Dr Guillaume Leblond, an American Specialist in Neurology at North Downs Specialist Referrals in Bletchingley, Surrey, reports having 'remarkable' success using dorsal atlantoaxial stabilisation to treat spinal malformations in dogs.

His most recent case was five-year-old bulldog called Jesse.

Guillaume said: "Jesse was suffering from both atlantoaxial instability and a spinal arachnoid diverticulum in the thoracic spine. 

“As a result of the two conditions, he had lost a lot of mobility and was dragging his hind legs behind him. 

“We decided it was best to carry out two separate operations, prioritising the surgery to tackle the atlantoaxial instability as that was potentially life-threatening. 

“I used a new technique for this, adopting a dorsal approach, which involves an insertion through the top of the neck when normally this type of surgery is generally performed ventrally, through the bottom of the neck. 

“We have had great success with this approach so far.

"The normal mortality rate is between 5 to 10%, however, we have now done 20 of these procedures together with colleagues, all of which have been successful. 

“The main advantage of the technique is it likely reduces the risk of complications, which is why I prefer it. 

“With the ventral approach you go through the soft tissue and nerves in the neck which brings the risk of vomiting, regurgitation, megaesophagus, swelling and even tracheal injury.” =

Guillaume has co-authored a publication on the dorsal surgical technique which can be found at: https://doi.org/10.3390/life11101039 

Sue Paterson FRCVS, the RCVS and European Dermatology Specialist, Past-President of the BSAVA and founder of Virtual Vet Derms has launched PetDerm shampoo soap bars.

The new bars are designed specifically for owners who want a sustainable choice. They contain no harmful preservatives or foaming agents and are SLS and parabens free. Sue says that all the ingredients in the soaps have been selected to minimise their environmental impact and help maintain a healthy skin and coat.

Sue said: "Dog owners are environmentally conscious and recognise that in addition to their own carbon footprint their furry family member also has an important part to play when it comes to sustainability."

Apparently, Zurich’s Institute of Environmental Engineering has shown liquid soap has ten times the carbon footprint of bar soap: bottles need more energy and water to produce them, they are less efficient to transport, and many contain synthetic chemicals which can cause damage to the ecosystem if they get into water sources.

Sue added: “We need to make the same sustainable choices for our pets as we make for ourselves. One shampoo soap bar is the equivalent of two bottles of shampoo so they are not only good for the planet they are great for your pocket as well. It makes it easy for pet owners to make the right choice and reduce their pet’s carbon footprint without compromising on their care.”

For more information visit: https://virtualvetderms.com/login/product/antibacterial-shampoo-bar or https://virtualvetderms.com/login/product/soothing-shampoo-bar.

TerraCycle, a global recycling company, has launched VetCycle, a national recycling scheme through which veterinary practices can dispose of hard-to-recycle waste, such as personal protective equipment, plastic pet food packaging, medicine blister packs, pet products such as dog leads, muzzles and brushes, and general business waste. 

To use the service, you order recycling boxes to suite your needs, and then place them where it will be most convenient for staff to throw the rubbish in.

Once full, you send the box back to TerraCycle via UPS.

It is then saved from incineration or landfills and recycled by TerraCycle.

Once collected, products and packaging are sorted and separated by material composition.

The separated items are then cleaned, shredded, and made into new recycled products such as outdoor furniture and decking, playgrounds, benches, or watering cans.

Hannah James, Head of Environment, Social & Governance at VetPartners said: “We started using the Zero Waste Boxes at our practices during the pandemic to recycle the large volumes of PPE being used, and they were instantly popular with practice teams.

"We’re now recycling plastic packaging, pet food packaging and medicine blister packs through TerraCycle as well, and since 2020 we’ve saved over 14 tonnes of waste from landfill and incineration.

"The Zero Waste Boxes are an important feature of our sustainability strategy, providing a solution for much of the waste generated by veterinary practice that isn’t hazardous and yet isn’t widely accepted for recycling.”

www.vetcycle.co.uk

A new study published this week in the Journal of Internal Veterinary Medicine has found that canine Chiari-like malformation (CM) can cause significant pain and impact on activity, temperament and sleep¹.

Lead author Professor Clare Rusbridge, Chief of Neurology at Fitzpartick Referrals, conducted the study because of a lack of clarity on the recognition and diagnosis of the clinical signs associated with CM as opposed to syringomyelia (SM).

CM is an abnormality in the skull, making it smaller, and impacting on the brain to alter the flow of cerebrospinal fluid; this results in pain and a collection of fluid pockets within the spinal cord. These fluid pockets are commonly known as SM and over time can cause irreversible damage to a dog’s spinal cord. However it is not clear whether signs of pain in affected dogs are due to CM or SM or both. 

To try to rectify this, Clare studied the medical records of all the cavalier King Charles spaniels diagnosed with CM-associated clinical signs presenting to her at Fitzpatrick Referrals over a five year period. She documented the historical and examination findings and related them to the MRI findings, including presence and size of the SM. 

She found common signs in all dogs were vocalisation, spinal pain (neck, middle or lower back), reduced activity, reduced stairs or jumping ability, aversion to being touched or groomed, altered emotional state (described as being more timid, anxious, withdrawn or aggressive) and sleep disturbance.

A tendency to rub or scratch at the head or ears was common but was more likely in dogs with small or no SM suggesting that this may be a sign of head discomfort associated with CM. Head and ear rubbing was not associated with the presence of material within the middle ear (a condition which is also common in this breed and often given the acronym PSOM).

The only signs that were specific to SM were phantom scratching, scoliosis (twisted spine) and weakness and these were only present when the SM was large (at least 4mm wide).

Clare says this study is important because it suggests that CM alone is a cause of pain in many dogs. The aim now is to use the information gained in this study to develop a questionnaire to determine risk of CM and monitor the response to clinical signs.  

Reference

1. Rusbridge, C, McFadyen, AK, Knower, SP. Behavioral and clinical signs of Chiari‐like malformation‐associated pain and syringomyelia in Cavalier King Charles spaniels. J Vet Intern Med. 2019; 1– 13. https://doi.org/10.1111/jvim.15552

Photo: Charlie on a bad day

Ceva Animal Health has launched a new guide to help vet nurses set up and run senior pet clinics.

The publication of the guide follows a study of vet professionals published in the Journal of Feline Medicine and Surgery which revealed that the main barriers to blood pressure measurement are a lack of time (72.8%) and situational hypertension (92%)¹. 

Vet professionals also thought the main barrier for owners was cost (80%) whilst the least problematic aspect is the longer consultation needed to accommodate a blood pressure measurement  (48.8%).

The guide has been written to address these concerns and empower vet nurses to run nurse-led clinics for older pets.

Written by RVN, Beth Kirwan, the guide provides information on the benefits of vet nurse-led senior pet clinics, which can either be free or paid, together with hints and tips on how to get started and promotion. 

The guide also covers the importance of a senior health-check questionnaire, tips on preparing and setting up a clinic, a 10-point health check providing guidance on what should be covered and information on additional senior pet tests that can be carried out, such as blood pressure checks for senior cats aged seven years or older to help identify feline hypertension.

Beth said: "I was really excited to be asked by Ceva to create this resource for veterinary nurses and grateful for the opportunity to share my experiences and knowledge. 

"I have been a nurse for over 22 years, and I am passionate about making our nurses feel valued in practice. 

"Nurse clinics are a really good way to do this, but I feel that setting up a senior nurse clinic service in a practice creates so much value in many ways and for every member of the practice, from the receptionists to the vets.

"Our RVNs are the stars of the show with senior nurse clinics; they bring so much experience, care and compassion and are a great reflection of our practice values. 

"They often have the time that the vets don't have and will go home knowing they made a difference to a pet and an owner, or a family.

"Veterinary nurses can help identify disease early, support the owners with home adaptations or new medicine regimes. 

"They can also educate the clients in senior and super senior care as our pets are living longer and provide quality of life and end of life support. 

"The benefits are huge; as well as a financial benefit support like this will bond clients to a practice for life.

"We are all businesses, but we need to be caring businesses. 

"I hope the guide provides inspiration to many nurses and empowers them to set up a new service or helps them to improve their current one."

Dr Sarah Caney, RCVS recognised Specialist in Feline Medicine who led the study said: “Our recent survey had more VN participants than vets, showing just how enthusiastic and engaged nurses are when it comes to assessing blood pressure in cats.

"Owners very much appreciate nurse clinics and I’m delighted to hear that there is a new senior pet clinics guide to support nurses in setting up and running successful clinics.”

https://easethepressure.co.uk/feline-senior-health-clinics 

Reference

1. Caney S et al (2023). Understanding the barriers to blood pressure assessment in cats, J Feline Med Surg https://journals.sagepub.com/doi/10.1177/1098612X231183244 

Animalcare has launched Procanicare, billed as the first bacterial GI support product developed from the intestinal bacteria of healthy dogs.

Procanicare contains three live strains of canine-specific Lactobacillus bacteria, which, according to the company, make it an ideal GI support product to maintain balance in the GI intestinal microbiome of dogs, particularly when an alteration to the intestinal microbiome is a risk.

Animalcare says studies show that the strains of Lactobacillus found in Procanicare have been shown to promote indigenous intestinal commensal populations, reduce numbers of potentially pathogenic bacteria and improve stool consistency.^1,2 

Dr Shea Beasley, Product Development Manager at Vetcare Ltd said: "The strains of Lactobacillus found in Procanicare have been commercially available in Scandinavia for two years now. It has achieved great success, with Scandinavian vets frequently recommending it in situations where the gastrointestinal microbiota can become unstable such as following antibiotic use and in stressful situations such as travelling and kennelling, as well as when supporting the intestinal microbiome is particularly important, such as during pregnancy and lactation."

Available exclusively through vets, Animalcare has produced a range of waiting room materials to help you educate about and promote Procanicare in practice, including a poster, bunting, leaflet and leaflet holder.

There is also a free webinar for veterinary professionals on the importance of the intestinal microbiome, available to view at www.thewebinarvet.com/webinar/the-gastrointestinal-microbiome-and-its-effects.

To find out more or to try Procanicare in your practice, contact your local Animalcare representative via email animalcare@animalcare.co.uk or telephone 01904 487687 or visit www.procanicare.com.

References

1. Grzeskowiak et al (2014) Pathogen exclusion properties of canine probiotics are influenced by the growth media and physical treatments simulating industrial processes. J Appl Microbia/. 116:1308- 1314.
2. Gomez-Gallego.C .et al (2016) A canine-specific probiotic product in treating acute or intermittent diarrhea in dogs: A double-blind placebo-controlled effi cacy study. Vet Microbial. 197:122-128.

Hannah Tombs MRCVS, who runs a hedgehog rescue as well as working at VetPartners' Ashworth Vets in Farnborough, has published a guide to help other vets who treat hedgehogs.

Hedgehogs: A Practical Guide for Vets aims to help vets assess sick hedgehogs and administer emergency treatment to stabilise them so they can be transferred to a wildlife rescue centre for specialist care.

Hannah, who has examined and treated more than 1,500 hedgehogs since setting up her sanctuary four years ago, said she also wants to create more awareness that hedgehogs seen during the daytime need urgent help.

She said: “As soon as a hedgehog comes out in the day it is usually a cry for help and they should be taken to the vets or a rescue centre as a matter of urgency.

“I wrote the book to help vets who are more familiar with treating small pets like dogs and cats know what to do if a sick hedgehog is brought to them, and to increase their confidence when treating wildlife.

"There are three simple things that every sick hedgehog needs, which are warmth, fluid and pain relief.”

https://www.facebook.com/p/Hannahs-Hedgehog-Rehabilitation-100070882987122 

A new company called ReCoVa-19 has launched a coronavirus testing and wellness programme designed to help veterinary professionals back into the workplace.

The programme offers employers a variety of options, including antigen and antibody testing, environmental testing, a daily wellness symptom checker app and ongoing site monitoring to identify asymptomatic spreaders and pre-symptomatic spreaders, neither of which are identified by the current routine government testing programmes.

Dr Tony Cooke, lead scientist and director at ReCoVa-19 (pictured right) said: "Businesses, such as veterinary practices are struggling to serve the needs of their clients while also protecting their employees in their role as essential workers. Vets also recognise the value of reliable testing at a sustainable cost and the best practice approach. Concerns over obligations with regard to the health and safety of employees and uncertainty, are significant barriers to normal working practices but with the level of testing and support we can provide that’s no longer necessary.”

The company says the new programme is highly accurate and affordable, and can be tailored for businesses of all sizes.

For more information, visit: www.recova-19.com.

The RCVS Disciplinary Committee has ruled that whilst the care given to a diabetic dog by Paul Roger MRCVS fell short, it did not amount to serious professional misconduct. 

Mr Roger faced three charges: that he had failed to provide adequate care, failed to communicate with the owner adequately and failed to keep adequate clinical records for Honey, a Shiih Tzu dog who, it transpired, had hypergycaemia.

At the initial consultation, Mr Roger took a blood sample which showed that there was an elevated blood glucose, an elevated white blood cell count, an elevated ALT and an elevated ALP (which Mr Roger took to be indicative of liver damage secondary to infection).

Mr Roger prescribed a cholagogue (ursodeoxycholic acid), an antibiotic (Synulox) and a diuretic (Frusemide).

In its findings of fact, the Committee found it likely that Mr Roger would have realised that Honey had a potential diabetes mellitus diagnosis with an elevated blood glucose of 28.

However, Mr Roger explained that he had believed the elevated blood glucose was due to the stress Honey had undergone in taking the blood samples.

The Committee therefore accepted that Mr Roger’s actions did not indicate a complete failure by him to notice the elevated blood glucose because he had explained he believed at the time it was due to stress.

Honey’s owner took her back to the veterinary practice that Mr Roger worked at three days later.

A different veterinary surgeon examined Honey and flagged that her blood sugar was high and that her liver was damaged.

She was taken to an alternative veterinary practice for follow-up but died later that day.

Mr Roger admitted failing to ask Honey’s owner if there was a history of diabetes mellitus, failing to take repeat blood glucose tests or carry out urine analysis or carry out additional blood tests, failing to communicate adequately with Honey’s owner about the significance of the hyperglycaemia and the options for investigation/management and failing to keep adequate clinical records in regard to Honey’s blood glucose levels.

The Committee found the admitted facts proved.

The evidence presented to the Committee included the clinical notes taken during Honey’s consultations, emails sent from Honey’s owner to the RCVS outlining the complaint, and evidence from experts in small animal veterinary practice.  

Although the Committee found some matters not proved, it did find proved that Mr Roger had failed to recognise and/or pay adequate regard to Honey’s elevated blood glucose levels, had failed to manage Honey’s hyperglycaemia either by treating it or by documenting an appropriate plan to do so and had failed to communicate adequately with Honey’s owner about the significance of her elevated glucose and the reason for it.

Having reached its decision in relation to the facts, the Committee went on to consider whether the facts it had found proved either individually or cumulatively amounted to serious professional misconduct.

Judith Way, Chairing the Committee and speaking on its behalf said: “The Committee found that the charges and particulars it had found proved did not amount to disgraceful conduct in a professional respect either individually or cumulatively.

"In its judgment, the conduct found proved fell short of the standard to be expected of a reasonably competent veterinary surgeon but not far short of the standard which is expected of the reasonably competent veterinary surgeon.”

As a result of the Committee finding that Mr Roger was not guilty of serious professional misconduct on any of the proven charges, either individually or in any combination, the hearing did not proceed further.

The RCVS has published the results of its third survey on the impact of the COVID-19 pandemic on veterinary businesses, finding a marked improvement in the veterinary business climate since last month. 

The survey was held in mid-June and gathered 196 responses from UK practices. That compared with the 532 responses to the initial survey conducted early in April and 251 responses to the second survey conducted at the start of May.

One of the main findings was a marked increase in the number of practices running a near-normal caseload, from 3% in May to 32% in June. Practice turnover data similarly reflected a shift back towards normality, with 46% now reporting a reduction of less than 25%, compared with 19% last month.

Other findings included: 

• Fewer staff are self-isolating, with around 15% of practices having veterinary surgeons and veterinary nurses self-isolating/or with Covid-19, compared with 30% in the first survey and 20% in the second survey.
• Fewer practices have staff on furlough. The most frequent response for the percentage of staff furloughed was 11-25% for both veterinary surgeons and veterinary nurses in this survey. This compares with the previous two surveys where the most frequent response was 26-50%.

Lizzie Lockett, RCVS CEO, said: "This latest survey has demonstrated a continuation of the previous survey’s positive trends including an increase in practice turnover with more practices approaching a ‘near normal caseload’ and with a reduction in the number of practices impacted by staff self-isolating or with confirmed cases of Covid-19.

“In this survey we also asked about what difficulties practices may be experiencing with EMS placements for vet students and VN training placements as a result of Covid-19, and this will help us to understand how we can better support students and practices in these areas.

“We will continue to monitor the situation via these regular surveys, with the next one planned for later this summer. I would urge as many practices as possible to continue to complete them, so that we can build up a stronger evidence-base on how veterinary businesses have been affected and how they are recovering.

"This information is not only vital for our own policy decisions but also allows us to present a stronger case to the Government and other public bodies where we wish to influence the decisions they make that will impact the veterinary professions and businesses.”

The survey results can be read in full at www.rcvs.org.uk/coronavirus-resources.

North Downs Specialist Referrals is celebrating the success of two of its clinicians after they passed their exams to become European Specialists in Veterinary Ophthalmology.

Andra-Elena Enache and Savina Gogova join the head of service Richard Everson, an RCVS and European Recognised Specialist, to form one of the strongest ophthalmology teams in the UK. 

Richard said: “It is fabulous that Andra and Savina were both successful in their specialist examinations. 

“Of course, we already knew their expertise but passing the examination requires not just an unparalleled knowledge of their subject but also the constitution that allows them to prove their knowledge, skills and professionalism in the crucible of the examination environment. 

“For both Andra and Savina to pass at the first time of asking is remarkable and just confirms their brilliance. It’s also a big boost for NDSR. 

“Having three internationally-recognised specialists in ophthalmology in one hospital makes the service so much more resilient; for example, we will never have to close due to annual leave or lecturing commitments. 

“This strength in depth means we really can offer the best possible service to our referring vets and poorly pets.” 

For more information, visit: www.ndsr.co.uk.

A survey commissioned by the RCVS has found that a significant number of pet owners think veterinary surgeons offer poor or very poor value for money, suggesting more work needs to be done to communicate the value of veterinary services.

The survey was conducted by Mo Gannon & Associates, which asked 2,000 UK adults about their satisfaction with the service they and their animals received from veterinary surgeons, levels of trust in the profession, and whether the service provided by vets represents value for money.

32% of the respondents felt that veterinary surgeons represented excellent (8%) or good (24%) value for money. 38% thought that veterinary fees are fair. However, 29% thought that veterinary surgeons and their services provided poor (21%) or very poor (8%) value for money. The results were very similar to the last time the survey was conducted, in 2015.

Nevertheless, veterinary surgeons continue to enjoy very high levels of trust amongst the public. 94% said they either completely trust (34%) or generally trust (60%) vets. This put veterinary surgeons in third place amongst the most trusted professions, below opticians and pharmacists but above GPs and and dentists. 

Satisfaction with the profession was also high. 80% said they were either very satisfied (39%) or satisfied (41%), putting vets in fourth place below opticians, pharmacists and dentists, but above general practitioners and accountants.

RCVS President Dr Niall Connell, pictured right (would you trust this man?) said: "These results clearly demonstrate that there is a great deal of good will towards the veterinary profession and the work they do in treating the nation’s animals and serving their communities. The basis of all good relationships is trust, and it is fantastic to see that our clients continue overwhelmingly to trust our knowledge and expertise and remain very happy with the service we provide them.

"The picture on value for money is clearly a bit more mixed, although clearly 70% of the respondents recognise that we at least charge fair fees in terms of our time and expertise. There is, of course, always more work that we can do in order to help the public understand veterinary costs and fees and promote the value of veterinary care, as demonstrated by last year’s joint Pets Need Vets social media campaign with BVA, in which we highlighted the benefits to pet owners of being registered with a vet."

A new study published in the Journal of Small Animal Practice (JSAP) has concluded that the quick sequential organ failure assessment is poor indicator of mortality, has a low sensitivity to to detect canine patients with severe sepsis and septic shock, and should not be used alone when screening for sepsis.

The study “Evaluation of quick sequential organ failure scores in dogs with severe sepsis and septic shock¹” reviewed electronic records from dogs that presented through the veterinary medical teaching hospital emergency service between January 2010 and December 2019 using the search terms “sepsis” or “septic”.

The quick sequential organ failure score was calculated by evaluating respiratory rate (>22 breaths per minute), arterial systolic blood pressure (≤100mmHg) and altered mentation.

Forty-five dogs with severe sepsis and septic shock and 45 dogs with non-infectious systemic inflammatory response syndrome were included in the final analysis.

It was found that the quick sequential organ failure assessment score provided poor discrimination between survivors and non-survivors for dogs with severe sepsis and septic shock.

In addition, the quick sequential organ failure score demonstrated a poor sensitivity and fair specificity to detect this population of canine patients.

The authors say that previous studies on quick sequential organ failure score have provided conflicting results, but that this may just be due to the inherent heterogeneity of the population.

Considering the results of this study, it may not be possible to identify a single scoring system that serves the purpose that quick sequential organ failure assessment is intended for.

Nicola Di Girolamo, Editor of the JSAP said: “The results of this study have strong clinical implications.

"The JSAP values studies with negative findings such as this one, as much as studies with positive findings.

"The fact that a diagnostic tool or a treatment does not reach the desired objective, should not hinder publication of methodologically sound research”

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsap.13522 

Reference

1. Osgood, AM, Hollenbeck, D, and Yankin, I (2022) Evaluation of quick sequential organ failure scores in dogs with severe sepsis and septic shock Journal of Small Animal Practice, Available at: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsap.13522