The new guidance will remove the absolute requirement for veterinary surgeons to perform a physical examination before prescribing POM medicines, making it instead a matter for professional judgement.
However, the proposed new guidance also imposes a requirement for veterinary surgeons who do NOT physically examine the animal prior to prescribing to provide a 24/7 follow-up service which includes a physical examination.
Furthermore, the new guidance will state that: "Where the veterinary surgeon is not able to provide this service [the physical exam] themselves, they should arrange for another veterinary service provider to do so. This arrangement should be made before veterinary services are offered and confirmed in writing as part of the conditions of service agreed by the client."
This requirement to provide a physical 24/7 follow-up would appear to safeguard animal welfare and protect against the risk of online-only businesses (in the UK or abroad) with lower overheads cherry-picking the job of prescribing medicines.
It should also protect against veterinary surgeons feeling pressured to prescribe inappropriately, because the new, stricter requirements will make it easier for them to decline to do so.
However, the BVA doesn't agree with the new proposals. It feels that remote prescribing should be delivered under the auspices of a Veterinary Client-Patient-Relationship (VCPR), which, according to the American Veterinary Medical Association, requires a physical examination.
BVA President Malcolm Morley, said: “The changes to ‘under care’ guidance are a watershed moment, so it’s positive to see that they have evolved in response to feedback from the profession. New technology presents exciting opportunities to enhance existing veterinary services and has benefits for practices as well as clients and their animals.
"However, BVA has been very clear that we believe remote prescribing can only be safely delivered where a vet-client-patient relationship has been established.
"This is an internationally recognised concept, and we are disappointed that the RCVS has decided not to embrace it.
“Having voted to implement these changes, it is incumbent upon the RCVS and the profession to scrutinise how they play out.
"At BVA we plan to develop advice and resources to support our members and help them comply with the new guidance and realise any benefits of remote veterinary service provision.’
“It is now vital that a timeframe for a review is quickly put in place, so any negative impacts on animal welfare or the sustainability of veterinary services can be dealt with swiftly.”
Council voted by a majority of 20 to 3 in favour of the changes, which it then decided should come into force between 1st June and 23rd December 2023, subject to a review at the next meeting.
Discuss the propose changes here
The study, which was led by the College's VetCompass programme, found that British bulldog ownership has increased from 0.35% of all puppies born in 2009 to 0.60% in 2013.
At the same time, the study found that British bulldogs suffer more than other breeds from a number of conditions associated with their aesthetic characteristics, including: skin fold dermatitis (7.8%), prolapsed gland of the third eyelid or 'cherry eye' (6.8%), interdigital cysts (3.7%), entropion or inward turning of the eyelid (3.6%), and corneal ulceration (3.1%).
Worse still, only 3.5% of the 1,621 British bulldogs analysed in the study were diagnosed with brachycephalic obstructive airway syndrome (BOAS), despite an earlier study reporting that 84.8% of tested Bulldogs are affected by BOAS to some extent, with 44.0% exhibiting clinically relevant disease2.
This, say the researchers, suggests owners consider breathing problems such as snoring as normal and are not therefore taking their dogs for needed check-ups.
Other findings included:
12.7% of British bulldogs suffer from ear infections, 8.8% from skin infections and 8.7% from obesity
Males are more likely than females to develop skin infection, interdigital cysts, atopic dermatitis and aggression, whereas females are more likely to develop dental disease and obesity.
The average adult bodyweight for a British bulldog is 26kg.
The average lifespan of bulldogs is 7.2 years.
The most common causes of death are heart disease (11.8%), cancer (10.9%) and brain disorder (9.1%).
The RVC says that the results of the study will support initiatives by the Kennel Club and the UK Bulldog Breed Club to improve breeding and also help owners and vets prioritise tackling the leading issues British bulldogs face.
Dr Dan O’Neill, VetCompass epidemiologist at the RVC and Chairman of the Brachycephalic Working Group, said: "The UK has seen unprecedented increases in the popularity of certain short-faced breeds over the past decade. This has led to a series of well-documented welfare issues relating to how these dogs are bred and sold for the UK pet-owning market, high levels of dumping of unwanted dogs into the UK charities and health problems that are intrinsically linked to the extreme body shape of these dogs.
"This new study gives firm evidence for the first time on the true levels of popularity and also of disease diagnosed in the wider population of bulldogs in the UK. This information can help to move the conversation on welfare from 'what are the issues' to 'how do we deal with these issues'. Reliable evidence is pivotal to good decision-making."
Dr Rowena Packer, BBSRC Research Fellow at RVC, said: "The bulldog is an iconic breed but concerns over the health problems allegedly facing these popular dogs have mounted in the past decade. It is extremely valuable to have solid data on the health problems facing this breed, confirming a number of inherent breed predispositions that need to be tackled.
This data supports current initiatives encouraging breed reform, particularly regarding health problems inherently related to their looks, and the need for selection for healthier body shapes. For example, skin fold dermatitis was common in bulldogs and is associated with the desired wrinkled face in this breed – this calls into question the justification of this and other such breed traits that put dogs at risk of potentially avoidable disease."
Steve Dean, Chairman of the Kennel Club Charitable Trust said: "The Kennel Club has put into place a number of crucial measures over the years to monitor, protect and improve bulldog health and to provide the many responsible breeders with the tools they need to do the same, but this paper highlights there is still work to be done."
The study is published open access in PLOS ONE.
References:
The CVS practice aimed to change its prescribing culture by adopting an evidence-based, case-by-case approach and supporting its vets in only using antibiotics where absolutely necessary.
The practice identified the use of antibiotics in the treatment of cat bite abscesses (CBAs) as worthy of investigation.
Cefovecin, a third-generation cephalosporin and critically important antibiotic, is often used in the treatment of CBAs.
The practice first sought guidance from a dermatology specialist with an active research programme involving the study of antimicrobial resistance (AMR).
It then developed a clinical guideline advising that if a cat has a discrete abscess, with no pyrexia (raised temperature) and no cellulitis, antibiotics are not required.
White Lodge then conducted an eight-month clinical audit across its Exmouth Hub, with the aim of measuring the effect of the new guideline.
The practice treated patients with CBA’s with NSAIDS, lancing and flushing (if necessary), and cleaning of the abscess.
Owners were advised to flush the affected area at home once daily.
An antibiotic awareness leaflet was given to clients with an explanation of the reasoning behind not prescribing antibiotics.
Cats presented 5-7 days after treatment for a nurse re-examination.
A consultation template was created for both the vet at initial presentation and another for the nurse’s post treatment check, to gather standardised information.
The measure of successful treatment was whether, on re-examination, the CBA site appeared free from infection and wound healing was evident.
If the wound had not started to heal or if there was infection or pyrexia, the treatment was deemed to have failed and further treatment was provided.
Analysis of the results showed that of the 22 cats included in the audit, 19 (86%) did not need antibiotics to successfully treat the abscess.
There was also a 32.6% reduction in the number of times cefovecin was dispensed in the eight-month period after the audit started, compared with the previous eight months.
Emily Parr, Head Veterinary Surgeon at White Lodge, said: “We think, due to lack of confidence in treatment without antibiotics as well as client pressure or expectation, the profession tends to default to the prescribing of antibiotics.
“However, this clinical audit has given our veterinary colleagues increased confidence in treating CBA’s without antibiotics.
"There has also been an improved client understanding in accepting treatment without antibiotics.
"Clients have also been positive when minimal intervention has been required, particularly as it eliminates the cost of antibiotics.
"This has had a positive impact on the vet-client relationship and trust in our practice.
“Antimicrobial resistance is continuing to threaten the efficacy and treatment of an ever-increasing range of infections.
"So we hope that our CBA clinical audit outcome results will help to set a benchmark and shape clinical guidelines for the wider veterinary profession in this area.”
The trial, which was launched last November, will now continue until May, when Council will decide whether to provide e-certificates to new registrants as a standard practice.
Newly qualified nurses who have been taking part in the trial have been able to download their e-certificate from the RCVS website, although they are also able to request a printed hard copy.
Robert Hewes, RCVS Head of Insight and Engagement, said: “Thank you to all those newly-qualified veterinary nurses who took part in the trial and especially to those who provided their feedback and thoughts on the e-certificate.
“From those that have completed the survey, it is clear that there is still a great deal of pride and meaning attached to having a hard copy certificate which is why we will continue to offer these to all our newly-qualified veterinary nurses.
"However, the feedback from the vet nurses overall regarding the e-certificates were that they appreciated that there was a benefit from an environment and sustainability point of view, as well as the practicalities of having immediate and easy access to their proof-of-registration.”
E-certificates for newly-qualified veterinary surgeons was trialled in early 2021 and rolled out as standard practice to all new veterinary registrants from summer 2021.
Robert added: “We would like to take this opportunity to make clear to prospective employers of both newly-qualified veterinary surgeons and veterinary nurses involved in the trial, that the e-certificates are now a legitimate form of identification of registration and that they no longer require a hard copy.
"However, if they are in any doubt about an individual’s registration status, they shouldn’t hesitate to contact the Registration Team on registration@rcvs.org.uk or 020 7202 0707.”
Bordetella bronchiseptica is a clinically significant pathogen for canine infectious respiratory disease (CIRD), otherwise known as kennel cough, with 78.7% of dogs with acute respiratory signs testing positive for the bacteria1.
In the same study, 45.6% of clinically healthy dogs also tested positive for Bordetella bronchiseptica, illustrating that clinically healthy dogs can carry respiratory pathogens and could act as sources of infection for susceptible dogs1.
Administered via subcutaneous injection, Canigen Bb is an inactivated subunit vaccine which offers vets a new option when intra-nasal vaccination with a live aerosolised vaccine is not possible or preferred, for example when the dog is in contact with known immunocompromised individuals.
Licensed for use in dogs from 6 weeks of age, Canigen Bb extends protection against Bordetella bronchiseptica in dogs vaccinated with Canigen KC in the last 12 months for a further year with a single dose.
Canigen Bb is presented as a ready-to-use formula in a 10ml multi-dose bottle and can be stored at room temperature (2°C - 25°C) for up to 4 weeks once broached.
It can be administered concurrently (at the same time but separate injections) with Canigen DHP, Canigen DHPPi, Canigen Pi & Canigen Lepto 4.
Andrew Connolly, Marketing Director at Virbac, said: ‘It is our hope that Canigen Bb will increase the overall uptake of Bordetella bronchiseptica vaccination to provide increased protection against this widely prevalent and clinically significant disease’.
Reference
Claire Gotto, Veterinary Advisor at MSD Animal Health said: "With increasing numbers of pets travelling abroad1 and the risk of exposure to exotic diseases, we need to ensure Britain’s pets are protected by providing owners with advice on comprehensive preventative healthcare for their travelling pets.
"This is particularly important as pet travel legislation is primarily in place to protect human health, and pet owners may be unaware of the similar risks to their pets.
"As an industry, we should therefore be advocating preventative healthcare, in addition to the legislation, in order to protect not only individual travelling pets from exotic disease, but also the UK pet population as a whole."
MSD says the risk of exotic disease to travelling pets was highlighted by the results of the Big Tick Project which showed that 76% of dogs travelling abroad returned with ticks2. This included Rhipicephalus sanguineus and Dermacentor reticulatus, the latter of which was found to carry Babesia canis3, a potentially life-threatening pathogen.
The risk to the UK pet population from travelling pets have been highlighted by recent cases of babesiosis4 and leishmaniasis5 in untravelled dogs within the UK.
The Safe Journey campaign includes educational materials about potential exotic disease risks abroad, including Babesiosis, Ehrlichiosis, Rabies, Dirofilariasis (heartworm), Leishmaniasis, Leptospirosis and Echinococcus multilocularis (tapeworm), and the preventive healthcare required to reduce the risk.
Materials available include veterinary practice posters, social media material and leaflets.
For further information contact your MSD Animal Health account manager.
References
The Disciplinary Committee, chaired by Mr Stuart Drummond, considered six charges against Dr Gunn.
The first charge alleged that, early in 2018, Dr Gunn failed to provide appropriate and adequate care to the dog. In particular, having removed a mass from the right thorax, he undertook an excess number of surgical procedures, including under general anaesthetic, within a 13 day period; performed these procedures without offering alternative treatments or discussing referral with the owners; failed to recognise infected wounds; and administered an antibiotic when the dog was infected with MRSA and E-coli.
The second charge alleged that Dr Gunn failed to communicate adequately, openly and honestly with the owners of the terrier on multiple occasions between 16 January and 3 February 2018. This included but was not limited to: failing to provide the owners with an estimation of fees; failing to inform them in advance of the procedures performed; failing to inform them of options for treatment; and failing to inform them that the terrier had an infection when he knew or ought to have known that she did.
The third charge alleged that Dr Gunn failed to obtain informed consent in relation to the further procedures performed on the terrier in charge one.
The fourth charge alleged that Dr Gunn failed to maintain adequate clinical records in relation to the management of the dog, and that he failed to record the prescription and administration of drugs to treat the terrier.
The fifth charge alleged that Dr Gunn indicated to the owners that euthanasia was the most appropriate treatment option and/or that there were no other realistic treatment options, when this was not the case and when he ought to have known this was not the case.
The sixth charge alleged that, during the course of a referral of the terrier to another practice, Dr Gunn failed to provide an adequate history of his management of the dog and that he informed the practice that the owners had no finances when this was not true, amounting to an incomplete account of his dealings with the owners and to a breach of their confidence.
At the outset of the hearing the respondent admitted to a number of the allegations within the main six charges, which were found proved by the Committee.
Of the charges not admitted to, a number were found proved and the Committee then went on to consider whether or not Dr Gunn’s conduct amounted to serious professional misconduct.
In considering the aggravating factors, the Committee took into account that the dog’s suffering was prolonged because of the persistence of Dr Gunn in pursuing a single ineffective treatment approach.
With regards to mitigating factors, the Committee found that Dr Gunn was remorseful as to his actions, that there was no financial motivation on the part of Dr Gunn in respect of his treatment of the terrier, and that there is a low risk of repetition because Dr Gunn has sought to learn from this experience. A number of relevant and high-quality testimonials were also provided by colleagues and many satisfied owners on behalf of Dr Gunn.
Considering both the aggravating and mitigating factors, the Committee was satisfied that Dr Gunn’s conduct fell far below the standard expected of a registered veterinary surgeon for a number of the charges.
The Committee then considered what sanction to impose on Dr Gunn. The Committee was satisfied that the misconduct found proved was in relation to the treatment of one dog only and therefore it was at the lower end of the spectrum. However, the conduct took place over a prolonged period of two weeks which in the Committee’s view required a sanction. In such circumstances, and with the significant mitigation, the Committee decided that the appropriate and proportionate sanction was to reprimand Dr Gunn and to warn him about his future conduct.
Speaking on behalf of the Committee, Mr Stuart Drummond said: "The Committee concluded that the effect of a reprimand alongside the Committee’s findings on disgraceful conduct in a professional respect was a sufficient and proportionate sanction. The Committee found Dr Gunn to have developed sufficient insight into his failings and it was satisfied that the disciplinary process had been a salutary experience and that he is very unlikely to pose a risk to animals in the future or to contravene professional standards.
"The Committee decided that a warning as to future conduct was necessary to reduce the risk of any repetition of any similar conduct for Dr Gunn in the future. It therefore concluded that the sanction of a reprimand and warning would be a sufficient in the circumstances of this case having taking into consideration all the powerful personal mitigation."
The complete list of charges and the Committee’s full facts and findings can be found at www.rcvs.org.uk/disciplinary
The study, titled “The utility of combined urine dipstick analysis and specific gravity measurement to determine feline proteinuria”, assessed the utility of the urine dipstick alone and combined with the urine-specific gravity (USG) for detecting proteinuria in cats.
For the study, the clinical records of cats presenting to a referral hospital between January 2011 and January 2017 were reviewed retrospectively.
To be eligible for inclusion, feline urine samples had to have undergone a complete urinalysis including dipstick evaluation, USG and urine protein-to-creatinine (UPC) measurement.
A total of 121 urine samples were included and diagnostic agreement and test accuracy were calculated for the dipstick test alone and in combination with the USG, using different cut-off values for proteinuria. Receiver-operating characteristic (ROC) curves were also calculated.
Jorge Pérez-Accino, corresponding author for the paper, said: “The diagnostic agreement between the urine dipstick and UPC ratio was poor and did not improve if the USG was considered together with the dipstick.
"A dipstick result of equal or greater than “Trace” (0.1-0.3g/L) had a sensitivity of 81% and a specificity of 31% to detect proteinuria.
"With regards the ROC curves, the area under the curve (AUC) of the urine dipstick alone was poor (0.57). When combined with the USG results, this improved to fair (0.78) but the specificity and negative predictive value (NPV) were still low.”
Nicola Di Girolamo, Editor of JSAP said: “These findings indicate that clinicians should not rely on the results of the urine dipstick test in combination with USG in cats for detecting proteinuria. Instead other quantitative methods, such as UPC ratio, should always be performed to detect proteinuria in cats.”
The full article can be found in the September issue of the Journal of Small Animal Practice which is free for BSAVA members. It can also be read online here: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13184
The BSAVA has put together a collection of resources relating to urinalysis and proteinuria, available here: https://www.bsavalibrary.com/content/urinalysis--160
Melissa, who was invested at the RCVS AGM last week, graduated from the University of Glasgow School of Veterinary Medicine in 1987, starting her career as a food animal intern at Iowa State University in the United States before moving into mixed veterinary practice in Ayrshire in 1990.
Over the next 25 years, she and her husband Kenny developed Oaks Veterinary Centre into a small animal practice with a focus on dentistry.
Melissa was first elected to Council in 2016, was re-elected in 2020 and has served on a number of committees including the Education Committee and Finance & Resources Committee.
Since 2019, she has served as Chair of the Standards Committee, leading the development of proposed new guidance on under care and out-of-hours emergency care and pain relief.
Melissa has also been President of the British Veterinary Association’s Scottish branch and the Ayrshire Veterinary Association and, outside of work, enjoys running, and caring for her dogs, cats and sheep.
In her opening speech as RCVS President, Melissa outlined her sense of community with her fellow vets, as a relatively small but prominent profession that punches above its weight, and how she intended to strengthen this as President.
Melissa said: “When I looked this up in June, there were over 300,000 doctors registered with the General Medical Council.
"We, the veterinary profession, have around 30,000 registered with the RCVS to look after farmed, pet, lab animal, exotic, zoo and wildlife species.
"In other words, all animals EXCEPT the human, and we protect humans too, with public health work!
“Even excluding farmed fish, over 300 million animals are being cared for by 30,000 professional veterinary surgeons and their teams.
"That is the scale of our small but mighty community.
"Being part of a community doesn’t mean we all have to be clones of each other, but a group that can agree to disagree, and is there for each other in times of need.
“With this close proximity to each other, communication is key.
"My mother has offered me many wise words over the years, most frequently being ‘engage brain before opening mouth’ but just as important as speaking is listening and actually hearing what is being said.
"So, over this year I will try to get out and about as much as possible, focus on hearing what our community is saying and engage in many conversations as we work together."
Under the protocol trial, the RCVS can launch private prosecutions against unqualified people practising veterinary surgery or using the title 'veterinary surgeon'.
The College says that where breaches of the Veterinary Surgeons Act cross over to other criminal offences, for example, fraud by false representation, they will be more properly dealt with by the relevant police force.
Local authority trading standards agencies will also deal with issues around, for example, misleading courses that purport to lead to registration with the RCVS but do not; concerns about dog grooming businesses and concerns about dog breeding establishments (other than where there is illegal practice of veterinary surgery by unqualified persons).
Eleanor Ferguson, RCVS Registrar and Director of Legal Services, said: “This protocol recognises that there are constraints on the time, resourcing, and budgets of both the police and public prosecutors which means that the pursuit of these breaches of the Veterinary Surgeons Act, both of which carry minor criminal penalties, is not necessarily a priority.
“While we are always willing to work with the police and other agencies to pursue such breaches, the protocol details how we can act independently where appropriate and ensure we are fulfilling our stated ambition to safeguard the interests of the public and animals, as well as the reputation of the professions, by ensuring that only those registered with us can carry out acts of veterinary surgery.
“We would like to manage expectations around this trial period as we will only be launching private prosecutions where they meet the criminal evidential standards of ‘beyond a reasonable doubt’ and it is judged to be in the public interest to do so.
"We will also be relying on members of the professions and the public to report breaches and provide sufficient evidence to us, as we have no statutory investigatory powers.”
The trial period will last for one year and the College has set aside £50,000 to pursue private prosecutions.
The trial will be overseen by the Disciplinary Committee/ Preliminary Investigation Committee Liaison Committee while decisions on whether to pursue private prosecutions will lie with the Registrar/ Director of Legal Services.
Suspected breaches of the Veterinary Surgeons Act can be reported to the RCVS Professional Conduct Department on breachvsa@rcvs.org.uk.
Dr Power faced a number of charges relating to alleged clinical and communications failings surrounding surgery carried out on two separate dogs on two separate occasions.
The first concerned laryngeal tieback surgery carried out on Harvey, a Tibetan Terrier in March 2018, and the second concerned oesophageal surgery carried out on a boxer dog, Boss, in October 2018.
The College withdrew a number of the charges at the start of the hearing, and more later after hearing from witnesses.
Of the remainder, Dr Power admitted that she had not undertaken pre-operative radiographs before proceeding with the laryngeal surgery, had failed to perform the surgery appropriately (she dissected excessive tissue and had inappropriately placed sutures), and had undertaken the surgery when it was outside her area of competence.
In relation to the oesophageal surgery, Dr Power admitted failing to provide a referral report and/or clinical records to the veterinary practice he was referred from, despite requests from the practice.
The Committee found that the majority of the charges which had not been withdrawn or admitted by Dr Power, not proven.
However, the Committee found that in addition to the admitted charges, Dr Power had subjected the dog undergoing oesophageal surgery to an excessive 9.5 hours of anaesthesia.
The Committee then went on to consider whether the proven charges amounted to serious professional conduct.
Counsel for the College submitted that Dr Power’s conduct breached the part of the Code of Professional Conduct relating to veterinary surgeons keeping within their area of competence and referring responsibly; and providing veterinary care that is appropriate and adequate.
In terms of aggravating factors, the College submitted that there was both actual injury to the animal, as well as actions that posed a risk of injury, that Dr Power financially benefitted from the alleged misconduct as she was paid to perform a procedure outside her competence, and that she occupied a position of increased trust and responsibility as she advertised herself as a practitioner who accepted referrals and was competent to perform soft tissue surgery.
Dr Power’s counsel submitted that the charges that had been found proven amounted to clinical and administrative failings and that this was not a case of a veterinary surgeon deliberately or recklessly acting outside of their capabilities, but rather a case where a diligent and responsible veterinary surgeon had fallen short in discrete areas of her clinical practice and had reasonably believed at the time that she was competent to perform the surgery.
The Committee found that although the conduct within the proven charges fell short of what would be reasonably expected of a veterinary surgeon, it did not fall so far short that her conduct constituted serious professional misconduct.
Paul Morris, chairing the Disciplinary Committee and speaking on its behalf, said: “The Committee understood that it had a responsibility to consider the wider public interest, taking into account the view of a reasonable member of the public in possession of all the relevant facts and information.
“The Committee considered that such a member of the public would understand that veterinary surgery is a challenging profession. It was of the view that such a member of the public would not expect perfection, but understand that any professional practitioner may make mistakes in the course of their practice.
“It is the judgement of this Committee that the respondent’s conduct does not constitute disgraceful conduct in a professional respect.”
The full findings of the Disciplinary Committee can be found at www.rcvs.org.uk/disciplinary
The company says the two main benefits of the liquid formulation are precise dosing and ease of administration.
Vetmedin oral solution comes with a kg-bodyweight calibrated syringe to make it easy to give the preferred dose of 0.25 mg/kg twice daily to the nearest 0.5 kg bodyweight.
The maximum syringe volume is for a 12 kg dog.
The solution has a sweet taste to make it palatable and Boehringer says it is also ideal for dogs that need dental work but require treatment for their heart disease before general anaesthesia.
These dogs might struggle to eat chewable tablets due to oral discomfort, so a liquid treatment might be a better option.
The company highlights the EPIC1 and PROTECT2 studies which showed that Vetmedin delays the onset of CHF for dogs in the asymptomatic stage of heart disease and improves both the quality and length of life for dogs with MVD and DCM.
Vetmedin oral solution comes as a 50 ml bottle (each bottle lasts a 5 kg dog approximately 30 days), doesn't need to be refrigerated, has an 8-week shelf life once opened, and a 2-year shelf life as packaged.
VetMedin oral solution is now available to order from wholesalers.
During June, Vets Now’s 1300 employees up and down the country will focus on activities which make them feel happy and supported at work including; Feelgood Friday which inspires lunchtime yoga sessions and taking time to unwind, Workout Wednesday which will see teams across the country taking 10,000 steps, and encouraging colleague picnics outside on National Picnic Day (18th June).
The company has also enlisted the help of nutritionist Lily Soutter (pictured right), a regular on ITV’s This Morning, to devise healthy and quick recipes for busy shift-working vets and vet nurses.
Laura Black, Vets Now’s head of health, safety and wellbeing said: "The issue of mental health is more prevalent than ever in the veterinary profession and we recognise that out-of-hours work, in particular, can present its challenges.
"That’s why, as an organisation, health and wellbeing is one of our key priorities. So whilst our Wellness Month has some fun elements, the overall goal is to make sure our teams feel they are supported at work."
The proceedings will begin at 10am with the formal adoption by RCVS Council of the Annual Report and Financial Statements for 2020, which will be published prior to the event.
The College will then answer any written questions that have been submitted about the Annual Report by veterinary surgeons and veterinary nurses.
If you have any questions about the Annual Report, you'll need to submit them to RCVS Events Manager Deborah Rowlanes on d.rowlanes@rcvs.org.uk no later than Friday 2 July 2021.
RCVS President Mandisa Greene will then formally welcome the newly-elected RCVS Council members – Louise Allum, Danny Chambers, Tshidi Gardiner and Colin Whiting – onto Council for their four-year terms, and newly-elected VN Council members Susan Howarth and Donna Lewis for their three-year terms, as well as saying farewell to retiring members of both Councils.
After a short break, the AGM will reconvene at 11am to approve Kate Richards (pictured right) as President for 2021-22, Melissa Donald as Junior Vice-President, Mandisa as Senior Vice-President, and Niall Connell as Treasurer.
There will then be addresses from Matthew Rendle as Chair of Veterinary Nurses Council, and from Mandisa as the outgoing RCVS President for 2020-21, followed by the formal investiture of the new RCVS Officer Team.
There will then be closing remarks from Kate Richards as the newly invested RCVS President.
If you'd like to attend the AGM, you'll need to register here: www.rcvs.org.uk/agm21-registration.
In the study titled 'Staphylococcal bacterial contamination of portable electronic devices in a large veterinary hospital1', samples were taken from the screen and any button of PEDs (such as mobile phones and tablets) of staff working directly with feline and canine patients. Hospital staff were asked to complete a questionnaire to ascertain the frequency of PED use and the frequency and method of PED cleaning.
The aim of the study was to determine the prevalence of Staphylococcal contamination of PEDs in a veterinary hospital, and to identify the source and determine the pathogenesis of any cultured strains.
Positive cultures were tested for resistance to oxacillin and vancomycin using a Kirby-Bauer disc diffusion test and then by using a broth microdilution test to EUCAST guidelines and breakpoints. PCR was used to specifically genotype the isolated staphylococci.
Georgia Vinall, corresponding author for the paper, said: “Useable swab samples were taken from 47 devices. Staphylococcus spp. were cultured from 68% of PEDs with a median of 10 colonies grown per device. Vancomycin-resistant Staphylococcus spp. were found on 36% of devices, whilst oxacillin-resistant Staphylococcus spp. were cultured from 2% of devices. DNA sequencing identified three Staphylococcus species; S. capitis, S. epidermidis and S. hominis which are most likely associated with humans as either sources or transmission vectors."
“The results of the survey indicate that 96% of staff had a PED which they used in the hospital environment, of which 85% use their device every day. Despite the high usage of PEDS in the hospital environment, only 6% of staff cleaned their device daily, with 33% of staff cleaning their PED less than weekly. Furthermore, only 54% of staff cleaned their device with a disinfectant."
Nicola Di Girolamo, Editor of JSAP said: "This study demonstrates that PEDs may become contaminated with potentially pathogenic microorganisms. Although this specific study did not focus on transmission of these microorganisms, and therefore it is unclear what are the clinical implications of this finding, it seems prudent to develop appropriate protocols for cleaning of PEDs in veterinary hospitals."
The full article can be found in the April issue of the Journal of Small Animal Practice and can be read online here: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13289.
Two equine journals have joined forces to create a free online collection of their recent articles on endocrinology to raise awareness of these common disorders and to provide veterinary surgeons with what they say is a definitive source of references all in one place.
The collection of references published by Equine Veterinary Education (EVE) and Equine Veterinary Journal (EVJ) covers a range of topics within the field of endocrinology and includes authoritative review articles on insulin dysregulation2, glucocorticoids and laminitis3 and paraneoplastic syndromes4.
The initiative has been made possible with the support of British Equine Veterinary Association Trust and has been compiled by leading international authorities on equine endocrinology, Professor Philip Johnson, of University of Missouri and Professor Nicholas Frank of Tufts University, Boston and the University of Nottingham.
They say that equine endocrine disorders, such as Pituitary pars intermedia dysfunction (PPID), are becoming more promptly identified and treated, thanks to ongoing research and advances in diagnosis, pharmacokinetics and management protocols.
PPID, or Cushing's, is a progressive neurodegenerative condition that is more easily recognised in its advanced form in older horses. Surveys show a PPID prevalence rate of up to 22% in horses over the age of 155, with the odds of developing clinical signs associated with PPID increasing by approximately 20% per year after this age.
Insulin dysregulation (ID), characterised by increased insulin response to oral sugars, hyperinsulinaemia and insulin resistance, is identified in both PPID and equine metabolic syndrome (EMS)2. Both PPID and EMS have been linked to the development of recurrent laminitis with subsequent high risk of mortality6. The exact mechanisms which link insulin to laminitis remain to be clarified1 but this online collection highlights several studies, which partially address this important jigsaw7-12.
Best practice for the management of EMS is outlined by Professors Nick Frank and Ray Geor in the December issue of EVE13. The first goal is to induce weight loss, and guidelines for designing diets for obese equids are provided. Exercise and dietary management14 have been shown to reduce the clinical signs and indices of inflammation in equine metabolic syndrome13 - 15, however, further studies are needed to quantify the efficacy of these management changes on long-term outcomes.
The online collection also includes several studies addressing the diagnosis of PPID. The value of plasma adrenocorticotropin hormone (ACTH), when interpreted with seasonally adjusted reference ranges, is discussed by several authors18-20. Professors Frank and Geor advocate it as the most readily accessible test for monitoring PPID cases in a field setting, although they maintain that the thyrotropin- releasing hormone (TRH) stimulation test is more sensitive and therefore has advantages when diagnosing PPID in its early stages13.
Pergolide has emerged as the drug of first choice for treatment of PPID13. While many vets recommend the early introduction of medication in the hope that it may avert the specter of laminitis, at present, there are no trials comparing pergolide with alternatives. Furthermore, there have been no long-term studies to show that horses treated with pergolide before the onset of clinical signs of PPID have better outcomes, including a reduced incidence of developing laminitis, than horses in which treatment is delayed until clinical signs become apparent.
Professor Celia Marr, Editor of Equine Veterinary Journal said: "Better control of PPID and insulin dysregulation should lower the risk of laminitis to help improve the health and longevity of many predisposed horses and ponies.
"Raising awareness of the benefits of early diagnosis and sharing the latest research on these and other associated conditions are imperative to provide horse owners with the best diagnostic and treatment programmes for their horses. However, it is easy to under-estimate obesity: horse owners need to think about improving management of their horses' feeding and exercise in order to avert problems before they become a veterinary issue."
Feliway Help! comes as a starter pack with a pheromone cartridge which lasts seven days and covers 50m2.
The cartridge is inserted into a diffuser which is plugged into an electrical socket, two days before the stressful event.
Ceva says that 83% of cat owners saw an improvement in their cat’s signs of stress after using Feliway Help!1.
The company adds that the Feliway Help! is particularly useful for clients of those practices which Feliway on the premises, with Feliway helping keep the cat calm at the practice, and Feliway Help! taking over when they return home.
Sarah Heath BVSc PgCertVE DipECAWBM(BM) CCAB FRCVS, an RCVS and EBVS European Veterinary Specialist in Behavioural Medicine and Certified Clinical Animal Behaviourist, said: “Cats can find the veterinary visit challenging and when they go home they can sometimes find it hard to settle.
"Feliway Help! can be very beneficial in easing the transition between home and the practice.
"This can be particularly helpful when cats have had a stay in hospital.”
For more information, visit www.feliway.com/uk, call the Ceva Animal Health head office on 01494 781510 or email cevauk@ceva.com.
The company says Dormazolam works in synergy with other induction agents to provide an extended duration of anaesthesia without adversely affecting the quality of recovery 2,3,5.
Benzodiazepines are commonly incorporated into anaesthetic regimens to alleviate issues seen with the administration to ketamine alone2,3,4, including inadequate muscle relaxation2,3,4, anaesthesia not lasting long enough2 and induction failure2.
Despite the issues caused by the sole use of ketamine, it remains the primary anaesthetic induction agent of choice for more than 90% of equine vets2.
Dechra Brand Manager Emma Jennings said: “Using Dormazolam as part of an equine anaesthesia protocol will give optimal general anaesthetic conditions every time, including a rapid onset of action1.
"Anaesthetic co-induction with ketamine and midazolam has been shown to provide a superior quality of anaesthesia compared to ketamine alone3 and midazolam is equally as effective as diazepam when used as a co-induction agent alongside ketamine4. It also cuts down on the number of ketamine ‘top-up’ doses required compared to using ketamine3 alone.
"Additional benefits include no clinically significant differences in cardiopulmonary function1 or recovery times1 between midazolam and diazepam and it can be mixed in the same syringe as ketamine for ease of use4.”
Emma added: “The introduction of Dormazolam provides an exciting new option for equine vets. It delivers enhanced anaesthetic and surgical conditions by improving anaesthetic induction quality2,3,4 and giving better surgical relaxation scores2,3,4. It also reduces involuntary movements because, as a co-induction agent, midazolam only causes minimal cardiovascular and pulmonary depression2,4.”
Dormazolam is available in a 20 ml vial. It has a shelf life of four years and a broached shelf life of 28 days.
For more information, visit: www.dechra.co.uk/therapy-areas/equine/anaesthesia/analgesia.
The two sets of guidance cover:
RCVS President Dr Mandisa Green said: “I would like to reassure my colleagues once again that we understand the extreme challenges and difficult decisions they are facing.
"The College has no interest in taking anyone to task for considered professional judgement, providing they act reasonably in the circumstances, can justify their actions and take reasonable notes.
"Sadly, we’re seeing the pandemic situation deteriorating again in the UK, but to varying degrees across the country. This presents a significant challenge in ensuring our guidance is clear and straightforward, while remaining relevant to as many people as possible.
For more information, visit: https://www.rcvs.org.uk/setting-standards/advice-and-guidance/coronavirus-covid-19/
Amanda Melvin, Marketing Manager for the Companion Animal Team at MSD Animal Health said: "Research has shown that up to 20% of diabetic pets die, or are euthanised, within a year of diagnosis1 so we want to do everything we can to prevent any further increases in this figure.
"Recent circumstances have put most practices under a great deal of strain and it's become clear from the increase in calls we're receiving that there is a high demand for more information and resources to support the care of diabetic pets.
"We've therefore decided that with Pet Diabetes Month in November, our best way of supporting veterinary practices is to make them aware of, and know how to access the resources we have available to help them."
The diabetes resources include veterinary nurse clinics and training, getting the most out ofVetPen, monitoring support tools and case advice.
Veterinary professionals can subscribe for access to the materials as individuals or as a practice team.
For further information, visit https://www.msd-animal-health-hub.co.uk/ahp/caninsulin/tools.
The tips, put together by Tessa Plagis (communication advisor at St. Anna Advies), Alan Robinson (director of VetDynamics) and Rebecca Robinson (coach at VetDynamics and senior clinician in veterinary anaesthesia at the AHT), are being shared to set the scene for Congress 2023, where international experts will be exploring how time management at organisational, systems, teams and an individual levels can lead to drastic improvements in performance, job satisfaction and wellbeing.
The Association points to the demands on the profession caused by the fact that veterinary professionals have been saying 'yes' to everything for years: yes to more clients, more patients and more overtime.
This, says BSAVA, is taking its toll: experienced practitioners and recent graduates are leaving the profession, and many more are suffering mental and physical health issues associated with sustained high stress.
Tessa Plagis, communication advisor at St. Anna Advies, said: “We are at a tipping point and can’t keep doing what we’ve always done. If we want sustainable veterinary businesses going forward we need to change the structure of how we work.”
Tessa says the issues are both organisational and individual: “Many veterinary professionals struggle to give boundaries.
"We are people pleasers and tend to say ‘yes’, even if that means compromising other important aspects of lives, such as family.
"This set against a background of too few vets, which means that there’s nobody to help us out when there’s too much to-do.”
To find out more about time management, book your ticket for BSAVA Congress at: https://www.bsavaevents.com/bsavacongress2023/en/page/home, and in the meantime, here are Tessa, Alan and Rebecca's time management tips.
Tessa's tips
Alan's tips
Rebecca's tips
Muriel joined Pennard Vets as an office junior on 7th January 1950, when she was 15 years old
She earned a weekly wage of £1 10 shillings, equivalent to £1.50 in today’s money.
Andy Green, a Director at Pennard Vets, said: “Few people in this country have achieved what Muriel has.
"Pennard Vets has been around for over 125 years and Muriel’s journey with us has encompassed a staggering 70 years of that, making her one of only a handful of people in the UK who have completed 70 years with a single employer.
“Muriel is ever-present, reliable, caring, dependable and she makes the best biscuits around.
"She started work at our Sevenoaks practice as a 16-year-old in 1950, when it was just as likely a client would be bringing in a sheep, goat or horse as a dog or cat, and we used loose boxes outside for examinations, treatments isolation and even post-mortems.
“During the subsequent 70 years she was part of the growth in the practice from a single site to multiple sites.
"She was also fantastic at embracing the latest technology as the practice went from handwritten ledgers, double entry bookkeeping and dealing with the terribly difficult to decipher handwritten notes of the vets, to digitalisation, computers, online systems, email, mobile phones and a host of other technological advances.
“Throughout the years her role changed dramatically, and she learned new skills, adapted, and moved with the times, demonstrating our core values of continuous improvement, client focus, compassion and clarity every step of the way.
“When Muriel retired in 2020, sadly lockdown rules denied us the chance for a proper celebration, so we are very pleased to have been able to celebrate together with such a fabulous party.”
Muriel said: “When I started at Pennard Vets, the practice cared for large animals including horses, sheep and cattle on the local farms, but we also had some more unusual clients.
"A special highlight was fielding telephone calls from former Prime Minister, Sir Winston Churchill, who lived at Chartwell country house, near Westerham, in Kent and employed the practice to look after the health of the black swans living on the estate’s lake.
“Two of the biggest changes I saw during my seven decades at the practice were the business giving up farm work to focus on small animal work as dogs and cats became a bigger part of our families, and the transition from my handwritten notes in ledgers to modern computer systems, but I have always embraced change and enjoyed learning new skills.
"I miss everyone at Pennard Vets but will keep in touch and keep baking for them!”
Mr Makepeace faced five charges.
The first charge was that in 2022 Mr Makepeace was convicted at Scarborough Magistrates Court of assaulting by beating his ex-partner.
He was sentenced to a community order and a curfew order and was ordered to pay a £95 surcharge and £85 in costs.
It was alleged that the conviction rendered him unfit to practise as a veterinary surgeon.
The second was that in August 2022, Mr Makepeace submitted a character reference which purported to have been written by his ex-partner saying that they "still live happily together", when this was untrue. It was also alleged that the reference purported to have been signed by Mr Makepeace's ex-partner when he knew that was not the case.
The third charge alleged that Mr Makepeace had sent WhatsApp messages to his ex-partner which were offensive, insulting, abusive, threatening and/or intimidating.
The fourth charge was that was a repetition of the second.
The fifth and final charge was that in relation to charges 2 and 4, that Mr Makepeace’s conduct was misleading and/or dishonest; and that it is alleged that in relation to charges 2,3,4 and/or 5, whether individually or in any combination, that Mr Makepeace was guilty of disgraceful conduct in a professional respect.
The first charge was proven by virtue of a certified copy of the memorandum of an entry in the Magistrates’ Court register.
Mr Makepeace also admitted the facts of all the other charges, meaning they were found proven by admission.
In terms of the conviction, the Committee assessed the incident to be serious – the assault was prolonged, involved strangulation and biting which led to physical injuries, and involved a pursuit.
This was found by the Committee to bring the reputation of the profession into disrepute.
The Committee therefore found that the conviction rendered Mr Makepeace unfit to practise.
With regard to the remaining charges, the Committee found Mr Makepeace’s behaviour serious, saying that it showed a blatant and wilful disregard of the role of the RCVS and the systems that regulate the veterinary profession, and that his actions were intended to dishonestly subvert that process.
The Committee considered that his actions fell sufficiently below the standards expected in terms of honesty and integrity, as well as in terms of the behaviour expected of a registered professional.
All this constituted disgraceful conduct in a professional respect.
When making a decision on the appropriate sanction, the Committee took into account evidence from Mr Makepeace, two character witnesses, and a document bundle including evidence of training, continuing professional development (CPD) and other testimonials.
Aggravating factors taken into account were:
Mitigating factors taken into account were that Mr Makepeace made full admissions at the start of the hearing; he expressed remorse; was shown to be of previous good character; that there had been a significant lapse of time since his conviction; he had made subsequent efforts to avoid repetition of the behaviour which led to the conviction; the financial impact upon Mr Makepeace if he was prevented from being able to practise; and the testimonials.
Neil Slater, Chair of the Disciplinary Committee and speaking on its behalf, said: “The Committee’s view was that the demands of the public interest in this case were high, and in light of all of the circumstances, removal from the register was the only means of upholding the wider public interest, which includes the need to uphold proper standards of conduct and performance, and to maintain confidence in the profession and its regulation.
“The Committee therefore decided to direct that the respondent should be removed from the Register.
"In coming to this decision, the Committee carefully applied the principle of proportionality and took into account the impact of such a sanction on the respondent’s ability to practise his profession, as well as the financial impact upon him, taking into account his evidence in this regard.
“However, the Committee determined that the need to uphold the wider public interest outweighed the respondent’s interests in this respect.
"In light of the gravity of the conduct, and all of the factors taken into account, any lesser sanction would lack deterrent effect and would undermine public confidence in the profession and the regulatory process.
"Removal was the only appropriate and proportionate sanction.”
https://www.rcvs.org.uk/concerns/disciplinary-hearings
The new line, which is available from veterinary wholesalers, is described as a complete feeding solution with everyday wet and dry food and treats. It is made with a minimum of 95% fresh, organic ingredients from controlled and certified origins, presented in an eco-friendly packaging. This, says Dechra, means it is tasty, nutritious and better for the environment.
The wet diets for cats contains organic chicken or fish whilst the dog food contains organic beef or fish.
The Specific treats are made with more than 80% fresh chicken, beef and pork. Dechra says that in taste tests, nine out of ten cats, and 100% of dogs accepted the treats1.
Dechra highlights that unlike competitor products, which use layers of different plastic in their packaging which cannot be recycled, Specific uses single layers of the same plastic with a gas barrier in between. This makes its dry pet food bags fully recyclable, as well as lighter and stronger than PET/PE laminates of the same thickness2.
Once Specific dry pet food bags have been used and recycled, they can be processed into granules and made into a film which can be used to make new things – including dry pet food bags.
Dechra Brand Manager Claire Morgan said: “The exciting new range of organic food that’s as kind to the environment as it is to pets.
"The Specific organic range provides a new option for owners who are committed to providing their animals with the optimum chance of good health. The tried and trusted Specific brand is already available for vets to stock so this is a useful addition for practices looking to add value to the service they provide to pet owners.
"We have committed to making all of our packaging fully recyclable by 2023, starting with the Specific organic range. As well as providing a more ethical and environmentally sound choice for eco-conscious pet owners, it’s part of Dechra’s ‘Circle of Good’ commitment to reduce our business’ impact on the world.”
For more information visit: www.specific-diets.co.uk.
Kit, who has served on Council as an elected member since 2013, is currently the Chair of the RCVS Finances & Resources Committee and has been RCVS Treasurer for the past three years.
He is also a member of a range of committees and project groups across the RCVS including: the Audit and Risk Committee; the PIC/ DC Liaison Committee; the Certification Subcommittee; the Estate Strategy Project Board; the RCVS Knowledge Board of Trustees; and the Advanced Practitioners Panel.
Since 2003 Kit has been working as an internist (he is an RCVS-recognised Specialist in Small Animal Medicine) in private referral practice. In 2006 he became a founding partner in a multidisciplinary referral centre that he saw grow from five to 65 members of staff within five years.
His interests include workforce issues, communicating the diverse clinical and non-clinical skills of veterinary surgeons to the general public and government, and facilitating life-long learning through achievable further professional qualifications and effective CPD.
Kit said: "It was a great honour to be elected as the next Junior Vice President by my fellow council members. I feel that I can make a positive contribution to the work that the RCVS is already undertaking in ensuring the veterinary team remains healthy and respected. In particular I am keen to look at how the RCVS can help find solutions to our workforce issues - improving retention as well as encouraging and facilitating vets and nurses back into the profession."
In addition to Kit being elected as JVP, the current holder of that office, Dr Mandisa Greene, was confirmed as President for 2020-21 and current President, Dr Niall Connell, was confirmed as Senior Vice-President for this period.
Professor Susan Dawson was voted in as RCVS Treasurer, and she will be formally invested in this role at Royal College Day on Friday, 10 July.
Professor David Argyle has been elected as Chair of Advancement of the Professions Committee for a second year, Dr Susan Paterson has been elected as Chair of Education Committee for her second year, and Dr Melissa Donald has been elected Chair of Standards Committee for her second year.
Kit and Melissa's positions are subject to their successful re-election in the 2020 RCVS Council Elections
More information on the RCVS Council and its members can be found on the RCVS website: https://www.rcvs.org.uk/who-we-are/rcvs-council.