John Kenward MRCVS, a director of Maidstone practice Pet Emergency Treatment Services, has been given a conditional discharge for allowing an employee to X-ray her own foot after a horse stamped on it.
Maidstone Magistrates heard that the employee, a 25 year-old vet and equine intern, was afraid the foot was broken and she might be unable to do that evening's on-call duty.
As a result, she rang Mr Kenward. As they were both concerned she could be held up in hospital A&E, Mr Kenward suggested she use the in-house X-ray kit. He gave her the settings to use and she carried out the test, which showed no break so she continued to work as normal.
Another director, who acts as Radiation Protection Supervisor, later noticed a human image on the digital processor. This led him to notify other practice board members of his intention to interview staff about the suspected breach of site radiation safety policy. He was immediately told by Mr Kenward not to discipline the vet intern as he had suggested that she use the X-ray.
As a result the Health and Safety Executive was contacted and an investigation confirmed a breach of radiation regulations.
Although the vet intern, from Maidstone, was the only person present during the X-ray exposure, she did not wear a personal dosemeter during the procedure.
However, HSE told the court that Mr Kenward was fully aware that the rules of the practice clearly stated nobody should be placed within the beam of the X-ray machine.
Mr Kenward was ordered to pay £1,296 in costs after admitting a breach of the Health and Safety at Work etc Act 1974.
After the hearing, HSE inspector Rob Hassell said: "Any vet practice using ionising radiation for medical exposures must ensure that the X-ray equipment is properly maintained and that the requirements of the Ionising Radiations Regulations are complied with. The view of HSE and the Department of Health is that it is highly unlikely that all these conditions can be met by a veterinary practice.
"It follows therefore that X-rays must not be taken of human beings at practices. We are aware that the X-raying of people may not be unique to this particular practice so I hope others will take note that HSE is prepared to prosecute if such breaches come to light."
The DC heard that Mr Hutton had attended to a horse called Angel at a livery yard in Sheffield.
As he examined the horse, it kicked Mr Hutton in the leg, whereupon he kicked it back in the abdomen.
Mr Hutton admitted the facts of the allegation against him.
The Committee noted that there was a dispute between the parties about the exact manner in which the kick had been administered and whether the conduct amounted to disgraceful conduct.
Both the College and the defence obtained the opinion of experts, who were not in agreement as to whether the conduct amounted to serious professional misconduct.
The Committee heard evidence from Angel’s owner, Ms A, who was present when Mr Hutton kicked Angel and from Ms B, Mr Hutton’s life partner, who was also present.
In his witness statement, Mr Hutton said that his kick “was an instinctive reaction to what had happened and an instinctive reprimand for what I felt in the aftermath of the kick from her was malicious behaviour”.
Mr Hutton also stated that the reprimand was an appropriate response which a horse would understand, in order to modify its future behaviour.
In the hearing, Mr Hutton apologised for the incident with Angel. He said it had happened in the heat of the moment. He wished that he had apologised straight away.
In his expert evidence before the Committee, Mr T Gliddon MRCVS, called by the College, agreed that attitudes to physical reprimands had changed over time.
In his expert report, he stated that a reprimand administered by a veterinary surgeon that may have been considered acceptable by a significant body of the veterinary profession some decades ago would no longer be regarded as such now, in his opinion.
In re-examination, he stated that in his opinion, there was not a reasonable body of veterinary opinion which would consider kicking a horse as an acceptable form of negative reinforcement of behaviour.
In his expert evidence to the Committee, Dr H Tremaine FRCVS, called by Mr Hutton, stated that in the case of the minority of veterinary surgeons who used physical reprimands as a means of modifying behaviour, he was not aware that such reprimands would include the use of a kick.
The Committee concluded from the evidence that, following the kick from Angel, Mr Hutton moved away from the horse, so that he was no longer in immediate danger and that his kick in response had come after a gap in time, albeit brief.
Ms Greaney, Counsel for the College, provided written submissions on serious professional misconduct, submitting that principles 1.1 (Veterinary surgeons must make animal health and welfare their first consideration when attending to animals) and 6.5 (Veterinary surgeons must not engage in any activity or behaviour that would be likely to bring the profession into disrepute or undermine public confidence in the profession) of the Code of Professional Conduct had been breached.
It was submitted that, on the basis that there had been a deliberate decision by Mr Hutton to kick Angel in the abdomen, he had time to consider his actions.
The College submitted that deliberately kicking Angel, either as punishment or by way of teaching or training a horse, fell far below the standard expected of veterinary surgeons.
The Committee found Mr Hutton’s state of mind when kicking Angel was not an issue and that Mr Hutton had intentionally kicked the horse.
In reaching its decision in relation to whether Mr Hutton’s conduct amounted to serious professional misconduct the Committee took into account that:
Mrs Judith Way, chairing the Committee and speaking on its behalf, said: “The Committee determined that taking all circumstances and its findings into account, this conduct was a single, but serious failure on the part of Mr Hutton and found the facts proved amounted to disgraceful conduct in a professional respect.
“On deciding what, if any, sanction ought to be imposed, the Committee considered the aggravating and mitigating factors of the case, based on findings at the earlier stages of the hearing.
"The Committee found that there had been a risk of physical and/or mental injury to Angel from Mr Hutton’s conduct but accepted that there were a number of mitigating factors.
“It had been found that the incident had occurred over a very brief period and that Mr Hutton had not taken proper time to consider his response to Angel’s unexpected kick.
"This was found to be a single isolated incident and the character evidence indicated that otherwise, Mr Hutton was a competent and well-regarded veterinary surgeon.
"Mr Hutton admitted the kick early on in the proceedings and had issued an early apology, albeit seeking initially to raise some justification for his actions.
“The Committee was persuaded, in light of Mr Hutton’s admissions, heartfelt apologies, developing insight and the testimonial evidence, that he is very unlikely to repeat his past misconduct.
"However, despite the low risk of repetition, the Committee considered that the nature of the kick, delivered without the consent of the owner, could undermine public confidence in the profession.
"Thus, the Committee considered that it was proportionate to issue a reprimand together with a warning as to Mr Hutton’s future conduct.
"It has determined that this would be proportionate and sufficient to provide adequate protection for animals and maintain public confidence in the profession.”
The full details of the hearing and the Committee’s decision can be found at www.rcvs.org.uk/disciplinary.
Duncan, an 85kg miniature horse, was first admitted to the Philip Leverhulme Equine Hospital in July this year for investigation of severe hind limb lameness. A CT scan revealed that Duncan had dislocated the left hip joint and damaged it irreparably.
Equine surgical specialist Dave Stack said: "Treatment options for this problem are very limited, especially with extensive damage to the head of the femur.
"I discussed Duncan’s predicament with two small animal surgical specialists, Professor Rob Pettitt and Andy Tomlinson, who agreed that performing a total hip replacement offered Duncan the best chance for recovery."
The procedure had been attempted in small ponies before, however, all known previous attempts had failed. The surgery required careful preparation and the combined knowledge of specialists in both small animal and equine surgery, as well as colleagues from the anaesthesia and internal medicine departments.
Working together, the teams were able to replace Duncan's left hip using implants designed for use in large dogs.
Equine Surgical Resident, Matthew Cullen said: “Although always complex, hip replacements are relatively common in dogs, so the experience of the small animal surgeons was absolutely vital as Duncan presented a highly unique challenge.
"Despite that he has made an excellent recovery and was able to walk and trot almost normally at his last check up!”
Duncan was hospitalised for over three weeks and required round-the-clock supervision in the first few days after surgery. As he grew stronger, physiotherapy formed a large part of the postoperative care to help him get back on his feet.
Rob Pettitt, Professor of Small Animal Orthopaedics at the University’s Small Animal Teaching Hospital, said: "The opportunity to provide Duncan with a normal life using a procedure that we perform regularly in dogs but that has never been successful longer term in equids was a unique experience. Our role as surgeons was just a small part of the huge teamwork that has resulted in this successful outcome."
Dave Stack added: “I would like to express my gratitude to all who contributed to the success of Duncan’s recovery, not least Rob Michael of Thompson House Equine Clinic, Duncan’s vet at home, whose care of him has been invaluable. I am thrilled that Duncan will live a comfortable life and delighted that Duncan’s owners have the opportunity to continue to spoil him for many years to come."
In its statement, the company blamed the situation on the poor performance of 24 practices it bought in the Netherlands, and its new farm and equine divisions.
CVS says that another important factor has been employment costs, in particular the increase in market rates for locum veterinary surgeons and nurses on which it remains heavily reliant.
The company also blames its financial performance on the poor support of pharmaceutical companies, which it says it is continuing to push for transparent and 'appropriate' pricing.
Aside from trying to drive down the costs of drugs, the company says it has introduced 'additional procedures' designed to reduce the cost of employing locums, although it didn't specify what these are.
The group is also reevaluating its pipeline of acquisitions, in particular the multiples it is prepared to pay.
At the time of writing, the CVS share price had dropped over 28% to 465p overnight and 70% since the share price peaked at 1477p in November 2017.
In the game of acquisitions musical chairs, did the music just stop?
Full trading statement.
After the contamination was first identified, sales of the product in Australia were stopped immediately and Bova initiated an investigation.
The British Horseracing Authority then conducted its own analysis of samples of the UK product, discovering that it too was contaminated with testosterone.
However, Bova says the levels of testosterone in the end product were confirmed to be 400-700 pg/ml, which is less than one millionth of the internationally accepted standard for impurities (1 picogram being equal to one billionth of a milligram).
Nick Bova, managing Director of Bova UK, said: "We have consulted veterinary pharmacologists and sports medicine specialists who have given their opinion that these levels are within accepted standards and could neither have a clinical effect nor result in a positive blood or urine test for testosterone in competition horses.
"The levels of testosterone within the product are inconsequential compared to endogenous production in mares and geldings as well as stallions and higher levels are found frequently in feed and water sources; testosterone being a common compound produced by humans and animals from multiple organs."
The source of the contamination was traced to the excipient used in the product, which was used by Bova Aus and Bova UK. Both companies have now switched their supplier of this excipient. Bova says all testing done on the new supplier has shown no traces of testosterone, even with the new extra sensitive method of analysis which is capable of reaching picogram levels.
Nick added: "Whilst we hope to reassure you that the use of long acting injectable omeprazole will not have had adverse implications for your patients or clients we can also reassure you that we are not complacent about the presence of impurities in any of our products, particularly an impurity that is of such significance to equestrian sport.
"Although the level of impurities is well within the accepted international standard, we have changed the supplier of the excipient in question. We have established an analytical method capable of testing down to picogram levels, which has been used to test the end product to ensure there are no further concerns with future batches.
"We sincerely apologise for any inconvenience this issue may have caused. Many vets and horse owners now rely on long acting injectable omeprazole for horses that do not respond to oral treatment and we can reassure anyone who has used the product in recent months, or has product that they are due to use, that they can do so safely.
"However, we would draw attention to the recent statement from the BHA that they do not wish the product to be used in horses in training currently."
Visit www.bova.co.uk for further information.
Henry Schein said in a statement on Friday that it had sold the business in order to focus on its dental and medical markets and pursue new investment opportunities.
Covetrus says it will be using the experience, technology and global scale of the merged companies to provide veterinary practices with a more comprehensive set of integrated services and technology solutions, and tools to strengthen client relationships and grow their practice.
Covetrus launched on Nasdaq last Friday, when President and Chief Executive Officer Benjamin Shaw, said: "Today marks an important new chapter in the world of veterinary medicine, as we launch Covetrus as a new company listed on Nasdaq.
"We look forward to strengthening our customer relationships and expanding our veterinary practice partnerships worldwide as we bring more comprehensive and powerful solutions to market to meet their evolving needs and improve health and financial outcomes."
In the trial, published in the Equine Veterinary Journal, synovitis was induced in the right intercarpal joint of 24 horses by intra‐articular injection of 0.5 ng lipopolysaccharide (LPS) of Escherichia coli. After intra‐articular challenge, the nutraceuticals resulted in significantly lower synovial fluid TP, TNCC and PGE 2 compared with placebo, leading the authors to conclude that: "The preventive administration of these nutraceuticals showed anti‐inflammatory effects in this validated synovitis model."
Dr Maarten Oosterlinck DVM, PhD, Dipl. ECVS, one of the authors of the study, said: "Nutraceuticals are often used in the management of osteoarthritis, which is a common cause of chronic lameness in horses but their 'curative' efficacy remains controversial and the quality of the relevant studies is generally low. We set out to evaluate ArtiTec in a well-designed and controlled study. Our research shows that ArtiTec significantly decreased joint inflammation and could be useful in preventing the onset of arthritis."
Cavalor also points to a further field trial of the product by vets in Belgium which showed that it improved lameness in 74% of cases.²
ArtiTec contains glucosamine, MSM, chondroitin, hyaluronic acid, blackcurrant extract, feverfew and pineapple, turmeric root and Boswellia Serrata.
Lieselot Hamerlinck, managing partner at Cavalor said: "Joint supplements account for 34% of the equine supplement market so we know how important these products are to horse owners. Cavalor ArtiTec is the result of an extensive research and development programme and its anti-inflammatory effect has been documented in both scientific studies and a field trial. It can also be used in combination with our other joint supplements, Arti Matrix and Arti Base."
For more information, contact Zebra Products on 01352 763350.
References
Two new campaigns which call on the veterinary profession to unite against the practice of homeopathy have been launched this week.
Both campaigns raise concerns about the ethics of veterinary surgeons using irrational, unscientific and ineffective remedies to treat ill animals or in place of conventional vaccinations.
The Campaign For Rational Veterinary Medicine presents the case against homeopathy on a new microsite, and asks the profession to unite around a call for the Royal College of Veterinary Surgeons to issue a public position statement that homeopathy is ineffective in animals, bringing it into line with the NHS, the findings of the British government's own review of homeopathy, and the BVA.
The campaign also asks that veterinary surgeons who prescribe homeopathic remedies be required to get owners to sign a consent form, prepared by the College, giving the College’s views on the ineffectiveness of homeopathy.
Lastly, the campaign asks that promotion or advertising of homeopathy by veterinary surgeons should abide by Advertising Standards Authority regulations and carry a statement from the College.
The Campaign for Rational Veterinary Medicine has been set up by a group of practitioners including the BSAVA Past President, Mike Jessop, Alex Gough, Martin Whitehead, Niall Taylor, Phil Hyde, Martin Atkinson and Brennen McKenzie, supported by VetSurgeon.org Editor, Arlo Guthrie. It also has the support of the noted author, academic and erstwhile dog owner, Professor Edzard Ernst.
Arlo said: "This is not just about the ethics of prescribing or tolerating the practice of prescribing water to animals that are dependent on us. There are 13m pet owning households in the UK. As well as visiting the vet, they will all be patients at some stage in their lives. So what you and the College say about homeopathy in animals has the potential to affect the choices they make for themselves too. Think how much money and false hope you could save them, and the consequent benefit to human welfare."
By complete coincidence, another campaign against veterinary homeopathy was launched last week. This one, by Danny Chambers MRCVS goes further, calling for a complete ban on the prescription of homeopathic remedies by veterinary surgeons. The petition has already gathered over 750 supporters.
Arlo said: "I think it’s important to say that the two petitions are not mutually exclusive. If you think both represent acceptable solutions, then sign both!"
Visit the Campaign for Rational Veterinary Medicine here, and sign the petition here.
Sign Danny Chambers' petition on change.org here.
Ophtocycline is licensed for the treatment of keratitis, conjunctivitis and blepharitis caused by Staphylococcus spp., Streptococcus spp., Proteus spp., and/or Pseudomonas spp.
Dechra says chlortetracycline hydrochloride works against both aerobic and anaerobic Gram-negative and Gram-positive bacteria.
The recommended dosage is four times a day for five days. The 10 mg/g ophthalmic ointment has a 14-day broached shelf life. There is a one-day withdrawal period for meat and offal.
Dechra Brand Manager Carol Morgan said: "Ophtocycline provides veterinary professionals with a targeted treatment to effectively tackle the growing and reproducing bacteria that causes these eye conditions.
"Chlortetracycline is a bacteriostatic antibiotic which interferes with bacterial protein synthesis in the rapidly growing and reproducing bacterial cell and has both time-dependent and concentration dependent effects.
"We are very pleased to be able to roll out this product to the UK market as part of our ophthalmic range alongside popular products such as Isathal."
For more information visit: www.dechra.co.uk
At the June 2017 meeting of RCVS Council, members decided to look into two models by which paraprofessionals working in the veterinary, animal health or related fields, might be regulated by the College under powers granted by the RCVS’s Royal Charter in 2015.
The first was an accreditation model, which would involve the RCVS accrediting an organisation which would regulate the profession in question. The second was an associate/ full regulation model, in which individual paraprofessionals would receive a similar level of regulation to that already received by veterinary surgeons and veterinary nurses.
At its January 2019 meeting, RCVS Council agreed to proceed with both proposed models of paraprofessional regulation, with the suitability of each model being considered on a case-by-case basis, depending on the nature of the profession applying for recognition.
Paraprofessions whose work will need to be underpinned by Schedule 3 reform would need to apply for the associate model, as the RCVS would be required to be directly responsible for the register of any individuals undertaking such minor acts of veterinary surgery.
Two paraprofessional groups that have already expressed an interest in being regulated by the College, namely meat inspectors and animal behaviourists, will now be invited to apply for associate or accredited status.
Eleanor Ferguson, RCVS Registrar, said: "This is a very significant decision by Council to open up a pathway to related paraprofessions to apply to become regulated by the College.
"It is difficult to give a time-frame at this stage as to when these particular professions will be brought on board, as we will have to go through a process of developing a number of new regulatory structures including registration, education and investigation and disciplinary, as well as the appropriate governing bodies for each of the professions.
"However, we are very pleased that the Association of Meat Inspectors (AMI) and the Animal Behaviour and Training Council (ABTC) have expressed an interested in being regulated by the College and we look forward to working with them to make this happen."
David Montgomery, President of the ABTC, said: "The ABTC enthusiastically welcomes the news that the RCVS is expanding its influence to include paraprofessionals. We look forward to exploring the opportunity to demonstrate the professional status of ABTC-registered Animal Trainers and Behaviourists by coming under the regulatory umbrella of the RCVS for the benefit of animal welfare."
Ian Robinson, a Trustee of the AMI, said: "The Association of Meat Inspectors welcome the news that the Royal College of Veterinary Surgeons intends to invite paraprofessionals to be regulated under the ambit of the RCVS. We believe it will offer enhanced security, opportunity and status, and we look forward to further dialogue to explore the various models in due course."
The College says it is also in touch with a number of other paraprofessional groups, including those representing animal musculoskeletal practitioners and equine dental technicians, about the future of paraprofessional regulation. However, before such professions could become associates, there would need to be reform of the Veterinary Surgeons Act in order to remedy some of the deficiencies of the current legislative regime and make sure that these groups have appropriate legal underpinning for their work. This, says the College, complements ongoing discussions on changes to the legislative framework to bolster the role of veterinary nurses.
On particular issue that the College says the new proposals are designed to remedy is that of equine dental procedures being carried out by well-trained but nevertheless unregulated paraprofessionals. Neil Townsend, Chair of the British Equine Veterinary Association’s (BEVA) Allied Professional Committee, said: "Change to the current situation, where legislative enforcement is impossible, horse owners are confused, and horse welfare is compromised, is long overdue. BEVA is really pleased that the RCVS has listened and is supporting a proposal for regulation of all equine dental procedures. We hope that Government will act."
RCVS President Amanda Boag, said: "This is a real milestone in the history of the RCVS and represents quite possibly the biggest change to our regulatory role since the introduction of the Register of veterinary nurses in 2007, and should Schedule 3 reform be achieved it would be the most significant change since the role of veterinary nurses was first recognised in law in 1991. It is particularly befitting for our 175th anniversary year, as it demonstrates we are an organisation that can evolve to meet the changes occurring in the wider veterinary and animal health sector and use our regulatory experience and expertise to ensure that animal health and welfare and public health is safeguarded in different, but related fields of endeavour."
The full approved paper regarding the review of the minor procedures regime and paraprofessional regulation can be found on the RCVS website at: https://www.rcvs.org.uk/news-and-views/policy/veterinary-legislation-review/
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."
Kruuse has announced that it has become the exclusive distributor for VideoMed GmbH and its range of veterinary endoscopes and documentation systems.
VideoMed produces a range of equine and small animal endoscopes, gastroscopes and laryngoscopes that multifunction with a flexible documentation console. This provides a mobile capability to file, frame and forward digital and dicom images for review and referral diagnosis.
According to Kruuse, VideoMed products are synonymous with the very highest quality of design, function and reliability that have been developed through years of close working relationship with veterinary professionals. An after care and repair service is also provided by the company for its own and a range of other scopes.
Kruuse says the Overground scope gives a mobile, high resolution, recordable image that clearly determines functional and morphological abnormalities of the larynx, pharynx and upper respiratory system (see image right).
Andrew Groom, Managing Director, Kruuse UK Ltd., said: "This exciting agreement will further enhance our equine and small animal presence within the veterinary industry to bring even more leading edge technology to our customers."
For more information, visit www.kruuse.com and http://www.videomed-gmbh.de/
Picture courtesy of:Neil Townsend MSc BVSc Cert ES (Soft Tissue) DipECVS MRCVSClinician in Equine Soft Tissue SurgeryPhilip Leverhulme Equine Hospital
The effect of changing diet on gastric ulceration in exercising horses and ponies following cessation of omeprazole treatment was conducted by Nanna Luthersson (Hestedoktoren, a private practice in Denmark) and Coby Bolger (Horse1 Spain), with colleagues from the University of Madrid and Glasgow, in collaboration with Spillers and the Waltham Equine Studies Group.
The study evaluated the effect of dietary change in combination with omeprazole treatment and after the cessation of treatment.
The 32 horses in this part of the trial had been diagnosed with significant equine squamous gastric disease (ESGD) and were in hard work.
On a random basis one of each pair was assigned to a specified low starch, fibre-based diet consisting of their own forage alongside a restricted starch, high fibre, high energy cube (Spillers HDF Power Cubes, which are commonly used in racing yards) and a high oil, low starch, chopped alfalfa based feed (Winergy Equilibrium Growth) and the other stayed on their original diet. All animals were scoped before, after the recommended course of omeprazole treatment and then six weeks after the omeprazole finished.
The horses in the no diet change group improved significantly with the omeprazole but when the treatment was stopped many regressed. Overall, by the end of the trial they were not significantly different to when they had started.
However, the horses in the dietary change group overall showed significantly improved ESGD scores, not only following the omeprazole treatment but also after the treatment had stopped. This showed that a change in diet was able to help maintain the beneficial effect of omeprazole even after the omeprazole was removed.
The study achieved an award in 2016 for research in horse welfare from the Fundación para la Promoción del Deporte Ecuestre, Spain.
Clare Barfoot RNutr, the research and development manager at Spillers, said: "This exciting work confirms what we suspected; that whilst appropriate dietary change can provide additional support to medical treatment for EGUS most importantly it can help maintain better gastric health post medical treatment."
Last year the British Equestrian Trade Association, in consultation with the Veterinary Medicines Directorate, introduced a new feed approval mark to help owners identify feeds suitable for horses and ponies prone to equine gastric ulcer syndrome (EGUS).
Currently six feeds in the UK carry the BETA Equine Gastric Ulceration Syndrome (EGUS) Certification Mark including Winergy Equilibrium Growth and Spillers Alfalfa Pro Fibre.
The company says that so far, it has had no cases of flu reported in horses vaccinated with Equip F or Equip FT in the UK. However, it cautions that in the present flu outbreak it is not clear if any of the current influenza vaccines will provide complete clinical protection against the mutated strain.
In addition, Zoetis highlights that:
Equip F and Equip FT are both indicated for reduction in clinical signs caused by Equine Influenza, including Florida Clade 1 strains.
Cross protection has been demonstrated by virulent challenge for representative strains of Florida Clade 1 (Paillot et al 20081, Bryant et al 20102) and Clade 2 (Paillot et al 20153).
Vaccination with Equip F stimulated a flu specific cell-mediated immune response to a Clade 1 strain which was detectable for up to one year after the third vaccination in primary course (Paillot et al 20153).
Zoetis says it is confident that the Equip range continues to be effective against its licensed indications.
If you have further questions about the vaccines, ring 0845 300 8034 and choose option 1 to speak to Zoetis' technical team.
Equine glandular gastric disease is a complex syndrome that is distinct from gastric ulceration. A number of studies now indicate that it is an inflammatory gastritis, predominantly at the gastric outflow, which has different causes and risk factors from gastric ulcers. As such, medication effective in treating gastric ulceration may be less effective for this specific condition.
The clinical signs of EGGD are diverse and non-specific and may be mild or recurrent. They may include changes in temperament, changes in rideability, unexplained weight loss, reduced appetite or cutaneous sensitivity manifesting as biting of the flanks or resentment of girthing, grooming, leg aids or rugging. Recommendations for reducing the prevalence of disease, based on putative risk factors, include providing rest days from work, maximising turn-out, minimising management changes and other potential stress factors and minimising changes in equine companions and human carers.
The new guidelines have been published by a group of equine medicine specialists, based on a review of published and unpublished evidence. The intention is to provide veterinary practitioners with up-to-date guidance on risk factors, diagnosis, treatment, dietary management and prevention of EGGD.
David Rendle, an internal medicine specialist at Rainbow Equine Hospital in North Yorkshire who chaired the group and is a consultant editor of UK Vet: Equine said: "Our findings challenge long-standing dogma on EGGD, a condition about which there is currently very little advice available to vets and horse owners. It is becoming increasingly clear that the distinction between disease of the squamous and glandular mucosa is important clinically and the group felt that updated guidance may help to improve management of EGGD in practice."
Provision of evidence based clinical guidelines should enable practitioners to adopt more standardised and logical approaches and base EGGD management decisions on the most current data.
Professor Josh Slater, Professor of Equine Clinical Studies at the Royal Veterinary College said: "Clinical guidelines are commonly used in human health care and have been shown to improve clinical outcomes by condensing data from large numbers of research publications and promoting rapid adoption into clinical practice. These new guidelines represent a step forward in the management of this complex condition by combining a consensus of expert opinion with the best available current clinical research and evidence."
Mark Bowen, Professor of veterinary internal medicine at the University of Nottingham who is based at Oakham Veterinary Hospital said: "Whilst the panel hasn’t come up with miracle cures there was universal agreement that new treatment options have to be integrated in a logical and responsible manner."
"Our understanding of this condition is in its infancy but we hope that the summary document, which also highlights the gaps in our knowledge, will provide a useful framework for vets to follow and will be a stimulus for future research."
The guidelines can be found here: https://www.magonlinelibrary.com/doi/full/10.12968/ukve.2018.2.S1.3
Photo: Marked multi-focal depressed haemorrhagic and fibrinosuppurative lesions
The OIE represents 178 Member countries and territories with international surveillance programmes that monitor antigenic drift among equine influenza viruses, and its Expert Surveillance Panel (ESP) for EIV makes annual recommendations for the composition of equine vaccines.
ProteqFlu, manufactured by Merial Animal Health, is currently the only vaccine in Europe to meet these recommendations.
Brand manager Dr Clare Turnbull said: "These recommendations, which have been in place since 2011, call for the inclusion of both Florida Clade 1 and 2 strains; as these are representative of the EIV strains that competing horses encounter globally.
"Although all licensed vaccinations should give clinical protection to individuals when challenged with a heterologous strain, mathematical modelling demonstrates that when scaled up to population level, this mis-match between challenge strain and vaccine strain significantly increases the risk of an epidemic occurring."
The FEI imposes mandatory equine influenza vaccination for horses competing under their jurisdiction to improve equine welfare by reducing clinical disease in individuals; but also because of the financial losses that an outbreak could have on the equine sport industry.
Göran Akerstrom, veterinary director of the FEI said: "The FEI has been a part of a Public Private Partnership with OIE for many years and we admire the work that they do in disease surveillance and global animal health.
"We stand behind their recommendations on vaccination for equine influenza and recommend our athletes to discuss these with their veterinary surgeons when considering their vaccination schedules."
For further information on FEI vaccination requirements visit https://inside.fei.org/node/3289
Having investigated alternative sources of isoflurane, and alternative products, the associations proposed ways that the VMD might mitigate the risks to animal welfare including consenting to the use of unlicensed (“special”) isoflurane formulations.
The VMD responded rapidly and positively. It is understood that one specials manufacturer is now intending to produce isoflurane to fill or partially fill the gap in supply. This should be available in three to four weeks.
David Rendle, a member of BEVA’s Health and Medicines Committee commented: "BEVA has a close relationship with the veterinary pharmaceutical industry and will always work swiftly and collaboratively to help develop practical solutions to supply problems for our members."
BSAVA President Philip Lhermette praised the VMD for such prompt action. He said: "The VMD listened to our concerns and acted immediately. By doing so they have addressed and helped to prevent any potential welfare risks associated with a lack of isoflurane."
Carl Bradbrook, AVA Junior Vice President, reminded clinicians to "seek advice when considering the use of unfamiliar anaesthetic protocols."
The associations say that the situation doesn’t give vets free rein to ignore the medicines legislation; the cascade must still be followed, and client informed consent obtained if an unregulated anaesthetic is used.
Extemporaneous products are the last tier of the cascade. Vets are expected to use either an authorised human medicine or an EU authorised veterinary medicine before an extemporaneous preparation. If, after diligent attempts to source a product higher up the cascade, the vet has not been successful they could consider using an extemporaneous preparation for the immediate need. However, should an authorised product or a human product become available vets are obliged to use it over an extemporaneous preparation.
BEVA, the BSAVA and the AVA have each produced general advice on the use of specials or anaesthesia options at https://www.bsava.com/News/ArticleID/2535/Isoflurane-supply, https://www.beva.org.uk/Resources-For-Vets-Practices/Medicines-Guidance/Veterinary-specials and https://ava.eu.com/
Equip EHV 1,4 is licensed for the active immunisation of horses to reduce clinical signs due to infection with Equine Herpesvirus 1 and 4 and to reduce abortion caused by EHV-1 infection.
Zoetis says it has already communicated directly with veterinary surgeons to inform them that Equip Rotavirus will be out of stock from the end of November 2017 until mid-2018.
During this time an imported vaccine for Rotavirus, will be available to provide an interim solution until supply is restored.
Practices wanting to buy the alternative imported Rotavirus vaccine will need to apply to the VMD for a Special Treatment Certificate (STC).
The company says it acknowledges the concern and frustration this causes its customers and wants to reassure the equine community that it is working diligently to restore the supply of Equip Rotavirus as soon as possible.
For more information, contact your Zoetis account manager or Zoetis technical team.
Bayer has introduced a new microchip scanner which is capable of reading all chips, including encrypted ones.
The company says the new Tracer Advance Isomax V scanner offers exceptional reading distances of more than twice those of other scanners on the market, making it a very versatile tool ideally suited for use in companion animal practices or for detecting microchips in larger animals such as horses.
The technology that gives this scanner its backward compatibility with non ISO standard chips means practices can now save money by only having to buy one scanner, whereas previously two were required to be able to read all types of chip.
Other features of the device include digital signal processing (DSP), which protects against radio interference from TVs and PCs, and connectivity via USB, RS232 or optional Bluetooth interface.
The Tracer Advance Isomax V scanner is available from Bayer and is priced at £499.95. It comes with a 30-month warranty. Contact your Bayer territory representative for further details.
Elanco Animal Health has launched Vulketan, a POM-V sterile topical gel developed to encourage the healing of equine wounds.
Vulketan contains ketanserin - a serotonin-S2 antagonist.2 Elanco says that although serotonin is more widely known as a neurotransmitter in the brain, it is also found in platelets and released during platelet aggregation where it can have negative effects on wound healing.4, 7
Managing equine wounds is an everyday occurrence in equine practice1 and can be difficult and time-consuming, with many potential complications such as infection or the development of proud flesh which could delay healing or lead to reduced functionality. Repeated dressings can be a hassle for owners, and if used inappropriately can lead to their own complications.5
Elanco representative Kirsty Prudon said: "Vulketan gel is easy to use and is designed to be applied to undressed wounds, although it has been demonstrated that wounds may be dressed, if required, without affecting Vulketan's efficacy2,6.
Elanco also points to studies which it says demonstrate that Vulketan has been shown in client owned horses to be highly effective in preventing the formation of hypergranulation tissue and may facilitate the control of secondary infections.2,3,6. In addition, owners expressed satisfaction with Vulketan in over 90% of cases.6
Practising equine vet Linda Belton MRCVS said: "Vulketan is easy to use, well tolerated by horses and produces an excellent end cosmetic result and return to function. With the reduction in the need for dressings and proud flesh control Vulketan has proven to be an advantageous product which owners value."
Vulketan is suitable for use in all horses including pregnant and lactating mares. It is supplied in 75 gram tubes and should be applied twice daily.
For more information, contact your Elanco territory manager call Elanco on 01256 353131.
NEV was first identified in 2013 by veterinary surgeon Dr Isabel Fidalgo Carvalho, who went on to found Equigerminal to develop a commercially viable NEV diagnostic test that can be used by veterinary surgeons, vet labs and horse owners.
Isabel says that NEV - the equine equivalent of HIV - is often misdiagnosed or hidden by other diseases that induce similar symptoms, like anaemia and neurological issues in horses. It is most commonly confused with the Swamp Fever virus (EIAV) and Equine Herpesviruses (EHV).
Indeed, when they tested a number of horses with anaemia, Equigerminal researchers first believed they had found the presence of a divergent strain of the Swamp Fever Virus (EIAV) - because the horses cross reacted with EIAV, but were negative in the official tests. Subsequent research found they were actually suffering from NEV.
Equigerminal says it is believed that NEV is present in up to 10% of horses. Isabel said: "We did test 213 samples from Ireland and found 7% of positive samples for NEV. These Irish horses were horses that usually travel to UK and other locations for sports events."
For the new test, a veterinary surgeon needs to take a blood sample which is sent to the Equigerminal lab.
Isabel says treatment is currently targeted towards improving the general well-being of the horse, health monitoring, and boosting the animal’s immune system. The next stage is to find a treatment, and ideally a cure for NEV. Meantime, Isabel said: “We now need to raise awareness of the problem and help vets to diagnose this disease correctly.”
Dechra Veterinary Products has launched free online Fluid Therapy Calculators to help veterinary staff calculate their patients' fluid requirements.
There are two versions available, small animal and equine. Both are available as an online tool or as a download to your desktop (note that to get hold of the desktop version, you need to try out the online calculator first).
For small animals, there are three options available. The M1/M2/M3 Plan calculates simple multiplications of the maintenance rate, while the Comprehensive Plan calculates fluid required to provide maintenance requirements, correct dehydration or replace ongoing losses. The third option, the Simple Rate Calculator, is a tool for calculating resuscitation fluid rates and can also be used for large animals. The Equine Plan calculates fluid requirements and infusion rates for both adult horses and foals.
Dechra says it has launched the calculators as the next component of its Vetivex Fluid support package. Along with the Fluids Knowledge Programme, this initiative aims to help veterinary staff across the UK to deliver effective fluid therapy.
Larry King, Product Manager at Dechra, said: "The calculators are a quick and easy reference tool for today's busy vet. You simply fill in the body weight and animal type, key in a few details and you have an instant but very accurate fluid rate calculated for you. It saves time and effort and ensures the animal is given the correct amount of fluid. The more effective the fluid therapy regime the faster the animal recovers."
The free Fluid Therapy Calculator is just one of a number of tools Dechra uses to support its Vetivex range of fluids. There is a range of downloadable reference documents, charts and guides available on the website http://www.fluidtherapy.co.uk/ including the Fluid Knowledge Programme and a full CPD Programme focused on effective fluid therapy.
Virtual Vet Derms has been set up to be able to give advice to veterinary surgeons on any aspect of skin or ear disease whether it is allergy, otitis media, cutaneous neoplasia or endocrine-based in any species, including dogs, cats, small furries, exotic pets including raptors, birds and reptiles, horses, camelids, zoo and farm animals.
Sue, herself an RCVS Recognised Specialist in Veterinary Dermatology, is supported by a team of veterinary dermatology colleagues as well as veterinary specialists in exotic medicine, internal medicine (including endocrinology) and consultants with expertise in oncology.
Sue said: "We recognise that not every veterinarian has got access to a local dermatology specialist and that not all clients can or want to travel to a referral centre. The aim of the service is to formalise the advice that dermatology clinicians give to veterinary surgeons to allow them to get detailed help to manage difficult or challenging dermatology cases within their own practice."
The service has been set up under the RCVS Vivet initiative, is approved by all of the major insurance companies and supported with Veterinary Defence Society Insurance cover.
Virtual Vet Derms offers support in a range of ways.
Quick questionsShort questions that veterinary surgeons can submit via the online form on the Virtual Vet Derms website that just require a brief reply. This may be a dose of a drug, a parasite you want identifying, or the interpretation of a blood sample such as an ACTH stimulation test.
Veterinary reportsVeterinary surgeons can use online request forms on the Virtual Vet Derms web site to submit a brief history of the animal and the problem and some good quality photos of the skin condition. There is also the ability to upload histopathology reports, blood samples and any other pertinent information. A detailed written report is sent back to the vet within 48 hours which will describe clinical signs, differential diagnoses, recommended diagnostic tests and treatment option where appropriate. Where possible, Virtual Vet Derms aims to pass the advice request to the nearest dermatologist but vets can ask for advice from any of its specialists.
Telemedicine consultationsFor new cases or for cases where initial advice has been sought, in the client's own primary care veterinary practice via the internet. The Virtual Vets Derms specialist can consult with the owner to provide even more specific advice and support. After each teleconsultation the Virtual Vet Derms specialist will produce a report in the same format as the veterinary report to allow the primary care veterinary surgeon to continue to manage the case more effectively.
Face to face consultationsCan also be arranged via the owner’s vet at the specialist's own practice if there is the need for more specialist investigation that may not be available in the primary care veterinary surgery. In these cases, the specialist will take on the direct care of the case and work with the owner and vet on the best course of action.
General advice Also possible if the vet wishes to direct an owner straight to Virtual Vet Derms.
For more information, visit: https://virtualvetderms.com
All bar one of the suspended drugs contain the NSAID flunixin. The other affected drug is the antibiotic, Tribrissen:
Allevinix 50 mg/ml Solution for Injection for Cattle, Pigs and Horses (Ceva Animal Health)
Cronyxin Injection, 5% w/v Solution for Injection, for cattle and horses (Cross Vetpharm Group Ltd)
Finadyne 50 mg/ml Solution for Injection for cattle, pigs and horses (Intervet UK Ltd)
Flunixin 50 mg/ml Solution for Injection for Cattle, Horses and Pigs (Norbrook Laboratories Limited)
Meflosyl 5% Solution for Injection for horses and cattle (Zoetis UK Limited)
Norixin 5% Solution for Injection for cattle and horses (Norbrook Laboratories Limited)
Pyroflam 50 mg/ml Solution for Injection for Cattle, Horses and Pigs (Norbrook Laboratories Limited)
Tribrissen 48% Suspension for Injection for horses, pigs and cattle (Intervet UK Ltd)
The British Equine Veterinary Association says that the decision to suspend the drugs was taken without consultation with the veterinary profession, and is urging the VMD to overturn the suspension in horses not destined for the human food chain, to reduce the potential impact on equine welfare.
Jonathan Pycock, BEVA president said: "BEVA is fully supportive of all attempts to promote food safety, however flunixin is widely viewed as the gold-standard pain killer in horses and is commonly used in horses undergoing both elective and emergency surgery, for the crippling pain associated with laminitis and for severe forms of colic.
"BEVA is calling on the VMD to immediately enable limited batch release of flunixin for use in horses not destined for the human food chain in the interests of animal welfare. The equine veterinary profession has always been open to consultation with the VMD on a range of important matters relating to responsible medicine use, antibiotic resistance, horse identification, passports and the horse meat issue. BEVA is perplexed as to why the VMD failed to consult with the equine veterinary industry on the animal welfare impact of withdrawing such an important drug.”