Companion
FOR GEORGIA’S VETERINARY COMMUNITY FROM BLUEPEARL VETERINARY PARTNERS FALL 2015
What’s New in
Dermatology?
Chemotherapy Safety is our Responsibility
GONE ARE THE DAYS of mitaban dips, doramectin
DOG BITES AND CAT SCRATCHES are an everyday risk in our field. We work hard to train our staff how to restrain
injections and daily oral ivermectin for months
on end. Two new weapons have emerged in the
evolving war on demodicosis: Merial’s Nexgard®
(afoxolaner), and Merck’s Bravecto® (fluralaner).
Veterinary dermatologists have been discussing
treatment successes they are seeing following
once-monthly administration of Nexgard, or
once every 2-3 months of Bravecto. Currently,
as with doramectin and ivermectin, treatment
of demodicosis with these drugs is extra label;
thus, pet owners should be informed of this prior
to prescription. The serious adverse reactions
reported with ivermectin and/or doramectin (i.e.
blindness, ataxia, possible death in MDR1 genedeficient dogs) were not reported in well-controlled
field/laboratory studies. Common side effects
observed include GI upset (vomiting, inappetence,
diarrhea, flatulence), polydipsia and/or lethargy.
Monitoring of treatment progress with every 4-6
weeks skin scrapings is still recommended, and
continuation of treatment until achieving two
negative scrapings 4 weeks apart remains the
standard of care.
As we know, Apoquel® (oclacitinib) has been
popular during the last two years. While Zoetis is
challenged to keep up with demand for this ‘miracle’
drug, veterinary dermatologists have had a fairly
steady supply of the drug and are currently reporting
fair to excellent control of atopic symptoms in
approximately 65% of patients. When prescribing
Apoquel, it’s important to understand that this drug
is not without limitations and/or adverse effects,
including labeled for use in dogs one year and
older, increased incidence of papillomatous
growths, development of urinary tract infections,
weight gain, elevations in liver enzymes, blood
dyscrasias, and rarely, acute death. Furthermore,
it is important to perform a full medical work-up
to rule out other possible causes for pruritus,
such as bacterial pyoderma secondary to
demodicosis, cutaneous lymphoma, or other
non-allergic pruritic dermatoses, as failure to
do so can result in further progression of the
disease. Clinical improvement of allergic otitis is
lacking. Apoquel may be
an excellent secondary
drug for managing
symptoms of atopy in
the initial stages of
immunotherapy;
however, it should
not be seen as a
replacement.
b lu ep ea rlve t.co m
our patients in order to minimize this danger. But are all of us paying as much attention as we should to less
obvious dangers, such as handling of cancer drugs? Chemotherapy administration has been linked to infertility,
abortion, miscarriage, leukemia and other forms of cancer in human studies. More immediate side effects such
as headaches, skin irritation and intestinal upset have also been associated with the handling of anti-cancer
agents.
Strict rules and government regulations exist in many industries for managing hazardous materials. If
these rules are broken, OSHA can take action against the employer. Most of us would consider chemotherapeutic
agents to be hazardous materials. However, there is limited government oversight of chemotherapeutic agents
in both the human and veterinary medical fields. What does exist are voluntary guidelines created in 1986 by the
National Institute for Occupational Safety and Health (NIOSH).
It is up to us to educate ourselves
and our staff about the risks and
safety steps, which should be taken
when administering cancer agents.
Wearing gowns and gloves is strongly
recommended to prevent direct contact
of the drug with skin and clothing if any
drips or spills occur. Face protection with
goggles or shields is also recommended in
case there is splashing or spraying of the
drugs.
One of the biggest means of human
exposure is aerosolization of the cancer
agent when drawing up the chemotherapy
drugs and during their administration. To
reduce exposure while drawing up the drug
a biological safety hood is recommended.
Closed administration systems are
available that lock the syringes to the drug Proper handling of chemotherapy medications is just as important to our
safety as proper restraint techniques. Both are displayed here.
vials to further minimize the chance for
aerosolization or spillage.
Many chemotherapy drugs come as
tablets or capsules. It is important to not crush, split, or break open these tablets or capsules as this also causes
aerosolization. Furthermore, not all drugs are evenly distributed within the tablet or capsule. Halving the tablet
does not mean the patient is receiving half the dose. Compounding pharmacies are good resources if specialsized tablets are needed. Make sure the compounding pharmacy uses sterile procedures and pharmaceutical
grade components. Owners giving oral chemotherapy at home should wear gloves when administering the tablets
and capsules; be educated on the risks to their health; and be instructed on how to dispose of urine and feces.
Many injectable chemotherapy drugs are vesicants, i.e. they cause damage to the tissues outside the vein.
It is important to know the side effects and risks of the drugs you are using. Intravenous drugs should be given
through a catheter. A butterfly catheter may not be adequate for many vesicant drugs as it can easily pierce
through the vein.
After giving chemotherapy, left over items such as gloves and syringes should be disposed of properly in
specially marked waste containers. Check with your medical waste disposal company to determine how they want
the chemotherapy supplies disposed of.
At BluePearl Veterinary Partners, our clinicians and technicians continually strive to educate pet owners
about these medications.
The NIOSH website for more information is www.cdc.gov/niosh/docs/2004-165/.
MANY CHEMOTHERAPY DRUGS COME AS TABLETS OR CAPSULES. IT IS
IMPORTANT TO NOT CRUSH, SPLIT, OR BREAK OPEN THESE TABLETS OR
CAPSULES AS THIS ALSO CAUSES AEROSOLIZATION.
Sandy Springs
455 Abernathy Road NE
Atlanta Georgia 30328
404.459.0903
Gwinnett
1956 Lawrenceville-Suwanee Road
Lawrenceville Georgia 30043
770.277.8600
Healthcare-Associated Infections:
Don’t Be the Cause of the Problem
SNIFF…
Meet our specialist…
Kevin Winkler, DVM, DACVS
Surgery Service
HEALTHCARE-ASSOCIATED INFECTIONS (HAI), also called nosocomial infections, are those that
Kevin Winkler, DVM, DACVS,
is a home-grown Georgia boy
who readily admits he’s an
adrenaline junkie, stubborn, a
bit geeky, sometimes a little full
of himself, but always honest.
He loves to share his knowledge,
which includes instructing K-9
officers in emergency first aid or teaching veterinary interns
and residents. Prior to joining the Georgia team, Dr. Winkler
spent more than 10 years in surgery and emergency critical
care for referral hospitals in North Carolina and Wisconsin.
He graduated from the University of Georgia College of
Veterinary Medicine and completed an internship and
residency at the University of Illinois-Urbana. In his spare
time he enjoys spending time with his wife, children and
granddaughter. Get to know Dr. Winkler.
What was your first job?
Making burgers at Hardees. They still make the best biscuits!
How do you like to work with the primary care veterinarian?
I see my role as support to the primary care veterinarian.
I like to share knowledge and help the primary care
veterinarian with the surgical management of a case, whether
that is through simple advice over the phone, or direct care of
their patient for a specific problem. develop in patients during hospitalization. Most HAIs in humans are introduced during
surgical procedures or develop secondary to the presence of invasive devices such as
intravenous and urinary catheters. The most common cause of HAIs is microbes residing on
or in the patient themselves. Studies have also demonstrated that microbes residing on the
hands of healthcare workers and those present on surfaces of furnishings, equipment and
instruments can serve as sources of HAIs. In 2002, approximately 1.7 million human HAIs
resulted in close to 100,000 deaths.
The prevalence of HAIs in the veterinary field and their effect on the health of canine
and feline patients has not been extensively studied. Similar to humans, HAIs have been
described in dogs secondary to surgical procedures and associated with urinary catheters. In
one study 83% of veterinary teaching hospitals reported HAIs in their patients during a fiveyear period. Fifty percent of these hospitals reported at least one incident of a zoonotic HAI
developing in a staff member.
HAIs should be of concern to us in the veterinary field. They can increase and/or prolong
hospital stays, add to the patient’s expense, and increase patient discomfort and morbidity.
They may contribute to the death of our patients both directly from the infection and indirectly
when owners decide they can’t afford the additional expense required to treat a new or
complicating problem. HAIs gain entrance to a patient’s body via contamination of open
wounds, or they can be inhaled/ingested, be introduced with instrumentation, or enter along
medical devices such as catheters.
It is cheaper and much safer
to prevent invasion of the body by
What’s your definition?
microbes than to try to kill them after
infection has set in. What can we do to
Disinfectant: an agent that reduces
minimize HAIs?
1. Disinfect the hospital
environment frequently.
Microbes on surfaces
(faucet handles, cage doors,
tub sinks) can directly
contaminate our patients who
come in contact with these
surfaces or be transmitted
indirectly when we handle
these items and then the
patient.
What keeps you interested in cases day-to-day?
There is always something new. However, you have to
use your brain because that new toy/drug/procedure isn’t
necessarily always better.
Was there a college professor that changed your life?
Dr. Aron, at UGA, had a nickname for everyone. Liked by
some and not so much by others, Dr. Aron was always up
front with you. What I remember most was his intolerance
for blaming a failed outcome on client compliance. There
was always something else the surgeon should have done to
anticipate and avoid any client-created complications. He
didn’t tolerate excuses such as, “the owner must not have
restricted the pet.” The onus was on you, the DVM, to find a
technique that would result in a successful outcome. Because
of this, I will always be my toughest critic and have a hard
time accepting a failed outcome. Even in a no-win scenario, I
always feel there is something we could have done differently
to allow success.
What is something people might be surprised to know about you?
I have a fear of heights, so I went skydiving. I’ve also always
wanted to go into space, so I tried the next closest thing,
SCUBA.
If you knew then what you know now, what would you do
differently?
Spend more time with my kids when they were young and
less time at work.
Medical Director :
Mark Dorfman, MS, DVM, DACVIM
Hospital Administrator:
Barbara Schick, RVT
CARDIOLOGY
Danielle Laughlin DVM, DACVIM
Brandon Pogue DVM, DACVIM
CRITICAL CARE
Chris Piscitelli DVM, DACVECC
Jennifer Pittman DVM, DACVECC
Tom Walker DVM, DACVECC
Antiseptic: an agent that reduces
the quantity of potential microbial
pathogens on living objects such as the
skin of our patients and ourselves
Sterilization: the complete elimination
of all forms of microbial life
2. Reduce ourselves as a source
of transfer of microbes.
a. Wear and then dispose of gloves when cleaning
contaminated environmental surfaces.
b. Wash our hands with an antiseptic/soap
combination after each patient.
c. Wear gloves when handling compromises to the
skin or membranes including open wounds and
surgical incisions, as well as catheters.
3. Reduce the quantity of potential pathogens on the
patient through the appropriate use of antiseptics and
antiseptic scrubs.
4. Attempt to maintain barriers to infection in our patients
by practicing good surgical technique; appropriate
wound care, such as keeping wounds and drains covered
with sterile bandages; and the judicious placement
and care of catheters and their removal when no longer
needed.
Outside of veterinary medicine, what do you consider yourself to be
an expert at? Having an opinion.
If you didn’t choose veterinary medicine, what do you think you’d
be doing today?
I wanted to fly for the Navy.
the quantity of potential microbial
pathogens on inanimate objects such
as table surfaces, faucet handles,
floors
Frequent hand washing is
one of the easiest ways to
minimize the transmission
of infection among patients.
5. Utilize sterile equipment and instruments.
Is sterility always necessary?
Potential microbial pathogens, i.e. bacteria, viruses, fungi and
protozoa, vary in their ability to subsist in the environment and in
their ability to be transmitted and develop within potential hosts.
The goal of disinfectant and antiseptic use is not necessarily to
eradicate all potential pathogens but to reduce their numbers
below that which might be necessary to induce an HAI. Barriers to
infection, i.e. the skin and mucus membranes as well as the local Gloves should be worn
and systemic immune system, will also protect the patient. Those whenever handling open
patients with compromised barriers to infection secondary to skin wounds.
breaks or immunosuppression from illness are at greater risk for
developing an HAI.
DERMATOLOGY
Robert Schick DVM, DACVD
DIAGNOSTIC IMAGING
Mason Savage DVM
Gustavo Sepulveda DVM, DACVR
EMERGENCY MEDICINE
Amanda Cobb DVM
DaShaunté Coleman DVM
Katherine Conlon DVM
Stanley Hunter DVM
Keith Mihansky DVM
Kevin Nix DVM
Sayra Reyes DVM
Jean Sonnenfield DVM
INTERNAL MEDICINE
Nick Berryessa DVM, DACVIM
Alysa Cook DVM, DACVIM
Michael Di Cicco DVM, DACVIM
Mark Dorfman DVM, DACVIM
Derek Duval VMD, DACVIM
Lisa Langs DVM, DACVIM
Meri Miller DVM, DACVIM
NEUROLOGY/NEUROSURGERY
Ronald Johnson DVM, DACVIM
Jennifer Parkes DVM, DACVIM
Vaccines or Titers?
IT’S NO SURPRISE THAT THE ANTI-VACCINATION trend in human medicine has carried
over into veterinary medicine. We’re sharing this article, written by our colleague in
Illinois, Susan Yohn, DVM, MS, DABVP Canine/Feline, DACVIM, to provide you with more
information.
Vaccine products have been used in companion animal medicine for more
than 40 years. They could arguably be considered one of the most important
scientific advancements that have helped us improve quality and longevity of the
life of our cat and dog patients. In the last decade, a significant change in our
thinking about vaccination protocols has been seen due to several different factors.
Our understanding of the science of vaccination-induced immunity has evolved
suggesting more prolonged infectious disease protection with specific core vaccines
(canine distemper, parvovirus, adenovirus; feline panleukopenia virus). Major
veterinary associations (AAHA and AVMA) with the support of vaccine manufacturers
now recommend reassessment of annual vaccination protocols, especially for the
core vaccines. Vaccination every three years has become accepted practice by many
veterinary practices. Vaccine manufacturers have introduced new products with more
extended duration of immunity and fewer antigenic components.
Our society has become more concerned about possible vaccine reactions in
children, and this has also created concern over side effects in pets. Side effects
are fortunately infrequent in dogs and cats, but there has been association between
vaccination and the development of vaccine sarcomas in cats and immune-mediated
disease in dogs. With the concern from pet owners about “over vaccination” and the
possibility of serious vaccine side effects, clients may now be requesting vaccine
titers instead of vaccines.
How reliable are these vaccine titers?
Vaccine titers have been the cornerstone of the change in our knowledge about
vaccine protection. They measure the presence of serum antibody able to neutralize
the virus and prevent infection. IgG is the antibody class measured by vaccine titer
assays. Studies have shown that for specific viral diseases in dogs (parvovirus,
distemper, adenovirus) and cats (panleukopenia virus) protection after initial
appropriate vaccination can last for 4 to 10 years based on serologic titer results and
challenge studies.
The “gold standard” assays for these virus titers are the viral neutralizing
titer (VIN) and hemagglutination inhibition (HI). Most state diagnostic labs utilize
the gold standard methodologies. Most, if not all, commercial veterinary laboratories
have qualified and standardized alternative methodologies including enzyme
immunoassays (ELISA) and immunofluorescence assays (IFA) to provide similar titer
information compared to the gold standard VIN and HI assays. Due to variations in
lab assay methodologies, different reference ranges, and potential change in titers
from the pet over time, titers should not be compared between different laboratories.
In-clinic titer test kits for canine distemper, parvovirus, and adenovirus and feline
panleukopenia virus are now available. TiterCHEK® (Zoetis) and VacciCheck® are the
names of two commercially available in-clinic titer kits. Both test kit systems have
been validated independently and correlated with the gold standard titer assays.
Rabies virus titers can also be assayed by the fluorescent antibody virus
neutralizing titer, but the assay is available only through a limited number of certified
laboratories.
How are these titers interpreted?
Depending on the individual lab and test methodology used, vaccine titer results may
be reported as “protective” or “positive” (high antibody titer), “not protective” or
“negative” (low antibody titer), or “borderline.” Some assays will provide an actual
titer level from the laboratory to use in interpretation. The in-clinic titer test kits
provide either a protected or not-protected result (TiterCHEK®) or a semi-quantitative
score for serum antibodies (VacciCheck®). Protective, positive or high titers indicate
that there is a high antibody titer to that virus either from vaccination or previous
natural exposure or disease. For pets with a not protective, negative or low titer, lack
of virus protection is of concern and booster vaccinations are recommended.
The best correlation between antibody and protective immunity are for the
viruses previously discussed (canine parvovirus, distemper, adenovirus, feline
panleukopenia, rabies).
It is important to remember that other factors may affect titer interpretation
and risk for the pet. The immune system is complex. Antibodies target the foreign
invaders for destruction, but other immune system cells actually destroy the invader.
An insufficiency in the cell-mediated immune system (immunosuppression) may
leave a pet at risk for disease even if protective titers are present. Even if a titer is
considered low, exposure to the same antigen may result in a rapid immune response
with new antibodies produced within hours to days. These animals may be susceptible
to infection but may be fully protected due to immune-cell memory and cell-mediated
immunity. By law, rabies vaccine titers cannot be used in place of re-vaccination.
When a rabies vaccination is not current, a pet that bites someone must be considered
unvaccinated and quarantined.
Antibody titers to vaccines other than the core viruses have limited or no
value as “protective titers.” Antibodies may persist for a short time, and there is no
correlation between serum antibody testing and protection. This includes antibody
testing for leptospirosis, feline herpes virus, feline calici virus, Lyme disease, and
Bordetella. With other diseases, feline immunodeficiency virus for example, titer levels
equate only to exposure to the pathogen or active infection.
What is the appropriate clinical application of these titers for the veterinary
patient?
Protective titer levels may be appropriate clinically for specific patients. The most
common application of vaccine titers is to help determine the need for vaccination
in an adult pet. The reason for the request for titer assessment is often because
of previous history of suspected or severe vaccine reactions in the pet, concurrent
medical illness or just the owner’s concern about the need for vaccination. Evaluation
of vaccine titers may be helpful to determine the need for core vaccines in other
clinical scenarios:
• Evaluation of vaccine response in a young pet to help identify nonresponders that may not be able to produce a protective antibody response
• Identification of possibly unprotected pets with recent exposure to a
contagious viral disease
• Determination of antibody level in pet with unknown vaccination status
• Management of infection risks and infectious disease outbreaks in shelters
Vaccine titers may be helpful in determining the need for specific vaccines
in the individual pet, but it is important that the owner understand the factors
other than titer results that may affect the decision to vaccinate. Each veterinarian
must determine the appropriate vaccination schedule for a patient based on risk of
exposure, age of the pet and current medical status of the pet.
Vaccine titers should not be considered a substitute for an appropriate core
vaccine protocol for most clinically healthy pets.
The recent outbreak of measles in children exposed to the virus at a national
amusement park was suspected to be correlated with a decline in vaccination
for this virus. This is a warning to us all and a reminder of the importance of
consistent vaccination for “herd health.” All puppies and kittens should complete the
recommended core vaccination protocols recommended with the last vaccine being
at or beyond 16 weeks of age. An evaluation of pathogen exposure risk, lifestyle, age
of the pet and concurrent medical problems along with vaccine titer status are all
factors that should affect the decision to vaccinate the individual adult pet.
Gastrointestinal Ulcers in Fido?
GASTROINTESTINAL (GI) ULCERATIONS are inflammatory lesions that extend into the
deeper layers of the gastrointestinal tract, going beyond the mucosa. GI ulceration is
the result of factors that alter, damage or overwhelm the normal defense and normal
repair mechanisms of the GI mucosal barrier. There is no predilection for a particular
age group or breed, and signs can be extremely variable from patient to patient.
Some patients may have no clinical signs, while others may be in immediate need of
intensive support and hospitalization, including blood transfusions.
Causes
There are many potential causes of GI ulceration ranging from drugs/medication to
tumors. Some cases of ulceration are clear-cut. A prime example would be in a case of
high dose aspirin administration in a dog with severe arthritis. Others, and perhaps
the majority, are more difficult to determine.
NUTRITION
Susan Wynn DVM
OPHTHALMOLOGY
Stacy Andrew DVM, DACVO
ONCOLOGY/RADIATION THERAPY
Terrance Hamilton DVM, DACVIM
Nathan Lee DVM, DACVR-RO
Rebecca Regan DVM, DACVIM
Some of the more common causes of GI ulceration in our pets include
•• the ingestion of certain medication (nonsteroidal and steroidal anti-inflammatory
drugs)
•• metabolic disorders such as kidney failure, liver disease and hypoadrenocorticism
(Addison’s disease)
•• neoplasia/large tumors such as gastric carcinomas
•• stress, pain, and/or major medical illness/surgery
•• dietary indiscretion or the ingestion of foreign objects
•• pancreatitis (inflammation of the pancreas)
•• microscopic disease of the GI tract including inflammatory bowel disease or certain
types of cancer (lymphosarcoma)
•• toxins such as lead
CONTINUED ON PAGE 4
SURGERY
Alan Cross DVM, DACVS
Julie Duval VMD, DACVS
Lori MacDougall DVM, DACVS
Cassandra Ruthrauff DVM, DACVS
Kevin Winkler DVM, DACVS
Associate Veterinarians
Jyothi Algappen DVM
Matthew Boothe DVM
Kenneth Brand DVM
Danielle DeBrincat DVM
Emily Donaldson DVM
Lauren Fout DVM
Emily Harris DVM
Kalyn Kitchings DVM
Carolynne Kruckman DVM
Leslie Shelnutt DVM
Greysi Tavarez DVM
Edward Trainor DVM
Gastrointestinal Ulcers in Fido?
CONTINUED FROM PAGE 3
Symptoms- What to Watch For
There are a number of symptoms that patients with gastrointestinal ulceration may
exhibit. The most common include any/all of the following:
•• vomiting (with or without digested blood) •• melena •• decreased appetite •• weakness • hematemesis
• abdominal pain
• pale gums
• collapse
Diagnosis
A presumptive diagnosis of GI ulceration can sometimes be made on the basis of history
and clinical findings such as the previously mentioned aspirin administration or known
foreign body ingestion. A full diagnostic work-up is recommend, regardless of the cause.
A complete blood cell count (CBC), biochemical profile and urinalysis should
be performed in all cases. A CBC will evaluate for the presence of infections,
inflammation and anemia, sometimes associated with gastrointestinal ulceration. A
biochemical profile evaluates organ function, which is important to establish if there
may be an underlying metabolic disorder.
Screening abdominal radiograph, although often within normal limits, may
support the diagnosis of an ulcer secondary to a tumor or foreign body, although an
ulcer cannot be seen. An abdominal ultrasound evaluates the abdominal organs and
helps assess for the presence of tumors that may be associated with ulcers; however,
ultrasound may not identify the GI ulcer itself.
A contrast upper GI study with barium may identify ulcers. It is a safe test;
however, is quite time consuming, and although helpful in some patients, results are
not always conclusive. Gastrointestinal endoscopy is the gold standard in diagnosing
GI issues. It may facilitate the removal of foreign bodies, evaluate for ulcers, and
sample tissue for the presence of inflammation or cancer, which may cause the ulcer.
It does require general anesthesia in our veterinary patients; however, it is a fairly
quick and safe procedure.
Other tests may be recommended on a case-by-case basis. These may include
a liver function test for certain liver disorders, an ACTH stimulation test to rule out
hypoadrenocorticism (Addison’s disease), and/or a blood lead level if lead exposure is
a possibility.
Treatment
Management of gastrointestinal ulcers centers on treatment of the primary cause
and blocking excessive stomach acid production. Rarely, in severe cases control of
bleeding and blood transfusions may be indicated.
Withholding all oral intake for a period of time allows the GI tract to rest and
is an important part of treatment. Fasting allows the lining of the GI tract to heal.
Gradual reintroduction of small amounts of bland food should then be instituted,
gradually increasing the amount over several days.
CONTINUED BELOW
Companion
455 Abernathy Road NE
Atlanta GA 30328
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Gastrointestinal Ulcers in Fido?
Continuing Education
CONTINUED FROM ABOVE
Drugs that decrease acid production by the stomach
expedite the resolution of GI ulcers. Examples include
Pepcid® (famotidine), Cytotec® (misoprostol) and Prilosec®
(omeprazole) to name a few. Gastrointestinal protectants
and adsorbents sooth and coat an irritated GI lining and
help bind harmful agents. A commonly used medication is
Carafate® (sucralfate). Anti-emetic drugs and/or antibiotics
are considered to treat some patients on a case-by-case
basis. Pain medication should be considered in pets
with ulcer disease. Ulcers can cause intense abdominal
discomfort, and affected patients may benefit greatly.
Endoscopy or surgery may be indicated to remove
foreign objects or tumors causing ulcers, biopsy associated
tissue with the ulcer, or remove an area of persistent
hemorrhage (surgery). Fluid therapy may be necessary
in some patients with severe GI ulceration to correct
dehydration. Additionally, blood transfusions may be
indicated in the severely anemic patients.
BLUEPEARL IS STRONGLY COMMITTED to the
veterinary community. One of the ways we
demonstrate this commitment is through
our continuing education program, which
is subsidized in part by our Partners in
Education.
All BluePearl CE lectures are free and open to
all area veterinary professionals. Registration is
required, please. Programs begin with a
light dinner prior to the presentation, which
starts at 7:30PM. To RSVP, please email
[email protected].
For the most current information about BluePearl CE, please click the
For Veterinarians tab on our homepage: bluepearlvet.com/georgia.
DATE
TIME
TOPIC & PRESENTER
LOCATION
Oct 20
Nov 17
CE HRS
7:30PM
DVM CE: Hyperadrenocorticism
Derek Duval, VMD, DACVIM
Sandy Springs
2 hr
7:30PM
DVM CE: Head Trauma
Ronald Johnson, DVM, DACVIM-Neurology
Thomas Walker, DVM, DACVECC
Sandy Springs
2 hr
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© 2015 BluePearl Veterinary Partners