Elanco has increased the pack size of its Coliprotec vaccine, which protects piglets against the F4 and F18 strains of E. Coli that lead to post weaning diarrhoea (PWD), to treat 200 piglets.

Jack Fellows, Elanco swine sales leader, said: "With the potential zinc oxide restrictions coming into place next year, it’s crucial that vets work with their farmers to start trialling alternative PWD prevention strategies now, while the use of zinc is still permitted.

“Keeping PWD at bay going forward will require a multifaceted approach to piglet management. Gradually reducing the level of zinc oxide, while simultaneously incorporating alternative preventive techniques, will reduce the likelihood of problems arising during this transition.

“It’s far more convenient to have the vaccine in a 200 head dose, rather than the current pack size that offers 50 treatments. This will greatly cut down the time required to dilute and stabilise multiple individual packs, while helping to minimise any margin of error during administration."

Research has shown over 90% of farmers¹ would head to their vet as the first port of call when it comes to advice on treating PWD.

“It’s crucial that vets are aware of all the preventive tools and options for managing the disease as over half of farmers surveyed² also said they would treat PWD with antibiotics, which is obviously something we’re trying to steer away from as an industry, and why vaccines play such an important role going forwards.

“The Coliprotec vaccine is proven to prevent against these issues, delivering healthy pigs that reach a heavier market weight up to 7 days earlier³, while substantially reducing the in-nursery use of antibiotic treatments."

To mark the launch of the new 200 dose pack size, Elanco is offering veterinary practices the chance to buy five packs for the price of four, a total of 1000 doses, through their wholesaler.

For more information, contact Jack Fellows at jack_michael.fellows@elancoah.com or call 07771 798157.

References

1. Farmers Weekly Elanco PWD research
2. Farmers Weekly Elanco PWD research
3. Vangroenweghe, F. et al., 2018. Proceedings of the 10th ESPHM: 252.

The BVA and the BCVA have launched a joint position paper which states that calves should be routinely provided with appropriate analgesia alongside local anaesthesia to effectively manage pain during necessary veterinary and husbandry procedures.

The recognition, management and treatment of pain in calves was identified by the BVA and the BCVA as a priority animal welfare problem following the launch of the BVA’s Animal welfare strategy last year, with the two organisations working closely together to progress an evidence-based best practice position and set of recommendations for the profession.

The new position statement specifically recommends the use of non-steroidal anti-inflammatory drugs (NSAIDs) in addition to local anaesthesia when conducting disbudding and castration in calves, as these are procedures that have been shown to cause acute pain at the time of the procedure and chronic pain afterwards. Analgesics have been shown to reduce the signs of pain in this post-operative period in a wide range of research studies. 

The position also recommends the 'Three Rs' approach to castration and disbudding of calves, advocating that, where possible, these procedures are: Replaced by, for example, selecting polled sires to replace disbudding; Reduced by, for example, appropriate use of sexed semen to reduce the number of male calves requiring castration; or Refined, with the use of analgesics.

BVA President Gudrun Ravetz said: "BVA and BCVA’s joint position further reinforces the profession’s focus as animal welfare advocates, and conveys the need for adequate pain management that is reflective of current scientific understanding of pain recognition and treatment in cattle.

"Existing legislation requires a level of anaesthesia and we would encourage veterinary colleagues and stock-keepers to also discuss appropriate analgesic regimes used so that vets prescribe appropriately licensed NSAIDs and other analgesic medicines as required, as part of ensuring a good life for the animals we farm for food."

The recommendations support the University of Nottingham School of Veterinary Medicine and Science’s study, published yesterday in the Veterinary Record, which has found that calf husbandry procedures were significantly less likely to include the use of analgesics in addition to the local anaesthetic (that is routinely used) for other similarly painful procedures. While local anaesthesia can reduce or eliminate much of the acute pain, chronic pain may still remain once the relatively short duration of local anaesthetic action wanes.

John Remnant, a member of BCVA Board and Clinical Assistant Professor in Farm Animal Health and Production at the Nottingham Vet School, said: "It appears that veterinarians’ awareness of pain in cattle and willingness to use analgesics in general has increased over the last decade. However, whilst this should be commended, the apparent lack of use of appropriate analgesia specifically in calves undergoing routine husbandry procedures such as castration and disbudding requires urgent action. I am delighted that the findings of Nottingham University’s study support BVA/BCVA’s statement."

BVA and BCVA’s joint position paper on Analgesia in calves can be found at: https://www.bva.co.uk/uploadedFiles/Content/News,_campaigns_and_policies/Policies/Ethics_and_welfare/Analgesia%20in%20calves%20BVA%20branded.pdf

Photo: A calf in England, New Forest national park. Jim Champion. Wikipedia.

Merial has launched Supleneo flex, a nutraceutical supplement designed to be part of a Total Joint Health programme for dogs, administered once daily. 

Merial says the new product supports its market position as a leading force in canine pain management, supported by the canine NSAID Previcox.

According to the company, Supleneo flex is suitable for all breeds, sizes and ages, and contains three key ingredients associated with joint health: glucosamine hydrochloride, chondroitin sulphate and mixed tocopherols (Vitamin E). It is designed to be used as part of an all-round joint care programme, alongside nutrition, weight management and exercise.

Merial says the soft chews are highly palatable and when tested against a range of competitor products, a significant difference was observed, with Supleneo flex readily taken and preferred by dogs.¹

Supleneo flex is supported by printed and digital materials to help with owner education, including a waiting room video and an online information website at www.supleneoflex.co.uk for clients.

For veterinary surgeons, Merial is offering product advertising support and a loyalty programme. 

For more information, telephone Merial on 0870 6000 123 or contact your Territory Manager.

Vet tech startup Creature Comforts, which two months ago opened its first practice in Notting Hill Gate, London, has now opened its flagship practice in St John’s Wood.

Spread over two floors, the 3,300 sq ft flagship practice is unusually large for a London clinic, and has a dedicated dental suite and laboratory, as well as six spacious and bright consulting rooms.

Notably absent from the practice are a reception desk and continuously ringing telephones.

Instead, customers receive a warm welcome in the members’ area, with separate spaces for cats and dogs.

Shades of lilac on the walls have been carefully chosen to keep animals calm, while a pick and mix wall filled with toys and treats is designed to help pets develop positive associations with vet visits. 

Co-founders Russell Welsh MRCVS and online estate agent entrepreneur Daniel Attia say that a large portion of Creature Comforts’ customers have signed up as ‘All Access’ members, paying £20 per month to get unlimited access to expert care from vets and nurses.

This includes as many consultations as they need, annual vaccinations and discounted routine treatments e.g. 50% off microchipping.

The remainder have opted to pay as they go for treatment.

Creature Comforts’ chief veterinary officer, Dr Simon Hayes, says: “One of the biggest problems with UK veterinary care is that, due to the expense of consultations, pet owners are understandably reluctant to book in to see a vet until their animals are really sick.

"With a subscription model that includes unlimited consultations, we’ve removed the cost barriers to accessing expertise easily and quickly, so pets are seen more frequently, and conditions can be identified and treated earlier in the disease process, meaning a vastly better outcome for pets and hopefully greater financial savings over their lifetime, too.”

Simon added: “Many people comment on the peace and quiet.

"The absence of phones ringing or receptionists permanently on calls is unusual.

"But because our customers book in, submit queries and request medications via our app, we don’t need these things.

"While our virtual care team can take calls, they’re not based in the practice.

"This frees up our people to welcome customers and make a fuss of their pets so we can turn what has long been a stressful appointment into a positive experience.

"People have told us their pets, who trembled and cried at their previous vet, are now pulling to come inside because they know they’re going to get a treat and lots of attention.

"We’re still doing all the things vets do, in terms of offering excellent care, expertise and advice, but the entire experience around it has been totally transformed.”

Creature Comforts’ third site, also in London, will open towards the end of this year, and the company is keen to hear from veterinary surgeons, nurses and others who may be interested in upcoming vacancies.

The RCVS is calling for veterinary surgeons to help test its new continuing professional development (CPD) recording platform which is currently in development.

Earlier this year, the RCVS Council approved the roll-out of a more outcomes-based model of CPD to encourage veterinary professionals to engage in greater reflection on learning and development, and the impact that it has on their professional practice.

To support this approach, Council also approved the development of a new CPD recording platform designed to be more intuitive and to make it easy to record CPD in real time.

The College says the new platform – which has the working title of 'One CPD' – will be a ‘one stop shop’ CPD management solution for veterinary surgeons and nurses at all stages of their careers, including veterinary students and student veterinary nurses.

Richard Burley, RCVS Chief Technology Officer, said: "We’re excited to open up access to this powerful, next-generation, tool we’ve been building and welcome our members into an important phase of the development process. Testing with our members will be absolutely critical in delivering the very best experience possible for all those that use 'One CPD' in the future. Ease of use and truly valuable functionality are key deliverables for us and both these need the feedback of our members to perfect."

Dr Linda Prescott-Clements, RCVS Director of Education (pictured right), added: "The first stage of the development of the CPD recording platform is due to finish in October and so we are looking for a cohort of both veterinary surgeons and nurses who can spend a few months this autumn using the new platform to record and reflect on their CPD, in order to test out some of the new features which aim to make this process so much easier to do. We will consider their feedback carefully in order to improve the recording platform ready for launch in January 2020.

"The new ‘One CPD’ platform will ultimately replace the current Professional Development Record, and its use will become mandatory for recording CPD from January 2022.

"In addition to setting up the testing group, we are also looking to meet with key CPD providers for veterinary surgeons and veterinary nurses over the coming months to discuss our plans for outcomes-based CPD and the development of the recording platform in greater detail."

Veterinary surgeons who'd like to take part in the testing for the CPD app, as well as CPD providers who want to discuss the College’s CPD policy plans, should contact Jenny Soreskog-Turp, RCVS CPD Officer, on cpd@rcvs.org.uk or 020 7202 0701.

Pfizer Animal Health and Central Veterinary Services are collaborating in a new venture to create a unified National Benchmarking Database open to all veterinary practices.

In what it says is an unprecedented move, Pfizer will integrate 15 years' worth of data from its Performance Index practice benchmarking service (formerly known as the Fort Dodge Index) with that of the Central Veterinary Services' Management Analysis Indices (MAI). These two benchmarking services have been in co-existence for a number of years, each using different databases. Combining the data from the participating practices within each benchmarking service will create a database of almost 300 practices, representing in excess of 10% of all UK companion animal and mixed practices. This, says the company, will provide a more accurate and relevant benchmarking of UK companion animal practice performance. 

The first combined reports from this new National Database will be available in May providing a comprehensive analysis for the first quarter of 2012. For Performance Index practices, this will be available via a new web portal.

Participating practices will continue to access their reports and services independently via their respective portals for PI and MAI, but will benefit from the larger database providing greater accuracy, granularity and relevance of exactly who a practice chooses to benchmark itself against. This, in turn, should provide all participating practices with an even better understanding of both their critical success factors and where there are clear opportunities for growth. Pfizer says that as ever, practice data confidentiality will be guaranteed for all subscribing practices.

Ned Flaxman, Director Business Innovation, at Pfizer Animal Health said: "We have recognised that what veterinary practices really need is to be far more specific about who they benchmark themselves against. There is little relevance to a rural mixed practice in the Lake District employing 3 full time vets (FTVE) benchmarking themselves against a large 5 FTVE companion animal practice in the centre of Manchester - you are comparing apples and pears! My vision for creating the National Database was really to increase the business benefits of practice benchmarking and enable practices to compare apples with apples. With the new system, the large urban practice in Manchester should be able to compare its performance against other urban practices in the North of England employing 5FTVE!

"To ensure practices have accurate and relevant data from which to make informed decisions to grow and thrive in these turbulent conditions, the creation of a single national benchmarking database is the only sensible solution. Although we are effectively levelling the playing field by enabling other veterinary suppliers to offer benchmarking, we believe it is the right thing to do for veterinary practices and the market as a whole. For Pfizer Animal Health, the needs of our veterinary clients are the driving force for our business decisions, veterinary support services and product development."

Martin Barrow, Managing Director of Central Veterinary Services said: "We fully agree that a single benchmarking database is the right solution for the market. The creation of this National Database, open to all practices irrespective of their supplier, will provide the participants with unique tools to give them powerful insights for their practices' future continued success.

"MAI and the Performance Index have competed with each other for years and provided a very useful added value service for their respective subscribers but when we were approached to integrate the two databases, we immediately saw the bigger picture and recognised the significant benefits this could bring to a wider audience of UK veterinary practices.

"The national database uses open standards for data collection and data is accepted from all practices irrespective of which practice management system they use. We believe it is the right thing to do for veterinary practices and brings significant benefits to the whole veterinary profession."

Practices are urged to subscribe to the PI or MAI services either independently or through one of their practice development partners. Although run from a common database each service will continue to be provided with its own unique features. 

For further information on Performance Index practices should contact their Pfizer Account Manager, email Pfizer at Vetsupportplusuk@pfizer.com.

For further information on MAI, practices should contact Central Veterinary Services at mai@centralvet.com, or telephone 01359 245310

Jurox (UK) Limited has launched the Anaesthesia Academy CPD platform to help veterinary surgeons refresh their knowledge on premedicating patients, and to improve induction, maintenance and recovery protocols. 

The course counts for four hours CPD, split into six short sessions which can be completed in your own time. 

Presented by Dr Dan Cripwell BSc (Hons) BVSc CertAVP PgCert (VPS) MRCVS, Advanced Veterinary Practitioner and senior veterinary technical advisor at Jurox, the sessions consist of:

• Understanding pre-anaesthetic induction – the importance of pre-anaesthetic medication. Examining pre-medicant choice and appropriate selection leading.
• Understanding Methadyne – exploring the main clinical features of the widely-used opioid analgesic methadone.
• Understanding Buprelieve – investigating the main clinical features of the widely-used opioid analgesic buprenorphine.
• Understanding AceSedate – examining the main clinical features of the widely-used anxiolytic and sedative agent acepromazine.
• Introduction to Alfaxan – exploring the main clinical features of the injectable anaesthetic agent Alfaxan Multidose, including the basic pharmacology of the drug, its clinical use and how to use Alfaxan Multidose for best results.
• Achieving the best results with Alfaxan, cat and dog user guide – discussing practical advice which will help achieve the best clinical outcomes for patients and the veterinary team when using Alfaxan Multidose for the induction of general anaesthesia in dogs and cats.

There is a quiz at the end of each module, following which, you can download a CPD certificate.

Suzy Ramsay, head of sales and marketing at Jurox (UK) Limited, said: “We are committed to developing unique and world class anaesthesia and analgesic products and practices within the animal health industry through the provision of up-to-date technical support and education. Our new Jurox Anaesthesia Academy CPD platform will enable veterinary professionals to adopt an evidence-based approach to their anaesthetic product choice and, in turn, help achieve the best possible anaesthetic outcomes for their patients.”

For access to the Jurox Anaesthesia Academy CPD platform, visit https://cpd.jurox.co.uk.

For further information, contact your local Jurox account manager, phone 0800 500 3171 or email customerservice@jurox.co.uk.

IVC Evidensia has opened two veterinary training centres, one at the Vets Now headquarters in Dunfermline and the other based at Blaise Referral Hospital in Birmingham. 

The centres have cutting-edge facilities, including high-tech audio-visual equipment with ceiling-mounted cameras to relay demonstrations, phantom models for abdominal ultrasound training and advanced simulators for practicing echocardiography.

The courses will be taught mainly by clinicians from across the IVC Evidensia network, 

IVC says the centres will deliver 20,000 hours of CPD for its staff this year, and it aims to make its training available to the broader veterinary community towards the end of 2025. 

Daniella Dos Santos, Director of Professional Culture at IVC Evidensia, said: “These centres will allow us to provide tailored training, whether you’re just starting your career or you’re looking to develop new skills and techniques.

"The training will help us deliver exceptional care for pets and their owners by ensuring our colleagues and eventually the wider profession continue to grow and develop their expertise.”

In the week that the National Office of Animal Health has revealed significantly greater levels of pessimism in the animal medicines industry over the impact of Brexit on public health and food production, the BVA also reports that the Department for Exiting the European Union (DExEU) has prevented Defra from consulting the profession over the predicted shortage of veterinary surgeons post-Brexit.

NOAH's third Brexit Barometer found that where in the last report, 17% of its members reported feeling 'very' or 'somewhat pessimistic', that figure has now risen to 32%.

Meanwhile, the National Audit Office has revealed in its 'Progress in Implementing EU Exit' report that Defra has been prevented from consulting with the veterinary market by DExEU.

The report states that Defra is one of the government departments most affected by EU Exit and looks in detail at four of Defra’s main workstreams, including ‘import of animals and animal products’ and ‘exports of animals and animal products’.

In an accompanying press release, the National Audit Office notes that in a no-deal scenario there will be a significant increase in certificates needing to be processed by veterinary surgeons. It says: "Without enough vets, consignments of food could be delayed at the border or prevented from leaving the UK. Defra intended to start engaging with the veterinary industry in April 2018, but has not been permitted to do so and now plans to launch an emergency recruitment campaign in October to at least meet minimum levels of vets required. It plans to meet any remaining gaps through the use of non-veterinarians to check records and processes that do not require veterinary judgement."

The BVA says it has previously outlined concerns about the potential for diluting veterinary certification, and is calling on the Government to fully engage with the veterinary profession before making any changes that could impact the UK’s ability to trade animal products safely and in line with high animal welfare standards.

The RCVS has also weighed in. Amanda Boag, RCVS President, said: "We are glad to see the National Audit Office report recognises that a ‘no deal’ Brexit scenario would be likely to reduce the supply of EU veterinary surgeons to the UK and cause uncertainty regarding the status of those EU veterinary surgeons who are currently living and working in the UK and that this would have a particularly serious impact on necessary veterinary work in public health and certification. 

"We continue to engage with Defra and, like the BVA, we want to emphasise the essential need for Government to consult with the profession to ensure their plans meet requirements, including maintenance of the high veterinary standards for which the UK is known. We also want to highlight the importance and value of the veterinary profession in other areas of society including caring for pets, horses and farm animals as well as research, education and industry, and emphasise the impact of workforce shortages on all sectors."

The International Society of Feline Medicine (ISFM) has announced the launch of two new cat friendly courses aimed at individuals working in veterinary practice.

The Cat Friendly Veterinary Professional course is aimed at veterinary surgeons and nurses and covers all aspects of being cat friendly over six modules, including understanding where cats come from, their behaviours, stress free handling, how to be more cat friendly in practice and client communication.

The four-module Cat Friendly Veterinary Receptionist course is aimed at receptionists and includes everything a receptionist needs to know about cats and how to be cat friendly, including their role in making the practice cat friendly.

Both are 3 month online courses, with students working through the modules at their own pace. There is a short assessment at the end of each module and on successful completion of the course students will receive a certificate and badge.

Sarah Endersby, ISFM’s Veterinary Development Manager, said: "We are very excited to offer cat friendly training for individuals. The courses are suitable for all members of the practice team, and you do not have to work in an accredited Cat Friendly Clinic to study with us, meaning that there is something for everyone."

For more information and to sign up, visit https://icatcare.org/cat-friendly-courses. 

Yorkshire-based Paragon Referrals has launched a superficial radiation therapy (SRT) service for pets, the first of its kind in the country. 

The service uses an Xstrahl 100 superficial radiotherapy system, a £150,000 piece of equipment installed by Paragon after it was used successfully in the USA by the hospital's medical and radiation oncology specialist, Dr Rodney Ayl.

Rodney (pictured right) says the new equipment will transform the way Paragon can treat skin cancers, dermatological disorders and some other common superficial conditions.

He said: “This is a very exciting development for us and our clients because Xstrahl systems have been used so successfully in human medicine for many years.

“This prompted us to explore adapting the SRT system for veterinary use in the UK and we hope to collaborate with Colorado State University, which has a similar unit, to develop protocols for pets.

“We believe this will be a significant advance in the treatment and care of animals and we’re delighted to be at the forefront of introducing this new service.

“It is the only one of its kind for pets in the UK and there are very few units like this anywhere in the veterinary industry, so it really is an important move forward.”

Xstrahl radiotherapy systems were originally designed for the treatment of skin cancer, dermatological disorders, certain types of benign disease and some palliative care in humans.

Rodney says that having adapted the SRT system for animals will transform their treatment and the logistics and cost of getting radiation therapy for superficial skin conditions.

He added: “Superficial radiotherapy is particularly useful for treating some types of skin cancer where it may be preferable to surgery as it can deliver excellent non-invasive outcomes with curative or palliative intent.  

“The treatment is less stressful from the outset and, thanks to its mechanism of action, it is also pain-free. 

“Its use of different size cones, directly over the lesion, minimises effects on healthy skin and the fast treatment means a large reduction in time and impact on the patient’s day-to-day life, while providing a highly-effective treatment.

“The machine’s flexibility also makes it particularly suited for treating multiple lesions that are difficult to access, such as the head and neck, without changing patient positioning.

“The Xstrahl 100 system will help us to respond to the growing demand for radiation treatment and we can treat these patients on an outpatient basis, helping us to reduce surgical and hospitalisation costs. 

“The technology is a real winner. It is easy to use and helps us to deliver safe and effective radiotherapy to our animal patients.

“It provides a quicker, easier, cheaper and non-invasive alternative for superficial tumours, especially in geriatric patients where surgery is not always an option. We’re looking forward to seeing the positive results here at Paragon.”

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

The RCVS Disciplinary Committee has reprimanded one veterinary surgeon and suspended another for four months, following a joint hearing regarding their professional conduct while they were in practice in Slough, Berkshire in August 2016.

The Disciplinary Committee considered a number of charges against Javier Salas Navarro MRCVS and Roman Kristin over 35 days.

The charges against Dr Navarro concerned his treatment of a kitten named Marnie. They included: 

• In August 2016, failing to read the anaesthesia consent form in relation to a surgical spay he performed;

• When Marnie was readmitted for surgery, failing to read the anaesthesia consent form, failing to undertake adequate assessment of Marnie’s condition; performing surgery without adequately considering her condition; subjecting Marnie to anaesthesia without recognising the seriousness of her illness; failing to obtain informed consent from the owners; administering medication which was contra-indicated; and failure to make an adequate record of his involvement in Marnie’s care.

The charges against Dr Kristin also related to his treatment of Marnie. They included:  

• In August 2016, failing to undertake an adequate assessment of her condition; failure to recognise and record the fact that Marnie could not pass urine; failure to refer or offer her for specialist treatment; and failure to ensure Marnie received care and treatment overnight. 

• When admitting Marnie for surgery, that he made a number of clinical mistakes including failure to gain informed consent; and failure to recognise the seriousness of her illness;

• that there were a number of failings in relation to Marnie’s care, including failure to arrange adequate overnight care, failure to monitor and record her condition, and failure to gain informed consent for the overnight care.

• that he failed to advise Marnie’s owners that he suspected her uterers had been ligated during the spay, failed to advise Marnie’s owners that she required specialist veterinary treatment; and advised that Marnie undergo further surgery at the practice in spite of this meaning her having to undergo further anaesthesia in a week and with poor chances of survival;

• that the above conduct was misleading and dishonest.

The Disciplinary Committee found a number of the facts in the charges against both Dr Navarro and Dr Kristin proven (the full details can be found in the documentation at www.rcvs.org.uk/disciplinary). 

The Committee found that Dr Navarro breached a number of aspects of the Code of Professional Conduct for Veterinary Surgeons including: making animal health and welfare the first consideration when attending to animals; the provision of appropriate and adequate veterinary care; responsible prescription, supply and administration of medicines; communication with professional colleagues to ensure the health and welfare of the animal; being open and honest with clients and respecting their needs and requirements; effective communication with clients; keeping clear and accurate clinical records; and working with the veterinary team to coordinate the care of animals. 

Of the proven charges, the Committee found that his initial failure to read Marnie’s anaesthesia consent form on 5 August did not amount to disgraceful conduct in a professional respect, but that the repetition of this failure on 9 August did amount to disgraceful conduct. It also found that Dr Navarro’s failure to undertake adequate assessment and perform surgery without this assessment amounted to serious professional misconduct. Furthermore, the Committee found that subjecting Marnie to anaesthesia in spite of her being unwell, failure to obtain informed consent and failure to keep adequate records also amounted to serious professional misconduct. 

For Dr Kristin, in summary, the Committee found not proven the allegation that he had failed to respond on 5 August 2016 to concerns from Marnie’s owners about her condition while she was recovering from a surgical spay and also all the allegations relating to Dr Kristin’s admission of Marnie to the practice on 9 August on the basis that it was not satisfied so as to be sure that Dr Kristin had been the veterinary surgeon who admitted Marnie on that day. 

The Committee found proven the remaining charges and found he breached the following parts of the Code of Professional Conduct for Veterinary Surgeons: making animal health and welfare the first consideration when attending to animals; keeping within area of competence and referring responsibly; providing appropriate and adequate veterinary care; responsible prescribing, supply and administration of medicines; communication with colleagues to ensure the health and welfare of the animal; being open and honest with clients and respecting their needs and requirements; communicating effectively with clients and obtaining informed consent; keeping clear and accurate clinical records; and working with the veterinary team to coordinate the care of animals.

Of the proven charges, the Committee determined that his failure to adequately assess Marnie’s health, to obtain a clinical history, to undertake blood tests and recognise that she was seriously ill, amounted to disgraceful conduct in a professional respect and led to “Marnie’s underlying condition going undetected and undoubtedly contributed to her eventual death two days later”. 

The Committee also found that Dr Kristin’s decision to hospitalise Marnie without adequate overnight care, place her on IV fluids without monitoring the treatment or her condition, and failure to obtain adequate informed consent – among other things – amounted disgraceful conduct in a professional respect.

Stuart Drummond, chairing the Committee and speaking on its behalf, said: "As a direct result of Dr Kristin’s acts and omissions, Marnie was left alone overnight on fluids when those fluids had nowhere to go. Had he done his job properly he would have known that and Marnie could have avoided the prolonged suffering caused by the chosen course of treatment that did not address the underlying condition. Every element of Dr Kristin’s behaviour was catastrophic for Marnie, and yet he took no personal responsibility for her welfare and just went home.” 

Following its findings on disgraceful conduct in a professional respect, the Committee then went on to consider its sanction for both Dr Navarro and Dr Kristin.

In respect of Dr Navarro, the Committee considered the mitigating factors including previous good character, admissions to some of the facts of the case from the outset; genuine insight and remorse into the seriousness of the actions; his youth and inexperience; and relevant and good-quality testimonials from colleagues. The Committee noted that the testimonials were universally positive and demonstrated that Dr Navarro had reflected on his conduct, had become more mature and confident in his practice and made efforts to rectify the areas in which he had fallen below standards. 

Stuart Drummond said: “Although the consequences for Marnie and her owners were clearly devastating, the Committee considered that Dr Navarro’s part in her demise has to be seen in the context of all the evidence. In light of the extensive mitigation, including significant evidence of insight and remediation, the Committee was able to conclude that Dr Navarro did not represent a future risk to animals or the public. In such circumstances, the Committee considered that it was not necessary to restrict Dr Navarro’s registration and that a reprimand was the appropriate and proportionate sanction in his case.”

In relation to Dr Kristin, the Committee took into account positive character evidence from Mr Karel Daniel, a semi-retired veterinary surgeon and Vice-President of the Czech Republic Veterinary Chamber, a similar body to the RCVS in that country, as well as other testimonials on his behalf. In mitigation, the Committee considered Dr Kristin’s previously unblemished career, the fact that it was a single case involving a single animal; some development of insight into his conduct; no evidence of repetition; expressions of remorse; the impact of a family bereavement during the course of proceedings; and his financial position.

However, the Committee also took into account aggravating factors including a lack of candour from Dr Kristin when he was giving evidence, demonstrated by a tendency to blame others rather than take responsibility, as well as his recklessness in suggesting a third operation on Marnie that was not in her interests, rather than referring her into specialist care.

The final decision of the Committee on the sanction for Dr Kristin was that, given the seriousness of the misconduct, it was satisfied that this warranted a six-month suspension period. However, given the mitigating factors, the Committee decided that four months was appropriate and proportionate. 

Commenting on the sanction Stuart Drummond said: “The Committee determined that it was important a clear message be sent that this sort of behaviour is wholly inappropriate and not to be tolerated. It brings discredit upon the respondent and discredit upon the profession and, most importantly, caused harm to Marnie and great distress to her owners.

"The Committee did consider whether to remove Dr Kristin from the Register. However, in light of the mitigation in this case, the fact that this was a single case in an otherwise unblemished career, together with the unlikelihood he would repeat his disgraceful conduct, the Committee decided that, in all the circumstances, to remove him from the Register would be disproportionate.

"The Committee therefore decided to order that the Registrar suspend Dr Kristin’s registration…. The Committee was satisfied that a period of four months was appropriate and proportionate in all the circumstances."

The full facts and findings from the case can be found at www.rcvs.org.uk/disciplinary 

Eskimo, a reindeer at Edinburgh Zoo has received life-saving surgery just in time for Christmas, making him the first reindeer in history to receive keyhole surgery.

Vet Romain Pizzi successfully removed one of Eskimo's testes, which had been lodged in its abdomen since birth, using specialist surgical instruments donated to the zoo by one of Ark Surgical's strategic partners Surgical Innovations.

The zoo was worried that the retained testicle may have been developing into a tumour giving off abnormal hormones, and that this could become life-threatening. Thankfully, zoo surgeons found that the retained testicle, although abnormally sized, had not yet developed a tumour.

It is thought that the abnormal testicle was affecting Eskimo's production and flow of testosterone and, as a result, he was showing submissive behaviour and being bullied by the other male reindeer in the herd. He had also started to show some abnormal and delayed antler growth and development. Removing the testicle will halt any abnormal hormone production so hopefully Eskimo will return to full vigour just in time for Christmas.

Gavin O'Brien, Director at Ark Surgical said: "We were only too happy to help when Romain mentioned the challenging operation faced by Eskimo and in the season of goodwill we approached Surgical Innovations who kindly donated the instruments for this pioneering surgery." 

Although laparoscopic surgery is routine in humans, the standard procedure in animals is still open abdominal surgery.  Open abdominal surgery is 20 years behind human medical advances and has a number of negative factors on animals such as more post-operative pain, slower recovery and a higher risk of post-operative complications and infections.

Romain, a veterinary surgeon for the Royal Zoological Society of Scotland, based at Edinburgh Zoo, said: "Laparoscopic surgery is still very uncommon in veterinary medicine, even amongst common species such as dogs, cats and horses, so for keyhole surgery to be carried out on a reindeer shows a great advancement in veterinary surgery."

It is estimated that nearly one out of every two households in the UK are pet owners. Veterinary surgeons perform on average 600,000 open abdominal procedures annually but it is believed that less than 1% of vets currently practice laparoscopic surgery. 

Romain believes that with the right instrumentation available through innovative companies such as Ark Surgical, UK vets now have more opportunity than ever to introduce laparoscopic techniques as part of their operating procedures.

Romain said: "This procedure was only really possible thanks to a cutting-edge designed retractor which we were able to use in this case. Ironically although a reindeer is a reasonably large animal, due to their unique anatomy and massive four chambered stomach that takes up most of the space in the abdomen, there is a very limited internal operating space. For this reason the operation was much more difficult than in a human, or in a dog, where there is more space to work, despite their smaller size."

"We were especially pleased with how quickly Eskimo recovered after surgery, he was standing and happily eating lichen again within 10 minutes of recovery from anaesthesia. He hardly seemed to notice he had even had surgery, although he was still slightly groggy from the anaesthesia. This would simply not have been possible with traditional open abdominal surgery, as the long wound would have been much more painful and debilitating."

The minimally invasive nature of laparoscopic surgery means there are numerous benefits for animals such as a reduction in post-operative pain, a faster recovery and reduced post-operative care.   It also has a decreased risk of infection after surgery and a lower risk of any wound complications. 

For veterinary surgeons laparoscopic surgery can offer better visualisation of the operated area, allowing them to be more precise and reach areas that are difficult to see in open surgery such as the liver and pelvic canal.

Romain carries out laparoscopic operations on dogs, cats and exotic pets at his own veterinary practice Inglis Veterinary Centre (Scotland) and has pioneered several new laparoscopic techniques.

He said: "Laparoscopic surgery has so many benefits for the animal, the veterinary surgeons and the zoo, so there is no reason why it should not be more common practice within veterinary surgery.  I hope Eskimo's experience helps raise its profile and encourage more veterinary surgeons to look in to it as a standard surgical procedure."

Ark Surgical offers a wide range of laparoscopy instruments and peripherals to vets across the UK and to suit all budgets. The company says it is already working with many of the UK's leading vets and agencies such as the Royal Zoological Society of Scotland, as well as the UK foremost laparoscopic medical device manufacturer Surgical Innovations, to be at the forefront of veterinary laparoscopic surgery

For more information on animal laparoscopic surgery contact Ark Surgical on 01732 862882 or http://www.arksurgical.co.uk/