VVMA POSITION STATEMENTS
Approved by VVMA Executive Board November 2012 after member comment period.
Purpose: This position statement confirms that the practice of veterinary dentistry falls within the scope of the practice of veterinary medicine. It also outlines expectations and requirements for professional oversight, supervision and delegation as well as follow up care, record keeping, anesthesia and equipment.
Scope: This position statement applies to the practice of veterinary dentistry in Vermont.
General: Veterinary dentistry requires both diagnosis and treatment of stages of periodontal disease or other conditions to be effective. As such, veterinary dentistry should only be practiced in Vermont by licensed veterinarians. A veterinarian practicing dentistry in Vermont may be assisted by an appropriately trained veterinary technician under the direct supervision of said veterinarian. Veterinary dentistry includes the maintenance or repair of proper oral health through: scaling and polishing, adjustment, extraction, power-assisted filing or power-assisted floating, or repair of animals’ teeth (not including simple brushing). It also includes any medical or surgical treatment performed within the oral cavity. The practice of veterinary dentistry requires extensive knowledge of anatomy, analgesia, anesthesiology, pharmacology, physiology, pathology, radiology, neurology, medicine, and surgery, all of which is acquired during the course of veterinary training. Only a properly trained and licensed veterinarian is fully equipped to recognize and address the possible complications, unexpected conditions or diseases that may arise during the examination or treatment portion of the practice of veterinary dentistry. Veterinarians who perform dentistry in Vermont are obligated to stay current with evolving professional standards and techniques.
Supervision: Veterinarians who offer veterinary dentistry in Vermont may choose to delegate some of the service provided to a veterinary technician under direct supervision. Ultimately, the supervising veterinarian is responsible for the well-being of the patient and must remain on the same premises in order to supervise the veterinary technician properly. Only a licensed veterinarian may perform the examination necessary to assess the patient, develop a diagnosis and formulate a treatment plan. The veterinary technician may then be directed to perform a procedure that falls within the veterinary technician’s abilities but the veterinarian is still responsible for that individual’s actions and must re-examine the entire oral cavity of the animal upon completion of the veterinary technician’s activities to ensure that the veterinary technician has properly performed the procedure. Any person performing veterinary dentistry in Vermont without the direct supervision of a licensed veterinarian will be considered to be practicing veterinary medicine without a license. Dental extractions fall within the definition of surgical procedures and as such can only be performed by a licensed veterinarian.
Titles: The use of the title veterinary dentist, equine dentist, veterinary or equine dental technician or any other similar title by a layperson should be contrary to the existing practice act. It is improper for any person who is not a licensed veterinarian to use a term, title or description that would lead a member of the public to believe or assume otherwise. Likewise the terms dentist, dental surgeon and the associated abbreviations should be protected under Vermont law and should not to be used by any veterinarian except in cases of appropriate board certification.
VCPR: Veterinary dentistry, as per other areas of veterinary practice, requires a valid veterinarian-client-patient relationship. If a veterinarian does not provide dental services, he or she should recommend referral to a licensed colleague who does practice veterinary dentistry if the animal’s condition warrants it. The owner may seek another veterinarian who does perform these services or ask for a referral from their primary care veterinarian.
Informed Owner Consent: Dental procedures should not be performed on an animal without first obtaining informed consent from the owner or owner’s agent. Clients should be informed about the professional status of who will be performing the dental service. As part of informed consent, the owner should also be advised that unexpected findings often occur and that it is important to provide accurate contact information to the veterinarian in case consent for additional treatment is required during a procedure.
Medical Records: Veterinarians are advised that quality medical-dental care for animals requires clear and complete medical records. When an animal is referred for dental treatment to another veterinarian, communication and coordination between the primary care veterinarian and that veterinarian is mandatory. Records, including relevant medical history, must be shared as appropriate between any veterinarian performing referral dentistry and the primary care veterinarian. In Vermont, the client has right to access any and all medical records regardless of outstanding balances or other issues that may damage the veterinary client relationship.
Radiographs: If radiographs are taken to diagnose or monitor disease progress it is important they are clearly labeled with: the veterinarian and/or facility name; animal identification; date; and indication of the left or right side; and if a sequential study is performed, an indication of elapsed time would be required. Having this imprinted on the radiograph via the emulsion is best for film radiographs but external marking methods are also acceptable.
Follow Up Care: Any veterinarian performing dental procedures on an animal in Vermont must remain available for consultation with the owner and for re-assessment of said animal on completion of the service for a reasonable period of time. The treating veterinarian needs to provide the client with the name of who to contact in the event of an emergency related to the dental procedure after such time has elapsed, and this should be coordinated beforehand. In the case where the treating veterinarian is not the primary-care veterinarian, the former must ensure that the latter is informed of the service performed, the outcome, and what procedures should be followed in case of emergency.
Anesthesia: The cleaning and scaling of the teeth of companion animals must be performed under general anesthesia with the use of an endotracheal tube with an inflated cuff in order to meet acceptable standards of care for veterinarians practicing in Vermont. Vascular access should be available via an intravenous catheter and intravenous fluid therapy is considered a minimum standard for a patient under general anesthesia for dentistry procedures.
Equipment: While the minimum standards do not include specific specifications for dental equipment in treatment areas, the State of Vermont expects that any veterinarian performing veterinary dentistry will use the appropriate equipment as per generally accepted standards of care and that this equipment will be maintained in such a way as to prevent the transmission of disease between animals.
Horse Tail Docking
Approved by the VVMA Executive Board June 22, 2011
The Vermont Veterinary Medical Association (VVMA) is opposed to the surgical or chemical alteration of the tail of the horse for cosmetic or competitive purposes. This includes the practices of docking, nicking, and blocking the tail of a horse. Tail docking in horses should only be performed when it is a medical necessity and should be performed by a licensed veterinarian to ensure adequate pain management, sterile technique and appropriate aftercare.
Cattle Tail Docking
Approved by the VVMA Executive Board June 22, 2011
The VVMA opposes routine tail docking of cattle. Current scientific literature indicates that routine tail docking provides no benefit to the animal, and that tail docking can lead to distress during fly seasons. When medically necessary, amputation of tails must be performed by a licensed veterinarian.
Also endorsed by the AVMA and reaffirmed April 2009.
(This position statement replaces the cattle tail docking position statement adopted by the VVMA Executive Board on February 9, 2008.)
Sales and Use Taxation on Veterinary Services
Approved by the VVMA Executive Board March 6, 2011
The Vermont Veterinary Medical Association (VVMA) opposes the extension of state and local sales tax to veterinary services.
Veterinarians are on the front lines of public health, protecting families from zoonotic diseases (illnesses that spread from animals to people) from their pets as well as protecting our food supply animals. Adding this additional cost to the veterinary medical care people need for their pets can cause more animals to go undiagnosed and untreated. Veterinary medical care should not be taxed differently than human medical care (veterinarians are health care professionals and subject to many of the same laws and regulations as other health care providers).
From the AVMA (reaffirmed in 2011):
Government Fees and Taxes on Veterinary Products and Services
Economic factors are a major reason animals are not given optimal medical care. Government fees and taxes on veterinary products and services result in additional costs to treat animals and can lead to decreased; 1) availability of important veterinary medical products; 2) crucial purchases and/or use of these products by owners; and 3) essential animal health care needs/services. Animal health and human health have been shown to be strongly associated. Any cost initiatives that negatively impact animal health care can also have an adverse effect on human health and potentially increase the risk of zoonotic disease outbreaks. The AVMA believes government entities should strongly consider the possible negative effects on human health, animal health and animal welfare that may result from any proposed fees or taxes on veterinary products or services.
Best Practices for Calf Transport and Slaughter
Approved by the VVMA Executive Board 5/6/2010
- All newborn calves, regardless of sex, should receive appropriate amounts (generally, at least 3 quarts) of high quality colostrum or a colostrum replacer containing at least 150g IgG, as soon as possible after birth , but at least within 8 hours.
- After the initial feeding of colostrum, all calves under 30 days of age must be offered colostrum, whole milk, or milk replacer that is mixed to label specifications, at a minimum rate of 1 liter per calf per 12 hours with at least 8 hours between feedings. This should occur whether on the farm, in transport, at the sale barn or at the slaughter plant.
Shipping calves directly to a slaughter facility, if available, is preferable to shipping calves to a sale barn or other holding facility before the calves are taken to slaughter. Calves should be shipped to the nearest available slaughter facility.
- During all parts of transport calves should have enough space to achieve sternal recumbency without being stepped on and be provided adequate bedding to keep them warm and dry. Transport vehicles must provide solid sides with adequate air exchange and protection from the weather.
- Water must be available at all times when calves are not in transit.
- If travel time is longer than 12 hours, the calves will be rested and fed at a holding facility for at least 2 hours before resuming their journey. Transport staff must be trained to move calves humanely.
- The use of electric prods or excessive force of any kind – including, but not limited to, kicking, striking, throwing or dragging -- is strictly prohibited during any part of calf transport or slaughter.
- Calves should not be moved without adequate staff assistance at slaughter or holding facilities; i.e. every 15 calves should have no less than 1 staff worker to help guide them at the time of movement. Loads of calves should be broken up into smaller groups to facilitate movement if workers are limited. Staff at these facilities must be trained to move calves humanely.
- All facilities must have available, and use, sleds to move down calves without dragging them directly on the ground. If a sled is not available, down animals must be carried.
- Any down calf that will not stand after a humane attempt has been made to assist (people lifting front and hind end and rubbing vigorously) must be euthanized immediately and must not enter the food chain.
- Concussion (stun) devices must be used correctly. Staff at slaughter facilities must be trained in proper placement of the concussion device and in the necessity to observe that the pupil of the eye becomes fixed and dilated after a successful use of the device. Diagrams to this effect must be posted at multiple locations in the slaughter plant.
- Facilities must have sufficient staff involved in stunning animals such that after an animal is stunned it is hung and bled out within 45 seconds.
While it may not be possible, for economic reasons, to transport calves only after the age of 10 days, it is possible to make the existing transport of young calves more humane.
Many bull calves are weak and have scours due to failure of passive transfer. Ensuring adequate colostrum intake should reduce the incidence of scours and dehydration.
Calves may also be weak because they are hypothermic, tired or hungry. These can be addressed by proper transport and handling. Transport, sale barn and slaughter workers will be expected to know and follow the guidelines. Schedules for feeding responsibilities need to be arranged among the parties involved and are subject to inspection.
Calves do not herd well and do not respond well to being hit with prods or paddles. Leading calves by encouraging them to suck on the gloved fingers of a worker or the nipple of a bottle works well for individuals who will not move. Using fence or gate panels to guide groups of animals is more humane than striking the hind animals. Leading the lead animals with rubber nipples is a good way to start a group of unruly animals. Calves can also be picked up and carried.
Providing training, posting these guidelines, and ensuring that these guidelines are followed by all who handle young calves is a major goal of this effort.
Approved by the VVMA Executive Committee 9/10/09
Dog tethering is generally defined as the tying of a dog by rope or chain to a stationary object. When used continuously and for extended periods of time, tethering is an undesirable method of companion animal husbandry. Vermont statutes prohibit tethering “in a manner that is inhumane or detrimental to [the animal’s] welfare.” [Title 13, Section 8, 352:3]. The Vermont Veterinary Medical Association (VVMA) believes that most instances of continuous, long-term tethering are, in fact, inhumane and detrimental to the welfare of the tethered animal and thus constitute cruelty.
The VVMA believes that dogs are inherently social animals that are genetically programmed to live in close contact with others. Tethering is “solitary confinement,” and has predictable negative impacts on both the tethered dog and on other animals or people who may stray into the dog’s territory. Continuously tethered dogs are improperly socialized, and their instinct to defend their territory is exaggerated by their inability to avoid a fearful situation by running away. This fosters territorial aggressive behavior.
In addition, chained dogs are at risk from other animals and from humans. They are “sitting ducks,” and may be trapped in potentially terrifying or harmful situations. There is no physical barrier to prevent either unsuspecting young victims or potential aggressors from approaching the tethered dog. Tethers can also become tangled around or hooked on the dog’s shelter structure, or around his limbs or neck, causing injury or strangulation.
Other issues associated with tethering include the greater likelihood of accompanying neglect, cruelty and abuse, and the greater likelihood of nuisance barking leading to neighborhood complaints.
The American Veterinary Medical Association (AVMA) has stated in a 2003 forum on dog bite prevention: “Never chain or tether your dog because this can contribute to aggressive behavior.”
In 1996 the USDA issued a statement in the Federal Register against tethering, stating: “Our experience in enforcing the Animal Welfare Act has led us to conclude that continuous confinement of dogs by a tether is inhumane.”
Raw Milk Sales and Consumption
Approved by the VVMA Executive Committee on March 1, 2009
The VVMA recognizes that the U.S. Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), the American Medical Association, the American Academy of Pediatrics, and the Vermont Department of Health warn that drinking milk which has not been pasteurized (raw milk) may be harmful to human health.
Raw (unpasteurized) milk and fresh products made from raw milk such as cream, soft cheeses, yogurt, or ice cream can be a source of exposure to organisms which are pathogenic to humans including, but not limited to Brucella spp., Campylobacter jenuni, Coxiella burnetii, Escherichia coli, Listeria monocytogenes, Mycobacterium bovis, Salmonella spp., Staphylococcus spp., and Streptococcus spp. Only pasteurized milk and pasteurized fresh milk products should be sold for human consumption. Putative benefits of raw milk consumption on human health are either unsupported by scientific evidence, or cannot be separated from the potential hazards associated with raw milk consumption. Therefore, consumption of raw milk cannot be recommended as a preventive or protective human health measure.
Approved by the Executive Committee on December 2, 2008 and confirmed on February 7, 2009.
Presented at the VVMA Winter Meetng February 8, 2009
The Vermont Veterinary Medical Association expresses serious concern about the infectious disease risk inherent in the importation of cervidae from outside of Vermont's borders. Many states have identified the presence of Chronic Wasting Disease in both captive or wild deer and elk. In addition, several states have identified wild ruminants (deer or bison) as reservoirs for Mycobacterium bovis (bovine tuberculosis). Importation of these animals thereby presents a significant medical risk, not only to native white-tail deer and moose populations of Vermont, but also to the state's valuable herds of dairy and beef cattle. Such importation, if allowed to occur at all, should be under strict regulation and surveillance by the Vermont Agency of Agriculture and/or the Vermont Department of Fish & Wildlife.
Ear Cropping and Tail Docking of Dogs
Adopted by the VVMA Executive Committee 2/7/09
Presented at the VVMA Winter Meetng February 8, 2009
The Vermont Veterinary Medical Association endorses the AVMA policy statement opposing ear cropping and tail docking of dogs when done solely for cosmetic purposes. The VVMA encourages the elimination of ear cropping and tail docking from breed standards.
Horse Transportation and Processing
Approved at the VVMA Executive Committee Meeting 6/18/08
Presented at the VVMA Summer Meeting 6/19/08
The VVMA concurs with the policy statement on transportation and processing of horses endorsed by the AVMA and developed by the American Association of Equine Practitioners (AAEP), which reads as follows:
“The AAEP advocates the humane treatment of all horses and believes the equine industry and horse owners have a responsibility to provide humane care throughout the life of the horse. However, a small percentage of horses are ultimately unwanted because they are no longer serviceable, are infirm, dangerous, or their owners are no longer able to care for them.
The AAEP recognizes that the processing of unwanted horses is currently a necessary aspect of the equine industry, and provides a humane alternative to allowing the horse to continue a life of discomfort and pain, and possibly inadequate care or abandonment. The AAEP encourages, fosters and provides education regarding responsible ownership and management that will reduce the number of unwanted horses. In addition, the AAEP supports and commends the efforts of equine retirement facilities and adoption
Regarding the care of horses destined for processing, the VVMA’s position is that these horses should be:
• Treated humanely and with dignity;
• Transported to any facility including a processing plant according to the guidelines approved by the United States Department of Agriculture in 2002;
• Euthanized in a humane manner in accordance with the guidelines established by the American Veterinary Medical Association.
• Euthanized on-site prior to transport when available or otherwise minimize distance of transport prior to euthanasia.
The VVMA further supports the concluding statement, “…the AAEP recognizes that the human consumption of horsemeat is a cultural and personal issue and does not fall within the purview of the association, whose mission is the care of the health and welfare of the horse throughout its life.”
Compensatory Value for Animals Beyond Their Property Value
Adopted at the VVMA Executive Committee Meeting 4/3/08
Presented at the VVMA Summer Meeting 6/19/08
The Vermont Veterinary Medical Association recognizes and supports the legal concept of animals as property. However, the VVMA recognizes that some animals have value to their owners that may exceed the animal's market value. In determining the real monetary value of the animal, the VVMA believes the purchase price, age and health of the animal, breeding status, pedigree, special training, veterinary expenses for the care of the animal's injury or sickness, related to the incident in question, and any particular economic utility the animal has to the owner should be considered. Any extension of available remedies beyond economic damages would be inappropriate. Therefore, the VVMA opposes the potential recovery of non-economic damages.
Complementary Veterinary Medicine
Approved at the VVMA Executive Committee Meeting 2/9/08
Presented at the VVMA Winter Meeting 2/10/08
The VVMA defines Complementary Veterinary Medicine by the AVMA Model Practice Act definition: “Complementary, alternative, and integrative therapies" means a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices, which at the time they are performed may differ from current scientific knowledge, or whose theoretical basis and techniques may diverge from veterinary medicine routinely taught in accredited veterinary medical colleges, or both. These therapies include, but are not limited to, veterinary acupuncture, acutherapy, and acupressure; veterinary homeopathy; veterinary manual or manipulative therapy (ie, therapies based on techniques practiced in osteopathy, chiropractic medicine, or physical medicine and therapy); veterinary nutraceutical therapy; and veterinary phytotherapy.”
The VVMA recognizes that clients may seek any of a number of treatment modalities for their animals. However, when applied to animals, these treatment modalities represent the practice of veterinary medicine, and as such, should be subject to regulation as outlined in the practice act. Veterinarians should ensure that they have the requisite skills and knowledge for any treatment modality they may consider using. The foremost objective in veterinary medicine is patient welfare. Owner consent should be obtained prior to initiating any treatment, including complementary, alternative, and integrative therapies.
Housing Layer Chickens in Cages
Approved at the VVMA Summer Meeting 6/21/07
Cages should be designed and maintained so as to avoid injury to birds. Construction of cages, feeders and waterers should take into account scientifically documented advantages for bird comfort and health, and facilitate the safe removal of birds. Cage configuration should be such that manure from birds in upper level cages does not drop directly on birds in lower level cages. All hens should be able to stand comfortably upright in their cages and be able to fully spread their wings without touching the sides. Feeder space should be sufficient to permit all birds to eat at the same time.
Colonies of Free-Roaming Abandoned and Feral Cats
Approved at Executive Committee Meeting 5/4/05
We recognize that this issue is complex, and carries a high emotional charge for many. The following is the position statement of the VVMA on colonies of free-roaming, abandoned, and feral cats. We have arrived at this position after careful study of the issues involved, and have closely referenced similar position statements of the AAFP (American Association of Feline Practitioners), HSUS (Humane Society of the United States) and AVMA (American Veterinary Medical Association).
Cats labeled as "feral" may be well-socialized to humans, not at all socialized, or somewhere in between. People who feed cats in colonies feel that they are doing good for the cats, but in reality the quality of life for these cats, in terms of their medical care, is often far below an acceptable standard for pet cats.
We feel that it is in cats' best interest to be loved, fed, and provided with medical care by their owners, and usually to live at least partly, if not completely, indoors. Cat group numbers should be small enough that owners can afford to provide each cat with the personal attention and medical care that it needs.
We do not feel that feral cat colonies are a good idea for the colony cats, for other pet cats, or for humans or local wildlife. Feral cat colonies can serve as reservoirs of feline or human diseases. They can contribute to the pet overpopulation problem. Even if well fed, cats may kill local wildlife, such as songbirds. Finally, the colony members themselves are not getting good medical care.
Cats have the ability to exist as wild animals, outside of human intervention; but cat colonies usually form near humans due to humans' laxity about control of garbage and other food sources. The colonies are then perpetuated and expanded by compassionate humans who leave food out. Often the food is attractive to other wildlife and sanitation problems worsen. Previously owned cats may be abandoned at colony sites, compounding the problem.
Trapping and euthanizing entire colonies is not a workable solution and often creates an unbridgeable emotional gap between animal control authorities and people who care for cat colonies. If the conditions that gave rise to the colony in the first place are not changed, new cats will arrive to fill the gap.
In recent years, strategies such as trap-neuter-release and its variants have been advocated as an alternative method of colony management. Studies differ as to whether this approach actually prevents growth of the colony; effectiveness seems to depend on thorough, attentive management, and close cooperation between animal control authorities and cat care providers.
1. New colonies should be discouraged from forming by appropriate human control of potential habitat, garbage and other food sources.
2. Each existing colony should be managed with the goal of eventual reduction of the cat population to zero.
3. Each colony should be well-managed, with designated human caretakers to track population, individual cats, and medical care.
4. Each cat should be humanely trapped. Cats should undergo a complete medical evaluation by a veterinarian, including testing for FELV and FIV. Viral-positive cats or cats who are in poor health should be humanely euthanized. Cats who are sufficiently socialized to humans should be adopted out to caring homes through shelter channels. Cats who are to be returned to the colony should be vaccinated against FELV, rabies, panleukopenia, feline herpesvirus-1, and calicivirus; sterilized; and marked by ear tipping.
6. Cat colonies should be inconspicuous so as not to encourage abandonment of owned cats and food must be consumed or removed by nightfall so as not to attract pests and wildlife.
7. Cat colonies must be managed in accordance with local ordinances, with landowner permission, and not on public land or in locations where protected wildlife is threatened. All free-roaming cats not in official managed colonies should be removed and treated according to local ordinances.
8. We recognize the need for and support public education concerning the causes of cat abandonment and the potential negative impacts of free-roaming cat colonies on the health and well-being of humans and felines.
This document was prepared in May, 2005, using the current cat colony position statements of the AAFP, HSUS, and AVMA.
A copy of the AAFP position statement on free-roaming cat colonies is available at www.aafponline.org/feral_info_brief.htm. This position has been endorsed by AAHA (American Animal Hospital Association).
The AVMA position statement can be found at www.avma.org/policies/animalwelfare.asp#companion.
The HSUS position statement can be found at: www.hsus.org/pets/issues_affecting_our_pets/hsus_statement_on_freeroaming_cats.html.