Essex-based Anne Mullen has been struck off by the RCVS Disciplinary Committee for a series of clinical failures and failing to respond to requests from the regulator.

Mrs Mullen faced four charges against her.

The first was that she failed to provide information to her clients about her practice OOH provision.

She was also charged with discharging a Labrador, called Cleo, that was unfit to be discharged following spay surgery, with an inadequate abdominal dressing and inadequate information given to the dog's owners regarding complications from surgery, the risk of post-operative haemorrhage and arrangements for out-of-hours care, as well as failing to make adequate clinical records.

The third charge alleged that she had failed to obtain informed consent for anaesthesia/ surgery performed on an English Bulldog, called Boycie, from his owners, failed to ensure the dog had adequate monitoring whilst recovering from anaesthesia, failed to offer an adequate range of overnight care for the dog, left the dog alone overnight when it was not in a fit condition to be left, failed to provide information to its owners on post-operative care at home and out-of-hours emergency arrangements, and failed to make adequate clinical records relating to its treatment.

Finally, she was charged with failing to have Professional Indemnity Insurance (PII) or equivalent arrangements in place or failing to provide details of it, failing to respond to requests regarding her continuing professional development records and failing to respond adequately to reasonable requests from the College for details and documents regarding her treatment of the two dogs.

Mrs Mullen indicated to the RCVS before the hearing that she would not be engaging with the disciplinary process.

The Disciplinary Committee therefore granted the RCVS permission to proceed in her absence on the basis that Mrs Mullen had made it clear that her absence from proceedings was deliberate and voluntary, that there was no indication she would attend any future hearing if it was adjourned and that the charges were of sufficient seriousness that it was in the interests of animal welfare to proceed with them. 

The Committee heard evidence from a number of witnesses including the animals’ owners, an expert veterinary witness and College staff.

In the evidence, the Committee heard that the Labrador had died while undergoing treatment at another veterinary practice from complications arising from blood loss following Mrs Mullen’s surgery.

The Committee also heard that the English Bulldog had suffered brain damage and had lost its sight due to post-operative hypoxia, although it had otherwise recovered.

Having heard all the evidence, the Committee found all the charges against Mrs Mullen proven.

The Committee then went on to consider whether the proven charges amounted to serious professional misconduct.

In doing so it considered the aggravating factors, including that there was actual injury to animals, that the misconduct was sustained and repeated over a period of time, that the conduct directly contravened advice issued by the RCVS, and the blatant disregard of the RCVS’s regulatory role.

It also considered that Mrs Mullen had previously been suspended from the Register by the Disciplinary Committee for two months in April 2017 for failing to have Professional Indemnity Insurance arrangements in place.

It considered that there were no mitigating factors in the case and accordingly found serious professional misconduct in relation to all the proven charges.

The Committee then considered what the most appropriate sanction would be. 

Judith Way, chairing the Committee and speaking on its behalf, said: “Animal welfare lies at the heart of the veterinary profession.

"The Committee considers that  [Mrs Mullen’s] treatment of Cleo and Boycie constitutes a breach of this fundamental tenet of the profession.

"Other serious findings of disgraceful conduct against [Mrs Mullen] are her failure to provide informed consent, failure to provide details about out-of-hours cover, failure to have in place Professional Indemnity Insurance (PII), continuing professional development (CPD), and failure to respond to the College’s request for information.”

The Committee considered that the conduct was so serious that the only means of protecting animal health and welfare and public confidence in the profession was to direct the Registrar to remove Mrs Mullen’s name from the Register of Veterinary Surgeons.

Judith added: “The Committee considers that [Mrs Mullen] has displayed a persistent lack of insight into the seriousness of her actions or their consequences.

"The Committee considers that [Mrs Mullen’s] conduct raises serious clinical concerns, shows disregard of obligations in relation to out-of-hours care, indicates deficiencies in making decisions, demonstrates an obstructive attitude to her regulator and creates a potential risk to patients.

"She has not engaged with the regulator, she has not demonstrated insight into her misconduct, has learned nothing from her previous suspension in relation to PII, and has done nothing to remediate her disgraceful conduct.

"There is no evidence that [Mrs Mullen}  has complied with any of her obligations in relation to CPD."

“In the view of the Committee, if [Mrs Mullen] were permitted to remain on the Register, there would be a serious risk of harm to animals. She has demonstrated a reckless disregard for the obligations of a registered veterinary surgeon.” 

Mrs Mullen has 28 days from being informed of the Committee’s decision to lodge an appeal with the Privy Council.

TVM has launched Carbodote Prime and Carbodote Repeat, two complementary products designed to make dealing with poisoned pets easier, safer and more convenient.

Carbodote Prime is the first activated charcoal product for cats and dogs to contain a cathartic, which speeds up intestinal transit time so that bound toxins are expelled more quickly.

Carbodote Repeat is for those situations where repeated administration of plain activated charcoal is needed due to the type of the toxin involved. 

Carbodote Repeat can be administered to the patient every 4-6 hours over 24-48 hours.

Both products are presented as a ready-mixed, easy to swallow gel formulation, for less mess and reduced risk of aspiration.

TVM says the 60ml ‘dial and dispense’ syringes make administration easy for both veterinary staff and pet owners.

For more information, visit www.tvm-uk.com/carbodote or contact your Territory Manager.

The RCVS Disciplinary Committee has reprimanded Anglesey-based Louise Marie Henry MRCVS for writing a letter on behalf of a client that dishonestly certified incorrect details surrounding the death of a ewe.

Dr Henry faced one charge, that in January 2020 she wrote and/or signed an undated letter confirming that a ewe had died in transit to the surgery due to dystocia and peri-parturient stress, when in fact she had euthanised the animal at the veterinary practice the day before. The letter, which was addressed 'To whom it may concern’, was on practice letterheaded paper and signed "Louise Henry MRCVS". 

The second part of the charge outlined that her conduct concerning the letter was dishonest.

The Committee heard that the ewe was lambing and brought to the practice by a client. Dr Henry was on-call at the time and advised a Caesarean section. The client agreed and Dr Henry delivered two live lambs and one dead lamb.

Dr Henry was concerned about the welfare of the ewe post-surgery because of the risk of peritonitis and advised that the ewe should be euthanised.

The client agreed to the ewe being euthanised and then asked Dr Henry to write a letter in which it was stated that the ewe had died in transit on route to the practice. Dr Henry agreed to write the letter in which she falsely certified that the ewe had died in transit. 

The letter came to light when the practice director found it in an insurance file. The practice arranged an investigatory meeting with Dr Henry where she admitted that writing the letter was an error of judgement. When asked about her conduct, Dr Henry explained that the client had subsequently been dissatisfied with the letter she had written and asked her to change it. She refused to amend the letter and told him that it was wrong of her to have written it in the first place and that she regretted having done so.

Dr Henry told the Committee that she valued integrity very highly and that she was deeply ashamed that she had been prepared to write the dishonest letter.

The Committee heard several testimonials from people who had worked with or studied alongside Dr Henry, who all attested to her skill as a veterinary surgeon and that they had no concerns about her integrity and honesty. She self-reported her actions from January to the RCVS and from the outset admitted the facts of the charge. During the hearing, Dr Henry submitted that her action of dishonest false certification amounted to disgraceful conduct in a professional respect.

Dr Martin Whiting, chairing the Committee, and speaking on its behalf, said: “The Committee considered that, in this case, the aggravating features were limited and the mitigating factors extensive. There was no premeditated dishonesty or financial gain involved, there was no actual harm or risk of harm to an animal or human and this was a single incident in an otherwise unblemished 13-year career. The Committee found that the shame and remorse expressed by Dr Henry were entirely genuine. Her conduct on this occasion was entirely untypical of her practise.

“After careful consideration, the Committee concluded that the substantial mitigating features permitted it to take the somewhat unusual course of issuing a reprimand in a case involving dishonesty. In taking this course, the Committee attached significant weight not only to the isolated nature of the event but also to the genuine insight shown by Dr Henry and the lasting impact this event has had upon her. In the Committee’s assessment, a reasonable and fully informed member of the public would, in this particular case, regard a reprimand as a sanction which protected the public interest in the profession and upheld its standards.”

The full documentation for the hearing can be found at www.rcvs.org.uk/disciplinary

The Migration Advisory Committee (MAC) has published its full review of the Shortage Occupation List and recommended that veterinary surgeons are added to it (page 82).

The Committee's decision to recommend the addition of vets to the list is seen as a major win for the RCVS and the BVA which together submitted evidence as part of the review, which began in autumn last year.

Professions on the list are prioritised for visas required to live and work in the UK. Employers wishing to hire professionals on the list are not required to complete the Resident Labour Market Test, meaning they don't have to advertise vacancies locally before offering the role to an employee from overseas.

The RCVS/BVA submission focused on the need for the UK immigration system to recognise that the veterinary workforce is already under capacity and that this problem is likely to be exacerbated after Brexit. This is due to the potential for increased demand for veterinary surgeons in areas such as export certification, and also the likelihood that fewer veterinary surgeons from the European Union will be joining the Register. It also reiterated the importance of veterinary surgeons in areas such as public health, food safety, disease surveillance and control, as well as education, research, clinical practice and animal welfare.

RCVS President Amanda Boag said: "We are very pleased to see that our submission, made with our colleagues at the BVA, has been welcomed by the Committee and that this recommendation will now be going to the key decision-makers at the Home Office for consideration. While we are still unaware of how the process of the UK leaving the EU will pan out, this is a very important step in ensuring the future security of the profession and mitigating against worsening  workforce shortages. 

"We would reiterate to the Government that the UK is currently reliant on overseas registrants to meet the demand for veterinary surgeons, with veterinary surgeons from the rest of the EU making up around 50% of new registrants each year.  By adding veterinary surgeons to the Shortage Occupation List, and therefore reducing the immigration requirements needed to live and work in the UK, the Government will be helping ensure vital veterinary work continues to be done particularly in areas such as food safety and public health."

Simon Doherty, BVA President, said: "MAC’s recommendation is a huge win for animal welfare and a resounding vote of confidence in the veterinary community and the multiple benefits it realises across the UK. We are absolutely delighted that the committee has heeded our calls and recognised the need to reinstate vets on the list to keep workforce supply and resilience high in the unpredictable times ahead."

The BSAVA has published its Manual of Backyard Poultry Medicine and Surgery, written to help veterinary surgeons provide a level of care for backyard birds that clients expect.

The BSAVA says there has been a real resurgence in the number of people keeping backyard poultry for a self-sufficient supply of food and because they often become part of the family, owners have come to expect a standard of veterinary care akin to that available for their cat or dog. Yet many veterinary surgeons are unfamiliar with consulting on and treating these birds.

The BSAVA Manual of Backyard Poultry Medicine and Surgery has been written by an international selection of specialist authors. It covers everything from husbandry and basic clinical techniques to medical and surgical treatment of conditions, and more advanced practices such as endoscopy and post-mortem examination.

The manual covers chickens, turkeys, ducks, geese, guinea fowl, ornamental pheasants and peafowl. The BSAVA says it is hoped that the manual will make treating backyard poultry more interesting and rewarding, and therefore encourage more practitioners to see feathered patients.

One of the editors, Guy Poland said: "We are very proud of the valuable contributions made by all the authors to the manual. We hope that their hard work will provide a useful resource for veterinary practitioners unfamiliar with poultry medicine to deliver improved care for their patients and maybe inspire an interest that they develop further."

BSAVA Manual of Backyard Poultry Medicine and Surgery is available in a printed edition (£85; £55 to BSAVA members) and online edition (£70.83+VAT; £45.83+VAT to BSAVA members).

nutravet has launched nutraren, a new product designed to support healthy renal function in cats and dogs.

The new product contains a combination of Omega-3s, toxin binders and antioxidants which the company claims flush out toxins, aid blood flow to the kidneys and maintain kidney architecture.

Matthew Shaw, Managing Director of nutravet said: "We’re really excited to launch nutraren, it’s a product our team have been working on for some time to make sure we have developed the best renal product for vets to recommend to their clients. 

"Using independent trial data, we’ve been able to develop a unique formulation for nutraren containing 100% natural ingredients to benefit a pet’s long-term kidney health."

Authorised veterinary practices can now order nutraren from nutravet.

For more information, contact nutravet on 0845 604 1688, visit: www.nutravet.co.uk or email: info@nutravet.co.uk.

The RCVS ViVet innovation project is hosting a series of Zoom meetings which vet nurses are being encouraged to come and join, to reflect on the changes that have taken place in the delivery of veterinary services in the past few years and think about the improvements and innovation that have taken place.

The first meeting takes place on Thursday 27th May from 12.30pm to 1.30pm. It will look at how veterinary practices have had to work differently and adapt to the challenges posed by the coronavirus pandemic.

Chris Tufnell, RCVS Council Member and Innovation Lead (pictured right), will be chairing the session. He said: “In the past 15 months we have been in innovation overdrive, adapting at a unprecedented pace to transform how we work, serve our clients and patients, and continue to function as veterinary businesses in less-than-ideal circumstances.

"This event is an opportunity to take a step back, look at what has happened, how we have changed and consider what aspects of these changes we might carry over when we return to near normal working conditions.

"For those who join us, we would like to know what kind of innovation solutions you and your colleagues have developed, and share your stories and ideas to help and inspire others.”

Joining Chris on the panel will be a selection of veterinary professionals who will share their own experience of how they have had to adapt the way they work during the pandemic. Participants include Anita Patel, an RCVS-recognised Specialist in Veterinary Dermatology, who runs her own dermatology referral service, and Richard Artingstall, Clinical Director of Vale Referrals in Gloucestershire.

The event, which will feature short presentations followed by a reflective discussion, is free to attend and can be signed up to via its Eventbrite page at: www.eventbrite.co.uk/e/152857028487

More meetings are planned for later in the year: 

• Wednesday 16 June: A special session for veterinary nurses titled ‘Problem-solving in difficult circumstances
• Tuesday 20 July: Implementing new technology
• Wednesday 8 September: Innovative technology and learning new skills

If you have any questions about the sessions or would like to take part as a speaker, email the ViVet Manager, Sophie Rogers on s.rogers@rcvs.org.uk or info@vivet.org.uk

The Royal Veterinary College has published the latest findings from its VetCompass programme, this time identifying the most common medical issues and causes of death in pet rabbits¹.

The research analysed data from 6,349 rabbits that attended 107 veterinary care clinics across the UK.

The researchers found that the most common causes of death recorded by veterinary surgeons were flystrike (10.9% of pet rabbits), anorexia (4.9%), collapse (4.9%) and gut stasis (4.3%).

The average lifespan of pet rabbits was 4.3 years, although survival up to 14.4 years had been recorded. Male rabbits tend to live longer at 5.2 years on average compared to the 3.7 years females live on average.

The most common medical issues are overgrown nails (16%), overgrown molars (7.6%), dirty bums (4.5%), overgrown incisors (4.3%) and gut stasis (4.2%). Many of these problems are associated with inappropriate housing or feeding. However, the researchers also point out that the fact rabbits evolved as a prey species has not helped owners and vets. Evolution has meant rabbits can disguise external signs of disease so that they are less likely to be targeted by predators but this also makes it harder for owners to spot that their rabbit is ill until it is often too late.

The researchers say that they hope this new study will help owners and vets prioritise what signs of illness need to be monitored. 

Other findings included: 

• Male rabbits are more likely than females to have overgrown claws, overgrown molars, overgrown incisors and dental disease.

• The average age of pet rabbits presented to vets is 3.2 years in this country.

• The average adult bodyweight of rabbits presented to vets is 2.1kg.

Dr Dan O’Neill, VetCompass researcher and Senior Lecturer at the RVC, said: "For years, rabbits were considered as the perfect child’s pet: fluffy, cute, passive and only needing minimal care and handling while being fed muesli-type food in a hutch in the garden where it was generally kept on its own.

"We now know that this level of care is completely unacceptable from a welfare perspective. This new paper can further improve the lives of rabbits by helping owners and vets to recognise the common health problems of rabbits and therefore to prioritise the key management factors that will make our rabbits even healthier. Rabbits don’t exhibit their suffering like other species so it behoves all of us to be prevent and recognise their problems."

Dr Jo Hedley, VetCompass researcher and Lecturer at the RVC, added: "This study definitely highlights some of the most common presentations seen in pet rabbits. Unfortunately, due to the rabbit’s ability to hide disease, signs of a problem are often non-specific and recognised far too late, hence the causes of death recorded are in fact often just end-stage symptoms of underlying disease. Many of the key medical issues are still problems that we should be able to completely prevent by appropriate husbandry, diet and health checks. Better owner education is necessary if we are to improve rabbit health and welfare in future years."

Reference

1.  O'NEILL, D. G., CRAVEN, H. C., BRODBELT, D. C., CHURCH, D. B. & HEDLEY, J. 2019. Morbidity and mortality of domestic rabbits (Oryctolagus cuniculus) under primary veterinary care in England. Vet Record. https://doi.org/vetrec-2019-105592

The RCVS has launched a series of events and activities to celebrate 60 years of veterinary nursing, including webinars, podcasts, an eBook looking at the history of veterinary nursing and an online Diamond Jubilee activities area.

As well as marking the 60th anniversary of the first RCVS-accredited Animal Nursing Auxiliary training scheme, the profession has also recently reached another milestone: 20,000 veterinary nurses on the Veterinary Nurses Register.

The Diamond Jubilee events include a series of webinars covering the past, present and future of the profession, with presentations from eminent veterinary nurses, including:

• ‘Creating diamonds: A decade of progress’ – A webinar exploring the highlights of the last ten years of veterinary nursing, hosted by VN Council Member, Jane Davidson RVN.
• ’60 years on and still shining’ – Hosted by Liz Cox RVN, former Chair of VN Council, this webinar will look at what career development opportunities have been made available for veterinary nurses and what has been put in place to attract the next generation of VNs.
• ‘Creating diamonds of the future’ – Hosted by practicing veterinary nurse, Carla Husband RVN, who will be looking at the future of the profession including how VNs will engage with the recently adopted proposals of the Legislative Working Party (LWP), how they can work towards the recently established Certificate in Advanced Veterinary Nursing and what the future of the profession could look like.

The RCVS will also be running a series of podcasts with prominent members of the profession. Each podcast episode will have a different host, reflecting on an area of veterinary nursing that they are passionate about.

The first webinar and podcast episode are available to watch and listen to on the Diamond Jubilee webpage www.rcvs.org.uk/VNdiamonds.

Matthew Rendle RVN, Chair of the Veterinary Nurses Council, said: “The veterinary nursing Diamond Jubilee celebrations are a fitting way of paying tribute to veterinary nursing – a profession that does so much for animal health and welfare. The celebrations will look back on all that has been achieved by the profession and give us an opportunity to engage with RVNs to come up with ideas for how we can continue to advance and develop our amazing profession.

“I am particularly happy about the fact that, earlier this month, I was informed that we have reached the milestone of 20,000 veterinary nurses on the Register which is an amazing achievement. When the VN Register was launched in 2007 there were just over 7,000 members of our profession – the fact we have almost trebled in number since then shows just how far we have come in a short space of time as invaluable members of the veterinary team providing professional care for the nation’s animals.”

Anyone wishing to take part in the celebrations can share their memories or pictures of veterinary nursing on social media, using the hashtag #VNDiamonds

The RSPCA will be highlighting the importance of neutering to guinea pig owners during Guinea Pig Appreciation Day tomorrow, after getting over 1,000 reports about guinea pigs last year.

The charity says that one of the biggest issues it faces with guinea pigs is multi-animal households where breeding has become out of control. 

Dr Jane Tyson, the RSPCA’s rodent expert, said: "We would always advise owners to have their male guinea pigs neutered before introducing them to a female. We also find that they can sometimes be mis-sexed by the seller or previous owner which leads to accidental breeding so it’s also important to make sure that guinea pigs see a vet regularly who would be able to spot if they have been identified incorrectly.

“Many of the guinea pigs that come into our care have come from a multi-animal home where there have been large numbers of guinea pigs living in often cramped, dirty and unsuitable conditions. This also means that they may have experienced very little handling and are wary and fearful of human hands and need their confidence building up in RSPCA care.

“This is why, this Guinea Pig Appreciation Day, we wanted to encourage people to neuter their guinea pigs and help tackle the problem of overbreeding.”

The RCVS and the BVA have issued statements after hearing reports of individual vets and veterinary practices being on the receiving end of abusive and threatening messages from groups campaigning against the XL Bully ban. 

The RCVS said: "We understand that there are very strong opinions about the ban, and we respect the rights of individuals to make their own decisions.

"However, expressing these opinions can never justify or include the harassment and abuse of individual vets, vet nurses or their practice colleagues."

The BVA added: “The Government’s XL Bully ban is also placing additional pressure on veterinary teams who are doing their best in very challenging circumstances to help keep responsible XL Bully owners with their pets wherever possible.

"Their commitment extends to supporting clients with any decision-making around euthanasia in individual cases.

"It’s simply unacceptable for these professionals to face additional challenges through abuse, intimidation or threats.

"Such actions can have a hugely negative impact on individual vets and the wider team."

Resources:

• RCVS XL Bully Guidance: https://www.rcvs.org.uk/setting-standards/advice-and-guidance/xl-bully-dog-ban/
• RCVS Advice line for questions about the legislation: https://www.rcvs.org.uk/setting-standards/advice-and-guidance/contact-the-advice-team/
• BVA toolkit for dealing with abuse: https://www.bva.co.uk/take-action/end-the-abuse-of-veterinary-professionals/
  
• Vetlife helpline: https://www.vetlife.org.uk/how-we-can-help/

Photo: Dlexus

Boehringer Ingelheim has launched NexGard Combo spot-on, billed as the first and only broad-spectrum parasiticide to treat cats for fleas, ticks, ear mites, roundworms and tapeworms.

NexGard Combo is a systemic isoxazoline-based endectocide designed specifically for cats which contains esafoxolaner, eprinomectin and praziquantel.

The new product provides one month’s protection against fleas and five week's protection against the most common tick on cats, Ixodes ricinus. It also treats the roundworms, Toxocara cati and Toxascaris leonina, hookworms, tapeworms and ear mites, against the last of which Nexgard Combo provides 97.2 to 99.9% efficacy following one treatment¹.

NexGard Combo can be used in kittens from eight weeks of age and 0.8 kg in weight, making it suitable for most kittens at first vaccination. It is available in two pack sizes: small, for kittens weighing 0.8 - 2.5kg and large, for adult cats weighing 2.5 - 7.5kg. For cats weighing 7.5kg or over, an appropriate combination of applicators should be used.

Jackie Sterratt, senior brand manager at Boehringer Ingelheim, said: “We’re excited to add to the successful NexGard range and to help vets treat more cats. We know only one in two cats is treated for fleas² and cats are only wormed on average three times per year³ despite all cats being at risk of fleas and most cats requiring monthly roundworming treatment^{2, 3}, so there is a big opportunity to increase treatment rates and compliance. As the only product on the market to treat fleas, ticks, ear mites, roundworms and tapeworms, NexGard Combo offers a simple solution for cats at risk of multiple parasites."

To support the launch Boehringer has produced a marketing package which includes a kitten support pack, client leaflets, dispensing envelope and parasite risk checker.

For further information, contact your local Boehringer Ingelheim territory manager or phone 01344 746957 (UK) or 01 291 3985 (Ireland).

References

1. Tielemans E, Prullage J, Tomoko O, et al.  Efficacy of a novel topical combination of esafoxolaner, eprinomectin and praziquantel against ear mite (Otodectes cynotis) infections in cats.  Parasite 2021:28.
2. Cooper A-R. et al. (2020). Fleas infesting cats and dogs in Great Britain; spatial distribution of infestation risk and its relation to treatment. Medical and Veterinary Entomology. Doi:10.1111/mve12462.
3. McNamara J. et al. (2018). Survey of European pet owners quantifying endoparasitic infection risk and implications for deworming recommendation. Parasite Vectors;11:571.