The veterinary dermatologist Sue Paterson has launched Virtual Vet Derms, an online advice service which aims to give general practitioners the advice they need to manage cases within their own practice, without the need for referral.

Virtual Vet Derms has been set up to be able to give advice to veterinary surgeons on any aspect of skin or ear disease whether it is allergy, otitis media, cutaneous neoplasia or endocrine-based in any species, including dogs, cats, small furries, exotic pets including raptors, birds and reptiles, horses, camelids, zoo and farm animals. 

Sue, herself an RCVS Recognised Specialist in Veterinary Dermatology, is supported by a team of veterinary dermatology colleagues as well as veterinary specialists in exotic medicine, internal medicine (including endocrinology) and consultants with expertise in oncology. 

Sue said: "We recognise that not every veterinarian has got access to a local dermatology specialist and that not all clients can or want to travel to a referral centre. The aim of the service is to formalise the advice that dermatology clinicians give to veterinary surgeons to allow them to get detailed help to manage difficult or challenging dermatology cases within their own practice."

The service has been set up under the RCVS Vivet initiative, is approved by all of the major insurance companies and supported with Veterinary Defence Society Insurance cover. 

Virtual Vet Derms offers support in a range of ways. 

• Quick questions
  Short questions that veterinary surgeons can submit via the online form on the Virtual Vet Derms website that just require a brief reply. This may be a dose of a drug, a parasite you want identifying, or the interpretation of a blood sample such as an ACTH stimulation test.

• Veterinary reports
  Veterinary surgeons can use online request forms on the Virtual Vet Derms web site to submit a brief history of the animal and the problem and some good quality photos of the skin condition. There is also the ability to upload histopathology reports, blood samples and any other pertinent information. A detailed written report is sent back to the vet within 48 hours which will describe clinical signs, differential diagnoses, recommended diagnostic tests and treatment option where appropriate. Where possible, Virtual Vet Derms aims to pass the advice request to the nearest dermatologist but vets can ask for advice from any of its specialists. 

• Telemedicine consultations
  For new cases or for cases where initial advice has been sought, in the client's own primary care veterinary practice via the internet. The Virtual Vets Derms specialist can consult with the owner to provide even more specific advice and support. After each teleconsultation the Virtual Vet Derms specialist will produce a report in the same format as the veterinary report to allow the primary care veterinary surgeon to continue to manage the case more effectively. 

• Face to face consultations
  Can also be arranged via the owner’s vet at the specialist's own practice if there is the need for more specialist investigation that may not be available in the primary care veterinary surgery. In these cases, the specialist will take on the direct care of the case and work with the owner and vet on the best course of action.

• General advice 
  Also possible if the vet wishes to direct an owner straight to Virtual Vet Derms. 

For more information, visit: https://virtualvetderms.com

Hysolv Animal Health UK has launched Respiporc FLUpan H1N1, a newly-developed vaccine against swine influenza which protects against the pandemic strain, pdmH1N1(2009).

Hysolv says the vaccine, which was developed by IDT Biologika, has been used successfully in Germany, where 1.7 million doses have been prescribed. The company says field trials have shown that vaccination not only protected against clinical signs of influenza but also resulted in improvements in reproduction and piglet performance.

Two 1 ml doses of the inactivated vaccine can be injected intramuscularly three weeks apart to pigs from 56 days old, providing immunisation to the majority of animals within seven days. 

Hysolv director, Geoff Hooper said: "Swine flu can be devastating to a herd and this vaccine will broaden protection, particularly when used with our existing vaccine Respiporc FLU3, which we are strongly advising."

Respiporc FLU3 protects against three other strains of swine flu (H1N1, H1N2 and H3N2). Hysolv says that when used together, the two vaccines protect pigs against the most relevant strains in the British Isles.

Geoff added: "There have been several flu pandemics throughout the years – the latest in 2009. It is not possible to predict the emergence of a pandemic strain accurately but this vaccine combined with Respiporc FLU3 will greatly decrease the chance of pigs becoming infected."

MSD Animal Health has announced the launch of Bravecto Plus, a topical endo- and ectoparasiticide for cats.

Bravecto Plus contains fluralaner (280 mg/ml), an ectoparasiticide which provides systemic activity against ticks (lxodes ricinus) and fleas (Ctenocephalides felis), and moxidectin (14 mg/ml), an endoparasiticide which provides systemic activity against a range of internal worms, including heartworm (Dirofilaria immitis), intestinal roundworm and hookworm.

Bravecto Plus is applied topically using the "Twist'n'Use" pipette. Once applied, the product kills ticks and fleas for 12 weeks, while also treating intestinal roundworm and hookworm and preventing heartworm disease for eight weeks.

Bravecto Plus can also be used as part of a treatment strategy for flea allergy dermatitis.

Bravecto was first launched in 2014 as a chewable tablet for dogs. In 2016 Bravecto spot-on was launched as a topical solution for dogs and cats. More than 80 million doses of Bravecto have been sold in 72 countries since 2014.

Amanda Melvin, marketing manager, at MSD Animal Health, said: "We are pleased to introduce the latest innovation in feline parasite protection to the Bravecto family."

For more information, refer to the summary of product characteristics or contact your MSD account manager.

Sky News reports that IVC, the Bath-headquartered corporate veterinary group, is putting itself up for sale for a cool £1.5 billion.

IVC was formed in 2011, the result of a merger of several independent veterinary hospitals. Under the leadership of David Hillier, and with backing from Summit Partners in 2014, it grew to over 300 practices before being acquired by the Swedish EQT Partners in January 2017.

In August last year the company merged with Evidensia Group, another veterinary corporate group with practices around Europe, bringing the total to more than 850 clinics and hospitals in eight countries. 

EQT has reportedly now instructed Jefferies Investment Bank to auction the business in the first week of November. 

No word yet on where the auction will take place. If you go, be careful not to scratch your nose at the wrong moment ("1.7 billion from the gentleman at the back. Yes, that's YOU, Sir."). 

Lintbells has launched its 'new and improved' Mobility Matters initiative which provides a framework for introducing nurse–led mobility clinics in practice.

The Lintbells Mobility Matters initiative provides materials designed to help improve communication and client understanding of their pet’s condition. It includes a guide on how to set up a mobility-focused nurse-led clinic, together with a step-by-step guide in a flip chart format to help RVNs recommend dietary supplements or modifications. 

To help launch the clinic, Lintbells Veterinary Business Development Executives can provide lunch and learn sessions. Practices can also become approved Mobility Matters practices with certified CPD for the whole team to ensure that the process of recommendation and referral to the clinic occurs seamlessly and involves everyone in the practice. 

Yumove Brand Manager Gemma Cunningham said: "Feedback about the pack is that it helps vets and vet nurses explain mobility problems to owners in a simple but structured way to improve buy-in to a multimodal approach".

Practices that want to register an interest in the initiative can contact their local Lintbells Veterinary Business Development Executive or visit www.lintbellsvet.com.

The RCVS has published a series of case studies designed to help veterinary surgeons and veterinary nurses in gaining properly informed consent from clients for procedures and treatments.

The case studies were developed by the RCVS Standards Committee and use a variety of examples of where miscommunication between a client and the veterinary practice can lead to an inadequate level of consent being gained for procedures and treatment, including euthanasia.

Examples include damaged teeth being removed during a clean and polish dental procedure without the owner’s express permission and not giving the full range of options available in the case of a dog with an osteosarcoma.

The case studies follow the Standards Committee approving changes to chapter 11 (‘Communication and consent’) of the supporting guidance to the RCVS Code of Professional Conduct in January 2018 to give further advice on how to discuss informed consent with clients, who can be responsible for gaining consent for a procedure and additional guidance on consent forms.

Dr Kate Richards MRCVS, Chair of the RCVS Standards Committee, said: "We hope these case studies will prove useful to practitioners who are having to deal with the complexities around making sure that procedures are fully explained to ensure informed consent is gained.

"We understand the difficulties that are encountered and so these case studies, based on real-life scenarios, highlight where things may go wrong and how these incidents can be avoided by being thorough and ensuring that good communication is at the heart of all we do."

To view the case studies, visit www.rcvs.org.uk/informed-consent.

Chapter 11 of the RCVS supporting guidance on communication and consent is available to view at www.rcvs.org.uk/consent

The RCVS reports that its Veterinary Client Mediation Service (VCMS) has passed the one-year mark, dealing with over 2,000 disputes between veterinary practices and clients in that time.

The VCMS, which is administered by Nockolds Solicitors, was formally launched by the RCVS as an alternative dispute resolution service in October 2017 following a year-long trial.

The aim of the service is to resolve, by mediation, disputes between clients and veterinary practices that do not meet the threshold of serious professional misconduct that is needed for the RCVS to investigate a concern through its formal processes.

Since the service’s trial, which started in October 2016, the VCMS has given preliminary mediation advice on how to resolve a case in more than 1,700 instances with over 580 cases having gone to full mediation of which 89% have concluded with a resolution. 

Eleanor Ferguson, RCVS Registrar and Director of Legal Services, said: "From the perspective of both the public and the profession, the establishment of the VCMS has been a "win-win" situation. For the public it has provided them with an additional route to solve those complaints which wouldn’t cross the threshold to progress in the concerns investigation process.

"For the profession it has provided a more appropriate format for resolving a client dispute that doesn’t involve the time, effort and formal process of an RCVS investigation for those cases that will never amount to serious professional misconduct. I think this has been demonstrated by the fact that the vast majority of the profession are willing to engage with the VCMS process, even though it is entirely voluntary.

"The VCMS has also had a positive impact on the College and its concerns investigation process, allowing us to focus greater resources on those cases that do meet our threshold of serious professional misconduct. This has had a very clear impact on the speed with which we either close cases or move them on to the next stage of consideration by the Preliminary Investigation Committee (PIC), which, again, is important to both the public and the profession."

The College says that around 90% of cases investigated at Stage 1 of the process are now either closed or referred to PIC within four months – the College’s key performance indicator at this stage. This compares to around 50% of these cases being closed or referred within four months at Stage 1 in 2016.

The College also says that in total (including both preliminary and full mediation cases), 86% of the cases dealt with by VCMS were successfully mediated and feedback from both clients and veterinary practices has been largely positive. In client feedback from the third quarter of 2018, 93% said they would use the VCMS again and 79% considered it to be fair, while the equivalent figure amongst veterinary practices was 94% and 87% respectively.

Jennie Jones, a partner at Nockolds Solicitors who heads up the VCMS, said: "It is a good sign that mediation is largely working as it should when both parties are reporting similar satisfaction rates and we pride ourselves on negotiating resolutions that are acceptable and beneficial for both the clients and the practices.

"It is great to see that our efforts are also having an impact on the RCVS concerns investigation system by allowing it to concentrate on more serious cases."

More information about the RCVS concerns investigation process, including the different stages of an investigation, can be found at www.rcvs.org.uk/concerns

Further information about the VCMS can be found on its website at www.vetmediation.co.uk or by calling 0345 040 5834.

Invicta Animal Health has launched an improved version EthyCalm, its vapo-coolant spray for desensitising skin before needling a patient.

EthyCalm is sprayed directly on the skin, or, for more fractious patients, can be applied with a swab. 

Invicta says that unlike other products the effect is instant and EthyCalm leaves no residue on the skin surface.

The improved product, EthyCalm Plus, contains 50% more product (good for over 100 applications) and incorporates a new 'on-off' switch for easier application. It is also now packed in a 'no-roll' case to protect from damage.

Rob Watkins, Managing Director of Invicta, said: "EthyCalm has been an incredibly popular product with nurses and vets. As a small company we always listen to our customers and have taken the opportunity to incorporate suggestions for improvement. The result is EthyCalm Plus which offers significant enhancement over the original product".

EthyCalm Plus is available from veterinary wholesalers and for a limited time the price has been held at £25 each.

New research from the RVC has revealed that young, male, crossbred cats are at greater risk of being hit by a car, begging the question as to why they tried to cross the road in the first place.

The study, which was carried out by the VetCompass programme at the RVC, in partnership with Vets Now, also found that cats are most likely to be involved in a traffic accident in the autumn. 

1,407 cat road traffic accident cases that attended Vets Now clinics across the UK between December 2011 and February 2014 were analysed, with researchers finding: 

• Younger cats, aged six months to six years, are at the greatest risk of road traffic accidents.

• Male cats are 1.3 times more at risk of road traffic accidents than female cats. 

• Crossbred cats are 1.9 times more at risk of road traffic accidents compared to purebred cats.

• Cats are more likely to be involved in a road traffic accident in the autumn. However, they are less at risk in winter as compared to spring.

• Those cats that present with abdominal or spinal injuries are more likely to die, as are those that present with an increasing count of injuries.

• The 1,407 cats that were admitted after being hit by a car represented 4.2% of all cats treated at emergency veterinary clinics (n=22,586) during the period. 

RVC veterinary epidemiologist and VetCompass researcher Dr Dan O’Neill said: "One of the scariest times for any cat-owner is when they first start to let their cat go outside unattended. Owners of younger, and especially male, cats need to be especially vigilant. These results help owners to understand the true risks and therefore assist these owners to make the best decisions about if and how they let their cats go outside."

Dr Amanda Boag, Clinical Director of Vets Now, said: "We are very proud to have worked with VetCompass to ensure this important information about risks to our pet cats is made available to vets and the public. Working with our partners such as the RVC, we are committed to ensuring our large clinical database is used to help advance veterinary knowledge and understanding of emergency and critical care practice."

The full paper entitled 'Epidemiology of Road Traffic Accidents in Cats attending emergency-care practices in the UK' is published in the Journal of Small Animal Practice.

Ayrshire-based John Hendrie Smith has been struck off by the RCVS Disciplinary Committee after it found allegations of a number of charges in relation to his euthanasia of a dog proven.

In total Mr Hendrie Smith had faced eight charges against him, all of which related to him undertaking the euthanasia of a German Shepherd named Bouncer during a home visit in January 2017.

The charges alleged that when John Hendrie Smith undertook the euthanasia of Bouncer he had:

1. failed to ensure he was sufficiently prepared for the euthanasia in that he failed to attend the visit with a muzzle and failed to attend with any sedative and the means of administering sedative;

2. failed to delay the euthanasia until he was in possession of the above items;

3. undertook the euthanasia by means of an injection without first sedating Bouncer;

4. failed to provide Bouncer’s owner with an adequate explanation of the procedure. Including:

a. failing to explain that the procedure involved an attempt at injection directly into the heart;

b. failing to explain that an injection into the heart without sedation is (except in extreme circumstances) not an accepted means of euthanasia;

c. wrongly stated that Bouncer would not feel the injection;

d. failed to provide an explanation of the risks;

e. failed to explain the risks and signs of narcotic excitement;

f. failed to explain the risks of injection into the heart without sedation;

5. failed to obtain Bouncer’s owner’s informed consent for the procedure;

6. failed to make any clinical records in respect of the procedure;

7. provided inadequate veterinary care to Bouncer and caused him unnecessary suffering; and

8. failed to communicate with Bouncer’s owner.

Having considered evidence about the case from Bouncer’s owner, his owner’s former partner, two expert witnesses and Mr Hendrie Smith, the Committee found all of the charges against Mr Hendrie Smith proven, with the exception of charge 4(e) on the grounds that there was insufficient evidence against him on this particular charge.

In considering whether the charges that were found proven amounted to serious professional misconduct, the Committee heard further evidence from the College’s two expert witnesses, and submissions from both the College and Mr Hendrie Smith. Having considered the evidence and submissions, the Committee concluded that in relation to each of the charges found proven, Mr Hendrie Smith’s conduct had fallen far below that which was to be expected from a veterinary surgeon and was therefore serious professional misconduct.

The Committee went on to consider what sanction was appropriate following its earlier findings against Mr Hendrie Smith. The Committee took into account a number of mitigating and aggravating factors. In mitigation the Committee considered that this was a single, isolated incident and that Mr Hendrie Smith had been a practising veterinary surgeon for 65 years and had an otherwise unblemished career with no adverse professional findings against him. It also took into account testimonials from professional colleagues, clients and his local community.

However, the Committee also considered the aggravating factors which included actual injury and unnecessary suffering to an animal, a blatant disregard of the systems that regulate the veterinary profession including the RCVS Code of Professional Conduct and its supporting guidance relating to euthanasia, informed consent, preventing unnecessary suffering and working within one’s area of competence.

In explaining its decision to direct his removal from the Register of Veterinary Surgeons, the Committee noted Mr Hendrie Smith’s lack of insight into his behaviour, which included denying that he was at fault, challenging several of the Committee’s findings and disputing that an intracardiac injection into the heart of a dog without administering sedation or anaesthesia was wholly unacceptable, despite expert opinion to the contrary.

Chitra Karve, chairing the Committee and speaking on its behalf, said: "The respondent, in his oral evidence, admitted that he was not really a small animal vet, and had not been dealing regularly with small animals for a significant period of time. His specialisation in recent years was with large farm animals. The Committee considered that the respondent had, and still has, no concept of the difficulties now recognised as inherent in the procedure he performed, or the risks of pain and suffering it posed to the animal."

She added: "The Committee has found that the respondent’s conduct in attempting an intracardiac injection without prior sedation or anaesthesia caused appalling pain and suffering to Bouncer, as evidenced by his screaming, and was wholly unnecessary. The respondent accepted that he had a sedative in his car, but chose not to postpone attempted euthanasia so that he could sedate his patient first.

"The respondent explained in his oral evidence that he had, in the past, euthanased over 200 dogs by intracardiac injection without sedation or anaesthesia. The Committee concludes that this was the respondent’s customary method of euthanasia, and he did not understand why it was wholly unacceptable for a reasonably competent veterinary surgeon to carry out euthanasia in this way. Given his lack of insight, the Committee considers that there is a risk that, if the respondent were to be asked to euthanase a dog in the future, he would be likely to use his customary method, and thereby cause injury and suffering to another animal."

In determining the sanction the Committee decided that, because there had been a serious departure from the professional standards set out in the Code, serious harm was caused and there was a serious risk of harm to animals in the future, that removing Mr Hendrie Smith from the Register was the only means of protecting animals and the wider public interest.

Mr Hendrie Smith has 28 days from being informed of the Committee’s decision to make an appeal to the Privy Council.

The RCVS Council has approved changes to the supporting guidance that underpins its Code of Professional Conduct to allow for non-veterinarians to support veterinary surgeons in the certification of products of animal origin for export.

The plans developed by the Animal and Plant Health Agency (APHA), an agency of the Department for Environment, Food & Rural Affairs (DEFRA), involved the creation of a new role of Certification Support Officers (CSOs), non-veterinarians who would support the work of Official Veterinarians (OVs) in the signing of export health certificates for products of animal origin such as meat, dairy, processed products and animal by-products.

The proposals for the creation of CSOs by APHA has arisen due to concerns about the growth of exports in recent years and the potential for an up to 300% increase in products requiring OV certification if the UK has to certify exports of products of animal origin to the EU once the UK leaves the EU. Under APHA’s plans CSOs will work under the direction of veterinary surgeons and support their certification work (for example, verifying temperature checks), although the final certification will always need to be signed by OVs. The role will not involve certification relating to live animals or germinal products.

At the RCVS Council meeting on Thursday 1 November 2018 Council members agreed to facilitate APHA’s proposals and to make changes to the RCVS requirements so as to allow CSOs to support OVs in their certification work.

Amanda Boag, RCVS President, said: "As we have stated in our recent statement on ‘no-deal’ Brexit, it has been estimated that there would be 325% increase in veterinary certification requirements if the UK leaves the EU without a deal, and with these proposals Defra and APHA are preparing for this by increasing the support available for Official Veterinarians. Furthermore the proposal is in line with the concept of a vet-led team, with veterinary surgeons focusing on tasks only vets can do, whilst delegating some tasks to suitably trained and quality-assured members of our teams.

"We appreciate that there were some concerns over the level of education and training required by CSOs and are glad that the APHA has accommodated those views by increasing the level of education to three A-Levels (or equivalent in Scotland) and clarifying the nature of the training required by CSOs.

"By signalling its support for the proposals, RCVS Council has been assured that the integrity and value of the veterinary signature will be upheld and we are glad that we can play a key role in helping the veterinary profession prepare the UK for leaving the EU."

The RCVS position statement on the potential impact of a ‘no-deal’ Brexit scenario is available at www.rcvs.org.uk/brexit

Elanco has announced the launch of Credelio (lotilaner) for cats, the first oral flea and tick treatment to be licensed for cats.

In trials, Credelio killed more than 98% of ticks within 24 hours¹, and more than 99% of fleas within 12 hours with all fleas killed within 24 hours, for one month². 

Credelio is available in two vanilla-yeast-flavoured tablet strengths and is approved for kittens and cats from 8 weeks of age and older and 0.5 kilograms or heavier.

The tablets are well-accepted by cats: in a three-month field study pet owners were 100% successful in administering the product, replicated each consecutive month³.

Elanco says the new product will be of particular interest to the one in three cat owners who currently use a topical spot on or collar that - according to its research - would prefer to give their cat a tablet when it comes to tick and flea control⁴.

Victoria Sumpter, Companion Animal Technical Marketing Manager at Elanco UK & Ireland said: "Not only can it be stressful to give a tick and flea treatment to a cat, it can completely disrupt a cat’s daily routine.

"With Credelio, treating a cat for ticks and fleas doesn’t have to be a big to-do. The chewable, vanilla-yeast flavoured tablets are widely accepted by cats, so owners have the flexibility to treat with or immediately after food in a way that suits their cat’s needs."

For more information, visit: www.credelio.co.uk

References

1. Cavalleri D et al. Laboratory evaluation of the efficacy and speed of kill of lotilaner (Credelio™) against Ixodes ricinus ticks on Parasites & Vectors 2018 11:413 
2. Cavalleri D et al. 2018. Laboratory evaluation of the efficacy and speed of kill of lotilaner (Credelio™) against Ctenocephalides felis on cats Parasites & Vectors 2018 11:408
3. Cavalleri D et al. A randomized, controlled field study to assess the efficacy and safety of lotilaner (Credelio™) in controlling ticks in client-owned cats in Europe. Parasites & Vectors 2018 11:411
4. Kynetec. March 2018.