The review was recommended to Council by its Standards Committee following its exploration of the implications of new technologies for both animal health and welfare and veterinary regulation.
The main areas under consideration are the interpretation and application of an animal being under the care of a veterinary surgeon, and the provision of 24-hour emergency cover.
The College says that during the course of its research, which included numerous meetings and reports, a public consultation and examination of external legal advice, the Committee identified a number of anomalies in the College’s existing guidance that could affect how the Code’s provisions were applied across a range of different scenarios.
Chair of the Standards Committee, Dr Kate Richards, said: "It became clear to us that we could not consider telemedicine and remote prescribing in isolation and that it raised broader questions around the appropriateness of, and justification for, certain elements of existing RCVS guidance. I’m therefore pleased that RCVS Council has decided that the right and responsible approach is first to conduct a full review of these provisions."
The College anticipates that the review will require wide engagement from all relevant sectors, potentially including a Select Committee-style hearing in certain areas. This, it says, would help to ensure any decision to treat different groups differently, in relation to 'under care' and 'out-of-hours', is both reasoned and justified.
In the meantime, the College says that the current provisions of the RCVS Code of Professional Conduct and its supporting guidance remain in full effect.
Further information about the review will be made available in due course.
UPDATE (19/06/2019)
Following a number of concerns raised by members of the profession about this story, the RCVS has issued a further statement as follows:
We would like to acknowledge and address a number of concerns that have arisen amongst the profession following RCVS Council’s discussion last week that followed up queries raised during the previous debate in November, around the provision of telemedicine services, including remote prescribing.
The RCVS Council decision, made unanimously, was to proceed with a wide-ranging review of RCVS supporting guidance concerning 24-hour emergency cover and the interpretation and application of ‘under veterinary care’, and to postpone the proposed telemedicine trial for the foreseeable future and certainly until the conclusion of this review. The review will encompass, but not be limited to, consideration of what restrictions or safeguards to place on remote prescribing in the form of vet-to-client telemedicine.
RCVS Council discussed this paper ‘in committee’ in order to be able to examine the confidential legal advice it had requested at its previous meeting. The decision to hold these discussions privately was purely related to the privileged nature of legal advice and in no way related to any ‘commercial interests’.
We recognise fully that this is a complex issue, with strong views held on all sides. However, it is entirely right and proper for RCVS Council members to be able to discuss and debate such topics in detail, before reaching a decision through a vote. In the course of such discussions, issues may arise that had not previously been identified, and which may alter the original direction of thinking.
We appreciate that Council’s decision was perhaps unexpected, especially as the original topic had been under consideration for some time. This is why we announced it as soon as possible, along with an indication of what Council would like to happen next.
Whilst it is far too early to have worked out the details of the agreed review, it will be open and inclusive in parallel with our previous consultations, which continue to receive considerable levels of engagement across the veterinary professions and wider industry stakeholders.
We will publish full details about our plans for this review over the coming weeks, and will continue to work hard to engage all veterinary professionals in these important decisions.
The Disciplinary Committee considered a number of charges against Javier Salas Navarro MRCVS and Roman Kristin over 35 days.
The charges against Dr Navarro concerned his treatment of a kitten named Marnie. They included:
In August 2016, failing to read the anaesthesia consent form in relation to a surgical spay he performed;
When Marnie was readmitted for surgery, failing to read the anaesthesia consent form, failing to undertake adequate assessment of Marnie’s condition; performing surgery without adequately considering her condition; subjecting Marnie to anaesthesia without recognising the seriousness of her illness; failing to obtain informed consent from the owners; administering medication which was contra-indicated; and failure to make an adequate record of his involvement in Marnie’s care.
The charges against Dr Kristin also related to his treatment of Marnie. They included:
In August 2016, failing to undertake an adequate assessment of her condition; failure to recognise and record the fact that Marnie could not pass urine; failure to refer or offer her for specialist treatment; and failure to ensure Marnie received care and treatment overnight.
When admitting Marnie for surgery, that he made a number of clinical mistakes including failure to gain informed consent; and failure to recognise the seriousness of her illness;
that there were a number of failings in relation to Marnie’s care, including failure to arrange adequate overnight care, failure to monitor and record her condition, and failure to gain informed consent for the overnight care.
that he failed to advise Marnie’s owners that he suspected her uterers had been ligated during the spay, failed to advise Marnie’s owners that she required specialist veterinary treatment; and advised that Marnie undergo further surgery at the practice in spite of this meaning her having to undergo further anaesthesia in a week and with poor chances of survival;
that the above conduct was misleading and dishonest.
The Disciplinary Committee found a number of the facts in the charges against both Dr Navarro and Dr Kristin proven (the full details can be found in the documentation at www.rcvs.org.uk/disciplinary).
The Committee found that Dr Navarro breached a number of aspects of the Code of Professional Conduct for Veterinary Surgeons including: making animal health and welfare the first consideration when attending to animals; the provision of appropriate and adequate veterinary care; responsible prescription, supply and administration of medicines; communication with professional colleagues to ensure the health and welfare of the animal; being open and honest with clients and respecting their needs and requirements; effective communication with clients; keeping clear and accurate clinical records; and working with the veterinary team to coordinate the care of animals.
Of the proven charges, the Committee found that his initial failure to read Marnie’s anaesthesia consent form on 5 August did not amount to disgraceful conduct in a professional respect, but that the repetition of this failure on 9 August did amount to disgraceful conduct. It also found that Dr Navarro’s failure to undertake adequate assessment and perform surgery without this assessment amounted to serious professional misconduct. Furthermore, the Committee found that subjecting Marnie to anaesthesia in spite of her being unwell, failure to obtain informed consent and failure to keep adequate records also amounted to serious professional misconduct.
For Dr Kristin, in summary, the Committee found not proven the allegation that he had failed to respond on 5 August 2016 to concerns from Marnie’s owners about her condition while she was recovering from a surgical spay and also all the allegations relating to Dr Kristin’s admission of Marnie to the practice on 9 August on the basis that it was not satisfied so as to be sure that Dr Kristin had been the veterinary surgeon who admitted Marnie on that day.
The Committee found proven the remaining charges and found he breached the following parts of the Code of Professional Conduct for Veterinary Surgeons: making animal health and welfare the first consideration when attending to animals; keeping within area of competence and referring responsibly; providing appropriate and adequate veterinary care; responsible prescribing, supply and administration of medicines; communication with colleagues to ensure the health and welfare of the animal; being open and honest with clients and respecting their needs and requirements; communicating effectively with clients and obtaining informed consent; keeping clear and accurate clinical records; and working with the veterinary team to coordinate the care of animals.
Of the proven charges, the Committee determined that his failure to adequately assess Marnie’s health, to obtain a clinical history, to undertake blood tests and recognise that she was seriously ill, amounted to disgraceful conduct in a professional respect and led to “Marnie’s underlying condition going undetected and undoubtedly contributed to her eventual death two days later”.
The Committee also found that Dr Kristin’s decision to hospitalise Marnie without adequate overnight care, place her on IV fluids without monitoring the treatment or her condition, and failure to obtain adequate informed consent – among other things – amounted disgraceful conduct in a professional respect.
Stuart Drummond, chairing the Committee and speaking on its behalf, said: "As a direct result of Dr Kristin’s acts and omissions, Marnie was left alone overnight on fluids when those fluids had nowhere to go. Had he done his job properly he would have known that and Marnie could have avoided the prolonged suffering caused by the chosen course of treatment that did not address the underlying condition. Every element of Dr Kristin’s behaviour was catastrophic for Marnie, and yet he took no personal responsibility for her welfare and just went home.”
Following its findings on disgraceful conduct in a professional respect, the Committee then went on to consider its sanction for both Dr Navarro and Dr Kristin.
In respect of Dr Navarro, the Committee considered the mitigating factors including previous good character, admissions to some of the facts of the case from the outset; genuine insight and remorse into the seriousness of the actions; his youth and inexperience; and relevant and good-quality testimonials from colleagues. The Committee noted that the testimonials were universally positive and demonstrated that Dr Navarro had reflected on his conduct, had become more mature and confident in his practice and made efforts to rectify the areas in which he had fallen below standards.
Stuart Drummond said: “Although the consequences for Marnie and her owners were clearly devastating, the Committee considered that Dr Navarro’s part in her demise has to be seen in the context of all the evidence. In light of the extensive mitigation, including significant evidence of insight and remediation, the Committee was able to conclude that Dr Navarro did not represent a future risk to animals or the public. In such circumstances, the Committee considered that it was not necessary to restrict Dr Navarro’s registration and that a reprimand was the appropriate and proportionate sanction in his case.”
In relation to Dr Kristin, the Committee took into account positive character evidence from Mr Karel Daniel, a semi-retired veterinary surgeon and Vice-President of the Czech Republic Veterinary Chamber, a similar body to the RCVS in that country, as well as other testimonials on his behalf. In mitigation, the Committee considered Dr Kristin’s previously unblemished career, the fact that it was a single case involving a single animal; some development of insight into his conduct; no evidence of repetition; expressions of remorse; the impact of a family bereavement during the course of proceedings; and his financial position.
However, the Committee also took into account aggravating factors including a lack of candour from Dr Kristin when he was giving evidence, demonstrated by a tendency to blame others rather than take responsibility, as well as his recklessness in suggesting a third operation on Marnie that was not in her interests, rather than referring her into specialist care.
The final decision of the Committee on the sanction for Dr Kristin was that, given the seriousness of the misconduct, it was satisfied that this warranted a six-month suspension period. However, given the mitigating factors, the Committee decided that four months was appropriate and proportionate.
Commenting on the sanction Stuart Drummond said: “The Committee determined that it was important a clear message be sent that this sort of behaviour is wholly inappropriate and not to be tolerated. It brings discredit upon the respondent and discredit upon the profession and, most importantly, caused harm to Marnie and great distress to her owners.
"The Committee did consider whether to remove Dr Kristin from the Register. However, in light of the mitigation in this case, the fact that this was a single case in an otherwise unblemished career, together with the unlikelihood he would repeat his disgraceful conduct, the Committee decided that, in all the circumstances, to remove him from the Register would be disproportionate.
"The Committee therefore decided to order that the Registrar suspend Dr Kristin’s registration…. The Committee was satisfied that a period of four months was appropriate and proportionate in all the circumstances."
The full facts and findings from the case can be found at www.rcvs.org.uk/disciplinary
It might explain why, according to the research, around 14% of British adults actively encourage fox visitors into their garden, with 10% of adults leaving out food, water or toys for foxes and 48% of them admitting they would feel disappointed if their garden fox did not return at night.
Bayer highlights research which showed an increase in the number of foxes infected with Angiostrongylus, from 7.3% in 2008 to 18.3% in 20152,3.
More recent work led by the aptly named Professor Mark Fox at the Royal Veterinary College has shown that, in the Greater London area, nearly three out of four foxes (74.4%) are infected with the parasite.4
Mark said: "We had previously mapped the distribution of Angiostrongylus in pet dogs by seeing how many cases every small animal practice in Britain had seen over the previous 12 months. This revealed the parasite’s widespread distribution coupled with hotspots of infection in Greater London/south-east England and South Wales, where dogs were four to five times more likely to be infected than elsewhere in the country.
"We then investigated why hot spots were seen in these locations and, apart from land type, dog density and climatic factors, we found that the mere presence of foxes locally increased the risk of infection in dogs five-fold."
"The overall prevalence of infection in Greater London was very high, at just under 75 per cent4, and prevalence was maintained at this level throughout the year. These results suggest that foxes act as year-round, wild animal reservoirs of infection for urban dogs."
Donna Tomlinson, Bayer Senior Brand Manager said: "The recent ‘pet foxes’ pet owner research results coupled with the lungworm prevalence fox studies highlights the growing concern of the spread of Angiostrongylus vasorum in the UK and the need for adequate preventative measures for pet dogs.
"Veterinary professionals are perfectly placed to advise dog owners on the risk of their pets becoming infected with the parasite, including the growing role of foxes as potential wild animal reservoirs of Angiostrongylus, as well as advising pet owners to use a monthly spot-on prevention such as Advocate.
"Treatment with products containing moxidectin, such as Advocate, not only kills lungworms present at the time of treatment but also kills larvae after ingestion preventing new infections. Regular monthly use prevents disease and ensures that no lungworm larvae are shed in dogs’ faeces which helps to prevent the spread of the parasite in the environment."
To highlight the increased prevalence of lungworm in foxes Bayer has created a poster for veterinary practices, which you can get from the Bayer Vet Centre at: https://www.vetcentre.bayer.co.uk/marketing-and-resources/advocate-fox-poster
References
Professor Susan Dawson (pictured right), Chair of the Mind Matters Taskforce, will introduce the event and will be followed by the symposium’s plenary speaker, Rory O’Connor, Professor of Health Psychology at the University of Glasgow and President of the International Association for Suicide Prevention.
Rory's talk: ‘When It is Darkest: Understanding Suicide Risk’ will draw upon his research and work on the psychological processes which precipitate suicidal behaviour and self-harm, an area of expertise that has seen him advise the Scottish Government, as well as other national and international organisations, on suicide prevention strategies.
The next presentation will be from Dr Victoria Crossley from the Royal Veterinary College and Navaratnam Partheeban, co-founder of the British Veterinary Ethnicity & Diversity Society (BVEDS), on their research into the mental health impact of racism and discrimination on Black, Asian and minority ethnic (BAME) veterinary surgeons.
They'll be followed by Professor Neil Greenberg and Dr Victoria Williamson from King’s College London, who will talk about their research into the impact of ‘moral injury’ on the mental health and wellbeing of vets.
The day will then split into different research streams with presentations on a variety of topics including: the impact of cyberbullying and harassment; the wellbeing of veterinary interns and residents; stigma and stress in veterinary nursing; mental health awareness training in the undergraduate veterinary curriculum; and the relationship between ‘patient safety culture’ and staff burnout.
Lisa Quigley, Mind Matters Manager, said: “As with previous years the Mind Matters Mental Health Research Symposium promises to be a very informative and important day in terms of international researchers coming together to share their research, their conclusions, areas for further work and study, and best practice.
"Some of the topics we will be discussing, such as suicide, will be difficult, but research into issues affecting the international veterinary community is a vital first step to putting in place strategies and support mechanisms to help those in need. This is why research will be one of the key strategic priorities for the Mind Matters Initiative and our forthcoming actions in this area will be published later this year in our Mind Matters Initiative Strategic Plan.
“I would like to thank Dr Rosie Allister, a veterinary mental health researcher from the University of Edinburgh and manager of Vetlife Helpline, for putting together an excellent programme.
"As with previous years we are also offering free attendance of the symposium to those who have lived experience of mental ill-health, those who are currently not working, and veterinary and veterinary nursing students. If you have any queries about the event, please don’t hesitate to contact me on l.quigley@rcvs.org.uk to discuss further.”
Registration for those not entitled to a free ticket is £10.
To register for the event visit: www.vetmindmatters.org/events.
Su Page MRCVS, Amodip Product Manager at CEVA, said: “If left untreated, hypertension can result in target organ damage (TOD), with ocular problems developing in at least 80% of hypertensive cases1.
"Other major body systems that are commonly affected include the brain, heart and kidneys.
"Despite the potential for catastrophic sequelae such as retinopathy and blindness, owners may see very little in the way of warning signs.
"That means these patients are completely reliant on a veterinary recommendation for blood pressure monitoring.”
Ceva says that ideally, all cats over nine should be screened regularly. But given the pressure the profession is currently working under, the priority is to address the needs of the most at risk cats, ie those with predisposing conditions such as kidney disease and hyperthyroidism.
Su said: “There is a real danger that many of those cats will be close to crisis point right now and the sooner we can identify those that need help, the better a chance we have of extending their quality and quantity of life.”
Vet nurses looking to update their knowledge on feline hypertension, including the importance of regular screening, blood pressure monitoring techniques, and appropriate treatment options, can complete Ceva's free Feline Hypertension Ambassador CPD course at: https://veterinarywebinars.com/community/ceva/.
Reference
For the research1, 190 faecal samples were collected from dogs in 140 households (114 samples from raw fed dogs and 76 from non-raw fed dogs).
Salmonella species was detected in 4% of the samples (all raw fed) and antimicrobial-resistant E. coli was detected in 40% of all dogs, but in 62% of raw fed dogs.
The authors say that statistical analysis confirmed that this represented a significantly higher prevalence of AMR E. coli, including multidrug resistance and third generation cephalosporin resistance, and Salmonella species in dogs fed raw compared to non-raw meat diets.
The authors concluded that strategies should be implemented to increase the awareness of the risks of feeding raw meat diets to dogs, to reduce any potential risk to owners, their families, and their pets.
Nicola Di Girolamo, Editor of JSAP says: “In this study, an association between raw meat diets in dogs and faecal carriage of potentially dangerous enteric bacteria has been observed.
"Readers should keep in mind that cross-sectional studies such as this one lay the basis for additional research more suited to prove causality.”
Hedgehogs: A Practical Guide for Vets aims to help vets assess sick hedgehogs and administer emergency treatment to stabilise them so they can be transferred to a wildlife rescue centre for specialist care.
Hannah, who has examined and treated more than 1,500 hedgehogs since setting up her sanctuary four years ago, said she also wants to create more awareness that hedgehogs seen during the daytime need urgent help.
She said: “As soon as a hedgehog comes out in the day it is usually a cry for help and they should be taken to the vets or a rescue centre as a matter of urgency.
“I wrote the book to help vets who are more familiar with treating small pets like dogs and cats know what to do if a sick hedgehog is brought to them, and to increase their confidence when treating wildlife.
"There are three simple things that every sick hedgehog needs, which are warmth, fluid and pain relief.”
https://www.facebook.com/p/Hannahs-Hedgehog-Rehabilitation-100070882987122
In the study1, which was funded by Universities Federation for Animal Welfare (UFAW), an online questionnaire was completed by 744 snake owners worldwide but predominantly from the UK (68.8%).
The questionnaire investigated housing and husbandry practices and snake health and welfare as measured by clinical signs and behavioural indicators.
Associations between clinical signs, behavioural indicators and housing and husbandry aspects were tested for the three most common snake families: Pythonoids, Boids and Colubrids.
The study found 54.7% of snakes were kept in enclosures shorter in length or height than their body, preventing them from stretching out fully.
10.2% of snakes in the UK were kept in enclosures that do not comply with current recommended guidelines (minimum enclosure length <0.66 of snake length).
Whilst most snake owners (93.1%) reported measuring the temperature in their snakes’ enclosures, 24% of these checked less than the recommended once daily.
When looking at the most commonly owned snake species (royal pythons, corn snakes and common boa constrictors), 47.2% were kept in sub-optimal temperatures for their species.
Furthermore, 48.1% of owners reported not measuring the humidity in their snakes’ enclosure.
Owners reported that many snakes experienced at least one of the listed clinical signs, with the most common issues being skin shedding (28.2%), parasites (11.2%), rostral cuts and scrapes (7.4%) and respiratory problems (5.6%).
Snakes that were kept in enclosures <1 snake length had significantly more clinical signs compared to those snakes kept in enclosures >1 snake length.
Similarly, most snakes were reported to experience at least one of the listed negative behaviours, most commonly interacting with transparent boundaries (52.8%), wincing or withdrawal of head when gently touched (52.4%), putting the head under the substrate (52.1%), unusually high level of activity (51.1%) and attempting to escape (45.9%).
All these negative behaviours have previously been described as associated with captive stress.
Snakes that were reported as having more clinical signs tended to show more reported negative behaviours.
Dr Nicola Rooney, Senior Lecturer in Wildlife and Conservation at Bristol Veterinary School and corresponding author for the paper, said: “Our study has highlighted various concerns for snake welfare.
"The first of these relates to enclosure size, with snakes commonly being kept in vivaria preventing straight-line postures and movement.
"Snakes that were unable to stretch out fully had more clinical signs than those that were able to stretch out fully.
“Whilst we did not find a significant association between temperature or humidity and measures of health and welfare in this study, it is a concern that many snakes were housed in conditions considered sub-optimal for their species.
"We know that appropriate temperature and humidity is vital for maintaining the health of snakes and it would therefore be prudent to investigate these associations further, using methods other than owner reporting.”
Dr Huw Golledge, Animal Welfare Editor-in-Chief, said: “Until now, there has been little empirical data on the housing and husbandry practices of privately kept snakes, and how these impact on their welfare.
"As the first study of this size, this research provides valuable baseline data against which future surveys or welfare interventions can be compared.
“As this survey relies on owner-reported information, it is very likely that many of the frequencies of clinical and behavioural signs are underestimated.
"This demonstrates the need for evidence-based recommendations, and the importance of such recommendations being made accessible to owners to improve snake welfare.”
Photo: Brown and Black Snake in Close Up Photography © deedee Pexels
The webinar, which takes place on Thursday 30th June at 7.30pm, is being presented by Debbie Boone, billed as one of America’s most prominent and experienced veterinary communications consultants.
Gerrard Harkins, Premier Vet Alliance’s Commercial Director said: “Many people struggle with managing challenging behaviour and confrontation in the workplace and Debbie will be focusing on providing delegates with pragmatic advice and skills to put into practice.
"She is one of the veterinary industry’s most prominent and successful communicators so we’re extremely fortunate to be able to access her advice.
“We’re also looking forward to gaining a US perspective on this important subject.”
To register for the webinar, visit: https://tinyl.io/5aIk
Mike, an RCVS Queen’s Medal winner, will be in conversation with Catheryn Partington BVSc CertAVP(VC) MSc MRCVS, Jose Matos DVM DipECVIM (Cardiology) MRCVS European and RCVS Recognised Specialist in Small Animal Cardiology (canine and feline cardiology) and Paul Freeman MA, VetMB, Cert SAO, Dip ECVN, MRCVS (European and RCVS Specialist in Veterinary Neurology) (canine and feline neurology).
During the event, they will be explaining how Improve's new Academy Series can help vet professionals meet their annual CPD targets, learn through self-assessment and reflective study, and bring them to the forefront of medicine in several specialist areas.
Heber Alves, CEO of Improve International, said: “Here at Improve International, we are proud to be providing CPD training alongside the historic and prestigious University of Cambridge for our first Academy Series.
"We are excited to be working with many of its pioneering specialists at the Department of Veterinary Medicine and, as a former vet myself, I look forward to hearing how my fellow veterinarians handled the most difficult challenges of their careers.”
www.improveinternational.com
The new Improve Veterinary Academy Series is comprised of five month-long semesters, each of which will focus on a different clinical topic.
Each semester will consist of videoed lectures, discussion forums, journal clubs, as well as the ability to access the university’s latest evidence-based research in these areas.
The clinical topics to be explored are:
Each semester counts towards your annual CPD requirement.
Professor James Wood, Head of the Department of Veterinary Medicine at University of Cambridge, said: “This new partnership will allow veterinary nurses to get the latest evidence-based knowledge directly from our top specialists.
"They will also learn to apply valuable skills in their everyday practice life and engage with others on Improve International’s global, interactive online platform.
Charlotte French, Head of Curriculum & Quality at Improve International, said: “We are thrilled to be working with University of Cambridge Department of Veterinary Medicine as another innovative way to help the veterinary community take their careers to the next level.”
Professor Mike Herrtage, Trustee of the University of Cambridge Veterinary School Trust and former Dean of the Cambridge Veterinary School, said: “The new joint agreement brings together Improve International, with its outstanding record of high-quality and innovative CPD provision and the staff of the Department of Veterinary Medicine with their excellent specialist clinical knowledge and experience, as well as their recognised quality in small group teaching to stage the Improve International Academy Series.
"This will provide a new milestone in CPD course delivery.”
Apoquel chewable tablets were approved by the Veterinary Medicines Directorate (VMD) in November 2021.
Apoquel Chewable contains the same active ingredient, at the same dosing regime, for the same indications as original Apoquel, but in a palatable formulation which, in a field-study of client-owned dogs, was found to have a 91.6% acceptance rate.1
Dr Carly Mason, President of the British Veterinary Dermatology Study Group (BVDSG), said: “The new chewable form of Apoquel provides owners with a means of controlling itch using a tablet that can be given like a treat or mixed with a meal, making it much easier for owners and more acceptable to their pet.
“In many cases, the chewable formulation will be the obvious first-line Apoquel for veterinarians to prescribe to control canine itching while the underlying cause of allergic dermatitis is investigated.”
The study “Evaluation of quick sequential organ failure scores in dogs with severe sepsis and septic shock1” reviewed electronic records from dogs that presented through the veterinary medical teaching hospital emergency service between January 2010 and December 2019 using the search terms “sepsis” or “septic”.
The quick sequential organ failure score was calculated by evaluating respiratory rate (>22 breaths per minute), arterial systolic blood pressure (≤100mmHg) and altered mentation.
Forty-five dogs with severe sepsis and septic shock and 45 dogs with non-infectious systemic inflammatory response syndrome were included in the final analysis.
It was found that the quick sequential organ failure assessment score provided poor discrimination between survivors and non-survivors for dogs with severe sepsis and septic shock.
In addition, the quick sequential organ failure score demonstrated a poor sensitivity and fair specificity to detect this population of canine patients.
The authors say that previous studies on quick sequential organ failure score have provided conflicting results, but that this may just be due to the inherent heterogeneity of the population.
Considering the results of this study, it may not be possible to identify a single scoring system that serves the purpose that quick sequential organ failure assessment is intended for.
Nicola Di Girolamo, Editor of the JSAP said: “The results of this study have strong clinical implications.
"The JSAP values studies with negative findings such as this one, as much as studies with positive findings.
"The fact that a diagnostic tool or a treatment does not reach the desired objective, should not hinder publication of methodologically sound research”
https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsap.13522
At the heart of the new system is a transportable monitor (pictured right) which starts automatically after you connect two sensors and press the power button.
The system uses the handheld Darvall H100N Pulse Oximeter, which uses Nellcor OxiMax pulse oximetry technology.
It also comes with veterinary blood pressure NIBP small animal cuffs which are designed for accurate pressure detection in exotic animals, cats, and all sizes of dog.
Completing the Darvall Express system is the Darvall Capnograph which continuously measures the EtCO2 and respiratory rate, and features EtCO2 waveform Cardiac Oscillation artifact detection, for correct respiratory rate determination.
There's a default system set-up for cats and small dogs, a colour-coded display and a ten-hour battery life.
Darvall says the monitor has been thoroughly tested at veterinary practices in Australia, where it displayed outstanding performance in small dogs and cats, which are notoriously difficult to get reliable readings.
Darvall founder, Dr Colin Dunlop said: “Anaesthetic monitoring plays a vital role in keeping patients safe, giving peace of mind to the hospital veterinary team, and boosting pet owner confidence in the care their pet is receiving.
"This is vitally important when you remember mortality in veterinary patients is many times higher than in human hospital practice”.
http://www.aasmedical.co.uk
Hospital director David Walker said: “Ewan Ferguson has been providing our dermatology service for many years and with Hilary joining him, we will now be able to provide a full-time service to support our referring vets, their clients and pets.
He added: “We are really delighted that Hilary is joining the dermatology team at Anderson Moores. Her passion for dermatology is infectious and with a particular interest in chronic ear disease, I’m sure she’s going to be very busy!”
Hilary has been a past Board member and organiser of the scientific meetings for the British Veterinary Dermatology Study Group, a member of the In Practice editorial board for 20 years and a past chief examiner for the RCVS Small Animal Medicine Certificate. She continues to act as a mentor for the BSAVA PGCertSAM course and as an assessor for the RCVS Advanced Practitioner in Small Animal Dermatology.
Hilary has worked in first opinion and referral clinics around the south west, including running her own dermatology referral service within several veterinary practices. From 2018 to 2021, she had been working as lead clinician in dermatology at Langford Vets (University of Bristol).
Hilary said: “I’m very excited to be joining the fantastic team at Anderson Moores and really looking forward to helping make a difference with the new dermatology service we’ll be offering.
For more information, visit www.andersonmoores.com.
The initiative comes after BEVA's new nurse committee ran a survey which found a poor understanding within the profession and amongst clients of what equine nurses can do.
Nurses said they believed they could be given more responsibility and do more within their roles and that there was a lack of opportunity for progression.
BEVA President David Rendle, who is championing this initiative, said: “RVNs are a significant an asset to any equine practice.
“They have invested a lot of time and effort to become highly skilled but in some instances their significant attributes are not being utilised to the full.
“Allowing RVNs to perform the clinical tasks that they are qualified to carry out under Schedule 3 of the Veterinary Surgeons Act 1966, will provide better job fulfilment and career development as well as free up veterinary surgeons to carry out other tasks, all increasing the efficiency of the veterinary team.
“I feel, and the RVN survey results would seem to confirm, that veterinary surgeons and practice managers do not appreciate how much veterinary nurses are allowed to do in equine practice.
"We all know veterinary nurses have the ability; look at what they do in small animal and human nursing, but we have felt unnecessarily constrained by Schedule 3 of the Veterinary Surgeons Act 1966 and the associated RCVS guidelines.
"If you actually look at Schedule 3 it is clear that we can and should be letting our qualified equine nurses do far more.
“There are so many things in equine practice that nurses do better than vets.
"In addition to performing clinical tasks they can add wider value; they are generally (or are perceived by clients to be!) more patient, empathetic and caring so we should utilise these skills and get nurses to take on some of the roles that take more time and require longer client interactions – discussing parasite control programmes, running weight loss clinics, reviewing healthcare plans, making follow-up phone calls and visits to name just a few.
"Nurses can take a lot of pressure off vets and can add a significant revenue stream for the practice.”
On the 9th February, the BEVA will be hosting an online discussion forum for all members of the practice team to discuss the role of nurses and how their skills, experience and knowledge can be better-used.
It's free for BEVA members: https://www.beva.org.uk/Home/Events/BEVA-Events/Event-Details.aspx?eventDateId=1716
In addition, the Association is organising a number of other career events for nurses throughout the year:
Marie Rippingale Chair of the BEVA Nurse Committee said: “Last year’s recruitment and retention survey revealed that 50% of nurse respondents were earning less than £25,000 per annum and 48% of nurses said they were likely to look for a new job in the next two years.
"When asked their top reasons for leaving, salary was the biggest reason, and common themes on what would help the retention of nurses included salary, work-life balance and career progression.
“The review of Schedule 3 is important so we can encourage delegation of tasks to RVNs.
"This will allow RVNs to demonstrate their value and worth, earning money for the practice and achieving job satisfaction at the same time. This will contribute positively towards the current retention crisis.”
To find out more about what equine veterinary nurses can do in practice visit https://www.beva.org.uk/nurses
Photo: Liphook Equine Hospital.
BVA President Malcolm Morley said: “Judging this competition has been genuinely both extremely enjoyable and really difficult.
"The entries this year have absolutely surpassed expectations and the level of talent on display is amazing.
"However, the photographs we have chosen are all well worthy of being finalists.
"From photos that made us laugh out loud, to others that made some of us feel close to tears, they evoked a range of emotions, but we were also impressed by the quality of the images, the creativity of the photographers and the composition of the photos, as well as the stories behind the lens.
The finalists are:
Vets at work
All creatures great and small
Happy pets that make us smile
The winners will be announced at BVA Live at Birmingham’s NEC in May, where this year there is also an opportunity for BVA Live delegates to vote for their favourite image from the shortlist, with a new ‘People’s Choice’ winner being announced in the weeks following the event.
Titled Nurses and Dermatology – the Bite Sized Guide to Getting Started, the series is presented by Frances Gaudiano, the RVN who wrote Veterinary Dermatology: A Manual for Nurses and Technicians.
Accounting for two hours’ CPD, the series is split into four 30-minute webinars covering:
Ceva is also including further training on its Douxo S3 range.
To pre-register for Nurses and Dermatology – the Bite Sized Guide to Getting Started, visit: https://www.thewebinarvet.com/pages/ceva-register-nurses-and-dermatology-bite-sized-guide/
The company is also hosting another series which is aimed at vets, but may also be of interest to nurses, called The Dermatology Extravaganza.
The Dermatology Extravaganza is presented by Dr Tim Nuttall, RCVS Specialist in Veterinary Dermatology and Head of Dermatology at The Royal (Dick) School of Veterinary Studies in Edinburgh and Dr Sarah Heath, RCVS and European Veterinary Specialist in Behavioural Medicine. The three sessions, which are between 30 minutes and an hour in length, will cover: ‘Topical therapy in canine atopic dermatitis’ and ‘Antimicrobial resistance’ presented by Dr Tim Nuttall and ‘Emotional considerations in dealing with dermatology cases’ by Dr Sarah Heath.
To register for The Dermatology Extravaganza, visit: https://www.thewebinarvet.com/pages/ceva-dermatology-tea-time-top-ups-bite-size-cpd-sessions/
All viewers will be able to enter into a prize draw to win a £50 Love2Shop voucher and a free Cytology Manual.
The new clinic is led by Marie Kubiak, an RCVS Specialist and diplomate in Zoo and Wildlife Medicine and one of only a small number Specialists that are accredited for reptiles, birds, pet mammals, wildlife, zoo species, fish and invertebrates.
The open day offers a chance to see the new clinic, meet the team, find out how it can support your practice and discuss any challenging cases you have.
Light snacks and drinks will be provided.
RSVP: evolutionexoticsreferrals@gmail.com
https://evolutionexoticsreferrals.co.uk
Evolution Exotics Referrals, Tenbury Road, Cleobury Mortimer, South Shropshire, DY14 0AD
Eight dogs being treated at three veterinary clinics in Norway took part in the study1.
Previous research2 has found a complication rate of 55% when fibreglass casts are used, 20% of them severe. In this study using the Upets Splinting System, only 12.5% of dogs (n=1) had complications that required treatment, and the complications were minor.
Dassiet says the results suggest that the new product has the potential to make veterinary casting safer, more sustainable, and can help control costs associated with cast replacement and treatment of complications.
86% of the veterinary surgeons participating in the study rated the Upets Splinting System as easy to use and said they would use the product on their own dog.
An earlier poll3 questioned vets on their most common concerns about casting and identified that the most significant were fear of complications (57%), the time-consuming nature of casting (54%) and inconvenience (51 %).
Dr. Martin Kaufmann, OrthoPets founder and Dassiet VET COO, said: “Complications often result from a cast that does not fit as well as it should.
"The results of this study suggest that Upets might be the ground-breaking tool that veterinarians have been waiting for as it provides them with the means to achieve a cast shape that is more precise."
For the white paper detailing the trial, visit: www.upets.vet/research.
The findings will be published in a freely-available and independently-authored report.
Jane Balmain, Chief Operating Officer at Vets4Pets (pictured right), said: “The last 18 months have been indescribably tough for everyone, not least the veterinary practice teams. Soaring levels of pet ownership coupled with recruitment challenges have meant that an already-stretched profession has been almost brought to its knees.
"As a profession, you’ve always put pets first. But now it’s time to also concentrate on you - the vets, nurses and support teams that make up our beloved sector. We want to hear how you’re feeling and give you the power to help us make change.
“By launching this sector-wide survey, we’re kick-starting a vital conversation to protect the wellbeing of vet teams and the future of the profession. We believe that, by sharing experiences openly and honestly from all corners of the sector, we can come together to bring about the much-needed changes to ensure it remains an attractive, long-term career option.”
The survey, which runs until 16th November 2021, can be completed at www.projectlisten.co.uk. Respondents will remain anonymous and no data will be collected via the survey.
Rosemullion Veterinary Practice is a three-site small animal practice owned by CVS.
It has 100 members of staff and dispenses 3,584 medications in an average month.
According to an article in Companion Animal, medication errors account for 30% of all reported errors in veterinary practice1.
Errors can be prescribing errors - where the vet prescribes the incorrect medication or dosage, or dispensing errors where the incorrect medication, strength or volume is dispensed by the pharmacy team.
Some errors can ‘look or sound alike’ – where medications have similar names or packaging – making them easy to mix up.
Rosemullion conducted an initial clinical audit of entries on its VetSafe system between 1st March and 31st May 2023.
Analysis was conducted on the drugs involved, whether they were prescribing or dispensing errors or near misses, and looking for patterns of behaviour or the drugs involved.
During this time there were 29 (0.27%) near misses and 14 (0.13%) errors.
Prescribing near misses most often involved flea and worm products.
Here additional feedback from vets was that it was difficult to remember weight brackets for all products and when weight brackets were included in the drug description this made them easier to prescribe accurately.
As a consequence, the Rosemullion pharmacy team introduced the inclusion of weight brackets on all flea and worm products.
Dispensing errors and near misses were mostly related to ‘look or sound alike’, particularly in worming tablets, flea treatments and Rheumocam cat and dog.
To address this, the Rosemullion pharmacy team added extra labelling to dispensary draws and separated draws for flea and worm treatments into different weight brackets.
Rheumocam – with its similar packaging design and box sizes – was also split into separate cat and dog drawers, and drawers clearly labelled up with the version and volume to make dispensing clearer.
Feedback was also given to the drug manufacturer.
Rosemullion also held a CPD session to highlight the common errors that were occurring, to explain resulting process and systems improvements, and ask the team to take extra care with these dispensaries.
A new ‘handing out medication’ process was also created – involving checking the medication in the bag matched the on the screen notes, confirming it was for the correct animal and validating it was what the owner was expecting.
A subsequent audit was run from 1st October to 31st November 2023.
The results revealed there were no prescribing or dispensing errors (0%) and only 8 (0.13%) near misses during this time.
Alice Bell, Senior Vet and Quality Improvement Lead at Rosemullion Veterinary Practice, said: “We place patient safety at the forefront of all we do.
"We wanted to conduct this extensive audit to assess our prescribing and dispensing processes and systems.
“The methods we had in place made it easy to do the task correctly and the changes we have now put in place have made the process even safer for our clients.
"Our overall error and near miss is now at a really low number compared to our total number of medication dispenses.
“The teams have been very receptive to the improvements and the project has had a positive impact on various aspects of the practice, including on team wellbeing.”
Rosemullion Veterinary Practice’s initiative has recently been recognised with a RCVS Knowledge Highly Commended status at its 2024 awards.
Sponsored by Vets4Pets, Sarah will look at ways the veterinary profession can improve the detection of this condition and enable you to offer practical advice and support for older animals and their owners.
Sarah is an RCVS and European Veterinary Specialist in Behavioural Medicine and was made a Fellow of the Royal College of Veterinary Surgeons in 2018.
She is a Certified Clinical Animal Behaviourist under the ASAB accreditation scheme and registered as a Veterinary Behaviourist with the Animal Behaviour and Training Council.
Dr Huw Stacey, Director of Clinical Services at Vets4Pets (pictured right) said: “Sadly, cognitive dysfunction is a progressive degenerative disease that can affect many of our beloved pets during their lifespan.
"However, various studies have shown that early intervention, using a combination of environmental, nutritional and medicinal approaches, can lead to significant improvement in quality of life.
“As part of our commitment to the wellbeing of pets, we are partnering with Sarah to sponsor this webinar and enable the entire industry to access the latest insights into early detection and proper management of the condition.
“Our aim is to help educate vets and nurses across the nation and empower them in their decision making when diagnosing elderly pets.”
The webinar will consist of a 45-minute webinar and 15-minute Q&A session.
It will count as one hour of CPD, and a recording will be available to attendees for a year following the event.
The webinar also forms part of a wider campaign which will see pet owners polled to ascertain their current understanding of the condition, and ultimately help to raise consumer awareness of cognitive dysfunction.
To register for a free place, visit: https://bit.ly/3IkuC9e
Pill Assist Cat is a soft treat pouch into which you insert a tablet, mould the pouch around the tablet and then feed to the cat.
Royal Canin says that in its tests, tablets were administered to cats successfully in 91% of cases using Pill Assist, which is not far off the 97% achieved with Pill Assist Dog which was launched earlier this year.
Erin Carr, Veterinary Marketing Executive at Royal Canin, said: "It’s an honour to be recognised by such an important industry body.
"Pill Assist Cat is set to launch next year. As with our Pill Assist Dog products, the aim is to make a real difference to pet’s health and wellbeing by turning pill time into a positive experience for both the pet and the owner."
Amy Scott MRCVS, Boehringer Ingehlheim’s performance horse portfolio manager, said: "Arti-Cell Forte is the first 'ready-to-use' stem cell-based product to be licensed in any veterinary species, and the only stem cell treatment to contain induced cells, representing a significant leap forward in both stem cell therapies and medicine as a whole.
"Arti-Cell Forte contains stem cells that have been chondrogenically induced and therefore primed to develop into the cartilage cell lineage. Studies have shown that chondrogenically induced stem cells demonstrate an enhanced clinical outcome compared to un-induced stem cells in the treatment of joint disease in horses¹."
"This makes Arti-Cell Forte a highly targeted and effective treatment for cartilage damage associated with degenerative joint disease."
Arti-Cell Forte is available direct from Boehringer Ingelheim to veterinary practitioners.
It needs to be stored at ultra-low temperatures to maintain its two year shelf life from manufacture, either frozen at -70 ⁰C to -90 ⁰C (dry ice, -80 ⁰C freezer) or -196 ⁰C (liquid nitrogen) until immediately prior to injecting.
The company is providing full training on storage and administration via face-to-face CPD at practice meetings or specific CPD events*.
For more information, contact your local territory manager or ring Boehringer's Technical Services Team on 01344 746957, or email vetenquiries@boehringer-ingelheim.com