Boehringer Ingelheim is urging veterinary surgeons in the UK to test for PPID routinely at the annual health check or vaccination visit for horses over the age of 15.

The recommendation follows the analysis of data collected as part of the company's Talk About Laminitis disease awareness initiative, which has seen more than 47,000 horses tested for PPID since it was launched in 2012¹. 

The data revealed that, regardless of presenting clinical signs, a horse aged 15-20 is three times more likely to have PPID compared to a horse under 10, and this risk increases with age. For example, a horse of 20-25 is six times more likely to have PPID compared to a horse under 10 and a horse that is 25-30 is 10 times more likely to have PPID.

Boehringer says that despite the high prevalence of PPID in the older horse population, the clinical signs of the disease are insidious in onset and owners may simply associate them with the ageing process. 

One study demonstrated that in a single population of horses over the age of 15 only 1.6% of owners reported signs of PPID². However, when the same group of horses were examined by a veterinary surgeon, 21% were found to have signs of the disease.

Dr Jo Ireland, veterinary surgeon at the University of Liverpool, said: "It is often difficult for owners to spot the signs of PPID as they frequently associate them with the ageing process. However, PPID is now the fifth most commonly diagnosed disease in horses in the UK³.  

"We are therefore encouraging veterinary surgeons to routinely test horses over 15 years of age or those that are displaying signs of PPID with an ACTH test."

The 'Talk About Laminitis' disease awareness initiative runs from June until the end of October and aims to raise awareness of the underlying hormonal causes of laminitis – PPID and Equine Metabolic Syndrome (EMS). As part of the scheme, the laboratory fees for the blood test which detects PPID (the basal ACTH test) are free.

Redwings’ head of veterinary and care, senior veterinary surgeon Nicky Jarvis, said: "Any initiative that decreases the incidence of laminitis developing in an older equine is invaluable. Laminitis is an extremely distressing condition for both the horse and the owner and the long-term consequences can be devastating. Knowing the underlying cause is a huge help in tackling the disease and we would encourage anyone to take advantage of this offer and get their veteran checked out."

For further information about 'Talk About Laminitis', visit www.talkaboutlaminitis.co.uk or contact your local Boehringer Ingelheim account manager.

References

1. Talk about Laminitis data 2012-2015 Boehringer Ingelheim
2. McGowan T. et al (2013) “Prevalence, risk factors and clinical signs predictive for equine pituitary pars intermedia dysfunction in aged horses”
3. National Equine Health Survey (NEHS) 2016

Francesca Beorby, Head Veterinary Nurse at Putlands Veterinary Centre, has performed a clinical audit which has revealed that neutering patients premedicated with medetomidine and methadone were significantly less likely to become hypotensive than when ACP and methadone were used.

Francesca's initiative was recognised with a RCVS Knowledge ‘Highly Commended’ status at its 2024 awards.

The idea for the audit came about after Francesca noticed a trend for patients to become hypotensive during anaesthesia for routine feline neutering and need additional treatment.

CVS says clinical evidence suggests a minimum value of 60mmHg for perfusion of vital organs such as the brain, heart and kidneys. 

So a clinical audit was undertaken to look at perioperative blood pressure in both cats and dogs having routine neutering procedures.

The target was for patients to maintain a mean arterial blood pressure of 60mmHg during their anaesthetic.

The animals chosen for auditing were to be classed ASA 1 and under 5 years old.

They received a pre-operative health check including a blood pressure reading to ensure they were normotensive.

A first audit looked at a standard premedication protocol of ACP at a dose rate of 0.02mg/kg combined with methadone at a dose rate of 0.3mg/kg.

A second audit initiated a change to the pre-medication drugs, using 0.005mg/kg medetomidine combined with the same dose of methadone.

Both received anaesthesia induction with Propoflo at a dose rate of 6mg/kg for cats and 4mg/kg for dogs.

All patients under anaesthetic were maintained using isoflurane and kept at a surgical plane of anaesthesia appropriate for that patient.

The patients were monitored throughout their surgical procedure using an oscilliometric monitoring machine - for systolic, diastolic and mean arterial blood pressure – and measurements recorded on an anaesthetic chart.

The collected data revealed that in the first audit, where patients received ACP and methadone, 42% (50% of cats and 38% of dogs) had a mean arterial blood pressure lower than 60mmHg after the first five blood pressure readings post induction.

In the second audit, with medetomidine combined with methadone, only 11% of patients (0% of cats and 15% of dogs) with a mean arterial blood pressure lower than 60mmHg.

In addition to the reduction in hypotensive patients during anaesthesia when the medetomidine/methadone combo was used, Francesca says the audit suggests a link to hypotension with ACP used as a premedication in anaesthetised patients.

Francesca said: “My passion in veterinary nursing is anaesthesia. And there is always room for improvement and striving to achieve gold standard care.

“These results clearly show that a change from our current premedication protocol of ACP and Methodone to Medetomidine and Methadone decreased the number of patients having hypotension during anaesthesia. The change means fewer patients were at risk of developing the side effects associated with hypoperfusion of the vital organs.

“Our quality improvement initiative has made a really positive impact in practice for both patient care and clinical team.”

The RCVS has announced a total of £1 million funding to address mental health and wellbeing within the veterinary profession over the next five years.

The RCVS Operational Board has agreed £100K of funding for the first year of the Mind Matters initiative, with a view to a similar amount per year for the subsequent four years.

Additionally, the College says it intends to contribute approximately £500K over the next five years to the Veterinary Surgeons' Health Support Programme (VSHSP). This is a continuation of previous funding, effectively doubling the College's contribution. The VSHSP, independently run by the Veterinary Benevolent Fund, offers a confidential service that aims to combat problems with alcohol, drugs, eating disorders and other addictive and mental health issues.
 
Neil Smith, Mind Matters' Chair said: "I am delighted that we have £500K of new funding over the next five years to dedicate to improving the mental health and wellbeing of the veterinary team, together with the increase to our support for the VSHSP. It shows the College's commitment in this vital area, and is a substantial amount that will really help change lives."

The funding will be reviewed annually as part of the RCVS budgeting process.

Mind Matters activities will fall into five streams:

• Learning and understanding best practice - research within the veterinary profession, for example, into occupational stress factors; and among other related professions and private and public sector organisations that have successfully tackled similar issues.
• Changing the culture - a programme of communications activities to help generate a positive environment for discussion, reduce stigma, increase awareness and the ability to identify risks, and encourage help-seeking behaviour.
• Intervention: personal level - financial and other support for existing services, such as Vet Helpline and Veterinary Surgeons Health Support Programme, together with an investigation into what more may be required to support those in need.
• Intervention: supporting the supporters - training and guidance for those who may be working or living with someone who needs assistance, in order to help supporters spot and understand signs of stress and mental illness, and help the person seek expert help.
• Making changes - working closely with the joint RCVS/British Veterinary Association Vet Futures project (www.vetfutures.org.uk) to help identify aspects of how the profession is structured and run (from student to retirement) that exacerbate stress and mental health problems - and consider how they may be addressed.

Mind Matters is supported by a taskforce comprising the Veterinary Benevolent Fund, the British Veterinary Association, the British Veterinary Nursing Association, the Veterinary Practice Management Association, the Veterinary Schools Council, the Veterinary Defence Society, the Society of Practising Veterinary Surgeons and the Association of Veterinary Students.

Vetoquinol, distributor of the Phovia light system, is highlighting a new study in Veterinary Dermatology which concluded that fluorescent light energy reduces the time to clinical resolution, increases the resolution rate and minimises the need for antibiotics in cases of canine  interdigital furunculosis (CIF)^₁.

Conducted as a multicentric international study involving board-certified veterinary dermatologists, the trial included 35 dogs with CIF in at least two paws.

Each dog acted as its own control, and was treated with systemic antibiotics, with one paw being treated with FLE and the other paw without. 

Paws were allocated based on a coin toss, and the study was single blinded: the principal investigator was responsible for the assessment of lesions, and the co-investigator was responsible for administration of FLE treatment.

The dogs were assessed over an 8-week period with check-ups every 14 days.

At every check-up the paws treated with FLE showed a greater improvement than paws without FLE treatment.

The lesions were assessed and scored with the global lesion score, the pruritic visual analogue scale, a cytological scoring, and photographic documentation.

The results of the study demonstrated that FLE combined with systemic antibiotics significantly reduced the time to clinical resolution compared to antibiotics alone.

By week four, 50% of paws in the FLE group had reached clinical resolution compared to 17% in the control group.

By week eight, 88% of paws in the FLE group had healed compared to 54% in the control group.

Dr Anja Lange, DVM, Department of Dermatology, AniCura Kleintierspezialisten Augsburg GmbH, Augsburg, Germany, said: “Canine interdigital furunculosis is a challenging condition to treat that can be prolonged and frustrating.

"Having FLE as an additional management tool is very exciting, not least because it speeds up time to healing, but it also requires us to use less antibiotics.

"The use of FLE was well accepted by all of the dog owners from the study and the dogs themselves tolerated it well, showing it can be a very useful adjunct to cases in clinical practice.”

Reference

1. A blinded randomised split-body clinical trial evaluating the effect of fluorescent light energy on antimicrobial management of canine interdigital furunculosis A. Lange, U. Mayer, E. Bensignor, L. Cornegliani, D. Ferreira, I. Matricoti, M. Mosca, L. Ordeix, D. Pin, F. Scarampella, E. Videmont, A. Yu, O. Fantini https://doi.org/10.1111/vde.13340

Royal Canin is launching a new packaging format for its range of feline wet diets.

The company says the launch comes in response to research showing that more than three-quarters of pet owners (76%¹) feed their cats wet food and almost half of wet cat products sold are in a canned format (48%²).

The current alutray packaging will be replaced by 195g cans, which Royal Canin says are easier to use and store, and which clients believe to be better value for money than other packaging formats.

The new cans will contain the same recipes as before, with the same balance of nutrients in each wet diet. They will consist of a loaf or mousse, providing a complementary texture to the chunks in gravy found in the equivalent pouched diets.

Royal Canin is also highlighting the benefits for veterinary practices: The cans are designed to provide greater clarity of display and on-shelf presence. They are also easier to stack for storage, and they meet an established demand.

Ian Williams, one of Royal Canin's small animal vets, said: "We believe the new packaging is an improvement on our established and popular range of wet Veterinary Diets for cats. The range is extensive which allows owners to follow a vet's nutritional recommendations without changing their pets' feeding habits, an excellent way to increase compliance."

The new canned format will be phased in as stocks are replenished, with the following cans being added to the Royal Canin range of wet feline foods: a new Renal and Urinary S/O can, joining the existing Recovery can within the range of Veterinary Diets; and a new Paediatric Weaning can within the Veterinary Care Nutrition range.

For more information about Royal Canin and the diets, visit www.royalcanin.co.uk.

References

1. Feeding diaries study - MARS PETCARE 2010
2. Study report about therapeutic wet food - BIO'SAT 2012

The British Equine Veterinary Association has announced that it will be hosting a debate exploring the pros and cons of corporatisation on the Friday of this year's Congress, which runs from Wednesday 13th to Saturday 16th September.

The session will be conducted in the style of the BBC Radio 4 Moral Maze discussion programme, with panelists and witnesses arguing for and against the viewpoint corporatisation is inevitable and will benefit vets and their clients.

Moderated by Madeleine Campbell, Keith Chandler and Karl Holliman will argue for corporatisation and Andrew Harrison and Tim Greet will be against. They will call upon a series of 'witnesses' for detailed questioning before the topic is more broadly debated.

CVS, the UK’s biggest veterinary group now owns more than 410 veterinary practices, of which over 30 are specifically equine or mixed practices.

The latest equine acquisitions include Bell Equine, a one-site Equine Referral Hospital in Kent, in January 2017 and Severn Edge Veterinary Group, a mixed practice with 12 sites in Shropshire, including a six-vet dedicated equine practice, in April 2017.

One line of argument says that the commercial and business advantages of a corporate, together with their scale and diversity, can give veterinary surgeons greater potential for a more flexible career path and advancement within the industry, and a more sustainable working career in equine practice.

On the flip side, there's the removal of any opportunity to buy into ownership, reduced decision-making ability because of adherence to corporate procedures, extra paperwork, longer approval processes and an increased emphasis on the bottom line.

David Mountford, Chief Executive of BEVA said: "The auditorium is usually full to bursting for our Moral Maze sessions because they bring a broader and more engaging dimension to important topics. The statement Corporatisation of equine practices is inevitable and will benefit vets and their clients is bound to generate some stimulating and possibly heated debate."

This year's BEVA Congress will be held at Liverpool Arena Convention Centre, and anyone who registers before 3rd August will receive significantly reduced booking fees.

For more information, visit: www.beva.org.uk.

Vetoquinol, makers of Sedalin (acepromazine), has published a free clipping guide for horse owners.

The company says the launch of the guide has been timed to coincide with the horse clipping season, when owners may be considering sedating horses to make things safer for themselves and their horses.

The guide refers owners to their veterinary surgeon for professional advice if sedation is appropriate.

The company has also produced promotional practice posters: ' Less Stress more Success'

For your poster and accompanying guides, contact your Vetoquinol Territory Manager or Teleservices directly on  01280 825424. You may also wish to put a link to a downloadable version of the guide on your practice website: http://www.vetoquinol.co.uk/clippingguide.pdf

Tickets for BSAVA Alba, which will take place on 22nd – 23rd September at the MacDonald Inchyra Hotel near Falkirk, have gone on sale.

Open to all in the veterinary profession, the event offers up to ten hours of CPD,  and covers a range of topics such as orthopaedics, ECC, medicine, wellbeing, and education.

There will also be practical sessions to attend on both days on transfusions, CPR, and physio.

Speakers include:

• Ross Allan – Clinical Director of Referrals at Pets ‘n’ Vets, Glasgow
• Dr Rosie Allister – Vetlife and researcher at the University of Edinburgh
• Lara Brunori – ECVECC Small Animal Residency at Vets Now 24/7 Pet Emergency Hospital, Glasgow
• Emily Gorman – Senior ECC nurse and phlebotomist for the Pet Blood Bank
• Tobias Grave – ECC at Veterinary Specialists Scotland
• Professor Danièlle A. Gunn-Moore – Professor in Feline Medicine at Royal Dick School of Veterinary Studies and The Roslin Institute
• Luis Santos – Senior Clinician in veterinary anaesthesia at the University of Glasgow
• Charlotte Swarbrick – Senior Veterinary Physiotherapist and Teaching Associate
• Paul Wood – Programme Director for the veterinary school at Scotland’s Rural College

There's a commercial exhibition, and social events including the Ceilidh at the annual BSAVA PetSavers Gala Dinner on Friday evening.

Prices start at £85 +VAT for a day pass, with early bird rates offered to both BSAVA members and non-members until 27th July.

Additional discounts are available when sending the whole practice team.

https://www.bsavaevents.com/bsavaalba23/en/page/home 

The consumer body, Which? has published a research paper looking at the complaints process in the veterinary profession, finding that it is difficult for consumers to make a complaint, and when they do, only 31% are resolved positively, compared to 52% across all sectors.

For the research, Which? conducted an online poll of 1,009 pet owners who had had an issue with their vet in the past two years. 

It also conducted qualitative interviews with 14 owners who had complained.

The most common reasons for complaint were:

• Excessive price of care or treatment (53%)
• Price higher than told to expect (27%)
• Not happy with the quality of care (23%)
• Not happy with the level of customer service (22%)
• Not given information about all the treatment options (16%)
• Charged the incorrect price (11%)
• Vet or practice made a mistake when delivering care (11%)
• Other (6%)

Of the 1009 pet owners who had experienced some kind of problem with their vet, 57% did NOT make a complaint, 33% because they did not want to fall out with their vet.

Pet owners who wish to complain about veterinary services have three options: to complain directly to their practice, to use the voluntary Vet Client Mediation Service (VCMS), or to raise a 'concern' with the RCVS.

The Which? report found that of those who did complain to their practice, 35% were not happy with the outcome and 31% with the way it was handled. 

Which? found that although the VCMS reported a high resolution rate of 84% in 2022-23, its interviewees had found it a bit hit or miss. 

Finally, Which? found the process of complaining to the regulator flawed by the fact that the threshold for the College to progress a 'concern' is set so high, because College has no jurisdiction at a practice level, and because it has no sanctions to use in enforcing consumer law. 

The report recommends that:

• the government updates the regulatory framework to allow regulation at a practice level
• the government ensures that the RCVS is sufficiently equipped to independently enforce consumer law
• that vet practices should be required to have a written complaints process
• a more comprehensive and mandatory alternative dispute resolution (ADR) scheme for when issues cannot be resolved at the practice level is introduced

Full report: https://www.which.co.uk/policy-and-insight/article/complaints-and-redress-in-veterinary-services-a5z611X9tZzf 

Comment
I loved the regal response from the RCVS to The Guardian about the case studies in the Which? report: “the facts presented in the case studies do not completely align with those reported to us”. 

That aside, surely the big issue here is not so much that consumers have little way to complain effectively.

That is important, of course, but isn't it more important to consider what they are complaining about, which in the main is MONEY. 

Driven by the advances in veterinary medicine, the innate desire of vets to provide the best possible care, anthropomorphising pet owners saying they want 'the best' for their fur baby (without necessarily having the wherewithal), corporatisation and society's changing expectations about working conditions, prices have been going up at a rate far outstripping inflation. 

Increasing prices have of course been accompanied by an increase the standards of care and the range of clinical equipment. 

But the question everyone must ask is at what point the cost of veterinary care for a dog outstrips the benefits of owning one?

These complaints are the canary in the coalmine. 

The Small Animal Medicine Society (SAMSOC) and the BSAVA have together produced a new poster containing guidelines for the appropriate use of antibiotics in practice.

In recent years, alongside wider recognition of resistant bacteria such as MRSA in animals, the veterinary profession's use of antibiotics has been under the spotlight as a possible factor contributing to the increasing prevalence of bacterial resistance seen in human patients. Veterinary surgeons are faced with the dual problem of treating more and more resistant bacterial infections, whilst the threat of withdrawal of the right to prescribe certain antibiotics hangs over the profession.

SAMSoc and the BSAVA say they feel the time has come for the veterinary profession to take a coordinated responsible approach to its prescribing practices.

Ian Battersby of the Small Animal Medicine Society (SAMSoc) has sought to address the need for rational guidelines for the most appropriate antibiotics, for the correct duration, to maximise clinical efficacy but minimise selection of resistant bacteria. Collaboration with BSAVA resulted in a set of helpful prescribing guidelines in poster form, being sent to members of both associations. A limited number of copies will also be available from the BSAVA Balcony at Congress 2012, and BSAVA has dedicated the October issue of its membership magazine, companion, to the subject.

Ian said: "Of course these PROTECT guidelines are suggestions based on current knowledge and in the future we hope they will be further refined as our experience grows. This is an evolving situation and hopefully more work will be undertaken, in particular looking at treatment durations, allowing further refinement and optimization of practice policies. The key principles are that by implementing a prescribing protocol in our practices we are treating our prescribing privileges responsibly and maximizing the efficacy of the presently available agents for the benefit of both veterinary and human patients now and in the future.

"I would like to particularly thank everyone who has helped with this project; Andrew Jagoe, Professor Ian Ramsey, Tom Maddox, Jon Camillari, Alison Woodward and Dr Tim Nuttall, and BSAVA for facilitating the production of the poster".

New research from the Royal Veterinary College has revealed that a chromosomal defect is the reason why a significant proportion of horse pregnancies fail within the first two months of development.

The College says this will pave the way for new diagnostic tests for what could be one of the most common causes of pregnancy loss in mares.

The researchers, led by Dr Mandi de Mestre (pictured right), Reader in Reproductive Immunology and Head of the Equine Pregnancy Laboratory at the RVC, collaborated with seven different veterinary practices to gain access to samples from across the UK and Ireland and found that around 20% of the pregnancies lost were aneuploid, which is when a copy of a whole chromosome is either duplicated or lost (similar to Down's).

Charlotte Shilton, RVC PhD, the student who performed the analysis, applied three different genetic approaches to confirm the results.

Work is now underway to identify the underlying cause of these aneuploid pregnancies, with early data from this study suggesting it is most commonly introduced via the egg or sperm. Until now, chromosomal defects such as aneuploidy have only been reported as a rare condition in young horses with developmental disorders. 

The researchers say the study explains why the condition is so rare in horses, with most embryos and foetuses possessing this genetic change dying very early in development, as is also observed in human pregnancy. The study highlights the need to reconsider this genetic condition both in pregnancy loss but also for early developmental disorders.

Dr Mandi de Mestre, Reader in Reproductive Immunology at the RVC, said: “Early pregnancy loss remains a very frustrating condition for clinicians to treat as the underlying cause is unknown in around 80% of cases. These findings will allow researchers to develop new diagnostic tests for pregnancy losses, which would offer hope to thousands of owners of breeding mares that suffer this condition.

“A diagnostic test would allow them to make informed decisions on treatment strategies and to advise on whether they should invest in further attempts to breed their mare benefiting both horses and their breeders alike in the future. I would like to thank both the Thoroughbred Breeders Association and our collaborators at Texas A&M University and the participating veterinary surgeons for their support on this project.

Reference

1. 10.1038/s41598-020-69967-z "Whole genome analysis reveals aneuploidies in early pregnancy loss in the horse" www.nature.com/articles/s41598-020-69967-z

The BSAVA reports the highest ever attendance at Congress this year: 6,178 veterinary surgeons, nurses, practice managers and students, 6% cent higher than in 2011 (the last time the BSAVA hosted its own Congress).

According to the association, a significant number of international delegates attended this year with almost 60 countries represented - notably Scandinavia (186 delegates), Germany (56), the Netherlands (40) and the USA (31).

Other highlights included:

• Vets and vet nurses jointly acquired more than 100,000 CPD hours in a scientific programme which included subjects such as orthopaedics, neurology, anaesthesia and analgesia, dermatology, oncology and pain management.
• Nearly 300 exhibitors filled the National Indoor Arena.
• The top five most popular titles at the BSAVA Publications stand were: Feline Practice, Neurology, the Pocketbook for Nurses, the Pocketbook for Vets, and Practice Management.
• According to the Birmingham Convention Bureau,  BSAVA Congress brings in an estimated £15m to the regional economy. This includes accommodation, meals, events, entertainment, and travel around the cosmopolitan destination.

Outgoing BSAVA president Mark Johnston said the event was the highlight of his presidential year: "Last year we showed the world how well the BSAVA can organise a major veterinary congress. But what is pleasing is that the momentum we gained from hosting the World and European meetings has continued into this year.

"We had more delegates in 2013 than in the last purely BSAVA Congress two years ago and to accomplish that in these difficult financial times is a remarkable achievement."

Newly inducted BSAVA president Michael Day (top right) said he was looking forward to extending the international aspect of BSAVA. The Australian-born Professor who has lived in the UK for well over two decades said: "BSAVA has made huge contributions to veterinary practice in the UK, and already has a global reputation for Congress and publications - I believe we have such a wealth of resources and so I am convinced we have so much more to offer the world".