Alabama rot, properly known as Cutaneous and Renal Glomerular Vasculopathy (CRGV) first emerged in Alabama in the 1980s, hence the nickname. The lack of understanding on how it spreads or can be stopped has led to high fatality rates for dogs who develop it.
The reason for its sudden appearance in the UK six years ago also remains a mystery.
The disease causes small clots in blood vessels, which eventually result in skin ulcers, tissue damage, and kidney failure in many cases.
Many theories have been put forward about the cause; anything from E. coli-produced toxins to parasites and bacteria. However, without knowing the exact source it is impossible to develop an effective cure.
The treatment offered by QMHA is known as Therapeutic Plasma Exchange (TPE) or ‘plasmapheresis.’ This method involves filtering all the patient’s blood so that toxic substances, including whatever causes CRGV, are removed. Once filtered, the blood is returned to the patient.
The development of this treatment was made possible by the discovery of the similarities between Alabama Rot in dogs and thrombotic microangiopathy in humans, which is also treated with plasma exchange.
The QMHA academics reported that two out of six dogs who underwent plasmapheresis made a full recovery.
The full findings of the research have been published in Frontiers in Veterinary Science1.
Dr Stefano Cortellini, an author of the study and Lecturer in Emergency and Critical Care at the RVC, said: "Despite the fact that only a third of dogs treated with TPE recovered from their disease, this is the first time that dogs so severely affected by CRGV have been reported to survive and so we remain optimistic that TPE may play an important role in the treatment of this deadly disease."
Reference
Linnaeus was founded in 2014 from Willows Veterinary Centre and Referral Service and a team of 120. It was acquired in 2018 by Mars Veterinary Health and has continued to grow, now employing around 3,500 staff.
The referral practices joining Linnaeus are Anderson Moores near Winchester, Dick White Referrals near Cambridge, North West Veterinary Referrals and Eye Vet in Runcorn and Veterinary Specialists Scotland in Livingston.
Linnaeus says the practices will retain their existing branding and will initially continue with business as usual, with all staff transferring to Linnaeus after completion.
Bart Johnson, CEO of Linnaeus, said: “We are delighted to welcome our new colleagues and these fantastic and highly-respected referral practices into the Linnaeus family and to grow our offering further, taking another step towards making an even better world for pets.”
Alejandro Bernal, President, Mars Veterinary Health International, part of Mars Petcare which owns Linnaeus, said: “Pet care has been an important part of Mars for over 80 years and this strategic acquisition reaffirms our commitment both to the pet care industry and veterinary profession.
For more information, visit www.linnaeusgroup.co.uk.
Davies says pulmonic stenosis is one of the most common congenital heart defects in dogs. In most cases it is caused by a malformation of the pulmonic valve with fusion of the leaflets (type A stenosis) or with the presence of rudimentary valves accompanied by hypoplasia of the annulus (type B stenosis).
Dogs with severe stenosis are at risk of sudden death, heart failure and have a decreased survival time in comparison to normal dogs.
Minimally invasive catheter based procedures (balloon valvuloplasty) have become the treatment of choice for valvular pulmonic stenosis, with good results in most but not all cases. French Bulldogs are predisposed to the condition and tend to not respond to valvuloplasty as well as other dogs.1
In this case, the dog was first referred to Pedro Oliveira, RCVS and European Veterinary Specialist in Small Animal Cardiology at Davies, for treatment of severe pulmonic stenosis.
An echocardiogram confirmed the presence of a type B stenosis accompanied by marked right ventricular hypertrophy and also an atrial septal defect.
A standard balloon valvuloplasty procedure was performed without complications and the dog initially showed improvement (click image right to enlarge). Soon after, however, she began to suffer episodes of weakness and collapse and was readmitted.
An echocardiogram showed that the right ventricular obstruction had worsened.
Pedro said: "Re-stenosis has been reported in up to 16% of cases following balloon valvuloplasty and in this case it was suspected to be due to the formation of scar tissue in the valve leaflets. The pressures inside the right side of the heart were now higher than left allowing blood to flow through the atrial septal defect from the right to the left atrium directly without receiving oxygen from the lungs.
"Whenever Gracie got excited or tried to exercise she would go 'blue' from lack of oxygen and collapse. In fact her quality of life was so poor that euthanasia was suggested at that point. For this reason we decided we should attempt this novel procedure. The only other option would have been open-chest surgery (patch graft) but this held a higher risk of complications during the anaesthesia and even death. Also, the cost of surgery would have been higher than this new option."
Pedro performed the procedure with fellow Davies cardiologist, Jose Matos, while Antonia Mavropoulou guided them using transoesophageal echocardiography.
Under a general anaesthetic the heart structure was assessed using transoesophageal echocardiography and angiography to choose the correct size of the stent for Gracie.
An 8mm wide and 4cm long stainless steel catheter tightly mounted on a balloon was chosen.
This was then positioned across the pulmonic valve and the balloon was expanded forcing the stent to open up to its full size (figure 2B). There was an immediate and significant improvement of blood flow through the stent (figure 2C), the patient recovered well and she was discharged four days later.
Re-examination after three months showed improved flow across the stent and a reversal of the right to left shunting across the atrial septal defect. Gracie stopped experiencing episodes of collapse or cyanosis and is now able to exercise and lead a more normal life.
Pedro said: "This technique has been used in very few cases in the whole world and to the best of our knowledge this is the first time it has been used in the UK.
"It is more technically challenging and costly than a standard ballooning although it may provide an effective, safe, and cheaper alternative to patch graft surgery. In this particular case we feel it made an important difference in terms of quality of life and prognosis for Gracie.
The practice's dentistry and oral surgery team, led by Peter Southerden, has now carried out its first two successful reconstructions using the technique, following oral tumour resection.
Use of patient-specific implants (PSI) for jaw reconstruction is a new technique, which provides an alternative to bone regenerative techniques. Both techniques can be used in cases which have had significant jaw resection or need reconstructive surgery after a trauma.
Peter said: "To my knowledge, using this technique to create patient-specific implants for rostral mandibular reconstruction following bilateral rostral mandibulectomy has not been reported in dogs before.
"The reconstructive surgery involves taking pre and post-operative CT scans of the affected area and sending them to a specialist human medical PSI design company, which then uses 3D titanium printing technology to recreate the missing bone.
"In our first two cases, both dogs are doing really well. The feedback we’ve received from owners suggests their dogs have gained significant benefit from the jaw reconstruction process."
Peter is one of three dentistry and oral surgery clinicians at Eastcott alongside Andrew Perry and resident Ingrid Tundo, with a second resident due to join in 2019.
The team caters for dentistry cases including periodontology, endodontics, orthodontics and restorative dentistry, to complex cases including oral tumours, traumatic injuries and congenital issues such as cleft palates.
Peter added: "There aren’t many people with specialist qualifications in this field, possibly only six in the UK and we are the only team working with the backup of a multi-disciplinary referral hospital.
"Having a team of three, soon to be four, is unusual and means we have a big caseload and see a wide range of different cases. We are very keen on developing new techniques such the ones we have already introduced."
For more information about Eastcott Referrals, visit www.eastcottreferrals.co.uk.
Sylvie, a four-month-old Maine Coon, was referred to NDSR with a loud heart murmur. Scans revealed she was suffering from a severe obstruction on the right side of her heart which was steadily becoming worse.
Her condition, double chambered right ventricle, is very rare and, until now, could only be corrected by open heart surgery. However, NDSR specialist cardiologist João Loureiro believed this would be too much of a risk for frail Sylvie, so he opted for a cutting balloon angioplasty which had never been applied to cats before because their hearts are so small.
He and fellow cardiology specialist Joel Silva carried out the procedure, which involved inserting two balloons on a wire into a vein in Sylvie’s neck and on to her heart. The first had four cutting blades, which were manipulated to score the obstruction before the second was gently inflated in order to relieve it. After the wire and balloons had been removed, the incision in Sylvie’s neck required just two stitches and within 48 hours she was well enough to return home.
A subsequent scan showed the level of obstruction had been reduced from severe to mild and her owner, Dr Bob Baxter, described her as “much more lively”.
João, who has a special interest in the treatment of congenital heart disease in small animals, said the decision to perform the interventional ballooning was made because of the risks of open heart surgery and the recent development of veterinary applications of the cutting balloon technique.
João said: "As Sylvie’s condition was so rare, wider application of the technique is limited in terms of the number of cats which could benefit from it. However, it is extremely relevant to those individuals who are affected and could be of use in the treatment of other, more common, conditions."
Joel said: "Cutting balloon angioplasty is routinely used in human medicine for treating narrowed and stiffened blood vessels and has recently been adapted to treat a heart condition in dogs but we believe this may be the first time it has been used to treat this condition in a cat."
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
The practice, which is owned by the Linnaeus Group, says it will be refurbishing its existing facilities, extending its premises, hiring more specialist veterinary surgeons, veterinary nurses and support staff and installing state-of-the-art new equipment.
In addition, it plans to refresh its intern programme and launch a nurse training programme.
A six-month programme of building works will include a new reception area, consultation room and medicine and surgery wards.
New services and facilities will include a cat ward, X-ray department and endoscopy and chemotherapy facilities.
Operations manager Daniel Hogan (pictured right), said: "This is a very exciting period as we grow in every possible area and work more closely with referring practices to continue to develop our bespoke and exceptional service for patients and clients.
"Our aim is aspiring and simple: to create the very best referral centre possible by bringing together the expertise of the very best of veterinary professionals supported by the very latest in technological innovation."
For more information about Southfields Veterinary Specialists, visit: www.southfields.co.uk.
DVS highlights that the phenomenon of large group veterinary businesses is on the rise: big corporations such as Pets at Home Vet Group have recently bought stakes in several of the UK’s biggest referral practices and CVS Group, for example, now owns more than 360 of the UK’s veterinary surgeries, including referral practices.
By contrast, Davies Veterinary Specialists has now reduced the shareholdings of its founder (Jerry Davies), financial director (Mike Thomas) and managing director (Clive Elwood), in order to increase the holdings of Ian Battersby (internal medicine), Ronan Doyle (soft tissue surgery), David Gould (ophthalmology) and Nat Whitley (internal medicine) and create 8 new shareholders: Louise Clark (anaesthesia), Nuria Corzo-Menendez (diagnostic imaging), Mike Farrell (orthopaedic surgery), Laurent Garosi (neurology), Mark Goodfellow (oncology), Patricia Ibarrola (internal medicine), Pedro Oliveira (cardiology), Peter Smith (neurology).
The company says that its increasing number of shareholders will build a more effective business democracy, and in turn help uphold its core values of integrity, professionalism, compassion and respect.
Clive Elwood said: "Maintaining our independence is important to us as a business because it ensures we retain the culture and ethos that provides leading multi-specialist care to all of our patients and exceptional service to our customers and referring colleagues.
"I am delighted we have managed to achieve this transaction, which represents the next stage in the development of our amazing practice. Retaining ownership means we can demonstrate that there remain alternative business models and career paths outside corporate practice. It is a pleasure to welcome such a fantastic group of new shareholders who will, I am certain, contribute greatly to our future success."
DVS says it will continue to evolve the management and governance structure of the practice as it grows. In the future DVS shareholders will set overall strategy and direction for the business and ensure effective governance by the Board of Directors. As well as clinical skills, the development of management and leadership skills will be encouraged across the practice. A strong commitment to learning, research, innovation and teaching will support the delivery of exemplary patient care.
To find out more visit www.vetspecialists.co.uk
Josep Aisa has arrived from Glasgow University, where he spent four years as a lecturer focusing on soft tissue procedures. He has authored numerous scientific papers and given presentations to international veterinary meetings, specifically on orthopaedic conditions.
Josep has a keen interest in oncological surgery and also boasts a broad area of expertise including orthopaedics.
Veronica Mortera has just finished a three-year residency in Neurology and Neurosurgery at Bristol University where she specialised in spinal surgery and inflammatory diseases of the brain. In 2014, she completed an internship in Small Animal Medicine and Surgery at Glasgow University where she authored a paper on MRI abnormalities in dogs with portosystemic shunts.
Veronica also spent three months in Geneva with the World Health Organization helping in the development of Public Health guidelines.
Joining Veronica in the neurology department is Francesca de Strobel, who earned a PhD from the University of Padua, in Italy, after writing a thesis on intervertebral disc degeneration in a large animal model.
Francesca began work as a Small Animal Veterinarian and Clinical Assistant in Neurology at the University’s Veterinary Teaching Hospital before moving to the UK in 2014 to begin an internship in neurology at Dick White Referrals, where she completed a three-year residency programme in small animal veterinary neurology and neurosurgery.
She enjoys all aspects of neurology and neurosurgery, with a particular interest for spinal surgery, metabolic and intracranial disorders.
North Downs is also extending its facilities with new consultation rooms, extra theatre and procedure rooms, more kennels, new staff facilities and extended vet space, along with a new meeting room. It is also creating a central imaging suite, with new MRI and CT scanners.
Hospital director Terry Emmerson said: "These are very exciting times at NDSR as work on the new extension begins and the plans actually start to take shape.
"It’s definitely a powerful illustration of our commitment to offer the very best service possible to all our patients, both in terms of facilities and equipment and in our clinical care."
Photo: From left, Veronica Mortera, Josep Aisa and Francesca de Strobel
Nat Whitley, clinical director at Davies Veterinary Services, said: "We are delighted to become part of the Linnaeus Group. We pride ourselves on delivering excellent service, so when the opportunity arose to become part of such a forward-thinking, impressive group it was a great match."
Emma Barnes, Linnaeus Group operations director, said: "We are very pleased to welcome Davies Veterinary Specialists to the Linnaeus family and look forward to combining their excellent work and care with our expertise, experience and support.
"We carefully select our partners in the Group to ensure the delivery of the highest quality of care and service across the entire business, which is why we are so pleased to have the Davies team on board."
Davies says its Cardiac Electrophysiology Laboratory, headed by Pedro Oliveira (pictured right), is one of only four centres in the world to perform the procedure, and it has usually required human medical support. The fact that they've been able to operate independently means the procedure should now start to become more readily available.
The procedure involves introducing special catheters via peripheral veins into the heart, where they are used to record the electrical activity of the heart muscle, thereby allowing the identification of the source and mechanism of cardiac arrhythmias.
Once the abnormal tissue is found, it is destroyed using intense localised energy delivered by another specialised catheter: radiocatheter ablation.
This technique is common in human medicine but very rare in veterinary medicine because of the level of specialisation needed.
In the past, the cardiology team at Davies needed the support of a consultant and a cardiac physiologist from the human field to help carry out the surgery. Having now done it unaided, Pedro is confident that in time Davies will be able to help considerably more patients, promptly after diagnosis.
Pedro said: "In three years we have treated one cat and 19 dogs. Several cases did not survive long enough for surgery despite a waiting time of only a few days to up to two weeks from referral to the procedure. Most of these dogs were puppies. This is incredibly frustrating as if performed early these procedures are curative for most patients."
Davies says that to date it has had a procedural success rate of 100%, with recurrence of the arrhythmia in just one dog. The remaining dogs were cured from their arrhythmias and recovered fully except for two dogs that had sustained too much heart muscle damage and continued to suffer from congestive heart failure.
Pedro added: "Hopefully in the future severe muscle damage can be avoided by early referral when the arrhythmia is detected. If you diagnose a cardiac arrhythmia, especially supraventricular tachycardia, please consider this treatment option because it is very likely to be curative."
The Davies cardiology team can be contacted at cardiology@vetspecialists.co.uk.
Incidentally, Pedro has also co-authored (with Ruth Willis and Antonia Mavropoulou) a new book on electrocardiography. Guide to Canine and Feline Electrocardiography will be published in September 2018 and is available for pre-order on Amazon now, priced at £89.99.
The buy-out was led by Professor Nick Bacon, Clinical Director, Dr Laurent Findji, Senior Clinician, Dr Jonathan Bray and Dr Gerard McLauchlan, who will collectively take the hospital forward with the financial backing of a small team of external investors.
Professor Noel Fitzpatrick will continue to lead Fitzpatrick Referrals Orthopaedics and Neurology and Fitzpatrick Referrals Institute for the Restoration of Skeletal Tissue which are both based in Eashing, Surrey.
Fitzpatrick Referrals Oncology and Soft Tissue is rebranding as AURA Veterinary, continuing to focus on animal oncology, soft tissue surgery, interventional radiology and internal medicine.
Under the new management team, AURA Veterinary says it has plans to invest in its team, equipment, scientific innovation and research.
Noel said: “I am proud of everything and everyone who has been part of the journey over the last seven years.
"It is a world-class hospital with an unrivalled team and the foundation we have built together is incredible.
"The time is now right for the team to embark on the next part of their journey - allowing me to also go forward and focus my passion, energy and time at Fitzpatrick Referrals Orthopaedics and Neurology and lead that team into its exciting new phase.”
Nick Bacon, Clinical Director, said: “It was a wonderful opportunity to be involved with a hospital like this from the very beginning, and it’s exciting to be part of its new chapter.
"Laurent and I are hugely grateful to Noel for his vision in creating the hospital, which is unparalleled in the level of care, skill and innovation our team can provide for our patients.
"We look forward to the growth and success of AURA Veterinary.”
Photo: Dr Gerard McLauchlan (standing, back left, in darker scrubs), Professor Nick Bacon, Clinical Director (sitting, front left), Dr Jonathan Bray, (sitting, right), Dr Laurent Findji, Senior Clinician (standing, far right)
The clinic will offer referrals in orthopaedics, internal medicine, soft tissue surgery, neurology and advanced imaging from a team which includes Rory Bell, an RCVS and European Recognised Specialist in Internal Medicine, and Jonathan Bell, an EBVS and RCVS Specialist in Small Animal Surgery.
The practice says it has some of the most advanced equipment in Europe, including a Siemens 128 slice CT scanner and a Siemens 1.5T Aera MRI scanner. The clinic also has three environmentally-controlled theatres, with CT and MRI scanning capabilities.
Dr Stuart Cooke BVetMed CertSAS MRCVS, one of Swift Referrals founders said: “We’re delighted to launch Swift Referrals, and would like to thank everyone who helped us get here. We are proud to be able to say that we house some of the most advanced equipment in the continent, from the very best advanced imaging machines, to specialist treatment and aftercare rooms. We also have some of the most skilled veterinary experts operating in them, day in and day out. Our clinicians are leaders in their field of expertise, with years of experience and very advanced training."
For more information: www.swiftreferrals.co.uk/.
A graduate of University College Dublin, Richard started out in first opinion practice after completing an internship at the University of Glasgow.
While studying medicine, Richard researched mast cell tumours in dogs, which led to an MSc in clinical Oncology. He went on to complete a PhD on mast cell tumours at the Royal Veterinary College in 2008.
Richard works with referral oncology patients and clients two days a week at LVS and currently spends the rest of his working week as an oncology consultant for IDEXX Laboratories.
From February, Richard will also be working at Southfield Veterinary Specialists in Laindon, Essex, thereby allowing him to refer oncology patients for radiation therapy at Southfields when necessary.
Richard said: "Having never been comfortable with operating myself, working with a team of this calibre and experience in a welcoming environment within central London was very attractive. It has been a very fulfilling role for me, especially as both our team and the scope of the services we can offer continue to expand.
"Given the high standard of care offered by local vets in the area, the patients referred to LVS are often very challenging. Together with our clients’ high expectations, the service is definitely not run-of-the-mill but all the more rewarding because of that.
"I’m looking forward to bringing my experience in both research and clinical spheres to LVS."
Richard’s main professional interests are mast cell tumours, novel diagnostics and immunotherapeutics, but he is experienced in all aspects of veterinary oncology and can also offer advice about internal medicine cases.
The referral centre recently extended its floor space at its base in Cheshire to support a major expansion of the services being offered, which include orthopaedic, soft tissue and spinal surgery and internal medicine; with specialist support in anaesthesia and pain management, a diabetes clinic, intensive care, cardiology, diagnostic imaging, neurology (medical and surgical) and oncology.
Liz Cousins, hospital manager at Northwest Veterinary Specialists, said: "The success of NWVS is down to the dedication of our highly skilled clinical, nursing and support teams.
"Our clinicians are well respected specialists in their chosen disciplines and it’s fantastic to be able to offer new services to pets and first opinion vets.
"The hospital is home to 88 colleagues and the change of name now reflects the growth and dedication by everyone here at Northwest Veterinary Specialists since opening in 2002."
Northwest Veterinary Specialists provides specialist veterinary services to veterinary practices in north west England and north and mid Wales.
Liz added: "At Northwest Veterinary Specialists we treat pets from as far apart as Carlisle, North Yorkshire and Staffordshire.
"The facilities are state-of-the-art, demonstrating a quality of service both for our clinicians and our clients, but most importantly the pets that we treat."
Lead surgeon at Roundhouse, Ross Allan (pictured right), an RCVS Advanced Practitioner in Small Animal Surgery, said: "We know many practitioners and clients have been frustrated by the difficulties in availability of TPLO in Scotland and we wanted to change that.
"As with our other Roundhouse Referral offerings, we have done away with long waiting lists, unpredictable pricing, and challenges in clinical continuity. We know that in doing so we will revolutionise access to this service and the experience of its users.
"Our TPLO service offers excellent value and quality – we have invested heavily in the very best DePuy Synthes TPLO plates and implants and, together with our hospital status, standards and track record, we are offering a premier TPLO service in Scotland: a TPLO with a recovery that is as reliable and predictable as our Fixed Price!"
The fixed prices for a TPLO are £3000 for dogs under 40kg and £3100 for dogs over 40kg.
The price includes the consultation, diagnostic X-rays/assessment, pre-surgical blood samples, hospitalisation, anaesthesia, surgery (including implants), follow up consultation and follow up X-rays.
Ross added: "We don’t expect anything to go wrong, but should we need to revise our surgery we would do so at no additional cost to the client – that’s our Fixed-Price Fix!"
To make an enquiry, or refer a patient for a Fixed Price Fix TPLO contact Roundhouse Referrals at 0141 649 1316 www.rhr.vet
The practice has also strengthened its surgery services with the appointment of Dr Delphine Holopherne-Doran, European Specialist in Veterinary Anaesthesia and Analgesia.
Ivan graduated from Bristol University in 1997. He worked in Hertfordshire before completing a surgical residency under the tutelage of Professor Peter Holt at Bristol University. Ivan has worked in referral centres in the UK and France. He is an RCVS Diplomate in Small Animal Soft Tissue Surgery and a Recognised Specialist in Small Animal Soft Tissue Surgery. Before joining Highcroft, he spent six years working as a senior staff surgeon at Bristol University.
Ed graduated from the Royal Veterinary College (RVC) in 1996. He worked in a mixed practice in Buckinghamshire before undertaking training positions at the RVC, University of Liverpool and the University of Cambridge. He passed the specialist Diploma examinations of the European College of Veterinary Surgeons in 2003. He has previously been a senior surgeon and member of academic staff at the University of Bristol and has worked in private referral practice.
Delphine graduated from Maisons-Alfort (Paris) Vet School in 1998. After working as an equine vet, where she developed an interest in veterinary anaesthesia and analgesia, she returned to vet school in Nantes where she ran the Anaesthesia department for 11 years. During this time, she gained a Master’s degree and a PhD in cardiovascular pharmacology and completed a residency, gaining European board certification in anaesthesia and analgesia, which led her to visit and train in universities around the world.
Highcroft Hospital Director Mr Chris Mayers said: “Ivan and Ed bring a wealth of experience in urinary tract surgery and, in particular, in urinary incontinence to Highcroft. The most common presentations are juvenile animals with ectopic ureters or urethral sphincter mechanism incompetence (post-spay incontinence). Ivan and Ed offer an innovative, minimally-invasive procedure using cystoscopically-guided laser ablation for patients with intramural ectopic ureters. Interventional radiology techniques are also a major interest for the team providing new, minimally-invasive solutions for intrahepatic shunts. The two surgeons have firmly adopted Subcutaneous Ureteral Bypass Systems (SUBS) in treating cats with ureteral obstruction, typically caused by calculi.
"Delphine adds world-class expertise in anaesthesia and analgesia and is already making a huge contribution to our hospital. With a high degree of skill in managing cardiovascular physiology and pharmacology cases, Delphine boosts our ability to support highly challenging and complex patients. Her knowledge of the use of local and region blocks for treating highly challenging pain cases and the anaesthesia of complex cardiovascular patients provides outstanding care for patients and promotes the highest standard in analgesia."
Highcroft Veterinary Group is based at 615 Wells Road, Whitchurch, Bristol and can be contacted on 01275 832410.
The 18,000 sq ft centre's facilities include a £1 million imaging suite with state-of-the-art MRI and CT scanners, five operating theatres and extensive kennelling facilities and cat wards. It is also equipped with fluoroscopy equipment with additional mobile C-arm, mobile digital radiography, a Phaco machine and Mindray WATO anaesthetic equipment.
A total of up to 80 staff will be employed at Paragon, including up to 18 referral veterinary surgeons and 32 nurses. Treatment will include ophthalmology, orthopaedics, soft tissue surgery, cardiology, neurology, medicine, oncology and dermatology.
The centre, which is part of Dewsbury-based Calder Vets, which has 12 practices across Yorkshire, is being led by managing director Ian Monteith and clinical director Adam Bell.
Adam said: "The opening of Paragon is the culmination of an 18-month project to bring the very best quality referral veterinary centre here to Wakefield.
"We’re delighted to open our doors and the team here at Paragon Veterinary Referrals are totally committed to, and looking forward to, providing excellent care for patients using the latest veterinary techniques."
For more information about the services Paragon will be offering, and for details of the vacancies on offer at the vet centre, as well as Continuing Professional Development (CPD) opportunities, visit www.paragonreferrals.co.uk.
The team at the centre will be led by Dr Ryk Botes (pictured right), a Medivet Branch Partner with a special interest in orthopaedics and, in particular, replacement surgery.
The company says it is investing in specialist equipment to help the team refine current surgical techniques, including a gait analysis walkway which will be used to help diagnose the cause of lameness and be a means to measure improvement in surgical cases objectively. The data it provides will also enable the team to publish its results in peer-reviewed papers.
Ryk, who qualified in South Africa and joined Medivet in 2013, said: "The volume of elbow, hip and knee replacements we undertake is growing rapidly and the creation of this new centre of excellence at Medivet Faversham will enable us to provide an even higher standard of service to our clients and to help develop and refine orthopaedic techniques for use by the wider veterinary community.
"Data from the gait analysis walkway will be particularly useful in sharing our findings in scientific papers. We will also use the data to support an ongoing research project in elbow replacement surgery in partnership with one of the leaders in implant technology based in Zurich, Switzerland.
CVS says there has been a steady increase in the number of clinicians offering peripatetic services on the premises of host practices in almost every area of clinical work, including surgery, cardiology, diagnostic imaging and dermatology. It's a model for improving patient access to more advanced levels of clinical care.
The company has appointed Ben Walton BVSc DSAS(Orth) MRCVS (pictured right), an RCVS Specialist in Small Animal Surgery (Orthopaedics) at Chestergates Veterinary Specialists, to head up the new network (called the Advanced Clinical Services Network, or ASCN). In a previous life, he offered a peripatetic surgery service in the North West of England and North Wales for several years.
Ben said: "I believe that the new network will deliver huge advantages to a number of stakeholders. The peripatetic model is an attractive proposition from a number of perspectives.
"For the host practices, is allows cases to be managed to a greater depth in-house, improving their service offering, and increasing opportunities for development of the practice team. It also allows the retention of revenue from these cases, which in turn justifies investment in facilities.
"For the client and patient, it improves the level of care that they receive at their home practice. Visiting clinicians bring expertise into practices through their own knowledge and experience, but also through development of the practice team, thus improving standards across the board."
Ben believes the model also offers better clinical career progression for experienced vets: "I believe that clinically-satisfying roles can be hard to come by at the moment.
"As a profession, we tend to be good at looking after our recent graduates. CVS, other large groups and independent practices have worked really hard on this over the last few years. There are also plenty of opportunities to develop your career on a management track, especially in the large groups.
"What there is a real lack of, though, are jobs that allow genuine clinical development. Many vets are well-supported to gain certificates and Advanced Practitioner status, but often there isn’t a satisfying caseload at the end of it.
"Within the new network, experienced vets will have a caseload that is predominantly or exclusively within their preferred discipline, and as they will be performing higher-value work than they would in a GP position, better remuneration packages will be justifiable. Ultimately, we want to be able reward experienced vets well, for doing a job that is clinically satisfying, and provides a valuable service to host practices and their clients."
CVS says it intends to develop the Advanced Clinical Services Network in multiple disciplines nationwide over the next few years.
Ben added: "Primarily, the ACSN is being established to service CVS practices, but we envisage that many of the services will also be available to non-CVS practices."
For more information, visit careerswithcvs.co.uk
The new practice was created by refurbishing the premises of what was a purpose-built human hospital, turning it into a referral clinic with two operating theatres, separate accommodation and waiting rooms for cats and dogs, offices and a seminar room.
Funding for the refurbishment came from NatWest, with further funds for things like digital radiography and a CT scanner coming from Lombard Asset Finance.
Martin said: "We decided to open East of England Veterinary Specialists to offer a more personal, yet professional service for pet owners in the local community. Thanks to the funding from NatWest and Lombard, we have been able to create a well-equipped surgery where we can offer the highest level of veterinary orthopaedic expertise.
"We have enjoyed welcoming our first customers over the past month and look forward to continuing to establish ourselves as an expert orthopaedic veterinary clinic, where 100% of referred cases will be managed by a Recognised Specialist."
For more information, visit: https://eoevets.com or telephone 01223 795023
Photo: L-R Karl Simper, relationship manager at NatWest, Martin Owen, co- founder of East of England Veterinary Specialists, Mat Parkhouse relationship manager at NatWest and Mark Bush, co- founder of East of England Veterinary Specialists.
Sam and Dick will be joint Clinical Directors of the hospital and co-owners of the business alongside the Pets at Home Vet Group, their Shared Venture Partner.
They say the vision is to create a world-class facility with a team of highly motivated veterinary specialists, nurses and support colleagues providing outstanding levels of service to meet the needs of referring veterinary surgeons, their clients and patients.
The purpose-built facility will offer specialist referral services across a range of disciplines, including anaesthesia, diagnostic imaging, internal medicine, orthopaedics, neurology and soft tissue surgery. Emergency referrals will be accepted seven days a week, 24 hours a day.
Sam said: "It is truly exciting to build a new team of experienced specialists who have clinical excellence as their priority. We also relish the chance to develop great relationships with professional colleagues in first opinion practices. This will allow our hospital to deliver an exceptional level of service for referring veterinary surgeons and their patients."
Dick said: “This is a very exciting step and I am delighted to be instrumental in ensuring that our new centre in Scotland offers the very best in veterinary care”.
The hospital will be based at Deer Park in Livingston, with convenient parking and easy access to the M8 and other major road and rail networks. In addition to clinical services, it will provide a CPD programme, including internship and residency opportunities.
The UK has now seen a total of 169 confirmed cases of Alabama Rot across 38 counties, since 2012. Six cases were confirmed in 2012, climbing to 40 in 2017 and 46 so far in 2018.
The new research, which was carried out in conjunction with the Royal Veterinary College, found that almost 95% of confirmed cases of Alabama Rot have occurred between November and May, with the highest number of cases being reported in February.
It also found most of the cases have been confirmed in western and southern parts of England, with the highest number found in West Sussex, Dorset, southern Hampshire, Greater Manchester and Monmouthshire. Far fewer cases have been reported from the eastern half of the country and East Anglia in particular.
David Walker, Head of medicine at Anderson Moores and co-author of the research, said: "This research, which was funded by the New Forest Dog Owners Group and the charity Alabama Rot Research Fund, was designed to look for geographical patterns, as well as environmental and climatic risk factors.
"A distinct seasonal pattern is suggested, with the vast majority of cases occurring between November and March, and limited cases over the summer months – just 6.5% of cases have been confirmed from June to October.
"In the scientific world a lot of research is not earth-shattering, but it all builds together and little by little we make progress.
"This information is good in terms of how we manage the next stage of research, however we need to be careful and not jump to any conclusions at this point".
Researchers say the disease has been reported in a wide range of breeds (35 in total) but, due to the small number of cases, it is not yet possible to say with any certainty whether a specific breed has an inherently increased or decreased risk of the disease. Any patterns may simply be the result of varying breed populations in different parts of the country.
Dr Huw Stacey, vet and director of clinical services at Vets4Pets, has been supporting research on the condition for a number of years. He said: "Since we held the first Alabama Rot conference in May 2017, vets and relevant professionals have been working hard to understand more about the condition.
"We know how the disease presents and how it affects dogs internally, and this research adds some interesting information that may help to increase vets’ index of the suspicion for the disease.
"The information on climate and ground type will help us further explore possible triggers for the disease, but at the moment we can’t say if any breeds are more likely to develop the disease.
"The first sign of the disease that is normally seen is a skin sore or lesion that isn’t caused by a known injury. Most commonly these sores are found on the lower half of the leg and appear as a distinct swelling, a patch of red skin or are open and ulcer-like.
"With 46 cases in 2018 already, it is understandably very worrying for dog owners, but we think the increase in cases is partially due to an increased awareness of the disease.
"However, this disease is still very rare, so we’re advising dog owners to remain calm but vigilant, and seek advice from their local vet if their dog develops unexplained skin lesions.
"While this research may be a stepping stone to finding the cause of Alabama Rot, there is currently no known way to prevent a dog from contracting the disease."
*also clinically known as
Ludivine, who graduated in 2008, has come over from America to take up the new post, having just completed a three-year residency at the University of Pennsylvania in Philadelphia.
She said: "I’m really enjoying working as part of a great team and working with the various different disciplines here.
"I’m passionate about my ECC speciality and I have a keen interest in respiratory diseases, trauma and acid base disturbances.
"I also like teaching and being updated about the most recent studies in ECC to ensure I can deliver the most up-to-date care possible for our patients."
Ludivine was born in France and originally studied at her home town university in Lyon, progressing to a rotating internship there after graduation.
In 2012, she worked as an emergency veterinary surgeon in several general practices across France and Switzerland, before moving to the United States in 2014 to see how ECC medicine was practiced overseas.
First, she undertook an ECC internship at the University of California, followed by a three-year residency at the University of Pennsylvania.
Away from work, Ludivine enjoys horse riding, running, work-outs and practising her skiing in the French Alps. She also has two dogs Dalhi her Golden Retriever and Baya her German Shepherd.
For more information, visit www.willows.uk.net/en-GB/specialist-services.
Cancer Care for Pets offers both clinical and palliative care for pets with cancer, supporting the work of the first opinion team at Donaldson's and taking referral cases from far and wide.
Neil and Kirsty have worked in practice together in the Yorkshire area for seven years, working with owners and families to create treatment plans involving diagnostic investigations, specialised imaging, surgery, chemotherapy and palliative care.
Neil said: "As far as we know, we are one of very few services to offer this combination of veterinary and nurse-led consultations, where comprehensive cancer treatment and care plans are developed together with owners. We have worked hard to instil our team approach where, following surgery and treatment, the Cancer Care team, the owner and the referring practice are all involved in the pet’s ongoing care and wellbeing."
Kirsty said: “Neil and I do many of our consults together. Neil will give his clinical overview and I will help owners to process and understand the treatment and the next steps for their pet.
“It was incredibly important to us to create a friendly, welcoming environment in our new dedicated consultation area at the hospital. We need people to trust us and be honest about how fit and well their pet really is, in the knowledge we are not automatically going to tell them there is nothing we can offer them. Treating cancer is about life, not managing a death, and making sure that the pet’s life – even if it is limited – is as good as it can be.”
Neil said: "The Cancer Care for Pets team will be working alongside the wider Donaldson’s veterinary and nursing teams and we are keen to learn from each other. The facilities at the hospital are second to none, particularly our new purpose-built consultation area, the practice’s new CT scanner and the high spec operating facilities. Donaldson’s also has a well-respected rehabilitation and pain clinician with whom we can work closely to help our older patients to keep mobile, flexible and maintain activity levels.”
Neil and Kirsty are supported by a third member of the Cancer Care for Pets team, oncology nurse Jenna Carrick RVN.
Cancer Care for Pets is now accepting referrals. Contact: info@cancercareforpets.co.uk or 01484 242911.