A new study published this month in the Equine Veterinary Journal (EVJ)¹ has concluded that toxins from the seeds of the sycamore tree (Acer pseudoplatanus) are the likely cause of Atypical Myopathy (AM) in Europe.

However, to avoid confusion, the authors of the study point out that the American Sycamore (also just called 'the sycamore' in the USA), is a completely different species: Platanus occidentalis. Furthermore, the sycamore found in the UK is also known as the sycamore maple in other countries.

The new research follows on the heels of a study in the USA earlier this year that linked toxins from the box elder tree (Acer negundo) with Seasonal Pasture Myopathy (SPM), the US equivalent of AM². The discovery marks an important step for the future prevention of this fatal disease.

Atypical Myopathy is a highly fatal muscle disease in the UK and Northern Europe. In ten years, approximately twenty European countries have reported the disease. Incidences tend to occur repeatedly in the autumn and in the spring following large autumnal outbreaks. Horses that develop AM are usually kept in sparse pastures with an accumulation of dead leaves, dead wood and trees in or around the pasture and are often not fed any supplementary hay or feed. SPM is a very similar disorder, prevalent in Midwestern USA and Eastern Canada that is now known to be caused by the ingestion of hypoglycin A, contained in seeds from the box elder tree.

The new European research¹ was conducted by an international team led by Dominic Votion, University of Liege and involved 17 horses from Belgium, Germany and The Netherlands, suffering from Atypical Myopathy. High concentrations of a toxic metabolite of hypoglycin A, were identified in the serum of all of the horses. The pastures of 12 of the horses were visited by experienced botanists and the Acer pseudoplatanus, the sycamore maple, was found to be present in every case. This was the only tree common to all visited pastures.

Researchers believe hypoglycin A is the likely cause of both AM in Europe and SPM in North America. The sycamore and the box elder are known to produce seeds containing hypoglycin A and the pastures of the afflicted horses in Europe and the USA were surrounded by these trees.

Hypoglycin-A is found in various levels in the seeds of plants in the genus Acer as well as in various other genera in the family Sapindaceae such as ackee (Blighia sapida).  In ackee, hypoglycin-A levels do vary with ripeness of the fruit and, if the fruit is eaten before it is mature, it causes hypoglycaemia to different degrees including a condition called "Jamaican vomiting sickness" (because of ackee's use in Jamaican cooking) and occasionally death in humans.

Researchers at the Universities of Minnesota² and Liege are continuing their work to try to uncover exactly how the equine disease occurs. Dr Adrian Hegeman of University of Minnesota said: "It is likely that the most important contributing factors to horses becoming poisoned by hypoglycin-A are the availability of seed in the field combined with lack of other feeding options. The seeds from two species of maples (box elder and sycamore maples) that we have tested include significant quantities of hypoglycin-A.

"We know that seeds contain highly variable quantities from seed to seed, even within a single tree. We do not know yet how hypoglycin-A levels vary seasonally, nor do we know how its abundance varies with different levels of stress to the plant, though this may well explain seasonal variability in the occurrence of the malady. It is possible that conditions that stress the plants may contribute to significant seasonal changes in hypoglycin-A levels.  At this point we just don't know.  It is common held knowledge that trees under stress usually produce more seed."

Dr Jeff Gillman of University of Minnesota said: "Without question, further analysis of the seeds and other tissues from Acer species needs to be performed along with sampling of plant materials over multiple seasons and at various stress levels. Additionally, one cannot rule out more complex explanations for the seasonality of disease occurrence such as: animals may begin feeding on seed materials in response to depletion of more palatable choices under drought conditions; or simple explanations such as high wind events driving seeds into fields. These sorts of explanations for the occurrence of the disease do not depend on botanical variations in toxicity across seasons, sites or stress levels, yet also require consideration.

"Although limited examples are available, the experience of animals at a pasture site might also confer some degree of behavioral resistance to poisoning due to exposure at sub-lethal levels with prior exposure to seeds in the pasture."

Professor Celia Marr, Editor of Equine Veterinary Journal said: "This is an important advancement in our understanding of what causes AM and how it can be prevented. In immediate practical terms owners can take prompt measures to avoid exposing their horses to sycamore seeds this autumn. Where horses are grazing in the vicinity of sycamore trees, it is imperative that they are provided with sufficient supplementary feed as this will minimise the risk that horses might be tempted to ingest seeds containing this toxin. This must be done carefully and leaving wet hay on the ground should be avoided so providing extra carbohydrate feeds may be more practical."

References

1. The European study can be accessed at http://onlinelibrary.wiley.com/doi/10.1111/evj.12117/abstract
2. Related research from the University of Minnesota can be accessed at http://onlinelibrary.wiley.com/doi/10.1111/j.2042-3306.2012.00684.x/abstract

Royal Veterinary College research, published in the journal PLOS ONE, has revealed that 1 in 4 cases of Diabetes Mellitusin domestic cats are caused by excess secretion of pituitary growth hormone.

According to the researchers, this is much more common than previously thought. Furthermore, they say that cats with this condition are easily misdiagnosed as having primary (type 2) diabetes mellitus but do not respond to the standard treatment to that condition, resulting in increased morbidity and ultimately leading to euthanasia on welfare grounds.

Researchers collected data between 2003 and 2011 on cats treated at vet practices across the UK, to estimate the prevalence of hypersomatotropism or acromegaly in the largest cohort of diabetic cats to date and look how easy this is to recognise.

Findings revealed that the presence of Diabetes Mellitus in 1 in 4 domestic cats can be explained by hypersomatotropism, which is caused by a pituitary benign tumour and can be effectively treated by one operation in specialist centres.

However only 24% of clinicians who submitted samples suspected that this was the case, as most hypersomatotropism cats did not display typical signs, instead displaying symptoms indistinguishable from cats with primary (type 2) Diabetes Mellitus. This suggests that hypersomatotropism screening should be considered when treating diabetic cats.

Lead researcher, Dr Stijn Niessen from the Royal Veterinary College, said: "It has been common practice to automatically suspect a cat with Diabetes Mellitus to be suffering from a form of diabetes akin to human type 2. The current study suggests that this is an oversimplification. Approximately one in four of assessed diabetic cats were actually found to be suffering from hypersomatotropism-induced Diabetes Mellitus, which requires specific treatment and manifests itself very differently as it develops.

"Interestingly, only a small proportion of clinicians reported they strongly suspected acromegaly to be present on the basis of the clinical picture. These data therefore highlight the need for veterinarians working with the spontaneously diabetic cat to consider routinely screening for the presence of hypersomatotropism-inducedDiabetes Mellitus, given the significant clinical consequences of its presence.

"Should the hypersomatotropism be diagnosed and treated with one operation, most cats will enter a state of diabetic remission. If it remains undiagnosed, diabetic cats tend to be difficult to regulate glycaemically which often results in euthanasia, or in the long-term, they will suffer from other growth hormone-induced negative conditions such as heart disease, as well as central nervous system problems."

Evaluation of serum fructosamine was offered free of charge for all diabetic cats attending any veterinary practice in the UK from October 2003 till April 2011. Veterinary surgeons were asked to record clinical data about the patient, including age, breed, gender, current body weight, current administered insulin dose and whether they clinically suspected acromegaly/ hypersomatotropism. Diabetic cats were screened using serum total insulin-like growth factor-1, followed by further evaluation through pituitary imaging and/ or histopathology.

In total, 1221 diabetic cats were screened; 319 (26.1%) had a blood IGF-1 suggestive of hypersomatotropism. Of these cats a subset of 63 (20%) underwent pituitary imaging and 56/63 (89%) had a pituitary tumour on computed tomography; an additional three on magnetic resonance imaging and one on necropsy.  These data suggest a positive predictive value of serum IGF-1 for hypersomatotropism of 95%, suggesting the overall hypersomatotropism prevalence among UK diabetic cats to be 24.8%.

The paper also suggests that although great opportunities exist for comparative research between primary (type 2) diabetes in cats and humans, researchers should exercise caution in light of these new findings.

Stijn added: "The similarities between feline and human type 2 diabetes emphasise great opportunities for valuable comparative research benefiting all species into this major disease, which is fast becoming a global epidemic. However our latest research proves that there is a need for more regular hypersomatotropism screening, to identify the root cause of diabetes in domestic cats before samples are used, so as not to corrupt results."

Purina has launched a range of services and support materials to help veterinary professionals approach the subject of nutrition with owners.

The Gastrointestinal Support Pack includes a GI handbook, "lunch and learn" educational sessions, a diagnostic support tool (available at www.purinavets.eu/giapplication) and a toolkit containing information sheets and diagnostic advice.

The company has also announced the result of some consumer research it conducted through One Poll in 2013, which revealed that 77% of dogs have experienced some form of digestive health issue, but only 20% of owners had visited their vet to discuss it. The research also found that 80% of owners would be willing to change their pet's diet if it would improve their digestion. 

Esther Rawlinson, Purina UK Veterinary Affairs Manager said: "GI upsets and associated 'accidents' can be really distressing for both owner and pet but are seemingly suffered as 'just one of those things' by many. This needn't be the case though, as a lot of GI-related conditions could be prevented or at least managed by the correct nutritional advice and a specially formulated veterinary diet. By addressing nutrition at every consultation, vets can better identify those patients who suffer regular GI disturbance but whose owners do not feel it worthy of mentioning when in the clinic. The survey results show that there is a huge opportunity for vets to improve the health of many more of their clients' dogs and this is why Purina has introduced a range of GI services and support materials. We aim to help vets to include a nutritional assessment in all of their consultations."

For more information call PURINA PetCare Team on 0800 212 161.

The Kennel Club has announced the results of a survey of 329 Breed Kennel Rescue organisations which has revealed that over 50% of dogs given up for rehoming are given up by women, compared to 17% by men and 27% by couples who made the decision jointly.  

The Kennel Club said the survey also revealed lifestyle changes, a lack of training and time to look after the family pet adequately are the main reasons why dogs are rehomed.

Caroline Kisko, Kennel Club Secretary, said: "People really need to explore their reasons for wanting a dog in the first place, do the research properly and invest time into training their dog. We are seeing an increasing number of owners being driven by celebrity trends in choice of dog breed, such as the French Bulldog, owned by Millie Mackintosh, Jessie J and Jonathan Ross.  

"Every year dogs are abandoned or given up when the novelty wears off. Dogs are a lifelong commitment and anyone considering getting a pet needs to be sure that they will be able to properly care for the animal for the rest of its life."

Kennel Club Breed Rescue organisations last year rehomed over 20,000 dogs, more than Dogs Trust and Battersea Dogs & Cats Home combined. January was revealed to be the busiest month, highlighting the impact of many families being unprepared for getting a dog and potentially still buying them as a Christmas gift, despite advice to the contrary. More than one in three breed rescue organisations reported an increase of dogs needing to be rehomed compared with 2012.

Caroline continued: "Although not as well-known as other organisations, Kennel Club Breed Rescues work incredibly hard to support their breed. They are set up and run by people passionate about dogs and their particular breed in particular. There is a breed rescue organisation for almost every one of the 212 breeds of pedigree dog in the UK, and more than one in three of the breed rescue organisations also accept crossbreeds as well as pedigrees.

"Breed rescue is a fantastic place to consider when looking for a dog. The expert staff and volunteers will often know the full history of the dogs in their care and provide you with invaluable knowledge on the breed and tips for caring for individual dogs to make sure the dogs find a family for life."

Maverick Television is looking for three veterinary surgeons and two veterinary nurses to front a new Channel 4 television show.

Maverick, makers of Embarrassing Bodies and Bizarre Animal ER, says the new show will be about embarrassing animal behaviours and their bizarre or weird medical conditions.

For further information, contact Laura Wolf on 0121 771 1812, or email her your CV and a recent photograph: l.woolf@mavericktv.co.uk.

CVS has announced a two year programme of investment of more than £3 million in two high-field (1.5 Tesla) MRI scanners and seven CT scanners as part of a programme to provide advanced imaging resourcing across the group.

The first of the MRI scanners will be installed at ChesterGates, CVS' multi-disciplinary veterinary referral hospital, in Spring 2015. CVS says it believes it will be the most advanced MRI system for pets in the North West of England.

The seven 16-slice CT scanners will be installed at CVS hub practices, including ChesterGates, PetMedics in Manchester, Beechwood Veterinary Hospital in Doncaster and St David's in Devon.

CVS Referral Director John Innes said: "We are committed to utilising the latest technology across the group and this investment in our scanning capability is a good example. The new MRI scanner at ChesterGates will enhance the high quality specialist referral services we offer, particularly in neurology because MRI is used mainly to image the brain and spinal cord.

"The seven new CT scanners will enable our teams to scan a chest or abdomen rapidly and with outstanding image quality. Image data can be processed and viewed in other planes or 3-D rendered to assist with decision making and surgical planning. The installation of the new CT scanners will be rolled out over the next two years, enabling us to offer cost-effective advanced imaging to many more of our clients across the country."

Bayer Animal Health, maker of Advocate, has announced that it will be running its 'Be Lungworm Aware' campaign in April.

The company says the campaign aims to help raise awareness of Angiostrongylus vasorum amongst dog owners and support the veterinary practice as a source of further information. The initiative will be backed by a national TV and print advertising campaign.  Media vet Joe Inglis will also be supporting the initiative and will be talking about Angiostrongylus vasorum during a series of radio and web broadcasts.

Bayer has produced new support materials, including an updated lungworm PR pack. The materials are designed to allow veterinary practices to educate owners on the disease, whilst helping to raise the profile of the practice in the local community.

Meanwhile, the research carried out by the company has revealed some interesting insights into dog owners' understanding of lungworm.

Despite awareness being fairly high with nearly half of owners claiming to know about the condition, 84% of this group did not know any of the clinical signs associated with the infection, while only 60% were aware that the disease could be fatal if left untreated.   Understanding of how dogs become infected was also relatively low with only 24% of owners recognising the role of slugs and snails as the intermediate host for the parasite.  As well as playing a vital role in alerting owners to the emergence of the disease, the veterinary practice was cited as the primary source of information that owners would refer to if they needed advice on treating this parasite.

Eric Morgan from the University of Bristol said: "Angiostrongylus vasorum appears to be continuing its spread to new locations in the UK. It is therefore important that dog owners are educated on the infection and the signs to look out for, to enable them to seek treatment before it is too late."

For further details, or to order the new practice materials, please contact your Bayer representative or ring 0845 2574798 quoting 'Be Lungworm Aware'.

I think it'll fly, and if it does, it will be one for many in the profession to keep a close eye on. Reputations can (and have) be made or lost on these kinds of websites.

What's more, previous community sites for pet owners based on the more simple forum model have shown the danger of attracting, well, the nutters. I've seen at least two populated almost entirely by raw meaty bones evangelists firing false (or at least unproven) accusations at everyone from pet food manufacturers to individual vets.

Worse than that, the same people seem to advocate alternative therapy for just about every medical condition under the sun. 'Heart failure you say? Wave some of these crystals over its tail'.

I can see pet owners flocking to this kind of site in their hordes. But for it to have any kind of credibility within the profession, I fear Mr Abraham will have to be absolutely ruthless in weeding out those who will inevitably try to use the site as a soapbox for extremist viewpoints. That'll be a challenge. I have first hand experience of just how tenacious some of these people are!

Krka, the Slovenian pharmaceuticals company, is offering UK veterinary nurses the chance to win an all-expenses paid luxury trip to its home country in a 'spot-the-difference' competition.

Two winners will be flown from a London airport to spend 2 nights at the Krka Terme Hotel Svoboda Strunjan, a night at the Grand Union Hotel Ljubljana and a night at the Grand Hotel Bled, plus car hire.

To enter, visit www.discoverkrka.co.uk and pick out the differences between the Dalmations. 

Ned Flaxman from Krka said: "I’ve only recently joined KRKA and I’m sure like many people I imagined Slovenia to be some far-off country in Eastern Europe. But it’s much closer than you might think - being only a couple hour’s boat ride from Venice.

"I would urge anyone to enter the competition to be in with the chance of winning this truly memorable trip. From the cliffs and stunning beaches of Strunjan to the lively and beautiful city of Ljubljana, Slovenia is a hidden gem just waiting to be discovered."

The RCVS Mind Matters Initiative and the Doctors’ Support Network (DSN) have now signed up seven ambassadors for their AndMe (#AndMe) mental health campaign, designed to de-stigmatise mental ill-health within the healthcare professions.

The College says that although professional bodies advise their members to value their own wellbeing and seek help if unwell, there has been an absence of senior professionals who have felt able to say 'been there myself'.

By asking senior medical professionals to share their stories of overcoming struggles with mental health, &me aims to encourage other medical professionals to seek help, in part by showing that such experiences do not exclude people from achieving leading roles in healthcare.

With the addition of Dr Cathy Wield in August, there are now seven ambassadors for the &me campaign, and all of their stories can be read at www.vetmindmatters.org/&me: 

• Dr Caroline Reed O’Connor, who went on to be a senior trainee psychiatrist and psychotherapist after being diagnosed with bipolar disorder
• David Bartram, a veterinary surgeon and member of RCVS Council who was in hospital multiple times as a result of depression before gaining additional qualifications and moving into roles of increasing responsibility
• Dr Malcolm Kinnear, a psychiatrist who took long-term sick leave for depression before completing his training to become a consultant and taking an honorary teaching position at the University of Dundee
• Dr Susan Atcheson, a senior GP who has experienced multiple episodes of psychotic depression
• Rob Pettitt, a vet and Senior Lecturer at the University of Liverpool who experienced depression, taking eight weeks off work before slowly returning to a full-time schedule 
• Professor Jamie Hacker Hughes, a psychologist, psychotherapist and supervisor, who was diagnosed with bipolar affective disorder. He then went on to gain a consultant post with the Ministry of Defence, achieve three fellowships and four professorships, establish a research institute and become President of the British Psychological Society
• Dr Cathy Wield, a doctor who experienced two bouts of severe depression including hospital admissions and brain surgery. She returned to work in emergency medicine, and has written two books about her experience of being a doctor with depression.
• Dr Susan Atcheson, a senior GP who first experienced recurrent psychotic depression 20 years ago.

Lizzie Lockett, Director of the Mind Matters Initiative, said: "Over the past eight months we have seen an incredible level of support for our &me ambassadors. Our Facebook post about Rob Pettitt, for example, reached nearly 25,000 people, many of whom posted stories about Rob helping them navigate veterinary school and better understand their own mental health issues. These kind of role models really do help reduce stigma, and we thank every one of our ambassadors for having the courage to share their own experiences with mental health."

Louise Freeman, Vice-Chair of the Doctors’ Support Network, said: "The &me campaign has really shown how the medical professions can work together when it comes to mental health. Medical professionals face many of the same challenges, and we needn’t face them alone – instead we can work as one to tackle stigma and speak openly about mental health issues. And it’s not just in the UK that health professionals can feel as if they are ‘not allowed’ to experience mental health problems. As a direct result of the &me campaign, health professionals from around the world including Australia and the U.S. have been in contact with DSN to confirm that they have similar issues within their local health culture."

The campaign is still interested in hearing from not only doctors and veterinary surgeons but also nurses, veterinary nurses, dentists, pharmacists and other healthcare professionals who want to open up about their experiences of mental ill health. To participate in the campaign, please email Dr Louise Freeman on vicechair@dsn.org.uk.

On social media tweets about the campaign are sent from @vetmindmatters and @DocSupportNet twitter accounts using the hashtag #AndMe.

A project which aims to standardise the assessment of veterinary nurse practical training across Europe will have life beyond its pilot phase, thanks to European VN training network, Vetnnet.

The announcement was made in September at an Oslo-based conference to mark the conclusion of the pilot phase of the Pan-European Practical Assessment System project (PEPAS).

During its two-year pilot, the Leonardo da Vinci-funded project developed 111 new stations for Objective Structured Clinical Examinations (OSCEs), including mark-sheets and examiner notes, and trained over 50 veterinary nursing examiners from eight countries across Europe. The new OSCE stations have been trialled across 250 students by seven European veterinary nurse schools.

Vetnnet has now committed to continuing the project, enabling its members to access the OSCEs and associated training.

The Royal College of Veterinary Surgeons was a main project partner in the pilot, with specific responsibility for training and quality assurance of the system. Victoria Hedges, RCVS VN Examination and Higher Education Quality Manager said: "It's great that the hard work put into the project by so many countries will continue to bear fruit.

"Feedback in Oslo was excellent and it was heartening to see that when examiners' marks were compared across countries, standardisation was very good. The feedback also helped us to see where students were not achieving the desire results, indicating where more training is needed."

See www.vetnnet.com for more information.

CVS has announced its acquisition of the Severn Edge Veterinary Group, a large mixed veterinary practice with 12 sites covering a wide area of central and south Shropshire.

Severn Edge was formed six years ago with the merger of two long-standing neighbouring practices, and now employs 135 people, including 43 veterinary surgeons. 

Mrs Karyn MacKenzie, Director of CVS’ Practice Division, said: "Severn Edge is an impressive practice with an outstanding leadership team and an ambitious and exciting vision for the future which we share. We are delighted to welcome the team to CVS and look forward to working with them to help them build an even more successful future."

Dr John Brentnall BVSc MRCVS, a Director of Severn Edge, will continue in the role of CVS Regional Director. He said: "It was clear from our early discussions that CVS understood what we are trying to achieve. We have embarked on a significant investment programme, including upgrading our surgery at Madeley outside Telford, and the redevelopment of the site of an additional clinic which we have recently acquired in Craven Arms.

"In order for us to continually upgrade our clinics, provide the widest range of career opportunities for our staff and steer our practice through an increasingly competitive world, we believe that the best interests of us all lie in joining forces with CVS.  It is known for its interest in equine and farm practice, as well as companion animal practice, and has a policy of significant investment in both infrastructure and staff. We believe it offers the best fit with Severn Edge."