Veterinary Intern Program for Entrustable Professional Activities Skills, a.k.a. Intern Boot Camp.

The University of Tennessee College of Veterinary Medicine (UTCVM) Department of Large Animal Clinical Sciences has developed an intensive training program that all large animal veterinary interns are required to complete at the onset of their internship year. This program was designed to establish a uniform approach to entrustable professional activity (EPA) skills deemed essential by the large animal faculty. These EPA skills emphasize the clinical approaches and skills that interns should understand and demonstrate competency in early in their internship year. The EPA program, completed over 4 consecutive days, was coined the "Intern Boot Camp" and structured to fuse case-based lecture discussions and hands-on wet labs designed to develop or improve skills and techniques. At the conclusion of the boot camp, participants were given an evaluation survey to provide feedback on the program. The results were overwhelmingly positive, with 90% of the participants giving the program a rating of 5 on a scale ranging from 1 (poor opinion or experience) to 5 (excellent opinion or experience). Nearly 95% of participants stated that they felt more prepared for their internship year after attending the boot camp, and 100% of the participants indicated that they would recommend this program to future candidates. Given the positive outcomes over the past 4 years, the implementation of the Veterinary Intern Entrustable Professional Activities program (Intern Boot Camp) is considered a valuable component of the veterinary intern training program and could readily be adapted to other programs.

Distribution of equine and food animal emergency caseload by time of day, day of week, time of year, holiday, and phase of moon at an academic ambulatory and referral hospital.

OBJECTIVE: Determine the association of time of day, day of week, time of year, holiday, and phase of moon on academic ambulatory and hospital emergency caseload for equine and food animal species. DESIGN: Retrospective study. SETTING: Large animal teaching hospital emergency service. ANIMALS: Equine and food animals. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The hospital database was searched for after-hours on-farm and in-hospital emergencies seen from 2014 to 2020. Variables included date and time of admission, species (equine or food/fiber animal [FA]), and hospital service (field or in-hospital). The association of the caseload with time of day, day of week, day of year (holiday, full moon, or new moon), and season of year was defined and examined. The majority of equine field-based emergencies occurred on the weekend, in contrast to 44.8% of hospital cases. Most equine emergencies occurred between 4:00 p.m. and midnight on weekdays and between 8:00 a.m. and 4:00 p.m. on weekends for both field (89.1% and 46.9%) and hospital (82.8% and 48%) services. The same was true for FA cases on the farm (90% and 49.2%) and in the hospital (85% and 51.4%). More equine cases (67%) were seen in the field than FA. Winter had the fewest emergency cases for all species and locations, and spring had the most for FA. The majority of holiday equine emergencies were seen in the field (62.2%), but the majority of holiday FA emergencies were seen in the hospital (66.3%). Moon phase had no significance on caseload for all species and locations. CONCLUSIONS: Saturdays and Sundays were the busiest days for all species and services. Winter was the slowest time for emergencies for all species and services. Most emergencies were seen between 4:00 p.m. and midnight on weekdays and between 8:00 a.m. and 4:00 p.m. on Sundays and Saturdays.

Large Animal Emergency Relief Services-A Model for University Engagement With Private Practitioners and Development of Practice Readiness for Veterinary Students.

Large animal teaching hospitals often struggle to maintain consistent teaching caseloads, which are affected by seasonal variations, economic pressures, increased abilities of local large animal practices to hospitalize large animals, and client intolerance for the operational needs of an academic mission. Non-academic large animal practices enjoy a more consistent caseload but suffer from a lack of emergency relief and a limited ability to share emergency duties, which may have adverse effects on work-life balance. An academic, on-farm, large animal emergency relief service can combine multiple clinics' emergency services to increase overall caseload and the probability of consistent teaching exposure for veterinary students. In late November of 2013, the Large Animal Teaching Hospital at the University of Tennessee, College of Veterinary Medicine adopted a business model to provide a large animal emergency relief service to area practitioners; enhance student learning via increased emergency caseload; and advance the academic mission to develop practice-ready graduates. Providing this service contributes to the well-being of area practitioners and enriches student learning through increased caseload.

Evaluation of the pharmacokinetics and efficacy of transdermal flunixin for pain mitigation following castration in goats.

The mitigation of pain associated with common management procedures is a rising concern among veterinarians, producers and consumers. Nonsteroidal anti-inflammatory drugs are vital compounds for this purpose due to their cost, convenience, and efficacy. A transdermal formulation of flunixin meglumine (FM) was approved for the treatment of pain in cattle; however, the efficacy has yet to be determined for small ruminants. The current study had two aims: 1) to determine the pharmacokinetics of transdermal flunixin meglumine (TD FM) in bucklings and 2) to evaluate pain mitigation by TD FM following castration. To evaluate pharmacokinetics, 12 male goats (mean age = 6 mo) received 2.2 mg/kg of FM IV (n = 6) or 3.3 mg/kg TD FM (n = 6). Plasma FM concentrations were measured. The mean C max, T max, and harmonic mean half-life for TD FM were 1.09 ± 0.65 µg/mL, 5.50 ± 2.95 h, and 7.16 ± 2.06 h, respectively. To evaluate the efficacy of pain mitigation, 18 goats were randomly assigned to three treatment groups: 1) TD FM and castration (FM CAST) (n = 6); 2) transdermal placebo and castration (PL CAST) (n = 6); and 3) TD FM and sham castration (SHAM) (n = 6). Plasma samples were collected at 0, 12, 24, 36, 48, 72, and 96 h to assess cortisol and prostaglandin E2 (PGE2). Daily dry matter intake (DMI) was recorded and body weight was measured at the beginning and end of the study. Thermography (IRT) images of the scrotum, as well as heart rate (HR), respiratory rate (RR), and rectal temperature, were taken twice daily. Separate mixed analysis of variance models were used to test the effects of treatment, time, and their interaction on mean body temperature, IRT, HR, and RR. Autoregressive covariance structure was utilized to account for repeated measures and individual goat DMI prior to the study was added as a covariate. There were no differences in vital parameters, IRT measurements, cortisol, or PGE2 in animals receiving either TD FM or placebo following castration (P > 0.05). DMI had a treatment by hour interaction and was significantly higher in FM CAST and SHAM groups than the PL CAST group (P = 0.04). Goats in the SHAM group gained weight throughout the study, whereas goats in all other groups lost weight (P = 0.02). Results indicate that TD FM may mitigate pain as demonstrated by increased DMI; however, a single dose may not be sufficient to reduce physiological indicators of pain associated with castration in goats.