The RCVS is reminding veterinary surgeons that their renewal fees to remain on the Register for 2014/15 are now due.

Registration renewal forms have been sent to all vets reminding them that payment to remain on the Register is due by 31 March 2014. If the College does not receive payment before 1 April, £35 will be added to the renewal fee and any vets who have still not paid before 1 June will be removed from the Register.

This year the RCVS has updated its online 'My Account' area (www.rcvs.org.uk/login) to allow vets to manage their details and pay their renewal fees more quickly and easily. Login details have been sent to all vets and the system is now operational. The changes to the area are the first phase of a project to make it more accessible and user-friendly and to allow vets to better manage their details online.

As part of the renewal process, vets are asked to confirm that their details on the Register are correct, including membership category and correspondence details. Those who are in the 'UK Practising' or 'Practising outside the UK' membership categories should also confirm - via the registration renewal form or the online 'My Account' area - that they are compliant with the requirements for continuing professional development (CPD) of 105 hours over three years. Vets with any cautions, convictions or adverse findings against them dating from 1 January 2006 onwards, should also declare them. For further details on these declarations vets should visit www.rcvs.org.uk/convictions.

Fees can be paid by credit card through the 'My Account' area or by cheque, bank draft or credit card via the registration renewal form sent in the post. Details of how to pay by bank transfer are also on the form.

Vets who have any concerns or questions about renewing their registration, logging in to 'My Account' or who need to request a registration renewal form, can contact the Registration Department on 020 7202 0707 or email membership@rcvs.org.uk.

CVS has announced that its Healthy Pet Club loyalty scheme, already the largest of its type in the UK, has reached the 300,000-member milestone.  

Mrs Angie Scullion (pictured right) from Okehampton joined the Healthy Pet Club in May 2017 at Okeford Veterinary Centre with her Border Collie, Cassie. She was awarded a year’s free membership by the practice to celebrate the milestone.

Launched in 2010 with 11,000 members, the Healthy Pet Club helps pet owners budget for their pets’ healthcare by spreading payments over a year. They also make savings on vaccinations, flea and worm treatments and receive access to a wide range of other benefits.

Mr Mukesh Rughani, Healthy Pet Club Manager at CVS, said: "Pet owners want value so we constantly research the market to check that the discounts and benefits we offer through the Healthy Pet Club are the ones that we know they will find most meaningful.

"We are delighted that the Healthy Pet Club has reached the 300,000-member mark and we have a number of exciting developments planned for later this year which we believe will make it an even more useful tool for our member practices while setting a new standard in value for our clients."

VetSurgeon member Simone Kirby Dip EVDC MRCVS, a veterinary dental specialist in London and Hertfordshire, will be running the BUPA London 10,000 for SPANA: Society for the Protection of Animals Abroad.

The charity provides free veterinary care to working animals (donkeys, mules, horses and camels) in some of the poorest parts of the world. They treat around 400,000 hard-working animals every year, ensuring that they can continue providing an income and livelihood for their impoverished owners. Through an extensive education programme, SPANA speak to animal owners to teach them how to improve husbandry and management. They also have initiatives of visiting schools to encourage positive attitudes to animals in school children.

Simone said: "Please give generously for this worthy cause. It would be wonderful if I can meet my fund-raising target of £1,500 - and every penny counts! Thank You!"

To support Simone, please visit her fund-raising website www.justgiving.com/Simone-Kirby

Ceva Animal Health will be hosting Derma Day, a free online conference about the latest developments from the world of veterinary dermatology, on Thursday 28th October from 12:00 - 4:00pm.

Dr Natalie Marks DVM CVJ will present "Meeting the expectations of the new generation of pet owners. Let’s go digital!" and Dr Sarah Heath RCVS & EBVS European Veterinary Specialist in Behavioural Medicine will talk about "Approaching dermatology cases with behaviour in mind".

Natalie's presentation will focus on what the millennial generation of pet owners expect from interactions with their vets and how clinicians need to dig deep to understand how these client groups process information. The talk will demonstrate the benefits of new digital technologies for communication and treatment follow ups, focusing on digital tools to meet client expectations and help the veterinary team offer the best advice.

Sarah's presentation will offer hands-on tips for everyday dermatology work in practice, focusing on the importance of considering emotional health when investigating and treating dermatology patients. She will also discuss the links between emotional state and dermatological disease.

There will also be live studio discussions with vets and nurses including Emma Lindbland Åström DVM, Kerstin Bergvall Diplomate DVM and Cecilia Friberg Diplomate DVM from Sweden. These discussions will focus on communication with pet owners and how the veterinary team copes with the many challenges that occur, especially when it comes to detailed dermatology treatments.  Emma will be joined in the studio by a dog owner who will provide owner insights.

Andrew Fullerton BVSc (Hons) MRCVS, product manager at Ceva Animal Health, said: “Today’s pet owners are often millennials who embrace their new family member with huge enthusiasm, however they often have very different expectations than those of previous generations because they can easily access a wealth of pet health information online.

"The Ceva Derma Day will address this by providing online delegates with extensive information on what makes millennials tick and offer proactive communication tools to strengthen vet/client relationships.”

To register for Ceva Derma Day visit: https://ceva-derma-day-2021.confetti.events 

The event will count for four hours CPD. Delegates who pre-register in advance will be issued with a certificate and be able to watch a recording of the sessions afterwards. Those who don't, won't.

Hill's Pet Nutrition has released the results of a survey of how last year's graduates feel about clinical nutrition.

Despite teaching of clinical nutrition moving up the agenda for most vet schools, over one third of respondents said that they did not feel confident about applying their knowledge of pet nutrition to clinical cases. The remaining two thirds claimed to be reasonably confident but no respondent felt very confident in this area.

When it comes to advising clients 86 per cent would make a nutritional recommendation for their clinical cases but of those, half left it up to the nurse to decide on the brand of food. For 14 per cent of the new graduates, the decision was made to allow nurses to decide on the type of nutrition and brand.

The respondents were also asked about their preferred form of nutritional CPD support. Despite the advances in on-line CPD, the majority expressed a preference for face-to-face teaching in the form of in-clinic updates from reps, speaker tours and roadshows. However e-updates and on-line courses were preferred over paper correspondence courses.

Adrian Pratt, Veterinary Affairs Manager at Hill's Pet Nutrition said: "We recognise that our short survey dealt with only a small number of respondents but it gave us much food for thought. It's disappointing, for ourselves, but more so for the newly qualified vets, that a significant number don't feel confident about making nutritional recommendations. Having been in those 'new vet' shoes, I have to wonder whether this is a crisis of confidence or actually founded on a real or perceived lack of knowledge and also whether this is a finding that applies only to nutrition or affects other areas too. We would very much like to know the answers to these questions because we think that this could be a source of very considerable stress to the individuals concerned.

"Our survey doesn't really tell is whether this is resulting in vets delegating nutritional matters to their nurses because nurses are seen to have at least equivalent, or possibly greater knowledge of nutritional matters and are respected as fellow professionals, or whether these cases are being passed to the nurses with a sigh of relief because the vet doesn't feel able to deal with them. I also found it interesting that vets did not want to be seen to be actively recommending a particular brand, despite the wide variations in clinical evidence and nutritional make up between brands. I do wonder if there could be a perception here that 'brand' is a commercial decision that can be made by another member of the healthcare team, rather than a clinical decision."

Marge Chandler, DVM, MS, DACVN, MACVSc, DACVIM, DECVIM-CA, MRCVS is one of the two American College of Veterinary Nutrition diplomates in the UK (along with Dr Dan Chan) and believes that nutrition is well integrated at the R(D)SVS, "In addition to the general basics, we also teach the basics of small animal nutrition for healthy adult cats and dogs, kittens and puppies, with some emphasis on the special needs of cats. During the clinical lectures there is information provided for disease specific nutritional needs, for example with chronic kidney disease, liver disease, and gastrointestinal disorders.  In their final year, our students are given an interactive tutorial on clinical nutrition for hospitalized small animal patients. In addition to this tutorial, we discuss the patients' nutritional requirements and supplementation during rounds, and there is a nutrition form for each medicine in-patient requiring supplementation."

For those who need access to good quality post-graduate CPD on the topic, Hill's has just launched the latest Veterinary Nutrition Academy (VNA) course. VNA Level 3 is all about applying nutritional principles to make a recommendation appropriate to a clinical case. Anyone who would like to brush up on the topic can register with VNA - registration and the course itself is free of charge.  VNA also gives access to booking forms for Hill's roadshows and other events.

Adrian said: "While face-to-face training events are still proving to be highly popular, it is clear that travel time and cost can significantly hinder access to CPD particularly for those with family commitments or in geographically remote locations and our on-line training courses are continuing to grow in popularity."

Registration to VNA is free at www.myhillspet.com/vna. To complete registration the practice U number will be required and this is available by contacting Jane Quail at Hill's on 01923 814454.

The RCVS has published a summary of the goings on at its 6 November meeting.

Amongst other things, Council agreed to continue to display postnominals in the Register, undertake a consultation on whether members should be able to use the courtesy title 'doctor' and make amendments to the College's current registration regulations.

In addition, 

• Council discussed and approved the College's budget for 2015.
• Council heard that the new Royal Charter had been approved by the Privy Council the previous evening and approved new rules relating to the registration of veterinary nurses which need to be in place when the new RCVS Royal Charter comes into effect and new bye-laws to replace the existing ones which will be revoked when the Charter is sealed and brought into effect.
• Council agreed to amend a number of the current regulations for the registration of veterinary surgeons in order to make the process more convenient for registrants. Key changes include allowing veterinary surgeons to supply either a work or home address for publication in the Register, not charging a punitive additional restoration fee for those who are restored to the Register at the direction of the Disciplinary Committee and no longer levying an administrative charge on credit card payments - a change which will also now allow the College to accept debit card payments. The new registration regulations have now been submitted to the Privy Council, which will need to grant approval before they come into effect.
• Council confirmed that the College will continue to display postnominals for postgraduate qualifications in the Register - reversing a previous decision to remove all postnominals except those for the registerable degree and MRCVS or FRCVS. Council agreed that the following postnominals would be included on the Register - primary veterinary qualifications that the College has a legal obligation to display; qualifications approved for Advanced Practitioner and Specialist status; and other qualifications and honorary postnominals deemed relevant by Council including some non-veterinary/science-related qualifications.
• Council agreed to undertake a consultation on whether members of the College should be allowed to use the courtesy title 'doctor'. The proposals were brought forward by RCVS President Professor Stuart Reid who cited the fact that international veterinary surgeons used the title, that medical practitioners in the UK carry the courtesy title and a recent decision by the General Dental Council to allow dentists the use the title. Council agreed to open the issue to an online consultation with both the public and profession, which is likely to be launched before Christmas.
• Council members heard reports from VN Council and the Audit and Risk, Education, Standards, Preliminary Investigation, Disciplinary and PIC/DC Liaison Committees. Papers for each can be also be found at www.rcvs.org.uk/about-us/rcvs-council/council-meetings
• During the afternoon session of Council, members considered a range of possible options for reforming the governance structure of the College. The case for reform was outlined by Professor Reid who asked Council members to consider its decision-making functions, size, composition and frequency of meetings. Following group discussions various views were put forward, including a larger consultative Council which would meet less frequently, alongside an enlarged Operational Board which would meet monthly; and having a smaller Council which would meet more frequently. The Operational Board will now be considering these views and will put further proposals to Council in March.
• Council agreed a recommendation put forward by members Mark Elliott and Richard Stephenson that recognised that while much decision-making had been delegated to committees (eg the Standards and Education Committees), Council members should feel able to discuss decisions made in committee with which they disagree. Furthermore, the recommendation stated that committees should be encouraged to refer major policy decisions to Council for ratification. The majority of recommendations were accepted in principle by Council.

More information about these decisions can be found in the latest edition of RCVS News, copies of which have been sent to all veterinary surgeons and listed/registered veterinary nurses.

The full papers for the Council meeting can be found on the RCVS website at www.rcvs.org.uk/about-us/rcvs-council/council-meetings

North Yorkshire-based Amelia Briggs MRCVS has been reprimanded and warned by the RCVS Disciplinary Committee after she was found to have been dishonest in documentation relating to her official avian influenza surveillance visits. 

Dr Briggs faced four charges and admitted to her conduct in the first three at the outset. 

They related to three official Animal and Plant Health Agency (APHA) clinical investigation report forms she submitted following three official avian flu surveillance visits she'd undertaken as an Official Veterinarian (OV).

The three surveillance visits all took place during an outbreak of avian influenza in North Yorkshire and were on behalf of the APHA.

Dr Briggs admitted that she'd certified on each of the three forms that she had inspected specific poultry, that she had seen no clinical signs of avian influenza in the poultry and that in her opinion avian influenza did not exist and had not existed in the previous 56 days.

Dr Briggs also admitted that that she had subsequently submitted the three forms to the APHA.

The fourth charge alleged Dr Briggs conduct in certifying the three forms had been dishonest and that her actions risked undermining procedures, regulations and rules designed to protect animal welfare and public health.

Dr Briggs denied that she had been dishonest in any of her actions but admitted that her conduct had risked undermining procedures designed to protect animal welfare and public health.

Dr Briggs explained that in two cases she had relied on information given to her by the keepers of the poultry and in the remaining case it was possible that she had not visited the correct location of the poultry, had posted a letter through the wrong door and had then accidentally submitted a pre-populated inspection form to APHA.

Having heard evidence from the relevant poultry keepers, fellow Official Veterinarians, officials from the APHA and Dr Briggs herself, the Committee gave its determinations on dishonesty.

In relation to the first two charges, which concerned the visits that did take place, the Committee found Dr Briggs had been dishonest both in submitting the inspection forms to the APHA and also in certifying that she had seen no clinical signs or history of avian influenza in both cases.

The Committee concluded that an ordinary decent person would regard the submission of a signed form which contained false information as dishonest.

It also concluded that Dr Briggs had deliberately signed an official form which contained information which she knew to be untrue.

However, the Committee found that Dr Briggs was not dishonest in asserting on these forms that she was of the opinion that disease did not exist based upon the information provided to her by the poultry keepers.

In relation to the third charge, where Dr Briggs did not visit the property concerned, the Committee did not find it proven that she had been dishonest, having heard her evidence that, in this case, she had accidentally submitted a pre-populated inspection form.

The Committee next considered whether the admitted and proven charges amounted to serious professional misconduct.

Paul Morris, chairing the Committee and speaking on its behalf said: “In considering the seriousness of the misconduct, the Committee took into account the fact that the misconduct had involved dishonesty, that there had been a risk of injury to animals and humans (though this risk had not materialised), and that the misconduct had occurred when the respondent, as an Official Veterinarian, occupied a position of increased trust and responsibility.”

He added: “The Committee considered that honest, accurate and careful veterinary certification was a fundamental component of the responsibilities of a veterinary surgeon.

"The matters which the Committee had found to be proved fell far short of the standards expected of a registered veterinary surgeon and amounted, in the Committee’s judgment, to disgraceful conduct in a professional respect.”

In considering the sanction for Dr Briggs the Committee heard positive character testimonials from former employers and clients, as well as a representative from the APHA who said that Dr Briggs had shown contrition for the breaches while recognising that there was unlikely to be a repetition of the conduct and that Dr Briggs was a relatively new and inexperienced vet at the time of her actions.

Mr Morris said: “In the Committee’s judgement the circumstances of the incident were a mitigating factor in the sense that the respondent was working in a pressurised environment, and in a field of practice which was unfamiliar to her.

"The Committee had heard a considerable amount of evidence from various witnesses that the surveillance system created, to monitor the prevalence of avian influenza was one which placed considerable pressure on OVs and, perhaps inevitably, had some shortcomings.

"The respondent had not worked with poultry before so her inexperience in this area fed into this situation.

“The Committee took into account the fact that no actual harm had occurred and there was no financial gain to the respondent.

"The matters with which the Committee was concerned formed a highly unusual, and short-lived, episode in the respondent’s career.”

The Committee also considered that Dr Briggs had made open and frank admissions regarding most of the charges against her and had also shown genuine contrition over her failings.

In light of this, the Committee considered that a reprimand and warning as to future conduct was the most appropriate sanction.

Mr Morris added: “False certification can never be acceptable.

"Veterinary surgeons should never certify any matter which they know, or ought to know, not to be true.

"However, the Committee considered that this case was at the lower end of the spectrum of gravity of false certification cases, that there is no future risk to animals and that the respondent has demonstrated insight.

"In relation to the public interest, the Committee considered that a reasonable and fully informed member of the public would recognise that, in all the circumstances of this particular case, a reprimand and warning as to future conduct would be sufficient to satisfy the public interest.”

www.rcvs.org.uk/disciplinary

A report published by the Environmental, Food and Rural Affairs committee this week has concluded that The Veterinary Surgeons Act 1966 is in need of updating. However, lack of available budget in the current Comprehensive Spending Review period means that further work on a White Paper won't happen till 2011 at the earliest.

In particular, the report found consensus within the profession that the disciplinary procedure is in urgent need of updating. However, the Royal College of Veterinary Surgeons does not have majority support for its proposals on compulsory practice standards and compulsory continuing professional development.

The report crticised the RCVS for not having done enough to provide a clear picture of its proposals for a new statutory framework for the regulation of the profession.

However, an RCVS spokesman said: "In fact, we have invested considerable time and resources in the development of proposals, led by a working party that included stakeholders. However, we have been awaiting further input from Defra before taking matters further."

Chairman of the Committee the Rt Hon Michael Jack said: "We urge the profession to coalesce round some specific proposals to amend the disciplinary process for veterinary professionals. We believe that a working party should be set up between Defra, the Royal College of Veterinary Surgeons and the British Veterinary Association to produce a new Bill for introduction in 2009."

Responding to the publication of the report, BVA President Nick Blayney said: "While we will certainly consider EFRACom’s proposal that BVA work with Defra and RCVS to produce a draft bill, the BVA is a voluntary association and our focus is the benefit of our members. Given that we are not even persuaded of the need for a new Act, it is likely that our contribution will be advisory and not financial."

Click here for the full report

Pfizer Animal Health, maker of the equine wormers Equest and Equest Pramox, has unveiled www.wormingyourhorse.info, a new website which aims to make it easier for horse owners to understand and follow the most up-to-date principles of sustainable worm control.

Based on the company's Manage, Test, Plan, Dose campaign, Pfizer says the new website is designed to take the confusion out of equine worm control with clear, logical and easy-to-understand guidance and advice.

The four main sections use diagrams and text to explain how and why it's important to manage the worm challenge on the pasture; the role of faecal worm egg counts (FWECs); how history and management play a part in planning the best worm control programme and how to choose and use the right wormer at the right time of year.

There's an interactive and educational parasite page that shows the parasites that can affect the health of your horse. There are click through buttons on parts of the horse's anatomy revealing details about the appearance of each particular parasite, their lifecycle and the symptoms they can cause. In addition there's a section on frequently asked questions which provides no-nonsense answers to some of the most commonly asked questions about worm control.

Paul Blanc, Pfizer's equine brand manager said: "In developing our new website we have listened carefully to what horse owners really want and need to know. The result is a source of plain-speaking, unbiased facts and advice, providing horse owners with the most current thinking on sustainable worm control in a format they can really identify with."

VetHelpDirect.com has conducted a survey of 380 vets which found that 54% have received verbal abuse referencing the Competitions and Markets Authority report.

15.3% said they had received written abuse and 13.4% had received online abuse.

One in ten (9.87%) had cited receiving generally negative grumbles from their clients and a small percentage (0.8%) said they had noticed negativity from usually supportive clients.

17% reported abuse relating to the CMA across more than one platform. 

On the other hand, the survey also revealed that 22.4% had received support in person, almost one in twenty (4.5%) had received online support, and 2.4% cited they had received supportive correspondence.

The National Office of Animal Health (NOAH) is calling on vets to support the #VaccinesWork campaign.

Starting in the New Year, the benefits of vaccination will be communicated to both farmers and pet owners, initially focussing on farm use. 

The aims of the campaign are to raise awareness of how and why vaccines work and the range of diseases they protect against, to review and improve how vaccines are stored and administered, and to encourage better uptake of existing vaccines. 

Further information and tips on storing and using vaccines correctly will be shared, to help ensure that vaccines used will be effective.

NOAH says that research has shown that:

• Only 53% farmers know the correct temperature for vaccine storage
• 73% do not have a separate thermometer or data logger
• Less than 10% check fridge temperatures daily

Dawn Howard, NOAH’s Chief Executive said: “It is encouraging that vaccination of the UK’s calves and sheep against livestock diseases has risen to one of the highest levels in seven years¹. This increase is encouraging, however still more needs to be done in relation to uptake, storage and usage. We are asking the vet profession to support the #VaccinesWork campaign by spreading the messages with their clients and engaging on social media."

"We will be providing information for farmers e.g. if vaccines are not stored correctly, it will impact on their potency, meaning they could be less effective – not only will there be the potential for the vaccine to fail to protect animals against disease but also farmers may have wasted their efforts – and may be deterred from vaccinating again."

Whilst correct use by farmers is the initial focus, the campaign will include pets. Dawn said: "The topic of vaccine hesitancy is becoming increasingly important. Recognised by the WHO as one of the top 10 global health threats for people in 2019, this phenomenon is translating to the veterinary sector as well, especially in companion animals. The PDSA reports an ‘alarming’ drop in pet vaccinations: the proportion of pet dogs, cats and rabbits receiving a primary course when young has fallen by 18% over the past 3 years, down to 66%³.”

"This is bad news for the health and welfare of the nation’s pets, who are increasingly at risk of disease, and we need to work to address this."

References

1. https://ahdb.org.uk/knowledge-library/use-of-vaccines-in-cattle-and-sheep-2018-sales-update

2. https://www.noah.co.uk/wp-content/uploads/2019/10/NOAH-Vision-Paper-8pp-A4-Sep-19-vf.pdf

3. https://www.pdsa.org.uk/media/7420/2019-paw-report_downloadable.pdf 

New research, conducted by the WALTHAM-initiated Laminitis Consortium, has raised questions over the assumption that soaking hay will make it safe to feed to laminitis-prone horses and ponies¹. 

The Laminitis Consortium comprises world-leading equine veterinary, nutrition and research experts interested in collaborating on the important topic of laminitis. It includes the authors of this work: Dr Pat Harris of the WALTHAM^® Equine Studies Group, Clare Barfoot of Mars Horsecare UK Ltd and Dr Annette Longland of Equine Livestock and Nutrition Services (ELNS).

Over-consumption of water-soluble carbohydrates (WSC) has been associated with the onset of laminitis. It has been recommended that hay with a non-structural carbohydrate (WSC and starch) content of less than 10% should be fed to obese animals as well as those at risk of laminitis² and that hay should be soaked in water before being fed in order to reduce the WSC^3,4,5.  The study, which was completed earlier this year, examined the loss of water-soluble carbohydrates from nine different hays submerged in water for up to 16 hours.  It was presented to the biannual Equine Science Symposium in America in May 2009.

Previous studies have shown that the prolonged soaking of chopped hay in large volumes of water can result in the leaching of nutrients, including soluble carbohydrates. However, because common practice in the UK tends to involve long-stemmed hay, soaked in relatively small volumes of water over varying timescales, the Laminitis Consortium's study aimed to replicate such a practice⁶.

The nine different hay samples were analysed for WSC and then soaked in cold water. The soaked samples were subsequently analysed at four intervals of 20 minutes, 40 minutes, three hours and 16 hours.

Clare Barfoot said: "The results showed a highly variable leaching of WSC and substantially less leaching than reported previously for chopped hay soaked for 30 minutes.³

"Very few samples reached below 10% WSC, despite prolonged soaking. The concern is that this strongly suggests that soaking may not be sufficient to render some hays safe to feed to horses and ponies prone to laminitis. 

"Our current advice is that ideally you should analyse your hay before feeding it to an animal at high risk of laminitis and choose hay with the lowest WSC content you can find. Soaking hay provides an additional safeguard but should not be relied upon."

The study also highlights that if hay is soaked for extended periods, it may not meet the nutritional requirements of the animal because substantial amounts of other nutrients, protein, vitamins and minerals will also be lost ⁵. In such cases it is even more important that the horse or pony should receive a balanced supplementary feed.

The Laminitis Consortium is continuing its work in this area and hopes to be able to identify practices that will be of greater benefit to the horse owner faced with hay of unknown WSC content.

¹Longland AC Barfoot C &  Harris PA  (2009) The loss of water- soluble carbohydrate and soluble protein from nine different hays soaked in water for up to 16 hours.  J. Equine Vet Science 29 (5 ) p 383 - 384, ² Frank  N Equine Metabolic Syndrome J Equine Vet Sci 29 (5) p 259 - 267, ³Cottrell, E., Watts, K., Duarte, S. and Ralston, S. (2005). Equine Science Symposium, 2005, ⁴Kenny, D. (2007). Proceedings of the British Society of Animal Science. ⁵Warr EM, Petch JL. Equine Vet Educ 1993;5:169-171, ⁶Longland, A.C. (2009) In preparation.