma caninum, Uncinaria stenocephala, Ancylostoma braziliense). DOSAGE: HEARTGARD Plus (ivermectin/pyrantel) should be administered orally at monthly intervals at the recommended minimum dose level of 6 mcg of ivermectin per kilogram (2.72 mcg/lb) and 5 mg of pyrantel (as pamoate salt) per kg (2.27 mg/lb) of body weight. The recommended dosing schedule for prevention of canine heartworm disease and for the treatment and control of ascarids and hookworms is as follows: Color Coding 0n Dog Chewables Ivermectin Pyrantel Foil Backing Weight Per Month Content Content and Carton Up to 25 lb 1 68 mcg 57 mg Blue 26 to 50 lb mcg 114 mg Green 51 to 100 lb mcg 227 mg Brown HEARTGARD Plus is recommended for dogs 6 weeks of age and older. For dogs over 100 lb use the appropriate combination of these chewables. ADMINISTRATION: Remove only one chewable at a time from the foil-backed blister card. Return the card with the remaining chewables to its box to protect the product from light. Because most dogs find HEARTGARD Plus palatable, the product can be offered to the dog by hand. Alternatively, it may be added intact to a small amount of dog food.the chewable should be administered in a manner that encourages the dog to chew, rather than to swallow without chewing. Chewables may be broken into pieces and fed to dogs that normally swallow treats whole. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes after administration to ensure that part of the dose is not lost or rejected. If it is suspected that any of the dose has been lost, redosing is recommended. HEARTGARD Plus should be given at monthly intervals during the period of the year when mosquitoes (vectors), potentially carrying infective heartworm larvae, are active. The initial dose must be given within a month (30 days) after the dog s first exposure to mosquitoes. The final dose must be given within a month (30 days) after the dog s last exposure to mosquitoes. When replacing another heartworm preventive product in a heartworm disease preventive program, the first dose of HEARTGARD Plus must be given within a month (30 days) of the last dose of the former medication. If the interval between doses exceeds a month (30 days), the efficacy of ivermectin can be reduced. Therefore, for optimal performance, the chewable must be given once a month on or about the same day of the month. If treatment is delayed, whether by a few days or many, immediate treatment with HEARTGARD Plus and resumption of the recommended dosing regimen will minimize the opportunity for the development of adult heartworms. Monthly treatment with HEARTGARD Plus also provides effective treatment and control of ascarids (T. canis, T. leonina) and hookworms (A. caninum, U. stenocephala, A. braziliense). Clients should be advised of measures to be taken to prevent reinfection with intestinal parasites. EFFICACY: HEARTGARD Plus Chewables, given orally using the recommended dose and regimen, are effective against the tissue larval stage of D.immitis for a month (30 days) after infection and, as a result, prevent the development of the adult stage. HEARTGARD Plus Chewables are also effective against canine ascarids (T. canis, T. leonina) and hookworms (A. caninum, U. stenocephala, A. braziliense). ACCEPTABILITY: In acceptability and field trials, HEARTGARD Plus was shown to be an acceptable oral dosage form that was consumed at first offering by the majority of dogs. PRECAUTIONS: All dogs should be tested for existing heartworm infection before starting treatment with HEARTGARD Plus which is not effective against adult D. immitis. Infected dogs must be treated to remove adult heartworms and microfilariae before initiating a program with HEARTGARD Plus. While some microfilariae may be killed by the ivermectin in HEARTGARD Plus at the recommended dose level, HEARTGARD Plus is not effective for microfilariae clearance. A mild hypersensitivity-type reaction, presumably due to dead or dying microfilariae and particularly involving a transient diarrhea, has been observed in clinical trials with ivermectin alone after treatment of some dogs that have circulating microfilariae. Keep this and all drugs out of the reach of children. In case of ingestion by humans, clients should be advised to contact a physician immediately. Physicians may contact a Poison Control Center for advice concerning cases of ingestion by humans. Store between 68 F - 77 F (20 C - 25 C). Excursions between 59 F - 86 F (15 C - 30 C) are permitted. Protect product from light. ADVERSE REACTIONS: In clinical field trials with HEARTGARD Plus, vomiting or diarrhea within 24 hours of dosing was rarely observed (1.1% of administered doses). The following adverse reactions have been reported following the use of HEARTGARD: Depression/lethargy, vomiting, anorexia, diarrhea, mydriasis, ataxia, staggering, convulsions and hypersalivation. SAFETY: HEARTGARD Plus has been shown to be bioequivalent to HEARTGARD, with respect to the bioavailability of ivermectin. The dose regimens of HEARTGARD Plus and HEARTGARD are the same with regard to ivermectin (6 mcg/kg). Studies with ivermectin indicate that certain dogs of the Collie breed are more sensitive to the effects of ivermectin administered at elevated dose levels (more than 16 times the target use level) than dogs of other breeds. At elevated doses, sensitive dogs showed adverse reactions which included mydriasis, depression, ataxia, tremors, drooling, paresis, recumbency, excitability, stupor, coma and death. HEARTGARD demonstrated no signs of toxicity at 10 times the recommended dose (60 mcg/kg) in sensitive Collies. Results of these trials and bioequivalency studies, support the safety of HEARTGARD products in dogs, including Collies, when used as recommended. HEARTGARD Plus has shown a wide margin of safety at the recommended dose level in dogs, including pregnant or breeding bitches, stud dogs and puppies aged 6 or more weeks. In clinical trials, many commonly used flea collars, dips, shampoos, anthelmintics, antibiotics, vaccines and steroid preparations have been administered with HEARTGARD Plus in a heartworm disease prevention program. In one trial, where some pups had parvovirus, there was a marginal reduction in efficacy against intestinal nematodes, possibly due to a change in intestinal transit time. HOW SUPPLIED: HEARTGARD Plus is available in three dosage strengths (See DOSAGE section) for dogs of different weights. Each strength comes in convenient cartons of 6 and 12 chewables. For customer service, please contact Merial at HEARTGARD and the Dog & Hand logo are registered trademarks of Merial Merial Limited, Duluth, GA. All rights reserved. HGD13TRTRADEAD3 (03/13). Veterinary advantage ««January/February

90 »» Editor s Note Pearls of Wisdom By Mark Thill We all want to excel. We all work hard. That said, it s possible to give your best to animal health while simultaneously nurturing your family life, spiritual life, and personal growth, they told us. There s much to learn in this month s issue of Vet-Advantage. For example, I don t think I ve heard a more succinct characterization of successful leadership as that offered by Bob Weinschenk, who is retiring as senior regional sales manager from MWI Veterinary Supply after 45 years in the industry. Referring to MWI s growth from about $195 million in sales in 2000, to more than $2 billion today, Weinschenk says, It s a testimony to leadership, to manage that growth without the wheels coming off. A great image, simply stated. Weinschenk learned about leadership and teamwork while serving in Vietnam. The type of leadership he admires and found at MWI is insightful, thoughtful, firm and decisive. It s not seat-of-the-pants. It s strategic. He offers another nugget: Don t burn bridges. He speaks from experience, he says, adding, With consolidation, you never know who you ll end up working for in the future. Something to keep in mind. We purposely sought out wisdom this month by asking a few veterans veterinary doctors and salespeople to reflect on the things they know today that they wish they had know 20 or 30 years ago. Some example: Bud Dorris, retired, PRN Pharmacal: To young managers, he says, ask your sales reps for their opinions and desires about marketing programs, promotions, etc. And to young reps he says, don t be intimidated by management; share your thoughts and ideas with them. Dorris also advises young sales professionals to pay attention to their personal finances. Salespeople are on the road four or five days a week, he says. They either let somebody else organize their finances, or they do it themselves haphazardly. You re better off doing it in an orderly and logical way. Dennis Cloud, DVM: Build a great team around you, use them. That was true 40 years ago, he says, and it s true today. Rick Sain, retired, Henry Schein Animal Health: Never waste a veterinarian s time; instead, focus on delivering value. I never reached in my billfold and paid for an office call, he says. But I paid my doctors with information and service. Dave Manley, retired, Welch Allyn: Stay connected with others. When you re 30, you feel, I can get this done by myself, he says. Not true. Better to learn early how to rely on others. Dan Segna, DVM: Keep learning new things. My practice was primarily cats and dogs, but I had an exotic animal component too, he says. It was a constant challenge, which I enjoyed. One more note: Everyone we spoke to emphasized the importance of maintaining a sense of balance in one s life. We all want to excel. We all work hard. That said, it s possible to give your best to animal health while simultaneously nurturing your family life, spiritual life, and personal growth, they told us. One way to do so? Build that strong team around you. Did I miss some things [at home]? asks Cloud rhetorically. Yes. But I was able to maintain some balance, because of the associates I had. 90 January/February 2014»» Veterinary advantage

91 MiSSiNg something?. More complete.* NEW NEW New for ferrets See the difference at bayerdvm.com/multi *Based on label indications: spectrum of species, parasites (dog) and life stages (dog and cat). Advantage Multi for Cats (imidacloprid + moxidectin) (0.4 ml) is indicated for ferrets that weigh at least 2 lbs. CAUtion: Federal (U.s.A.) law restricts Advantage Multi for Dogs (imidacloprid + moxidectin) to use by or on the order of a licensed veterinarian. WARning: DO NOT ADMiNiSTER THiS PRODUCT ORALLY. For the first 30 minutes after application ensure that dogs cannot lick the product from application sites on themselves or other treated animals. Children should not come in contact with the application site for two (2) hours after application. (See Contraindications, Warnings, Human Warnings, and Adverse Reactions, for more information.) ContRAinDiCAtions: Do not administer this product orally. (See WARNiNgS.) Do not use this product on cats. CAUtion: Federal (U.s.A.) law restricts Advantage Multi for Cats to use by or on the order of a licensed veterinarian. WARnings: Do not use on sick, debilitated, or underweight cats (SEE ADVERSE REACTiONS). Do not use on sick or debilitated ferrets. PReCAUtions: Avoid oral ingestion. human WARnings: Children should not come in contact with the application site for 30 minutes after application Bayer HealthCare LLC, Animal Health Division, Shawnee Mission, Kansas Bayer, the Bayer Cross and Advantage Multi are registered trademarks of Bayer. AM14073

92 Repeat after me. Midmark is more than just equipment. We re committed to giving you a worry-free equipment selling experience with: Special Offers and Rebates to help your clinics stay within budget Territory Managers and Clinical Specialists will support you before, during and after the sale In-clinic Training Network help get your clinics up and running with their new equipment Nationwide Service Network support for your clinics after the sale Customer and Technical Service ensure a positive experience for you and your clinics Many Online Resources product info, training and webinars are available at your fingertips Midmark Animal Health is more than just equipment, we re partners in your success. And to help you succeed, our dental promotion has been extended through February so your clinics can still get rebates and special offers of up to $2,600. To learn more, contact your Midmark Animal Health Territory Manager or visit: midmarkanimalhealth.com/yearend2013.