Rob Loxley's Activities

Neuropathic Pain Treatment choices in cats

Anthony Dennison — Fri, 20 Mar 2026 13:52:47 GMT

15 year old DSH, diagnosed with a possible polyp/neoplasm in the left tympanic bulla end of last year that is causing some compression of the trigeminal nerve and skull base.

Owner opted for palliative treatment with meloxicam after being referred to a local neurologist, and is doing very well. Saw her for a check up this morning and she is great, apart from squinting and epiphora. No corneal ulcer present, I think it may be almost like a headache, or cranial nerve neuritis (especially if compressing the trigeminal nerve).

I'd like to consider adding in some medication as trial to help neuropathic pain - I was considering either amantadine or gabapentin. Does anyone have any alternative options or recommendations?

Older coughing dogs.

Claire Godfrey — Wed, 28 Jan 2026 14:12:50 GMT

Just wanted to ask what you all do for older coughing dogs, seem to be having a run recently.

Those dogs that are generally well but old, owners don't want diagnostics but want to make more comfortable.

I have tried codeine, pardale, honey and benyllin. Anything else? Most are already on Nsaids.

Thanks in advance.

BBC Panorama: Why Are Vet Bills So High?

Arlo Guthrie — Mon, 12 Jan 2026 12:46:51 GMT

Time to get out your kevlar suits again. Panorama airs tonight at 8:00pm or on iplayer now: https://www.bbc.co.uk/iplayer/episode/m002pwsm/panorama-why-are-vet-bills-so-high

I've just watched it. I'll withhold comment for the moment. What do you think?

Low flow anaesthesia. Is it worth it?

Arlo Guthrie — Tue, 10 Feb 2026 09:58:22 GMT

I have a plan. Once a week, I'm going to try and post a question which challenges the prevailing veterinary orthodoxy. Not to criticise or judge, just to raise the question.

This week’s question was prompted by IVC Evidensia’s £500,000 investment into low-flow anaesthesia:

https://www.vetsurgeon.org/b/veterinary-news/posts/ivc-evidensia-invests-500-000-to-support-adoption-of-more-sustainable-low-flow-anaesthesia

The announcement very much led on sustainability. I dug a little deeper and discovered that UK veterinary anaesthesia emissions are estimated at under 100,000 tonnes of CO₂ equivalent per year. A single medium-sized coal-fired power station emits several million tonnes annually. One plant. Millions.

Even allowing for hundreds of such plants globally, veterinary anaesthesia is — in planetary terms — a very small contributor.

Which brings me to the question: is low-flow worth it?

People talk about smoother recoveries, reduced hypothermia, better airway humidity, lower volatile use. But is there hard data showing meaningful patient benefit? I can’t see evidence of improved survival rates, and mortality under modern anaesthesia is already low.

So the practical questions are:

How much more does low-flow cost once you factor in monitoring, consumables and training?

Does it actually shorten recovery in a way that changes discharge timing or cost to the owner?

Is there a clear per-case cost-benefit analysis?

I’m not taking a position. I’m simply asking whether the numbers stack up — clinically and economically — not just environmentally.

Clinical notes

Alistair Graham-Evans — Thu, 06 Nov 2025 05:48:32 GMT

I find that new graduates are increasingly taught to produce voluminous notes during a consultation. This involves commenting on every single body system in detail which often becomes a time consuming tick box exercise. I wonder how they find the time to examine the animal and talk to the client and every consultation seems to take on a referral type approach.

I am concerned that my concise approach stating in the main clinically normal but concentrating on relevant findings, my treatment options and a plan to follow from in future is becoming outdated.

When questioned it becomes apparent that they live in perpetual fear of litigation despite me informing them that they are not going to get struck off for not specifically commenting on a dog’s normal sized lymph nodes.

Is this a worldwide trend?

Diet recommendations for a hypercalcaemic dog?

Yantha Smyth — Sun, 14 Dec 2025 10:01:43 GMT

I have a 13+yo patient with hypercalcaemia that has had some investigations that point to primary hyperparathyroidism.

There is a chance the owners will not pursue definitive identification and surgery.

So I am looking for a conservative palliative kind of option as an alternative, which could/would include low calcium diet (urinary? Renal?), +\- pred- increase calcium excretion, +\- bisphosphonates- decrease osteoclastic resorption.

Any advice on a balanced diet that is also low on the calcium content?

thanks in advance

Corporatisation debate ... has Facebook got worse?

Arlo Guthrie — Tue, 02 Dec 2025 17:12:18 GMT

For years, I've syndicated news content from here to other social media platforms (linkedin, facebook etc). But recently I decided instead to share the news elsewhere with a small amount of commentary attached, largely to highlight and promote discussion about important issues facing the profession, and if it encourages anyone to come and engage in discussions here, well that's nice.

Now I know that these forums have got heated at times in the past, and I know that if 100 people read the same post, there will be 100 different interpretations of what you wrote, but I really wasn't prepared for the level of criticism I've had posting on Facebook and Linkedin!

Yesterday, I posted:

I'm not the biggest fan of corporatisation because it churns out a homogenised blob of blandness and removes variety from our lives. Take coffee. I don't want a predictably average Costa, served by an averagely attentive barista, in every city I visit. What I really want is the occasional shit cup of coffee served by someone who clearly got out of bed the wrong side, so I've got something to moan about and a benchmark against which to measure a great cup of coffee. For that reason, a big round of applause for NVS Group and its new initiative to support independent veterinary start ups, which it was talking about at London Vet Show & BVA Live the other week.

Which seemed to open the gates to hell!

I found that surprising because I would have thought that it is self-evidently true that corporatisation reduces variety and choice. That's not having a dig at the people who work at corporates, it's just a fact of life. The question is whether it is important and if it is, then whether it can be mitigated.

On that front, I think that at a time when trust in the profession is at an all time low, perhaps corporates should do more to showcase the unique individuals in their teams and less on the brand.

Anyway, apparently I was being roasted alive on Veterinary Voices, I suspect rather worse than ever happened to anyone over here.

I wonder, has it always been this bad on Facebook, or has it got worse?

Or maybe it's me. Maybe I've got worse!

ACP tablets?

Beats — Tue, 25 Nov 2025 21:29:55 GMT

Does anyone have a good source of ACP 10mg tablets? (or reliable first-hand information on whether it is likely to return to supply - I always find it hard to figure when something has been genuinely permanently discontinued versus temporarily unavailable for any number of reasons...)

If genuinely gone for good, and not just a rumour, has anyone already looked for a decent replacement supply of oral acepromazine suitable to give in a convenient formulation to the occasional dog at a sensible price with a sensible shelf-life?

Thanks!

Anyone noticed the veiled insult in the CMA report?

bill bowler — Tue, 04 Nov 2025 19:30:41 GMT

The CMA is talking about introducing a compulsory price comparison website to be overseen by the RCVS. Putting aside the cost implications to the profession and the increase in professional fees that would follow, has anyone bothered to see what other UK industries have compulsory comparison websites- I think not, otherwise it would be all over the veterinary press. Currently the only industry with a compulsory price comparison website as far as I can establish is Payday Loan companies AKA loan sharks. Have we really stooped so low? Is it so morally corrupt to have the temerity to make a living out of treating the nations pets?

RCVS extends conditional accreditation of Cambridge veterinary degree for a year

Arlo Guthrie — Thu, 27 Nov 2025 17:28:00 GMT

The RCVS Education Committee has granted conditional accreditation of the veterinary degree offered by the University of Cambridge’s Department of Veterinary Medicine, to allow for further improvements to be made to meet accreditation standards for another year.

In November 2024, the RCVS Education Committee agreed to grant the veterinary degree conditional accreditation after an accreditation visitation earlier that year found deficiencies with the degree meant it only met 27 of the 77 RCVS accreditation standards.

55 recommendations for improvement were made by the visitation panel.

A subsequent visit in September 2025 found that while there were still a significant number of standards to be met, many of the recommendations for improvement had either been achieved, or significant progress had been made towards them being met.

The Education Committee therefore decided to grant the programme conditional accreditation for one year, with an action plan and timetable being put into place to guide how and when the 20 outstanding recommendations would be met.

The next accreditation visit to Cambridge will take place in October 2026.

It was agreed that this timeframe and accreditation status would ensure that progress towards meeting accreditation standards continued at pace, allowing the Department to demonstrate its commitment to student wellbeing and support for learning across the entirety of the veterinary programme.

An RCVS spokesperson said: “We appreciate the considerable efforts and hard work that the staff team within the veterinary department at Cambridge University have put into rectifying many of the issues identified in the 2024 accreditation event, for taking on board the constructive advice that was given and working together to make many of the necessary improvements.

“However, as the report shows, there are still several outstanding areas of concern, and so the Education Committee agreed that it was not yet in a position to grant Cambridge’s veterinary degree full accreditation.

“We have collaborated with Cambridge on putting together an action plan and timeline for meeting the 20 remaining recommendations and we hope that it will continue on its current trajectory towards meeting the RCVS accreditation standards.”

https://www.rcvs.org.uk/document-library/university-of-cambridge-2025-report/

How far should we go in the treatment of animals?

Arlo Guthrie — Fri, 31 Oct 2025 13:54:45 GMT

This is the first question raised by the new book Veterinary Controversies and Ethical Dilemmas, so I met up with the author, lovely man called John Webster, who developed the five freedoms, and this is what he thinks...

What do you think?!

By the way, if you'd like to buy the book here's a link: https://amzn.to/3Jqynjy

Ov66 form

Allison Gleadhill — Wed, 15 Oct 2025 18:03:55 GMT

Did a couple of these earlier in the year without too much of a problem & another one to do later this week. I think there are some changes in the form requiring the colour photo to be embedded in the form rather than just sent in the same email. How?
but then if the form is printed out to be signed & stamped & then scanned to be sent the photo will be in black & white as I don’t have a colour printer at work & I doubt many people do it mainly being used for invoices lab forms & consent forms which are b&w.

anyone done one recently?

Has the CMA just rearranged a few deckchairs?

Arlo Guthrie — Wed, 15 Oct 2025 11:24:37 GMT

https://www.vetsurgeon.org/b/veterinary-news/posts/cma-vet-investigation-rearranges-deckchairs-on-the-titanic

I wasn't really expecting the CMA to do very much, and at least on that score, it hasn't disappointed.

But what do you think about the proposed remedial actions, and whether they will make a blind bit of difference?

Clippers

Beats — Wed, 08 Oct 2025 10:01:39 GMT

In 2025, what are your favourite clippers for small animal work?

Maropitant in rabbits.

Clive Ansell — Fri, 03 Oct 2025 17:17:01 GMT

Does anyone use or have experience of Maropitant and Methadone for treating gut stasis in rabbits?

Any other tips for treating gut stasis?, I seem to be getting a few cases at the moment. I tend to treat with analgesics, metoclopramide and fluids, and try and rule obvious causes such as teeth etc.