Surrey-based North Downs Specialist Referrals (NDSR) reports that it has become one of the first in the country to operate on dogs and cats with tumours in the pituitary gland.

NDSR’s European Specialist in neurology and neurosurgery Niklas Bergknut is performing the surgery.

He said: "This type of surgery for dogs is not performed in many clinics across the country.

"The pituitary gland is, of course, a very small gland which is very close to the brain, so it requires considerable expertise to perform the operation, followed by a lot of after-care to help the animal recover properly after surgery.

"The pituitary gland produces hormones which are essential for life, so it is then vital to constantly monitor the dog, its blood, hormones and fluid levels both during surgery and for a longer period after surgery.

"Although surgery may be challenging, the aftercare can be even more challenging and requires very skilled internal medicine specialists to manage the patients after surgery.

"Our medics and nurses carry out various blood tests and manage the fluid balance every hour after surgery and all the way through to the dog going home.

"Every department in the hospital has to work closely together to ensure the best possible treatment and the best possible outcome."

Niklas, who learned the technique from Bjorn Meij, Professor of Surgery at the University of Utrecht, described how the operation is performed. He said: "We go in through the mouth, up through the soft palate and into the underside of the cranium. Then you drill a little hole to access the tumour that way.

"It is obviously essential to make sure you are in exactly the right place or the outcome could be disastrous.

"It is also important to operate as early as possible before the tumour gets too big.

"Trying to remove a big tumour is more difficult and holds greater risks because of the damage that can be done to the surrounding brain in attempting to remove the tumour."

Niklas says that if surgery is successful, the results are impressive, with most dogs making a full recovery and not suffering any recurrence of the tumours, a better outcome than treating the dogs with traditional methods such as radiotherapy.

He added: "Removing the tumour like this is the only way of permanently treating tumours of this type. Radiotherapy is very good too but there is a much larger likelihood of the tumour growing back."

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

The Veterinary Defence Society has launched the Veterinary Nurse Leadership Programme, a new course designed to help veterinary nurses in leadership roles, such as practice managers, head nurses, partners, nurse branch managers and team leaders, develop their leadership skills.

The course comprises two two-day workshops and begins by helping you understand your personal strengths and weaknesses. The course then teaches strategies for resilience, communicating with others, motivating team members, and resolving conflict. 

The VDS says that the course will enable you to create a culture that strengthens and develops your practice’s veterinary team and that enables team members to fulfil their potential.

The courses take place on the 21st-22nd March, and the 12th-13th June. 

For more information, visit: https://www.thevds.co.uk/training/veterinary-nurse-leadership-programme/ or email: training@vetdef.co.uk 

Petplan has launched a competition to find a registered veterinary nurse to star in a video offering top tips for pet owners on the company's social media channels.

The winner will spend a day filming with Petplan’s social media and production team, and will also receive £250 worth of vouchers for their practice.

James Barnes, Head of Partnerships at Petplan, said: "We are really excited to offer a talented veterinary nurse the opportunity to share their expertise with our online community of pet owners.

"We have a strong social media presence with more than 150,000 fans, so this is a great opportunity to help the nation’s pet owners and build your social media profile at the same time!"

Petplan says the video will also name the practice where the winner works, so it's good publicity for the practice too. 

Applicants must be a registered veterinary nurse (RVN) with at least two years' experience in the field and work at a practice that is a partner of Petplan.

To enter the competition, you need to submit a 60 second video clip explaining why you deserve to win to social@petplan.co.uk before the 31st March 2018.

Full terms and conditions can be requested from vetline@petplan.co.uk. 

Cardiologists at Davies Veterinary Specialists in Hertfordshire have implanted a stent across the pulmonic valve of a four-month-old French Bulldog with severe and deteriorating pulmonic stenosis, believed to be a first in the UK.

Davies says pulmonic stenosis is one of the most common congenital heart defects in dogs. In most cases it is caused by a malformation of the pulmonic valve with fusion of the leaflets (type A stenosis) or with the presence of rudimentary valves accompanied by hypoplasia of the annulus (type B stenosis).

Dogs with severe stenosis are at risk of sudden death, heart failure and have a decreased survival time in comparison to normal dogs.

Minimally invasive catheter based procedures (balloon valvuloplasty) have become the treatment of choice for valvular pulmonic stenosis, with good results in most but not all cases. French Bulldogs are predisposed to the condition and tend to not respond to valvuloplasty as well as other dogs.¹

In this case, the dog was first referred to Pedro Oliveira, RCVS and European Veterinary Specialist in Small Animal Cardiology at Davies, for treatment of severe pulmonic stenosis.

An echocardiogram confirmed the presence of a type B stenosis accompanied by marked right ventricular hypertrophy and also an atrial septal defect.

A standard balloon valvuloplasty procedure was performed without complications and the dog initially showed improvement (click image right to enlarge). Soon after, however, she began to suffer episodes of weakness and collapse and was readmitted.

An echocardiogram showed that the right ventricular obstruction had worsened.

Pedro said: "Re-stenosis has been reported in up to 16% of cases following balloon valvuloplasty and in this case it was suspected to be due to the formation of scar tissue in the valve leaflets. The pressures inside the right side of the heart were now higher than left allowing blood to flow through the atrial septal defect from the right to the left atrium directly without receiving oxygen from the lungs.

"Whenever Gracie got excited or tried to exercise she would go 'blue' from lack of oxygen and collapse. In fact her quality of life was so poor that euthanasia was suggested at that point. For this reason we decided we should attempt this novel procedure. The only other option would have been open-chest surgery (patch graft) but this held a higher risk of complications during the anaesthesia and even death. Also, the cost of surgery would have been higher than this new option."

Pedro performed the procedure with fellow Davies cardiologist, Jose Matos, while Antonia Mavropoulou guided them using transoesophageal echocardiography.

Under a general anaesthetic the heart structure was assessed using transoesophageal echocardiography and angiography to choose the correct size of the stent for Gracie.

An 8mm wide and 4cm long stainless steel catheter tightly mounted on a balloon was chosen.

This was then positioned across the pulmonic valve and the balloon was expanded forcing the stent to open up to its full size (figure 2B). There was an immediate and significant improvement of blood flow through the stent (figure 2C), the patient recovered well and she was discharged four days later.

Re-examination after three months showed improved flow across the stent and a reversal of the right to left shunting across the atrial septal defect. Gracie stopped experiencing episodes of collapse or cyanosis and is now able to exercise and lead a more normal life.

Pedro said: "This technique has been used in very few cases in the whole world and to the best of our knowledge this is the first time it has been used in the UK.

"It is more technically challenging and costly than a standard ballooning although it may provide an effective, safe, and cheaper alternative to patch graft surgery. In this particular case we feel it made an important difference in terms of quality of life and prognosis for Gracie.

Reference

1. Retrospective review of congenital heart disease in 976 dogs. Oliveira P, Domenech O, Silva J, Vannini S, Bussadori R, Bussadori C.J Vet Intern Med. 2011 May-Jun;25(3):477-83. doi: 10.1111/j.1939-1676.2011.0711.x. Epub 2011 Mar 21.PMID:21418326 Free Article

CarefreeCredit, which provides loans to uninsured owners of pets in need of medical attention, is now offering a free public relations service to member practices to help them promote their work in their local media.

Stewart Halperin (pictured right), the vet who founded CarefreeCredit, said: "We originally started out by helping vets provide loans to treat pets needing medical attention which wasn’t covered by insurance, allowing them to provide the care needed, while also being paid immediately, improving cash flow and reducing bad debts.

"With this new service, vets can make their services better known in their local communities, which will also boost their turnover and allow them to care for even more animals."

Practices that use CarefreeCredit are given access to an online application process that takes around five minutes, providing loans from £250 upwards for use against any veterinary bills.

A range of credit terms are available from 0% APR upwards. They are also the only company to offer loan rates based on risk, which they say means more clients are likely to be accepted for finance.

CarefreeCredit practices that want to use the PR service need to contact the company, whereupon they'll arrange for an award-winning public relations consultant to provide the support they need - free of charge.

For further information, visit: www.carefreecredit.co.uk or call 0345 313 0177.

Kent-based veterinary surgeon, David Edward Smith has been struck off by the RCVS Disciplinary Committee following a conviction for fraud, and for a number of clinical failings.

Mr Smith was convicted of conspiracy to commit a fraud in which potentially dangerous horses were drugged and then sold to unsuspecting owners, at Maidstone Crown Court in June 2016. He was given 30 months' imprisonment, which formed one of the charges heard by the Disciplinary Committee.

There were also a number of charges related to his treatment of five different animals while in practice at the Lakeview Veterinary Centre in Folkestone, Kent. The charges were: 

• In relation to a Clydesdale mare named Grace on 14 August 2014 he failed to perform an adequate examination and/or undertake sufficient investigation and/or take a history of her; that after his initial visit to Grace on that day he failed to respond adequately to the owner’s telephone reports that Grace had deteriorated and/or failed to improve; and, that he failed to make adequate clinical records for Grace.

• Between 29 September 2014 and 31 January 2015, in relation to a Labradoodle named Holly, he failed to keep adequate clinical records.

• In relation to a cat named Maisey the allegations were that he failed to examine and investigate the cat adequately, he made a diagnosis of diabetes mellitus and gave insulin to administer to the cat without first undertaking the minimum investigation required, failed to keep adequate clinical records and sent an incorrect, misleading and dishonest statement to the RCVS regarding his treatment of Maisey. All charges date between 30 October and 19 December 2014.

• In relation to a cat called Comet the allegation was that between 1 April and 17 April 2015 he failed to keep adequate clinical records and failed to respond adequately and appropriately to concerns raised by the owner.

• Regarding a Yorkshire Terrier with diabetes named Poppy the allegation was that in two emergency out-of-hours calls made by Poppy’s owner to Mr Smith in April 2015 regarding the dog’s condition, he failed to recommend veterinary treatment or keep adequate clinical records. Furthermore, when the owner attended the practice following the two calls and the death of Poppy, he attributed the care to another member of the practice and failed to communicate effectively with the owner. 

Having heard from a number of witnesses, including Mr Smith, and having received representations from Mr Smith in relation to the above charges, the Committee found almost all of the charges proven, with the exception of those relating to Mr Smith’s alleged conversation with Poppy’s owner at the practice following her death.

The Committee then went on to consider whether the various proven charges amounted to disgraceful conduct in a professional respect and whether the conviction rendered Mr Smith unfit to practise veterinary surgery.

In relation to the clinical charges the Committee found that, both individually and cumulatively, they amounted to disgraceful conduct in a professional respect.

The Committee also determined that the conviction rendered Mr Smith unfit to practise veterinary surgery and noted that it involved prolonged dishonesty, breach of trust, disregard for animal health and welfare and a "total abrogation of Mr Smith’s professional responsibilities."

Cerys Jones, chairing the Committee and speaking on its behalf, said: "The Committee was particularly concerned because the dishonesty went to the heart of Mr Smith’s responsibilities as a veterinary surgeon. His registration as a veterinary surgeon enabled him to take part in the conspiracy, and that role involved him conducting certified examinations on animals and supplying drugs for administration to animals. Reliable and honest certification is a vital element of the veterinary surgeon’s public role."

In considering the sanction against Mr Smith the Committee looked at the clinical charges and the conviction separately.

In relation to the clinical charges the Committee found that his treatment of the animals in these cases was fundamentally incompatible with being a veterinary surgeon. The Committee therefore directed that Mr Smith’s name should be removed from the Register of Veterinary Surgeons.

The Committee said that the case demonstrated that Mr Smith’s lack of treatment or his inappropriate treatment of these animals caused harm and that in some regards, for example the writing of accurate and contemporaneous clinical notes, Mr Smith demonstrated a total disrespect for the Code of Professional Conduct.

The Committee went on to say: "Further, he deliberately lied to his regulator. He demonstrated deep-seated attitudinal issues including a misplaced belief in his own abilities and had no insight or commitment to do anything different in the future. In those circumstances the likelihood of repetition was significant in the Committee’s view."

In considering the sanction for his conviction of conspiracy to commit fraud the Committee took into account a number of aggravating factors including the premeditated nature of the conduct, the fact it was repeated over four years and the fact that harm was caused to both animals and people as a result of his actions. 

Cerys Jones said: "As the decision notes, some of the riders were novices or children and as a result of their experience they lost confidence in riding a horse. As the independent veterinary surgeon Mr Smith was in a position of responsibility because he was certifying the horses as to their suitability. A particularly aggravating feature in this case is that Mr Smith had previously been removed from the Register for falsely certifying horses for export."

In relation to the conviction the Committee also directed that the Registrar remove Mr Smith from the Register.

Mr Smith has 28 days from being informed of the Committee’s decision to make an appeal against it.

The full findings can be found here.

Medivet has announced that it is reducing the pace of its new practice acquisitions to allow its Regional Directors Team time to integrate.

Medivet owns 245 veterinary practices in the UK and its rate of practice acquisition had tripled in the last 12 months.

CEO, Arnold Levy said: "The 25 strong Regional Directors Team is a key strategic line of management and support for all our existing practices, and they are central to the successful integration of our new practices into our hub and spoke model. Even though each of our Regional Directors is an experienced, qualified veterinary surgeon, it is vital that they have time, knowledge and understanding of the Medivet business and operation to confidently support their practices in line with our model, in the right way.

"With the support of the Leadership Team, we will be using these next few months to ensure this newly formed group have all the skills needed to do just that." 

Arnold added: "We have taken this deliberate decision to ensure we can maintain the very highest standards of client and patient care. Where our management team and support structures are already in place we will continue with our new acquisitions program, and once our Regional Management operation is fully embedded, we will confidently continue to grow our business in a sustainable, people and patient-first way."

Idexx has announced the UK and Ireland launch of the Catalyst SDMA Test, a kidney function test for cats and dogs which can be added to the routine chemistry panel of the company's Catalyst One and Catalyst Dx chemistry analyzers and performed by practices in-house, with results available in minutes.

Idexx says the new test is proven to identify kidney disease earlier than creatinine^1–3, enabling veterinary surgeons to intervene earlier and have a greater impact on patients' health outcomes and quality of life. 

The Catalyst SDMA Test was first launched at the company's reference laboratories in 2015, since when Idexx says it has run more than 14 million SDMA patient tests, creating the world's largest database on kidney disease in dogs and cats.

The test was then launched to veterinary practices in the USA and Canada last December, where Idexx says it has now been used by thousands of practices.

Jonathan Ayers, Chairman and Chief Executive Officer of Idexx Laboratories said: "We've seen great enthusiasm for the ability to run SDMA as part of the routine chemistry panel at the point of care, and the North American launch has exceeded our expectations.

"The Idexx SDMA Test represents one of the most significant diagnostic innovations in veterinary medicine in the last 30 years. We're thrilled to bring this essential element of the chemistry panel to our point of care Idexx VetLab suite, allowing veterinarians to utilize the benefits of SDMA immediately during the pet's appointment."

Idexx has also signed an agreement to collaborate with Yale University to explore the test's applications in human health. As a result of the partnership, the SDMA Test has been validated for accuracy in measuring SDMA in human blood samples and the results presented at the 2017 annual meeting of the American Society of Nephrology last November by Yale and IDEXX researchers. 

Jonathan added: "SDMA has tremendous potential benefit in human applications as well. And with the Idexx test technology now validated to be able to run on commercial chemistry systems that routinely produce chemistry results in human reference laboratories, we have greater reason to explore the clinical value of this incredible biomarker in human applications. We are excited and grateful for our partnership with Yale University."

Idexx says SDMA is now the subject of more than 30 ongoing research collaborations and has been incorporated into the veterinary profession's International Renal Interest Society (IRIS) kidney disease staging guidelines. 

For more information about the IDEXX Catalyst SDMA Test, visit www.idexx.eu/sdma.

References

1. Nabity MB, Lees GE, Boggess M, Yerramilli M, Obare E, Yerramilli M, Rakitin A, Aguiar J, Relford R. Symmetric dimethylarginine assay validation, stability, and evaluation as a marker for early detection of chronic kidney disease in dogs. J Vet Intern Med. 2015;29(4):1036–1044. 
2. Hall JA, Yerramilli M, Obare E, Yerramilli M, Jewell DE. Comparison of serum concentrations of symmetric dimethylarginine and creatinine as kidney function biomarkers in cats with chronic kidney disease. J Vet Intern Med. 2014;28(6):1676–1683. 
3. Hall JA, Yerramilli M, Obare E, Yerramilli M, Almes K, Jewell DE. Serum concentrations of symmetric dimethylarginine and creatinine in dogs with naturally occurring chronic kidney disease. J Vet Intern Med.2016;30(3):794–802.

• Try to remain calm, at all times; be confident but never aggressive.
• Personal safety for the veterinary team is the highest priority. If you feel intimidated by a client, try to not be alone with them.  If you do not feel able to resolve the immediate scenario and you are concerned about your safety then politely ask the client to leave. If you see other team members facing difficult clients, do not leave them alone, remain within sight so you can go and get more help or step in and support your colleague.
• Although easier said than done, try not to take it personally. If you are on the receiving end of this behaviour, it can be upsetting and a cause of significant stress.
• Always discuss with your colleagues any difficult situation you have encountered with a client. Consider how well you handled the situation: what did you do well, what could you have done better, what was the final outcome. Think about what you have learnt and use it when you next encounter a difficult client and learn from each other.  Work together to have a practice policy on how to deal with intimidating situations.
• Remember to inform the practice manager or practice principal so that appropriate practice level steps can be taken.
• Use clear messaging within the practice that harassment and violence will not be tolerated. Clients should be made aware of what unacceptable behaviour means.
• Remember that people’s behaviour can arise for many different reasons, including distress associated with their pet being ill. While not excusing the behaviour, it can help to diffuse a situation if the owner can have the opportunity to get all their concerns out. This can be done by active listening attentively and ensuring the client knows you have heard by reflecting these concerns back to them. Clients may also need to be reassured that ‘they’ve made the right decision’ or ‘we’re doing everything we can’, or even checking with the owner that they understand everything you’ve told them or ask them if they have any questions they’d like to ask.
• Consider attending training courses on understanding and dealing with these types of situations to help you and your clients. 

Photo: Dimitry A / Shutterstock 

An expert panel of veterinary surgeons at the FECAVA/WSAVA/DSAVA Congress in Copenhagen have issued a series of recommendations about the role of the veterinary profession in addressing the problems associated with brachycephalic breeds.

The expert panel consisted of Peter Sandøe (Denmark), Professor of Ethics and Welfare; Helle Friis Proschowsky (Denmark), a veterinary surgeon working with the Danish Kennel Club; Laurent Findji (France/UK), Specialist in Soft Tissue Surgery; Gudrun Ravetz (UK) – Senior Vice President, British Veterinary Association; Kristin Wear Prestrud (Norway) – Veterinary Scientific Director of the Norwegian Kennel Club and Åke Hedhammar (Sweden), Professor Emeritus in Internal Medicine (companion animals), a veterinary consultant for the Swedish Kennel Club and a member of the WSAVA Hereditary Disease Committee.

Kristin Wear Prestrud said: "Vets should dare to speak out. We must educate owners on all health and welfare matters, whether we are simply advising them that their dog is overweight or if we need to give advice on breeding or refuse planned Caesarean sections."

The panel's recommendations are:

At a practice level, veterinary professionals should:

1. Advise the public not to buy animals with extreme conformation. This applies both to breeds and to individual dogs.
2. Raise awareness among dog owners and advise them about health and welfare issues in dogs with extreme conformations. 
3. Raise awareness among breeders, breed clubs and show judges and advise them as to health and welfare issues in dogs with extreme conformations. Take an active role in pre-breeding examinations and in giving advice regarding potential breeding stock.
4. Inform dog owners and breeders about breeding restrictions if a dog is surgically treated for BOAS or other problems related to extreme traits linked to breeding (in countries where no such restrictions exist, strongly advise against breeding). Advise neutering at the time of surgery if good practice allows.
5. Share data on health and welfare issues related to extreme breeding. Where a national submission system exists, submit details on conformation-altering surgery and caesarean sections related to extreme breeding traits. 

At an organisational level, the veterinary profession should:

1. Implement a communication campaign to proactively raise awareness among the public in general and to advise them about health and welfare issues in dogs with extreme conformations. 
2. Work together with national cynological organisations and other stakeholders to set up registers of confirmation-altering surgeries and caesarean sections as well as relevant screening programmes (ie pre-breeding examinations).
3. Call for the revision of breed standards to help prevent BOAS and other brachycephalic-related disorders. Breed standards should include evidence-based limits on physical features (eg muzzle length) and approaches such as outcrossing should be considered.
4. Launch and distribute veterinary health certificates for puppies and/or checklists for prospective buyers in support of responsible, healthy breeding.
5. Develop evidence-based international standardised protocols for the examination of breeding animals regarding respiratory function and thermoregulation.
6. Set up systems allowing the gathering of data from veterinary practices regarding health and welfare-related issues in dogs with extreme conformations.
7. Set up undergraduate training / CPD to equip vets to take a more active role in providing breeding advice to breeders, breeder organisations and judges, related to extreme conformation and screening procedures.

Photo: ponpimonsa_bibi/Shutterstock

The Veterinary Medicines Directorate has announced that Norbrook Laboratories Ltd has issued a recall for Meloxaid 5mg/ml Solution for Injection for Dogs and Cats (Vm 02000/4397).

Norbrook has verified that the pH of certain batches has increased over time and is out of specification.

This issue impacts the following batches:

• Batch No 6094-93B Expiry Date: 03/2019 10ml pack
• Batch No 6094-94M Expiry Date: 03/2019 20ml pack

A spokesperson said: "There has been no increased risk to animal safety identified but we take quality extremely seriously so we initiated a voluntary recall. We have informed all of the competent authorities and we are working with our distributor to advise immediate quarantine of any remaining inventory."

If you have any questions concerning the recall, contact Ms. Anita Vanderlaan Tel: +44 (0)28 3026 4435, Email: anita.vanderlaan@norbrook.co.uk

The exotic species department at Bristol-based Highcroft Veterinary Referrals has been awarded Gold Rabbit Friendly Status by the Rabbit Welfare Association and Fund (RWAF).

The award has been granted to only a handful of practices and requires the achievement of high standards of care and a detailed understanding of the species.

Highcroft has three dedicated exotic species veterinary surgeons, including a European small mammal Specialist and four exotic species nurses, who have either obtained or are studying for their City and Guilds Exotic Species Veterinary Nursing Certificate.

The practice has a dedicated exotic species consulting room, waiting room, ward and an operating theatre, containing state-of-the-art equipment.

In addition to treating rabbits, both vets and nurses in the exotic species team lecture widely to promote the importance of providing a high standard of care to rabbits and to ensure that their welfare is optimised.  

Dr Elisabetta Mancinelli DVM CertZooMed Dipl ECZM (Small Mammal) MRCVS heads the exotic species team at Highcroft.  A European Veterinary Specialist in Zoological Medicine (Small Mammal Medicine and Surgery) and a RCVS Recognised Specialist in Zoo and Wildlife Medicine, she said: "We are very proud to have been awarded Gold Status by the RWAF. We will continue to enhance the level of care we provide, not just to rabbits but to all exotic species and strive to improve the welfare of all animals under our care, in hospital and at home."

Ceva Animal Health has launched a new marketing pack to support its range of Douxo shampoos, waterless mousses and localised dermatology solutions.

Featuring imagery of the Great Barrier Reef to demonstrate that the skin barrier is a fragile ecosystem needing care and protection, the new marketing material includes:

• New client leaflets that explain how to use the shampoo and mousse with a detachable application reminder to help with owner compliance
• A choice of two waiting room posters to generate interest from clients

The pack is supported by a new vet detailer focusing on the skin as a complex and fragile ecosystem, with a detachable poster covering the range.

For further information on the Douxo range of products, visit www.douxo.eu or contact your local Ceva Animal Health territory manager.