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Dr. Carmack formed Hampton Roads Veterinary Hospice and the Hampton Roads Pet Loss Support Group in 2011. The practice added aquamation to it's services in 2016 and currently employs 2 full-time veterinarians, 1 part-time veterinarian and 5 support staff. Outside of work Dr. Carmack enjoys traveling, reading, and sailing. 

Title: “If a picture is worth a thousand words, then a video is worth a million”
Abstract:Learn cost-effective ways to utilize video in your hospice marketing plans. We will discuss video editing tools, video content ideas, and discuss which social media platforms are most conducive to utilizing video.

Title:You get a comfort kit and you get a comfort kit... everyone gets a comfort kit! 
Abstract:This session will be a guided discussion on comfort kits and will encourage audience participation and feedback. We will discuss the rationale behind leaving a comfort kit with owners, the most common conditions where comfort kits are used, common medications to include in kits, and the logistics of putting them together. We will also discuss pricing strategies, how to encourage pet families to purchase them, and the family education required to leave them behind safely. The active, facilitated discussion period will allow us to see how different practices are using these kits and share tips and tricks learned along the way.


Kathleen Cooney, DVM, MS, CHPV, has been practicing advanced end-of-life care since 2006. She is the founder of the Companion Animal Euthanasia Training Academy (CAETA), Guardian Pet Aquamation and Cooney Animal Hospice Consulting. Dr. Cooney is a past President of the International Association for Animal Hospice and Palliative Care(IAAHPC) and remains active in their organization, including design of their Animal Hospice and Palliative Care Certification Program, launched in 2016. Dr. Cooney was one of the first in the world to become a certified provider of animal hospice and palliative care (CHPV). She is well-known for her work in companion animal euthanasia and has authored two books on the subject along with numerous hospice-related articles. Dr. Cooney has collaborated in euthanasia training for the AVMA, AAHA, HABRI, IAAHPC, Fear Free Program, and more. She is a strong advocate for best practices in all aspects of end-of-life care and speaks nationally and internationally on related topics.


Title: Taking the Sting out of Telazol 
Abstract:While there are many 'Got to get everything right' facets of euthanasia, one of the biggest hurdles out there is that darn Telazol sting. While the 'ouch' is expected with any low pH injectable, dissociative drugs like Telazol are the big culprit. We like these drugs for their ability to induce fast, deep sleep before euthanasia, but at what price? It's time to tame the beast! This talk will reveal the best peer-reviewed ways to lessen the burn and reduce away the risk of that negative last impression.

Title: I Can't Say No....or Can I?
Abstract:I'm a helper. You're a helper. And helpers have a hard time saying no. For many of us, turning away a client and their pet, who let's face it is likely feeling awful and needs you, might be about the hardest thing we have to do in our work. Can we say no? In this session, we will first explore why we feel compelled to say Yes, how we can increase communication with clients to set up better expectations, and strategize to reduce those No's
in the first place. This is a must for everyone. 

Title: Final Stages of Dying: Panel Discussion on End-of-life Options
Abstract: This is a panel discussion lead by Dr. Kathleen Cooney and guests


Dr. Cox is a progressive leader in animal hospice with a hyper focus on technology, innovation, and education. In 2012, she founded the country’s first fully-integrated hospice practice within a specialty referral setting, and has since this time, recreated her model within 2 other specialty hospitals. In 2018, she launched the country’s first telehealth and online support platform focused solely on quality of life. She has authored twelve hospice-related chapters in three veterinary textbooks, helped develop the American Animal Hospital Association End of Life Guidelines, and is currently authoring AAHA’s newest textbook, “Integration of Hospice and Palliative Care Services into General and Specialty Practices.” Other endeavors include co-chairing the development of the Hospice and Palliative Care Certification Program and serving as the Immediate President of the International Association for Animal Hospice and Palliative Care.


Title: The Hospice and Quality of Life Assessment Intake
Abstract: This hour will share our approach to performing a hospice and/or quality of life assessment intake, walking you through each of the areas we cover in our appointments. Our intake includes an in-depth discussion around the following: education about the disease process, disease trajectories, management of clinical signs, nutritional support, education about natural death, implementation of the medical plan, evaluation of needs/beliefs/goals, pet QOL, family QOL, monitoring, adjunct care, environmental assessment, and preparation and planning for death. We will discuss the nuances of what is covered in each area in detail, including the various tools we use, helping you to form your own version of a Hospice/QOL intake. We will also discuss how our intake can be modified for a solo practitioner, as well as approaches for those practices that have a veterinary nurse as part of the care team.

Title: Utilizing Telehealth to Turn Your Hospice Practice into a Digitally Connected One
Abstract: Discussion around what telehealth/telemedicine is, what the legal implications are with regards to virtual care and the VCPR, technology options and what platforms can be used, pricing strategies, and how telehealth can not only augment the level of patient and family care, but improve the burden of care for the hospice provider.


Kelly is a graduate of California State Polytechnic University Pomona in Animal Health Science, as a pre-vet major she stumbled upon a job as a receptionist in an emergency vet hospital. She quickly changed her major to Animal Health Science which put her on track to become a Registered Veterinary Technician. She found that in that role she could have more time with patients and clients on a deeper level. Twelve years as an emergency technician in ER and Specialty medicine led her to a desire to learn more about rehabilitation. Seeing emergencies come in for IVDD, vestibular disease, older patients who couldn't move as well anymore, and injured joints led her to the University of Tennessee where she completed her CCRP in 2015. Kelly has found a whole new appreciation and understanding for the importance of quality of life for her patients and clientele.

Title: Enhance the Bond, Enhance the Life
Abstract:The human animal bond has evolved so much in my own life. From having a dog that stayed in the backyard to now not being able to sleep unless all three dogs are in bed with me. This has become the norm for so many in the world. Our animals are our family, our children, our pride and joy. But for many, they still don't know what to do with their pets when they get older. We have all these puppy training classes and advice, but no real advice for the older patients. Starting to educate people on how to connect with their pets can help them create better lives for their animals. Some education on exercises and goals will help them to invest more in their time with their pets. Maybe there wouldn't be so many obese pets that have to be put down for joint issues, or being abandoned because of energy requirements or illness. If we help create a better bond for owner and animal, we can help so many lives.


Dr. Durocher-Babek is a small animal Internal Medicine Specialist. She graduated from vet school at UGA and did her internship at Ontario Veterinary College, followed by a residency at The Ohio State University. She has practiced in multiple private specialty practices in North Carolina and New Jersey. She currently works at Veterinary Specialty Hospital in Hong Kong.

Title: Lessons from the NICU – what we can learn from the NICU and how to apply these lessons to veterinary medicine
Abstract:The closest human medical environment to a veterinary hospital is the Neonatal Intensive Care Unit. The patients are non-verbal and don’t understand their situation, while requiring high levels of medical and emotional care. The NICU staff has learned to balance the competing requirements of their patients, the patients’ families, and their own emotional well-being. There is significant research and resources developed in the NICU that may be translatable to veterinary medicine that could allow us to take better care of our patients as well as ourselves.


Meredith is a house call vet with a practice limited to end-of-life care for companion animals. In 2017 she obtained her CHPV. She has various family members who have been prescribed medical cannabis but who were given little specific guidance from their doctors about how and when or even what to take, so she decided to look deeper into the literature in a quest for answers. She does not think of herself as an expert on the topic but her wide and varied readings have lead to a fascination with the subject and an increasing comfort with the material. She is keen to contribute to the ongoing conversation around cannabis as medicine and has no fear of thoughtfully including cannabis medicine in her own palliative care practice. She is a member of The Canadian Association of Veterinary Cannabinoid Medicine and The Canadian Consortium for the Investigation of Cannabinoids.

Title:Cannabis in Context: Wolf in sheep's clothing or vice versa? What do we need to know now?
Abstract:This lecture is my effort to share practical information and context with anyone thinking about incorporating cannabis medicine into their palliative care practices. 

The landscape around cannabis is shifting at an exponential rate. Laws are changing rapidly around the world, former staunch opponents are now advocates and cannabis entrepreneurs, huge amounts of money are being invested in the cannabis industry worldwide, and also (finally!) into quality research and education. We hear stories of amazing clinical recoveries but also cautionary tales, and the more we look for answers, the more questions we find. The truth is that this is an incredibly complex field of enquiry, with fascinating revelations made on an almost daily basis. It is also true that veterinarians are being asked to contribute to the ongoing dialogue right now and many of us feel woefully unprepared.

Even if we don’t broach the topic of cannabis medicine with clients they are going to broach it with us. It is happening already. Articles and ads about the benefits of cannabis products are ubiquitous. Many people have heard of a person or pet who has benefited, they want to try it, and it is increasingly available. The most cautious among us may have no intention of even considering the use of cannabis medicine pending publication of persuasive clinical trial data. However having an informed opinion now still matters. Who better than veterinarians to help our clients navigate through the currently uncharted waters of cannabis medicine for their pets, its risks and potential benefits, what is currently known and what is not yet known? And who better than palliative care veterinarians, with their focus on bespoke medicine, to be thought leaders in this emerging field.


Dr. Toby Goldman is a full-time hospice veterinarian in Las Vegas Nevada. He has a Bachelor of Science in Animal Science from Cal Poly in San Luis Obispo, and earned his DVM at Ross University, completing his senior clinical year at Oklahoma State University. Las Vegas is home where he’s been spotlighted in news stories, personalities, and politics. Toby built several veterinary practices, and maintains a part-time exotic and zoo animal practice. Working through his travels and schooling performing juggling and comedy, he still brings his shtick to work in some form every day making smiles. He is dad to three great young adults, and an interpreter in American Sign Language for the deaf. Toby is happiest when trail running in the southwestern mountains and parks with his cattle dog. He is currently the USA Track and Field National Champion in his age group for the 100 mile road run.


Title: The Aha in Haha - Hospice Humor
Abstract: Humor and laughter fulfills one of the main goals of veterinary hospice and palliative care, namely, improving the overall quality of life for human caretakers and their animal patients. Very little has been written on Veterinary Hospice Humor, yet the subject has been well thought out and documented in human medicine for us to use. Veterinary hospice humor is more than the traditional gallows dark humor, as there are different forms of humor. Laughter helps us cope with each situation in our own way and aids with grieving. There are some great things about laughter: It’s contagious and cross cultural. Humor causes laughter and levity producing positive benefits of humor for the mind and body. It regulates cortisol and epinephrine, boosts your immune system, and increases endorphins and dopamine to regulate mood, motivation, and learning. Laughter burns calories, lowers blood pressure, improves breathing, stimulates circulation, relaxes muscles, and helps prevent heart disease. With that known, I would like to take a look at how humor might benefit animals, and if indeed animals can laugh and share some of the same benefits. Funny stories, jokes, pictures, and a bit of “shtick” will be used to illustrate how we can benefit from humor in our work and play each day.


Bobby Jackson is the founder of RedRidge Consultants, a business consulting and coaching practice that helps medical and veterinary practices improve profitability and revenue. Before starting his consulting practice, Bobby spent 20 years working in corporate America for several Fortune 500 medical device companies in various sales and marketing positions. He has over 20 years of healthcare industry experience and is comfortable in the boardroom or doing clinical procedures with physicians. Bobby has a master’s degree in health administration from the University of Southern California in Los Angeles, CA and completed the mergers & acquisitions and medical marketing executive education programs at the UCLA Anderson School of Management in Los Angeles, CA. Bobby is a member of the American College of Healthcare Executives.

Title: Get Maximum Value When You Sell Your Practice
Abstract: For many practice owners, selling their practice is a part of their financial retirement plan. You have a target date to retire and you become receptive to offers as you near your retirement date. Is that the best approach to get maximum financial value for your practice? We will walk through preparing your practice for maximum financial value.

Marilyn has facilitated Grief & Bereavement Recovery for ages 5-99. She uses Modalities of Grief Therapy, Brief Solution-Oriented Therapy, Mindfulness Practices, using Therapy for Children-Elders in her Private Practice and in Psycho-Educational Bereavement Groups for both people and pets. 

Title: Tools for Life's Challenges-The 7 R's of Bereavement Recovery
Abstract: Using a straightforward Psycho-educational Model, while, at the same, time, teaching and building Interactive Communication &Emotional Coping Skills, mixed with a newer, more stimulating, 7-stage Theory for Grief Recovery allows our Pet Loss Support Groups to delve more deeply into Understanding the "how's" and the "why's" of our Grief. Spouses and Families become Mindful of the Needs & Wants of Others.


Kristi Lehman, MSW, LISW is the Director of Operations at DVMcenter. She earned her Master of Social Work degree from the University of Minnesota, where she had a concentration in clinical mental health and received specialized veterinary social work training at the University of Minnesota Veterinary Medical Center. She first began working with MN Pets, an in-home euthanasia practice in Minnesota, before the practice branched into what is now DVMcenter. DVMcenter provides support to mobile end-of-life veterinarians by managing their client-care services, including client communications, grief and decision-making support, scheduling, and record-keeping. Kristi’s passion is helping veterinarians provide high-quality, personal end-of-life care to pet families when they need it the most.


Title: Gaining Traction with Your Growing Team
Abstract:For most practice owners and managers, personnel management can feel like an uphill battle. We know that our team members are what make our practices successful, and we also know that when we experience issues with our team, the whole company feels the effects. In addition, small, mobile practices experience a unique set of challenges due to the nontraditional structure and less face-to-face contact. This lecture will touch on some of the most important supervision challenges you may be facing including how to create accountability and transparency, how to promote open yet structured communication, and how to approach difficult personnel decision. We will utilize the Entrepreneurial Operating System (EOS) as a framework, and will share concrete, practical tools that you can use to help you gain traction with your team.

Title: Supporting families with children: Practical tips for home visits
Abstract: When a veterinarian enters a family’s home to help their pet at the end-of-life, they provide more than the medical component – they are a resource, a support, and an expert. End-of-life veterinarians bear witness to the family’s intimate experience with loss, and parents ask many questions about how to guide their children through their grief. This talk will focus on practical tools for supporting parents with their most common concerns. We will discuss language around death, dying and aftercare; ideas for including the entire family in the pet’s care; and tips for creating a resource kit for parents. In addition, we will share ideas for how to interact and support children of all ages and developmental stages, from infants to young adults. 


Title: Unpacking the Mystery of Teenage Grief
Abstract: Families with teenagers experience a unique set of challenges during a pet’s end-of-life, and veterinarians often find themselves right in the middle of difficult family dynamics during a home visit. Teenagers can be mysterious and unpredictable, and even the most skillful professionals may struggle with how to engage them during the visit. In addition, many parents ask veterinarians and support professionals for advice when they are feeling at a loss in supporting their teens. During this discussion, we will talk about how teenage grief differs from that of children’s’ and adult’s, how to better understand and support parents of teenagers, and share concrete tools for engaging with and supporting teenagers through their pet’s end-of-life.


Beth Marchitelli, DVM Dr. Marchitelli received her degree from Cornell University’s College of Veterinary Medicine in 2001. Shortly after graduating from veterinary school, she practiced small animal medicine in Huntington, New York for ten years. For the last seven years she has been the owner and operator of 4 Paws Farewell - Mobile Pet Hospice, Palliative Care and Home Euthanasia in Asheville, North Carolina. She is currently pursuing a Masters of Science in Palliative Care in human medicine to advance her knowledge and training in the areas of veterinary hospice, palliative care and euthanasia. She is especially interested in providing high quality compassionate care for pets during the end of their lives as well as the families who care for them. When she is not caring for pets or their families she enjoys yoga and mountain biking with her husband and her two dogs in beautiful Western North Carolina.


Title: Euthanasia Triggers in the Context of Chronic Illness
Abstract: This lecture explores specific triggers contributing to euthanasia of sick companion animals in the form of clinical signs, diagnoses , pet owners’ decisional framework, and environmental factors. Clinical diagnoses and/or clinical signs are often used to describe the reasons a pet owner opts for euthanasia of a sick pet. Although these descriptors may be accurate, they represent only part of a complex emotional, ethical and social decision making process. Often such a decision is made dynamically and can be revisited at different points along a pet’s illness trajectory. Additionally, reducing the decision to euthanize a sick pet to the results of a quality of life scale runs the risk of simplifying inherent complexities and may also obscure the emotional impact on pet owners. Evaluating specific factors individually and collectively sheds light on what influences decision making in this context and how to best support our patients and families.

Title: Comfort Care Tips for Palliative Care and End-of-Life Patients
Abstract:This lecture will highlight specific comfort care tips for palliative care and end-of-life patients. Proceeding anatomically , this lecture starts at the head and ends at the tail. Innovations from human medicine will be discussed where appropriate. The goal of this lecture is to draw attention to the small details in providing comforting and care that can make a difference in overall patient well being.


Dr Kerry Muhovich is a 2001 DVM graduate of Colorado State University. Since graduation she has worked in a variety of aspects of veterinary medicine, first and foremost working as a trainer and educator as well. She began her veterinary career at (Denver) Dumb Friends League teaching animal sheltering staff across the country about animal behavior. Now in her fourth year at Caring Pathways she works in the field of pet hospice and in home euthanasia and continues to educate the public and her clients and peers in various aspects of animal care. Dr Muhovich is certified in Canine Rehabilitation, low stress handling, and fear free methods. 

Title: Managing and Handling Aggression Appointments
Abstract: Do appointments for aggressive pets fill you with fear and anxiety? Are you uncertain if you are the best option for pets with aggressive tendencies. Come learn how to determine the best course of action for animals with aggressive potential. Pre-appointment consultation, drug protocols, and family and patient safety will all be discussed. Appointments due to intractable aggression as well as aggression due to illness or injury will be covered as well. Feel better about your processes for managing aggressive pets with compassion and safety.


I graduated from Michigan State University and spent three years in private practice before completing a residency and becoming boarded in laboratory animal medicine (DACLAM). I spent 26 years working with research animals, making sure that they were well cared for, had adequate pain management and if euthanasia was required, that it was performed in a humane and compassionate manner. Through this experience, I became a compassionate advocate for peaceful and painless end-of-life transitions. So it was through this natural transition that I was drawn to the field of animal hospice. I opened Peaceful Journey in 2015 to provide hospice care and in home euthanasia for families in Bozeman Montana. I have been a member of IAAHPC since 2013 and was in the first class (2017) to receive hospice certification (CHPV). 


Title: Getting started with Tricks of the Trade
Abstract:In our in home euthanasia practices we are all working solo. That can make it difficult to share or learn some basic tricks of the trade that come in handy. This would be a round-table session led by three more experienced practitioners who would provide a "show and tell" for the audience. The session would be split into three 20 minute blocks, with each presenter giving a quick show and tell of the following three topics: 1. What's in your bag? (each would bring their bag show what they put in it/how they pack it) 2. How do you fit all that in your car? (would show slides of vehicle and how its organized) 3. How do you make that paw print?


KaLee Pasek, DVM, CVFP, CHPV is a passionate veterinary practitioner, educator, and author. As a sought-out speaker at multidisciplinary conferences and venues, Dr. Pasek engages her audience with ready-to-use information and has a speaking approach that is warm and inviting.She owns and operates Transitions Veterinary Care; a practice limited to geriatric, palliative, hospice and end of life care. As an author, Dr. Pasek has published "Honoring the Journey: A Guided Path Through Pet Loss". This book captures the reader with powerful illustrations and raw emotion to assist with the loss of a pet.

Title: Marketing Hospice and Palliative Care to Referring Veterinary Hospitals
Abstract: For many veterinarians who operate in-home, end-of-life practices, the client phone calls can be the most emotionally exhaustive part of their work. After hundreds of phone calls, many doctors feel a sense of dread at the sound of their phone’s ringtone, even while knowing that their phone is their lifeline to a successful practice. Most veterinarians do not have extensive training on how to support pet owners, and are therefore jumping into one of the most important functions of their practice with an empty toolbox. This can lead to
feelings of burnout, compassion fatigue and poor business results. Using both qualitative and quantitative data from over 50,000 phone calls and from client survey results, we will break down the typical phone call, identify myths and assumptions about client needs, and share tools for ensuring that every phone call is successful.

Title: Nursing Care for Common Palliative Care and Hospice Cases
Abstract: Your role on the Hospice Team is extremely valuable. Hospice and Palliative Care Technicians possess solid nursing skills and excellent communication skills. You are often the voice of the patient and sometimes the voice of the caregiver. You are the liaison to the medical director. This lecture will discuss the types of nursing visits that you may encounter. We will review the systematic physical exam, monitoring parameters, and implementation of nursing care as it pertains to each case. The education and communication aspects required to support the caregiver will also be discussed. The Cases to be covered include; Chronic Renal Disease, Cancer including Osteosarcoma, and Hemangiosarcoma, mobility challenged pets, and active dying. 

Title: Understanding Caregiver Responses to Impending Loss
Abstract: As veterinary technicians exposed to a population of clients facing loss more often than others, you will encounter Caregivers suffering from Anticipatory Grief. As well, caregivers often express their emotions to the nursing staff more readily than to the DVM. Anticipatory Grief can run amok, often-unnoticed, wreaking havoc in the emotional body of the individual experiencing it. This lecture will focus on the hallmark signs of Anticipatory Grief and give you language to untangle the emotional ties to anxiety. In turn the caregiver can soon feel the relief from the accompanying anxiety and rest in the quality of awareness. That awareness alone can give the caregiver more clarity about decisions and maybe more importantly, allow the caregiver to truly be in the present, holding the space for their pet’s remaining time and transition.


Dr. Robertson is board certified in anesthesia and animal welfare by the respective American and European Colleges and is trained in small animal acupuncture. Her research interests include the assessment and alleviation of pain in several species. She is co-editor of the first text book dedicated entirely to Feline Anesthesia and Pain Management. In 2014 she obtained her graduate certificate in shelter medicine from the University of Florida. In 2018 she completed the Chi Institute’s online TCVM Palliative Care and End-of-Life class. She has been a faculty member at the Western College of Veterinary Medicine (Canada), the University of Florida, Michigan State University and served as an assistant director in the Animal Welfare Division of the American Veterinary Medical Association. Currently she is the senior medical director for Lap of Love Veterinary Hospice.


Title: Pain management for common diseases: canine and feline osteoarthritis
Abstract:Mobility issues and pain related to osteoarthritis are common in dogs and cats and have a significant impact on quality of life (QoL) and the human-animal bond. Unfortunately, many pets, especially cats suffer from other comorbidities which also impact on their overall health related QoL and make treatment challenging. Studies including techniques such as quantitative sensory testing demonstrate that we need to address not just
inflammatory related pain, but central plasticity and functional pain. Understanding the etiology of the pain and phenotyping it, helps us make more rational treatment choices that includes peripherally and centrally acting drugs. The role of NSAIDs, grapiprant, amantadine, gabapentin and monoclonal antibodies will be discussed. Updates on the treatment of feline OA include the approval of robenacoxib for long term use in European countries.

Title: Prospective analysis of feline euthanasia appointments (March – December 2018)
Abstract: Between March and December 2018, 2,500 feline euthanasia events were prospectively recorded. Information collected included the reason the owner requested euthanasia, age, sex, breed, body condition score, and health status of the cat. The sedation protocol, route of administration and any reaction to the injection or adverse event (e.g. vomiting) was noted. Whether or not a single pre-euthanasia sedation injection was sufficient was recorded. The specific euthanasia solution used, dose and route of administration and any adverse events following administration were noted. One minute after administration of euthanasia solution cardiac auscultation was performed; if there was still a heartbeat, time to cessation was recorded. If additional doses were required, these, and the route of administration were noted. The data is currently being coded for statistical analysis. 

Title: Updates on osteosarcoma pain in dogs
Abstract: Osteosarcoma related pain is one of the most challenging to alleviate in humans and animals and inability to relieve pain is one of the most common reasons for owners choosing euthanasia. Monteiro et al (2018, Plos One) recently characterized pain associated with osteosarcoma (OSA) in dogs, along with other objective scores such as stance (a)symmetry index and activity, including night-time restlessness. Pain and quality of life scores were tracked during a stepwise palliative treatment regimen. Characterization was performed using quantitative sensory testing (QST), specifically mechanical thresholds (primary and secondary); dogs with OSA were compared to healthy dogs. Dogs with OSA have significant abnormalities of the somatosensory system with peripheral hyperalgesia and central plasticity. A non-steroidal anti-inflammatory drug, amitriptyline and gabapentin were administered in a stepwise manner. Although this is preliminary data (13 dogs), it provides a rational for targeted therapy. OSA related pain is highly refractive to therapy and gabapentin may be contraindicated.

Title: Myths and misconceptions about transdermal drugs
Abstract: A popular method of drug delivery is transdermal application; this is especially attractive in pets that are difficult or impossible to medicate orally, and for certain drugs (e.g. opioids) that have a high first-pass metabolism after oral administration. Skin is the largest body organ and one of its primary roles is to provide a barrier between the interior and exterior; there are significant differences in the anatomy of skin among species which impact on dermal penetration of drugs. Transdermal vehicles have been tested on human skin in vitro, but not on a wide range of animal skin models. There are many unsubstantiated, empirical, and non-referenced claims about compounded formulations of drugs for transdermal application in dogs and cats. Compounded veterinary drugs are not FDA approved and efficacy data is lacking. Atenolol, amitriptyline, gabapentin, ondansetron, buspirone and dexamethasone do not achieve clinically relevant plasms levels after transdermal application in cats. Methimazole and mirtazapine are suitable for transdermal use in cats. A formulation of mirtazapine has been FDA approved meaning that safety, pharmacokinetic, and efficacy data are available. Veterinarians must be cognizant of evidence-based information when prescribing transdermal drugs.


Title: Case study (canine – Osteoarthritis and degenerative myelopathy) 
Abstract: The owner of a 14-year-old mixed breed dog requested a consultation / possible euthanasia appointment. The dog had an unknown history prior to age 2 (stray). Since adoption she had undergone a hemilaminectomy for an acute episode of IVDD and paralysis (at age 6); surgery followed by rehabilitation was successful. The current crisis was progressive hindlimb weakness followed by “collapse” and inability to rise on her own. The dog was < 75% weight bearing with assistance and was overweight but could urinated and defecate normally. There was evidence of neuropathic pain (licking and chewing of the limbs and feet). No acute spinal pain was evident, but hip range of motion was significantly restricted. A multimodal and integrative medicine plan was developed – a western and traditional Chinese medicine diagnosis was made. Drugs used over the following 18 months included carprofen, grapiprant, amantadine and gabapentin. Physical modalities included Tui-na (Rou-fa), acupuncture (dry, electrical and aqua), underwater treadmill and cavaletti exercise. Nutrition and weight loss were addressed. S-Adenosylmethionine (SAMe), Silybin A + B and polysulfated glycosaminoglycan were also used. Challenges included owner compliance and significantly elevated liver enzymes during NSAID treatment. The rationale for the treatments, side effects and alternatives (including herbal formulations) will be discussed along with previously overlooked orthopedic disease.


Dr. Tamara Shearer is a 1986 graduate of the Ohio State University College of Veterinary Medicine.  She has acquired 4 certifications: Certified Canine Rehabilitation Practitioner, Certified Veterinary Acupuncturist (Chi Institute), Certified Veterinary Pain Practitioner, Certified Hospice and Palliative Care Veterinarian and Certified TCVM Palliative and End-of Life Practitioner.   

She was the recipient of the Ingleheim Behringer Award in for her groundbreaking work in animal hospice, was voted Veterinarian of the Year by the Hartz Mountain Corporation and also received the Ohio Animal Foundation’s Award for Community Service.  In 2004, the Washington Post ran a feature on the Pet Hospice and Education Center that she founded.  Her early hospice efforts were documented in numerous publications including the AVMA Journal and Veterinary Practice News.

Dr. Shearer was the guest editor and author, Veterinary Clinics of North America on hospice and palliative care.  She was also co-author for the text book Hospice and Palliative Care for Companion Animals: Principles and Practice.  

Dr. Shearer helped develop the International Animal Hospice and Palliative Care Certification Program that provides over 100 hours of continuing education on hospice and palliative care. She also contributed to the development of the Chi Institute’s TCVM Palliative and End-of Life course.  In addition to the development of courses, she has lectured at major national and international veterinary meetings.  

Dr. Shearer is the practice owner of Shearer Pet Health Services and Smoky Mountain Integrative Veterinary Clinic where she focuses on rehabilitation, pain management, hospice care and Traditional Chinese Veterinary Medicine for her patients.  

Dr. Shearer served as 2009-2010 President of American Association of Human-Animal Bond Veterinarians, is a member of the International Veterinary Academy of Pain Management and the American Association of Traditional Chinese Veterinary Medicine.

Title: Mobility Support Devices
Abstract: Mobility Support Devices and Creative Ideas for Providing Affordable Options for CaretakersThis lecture will cover the history of mobility support and various devices that are preferred. Affordable options will be discussed for caretakers that might not have the resources to invest in equipment.

Title: Physical Therapy Golden Rules for End of Life
Abstract: Physical Therapy Golden Rules for Pets that are Recumbent. This topic should follow the discussion about mobility devices. It will cover tips on how the veterinary staff needs can better fit the needs of a patient by providing physical medicine.


 Dave Shuey is a Veterinary Nurse, pianist, horse-owner, and (very) amateur dressage rider. He holds certifications from the International Association for Animal Hospice and Palliative Care, the Companion Animal Euthanasia Training Academy, and the Human-Animal Bond Research Institute. He served for several years at the University of Georgia Veterinary Teaching Hospital in Athens, GA in Anesthesia and Large Animal ICU, before pursuing his passion in end-of-life care. Dave is the Senior Technician at Main Street Vet in Madison, GA, providing hospice and palliative care including euthanasia, as well as education for clients, staff, and the community. He has been published in the NAVTA Journal, and is a sought-after speaker on end-of-life-topics. He is currently working on a chapter for the 10th edition of McCurnin’s Clinical Textbook for Veterinary Technicians. Dave holds a Doctor of Musical Arts degree in piano performance and pedagogy, and performs solo recitals in public from time to time. He lives in Greensboro, GA with his wife Jenny and their five horses, two dogs, and six cats.

Title: Bereavement in Horse owners and horses
Abstract: Recent evidence has reinforced the idea that horse-owners experience deeper and more prolonged levels of grief after losing a beloved equine companion, especially surrounding the euthanasia of an older horse with a long and rich life in a committed family. This lecture seeks to give veterinary social workers some basic ideas and tools for helping horse-owners faced with the death of a horse that has held a central place in their lives over many years and even decades. 


Title: The Equine Hospice Nurse
Abstract: Of all the species cared for in veterinary medicine, the horse is the most challenging. Their size, strength, intelligence, and psychosocial world demand a uniquely heightened standard of care and skill set. In this lecture, I present the roles of the hospice nurse as they pertain to horses and their families. The first hour will focus on the roles of medical care and education, and the second hour on the role of advocate. Many studies have pointed out the need for higher standards in end-of-life care for horses, and the Veterinary Nurse is in a unique position to uphold those standards for horses as they approach the end of life.


 Dr. Stoewen is a veterinarian and social worker with a PhD specializing in veterinary medical communication. She is the Director of Veterinary Affairs for LifeLearn, wherein she supports innovative initiatives in veterinary CE across North America and provides a fully accredited, evidence-based CE program called "The Social Side of Practice." She has given over 300 presentations internationally in the areas of veterinary wellness, veterinary-client-patient communication, teamwork, organizational culture, and leadership.

Title: Facilitating Euthanasia Conversations
Abstract: Euthanasia is much more than the simple act of giving an injection. In fact, there is so much to include that most specializing veterinary teams offer hour long appointments to cover it all: caregiver support, proper sedation protocalls for the pet, time management, skillful euthanasia itself, and more. Euthanasia has become an experience more than the medical act itself. This hour, we will dive into the art of euthanasia and the important ways to elveate death itself.

Title: IMPROVe Your Conversations for Success!
Abstract: Success in practice depends on the quality of the workplace culture, which depends on the quality of the relationships, which depends on the quality of the conversations. The bottom line: success depends onconversations. Are the conversations in your hospital structured to include or exclude? Are outcomes achieved through command, authority, and control or by enabling autonomy within an interdisciplinary collaboration? Are there silos and competition or mutuality and support? The ability to connect, navigate, and grow with one another, all keys to success, happens with “Yes, and...”.
“Yes, and...” is the rule-of-thumb in improvisational comedy (or “improv”). From a communication perspective, improv can be thought of as “the art of co-creating mutually beneficial conversations.” All conversations, in truth, are improvisations, which means all of us are improvisors – not just comedians, jazz musicians or politicians! This session incorporates improv (games) to foster open communication, community, and connectedness, which are foundational to building a collaborative workplace culture, the culture through which personal, professional, and practice success can be achieved. Within a collaborative workplace culture, anyone can connect with anyone and make great things happen.

Title: The Client Experience: Making Memorable Moments
Abstract: When thinking about life experience and how it can affect the way one practices, it was fostering children-in-need that most influenced the way that I practice. Fostering sensitized me to the commonality of “the human experience,” and how people can feel and respond similarly despite differences in age and context. It also helped me realize how we, as caregivers – whether foster parents or veterinary professionals – can make such a difference in the lives of others, depending on “how” we provide that care. As with caring for children-in-need, caring for clients requires us to do two things: attend to expectations (i.e. needs, wishes, and values) and engender comfort.
As drawn from the literature and my experience as a practitioner and foster parent, this session focuses on why the client experience is so important, what the client experience is, and how to create experiences. The “how” will highlight the communication elements and strategies to intentionally engage clients and connect with them in a personal, memorable way, and move from "practicing" medicine to "gifting" medicine. This session, thought-provoking by nature, weaves from one story to another to invite a new understanding of “the client experience,” one that comes from a truly human perspective.

Monica Turenne is the owner of Four Paws Veterinary Wellness, an integrative veterinary house call practice. Her practice was founded in 2012 with just a few acupuncture patients. Four Paws has grown significantly in 7 years and now proudly counts 900 active clients. Her focus is on integrative and palliative, hospice and end of life care. Dr. Turenne is a Certified Veterinary Acupuncturist, Certified in Thanatology: Death, Dying and Bereavement and is a Certified Hospice and Palliative Veterinarian. 

Title: Natural Death- Part I - Why pet parents choose natural death and how do we guide them 
Abstract: Many pet parents, because of ethical or religious considerations, do not believe in euthanasia or would prefer to have their pet die naturally. These pet parents often do not present to veterinarians because they feel they will be judged. Instead, their pets die naturally without veterinary guidance. The reasons pet parents choose natural death will be discussed as well as how to approach a natural death consultation. 

Title: Natural Death- Part 2 – How to support a natural death using complimentary and integrative medicine (CIM) 
Abstract: Pet parents who choose natural death often prefer natural and holistic modalities. This lecture will give an overview of complimentary modalities, including a practical guide all hospice veterinarians can use to support the dying patient. Acupuncture, herbal therapy, homeopathy and Bach flower essences will be discussed. 


Dr. Jessica Vogelsang is a veterinarian and bestselling author from San Diego, California. Her award winning website pawcurious.com is one of the first veterinary-authored sites on the internet. She frequently lectures on communication in the digital age, narrative storytelling, and personal branding. She is a regular contributor to both industry and national publications and was a featured expert on NatGeo’s Animals Gone Wild. As founding Editorial Director, Dr. Vogelsang helped launch DrAndyRoark.com, a site with over 200,000 fans from the veterinary community. Her debut book, All Dogs Go To Kevin, was published in July 2015 to stellar reviews and is an Amazon bestseller.

Title: Stand Up Be a Tesla in a World of Fords: How Brand Messaging Sets You Apart, Sets You Above, and Builds a Tribe for Life
Abstract: Are you constantly fighting the clients who call complaining about how expensive you are? Ever wish you could just pre-sort clients to attract the ones who understand your value and don't mind paying you what you are worth? If that isn't how your business runs already, you need better branding. 
The truth is, we can't be all things to all people. We can and should do a better job identifying our core values, what makes our practice unique, and most importantly- how to convey that to clients. When we do this correctly, we attract the clients who already want what we have to offer and cause those who don't want what we have to move along. The principles of strong branding are surprisingly straightforward, yet few people in veterinary medicine utilize them well. 
While most branding consultants spend weeks or months working with a business to identify brand messaging, you can accomplish a fundamental understanding of the concept within a workshop. This workshop will combine lecture with exercises so attendees will leave with a stronger understanding of their core brand, and what they need to do to communicate that to potential clients. 

Title: Brand Blueprint : Using Your Strengths to Market Your Practice and Become Irresistible
Abstract:You have a unique and strong brand, you just may not know it yet. Whether you're a relief vet building a reputation or a practice looking to grow, your brand is what sets you apart. In the first half of this two hour lecture series attendees will learn the building blocks of a cohesive, concise, and compelling brand. Using brainstorming exercises, attendees will narrow their focus and start carving their own, one-of-a-kind niche.
Nailing down a brand is only half the battle. What do you do with it? In the second half of this lecture series, we will continue to build on the brand exercises and learn how to use that to build cohesive messaging that clearly communicates your purpose. A style guide is important in both content and tone when it comes to setting the stage for the client experience and expectations. Do it right and your words do the heavy communication lifting for you without you having to say a word!


Title: Putting Your Brand to Work: Implementing a Cohesive Brand Online, on Social, and In Practice
Abstract: What does successful branding look like out in the wild? You've got your brand, you know your messaging, now get it out there. The days of yellow pages are over. Clients expect an engaging website, social media that offers a glimpse into who you are, and a consistent customer experience. In this hour we'll discuss the dos and don'ts of bringing your brand to life.


 Dr. Susan Wagner is a veterinary neurologist whose pioneering work acknowledges the spiritual interaction between people and animals. Dr. Wagner is co-author of Through A Dog's Ear: Using Sound to Improve the Health and Behavior of Your Canine Companion. She founded the integrative medicine program at MedVet Medical & Cancer Centers for Pets, and is adjunct faculty at The Ohio State University College of Veterinary Medicine. Dr. Wagner is also faculty with the College of Veterinary Integrative Therapies. In addition to being published in scientific journals and magazines, Dr. Wagner has been interviewed on CBS Early Morning and The Today Show on NBC.

Title: A Comprehensive Approach to Pain
Abstract: The anatomic pathways and mechanisms of pain will be presented. An interplay between fear and anxiety and pain control will also be discussed. In addition to conventional medications, complementary options to pain control will be offered. These include botannicals, homeopathics, Traditional Chinese Medicine and biofield therapies. 

Title:  An Integrative Approach to the Care of the Chronic or Palliative Neurologic Patient
Abstract: A brief review of signs seen with lesions in the nervous system will be presented, including Degenerative Myelopathy, Cognitive
Dysfunction and chronic disc disease. Conventional and complementary therapies for managing these patients will be discussed.

Title: A Novel Approach to Compassion Fatigue: Chicken or Egg?
Abstract: This lecture will begin with defining Compassion Fatigue and elucidating risk factors. We will also discuss how compassion fatigue can be useful in looking at broader issues and patterns in our lives. Mechanisms for prevention and resolution will be presented, including breathing exercises, pressure point techniques and resources for optimum health. Ideally, this presentation is two hours, but can be cut to one hour if necessary. 


 Page Yaxley, DVM, Diplomate of the American College of Veterinary Emergency and Critical Care, is currently an Assistant Professor in Small Animal Emergency and Critical Care Medicine at The Ohio State University, College of Veterinary Medicine. During her residency at Michigan State University, she became interested in medical ethics, quality and end of life care, in addition to her interest in critical care medicine. She founded Veterinary Hospice Care at MSU, the countries 2nd veterinary hospice affiliated with a teaching institution from 2011-2014. She is an active member of the American Academy of Hospice and Palliative Medicine, and is a founding member and co-president of the Veterinary Society for Hospice and Palliative Care. Dr. Yaxley has been the recipient of many teaching awards, most notably the Zoetis Distinguished Veterinary Teacher Award, and the John Lyman Jr. Award for Clinical Teaching.

Title: More than Just Skin Deep: Advanced Wound Management
Abstract: Non healing wounds and decubital ulcers can pose significant threats to both the health and comfort of the animal hospice patient. Similarly, they pose challenges in the care of the hospice patient for owners and hospice practitioners alike. Caring for advanced wounds, specifically in the home setting often requires both knowledge of wound management strategies, as well as ingenuity and creativity. Many products for would healing are on the market (Manuka honey, silver, electroceuticals, etc.), but determining both the best wound for a certain wound, ease of use in the home setting, and the practicality of having them in your arsenal can be difficult. In this lecture, we will explore common wounds encountered in the hospice patient, as well as the physiology of wound healing, and options for the home care practitioner. Case examples may be provided. 

Title: Senior Moments: Canine and Feline Cognitive Dysfunction
Abstract: Canine Cognitive Dysfunction Syndrome (CCDS) is a progressive, age related, neurodegenerative disease affecting aged dogs and cats. The onset of clinical signs can be insidious, such that early diagnosis and intervention is often missed. As the disease progresses, abnormal behaviors such as changes in elimination habits, inability to navigate the well-known environment, and changes in the sleep wake cycle of patients can place challenges both on the patient and the family, and test the human animal bond. This lecture will review the pathophysiology of this disease, and highlight medical and behavioral modifications to enhance quality of life for the patient and the owner.

Title:  Living Until You Die: Physiology of Death and Associated Stages of Dying
Abstract: All living beings will one day face death. Animal hospice providers are often tasked with educating owners about what they can expect as well as how and when death will occur. Death, or the cessation of all biological functions, can indeed be elusive and mysterious, despite what is known. Circumstances that lead to death, and specific causes of death can be unique to individuals. Dying is a process of events that culminates in failure of oxygen delivery to the tissues, and cessation of intracellular signaling. Common reasons for death amongst small animals include senescence (aging), disease, malnutrition, starvation, dehydration, or trauma. With the prevalence, acceptance and availability of euthanasia, some hospice practitioners and animal care providers, may not always comfortable answering these questions. This lecture is intended to review the pathophysiology behind death, including review of shock and compensatory mechanisms that occur, culminating in widespread organ system dysfunction and death. There will be review of the human patient death experience as a reference point for the animal patient, and discuss the stages of death that might be anticipated for individual canine and feline patients. 

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