A new expert panel has been formed to evaluate pain management in canine osteoarthritis following a recent shift to a more integrated approach to pain and disease research.

In the past, pain and joint disease have been considered as separate areas of research, with pain perceived simply as a consequence of disease. Over the last few years, however, it has become increasingly apparent that the relationship is far more complex and that pain may be a driver of disease rather than just a consequence of it. The expert panel hopes to apply the new knowledge to the management of joint pain in veterinary practice.

The panel, which had its inaugural meeting in Paris recently, brings together acknowledged veterinary experts in the fields of pain and joint disease. Its focus will be on the assessment and management of pain in canine osteoarthritis (OA), with the objective of educating veterinary surgeons to better understand and manage pain in canine OA and thereby improve the well-being of pets that suffer from this common disease.

'Central sensitisation' is one of the latest theories that has been suggested to explain the complex interaction between pain and disease progression in canine OA. Duncan Lascelles, Associate Professor of Surgery at North Carolina State University, said that research has shown that the components of the pain pathway can change in response to a pain stimulus. Pain receptors 'up-regulate' in response to painful stimuli and become more sensitive to subsequent pain.

CNS sensitisation is likely a significant contributor to chronic or maladaptive pain; this pain leads to decreased mobility, reduced muscle support and reduced muscle function, thus leading to disease progression. In other words, joint diseases cause pain, which in turn feeds back to create more disease.

Professor Lascelles said: "The link between the clinical signs associated with OA and joint pathology is not a simple one and may be much more complex than we have previously thought.

"There is some evidence that COX inhibition reduces central sensitisation. And some evidence suggests that reducing central sensitisation may have a modulatory effect on disease progression by reducing signals going out to the periphery.

"The relationship between pain and disease progression is a very new area of research, and is at the forefront of our knowledge of how pain and joint disease are linked."

Professor John Innes, Head of Division, Small Animal Studies, University of Liverpool Veterinary School, told the meeting that OA is likely to be one of the major reasons for euthanasia of pet dogs in Europe. He and two co-investigators have performed a systematic review of the published evidence for the use of long-term, continuous NSAID treatment (at least 28 days) in OA. They found that this form of management is associated with better outcomes than short-term NSAID therapy, with no evidence of additional safety issues. This review is to be published shortly.

The expert panel comprises:

Prof Dr Stuart Carmichael, Vets Now Ltd. Formerly at: Veterinary School, University of Glasgow, UK
Prof Dr John Innes, Small Animal Teaching Hospital, University of Liverpool, UK
Dr Bernard Bouvy-Centre, Hospitalier Vétérinaire de Frégis, Arcueil, France
Prof Dr Jean-Pierre Genevois, Ecole Nationale Vétérinaire de Lyon, France
Dr Carlos Macías, Centro Veterinario de Referencia Bahia de Malaga, Spain
Prof Dr Martin Kramer, Klinik für Kleintiere, Chirurgie , Justus-Liebig-Universität Gießen, Germany
Dr Sabine Tacke, Klinik für Kleintiere, Chirurgie, Justus-Liebig-Universität Gießen
Prof Dr Duncan Lascelles, North Carolina State University College of Veterinary Medicine, Raleigh, USA
Prof Dr Herman A.W. Hazewinkel, Faculteit Diergeneeskunde, Departement Gezelschapsdieren, Utrecht, Netherlands
Dr Emilio Feltri, Anaesthetist and specialist in Pain Management, Ambulatorio Veterinario Associato, Tortona, Italy
Dr Peter Vandekerckhove, Specialist Surgeon Companion Animal, Wondelgem, Belgium

The Practice Standards Group, which comprises representatives from all of the key veterinary and veterinary nursing organisations, has updated the standards of the Practice Standards Scheme and a draft of the new Manual is now available for comment.

The Scheme is a voluntary accreditation programme that aims to promote and maintain high standards of facilities and care within UK veterinary practices. When it was launched in 2005, a commitment was made that the standards would not change for five years, unless new legislation (such as the Veterinary Medicines Regulations) required it. Following a detailed review of the standards, to ensure they continue to be relevant to current veterinary practice, proposals have been made by the Group for new standards to be implemented during 2010. 

Jill Nute, Chairman of the Practice Standards Group said: "It is unlikely that any already-accredited practices will be required to invest in additional facilities or equipment to meet the new standards.

"Instead, greater emphasis has been placed on clinical outcomes and training. For example, performance review has been introduced for all clinical staff, including the Professional Development Phase for new graduates. We are keen to hear feedback on the proposed new standards."

One recommendation is that the 'tiers' should be dropped. The categories will retain their descriptive names, for example, Small Animal General Practice or Equine Veterinary Hospital. Feedback suggests that clients, and the profession, found the tiers to be misleading.

The layout of the Manual has been revamped, to include guidance that was previously available online. Guidance for each relevant standard can now be seen at a glance. There is also an icon to indicate if documentary evidence will be required by the inspector. In addition, the new format clarifies the derivation of each standard, so that legislative requirements are distinguished from those required under the RCVS Guide to Professional Conduct and those indicated by better practice.

Membership of the Scheme continues to grow, with 126 applications to join the Scheme in the first six months of this year, representing 264 premises, compared with 61 applications in the whole of last year. There are currently 2,351 practice premises under the ambit of the Scheme - approximately 50%.

The draft new Manual is online at www.rcvs.org.uk/consultations.

Hard copies are available from Eleanor Ferguson, Practice Standards Scheme Manager: e.ferguson@rcvs.org.uk or 020 7202 0720.

The deadline for comments is 31 August 2009. Responses will be considered by the Practice Standards Group at its September meeting and thereafter by Council in November.

The RCVS Trust is offering vets, veterinary nurses and their friends chance to win a stylish small car - and support this small charity - for a mere £2.00.

On offer in this better-than-the-average raffle is a Fiat 500, the 2008 European Car of the Year winner - and described by Jeremy Clarkson as "practical without being boring". 

You can buy tickets online at http://www.everyclick.com/rcvstrust until 21 August, or ask Sarah Briggs at the Trust (020 7202 0743 or s.briggs@rcvstrust.org.uk) for a book to sell to colleagues, friends and family.

Tickets will then be entered into the Small Charity Car Draw, organised by the Foundation for Social Improvement, with the Trust receiving over 95% of the ticket price. The draw will take place on 1 October 2009. 

Vetoquinol has made changes to Zentonil®, its liver support range for dogs and cats.

New Zentonil® is the UK's FIRST palatable and divisible tablet range of S-adenosyl-methionine (SAMe) supplementation and now comes with the added benefit of choice: Zentonil® Advanced which contains pure SAMe plus silybin and Zentonil® Plus which contains pure SAMe only.

A patent pending microencapsulation technique protects the SAMe from the harmful effects of stomach acid, even when the tablet is split or chewed.

The ability to split the tablets makes administration more accurate and also makes the product more cost-effective for clients.

Vetoquinol's new Zentonil® formulations have proven SAMe bioavailability curves in a market where this particular type of data is often lacking

Simon Boulton, product manager said: "Our customers told us that they had difficulties associated with SAMe supplementation.  We have listened to their comments and provided the solutions."

The new formulations will become available as wholesalers' Zentonil® stocks are depleted.  If you wish to try new Zentonil® now, you can place an order for Zentonil® Advanced or Zentonil® Plus with your wholesaler.

For more information, please contact your local Vetoquinol sales representative or telephone the free practice support number - 0800 1698197.

The Disciplinary Committee (DC) of the Royal College of Veterinary Surgeons has suspended a veterinary surgeon for a period of six months for issuing two false horse passports, having found him to have been “consciously dishonest”.

At a hearing which concluded on 15 July, Andrew Dominic Illing, Director of the Chapelfield Veterinary Partnership, Norwich, admitted charges of backdating the passports of two different horses on 1 May 2008, to indicate that they had been vaccinated on 24 April 2008 against equine influenza and equine influenza and tetanus, when he knew that the vaccinations had not been carried out on that date.

The Committee heard that, whilst on a routine visit to a local livery yard on 30 April 2008, a junior veterinary surgeon at the practice, Ms Charlotte Alice Mayers, had been pressured to backdate the equine passports of two horses, owned by Mrs Scriven and Mrs Kippen respectively, because their booster vaccinations had been carried out beyond the 12-month window prescribed by the Horse Racing Authority. Ms Mayers had declined to do so and had brought the passports back to the practice to seek the advice of its Director, Mr Illing.

Ms Mayers explained to Mr Illing, both in a note and in discussion with him, that the boosters had been administered outwith the prescribed period and that she had told the owners that she was not willing to backdate the passports, one of which she had already signed. The DC heard that Mr Illing had told Ms Mayers “not to worry about it” and that he would deal with the situation. It did not surface until the livery yard manager later made a complaint, that Mr Illing had in fact signed the second passport and backdated both to 24 April.

In mitigation, Mr Illing said that he had been under considerable stress at the time, as he had been dealing with a protracted and difficult disciplinary meeting concerning a senior veterinary colleague. As a consequence of this, the Committee heard from Mr Illing’s practice partner that Mr Illing was required to take on more work than he was already performing, which was already 10-15% more than the other three vets in the practice. In addition, Mr Illing had been in a degree of pain at the time, following a knee injury. The Committee also heard evidence from a veterinary surgeon who testified to Mr Illing’s good character; and received many written testimonials.

In reaching its decision, the Committee held the view that: “the public must be able to trust certificates which are signed by members of this profession. If the public cannot trust the authenticity of such certificates, the Committee considers that public confidence in the profession would be undermined, and undermined in a very significant way.” It also cited the obligations of the RCVS Guide to Professional Conduct in terms of the integrity of veterinary certification, and the ‘12 Principles of Certification’, as agreed by the RCVS, the British Veterinary Association and the Department of Environment, Food and Rural Affairs.

The Committee considered many factors when making its final decision. It did not accept that stress overbore Mr Illing’s normal way of dealing with certification, particularly where he had had a period of overnight reflection before taking the action that he did. However, it felt that the most troubling feature in his decision to backdate the certificates was that, in advising Ms Mayers on a difficult ethical issue, Mr Illing had “set a disgraceful example and wholly failed to provide her with the support to which she was entitled”. Furthermore, in backdating a certificate that Ms Mayers had already signed, he was putting her integrity at risk.

Alison Bruce, chairing the Committee, commented: “It is only by upholding the importance of each and every certificate issued by a member of the veterinary profession that public confidence in such certificates can be maintained.” She went on to say: “Without significant mitigating circumstances, false certification will result in removal from the Register. In Mr Illing’s case, having regard to all the evidence, both the oral and written testimonials, and taking into account all the aggravating and mitigating circumstances detailed above, the Committee has decided to suspend Mr Illing’s name from the Register for a period of six months.”

Vetoquinol UK is offering vets and nurses the opportunity to win a day's free CPD by entering its new Marbocyl^® P Challenge.

The challenge runs for three months with a prize each month for a veterinary surgeon's one day CPD voucher worth £300 and a nurse's one day CPD voucher worth £200 from Improve CPD.  There are also 10 runners up goodie bags available each month.

Each challenge focuses on knowledge of fluoroquinolones. July's challenge involves use in pyoderma, August's challenge focuses on respiratory tract infections and September's challenge will be on canine urinary tract infection.

Russell Roan, Vetoquinol's Veterinary Services Manager said: "Fluoroquinolones are an often-discussed antibiotic in the veterinary and medical world, but all too often they are mentioned as a class rather than as the individual molecules. This can cause the common misconception that all fluoroquinolones are the same. The Marbocyl^® P Challenge aims to address this misconception and to highlight the varied uses for fluorquinolones."

To enter, visit http://www.vetoquinol.co.uk/, click on the Marbocyl^® P Challenge banner at the top of the home page and complete the short quiz.

Veterinary surgeons who can keep it short and sweet have a chance of receiving an all (reasonable) expenses paid trip to BVA Congress this September.

The RCVS Trust is offering to pay the registration fee, plus travel, food and accommodation costs for two nights for two vets to attend the whole conference. 

The catch?  Would-be delegates must have graduated within the past eight years and be able to explain - in fifty words or less - how this support would benefit them educationally. 

Cherry Bushell, RCVS Trust Director said: "It is a bit of a light-hearted approach, however, the idea is to make relatively new vets think in a focused way about what they would get out of going to BVA Congress. They need to tell us how they will benefit educationally from the opportunity we're offering - it's not simply about financial need." 

Applicants should send an email to info@rcvstrust.org.uk before 24 August, with their name and contact details and convince the Trust, in fifty words or less, that they would get the most out of attending BVA Congress. Only the first 100 emails received by the Trust will be considered.  Registration fees will be paid directly to the BVA and all costs claimed must be reasonable.

The BVA 2009 Annual Congress will be held at the Mecure Holland House Hotel, Cardiff, from 24-26 September.  For more details visit http://www.bva.co.uk/events/BVA_Congress.aspx.

Ark Surgical has completed an exclusive agreement with Cory Bros, the UK's largest independent manufacturer and distributor of surgical devices and instrumentation, in order to offer a new range of operating theatre equipment and consumables.

This takes the range of products available through Ark Surgical to in excess of three hundred, including trocars, laparoscopic instruments, laparoscopic suction and irrigation systems, safe sharps management systems and operating theatre essentials.  

Gavin O'Brien, Marketing Director at Ark Surgical said: "This is exciting news for the veterinary community. Since launch, we have been told time and time again about the lack of choice and the high cost of surgical instruments and devices. This is a major step towards our goal of bringing greater choice and better value to surgeons and we are very excited that Cory Bros share our commitment and vision in achieving this."

Gary Hopkins, Sales & Marketing Director at Cory Bros said "We have an excellent track record for innovation, most recently with the development of our extensive range of premium quality, cost-effective Ultimate laparoscopic instruments and devices. Our progressive approach has enabled us to forge successful partnerships with forward thinking distributors, such as Ark Surgical, which has resulted in significant business growth and a far wider choice for healthcare practitioners, both human and animal."

For more information, see: http://www.arksurgical.co.uk/

Professor Sandy Trees has been invested as the new President of the Royal College of Veterinary Surgeons during RCVS Day, held on 3rd July. 

Sandy is an Edinburgh graduate, qualifying from the Dick Vet in 1969. After graduation, he undertook a mixture of research posts at home and overseas, plus a spell in general practice, before completing his PhD in 1976, also at Edinburgh. He then spent some time in the animal health industry before moving into academia in the early 1980s, starting as a lecturer in veterinary parasitology in Liverpool University's Faculty of Veterinary Science, based in the Liverpool School of Tropical Medicine. He was awarded a personal chair in veterinary parasitology and became Head of the Parasite and Vector Biology Division in 1994. Sandy held the post of Dean of Faculty from 2001 until 2008, and still teaches BVSc, MSc and PhD students.

Sandy's broad veterinary political experience includes spells on the BVA's Veterinary Policy Group and Education Group, President of the Association of Veterinary Teachers and Research Workers, Vice-President of the European College of Veterinary Parasitology and Chairman of the Heads of Veterinary Schools. Serving on RCVS Council since 2000 as one of the Liverpool veterinary faculty's appointed members, Sandy has been a member of the Education Policy and Specialisation, Planning and Resources, and Preliminary Investigation Committees.

RCVS Day also brought other changes to the RCVS Officer team: Jill Nute, outgoing President, became Senior Vice-President, Peter Jinman took up the role of Junior Vice-President, and Dr Jerry Davies was confirmed as Treasurer for another year.

Dr Bob Moore stood down as Senior Vice-President, with Jill Nute commenting that: "Bob has been an extremely valued member of the Officer Team and I would like to express my grateful thanks for the unstinting support he has given me during my term as President."

Retiring Council members included David Harding, Nigel Swayne and Brian Jennings, a Privy Council appointee.

As part of the AGM, newly-elected Council members Chris Tufnell and Chris Gray were welcomed. It was also announced that Professor Stephen May had been appointed for a further year by the Royal Veterinary College, Professor Stuart Reid had been appointed for a further four-year term by the University of Glasgow, and likewise Caroline Freedman by the University of Edinburgh. Dr Frank Taylor, whose role as Head of Bristol Veterinary School is due to conclude at the end of the month, will stay on Council until a successor is appointed.

The President then made her outgoing address, in which she described how she had been keen during her presidential year to ensure that the College is "open, approachable, accountable and transparent," citing the work of the Corporate Governance Group as a good example of activities to this end: "Under the guidance of Sir Anthony Holland, Chairman of the Group, we have robust procedures in place for managing conflicts of interest and have put in place arrangements to keep corporate governance under regular review," she said.

Discussing the activities of the College during the year, she made mention of work with the Veterinary Medicines Directorate to produce the Register of Veterinary Practice Premises and with the Office of Fair Trading regarding monitoring the reintroduction of prescription charges. She also touched on the review of the Practice Standards Scheme and the work of the 24/7 Working Party. She conceded that the College faced a challenge with regards to out-of-hours cover, which the majority of vets questioned in a recent survey would like to maintain: "The question is, how can this be achieved within the law [Working Time Regulations] and without a hike in charges that might, perversely, have a negative effect on animal welfare by reducing take-up of veterinary services?" she asked.

Finally, Jill paid tribute to the hard work of College and Trust staff, Council members and her fellow Officers: "One thing you learn as President is that you are just part of the bigger picture and things can only be achieved with the support and collaboration of those across the profession."

Incoming President Sandy Trees described Jill Nute as having "presided over the College with utter fairness and even handedness, working incredibly hard for the interests of the College and its members, certainly delivering on your aim for openness and accessibility". He looked forward to his own presidency with "honour, excitement and trepidation".

New research, conducted by the WALTHAM-initiated Laminitis Consortium, has raised questions over the assumption that soaking hay will make it safe to feed to laminitis-prone horses and ponies¹. 

The Laminitis Consortium comprises world-leading equine veterinary, nutrition and research experts interested in collaborating on the important topic of laminitis. It includes the authors of this work: Dr Pat Harris of the WALTHAM^® Equine Studies Group, Clare Barfoot of Mars Horsecare UK Ltd and Dr Annette Longland of Equine Livestock and Nutrition Services (ELNS).

Over-consumption of water-soluble carbohydrates (WSC) has been associated with the onset of laminitis. It has been recommended that hay with a non-structural carbohydrate (WSC and starch) content of less than 10% should be fed to obese animals as well as those at risk of laminitis² and that hay should be soaked in water before being fed in order to reduce the WSC^3,4,5.  The study, which was completed earlier this year, examined the loss of water-soluble carbohydrates from nine different hays submerged in water for up to 16 hours.  It was presented to the biannual Equine Science Symposium in America in May 2009.

Previous studies have shown that the prolonged soaking of chopped hay in large volumes of water can result in the leaching of nutrients, including soluble carbohydrates. However, because common practice in the UK tends to involve long-stemmed hay, soaked in relatively small volumes of water over varying timescales, the Laminitis Consortium's study aimed to replicate such a practice⁶.

The nine different hay samples were analysed for WSC and then soaked in cold water. The soaked samples were subsequently analysed at four intervals of 20 minutes, 40 minutes, three hours and 16 hours.

Clare Barfoot said: "The results showed a highly variable leaching of WSC and substantially less leaching than reported previously for chopped hay soaked for 30 minutes.³

"Very few samples reached below 10% WSC, despite prolonged soaking. The concern is that this strongly suggests that soaking may not be sufficient to render some hays safe to feed to horses and ponies prone to laminitis. 

"Our current advice is that ideally you should analyse your hay before feeding it to an animal at high risk of laminitis and choose hay with the lowest WSC content you can find. Soaking hay provides an additional safeguard but should not be relied upon."

The study also highlights that if hay is soaked for extended periods, it may not meet the nutritional requirements of the animal because substantial amounts of other nutrients, protein, vitamins and minerals will also be lost ⁵. In such cases it is even more important that the horse or pony should receive a balanced supplementary feed.

The Laminitis Consortium is continuing its work in this area and hopes to be able to identify practices that will be of greater benefit to the horse owner faced with hay of unknown WSC content.

¹Longland AC Barfoot C &  Harris PA  (2009) The loss of water- soluble carbohydrate and soluble protein from nine different hays soaked in water for up to 16 hours.  J. Equine Vet Science 29 (5 ) p 383 - 384, ² Frank  N Equine Metabolic Syndrome J Equine Vet Sci 29 (5) p 259 - 267, ³Cottrell, E., Watts, K., Duarte, S. and Ralston, S. (2005). Equine Science Symposium, 2005, ⁴Kenny, D. (2007). Proceedings of the British Society of Animal Science. ⁵Warr EM, Petch JL. Equine Vet Educ 1993;5:169-171, ⁶Longland, A.C. (2009) In preparation.

Petplan Equine is now seeking nominations for the Equine Vet of the Year Award 2009, an award to recognise vets that go above and beyond with their care of horses and their owners. 

Andrew Dobson of The Barn Equine and Large Animal Practice in Great Wakering, Essex, is the current 2008 Equine of the Year. He was nominated by a number of his grateful clients and their glowing testimonials impressed the judges enough to give him the edge over his closest rivals for the title.

The 37 year old qualified in 1999 and for the last four and a half years has run his own practice. His involvement with horses evolved from a desire to work with large animals and the outdoor life it would bring.

Andrew said: "I was absolutely stunned. I'm so honoured and amazed to have received the Petplan Equine Vet of the Year award. I really enjoy what I do and would like thank all my clients, Petplan Equine and The Animal Health Trust for their support."

If you feel you know a vet that displays equine clinical excellence and fantastic customer care you can nominate online by visiting www.petplanequine.co.uk/events Nominations close 3^rd October 2009.  An independent panel will judge the nominations and the winning vet will be announced at the Animal Health Trust UK Equestrian Awards in London, in November 2009.

CABI has given VetMed Resource, its online veterinary information service, a new look and some new features. See:  www.cabi.org/vetmedresource.

VetMed Resource is a database of over 1.3 million veterinary and animal science research records from 1972 to the present. CABI says searching the records has been made more user friendly with a new design, and improved navigation across the site.

Robert Taylor, Editor of VetMed Resource said: "This newly-launched VetMed Resource has been designed after consulting with practicing veterinarians from around the world. They provided feedback on usability, design, and research needs, and the new look reflects the changes suggested."

Fort Dodge Animal Health has launched PropoClear, a short-acting, intravenous general anaesthetic for dogs and cats.

The company believes that PropoClear, based on novel lipid-free micro-emulsion technology, will deliver significant clinical benefits over conventional lipid-based propofol emulsions, and will also deliver increased cost-effectiveness and convenience to practices.

PropoClear is indicated for use as a short-acting general anaesthetic for procedures lasting up to five minutes. It is also indicated for the induction and maintenance of general anaesthesia using incremental doses and for the induction of anaesthesia where maintenance is provided by inhalation. 

According to Fort Dodge, PropoClear's unique lipid-free, nano-emulsion formulation and its inclusion of antimicrobial preservatives provide the following key benefits to practices:

• Extended microbial stability
  PropoClear's formulation requires no lipid content and facilitates the inclusion of effective microbial preservatives to reduce the opportunity for microbial contamination. Fort Dodge says that its extended microbial stability has the potential to reduce the risk of post operative infections.
• Broached vial shelf life of 28 days
  Unlike conventional propofol emulsions which are susceptible to bacterial contamination and must be used or disposed of quickly, broached PropoClear vials have a shelf life of up to 28 days, which Fort Dodge says will improve clinic compliance and reduce waste.
• Presentation in multi-dose vials (50 and 100 ml)
  PropoClear, which presents as a virtually clear and colourless liquid, is the first product to be offered in multidose vials in a move to make it more convenient and cost-effective for practices, according to Fort Dodge. It has a shelf life of three years unopened.

Dr Jo Murrell, Department of Clinical Veterinary Science, Division of Companion Animals, the University of Bristol, said:  "With currently available lipid-based propofol formulations unused drug should be discarded immediately once the vial has been opened leading to drug wastage or the potential for bacterial contamination of the remaining solution if this regulation is ignored. The new lipid-free propofol formulation, which also contains antimicrobial preservatives, overcomes this limitation and will provide significant clinical benefits in terms of the 28 day shelf life once broached."

Matthew Rowe, Marketing Manager for Companion Animals at Fort Dodge, said:  "In developing PropoClear, it was our goal to deliver an anaesthetic product with the same proven efficacy as the existing solution but which offered significant benefits in terms of enhanced safety, cost and convenience.

"PropoClear contains the same concentration of the established active molecule and follows familiar guide dose protocols to ensure ease of use. We have been encouraged by the positive feedback received during product trials and believe the significant advantages its offers, both clinically and financially, to practices in challenging times, will ensure its rapid adoption by veterinary practices across the UK."