Animalcare has launched Buprecare into the UK and Ireland veterinary markets. Buprecare (POM-V) is a veterinary licensed analgesic, containing buprenorphine, for use in dogs and cats. It is licensed for post-operative analgesia in dogs and cats, and potentiation of the sedative effect of centrally acting agents in dogs.
This is the second major product the company has introduced in the last 18 months as Animalcare continues to grow its portfolio of veterinary products with the launch of an ACE inhibitor Benazecare (benazepril hydrochloride) earlier in 2007.
To complement the product launch, Animalcare is offering an ampoule breaker to help practice staff to open ampoules safely, together with a practice support package, containing pain scoring pads to aid in the assessment of pain of patients and judging of adequate analgesia requirements. In addition a dosing table and poster detailing common behavioural changes that can be associated with pain are available. Buprecare 0.3mg/ml is available in 1ml ampoules, in cartons of 5 ampoules.
Stephen Wildridge, Managing Director of Animalcare Ltd. said: "We have a very exciting time ahead with the launches of several new pharmaceutical products over the next twelve months, and the proposed expansion of our business into the major European veterinary markets."
Please contact your Animalcare representative, or ring 01904 487687 for more details.
Online veterinary pharmacy Vet-Medic has announced the results of a survey which showed that veterinary practices are charging pet owners 100% more than online pharmacies for well-known drugs.
The survey compared the prices charged by veterinary practices, online pharmacies, pet superstores, supermarkets and veterinary medicine suppliers. Amongst other things, it found a six-pack of Frontline for cats available online for £16.33, vs £38.95 in practice. Optimmune was available for £23.86, compared to a practice in North London selling it for £59.81.
Andrew Evans, Managing Director of Vet-Medic said: "This research offers huge insight into the pricing structures of pet medication. When we commissioned the research to help us keep our own pricing competitive, we made an assumption that online shopping should come out cheaper but were staggered by how much."
He added: "Not many pet owners are aware that vets are obliged, in most circumstances, to provide them with a prescription when asked. How and where the prescription medicine is purchased is actually the owners' choice."
The BVA responded to the survey yesterday. President-Elect Harvey Locke said: "The Vet-Medic claim that veterinary practices are over-inflating the price of veterinary medicines is an unfair accusation.
"Veterinary practices will mark up the cost of the medicines they supply in order to cover the costs of keeping and dispensing them. This includes having trained staff available, buying the necessary equipment, and storage facilities that are governed by strict rules, and covering the cost of wasted medicines that have a short shelf life.
"Online pharmacies have similar overheads but are able to buy in much larger quantities than the average veterinary practice due to the much higher volumes sold. Many of the internet prices revealed in the survey are around the same cost as veterinary practices can buy the medicines from wholesalers suggesting that some of the internet companies are sourcing cheaper drugs abroad.
"As with many products buying online can be cheaper and consumers have a choice. Many pet owners choose to use the veterinary practice pharmacy because a lot of advice and assistance is available, including demonstrations on how to administer the treatments.
"Vet-Medic's assertion that pet owners don't know that they can obtain a prescription from their veterinary surgeon is also false. Over 50% of UK practices are registered under the RCVS Practice Standards Scheme. One of the conditions of the scheme is that a notice must be displayed in the waiting room informing clients that prescriptions are available on request, the price of a prescription, and the price list of the top ten medicines that the practice has dispensed in the last three month period.
"It's important to remember that under the law veterinary practices are not allowed to fix the price of medicines. As they are independent businesses this means that it is up to each practice to charge according to their own circumstances to cover their individual overheads."
16 clinics are affected by the investigation, namely Penrose Veterinary Group Limited, Kevin Castle (Pet Care) Ltd, Swayne & Partners Ltd, Treforest Veterinary Clinic Ltd, Mercer & Hughes Limited, Swaffham Veterinary Centre Limited, Anglesey Pet Clinic Ltd, Chiltern Equine Clinic.
It's not the first time, of course, that the CMA has intervened in the veterinary profession.
Earlier this year, it investigated the acquisition of Quality Pet Care (trading as The Vet) by CVS, and then Vet Partners' acquisition of Goddards, which led to CVS selling The Vet and Vet Partners selling eight of the 47 Goddards sites to Linnaeus.
An IVC spokesperson said: “IVC Evidensia is working closely with the CMA and engaging constructively with this review."
The hearing took place in Mr Prichard's absence after he failed to respond to Colleges attempts to contact him, including by email, post, telephone and personal service of documents.
However, in its decision to proceed in Mr Prichard’s absence, the Committee confirmed that it would not hold his non-attendance against him or attach any adverse inference to that fact.
Mr Prichard was charged with taking quantities of the controlled, prescription-only drug Vetergesic from the practice’s stock other than for legitimate veterinary use.
He was further charged that he took Vetergesic from the practice by drawing it into a syringe for the purposes of self administration, and that in doing so, his conduct was dishonest.
In another set of charges, it was alleged that on five separate occasions, Mr Prichard had attended the practice to work as a veterinary surgeon whilst unfit to do so.
The final charge related to Mr Prichard’s failure to respond adequately or at all to all reasonable requests from the RCVS for his response to concerns raised about his conduct.
At the beginning of the hearing Nicole Curtis, acting on behalf of the College, read the written evidence from 11 separate witnesses outlining the facts related to the charges against Mr Prichard, including the record of an investigative meeting held by the practice in which he admitted his theft and use of the controlled drug and following which, he was dismissed from his employment.
The Committee found all the charges proven and then considered whether they amounted to serious professional misconduct.
In terms of aggravating factors the Committee found that there was a risk of injury, recklessness, premeditated and sustained misconduct, and that there was an abuse of his professional position in accessing prescription-only controlled drugs for reasons other than legitimate veterinary use.
In mitigation, the Committee considered that he had made admissions as part of the practice’s internal disciplinary investigation.
Overall, the Committee found he had breached aspects of the Code of Professional Conduct related to honesty and integrity, making animal health and welfare his first priority, appropriate use of veterinary medicines, taking steps to address physical and mental health conditions that could affect fitness to practise, responding to reasonable requests from the RCVS, and bringing the profession into disrepute.
Therefore, the Committee found him guilty of serious professional misconduct in relation to all of the charges charges.
The Committee felt that, considering the seriousness of the misconduct, removal from the Register was the most appropriate decision.
Austin Kirwan, chairing the Committee and speaking on its behalf, said: “This is a case involving serious dishonesty, sustained over a period of time, and conduct potentially detrimental to animal welfare, as well as wilful disregard of professional regulations.
“Regrettably, Mr Prichard’s failure to engage with the College and with the regulatory process limited the options open to the Committee.
"Notwithstanding this, Mr Prichard’s disgraceful conduct is so serious that removal from the Register is the only means of protecting animals and the wider public interest which includes the maintenance of public confidence in the profession and the upholding of standards.”
www.rcvs.org.uk/disciplinary
The petition was set up by veterinary surgeon and journalist Pete Wedderburn, after discussion with colleagues, in response to an open letter to the profession from Jemima Harrison, producer of the Pedigree Dogs Exposed documentary broadcast in 2008.
In the letter, Jemima notes that Kennel club registrations of Pugs rose from 2,000 in 2005 to 10,000 last year. Over the same period Bulldog registrations more than doubled to 7,000 and the number of French Bulldogs increased 4000% to 14,607.
All vets do, she says, is 'organise CPD days on how to manage the increasing numbers of creatures that turn up at your practice doors gasping for air', 'refer clients on to soft-tissue specialists who do their best to remedy the deformity that has been bred into them', and 'section that Bulldog and say nothing to the breeder about how wrong it is that the dogs are no longer capable of birthing their own pups'.
She argues that there is 'institutional kow-towing to the Kennel Club and a reluctance to do anything other than accept their platitudes that they have to take things slowly or risk "losing" the breeders'.
In response, Pete's blog and petition calls for a working party to develop concrete proposals to tackle the issues as a matter of urgency: 'Despite the evident appeal of short-nosed pets to many of our clients, it is our duty as vets to not just treat these animals, but also to lobby for reform in the way they are bred – in particular the 'extreme' brachycephalics such as Pugs, Bulldogs, French Bulldogs and flat-faced Persian cats'.
The Dog Breeding Reform Group has welcomed the petition. Chris Laurence MBE, DBRG Trustee and former veterinary director of the Dogs Trust who has signed the petition, says: "Vets in companion animal practice see dogs with inherited breathing difficulty almost every day and are frustrated that there seems to be no end to the daily suffering of these breeds. The DBRG is delighted that vets are now getting together to highlight the issue and to plead with breeders to stop producing puppies with such malformed heads that they are unable to breathe easily."
The petition, which has already gathered nearly 1000 signatures, can only be signed by veterinary surgeons and nurses. You can sign it here.
The Disciplinary Committee heard that Mr Samuel had been convicted of five animal welfare offences at Leeds Magistrates' Court in January 2016. The charges related to causing unnecessary suffering to a number of animals including twelve dogs and four cats, and failing to take steps to ensure that the needs of the animals for which he was responsible were met. The animals were kept at the Armley Veterinary Practice, for which Mr Samuel was, at the time, practice principal.
Mr Samuel was sentenced to 12 weeks' imprisonment suspended for 12 months on the condition he completed 150 hours' unpaid work and paid a fine of £100. He was also ordered to pay costs of £500 and a victim surcharge of £80. He was also made subject to a disqualification order for three years.
Dr Samuel subsequently appealed against his conviction in April 2018. His appeal was dismissed in respect of five of the charges but was upheld in respect of one charge, which, as a result, did not form part of the College’s case.
Dr Samuel declined to attend the hearing in person and was not represented before the Disciplinary Committee. In considering the facts of the charges against Dr Samuel the Committee found them proven.
The Committee then went on to consider whether the proven charges, both individually and cumulatively, rendered Dr Samuel unfit to practise as a veterinary surgeon.
The College’s case was that the convictions concerned animal welfare and therefore went to the heart of his practice as a vet, that Dr Samuel behaved in a manner incompatible with being a veterinary surgeon, that he failed in his core responsibility as a veterinary surgeon to protect and act in the best interests of animal welfare, and that he maintained he had no responsibility for the animals on his practice premises – an assertion referred to as ‘an extraordinary position for a veterinary surgeon to take’.
Ian Green, chairing the Committee and speaking on its behalf, said: "ust as the judgment of the Crown Court and the Magistrates Court had found, the Committee also found that Dr Samuel must have known that the animals were in distress and were in a neglected state. The Committee was sure that Dr Samuel must have been aware of the animals notwithstanding his continued denial. The Committee concluded that Dr Samuel was unfit to practise because of the facts underlying the convictions. Dr Samuel had an overriding duty of care for the animals and to take action in relation to their health and welfare because they were living under the roof of his veterinary practice."
In considering its sanction against Dr Samuel, the Committee concluded that removal from the Register was the most appropriate option. It took into account the fact that the animals were found starving in a cellar without water, that Dr Samuel had not demonstrated insight into the serious nature of his offences, that he continued to deny responsibility and, furthermore, found no evidence that he no longer posed a risk to animals in the future.
Ian Green added: "The Committee decided that the behaviour found proved was fundamentally incompatible with being a veterinary surgeon because in this case there had been a serious departure from standards as set out in the RCVS Code of Professional Conduct for Veterinary Surgeons…. Furthermore, there had been serious harm caused to a number of animals and a risk of harm to a number of other animals."
Dr Samuel has 28 days from being informed of the Disciplinary Committee’s decision in which to make an appeal to the Privy Council.
The Committee’s full decision and findings can be found here
Bayer has introduced a new microchip scanner which is capable of reading all chips, including encrypted ones.
The company says the new Tracer Advance Isomax V scanner offers exceptional reading distances of more than twice those of other scanners on the market, making it a very versatile tool ideally suited for use in companion animal practices or for detecting microchips in larger animals such as horses.
The technology that gives this scanner its backward compatibility with non ISO standard chips means practices can now save money by only having to buy one scanner, whereas previously two were required to be able to read all types of chip.
Other features of the device include digital signal processing (DSP), which protects against radio interference from TVs and PCs, and connectivity via USB, RS232 or optional Bluetooth interface.
The Tracer Advance Isomax V scanner is available from Bayer and is priced at £499.95. It comes with a 30-month warranty. Contact your Bayer territory representative for further details.
The Allium species includes onions, garlic, and their relatives. All members of the Allium family are poisonous to cats and dogs and even minimal amounts can be dangerous. For example, a 5kg cat would only need to ingest 1-2 garlic cloves to show clinical signs. Poisoning causes haemolytic anaemia with treatment being supportive, as there is no antidote. In severe cases blood transfusions may be required.
Powdered versions of these plants are more concentrated and are often used in gravy and stuffing in the traditional Christmas dinner, so toxicity can occur much more easily.
Will Peel, Product Manager at TVM UK said: "Alliums are toxic to animals and as there is no antidote it’s important that veterinary staff are fully prepared and are able to react quickly and provide the best care possible.
"Our focus is on helping veterinary staff prepare for all eventualities so we hope that these new guidelines will prove beneficial."
The guidelines can be downloaded for free from https://www.tvm-uk.com/vet-resource-library/.
Nerfasin vet is available in two concentrations - a 100 mg/ml (10%) solution for cattle and horses and 20 mg/ml (2%) solution for cattle, horses, cats and dogs.
Nerfasin vet is on sale in 25 ml vials.
For more information visit: www.dechra.co.uk.
RIP Fleas, the environmental flea treatment from Genitrix, has been given a new formulation to ensure it acts more quickly in the killing of adult fleas and that it continues to kill fleas as they emerge from pupae for up to 12 months.
Now known as RIP Fleas Extra, the product is also licensed for the control of house dust mites in the environment for up to 12 months.
According to Genitrix, the reformulation makes RIP Fleas Extra the only environmental flea treatment to contain three active ingredients while complying fully with new EU Biocides regulations. It is the only such treatment to be fragranced and is also the only product to be presented in a volume which will cover 120 square metres – ie the size of an average house. RIP Fleas Extra contains:
Tetramethrin – a second generation synthetic pythrethroid and a contact insecticide with a rapid knockdown action of insect pests
Permethrin – a potent insecticide with a powerful contact action on insects but with a low toxicity to most mammals
Methoprene – a compound that mimics the insect juvenile hormone and arrests development of fleas and house dust mites in the environment.
When used synergistically, Tetramethrin and Permethrin provide a rapid knockdown and kill of fleas as they hatch from pupae. Studies have shown that this combination works four times more quickly than Permethrin alone.
Dogs with RVED develop retinal degeneration from around four years of age which, if untreated, leads to blindness.
In partnership with James Oliver, Head of Ophthalmology at DWR Veterinary Specialists (pictured), researchers set out to discover why some Cocker Spaniels have such low vitamin E levels in their blood, despite it being present at normal amounts in their diet
James helped to design the study, recruit cases and collect samples.
Cathryn Mellersh, Senior Research Associate at the Canine Genetics Centre, said: “The team strongly suspected a genetic cause and has been trying to discover the responsible gene for several years with the help of owners and vets, who have contributed DNA samples.
“Thanks to updated information on the canine genome, Katherine Stanbury, one of our research associates, found a mutation in the alpha tocopherol transfer protein gene which is causative of the disease.
“This gene is responsible for getting vitamin E into the blood stream.
"We now know that RVED is a recessive disease, meaning that affected dogs must have two copies of the faulty gene to develop low vitamin E levels and retinal degeneration.”
The team’s DNA test can be used by dog breeders to find out if dogs carry the gene mutation, so they can avoid matings which result in affected puppies being born.
Cathryn said: “This DNA test is a rare example of one which not only can be used to identify dogs that are carrying the mutation and thus reduce the frequency of the mutation in future generations, but also has the incredible benefit of providing a sight-saving treatment option for dogs with the disease.
“From the research we have done we estimate that there could be several hundred Cocker Spaniels alive today that have two copies of this mutation, whose eyesight could be saved by this test.”
A DNA test for the mutation that causes RVED is now available from Canine Genetics Testing, which operates alongside researchers from the Canine Genetics Centre.
www.cagt.co.uk.
The team’s RVED research can be viewed at https://academic.oup.com/g3journal/advance-article/doi/10.1093/g3journal/jkaf016/7985679?searchresult=1
IMV says it has acquired BCF to widen its offering in the reproduction management sector, particularly in imaging. As part of this strategy the company acquired ECM, a French veterinary ultrasound manufacturer, last June, and has launched AlphaVision, a video-assisted bovine insemination system.
Alan Picken, Managing Director of BCF, will lead the imaging division of IMV Technologies and become a member of the Management Board of the Group.
Philippe Gravier, Chief Executive Officer of IMV Technologies, said: "For over 50 years, IMV has been at the forefront of innovations in animal artificial insemination and embryo transfer. Following the acquisition of ECM earlier this year, the integration of BCF supports our vision to supply health status and reproduction-readiness tools to veterinarians, breeding technicians and livestock owners.
"I am very excited that BCF is joining the IMV Technologies Group. Our 100 employees have worked hard to build this company to where it is now. There is no doubt that IMV’s strong brand, customer loyalty and extensive distribution network will help to expand further our imaging activities. Like IMV, I share the vision that market differentiation is in supporting customers to improve animal care, achieved through constant innovation and marketing leading products and services."
Credelio Plus is a palatable, chewy, monthly tablet which contains milbemycin oxime for the control of the gastrointestinal nematodes: hookworm (L4, immature adult (L5) and adult Ancylostoma caninum), roundworms (L4, immature adult (L5) and adult Toxocara canis and adult Toxascaris leonina) and whipworm (adult Trichuris vulpis). Also for the prevention of angiostrongylosis by reduction of the level of infection with immature adult (L5) and adult stages of Angiostrongylus vasorum (lungworm) with monthly administration. Also for the prevention of heartworm disease (Dirofilaria immitis).
Credelio Plus also contains lotilaner for the immediate and persistent treatment of ticks (Dermacentor reticulatus, Ixodes ricinus, Rhipicephalus sanguineus and I. hexagonus) and flea (Ctenocephalides felis and C. canis) infestations in dogs.
Credelio Plus is licensed for puppies as young as 8 weeks and weighing 1.4 kg or more.
Tina Hunt, General Manager of Elanco UK/Ireland said: "The launch of Credelio Plus represents another exciting evolutionary leap for Elanco’s parasiticide portfolio.”
Cat Henstridge MRCVS, otherwise known as 'Cat the Vet' said: "As a companion animal vet, one of the common challenges I see from pet owners is the need to remember and administer multiple treatments to cover a variety of parasites.
"So a simple, easy-to-remember treatment will be welcomed by my clients who need a combination solution to protect their dogs from ticks, fleas and worms.”
To mark the launch of Credelio Plus, Elanco is inviting vets and nurses to register for an online event at which the astronaut Major Tim Peake will talk about the lessons he’s learnt about leadership and teamwork, performing in high-pressured environments and the future of medicine and science. He'll be followed by Cat Henstridge, who will give a presentation about the power of wider veterinary teams working ‘better together’ to support each other, and how practices can start to reconnect with their clients following lockdown.
Lepha McCartan, BVetMed MRCVS, Veterinary Technical Consultant, Elanco Animal Health, will also speak about Elanco’s ongoing work within the parasite space. There will also be a live Q&A where attendees can put questions to the panel.
To sign up for the launch event, visit https://www.myelanco.co.uk/brand/credelio-plus-launch-registration
The Codes of Professional Conduct for both veterinary surgeons and veterinary nurses stress the need for effective communication with clients and ensuring that informed consent is obtained and documented before treatments or procedures are carried out.
At its January meeting RCVS Standards Committee approved changes to chapter 11 (‘Communication and consent’) of the supporting guidance to the Codes to provide further advice to the professions on matters that should be discussed with clients to ensure informed consent is gained, provide clarification on who can gain consent for a procedure and give some additional guidance on consent forms.
Nick Oldham, Standards and Advisory Manager at the RCVS, said: "We hope that this updated guidance is more accessible, readable and will aid members of the profession in developing a more comprehensive approach to gaining informed consent for treatments and procedures and therefore reduce the risk of miscommunication and misunderstanding which can lead to concerns being raised by clients.
"For example, we have updated our guidance to encourage veterinary surgeons to consider discussing a number of additional factors with a client before obtaining consent. This includes the nature, purpose and benefits of any treatment or procedures, the likely outcomes including potential risks, financial estimates, informing the client when other treatments may have available and checking that the client understands what they are agreeing to rather than assuming the client understands both the potential financial outlay and possible side effects.
"Furthermore, there is now additional guidance for veterinary surgeons on who should be seeking consent. While ordinarily it is expected that the veterinary surgeon undertaking the procedure or providing treatment is responsible for obtaining the client’s consent we know that this is not always practical.
"Therefore we clarify that the responsibility of obtaining consent can be delegated to another veterinary surgeon and, failing that, a registered veterinary nurse or student veterinary nurse could obtain consent provided that they are suitably trained, have sufficient knowledge of the proposed procedure or treatment and understand the risks involved.
"The RCVS Standards and Advice Team is also in the process of producing a series of fictional case studies based on informed consent issues encountered by the College’s Preliminary Investigation Committee which we hope will further help the profession."
The updated supporting guidance can be found in full at www.rcvs.org.uk/consent
The Code of Professional Conduct and its supporting guidance can also be downloaded as an app for smartphones and tablets at www.rcvs.org.uk/codeapp
Members of the profession seeking confidential advice on matters relating to professional conduct can contact the Standards and Advice Team on 020 7202 0789 or advice@rcvs.org.uk
The Disciplinary Committee, chaired by Mr Stuart Drummond, considered six charges against Dr Gunn.
The first charge alleged that, early in 2018, Dr Gunn failed to provide appropriate and adequate care to the dog. In particular, having removed a mass from the right thorax, he undertook an excess number of surgical procedures, including under general anaesthetic, within a 13 day period; performed these procedures without offering alternative treatments or discussing referral with the owners; failed to recognise infected wounds; and administered an antibiotic when the dog was infected with MRSA and E-coli.
The second charge alleged that Dr Gunn failed to communicate adequately, openly and honestly with the owners of the terrier on multiple occasions between 16 January and 3 February 2018. This included but was not limited to: failing to provide the owners with an estimation of fees; failing to inform them in advance of the procedures performed; failing to inform them of options for treatment; and failing to inform them that the terrier had an infection when he knew or ought to have known that she did.
The third charge alleged that Dr Gunn failed to obtain informed consent in relation to the further procedures performed on the terrier in charge one.
The fourth charge alleged that Dr Gunn failed to maintain adequate clinical records in relation to the management of the dog, and that he failed to record the prescription and administration of drugs to treat the terrier.
The fifth charge alleged that Dr Gunn indicated to the owners that euthanasia was the most appropriate treatment option and/or that there were no other realistic treatment options, when this was not the case and when he ought to have known this was not the case.
The sixth charge alleged that, during the course of a referral of the terrier to another practice, Dr Gunn failed to provide an adequate history of his management of the dog and that he informed the practice that the owners had no finances when this was not true, amounting to an incomplete account of his dealings with the owners and to a breach of their confidence.
At the outset of the hearing the respondent admitted to a number of the allegations within the main six charges, which were found proved by the Committee.
Of the charges not admitted to, a number were found proved and the Committee then went on to consider whether or not Dr Gunn’s conduct amounted to serious professional misconduct.
In considering the aggravating factors, the Committee took into account that the dog’s suffering was prolonged because of the persistence of Dr Gunn in pursuing a single ineffective treatment approach.
With regards to mitigating factors, the Committee found that Dr Gunn was remorseful as to his actions, that there was no financial motivation on the part of Dr Gunn in respect of his treatment of the terrier, and that there is a low risk of repetition because Dr Gunn has sought to learn from this experience. A number of relevant and high-quality testimonials were also provided by colleagues and many satisfied owners on behalf of Dr Gunn.
Considering both the aggravating and mitigating factors, the Committee was satisfied that Dr Gunn’s conduct fell far below the standard expected of a registered veterinary surgeon for a number of the charges.
The Committee then considered what sanction to impose on Dr Gunn. The Committee was satisfied that the misconduct found proved was in relation to the treatment of one dog only and therefore it was at the lower end of the spectrum. However, the conduct took place over a prolonged period of two weeks which in the Committee’s view required a sanction. In such circumstances, and with the significant mitigation, the Committee decided that the appropriate and proportionate sanction was to reprimand Dr Gunn and to warn him about his future conduct.
Speaking on behalf of the Committee, Mr Stuart Drummond said: "The Committee concluded that the effect of a reprimand alongside the Committee’s findings on disgraceful conduct in a professional respect was a sufficient and proportionate sanction. The Committee found Dr Gunn to have developed sufficient insight into his failings and it was satisfied that the disciplinary process had been a salutary experience and that he is very unlikely to pose a risk to animals in the future or to contravene professional standards.
"The Committee decided that a warning as to future conduct was necessary to reduce the risk of any repetition of any similar conduct for Dr Gunn in the future. It therefore concluded that the sanction of a reprimand and warning would be a sufficient in the circumstances of this case having taking into consideration all the powerful personal mitigation."
The complete list of charges and the Committee’s full facts and findings can be found at www.rcvs.org.uk/disciplinary
Having investigated alternative sources of isoflurane, and alternative products, the associations proposed ways that the VMD might mitigate the risks to animal welfare including consenting to the use of unlicensed (“special”) isoflurane formulations.
The VMD responded rapidly and positively. It is understood that one specials manufacturer is now intending to produce isoflurane to fill or partially fill the gap in supply. This should be available in three to four weeks.
David Rendle, a member of BEVA’s Health and Medicines Committee commented: "BEVA has a close relationship with the veterinary pharmaceutical industry and will always work swiftly and collaboratively to help develop practical solutions to supply problems for our members."
BSAVA President Philip Lhermette praised the VMD for such prompt action. He said: "The VMD listened to our concerns and acted immediately. By doing so they have addressed and helped to prevent any potential welfare risks associated with a lack of isoflurane."
Carl Bradbrook, AVA Junior Vice President, reminded clinicians to "seek advice when considering the use of unfamiliar anaesthetic protocols."
The associations say that the situation doesn’t give vets free rein to ignore the medicines legislation; the cascade must still be followed, and client informed consent obtained if an unregulated anaesthetic is used.
Extemporaneous products are the last tier of the cascade. Vets are expected to use either an authorised human medicine or an EU authorised veterinary medicine before an extemporaneous preparation. If, after diligent attempts to source a product higher up the cascade, the vet has not been successful they could consider using an extemporaneous preparation for the immediate need. However, should an authorised product or a human product become available vets are obliged to use it over an extemporaneous preparation.
BEVA, the BSAVA and the AVA have each produced general advice on the use of specials or anaesthesia options at https://www.bsava.com/News/ArticleID/2535/Isoflurane-supply, https://www.beva.org.uk/Resources-For-Vets-Practices/Medicines-Guidance/Veterinary-specials and https://ava.eu.com/
Virtual Vet Derms has been set up to be able to give advice to veterinary surgeons on any aspect of skin or ear disease whether it is allergy, otitis media, cutaneous neoplasia or endocrine-based in any species, including dogs, cats, small furries, exotic pets including raptors, birds and reptiles, horses, camelids, zoo and farm animals.
Sue, herself an RCVS Recognised Specialist in Veterinary Dermatology, is supported by a team of veterinary dermatology colleagues as well as veterinary specialists in exotic medicine, internal medicine (including endocrinology) and consultants with expertise in oncology.
Sue said: "We recognise that not every veterinarian has got access to a local dermatology specialist and that not all clients can or want to travel to a referral centre. The aim of the service is to formalise the advice that dermatology clinicians give to veterinary surgeons to allow them to get detailed help to manage difficult or challenging dermatology cases within their own practice."
The service has been set up under the RCVS Vivet initiative, is approved by all of the major insurance companies and supported with Veterinary Defence Society Insurance cover.
Virtual Vet Derms offers support in a range of ways.
Quick questionsShort questions that veterinary surgeons can submit via the online form on the Virtual Vet Derms website that just require a brief reply. This may be a dose of a drug, a parasite you want identifying, or the interpretation of a blood sample such as an ACTH stimulation test.
Veterinary reportsVeterinary surgeons can use online request forms on the Virtual Vet Derms web site to submit a brief history of the animal and the problem and some good quality photos of the skin condition. There is also the ability to upload histopathology reports, blood samples and any other pertinent information. A detailed written report is sent back to the vet within 48 hours which will describe clinical signs, differential diagnoses, recommended diagnostic tests and treatment option where appropriate. Where possible, Virtual Vet Derms aims to pass the advice request to the nearest dermatologist but vets can ask for advice from any of its specialists.
Telemedicine consultationsFor new cases or for cases where initial advice has been sought, in the client's own primary care veterinary practice via the internet. The Virtual Vets Derms specialist can consult with the owner to provide even more specific advice and support. After each teleconsultation the Virtual Vet Derms specialist will produce a report in the same format as the veterinary report to allow the primary care veterinary surgeon to continue to manage the case more effectively.
Face to face consultationsCan also be arranged via the owner’s vet at the specialist's own practice if there is the need for more specialist investigation that may not be available in the primary care veterinary surgery. In these cases, the specialist will take on the direct care of the case and work with the owner and vet on the best course of action.
General advice Also possible if the vet wishes to direct an owner straight to Virtual Vet Derms.
For more information, visit: https://virtualvetderms.com
Davies says the new treatment is appropriate for dogs with severe diffuse elbow dysplasia, where cartilage wear results in bone rubbing against bone, called medial compartment disease (MCD). In these cases, Davies says that the prognosis is typically poor but now CUE is providing a promising alternative surgical option when arthroscopic and non-surgical options have failed.
The surgery involves partial resurfacing of the elbow joint. By focusing on the specific area of disease in the medial compartment, the CUE implant provides a less invasive bone-sparing option for resurfacing the bone-on-bone medial compartment while preserving the dog’s own good cartilage in the lateral compartment. Davies says that in most dogs, the technique significantly improves the pain and lameness that was caused by bone-on-bone grinding.
Unlike total elbow replacements, CUE does not require major bone cutting. On average, recovery tends to be significantly faster with progressive improvement peaking six months after surgery.
Mike Farrell, EBVS European and RCVS Specialist in Small Animal Surgery (Orthopaedics) at Davies recently performed a successful CUE procedure on Rubee, an 11-year-old Labradoodle diagnosed with severe MCD. At the recheck, six weeks after surgery Mike said: "Rubee’s early response to CUE has been nothing short of astonishing. I would have been pleased if she had made the improvement seen today after six months rather than six weeks."
Louise Clark Head of Anaesthesia and the Pain Clinic at Davies Veterinary Specialists continued: "CUE potentially provides a surgical alternative for what is currently an incredibly frustrating condition to manage and one that causes animals a lot of pain, and owners a great deal of angst.
"Arguably it is an ethically robust procedure because it can dramatically reduce patient pain with a relatively well defined risk of complications in a patient cohort that is otherwise at risk of euthanasia because of elbow disease."
For more information, visit: https://vetspecialists.co.uk/services/orthopaedics/
The consultation invited members of the professions to explain how they currently understand and interpret Schedule 3 in practice, how it could be clarified and how it might be amended to bolster the veterinary nursing profession.
11,625 people responded to the consultation, the highest number that has ever responded to an RCVS consultation. 6,873 were veterinary nurses (around 35% of the profession and including 1,665 student veterinary nurses) and 4,752 were veterinary surgeons (around 21% of the profession).
The report on the consultation, which is published today by the Institute for Employment Studies, found that 92% of veterinary nurses and 71% of veterinary surgeons think veterinary nurses should be able to undertake additional areas of work.
However, neither vets nor nurses seem to have an especially good understanding of the current scope of Schedule 3 and how it applies in practice, rating their personal understanding at 5.6 and 6.7 out of 10 respectively.
When asked what prevented the full utilisation of veterinary nurses, the majority of both vet and vet nurse respondents highlighted a lack of understanding of what tasks can be delegated under Schedule 3, with around 60% of veterinary surgeons also admitting that they are not good at delegating.
61% of veterinary nurses and 50% of veterinary surgeons thought that the RCVS gives sufficient support and advice about Schedule 3, though the relatively poor level of understanding amongst veterinary surgeons in particular suggests more needs to be done.
In corresponding comments both veterinary nurses and veterinary surgeons said they would like more clarity, especially around 'grey areas' such as the meaning of the term 'minor surgery', as well as further communication from the College about Schedule 3 and for more training for veterinary nurses to ensure they have the competence and the confidence to carry out delegated procedures.
Liz Cox, Chair of RCVS Veterinary Nurses Council, said: "Thank you to all those who responded to the consultation in such large numbers and who shared their views on this topic. The consultation grew out of the government’s suggestion that we review Schedule 3 as a means of bolstering the VN profession, and from the VN Futures project last year, when Schedule 3 was identified as an area where there could be some additional work to clarify the rules around delegation to veterinary nurses.
"There was a clear consensus that veterinary nurses could do more in their role and under Schedule 3 and so we will be feeding the findings back to the RCVS Legislation Working Party, which will be looking, in the round, at possible changes to the framework of veterinary legislation, including how it applies to veterinary nurses and other paraprofessionals.
"In terms of the understanding of Schedule 3 and how it applies in practice it is clear that we need to do some further work to clarify the rules and develop guidance to assist both veterinary nurses and veterinary surgeons in exercising their professional judgement in respect to delegation, for example, through case studies and other examples."
Looking at the tasks currently performed by veterinary nurses, the survey found the five most commonly performed are: clinical cleaning (92%), administration of medicines by subcutaneous injection (91%), administration of medication (90%), monitoring of anaesthesia (86.5%) and administration of medicines by intramuscular injection (86%).
The consultation also found that the majority of veterinary nurses are involved in clinics aimed at educating animal owners on various different aspects of animal health and welfare. The most common include puppy/kitten care (66.5% of respondents), nutrition (65% of respondents), general check-ups (62.5% of respondents) and dental care clinics (57% of respondents).
Post-survey interviews with 10 veterinary nurses and 10 veterinary surgeons found a number of recurring themes, including: limited career paths for veterinary nurses; poor pay for VNs relative to their training and complexity of work; lack of recognition and appreciation for the VN role; enthusiasm for advanced practitioner and specialist status for VNs; and difficulty recruiting experienced VNs.
The College says the results of the consultation will now be considered by the RCVS Schedule 3 and Legislation Working Parties, which are reviewing the efficacy of the current Veterinary Surgeons Act and whether changes need to be made to bring the legislative framework for the profession up-to-date, including consideration of the part played by allied professions like veterinary nurses in the veterinary team.
The full report can be downloaded here.
A group of UK-based investigators from Davies Veterinary Group and the UCL School of Pharmacy has published the results of a study which suggests Keppra (levetiracetam) shows promise for the treatment of feline audiogenic reflex seizures (FARS).
The condition, which was first documented by the same investigators last April, affects older cats which typically exhibit myoclonic seizures (brief, shock-like jerks of a muscle or a group of muscles) in response to certain high-pitched sounds. Both non-pedigree and pedigree cats (in particular, Birmans) may be affected. A range of sound stimuli has been reported, including the crinkling of tin foil and a metal spoon dropping into a ceramic feeding bowl, through to firewood spitting and even texting on a phone. While avoiding the triggering sounds can reduce the incidence of seizures, this is not always practical, so this research is potentially good news for owners of affected cats.
The study, Levetiracetam in the management of feline audiogenic reflex seizures: a randomised, controlled, open label study, has been published in the Journal of Feline Medicine and Surgery1.
It compared the efficacy of two antiepileptic drugs, levetiracetam (a relatively novel medication that has proven effective in studies of people with generalised epilepsies that experience myoclonic seizures) and the much older first generation drug phenobarbital, in 57 cats diagnosed with FARS. Cats were treated with one or other drug over a 12 week period; and owners were asked to record the date, number and type of seizures, any signs of illness, side effects and changes in activity or attitude, as well as whether they thought their cat's quality of life had improved, remained the same or deteriorated since starting the medication.
All cats receiving levetiracetam showed a reduction in the number of days that they experienced myoclonic seizures by at least half. In comparison, only 3% of cats showed the same reduction when treated with phenobarbital. The majority of reported side effects, such as lethargy and inappetence, were mild to moderate in both groups and these resolved after about 2 weeks in the cats treated with levetiracetam; in the phenobarbital group, however, side effects were relatively persistent. Owners of cats treated with phenobarbital perceived no benefit from using the medication; in contrast, all of the owners of cats treated with levetiracetam commented that their cat appeared brighter and more responsive after the first couple of weeks of treatment. Moreover, five cats treated with phenobarbital were switched to levetiracetam after the study, as their owners desired improved seizure control.
Having established that levetiracetam is an effective and well-tolerated treatment for cats with hallmark myoclonic seizures, the next step is to identify whether levetiracetam will also prevent so-called generalised tonic–clonic seizures. This is another seizure type seen in cats with FARS, and is what most people think of as a 'seizure', with the cat losing consciousness and its body stiffening and jerking, often for several minutes.
Lead author on the paper, Mark Lowrie, said: "It is great to find a medication that works so well at controlling these seizures. Levetiracetam is not licensed in cats but it has proven to be a very safe drug. For affected cats to benefit, it is important that vets recognise the signs as this newly defined syndrome of FARS and that this medication is used in preference to other, less efficacious, anti-epileptic drugs."
Reference
The charge against Ms Law was that in November 2017, having performed surgery on Kiwi, a German Shepherd/Wolfhound-cross dog, to address gastric dilation volvulus (GDV), she failed to obtain informed consent to the entirety of the surgical process and management, including post-operative aftercare.
The charge also stated that she failed to provide adequate analgesia to Kiwi before, during or after the surgery, failed to provide appropriate and adequate fluid therapy to Kiwi, failed to offer an appropriate and adequate post-operative care plan and/or post-operative transfer for Kiwi to another practice and failed to inform the owners that there would be nobody present at the practice to provide post-operative monitoring and aftercare for Kiwi for approximately seven hours during the night.
Finally the charge stated that Ms Law allowed Kiwi to remain at the practice overnight from 12:30am to 07:45am without adequate monitoring or post-operative aftercare.
Ms Law admitted some of the charges against her, including that she had failed to obtain informed consent, failed to offer an appropriate and/or adequate post-operative care plan, failed to inform the owners that there would be nobody present at the practice and allowed Kiwi to remain at the practice overnight without adequate monitoring and/or post-operative aftercare. However, she denied that she failed to provide adequate analgesia or fluid therapy to Kiwi.
The Committee found all of the charges proved, with the exception of failing to provide adequate analgesia during the perioperative period.
Having considered the facts, the Committee then moved on to consider whether the admitted and proven charges against Ms Law amounted to serious professional misconduct, taking into account any aggravating and mitigating factors. The aggravating features were that, as a result of Ms Law’s failures in relation to analgesia and fluid therapy, there was either actual injury to Kiwi, or a risk of such injury.
In mitigation, the Committee considered that she promptly and accurately diagnosed GDV, and proceeded to perform the necessary emergency surgery. The Committee considered that the charges related to a single isolated incident and that Ms Law has had an unblemished career to date. They also noted that Ms Law had made open and frank admissions as to the majority of the charges.
The Committee found that the conduct of Ms Law set out in the majority of the charges did not amount to serious professional misconduct. However, in the judgement of the Committee, Ms Law’s conduct in allowing Kiwi to remain at the practice overnight without adequate monitoring or post-operative aftercare did amount to serious professional misconduct.
Jane Downes, who chaired the Committee and spoke on its behalf, said: "The Committee considers that the respondent (Ms Law) has insight into the serious mistake that she made in failing to ensure that Kiwi was checked or monitored overnight. The Committee has found that this was a single isolated incident, which involved a serious lapse of clinical judgement, which will probably stay in the mind of the respondent for the rest of her career.
"The respondent has been in practice for some nine years now, and apart from this incident, there is no suggestion that the respondent has fallen short of the standards expected of her on any other occasion. The Committee does not consider that there is a risk that the respondent is likely to leave an animal overnight after major surgery again, without ensuring that it is checked during that time, and, as such, the Committee considers that there is no future risk to the welfare of animals so far as the respondent is concerned."
The Committee considered that the finding of disgraceful conduct in a professional respect in this case is too serious for no further action to be taken, having regard to the need to maintain public confidence in the profession and declare and uphold proper standards of conduct.
The Committee therefore concluded that the appropriate sanction in this case was to issue a reprimand to Ms Law, in relation to the finding of serious professional misconduct.
Jane Downes added: "The Committee considers that this sanction, coupled with the findings of fact and disgraceful conduct made against the respondent, is sufficient to maintain public confidence in the profession and uphold proper standards of conduct. The Committee does not consider it necessary to issue a warning to the respondent about her future conduct, on the basis that the Committee has concluded that there is no risk of repetition."
There were three charges against Ms Creese, all pertaining to the period between July 2016 and November 2017.
The first charge was that she failed to ensure that there were adequate systems and processes in place for out-of-hours’ care for in-patients.
The second charge was that she publicised that the practice had "24 hour care provided by our vets at our practice" and/or "Care 24/7 for your pets" on its website, which suggested that staff were present at the practice 24 hours a day when they were not and as such publicity was dishonest and/or misleading.
The third charge against Ms Creese was that she failed to ensure that Kiwi's owners were informed about arrangements at the practice for out-of-hours’ care for in-patients.
At the outset of the hearing, Ms Creese denied all the charges against her.
After hearing evidence from relevant witnesses, the Committee considered that the practice did have in place systems and processes for out-of-hours care for in-patients and that there was no evidence of repeated or ignored failures of these systems and processes. The Committee therefore found the charges against Ms Creese not proved and all three were dismissed.
Mandy, an Australian-born small animal vet, won in the 'You and Your Work' category with her photograph "Happy Enterotomy", which captures a smiley squeeze-toy being removed from the stomach of a Labrador.
Mandy, who is currently taking time out from full-time work, said: "I am so thrilled to be able to share this photo. It was actually about 10 years or so ago that I encountered this dog. We knew from radiographs that he had eaten a ball, but it was a lovely surprise to make the incision into the stomach and have this happy little chap beam out at us! We have such a cool job as vets, and this just nails it."
Jen captured the judges' attention with her image of rare and native North Ronaldsey and Dartmoor sheep grazing under the Milky Way in Northumberland in 'The wonderful world of animals’ category'.
Jen, who works in mixed practice in Aberdeenshire, said: "I am completely shocked and delighted to have won this competition and it has definitely inspired me to get out with my camera more often. I was very lucky to get this shot as it was a single thirty second exposure - I had some very cooperative models!"
Commenting on Jen’s photo, competition judge and award-winning wildlife photographer George Stoyle said: "Jen Rowland has clearly put some thought into her photo and has shown skill in its execution. From a technical perspective, the exposure used for the sky is just long enough to make the stars visible whilst minimising star trails, and artificial light has been used just enough to highlight the sheep and the rest of the foreground. The entire scene along with the ragged appearance of the sheep gives the image a feeling of wild, remote, windswept moorland, which I love."
Alongside the two winning photographs, five photos in the ‘You and your work’ category and eight in ‘The wonderful world of animals’ category received Highly Commended awards – ranging from giraffes to gannets and Lackey Moths.
British Veterinary Association President Gudrun Ravetz said: "We are delighted by the number and quality of the entries we received this year. The veterinary team is uniquely placed to capture the many wonderful facets of its work on camera, and we are pleased that our members have shared their eye-catching snapshots for BVA’s photography competition, offering us a vet’s-eye-view of their daily work and interaction with the wonderful world of animals."
Mandy and Jen each receive £250 worth of gift vouchers from John Lewis. Their winning images alongside the commended photographs will premiere in an exhibition at BVA’s Members’ Day at W5 Odyssey Belfast later this month (21 September).
The BVA Veterinary Photographer of the Year gallery can be viewed at: www.flickr.com/photos/britishvets/albums
Photos:
For the research, 2000 pet owners were asked whether they they had bought counterfeit pet medicines online. 31.3% said yes. They were then asked if they had reported the matter. 62.2% said they had. Finally, they were asked what the outcome of their report was. 60.9% said their purchase was confirmed as a fake, suggesting that at least one in ten pet owners - probably more - have bought fake pet medicines.
Bayer says the true number of owners affected is likely to be even higher, as a further 12% of pet owners in the survey said they believed that they may have bought fake pet medicines but had not reported it.
The research also showed that 87% of shoppers purchased pet parasite prevention products from unaccredited sites that have been known to sell counterfeit pet medicines. Indeed since April this year, the VMD has removed over 500 veterinary medicine listings from online marketplaces.
The message to clients is that chasing the lowest price for veterinary medicines can be a false economy.
Photo: Can you tell whether this product is fake or not?
The British Veterinary Association has expressed concern following the announcement by the University of Surrey that it is launching a new school of veterinary medicine, with the first cohort of students due to start in 2014.
Peter Jones, President of the BVA, said: "Reports of a new veterinary course at the University of Surrey will be of significant concern to our members, particularly veterinary students and recent graduates.
"We are already seeing an increasing intake of students at the existing veterinary schools. Another veterinary course will place even more graduates onto the veterinary employment market putting significant pressure on the employment prospects of individual graduates.
"It could also impact on the ability of the profession to accommodate the increasing demand for extra mural studies (EMS) placements and the ability of all schools to continue to provide high quality education and high quality teaching staff.
"The end result could be an oversupply of highly qualified veterinary surgeons carrying significant amounts of debt unable to find employment within the profession.
"New graduates are already reporting difficulties in finding their first jobs with some saying that it takes 6 to 9 months.
"Last year the veterinary profession was removed from the Home Office's shortage occupation list because it became apparent that we currently have sufficient veterinary surgeons to meet demand. Another veterinary course could tip the balance too far the other way.
"The news from the University of Surrey also illustrates that a greater oversight of the number of veterinary graduates coming onto the market is badly needed to properly plan future requirements of the veterinary profession in the UK."
The College first became aware that confidential information had been leaked earlier this year after the Veterinary Record made the decision to publish details.
The College says it then provided a number of informal opportunities for the person leaking the information to come forward and discuss the reasons for their actions, but nobody stepped forward.
A Council member then made a formal complaint about the leak, which triggered the complaints policy set out in the College’s Code of Conduct for Council Members and instigated the investigation.
The investigation was run independently of the RCVS by an external specialist consultancy, and coordinated by a legal assessor.
Initially, the investigators were asked to focus on a single leak, but following a number of further leaks over ensuing months, it became necessary to widen the scope and depth of the investigation.
The investigators’ report concluded that there had been several separate and deliberate leaks of confidential information by a current or former Council member over an extended period.
However, they were not able to identify who specifically was responsible for the leaks, and because nobody admitted it, no further action under the complaints policy of the Code of Conduct for Council Members was appropriate.
The investigators concluded that the leaks were not the result of poor understanding of College or Council processes, but a deliberate decision to provide confidential information to third parties.
Council members have therefore agreed to review existing training requirements and mechanisms for handling confidential information and to explore in more detail the potential motivation of the person or people who leaked the information, together with the underlying culture of Council that might have influenced their behaviour.
RCVS President Mandisa Greene, said: “There is no denying this is a sad day for the College, and for RCVS Council in particular. As Council members of our professions’ regulatory body, we must maintain the very highest standards of probity and integrity if we are to maintain the trust and confidence of our professional colleagues. In the same way, we must subject ourselves to the same level of scrutiny and investigation if these values and behaviours are ever called into question.
“That someone chose to breach the trust placed in them by their peers is extremely disappointing, especially when they were given every opportunity to come forward to discuss their concerns, and avoid the College having to launch a formal investigation.
"Our default position during Council meetings is to hold as many discussions as possible in public session to ensure Council’s decisions are as open and transparent as possible – something that we will continue to increase as much as possible. Like any organisation, however, there may be a small number of issues that need to be discussed in closed session – for example, those still at concept stage prior to any decision being made public or put out for consultation, or those containing personal or commercially sensitive data.
"I sincerely hope that all of us on Council can learn from this unfortunate and unnecessary episode. We must rebuild and maintain sufficient confidence in each other, and in our processes, that, even if we disagree on certain matters, it is always best to do so in a direct, upfront and honest manner."