Animal Abuse or Neglect:
If a veterinarian suspects that an animal is being abused or neglected. What are his/her obligations?
According to the Ontario Society for the Prevention of Cruelty to Animals Act, a veterinarian is obligated to report suspected animal abuse or neglect. Specifically, the Act states that “every veterinarian who has reasonable grounds to believe that an animal has been or is being abused or neglected shall report his or her belief to an inspector or an agent of the Society.” (OSPCA Act, RSO 1990, c. O.36, s 11.3.)
Reporting suspected animal abuse or neglect is a permitted exemption from client confidentiality addressed in Section 17 of Ontario Regulation 1093 of the Veterinarians Act. It is not professional misconduct to reveal information concerning a client when reporting suspected animal abuse or neglect, because a veterinarian is required to do so by law. This is addressed in section 17 of Ontario Regulation 1093. (RRO 1990, Reg. 1093, s 17. (1) 6. ii.)
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Animal Ownership: Two owners are listed in my patient’s file. If one owner requests that the other owner be removed from the file, what should a veterinarian do?
In order to remove an owner from a patient’s file, consent must be obtained from the individual whose name is being removed from the file. Alternatively legal direction, such as a court order, may be provided to allow you to remove an owner from the file. The change to the medical record must then be made in such a way that original content is maintained.
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Business and Management Practices: Can I add an additional charge on the fees of an itinerant veterinarian?
The College regulations prohibit adding a charge to a disbursement or cost. A client may be billed for the services of an itinerant veterinarian who provides a service to a client at the primary veterinarian's clinic. For example, if an external surgeon or ultrasonographer performs a service in your facility for your client, but is not an employee of the practice, the fee of the itinerant veterinarian cannot be marked up. The practice may charge reasonable fees associated with coordinating appointments, providing the facility space, staff and some equipment; however, when a client is charged for these items, they should appear as separate invoice items so the client is aware of the individual charges. (RRO 1990, Reg. 1093, s 17. (1) 17.)
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Dispensing: Can a veterinarian dispense a controlled substance to the client of a veterinarian from a neighbouring clinic?
While it would seem the neighbourly thing to do, the College regulations only allow a member to dispense controlled substances to animals that are under his/her direct care. Clients do have the option of having the prescription filled by a pharmacist. (RRO 1990, Reg. 1093, s 28. (6))
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Dispensing: If a client has a prescription from a veterinarian in another city, am I able to fill it on behalf of the veterinarian?
Yes, a veterinarian can fill the prescription of another veterinarian under the following
conditions outlined in section 33 (1.1) of Ontario Regulation 1093 of the Veterinarians Act:
- it is not reasonably possible for the client to obtain the drug from the prescribing member or a pharmacy;
- it is necessary in the interests of the animal to administer or dispense the drug without the delay that would be associated with returning to the prescribing member;
- the member makes a reasonable effort to discuss the matter with the prescribing member;
- the member conducts a sufficient assessment of the animal’s circumstances, which may not require a physical examination in every case, to ascertain that it is unlikely that there has been a material change in the circumstances since the prescription was given;
- the quantity of the drug dispensed is no more than would reasonably enable the client to return to the prescribing member for future prescriptions or quantities of the drug; and
- the member makes a written record of the transaction as otherwise required by this Regulation.
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Management and Disposal of Controlled Drugs:
When we record entries in our controlled drug log, we list the client’s ID number. The revision to Regulation 1093 states the “name and address of the client” should be entered. Do we need to start writing out the client’s full address in our log now?
This requirement is not new. When an entry is made into the controlled substance log, the name and address of the client are recorded. This helps ensure controlled drug administration and dispensing can be traced if any concerns were to arise. Listing the client’s name and his/her unique hospital number is also acceptable if the hospital number links to the section of the patient medical record showing the client’s address.
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Mandatory Reporting: What diseases and hazards am I required to report under federal and provincial law?
The mandatory reporting obligations of veterinarians are described in the Legislative Overview: Mandatory Reporting.
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Medical Records and Information: A new client booked an appointment at our clinic. When we called the client’s previous clinic for a copy of the patient’s record, we were told there was a fee. The client does not wish to pay this cost. Are colleagues allowed to charge each other for copies of records? We were under the impression that veterinarians are obligated to provide copies of medical records to colleagues.
Veterinarians are allowed to charge a reasonable fee to recover the cost of making a copy of a patient’s medical record. Materials, staff time, and courier/postage fees are examples of these costs. How that fee is dealt with will be up to the parties involved. In a situation where the client or veterinarian has refused to pay for a complete copy of a record, a veterinarian is still obligated to provide relevant medical record information to a colleague. This information can be given verbally or as a written summary. The best interest of the patient and their continuity of care necessitate the timely and accurate transfer of medical information between colleagues. Patient information or a copy of the patient record should be transferred within two business days (or sooner) when a request for the information is made.
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Prescribing: Can veterinarians prescribe medical marijuana?
As per the Access to Cannabis for Medical Purposes Regulations (federal government legislation), veterinarians are not allowed to prescribe medical marijuana to their patients.
Veterinarians are not prohibited from prescribing cannabidiol (CBD) oil or capsules, and hemp (e.g., hemp oil, hemp seed oil). However, there is currently little evidence on the use of these products for animals.
If a veterinarian prescribes CBD oil, it must be purchased in Canada from a licensed dealer. CBD is a Schedule II drug in the Controlled Drugs and Substances Act and, therefore, veterinarians must maintain a controlled drug log.
Clients can sometimes find products containing active ingredients found in the cannabis plant without a prescription and will ask veterinarians about using them on their animals. The decision to advise clients about the use in animals of marijuana or related products will be based on the veterinarian’s professional judgment. Factors to consider in making recommendations about these products and discussing their use with clients are:
- Is there enough information in the literature about the use and benefits of marijuana and related products in animals for specific diseases?
- What are considered safe doses in animals?
- What are the risks of use?
- What quality control/safety measures are in place for the production of these products? Do they contain the label claimed components and strengths? Are they effective?
- Is it legal to be in possession of these products in Canada? In Ontario? The Controlled Drugs and Substances Act has very strict regulations. Advising clients to use illegal substances for their animals would also be considered Professional Misconduct (see Regulation 1093 (https://www.ontario.ca/laws/regulation/901093) section 17(1) ss 45 “45. Conduct unbecoming a veterinarian.”).
For more information, contact Health Canada (http://www.hc-sc.gc.ca/contact/index-eng.php#a1
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Rabies: What are my obligations for reporting animal bites?
The Health Protection and Promotion Act Regulation 557 requires a veterinarian to report to the local Medical Officer of Health (Public Health unit) any knowledge of an animal bite or other animal contact that may result in rabies in a person. An animal’s rabies vaccination status, clinical history, behaviour, and current health status does not preclude the legal requirement for a veterinarian to report. A veterinarian is not required to assess the likelihood of rabies disease in the biting animal. A veterinarian uses his/her professional judgment and knowledge of how rabies is transmitted to assess if there is a need to report an animal contact other than a bite.
When an animal bites a veterinarian or auxiliary staff member in a veterinary facility, the same reporting protocol is to the followed.
If a client reports that a bite occurred but there has been no report made to the local Public Health unit, the veterinarian must make the report.
Under the Health of Animals Act, animal to animal bites are to be reported to the Ministry of Agriculture, Food and Rural Affairs when there is reason to suspect rabies.
Prior to administering a rabies vaccine or euthanizing an animal, veterinarians should ask about any biting or other contact incidents that occurred within the preceding 10 days and report the incident accordingly. Animals involved in biting or contact incidents cannot receive a rabies vaccine or be euthanized until the Public Health Unit releases the animal from confinement. Public Health Units will authorize euthanasia only in cases where there is a clear and significant animal welfare concern with keeping the animal alive for the duration of the confinement period.
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Rabies: What should I do if an animal bites a staff person at my practice?
A veterinarian must follow the same reporting requirements for bites or other contact incidents with animals that could result in the transmission of the rabies virus to a person inclusive of when these incidents occur in a veterinary facility.
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Rabies: When should veterinarians ask questions about biting incidents?
Asking questions about biting or other contact incidents that occurred within the 10 days preceding a planned rabies vaccination is a critical part of the screening process that is undertaken prior to the administration of a rabies vaccine. This information should be sought whether the planned vaccination is part of a Rabies Program or a regular clinic visit.
Veterinarians must also ask questions about biting or other contact incidents that occurred within the 10 days preceding euthanasia of an animal. Animals involved in biting or contact incidents cannot be euthanized prior to completing the confinement period without the prior authorization of the Public Health Unit to do so. Public Health Units will authorize euthanasia only in cases where there is a clear and significant animal welfare concern with keeping the animal alive for the duration of the confinement period.
The College's Legislative Overview – Rabies is a helpful reference which explains the requirements under federal and provincial legislation in regard to the control of rabies and vaccination of animals.
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Rabies: What needs to be on a rabies vaccination certificate?
The legislative requirements for rabies vaccination certificates are found in the Health Protection and Promotion Act, Regulation 567. When an animal is immunized or re-immunized against rabies, the veterinarian must provide a certificate to the owner of the animal. The certificate must include:
- The name and contact information of the owner/custodian of the animal
- A description of the animal that includes the species, breed, sex, age, colour/markings
- The name and serial number of the vaccine
- The date of the immunization
- The date the animal is to be re-immunized
- The number of the rabies tag that is issued
- The address of the veterinary facility (or other location) where the animal was immunized
Rabies vaccination certificates are to be signed by the veterinarian who administered the rabies vaccine. A copy of the original signed certificate must be kept on file. If a certificate needs to be replaced, a copy of the original rabies vaccination certificate should be provided. New certificates should not be issued.
How long a rabies certificate is kept on file will depend on the situation. Regulation 567 indicates that certificates be kept for three years. This is the requirement when a rabies clinic is held. The Veterinarians Act
and Regulation 1093 requires that medical record information be retained for at least five years after the last entry in the patient record. This applies when a rabies vaccine is administered to a patient within the Veterinarian-Client-Patient Relationship.
Where justifiable, a veterinarian can provide a Statement of Exemption for those patients whose physical condition precludes them from safely being immunized/re-immunized against rabies.
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Rabies: What is required when a client has lost their rabies vaccine certificate and requests a new one?
Under Regulation 567 of the Health Protection and Promotion Act, veterinarians must issue a Certificate of Immunization to the owner/custodian of an animal that has been immunized or re-immunized against rabies. Veterinarians are required to keep a duplicate copy (scanned or paper copy) of the original signed Certificate of Immunization in the patient record. When the client requests a copy of their certificate, the veterinarian can provide him/her with a copy of the duplicate. If a duplicate copy of the original signed certificate is not available, the veterinarian will have to re-immunize against rabies and issue a new Certificate of Immunization.
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Veterinarian-Client-Patient Relationship: Are veterinarians allowed to sell therapeutic diets to non-clients?
A valid Veterinarian-Client-Patient Relationship (VCPR) must exist before any treatment product, whether prescription or not, is dispensed. References for this are found in Regulation 1093 and the Professional Practice Standard on the VCPR. Having said that, food is exempted from the definition of “drug” in the Regulations so technically, a veterinarian can sell therapeutic diets without a VCPR.
Before selling therapeutic diets to non-clients, assess the potential risks to this group of animals. Therapeutic diets used in the treatment of specific disease conditions that are fed to an animal without that particular condition can potentially put that animal’s health at risk. For these situations, it would be best to either call the regular clinic for verification and/or discuss further with the drop-in client before selling that product. For other therapeutic diets, there is a low risk in terms of selling to someone without a VCPR.
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If you have a question related to the regulations, policy and expectations associated with the practice of veterinary medicine, please contact the College. The practice advisory service offered by the College is free and confidential.
Practice Advisory Service
1-800-424-2856 / 519-824-5600 x2401 or email@example.com
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Frequently Asked Questions
Below are a few of the questions, and answers, that the College frequently receives through its practice advisory service. If you have other questions, please feel free to contact the College’s practice advisor.