In total Mr Hendrie Smith had faced eight charges against him, all of which related to him undertaking the euthanasia of a German Shepherd named Bouncer during a home visit in January 2017.
The charges alleged that when John Hendrie Smith undertook the euthanasia of Bouncer he had:
1. failed to ensure he was sufficiently prepared for the euthanasia in that he failed to attend the visit with a muzzle and failed to attend with any sedative and the means of administering sedative;
2. failed to delay the euthanasia until he was in possession of the above items;
3. undertook the euthanasia by means of an injection without first sedating Bouncer;
4. failed to provide Bouncer’s owner with an adequate explanation of the procedure. Including:
a. failing to explain that the procedure involved an attempt at injection directly into the heart;
b. failing to explain that an injection into the heart without sedation is (except in extreme circumstances) not an accepted means of euthanasia;
c. wrongly stated that Bouncer would not feel the injection;
d. failed to provide an explanation of the risks;
e. failed to explain the risks and signs of narcotic excitement;
f. failed to explain the risks of injection into the heart without sedation;
5. failed to obtain Bouncer’s owner’s informed consent for the procedure;
6. failed to make any clinical records in respect of the procedure;
7. provided inadequate veterinary care to Bouncer and caused him unnecessary suffering; and
8. failed to communicate with Bouncer’s owner.
Having considered evidence about the case from Bouncer’s owner, his owner’s former partner, two expert witnesses and Mr Hendrie Smith, the Committee found all of the charges against Mr Hendrie Smith proven, with the exception of charge 4(e) on the grounds that there was insufficient evidence against him on this particular charge.
In considering whether the charges that were found proven amounted to serious professional misconduct, the Committee heard further evidence from the College’s two expert witnesses, and submissions from both the College and Mr Hendrie Smith. Having considered the evidence and submissions, the Committee concluded that in relation to each of the charges found proven, Mr Hendrie Smith’s conduct had fallen far below that which was to be expected from a veterinary surgeon and was therefore serious professional misconduct.
The Committee went on to consider what sanction was appropriate following its earlier findings against Mr Hendrie Smith. The Committee took into account a number of mitigating and aggravating factors. In mitigation the Committee considered that this was a single, isolated incident and that Mr Hendrie Smith had been a practising veterinary surgeon for 65 years and had an otherwise unblemished career with no adverse professional findings against him. It also took into account testimonials from professional colleagues, clients and his local community.
However, the Committee also considered the aggravating factors which included actual injury and unnecessary suffering to an animal, a blatant disregard of the systems that regulate the veterinary profession including the RCVS Code of Professional Conduct and its supporting guidance relating to euthanasia, informed consent, preventing unnecessary suffering and working within one’s area of competence.
In explaining its decision to direct his removal from the Register of Veterinary Surgeons, the Committee noted Mr Hendrie Smith’s lack of insight into his behaviour, which included denying that he was at fault, challenging several of the Committee’s findings and disputing that an intracardiac injection into the heart of a dog without administering sedation or anaesthesia was wholly unacceptable, despite expert opinion to the contrary.
Chitra Karve, chairing the Committee and speaking on its behalf, said: "The respondent, in his oral evidence, admitted that he was not really a small animal vet, and had not been dealing regularly with small animals for a significant period of time. His specialisation in recent years was with large farm animals. The Committee considered that the respondent had, and still has, no concept of the difficulties now recognised as inherent in the procedure he performed, or the risks of pain and suffering it posed to the animal."
She added: "The Committee has found that the respondent’s conduct in attempting an intracardiac injection without prior sedation or anaesthesia caused appalling pain and suffering to Bouncer, as evidenced by his screaming, and was wholly unnecessary. The respondent accepted that he had a sedative in his car, but chose not to postpone attempted euthanasia so that he could sedate his patient first.
"The respondent explained in his oral evidence that he had, in the past, euthanased over 200 dogs by intracardiac injection without sedation or anaesthesia. The Committee concludes that this was the respondent’s customary method of euthanasia, and he did not understand why it was wholly unacceptable for a reasonably competent veterinary surgeon to carry out euthanasia in this way. Given his lack of insight, the Committee considers that there is a risk that, if the respondent were to be asked to euthanase a dog in the future, he would be likely to use his customary method, and thereby cause injury and suffering to another animal."
In determining the sanction the Committee decided that, because there had been a serious departure from the professional standards set out in the Code, serious harm was caused and there was a serious risk of harm to animals in the future, that removing Mr Hendrie Smith from the Register was the only means of protecting animals and the wider public interest.
Mr Hendrie Smith has 28 days from being informed of the Committee’s decision to make an appeal to the Privy Council.
The new NCert Dent, which is accredited by ESVPS, comprises six modules led by specialists Dr Gerhard Putter, Dr Richard Saunders and Dr Rachel Perry. Topics have been selected to support veterinary nurses in helping to develop dentistry within their practice and include canine and feline dental anatomy and function; canine and feline dental conditions and the canine and feline dental procedure.
Improve says it will soon be launching two additional Nurse Certificates in Medicine and Surgery.
The new one-day courses cover ultrasound triage for the emergency patient, infection control, cardiology and Feline Lower Urinary Tract Disease (FLUTD).
Claire Dorey-Phillips RVN (pictured right), Improve's Practical Course Coordinator and Nurse Programme Tutor said: "Veterinary nurses are ambitious to develop their skills so we want to offer them specific training which gives them access both to the latest thinking and to the world-class learning resources which are the hallmark of all of our veterinary programmes.
"The addition of our new Nurse Certificates and our one-day courses means that we will soon be providing a full complement of general training for nurses, as well as giving them the opportunity to study for a Certificate. We believe this training will enable them to take their veterinary nursing to the next level and equip them with knowledge that will help them to develop their careers in practice."
The courses will be run at Improve’s training facility in Swindon. Further information can be found at: www.improveinternational.com.
The motion was introduced by Kate Richards MRCVS, Chair of the RCVS Standards committee, who explained that it'd been driven by three things, namely: the Vet Futures Initiative, the RCVS Strategic Plan signed off by Council in 2017 and the RCVS telemedicine consultation that took place earlier this year.
The latter of these showed that 69% of vets opposed the idea of prescribing without a physical exam, which rather beggars the question why it's being discussed at all. However, as Kate explained, when asked whether certain types of products could be remotely prescribed, the answer was more equivocal: 52% of vets said "yes".
Kate also explained that over the last two years, there had been a number of good quality discussions at Standards Committee and Council, but that decision-making had been "hampered by a paucity of evidence on the opportunities, risks and benefits of telemedicine to animals and the public".
The full wording of motion was: "Council is invited to consider the recommendation of Standards Committee to conduct a limited and time-bound trial to assess the benefits and risks of allowing the remote prescription of POM-V (excluding opiates, sedatives and potentially also critically important antibiotics) where there has been no physical examination."
However, in order for the trial to take place, it would be necessary to make a temporary change to the Supporting Guidance of the Code of Professional Conduct concerning the definition of "Under his care" (Ed's note. C'mon RCVS, isn’t that a bit anachronistic? Both your CEO and your President are now "her". "Under Care" would do it.), adding the words in italics to para 4.1: "A veterinary surgeon cannot usually have an animal under his or her care if there has been no physical examination; consequently a veterinary surgeon should not treat an animal or prescribe POM-V medicines via the Internet alone, other than in circumstance where a telemedicine service is a part of the RCVS telemedicine trial".
In the best interests of animal welfare
Amanda Boag (MRCVS, Vets Now, RCVS President) then reminded everyone that: "RCVS Council needs to act in the best interest of animal welfare and the public, and whilst sustainability of veterinary services is important, it isn't our role to promote anything novel or to protect traditional models."
Really? Strikes me that the sustainability of veterinary services isn’t just "important", it's an essential part of ensuring good animal welfare. Surely, therefore, it most certainly is the role of Council to protect traditional business models or, for that matter, to promote novel methods if (and I stress "if") doing so protects or enhances animal welfare.
Don’t confuse telemedicine with remote prescribing
Jo Dyer (MRCVS, small animal locum, Devon) opened by pointing out that this is not about telemedicine per se. Telemedicine has been going on since the invention of the telephone in the late 1800s, supplemented over the last 20 years or so by photography and video sent over the internet. Telemedicine does not, in and of itself, require a change in regulation.
What this is about, she explained, is the much narrower act of remote prescribing without physically examining the animal, something which would require the profession to redefine "under his care", which in turn "makes up the foundation of what forms the relationship with the owner and the animal in order that we can safeguard the use of medicines, safeguard the animals under our care and safeguard our clients."
No evidence remote prescribing increases access to veterinary services
Jo argued that the only reason Council should be considering the prescription of medicines without a physical examination would be if it were in the interests of animal welfare. And yet, she said, there is no evidence to support this idea.
Some have suggested that it could increase access to veterinary care. However, Jo said she had been unable to find any evidence to support this idea either. Not just in the veterinary profession, but in the medical profession in the Western and the developing world.
Jo also noted that the trial proposal was to use commercial organisations which have a financial interest in a positive outcome, which would render the results biased and unreliable.
She then raised the issue of antimicrobial resistance, highlighting the use of cytology and culture sensitivity to make sure the right antibiotics are used. Remote prescribing, she said, would be a retrograde step, even if only non-critical antibiotics could be prescribed remotely.
Spawning a new class of limited service provider
Next she highlighted the impact of the trial on 24-7 cover. Under the proposal, "Those under a trial would be required to actively support clients in identifying a veterinary practice that could physically see their animal in both routine and emergency situations."
As Jo pointed out, this would by definition mean that any veterinary surgeon, not just those practising telemedicine, could set themselves up as a limited service provider and refer all cases they didn’t want to see (whether OOH or not) to a local practice. This, she argued, should only happen after a proper debate, and not be just the unintended side-effect of regulation change to allow remote prescribing.
In fact, there is evidence that this is exactly what is happening in human medicine. Only the following evening, the BBC aired Diagnosis on Demand: The Computer Will See You Now, a documentary about telemedicine and artificial intelligence in human medicine. It should be required watching for all RCVS Councillors.
The programme makers visited GP at Hand, a telemedicine business based on the Lillie Road in Fulham, London that has been formed in partnership with Babylon. Coincidentally just up the road from where I used to live, it's a pretty nondescript sort of a place, but now home to the fastest-growing GP surgery in the UK. Since late 2017, it has amassed a staggering 30,000 clients from across London, virtually none of whom will ever visit the place. The problem is that GP at Hand has skimmed away fee-paying clients from across the capital that had in effect been helping to subsidise local care elsewhere.
More information needed for such an important decision
Jo concluded by saying that a decision of this magnitude, particularly when it seems to go against the wishes of the majority of the profession, demands checks to ensure no conflicts of interest, legal advice and wider consultation with organisations such as the VMD, Defra, the BVA and its subdivisions and the VDS. Therefore, she would propose a new motion to delay the decision until more information is made available.
Chris Barker (MRCVS, small animal practice, Cumbria) was up next. He felt that the RCVS consultation was very effective and gave a good picture of what veterinary surgeons see as the risks inherent in remote prescribing. However, he felt that the analysis has been marshalled to suit an agenda and minimises the concerns of general practitioners.
Fragmentation and multiple consultants leading to a loss of responsibility
The trial, he said, will lead to fragmentation of veterinary provision and send the message to the public that it is quite OK to go to more than one vet for advice and treatment, and that will lead to confusion and the loss of individual responsibility for the veterinary care of an animal that exists today.
An inspection with no history: not a proper examination.
Chris argued that the act of prescribing demands a physical examination, but that a video consultation could only ever be an inspection. He also highlighted the importance of patient histories and argued that the immediacy of telemedicine simply doesn’t allow a practitioner to get the patient history from another vet.
Chris also argued that the profession is not structured to allow for clients to consult multiple veterinary service providers simultaneously: once a client leaves his practice, he has a duty under GDPR to expunge much of their records, and he for one didn’t much care for the idea of re-registering a client at 2:00am.
Some of the issues Chris raised may of course be solved by technology in the foreseeable future. GDPR already calls for data portability, presumably it will not be long before owners expect the same data portability for their animals' clinical histories.
Who wants clients who only ever call when telemedicine has failed?
Still, his overall point was an important one: whether or not there will be vets out there who are happy to pick up and see failed telemedicine cases at 3:00am in the morning from people who are not clients of their practice and who don’t otherwise contribute financially to the business.
90% of vets say remote prescription is high risk or inappropriate
Lastly, Chris drew attention to a question in the RCVS consultation which asked respondents what risk they thought there would be in a remote consultation when the consulting vet did not know the owner, did not know the animal and does not know the situation in which the animal is kept: "90% of responding veterinary professionals either chose it as high risk or simply not appropriate at all. I know of no better body of people than practitioners in Britain to understand the welfare and the risk to the welfare of animals."
The risk of misdiagnosis
Martin Peaty (MRCVS, equine practitioner, Wiltshire) spoke next, highlighting the risk he saw to animal welfare from misdiagnosis. He drew attention to concerns raised by the Quality Care Commission in human medicine, in particular that there is no access to the long term medical records of the patient, and the risk of misdiagnosis: "And that’s in human patients who can fluently articulate their symptoms", he said, "I think we should be much more cautious in exercising care before allowing remote diagnosis and prescription."
Martin's point seemed especially apposite in the light of an article which appeared in The Times two days later: 'NHS app 'no match for trip to the GP', in which Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs expressed concerns about online consultation systems, particularly for vulnerable groups, such as children.
Remote prescribing demands that vets sacrifice principles
Martin also outlined the three principles which underpin current practice: physically examining the animal, considering its history and providing 24 hour care, the latter in part in case of a reaction to a prescribed medicine.
"These proposals ask us to sacrifice these principles for telemedicine businesses whilst for good reason they remain in place for other veterinary practices. I think that is hypocritical. I think it is wrong."
Not enough follow-up
Sue Paterson (MRCVS, a referral specialist who offers a dermatology telemedicine service to the profession and the public, Merseyside) jumped in next. She was unashamedly enthusiastic about the benefits of telemedicine, in particular how it allows practitioners to engage with the public and make veterinary advice more accessible, not to mention because: "I am sick to death of people coming into consults when they have been on Facebook or they’ve been on to talk to Dr Google."
However, despite her enthusiasm and despite finding that users of her service do not want antibiotics, just advice, help and reassurance from people they trust, Sue was still against the idea of remote prescription: "I don’t want to prescribe because I can't follow those cases up, because I can’t maintain the level of client care that I think is really important, so for me, I would not want to see this change to the code."
We won’t know what we missed, or the consequences of what we missed
Caroline Allen (MRCVS, charity veterinary director, London) said the biggest issue for her is that without a physical examination, she won’t ever know what she missed (the heart murmur, the goitre, the subtle muscle wastage), or for that matter, the animal welfare consequences of what she missed.
As others had done, Caroline highlighted the importance of getting a weight every time and how difficult it is for clients to measure accurately.
Lastly, she made the thought-provoking point that allowing the remote prescription of drugs without a physical examination would risk legitimising Dr Google in the eyes of the public. After all, if no veterinary physical exam is needed, surely owners can just look it up on the internet for themselves?
In defence of the RCVS
At this point in the discussion, RCVS CEO Lizzie Lockett addressed the suggestion that the whole process of investigating and voting on telemedicine was being driven by hidden agendas, something she absolutely and eloquently rejected. She explained that sure, some parties had been more engaged in the whole process than others, but emphatically denied there had been any influence. Council, she said, had asked Standards to investigate and develop a proposal, which it had done diligently. Now it is down to Council to decide whether the proposal stands or falls; the College exists to implement the decision.
RCVS Vice President, Professor Stephen May went further, saying that many present would be aware that he'd been a vocal critic of the way that a number of other regulators in modern society push things out to court for decisions, rather than taking decisions collectively and then sticking by them. "I’m really proud that we are discussing this and I’m really pleased that this is up to us how we move things forward in the interest of animal health and welfare and supporting the public in that."
The need for a more nuanced, less polarised debate
However, he said he was worried about the way the debate was being polarised into a yes or no when he felt the profession should thinking about how it should adapt to the changing circumstances, thinking about cases which are amenable to a distant relationship and in what context that is appropriate, taking into account the risks.
Remote prescription is already happening, illegally
Melissa Donald (MRCVS, small animal practice, Scotland) questioned whether telemedicine and remote prescription is what the public wants. She said that remote prescription is already happening, illegally from abroad, and that the College needs to have a more robust response than "it’s not our problem". She therefore recommended a further period of consultation, particularly with public focus groups, and internet research to see how much remote prescription is already happening.
Vets are professionals
Tim Walker (Lay) said he was struck by the need to assemble better evidence. He felt there needs to be more thought given to the transference of responsibility for cases between a telemedicine provider and a traditional practitioner. Tim also felt that the definition of "under his care" will almost certainly need to be rethought in the not-too-distant future, because the idea of a patient being under the care of just one practitioner is starting to look dated; in the human sphere, patients are looked after by teams of people.
Tim highlighted the approach he said is taken by the GMC, which obliges doctors to be able to demonstrate that they have done sufficient due diligence to prescribe, not that they can simply do so automatically under certain circumstances. That, he said, is what professionalism should be about.
Taking the lead
Mark Castle (Lay) said he thought that the public was looking for a choice, that technology is constantly throwing up new opportunities, and he expected that in the future more and more will be able to be done remotely, so he wanted the RCVS to take the lead in this area.
Lucy Goodwin (MRCVS, BSAVA Head of Education) was positive about the idea of conducting a time-limited, controlled trial: "We say we want evidence, so let’s go and collect it", but had a number of reservations. Not least of these was the fact that the participants in any trial would be on best behaviour, so it may not be able to extrapolate the numbers to the profession at large. Beyond that, she was also concerned that the scope of the trial should be better defined, in particular which categories of drug could be included within it.
Vets don't want a trial of telemedicine
Mandisa Greene said that whilst she is positive about telemedicine as it had been described, and not averse to a trial, she didn’t see the point in a trial when the people who actually do the prescribing don’t want it.
A voice in favour
Chris Tufnell (Past President) began by declaring that he consults to the Affordable Pet Care Company which is shortly to launch a telemedicine service, although he said the service would be unaffected by the decision being taken by Council. He was also at pains to stress that he hadn’t had any other fingers in this particular pie, in particular that he hadn’t been to any of the Standards Committee meetings or presented to them, or been involved in formulating the proposed trial.
Whether you agree or disagree with Chris, it was at least good to hear someone speaking in favour of the motion. Chris opened by arguing that veterinary surgeons are good at making decisions based on imperfect information: "Client histories, as we know, are of variable quality. We make decisions daily on whether we are happy with the information we get from the practice lab or whether we need to send the sample to a reference lab. When I started in practice, practice lab machines were routinely described as random number generators."
"We make decisions on a daily basis on what the limitations of our abilities are. It’s called professional judgement and what we are proposing here is actually a test of our definition of 'in our care'. We’re talking about testing the possibility of making remote prescriptions. The responsibilities around prescribing won’t change, and those responsibilities include the responsible use of antibiotics."
Chris then argued that all the motion was calling for is a trial of something that unlike, for example, deregulating advertising and practice ownership, is not going to give a slice of the consultation fee to non-vets. He also pointed out that people will always be able to highlight cases that would be completely unsuitable for remote prescribing, but that this is not about replacing the consulting room.
Filling the void
What it is about, he said, is removing barriers to care; filling the vacuum between a concerned owner, and the £60 - £100+ they’ll be charged for a consultation. It’s a vacuum that is currently filled by the 'free' (except it's not) phone advice given out by practices, by Facebook and by Dr. Google.
He then pointed to an example from the US, where 83% of people who visited https://www.whiskerdocs.com for pet advice and thought their problem was suitable for home treatment, were in fact wrong and ended up being instructed to visit their veterinary practice. This, he said, could lead to better productivity in practice.
Could telemedicine help retention?
Telemedicine, he said, could also provide a role for people thinking of leaving practice, which is potentially an important factor at a time when retention is proving such an issue.
Evidence-gathering, clinical freedom and professional judgement
Like others, Chris argued that the trial is about putting the RCVS at the forefront of progression in our increasingly digitised society, at a time when remote information from wearables is going to become more and more common. In summary, he said: "This trial is about an evidence-based profession looking for evidence, it’s about clinical freedom and it’s about putting professional judgement in the hands of the professionals."
A two-tier service
Lynne Hill (Past President) said her main concern is about having to redefine "under his care" and how remote prescribing via telemedicine would lead to a two-tier level of care, which she thought would be wrong.
She also highlighted that the College had debated the definition of "under his care" in relation to farm animal practice, where some farmers have multiple vets, some of which offer herd health care and nothing else. Deregulating to account for this has, she said, been responsible for the demise of farm animal practice. Quite simply there are less vets around to see animals.
Show me the money
Lynn also noted the altruistic nature of the debate thus far, and reminded everyone that this is really about business and making money. The companies that are set up to provide telemedicine and possibly take part in the trial will not be in it for the welfare of animals, but to make money.
She also scoffed at the idea that telemedicine and remote prescribing will mean the 10% of people who do not currently have a vet are "now going to get madly involved in telemedicine." The reason they don’t have a vet at the moment, she said, is because they don’t want to pay. Telemedicine doesn’t change that.
Lastly, as others had done, she highlighted the difference between human medicine, where patients can describe their symptoms, and veterinary medicine, where they can’t.
Leadership is about taking the right decision, not jumping on the bandwagon
"Leadership is not always about jumping on the bandwagon and going forward because something is out there. Leadership is actually about looking and deciding and making the right decision."
The disingenuous antimicrobial argument
Dave Leicester (MRCVS) was up next, arguing that it would be wrong to say that a body of professionals can be trusted to make decisions about animal welfare, but not about prescribing. He also felt it was a little disingenuous to do a lot of hand-wringing over antimicrobials when, as a profession: "We’ve managed to make a 3rd generation cephalosporin the most prescribed antibiotic in cats."
Finally, Dave made the point that in his 15-year experience working for OOH emergency service providers, they’d managed to work very successfully without access to patient medical histories.
Setting veterinary standards
Claire McLaughlin (Lay) reiterated that the role of the RCVS is to set veterinary standards, something it can’t very well do without knowing what is going on in practice, and finding out how these things work in practice. “We need to be in a process which takes us to able to set those standards. Whether the trial that is proposed is the right trial or not, we can’t just say no, it’s fine as it is because people will work within their professional competence. As Eleanor [RCVS Registrar] will tell you, they don’t work within their professional competence because they come before disciplinary committee all the time. I think we would be remiss if we didn’t start a process now or continue this process in a way that allows us to set appropriate standards.”
Colonel Neil Smith (MRCVS, Chief Veterinary Office for the Army) began by declaring that he provides telemedicine services for animals in disparate parts of the world as part of his day job, but these animals are very much under care and there is an existing relationship with patients. He is also involved with the provision of limited veterinary services for homeless people via StreetVet, a charity which has had to form relationships with practices that can cover the 125 hours per week when it is not present.
Lowering veterinary standards
Neil explained that his "massive" concern with the proposal lies in particular with the part that says: "Given the limited nature of the service that can be provided by telemedicine alone, however, it is proposed that those under a trial would be required to actively support clients in identifying a veterinary practice that could physically see their animal in both routine and emergency situations."
This, he said, would lower veterinary standards, if all somebody providing telemedicine has to do is point people in the direction of a practice.
For that reason, Neil said, he could not support the proposal as is, and would instead recommend that it goes back to Standards and is then brought back at the next council meeting with a clearer idea of what the trial is all about.
Accessible care
Caroline Allen then jumped in again, saying that whilst she agreed with the idea that more data is needed, she also thought that telemedicine and remote prescription is being driven by the issue of accessible care, and it is that, in fact, which needs to be investigated and understood and debated first.
The digital age
Past President Professor Stuart Reid highlighted that the veterinary students of today live their lives in the digital environment and their world will be very different from ours. The same goes for pet owners. He reiterated that as the regulator, the RCVS needs to be ahead of the game, and that if this is what the public wants, then it has to find a way of regulating it.
Stuart finished by saying that he felt conflicted about the vote; that he had significant problems with the proposal and is not entirely sure that a trial is the right thing, but: "In the referendum we're about to have, I want to say yes but I want to see what the deal is as well." He added: "I didn't vote out by the way, in case this gets back to my employers, but I do think we have to think very carefully about throwing the baby out with the bathwater here."
Pressure to prescribe
Martin Peaty then recounted how at a Vivet Conference last year, a provider of telemedicine (which he thought was Babylon) explained that doctors on its system were retained on the basis of a post-consultation customer satisfaction survey. That, he thought, would make it difficult for practitioners not to prescribe things when they know it will affect their job.
David Bray (Lay), said he believed the telemedicine and remote prescribing will come and it will become more common to have pets treated by multiple vets, so he was fully supportive of a trial.
When it came to the vote ...
Guessing at which way the people who spoke might have voted, it seemed as though there were probably enough councillors with sufficient reservations about the motion, which would have given the go ahead for the trial, for it to be voted down.
That said, the overall sentiment in the room seemed to be that the discussion about the regulation of telemedicine and remote prescription needs to continue, and not get kicked into the long grass simply because of a disagreement over the proposed trial.
At this point, Jo Dyer and others stepped in to argue that the decision to proceed with the trial should not be made until the issues raised in the debate had been addressed. There was then a lot of going backwards and forwards, discussing whether this would need a new motion, which is not allowed under Council rules, or whether the existing motion could be amended, which is allowed.
In the end, the decision was taken to hold two votes, the first being to refer the issue back to the Standards Committee which was carried by 18 to 12, with one abstention.
The second vote was:
"Council is invited to consider the recommendation of Standards Committee to prepare and develop a proposal for a time-bound and limited trial to assess the benefits and risks of allowing the remote prescription of POM-V with appropriate stakeholder engagement and with consideration of the issues that we've discussed today and the detail on them, including 24/7 care and classes of drugs, especially antimicrobials. So we are asking for the detail on that to be worked up on the basis that it will at some time come back to Council."
The second vote was carried by 21 to 8 with 3 abstentions.
In other words, the trial will not now go ahead unless Standards can develop a new proposal which addresses the concerns raised by Council.
VetSurgeon Conclusion
Looked at solely in terms of its impact on animal welfare, this debate seems to come down to one question, which is whether more animals will benefit from easier, cheaper access to veterinary services available via telemedicine and remote prescription than will suffer as a result of misdiagnoses and missed diagnoses that will surely be the inevitable consequence of veterinary surgeons working only from the more limited, and potentially inaccurate or even false information they will get from a video consultation.
For sure, more wearables are coming, and they will overcome some of the problems caused by the fact that animal patients cannot describe their symptoms. Doubtless someone will also invent a set of weighing scales that makes it possible for owners to do the job reliably accurately. Patient histories will surely become more portable. But these things are not with us just yet.
In any event, it is not just about the immediate impact on the quality of care delivered to patients. The way the trial has been framed thus far takes us in the direction of a two-tier profession. What happens if more veterinary surgeons prefer, or make a better living from working from the comfort of their own home without the added responsibility that comes with providing the physical care. Who’ll do the ‘real' vetting?
If you look at the popularity of human telemedicine, the 30,000 patients who have signed up for telemedicine at the small practice in the Lillie Road in London, it seems obvious that patients want the convenience of consulting online, without having to schlep to the practice and find a parking space. It also seems self evident that if online consultations are offered at a lower price point, it will inevitably lead to more pet owners availing themselves of veterinary advice, though as Lynn Hill said, it’s unlikely to cause a mad rush whilst Dr Google is still free.
Perhaps, though, there is another valid way to solve this conundrum. Rather than rushing headlong into a trial that could irrevocably change the very nature of the profession, how about establishing some pragmatic ground rules from the outset. For example, that unless by unanimous agreement of Council in the future, telemedicine should only be allowed as an extension of the service offered by existing bricks and mortar practices to their existing clients.
When it comes to remote prescribing, surely the safest way to regulate it (if you’re going to allow it at all) is to do so on a drug-by-drug basis. Perhaps trial it with the endo- and ecto-parasticides for existing clients of existing practices. Find out whether the convenience of the online consultation leads to higher standards of parasite control for greater numbers of pets. If it doesn’t, then ditch it. Either way, it doesn't preclude trying another category of drug.
That’s my tuppence worth, for what it’s worth, which probably isn’t quite tuppence!
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The sessions are limited to groups of 30 and Zoetis says places are expected to fill quickly.
To reserve your free place, visit: http://www.zoetis.co.uk/LVS2018
If you are unable to secure a seat in the theatre, headsets will be available on the day so you can listen to the lectures whilst on the stand.
The study, which was carried out by the VetCompass programme at the RVC, in partnership with Vets Now, also found that cats are most likely to be involved in a traffic accident in the autumn.
1,407 cat road traffic accident cases that attended Vets Now clinics across the UK between December 2011 and February 2014 were analysed, with researchers finding:
Younger cats, aged six months to six years, are at the greatest risk of road traffic accidents.
Male cats are 1.3 times more at risk of road traffic accidents than female cats.
Crossbred cats are 1.9 times more at risk of road traffic accidents compared to purebred cats.
Cats are more likely to be involved in a road traffic accident in the autumn. However, they are less at risk in winter as compared to spring.
Those cats that present with abdominal or spinal injuries are more likely to die, as are those that present with an increasing count of injuries.
RVC veterinary epidemiologist and VetCompass researcher Dr Dan O’Neill said: "One of the scariest times for any cat-owner is when they first start to let their cat go outside unattended. Owners of younger, and especially male, cats need to be especially vigilant. These results help owners to understand the true risks and therefore assist these owners to make the best decisions about if and how they let their cats go outside."
Dr Amanda Boag, Clinical Director of Vets Now, said: "We are very proud to have worked with VetCompass to ensure this important information about risks to our pet cats is made available to vets and the public. Working with our partners such as the RVC, we are committed to ensuring our large clinical database is used to help advance veterinary knowledge and understanding of emergency and critical care practice."
The full paper entitled 'Epidemiology of Road Traffic Accidents in Cats attending emergency-care practices in the UK' is published in the Journal of Small Animal Practice.
One £1000 bursary will be made available to the student or qualified veterinary nurse in the UK, with the best research project application. There will be a further opportunity to win additional prizes at the MSD Animal Health Research Bursary Day.
Michelle Townley, Veterinary Advisor at MSD Animal Health said: "We are very excited to be extending our bursary scheme to student and qualified veterinary nurses. They play a vital role in the welfare of animals and the future of the veterinary profession. Our new research bursary, supported by the BVNA, recognises and celebrates the value of veterinary nurses and our commitment to the science of healthier animals. We view our investment in research, and the pursuit of new knowledge, as the lifeblood of the veterinary profession and would ask veterinary practices and colleges to encourage their nurses to apply."
Wendy Nevins, BVNA President added: "This is a great opportunity for student and qualified veterinary nurses to develop their research skills and contribute to new research in the industry. We would encourage students and qualified veterinary nurses to consider applying and seek support from their lecturers or practices to complete an entry; helping raise the profile of the profession."
The Veterinary Nurse Research Bursary is open for applications from Monday 15th October 2018 and has a deadline for entries of Friday 10th May 2019.
For more information, visit: www.msdahresearchbursary.co.uk.
EthyCalm is sprayed directly on the skin, or, for more fractious patients, can be applied with a swab.
Invicta says that unlike other products the effect is instant and EthyCalm leaves no residue on the skin surface.
The improved product, EthyCalm Plus, contains 50% more product (good for over 100 applications) and incorporates a new 'on-off' switch for easier application. It is also now packed in a 'no-roll' case to protect from damage.
Rob Watkins, Managing Director of Invicta, said: "EthyCalm has been an incredibly popular product with nurses and vets. As a small company we always listen to our customers and have taken the opportunity to incorporate suggestions for improvement. The result is EthyCalm Plus which offers significant enhancement over the original product".
EthyCalm Plus is available from veterinary wholesalers and for a limited time the price has been held at £25 each.
The course will be led by Dr Jon Hall, a European Specialist in Small Animal Surgery and Dr Danielle Gunn-Moore, an RCVS-recognised Specialist in Feline Medicine, supported by RVN Ms Claire Dorey-Phillips. It will take place at Improve’s new practical training facility in Sheffield in January 2019.
Improve says the programme will equip delegates with a full understanding of the causes of FLUTD and help them to advise owners with cats suffering from the condition in order to improve long-term outcomes. It will also provide a comprehensive overview of the nursing and medical options to treat feline idiopathic cystitis (FIC) and other causes of FLUTD including infection, calculi and neoplasia. The range of appropriate surgical methods to treat ureteral obstructions will also be covered, along with the post-operative nursing care, to ensure that delegates feel ready to perform a variety of bladder surgeries with confidence.
Juliet Pope MRCVS, Veterinary Operations Manager at Improve International (pictured right), said: "Treating patients with FLUTD is a team effort so we’re offering a special rate for a vet and nurse attending from the same practice though both vets and nurses can still, of course, book independently. The cutting-edge programme will be highly interactive and we aim to send delegates back to their practices with a revitalised approach to these tricky cat cases."
For further information visit www.improveinternational.com or email enquiries@improveinternational.com or call 01793 759159.
The VCMS, which is administered by Nockolds Solicitors, was formally launched by the RCVS as an alternative dispute resolution service in October 2017 following a year-long trial.
The aim of the service is to resolve, by mediation, disputes between clients and veterinary practices that do not meet the threshold of serious professional misconduct that is needed for the RCVS to investigate a concern through its formal processes.
Since the service’s trial, which started in October 2016, the VCMS has given preliminary mediation advice on how to resolve a case in more than 1,700 instances with over 580 cases having gone to full mediation of which 89% have concluded with a resolution.
Eleanor Ferguson, RCVS Registrar and Director of Legal Services, said: "From the perspective of both the public and the profession, the establishment of the VCMS has been a "win-win" situation. For the public it has provided them with an additional route to solve those complaints which wouldn’t cross the threshold to progress in the concerns investigation process.
"For the profession it has provided a more appropriate format for resolving a client dispute that doesn’t involve the time, effort and formal process of an RCVS investigation for those cases that will never amount to serious professional misconduct. I think this has been demonstrated by the fact that the vast majority of the profession are willing to engage with the VCMS process, even though it is entirely voluntary.
"The VCMS has also had a positive impact on the College and its concerns investigation process, allowing us to focus greater resources on those cases that do meet our threshold of serious professional misconduct. This has had a very clear impact on the speed with which we either close cases or move them on to the next stage of consideration by the Preliminary Investigation Committee (PIC), which, again, is important to both the public and the profession."
The College says that around 90% of cases investigated at Stage 1 of the process are now either closed or referred to PIC within four months – the College’s key performance indicator at this stage. This compares to around 50% of these cases being closed or referred within four months at Stage 1 in 2016.
The College also says that in total (including both preliminary and full mediation cases), 86% of the cases dealt with by VCMS were successfully mediated and feedback from both clients and veterinary practices has been largely positive. In client feedback from the third quarter of 2018, 93% said they would use the VCMS again and 79% considered it to be fair, while the equivalent figure amongst veterinary practices was 94% and 87% respectively.
Jennie Jones, a partner at Nockolds Solicitors who heads up the VCMS, said: "It is a good sign that mediation is largely working as it should when both parties are reporting similar satisfaction rates and we pride ourselves on negotiating resolutions that are acceptable and beneficial for both the clients and the practices.
"It is great to see that our efforts are also having an impact on the RCVS concerns investigation system by allowing it to concentrate on more serious cases."
More information about the RCVS concerns investigation process, including the different stages of an investigation, can be found at www.rcvs.org.uk/concerns
Further information about the VCMS can be found on its website at www.vetmediation.co.uk or by calling 0345 040 5834.
The case studies were developed by the RCVS Standards Committee and use a variety of examples of where miscommunication between a client and the veterinary practice can lead to an inadequate level of consent being gained for procedures and treatment, including euthanasia.
Examples include damaged teeth being removed during a clean and polish dental procedure without the owner’s express permission and not giving the full range of options available in the case of a dog with an osteosarcoma.
The case studies follow the Standards Committee approving changes to chapter 11 (‘Communication and consent’) of the supporting guidance to the RCVS Code of Professional Conduct in January 2018 to give further advice on how to discuss informed consent with clients, who can be responsible for gaining consent for a procedure and additional guidance on consent forms.
Dr Kate Richards MRCVS, Chair of the RCVS Standards Committee, said: "We hope these case studies will prove useful to practitioners who are having to deal with the complexities around making sure that procedures are fully explained to ensure informed consent is gained.
"We understand the difficulties that are encountered and so these case studies, based on real-life scenarios, highlight where things may go wrong and how these incidents can be avoided by being thorough and ensuring that good communication is at the heart of all we do."
To view the case studies, visit www.rcvs.org.uk/informed-consent.
Chapter 11 of the RCVS supporting guidance on communication and consent is available to view at www.rcvs.org.uk/consent
The Lintbells Mobility Matters initiative provides materials designed to help improve communication and client understanding of their pet’s condition. It includes a guide on how to set up a mobility-focused nurse-led clinic, together with a step-by-step guide in a flip chart format to help RVNs recommend dietary supplements or modifications.
To help launch the clinic, Lintbells Veterinary Business Development Executives can provide lunch and learn sessions. Practices can also become approved Mobility Matters practices with certified CPD for the whole team to ensure that the process of recommendation and referral to the clinic occurs seamlessly and involves everyone in the practice.
Yumove Brand Manager Gemma Cunningham said: "Feedback about the pack is that it helps vets and vet nurses explain mobility problems to owners in a simple but structured way to improve buy-in to a multimodal approach".
Practices that want to register an interest in the initiative can contact their local Lintbells Veterinary Business Development Executive or visit www.lintbellsvet.com.
IVC was formed in 2011, the result of a merger of several independent veterinary hospitals. Under the leadership of David Hillier, and with backing from Summit Partners in 2014, it grew to over 300 practices before being acquired by the Swedish EQT Partners in January 2017.
In August last year the company merged with Evidensia Group, another veterinary corporate group with practices around Europe, bringing the total to more than 850 clinics and hospitals in eight countries.
EQT has reportedly now instructed Jefferies Investment Bank to auction the business in the first week of November.
No word yet on where the auction will take place. If you go, be careful not to scratch your nose at the wrong moment ("1.7 billion from the gentleman at the back. Yes, that's YOU, Sir.").
According to the company, two promotional videos it prepared for social media have already reached more than 1.7 million people in the first two days of the campaign.
Virbac says that some of the UK's best loved pet influencers will also be promoting the campaign to their followers over the coming week.
What is a pet influencer, anyway? Someone who influences pets? I picture a Barbara-Woodhouse sort of character surrounded by a rapt audience of dogs: "Come on now, dogs, eat Veterinary HPM, it really is properly yummy, and sooo good for you."
I digress.
As part of the campaign pet owners will be able use an online protein calculator to check whether their current pet food is providing optimal levels of protein to their pet.
Pet owners will also be able to locate their nearest veterinary practice stockist using a new locator tool on the Virbac website and benefit from a discount voucher for their first Veterinary HPM purchase, which can only be redeemed in participating veterinary practices.
Tracey West, Nutrition Manager at Virbac, said: "Nutrition plays such a key role in the long-term health and well-being of our pets, and veterinary practices play such a key role in educating pet owners on this important subject.
"We’re delighted that as part of our ‘pro-veterinary’ strategy for Veterinary HPM, we will be able to help drive pet owners back into veterinary practices with this campaign."
For more information, speak to your Virbac Territory Manager.
Bravecto Plus contains fluralaner (280 mg/ml), an ectoparasiticide which provides systemic activity against ticks (lxodes ricinus) and fleas (Ctenocephalides felis), and moxidectin (14 mg/ml), an endoparasiticide which provides systemic activity against a range of internal worms, including heartworm (Dirofilaria immitis), intestinal roundworm and hookworm.
Bravecto Plus is applied topically using the "Twist'n'Use" pipette. Once applied, the product kills ticks and fleas for 12 weeks, while also treating intestinal roundworm and hookworm and preventing heartworm disease for eight weeks.
Bravecto Plus can also be used as part of a treatment strategy for flea allergy dermatitis.
Bravecto was first launched in 2014 as a chewable tablet for dogs. In 2016 Bravecto spot-on was launched as a topical solution for dogs and cats. More than 80 million doses of Bravecto have been sold in 72 countries since 2014.
Amanda Melvin, marketing manager, at MSD Animal Health, said: "We are pleased to introduce the latest innovation in feline parasite protection to the Bravecto family."
For more information, refer to the summary of product characteristics or contact your MSD account manager.
In case you need any reminding, acepromazine belongs to the phenothiazine family and acts as a dopamine receptor antagonist, providing calming effects1, 2. It causes sedation and anxiolysis, which is initially dose dependent, plateauing at higher doses1, 3. It is metabolised in the liver and has a long duration of action of approximately six hours in healthy patients1.
For best results AceSedate should be combined with an opioid (neuroleptanalgesia) to improve the quality and reliability of sedation and provide analgesia1, 2, 3.
Richard Beckwith, country manager of Jurox (UK) Ltd said: "AceSedate is a welcome addition to our analgesia and anaesthesia range providing our customers with a high-quality product at an economical price."
For further information, visit www.jurox.com/uk, contact your Jurox technical sales rep, ring the customer services team on 0800 500 3171 or e-mail: info@jurox.co.uk.
References
Virtual Vet Derms has been set up to be able to give advice to veterinary surgeons on any aspect of skin or ear disease whether it is allergy, otitis media, cutaneous neoplasia or endocrine-based in any species, including dogs, cats, small furries, exotic pets including raptors, birds and reptiles, horses, camelids, zoo and farm animals.
Sue, herself an RCVS Recognised Specialist in Veterinary Dermatology, is supported by a team of veterinary dermatology colleagues as well as veterinary specialists in exotic medicine, internal medicine (including endocrinology) and consultants with expertise in oncology.
Sue said: "We recognise that not every veterinarian has got access to a local dermatology specialist and that not all clients can or want to travel to a referral centre. The aim of the service is to formalise the advice that dermatology clinicians give to veterinary surgeons to allow them to get detailed help to manage difficult or challenging dermatology cases within their own practice."
The service has been set up under the RCVS Vivet initiative, is approved by all of the major insurance companies and supported with Veterinary Defence Society Insurance cover.
Virtual Vet Derms offers support in a range of ways.
Quick questionsShort questions that veterinary surgeons can submit via the online form on the Virtual Vet Derms website that just require a brief reply. This may be a dose of a drug, a parasite you want identifying, or the interpretation of a blood sample such as an ACTH stimulation test.
Veterinary reportsVeterinary surgeons can use online request forms on the Virtual Vet Derms web site to submit a brief history of the animal and the problem and some good quality photos of the skin condition. There is also the ability to upload histopathology reports, blood samples and any other pertinent information. A detailed written report is sent back to the vet within 48 hours which will describe clinical signs, differential diagnoses, recommended diagnostic tests and treatment option where appropriate. Where possible, Virtual Vet Derms aims to pass the advice request to the nearest dermatologist but vets can ask for advice from any of its specialists.
Telemedicine consultationsFor new cases or for cases where initial advice has been sought, in the client's own primary care veterinary practice via the internet. The Virtual Vets Derms specialist can consult with the owner to provide even more specific advice and support. After each teleconsultation the Virtual Vet Derms specialist will produce a report in the same format as the veterinary report to allow the primary care veterinary surgeon to continue to manage the case more effectively.
Face to face consultationsCan also be arranged via the owner’s vet at the specialist's own practice if there is the need for more specialist investigation that may not be available in the primary care veterinary surgery. In these cases, the specialist will take on the direct care of the case and work with the owner and vet on the best course of action.
General advice Also possible if the vet wishes to direct an owner straight to Virtual Vet Derms.
For more information, visit: https://virtualvetderms.com
Tyrina, pictured centre right, has worked at the People’s Dispensary for Sick Animals for almost four years, a vet nurse for 10 years and a champion of animals since she was a child.
In addition to her work for the PDSA, she is also the head nurse of The Wildlife Retreat department at Hilltop Farm Animal Sanctuary and helps rear kittens for Cats Protection, particularly during their busy summer months.
Tyrina's love of animals is not restricted to cats, dogs and wildlife in the UK, though. Her passion has taken her all around the world, including an elephant sanctuary and tiger sanctuary in Thailand. She plans to go to China next year to help with panda conservation work.
The people who nominated her for the award described her as inspirational: a champion for animals with extensive knowledge and incredible commitment.
Tyrina was presented with her award by David Catlow, the Clinical Director at Blue Cross last week.
David said: "Tyrina is held up as an inspiration for her tireless passion for helping pets, and she’s clearly highly regarded by her peers and her clients. When she’s not at the practice, she’s filling her spare time with looking after animals. Tyrina is a very deserving winner of this year’s award."
Tyrina said: "I was absolutely gobsmacked to win the award. It’s an amazing feeling and I really feel honoured. It means so much to me to get this recognition from my peers, simply for doing something that is my passion in life."
The practice's dentistry and oral surgery team, led by Peter Southerden, has now carried out its first two successful reconstructions using the technique, following oral tumour resection.
Use of patient-specific implants (PSI) for jaw reconstruction is a new technique, which provides an alternative to bone regenerative techniques. Both techniques can be used in cases which have had significant jaw resection or need reconstructive surgery after a trauma.
Peter said: "To my knowledge, using this technique to create patient-specific implants for rostral mandibular reconstruction following a bilateral rostral mandibulectomy has not been reported in dogs before.
"The reconstructive surgery involves taking pre and post-operative CT scans of the affected area and sending them to a specialist human medical PSI design company, which then uses 3D titanium printing technology to recreate the missing bone.
"In our first two cases, both dogs are doing really well. The feedback we’ve received from owners suggests their dogs have gained significant benefit from the jaw reconstruction process."
Peter is one of three dentistry and oral surgery clinicians at Eastcott alongside Andrew Perry and resident Ingrid Tundo, with a second resident due to join in 2019.
The team caters for dentistry cases including periodontology, endodontics, orthodontics and restorative dentistry, to complex cases including oral tumours, traumatic injuries and congenital issues such as cleft palates.
Peter added: "There aren’t many people with specialist qualifications in this field, possibly only six in the UK and we are the only team working with the backup of a multi-disciplinary referral hospital.
"Having a team of three, soon to be four, is unusual and means we have a big caseload and see a wide range of different cases. We are very keen on developing new techniques such the ones we have already introduced."
For more information about Eastcott Referrals, visit www.eastcottreferrals.co.uk.
Protexin says Pro-Kolin Advanced contains beneficial micro-organisms, several prebiotic sources, an optimal level of a dual-source binding agent and soothing fibres to support gastrointestinal function.
The company also says that in a study involving 148 dogs, Pro-Kolin Advanced significantly improved clinical outcome compared to a placebo1.
Protexin Veterinary Director, James Kyffin, said: "Pro-Kolin Advanced represents an exciting development for Protexin Veterinary and fits in perfectly with our ethos to produce innovative, research-based products of the highest quality for pets.
"It is the first product of its kind to be supported by a randomised, controlled clinical trial that was undertaken in first opinion veterinary practices across the UK and Ireland.
"Not only are we pleased to be able to offer veterinary surgeons with an evidence-based option for the management of acute gastrointestinal disturbances, but also a very palatable formulation that was readily accepted by 92% of the dogs in the study."
Pro-Kolin Advanced is available in 15ml, 30ml and 60ml syringes for dogs and 15ml syringes for cats. The flavourings used in the product contain no proteins or common allergens so Pro-Kolin Advanced can be used in animals with known hypersensitivities.
Reference
This year the College is seeking nominations for six awards:
The Queen’s Medal: the highest honour that can be bestowed upon a veterinary surgeon for a highly distinguished career with sustained and outstanding achievements throughout.
The Veterinary Nursing Golden Jubilee Award: this award is aimed at veterinary nurses who have had a sustained and distinguished career, who can demonstrate a leadership role within the profession and who can act as an ambassador for the value of veterinary nurses and their work.
RCVS International Award: this award is for vets, vet nurses or laypeople who work internationally, from either within or outside the UK, in making an outstanding contribution to, for example, raising veterinary standards, veterinary education and improving animal health and welfare.
RCVS Impact Award: this award is for vets or vet nurses who have recently, or are currently, undertaking a project, initiative or similar that has a significant impact on the profession at large, animal health or welfare, or public health. Such impact could have been made through any field of veterinary endeavour, including clinical practice, research, education or veterinary politics.
RCVS Inspiration Award: this award is for vets or vet nurses at any stage of their career who have demonstrated the ability to inspire and enthuse others consistently throughout. It is open to those who have inspired and motivated individuals anywhere within the profession and recognises those who have gone ‘above and beyond’ what may normally be expected from a professional colleague.
Honorary Associateship: this honour is conferred to a small number of laypeople each year, in recognition of their special contribution to the veterinary sphere. It recognises the full range of individuals who contribute to the veterinary sphere including scientists, lecturers, journalists, charity-workers, farriers, farmers and those involved in the commercial field.
For this year’s honours and awards nomination period, the College has produced a video using footage from Royal College Day 2018, featuring interviews with those who were recognised with RCVS honours and awards on the day.
The video is available to view at www.rcvs.org.uk/honours where you can also download further information and guidance about the criteria for nominators and nominees for the awards, as well as how to make nomination.
Dr Niall Connell, RCVS Junior Vice-President, is taking the lead in promoting the awards this year. He said: "Throughout my time in the veterinary profession, and particularly since joining RCVS Council, I have met so many veterinary nurses and veterinary surgeons who are truly inspiring individuals.
"The RCVS honours and awards scheme is a perfect opportunity to celebrate some of the individuals that have done or are doing something really special – whether that’s by inspiring their colleagues and peers or doing things that benefit animal health and welfare or society at large.
"Across all six awards there really is something for everyone – vets and veterinary nurses at all stages of their careers as well as laypeople are all up for recognition and so I’d strongly encourage everyone to think about someone they know who deserves recognition and get in touch.”
The deadline for nominations is Friday 18 January 2019.
For an informal talk about the awards and how to make a nomination you can contact Peris Dean, Executive Secretary, on p.dean@rcvs.org.uk or 020 7202 0761.
The UK has now seen a total of 169 confirmed cases of Alabama Rot across 38 counties, since 2012. Six cases were confirmed in 2012, climbing to 40 in 2017 and 46 so far in 2018.
The new research, which was carried out in conjunction with the Royal Veterinary College, found that almost 95% of confirmed cases of Alabama Rot have occurred between November and May, with the highest number of cases being reported in February.
It also found most of the cases have been confirmed in western and southern parts of England, with the highest number found in West Sussex, Dorset, southern Hampshire, Greater Manchester and Monmouthshire. Far fewer cases have been reported from the eastern half of the country and East Anglia in particular.
David Walker, Head of medicine at Anderson Moores and co-author of the research, said: "This research, which was funded by the New Forest Dog Owners Group and the charity Alabama Rot Research Fund, was designed to look for geographical patterns, as well as environmental and climatic risk factors.
"A distinct seasonal pattern is suggested, with the vast majority of cases occurring between November and March, and limited cases over the summer months – just 6.5% of cases have been confirmed from June to October.
"In the scientific world a lot of research is not earth-shattering, but it all builds together and little by little we make progress.
"This information is good in terms of how we manage the next stage of research, however we need to be careful and not jump to any conclusions at this point".
Researchers say the disease has been reported in a wide range of breeds (35 in total) but, due to the small number of cases, it is not yet possible to say with any certainty whether a specific breed has an inherently increased or decreased risk of the disease. Any patterns may simply be the result of varying breed populations in different parts of the country.
Dr Huw Stacey, vet and director of clinical services at Vets4Pets, has been supporting research on the condition for a number of years. He said: "Since we held the first Alabama Rot conference in May 2017, vets and relevant professionals have been working hard to understand more about the condition.
"We know how the disease presents and how it affects dogs internally, and this research adds some interesting information that may help to increase vets’ index of the suspicion for the disease.
"The information on climate and ground type will help us further explore possible triggers for the disease, but at the moment we can’t say if any breeds are more likely to develop the disease.
"The first sign of the disease that is normally seen is a skin sore or lesion that isn’t caused by a known injury. Most commonly these sores are found on the lower half of the leg and appear as a distinct swelling, a patch of red skin or are open and ulcer-like.
"With 46 cases in 2018 already, it is understandably very worrying for dog owners, but we think the increase in cases is partially due to an increased awareness of the disease.
"However, this disease is still very rare, so we’re advising dog owners to remain calm but vigilant, and seek advice from their local vet if their dog develops unexplained skin lesions.
"While this research may be a stepping stone to finding the cause of Alabama Rot, there is currently no known way to prevent a dog from contracting the disease."
*also clinically known as
The company says it recognises how frustrating it can be for veterinary surgeons if the owner doesn't recognise that their dog has a painful condition. This can be compounded by short consult times, leaving vets unable to fully communicate the implications and treatment options for the disease.
In the video, Zoe encourages vets to tailor their language to each case, in particular, using the language dog owners will use.
While undertaking her research Zoe noticed that many owners do not talk about OA in the same way that vets might; instead of referring to lameness or pain, many owners will refer to the actual physical signs of OA such as stiffness or communicate that their dog is slowing down.
Zoe has also warned that not all owners are convinced by visual demonstrations such as flexing and extending the dogs joints. Instead, she suggests encouraging the owner to get hands-on.
Zoe said: "Point out the visual changes suggestive of osteoarthritis that you can see, such as muscle loss, scuffed nails, and enlarged joints. And encourage them to have a look and a feel, comparing affected and unaffected joints. Hopefully, the owner may be more receptive to the conversation now they associate it with a symptom they can recognise."
Zoe says she also finds that many owners of older dogs often misinterpret the signs of OA as 'just old age' and may not be aware that the condition can be managed effectively with medication, the right exercise, diet and by making modifications in the home.
Elanco has also produced an OA management template which enables both the vet and the owner to create a tailored plan. It provides the owner with information to take away with them about how to modify their home, written in collaboration with Founder of Canine Arthritis Management, Hannah Capon.
Lastly, Zoe recommends a whole practice approach to becoming experts on OA, veterinary nurses in particular. She said: "Vet nurses often have great ideas about how to explain the condition in a way that owners understand. Better owner understanding of OA should lead to better adherence to treatment plans and ultimately better clinical outcomes."
To watch the video, click here.
To access the suite of assets Elanco has created for Onsior (which includes the management plan, social media posts for the practice, and infographic to help owners to spot the signs of OA) visit: www.myelanco.co.uk
The College says that until now, veterinary research has largely ignored lipomas because they are rarely referred for specialist treatment.
For the study, the RVC identified 2765 lipoma cases from a population of 384,284 dogs in its VetCompass Programme (which collects anonymised clinical data on dogs under primary veterinary care in the UK) in 2013.
The study found that 1 in 50 dogs are affected by lipomas each year and that Springer Spaniels, Dobermann Pinschers, Weimaraners and Labrador Retrievers are the most susceptible to lipomas (5-8% prevalence).
The study also found:
At least one lipoma was diagnosed in 1.94% of dogs during the single year of the study.
Individual dogs with an adult bodyweight that was equal or higher than their breed/sex average had 1.96 times the odds of lipoma.
As dogs age, their odds of getting lipoma increase. Dogs aged between 9-12 years were over 17 times more likely to be diagnosed with lipoma compared to dogs aged 3-6 years old.
Neutered dogs had higher risk.
Insured dogs had 1.78 times the odds of diagnosis.
Purebred dogs had 1.16 times the odds compared with crossbred dogs.
Dr Lynda Rutherford, Clinician and Lecturer in Small Animal Surgery at the RVC, said: "This paper has supported the theory that lipomas are more common in older, overweight dogs.
"This information is useful as it can be discussed with owners and used as another reason to keep pet dog’s weight under control. It also provides a useful insight into how common lipomas are within the UK dog population."
O'NEILL, D. G., CORAH, C. H., CHURCH, D. B., BRODBELT, D. C. & RUTHERFORD, L. 2018. Lipoma in dogs under primary veterinary care in the UK: prevalence and breed associations. Canine Genetics and Epidemiology, 5, 9. https://cgejournal.biomedcentral.com/articles/10.1186/s40575-018-0065-9
The one-day event, called VetQuest, will allow prospective students to spend the day being mentored by a current student whilst getting involved in interactive sessions, such as large animal skills, clinical skills and veterinary public health.
Participants will learn about the opportunities available to those interested in pursuing a veterinary career, have a tour of the school and attend talks on vet admissions and work experience.
Dr Louisa Slingsby, Teaching Fellow and Faculty Admissions and Recruitment Officer at the Bristol Vet School, said: "VetQuest allows those who are interested in a career in the veterinary professions to come along for a day to find out more about the roles of veterinary surgeons and veterinary nurses.
"They will also have the opportunity to learn what to think about when choosing and applying for courses and how to give themselves the best possible chance to make an informed decision about if vet medicine is the career for them."
There will also be an optional session for parents and carers to help them navigate the challenges of applying to study to be a vet or vet nurse. The morning starts with a tour and then a talk and a Q&A session and finishes around lunchtime.
The cost of the one-day event is £50 and there are a limited number of subsidised places at £10. Lunch is included in the registration fee. To book visit: https://www.bristol.ac.uk/vetscience/events/2018/vetquest-2018.html.
The event is primarily aimed at years 11 and 12, although anyone is welcome to attend.
For further information about VetQuest, email: svs-vetquest@bristol.ac.uk or tel: +44 (0)117 928 9280.
The company behind the research shall remain nameless because whilst it has a great PR agency which produces some interesting press releases, the tight so-and-sos have never spent so much as a single bean supporting the VetNurse.co.uk community with any advertising. And whilst we always publish stories that are of genuine importance and even the odd piece of PR propaganda-puff, we have to draw the line somewhere.
Where was I? Oh yes. 57 of the 100 veterinary surgeons (64 practice owners, 7 senior partners and 29 employed vets) surveyed by the unnamed company said they think their practice could do more to prevent the spread of infection.
79 said they are concerned that they are not consistently following correct hygiene protocols.
54 said they need more staff training and 53 said they want to be able to give staff more time between appointments to allow longer for more thorough disinfection of equipment and surfaces.
The company says its research suggests vets may need to do more to educate pet owners on the threats of poor hygiene and the spread of infection. Only 14 of the 100 veterinary surgeons surveyed believe that pet owners know enough about this, and pets not being vaccinated against disease was the second most common frustration vets felt about owners’ standards of pet care.
An unnamed spokesperson from the unnamed company said: "A busy vets practice is naturally focused on the care and health of its animal patients, however, hygiene standards are a vital aspect of this. With a full schedule of appointments, it can be difficult to effectively ensure all infection control procedures are covered. As a result, it’s easy for vets to overlook the important role laundry has to play as part of this process."
Incidentally, if you'd like to buy laundry equipment from a company that does support VetNurse.co.uk, we recommend Eickemeyer.