This is the first time Linnaeus has appointed PCAs to its 68-strong clinical board, which aims to make it more inclusive by including a wider range of experience and expertise from every level in clinical practice.
The appointment of Alice Boyle from Maven Veterinary Care in Sutton, and Lily Barnes from Paragon Veterinary Referrals in Wakefield (pictured L-R), means PCAs are represented at a national senior level within Linnaeus.
Professor Séverine Tasker, Chief Medical Officer at Linnaeus and Chair of the clinical board said: “When it comes to clinical excellence, a broad range of perspectives will strengthen our ability to explore and follow best practice.
"Everyone’s views and experiences are important.
"Our nursing teams are critical to the care of our patients, but until recently we only had RVN representation on the clinical board and wanted to involve our excellent team of PCAs as well."
www.linnaeusgroup.co.uk/medical-and-nursing/clinical-board
Firstly, pets that haven’t received primary vaccinations due to the coronavirus outbreak and develop an issue that would have been prevented by a vaccination they were unable to access, will now have that condition covered under their Agria policy.
Secondly, the company has now made it possible for owners of cats and dogs under the age of five to set up a 'Four Weeks Free' policy - which would ordinarily be set up in practice - themselves.
Simon Wheeler, Managing Director of Agria Pet Insurance (pictured right), said: "We have introduced these additional products during the pandemic to ensure that pets remain covered despite new and significant challenges faced by vets and owners. We hope that they alleviate a little of the pressure faced by veterinary staff and worry felt by owners."
Robin Hargreaves, who is Agria's Vet Lead and helped develop the solutions said: "Times are pretty tough in practice right now, and operating on a restricted basis isn’t ideal for us or the pets registered with us. One thing that would make life even harder would be if the percentage of uninsured pets was to rise.
"With Agria making it possible for owners to activate their own 4 Weeks Free policies at this time, even owners that can’t see vets as usual can still protect their pets with insurance.
“Relaxing restrictions around cover for unvaccinated pets will come as a huge relief in some cases, enabling any pets that have missed primary vaccinations or gone past their booster date due to current restrictions to still be insured."
For more information, visit: agriapet.co.uk/guide
Dr Mostert admitted to his conviction but denied that it rendered him unfit to practise as a veterinary surgeon.
He also admitted not disclosing his conviction to the RCVS but denied that it amounted to dishonesty or was misleading and that failing to do so amounted to disgraceful conduct in a professional respect.
The Committee first considered whether Dr Mostert’s conviction affected the public interest, which included the need to maintain public confidence in the profession by upholding proper standards of conduct and behaviour for members of the profession.
The Committee noted that the conviction involved dishonesty relating to false statements about the value of goods sent to the USA.
The Committee felt that a conviction for a serious offence involving dishonesty would have a negative impact on public confidence in the profession, and that its reputation would be damaged if proper standards of conduct and behaviour were not upheld.
The Committee also noted that as the products that Dr Mostert imported into the USA were not labelled as coming from a foreign market and were not labelled as needing to be administered by a vet, his conviction also related to animal safety, as anyone who accessed the medications could believe that it was safe for them to be given to an animal.
The Committee then considered Dr Mostert’s failure to declare the conviction to the College on three separate occasions.
Dr Mostert testified that, at the time, he did not believe he had to disclose his conviction as it occurred in a country where he had not practised as a veterinary surgeon.
He also said he had not taken the time to read and interpret the application form accurately.
However, the Committee considered that the wording around convictions on the application and annual renewal forms is very clear and that, as a veterinary surgeon, Dr Mostert would be familiar with such documents.
The Committee considered that it was inconceivable that an experienced veterinary surgeon, making a declaration of this kind to his regulator, would not have understood that a serious conviction in the USA, dating from June 2017, was a conviction that he was obliged to disclose.
The Committee therefore found Dr Mostert’s failures to declare his conviction dishonest.
Judith Way, Chairing the Committee and speaking on its behalf, noted that in deciding upon the appropriate sanction, the case did not involve any actual harm to an animal or human and that Dr Mostert had had a long and otherwise unblemished career.
However, a key aggravating factor was that the action that led to the conviction resulted in financial gain through the creation of a business enterprise and that Dr Mostert falsely declared the value of goods.
The extent of any financial gain was not known to the Committee, but the business operated on the basis that false declarations were repeatedly made.
Judith said: “After careful consideration the Committee has concluded that in all the circumstances, a lengthy period of suspension would properly reflect the gravity of the case and satisfy the public interest. The Committee has decided that the appropriate length of suspension is one of 18 months.”
The Committee’s full findings can be viewed at www.rcvs.org.uk/disciplinary
The initiative is called Project NURSE, which stands for Nurturing and Using REVN Skills and Experience.
The first stage of Project NURSE is to survey horse owners to find out what they understand about the role of REVNs and if they would be receptive to nurses visiting yards to carry out certain procedures, under the direction of a vet and within the scope of what is permissible by the RCVS.
Phillippa Pritchard (pictured right), an equine veterinary nurse and training manager at Liphook Equine Hospital, one of VetPartners’ practices, has been awarded a £1,000 grant by MSD Animal Health to promote the survey and is helping lead Project NURSE on behalf of VetPartners.
Phillippa said: “REVNs have an important role to play in equine practices and hospitals, but many nurses would welcome the opportunity to be more involved in yard visits and put their skills to the best possible use.
“There are many procedures we are qualified to do, including changing wound dressings, taking blood samples and administering prescribed doses of sedation, and by making more use of these skills we feel we would be able to help our practices provide an even better service to patients and clients.
“I also believe that having more interaction with owners and their horses would have a positive impact on job retention because equine nurses would be more fulfilled in their role and feel they have opportunities to develop their careers.”
VetPartners equine director Julian Rishworth added: “Our central ethos revolves around practices being a great place to work and striving for clinical excellence. Equine veterinary nurses are such an integral part of practice teams and if we don’t allow them to fully use their skills and fulfil their potential we are failing the team, our clients, their horses and our own group aspirations.”
The coils need to be cooled to -460 °F in order to get good quality images.
To achieve the same result without helium, Hallmarq’s new MRI uses a conduction-based cooling system in a strong vacuum, which eliminates the need for helium, a quench pipe, oxygen monitor, or any additional power.
This, Hallmarq says, makes the new system more environmentally friendly than its helium-based counterparts and reduces the upfront and ongoing costs of offering a veterinary MRI service to patients.
The new technology comes in response to growing concerns over helium supply.
Extraction and usage of helium is quickly outpacing its natural synthesis, as a result of which, Hallmarq says helium prices have soared from £12.75 per litre in December of 2017 to between £50 and £55 per litre in June 2022.
For veterinary hospitals already using high-field MRI machines, or for those considering them in the future, reliance on the 1,500-2,200 litres of helium required to keep a standard MRI functioning may not be sustainable.
Hallmarq’s Chief Technology Officer Dr. Steve Roberts said: “Hallmarq’s Zero-Helium Small Animal 1.5T MRI system increases access to diagnostic care for small animal patients, while lessening the financial, environmental and supply chain risks associated with traditional helium-based MRI systems."
www.hallmarq.net.
Expanding on the training available in autumn 2022, which was launched based on the results of an extensive training pilot, MMI is offering a total of 14 sessions taking place both online and in person over the next few months. Sessions will be running from January to April 2023. The courses will cover areas that have been identified as priority topics from previous MMI surveys, feedback from the professions, and evaluation of the training pilots.
Mind Matters Initiative Manager, Lisa Quigley, said: “Mental health and wellbeing are impacted by a whole host of structural and societal factors and maintaining a healthy workforce goes far beyond supporting people on an individual level.
"Whilst it is undoubtedly important to provide people with the skills they need to look after themselves, we are aiming to expand on this by providing individuals with the skills and knowledge needed to recognise and address wider collective issues. For example, the importance of creating and maintaining a positive workplace culture.
Session dates and specific topics are as follows:
Mental Health First Aid (£30 in-person)
9am – 5pm
Psychological Safety and Civility (£20 in-person, £15 online)
In-person – 9am – 4pm
Online – 9am – 1pm
Sustaining Your Emotional Health (£15 in-person)
2pm – 5pm
For more information on the training courses, visit: https://vetmindmatters.org/training/
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.”
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."
Skin diseases and palpable masses are a common presentation in guinea pigs brought for veterinary care2.
However, few studies have thus far looked at the prevalence of spontaneously arising diseases in pet guinea pigs.
"Lumpy bumpy guinea pigs: a retrospective study of 619 biopsy samples of externally palpable masses submitted from pet guinea pigs for histopathology" retrospectively analysed 619 biopsy samples submitted for histopathology from pet guinea pigs that had presented with externally palpable masses.
The purpose was to determine the most common tissue origins of these masses and the most frequent pathological diagnoses, together with signalment data for the most commonly diagnosed lesions.
Of the 619 samples submitted from 493 animals, 54 (8.7%) had arisen from the mammary glands3 and 15 (2.4%) from the thyroid glands, with the remaining 550 (88.9%) involving the skin and subcutis, muscle (n = 1), salivary glands (n = 4), lips (n = 2), ears (n = 4) and peripheral lymph nodes (n = 23).
Forty-seven (7.6%) of the masses were diagnosed as inflammatory in nature, including dermatitis, panniculitis, lymphadenitis, cheilitis, myositis, sialoadenitis, abscess and chronic inflammation with osseous metaplasia.
Non-neoplastic, non-inflammatory lesions accounted for a further 31 (5.0%), namely cysts, hamartomas, hyperplastic lesions, polyps, ectopic bone formation and salivary gland steatosis.
The remainder of the samples were neoplastic in nature (541; 87.4%), with 99 masses classified as epithelial in origin, 347 as mesenchymal, 23 as round cell, five as melanocytic and eight as unclassified malignant neoplasms.
Of these, mesenchymal neoplasms were further subdivided into benign (288) and malignant (59).
Lipomas were the most common neoplasm diagnosed, accounting for 286 of all samples submitted.
Of all 619 samples included in the study, the eight most commonly diagnosed lesions were lipoma (46.2%), trichofolliculoma (12.3%), sarcoma (of various subtypes: 9.5%), inflammation (all sites 7.6%), lymphoma / leukaemia (3.4%), mammary carcinoma (4%), mammary adenoma (3.2%) and thyroid carcinoma (1.5%).
Overall these eight diagnoses accounted for 87.7% of all submissions from the externally palpable masses from the pet guinea pigs submitted for histopathology.
Melanie said: “Guinea pigs are an increasingly popular household pet.
"Skin diseases, including palpable masses, are a common reason for veterinary presentation. But few studies have been published to date that provide information for clinicians about these conditions.
“This study illustrates the importance of neoplasms of the skin and subcutis in pet guinea pigs, with over 87% of the cases analysed having one of eight diagnoses.
"While most of these neoplasms are benign, a substantial minority are malignant and identifying those lesions is especially important in treatment planning.
"Clinicians dealing with pet guinea pigs should also be aware that some externally palpable masses may arise from the thyroid or mammary glands rather than the skin or subcutis, and that male guinea pigs may also develop mammary lesions.”
The paper has been selected as ‘Editor’s Choice’ by the Journal of Comparative Pathology and will be free to access until September on Lumpy, bumpy guinea pigs: a retrospective study of 619 biopsy samples of externally palpable masses submitted from pet guinea pigs for histopathology - ScienceDirect.
References
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."
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/
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.
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 first course will run in May and is already fully subscribed, with the next one planned for either June or July.
Participants will shadow Thrums’ nurses at the group’s Kirriemuir practice and learn about carrying out clinical examinations, suturing and bandaging, fluid therapy, patient care, radiography positioning and laboratory work.
Attendees will also find out how to qualify as a registered veterinary nurse.
In addition, the Thrums team will give talks on their professional experiences, highlighting other career paths within the veterinary industry.
Participants will then receive a goody bag and a certificate of attendance.
This latest course follows the launch last year of The Thrums Vet School Preparation Programme, a three-day programme designed to give 16 and 17-year-olds an understanding of the role of a mixed practice vet.
Associate Managing Director Ashley Wilkie said: “Both these courses are amongst the first of their kind in the UK and we’re hoping that they can help ease the veterinary industry’s recruitment crisis over the long-term.
"At the end of the course, attendees will have a mentor to support them if they choose to pursue a career in the industry.
"The mentorship is part of our ambition to help produce a cohort of skilled, engaged and talented individuals that will benefit both Thrums and the veterinary industry as a whole in the future.”
https://thrumsvet.co.uk
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.
The journal publishes original peer-reviewed papers of international or global significance that improve the veterinary care and welfare of domestic cats.
Until this year, access to JFMS for most veterinary practitioners was dependent on membership to the International Society of Feline Medicine (ISFM) or the American Association of Feline Practitioners (AAFP), or a separate paid subscription.
Now that the journal is open access, there are no restrictions on who can access the journal and all articles past and present are free to view.
The journal's editors say that making it open access greatly improves their ability to improve the health and welfare of cats by providing high-quality peer-reviewed information.
The AAFP and ISFM say they have already seen the positive impact this has had, with low- and middle-income countries now accounting for a quarter of the 20 most common geographic locations for visitors to the JFMS website.
Head of ISFM Nathalie Dowgray said: "Transitioning JFMS to an open access journal helps ISFM fulfil our parent charity’s (International Cat Care) mission of creating a cat friendly world through ensuring the latest knowledge in feline medicine and welfare is available to the global veterinary community."
For those interested in submitting to JFMS, authors can get a 50% discount on the article processing charge until 4 July 2023; after this date, a 22% discount will be in place for authors who are a member of ISFM or the AAFP.
Click here for more information about submitting an article to JFMS: https://journals.sagepub.com/author-instructions/JFM
https://journals.sagepub.com/home/jfm
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 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.”
At a hearing in April Dr Johnston had admitted all the charges against him, which related fraudulent claims for the treatment of animals, two of which were fictitious, where he arranged for the insurance claims to be diverted and paid into a personal bank account.
Dr Johnston had admitted all the charges against him as well as admitting that his conduct was dishonest and amounted to serious professional misconduct.
Committee Chair Paul Morris said: “The Committee has no hesitation in concluding that the respondent’s dishonest conduct will have severely undermined the confidence of the public in the veterinary profession and, further, that his conduct fell far short of the standards and conduct properly to be expected of a member of the veterinary profession.
"The Committee is satisfied that this conduct by the respondent brought the profession into disrepute.”
The proceedings were then adjourned to allow a psychiatric report and other mitigation to be prepared.
At its resumed hearing on earlier this month, the Committee considered what sanction to impose.
The Committee found that aggravating features of his misconduct were that it was premeditated, carefully planned and sophisticated in that it involved the creation of numerous and extensive false clinical records to support his fraudulent claims.
It also considered the fact that he implicated an innocent professional colleague who worked alongside him at the practice, that he abused the trust placed in him by clients, that the dishonest conduct was repeated and that it involved significant financial gain in excess of £13,200 to be further aggravating features of his conduct
In terms of mitigation, the Committee accepted that he had made early admissions regarding his conduct to his employer and the College and accepted responsibility.
The Committee also heard that he had made attempts at remediation involving repayments of some of the sums lost by the practice and insurers.
It also considered positive testimonials from family and professional colleagues and the fact that Dr Johnston had taken significant steps to deal with the gambling addiction that was at the root cause of his misconduct.
Having considered all the evidence, the Committee decided to postpone its decision on sanction for a period of 2 years on the condition that Dr Johnston agree to undertakings including refraining from any form of gambling, subjecting himself to a close regime of support and supervision, and repaying some of the sums he had defrauded.
Paul added: “In reaching this conclusion the Committee wishes to make it clear that it has taken an exceptional course in this case.
"Ordinarily conduct of the type covered by the charges which this respondent has accepted will merit the imposition of a sanction of removal from the Register or a period of suspension from the Register.
"In this instance the Committee has found it possible to take the course that it has because it is satisfied that the respondent was, at the time, suffering from a recognisable psychiatric compulsive addiction… and that the fraudulent attempts by the respondent to obtain funds with which to gamble would not have occurred but for this psychiatric condition.
“The Committee further considers that the undertakings offered by the respondent will serve to reduce the risk that he will relapse into gambling again, for his conduct will be closely monitored and he will accept continuing support and guidance from the organisations currently assisting him.
“The Committee is also satisfied of the requirements that neither animals nor the public will be put at risk by this proposed course of action; that the respondent has demonstrated insight into the seriousness of his misconduct and that there is currently no significant risk of repeat behaviour; that his practicing standards are not in need of improvement so long as he continues to fulfil his CPD obligations; that the undertakings offered are capable of being met, are appropriate and are measurable; that there is evidence that his underlying medical problem is being appropriately addressed, will be monitored and reported on; and that he has responded positively to the opportunities for support and counselling which have been offered to him.”
If Dr Johnston fails to comply with his undertakings the Committee will reconvene and consider the charges with the full range of sanctions at its disposal.
www.rcvs.org.uk/disciplinary
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.
Concern has been expressed in the profession about environmental contamination from products used in companion animal treatment for ectoparasites, such as fleas and ticks.
In recent years there has been a widely documented fall in the abundance of many terrestrial invertebrate populations1.
While the decline has been mostly linked to agricultural chemicals, there is a concern that companion animal ectoparasiticides could also be a contributing factor, with a recent study2 confirming the presence of common compounds used in flea-treatment3 in UK waterways.
However, the association with companion animal ectoparasiticides is currently poorly understood, with a significant knowledge gap and little robust research available to assess the true importance and environmental consequences.
The funded project ‘Assessing the Environmental Risk from Ectoparasite Treatments in Companion Animals’ will be led by Professor Richard Wall, Professor of Zoology and Dr Emily Bell, Senior Lecturer at University of Bristol in collaboration with Dr Imogen Schofield, Veterinary Statistician and Epidemiologist at CVS, and Lizzie McLennan-Green, Small Animal Veterinary Director at CVS.
It will be conducted via a PhD studentship at the University of Bristol as part of the CVS Clinical Research Awards.
The research will include a longitudinal ‘citizen science’ study with pet owners to develop a greater understanding of owner use and attitudes towards ectoparasiticides.
It will also include laboratory assessments of ectoparasiticide residues collected from companion animals to provide evidence-based information on the potential environmental impact of the treatments when applied to companion animals.
It is hoped the study will help the wider veterinary profession develop the most appropriate approaches to prescribing and use of ectoparasiticides in the future, and inform educational strategies to support owners with ‘responsible use’. The study is also set to benefit companion animals, as the research will inform strategies to ensure the most appropriate control of parasitic burden to pets.
The project starts in January 2023 and will run for three-years as a full time PhD.
CVS is providing £95,000 to fund the research.
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.
Reference
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!”
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.
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