The Veterinary Medicines Directorate (VMD) has published its Pharmacovigilance Annual Review 2015, which reviews 5674 reports of adverse events in animals, humans and the environment following the use of veterinary medicines over the course of the year.

5638 events were reported spontaneously, mainly by the marketing authorisation holder (61%), with the remainder largely reported by veterinary surgeons. 

Of these, 5512 were reports of adverse reactions in animals: 829 concerning suspected lack of efficacy, 4638 concerning safety. The majority of reports concerned dogs (2927), cats (1426) and cattle (386).

In dogs, medicines for the control of epilepsy were most often suspected of not having performed as expected (80 reports) whilst vaccines were most commonly reported as having failed to work (71).  However, the VMD points out that in many cases, vaccination failure was attributable to other causes (such as incomplete vaccination schedule).

In cats, flea spot-on products were most likely to be reported as not having worked (21). However, there are many reasons why owners may continue to see live fleas on their animal which are unrelated to product efficacy (such as reinfestation from the environment). 

Notably, the majority of efficacy reports in horses (12/19) related to euthanasia products, which the report says should serve as a reminder that alternative means of euthanasia should always be available in case the chosen method does not proceed as planned.

Of the safety reports, 59.6% involved dogs, 31% cats, 4.9% horses and 3.9% rabbits. The majority concerned vaccines (1360 reports, most commonly general signs or symptoms, such as lethargy or pyrexia), parasiticides (472 reports, most commonly lethargy, emesis, inflammation/pruritus, depending on method of administration) and inflammation control (412 cases, most commonly emesis, renal insufficiency and diarrhoea, depending on the drug type).

There were 124 reports of adverse events in humans. Of those involving veterinary professionals (about a quarter):

• There were two cases where owners were injured by a vet with a needle. In one case, despite the owner washing and disinfecting their hands immediately, the hand became too swollen to move and required anti-histamines and anti-inflammatories.
• A veterinary nurse developed a sore eye when vaccine was squirted into it as the needle came off the syringe. The symptoms resolved the following day.
• A veterinary surgeon reported brief periods of numbness around an injury sustained from a needle used for a rabies vaccination.
• A veterinary surgeon reported injection site pain after inadvertently injecting a small volume of a macrolide antimicrobial into his thumb. 
• A veterinary surgeon scratched his finger with a needle he had used to administer tilmicosin, and he thought a drop may have entered the wound. Nevertheless he did not seek medical attention until more than 3 hours later. Fortunately no treatment was required. 
• A veterinary surgeon pricked her finger with a needle on a syringe full of alfaxalone. No product was injected and she experienced no other symptoms than bleeding and pain from the puncture wound. 
• A veterinary surgeon was administering pentobarbital to a cat when the needle came off the syringe and between 1 and 20 ml of product squirted back into her eyes and mouth. She rinsed her eyes and mouth, drank some water and ate a banana. 45 minutes later she felt tired and ‘fuzzy’. She spoke to her GP by phone, but did not attend the surgery or receive treatment. She recovered within 3 hours. 
• A locum veterinary nurse developed swelling around an injury on her hand from a needle on a syringe of medetomidine. She had punctured a blood vessel, but thought only a small amount of product was injected. She felt light-headed and was monitored in hospital for a couple of hours, after which she returned to work with no lasting effects. 
• Two veterinary surgeons and a pet owner suffered needle stick injuries whilst an anti-emetic was administered to an animal that was being restrained by the owner. 

The VMD says that reports of needle stick injuries involving vaccines with a mineral oil adjuvant are of particular concern, because they often fail to show that the injured party has received prompt and correct treatment, either because they are themselves unaware of the necessity for swift intervention, or because they do not take the product package information leaflet with them when seeking medical treatment. 

Similarly, the VMD says that incidents involving injectable tilmicosin seem to be often dismissed as just a scratch, and that if you use these products, you should make sure you are fully aware of the warnings contained in the product leaflets.

To read the full report, visit: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/608968/PhV_Annual_Review_2015_v7.pdf 

Veterinary nurse Georgina Hills has been elected President of the Veterinary Management Group (VMG), the professional association for all those in leadership and management roles in the veterinary sector.

Since qualifying as an RVN in 1998, Georgina, aka George, has had a number of veterinary management roles, including Head Nurse, Business Support Manager and Regional Operations Manager. 

She is currently Practice Director for Irby and Neston Vets in Cheshire. 

George joined the VMG Board in 2016 and takes over as President from Richard Casey, who becomes Senior Vice President of the association. 

Stuart Saunders, Practice Manager at Devon-based Selworthy Vets, becomes Junior Vice President. 

All will serve a one-year term.

George said: “Becoming a manager or leader has an impact on the individual, but has an even stronger impact on the work and day-to-day experience of those around them. 

"These roles therefore bring with them a great responsibility to do them well. 

“We know from our members that the support, teaching, coaching and other resources that the VMG offers are making a positive difference and I’m particularly excited to take on the presidency following the recent launch of our Certificate of Veterinary Leadership & Management, an accredited taught qualification.

"I believe rigorous qualifications are the most effectively way to create the 21st century leaders and managers the veterinary sector needs.

“During my presidency, I will continue to focus on extending the range of support and help we offer to leaders and managers."

Dechra has launched Lodisure, a 1mg chicken-flavoured amlodipine tablet for the treatment of feline hypertension. 

Available in packs of 56 (4 x 14 tablet blister packs), Lodisure tablets are divisible for accurate dosing.

The recommended starting dose is 0.125-0.25 mg amlodipine per kg bodyweight per day, which equates to half a tablet for cats weighing less than 4kg (and more than 2kg) and one tablet per day for cats weighing between 4kg and 8kg.

It can be administered directly to the cat or given with a small quantity of food.

Dechra companion animal brand manager, Sarah Musgrave, said: “Feline hypertension is very often part of a more complex diagnosis, therefore it is important that antihypertensive therapies are easy to dose and administer. 

"Lodisure is a new, first-line, easy to dose and administer treatment to control systolic blood pressure in cats while the underlying primary cause is diagnosed and treated, which vets can rely on in their day-to-day practice.”

https://www.dechra.co.uk/products/cat/prescription/lodisure.

The RCVS Disciplinary Committee has dismissed a case against an Essex-based veterinary surgeon, having found him not guilty of charges relating to the measurement of horses and ponies.

At the ten-day hearing, Marc Auerbach of Oak Equine Veterinary Surgery, Ongar, answered charges relating to measuring the height of 29 horses/ponies presented for measurement by two agents in early 2009. Dr Auerbach had undertaken these measurements as an Official Measurer (OM) for the Joint Measuring Board (JMB), which provides a system for independently measuring and certifying the size of competition horses/ponies. An animal's financial value relates to its size, with larger animals being more likely to win in their competitive class.

The case centred on the expected accuracy of such measurements, whether Dr Auerbach was dishonest in colluding with the agents, or whether there had been signs of malpractice which a reasonably competent vet acting as an OM ought to detect.

From evidence submitted, the Committee determined a margin for measurement accuracy, and consequently dismissed from its consideration ten animals where the difference between the initial measurement and the re-measurement was 3 cm or less. However, the College submitted that the average difference was so great that, either, Dr Auerbach had failed to take sufficient steps to ensure that the correct measurements were recorded, or else he had been dishonest. Dr Auerbach's Counsel accepted the inference that presenting agents were dishonest, but denied that Dr Auerbach was dishonest or had failed to pick up signs of malpractice on the part of the agents.

The Committee was of the view that there may be unscrupulous presenters capable of materially interfering with the height of horses. While it was unable to determine with certainty the extent to which it could be done, the Committee formed the view that unscrupulous interference (together with intrinsic variables) could have caused the differences between measurement and re-measurement in the 19 horses.

The Committee noted there was no evidence of improper payments being received by anyone. It also accepted evidence that Dr Auerbach was not a dishonest man, taking into account his record of 23 years of honesty and excellence in the profession, unchallenged character references and the lack of any credible motive for him to act dishonestly.

Next, the Committee considered whether there had been signs of preparation malpractice which ought to have been picked up by any reasonably competent veterinary surgeon acting as an OM. The College submitted that Dr Auerbach had failed to take several steps including the amount of time and attention given to the animals he measured, and whether they might be drugged or sedated.

The Committee concluded from the evidence, including scientific papers, that mildly sedated animals may not be distinguishable from properly prepared animals; well-behaved horses were not an indication that something was amiss. The Committee accepted that Dr Auerbach took around 15-20 minutes to measure each of the horses presented on 9 January; and, in the absence of guidance from the JMB, it could not conclude this was rushed or unreasonable. Consequently, the Committee was unable to be satisfied, so that it was sure, that the allegation of failure to take sufficient steps to ensure the recording of correct measurements was proved.

"Accordingly, the decision of the Committee is that the facts set out in the Charge in relation to all the horses and ponies listed have not been proved to the necessary standard of proof," said Prof Peter Lees, speaking on behalf of the Committee as he directed the charges be dismissed.

Registration is now open for the ISFM 2021 World Feline Congress, taking place online from 25th to the 27th June.

The theme this year is 'The ever-complex cat: a multidisciplinary approach to feline medicine', around which there will be a full programme of talks and lectures, including more than 30 hours of CPD.

The main strands for each day are:

• The pancreas: endocrine/exocrine and the impact of obesity
• Gastrointestinal disease, therapeutics and clinical problem solving
• Liver disease, future horizons of gastrointestinal research and renal disease

Keynote speaker Professor Kenneth Simpson, BVM&S, PhD, Chief of the Section of Small Animal Internal Medicine at Cornell University will deliver a series of talks on his specialisms, including gastrointestinal (GI) disease, pancreatitis and liver enzyme interpretation.

Joining him are more than twenty international feline experts who will be considering the cat from all angles, from imaging and clinical pathology to histology.

Nathalie Dowgray, Head of ISFM, said: "We are very excited about the line-up of speakers for this year’s congress, it is a fantastic opportunity for vets to understand the complexity of feline medicine and come away better able to manage difficult cases."

New for this year are live panel sessions in which delegates will be able to join the speakers in expert discussion on key feline topics, as well as opportunities to network and chat directly with leading names in the veterinary industry.

Delegates will also have access to all of the content for six months of on-demand learning after congress ends.

Registration is open now and available at a special early bird rate until March 31st. This year there are bursary places available for veterinary surgeons and students from low-income countries. More information about eligibility and how to apply can be found on the website.

To register, visit: https://icatcare.org/events/isfm-world-feline-congress/ 

The BSAVA has teamed up with the Links Group to provide veterinary surgeons with free CPD sessions on how to deal with suspected cases of non-accidental injury to small animals.

Members of the profession are of course more likely than most to receive information about violent incidents that constitute abuse against an animal, and research has shown that such cases are often the index case that trigger investigation into violent households.

Jennie Bartholomew, education coordinator at the BSAVA said: "Suspecting animal abuse can be an alarming and sensitive issue to confront but our training courses should give veterinary teams the skills and support they need to help deal with such cases."

The sessions will provide guidance on setting up a practice protocol and identifying a Safeguarding Liaison Officer (SLO) who will aid practice staff in suspected cases of abuse. Through the SLO, relationships with RSPCA officers, police domestic abuse officers and aid agencies can be set up to give staff expert support to call upon if they suspect animal or human abuse.

Freda Scott-Park is a BSAVA Past President and is one of the lecturers on the Links Veterinary Training Initiative courses. She said: "There are few veterinary practices that do not encounter animal abuse, not daily, but the incidence is increasing.

"Cases can be quite complicated to diagnose but often vets find they develop a sixth sense that something isn’t right. By defining the complexities and difficulties in diagnosis, the course aids vets, veterinary nurses and receptionists to understand how to proceed – to ask the right questions and how to seek help from the correct people.

"Information from the veterinary practices may allow human healthcare professionals to investigate troubled households, offering support to the family and potentially improving or saving a human victim’s life."

Three sessions have been organised around the country during 2019. They are free for BSAVA members, with a non-member price of £40.00.

• Sunday 23 June: Wetherby Racecourse, Yorkshire

• Monday 16 September: Woodrow House, Gloucester

• Sunday 27 October: Jesus College, Cambridge

The RCVS has announced the launch of a consultation on the new proposed list of 'day-one' clinical skills needed by veterinary nurses when they first enter practice.

The College says it welcomes comments on the new list from veterinary nurses, veterinary surgeons and all those involved in veterinary nurse training and education.

The current Day-One Skills document was developed by RCVS Awards, the College's awarding body, in 2010 and provides a list of those skills student veterinary nurses are expected to have gained by the end of their training, and to be competent and confident in when they first go into practice.

As RCVS Awards will be closed by the end of this year, the RCVS is taking the opportunity to review the Day One Skills to bring them closer into line with our recently revised Day One Competences, and to reduce the number of required skills in order to make it more relevant to clinical practice.

Julie Dugmore, Head of Veterinary Nursing, said: "The current document was developed from an awarding body perspective and not that of the regulator, so it specifies a large number of non-clinical skills, for example, handling and moving equipment safely, which, while important, are somewhat out of our regulatory remit.

"Given the wide variety of veterinary practice settings to which student veterinary nurses are exposed, it is important that we, as the industry regulator, define the required day-one skills and ensure that these align with the required day-one competences. We need to review the skills list to ensure consistency, that it reflects current practice, and that it only includes those skills deemed necessary for registration purposes. A clearer focus on safe and effective clinical skills would support our primary regulatory role: that of protecting animal welfare and the public interest."

The consultation sets out the proposed Day-One Skills, grouped according to the corresponding day-one competences, and asks for feedback on their relevance, accuracy and completeness. Comments would be welcomed from higher education institutions, awarding organisations, centres, and training practices, as well as veterinary nurses and veterinary surgeons.

The consultation is available via the RCVS website at www.rcvs.org.uk/consultations and the deadline for responses is 5pm on 29 July 2015.

The Metropolitan Police Mounted Branch (Hyde Park) has joined forces with the Blue Cross to launch the charity's National Equine Health Survey, taking place this week.

The National Equine Health Survey is an online snapshot survey designed to uncover common health issues in horses, directly from horse owners themselves. Results of the survey are used to build a picture of equine health and disease in the UK and define priorities for future research, training and education. 

Over the past six years the survey, in partnership with the British Equine Veterinary Association, has developed to become one of the UK’s most important endemic disease monitoring initiative. The results are referenced in leading veterinary and equestrian publications and papers and are regarded as valuable benchmarks for our general knowledge of horse health.

Blue Cross Education Officer Gemma Taylor said: "These majestic police horses have taken part in our survey and we hope that they will encourage others to follow suit and be ambassadors for horse welfare.

"The more data we can collect from the National Equine Health Survey the more robust our results will be, helping us to steer equine awareness, education and research to keep our nation’s horses healthier."

Last year survey records were returned for almost 17,000 horses, ponies, donkeys and mules and the six most notable disease syndromes identified.

1. Lameness 32.9% including laminitis (compared to 24.4% in 2015, 21% in 2014, 19.2% in 2013 and 12.9% in 2010-12).
2. Skin diseases (sweet itch, mud fever, rainscald, external parasites, skin tumours and wounds) 25.5% compared to 17.2% in 2015 (18.3% in 2014, 14.6% in 2013 and 15.2% in 2010-12).
3. Laminitis 6.8% compared to 6.4% in 2015 (7.1% in 2014, 4.4% in 2013 and 3.6% in 2010-12).
4. PPID (‘Equine Cushing’s Disease) 6.6%. This is similar to the high prevalence of PPID reported in 2015 (6.4%) and 2014 (5.6%) and possibly reflects increased surveillance through sponsored testing programmes as opposed to true increases in prevalence from the pre-2014 surveys.
5. Recurrent Airway Obstruction 5.6% compared to 6.7% in 2015 (6.9% in 2014, 4.2% in 2013 and 3.6% in 2010-12).
6. Back problems 5.5% compared to 7% in 2015 (7.7% in 2014, 5% in 2013 and 3% in 2010-12).

To take part in the National Equine Health Survey, visit: www.bluecross.org.uk/NEHS

To find out more about Blue Cross’s rescue and rehoming work with horses and ponies visit bluecross.org.uk

Equistro® has produced a dust-free pelleted presentation of Secreta Pro, following requests from clients.  Secreta Pro-Max® was launched to vets at BEVA Congress.

Secreta Pro is a respiratory supplement used to support the bronchial system and natural defences on a long term basis.

For more information on Secreta Pro-Max® and all Equistro products, please visit http://www.equistro.co.uk/, or contact your Vetoquinol representative.

Merseyside police are urging members of the public and veterinary practices to exercise caution following the theft of some prescription veterinary medicines from a commercial vehicle in Prescot.

The missing medication is around ten 100ml bottles of Micotil, a prescription-only veterinary medicine used to treat respiratory problems in cattle and sheep, but which could prove fatal if taken by humans.

The drug, which was packaged in cardboard with Spanish labelling, was stolen from a lorry that had parked last Thursday night on an industrial park at Caddick Road, Prescot, prior to making a delivery to a company in Speke.

PC Dufton-Kelly of Huyton Police Station's Crime Management Unit said: "We believe this was simply an opportunist theft, which has left the offenders with a rather unusual product on their hands, with little or no opportunity for gain.

"We would like to alert the veterinary industry, particularly in the Merseyside area, in case the goods are handed in or offered for sale. The drugs could present a danger to the public if they fall into the wrong hands."

Anyone who finds the drugs is asked to contact their nearest police station via 0151 709 6010. Anyone with information about the theft can contact Crimestoppers on 0800 555 111. All information provided will be treated in strict confidence.

Photon Therapeutics is now taking orders for the PhotonUVC Vet, the new device which claims to treat corneal infections in five seconds which was first announced at the London Vet Show last November.

The device emits low dose 265 nanometre (nm) ultraviolet C light at a targeted area.

In a 2022 in vitro / ex vivo study to evaluate the therapeutic potential of 265nm UVC for infectious keratitis¹, UVC was found to inhibit all tested bacteria and fungi, including mixed culture and strains linked to antibiotic resistance.

In the study, no evidence of infection was found from 4 hours onwards, ulcers responded significantly in under 24 hours, and at the end point, those treated with UVC performed as as well as those treated with ciprofloxacin.

Photon Therapeutics says that in simple cases, one five-second treatment will suffice, but more complex cases can be re-treated after 24 hours. 

Currently, there are two main barriers to the successful treatment of eye infections in dogs.

The first is the difficulty diagnosing the infection and identifying the right antimicrobial to use, highlighted by a 2017 study: Bacterial Isolates from Canine External Ocular Disease and their Antimicrobial Sensitivities ². 

The second is whether the owner is able or willing to administer a topical treatment.

Here the evidence suggests that even when treatment is possible, people do not comply with clinical advice anything like as much as they claim.

Photon Therapeutics points to what it says is the nearest study there is, in which carers of young children with uveitis did not give the correct treatment in 75% of cases³.

If the device is as effective as claimed, then both these issues simply evaporate. 

PhotonUVC costs £4,995.

https://photon-therapeutics.com

VetSurgeon.org product briefing: https://www.vetsurgeon.org/m/veterinary-product-briefing/138134 

References

1. Sanjay Marasini, Simon J. Dean, Simon Swift, Janesha Perera, Ilva D. Rupenthal, Tao Wang, Hannah Read, Jennifer P. Craig, Preclinical confirmation of UVC efficacy in treating infectious keratitis, The Ocular Surface, Volume 25,
   2022, Pages 76-86, ISSN 1542-0124, https://doi.org/10.1016/j.jtos.2022.05.004.
2. Williams D., Bacterial Isolates from Canine ExternalOcular Disease and their AntimicrobialSensitivities". ARCJournal of Animal and VeterinarySciences. 2017;3(3):29-36 DOI: http://dx.doi.org/10.20431/2455-2518.0303005  
3. Green EKY, McGrath O, Steeples L, Ashworth JL. Monitoring compliance to topical therapy in children and young people with uveitis. Eye (Lond). 2024 Feb;38(3):572-577. doi: 10.1038/s41433-023-02736-0. Epub 2023 Nov 6. PMID: 37932371; PMCID: PMC10858091. https://pubmed.ncbi.nlm.nih.gov/37932371/ 

European veterinary practitioners are to receive guidance on the appropriate use of the fluoroquinolone group of antibiotics in treating a wide range of common diseases in companion animals.

The advice has been drawn up by the REQUEST team, a multinational and multidisciplinary group of experts which met for the third time last November. Their recommendations have been designed to help ensure the continued availability of this class of antibiotics in both veterinary and human medicine.

The REQUEST initiative aims to achieve a consensus on when and how to prescribe fluoroquinolones, based on a detailed assessment of published scientific data by its panel of nine acknowledged international experts. Following earlier meetings in Lyon and Vienna they have reached a stage in this ongoing project in which they can offer specific guidance on the use of fluoroquinolones in treating three important conditions in dogs: pyoderma, bacterial diseases of the upper respiratory tract and lower urinary tract infections. They will also be offering guidance on the appropriate use of this class of antibiotics in cats to avoid the development of retinal toxicities, which may occasionally result from treatment with one particular fluoroquinolone drug, enrofloxacin.

The guidance will be presented in papers to be submitted to those scientific journals which will be easily accessible to veterinary practitioners throughout Europe. Further papers will be produced and translated into the main European languages giving guidance on fluoroquinolones use in other important bacterial conditions in dogs and cats.

In the later stages of the project, the team will be highlighting priorities for future research and will use its influence to encourage collaborative studies involving the animal health industry, practitioners, veterinary schools and other research institutions, which will validate and redefine the current recommendations. They will also advise on studies which may provide the information needed in those clinical areas where there is currently insufficient published data on which to base any practical advice, such as the use of fluoroquinolones in minor companion animal species.

The REQUEST initiative is supported by Vetoquinol, a global supplier of fluoroquinolone medicines to the veterinary community. Further support is provided by the healthcare consultancy StratAdviser Ltd, which gives assistance on methodology and other scientific matters and also guarantees the independence of the expert group.