The RCVS Disciplinary Committee has postponed sanction against Oxfordshire-based veterinary surgeon, Susan Catherine Mulvey, provided she complies with a number of undertakings.

Ms Mulvey faced a number of charges relating to the treatment of a cat called Spooky: that she failed to provide Spooky’s owner, Mrs Parsons, with either Spooky’s lab results or an adequate explanation as to why they could not be provided; that she failed to respond adequately or at all to communications from Mrs Parsons; that she failed to respond to requests from the College for information relating to Continuing Professional Development (CPD), her professional indemnity insurance (PII), and her correspondence with Mrs Parsons.

At the beginning of the hearing Dr Mulvey admitted the facts to all the charges, and accepted that they constituted disgraceful conduct in a professional respect. The Committee had been provided with written evidence from Mrs Parsons, her husband, and four College staff, namely Gemma Crossley, Maria Fearon, Robert Girling and Michael Hepper.

Mrs Parsons provided a statement in which she spoke of how, in August 2016, she had taken Spooky to CornYard Veterinary Centre for a skin irritation where she was seen by Dr Mulvey.

Dr Mulvey decided to take blood tests and send them to the laboratory, but they agreed to defer them actually being tested until Mrs Parsons gave permission. Mrs Parsons then returned to the practice with Spooky to take said samples, after which followed a series of attempts to contact Dr Mulvey for the test results. Finally, in October, she demanded a refund, after which she began a small claim in County Court.

Mr Parsons went to the practice at the beginning of December 2016 and obtained the refund. At this point Mrs Parsons made a complaint to the College. The Committee received information from Mr Parsons, who corroborated the facts of the complaint, and from College staff who confirmed the many attempts to contact Dr Mulvey, starting with requests for documents by Ms Crossley and Ms Fearon, repeated requests for CPD and PII information from Mr Girling, and finally a hand-delivered letter by Mr Hepper, during which he learnt that her PII had lapsed at the beginning of 2017.

The College submitted that Dr Mulvey’s conduct fell far below the standard expected of a veterinary surgeon. It submitted that failing to provide the test results and communicate with the Parsons could have had a negative impact on animal welfare and damaged the reputation of the profession, while having PII is a fundamental obligation of the RCVS Code of Professional Conduct. Finally, not responding to the College about the concern raised, CPD or PII compromised the College’s ability to maintain public confidence in its regulatory processes.

The Committee considered that no harm had actually come to Spooky and that there were problems with the testing laboratory which slowed down the process. In addition, some of the lack of communication was due to a receptionist not following protocol, and Dr Mulvey was going through a particularly difficult part of her life and was clinically understaffed. The Committee heard from four different character witnesses, and were given 16 more written testimonials.

The Committee heard that in 2013 there had been complaints from three separate clients, all of which concerned Dr Mulvey’s failure to communicate and to process insurance claim forms, after which she agreed to participate in the Performance Protocol and entered into undertakings with the College. 

The Committee having considered all the facts and background circumstances found that Dr Mulvey’s conduct was disgraceful in a professional respect.

The Committee went on to consider what sanction was appropriate. In reaching its decision the Committee took into account a number of aggravating factors, namely that there was a slight risk to the health of Spooky and that the disgraceful conduct occurred over a prolonged period of time. The Committee also considered that there was blatant disregard of the role of the RCVS and the systems regulating the profession. 

In determining the sanction the Committee also considered mitigating factors, including that Dr Mulvey, apart from those previous concerns, had a long and unblemished career and that she’s made a huge difference to the health of the animals within her care. She also admitted her shortcomings, and had very impressive references.

The Committee therefore determined to postpone its decision on sanction for a period of one year on condition that Dr Mulvey enter into the following undertakings:

1. To agree to the appointment of a veterinary surgeon as a work place supervisor by the College and meet with them at least once every month

2. Allow the supervisor access to all aspects of running of the practice and to implement any recommendations made by the supervisor relating to the administration of the practice and the provision of out of hours’ cover.

3. To allow the supervisor to provide a report in relation to the matters set out in 2 above to the RCVS at least one month before the resumed hearing of this case.

4. To appoint within two months an experienced Practice Manager (who does not need to be full time).

5. To enrol in the voluntary Practices Standards Scheme and to achieve the Core standards of the Scheme within the next 12 months.

6. To submit a plan to the supervisor of CPD for the next twelve months within one month of agreeing to these undertakings. The plan should then be implemented and shall include aspects of practice management.

7. To pay all of the costs of complying with the undertakings, with the exception of the costs associated with the appointment and performance of the supervisor. 

Ian Green, chairing the Disciplinary Committee and speaking on its behalf, said: "The Committee recognised that Dr Mulvey has been subject to undertakings before and yet committed the disgraceful conduct the subject of this inquiry. But it bore in mind the context of that conduct and it observes that the undertakings previously imposed in reality address a particular aspect of her practice.

"This Committee hopes that when the matter is relisted before it, the Respondent will be able to demonstrate that she has finally been able to address her administrative shortcomings. If she cannot do so, she will know that the Committee that sits on her case at the resumed hearing is likely to have more restricted options for disposal of her case."

CVS has announced its acquisition of the Severn Edge Veterinary Group, a large mixed veterinary practice with 12 sites covering a wide area of central and south Shropshire.

Severn Edge was formed six years ago with the merger of two long-standing neighbouring practices, and now employs 135 people, including 43 veterinary surgeons. 

Mrs Karyn MacKenzie, Director of CVS’ Practice Division, said: "Severn Edge is an impressive practice with an outstanding leadership team and an ambitious and exciting vision for the future which we share. We are delighted to welcome the team to CVS and look forward to working with them to help them build an even more successful future."

Dr John Brentnall BVSc MRCVS, a Director of Severn Edge, will continue in the role of CVS Regional Director. He said: "It was clear from our early discussions that CVS understood what we are trying to achieve. We have embarked on a significant investment programme, including upgrading our surgery at Madeley outside Telford, and the redevelopment of the site of an additional clinic which we have recently acquired in Craven Arms.

"In order for us to continually upgrade our clinics, provide the widest range of career opportunities for our staff and steer our practice through an increasingly competitive world, we believe that the best interests of us all lie in joining forces with CVS.  It is known for its interest in equine and farm practice, as well as companion animal practice, and has a policy of significant investment in both infrastructure and staff. We believe it offers the best fit with Severn Edge."

Bayer Animal Health (makers of Advocate, Advantix, Advantage, Seresto, Profender, Drontal and Droncit) has launched 'It's a Jungle Out There', an educational initiative aimed at simplifying parasite control for veterinary practices and pet owners alike.

The impressive-looking initiative comes on the back of research carried out by the company which found:

• 73% of veterinary surgeons believe the vast array of different products and formulations currently available for the treatment of parasites can be very confusing and 35% think there are missed opportunities to increase owner compliance¹.
• 45% of dog and cat owners are not confident that their pet is protected from parasites².
• 83% of pet owners do not realise that a combination of products may be needed to obtain the required level of protection.
• 25% would welcome their vet practice discussing parasite protection options with them at their next visit.

Dan White, Group Product Manager for Bayer's Animal Health division said: "Our research concluded that many vet practices are missing an opportunity because of a lack of clarity regarding best practice for parasite control. With ongoing support and practical development tools, Bayer's 'It's a Jungle Out There' Programme is an educational initiative which will arm vet practices with the tools they need to make parasite control clearer and more accessible to owners, helping to ensure the UK is a nation of healthy parasite-free pets and happy owners."

Bayer says the first stage of the 'It's a Jungle Out There' initiative aims to help the veterinary community identify opportunities where they can help to improve pet owner compliance. Vet practices will then be supported in developing a parasite protocol which will then be launched to consumers via a heavyweight advertising and PR campaign.

The initiative comprises a new educational website: www.jungleforvets.co.uk, which includes practice development workbooks, market research and trends, extensive technical information on a wide variety of parasites and CPD assessments. Additional downloadable content includes a range of materials such as images, videos, downloads and web buttons.

From the end of August, practice support materials will be available including a waiting room display pack, parasite guide and dispenser, vet nurse reference guide, waiting room posters, lifestyle questionnaire, badges and static window stickers.

The pet owner focus will begin in September and will include an interactive website, advertising and an extensive print and broadcast PR campaign with celebrity ambassadors David Bellamy and TV vet Steve Leonard. This activity is aimed at driving owners towards their vet practice for advice on parasite risks.

References

1. Research conducted by Bayer Animal Health - survey of 150 UK vets, May 2012
2. Research commissioned by OnePoll - survey of 2,000 British cat and dog owners, May 2012

A veterinary ophthalmologist at Veterinary Vision in Penrith, Cumbria, has stumbled on what may prove to be the veterinary profession's answer to the Turin Shroud: the outline of a face on the retina of a dog.  

The strange phenomenon was spotted by Veterinary Vision's clinical director Chris Dixon when he examined Dachshund called Margo, which had been referred for the treatment of a corneal ulcer and fungal infection.

Chris said: “I was assessing Margo’s eye and was very surprised to see a face smiling back at me.

"It perhaps doesn't bear quite the same resemblance as the Turin Shroud. Still, I've never seen anything like it before. 

"The good news is that it does not appear to have affected her vision at all.”

Apparently the smiling face is still there, even after Chris performed a corneal graft.

Chris added: "I think we can safely say that Margo is a very happy dog, both inside and out!"

The BSAVA has released the second edition of its Manual of Canine and Feline Head, Neck and Thoracic Surgery.

The original editorial team of Daniel Brockman and David Holt has been joined by Gert ter Haar to produce a new edition which considers the substantial progress that has been made in this important field, including the challenges of treating airway abnormalities linked to brachycephalism, the constraints of complex bony anatomy and rich vascularity of the head when performing radical surgery, and the treatment of trauma.

The book includes a number of new techniques, including dorsal rhinotomy and total ear canal ablation.

The BSAVA says operative techniques, instructive photographs and full-colour illustrations remain a key feature of the manual, which is aimed at the general veterinary practitioner.

The BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd edition is available from the BSAVA website: www.bsava.com or by phone: 01452 726700.

Vets Now has launched a new small animal surgical residency programme following a recent £1.5m expansion at its Glasgow hospital.

The expansion, which was completed last year, added a whole floor dedicated to emergency and critical care, a new specialist oncology treatment area and additional theatre space.

Davinia Arnott (pictured right), a European and RCVS Specialist in Small Animal Surgery, is leading the new residency programme. She said: "To be awarded the ability to run a residency, you have to be accredited to the highest possible standard, and there is a range of stringent ECVS criteria that we needed to meet.

"We were able to put ourselves forward following the expansion of our hospital and all the new facilities we have added. We are all really proud to be in a position to offer this new small animal surgical residency.

"We now have four theatres so we can do multiple surgeries at the same time, allowing us to greatly increase our caseload. We can also do fluoroscopy for orthopaedics and soft tissue. We just didn’t have that capability before.

"To achieve specialist status, the standard is exceptionally high so we’ll only have one resident every three years. This is to ensure they’re mentored and guided properly throughout."

Leo Roses is the first small animal surgery resident to join the new Vets Now programme. She began her three-year tenure in January after completing a surgical internship in the hospital. Leo, who is originally from Majorca and has also worked for Vets4Pets, Fitzpatrick and PDSA, is realising a long-held dream by embarking on a surgery residency.

She said: "I realised during my degree that I wanted to specialise in surgery. I did two surgical internships before coming to Glasgow to do a third. I applied for a position here because I was aware of the incredible reputation of the surgeons and had been told they were really keen to teach."

Pavels Antonovs MRCVS, a Humberside-based locum veterinary surgeon, has been reprimanded by the RCVS Disciplinary Committee for working whilst under the influence of alcohol.

Mr Antonovs faced three charges.

The first was that in September 2020 whilst in practice at Beverley Vets4Pets, he attended work when under the influence of alcohol.

The second was that between September and December 2020, whilst at Peel Veterinary Clinic, he attended work on two occasions when under the influence of alcohol.

The final charge was that between February 2021 and February 2023, Mr Antonovs failed to respond adequately to requests from the RCVS regarding concerns raised about his conduct and/or health.

Mr Antonovs admitted the facts of the charges and the Committee decided that the facts amounted to serious professional misconduct.

The Committee therefore decided, in the particular circumstances of this case, to impose a reprimand and warning as to his future conduct on the basis that it would be proportionate in order to maintain public confidence in the profession and uphold proper standards of conduct and behaviour.

The full details of the hearing and the Committee’s decision can be found at www.rcvs.org.uk/disciplinary

Researchers at the Royal Veterinary College report that they've made a significant breakthrough in the search for a durable treatment for Duchenne muscular dystrophy (DMD).

Working in collaboration with researchers at University of Texas, Southwestern (UTSW) Medical Center, the team has succeeded in using gene editing techniques on dogs to restore the expression of the dystrophin protein that is absent in DMD patients’ muscles to levels that could be life changing.

DMD is the most common, fatal, genetic disease that affects children. The same disorder also occurs in many dog breeds. It is caused by mutations in the gene that encodes dystrophin, a crucial protein that helps protect muscle fibres and the heart when they contract. Patients with the disease produce effectively no dystrophin protein, so their muscles and heart become damaged during contraction, leading to inability to walk, skeletal deformities, breathing problems and heart failure. Patients with DMD have a life expectancy that does not go far beyond their twenties.

Researchers say that this preliminary research, published in Science, demonstrates an approach that could lead to an effective, in principle one-time treatment for DMD for the most common genetic mutations affecting human patients. Through a single intravenous injection, researchers have been able to modify the dystrophin gene in many muscles of the body, including the heart, with the result that some muscles now had almost the normal amounts of dystrophin protein.

The team, led by Eric Olson, Ph.D., professor and chair of the Department of Molecular Biology at UTSW Medical Center and founder and chief science advisor of Exonics Therapeutics, and Richard Piercy, Ph.D., MRCVS, Professor of Comparative Neuromuscular Disease at the RVC, identified a naturally-occurring mutation in the dystrophin gene in a dog brought to the RVC’s Small Animal Referral Hospital.

Working now with relatives of this first dog, the combined group has used a technique called ‘SingleCut CRISPR gene editing’, where the researchers target a specific region of the subject’s own DNA. Harmless viruses encoding the gene-editing protein CRISPR/Cas9 were used to express the enzyme in muscle to cut the dogs’ own DNA at a precise location in the dystrophin gene through use of a molecular guide. The body’s own processes then repair the cut, which results in removing the negative effects of the existing mutation.

The researchers have demonstrated that dogs treated in this way had restored ability to produce large amounts of the dystrophin protein in their muscles and heart, and in the dog with the highest dose, cardiac muscles were found to have restored dystrophin protein to up to 92% of normal amounts after the single treatment.

The team believes this is the first time that this form of gene editing therapy has been conducted after birth in an animal larger than a rodent. With further longer-term research, efficacy and safety testing, it is hoped that this breakthrough will have human application. This treatment may be a significant step toward developing a gene editing therapy to repair genetic mutations for DMD, as well as a range of diseases caused by genetic mutations.   

Richard Piercy, Professor of Comparative Neuromuscular Disease at the RVC, said: "Researchers have been looking for an effective and durable treatment for Duchenne muscular dystrophy for many years. This SingleCut gene editing approach, pioneered by Dr. Eric Olson’s group, has the potential to be a one-time treatment that could restore dystrophin protein. It is hugely exciting that through a single intravenous injection we’ve been able successfully to modify the dogs’ own DNA so they start generating dystrophin protein again. There is more work to be done, but with this exciting breakthrough, we feel we are a significant step closer to finding an effective treatment.

"A great many genetic diseases affect humans, dogs and other species - many, like DMD - with tragic consequences and this form of gene editing treatment might well be applicable in many of them. We’re hopeful that we’re paving the way for future research into treating some of the most serious genetic conditions that affect us today."

The Legislative Reform Order (LRO) to reconstitute the RCVS disciplinary committees separately from its Council has come into force and has amended the Veterinary Surgeons Act 1966 (VSA).

The LRO brings the RCVS in line with regulatory best practice and, says the College, improves the independence of its disciplinary processes, marking a major step towards the College becoming a 'First Rate Regulator'.

The amendment made by the LRO requires that the RCVS Preliminary Investigation and Disciplinary Committees are made up of veterinary surgeons and lay members who are not RCVS Council members, and who are appointed independently. This ensures that the same group of people is not responsible for setting the rules, investigating complaints and adjudication.

The LRO also brings lay people formally into the Preliminary Investigation Committee and will allow the RCVS to increase the pool of people available to investigate complaints and sit on disciplinary hearings.

The first external members will join the Disciplinary and Preliminary Investigation Committees from July 2013. After a two-year transition period, members of the RCVS Council will become ineligible for membership of these committees.

RCVS Registrar, Gordon Hockey, said: "The LRO has been the culmination of many years hard work by the RCVS and Defra, with the support of the British Veterinary Association. At first glance the change that the LRO makes to the Act may appear minor, but the reform fundamentally improves the way the veterinary profession is regulated, and will help to ensure public confidence in the RCVS disciplinary processes."

Cambridge-based Nebojsa Petrovic MRCVS has been suspended by the RCVS Disciplinary Committee for six months for dishonestly providing false information related to the export of horses.

Nebojsa Petrovic faced eight charges, although charge four was withdrawn at the start of the hearing.

At the outset of the hearing, Dr Petrovic admitted a number of allegations, including:

Charge 1 - that in November 2021, he falsely represented to the Animal and Plant Health Agency (APHA) that blood samples he submitted in respect of four horses were from the same horses as the samples he submitted on 1 November 2021.

Charge 2 – that in November 2021, he told APHA’s Veterinary Head of Border Control that he had checked the microchips and/or passports of the four horses when he hadn’t done so;

Charge 3 – that in November 2021, he signed Export Health Certificates for the four horses, in which it was stated that blood samples taken from these horses on October 2021 had been submitted to the Veterinary Laboratories Agency laboratory, Weybridge, with a negative result for Leptospirosis when in fact those samples had tested positive;

Charge 5 – that he failed to send the APHA’s Centre for International Trade, within seven days of signing, certified copies of the export health certificates;

Charge 7 – that in January 2022, he told an APHA officer that he was satisfied that he had properly identified the horses for which you had submitted the two samples when he had not done so;

Charge 8c – that he risked undermining government procedures designed to promote animal health and international relations in relation to the charges he admitted; and

Charge 9 – that in February 2022, he failed to have in place any or any adequate Professional Indemnity Insurance (PII).

Dr Petrovic, who was at the time of all the allegations carrying his duties as an Official Veterinarian on behalf of the APHA, denied charge 6 – that in November 2021, he failed to take sufficient steps to prevent the four horses being exported to Serbia, when he had been informed that there were concerns and/or doubts about whether those horses had tested negative for Leptospirosis.

He also denied charge 8 – that in relation to the allegations relating to his submitting the blood samples to the Veterinary Laboratories Agency on 8 November 2021, certification of the Export Health Certificates on 16 November 2021 and his subsequent conversations with members of APHA staff regarding both sets of documentation he had acted in a misleading (Charge 8a) and/or dishonest (Charge 8b) way.

The Committee considered evidence presented by the College including hearing from APHA staff witnesses called by the College and also hearing from a witness and character evidence presented by Dr Petrovic. Dr Petrovic also gave evidence to the Committee.

It found most charges proven with the exception of Charge 6, and also found that Dr Petrovic had not acted dishonestly in submitting the blood samples or certifying the EHC’s as alleged in charges 1 and 3.

The Committee concluded that Dr Petrovic had acted in a dishonest and misleading way in his conversations with the APHA staff as detailed in charges 2 and 7.

The Committee then considered whether the individual proven charges amounted to serious professional misconduct, determining that, with the exception of charges 3 and 5, all proven charges amounted to disgraceful conduct.

Paul Morris, chairing the Committee and speaking on its behalf, said: “In the Committee’s judgement, the respondent’s position as an Official Veterinarian also meant that he had a responsibility to ensure that the trust which was delegated to him was not breached.

"In his role, the respondent was acting in a position of trust, as a representative of the government, and the Committee found that he had breached that trust…. It took these matters into account when determining that the respondent’s behaviour cumulatively amounted to disgraceful conduct in a professional respect.”

Regarding the sanction for Dr Petrovic, the Committee considered his request that it consider suspension, rather than removal, from the Register.

In terms of aggravating factors – the Committee found that Dr Petrovic had acted without integrity, recklessly and without regard for the APHA’s systems relating to the export of animals.

In mitigation, it took into account: the fact that no animal was harmed by his conduct, albeit there was risk of harm; his long and unblemished career in the UK since 1994; admissions he had made to the APHA and Disciplinary Committee at the first day of the hearing; had remediated his lack of professional indemnity insurance by putting in place a retrospective policy; the significant amount of time that had elapsed since the conduct; and six positive character references from experienced fellow veterinary surgeons who held him in high regard.

Paul Morris added: “The Committee took into account that the respondent had continued to work as a veterinary surgeon with no subsequent complaints and that he had a previous long and unblemished record and there was support by several positive character references.

"The Committee also took into consideration the pressures of Brexit and the pandemic which the respondent had faced at the time, but which were unlikely to occur again.

“The Committee had concluded that the respondent was unlikely to repeat similar behaviour or to pose a risk to animals, particularly because he was no longer involved in certifying animals for export.

"Furthermore his admissions to most of the matters it had found proved showed that he had some insight.

"The Committee was also satisfied that the respondent had a genuine concern for the welfare of animals and it noted that the Respondent did not require any further training to continue in practice as a veterinary surgeon.

 “The Committee therefore concluded that a suspension from the Register was the proportionate sanction in this case taking into account the seriousness of the conduct it had found proved but also all of the mitigating factors.”

The Committee recommended that Dr Petrovic be suspended for six months to reflect the seriousness of the conduct and the damage it could do to public confidence in the profession, while meeting the public interest and sending a clear message of deterrence.

www.rcvs.org.uk/disciplinary

York-based Dr Michael Richard Jones has been suspended by the RCVS Disciplinary Committee for two months, for making dishonest entries in horse passports and subsequently making dishonest entries in the same horses’ clinical records.

The Disciplinary Committee heard three charges against Dr Jones.

The first and second charges were that, in March 2018, Dr Jones made signed entries in the passports and made corresponding entries in clinical records of four horses indicating that he had administered an influenza vaccination booster to each horse on 15 March 2018 and in relation to another horse a tetanus booster, when in fact he had administered the vaccination boosters on 21 March 2018, and that his conduct was misleading, dishonest and undermined the integrity of a vaccination process designed to promote animal welfare.

The third charge was that, on or around 21 March 2018, Dr Jones failed to make any entries in the clinical records for a horse in relation to an examination on 21 March 2018.

At the outset of the hearing Dr Jones admitted the facts in the first and second charges, and accepted that his actions were misleading, dishonest and that they undermined the integrity of a vaccination process. However, he disputed certain aspects of the written statements of the College’s witnesses. In particular he wanted his conduct to be taken in the context of the pressures that he was working under on that day, primarily that he was in a stressed state having had to euthanase a valuable stallion at the conclusion of his previous client appointment.

Dr Jones did not admit the third charge, explaining that he did not remember examining the horse on 21 March 2018 as alleged.

Based on Dr Jones' own admissions, the Committee found the first and second charges proven. 

Regarding the third charge, the Committee heard evidence from the horse’s owner who said they were present during the examination taking place and the Committee was satisfied that the respondent did examine the horse on 21 March 2018 and that he had a duty to make a brief clinical note on the examination. As Dr Jones admitted that he made no such note, the Committee found the charge to have been proven to the requisite standard.

Having found the charges proven, the Committee then went on to consider whether or not Dr Jones’ proven conduct amounted to serious professional misconduct. The Committee, having considered the aggravating and mitigating factors, found that Dr Jones’ conduct as found proved in relation to both charges one and two, did constitute serious professional misconduct.

However, with regards to charge three, the Committee accepted that the respondent simply forgot that he had examined the horse and, therefore, the Committee was not satisfied that the failure to compile a record entry covering the horse’s examination constituted serious professional misconduct.

The Committee then considered what sanction to impose on Dr Jones in relation to the facts found proven in charges one and two. In doing so it took into account the 78 written testimonials and 4 character witnesses called on behalf of Dr Jones.

Ian Green, who chaired the Committee and spoke on its behalf, said: "The Committee’s decision on sanction has been based on an acceptance that the respondent’s conduct on this occasion was out-of-character, as the evidence of his character witnesses and the contents of the letters submitted in his support by his clients and other veterinary colleagues assert. The Committee also accepts that the respondent self-reported himself to his employer and to the College and has made a full and frank admission of his wrongdoing.

"Consideration was given to whether the sanction of a reprimand and/or warning as to future conduct would adequately reflect the gravity of the misconduct, however, after careful reflection it was concluded that such a sanction could not be justified. The reason is that acts of falsification involve acts of dishonesty by a professional person acting in a professional capacity, and the gravity of the matter arises not simply from the dishonesty but also from the possible consequences of the false certification. It should be clearly understood by members of the veterinary profession that, in appropriate false certification cases, the sanction of removal from the Register is one which may well be imposed."

The Committee therefore decided that suspending Dr Jones from the Register for two months would be the most appropriate sanction.

A study published in the latest issue of the Journal of Small Animal Practice (JSAP) has revealed that the evidence base for recommending any one treatment for keratomalacia in dogs and/or cats over another is very weak. 

In the study titled “Outcomes of treatments for keratomalacia in dogs and cats: a systematic review of the published literature including non-randomised controlled and non-controlled studies”, a systematic review of the current literature was undertaken to determine the evidence base for the various treatments of keratomalacia in dogs and cats.

The aim of the review was to assess the evidence base and identify recommended treatment(s) based on globe survival, visual outcome, and time to resolution (while maintaining a globe).

An online literature search found 18 relevant studies which were then reviewed and assigned a level of evidence base as described in the Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence Working Group.

Each study was assessed for type of study described (e.g. retrospective, prospective, controlled, random/non-random, cohort study, case series/study), the number of animals included, criteria for assessing outcome (e.g. vision, corneal clarity, anatomic repair) and duration of follow-up and time to resolution.

Systematic reviews of randomised trials, randomised trials or observational studies with dramatic effects would have provided the most reliable evidence on which to base recommendations for treatment(s) but none were available for inclusion.

Only one study was classified as level 3 evidence (non-randomised controlled trial) and considered the use of corneal cross-linking (CXL) in the treatment of keratomalacia.

Most studies were level four evidence reporting the outcome of a single treatment, with three prospective studies and seven retrospective studies.

The remaining seven studies were level five evidence (mechanism-based reasoning) and were considered not to provide good evidence for answering the particular study question.

The findings of the study suggest that the evidence for improved outcome of one proposed treatment over another proposed treatment for keratomalacia in dogs and/or cats is very weak.

A combination of treatments – both medical and surgical – may be the most appropriate depending on the individual case.

Studies utilising mechanism-based reasoning would suggest that medical treatment with anti-collagenase treatment is a minimum requirement for keratomalacia cases to prevent globe loss through perforation, with associated pain and suffering.

Nicola Di Girolamo, Editor of JSAP, said: “The findings of this study highlight once more the infrequency of randomised controlled trials in the veterinary literature, and the need for such studies to expand the evidence base in this field.

“Focussing on collecting available evidence in well-conducted systematic reviews is a critical step in order to improve accessibility of the literature for general practitioners and specialists alike.”

The full article can be found in the October issue of the Journal of Small Animal Practice and can be read online here: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13326. It is open access and can be freely accessed by anyone.

Photo courtesy BSAVA