The British Association of Veterinary Emergency & Critical Care has released the results of a survey into practitioners attitudes to 24-7 and OOH home visits. 

360 veterinary surgeons took part in the survey, nearly all of whom have been practising for more than 2 years. 70% work in small animal practice, 12% at a dedicated OOH provider, and the bulk of the remainder in referral or mixed practice. 81% described the work they do as small animal first opinion, and 76% were employees. 35% said they had already responded to the RCVS call for evidence on the provision of 24/7 emergency cover.

26% said they work for a practice that outsources its OOH to a dedicated provider, and more than 85% of those said they would not return to an on-call system. 

In terms of dedicated out-of-hours providers, a clear pattern emerged. Namely those practitioners who outsource their OOH feel that patient care, staff safety and professional well-being are all enhanced by dedicated OOH services, but that dedicated OOH comes at a cost of reduced value for money for the pet owner. Customer service between the different OOH provisions is perceived to be similar (on-call better 25%, same 48%, and dedicated better 27%).

Among those practitioners who work for a dedicated OOH service, dedicated OOH services perform best in all categories. 68% responded that OOH customer service is better with a dedicated OOH service compared to an on-call system (12% responded that on-call provided better customer service on average). 44% responded that customer value for money was better with dedicated OOH service compared to 19% who responded that customer value for money was on average better with an on-call system.

Among those practitioners who do their own on-call, customer service and value for money were perceived to be better with an on-call system (42% v 26% and 61% v 15% respectively). In the other categories dedicated OOH services again out-performed an on-call system.

Whether routine or emergency, 'owner demands' were felt to be the biggest reason for home visit requests (41% and 30% respectively). However, 'genuine clinical need' was the main reason cited by 19% of respondents as the main reason for emergency home visits. Inability to move the animal was given as the main reason by a further 28%. 

Participants in the survey were asked to score (out of 10) how much their decision to perform a home visit was affected by the threat of a complaint, either to their employer or to the RCVS. Interestingly, 37% said a complaint to their employer weighed heavily on the decision (ranking it 8 or higher) where, by comparison, 52% said the threat of a complaint to the College ranked 8 or higher in their decision making.

69% of respondents said they make visits alone, either sometimes or always. When asked if they had ever felt threatened whilst performing an OOH visit, 48% said yes. This compared to 23% who said that they had felt threatened when performing a visit in normal hours.

When asked to rank (out of 10) the stress home visits cause, 7% said none at all and 36% said 8 or above. 

72% said they believe that the profession should continue to be obligated to provide 24/7 for animals.

Respondents were then asked to say whether they support or disagree with the suggestion that the need to perform house visits is removed from the CoPC. 59% were strongly for the idea (scoring it up to 3), compared to 22% who were strongly against it (scoring it 8 or above).

Opinions about whether the College should clarify the need to perform house visits was far more clear cut. 77% strongly supported clarification (scored up to 3), whereas only 16% said there was no need (scored 8 or above).

However, an overwhelming 93% said that they would continue to perform visits in the case of genuine clinical need even if the Code of Professional Conduct was changed to make it dear that there was no risk of disciplinary action for not attending off-site.  

Merial has announced the results of a survey which suggests that whilst diagnosis of gastric ulcers in horses is improving, there is still room for improvement.

The survey of 50 equine vets, which was conducted in May this year, showed that the number of practices owning a scope has more than doubled over the past six years. Half of equine practices now own a scope. Over the same period the average number of monthly scopes has risen from 1.5 to 9.25 and referrals from practices without a scope has risen by 65%.

Merial's Louise Radford MRCVS said: "The survey also showed that symptom recognition among vets prompting the need for an endoscopy has also risen. The vast majority of vets now consider changes in behaviour, loss of appetite and poor performance as potential signs. In addition, 100% of those surveyed would consider an endoscopy when presented with the signs of recurring colic.

"However whilst this is great progress, when diagnosis is compared to the incidence of ulcer, we know that more needs to be done. It is believed that up to 30% of leisure horses have some degree of gastric ulceration, and this increases in sports horses, yet just a fraction of this figure represents those scoped."

Richard Hepburn BVSc MS(Hons) CertEM(IntMed) DipACVIM(LA) MRCVS, American and RCVS Specialist in Equine Internal Medicine at B&W Equine Hospital says he is pleased that more horses are being scoped for gastric ulcers but says that further education is needed: "We've seen a huge leap in the appreciation of the incidence of gastric ulceration in non-racing animals, which long term will better our understanding of the individual clinical relevance of particular lesions, and the benefits of treatment and management change.

"This should improve both performance and horse welfare, as well as increasing client satisfaction. Despite the huge increase in the diagnosis and treatment of equine gastric ulcers it is still believed that many horses go undiagnosed."

Vetstream has updated the content on its Vetlexicon website so it is now available in a number of different languages.

Dr Mark Johnston, CEO of Vetstream said: “The usage data of Vetlexicon has continually shown us how important the client factsheets are to practices helping clients understand the health and welfare of their animals.

"Whilst most of our subscribers are accepting of the Vetlexicon content in English, the preferred language of many pet owners is not necessarily English, and we wanted to help practices with that.

"So a major new dimension to the new Vetlexicon website is to enable the content to be made available in many European and Asian languages so that when you are viewing a client factsheet, you can instantly see that content in Spanish, French or Korean and then print it out on paper and give to the owners for them to share with friends or family on their return to home; or to print it as a PDF and email it to them.

"Practices have told us that this will be so useful for the relationship with their clients, and so it is great to be able to provide that now.”

The company says it has also improved the interface and functionality of the site and made it mobile phone friendly.  

www.vetlexicon.com

The Veterinary Marketing Association has 10 tickets available for its annual debate being held at the House of Lords on Tuesday October 12th, this year entitled: Internet Pharmacies - Opportunity or Threat? 

The debate will be chaired by Professor Sandy Trees, and the panel will comprise:

• Jamie Critall - veterinary surgeon at Beech House Vets
• Matt Dobbs - veterinary surgeon with Westpoint Veterinary Group and director of online pharmacy Farmacy.co.uk
• Iain Booth - managing director of online pharmacy VetUK Limited
• Alison Glennon - NOAH
• Lesley Johnson - VMD
• Bob Moore - RCVS Council member and former president of BCVA and RCVS Council

The debate kicks off at 10:30am, and is followed by lunch at 12:30pm on the famous terrace, overlooking the Thames.

VetSurgeon members may buy tickets at the lower VMA member price of £120 + VAT, which includes the champagne reception and three course lunch with wine.

Click here for more information.

A debate held at BEVA Congress last month ended with more than 70% of voters disagreeing with the motion: this house believes that new vet schools will benefit equine veterinary practice in the UK.

The result reflects a recent industry survey indicating that up to five times as many veterinary graduates may be seeking work in equine practice as there are jobs available.

Chris Proudman, founding head of Surrey University's new School of Veterinary Medicine and Mark Bowen, Associate Professor of Veterinary Internal Medicine at the University of Nottingham's School of Veterinary Medicine and Science, advocated that new UK vet schools are important for the advancement of the profession. 

Mark Bowen said: "New UK vet schools will benefit the profession by improving the standards of veterinary education and creating what the consumer wants." He argued that new schools would help improve teaching methods and clinical training, while the resultant smaller class sizes would provide greater opportunities for hands on training. Competition would also help to drive up standards and inspire other universities to instigate much-needed changes such as focusing on quality of teaching rather than research.  

Chris Proudman emphasised the flexibility of a new vet school to be progressive and innovative in both curriculum design and teaching delivery. He said: "Designing a curriculum from scratch allows novel approaches to partnership working and to the One Health agenda. New schools can deliver veterinary graduates better equipped with the skills and knowledge to be the veterinary leaders of the future."

The proposers also reasoned that if school leavers cannot find a place in a UK vet school they can now attend English language veterinary schools in universities across the EU, many of which do not have European accreditation to ensure standards of education. Therefore the increase in numbers of veterinary graduates is irresistible and the authorities can only influence the numbers trained in the UK and govern the high quality of teaching that is provided in the UK.

Alastair Welch, a partner at Donnington Grove Veterinary Group in Berkshire and Lucy Grieve, vet at Darley Pre-Training in Newmarket, staunchly countered the motion. They maintained that new vet schools would have a detrimental impact on the industry over the longer term and that their introduction demonstrated a slackening of the RCVS's management of the profession. 

Alastair said: "Both anecdotal and empirical data suggest that becoming a horse vet has never been harder. The seemingly endless supply of hard-working, well-qualified school leavers determined to become equine vets provides universities with a reliable income stream for years to come but at what cost? I remain to be convinced that we will not end up educating veterinary graduates who cannot find a position in their intended career."

Lucy contended that it was irresponsible and immoral to allow individuals to commit five or six years, and tens of thousands of pounds, towards a veterinary career without them first being made aware of the limited opportunities available in very popular sectors of the profession such as equine practice.

Paul Jepson, President of BEVA, said: "With more than 70% of voters opposing the motion there is clearly a discernable level of disquiet amongst BEVA members about the current job market in equine practice and the further dilution of opportunities that increased numbers of graduates will create."

To help address the growing challenges faced by new graduates BEVA has recently introduced an Internship Awareness Programme (IAP). The scheme aims to help students and vets navigate the opportunities available as an intern and helps equine veterinary practices to find the most suitable employees for their practice.

You should be able to view the debate here: http://www.fsmevents.com/beva/congress13-session34. If not, the debate can be viewed on the BEVA website by following these instructions. Click the Webinar tab. Then click register. Then complete the £0 transaction and you will be able to access the free webinars. Select 'Free sessions' (Click the + symbol). Select 'Current Affairs: New vet schools - supply and demand?'

The RCVS is inviting all vets to attend its Annual General Meeting, taking place online, on Friday, 9 July 2021.

The proceedings will begin at 10am with the formal adoption by RCVS Council of the Annual Report and Financial Statements for 2020, which will be published prior to the event.

The College will then answer any written questions that have been submitted about the Annual Report by veterinary surgeons and veterinary nurses.

If you have any questions about the Annual Report, you'll need to submit them to RCVS Events Manager Deborah Rowlanes on d.rowlanes@rcvs.org.uk no later than Friday 2 July 2021.

RCVS President Mandisa Greene will then formally welcome the newly-elected RCVS Council members – Louise Allum, Danny Chambers, Tshidi Gardiner and Colin Whiting – onto Council for their four-year terms, and newly-elected VN Council members Susan Howarth and Donna Lewis for their three-year terms, as well as saying farewell to retiring members of both Councils.

After a short break, the AGM will reconvene at 11am to approve Kate Richards (pictured right) as President for 2021-22, Melissa Donald as Junior Vice-President, Mandisa as Senior Vice-President, and Niall Connell as Treasurer.

There will then be addresses from Matthew Rendle as Chair of Veterinary Nurses Council, and from Mandisa as the outgoing RCVS President for 2020-21, followed by the formal investiture of the new RCVS Officer Team.

There will then be closing remarks from Kate Richards as the newly invested RCVS President.

If you'd like to attend the AGM, you'll need to register here: www.rcvs.org.uk/agm21-registration.

Cresilon Inc., the US maker of the haemostatic gel, Vetigel, has signed a distribution agreement for the UK with Covetrus-owned Veterinary Instrumentation. 

In addition to the UK, Vetigel will be marketed and distributed to veterinary surgeons throughout Europe and elsewhere via Veterinary Instrumentation's global distribution network.

Matt Lewis, Vice President of Sales at Cresilon said: "Our partnership with Veterinary Instrumentation will help us provide more veterinary surgeons with a revolutionary hemostatic gel that significantly improves the standard of care for pets and animals.

"Vetigel has been used by thousands of veterinarians thus far and helps veterinary clinics and animal hospitals save time, reduce operating costs, and improve patient outcomes."

https://vetigel.com
https://veterinary-instrumentation.co.uk 

A review of past research papers on the treatment of feline diabetes carried out by Dr Stijn Niessen at the RVC has found that much of the research into the condition was based on low-level evidence, lacked a cooperative approach and, therefore, yielded questionable results.

According to Dr Niessen, current recommendations are often based on previous research studies which used small sample sizes; some included as little as 8 cats. The biggest sample sizes found contained from 50 to 60 cats, but Dr Neissen says that even this isn't a big enough sample size to yield effective results. He says that so-called power calculations, a statistical test performed as part of this new publication, indicate that at least 80-90 animals are needed to accurately compare the effectiveness of different insulin types and other treatments.

Stijn said: "The only way to improve the quality of research and its results is to design and implement well-structured clinical trials, similar to those used by pharmaceutical companies in human medicine.

"This sort of trial can have a powerful impact on a treatment and how it is used. They can more accurately gauge the pros and cons of specific diabetic treatments for cats, helping us pinpoint troublesome side effects as well as identifying the benefits.

"Current research into the condition is sporadic, lacking a long-term vision and not collaborative. A pet owner can, in theory, go to two different vets and get two very different treatments for the same condition. The owner could then go online and find a third way. These treatments aren't necessarily wrong, it is just one vet may have been trained in one methodology and another in a different way. This is why a collaborative approach is so important, so we can end these inconsistencies and can get closer to the actual truth about which way best to treat our feline friends."

For more information, visit: https://www.facebook.com/RVC.Diabetic.Remission.Clinic

The Royal Veterinary College, together with the University of Pennsylvania’s School of Veterinary Medicine (Penn Vet) and Mars Equestrian, has launched an international scholarship programme aimed at advancing the health and welfare of horses, and providing a learning experience for an aspiring veterinary investigator.

The new Mars Equestrian Veterinary Research Scholar Programme offers the opportunity to conduct research alongside some internationally-renowned experts in equine health and veterinary welfare while pursuing two advanced credentials: the Graduate Certificate in Animal Welfare and Behavior at Penn Vet during year one, followed by the Master of Research (MRes) program at the RVC in year two. 

The RVC says the new format offers an exclusive opportunity for the candidate to refine their critical research skills and expand animal welfare knowledge while learning on location at both the RVC in England and Penn Vet’s New Bolton Center in Kennett Square, Pennsylvania, United States.

The RVC’s MRes programme gives students the chance to develop into scientists who can work well across interdisciplinary teams, tackling problems of practical relevance to veterinary and medical science. Many of the courses’ graduates go on to work in some of the world’s leading scientific research institutes, as well as within industry and government.

Professor Richard Bomphrey, Interim Vice Principal for Research at the RVC said: “I am delighted that the RVC is able to support this new transatlantic initiative for veterinary graduates following a generous donation from Mars Equestrian. It strengthens the ties between the RVC, the University of Pennsylvania and Mars Equestrian while providing an outstanding training and research opportunity. We look forward to welcoming the successful scholar and helping them to make an impact in equine research."

The Veterinary Research Scholar program is open to interested UK, US and international candidates holding a veterinary degree (DVM/VMD/BVSc or equivalent). The chosen candidate will receive an annual stipend and tuition as well as travel expenses.

The programme will commence in September 2021 in the United States before moving to the UK in October 2022 until its conclusion in September 2023.

The deadline to submit applications for consideration is 30th June 2021 or until an acceptable candidate is identified.

Applications should be sent to the Penn Vet’s Dr. Kyla Ortved atkortved@vet.upenn.edu.

The Royal Veterinary College (RVC) has published the first standardised research-based radiographic guidelines to support the accurate checking of feeding tube placement in dogs and cats.

Although feeding tubes are widely used in practice, there has previously been no agreed radiographic criteria to confirm correct positioning, creating uncertainty and increasing the risk of serious complications such as aspiration pneumonia and pneumothorax.

The new guidelines address this gap by providing an evidence-based framework for interpreting lateral neck and thoracic radiographs.

Led by Andrea Vila Cabaleiro, Small Animal Diagnostic Imaging Resident at the RVC, the research team collected 256 lateral neck and chest radiographs of dogs and cats with nasoesophageal or nasogastric feeding tubes in place.

The images were sourced from ten private and academic institutions, including the RVC’s Queen Mother Hospital for Animals.

Expert veterinary radiologists then verified whether the tubes were correctly placed in the oesophagus or incorrectly in the trachea.

From this dataset, the researchers developed a three-point radiographic checklist to confirm correct tube placement:

1. whether the tube passes dorsal to the cricoid cartilage lamina
2. whether any part of the tube course is visible outside the trachea (i.e. not completely superimposed)
3. whether the tube passes dorsal to the dorsal wall of the carina

To assess the clinical value of the guidelines, six veterinarians with varying levels of experience reviewed the same radiographs on two occasions, first using their usual judgement and then, after a minimum seven-day interval, using the new guidelines.

Diagnostic accuracy improved from 82% to 96%, while uncertainty fell from 14% to 2%.

Agreement between clinicians also improved from moderate to almost perfect.

The guidelines performed consistently across dogs and cats, a wide range of patient sizes and multiple clinical settings.

The authors concluded that this structured, evidence-based approach improves both accuracy and confidence without requiring additional equipment, making it suitable for use in general practice, referral hospitals and emergency and critical care environments.

An accompanying step-by-step infographic has been produced to support uptake of the guidelines in day-to-day clinical practice: https://www.rvc.ac.uk/Media/Default/VetCompass/260105%20RVC%20Infographic%20-%20Radiographic%20guidelines%20on%20feeding%20tube%20placment.pdf 

Reference

1. Vila Cabaleiro, A., O'Neill, D.G., Cordella, A., Vilaplana Grosso, F.R., Gioele Rizzo, S., Matson, H.L., Porcarelli, F., Bosher, J.C., Matkar, V.S., Duggan, R.G., Diana, A., Stock, E., Pearce, H. and Fitzgerald, E. (2026) 'Introduction and Validation of Radiographic Guidelines for Identification of Nasoesophageal and Nasogastric Tube Position in Dogs and Cats', Veterinary Radiology & Ultrasound, 67(1), e70138, available: http://dx.doi.org/https://doi.org/10.1111/vru.70138 

The British Equine Veterinary Association has expressed its outrage that veterinary surgeons are regularly being asked to break the law by inseminating imported equine semen that doesn’t have an accompanying health certificate.

Thousands of shipments of equine germinal product (semen, ova or embryos) are imported into the UK every year. It is a legal requirement for all imported equine semen to be accompanied to the place of destination (usually to the side of the mare) by an original, valid health certificate (ITAHC), issued in the country of origin.

The BEVA says that recently, consignments of equine semen have been imported without the appropriate health certificates meaning that there is no guarantee that the semen is free from the stated diseases or even that it is from the chosen stallion.

According to the Association, some well-known importing agents have been advising mare owners that these certificates are unnecessary and openly criticising veterinary surgeons who refuse to inseminate mares with uncertified imported semen. 

The use of uncertified semen risks recipient mares being infected with diseases such as CEM or EVA, the potentially rapid spread of disease in breeding stock and eventual restrictions being placed on breeding premises. Recent outbreaks of Equine Infectious Anaemia (EIA) in Europe have increased the threat to the UK herd.

The personal and professional reputation of any veterinary surgeon involved with using uncertified semen is also in danger, with the RCVS likely to take a stringent line with any vets who disregard animal health laws and the high health status of British horses. 

Malcolm Morley, Partner at Stable Close Equine Practice was recently placed in a difficult position with a longstanding client when semen arrived without the requisite documentation. Following a discussion between the semen importer and his client, where the client was told that Malcolm was being pedantic and that the client should find someone else to inseminate the mare, Malcolm contacted the importer saying: "We have no intention of inseminating the mare without the correct health papers. Please will you ensure that when you speak to the mare’s owner that you make it clear that you do not expect us to inseminate the mare in these circumstances and that the health papers should have been shipped with the semen."

Another BEVA member who wishes to remain anonymous said: "I have one very big client I think I may be about to lose because of my refusal to inseminate his mare without papers … (the importing stud) did not feel it worth a three hour drive to get papers done. The semen importer has made it clear to my client that (they believe) I am just being awkward."

Mark Bowen Senior Vice president of BEVA said: "Import agencies have placed additional pressure on the vets to inseminate mares without the necessary paperwork. Not only is this action illegal but places recipient mares under a direct threat from a notifiable and incurable disease. This seems particularly cavalier given the recent outbreaks of EIA across Europe."

Tullis Matson, Founder and Managing Director of Stallion AI Services said: "No one should be inseminating mares with imported semen that isn’t accompanied by the original health certificate. If the UK wants to retain its high health status and continue to utilise the international market it needs the breeding industry and the veterinary profession to use the disease controls that are currently place until such a time as we can implement more efficient system."

The BEVA says it is taking the following action:

• Notifying owners that they must tell the agent that they will not accept semen without a valid health certificate, in order to protect the health of their own horses.
• Reassuring all vets performing stud duties that they are right to refuse to inseminate mares with semen that isn’t accompanied by a valid health certificate, in order to protect their professional status and safeguard the health status of the UK herd.
• Making sure owners and vets are fully aware that if they receive imported semen that isn’t accompanied by a valid health certificate they must report it immediately to their local animal health office and arrange for the semen to be destroyed.
• Reminding agents of the law and to make them aware that all BEVA members have been advised to report any indiscretions to their local animal health office.

The Company of Animals, makers of behaviour and training products, has announced the launch of a new Product and Training DVD, designed to be screened in practice waiting rooms.

The DVD features the entire range of products from Company of Animals, including its multi-award-winning dog training devices, being demonstrated by pet dogs and their owners. It is presented by Animal Psychologist and founder of The Company of Animals, Dr. Roger Mugford.

The Company of Animals says that playing the DVD during opening hours will grab the attention of your customers, raise their awareness of already popular products, and educate them about new ones.

This DVD is free and available to all veterinary retailers. To order the DVD or for more information see: http://www.companyofanimals.co.uk/

An online petition set up by the Worldwide Small Animal Veterinary Association (WSAVA) as part of a campaign to secure access to ketamine as an essential veterinary medicine has secured more than 11,300 signatures - with 15,000 the next milestone. 

The WSAVA is calling on veterinary surgeons around the world and anyone with an interest in veterinary – and human – medicine to sign the petition to ensure access to ketamine in the face of lobbying by some countries, principally China, to have it put under international scheduling.

According to the WSAVA, proposals for international control stem from the misconception that ketamine is merely a 'recreational drug.' The WSAVA says this is inaccurate and devalues its huge contribution to human and animal medicine. 

Dr Walt Ingwersen, WSAVA President Elect and Member of the WSAVA’s Global Pain Council, said: "In 2015, the WHO Expert Committee on Drug Dependence (ECDD) stated that the abuse of ketamine does not cause a global public health threat and that control would limit access for those using it as an anaesthetic. This view was confirmed at a meeting of the UN Commission on Narcotic Drugs in March 2016, helped by strong support view from the global medical and veterinary communities. However, China has repeated its view that ketamine should fall under international scheduling and we have no doubt that it will raise the issue again. This mean the risk to ketamine remains."

He added: "Ketamine is a safe anaesthetic which can be used without oxygen, ventilators, electricity and the support systems required for other products, making it the only anaesthetic suitable for both medical and veterinary use in lower and middle income countries. If developing countries were denied access to it, which would be the effect of international scheduling, the effects on veterinary medicine, human health and animal welfare would be devastating."

Dr Ganga de Silva, President of the Society of Companion Animal Practitioners of Sri Lanka, said: "Sri Lanka is a poor country with an underdeveloped veterinary profession. If ketamine was not available, in my opinion, all surgeries would have to cease as almost all of the veterinarians in the country rely on it for anaesthesia. The result would be suffering for animals and it would also seriously impact our ability to control rabies as we would not be able to carry out spay and neuter programs on stray dogs."

Dr Nancy Shaffran CVT, VTS(ECC), President of the International Veterinary Academy of Pain Management, said: “In addition to its use as an anaesthetic agent, ketamine is a critical medication used in the pain management in animals. The mechanism of action of ketamine (NMDA receptor antagonism) delivered as a Constant Rate Infusion has been well established to be effective in the prevention and correction of severe neuropathic pain and spinal cord wind-up. The loss of ketamine in veterinary practice would result in the needless suffering of many patients and we strongly oppose this action. We are very grateful for WSAVA’s efforts to keep ketamine available for our patients."

Dr Walt Ingwersen added: "Ketamine is also used in human medicine as it has a particular value for use 'in the field' - for instance, in treating trauma patients, those with traffic and sporting injuries or affected by natural disasters and conflict. Taking these factors together, it is clear that ketamine is an essential medicine and we are determined to ensure that it remains freely available. We are continuing to harness our global veterinary community to highlight the importance of ketamine because this is a battle our patients can’t afford us to lose. We ask all those agreeing with to sign our petition and help our collective voice grow."

The petition is here: http://chn.ge/1RFSou6.

The WSAVA’s Global Pain Council has produced a range of tools and resources, including an infographic, to support its ketamine campaign. They can be accessed here: http://www.wsava.org/educational/global-pain-council