The practice, which has nine clinicians (including three RCVS Recognised Specialists), eleven RVNs, two human-trained cardiac physiologists and a dedicated referral administrator is the first referral practice in the UK to become an EOT.
Dave Dickson, a director alongside Jo Harris, said: "The decision to transition the clinical side of the business into employee ownership was led by the core values of the team and the desire to preserve our independence as a referral service.
"In an industry dominated by corporate acquisitions, with business models increasingly focused on keeping referral offerings within the corporate groups and limiting choice for clients, we felt it was crucial to chart a different course.
"We have a very bonded and supportive team, working together to continuously improve and evolve, where the ideas of every team member are important and all roles are equally appreciated.
"We feel that employee ownership aligns perfectly with this ethos.
Jo Harris added: “By involving all our employees in the ownership of the business, we aim to foster a culture of engagement and collaboration.
"This new structure ensures that every team member has a stake in the success of the business and a voice in how it operates.
"We believe this will not only enhance our service quality but also promote sustainable growth and innovation.
"The transition to employee ownership is not just a change in structure; it is a reaffirmation of our values and a pledge to our patients, clients, and partners that we will continue to strive for excellence in every aspect of our work.”
https://heartvets.co.uk
Equip EHV 1,4 is licensed for the active immunisation of horses to reduce clinical signs due to infection with Equine Herpesvirus 1 and 4 and to reduce abortion caused by EHV-1 infection.
Zoetis says it has already communicated directly with veterinary surgeons to inform them that Equip Rotavirus will be out of stock from the end of November 2017 until mid-2018.
During this time an imported vaccine for Rotavirus, will be available to provide an interim solution until supply is restored.
Practices wanting to buy the alternative imported Rotavirus vaccine will need to apply to the VMD for a Special Treatment Certificate (STC).
The company says it acknowledges the concern and frustration this causes its customers and wants to reassure the equine community that it is working diligently to restore the supply of Equip Rotavirus as soon as possible.
For more information, contact your Zoetis account manager or Zoetis technical team.
Equine glandular gastric disease is a complex syndrome that is distinct from gastric ulceration. A number of studies now indicate that it is an inflammatory gastritis, predominantly at the gastric outflow, which has different causes and risk factors from gastric ulcers. As such, medication effective in treating gastric ulceration may be less effective for this specific condition.
The clinical signs of EGGD are diverse and non-specific and may be mild or recurrent. They may include changes in temperament, changes in rideability, unexplained weight loss, reduced appetite or cutaneous sensitivity manifesting as biting of the flanks or resentment of girthing, grooming, leg aids or rugging. Recommendations for reducing the prevalence of disease, based on putative risk factors, include providing rest days from work, maximising turn-out, minimising management changes and other potential stress factors and minimising changes in equine companions and human carers.
The new guidelines have been published by a group of equine medicine specialists, based on a review of published and unpublished evidence. The intention is to provide veterinary practitioners with up-to-date guidance on risk factors, diagnosis, treatment, dietary management and prevention of EGGD.
David Rendle, an internal medicine specialist at Rainbow Equine Hospital in North Yorkshire who chaired the group and is a consultant editor of UK Vet: Equine said: "Our findings challenge long-standing dogma on EGGD, a condition about which there is currently very little advice available to vets and horse owners. It is becoming increasingly clear that the distinction between disease of the squamous and glandular mucosa is important clinically and the group felt that updated guidance may help to improve management of EGGD in practice."
Provision of evidence based clinical guidelines should enable practitioners to adopt more standardised and logical approaches and base EGGD management decisions on the most current data.
Professor Josh Slater, Professor of Equine Clinical Studies at the Royal Veterinary College said: "Clinical guidelines are commonly used in human health care and have been shown to improve clinical outcomes by condensing data from large numbers of research publications and promoting rapid adoption into clinical practice. These new guidelines represent a step forward in the management of this complex condition by combining a consensus of expert opinion with the best available current clinical research and evidence."
Mark Bowen, Professor of veterinary internal medicine at the University of Nottingham who is based at Oakham Veterinary Hospital said: "Whilst the panel hasn’t come up with miracle cures there was universal agreement that new treatment options have to be integrated in a logical and responsible manner."
"Our understanding of this condition is in its infancy but we hope that the summary document, which also highlights the gaps in our knowledge, will provide a useful framework for vets to follow and will be a stimulus for future research."
The guidelines can be found here: https://www.magonlinelibrary.com/doi/full/10.12968/ukve.2018.2.S1.3
Photo: Marked multi-focal depressed haemorrhagic and fibrinosuppurative lesions
Leading equine veterinary surgeon Ian Wright has been setting a legal precedent this week, as the Court of Appeal ruled that his ex-wife could not expect him to continue to fund her lifestyle and that she should earn her own living.
Ian, an RCVS Specialist in Equine Surgery and a partner at the Newmarket Equine Hospital, divorced his wife Tracey in 2008 after 11 years of marriage. As part of the settlement, Mrs Wright was given a £450,000 house and Mr Wright was ordered to pay £75,000 per annum, which included £33,200 spousal maintenance.
Last year, Mr Wright, 59, went to the High Court to ask for a reduction in maintenance, arguing that it was unfair to expect him to continue to fund his ex-wife indefinitely, even after he retired at 65, when she made no effort to find a job and support herself.
The case was heard by Judge Lynn Roberts, who agreed there was no reason why Mrs Wright had not worked in the six years since her divorce and said she had been: "evasive on the subject of her own earning capacity".
Mrs Wright challenged the decision in the Court of Appeal this week, where Lord Justice Pitchford rejected her fight to have her future maintenance reinstated, saying: "There is a general expectation that, once children are in year two, mothers can begin part time work and make a financial contribution" and: "The time had come to recognize that, at the time of his retirement, the husband should not be paying spousal maintenance".
Speaking to The Times, Mei-Ling McNab, a partner at Brachers law, said: "This landmark decision provides some much needed clarity and will be a game-changer for future big-ticket divorce cases. The ruling confirms that mothers with children aged over seven should have financial responsibility to support themselves."
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.
Instead, eligible clients are being invited to join PDSA Pet Care, a new scheme costing £4.50 per month which entitles them to veterinary consultation, one primary vaccination course or booster each year (including a health check), a 20% discount on qualifying treatments in private practice, access to a nurse-led 24/7 triage service and preferential rates on PDSA pet insurance.
The PDSA says that pet owners and practices registered to the current Pet Practice service have been informed directly about the changes, which are being introduced over the next 12 months, as the current service is gradually phased out.
PDSA Director of Veterinary Services, Richard Hooker, said: "Following the review it was clear that the PDSA Pet Practice model was no longer financially sustainable for the charity in its existing form. However, it was important to many practices and PDSA to identify how we can best continue to offer some help to pet owners who live outside the catchment area of our Pet Hospital network and who have a need for affordable veterinary care and advice.
"We are grateful to all those in the profession who contributed to the development of the new scheme. It provides a more sustainable way in which to support households on low incomes across the UK. We are hopeful that practices will look to work with us to support pets and owners in their local communities by participating in the replacement scheme.
"We are mindful that any changes to our service can have an impact on some pet owners and our colleagues in the profession. This is why we have consulted on these moves and put measures in place to support those most affected."
Clients currently using the Pet Practice service who have a pet with a lifelong chronic condition will continue to receive some financial support towards the cost of their pet’s ongoing care and treatment via the PDSA Chronic Voucher scheme, which offers £25 per month towards the ongoing care of their pet for its lifetime.
The charity says it is also looking at a number of specific locations, where existing clients and their pets could supported by its Pet Hospital network when the current Pet Practice service closes.
Richard Hooker added: "The changes to the Pet Practice service are part of a much wider review of PDSA charitable services carried out this year. We have also made changes to our Pet Hospital service: reducing the number of eligible pets that owners can register for free treatment, from three to one, and withdrawing our Pet Treatment Fund.
"These important steps ensure that our available funds are targeted as effectively as possible, achieving our charitable aims of preventing illness, educating pet owners and treating sick animals.
"As a charity we receive no Government funding and rely on the generosity of our supporters and clients to run our services, which cost more than £60 million each year to fund."
When the Newmarket-based veterinary and scientific research charity launched the test, it was believed that one in twenty Petit Basset Griffon Vendeen puppies would grow up to be affected by POAG.
Three years later, through responsible breeders using the DNA test, the AHT says there have been NO affected puppies in the UK reported to The Kennel Club.
The AHT says the test results demonstrate how appropriate DNA testing can lead to the immediate disappearance of a recessive disease, improving the health and wellbeing of countless dogs and their families.
One breeder who has seen first-hand the benefits of this DNA test is Viv Phillips, who said: "As the breeder who first announced I had a dog affected by POAG I was delighted to work with the AHT and Prof Peter Bedford for 18 years in the research into this disease. I know how tough it is to not be able to avoid your dog going blind at a relatively young age. When the AHT discovered the DNA mutation in November 2014 which was subsequently launched at Crufts in 2015 it was the most wonderful result.
"I tested the PBGVs I still had, including their older parents, and was able to ascertain that puppies I had bred were either at no risk of going blind or sadly carried the gene and therefore treatment could be started to prolong their eyesight. Since this time I have bred 12 puppies and I am delighted that I know they will not be affected as a result of using the DNA test.
"Worldwide approximately 1800 Petit Basset Griffon Vendeen have been tested, and in the UK no puppies have been recorded as affected in the last three years. It is not a numerically large breed and if we can continue to spread the word worldwide and convince breeders to test their breeding stock, we can - with the help of the AHT - look forward to eliminating this awful disease completely."
Dr Cathryn Mellersh, Head of Canine Genetics at the AHT, said: "Years of work went into developing this DNA test which makes it even more rewarding to see it used so well to stop these lovely dogs from going blind. Glaucoma is a very debilitating and painful disease and some dogs have to their eyes removed as a result.
"We are studying glaucoma, and many other blinding diseases, in lots of dog breeds. These mutations can also affect cross bred as well as purebred dogs, so as the popularity of cross bred dogs continues to rise, DNA health testing is more important than ever to make sure you’re breeding, or buying, puppies that are going to have the very best start in life. Great things can be achieved through genetic research and as humans suffer many of the same diseases as dogs, there is always the possibility that our research is going to help human medicine as well. Unfortunately research is expensive and we always need more funding to be able to continue to maintain and expand our research of inherited diseases, including more complex diseases, such as epilepsy."
Mr Chaney was charged with stealing Trazadone and Metacam from the Hampstead practice he worked at, and of unlawfully possessing Trazadone and Metacam. He was also charged with unlawfully administering Butorphanol to a dog and failing to record the administration of the drug in the dogs records. He was also charged with making and deleting false entries into the clinical records of his own dog to the effect that it had been seen by a vet at the practice and that Metacam had been prescribed. The final charge was that his conduct over the false records was dishonest and misleading.
The Committee heard that Mr Chaney’s conduct in relation to the first two charges was discovered when, in July 2018, the Department for Environment Food & Rural Affairs (Defra), accompanied by police officers, executed a warrant (for unrelated matters) on the property where he lived. During the course of the search, police officers found Metacam and Trazadone in Mr Chaney’s bedroom which did not seem to have a prescription and so Defra officers launched an investigation.
During the course of this investigation, a Defra investigator was also provided with a video and messages that indicated Mr Chaney had unlawfully administered Butorphanol to a Husky dog in frustration with the animal as it was being too noisy.
The Committee heard that, in November 2018, Mr Chaney accepted a police caution in relation to his possession of Trazadone and Metacam, and the unlawful administration of Butorphanol. The Committee also heard that following the police attending his property and finding the medicines, Mr Chaney went on to create false records at the practice in relation to the examination of his dog in order to justify his unlawful possession of the drugs.
The Committee found all the charges against Mr Chaney proven.
The Committee then went on to consider if the charges, taken both individually and in totality, amounted to disgraceful conduct in a professional capacity.
Judith Way, chairing the Committee and speaking on its behalf, said: "The Committee had no doubt that administering a sedative to an animal that required prescription by a veterinary surgeon and then failing to record it in the clinical record with the resultant risk to the animal’s welfare due to lack of knowledge of the administration fell far below the expected standard.
"The Committee also considered that possession of prescription only medicines by a registered veterinary nurse, without the sanction of law, having stolen the same from a practice also fell far below the expected standard.
“The Committee also considered that tampering with the clinical record for a dog, in order to create a misleading impression and in doing so dishonestly, was conduct which fell far below the expected standard.
“Taken as a whole, the Committee considered that Mr Chaney’s conduct had fallen far below the expected standard.”
The Committee therefore found him guilty of disgraceful conduct in a professional capacity in relation to all seven charges.
It next went on to consider what sanction, if any, to impose taking into account the aggravating and mitigating factors.
In considering the aggravating factors, the Committee took into account that Mr Chaney’s conduct had presented a risk of injury to the animal and that much of his conduct was pre-meditated. It also considered that Mr Chaney’s conduct involved a breach of trust to both the practice where he was employed and the owner of the Husky, and it was also an abuse of position in gaining access to and stealing medication. Lastly, because the charges related to two separate incidents, there was a common thread in Mr Chaney disregarding rules on veterinary medicines.
In mitigation, the Committee considered that Mr Chaney had reflected on and gained some insight into his behaviour, and acknowledged he had made admissions at the outset of the hearing, including apologising for and showing regret about aspects of his conduct.
However, the Committee did not believe he had addressed his understanding of the effect that this conduct had on the risk to animals, the standards of the profession or the maintenance of public confidence in the profession. In mitigation the Committee also considered a number of positive character references and his previous good character.
Judith Way said: “The Committee determined that it would not be sufficient in the circumstances of the case, to satisfy the public interest to suspend the Respondent’s registration. In its view this case involved a serious departure from identified professional standards. The disregard had been deliberate, in relation to ignoring legislation in respect of prescription-only medication and dishonesty in stealing medication.
"There was evidence of attitudinal issues in relation to that behaviour and insufficient evidence of the development of insight. The dishonesty in relation to the clinical record relating to dog O [his own dog] had been an attempt to conceal earlier dishonesty relating to the theft of the medication. In administering the Butorphanol to dog L [the Husky], Mr Chaney had been putting his own interests in quieting the dog ahead of the dog’s interests, which would have required checking with a veterinary surgeon as to appropriate steps.
"The Committee acknowledged that, by directing removal, there would likely be professional reputational damage to Mr Chaney and possible financial loss. However, in the view of the Committee the requirements of the public interest outweighed these factors.”
Accordingly, the Registrar of the RCVS was directed to remove Mr Chaney’s name from the Register of Veterinary Nurses.
Full details can be found here: https://www.rcvs.org.uk/concerns/disciplinary-hearings/
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
A vet from Texas hit the headlines this weekend after allegedly killing a feral cat with a bow and arrow and then posting photographs and bragging about it on Facebook.
According to various news reports, Kristen Lindsey DVM's post quickly went viral, and one of two Facebook pages set up in response - Justice for Cat Murdered By Kristen Lindsey - has already attracted over 35,000 likes. There are also petitions to revoke her license on thepetitionsite.com and change.org which have each gathered around 18,000 signatures thus far.
Sky News reports that Ms Lindsey was quickly fired by her employer, the Washington Animal Clinic, which issued a statement on Facebook.
The veterinary clinic's website and Facebook page are both currently unavailable.
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.
Bovalto Respi Intranasal protects against the two main respiratory viruses – RSV and PI3, using modified live viral strains that have been shown to protect against experimental challenge from recent field isolates1.
The vaccine is delivered as a single shot, from 10 days of age and provides immunity for 12 weeks, from 10 days after vaccination2.
In order to overcome the challenges of effective delivery, Boehringer is offering dedicated administration packs, available directly from its ruminant specialist team.
The packs include a vaccinator, a set of nozzles that deliver the vaccine at the optimum droplet size and a soft Bovalto Respisafe applicator which fits against the calf’s nostril. The aim is to make sure that vaccination is a comfortable process for both farmer and calf, as well as addressing the challenge of the delivery of vaccine to the desired area in the nasal passages.
Correct administration of the vaccine ensures that the spray is delivered effectively to the mucosal surface and local lymphoid tissue, achieving the optimal immune response. If the droplet size is too big, the vaccine may be deposited lower in the airway and run out of the nose. If droplet size is too small then the vaccine may be carried to the back of the throat and swallowed. Time and money is spent vaccinating calves so the process needs to be as efficient as possible to give optimal protection.
Matt Yarnall, brand manager at Boehringer Ingelheim said: "The UK BRD vaccine market is growing each year but, as a management tool, vaccination remains quite low down the list of actions, according to the 2017 Calfmatters survey.
"If adding to the Bovalto range encourages more farmers to vaccinate against pneumonia so improving calf heath and lowering antibiotic use, that can only be a step in the right direction."
References
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
Dechra Veterinary Products has announced that it is to relaunch Fuciderm Gel, the topical skin product used to treat surface pyoderma in dogs, as Isaderm.
Isaderm contains fusidic acid, which Dechra says is highly effective against the bacteria Staphylococcus pseudintermedius, and the steroid betamethasone, which is both an anti-inflammatory and anti-pruritic.
Available as a white translucent gel in 15 g and 30 g tubes, Isaderm is a topical treatment which can be applied directly and stays on the affected area - the base of Isaderm is a carbomer gel which maintains contact on skin and wet lesions.
Dechra Dermatology Brand Manager Roger Brown said: "Fuciderm is one of our most popular products. As part of an international Dechra rebranding programme the name will now be Isaderm® but veterinary professionals can be assured that the only thing about the product that has changed is the name.
"This treatment was the subject of a multi-centre UK trial* comparing treatment of surface pyoderma with the gel or systemic therapy, and the gel product was shown to be as effective as systemic therapy."
For further information, visit www.dechra.co.uk
Part 1 of "Comparison of veterinary drugs and homeopathy", by Peter Lees, Professor Emeritis in Pharmacology at the RVC, Ludovic Pelligand, Senior Lecturer in Veterinary Clinical Pharmacology and Anaesthesia at the RVC, Martin Whiting, Lecturer in Veterinary Ethics and Law at the RVC, Danny Chambers, an RCVS Councillor currently working at Langford Veterinary Services, University of Bristol, Pierre-Louis Toutain, a European Veterinary Specialist in Pharmacology and Toxicology, and Martin Whitehead Co- and Clinical Director at the Chipping Norton Veterinary Hospital, is published in last week's (August 12th) edition of the Veterinary Record.
The paper considers some of the reasons why medicinal products work and the errors in human thinking which make them seem to work when actually they don't. It also takes a look at the history of veterinary and homeopathic medicine, which helps explain how something as scientifically implausible as homeopathy ever gained traction in the first place.
VetSurgeon.org Editor Arlo Guthrie said: "As the parent of a child with a severe, chronic and highly variable disease, I’ve had prolonged first-hand experience of just how easy it is to fall prey to the sorts of errors in human thinking that can make you believe a treatment is working when in reality it is not. It’s something I continue to have to fight against, despite being well-educated about things like cognitive bias and regression to the mean.
"I believe all veterinary surgeons, and doctors for that matter should constantly remind themselves of these errors and importantly keep them front of mind when advising clients. Not just so they can explain cogently why quack medicine offers nothing more than false hope and a thinner wallet, and why randomised, double-blind, placebo-controlled trials are so important, but also to improve their own assessment of a patient’s response to treatment."
The paper can also be downloaded here: http://veterinaryrecord.bmj.com/content/181/7/170
Part 2 of the paper is due to be published in next week’s edition of the Veterinary Record.
STOP PRESS VetSurgeon.org has funded the Open Access publication of this paper, so both parts are now available for all to read here:Part 1: http://veterinaryrecord.bmj.com/content/181/7/170Part 2: http://veterinaryrecord.bmj.com/content/181/8/198
Photo: The father of homeopathy, Samuel Hahnemann, Wikipedia
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.
NEV was first identified in 2013 by veterinary surgeon Dr Isabel Fidalgo Carvalho, who went on to found Equigerminal to develop a commercially viable NEV diagnostic test that can be used by veterinary surgeons, vet labs and horse owners.
Isabel says that NEV - the equine equivalent of HIV - is often misdiagnosed or hidden by other diseases that induce similar symptoms, like anaemia and neurological issues in horses. It is most commonly confused with the Swamp Fever virus (EIAV) and Equine Herpesviruses (EHV).
Indeed, when they tested a number of horses with anaemia, Equigerminal researchers first believed they had found the presence of a divergent strain of the Swamp Fever Virus (EIAV) - because the horses cross reacted with EIAV, but were negative in the official tests. Subsequent research found they were actually suffering from NEV.
Equigerminal says it is believed that NEV is present in up to 10% of horses. Isabel said: "We did test 213 samples from Ireland and found 7% of positive samples for NEV. These Irish horses were horses that usually travel to UK and other locations for sports events."
For the new test, a veterinary surgeon needs to take a blood sample which is sent to the Equigerminal lab.
Isabel says treatment is currently targeted towards improving the general well-being of the horse, health monitoring, and boosting the animal’s immune system. The next stage is to find a treatment, and ideally a cure for NEV. Meantime, Isabel said: “We now need to raise awareness of the problem and help vets to diagnose this disease correctly.”
ITV's Tonight programme broadcast last night portrayed a veterinary profession in which overcharging is commonplace.
Researchers for the programme took three healthy animals (a cat, a dog and a rabbit) to a number of different vets, telling them that the animals were off their food. The advice they were given varied. In the case of the rabbit from no treatment necessary, to dental work under general anaesthetic.
TV vet Marc Abraham then looked at each animal and told viewers that the correct advice in each case would have been the least expensive.
The programme also highlighted the substantial savings that pet owners can make by buying drugs online, and questioned whether the penalty meted out to a vet that had committed malpractice was sufficient (the vet had been struck off for 14 months, where presenter Jonathan Maitland argued it should have been for life).
Veterinary business consultant Mark Moran said: "So often, vets rely to a large degree on what owners are telling them, and the degree to which they insist the animal is ill, or off its food, will affect the advice and treatment given. Marc Abraham had the luxury of being presented three animals that he knew to be perfectly fit and well."
However he agreed wholeheartedly with the response from RCVS President Jill Nute this morning, that the thing both vets and pet owners need to learn from the programme is "the importance of communicating with each other".
Mark said: "It's a question of managing people's expectations. There'll always be a variance in the advice being given, but being up-front and open will help mitigate the risk of being accused of overcharging".
Click here to watch the programme. Click here to read the reactions to Marc Abrahams' blog
The updated guidance follows a public campaign known as ‘Tuk’s Law’, which was started after a healthy dog by that name was euthanased despite its microchip being dually registered with a rehoming centre as a 'rescue backup'.
In response, the RCVS and the BVA agreed that more should be done to prevent occasions where a dog might be needlessly put to sleep, but voiced concerns that a legislative approach could undermine a vet’s clinical judgement, unfairly involve veterinary surgeons in ownership disputes or potential criminality, and leave vets unfairly exposed to financial sanctions.
In consultation with Defra, the RCVS and BVA therefore jointly agreed to strengthen the Code of Professional Conduct as follows:
Chapter 8 (para 8.9)
There may be circumstances where a request is made by a client for the destruction of a dog, where in the clinical/professional judgement of the veterinary surgeon destruction of the dog is not necessary, for instance where there are no health or welfare reasons for the dog to be euthanised.
In these circumstances, before carrying out the request for euthanasia the veterinary surgeon should scan the dog for a microchip and check the relevant database if a microchip is found.
Chapter (paras 29.25 -29.27)
Clients may have a contract with the shelter from which they acquired the dog such that it can be returned to that shelter, and that it may be appropriate to discuss this with them prior to euthanasia. Alternatively, there may be another individual willing to take responsibility for the dog (who may be named on the microchip database), and this may also be discussed with the client.
The updated guidance supports existing best practice in terms of discussing alternatives to euthanasia with clients, and give vets flexibility where, in their professional judgment, scanning is not appropriate; this might be if scanning would itself cause a welfare problem, or where a vulnerable client might be involved.
The RCVS Standards Committee says it recognised the difficulties experienced by veterinary surgeons in dealing with the current microchip database system, but felt that introducing these provisions into the guidance was a more proportionate response than the alternative of legislation with substantial fines.
BVA Senior Vice President Dr Daniella Dos Santos MRCVS said: “One of the most important jobs as a vet is having those difficult conversations with clients about euthanasia where we talk through all the options that are in the animal’s best interests. But where the vet doesn’t consider that euthanasia is necessary, the new guidance clearly sets out the steps we need to take. We support this constructive approach that addresses the campaigners’ concerns without undermining veterinary judgement.”
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/
First out of the stalls was Vet AI, a company founded in 2017 by Paul Hallett and Robert Dawson MRCVS, which announced last November that it had filed patents for artificial intelligence technology to deploy in giving online consultations through its newly-launched app: Joii.
More recently, a Swedish company called FirstVet has announced the UK launch of a consultation service it has offered in the Scandinavian countries for a few years now.
All three companies charge £20 for an online consultation with a veterinary surgeon.
All of these services are currently limited in what they can offer pet owners here in the UK, because veterinary surgeons are not allowed to prescribe medicines without having physically examined the patient. FirstVet says that in Sweden, similar rules apply, except that under current guidance, antiparasiticides and feline contraceptives can be prescribed remotely.
This means that for the moment at least, online consultations in the UK can only advise pet owners whether they do or do not need to see a veterinary surgeon in person, or recommend OTC treatments, such as flea control.
Personally, I'm not convinced that it's worth £20 for the privilege of asking a vet whether or not my pet needs to see a vet, although to be fair, Joii includes a free symptom checker to differentiate between those cases that need directing to see a vet in person, and those that would benefit from the online consultation. Also, if a case needs to be referred to another vet after a consultation, Joii refunds the consultation fee.
Nevertheless I think I'd just ring my normal practice and ask. But that's just me. Perhaps others will see a value in the immediacy of the online service, or that it entails less commitment.
FirstVet does, however, have another string to its bow. It has been busy forging relationships with insurers to fund the majority of its consultations. The insured owner gets a free consultation subsidised by the insurance company; if the animal requires treatment, the owner is referred to their normal vet, unless they don't have one, in which case the referral is to the nearest practice which can help.
That seems to make all sorts of sense for insured clients. It really adds value to the insurance policy, to be told you'll have access to free, immediate online veterinary consultations. Almost certainly it will mean pet owners seeking veterinary advice sooner than they might otherwise have done. For the insurer, that in turn might mean earlier diagnosis and therefore cheaper treatment. One assumes it also translates into cost-savings for the insurer by dealing with certain queries without needing a trip to the practice.
Still, the really big prize here for remote consultation companies will come if and when the regulations allow remote prescribing. Not necessarily because they'll make a mark up on the sale of prescription drugs, though of course they will, but because suddenly the proposition to the pet owner is that the consultation can, in many cases, offer more convenient and cheaper treatment than if they had to visit a practice in person.
The problem with that, however, is that the £20 remote consultation may carry a greater risk of misdiagnosis. It may mean that the preventative approach to veterinary medicine goes out of the window, at least until remote monitoring technology catches up. There is also a risk that these new limited service providers will take the bread and butter consultations from bricks and mortar practices, consultations that may have been to some degree subsidising care for other patients. These are all the sorts of things that were hotly debated at RCVS Council last November.
Nevertheless, Vet AI is unashamedly pushing for remote prescribing rules to be relaxed. Founder Robert Dawson MRCVS said: "I think that the ease and reduced cost of access to veterinary advice and medicines will have a positive impact on animal welfare. I also think that it will free up vets' time to see the cases they really need to see.
"But in truth, what I think is not the point. The whole debate at the moment is characterised by members of the profession saying what they think will happen as a result of remote prescribing. What we actually need is some evidence. I'd really like to see some movement from the College on this, for a limited number of treatments like parasiticides, before the end of the year."
As Robert says, the debate is characterised by a lack of evidence. But there is, of course, another way that online consultations could really add value to the client/vet relationship without any of these problems, and that is as an adjunct to the service offered by bricks and mortar practices.
Bricks and mortar practices can already prescribe medicines to animals under their care without physically seeing the animal on every occasion. Furthermore, there are a number of situations where a remote consultation could save both the practice and pet owner time and money. For example, post-operative follow-up consultations.
However, none of the existing providers I've spoken to plan to offer a 'white label' solution. So, if I owned a practice, I tell you what, I'd be looking into online consultation software right now. It is already possible, of course, to offer online consultations via things like Skype. But better still would be a system that allowed clients to schedule an online appointment with their normal vet, perhaps slotted in between their face-to-face consultations. As opposed to the existing online providers, you wouldn't need to refund money if a physical consultation was needed, just - perhaps - set it against the later consultation. You could also offer annual plans to include a certain number of online consultations. You could have online triage consultations carried out by veterinary nurses.
There are lots of possibilities. But if you're a bricks and mortar practice, one thing is for sure, the time to look into all this is now. You could do worse than to start here: https://www.vetsurgeon.org/news/b/veterinary-news/archive/2019/01/15/now-all-vet-practices-can-offer-remote-consultations.aspx
The company says that Anallergenic can be used as the elimination diet of choice when working up dermatosis cases. Nutrient intolerance can be determined by feeding the extensively hydrolysed elimination diet for six to eight weeks followed by reintroduction of the pet’s original diet.
For cases where a nutrient intolerance is proven, Royal Canin says Hypoallergenic should be used for long-term nutritional management, although some refractory cases may need to remain on Anallergenic.
Anallergenic has been formulated with feather protein hydrolysate, starch instead of whole cereals and a combination of ingredients to help reduce water loss through the skin and strengthen the barrier effect of the skin.
John O’Connor, Veterinary Marketing Manager at Royal Canin, said: "When a nutrient intolerance is suspected, the cat’s diet should be changed to Anallergenic without any food transition. Dermatosis is complex to understand and identifying the underlying cause can be challenging. Managing cats with dermatosis requires a long-term commitment and it is essential for vets to use nutrition as part of their work up.
"The lower the allergenic potential of the diet, the more reliable the results¹ and nutritional management with Anallergenic can be continued for the cat’s lifetime. With the new, highly palatable² Feline Anallergenic diet, Royal Canin offers the complete nutritional approach to dermatosis."
Alongside the new diet, Royal Canin has produced a range of owner education materials, including a leaflet with top tips and a video about nutrient intolerances to raise awareness of the condition and the importance of owners seeking veterinary advice. The new materials are available via your Royal Canin Veterinary Business Manager.
For more information, visit royalcanin.co.uk/skin
Vet Futures, the joint initiative by the RCVS and the BVA to help the profession prepare for and shape its own future, has published a guest blog in which an academic argues that the profession needs to introduce safeguards to prevent inappropriate profit-seeking behaviour.
David Main is Professor of Animal Welfare at the School of Veterinary Sciences at the University of Bristol, with research interests in welfare assessment, animal welfare education and intervention strategies to improve welfare.
In his blog (www.vetfutures.org.uk/discuss), Professor Main says he believes the vast majority of individual veterinary surgeons and practices are not motivated by money and do have animals’ best interests at heart, but that the differences between the business structure of veterinary and medical practitioners in the UK means the profession is always at risk of standing accused of excessive profiteering.
He said: “Since we still live in the age of the media scare story, it would seem prudent for the profession to embed some anti-profit seeking safeguards in our regulatory controls before, rather than after, a problem is highlighted.” One suggestion he makes is for the prohibition of turnover-based incentive schemes in favour of incentives based on health outcomes.
He believes that such safeguards, which he says could be incorporated into the RCVS Practice Standards Scheme, would be a “healthy demonstration” that the profession has animal welfare rather than profit as its main priority.
Professor Main also argues that the profession urgently needs to deliver on society’s expectation of vets as animal welfare experts: “Veterinarians could perhaps... do more at an individual level to act as animal welfare advocates. It is easy to inform clients on the technical rationale for a specific husbandry change but then walk away knowing full well the client will not action the advice. In the medical profession, advanced communication techniques are becoming more widely accepted to promote positive change within their patients. Perhaps we should be more explicit in teaching our veterinary students influencing skills.”
In response to David’s blog, this month’s Vet Futures poll asks visitors ‘Do vets always act as animal welfare advocates?’
The previous month’s poll, which was based on an article co-written by Erwin Hohn and Adi Nell from MediVet, asked to what extent vets would be willing to work collaboratively with others if it would benefit all. Of the 50 people who answered the poll, 60% said they would be completely willing to work with others, 32% a lot and 8% to some degree – no one said they would be unwilling to work with others.
According to the authors, Miniature Schnauzers positively shone in their averageness in this study, because they were not commonly affected by any specific breed-related health problems.
In other words, the illnesses suffered by Miniature Schnauzers are just the common or garden things like dental disease, obesity, anal sac impaction, vomiting and ear infection, which can affect all dogs.
The study, which the authors say was the largest ever study of the breed, analysed 3,857 Miniature Schnauzers from a population of over 450,000 dogs across the UK. Its findings were that:
The average lifespan of Miniature Schnauzers was 11.7 years, which is similar to the average of 12.0 years for dogs overall.
The average adult bodyweight of Miniature Schnauzers was 10kg. Males on average were heavier than female breeds (11kg vs 9kg).
The most common disorder affecting the breed was dental disease (affecting 17.4% Miniature Schnauzers). This is similar to that of other similarly-sized breeds such as the Cavalier King Charles Spaniel (15.2%) and Border Terrier (17.6%).
Female Miniature Schnauzers are more likely to have dental disease, obesity/overweight and heart murmur. However, males are more prone to diarrhoea and claw injury.
The most common causes of death were neoplasia (14.7%), collapse (13.3%), mass-associated disorder (10.7%) and brain disorder (10.7%).
Dr Dan O’Neill, Senior Lecturer in Companion Animal Epidemiology at the RVC and Vet Compass researcher, said: "To do their best for their dogs, owners need to know what aspects of their dog’s health are the most important to protect. Thankfully, we now have the data to identify these: owners of Miniature Schnauzers and also dogs overall should pay special attention to dental care, weight management, anal sac issues and making sure their dogs eat a healthy diet."
"Based on VetCompass Programme data, the Miniature Schnauzer is currently Britain’s most average dog from the breeds that we have studied to date. Extreme breeds such as flat-faced, long-backed or teacup-sized dogs may currently be in vogue but we need to move away from extremes and towards the healthier middle-ground."
Dr Alex Gough of Independent Vet Care and co-author added: "Although a number of diseases were identified in the current study that affect Miniature Schnauzers, the commons ones did not occur more frequently in this breed than in others studied. Many popular breeds are prone to life-threatening and distressing conditions related to their breeding. Our study suggests that the Miniature Schnauzer should be considered as a relatively healthy breed, which can help owners make a decision when acquiring a new dog."
Bill Lambert, Senior Health and Welfare Manager at the Kennel Club, said: "The Kennel Club currently recognises 221 different breeds and registering these breeds with the Kennel Club provides opportunities for data to be collected so that it can contribute to high quality and large scale research, such as this study by the Royal Veterinary College.
'It is vitally important that this type of research is carried out so that breed specific information is gathered and can be made available to owners to help ensure their dogs are kept as fit and healthy as possible.
'The Miniature Schnauzer is a popular breed in the UK so being the ‘most average dog’ in terms of health, and having no breed specific health problems, is actually a good quality and is very welcome news.”
Reference
The Statutory Membership Examination must be taken by all individuals educated outside of the UK whose veterinary qualification is not recognised by the RCVS. Passing the exam allows them to join the UK Register, and practice as a veterinary surgeon in the UK.
The exam has existed in its current format for over 30 years, and the review was implemented to ensure the examination remains fit for purpose, and sits in line with international best-practice and the College’s current Day-one Competences.
The College says the review was also designed to make sure it is using the most appropriate means of assessment methods, to best prepare candidates for success, and to ensure candidates can work in the UK to the best of their ability.
The written examination will now consist of two parts; a clinical Multiple Choice Question (MCQ) paper (in a single best answer clinical vignette format) and an open book examination, which will be used to ascertain the candidate’s knowledge of the RCVS Code of Professional Conduct.
The Clinical, Practical Examination will now exist in the form of a multi-dimensional Objective Structured Clinical Examination (OSCE). This examination is set to measure a range of clinical, technical and professional skills including clinical reasoning, communication, professionalism, and ethical awareness. Following a tender process, Glasgow Veterinary School has been awarded the contract to host the OSCE examination for five years from 2019 to 2023.
RCVS Examinations Manager, Victoria Hedges, said: "The review of the Statutory Membership Examination has provided us with the opportunity to ensure that we continue to test the skills and knowledge needed to work effectively in a veterinary practice in the UK in a robust manner, and bring it in line with the final year examinations delivered at UK vet schools. In designing the examination, the RCVS has considered international best practice, in addition to approaches to regulatory examinations within both the veterinary and medical sectors."
A comprehensive handbook regarding this new examination will be available on the Statutory Membership Examination section of the RCVS website (www.rcvs.org.uk/statutory-membership-exam) shortly.
If you have any questions, please get in contact with Examinations Manager, Victoria Hedges: v.hedges@rcvs.org.uk