The RCVS has confirmed that surgical insemination in dogs is prohibited by animal welfare laws and amended Section 27 of the supporting guidance to the Code of Professional Conduct so that it now sits alongside tail docking, dew claw removal, prosthetic testicles and feline renal transplantation from living donors on the list of banned procedures.

RCVS Registrar, Eleanor Ferguson said: "Changes to the chapter of the supporting guidance to the Code of Professional Conduct titled ‘Miscellaneous procedures: legal and ethical considerations’, specifically in regards to surgical artificial insemination in dogs, were discussed at a meeting of the Standards Committee on 30 January 2019.

"The proposed changes to the guidance were to clarify that surgical artificial insemination (AI) in dogs is prohibited by animal welfare legislation – specifically the Animal Welfare Act 2006, which prohibits mutilations. Prohibited procedures are defined as those which interfere with sensitive tissue or bone structure. Surgical AI in dogs is not one of the exemptions permitted within the Mutilations (Permitted Procedures) (England) Regulations 2007.

"Due to an unfortunate oversight, the guidance had not been updated following this legislative change, although, in the interim, the guidance still made it clear that surgical AI in dogs was unlikely to be in the animal’s best interests and could only be carried out and justified in very limited circumstances and for exceptional reasons.

"However, we apologise for the oversight, and as soon as the College was made aware that the guidance on surgical AI did not conform exactly with the legislation and regulations, a paper was prepared for the Standards Committee to consider as soon as possible and update the guidance accordingly.

"As always, if any members of the profession or the public have any questions about any aspect of our Code of Professional Conduct and supporting guidance, they are welcome to contact our Standards and Advice Team on advice@rcvs.org.uk."

The eminent equine vet, Dr Sue Dyson FRCVS, has been struck off for a series of dishonest statements and actions, including fabricating a letter from a fictitious Home Office Inspector, in order to have her research project published in an international publication.

The Disciplinary Committee heard that in 2018, when Dr Dyson was employed as Head of Clinical Orthopaedics at the Animal Health Trust (AHT), she completed a research project: ‘Influence of rider: horse body weight ratios on equine welfare and performance – a pilot study’, for which she had previously been given the go-ahead by the AHT’s Clinical Research Ethics Committee. The results of the study were then submitted to the Journal of Veterinary Behaviour: Clinical Applications and Research for publication.

After peer-reviewing the project paper at the request of Journal Editor Karen Overall, Dr Matthew Parker, a Senior Lecturer in Behavioural Pharmacology at the University of Portsmouth, was concerned by the lack of a Home Office licence and asked for details of the licence or an explanation of why the project didn’t need one, and for the paper to be re-submitted.

In reply, Dr Dyson then emailed Ms Overall saying: “We have a former Home Office Inspector on our AHT Ethical Committee and two current licence holders (Named Veterinary Surgeons) who are fully conversant with the current legislation ... I also sought informal advice from a current Inspector. All were fully aware of the protocols to be employed and gave me assurance that in their opinion Home Office approval would not be required”.

Ms Overall then asked Dr Dyson to obtain a letter from the Home Office to support this position.

On 24 December 2018, Dr Dyson sent Ms Overall a letter purportedly from a Home Office Inspector called Dr Butler who, she explained, had advised her during the planning phase of the project. In the letter, the fictitious Dr Butler confirmed that their advice was sought for the project and that in their opinion, a Home Office Licence was not required.

Ms Overall then sent the letter to Dr Parker for further review, who decided to contact Dr Martin Whiting, Head of Operations at the Home Office Animals in Science Regulation Unit (ASRU) to ask if he knew of Dr Butler.

Dr Whiting confirmed that the Home Office had no record of employing a Dr Butler as an Inspector and that they were in the process of making further inquiries into the matter.

After Dr Whiting’s reply was forwarded to Dr Dyson, she replied to him saying that she thought the studies’ procedures did not meet the criteria for the Animals (Scientific Procedures) Act 1986 (ASPA), but that this was questioned by peer reviewers.

She said that her decision to send Dr Butler’s letter was one that she would ‘eternally regret’ and that she was ‘an inherently honest person’.

She explained that she was under a huge amount of pressure in her personal and professional life and that she was ‘fully aware that [she] acted completely inappropriately and she requested the incident be overlooked’.

In March 2019, Dr Dyson sent a letter to William Reynolds, Head of the Home Office ASRU, in which she expressed remorse for writing the letter. Mr Reynolds subsequently raised a concern with the RCVS about Dr Dyson’s alleged behaviour. 

Dr Jane Downes, who chaired the Disciplinary Committee, and spoke on its behalf, said: “The Committee heard from Dr Dyson that she had no recollection of several events detailed in the charge, including writing the letter from Dr Butler and sending the email to Ms Overall which contained Dr Butler’s letter. She accepted that the letter was dishonest and that it should not have been sent. However, she also claimed that, as she could not remember writing the letter, she did not act dishonestly.

The Committee heard testimonials from several witnesses who held Dr Dyson in high regard, including colleagues from the AHT, who attested to her integrity.

However, there were many dubious claims made by Dr Dyson throughout the hearing, including that the Home Office Inspector that she referenced as ‘my friendly inspector’ was someone who could have given informed consent to a project as Dr Dyson confirmed that she had met the individual briefly, around two and a half years ago at a drinks reception.

In reaching its decisions, the Committee considered Dr Dyson’s previously impeccable character, the written and verbal testimonies from witnesses. They also considered that during the hearing, Dr Dyson explained that at the time she fabricated the letter, she was under a lot of work and personal pressures, including managing a workload amidst colleagues’ resigning or going on maternity leave and it being the anniversary of her dog having to be humanely destroyed.

However, it did not accept Dr Dyson’s claims that she had amnesia at this time, and considered that she had not owned up to her wrongdoing until it was discovered. Although Dr Dyson maintained her actions were not pre-meditated, the Committee considered that, in the case of the forged letter, a certain amount of planning and careful thought was involved. The Committee believed that Dr Dyson knew what she was doing at the time, but acknowledged she may subsequently have blanked out what she did.

The Committee found all but one of the allegations proved and confirmed that it “was satisfied that the writing and sending of that letter was the culmination of a course of dishonest conduct.”

Committee Chair Dr Downes said: “In assessing [the evidence of] Dr Dyson the Committee took into account the difficulty faced by any Respondent appearing before their Regulator and also the various interruptions occasioned by issues which had to be dealt with during her evidence. Whilst [Dr Dyson is] undoubtedly highly qualified and highly respected, the Committee nevertheless considered her evidence lacked credibility and was not reliable.”

The Committee found that Dr Dyson’s conduct had breached parts of the RCVS Code of Professional Conduct for Veterinary Surgeons and amounted to serious professional misconduct.

Dr Downes continued: “The Committee determined that it was important that a clear message be sent that this sort of behaviour is wholly inappropriate and [was] not to be tolerated. It brings discredit upon Dr Dyson and discredit upon the profession.

"For whatever reason, Dr Dyson chose not to respond to Ms Overall’s email on 30th November 2018 in an honest and straightforward way. Instead, she lied about the makeup of the AHT Ethical Committee in order to cloak her response with authority.

"She also lied about having received advice from a current Inspector for the same reason. In the Committee’s view, she made a conscious decision to provide a dishonest response. She no doubt believed that would be the end of the matter.

"When that did not work, she lied further in the email to her co-author, Andrew Hemmings, claiming to have a letter from her friendly Inspector. When that too did not work, she impersonated a Home Office Inspector in creating the ‘Dr Butler letter’.

"She then added a false declaration to the manuscript, which she subsequently submitted to the Journal along with an email containing yet further lies. That was all done in a blatant and wilful attempt to deceive Ms Overall ... into believing the contents of the correspondence to be true, that confirmation a Home Office Licence was not required had been obtained and all was therefore well with the submitted manuscript.

"There was no rush, or urgency to have the paper published and the actions were not done in a moment of panic. No doubt she had not planned the entire course of events in advance, but instead reacted to each new obstacle that came her way, but her overall course of dishonest conduct spanned over three weeks.

“The Committee was well aware of the impact and ramifications for Dr Dyson of any decision to remove her from the Register but had to weigh her interests with those of the public.

"In doing so it took account of the context and circumstances of the case, all matters of personal mitigation, as detailed above, Dr Dyson’s undoubted distinguished international career and reputation and the need to act proportionally.

"However, for all the reasons given above, the Committee was of the view that the need to uphold proper standards of conduct within the veterinary profession, together with the public interest in maintaining confidence in the profession of veterinary surgeons, meant that a period of suspension would not be sufficient and that the only appropriate and proportionate sanction in all the circumstances of this case was that of removal from the Register."

Glasgow-based Roundhouse Referrals is urging veterinary surgeons to be on guard for easily overlooked lateral humeral condylar fractures (LHCFs) in French Bulldogs.

Ross Allan (pictured right), an RCVS Advanced Practitioner in Small Animal Surgery at Roundhouse, said: "It is well recognised that French Bulldogs have breed-related problems, specifically Brachycephalic Obstructive Airway Syndrome (BOAS), yet they remain one of the most popular dog breeds of the moment.

"Through the work we do with French Bulldog charities and the large number of BOAS procedures we undertake, we encounter many of this breed and recognise the frequency and challenges in diagnosing lateral condylar fractures in French Bulldogs.

"We are keen to highlight the ‘red-flags’ for vets faced with French Bulldog forelimb lameness, and hope these will assist vets in diagnosing these common fractures:

1. Age: most lateral humeral condylar fractures occur between 3-4 months of age.

2. Trauma: in 90% of cases the trauma is minor; a fall from the arms, or tumble off the bed.

3. Non-weight bearing: a French Bulldog presents with a non-weight bearing lameness X-rays are required even if no fractures are obvious on palpation.

4. Physical: feel for the medial and lateral epicondyles of the humerus. If they are not in line with each other there will be a fracture (in LHCFs the lateral condyle will generally move proximally).

5. X-rays: perfect positioning for X-rays is essential to pick up these fractures. Slight rotation can ‘hide’ small, or incomplete fractures.

"We urge vets to be mindful of LCHFs when presented with a French Bulldog with a forelimb lameness and recommend that they add this condition to their differential list. Swift diagnosis greatly simplifies the surgery required and improves the likelihood of a successful outcome.

"French Bulldogs are well-muscled, stoical dogs, so these fractures are often problematic to detect on clinical examination. The key point when undertaking a medical examination of French Bulldogs is that vets feel for the medial and lateral epicondyles of the humerus to assess if they are in perfect alignment: if one is higher than the other, this suggests a fracture; even if a fracture is not readily visible on X-ray.

"And great care must be taken to ensure that X-rays are positioned perfectly because if the elbow is rotated – even slightly – these fractures can easily be overlooked. They are good at hiding!"

Roundhouse Referrals says it has recently treated several French Bulldogs with lateral humeral condylar fractures deploying various surgical techniques: usually a transcondylar lag screw along with a supracondylar K-wire, or additional supracondylar positional screw or plate.

To make an enquiry or refer a patient contact Roundhouse Referrals at 0141 649 1316 www.rhr.vet

Virbac has announced the launch of Epirepress (phenobarbital) for the treatment of epilepsy in dogs, designed to make dosing and dispensing easy and accurate for practice staff and owners. 

Virbac says phenobarbital is the only medication licensed to treat both idiopathic and structural epilepsy, and that it provides clinical improvement in 85% of cases.¹ 

Epirepress is offered in the conventional 60mg tablet strength, which can be split into two or four so dosing can be tailored to the needs of individual patients. 

EpiRepress is the first epilepsy treatment to be offered in easy-to-dispense boxes of 30 tablets, removing the need for the practice team to count out tablets from larger pots – a process which can now be done without the need to handle individual tablets. Virbac says the smaller box size also makes the purchase price more manageable for clients.

Virbac has produced a range of client and marketing materials to support the use of EpiRepress, including an epilepsy diary, a folder to keep the diary and extra materials in one safe place, and a diagnostic and treatment poster for practices. 

Virbac Product Manager Sarah Dixon MRCVS said: "The prevalence of canine epilepsy means that most practices are seeing at least one case a week.²  Phenobarbital is the mainstay treatment for canine epilepsy and, in developing our product, we wanted to offer practices and owners an easier, more accurate and more cost-effective solution.¹  EpiRepress, with its divisible 60mg tablets and smaller box size, is the result and we are delighted to be able to launch it. 

"We are focused on supporting practices and owners with compliance so have also developed a novel practice support package for EpiRepress. It offers the latest guidance to both vet practices and pet owners on the diagnosis, treatment and management of this challenging disease."

References

1. Podell, M., Volk, H. A., Berendt, M., Loscher, W., Munana, K., Patterson, E. E., & Platt, S. R. (2016). 2015 ACVIM Small Animal Consensus Statement on Seizure Management in Dogs, Journal of Veterinary Internal Medicine, 30, 477-490.
2. IVETF (2015). International Veterinary Epilepsy Task Force Consensus Reports.  Available at: www.biomedcentral.com/bmcvetres/series/IVETF_consensus_reports.

Vets4Pets has announced that it is piloting a 'revolutionary' new 24/7 service at its practices in Rayleigh in Essex, Rustington in Sussex and Bournemouth in Dorset.

The company says that clients of the new 24/7 clinics will be able to have their pets seen and treated at any time by the same team, with the same level of service and at the same price as daytime treatment.

Research carried out by Vets4Pets showed that pet owners struggle to fit visits into their busy working lives, so the 24 hour practices will offer consultations up to 10:00pm and allow clients to drop pets off early in the morning, before traditional practices open. 

In addition, the 24/7 clinics will see emergency and routine cases around the clock at no extra cost and will provide care for pets that need to be hospitalised overnight. Vets4Pets says that the practices are equipped with in-house surgical facilities, lab, pharmacy, digital x-ray and ultrasound, and will have a veterinary surgeon and nurse on-site at all times, so its clients will get the highest standard of care.

Clients of other practices within the group will also be able to use these facilities if their own vet feels their pet would benefit from overnight care and is within driving distance of a 24/7 practice.

Kirsty Bridger MRCVS, Joint Venture Partner at Rayleigh Vets4Pets said: “We have been telling our clients about 24/7 for the last few weeks and we have only received positive responses. The perceived increase level of service has been so well received and customers are delighted that we will be offering out of hours services with no extra charge. This is about listening to what our clients need and providing them with more convenience and excellent service however and whenever we can.”

Sally Hopson, CEO of the Vet Group said: “All of us at Vets4Pets are focused on leading innovation in the veterinary sector, and as our clients live increasingly busy lives, these 24/7 pilot practices are our way of helping them manage their hectic schedules, while also ensuring that pets in need of urgent treatment can be seen at any time. We are very excited about the potential of our 24/7 practices and our ability to offer customers extended quality, service and convenience of veterinary care.”

VetSurgeon.org asked Vets4Pets some questions about the new 24/7 practices:

VetSurgeon: Is V4P going to offer an OOH referral service to other practices?
V4P: As this is a pilot, initially Rayleigh will only be offering this service to other practices within the VetGroup. However, once we understand more about how the model works, we may open the service to other practices, particularly in areas where there are few or no other options for them to outsource OOH cover.

VetSurgeon: How is V4P able to offer OOH consultations at the same price as daytime consults?
V4P: At Vets4Pets we care about offering our clients the best service we can. We believe that it's important that clients can access veterinary care at all times of the day or night without prohibitive surcharges. The 24/7 business model is built around this concept. This is clearly a significant change from the traditional way of thinking about out of hours care within the industry and we think clients and their pets will benefit.

VetSurgeon: How will it affect the quality of life of the vets & nurses working at the practices?
V4P: We have thought carefully about the rotas that the vets and nurses will be working. We've looked at best practice within the veterinary industry and in other industries which work around the clock and we have developed guidelines based on these benchmarks which will then be flexed depending on the requirements of each individual team.

VetSurgeon: Does V4P think others will follow?
V4P: We hope this is something that will expand across our own group once we've completed the initial pilot phase. We believe it's the right thing to do for our clients and for their pets. This is a new way of thinking about out of hours care and we're lucky to be able to work with forward thinking Joint Venture Partners who are putting their clients at the centre of their thinking. If others follow the model, that can only be a good thing for pet owners and for pets.

VetSurgeon: Does this threaten Vets Now?
V4P: We work with Vets Now in many of our practices and we hope to continue to have a positive working relationship in the future. VetsNow have a different and well established business model. Our objective is simply to offer our clients and their pets the best levels of care that we can by being able to provide them with the same level of service at the same price at any time of day or night.

MSD Animal Health has launched HomeAgain Thermochip, a new identification microchip which incorporates a temperature biosensor which measures the cat or dog's subcutaneous temperature.

MSD says the new chip is compliant with ISO standards, has proven temperature accuracy¹ and as yet is the only microchip on the market that combines identification and temperature monitoring.

The HomeAgain Thermochip has been designed to work for the lifetime of the pet, and it's being launched alongside the HomeAgain Pet Recovery Database, which is free of charge.

Michael Morrow BSc BVSc MRCVS, Director of St Vincents Veterinary Surgery in Wokingham, has been involved in trials of the new chip. He said: ''The launch of HomeAgain Thermochip is a real game-changer in the market.  

“We have been trialling the Thermochip for some time and it’s now our default option to measure temperature.

"It’s incredibly useful in everyday practice, particularly when it comes to fractious cats or extremely nervous dogs, and it improves efficiency in consultations.

"We also use the Thermochip extensively during anaesthetic and post operative monitoring – with minimal handling.

“Reassuringly, we’ve never had any issues with the microchip reader or with the chip migrating to other parts of an animal’s body so it’s very reliable.” 

In addition to the benefit of being able to measure temperature in a non-invasive way, MSD points to recent studies which suggest that a pet’s ‘normal’ temperature is not a specific number, rather a range of values that depend on numerous factors such as the time of day, the site of measurement, sex, breed, size, age, activity and stress levels².

The HomeAgain Thermochip makes it easier to take multiple temperature readings easily over time, thereby establishing a pet’s individual temperature range.

For animal identification, the microchip works in much the same way as other microchips. 

Once the owner registers their pet’s microchip with a recovery database, their animal – in theory – can be traced if lost.

The reality is often different, because owners' contact details are frequently out of date, making it difficult to reunite pets. 

MSD says it aims to have the most comprehensive reunification platform, with a database which:

• is free (including registration, transfer of keepership and updates on contact details)
• comes with 24/7 UK-based support to help owners locate their pet if they go missing
• provides regular prompts to encourage owners to keep their contact details up-to-date
• allows multiple contacts to be registered against a microchip
• Does not share data with third parties.

For more information, visit: homeagain.co.uk 

Reference

1. An independent laboratory study was conducted to evaluate the accuracy of the temperature-sensing identification microchip. The trial collated the microchip temperature values from 10 HomeAgain Thermochips and from 4 thermometers of different brands. Temperature values were collected at every 0.5 °C between 33 °C and 43 °C. Similar temperature values were recorded, with a difference range varying between 0.00 °C to 0.18 °C.
2. Bragg RF et al. (2015). Evaluation of the effects of hospital visit stress on physiologic variables in dogs. J Am Vet Med Assoc;246:212–15;
   Piccione G et al. (2010). The daily rhythm of body temperature, heart and respiratory rate in new born dogs.
   J Comp Physiol;180:895–904;
   Piccione G et al. (2011). Association between obesity and reduced body temperature in dogs. Int J Obes;35:1011–18;
   Ready AE & Morgan G. (1984). The physiological response of Siberian Husky dogs to exercise: effect of interval training. Can Vet J;25:86–91;
   Refinett R & Piccione G. (2003). Daily rhythmicity of body temperature in the dog. J Vet Med Sci;65:935–37

Reading-based Walter Dingemanse has been struck off by the RCVS Disciplinary Committee after he was convicted by Oxford Magistrates’ Court and subsequently sentenced at Oxford Crown Court for possessing indecent images of children and extreme animal abuse, or "dog porn" according to Wales Online.

The Committee heard that Mr Dingemanse had one conviction relating to four separate offences committed in 2019 of making indecent photographs of a child Category A, B and C and possession of 22 extreme pornographic images that were grossly offensive.

He had been sentenced at Oxford Crown Court to eight months’ imprisonment, suspended for 24 months, directed to sign the sex offenders register for 10 years and fined £420 for prosecution costs and £140 victim surcharge.

The Committee were presented with evidence taken from the transcripts of Dr Dingemanse’s Crown Court sentencing hearing.

The transcript outlined that Dr Dingemanse used an online messaging service to engage in conversations about child sexual abuse under a pseudonym. According to Wales Online, the conversations related to children as young as four.

His IP address was traced and he was arrested on suspicion of possessing indecent images of children.

Counsel for the College submitted to the Disciplinary Committee that the nature of circumstances of the offences rendered Dr Dingemanse unfit to practise as a veterinary surgeon. 

In its decision relating to Dr Dingemanse’s fitness to practise, the Committee described Dr Dingemanse’s behaviour which led to the conviction as “inexplicable” and “abhorrent”, and that his possession of the images of children and animals was “disgraceful conduct of the most grievous and reprehensible kind.”

The Committee did not consider that there were any mitigating factors in the case, but did consider there to be several aggravating factors including: actual (albeit indirect) injury to an animal or child; the risk of harm to an animal or child; lack of integrity for a regulated professional to have behaved in such a way; premeditated conduct; and, that the offences involved vulnerable children and animals.  

Cerys Jones, chairing the Committee and speaking on its behalf, added: “Dr Dingemanse’s conduct was [also] liable to have a seriously detrimental effect on the reputation of the profession and to undermine public confidence in the profession.

"The fact that he was a veterinary surgeon was made clear at the Crown Court hearing.

"The Committee considered that members of the public would rightly be appalled that a registered veterinary surgeon had committed offences of this nature.”

When deciding on the appropriate sanction, the Committee took into account all of the evidence, including Dr Dingemanse’s expression of remorse and steps towards rehabilitation.

Mr Dingemanse's solicitor invited the Committee to consider suspending Dr Dingemanse from the Register as his client’s sanction, but the Committee did not feel that this was appropriate.

Cerys Jones added: “The Committee considered that suspending Dr Dingemanse’s registration would not be sufficient to maintain confidence in the profession and that therefore, for public interest reasons, as well as animal protection, a suspension would not be sufficient.

"Committee was of the view that the nature and seriousness of Dr Dingemanse’s behaviour, which led to the conviction, was fundamentally incompatible with being registered as a veterinary surgeon and that all of the above matters listed were applicable in this case.

"The Committee decided that the only appropriate and proportionate sanction in this case was removal from the Register.”

Dr Dingemanse has 28 days from being notified of his removal from the Register to lodge an appeal with the Privy Council.

The Committee’s full findings can be viewed at www.rcvs.org.uk/disciplinary

A joint statement issued by the RCVS and the BVA with updated guidance for the professions about working during the coronavirus pandemic has led to an outcry on social media and highlighted flaws in the structure of the veterinary profession. 

Earlier this month, the government had exempted veterinary surgeries from the requirement to close their doors during the pandemic. Strictly speaking, the exemption meant that practices could carry on offering the same level of service as before, provided they followed further government guidelines on social distancing.

However, the College then advised that non-essential treatments should not be carried out until further notice, and that animals should only be seen in emergency, or if their health was likely to deteriorate as a result of inaction.

This included vaccination, where RCVS advice stated that whilst routine vaccinations were considered not urgent, there "may be scenarios where, in your professional judgement, vaccines are being given to reduce a real and imminent risk of disease; this includes in the face of an animal disease outbreak, or in a scenario where part of a vaccine course has been given and the animal may be exposed to the disease." 

The updated College guidelines, issued last Thursday evening, appeared little changed, except to say that its advice concerning vaccinations is under review. Meanwhile, its new flowchart gives a very clear framework for veterinary professionals to work within, essentially leaving it to your own professional judgement to weigh up the risks.

However, the BVA went further, declaring amongst other things, that:

Vaccinations – we are now recommending that primary vaccinations and year 1 boosters in dogs and cats go ahead due to the increased risk of disease outbreak over a longer period of time, and annual leptospirosis vaccination due to the zoonotic risk. If additional component of the core vaccine is due at the same time, it should also be administered. In addition, we’re recommending rabbit vaccinations go ahead due to the seasonal disease risks. Rabies vaccinations should be carried out if required for certification reasons

.... leading to an outcry that the BVA's advice appeared to be being relaxed at precisely the point when the government is imploring the public to stay at home, and that:

• it must have been the result of pressure from corporate veterinary businesses which are taking a severe financial hit from the loss of vaccination sales,
• that it would lead to veterinary surgeons being forced by their (probably corporate) employers to work when they believe it is wrong to do so,
• that it would put unnecessary strain on practices that are struggling to look after urgent case with reduced staff,
• that it would lead to pressure from the public to carry out non-essential vaccinations,
• that it would cause Vesuvius to erupt and the oceans to boil.

To add further fuel to the flames, the British Small Animal Veterinary Association then issued a statement to the effect that it had not been consulted during the preparation of the new BVA guidelines, which BVA past President Robin Hargreaves felt was so economical with the truth that he resigned his BSAVA membership on the spot.

COMMENT
At the end of it all, there is but one simple truth for every veterinary surgeon who is working in these difficult times, and it is this: The government and the RCVS guidance gives you the freedom to exercise your professional judgement concerning whether or not an animal needs to be seen for whatever reason. Provided you can explain why you reasonably concluded that an animal should or should not be seen, that is all that matters. It trumps everything else.  

This whole farago has highlighted a number of important issues in the profession, starting with the social media conspiracy theories that the new guidance came after pressure from corporate practices when as far as I can tell, it appears to have been driven by a genuine concern that that failure to vaccinate could cause significant welfare issues in the future.

That seems a reasonable argument, and very much in line with the College advice. But that in turn raises a far bigger question, which is what on earth the BVA (a voluntary membership organisation) was doing issuing what appeared to be instructions ostensibly for all members of the profession. Notwithstanding the fact that BVA recommendations have no legal weight, having all these chefs running around with different recipe books is itself a recipe for muddled communications and confusion over leadership.

In turn, that raises the even bigger question of what the BVA's role should be. Should it be snuggling up in bed with the RCVS, issuing joint edicts? Or should it instead be holding the College to account, challenging its decisions and demanding clarification where clarification is necessary. I would argue the latter. In this situation, the ONLY organisation issuing guidelines about vaccinations for practising vets should be the regulator. And it is the role of the BVA to challenge those guidelines if necessary, or to demand clarification.

Which leads me on to the next thing, which is that increasingly, members of the profession seem to demand explicit rules or guidelines to operate within. There are lots of hypotheses for why this might be true. Perhaps because we live in a more (or seemingly more) litigious world and veterinary professionals like the reassurance rules provide. Perhaps it is because the younger cohort of vets lack the self-confidence needed for decision-making. Perhaps corporatisation has a part to play, in that employees of larger organisations tend to play more by the rules. Or perhaps it is a consequence of the growth in the 'refer everything’ culture which means vets take fewer clinical risks.  

Whatever the reason, it seems clear that in some cases, the RCVS tack of "you're a professional, decide for yourself" is perfectly reasonable, whereas on other occasions, such as Schedule 3, more explicit guidelines are demonstrably necessary. Once again, surely the role of the BVA as the "Voice of the profession” is not to issue its own advice, but to press the College for more explicit guidelines as necessary.

Lastly, there is the role of Facebook in all of this. Quite obviously vets are no more immune to conspiracy theories than members of the public who think that coronavirus is spread by 5G telephone masts. Sadly, the truth is usually far less exciting. However, the problem at the moment is that the growth in social media and Facebook groups has left the regulator and the representative associations on the back foot, such that it is often left to individuals from those organisations who 'happen to come across OK online' (rather than having any properly defined role) to firefight.

Photo: https://www.scientificanimations.com/wiki-images/

The Royal Veterinary College has published the results of a study which has found that rottweilers are the breed most predisposed to suffer from osteoarthritis.

For the study the RVC used VetCompass, its pioneering technology which analyses the veterinary records of 10 million animals from 1,000 veterinary practices in the UK and is now the world’s largest research database of anonymised clinical records.

The college says this made the study the largest-ever conducted into osteoarthritis in dogs under veterinary care – covering 455,557 dogs.

The study found that: 

• Rottweilers are the breed most prone to osteoarthritis, with the Old English Sheepdog and Dogue de Bordeaux also being very prone to the condition.  

• The large population of Labrador Retrievers in the UK makes them the most commonly treated breed for osteoarthritis in the UK.

• 2.5% of dogs involved in the study had osteoarthritis (which would equate to a total of around 200,000 dogs in the UK).

• Dogs that were above average weight for their breed were nearly 2.3 times more likely to be diagnosed with the condition.

• Males dogs were 1.2 times more likely to have osteoarthritis than female dogs. 

• For treatments: Weight loss was recommended in 25.5% of cases, exercise restriction was advised in 18.8% of cases and in 4.8% of cases the dogs underwent surgery following the condition.

The RVC says that on average, dogs receive their first diagnosis by the age of 10.5 years. Of the dogs who are diagnosed with osteoarthritis, 75% of cases are recommended to remain on medication as a form of pain relief.

It is hoped that this research will improve diagnosis times, which will enable dogs suffering from osteoarthritis to be treated faster.

Dr Dan O’Neill, RVC Senior Lecturer and co-author said: "Breed predisposition to disease is now recognised as one of the biggest problems facing dogs. Studies of huge populations, such as this one, are giving us vital insights into breed-related health problems in dogs that would have been impossible before VetCompass. This study has enabled us to positively support changes in dog welfare."

Reference

Anderson KL, O'Neill DG, Brodbelt DC, Church DB, Meeson RL, Sargan D, et al.: Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Scientific Reports 2018,8(1):5641.

Photo: Dog hip arthritis. Richard Meeson. 

Alberto Fioletti has been struck off by the RCVS Disciplinary Committee after being jailed for life for the murder of his former partner, a veterinary nurse. 

Mr Fioletti was found guilty of the murder of Stephanie Hodgkinson at Bournemouth Crown Court in January, and was sentenced to life imprisonment with a minimum 15 years.

The hearing for Dr Fioletti took place on Thursday 6 June, with the Committee deciding to proceed in his absence after Dr Fioletti said in correspondence that he did not want to attend the hearing nor be otherwise represented.

The Committee found the facts of the case proven by the certificate of conviction and went on to consider whether the conviction rendered Dr Fioletti unfit to practise as a veterinary surgeon.

Aggravating factors in terms of fitness to practise included the fact that it was an offence involving violence and loss of life and the injuries caused by Dr Fioletti to Ms Hodgkinson.

The sentencing remarks, which were cited during the disciplinary hearing, also made clear the devastating impact that Dr Fioletti’s actions had on Ms Hodgkinson’s family, including her two young children.

Paul Morris, chairing the Committee and speaking on its behalf, said: “The Committee considers that, when consideration is given to the ferocity of the attack on Ms Hodgkinson and the number of stab wounds she suffered, when taken together with the finding by the sentencing judge, who presided over the trial, that the respondent “represent[ed] a significant danger to any female with whom you find yourself in a relationship”, members of the public would find it abhorrent for a veterinary surgeon to have acted in this way and would be concerned at the risk the respondent posed to some members of the public.

“This Committee considers that the offence of murder is so inherently deplorable and shocking that it must constitute conduct falling far short of that to be expected of a member of the profession; and is certainly liable to bring the profession into serious disrepute and undermine public confidence in the profession.” 

The Committee then went on to consider the most appropriate and proportionate sanction for Dr Fioletti.

In terms of the aggravating factors in this case, Mr Morris said: “The misconduct in this case relates to a savage, sustained and ferocious attack with a weapon on a defenceless woman in her own home.

"His victim trusted him to be in her home.

"He knew that she was the mother of two young sons, of whom she had custody, and to whom he knew she was devoted.

"He would have known that the effect of his attack on her would have devastating consequences for her sons and her other close relatives – and it did.

"This conduct constitutes disgraceful conduct of the most egregious and reprehensible kind.

“The Committee also considers that the misconduct raises serious concerns about the reputation of the profession in the eyes of right-thinking members of the public.

"This was abusive and controlling conduct of the worst kind and conduct of which the respondent had been guilty of in past relationships, as the sentencing judge found.

"Such acts by their very nature run contrary to the very essence of the practice of the profession of veterinary surgery, which is intended to protect and enhance the welfare and well-being of animals and of work colleagues.”

In mitigation the Committee noted that Dr Fioletti had no previous criminal history and had a hitherto unblemished career as a veterinary surgeon.

The Committee found that only complete removal from the Register was appropriate in this case.

Paul added: “The Committee has reached the conclusion that the respondent’s behaviour is fundamentally incompatible with being a veterinary surgeon.

"The respondent’s behaviour was so serious that removal of professional status and the rights and privileges accorded to that status is considered to be the only means of protecting the wider public interest and of maintaining confidence in the profession.”

The Committee expressed its condolences to the family of Stephanie Hodgkinson for their incalculable loss.

https://www.rcvs.org.uk/concerns/disciplinary-hearings 

Ayrshire-based John Hendrie Smith has been struck off by the RCVS Disciplinary Committee after it found allegations of a number of charges in relation to his euthanasia of a dog proven.

In total Mr Hendrie Smith had faced eight charges against him, all of which related to him undertaking the euthanasia of a German Shepherd named Bouncer during a home visit in January 2017.

The charges alleged that when John Hendrie Smith undertook the euthanasia of Bouncer he had:

1. failed to ensure he was sufficiently prepared for the euthanasia in that he failed to attend the visit with a muzzle and failed to attend with any sedative and the means of administering sedative;

2. failed to delay the euthanasia until he was in possession of the above items;

3. undertook the euthanasia by means of an injection without first sedating Bouncer;

4. failed to provide Bouncer’s owner with an adequate explanation of the procedure. Including:

a. failing to explain that the procedure involved an attempt at injection directly into the heart;

b. failing to explain that an injection into the heart without sedation is (except in extreme circumstances) not an accepted means of euthanasia;

c. wrongly stated that Bouncer would not feel the injection;

d. failed to provide an explanation of the risks;

e. failed to explain the risks and signs of narcotic excitement;

f. failed to explain the risks of injection into the heart without sedation;

5. failed to obtain Bouncer’s owner’s informed consent for the procedure;

6. failed to make any clinical records in respect of the procedure;

7. provided inadequate veterinary care to Bouncer and caused him unnecessary suffering; and

8. failed to communicate with Bouncer’s owner.

Having considered evidence about the case from Bouncer’s owner, his owner’s former partner, two expert witnesses and Mr Hendrie Smith, the Committee found all of the charges against Mr Hendrie Smith proven, with the exception of charge 4(e) on the grounds that there was insufficient evidence against him on this particular charge.

In considering whether the charges that were found proven amounted to serious professional misconduct, the Committee heard further evidence from the College’s two expert witnesses, and submissions from both the College and Mr Hendrie Smith. Having considered the evidence and submissions, the Committee concluded that in relation to each of the charges found proven, Mr Hendrie Smith’s conduct had fallen far below that which was to be expected from a veterinary surgeon and was therefore serious professional misconduct.

The Committee went on to consider what sanction was appropriate following its earlier findings against Mr Hendrie Smith. The Committee took into account a number of mitigating and aggravating factors. In mitigation the Committee considered that this was a single, isolated incident and that Mr Hendrie Smith had been a practising veterinary surgeon for 65 years and had an otherwise unblemished career with no adverse professional findings against him. It also took into account testimonials from professional colleagues, clients and his local community.

However, the Committee also considered the aggravating factors which included actual injury and unnecessary suffering to an animal, a blatant disregard of the systems that regulate the veterinary profession including the RCVS Code of Professional Conduct and its supporting guidance relating to euthanasia, informed consent, preventing unnecessary suffering and working within one’s area of competence.

In explaining its decision to direct his removal from the Register of Veterinary Surgeons, the Committee noted Mr Hendrie Smith’s lack of insight into his behaviour, which included denying that he was at fault, challenging several of the Committee’s findings and disputing that an intracardiac injection into the heart of a dog without administering sedation or anaesthesia was wholly unacceptable, despite expert opinion to the contrary.

Chitra Karve, chairing the Committee and speaking on its behalf, said: "The respondent, in his oral evidence, admitted that he was not really a small animal vet, and had not been dealing regularly with small animals for a significant period of time. His specialisation in recent years was with large farm animals. The Committee considered that the respondent had, and still has, no concept of the difficulties now recognised as inherent in the procedure he performed, or the risks of pain and suffering it posed to the animal."

She added: "The Committee has found that the respondent’s conduct in attempting an intracardiac injection without prior sedation or anaesthesia caused appalling pain and suffering to Bouncer, as evidenced by his screaming, and was wholly unnecessary. The respondent accepted that he had a sedative in his car, but chose not to postpone attempted euthanasia so that he could sedate his patient first.

"The respondent explained in his oral evidence that he had, in the past, euthanased over 200 dogs by intracardiac injection without sedation or anaesthesia. The Committee concludes that this was the respondent’s customary method of euthanasia, and he did not understand why it was wholly unacceptable for a reasonably competent veterinary surgeon to carry out euthanasia in this way. Given his lack of insight, the Committee considers that there is a risk that, if the respondent were to be asked to euthanase a dog in the future, he would be likely to use his customary method, and thereby cause injury and suffering to another animal."

In determining the sanction the Committee decided that, because there had been a serious departure from the professional standards set out in the Code, serious harm was caused and there was a serious risk of harm to animals in the future, that removing Mr Hendrie Smith from the Register was the only means of protecting animals and the wider public interest.

Mr Hendrie Smith has 28 days from being informed of the Committee’s decision to make an appeal to the Privy Council.

Dechra Veterinary Products has launched Pre-Vetoryl Cortisol (PVC) monitoring, an alternative method of monitoring dogs that are being treated for Cushing’s syndrome.

The company says the new method, which was developed with Professor Ian Ramsey at the University of Glasgow, has been introduced following recent studies that showed a lack of correlation between ACTH stimulation test results and the clinical status of dogs treated with Vetoryl ^1,2

Craig Sankey, Brand Manager at Dechra Veterinary Products, said: "Vetoryl is a medicine that will normally deliver major clinical benefits to a patient with canine Cushing's syndrome but finding a stable, long-term dosing regimen can be hard if ACTH stimulation tests return varying results.

"Pre-Vetoryl Cortisol monitoring is a reliable alternative to traditional ACTH stimulation tests for several reasons. It predicts clinical signs better, gives more consistent results, is less expensive and is easier to perform.

"Our online guide gives veterinary professionals a detailed insight into how they can integrate PVC into their treatment plans and the benefits it can bring to their patients and practice."

Information about Pre-Vetoryl Cortisol monitoring is now available at www.dechra.co.uk/prevetorylcortisol, together with other resources for patients on Vetoryl.

Dechra also hosts a website for owners whose pets have been prescribed Vetoryl: www.canine-cushings.co.uk.

References

1. WEHNER A. GLOECKNER S., SAUTER C., KRUSE D., STOCKHAUS C. & HARTMANN, K. (2013) Association between ACTH stimulation tests, clinical signs, and laboratory parameters in dogs with hyperadrenocorticism treated with Vetoryl. (Abstract) European College of Veterinary Internal Medicine Congress, Liverpool
2. MACFARLANE l., PARKIN T., RAMSEY I. (2016) Pre-trilostane and three-hour post trilostane cortisol to monitor trilostane therapy in dogs Veterinary Record 179 (23): 597