The BSAVA says there unique opportunities and risks to the use of antibiotics in rabbits.
For example, antibiotic combination therapy, which is discouraged in dogs and cats, can be safe and effective in this species.
Also, careful selection of appropriate antibiotics, in terms of active substance, dose and route of administration, is crucial when treating rabbits due to the risk of enterotoxaemia. The new guide gives advice on diagnosing bacterial infections, likely causal organisms and appropriate antibiotic and non-antibiotic management.
The guide covers dacryocystitis, ear disease, facial abscesses, enteritis, urinary tract disease, and upper and lower respiratory tract disease. John Chitty, one of the authors, said: “Choosing an antibiotic for rabbits is not simple.
"Their diseases do not necessarily mirror those of dogs and cats, and they do have gut sensitivities to certain antimicrobials.
"However, like dogs and cats, there are situations where antibiotics are not needed where we once thought they were.
"This is especially important in reducing antibiotic usage in rabbits and, of course, in reducing use of critically important antibiotics in them as well.
"We hope this guide will help practitioners to see when antibiosis is needed, what choices are available and how to sample and select the most appropriate drug if needed.” The new guide is free to all and can be accessed at bsavalibrary.com/protectme.
The advice includes buying healthier breeds, not overfeeding, and reducing the amount of toys and accessories people buy for their pet.
BVA members can download other resources to help start conversations with clients, including a poster, which can be displayed in practice, and social media graphics.
British Veterinary Association Senior Vice President Dr Anna Judson said: “We know many vets are concerned about the role the veterinary profession has in protecting the planet, with our Voice of the Veterinary Profession statistics showing 68% of vets feel that vets are either very responsible or quite responsible for prioritising and leading on environmental issues.
"It’s also clear that many pet owners are becoming more interested in being more sustainable and the impact of their pets on the world.
"This new resource aims to support vets to have those conversations with clients and inspire them to become more sustainable pet owners, right from the moment of choosing what pet to welcome into their family.”
https://www.bva.co.uk/resources-support/client-guides/pet-sustainability
The aim of the tool is to enhance the confidence of veterinary professionals in deciding when to prescribe and when to withhold antibiotics.
The tool is the next step in the PROTECT ME initiative, the core of which is the BSAVA/SAMSoc Guide to Responsible Use of Antibiotics: PROTECT ME guide in the BSAVA Library and the accompanying ‘Antibiotic use in our practice’ poster.
The current demo version of the tool provides advice on gastrointestinal infections.
Work is underway to cover all areas of the PROTECT ME guide.
Cameron Shuttlewood, Production Editor at BSAVA said: “Responsible use of veterinary medicines is key in supporting One Health and in retaining the right to prescribe antibiotics that are important in human medicine.
“We are pleased that the small animal veterinary community is embracing the importance of antibiotic stewardship, and we want this tool to make it quick and easy to follow existing evidence-based guidance.”
The full PROTECT ME guide, including printable posters and non-prescription forms, is available from www.bsavalibrary.com/PROTECTME.
BSAVA members can request free printed copies of the poster for their practice.
Non-members can purchase copies from www.bsava.com/shop for £5.
bsava.fillout.com/protectme
Acoording to news reports, a government minister has said that a package of measures to encourage responsible pet ownership is on the way, and that may include compulsory microchipping.
Replying to a question in the House of Lords, Lord Taylor of Holbeach said the government would put forward its arguments for and against microchipping when it announces its new strategy on dog ownership.
However, according to the BBC report, Conservative peer Lord Renton said ministers must think "carefully before" taking such a step: "There are many dogs that take very badly to having a chip in them," he said. "They get very sore."
Who ever said the Lords were out of touch, eh?
The solution is designed to streamline Animal Health and Welfare Pathway (AHWP) reviews, from on-farm sampling through to laboratory results, reporting, vet attestation and DEFRA compliance, by integrating faecal egg count testing at Sandhill Laboratories with the VetDX app,
VetDX says that by integrating every stage of the review process into a single digital workflow, the VetDX platform allows practices to carry out efficient, compliant visits with a reduced administrative burden.
Laura Eden MRCVS (pictured), farm animal vet at Bishopton Vets said: “What’s really improved the process for us is how straightforward it is to submit samples and how quickly we get results back from Sandhill.
"It takes a lot of the hassle out of coordinating AHWP visits and lets us focus on the clinical side.”
Rachel Kirkby MRCVS, Business Development Director at VetDX, said: “The AHWP is a real opportunity to tackle issues like anthelmintic resistance in a structured, funded way - but only if the process is workable on the ground.
"That’s why we’ve built the platform to fit naturally into how vets carry out these visits, supporting accurate on-farm data capture with features like in-app QR code scanning.
"It means lab results are securely linked to the right animals or groups, without the risk of transcription errors or lost paperwork.”
https://vetdxs.com
The British Veterinary Association has criticised the conclusions drawn by the Gloucestershire Wildlife Trust in its report on badger vaccine deployment.
The report considers the effectiveness of the Trust's programme of deploying the injectable BadgerBCG vaccine in seven nature reserves covering only 170 hectares (1.7 sq km) during the summer.
It concludes that the badger vaccine is a viable alternative to culling in the battle against bovine TB, but according to the BVA, does not give evidence to support this claim.
Carl Padgett, President of the BVA, said: "We welcome the initiative by the Gloucestershire Wildlife Trust to investigate the deployment of the badger vaccine but this work must not be confused with an investigation into the effectiveness of the badger vaccine in reducing or eradicating bovine TB.
"To conclude from this report that the badger vaccine is a viable alternative to culling in eradicating TB is unrealistic at best and spin at worst.
"The fact remains that the vaccine has no protective effect on infected badgers and we know that at least 30-40% of badgers within an area will be infected. Many young badgers will be infected before they can be trapped and injected.
"In terms of the practicalities of deployment this report provides interesting information but we will learn much more as a result of Defra's Badger Vaccine Deployment Project which is looking at a much larger area of 100 sq km.
"Vaccination of badgers certainly has a role to play in an effective TB eradication programme but it is only one tool in the toolbox."
The updated content includes instructions on interpreting blood test results and dosing with Felimazole (thiamazole), which is now available as both a tablet and a honey-flavoured oral solution.
The new Felimazole Oral Solution formulation is presented in a syringe graduated in 0.25 mg increments to ensure accurate dosing.
Thomas Johnson, Dechra companion animal brand manager said: “Consistent management and accurate treatment is key to enabling cats with feline hyperthyroidism to lead long and healthy lives.”
Dechra’s Endocrine app already covers Addison’s disease and canine Cushing’s syndrome. The inclusion of feline hyperthyroidism content aims to provide a single resource for veterinarians managing endocrine disorders in companion animals.
Dechra’s Endocrine app is available at the Apple App Store or Google Play Store
https://www.dechra.co.uk/products#/search=Felimazole
Petproject is updating its ProReward 100% Liver treats and have added three new varieties to the range, a low fat 100% Chicken, hypoallergenic 100% Venison and 100% Icelandic Cod which is high in Omega-3 fatty acids.
Petproject says that after speaking with vets and dog owners it found that many customers had switched on to ProReward because it had helped their dog through a stressful situation such as a trip to the vet or meeting strangers.
ProReward treats are fresh cuts of unprocessed meat and fish that are gently dried to enhance the flavour and lock in the nutrients. Petproject says the intense flavours are similar to those you experience when eating a dried strawberry.
According to the company, the new design uses less packaging and the new varieties will provide veterinary practices with more choice for customers wanting to avoid feeding processed derivatives to their dogs. ProReward is also available in large tubs for use in the consulting room.
Petproject will be embarking on a number of activities to raise brand awareness to get dog owners looking for ProReward products. A free sample pack is available for practices wanting to try ProReward, to request yours or for more information please email info@petproject.co.uk or call 020 8444 1800.
The awards are to recognise outstanding veterinary practices that have demonstrated exceptional performance and innovation in areas crucial to the future success of the profession.
There are three categories: Leadership and Management Skills, Team and Self-Development, and Veterinary Start-Ups.
The three category winners will each win day and evening tickets to SPVS Congress 2025 on Thursday 30th January for three team members, plus overnight accommodation at the Hilton Birmingham Metropole.
Shortlisted practices will each win a book of their choice.
The deadline for submissions is Friday 18th October 2024.
https://spvs.org.uk/business-excellence-awards/
The RCVS is inviting nominations from veterinary surgeons and veterinary nurses who are eligible to stand for RCVS Council and Veterinary Nurses (VN) Council, respectively, in next year’s elections.
The College says next year’s elections will not be affected by the current Department for Environment, Food and Rural Affairs (Defra) consultation on the College’s governance arrangements and so, as always, six seats will be contested for RCVS Council, while two places are available on VN Council. Successful candidates are expected to serve four-year terms and will take up their places at RCVS Day in July 2016.
The nomination period for both RCVS and VN Councils runs until 5pm on Sunday 31 January 2016. In order to stand, candidates for either Council will need to complete a nomination form, submit a short biography and personal statement and supply a high resolution digital photo.
Each candidate will also need to have two nominators. For RCVS Council candidates, these should be veterinary surgeons who are on the RCVS Register but are not current RCVS Council members; for VN Council candidates, the nominators must be registered veterinary nurses who are not currently on VN Council.
Gordon Hockey, RCVS Registrar, said: "We are looking for committed and motivated veterinary surgeons and veterinary nurses who are dedicated to their respective professions and who, through the Councils and their various committees and subcommittees, wish to have direct input in decisions relating to how the College sets and advances standards of education and professional conduct. If this sounds like you then please find out more about standing as a candidate."
Liz Cox, Chair of VN Council, added: "I would strongly encourage all those want to have a say and play a leadership role in veterinary nursing to stand up and be counted and put themselves forward as a candidate. It is a very exciting time to join VN Council as the new Royal Charter has formalised the Council’s powers to regulate education and our professional standards, meaning that the decisions you make can have a very real impact on the profession."
The election period will start around mid-March and run until 5pm on Friday 29 April 2016. Ballot papers will be sent to all registered veterinary surgeons and veterinary nurses who are eligible to vote and, during the election period, the College will be sourcing questions from the professions to put to the candidates.
Nomination forms, guidance notes and frequently asked questions for prospective RCVS Council candidates can be found at www.rcvs.org.uk/rcvscouncil16. The equivalent documents for VN Council candidates are available at www.rcvs.org.uk/vncouncil16.
Prospective candidates for either Councils are also invited a ‘Meet the RCVS Day’ at the College’s offices in Belgravia House on Tuesday 15 December 2015, where they will have the opportunity to find out more about the role of the College and RCVS and VN Councils.
RCVS President Dr Bradley Viner and Chair of VN Council Liz Cox will also be on hand to answer questions about the duties and responsibilities of members of the respective Councils. Those interested in attending should contact Emma Lockley, Events Officer, on e.lockley@rcvs.org.uk or 020 7202 0773. Reasonable expenses for travel will be reimbursed.
A rural social scientist has argued in this week's Veterinary Record that the dwindling influence of vets in the public health arena threatens food safety in the UK. Philip Lowe, from the Centre for Rural Economy at the University of Newcastle, argues that a shift in practice from treating animals used for food on farms to looking after pets in urban communities, is largely to blame. The proportion of time vets in private practice spent treating animals used for food halved between 1998 and 2006. Most vets run their own businesses, and pet owners have proved a more sustainable and lucrative source of income than farmers. Professor Lowe sympathises with the need to make money, but laments this drift towards the profession turning into "another private sector service industry." He says this fails to make use of vets' considerable and wide ranging expertise, adding: "I would argue that it also diminishes the public standing of the whole profession. I certainly couldn't imagine the medical establishment in this country accepting a role that marginalised public health, even if the NHS did not exist. More seriously for all of us, I believe that not involving vets in this important area also puts food safety in the UK at risk. "At the same time we live in an age when there is real and widespread public concern about welfare standards for farm animals, threats from animal diseases old and new (such as blue tongue, bird flu and swine flu), and food safety." Professor Lowe says that in the past, the veterinary arm of government traditionally provided leadership for the profession that was embodied by the Chief Veterinary Officer and was underpinned by the proportion of vets' income derived from public funding. But this is no longer the case, and is further undermined by the percentage of vets employed by government having shrunk from 11% to 4% over the past 40 years. Professor Lowe argues that the profession needs to rethink its role and the direction in which it is travelling. He says there needs to be more specialist support and training for student vets and novice practitioners so that they are not put off from farm practice before they have had a chance to develop their skills and confidence in this area. However, he cautions against returning to the stereotype popularised by the fictional James Herriot vet, who was depicted as a mainstay of the rural community: "The farm vet's position and respect for their expertise needs to be restored, but not in the old Herriot mould. He or she has to take on the much greater challenge of risk and welfare regulation and management across the whole food system".
The National Office of Animal Health has launched http://www.pethealthinfo.org.uk/, a new website that bills itself as: "A 'one stop shop' featuring a wealth of animal health information and advice to help owners and potential owners to make decisions about their pets' healthcare."
I must say, full marks to NOAH and the web designers 9xb for a really polished website that presents information in a very easy-to-navigate format. First class job.
In general, the site content seems very good too. There's help for owners deciding what pet to buy, health guides for various common conditions for each species, first aid advice, and much more.
Personally, I think it would have been a nice tweak to offer something a tad more interactive in the section about picking a pet - something that actually made suggestions depending on your answers to the questions the site poses.
I also wonder how useful the Vet FAQs are likely to be. There are so many possible questions a pet owner might have, that a slightly random list seems to me to be of limited use.
But these are small points in the grand scheme of things. Overall, an excellent production, and one you may want to link your practice website to.
The Department for Environment, Food and Rural Affairs (Defra) has today released details of the strategy for rolling out vaccination across England.
Under EU law, vaccination can only be carried out in a Protection Zone. As vaccine starts to be delivered by Intervet, vaccination will, therefore, commence in the Protection Zone only. Once vaccination is progressing across the Protection Zone, the intention is to extend or modify the Zone county by county, in order to permit further vaccination. The strategy has been developed and agreed with a Core Group of industry stakeholders. It is designed to be flexible, taking into account the changing nature of the disease, such as moving zones, the varying levels of disease risk in the zones and the availability of vaccine.
More details of the vaccination strategy, alongside indicative prices for the vaccine, can be found on the Defra website: http://www.defra.gov.uk/animalh/diseases/notifiable/bluetongue/control/vaccination-rolloutplan.htm
The Royal Veterinary College has established the Nestlé Purina RVC Intensive Respiratory Centre to provide advanced critical care for patients with severe respiratory diseases. The Centre will offer small animals the UK’s most advanced level of respiratory care with equipment that is more frequently found in human intensive care units, such as a state-of-the-art mechanical ventilator, a critical care monitor and specially made oxygen units (kennels).
Advances in veterinary care mean that animals are able to undergo more invasive procedures, such as extensive thoracic surgeries including cardiopulmonary bypass operations. These patients require more intensive post-operative care, including mechanical ventilation in some cases. The acquisition of this state-of-the-art equipment, to enable such an advanced level of care, has been made possible through sponsorship from Nestlé Purina.
Respiratory diseases are fairly common in companion animals – however there are limited options for treatment for animals that are severely affected with life-threatening respiratory failure. To date new techniques and treatments that have been developed for human patients with severe respiratory diseases have not been applied to animals. Some of the activities of the centre will involve evaluating the effectiveness and appropriateness of using some of these newly developed techniques on small animals.
“The RVC is perfectly placed to pioneer innovative treatment to improve the lives of animals with severe respiratory problems,” said Daniel Chan, Lecturer in Veterinary Emergency and Critical Care at the Royal Veterinary College.
“We’ve got the expertise of specialists in internal medicine, emergency and critical care, surgery, anaesthesia, diagnostic imaging and clinical nutrition – by combining these skills and with the support of Nestlé Purina, we will be able to deliver a comprehensive programme of care. This co-ordinated approach is unique.”
Specialised training modules and lectures for veterinary students, nurses and practitioners, will also be delivered as part of the Centre’s remit and the Centre is also creating a forum for clinicians and researchers from across the world to share information about advances in this field.
Hi ,
I appreciate that this is a advertsiement for a soft tissue society , but as i was approached by a member of the commitee as this years programm does have potential interest for a medic. Namely Congenital and Herediatary disease.
If you are interested please contact avstsadmin@fsmail.net for detail
Ian
AVSTS Autumn Meeting 2010, 1st – 2nd October
Congenital and Hereditary Disease in Dogs and Cats
FRIDAY 1
st OCTOBER
9.30-10.00 Registration & Coffee
10.00-10.45 Heritable and Congenital Disease – David Sargan A Geneticist’s View
10.45-11.30 Ethics of the Management of Diseases Siobhan Mullan Present at Birth – Individual versus Population
11.30-11.50 Coffee
11.50-12.50 Surgical Treatment of Congenital and Hereditary Disease in Children
12.50-1.50 Lunch
1.50-2.25 The Way Forward? Michael Herrtage
2.25-2.40
Panel Discussion:David Sargan, Siobhan Mullan and Michael Herrtage
2.40-4.15 Brachycephalic Diseases
2.40-3.30 Brachycephalics: Gerhard Oechtering
Trapped in Man-Made Misery? Turbinate Ablation in BAOS
3.30-4.00 Brachcephalic Airway Obstruction Syndrome Rob White
4.00-4.15
Panel Discussion:
Gerhard Oechtering and Rob White
4.15-4.30 Coffee
4.30-5.30 Urogenital Disease and Cancer
4.30-4.50 Not Zipped-Up: Treatment of Extreme Jane Ladlow
Hypospadias in a Dobermann, plus Review of Hypospadias
4.50-5.10 A (Chamber) Potpourri of Peter Holt
Congenital Urinary Incontinence
5.10-5.30 Cancer in the Genes: Jane Dobson
Histiocytic Sarcoma in Flatcoated Retrievers and LUPA
5.30 Close
Hill’s Pet Nutrition has launched Prescription Diet Feline c/d Multicare, formulated to manage both struvite and oxalate urinary stones. It's appropriate for cats with feline idiopathic cystitis, which accounts for an estimated 64% of all FLUTD cases. The new diet replaces x/d, which will be discontinued.
According to Hill's, a significant benefit is that c/d contains no excess salt and therefore presents no risk to cats that have hidden kidney disease. Libby Sheridan, Veterinary Affairs Manager, said: “It’s something that is always at the back of our minds when cats have shown signs of urinary tract problems: has there been damage to the kidneys that I can’t yet detect? We need to be cautious when it comes to managing urinary disease in cats. Limiting salt with careful diet formulation and therefore avoiding potentially worsening compromised kidneys is important in long term management.”
Feline c/d Multicare contains controlled levels of magnesium, calcium, phosphorus and oxalate to reduce the constituents of crystals and calculi, added citrate to reduce stone formation and enhanced levels of B6 specifically to decrease the risk of oxalate formation. Increases in omega-3 fatty acids help ensure that the inflammatory response is ameliorated, which is particularly important in the management of feline idiopathic cystitis.
Hills continue to recommend s/d for dissolution of struvite calculi and k/d in cases of feline urate calculi. Feline urinary disease is, of course, a condition that requires long term intervention to guard against recurrence and c/d Multicare is available in a variety of flavours and formats, including tender chunks in gravy pouches, 156 g tins and dry in chicken and ocean fish varieties, ensuring there is a enough choice to satisfy the most discerning of cats.
For more information call Hill’s Customer Service on 0800 282 438 or (ROI) 1-800 626002.
Royal Canin has announced a new Approved Weight Management Centre programme for vet practices across the UK.
As part of the programme, a number of practices across the UK will receive ‘Centre of Excellence’ status for managing overweight or obese cats and dogs educating clients on prevention.
To gain approved centre status, practices are required to establish a formal Weight Management Clinic and work as a team to refer clients with overweight pets through the clinic. The chosen practices will receive bespoke training from a member of the Weight Management Team, to provide them with the skills and protocols to discuss obesity with clients and encouraging vets, nurses and receptionists to work together to raise awareness of obesity.
Shelley Holden from the Weight Management Team said: "This is a unique platform for practices across the UK to take advantage of and really excel in addressing weight management issues in practice and tackling prevention. We are excited to currently work with an elite group of practices, all committed to raising awareness of obesity in cats and dogs."
Royal Canin has so far given nine clinics 'Centre of Excellence' status. They all now discuss body condition scoring with patients to identify whether the pet is in ideal condition. If overweight or obese, they are then referred for further advice and support to their weight clinic. The weight clinic is a complimentary 30 minute appointment with a weight management nurse, followed by ongoing monitoring, personalised advice and telephone support. Approved clinics also educate owners about prevention during puppy parties, puppy and kitten vaccinations, and at neutering to ensure owners are aware of the health risks of weight gain from the outset.
Jo Hammett BVSc MRCVS, Owner of The Stocks Vets (pictured right), said: "We have received bespoke training from Royal Canin to achieve centre status, giving our team the confidence to discuss the sensitive issues surrounding weight with clients, in addition to tackling education. This has really helped break down barriers in approaching the topic with clients about their pets’ weight and we are finding they are now much more open with the team during consultations, which is a major achievement in itself."
For more information about the Approved Weight Management Centre programme, contact your veterinary business manager or visit www.royalcanin.co.uk.
Virbac has launched Cooldent, described as a highly palatable, fast-acting tablet to freshen dogs' breath.
Claire Lewis, Product Manager, explained: "Bad breath in dogs is unpleasant and is most frequently caused by a build-up of plaque and calculus on their teeth.
"Cooldent's natural ingredients have an anti-plaque action and help both to maintain a balanced intestinal flora and to reduce gas production. They also help to freshen dogs’ mouths by contributing to the reduction of volatile compounds, produced by bacteria which can cause halitosis."
She added: "We are delighted to add Cooldent to our comprehensive dental range, alongside our VeggieDent, natural, all-vegetable, highly palatable teeth-cleaning chews for dogs and Vet Aquadent, an easy-to-use drinking water additive which helps to fight dental plaque and tartar formation in dogs and cats."
Programme attached including details of how to register
Clark Dental has launched the new Nomad Handheld X-Ray machine from Aribex™.
According to the company, Nomad already has a superb track record as a practical, effective and recognised state-of-the-art device. It boasts a multitude of benefits and features and is suitable for many different environments. Two rechargeable batteries provide 150 exposures each, and it’s compatible with both digital sensors and traditional X-ray film.
The operator is protected by a patented internal radiation shield as well as an external backscatter shield, which the company says provides excellent protection: one operator would have to expose over 10,000 E-speed films per year in order to approach the lowest measurable dose on a monitoring badge. With a direct digital sensor, the scatter dose is even less.
For further information, please contact the exclusive UK supplier, Clark Dental, on Tel: 01270 613750 or email maria@clarkdental.co.uk
Lincolnshire veterinary surgeon David Bull MRCVS has won a Vet Futures ‘Headlines of tomorrow’ competition with his entry: ‘Vets and medics collaborate to prevent human and animal obesity’.
The competition was held at BSAVA Congress in April where Vet Futures-themed fortune cookies contained a message asking those attending ‘What future headline do you want to see?’ and providing a weblink to enter the competition.
David, a joint partner at Vets4Pets in Lincoln South and an Advanced Practitioner in General Small Animal Surgery, said: "The headline was inspired by topical issues, having ‘One Health’ in mind and the issue of obesity in our patients, as well as the general human population. I feel that these are some of the big issues of our time, especially that of obesity which has been linked to so many other diseases and is essentially a self-induced problem.
“We see so many overweight cats, dogs and rabbits on a daily basis. It seems to be becoming a more common problem, as well as seemingly more accepted in society. This is to the extent that we have some clients that come in worried because they have been told that their dog is too thin, when in actual fact they are in an ideal body condition and are being compared to overweight pets which have become perceived as normal.”
Some of the other topics raised in the competition include the veterinary profession taking the lead in tackling ‘superbugs’, veterinary surgeons topping job satisfaction and wellbeing polls and the profession taking a leading role in One Health and medical advancements.
The Royal College of Veterinary Surgeons Council and the Veterinary Nursing Council have decided that there will be no increase in registration and retention fees for veterinary surgeons and veterinary nurses for 2012.
Last year, the Councils decided that a lower than inflation increase should apply to fees for 2011 to help mitigate the impact of the difficult economic climate on veterinary surgeons and veterinary nurses. Members who are over 70 and who cease practising do not have to pay fees if they wish to remain on the Register.
Bradley Viner, RCVS Treasurer said: "We know times are tough financially for many people and hope that freezing fees will help a little. Professional regulation can be costly, but we try to keep fees as low as possible."
The RCVS financial policy remains that fee increases should be small and incremental in order to avoid a need for periodic sharp fee hikes resulting from inflationary pressures.
Fees for 2012 will be as follows:
2012 fees (£)
Veterinary surgeons
UK-practising retention fee
299
Overseas-practising retention fee
150
Non-practising retention fee
49
Non-practising retention fee (over 70 years old)
0
Registration fee
Temporary registration fee
Restoration fee
Restoration fee following voluntary removal
75
Veterinary nurses
Retention fee
61