Skeldale Veterinary Centre reports that it has performed the world's first fish skin graft on a dog that was 'days from death' from a seriously infected wound.

The surgery was carried out in August 2018 and is, they say, the first time it has been performed on a companion animal anywhere in the world. The dog, a five-year old spaniel called Gigha, has now made a full recovery.

Gigha’s surgery was carried out by Dr Guy Killick and featured in a recent episode of The Yorkshire Vet. Guy said: "Gigha provides vital companionship to her owner, Mrs Taylor. She fell into a drainage ditch last summer and this caused a tiny cut on her elbow.

"The initial wound did not seem severe, however, despite intensive decontamination and treatment with broad spectrum antibiotics, the wound proved to have been infected with a resistant Haemolytic E. coli infection, causing a significant loss of skin from the medial aspect of the elbow. During this time, Gigha was hospitalised and was at significant risk of DIC and septicaemia."

"The skin loss was full thickness and, once the compromised tissue was debrided away, she was left with a large wound.

"We managed the wound in hospital for four days with daily dressing changes and an irrigation device to provide local anaesthesia and the delivery of topical antibiotics.

"Unfortunately, skin grafting in her case was not suitable given the infection and a lack of sufficient loose skin to donate. As such, we elected for healing by second intention but, given the large area, we felt it was important to explore novel methods to accelerate the healing process and reduce Gigha’s pain.

"Surgery using Tilapia fish skin grafts was pioneered at UC Davis in the USA and was used successfully on a horse with acid burns in the UK last year. It is still very rare, however, and had not been used to treat an infected wound before. Nor had it been used on a dog.

"Having done our research though and finding that these grafts have a natural anti-infective and analgesic effect, while also reducing the frequency of bandage changes that would cause discomfort and distress to the patient, we felt it was an appropriate treatment for Gigha and carried out the surgery a week after the initial wound."

Guy says the surgery was straightforward and simply involved tacking the skin in place. It adhered to the developing granulation bed, accelerating its growth and providing an antiseptic and analgesic effect. After application, Gigha’s owner reported that she was much brighter and seemed to be in less pain. Pain-scoring during check-ups confirmed this to be the case despite pain relief being voluntarily withdrawn by the owner.

This initial graft stayed in place for two weeks before breaking down and being removed. By this stage, granulation of the wound had been completed and around one cm of neo-epithelisation had occurred. A further graft was then placed which remained for a further two weeks until the wound was 50% of its initial size. No further grafts were placed as the team did not have access to further supplies so they simply bandaged the wound with traditional bandages. It was completely healed within nine weeks. Eight months on, Gigha has made a full recovery and the wound has healed completely.  

Guy said: "Given the large wound area and risk of further infection we decided on this novel approach to improve the quality of life for the patient while the wound was healing. While we were naturally apprehensive of making the first attempt at this potentially revolutionary technique, what we knew about fish skin grafts and suggested that they could work in her case so we were determined to give it a try.

"Looking at her now, you wouldn’t believe that she’d been days from death just a few months ago. Her case is a demonstration of the efficacy of fish skin grafts as a treatment for large wounds where there are no other suitable methods of closure – and for their use in dogs. We hope her story and her recovery will be useful to colleagues treating dogs with similar wounds in the future and are happy to discuss the case with them if this would be helpful.

"I would also like to thank Dr Jamie Peyton, Chief of Integrative Medicine Service at UC Davis for her invaluable help and advice during this case and her assistance in the use of the Tilapia graft."

The BSAVA charity, PetSavers has awarded a Citizen Science research grant to support the development of a new tool to help veterinary professionals and pet owners work together to provide the best care to senior dogs.

The grant has been awarded to Dr Carri Westgarth, a Lecturer in Human-Animal Interaction at the University of Liverpool, for her project entitled Using citizen science to develop a ‘Canine Ageing and Wellbeing’ tool for use in veterinary practice.

Dr Westgarth’s initiative aims to determine what senior dog preventative healthcare and treatment advice is currently offered in UK veterinary practices and then take steps to build a practical tool to facilitate knowledge-sharing between owners and veterinary professionals.

Carri said: "Dogs are living up to twice as long as they did 40 years ago and there are implications for senior dogs’ healthcare and wellbeing.

"As life expectancy increases, so does the amount of time spent in poor health. Many dog owners may not be aware of the signs of serious age-related diseases as they attribute them to normal age-related changes."

The Citizen Science project will investigate owner expectations, experiences and attitudes to ageing in dogs, including preventative care and general understanding of normal and abnormal changes during ageing.

A number of in-depth interviews and questionnaire surveys with veterinary professionals and dog owners will be conducted, and pet owners will be invited to submit diaries, photographs or videos to share their experiences of living with an older dog. The study will also examine electronic health records of senior dogs reported in the Small Animal Veterinary Surveillance Network.

The findings will be used to develop the Petsavers Canine Ageing and Wellbeing tool, to guide on best practice discussions in consultations with senior dogs.

A new app called What3words, which allows anyone to give their location using just three words, is being recommended by the emergency services for its potential to save lives.

What3words divides the globe into a grid of 57 trillion squares measuring three metres by three metres and gives each one a unique, 3 word name.

The app uses the GPS on your mobile phone to display your approximate position on a map, which you can then zoom in on and pinpoint more precisely. It then gives you the 3 word address for the square you're in. 

The reason the emergency services recommend What3words is that it can save them precious time getting to the scene of an accident. There are obvious benefits for veterinary surgeons too, not just when called to remote locations, but also when a client's postcode is ambiguous. 

What3words is free of charge and can be downloaded for Android and Apple phones. There is also a What3words website, what3words.com, which provides the same service, but that only works online (whereas the app works offline too). 

I've reviewed the app in more detail on YouTube here:

The RCVS has announced that it is putting its Westminster headquarters on the market and looking for new premises.

RCVS Council agreed, in principle, to the sale of Belgravia House and for the College and its London-based staff to move to different premises at its November meeting. 

The sale of the building and the move will be overseen by the College’s Estate Strategy Project Board headed by former RCVS President Barry Johnson and including current and former RCVS Council members and RCVS staff.

The RCVS has been based at its current premises in 62-64 Horseferry Road for 25 years, but says it now needs more up-to-date and modern facilities to accommodate a projected increase in the number of staff. 

The College says it has considered a number of alternatives, including expanding the current premises by adding or expanding floors. However, due to the fact that the building is in a conservation area, it has become clear that any such expansions would be unlikely to get planning permission from Westminster Council.

Lizzie Lockett, RCVS Chief Executive, said: "For a number of years it has become apparent that it is fast approaching the time at which our current premises will no longer be fit for purpose due to an increase in the number of RCVS staff – something that is projected to continue in the future – the ongoing need to use the building for Disciplinary Hearings, which take over the lion’s share of available meeting space, and the need for better and more modern facilities.

"Even putting our need for increased space on one side, Belgravia House requires major refurbishment in key areas such as air-conditioning and lifts, which would require staff to vacate the premises for up to 18 months, which would be costly and disruptive.

"We are therefore pleased that Council has recognised the need for the College to move somewhere that better reflects our needs and, over the coming months, we will be exploring a number of different options for new premises.

"In parallel to this we have put out an invitation to tender for agents to manage the sale of the building. The plan is for the arrangement to include lease-back so that we have time to find a suitable premises and enabling us to act quickly when we do."

Any organisations that are interested in putting forward a tender to manage the sale of the building should contact Corrie McCann, RCVS Director of Operations, on 020 7202 0724. Responses to tender are required by 30 November 2018.

Photo: Copyright Google 2018

Chris Jordan, veterinary surgeon at Companion Care vets in Chingford, Essex, is the 500^th vet to sign up to the RCVS Certificate in Advanced Veterinary Practice (CertAVP), which was launched in 2007.  

Having completed his Professional Development Phase in July, Chris is now working towards a designated certificate in Small Animal Surgery. He said: "The qualification looks well structured and I think it will serve me well whether I continue as a general practitioner or take up a more surgery-focused role."

Freda Andrews, RCVS Head of Education, said: "The modular approach means vets have much more choice about how and what they study. All certificates show the modules assessed, so that it is easy for veterinary employers to see what a vet has studied, whether or not they have taken a 'named' certificate."

To gain the qualification, vets must first enrol with the RCVS, and then enter for assessment in a combination of core and optional modules through an RCVS-accredited institution. Vets then have ten years in which to complete the qualification.  Study can be entirely self-directed; however, there are a number of courses on offer from educational institutions to help vets prepare for assessment.  Distance and online learning is a feature of many of these courses.

Vets who want to pursue an area of interest for continuing professional development without working towards any certificate, can equally enrol for assessment in any of the 85 individual modules currently available; this is done directly through the institutions offering assessment and does not need enrolment with the RCVS.  Full details of enrolment and module requirements can be found at www.rcvs.org.uk/modcerts

Carefree Credit has announced that it is now able to offer longer term loans for up to 3 years to help pet owners spread the cost of treatment.

All practices are eligible to register and no FCA authorisation is needed.

Carefree Credit says it will also process applications to make practice administration hassle free. 

Mike Aldred, Director at Carefree Credit, said: "With the deepening cost of living crisis, owning a pet has never been more expensive for many pet owners and having these longer terms available will really help their pets get the treatment they need."

To register your practice with Carefree Credit, email office@carefreecredit.co.uk or call 0345 313 0177.

https://www.carefreecredit.co.uk 

It looks like phenobarbital is all the rage this year: hot on the heels of Virbac's launch of Epirepress, Dechra has announced the launch of Soliphen, another phenobarbital presentation for the management of canine epilepsy. 

Dechra says phenobarbital is effective as a monotherapy in 60 to 80 per cent of dogs with idiopathic epilepsy, but that in 40% of dogs, seizures cannot be controlled with phenobarbital alone. In these cases the company's potassium bromide treatment Libromide, is licensed to be used alongside Soliphen as a concurrent therapy. 

According to the company, the combination of phenobarbital and potassium bromide has been shown to reduce seizure number and severity in dogs with refractory idiopathic epilepsy; in tests, the combination treatment reduced the mean seizure rate from 27.4 seizures per month to 2.2 seizures.

Dechra Veterinary Products Brand Manager Craig Sankey said: "Epilepsy is the most common chronic canine neurological disorder, affecting around 0.62 per cent of dogs.

"It can be a distressing condition for both the animal and its owner so we are launching a therapy that can reduce the number of seizures in even the most challenging cases.

"We have also produced new guidelines for prescribing vets, detailing step by step how the treatments can act alone or concurrently. We believe using Soliphen as a sole therapy or in conjunction with Libromide will make a positive contribution to veterinary professionals in their ongoing treatment and management of dogs with epilepsy."

For more information, visit www.dechra.co.uk

The BSAVA has announced the launch of a free new online publication: BSAVA Guide to the Use of Veterinary Medicines

Edited by Fred Nind and Pam Mosedale, with contributions from experts in the field, has been developed to provide a comprehensive guide to a wide variety of veterinary medicines issues that affect small animal practice. It looks like a very polished production, and should prove a valuable tool for all members of the practice team.

Many infringements of the law relating to the possession, use and disposal of veterinary medicines are criminal offences, and it was the aim of the Editors to produce an authoritative guide to help practitioners stay on the correct side of the law in an area where this can sometimes be problematic.

Legislation
As Fred and Pam noted in the March 2009 issue of Companion: 'Veterinary Medicines Regulations (VMR) change every year, whilst waste disposal provisions and dangerous drugs regulations seem to be updated even more often. This means that what you learned at a course attended last year or from a booklet published two years ago may no longer be accurate.' The format of the BSAVA Guide to the Use of Veterinary Medicines, means that it is capable of being updated as the rules and regulations change, helping veterinary surgeons, nurses, practice managers, receptionists, students and kennel staff to get it right - first time and every time.

Storage
Efficient stock control, ambient storage conditions, stock rotation based on expiry dates and correct labelling are just some of the areas that need to be addressed when considering management of the practice dispensary. The section of the guide on Correct storage and dispensary management provides recommendations on how this can be achieved.

Dispensing
Prescribing and labelling veterinary medicines are activities that every practitioner performs many times a day, and it is important that the detailed legal provisions governing these actions are adhered to. Covering such areas as: who may write a prescription; breaking packaging; and the additional regulations that apply for the supply of Controlled Drugs, the Prescribing and labelling section helps guide the practitioner through this complicated area.   

The BSAVA Guide to the Use of Veterinary Medicines is available to all, not just BSAVA members, and the Editors hope will 'provide balm for all those worrying about the practical and legal constraints on the use of veterinary medicines.'

Click here to download the BSAVA Guide to the Use of Veterinary Medicines (pdf 5mb)

Schering-Plough, is to launch Zylkene, a new product to help manage stress in cats and dogs at BSAVA Congress this April.

Zylkene is a globally patented bioactive decapeptide derived from the milk protein casein. The company says that it will provide cat and dog owners with a proven alternative to managing stress in their pets and help to manage many common behavioural problems.

Zylkene will be available in 75mg, 225mg and 450mg capsules, which can be given whole or opened and mixed with food or a treat. The initial period of use is 1-2 months, and can be repeated if necessary.

For further information, please contact your local Schering-Plough or Intervet representative on 01895 626 000.

Idexx Laboratories has produced a SARS-CoV-2 (COVID-19) RealPCR test for pets.

The company says it has made the test available in response to customer demand and growing evidence that in rare cases pets living with COVID-19-positive humans can be at risk of infection.

The test will be available to veterinary surgeons in North America this week and will roll out across most of the world in the coming weeks, via the company's worldwide network of laboratories.

Jay Mazelsky, President and Chief Executive Officer of Idexx Laboratories said: "We have continued to monitor the rapidly evolving public health crisis worldwide, paying special attention to the effects on pets.

"While there is currently no evidence that dogs or cats play a role in transmitting the disease to humans, it became clear offering the test was the right thing to do when we saw clinical evidence that pets—especially cats and ferrets—can in rare cases be at risk for infection. And, we heard from our customers around the globe that veterinarians needed a testing option."

Idexx recommends the test is used when three specific criteria are met: 

• Pet is living in a household with a human who has COVID-19 or has tested positive for the virus
• Pet has already been tested for more common infections, that a veterinarian has ruled out
• Pet (especially cats and ferrets) is showing clinical signs consistent with COVID-19

Idexx says leading health authorities agree with the company that transmission of the SARS-CoV-2 virus is primarily person-to-person and advise against testing asymptomatic pets. Since mid-February, the company has tested over 5,000 specimens for the virus, from cats, dogs, and horses with respiratory symptoms in 17 countries. To date, it has found no positive results, suggesting that dogs and cats living with infected people generally remain uninfected, except in rare and isolated cases. 

For information about the Idexx SARS-CoV-2 (COVID-19) RealPCR Test for pets, visit idexx.com/covid19-pet-test.

Tim Mair, internal medicine and equine surgery specialist at the Bell Equine Veterinary Clinic and editor of EVE has been appointed as President of the British Equine Veterinary Association for 2019/20.

Tim took over the role from Renate Weller at the end of BEVA Congress last week. Lucy Grieve, of Rossdales Veterinary Surgeons became President Elect.

After leaving Bristol in 1989, Tim worked in mixed practice before joining Bell Equine in 1993, becoming a partner in 1995. He led the hospital services at Bell Equine, as well as supervising the practice’s residency, intern and extern programmes, until it was bought by CVS in 2016. He continues to work as a clinician at Bell Equine whilst also working as the Equine Veterinary Director of CVS.

Tim is an RCVS Specialist in both equine internal medicine and equine soft tissue surgery and is a founding diplomate of the European College of Equine Internal Medicine; he became an Associate of the European College of Veterinary Diagnostic Imaging in 2011. He is an honorary Professor of the Royal Veterinary College and became a Fellow of the RCVS in 2016.

Editor of Equine Veterinary Education, the official journal of the British Equine Veterinary Association and the American Association of Equine Practitioners for the past 23 years, Tim has particular interests in clinical research, clinical standards and evidence based medicine, and has published widely in the professional veterinary literature, as well as authoring and editing several textbooks. He has been a member of the RCVS Practice Standards Group since 2012.

Tim has been chair of BEVA’s Education Committee since 2014, and says that during his presidential year he is keen to continue to develop BEVA’s educational activities for members at all stages of their careers.

In particular, he says he is particularly looking forward to supporting recent graduates in equine practice with relevant CPD and mentoring. He also hopes to advance the use of evidence-based veterinary medicine, and promote quality improvement in equine practice.

Tim said: "Equine practice is continuing to change and evolve with some rapidity. An important part of my focus will be on our Equine Veterinary Horizons Project, looking at anticipated advances over the next 10-15 years, what they will mean to individual practitioners and to practices and how we can adapt to and accommodate them to best advantage."

For further information visit www.beva.org.uk.

As of today, veterinary surgeons in the UK can call themselves 'Doctor', following a decision made by the RCVS Council.  

The decision to allow the use of the courtesy title followed a consultation which received 11,202 responses, of which 81% were in favour of the change, 13% against, and 6% did not mind either way.

The College says the idea is to align the UK with international practice, provide greater clarity for the profession and offer reassurance to clients and the animal-owning public that all veterinary surgeons registered with the RCVS, regardless of where they qualified, have veterinary degrees of an appropriate standard. Most international veterinary surgeons use the title and, in Australia and New Zealand, this is frequently tied to registration and professional standing, rather than necessarily academic attainment.

RCVS President Professor Stuart Reid said: "I am very pleased that the response from the consultation gave Council such clear direction and has allowed us to bring UK vets in line with the majority of veterinarians worldwide. It was my privilege to pose the question, which has been well and truly answered by the profession and the public.

"Whether one regards the decision as correcting a historical anomaly or simply providing greater clarity at home and abroad, there is no doubt that the issue has generated huge interest. Yet regardless of whether individual vets choose to use the title, it will not change the profession's ongoing commitment to the very highest of standards."

Nearly 50% of respondents to the consultation were veterinary surgeons, 22% veterinary students, 21% animal-owning members of the public, and the rest were veterinary nurses, veterinary nurse students, practice managers and non-animal-owning members of the public.

RCVS CEO, Nick Stace said: "I am delighted that such a strong message came from both the public and the profession on this issue. We have a responsibility to maintain confidence in the veterinary profession and this move will help underline to the public in particular that veterinary surgeons work to very high standards, regardless of where they qualified."

Use of the title is optional, and guidance has been produced to support the change. It stresses that veterinary surgeons using the title should be careful not to mislead the public, and that it is important that the use of 'Doctor' or 'Dr' by a veterinary surgeon does not suggest or imply that they hold a medical qualification or a PhD. If the title is used, the veterinary surgeon should use it in conjunction with their name and either the descriptor 'veterinary surgeon' or the postnominal letters 'MRCVS'.

The guidance is available as part of supporting guidance chapter 23 to the RCVS Code of Professional Conduct for Veterinary Surgeons, and can be read online at www.rcvs.org.uk/advertising (see paragraphs 23.6-23.8).

Veterinary surgeons may start using the title straight away; details about how their RCVS Register entry can be updated will be issued over the coming months.