Jurox has issued a statement confirming its commitment to those practices who want to use Alfaxan (alfaxalone) following what it describes as the second major shortage of the most widely used veterinary licensed propofol (Inductofol and Vetofol, Norbrook) in 18 months.

Alfaxan 10mg/mL solution for injection for dogs and cats is licensed as an induction agent prior to inhalation anaesthesia and as a sole anaesthetic agent for the induction and maintenance of anaesthesia for the performance of examination or surgical procedures. Jurox highlights that it has been safely used in patients from 12 weeks of age, for the induction of anaesthesia prior to delivery of puppies by caesarean section and for maintenance anaesthesia in procedures lasting up to an hour.

Jurox offers the following advice: "Part 1 (2) of Schedule 4 of the Veterinary Medicines Regulations states that 'if there is no authorised veterinary medicinal product' then the cascade may be followed. Alfaxan is an available and authorised veterinary medicinal product with very similar indications and therefore there is no clinical need to resort to non-licensed formulations of propofol, under cascade, for veterinary intravenous anaesthesia."

The company says that its UK team of veterinary surgeons will again respond proactively to the propofol shortage by delivering educational support to veterinary professionals and assisting them through the change to another veterinary licensed product for the anaesthesia of cats and dogs should they wish.

If you would like to discuss specific cases or need support using Alfaxan for the first time, contact Jurox on 0800 500 3171 or email alfaxan@jurox.co.uk

Liphook Equine Hospital in Hampshire has become the first veterinary practice in the UK to perform foraminotomies to address spinal nerve compression.

The procedure has already been performed in the US and Germany, where it is reported to have had a success rate of 70-80% in around 250 cases, many of which were show jumpers, eventers and dressage horses.

The team at Liphook, led by European Specialist Rachel Tucker (pictured), has now performed the procedure on six horses.

Rachel said: “Enlargement of the articular process joints of the lower neck is a relatively common finding in horses, but occasionally this can cause compression and irritation of the spinal nerves.

"The foraminotomy procedure means horses experiencing nerve pain can be made comfortable and have a good chance of returning to ridden work and a competition career.

“The surgery is minimally invasive but it is a very delicate procedure to perform because you are working very close to the spinal cord.

"Due to the location, the surgery is performed down a single portal under direct visualisation using a camera, guided by ultrasound and X-ray.

"What has been remarkable so far has been the rapid recovery of the horses, who have been home and out in a small paddock within a few days of surgery with some showing rapid signs of improved comfort and movement.

“We are very pleased with how the procedures at Liphook went.

"Our patients are continuing to recover well and we are looking forward to following their progress in the future.

https://liphookequinehospital.co.uk 

A survey published today by the veterinary recruitment agency recruit4vets has found 45.8% of salaried veterinary surgeons earning less than £35K per annum.

251 veterinary surgeons in full-time permanent employment took part in the survey, the largest number (37%) working in the south east and London.

The survey found that the typical starting salary was £31K per annum, rising to 41K for a more experienced vet in small animal practice, and £44K for more experienced large animal practitioners. The survey also found that senior vets with over 20 years experience earn up to £69K.

The survey also looked at locum charge-out rates, which varied from £220-£230 per day (17%) to over £250 (15%), with the greatest number (29%) charging between £240-£250.

62% of locums said their hourly pay rate had not changed in the last 12 months, compared to 45% of permanent staff who said their salary was unchanged over the period. This despite 65% of vets saying that the demands on them within the practice had increased in the last 12 months. 

Recruit4vets has produced a couple of video presentations about the results, locum pay covered here and permanent pay covered here.

Visit VetSurgeon.org Jobs for the largest selection of classified jobs for veterinary surgeons.

Following legislative changes, the British Veterinary Association has updated its 'Good Practice Guide to Handling Veterinary Waste' for England and Wales.

Supported by the Environment Agency the Guide primarily consists of a quick-reference poster enabling vets to categorise and segregate veterinary waste in line with Environment Agency requirements. The poster defines the types of hazardous waste, outlines the types of containers required and sets out the appropriate classification codes.

The Guide is complemented by more detailed web guidance which incorporates useful templates to download.

BVA President Carl Padgett said: "All businesses have a duty of care to ensure that all waste is stored and disposed of responsibly, that it is only handled or dealt with by those authorised to do so and that appropriate records are kept of all waste that is transferred or received.

"The BVA Guide has been a popular resource for the profession since we first launched it in 2008 making it considerably easier for vets to comply with Hazardous Waste Regulations. The revised poster is hopefully an incentive for practices to check if their requirements have changed and ensure they're still up-to-date."

The poster and web advice are available at http://www.bva.co.uk/activity_and_advice/1641.aspx and BVA members will receive a hard copy of the poster to display in their practice.

Kieran Borgeat and Jose Novo Matos, two RCVS Recognised Specialists in Veterinary Cardiology, have launched The Animal Heartbeat, a fortnightly podcast covering all things cardiac.

The first two episodes, which discuss feline cardiomyopathy, are available now at: https://www.buzzsprout.com/2189360 and all the leading podcast platforms (including Apple, Spotify, Amazon and Google).

Future topics will include pre-clinical feline cardiomyopathy and a practical approach to puppy murmurs.

There'll also be a number of special guests, including Prof Virginia Luis Fuentes from the Royal Veterinary College, who will discuss the treatment of feline heart disease beyond standard therapy, and Dr Brian Scansen from Colorado State University, who will talk you through the diagnosis and management of pulmonic stenosis.

To keep up with the latest from Kieran and Jose, you can follow them on Twitter or Instagram @heartbeat_pod. 

They'd also love you to post to questions for their guests, or any comments you have about the podcasts, on their social media channels. 

VetHelpDirect.com, the directory of veterinary practices in the UK founded in 2006 by Susie Samuel MRCVS, has added a new price comparison service with prices from 1600 practices to the website. 

The new service was reported in The Times, in an article titled "How much should your vet cost? Pet owners bitten by untamed fees."

Since launch, VetHelpDirect has offered owners information to help them pick a veterinary practice, including reviews, ratings (including a value for money score), RCVS accreditation, cat/ rabbit friendly status, health plan details and how out of hours cover is provided.

It has now added some basic information about each practices' charges, specifically the first consultation fee, a dog castrate and health plans, and then categorised them according with £££££ signs to indicate how far above or below the average they sit.  

Susie Samuel said:  “Most practices will give out these prices over the telephone, but there’s no way for the client to find them without directly getting in touch, something people are less and less likely to want to do nowadays.

"Our research data suggests that people want to find this information online, just as they would in any other service industry.

"When they can’t find any information at all on pricing, there can be a perception of secrecy that can do damage to the vet-owner relationship.”

Susie added: “True comparison for vet practices is of course very complex and no basket of services is ever going to capture the whole complexity.

"Every practice is different, from facilities and team qualifications; to the time allotted for consultations; to monitoring equipment for surgery; and of course the level of investigations undertaken which can also vary from vet to vet.”

“We can’t solve all this straight away but we started from a good place, over the years we have built up more information about vet practices than any other website.

"The aim is to provide commonly requested prices for owners to easily access and to add more and more detail on the vet practices over time so that owners can make the most informed choice on the vet that's most appropriate for them and their pet”.

VetHelpDirect says it will soon be adding prescription fees and out of hours consultation, and a much wider range of species-specific fees in the near future.

The company also points to the Competition and Markets Authority investigation into pricing in the UK, highlighting that in its 2019 Report into Funerals in the UK, the CMA noted that weaknesses in the sector included the fact that less than 40% of funeral directors posted any form of pricing online, and those that did were frequently not in a form that made for easy comparison.

Susie says the veterinary sector has an even lower rate of online pricing transparency.

To add your pricing information to VetHelpDirect, email: info@vethelpdirect.com.

COMMENT

Whilst greater transparency over pricing in almost any field is surely to be welcomed, it seems questionable whether comparing prices for consultations and standard procedures will be of much help to pet owners, because things like the level of investigations, how defensively a clinician practises and the owner's own relationship with risk are likely to have a far greater impact on the bill than whether a consult costs £20 more or less up the road. 

There is perhaps also a risk of practices rated as '£££££ / more expensive than average' will be seen as just that. Expensive and nothing more.

It's not like a restaurant where £££££ usually means particularly delicious.

Whilst this may not matter much whilst so many practices are having to turn away business, it may become more important in the future.  

Discuss here. 

MSD Animal Health has launched the Pet Diabetes Tracker, a free new app designed to help veterinary professionals and their clients track and manage diabetes.

The new app, which is being being made available in the run up to Pet Diabetes Month in November, allows owners to track water and food consumption, exercise, glucose levels and insulin injections on their smartphone or tablet. It can also send reminders for veterinary appointments and insulin injections, and creates charts that clients can share with their veterinary surgeon.

MSD says the Pet Diabetes Tracker will help improve client reporting and compliance, resulting in improved pet welfare and a reduction in risk to pets through its alert system.  

Caroline Darouj, Product Manager at MSD Animal Health said: "To help ensure the long-term health and well-being of a pet, successfully managing the various facets of the disease and treatments is critical.

"With proper management and monitoring a dog or cat with diabetes can lead a healthy, happy and active life, and the Pet Diabetes Tracker can help make it happen. This is an incredibly useful tool that links the pet owner with the vet and puts all the pertinent diabetic health information at their fingertips. It’s all about setting habits that save lives!"

The Pet Diabetes Tracker can be downloaded from iTunes, here: https://itunes.apple.com/uk/app/pet-diabetes-tracker-uk/id1284472796?ls=1&mt=8. 

MSD says an Android version will also be available soon.

For more information, visit www.petdiabetesmonth.co.uk or contact your MSD Animal Health account manager.

Ceva has announced the launch of GRAM, a practical guide on the rational use of antimicrobials in dogs and cats.

GRAM (Guidance for the Rational use of AntiMicrobials) is a 500-page guide written by a panel of 10 independent European experts from the fields of microbiology, pharmacology and dermatology, all of whom are specialists in internal medicine, surgery and epidemiology. Based on rational use with compliance at the forefront, GRAM provides tools for improved diagnosis and positive treatment outcomes.

The guide consists of 37 disease fact sheets, 29 practical recommendations and six reference synopses. It features a range of topics including:

• Which therapeutic approach is recommended while awaiting results?
• How to deal with multidrug resistant infections
• How can the development of resistance be limited when using antibiotics (timing, dosage, duration).

Andy Forsyth, senior technical veterinary advisor at Ceva said: "Antimicrobial resistance continues to be a concern in both human and animal health. GRAM will help educate veterinary professionals on how they can play their part in creating sustainable antibiotic use."

To request a copy of GRAM or for further information on sustainable antibiotic use, contact your local Ceva Animal Health territory manager.

The Journal of Small Animal Practice (JSAP) has published a new study which it says supports the use of weekly proteinuria monitoring during the first month of masitinib treatment for neoplasia.

The study, titled “Development and progression of proteinuria in dogs treated with masitinib for neoplasia: 28 cases (2010 – 2019)”, also suggests that a urine protein: creatinine greater than 0.5 should prompt reassessment within one week.

For the study, the clinical records of 38 dogs referred to a single university teaching hospital between 2010 and 2019 for treatment of neoplasia with masitinib were retrospectively evaluated.

Data was collected at masitinib initiation and at various timepoints following the start of treatment.

Data gathered included the masitinib dose given and any changes to medication administration or dosing since the previous visit, presence of gross disease and the results of haematology and biochemistry profiles, urinalysis and urine cultures.

Urinalysis results were only included if they were performed at a reference laboratory.

At each timepoint, the urine was classified as non-proteinuric (UP:C ≤0.5) or proteinurinc (UP:C >0.5). Proteinuria was then categorised as likely pre-renal, post-renal, physiological renal or pathological renal.

Dogs were grouped based on the presence or absence of proteinuria at baseline. Non-proteinuric dogs were further divided, based on whether proteinuria developed following treatment during the study.

Of the 28 dogs in the study, five were being treated for epitheliotropic lymphoma, one for vulval lymphoma, one for malignant melanoma and 21 for mast cell tumours.

Twenty-two (79%) dogs were non-proteinuric and six were proteinuric at baseline.

Of the dogs that were non-proteinuric at baseline, four (18.2%) developed proteinuria within one month of treatment initiation. Median time to first detection of proteinuria was 14.5 days (range: 13 to 31).

Of the dogs with pre-treatment proteinuria (n=6), masitinib treatment was discontinued due to lack of efficacy in three dogs, and three were euthanased during treatment, two for disease progression and one for an unknown reason.

Dr Margaux Kuijlaars, corresponding author for the paper, said: “Patients developing proteinuria should be investigated to exclude non-renal causes. This should allow for more informed recommendations on the monitoring and management of proteinuria and further masitinib treatment in these patients to be made. Masitinib treatment can be considered in patients with pre-treatment proteinuria and does not inevitably cause worsening of proteinuria.

“The findings of this study add to the evidence base for the use of masitinib in treating neoplasia in small animal patients. The use of masitinib in dogs in this study was off-licence as C-KIT MCT expression was not determined, and many dogs were treated for other tumours.”

Nicola Di Girolamo, Editor of JSAP, said: “Little is known about which dogs are predisposed to becoming proteinuric following treatment with masitinib for neoplasia. Due to the small number of dogs in this study that developed proteinuria, conclusions about predisposing factors cannot be definitely drawn.

"The findings of this study add to the evidence base and demonstrate the need for larger, prospective trials including a control population and longer period of follow-up.”

The full article can be found in the August issue of the Journal of Small Animal Practice and can be read online here: https://www.onlinelibrary.wiley.com/doi/10.1111/jsap.13305. It is open access and can be freely accessed by anyone.  

Reference

1. M Kuijilaars, J Helm and A McBrearty (2021) Development and progression of proteinuria in dogs treated with masitinib for neoplasia: 28 cases (2010-2019). Journal of Small Animal Practice, 62 (8). Available at: https://www.onlinelibrary.wiley.com/doi/10.1111/jsap.13305

John Lewis Pet Insurance has announced that it will not be charging its customers the £200 penalty introduced by underwriters RSA for non-urgent referrals outside its Preferred Referral Network.

The company said:"The RSA Referral Vet Network has been established to give customers access to a trusted network of vets that provide a high standard of service and value for money. However we do understand that in some cases where the primary vet recommends a referral practice and circumstances dictate that our nearest Network partner is not suitable, we will allow our customers to make a choice without being penalised.

If the treatment in question is covered under the policy, there will be no additional fee charged whether or not they choose to use a Network practice."

Vets For Choice, a group of referral practices campaigning against RSA's Preferred Referral Network, welcomed the news. 

However other brands, such as MoreThan, Tesco and Argos, have proceeded with the penalty.

Clive Elwood, one of the referral practitioners behind Vets For Choice, said: "The big question to ask now is if John Lewis can opt out of the fines why can’t Tesco and Argos?

"John Lewis clearly does not agree with springing extra charges on their customers at the point of need and this seems to be in line with their reputation for better customer service.

"MoreThan, Tesco and Argos customers should rightly ask why they are being treated differently to John Lewis customers."

In a press release, Vets For Choice highlighted RSA's July announcement that it was extending its then 29-practice strong referral network by 24, noting that only weeks later it announced its group operating profit was up 20% to £312 million.

In a robust response, an RSA spokesperson said: "The handful of vets behind Vets for Choice have point blank refused to discuss the real issue with non-emergency referrals - the huge variation in costs being charged to pet owners by some vets and paid for by insurers. Vets for Choice has refused to address this issue with us either directly or indirectly, and their desire remains to have a complete lack of transparency about their costs and charges. We are no longer prepared to duck the issue of cost and the lack of transparency in vets’ charges. This impacts on pet owners and means their cover limits do not go as far as they should.

"Our network partners recognise that for pet insurance to remain affordable, the veterinary and insurance industry needs to work more closely together on behalf of customers. Vets for Choice are happy to discuss any issue but the real one and they continue to knowingly distort the facts. The reality is that we have now had 12,700 referral claims from our Network partners, with only 79 customers choosing to pay the £200 charge to use a non-Network partner – well under one percent of all customers. The reality is there is no huge public outcry. The reality is that we have not seen any rise in complaints. The reality is that is our customers are more than happy to have our Network partners treat their pets, knowing that their cover limits are going further. 

"Vets for Choice also mentioned our 20% rise in Group Operating Profit. The key word here is Group – the fact is the majority of our profit was made from our international markets. Group operating profit bears no relation to how our UK pet insurance business performed and it is disingenuous to link the two. It is also disingenuous to imply that all brands should act in the same way as their business models differ according to the customer segment they wish to attract. As ever, the choice remains with the customer."

Parasitologist Dr Ian Wright, head of the European Scientific Counsel Companion Animal Parasites UK and Ireland (ESCCAP), has warned of a growing threat from exotic ticks arriving in the UK.

Speaking at Improve International's OV Conference last week, Dr Wright cited increased pet travel and importation as key risk factors, including the growing number of rescued dogs arriving in the UK from countries in Europe and further afield.

Dr Wright highlighted the Rhipicephalus tick (Rhipicephalus sanguineus) as being a particular cause for concern, as it can transmit Ehrlichia canis, Anaplasma platys, Rickettsias, Babesia vogeli and Hepatozoon.

Dr Wright said that Ehrlichia canis and Anaplasma platys are among the most common tick-borne diseases in imported dogs, particularly those arriving from Eastern and Southern Europe. There were also three cases of Hepatozoon canis in 2018, caused by dogs ingesting Rhipicephalus ticks while grooming.

According to figures from a Bristol University Pet Travel survey, 54.5% of dog travel on the Pet Travel Scheme from the UK is to France with Southern European countries also popular destinations. These are all countries in which Rhipicephalus is present and on the increase. Dr Wright said that the ticks are moving north into Austria, Switzerland, Central France, Romania and Bulgaria.

During the last few months, he has also been alerted to ticks found on dogs coming in from North America, Latin America and Africa. These bring with them the risk of new diseases, including a variety of zoonotic rickettssial pathogens, such as Rickettsia Rickettsii, which causes Rocky Mountain Spotty Fever.

To address this issue Dr Wright urged vets to redouble their efforts on tick prevention. In particular, he recommended tick prevention pre/during and post travel, using products that offer rapid kill and repellency in order to reduce transmission, repellents being especially important in Leishmania infantum and Rhipicephalus-endemic countries.

Dr Wright recommended drilling clients and staff on tick removal and reminding them that finding a tick on a pet is not a failure as no product is 100% reliable and it is easy to miss them in long-haired dogs. He also suggested asking clients to take photos of any ticks they find on their pet while abroad so that their vet will know on their return what pathogens they may have been exposed to. If necessary, the Public Health England Tick Surveillance Scheme can help with identification.

Dr Wright suggested that legislation to enforce tick treatment on entry was a poor strategy used in isolation as pets would still be exposed while abroad and no product is completely reliable. It would be useful however, to raise awareness and show that we are taking the issue of tick-borne disease seriously.

He said: "We’re seeing a significant increase in pet travel and import a wider range of countries from which dogs are being imported and this is significantly increasing our exposure to exotic ticks.

"What’s news about this is that while you could argue that diseases such as Lyme Disease are ‘lifestyle’ diseases because people and dogs are exposed to our native ticks while out enjoying the countryside, the Rhipicephalus tick comes to your home, exposing you to a wealth of rickettsial diseases for the first time. We are already seeing instances of this in France, Germany and Scandinavia and, as pet travel continues to grow, the risk here will only increase. It’s equally possible that a dog with a native tick could travel aboard and return hosting a new pathogen.

"The only way to manage this risk is to provide consistent advice to the public and to support increased disease surveillance. Vigilance is key – assume that any travelling dog may have ticks and do not assume that because it is tick-treated, it’s a case of ‘job done.’"

He said: "Put the onus on clients - gently. Remind them to seek advice, to check for ticks and to keep tick treatments up to date. Also remind them to visit the practice with their dog as soon as possible on their return. If you do find exotic ticks, please send them to the Tick Surveillance Scheme for identification."

He added: "If you know an owner who is planning to adopt a dog from abroad, explain the risks to them and encourage them to adopt from the UK. If they are determined to go ahead, work with them to ensure that you reduce the risk of exotic ticks arriving with their new family members. The risk to human and animal health from an infestation should not be underestimated."

Wear Referrals in County Durham has claimed a world-first double ankle replacement for a dog.

The patient was a four-year-old Labrador called Vinny who, in 2019, became the first dog in the UK to receive a BioMedtrix canine ankle replacement system, implanted by Wear's Head of Orthopaedic Surgery, RCVS Specialist Neil Burton, assisted by Maciej Krukowski.

That first surgery, on Vinny’s right ankle, was successful. However, two years later he needed similar treatment to his left leg.

Neil said: “Vinny first presented to us at Wear Referrals in 2019 with hind limb lameness.

“He was diagnosed with osteoarthritis in his hock joints bilaterally due to a developmental condition called osteochondrosis of the talus causing him ongoing pain and lameness. We operated on the right ankle, with Vinny becoming the first dog in the UK to have this ankle replacement system placed. 

“Vinny was significantly more comfortable on this limb postoperatively but his lameness progressively worsened in the left hind limb. The decision was made to perform the same surgery on the left ankle, making Vinny the first dog in the world to have this surgery performed bilaterally.

“Vinny has made another fine recovery from surgery and is now off medication, meaning he can exercise unrestricted and pain-free without a lifetime reliance on painkilling drugs.

“For our team at Wear to be able to offer him this pioneering surgery has been a great opportunity. He’s now a unique case, being both the first UK recipient of this BioMedtrix joint replacement as well as the world's first bilateral ankle replacement with the same system.”

For more information, visit www.wear-referrals.co.uk.

VET Festival has announced that the television and radio presenter Jonathan Ross OBE is to join the line-up at this year's event, taking place on the 8th and 9th June in Surrey.

Jonathan will be taking part in the VETFest Conversation on the Friday evening: a relaxed conversation with event founder Professor Noel Fitzpatrick in an intimate setting which organisers say allows delegates to really feel and be part of the conversation. 

Noel and Jonathan will be reflecting on some of the common experiences, fears and thoughts all people from all walks of life share.

Noel said: "We are so excited that Jonathan has agreed to join us for the official launch of the VETFest Conversation on Friday night. Jonathan will offer an illuminating new perspective on some of the matters we will all relate to professionally and personally. This is so much more meaningful than just a chat between two people. We want everyone present to feel part of the conversation and converse together as openly and comfortably as is we were in your living room. This is what the VETFest Conversation is about, a really special experience. 

"VET Festival has always and will forever be about providing a dynamic and engaging event that empowers all veterinary professionals who attend to leave the field with not only educational development but deep personal enrichment too. We all feel the stresses and strains of failure, financial stress, management challenges, difficult interpersonal relationships, self-confidence, fear and even depression. We lose our connectedness to each other with the weight of these burdens. 

"This conference isn’t just about Veterinary Education for Tomorrow – it’s about looking after each other. With the VETFest Conversation, we are aiming for something new; something that depends entirely on raw emotion, passion, knowledge and willingness to share. We want to be the best we can be, together in the open air surrounded by kindness and collegiality.

"Together we hope to entertain and inform, and in doing so join together with everyone present not only as a profession but as a global community. If you are struggling, professionally and/or personally, we want to reach out a hand and reassure you that you are not alone – we are all in this together.

"Whether you are a vet, a nurse, a rehab professional or a TV presenter, we share fears and disappointments as well as joy and fulfilment. Our motivation is to collectively become a positive force for good, so that every one of us, our friends and family, our work colleagues, our businesses, our profession and even our world may benefit. 

"There is nothing out there like this – and we want to lead the way in setting the agenda that this really does matter and create a lasting and meaningful community of compassion."

The VETFest Conversation is open to all delegates at VET Festival and takes place after the clinical programme on Friday 8^th June at 6.00pm – 6.45pm. 

VET Festival tickets are available to buy on Eventbrite: https://www.eventbrite.co.uk/e/vet-festival-2018-tickets-35876825551