HOD acts on resolutions

Delegates approve bylaws and policy revisions
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Matters concerning antimicrobial use, veterinary ethics, and association governance were on the Jan. 10 agenda for the AVMA House of Delegates regular winter session in Chicago.

Delegates passed one of two proposed revisions to the AVMA Bylaws intended to make member advocacy explicit in the AVMA’s mission as part of the Association’s new Strategy Management Process. Approval by a two-thirds majority of the HOD is required to amend the bylaws.

The HOD also approved a bylaws amendment whereby the AVMA Committee on Veterinary Technician Education and Activities—the accrediting body for veterinary technology programs—no longer needs AVMA Board of Directors approval to implement changes to its Accreditation Policies and Procedures.

Revisions to the “Principles of Veterinary Medical Ethics” were also approved by delegates. Most of the changes were for clarity and were based on comments from AVMA entities including the HOD, state and allied executive directors, and the general membership. The Judicial Council spent several years working on the revised version. See the eight overarching principles.

Additionally, the HOD adopted a policy on transporting research animals. The proposal was submitted by the American Society for Laboratory Animal Practitioners out of concerns over facilities’ continuing ability to humanely transport animals between them. The ASLAP, along with the American College of Laboratory Animal Medicine and American Association for Laboratory Animal Science, thought it important the AVMA take a proactive position in supporting the activity. The new policy now explicitly applies to “all animals” and reads as follows:

Transportation of Research Animals

Transportation of research animals refers to any movement of all animals intended for use in biomedical research, testing, and/or education from one facility (dedicated breeding or research) to another. The AVMA supports the transportation of animals for research, testing and education when that transportation is conducted in accord with guidelines that assure animals are handled properly and transport is conducted humanely. Those handling research animals during transport must be well trained and competent in performing related tasks and making related decisions.

Delegates voted down a resolution from the Arizona VMA that would have allowed each AVMA member to select any entity currently seated in the HOD to represent him or her. Opponents of the proposal said it would be a deterrent to state VMA membership as well as compel members to choose between loyalties.

The HOD did, however, approve updating the AVMA policy on veterinary participation in spay-neuter clinics. The updated policy, submitted by the Board, reads as follows:

Companion Animal Spay-Neuter Programs

Every animal, regardless of its ownership, should receive quality veterinary medical and surgical care. Because of a wide range of geographic and demographic needs, a variety of programs have been developed to increase delivery of spay-neuter services to targeted populations of animals; these include stationary and mobile clinics, MASH-style operations, shelter services, feral cat programs, and services provided through private practitioners. These services should conform to current standards of practice as described by The Association of Shelter Veterinarians’ veterinary medical care guidelines for spay-neuter programs and comply with local and state laws.

As the Board explained in the resolution background, the revisions were suggested as part of the Association’s five-year policy review cycle. The suggested revisions reflect the evolution of veterinary service and clarify the current professional expectations for those services in spay-neuter clinics, the Board explained. Further, the revised policy is in keeping with current standards of practice as described in the Association of Shelter Veterinarians’ July 2008 veterinary medical care guidelines for spay-neuter programs.

The delegates approved a resolution that encourages antimicrobial stewardship through creation of drug use guidelines, but they defeated two proposals that would have had the AVMA endorse more specific guidance documents on antimicrobial administration in treating urinary tract disease in dogs and cats and canine superficial bacterial folliculitis.

Background information given to delegates regarding the antimicrobial stewardship resolution states that the AVMA Task Force for Antimicrobial Stewardship in Companion Animal Practice had developed the proposal because veterinarians could use such guidelines as resources to improve antimicrobial use in companion animal practice. The proposal passed without debate.

Among the documents the HOD declined to endorse, one indicates urinary tract infections account for substantial amounts of use and potential misuse of antimicrobials, and antimicrobial use guidelines in human medicine have helped improve prescribing practices. The other document states that superficial bacterial folliculitis is the most common form of canine pyoderma, a principal reason for antimicrobial administration in companion animal practice, and resistance to commonly used drugs presents a need for prudent and more focused use. Both were submitted by the Board of Directors.

In the debates over the latter two resolutions, Dr. Katherine Knutson, alternate delegate for the American Animal Hospital Association, was among those who said the resolutions would have created policies too prescriptive for the AVMA. She said similar guidelines in human medicine are created within specialty colleges rather than the American Medical Association, and groups such as AAHA would be better suited to considering such guidance.

Dr. Derralyn Rennix, alternate delegate of Maine, said passage of the resolutions would set precedents for policies on an unlimited number of diseases and organ systems, which she does not think should be the AVMA’s role. It also could set care standards unattainable in some communities, she said.

Dr. Rennix said she would not object if the AVMA were to help veterinary practitioners find the documents, but she does not want AVMA policies endorsing them.

Dr. Bernadette Dunham, director of the Food and Drug Administration’s Center for Veterinary Medicine, said to the delegates that veterinarians look to the AVMA for information, and the documents considered in the resolutions provide expertise that people want. She sees the documents as reference tools.

Dr. Neil Moss, alternate delegate from Utah, expressed support for the two resolutions.

He noted that the guidelines on urinary tract infections call for bacterial culture and susceptibility testing any time cystitis is suspected, and stated that delegates have a responsibility to teach about principles of judicious use even though implementing them would increase costs for owners. In support of the resolution related to folliculitis, Dr. Moss said the guidance documents could help veterinarians reduce the risk that drug-resistant staphylococci could transfer between pets and owners.

One of the documents is “Antimicrobial use guidelines for treatment of urinary tract disease in dogs and cats: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases” (Vet Med Int 2011;2011:263768). The second is “Guidelines for the diagnosis and antimicrobial therapy of canine superficial bacterial folliculitis: Antimicrobial Guidelines Working Group of the International Society for Companion Animal Infectious Diseases” (Vet Dermatol 2014; 25:163-175).