WELCOME to our final digital newsletter of 2016!

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      President's Message
From the desk of your President…

I hope this newsletter again finds each and every one of you happy and well, especially as we enter this glorious season. At the risk of sounding repetitive, I cannot believe how fast time flies. It seems like just yesterday that was just something our elders told us would happen, never believing that someday it would come true! Regardless, it's a fun ride and we should all be thankful for our awesome profession and all the good we get a chance do!

With bittersweet sadness (and a little joy), I am writing my final President’s Message. My  two year term will conclude in the upcoming couple of months and the torch will be passed to Dr. Claudia Valderrama!

Looking back over the past two years, the SFVMA and its constituents have seen changes that have doubtless been for the better. The South Florida Veterinary Foundation took the Spay/Neuter initiative by the horns, working closely with local government and Miami Dade Animal Services to provide a successful program that has not only benefited our members, but more importantly, combats the pet overpopulation problem. Kudos to the SFVF and our SFVMA members for their hard work and efforts.

Our Task Force, led by members Diaz and Lista, continues to plug away and work closely with Miami-Dade Animal Services to provide programs that will better serve our community pets and local veterinarians. Their hard work and connections with the University of Florida will be bringing the Veterinary School a little closer to our community.  We believe that working together is superior to working alone - and I trust that you too will support their future recommendations this upcoming year.

Our Continuing Education chair, Dr. Valderrama, has continued to do a great job providing top notch CE to our members on a monthly basis. I would challenge anyone to deny that our county's CE program is superior to all others. This is a reflection of lots of hard work.

Our Social Chair committee has done an amazing job helping us join together and celebrate the Holiday Seasons! Both our December and Springs events have been well attended and successful  Looking forward to seeing you all on December 3rd!!!

During my term, we also lost Debbie Hawkes, past Board Executive Assistant extraordinaire, and gained Maria Reyes, our new Board Executive Assistant extraordinaire.  Without these two women, we would not be as successful and organized as we are. Please say hello and thank them when you can!

And last but not least, our Newsletter/Membership/Media committees have been having lots of fun with the launch of our digital newsletter last month. We hope you enjoy the new format and are happy to accept any constructive criticism. Please forward this message to fellow veterinarians as your see fit. The more we get our word out, the stronger we will become as an organization. 

And with that, I believe that I am signing off!  It’s been a wonderful experience and have truly enjoyed working with each and every one of you. Wishing the SFVMA the very best in 2017!!

- Robert Swinger, DVM, DACVO
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Beginning 2017, the South Florida Veterinary Foundation (SFVF) will be obsolete. No, we are not disbanding. We are just changing our name to the Miami Veterinary Foundation (MVF). To better promote the human-animal bond and provide increased services to animals in need in our community, the Board has been advised that the Miami Veterinary Foundation has better marketability.
Taking care of animals and serving the public is what we do. Giving back to the community is what we do individually every day and what the Foundation does because it is the right thing to do. As veterinarians, we are in a unique position to give back to our community by donating our time, expertise, and money to help people and animals in need in addition to educating the public in proper animal husbandry and health care. The value of giving back to one's community, taking care of animals, and helping people has had a transcendent impact on me. I have been practicing for 35 years and I have seen it all. I have been blessed in practice, in family and in health. My opportunity to give back and become a better guardian of this earth is facilitated by my association with my colleagues and friends on the Foundation Board. We care about animals, we care about our community, we care about each other. For all the good we have done through acts of civic engagement, serving the homeless and less fortunate pets, and for strengthening our community, may our acts inspire us for years to come. The Foundation is an important organization representing the veterinarians of Miami-Dade County. Please join and assist us in our mission to transform, strengthen, and heal this community. It takes a village.......... For more info, visit
SAVE THE DATE! November 18th is rapidly approaching. The 12th Annual SFVF Golf tournament VETS FORE PETS is being held at Melreese Golf Club. It is the Foundation's single largest fundraiser of the year. Last year's tournament was a grand success netting $27,000, not to mention all the fun and bonding that occurred with veterinarians, sponsors, and friends. Dean James Lloyd of the UFCVM made an appearance leaving no doubt this was a veterinary event. There are many ways to help. We always need more players - clients and friends. Finally, we need silent auction and raffle items. So please reach out to your friends and family, and businesses you frequent for gift items that will help make a difference. You will be surprised how generous people can be if only you ask. Always refer them to our website so they will understand who we are and what we do for the community.
ANOTHER SAVE THE DATE. For those that want to help and are not golfers, November 17th is the Miami Foundation's GIVE MIAMI DAY, a community wide fundraiser that gives a bonus for donations given that day only. The SFVF is enrolled and eligible. Please see:
For those hospitals participating in the spay/neuter partnership with Miami-Dade County, the Foundation will send notice to you when funds have been attained and the program can resume. Thanks for your patience.
Wishing all my friends and colleagues a happy and healthy holiday season.
Dr. Irving Lerner
SFVF President


Saturday, December 3, 2016
SFVMA Holiday Party
Miami Chic 
Biscayne Bay Yacht Club
2540 South Bayshore Drive

Friends, Food, Fun, and Dancing
Catering By: Mena
Cost: $40.00 members (limit 4 tickets per member)
$60.00 non-members


RSVP Via Square
                                             Tracheal Collapse
Robert Prošek, DVM, MS, DACVIM-Cardiology, DECVIM-Companion Animals
Florida Veterinary Cardiology and University of Florida

email: Phone: (305) 247-3001
Trachea is the scientific name for windpipe, the tube that connects the nose, mouth, and throat to the lungs and serves as a conduit to bring air in and out of the lungs. The trachea is meant to be a fairly rigid tube consisting of smooth muscle connecting a group of cartilage rings. The rings are actually not complete circles; they are C-shaped and aligned in a row with the open end of the C facing upward toward the animal's neck and back. The muscle covering the open end of the C connecting the row of C-shaped rings together is called the tracheal membrane. The trachea extends from the throat to the middle part of the chest cavity. Thus, it is often referred to as having both an extrathoracic portion as well as an intrathoracic portion.

Tracheal collapse is common condition in toy- and small-breed dogs, and on rare occasion large-breed dogs with no known sex predilection. The most common breeds we note here in South Florida are Yorkshire terriers, Pomeranians, toy poodles and Chihuahuas. Grades of tracheal collapse include, Grade I: minor protrusion of dorsal membrane into airway lumen, < 25% reduction in diameter and generally not associated with clinical signs; Grade II: 50% reduction in airway lumen, tracheal rings elongated and mildly flattened; Grade III: 75% reduction in airway lumen, tracheal rings markedly flattened; Grade IV: > 90% reduction in airway lumen, severely flattened tracheal rings, possibly with dorsal deviation of the ventral surface and generally associated with frequent, constant, or severe clinical signs. 

Decreased rigidity of tracheal cartilage rings (cartilaginous C-shaped rings lose their strength and flatten) results in dynamic collapse during inspiration with cervical involvement, and during expiration with thoracic involvement.  Physical exam findings include dry cough elicited by tracheal palpation (albeit, there are other conditions including pulmonary parenchymal disorders, where a cough can be elicited by tracheal palpation), wheezes over cervical tracheal region with cervical collapsing trachea and with thoracic collapsing trachea loud snapping noises may be auscultated due to dynamic opening and collapse of the large airways. 

The etiology of collapsing trachea is unknown, but suggested mechanisms include failure of chondrogenesis, acquired secondary to chronic small airway disease, cartilage degeneration, trauma, and loss of innervation of the trachealis dorsalis muscle.  In the author's humble opinion there may be a collagen abnormality/mutation in these dogs as they are the same patients that suffer from degenerative valve disease, disk disease, loss of teeth due to periodontal ligament degeneration, and various luxating patella malformations which are uncommon in large-breed patients. 

Panting or rapid breathing for any reason makes the collapse and anxiety worse, which unfortunately tends to generate more rapid breathing and a vicious cycle of distress. Making things worse still is the inflammation generated in the trachea. The collapse causes increased secretion and inflammation, thus promoting yet more coughing which subsequently leads to more inflammation. Ultimately, as the condition continues to progress and worsen, the tissues of the trachea undergo irreversible changes and lose their normal characteristics.

Many dogs with collapsing tracheas do not ever develop clinical signs until a secondary problem complicates matters. Factors that enhance clinical signs often include: obesity, anesthesia involving the placement of an endotracheal tube, development of kennel cough or other respiratory infection, increased respiratory irritants in the air (cigarette smoke, dust, etc.), heart enlargement (causing compression on the trachea and mainstem bronchi)
If a secondary factor, such as one of those listed above, is making a previously incidental collapsing trachea a problem, often removal of the secondary factor (weight loss program, air filters – HEPA filters, etc.) may clear up the signs of the collapsed trachea.
What is the treatment for tracheal collapse? If any of the above listed secondary problems are a concern, they must be addressed as these problems will exacerbate the cough. Thus, none of the other treatments listed below will be successful without addressing these problems first.

Many animals with collapsing tracheas are unable to efficiently and effectively clear infectious organisms from the lower respiratory tract. Antibiotics may be indicated in these situations to clear up secondary infections.

Cough suppressants, such as hydrocodone (Tussigon®), butorphanol, or diphenoxylate with atropine (Lamotil ® -- first line for collapsing treacheas in England, and many clinicans at UF) may work very well in some patients. However, it is important to make sure that a lower respiratory tract infection (i.e., pneumonia) is not present before instituting a cough suppressant.

Corticosteroids, such as prednisone, help minimize inflammation and mucous secretion, but are best used on a short term basis due to potential long-term side effects. Long term use may actually promote secondary infections and further weaken cartilage.

Bronchodilators, such as theophylline or terbutaline, are controversial as they may actually dilate the lower airways and not the trachea itself. However, by dilating lower airways, the pressure in the chest during inhalation decreases, which may therefore cause the trachea to collapse less.
Are there any surgical options for tracheal collapse?

If medical management does not produce satisfactory results, surgery may be used as a last resort. Several surgical techniques currently exist which are designed to strengthen the trachea from either outside or inside the airway to help prevent it from collapsing. Some techniques require a rigid prosthesis to be placed and bonded around the trachea effectively creating a non-collapsible tube. The newest technique uses a self-expanding stainless steel prosthesis which is applied inside the lumen of the trachea and is the author's preferred method.

Despite what technique is used, surgery is largely effective as long as the portion of trachea that is collapsed is external to the chest. Should the intrathoracic trachea or mainstem bronchi be involved, surgery becomes far less successful.
Is tracheal collapse associated with liver disease?

In a 2006 issue of the Journal of the American College of Veterinary Internal Medicine, a group of researchers led by Bauer pursued the common finding of enlarged liver in dogs with tracheal collapse. Her group looked at 26 dogs with tracheal collapse and compared 4 liver function test results to 42 dogs without tracheal collapse. Ninety-two percent (92%) of dogs with tracheal collapse were found to have abnormal results. Dogs that received stent placement to assist their breathing showed improvement in these tests. It was concluded that oxygen deprivation from the collapse had resulted in significant liver disease in many tracheal collapse patients. It was further recommended that tracheal collapse patients have liver function tests evaluated as liver supportive medications may be helpful.

 Figure.1 Drawing representation of normal trachea on the left and collapsing trachea on the right.

 Figure 2.  Lateral thoracic radiograph with severe cervical collapsing trachea extending to the thoracic inlet.

 Figure 3. Tracheal stent in place extending the length of the trachea. 
                FVMA DISTRICT VI
Drs. Sharon MacIvor, Geraldo Diaz, Marta Lista & Senator Miguel Diaz de la Portilla          

Our veterinary degree allows us to put our knowledge and compassion into practice while preventing diseases, healing animals and making positive impacts in the lives of people and our community. We are blessed in so many ways to have such exciting careers with so many possibilities. But what does the economic future of our profession look like?  We are facing a lot of challenges. How we handle these challenges today affects our day to day living as well as the future of veterinary medicine. Together we can strengthen veterinary medicine and enjoy a profession full of promises and opportunity with economic sustainability compatible with our education and hard work. We need and deserve this for wellness in our lives. Your membership in the SFVMA and FVMA works to protect our interest today and for generations to come.  As our association prepares for the upcoming legislative session, please contact me with what you feel is the primary problem in our profession today.

During the 2017 legislative session in Tallahassee we will be proactively tackling some of the issues affecting veterinary medicine such as unlicensed activity, compensatory damages, sales tax exemptions, telemedicine -- to name just a few. As the legislative session nears, more issues will arise. We closely monitor for bills that affect veterinary medicine and develop position statements in order to advocate for what we feel is in the best interest of veterinarians, animals and consumers. The SFVMA annually sends a delegation of veterinarians to Tallahassee to discuss our policy position with our legislators. 

In addition to our work in Tallahassee, the SFVMA has maintained strong relationships with our local legislators allowing us to collaborate with our government on innovative solutions for animal welfare problems. Led by Dr. Rick Diaz, we actively participated in the partnership between the UFCVM and MDAS. The presence of the UF shelter medicine program will enhance the adoptability of shelter pets, lend academic expertise to MDAS, and provide learning opportunities for veterinary medical students. We also obtained a contract with Miami Dade to spay/neuter pets from income-qualified residents and community cats in our private practices. To date the South Florida Veterinary Foundation has successfully sterilized over 5,000 pets. By taking advantage of our economies of scale and offering our government a more cost effective solution with better accessibility for the public, we were able to directly become part of the solution to pet overpopulation in our community.

These programs are part of our legislative efforts to provide solutions to public problems using private practices. Our lobbying efforts would not have been possible without your SFVMA, SFVF and FVMA membership and your contributions to our PAC. I encourage you to attend a board meeting and meet the dedicated group of SFVMA members that discuss these challenges and plan solutions.

Thank you for your support.
Marta Lista,DVM


November 16th, 2016
Sponsored by: Diamondback Drugs

"The Big, The Bad, and The Ugly: Hemangiosarcoma and Osteosarcoma"

Speaker: Stephanie Correa, DVM, ACVIM (Oncology)


President : Dr. Robert Swinger
Immediate Past President: Dr. Maria Oliveira
President Elect, CE Chair: Dr. Claudia Valderrama
Recording Secretary: Dr. Patty Khuly
Treasurer: Dr. Maria Oliveira
Website: Dr. Marc Kramer
FVMA District VI Representative: Dr. Marta Lista
SFVF President: Dr. Irving Lerner
Executive Director: Maria Reyes


Dr. Gerardo Diaz
Dr. Rick Diaz
Dr. Sharon MacIvor
Dr. Kenny Snyder
Humane Society News

The 24-Hour Mega Match-a-Thon Connects More Than 300 Pets
With Their Perfect, Human Families!
Cupid’s arrows were right on target this weekend for the fourth annual Mega Match-a-Thon adoption event as more than 300 dogs, cats, puppies and kittens from the Humane Society of Greater Miami, Miami-Dade Animal Services, The Cat Network and other local rescue groups met their perfect, human matches! Hundreds of eager adopters lined up at Tropical Park on October 21, 2016 to have their “pick of the litter” from the local rescue groups and organizations. As soon as the clock struck midnight, families swarmed the pet tents as they began their quests to find the furry companions of their dreams. “It is always exhilarating to kick-off this event and watch so many amazing human and animal bonds created,” says Laurie Hoffman, Executive Director of the Humane Society of Greater Miami.

The 24-hour adoption event resulted in a remarkable 81 adoptions for the Humane Society of Greater Miami, which is more than eight times the amount of adoptions completed on a regular day. The staff and volunteers experienced sheer bliss as they watched the dogs and cats connect with their forever humans, many of which had spent several months and even more than a year, at the Soffer and Fine Adoption Center waiting to meet their special humans.

In addition to heartwarming adoptions that unfolded that day, there was also food and entertainment for the whole family to enjoy. Children, and many adults, ventured to the Family Fun Zone to jump around for some bounce house fun, ascend the rock climbing wall and swoop down the slippery slide. All were entertained by the fabulous, local groups who took the stage and showed their musical and dance talents. Foodies enjoyed food truck grub and fresh juices and smoothies from the farmer’s market and pets frolicked around as they received giveaways from pet-friendly vendors. The sunny, crisp weather was the cherry on top to a fabulous day for animals and pet-lovers alike!

Please visit our website,, for more information about adoptable cats and dogs.
Are you interested in giving back to your community? Want to help in preventing thousands of homeless pets from entering Miami animal shelters? Project PetSnip is a 501(c)(3) spay/neuter organization that is seeking use of veterinary clinic space in Miami to perform high-quality spay & neuter work once or twice monthly. We have over 100 5-star reviews and have excellent references from clients, rescues, and veterinarians alike. Project PetSnip is run by chief veterinarian, Dr. Marc Kramer, who is looking to add an additional clinic location to do surgeries on a day your practice is closed or slow. Let’s make a difference! Contact: or 305-387-0721 

Members: Up to 7 lines at no charge
Non-Members: 5 lines $20.00/issue
Maria Reyes
Relief Veterinarians:
Dr. Karen Ashby     Dr. Keiko Hirokawa  
(305) 401-1266     (734) 730-1059  
Dr. Doly Baquero        Dr. Angela Guevara Nieveen
(786) 234-1946     (352) 318-1703  
Dr. Pierre Bland     Dr. Cyrena Rose  
(754) 265-5176     (305) 439-5411  
Dr. Katarina Boros      Dr. Mark Steele  
(305) 981-4721     (954) 942-7193  
      Dr. Claudia Valderrama
      (305) 297-8893

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South Florida Veterinary Medical Association · 6464 SW 8th ST · Miami, Florida 33144 · USA

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