London Vet Specialists (LVS), billed as the capital's first complete-service referral centre, has announced its official opening in Belsize Park.

The centre is headed up by senior surgeon and soft tissue specialist, Dr Janet Kovak McClaran DVM DACVS DECVS MRCVS, former head of the department of surgery at the Animal Medical Center in New York.

Janet leads a team of consultants specialising in internal medicine and surgery, diagnostic imaging, emergency and critical care, anaesthesia and analgesia, and minimally-invasive surgery. 

Janet says the new centre was set up to enable London-based vets to access close-by expert help across key areas: "When I was first approached about setting up a referral centre servicing central and greater London, I was surprised that a dedicated facility didn’t already exist. Previously, referring clinicians have had to send clients on long journeys outside of the capital, leading to patient stress and hassle and extra expense for the owners. Now, they have the reassurance of access to a highly-experienced secondary and tertiary level referral team on their doorstep."

The LVS facility boasts a state-of-the-art surgical theatre, complete with a Karl Storz operating tower enabling cutting-edge laparoscopic, thoracoscopic and cystoscopic procedures. The minimally-invasive surgery suite is one of only three such facilities in the UK. An onsite CT scanner, the GE Brivio CT 385, forms part of an array of imaging equipment, operated by European Specialist in Veterinary Diagnostic Imaging, Dr Livia Benigni. The immediate interpretation of even the most-complex of images is designed to allow seamless patient investigation and negate the need for repeated patient anaesthetics.

Internal Medicine consultant Dr Kaye Gugich, formerly of Vets Now Referrals in Swindon, together with board-certified Emergency and Critical Care Specialist Dr Adam Mugford, and Dr Karla Borland, a previous resident in anaesthesia and analgesia at Edinburgh University, complete the consultant team.

London Vet Specialists says it is the only facility in central London to offer a full time specialist surgery service alongside a specialist service in emergency and critical care. Emergency stabilisation and intensive care is available around the clock, with experienced clinicians and a nursing team ensuring continuous supervision, day or night. The LVS specialist surgical team is also on call to the hospital overnight should specialist emergency surgery be required out of hours.

Patient and customer care at LVS is based on the model used by Sydney’s SASH Vets (Small Animal Specialist Hospital). LVS Client Relations Manager Claire Newton helped to develop the SASH system during her time at the advanced referral hospital, which concentrates on delivering the highest standards of patient care, alongside a dedicated support system for the client and referring vet.

Claire said: "From the very start of the referral process, customer care is prioritised. In this we consider that we have two customers; the first, the referring vet, who needs to feel that he or she has an integral role in the ongoing management of the case, and that his or her client is well-looked after. Our second customer, the pet owner or client, needs to be looked after with compassion and respect, and have the ability to speak directly to the clinician in charge of their pet, at any point. Excellent two-way communication is key. We ensure that we listen and respond to the needs of both parties through every step of the customer journey."

For more information on London Vet Specialists, or to speak to Claire Newton about referring a patient, visit www.londonvetspecialists.vet, email Claire.newton@londonvetspecialists.vet, or telephone 0207 4330155.

Merial is offering four free tubes of Eqvalan Duo to practices that buy 20 tubes in February and March. In addition, to further boost the targeted worming message, Merial will supply 20 free worm egg count vouchers worth £10 each.

Eqvalan Product Manager Claire Edmunds said: "Last year's campaign was so well received by both practices and clients that we have decided to run it again and are hoping for even better results!

"The personalised online planner, worm egg count offer and new eye-catching point of sale all help you to engage your clients in a targeted worming strategy.  

For those practices with their own, in-house worm egg count testing facilities, Merial is also offering promotional support to help encourage increased uptake and client buy-in. The campaign forms part of Merial's promotion and education strategy for 2011, which includes extensive VN SQP CPD training opportunities.

To find out more contact your local Area Manager or call the Merial Customer Support Centre on 0845 601 4236

Linnaeus is inviting applications from final year undergraduates and newly-qualified veterinary surgeons to join its two-year Graduate Development Programme (GDP).

As part of the scheme, Linnaeus offers one-to-one mentoring, professional and clinical skills development in primary care practices across the UK as part of the scheme. 

The group, which now has more than 3,000 employees, delivers all clinical training in-house through its network of specialists, referral clinicians, certificate holders and primary care clinicians.

The 2021 programme applications will remain open until the end of May, unless all positions are filled sooner. 

Chloe Roberts, clinical and educational development manager at Linnaeus, said: “This will be the fourth cohort to join our GDP and we’re looking forward to building on the successes we have enjoyed over the last three years.

“This has been a challenging year for obvious reasons, so it has been extremely heartening to see our new vets rise to that challenge and continue their professional journeys with our support. 

“We’re excited to hear from the next intake of new vets and look forward to supporting them in their transition to clinical practice and recognise the additional challenges they faced joining the profession in the midst of a global pandemic.”

For more information, visit graduates.linnaeusgroup.co.uk or www.instagram.com/linnaeusgdp. 

New research led by academics at the University of Bristol's School of Veterinary Sciences has shown that 85% of pet cats are not neutered by the recommended age of four months, possibly due to cat owners needing better information about when to neuter their cat.

In 2006, the recommended neutering age of pet cats reduced from six to four months of age. The study assessed the proportion of cats neutered at these ages. Data was obtained from owner-completed questionnaires at recruitment, when kittens were aged eight to 16-weeks, and six and a half to seven months of age. Demographic and lifestyle factors were also assessed for potential association with neuter status.

The researchers found that of the 751 cats in the study, 14.1% and 73.5% had been neutered at or before four and six months of age, respectively. Cats were significantly more likely to be neutered at four months if their owners had always intended to have their cat neutered by this age. They were also significantly more likely to be neutered at four months if they were microchipped or from households in deprived regions.

The likelihood of being neutered, compared with unneutered, at six months of age was significantly increased for cats that were insured, obtained from an animal welfare organisation, given their second vaccination, from a household with an annual income of over £10,000 and owned by people intending to have their cat neutered by this age.

Dr Jane Murray, Cats Protection Research Fellow in Feline Epidemiology, said: "Neutering is recommended as an effective way of reducing the number of unwanted cats in the UK. Our study found that age of neutering was associated with the age of intended neutering.  Cats can reach puberty at four to five months of age therefore, it is important that owners are aware of the recommended age of neutering at four months, to reduce the number of unplanned pregnancies that occur."

The study suggests that while neutering rates were high at six months of age, they were low at four months of age, and that further work is required to publicise the recommended neutering age of four months to cat owners.

Paper: The neuter status of cats at four and six months of age is strongly associated with the owners' intended age of neutering, C. P. Welsh, T. J. Gruffydd-Jones and J. K. Murray, Veterinary Record published online April 19, 2013.

The RCVS Standards Committee has reintroduced the dispensation which allows veterinary surgeons to prescribe veterinary medicines remotely, in advance of the forecast wave of Omicron infections. 

Chair of the Standards Committee, Dr Melissa Donald, said: “We were very aware of the likelihood that both practice staff and clients will increasingly have to isolate over the coming weeks due to direct infection or positive contacts, particularly with the rise in cases amongst school children.

“Added to this, we know there are already workforce pressures across the profession, which will be exacerbated by reduced staffing levels over the Christmas and New Year period.

“We therefore felt it was appropriate to reintroduce these temporary remote prescribing measures at this time to help relieve pressure on practising professionals, and to provide them with the means to continue to look after the health and welfare of their patients in all circumstances.”

As before, the temporary dispensation is subject to the specific guidance found in FAQ4 (www.rcvs.org.uk/covidfaq4), including that veterinary surgeons must be able provide a 24/7 follow-up service involving physical examination, for example where the animal does not improve, or suffers an adverse reaction, or deteriorates, subsequent to the remote prescription of medicines.

The Committee agreed that the position should be reviewed in February 2022 at its next meeting.

Virbac Animal Health has announced that registrations on BackHome BioTec, the company's microchip identification service, were moved to the Petlog Database with effect from Monday 12 September 2011.

Virbac says it moved to the UK's largest independent microchip registration database in order to offer an enhanced level of service and support, both to veterinary staff and pet owners. 

Practices using the BackHome BioTec system are being asked to log onto www.virbacbackhome.co.uk to create a new account.

Gillian Brown, Product Manager for BackHome at Virbac, said: "BackHome has established itself as a popular, cost-effective and easy to use microchipping system. We believe that in appointing Petlog to manage our registrations we will now be offering a 'best of breed' service for veterinary staff and pet owners.  

"We're extremely grateful to Celia Walsom, Petlog Executive, and her team. They have demonstrated unfailing energy, expertise and total dedication to ensuring this move has run smoothly and effectively for all our customers. I am confident that they will benefit from Petlog's commitment to provide a comprehensive identification service which is easy, convenient and secure to use.

"All our existing customers need to do is go to the new website (www.virbacbackhome.co.uk/) and set up an account - it's a simple and quick process. We'll also be providing a range of promotional materials to help them communicate the change to their own clients."

Petlog is owned and managed by the Kennel Club. Virbac says it is fully data compliant and defers income to ensure it can honour its lifetime promise to pet owners. Its Lost and Found helpline is available 24/7, 365 days a year and it is also a founder member of the European Pet Network.

Further information on BackHome BioTec is available on the new website, which also contains a direct link to Petlog.

For further information about BackHome BioTec, please contact your Virbac Territory Manager or call the company on 01359 243243.

The BSAVA has added the first learning resources in dentistry, exotics and surgery to its free online CPD bank, matched to the RCVS Professional Development Phase (PDP) competences.

The new sections will sit alongside the Emergency and Critical Care (ECC) pages within the Practical and Clinical Skills section of the bank.

Dental subject areas include diagnosis, radiography and surgery. The new exotic subject areas include an overview, birds, small mammals and reptiles. Surgery subject areas include anaesthesia, peri-operative planning, abdominal surgery, ECC/trauma and post-surgical care.

New grad Ellie Morris MRCVS said: "There are some really good videos on emergency surgeries such as the A-Z of GDV, so when we’ve had quieter days I’ve had chance to look at some of these particularly excellent resources and I feel much more prepared for that situation.

"After watching the Anaesthesia of the Caesarean Section webinar, I discussed what I’d learned with my colleagues and how it compared to their approach. I’ve not done a caesarean yet, but I feel a lot more prepared for when the time does come."

BSAVA President Phil Lhermette said: "This fantastic resource is free to all our members with some sections open to non-members - especially employers, and is growing all the time providing great support for the whole profession at every stage of their career.

"The content is reviewed by committee who are currently helping to expand the Mentor & Employer pages, for practices supporting new graduates, which will be added to the site next."

For more information visit: www.bsava.com/pdp

Bristol-based Invatech Health has joined forces with MWI to establish a new distribution service whereby prescriptions are sent directly to the client from the wholesaler. 

The new distribution service uses Invatech's Patient Medication Record (PMR) system, called Titan, which was accredited by the NHS a little over a year ago. Titan has now been developed further to support the company's Home Pharmacy service, and integrate with MWI.

The company says the new system offers practices a seamless workflow between prescribing, dispensing and logistics systems.

Tariq Muhammad, CEO of Invatech Health, said: "“The use of PMR systems for the veterinary market has been very light touch until now. Knowing that that we can bring the same level of efficiency and workflow to a new market presents an opportunity to support animal health in the same way that we do for human health."

Alan White, Commercial Director at MWI Animal Health, said: “The Covid pandemic has presented many challenges to veterinary professionals in the UK. Travel restrictions and social distancing measures make it difficult for animal owners to collect the medications and treatments they need from veterinary practices.”

“We are excited to be able to work with Invatech to provide an innovative solution to this problem, where vets can send the medications needed directly to their client. Working in partnership with veterinary practices and Invatech means we can move animal health forward together.”

For more information, visit: https://www.invatechhealth.com/ 

Winchester-based Anderson Moores Veterinary Specialists has launched a new website about cutaneous and renal glomerular vasculopathy (CRGV), otherwise more snappily known as Alabama Rot.

The practice has been leading research into the devastating disease since 2012 and has collated information on all confirmed cases across the country. 

The disease, which originally appeared in the late 1980s, was first detected in the UK in 2012.

When it affects the kidneys, it has a 90% mortality rate.  

The new site offers advice and information, including a live map of confirmed cases across the UK, for both vets and pet owners.

David Walker, American, RCVS and EBVS European specialist in small animal internal medicine, leads the team at Anderson Moores and is the UK’s foremost authority on the disease. 

He said: “We have been at the forefront of research into CRGV for almost a decade now and have witnessed first-hand the often-devastating effects of the disease. 

“In launching this new website, we aim to inform pet owners and colleagues in the veterinary industry about CRGV. 

“We hope the confirmed case map will prove useful.

"Although an environmental trigger has not been definitively proven, the seasonality of the disease makes it eminently possible and the map allows everyone to see the location of confirmed cases.”   

So far this year, Anderson Moores has recorded a total of 26 confirmed cases of CRGV.

This number comes on the back of 47 confirmed cases during 2020, 19 cases in 2019 and 18 in 2018.

277 cases have been confirmed since the disease was first recognised in the UK in 2012. 

David said: “As we enter the winter months, we want to advise dog owners around the country to remain calm but vigilant and seek advice from their local vets if their dog develops an unexplained skin lesion(s), especially on the leg. 

“Unfortunately, we find ourselves in the time of year when cases are most commonly identified – 92% of dogs with the disease are seen between November and May.

"This is understandably a concern for dog owners; however, the disease remains rare.

“If a dog is suspected to be suffering from CRGV, the best chance of recovery probably lies with early and intensive management which may be best provided at a specialist facility. 

“Treatment primarily revolves around intensive management of the acute kidney injury and is sadly only successful in around 10% cent of cases.” 

Visit https://www.alabama-rot.co.uk .  

The RCVS Disciplinary Committee has ended an inquiry against Hampshire-based veterinary surgeon Jose Ignacio Messa MRCVS, after finding no case of serious professional misconduct against him. 

The case against Jose Ignacio Messa MRCVS related to two heads of charge against him.

The first charge was that, on 13th September 2015, Mr Messa failed to provide adequate and appropriate care to Barney, a border collie. The second charge was that on 14th September 2015 Mr Messa failed to ensure adequate and appropriate on-going care for Barney after his examination of him, including failing to take sufficient steps to ensure that Barney was referred urgently to the care of a referral practice and failing to ensure there were adequate arrangements in place for his ongoing care.

Barney was presented to the Basingstoke practice where Mr Messa was employed having suffered a severe 'stick injury' to his jaw on 12th September. 

The Committee heard that, on 13th September, Mr Messa re-examined Barney, administered medication and then discharged him to be cared for at home by his owners. During the examination the owners alerted Mr Messa to the condition of the skin on Barney’s neck, but the Committee heard Mr Messa had felt the area and reassured them it was not something to be concerned about.

The Committee heard that at some point on 13th September, after he was discharged, Barney developed a foetid smell from his mouth caused by an infection and the next day his owners went back to the practice because Barney’s condition had deteriorated – he was unable to walk and had laboured breathing.

On 14th September Mr Messa admitted and sedated Barney and examined him again, noting a hole in the side of his throat that was infected. He recommended referring Barney to a referral practice for further treatment, which was agreed by his owners.

The Committee heard that the referral practice was contacted by a veterinary nurse at the practice and that an appointment for 9am on 15th September 2015 was booked directly with the owner. It also heard that, during his time at Mr Messa’s practice, Barney did not receive intravenous fluids or any further antibiotics.

Barney’s owners said they met with Mr Messa again at around 5pm on 14th September when they came to collect Barney, this was disputed by Mr Messa, and the Committee were not satisfied so as to be sure that it had been Mr Messa who had met the owners and discharged Barney although the Committee found that all the witnesses had been honest and reliable.

Barney was admitted to the referral practice on 15th September but, as a result of sepsis, he suffered a cardiac arrest and died at 10.30pm.

In respect of the first charge the Committee concluded that, on 13th September, Mr Messa made only a rudimentary examination of Barney, and the absence of such basic clinical examination of the temperature, the respiration rate and the pulse of Barney was a failure on the part of Mr Messa and that, furthermore, he did not choose the best course of antibiotic treatment for the wound and infection.

In respect of the second charge Mr Messa admitted that he did not provide fluid therapy to Barney on 14th September before he was discharged.

With reference to the remaining aspects of the charge the Committee took into account the Code of Professional Conduct, particularly in respect of the need for veterinary surgeons to refer cases responsibly and the Code’s supporting guidance on referrals.

The Committee determined that, having delegated the arrangements of the referral to a veterinary nurse, Mr Messa made no attempts to follow up and ensure it was a same-day appointment when this would have better suited the severity of Barney’s condition. The Committee found that he was unaware of Barney’s location or of the time of the appointment and did not make provision for antibiotic or fluid therapy.

Having found the majority of the charges against Mr Messa proven, the Committee then considered whether this amounted to serious professional misconduct. 

Disciplinary Committee member Stuart Drummond, who was chairing the Committee and speaking on its behalf, said: "In the light of the facts found proved and considering that disgraceful conduct in a professional respect is that which is conduct falling far below that expected of a veterinary surgeon, the Committee had concluded that the heads of charge, when taken individually, or collectively, do fall below the standard expected.

"However, as a matter of judgement, the Committee did not conclude that Mr Messa’s conduct fell far below the requisite standard and therefore did not amount of disgraceful conduct in a professional respect.

"Whilst the Committee did not find Mr Messa’s actions fell far below the requisite standard, there were concerns expressed about several aspects of this case. There were a number of missed opportunities which occurred; in particular the Committee notes the failure of the care plan and to take adequate steps to ensure that the referral process has been timeously effected."

Researchers from the University of Melbourne’s Faculty of Veterinary and Agricultural Science, in conjunction with the Waltham Equine Studies Group, have identified a possible mechanistic link between high levels of insulin and equine laminitis.

Their study, which was published in the research journal PeerJ at the end of last year¹, investigated the effects of insulin on equine hoof lamellar cells in the laboratory.

The researchers say that high levels of insulin have been known for some time to cause acute endocrine laminitis, seen when ponies and certain types of horses graze lush pasture or consume a starch- or sugar-rich diet, or when they develop Cushing’s syndrome.

Many ponies and horses at risk of the condition produce large spikes of insulin in their blood stream after consuming meals high in non-structural carbohydrates (in particular starch and simple sugars) which indicates that this could be the way in which they succumb to acute endocrine laminitis.

The mechanism by which insulin can cause effects in the foot leading to laminitis has been the subject of much debate in recent years.

Hormones like insulin must interact with a specific receptor on the surface of cells in order to produce their effects. What has confused researchers in the past is that there appear to be no insulin receptors on the hoof lamellar cells (these cells give the lamellar tissues their strength and changes to their growth or structure weaken the bonds and cause laminitis).

The researchers considered the close similarities between insulin and a growth factor hormone called insulin-like growth factor -1 (IGF-1). There are receptors for IGF-1 on the lamellar cells, and the researchers speculated that high concentrations of insulin might be able to cross-stimulate these cells by activating the IGF-1 receptors. To investigate this possibility PhD student Courtnay Baskerville, together with her supervisor Professor Simon Bailey, developed a method for culturing lamellar epithelial cells in the laboratory, and incubated them with increasing concentrations of insulin.

They found that high concentrations of insulin stimulated the cells to proliferate. Furthermore, this effect could be prevented using an antibody that specifically blocks only the IGF-1 receptor. Further downstream effects within the cells were also shown. The changes seemed to occur mainly at very high concentrations of insulin. Similar concentration levels can be seen in ponies and horses with insulin dysregulation linked to Equine Metabolic Syndrome, but are not commonly seen in normal horses that are considered to be at lower risk of laminitis.

Further work is now ongoing to determine exactly how these cellular changes induced by sustained high insulin concentrations might cause laminitis. However, it seems that targeting the IGF-1 receptor may be an option for developing new drugs to prevent and treat laminitis.

Professor Simon Bailey said: "The information gathered in this study provides the equine industry worldwide with valuable insights into the causes of the common and serious condition of laminitis. The research group would like to acknowledge the support of the Waltham Centre for Pet Nutrition, in particular the involvement of Professor Pat Harris.” 

Reference

1. Baskerville C.L., Chockalingham, S., Harris, P.A., Bailey S.R. (2018). The effect of insulin on equine lamellar basal epithelial cells mediated by the insulin-like growth factor-1 receptor. PeerJ 6:e5945  (DOI 10.7717/peerj.5945).

Lumbry Park Veterinary Specialists, Axiom Veterinary Laboratories and Finn Pathologists have published a study which reveals the prevalent strains of bacteria in feline urine, and their sensitivity profiles.

For the study, urinalysis results from 2,712 UK feline urine samples submitted and analysed by Axiom and Finn over a period of 14 months² were reviewed.

Urine samples had to have been obtained by cystocentesis and signalment information recorded by their submitting vet³.

These samples did not have to come from cats presenting with FLUTD signs and the researchers therefore say that consideration should be given to a different (potentially even more increased) prevalence in cats presenting with LUT signs.

Bacterial urinary tract infections in cats with FLUTD are estimated to be present in around 8 – 19% of cases⁴.

However, FLUTD is one of the most common reasons for the use of antimicrobial drugs in veterinary medicine and is therefore an important condition to consider to minimise antimicrobial use and development of antimicrobial resistance⁵.

The study found that 15.7% of the samples had a positive culture, with E. coli (43.7%), other Enterobacterales (26.4%) and Enterococcus spp (14.9%) being the most common isolates identified.

Antimicrobial susceptibilities and resistance were also tested.

Notably, Enterococcus species were frequently found to be resistant to multiple antibiotics, and several other isolates demonstrated resistance to frequently used antibiotics.

The data showed Enterococcus spp. were much less susceptible to trimethoprim and sulfamethoxazole (TMPS) than have been previously documented (with 94% of isolates resistant).

Additionally, other Enterobacterales had resistance against cephalosporins and penicillins.

The authors say that data surrounding cephalosporin resistance is particularly notable and problematic; recent data has indeed shown that the cephalosporin cefovecin is a commonly prescribed antibiotic³ for cats presenting with lower urinary tract disease.

The authors also say that data in this study adds to the existing evidence that the use of cephalosporins such as cefovecin may be ineffective in many cases (intrinsic resistance of Enterococcus spp) and therefore should be avoided unless cystocentesis and signalment results support their use.

The inappropriate use of antibiotics for bacterial cystitis could not only be ineffective to manage bacterial cystitis in cats but promote further antimicrobial resistance.

Clarisse D’Août, lead author of the research and Internal Medicine Specialist at Lumbry Park Veterinary Specialists, said: “Even though feline lower urinary tract disease is one of the most common reasons for vets to prescribe antibiotics, the prevalence of bacterial strains in the urine of cats with this condition, and their resistance to commonly used antibiotics, had not been widely studied in the UK to date.

"So we hope that this study can add to the current evidence to making well-justified and practical recommendations in practices about which antibiotics to choose and those to avoid.

"We see this ongoing susceptibility testing as clinically important to avoid the development of further resistant bacteria.”

References

1. D’Août, C.; Taylor, S.S.; Gelendi, S.; Atkinson, C.; Defauw, P. Bacteriuria in Cystocentesis Samples from Cats in the United Kingdom: Prevalence, Bacterial Isolates, and Antimicrobial Susceptibilities. Animals 2022, 12, 3384. https://doi.org/10.3390/ani12233384 
2. Weese, J.S.; Stull, J.W.; Evason, M.; Webb, J.; Ballance, D.; McKee, T.; Bergman, P.J. A multicenter study of antimicrobial prescriptions for cats diagnosed with bacterial urinary tract disease. J. Feline Med. Surg. 2021, 24, 806–814.
   Burke, S.; Black, V.; Sánchez-Vizcaíno, F.; Radford, A.; Hibbert, A.; Tasker, S. Use of cefovecin in a UK population of cats attending first-opinion practices as recoarded in electronic health records. J. Feline Med. Surg. 2016, 19, 687–692.
3. January 2018 – February 2019.
4. Gerber, B.; Boretti, F.S.; Kley, S.; Laluha, P.; Müller, C.; Sieber, N.; Unterer, S.; Wenger, M.; Flückiger, M.; Glaus, T.; et al. Evaluation of clinical signs and causes of lower urinary tract disease in European cats. J. Small Anim. Pract. 2005, 46, 571–577. https://doi.org/10.1111/j.1748-5827.2005.tb00288.x.
   Sævik, B.K.; Trangerud, C.; Ottesen, N.; Sørum, H.; Eggertsdóttir, A.V. Causes of lower urinary tract disease in Norwegian cats. J. Feline Med. Surg. 2011, 13, 410–417. https://doi.org/10.1016/j.jfms.2010.12.012.
   Teichmann-Knorrn, S.; Dorsch, R. Signifikante Bakteriurie der Katze: Bakterielle Harnwegsinfektion und subklinische Bakteriurie. Tierarztl. Prax Ausg. K Kleintiere Heimtiere 2018, 46, 247–259. https://doi.org/10.15654/TPK-180521.
5. Murphy, C.P.; Reid-Smith, R.J.; Boerlin, P.; Weese, J.S.; Prescott, J.F.; Janecko, N.; McEwen, S.A. Out-patient antimicrobial drug use in dogs and cats for new disease events from community companion animal practices in Ontario. Can. Vet. J. 2012, 53, 291–298. PMID: 22942447, PMCID: PMC3280785.
   Schmitt, K.; Lehner, C.; Schuller, S.; Schüpbach-Regula, G.; Mevissen, M.; Peter, R.; Müntener, C.R.; Naegeli, H.; Willi, B. Antimicrobial use for selected diseases in cats in Switzerland. BMC Vet. Res. 2019, 15, 94. https://doi.org/10.1186/s12917-019-1821-0.
6. Breed, age, sex and neutering status.

Royal Canin has launched NATOM Explorer, an interactive online tool designed to help the entire practice team visualise and explain the cat and dog anatomy and disease conditions to their clients. 

NATOM (‘aNATOMical map’) hosts a library that supports explanations given by the veterinary surgeon or nurse to the owner during or after the consultation. The tool acts as an interactive reference for vets and vet nurses, boasting a 360 degree navigation of the anatomy, three levels of zoom, full image annotation and the ability to print and share bespoke images and save them for future reference.

Users of the charts are able to study the skeletal, nervous, circulatory, muscular, visceral and more superficial layers of the anatomy. In addition, there are ‘special views’ of over 100 common disease processes which graphically describe illness presentation, clinical signs, diagnosis and treatment as well as giving pointers on long-term management.

Marianne Lomberg, Veterinary Marketing Manager at Royal Canin, said: "The tool was initially launched to vet students in early 2015 and, excitingly, following its highly successful introduction, we have now rolled it out to vet practices.  NATOM Explorer™ is an easy to use, time-saving tool which can help explain all disease conditions in a simplified way, which is particularly key when presenting complex health topics and diseases to clients. We believe the tool will be highly beneficial to practices and look forward to seeing it going on to benefit owners and their pets across the country."

All information on NATOM can be personalised by the user by adding comments, sketches and uploading other files before saving and sharing the information. All the available content is written and verified by experts in anatomy and small animal practice, with significant contributions from Dr Alex German, Professor Tim Gruffydd-Jones and Dr. Kit Sturgess. 

Practices interested in the tool can visit www.vetportal.royalcanin.co.uk for further information