VP vol42 07_August 2010 24/08/2010 13:47 Page 1

And just what do you mean by Is enough being done about Are you fully up-to-date with sesquipedalianism? infectious diseases in cattle? changes in employment law? – page 12 – page 54 – page 68

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On TV soon SEPTEMBER 2010 Volume 42 Number 7 Keeping track of ‘rescued’ pets THE Nottingham veterinary school Throughout 2009, 7,686 cats were said to be, in part, a reflection of a earlier], facing the real issues in animal is to establish a database of animals taken into RSPCA care; between growing trend for aggressive-looking welfare today honestly, unflinchingly, being kept at rescue centres and January and July 2010, 4,135 cats were “status” dogs. duty bound and with compassion. shelters throughout the UK. taken into the 16 regional centres which One of those who took part in this “My feeling is that the solution is Dr Jenny Stavisky of the school’s operate as part of the national RSPCA programme was Dr Paul Manning, compulsory microchipping linked to Centre for Evidence-Based Veterinary (branches run as independent charities principal of the Astonlee Veterinary benefits: e.g. people who choose to Medicine is to spend three years on a and their figures are not yet available). Hospital in Newport Pagnell. have a dog and then abandon it choose project which will try to determine how He said it helped to show the to give up their rights to their benefit many animals are kept in all the various Another Panorama profession in a much better light [than cheques,” he said, and he called on the shelters, how many are euthanased and Then came a Panorama programme the Panorama programme It shouldn’t profession to be more proactive and to how many are rehomed, and also look broadcast on BBC1 on 10th August in happen at a vet’s broadcast two weeks play a more effective leadership role. at what can be done to stop the rise in which a reporter visited Battersea Dogs the numbers of both dogs and cats and Cats Home and discovered “a being abandoned or rescued. shocking rise” in the number of In the longer term, Dr Stavisky and aggressive dogs taken in, particularly Changing times her team hope to establish a shelter Staffordshire bull terriers, and the need n “Remove permission for antimicrobial Government should do only those things surveillance programme for increasing numbers to be veterinary medicinal products to be which only Government can do, we are to monitor diseases in euthanased. advertised to farmers.” examining how parts of the DEFRA animals in shelters. The home said that – the first paragraph of the summary of networks assets could be marketed or be The announcement of about a third of the dogs it proposed changes by the VMD to the Veterinary run better through the voluntary sector, this project coincided with takes in have to be put to Medicines Regulations (VMR) for this year. while protecting key DEFRA outcomes.” a report from the RSPCA sleep, although most of When the VMR were completely re- – Caroline Spelman, the new Secretary of State that its animal shelters in them are healthy animals, drafted a few years back, the VMD gave at DEFRA, lapsing into departmental England and Wales have because they are deemed to permission for these products to be gobbledegook. been inundated with cats be unsuitable for rehoming. advertised to “professional keepers of One of the simplest things which and kittens in need of Battersea is among a number animals”, including farmers and dog only DEFRA could do was pay farmers new homes, with many of centres which say the breeders but excluding veterinary nurses. what they were due from the EU within a now full. Dr Paul Manning. problem is on the rise and is The VMD later removed the ban on set time-frame. Failure to do this has advertising POM-Vs to nurses and now resulted in a fine of £160 million on the Mercury 3 Periscope 16 Equine pages 45 wants to impose a partial ban on farmers department which says it can’t afford to BVA president 4 Young graduates 18 Practice profile 51 – leaving only the regulation affecting dog work on a new Veterinary Surgeons Act. breeders unchanged. That, of course, was all the fault of the Cross-words 6 Focus on cardiology 20 Livestock 54 The full summary of changes (plus previous administration... Book reviews 8 The prostate – 2 28 Travel 62 comment) is on page 33. For more of what the Minister said, Events 14 Welfare symposium 40 Business & finance 64

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SEPTEMBER 2010 VETERINARY PRACTICE COMMENT 3 Facing the moral dilemmas ANYONE listening to the radio oil-for-terrorist deal”, as reported in The full term in prison while most, but today would be intrigued by the Guardian earlier in July, is quite frankly, not all, of those related to the British moral dilemma posed by US not going to simply go away. passengers who died saw merit in his senators calling for senior ministers It is, perhaps, good news for this release on compassionate grounds. from the London and Scottish beleaguered nation that around half of What is this carousel of moral Parliaments variously to attend the surface oil floating in the Gulf of dilemma to do with veterinary official hearings in the US with Mexico appears to have been dealt with practice? In direct terms, of course, reference to both the release of either through containment and very little. Whether the “special Abdelbaset Ali Mohmed Al Megrahi dispersal or by the forces of nature, and relationship” between our nations and the BP oil spill in the Gulf of observers are beginning to think that flourishes is of little consequence Mexico. BP’s Tony Hayward might have been within the walls of our practices but the A spokesman for the Scottish right after all when he said, at the issues of trust embodied in all of these will the pet-owning public believe us government was resolute in his rebuttal outset, that this would turn out to be, in twists and turns have immediate and not what they see on TV or read in of any moral ecological terms, not as relevance to us in the interface between the paper they have chosen to buy? imperative to attend big a disaster as many the practice and the public. When our ministers refuse to testify and testify at any THE MERCURY feared. in the US, what do we believe the US hearing at the request COLUMN Of course, Tony A lucky escape... media will make of that and what of the United States, Hayward has already After the screening of the BBC1 might we suppose the US populace will while an eloquent in which a guest become a casualty of Panorama programme, the profession believe once their media have finished spokesperson for the columnist takes this disaster himself, appears – on the face of it – to have their feeding frenzy? relatives of those US the temperature of the having failed to win enjoyed a very lucky escape. Amid Similarly, and on an admittedly citizens killed in the profession – the hearts and minds much discussion of the poor nature of more parochial front, why do we Lockerbie air disaster and the world around of the local the investigative believe that our good put a cogent and community which, in journalism, we have quite What has been relationship with our persuasive case that, with nothing to turn, has led to President Obama’s rightly heard left behind is bonded clients will simply hide, these ministers were sending all hasty political intervention and, condemnation of some the generally carry us away from any the wrong signals to those in the US potentially, further damage to whatever individuals featured in the unpleasant unfortunate comparisons who believed that our two nations “special relationship” may or may not TV footage as well as with what they saw on enjoyed a special relationship. exist between the UK and the US. some expressions of relief smell... the Panorama programme Fascinating stuff really and each of Without doubt, the clarion call of that the programme or read in their us, whatever our political allegiance, will those who deal in damage limitation is seemed to have focused more on the newspapers or heard on Radio 2? have different ideas on the way in to win the hearts and minds of those failures of proper supervision of young It might be a more parochial which we believe this moral dilemma affected at the earliest opportunity and, graduates and nurses, allowing any comparison but we live in the digital might unfold. in the situations cited above, very few major discussion of veterinary practice age and we were taken by surprise of the players – including the standards to slip away unchallenged. when the internet facilitated a lasting Buck passing at speed Governments in London, Scotland and What has been left behind, challenge to vaccination frequency, Nothing seems to be straightforward the US, BP and its officials, the media however, is the generally unpleasant mounted by a determined band of and, if it were not enough that Al and lawyers concerned – have done smell which accompanies the slow those pet owners who believed that Megrahi has, in political terms, rather anything to win the hearts and minds of realisation that something is not quite the profession, and the industry inconveniently failed to succumb to his anyone at all other than in a few right here. which serves it, had been less than terminal prostate cancer within the jingoistic stirrings of sovereign pride Of course, this profession is strong honest with them in the interest of period of time which was used to when we ask ourselves why the and resilient but why should it need to financial considerations. justify the decision to release him on Americans believe they can bully be resilient in such a situation? The vast These are all highly emotive issues humanitarian grounds, it seems that the anyone and everyone to comply with majority of practice staff are simply and, should we be brave enough to English and Scottish parliamentarians what they think is right. beyond question in their ask ourselves which lessons have are passing the buck between each professionalism and compassion shown been learned in the interim, shouldn’t other with the speed of a Nadal serve Right on their side? towards the animals under their care we expect that among the tens of at Wimbledon, to paraphrase one US Clearly, the Americans believe they have but, here yet again, we see footage and millions of viewers, readers and senator’s acerbic observation. right on their side with these issues. On read newspaper reports of practices listeners there might be a substantial Then, to add fuel to the fire, there the one hand, we need to have some which are simply unacceptable. number of practice users who might are accusations that Al Megrahi’s release sovereign resilience or we’d simply roll Unless we, as a profession, rise to believe that there’s no smoke without was influenced by commercial over every time something went wrong the challenge and make it clear to pet fire? considerations and news on the scale of but, on the other hand, it appears that owners across the nation that such Sitting still with our fingers “Hillary Clinton vows to look into most but not all of the US relatives of practices horrify us too and that we are crossed, hoping that it will all go claims oil firm lobbied for release of those who died in the Lockerbie air committed to expunge such behaviour away, is not the way to deal with this Libyan convicted over 1988 bombing in disaster wanted Al Megrahi to serve his and expel those who perpetrate it, why issue.

Veterinary Practice is an independent monthly publication for members of the veterinary profession in the UK. It is mailed free to all veterinary surgeons in Website: www.veterinary-practice.com practice and is available on subscription (£36 a year) to others interested. Published monthly by Advertising and subscriptions: © VP Publishing Ltd (2010): no part of Editor: David Ritchie, BA, HonAssocRCVS this publication may be reproduced in VP Publishing Ltd JCA Media Group Ltd ([email protected]) any form (except for 30 Diamond Ridge, Camberley, Lion Lane, Needham Market, Editorial consultant: John Tandy, BVSc, review purposes) Surrey GU15 4LD Suffolk IP6 8NT MRCVS without the express VP Telephone: 01276 686654 Telephone: 01449 720881 Advertising contact: Jennie Watson permission of the editor. PUBLISHING LTD Fax: 01276 63307 Fax: 01449 722772 ([email protected]) Printed by Buxton Press E-mail: [email protected] E-mail: [email protected] Design: Simon Wyatt Buxton, Derbyshire VP vol42 07_August 2010 25/08/2010 09:12 Page 4

4 BVA VETERINARY PRACTICE sEPTEMBER 2010 What a difference a year makes WHEN I became BVA president I wrote at length on this topic a are getting involved in campaigning at nearly a year ago I knew that I had a couple of months ago. Since then AH local, national and international levels to very short time to make my mark. has written to all OVs to inform them promote better welfare for all animals. As you will no doubt know by now I that not only will they have to tender This year has also seen changes chose to focus on the “public good” for OV work, some of the TB testing within the BVA. Many of the role of vets by championing the work is being retained by AH with innovations were in the pipeline before importance of the profession, as immediate effect. AH has now clarified I became president but I’m very proud well as re-establishing that in the first instance of the achievements nonetheless. The vets as the leading tendering will only new mediation and representation voice on animal apply to the provision services are already proving popular welfare. of TB testing and the with members and making a real Although it’s very availability for difference to the lives of individuals. difficult to quantify the contingency work. One member wrote in to tell us: level of success, I This latest “Due to their excellent help and advice believe on many issues development is yet [the case] did not go to an employment we have made huge another blow for tribunal, but was fully sorted out... This progress. The BVA’s those practices that especially has shown me that [BVA Professor Stuart Reid, who will annual review will be deliver OV services. membership] is great value for money!” deliver the Wooldridge Memorial published at the end of Professor BILL REILLY The BVA is working It’s comments like this that remind us Lecture at the BVA congress this August on president of the BVA, closely with the BCVA of the importance of the BVA and month; and (below) the congress www.bva.co.uk/annual looks back on his year to make what it can do for members. logo. and, reading through in office and forward representations to it, I hope you will be to this month’s Animal Health and Refresher days impressed with the congress DEFRA on behalf of In addition to the services we provide, impact the BVA has our members; I hope we also review our member benefits had on a wide range of all veterinary surgeons regularly. issues of animal welfare as well as can get behind our OV colleagues to The clinical Refresher Days running o issues relating directly to the support them through these very each month from September to profession. difficult and uncertain times. December are aimed primarily at On all of the major consultations While I should count myself as people returning from a career break, and legislative changes we have lucky (at the time of writing!) in not part-time workers, or those changing presented the strong voice of the having to face a disease outbreak during practice type. BVA members get a 50% C p veterinary profession, and we’ve been my time at the helm, the fallout from discount on the courses, which are as a lively contentious issues listened to. Our relationship with both the OV tendering situation could prove delivered by RVC lecturers here at the programme tackling, amongst other the Labour and new Coalition devastating in the longer term and it is BVA www.bva.co.uk/events. things, questions of over-treatment, the governments continues to be one of a something I will continue to work on in I must end with a final plug for links between domestic violence and well-respected critical friend. my year as past president. congress. As you know, this year’s animal abuse, and the role of vets as On welfare issues we’ve certainly congress is in my home town of expert witnesses. Considerable strain upped our game with a recent lobbying Glasgow and we will be showcasing The Wooldridge Memorial However, our relationship with success in the banning of hot branding the very best that Scotland’s academic Lecture, Vets and the public good: the DEFRA has come under considerable of horses in Scotland and the and research institutions have to offer broader perspective, will be delivered by strain this year due to the actions and beginnings of an important campaign in clinical CPD, covering companion Professor Stuart Reid of the announcements of its delivery agent for higher welfare labelling of food, and production animals and equids. University of Glasgow. Ours is a Animal Health (AH) regarding the amongst other issues. This year also sees a full non-clinical small but hugely varied profession future procurement of OV (Official Not only are vets enhancing the CPD stream covering important issues and the breadth of the contribution Veterinarian) services. welfare of animals in everyday work, we faced by many vets in practice, as well of vets to society may surprise us all.

Mary Brancker, 1914-2010 MARY Brancker, who graduated from the RVC in Mary elsewhere but it is worth recording some d 1937, died last month, just one month short of her notes from an interview with her some years ago in y 96th birthday. which she recalled some of the prejudice she faced The veterinary profession was not her first in her early years. Other prejudices abounded in choice of career but she made a huge impact upon that era and one was certainly stirred (though not it, becoming the first (and for a long time only) in Mary) when the appointment was announced of female president of the BVA. She was elected E. C. Amoroso as senior assistant in charge of FRCVS in 1977, received an honorary doctorate histology and embryology in 1934. from the University of Stirling in 1996 and was The news of the Trinidad-born lecturer’s apppointed CBE in 2000; she also received the two appointment prompted a delegation of senior . e highest awards of the BVA: the Dalrymple- students to see the principal, Sir Frederick Hobday, Champneys Cup and the Chiron Award. to protest at the possibility of being lectured to by During her remarkably single-minded career, a black man. Sir Frederick would have none of it she pioneered work with both zoo animals and fish and sent the students away with a flea in their ear. and was a highly respected member of many “Amo”, although not a vet, quickly became one of veterinary associations. She loved to attend the most popular lecturers, and eventually Mary Brancker, BVA president in 1967, at the 2009 congresses and meetings, her last being the BVA professor, at the RVC. “You can’t imagine a protest SPVS congress with last year’s BVA president Nicky past presidents’ dinner shortly before she died. like that nowadays,” Mary added with her Paull, who led the tributes to Mary at her funeral last month. Glowing tributes have already been paid to trademark smile. She will be greatly missed. – VP R VP vol42 07_August 2010 24/08/2010 13:48 Page 5

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6 CROSS-WORDS VETERINARY PRACTICE SEPTEMBER 2010 In search of the perfect destination... I HAVE written most of this whilst time to smoke and drink in the petrol abroad. are treated with a thinly disguised on holiday in France. The trip began stations I guess) and I’m not sure many Here is the last stanza from The mixture of contempt and pity. quite badly as I had got the day of of us would like that extended day. Importance of Elsewhere: Day in, day out, as vets at work we the ferry wrong. We arrived at the However, whilst I can see the attraction “Living in England has no such excuse: have to say and do the right thing, and port with all the usual excitement of a long lunch with a few glasses of These are my customs and also to some extent in the community and build-up with a car full of wine and a Gauloise or two, I think the establishments. we live in if you are “the local vet”. children, all wanting to be “the first clients may find the closed and It would be much more serious to Most of us get recognised occasionally to see the ferry”. shuttered-up practice frustrating for the refuse. and are also sometimes asked for advice As we entered the port there was an lunch hour and pre-school-run slot. Here no elsewhere underwrites my by friends and acquaintances. air of desolation as One bonus of existence.” Most of us are happy with this, but there was no ferry and working in France, “Here no elsewhere underwrites my just occasionally, just for a few weeks, no other cars. Luckily though, would be the existence.” That sums up travel and the it’s great to be a great big idiot who can there was one later that demeanour of their need for holidays, or rather the inverse barely speak and be someone no one day and the staff were dogs. They seem so does: being abroad and having an knows or cares about who you are: just very helpful as I much more laid back. “elsewhere” (i.e. your home country) to another tourist! But as a tourist we have begged them for It may be the heat that underwrite your failings in the country the security of Larkin’s “elsewhere”: our assistance. It worked makes them soporific you are visiting. home, our job, our money. out OK in the end as or the fact that they go It is important he uses the word I wouldn’t want to be a fool all the we got an overnight everywhere with their “underwrites” and not “excuse”. I love time. I have travelled widely and learnt a crossing. owners and the fact that I can barely order lunch in language a long time ago, I can get by Booking the ferry GARETH CROSS consequently don’t most foreign countries, fumble with the and do appreciate other cultures and was my main area of muses about his trip explode with currency and struggle with the opening civilisations. But now I am part of this responsibility in the with his family to excitement when out hours. culture and this civilisation (i.e. a vet in planning of the trip, foreign parts – which and about. At home we can’t ignore our normal the UK), it is nice to take a break from and it was an awful half got off to a less than It is quite normal customs, can’t struggle to get through a it and suddenly be free of any hour in the port perfect start... to see a small dog day with the language and as vets obligations to our customs, sorting out the riding in a shopping certainly can’t ignore our institutions. establishments and be able to refuse to alternative. There is, trolley in a supermarket, As vets we are paid for talking. Most be a fully functioning member of however, something liberating in making dogs in restaurants (where they are of us charge a decent sum to the public society. such a colossal balls-up right at the given a water bowl by the table) and for the privilege of hearing us gas on However, now I am back. And in beginning of a trip. dogs in the market sloping along on the for 10 minutes or so. What a relief it is my practice these are my customs, To completely cock up the one thing lead. One market day I saw shar-peis, a to be somewhere where there is no and I am governed by an you had sole responsibility for right at non wrinkly Basset, Briards and all sorts pressure to say or do the right thing, establishment. It would be much the start does lower the bar of of muts just mooching around taking it where you struggle to order a meal and more serious to refuse. expectations somewhat. It’s not all in. something I could recommend, I think our culture of dog-in-the- however, as you won’t always get such a house or out-going-mad on a walk may LETTER ready “plan B”. It also could not be be not helping our canine companions. Swift retrieval of useful information recommended as an approach to Whilst they are accepted in most pubs Dear Sir, help him get what he needs from it! working life where there are no nice in the UK, other public buildings are I read with interest of Gareth Cross’s Yours faithfully, French ladies in uniform to help you usually dog-free, thus necessitating that research travails (The information CHERRY BUSHELL, out. they be left at home. superhighway, August issue) and agree that Director, RCVS Trust, I was keen to go abroad to get away Alan de Boston wrote a fascinating swift retrieval of useful information from the Belgravia House, 62-64 Horseferry Road, from work and from seeing clients book entitled The Art of Travel. In it he minefield out there is a skill – it’s one in London SW1P 2AF. when out and about. Most of them are discusses, amongst other things, one of which RCVS Trust librarians are fine but it’s good to get away from them the main sources of dissatisfaction with experienced practitioners. Gareth Cross responds: I am glad that the occasionally. travel. In the case of his search on treating libriarians read my article and I take their France is a country of many dogs for uveitis, the librarians may have point. I was after all having a stab at doing eccentricities, the most frustrating of All the same problems steered Mr Cross away from Wikivet – an their job from my kitchen table one which is their opening times. In the It goes something like this. When you excellent resource, however designed for evening. So I would be disappointed if my village where my brother lives there is a see a holiday brochure, or surf the net veterinary undergraduates – and suggested results as a clinician in a kitchen were as branch of the chain “8 a huit” or “8 till looking for an ideal destination, you see that he consider instead Wiley Interscience, good as those achieved in a library by eight”. the destination and usually a model or a or VetMed, the largest bibliographic librarians. So yes, I will be in touch to try out What it should really be called is “8 perfect family in the picture, or no one database of veterinary medicine. your services! However, one issue I didn’t till eight apart from two-and-a-half at all. Mr Cross makes a serious point about discuss in detail was cost. The RCVS library hours in the middle of the day”. The When you arrive you find that you the difficulty for practitioners of textbook- is not free to join or use. Also, articles found opening hours over there can be have, unfortunately, brought yourself type information not being on hand during will be similar to those found via pubmed maddening, especially when looking for along with all the same problems, hang- consults; however, our librarians can check and other sources. essentials like fuel for the car. ups and anxieties that you had at home. references and do literature searches for They suggest that I try Wiley Another unusual sight for me was in And the perfect destination is in fact the practitioners, providing what is usually a Interscience: I did during the article and a petrol station. I was filling up the car same as anywhere else in terms of your same-day service and dealing with late that is how I accessed “Veterinary and the woman in the car next to me point of view. This can be multiplied up night e-mails first thing the next morning. Ophthalmology”. Typing my search terms was smoking with the window open. depending on the number of unruly So, if you want something checked for a into it just now yielded some good results, Whilst I admire her dedication to her children you have strapped in the back patient you have in, pick up the phone. but again access to most articles was at a addiction, this was maybe a health and of the car. I challenge Mr Cross to try out one of price unless you are already a subscriber. safety risk too far. (I was, however, I think the most fascinating insight the best stocked veterinary libraries in the Try billing that to the client: “What! You impressed to see an edge of town into travel, and particularly for vets in UK – the RCVS Trust library – and take mean you didn’t already know?” But I am garage that had a bar in it). practice, comes in one of Philip Larkin’s advantage not only of the wide range of sure that if we all used the RCVS library the They work late to compensate for poems. It is actually discussing being at print and online resources, but also of the cost would come down. Maybe they should the long lunches (which give them the home, but in comparison to being expertise of librarians only too happy to tack a bit onto the retention fee... VP vol42 07_August 2010 24/08/2010 13:48 Page 7

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8 BOOKS VETERINARY PRACTICE SEPTEMBER 2010

A useful also discussed well. the images relate Diagrams and illustrations are intimately to the labelled introduction to plentiful and text is detailed without diagrams lying adjacently neurology being too rambling, making it a and really do bring clinical relatively easy read – something that relevance to the book, reflects well on Teresa Gatesman, who pushing it forward into SMALL ANIMAL NEUROLOGY: translated the original version into the realm of usefulness. AN ILLUSTRATED TEXT English. This book really Edited by André Jaggy and Simon The book finishes with a number of strikes me as a great R. Platt appendices that provide for quick accompaniment to the 580pp.; £166.00; EV Veterinary access to information about breed undergraduate teaching Publications predispositions, drug use for experience, for use firstly neurological diseases and basic during dissection classes Veterinary neurology textbooks were neuroanatomy. Finally, nestling within but also as a great adjunct relatively few and far between for many the back cover, is a CD-ROM of videos for revision, as a great years, with the core texts by De that show the various components of visualisation tool. Lahunta and Palmer forming the basis the neurological investigation and a The images provided of established fact in the discipline. number of case examples to illustrate remind me of my Reflecting its increasing popularity as a the impact of lesions at specific sites. dissection classes even clinical specialty, neurology books are Overall, this book should be viewed now so I can only now more numerous and the market as a useful introduction to neurology, extrapolate that this has inevitably become more covering a broad range of topics in a would be even more competitive. This places an onus on any concise manner. If you can overlook useful just after completing the excellent list of references which are new book either to provide something the limitations, it should prove a good anatomy course. But beyond its use as used to support the statements made in that other books don’t or review the introduction to the subject and will an undergraduate text, I can see its use the text, so that this book is a very subject particularly well. likely become a handy reference text for in practice. Our anatomy could always useful resource for practitioners and The book starts out well: it is well the more experienced. be better and this book has proved researchers involved in tackling the presented, with well laid-out text and a – Peter M. Smith very useful in reminding us of the complex issues involved in this large number of diagrams. It also details of structures in areas which common disease. includes a good section on MRI have experienced traumatic injury. There is often a lot of anatomy of the brain – a feature that is Concise yet Standing alone, this book provides unsubstantiated talk at conferences on useful in an age where MR and CT detailed text on only details of the structures’ position this subject, or the evidence tends to imaging of the brain is becoming and course through the body and more be sidelined by strongly held beliefs commonplace. anatomy detailed information on their function and opinions that are not based on The chapters are logically laid out, and dysfunction would be needed. Use supporting evidence, but this book taking the reader from the basics of COLOR ATLAS OF as a supplement to such a book objectively looks at the opinions and clinical neuroanatomy and neurological VETERINARY ANATOMY: THE though would really reap its full the evidence. examination, through the range of RUMINANTS potential as a visual guide. It is a book that is relatively easy to most neurological ailments that are Volume 1; second edition Employed correctly I believe this read, and can be dipped into as a likely to be encountered in clinical By Raymond R. Ashdown and book does fit in well with anatomy reference, although the reading is practice. Again, these are divided in a Stanley H. Done teaching today and will become even compelling in that it really invites the rational manner and individual 260pp; £59.99; Mosby Elsevier more valuable as the depth of reader to explore the subject broadly conditions are readily found by either knowledge is continuously diluted as and in depth. perusing the appropriate chapter or by WHENEVER I consider purchasing the pressures of breadth grow more The contents include four main index. or referring to a new textbook I always forceful. Rating: seven out of 10. chapters on pain and lameness, the Despite this, I found the book look for a context and a gap in which – Richard O. Sanderson disease, multimodal management and frustrating in a number of areas. For a it will fit. Veterinary anatomy is an area physical rehabilitation. The whole book text as comprehensive as this, the students and veterinarians alike often is linked together throughout with referencing in several chapters is list as a weak point and much of this is concepts from the molecular basis of relatively sparse. In an age where the owed to the sacrifice in depth of Refreshing guide the disease to the appreciation and internet provides access to many teaching as the breadth of teaching evaluation of the clinical disease by medical search engines, this may not be continues to expand. to latest thinking practitioners and clients. a major problem, but some older As such I am always searching for on OA If I have any criticism at all it is veterinary references, which are quality supplementary texts to my own that I find the “multimodal approach is important in verifying basic facts, bible, “Dyce”. And that is exactly a trademark of Novartis AG” a bit remain difficult to locate. where this text is aimed to fit. MULTIMODAL MANAGEMENT strange when this disease complex A somewhat surprising finding was This book is concise yet OF CANINE OSTEOARTHRITIS requires a multifaceted approach as that a number of the figures are sufficiently detailed. Split into By Steven M. Fox and Darryl Millis part of what I would call common inaccurate – duplications and inaccurate anatomical areas, each chapter gives a 96pp.; £39.95; Manson Publishing sense, and no one has copyrighted that. labelling were both noted. For someone short introduction to the anatomy The references given to the “trade exploring neurology for the first time, covered, attempting to detail why this My enthusiasm and praise for this marked” chart tend to focus on the or trying to make sense of a complex area is clinically relevant. This is book is gushing. It even has that individual components of the approach case, this could be confusing. followed by a series of photographs delightful smell of a new hardback such as use of NSAIDs, weight Overall, there is a lot more to this accompanied by labelled diagrams and with quality paper in full colour that management, use of EFAs, or book than a dry re-writing of the old small caption boxes. always gets my attention. chondroprotectants. It is very neuroanatomy texts. In addition to the These pictures reminded me of the This is a beautifully presented small challenging to produce research that basic information on neurological process of dissection I went through hardback, which is a really refreshing, would be accepted by publishers of diseases, there are helpful sections on as an undergraduate, with memories compact, concise and very well research into more than one mode of neuroradiology and electrodiagnostics, a both good and bad flooding back. A illustrated guide to the latest thinking intervention simultaneously, although useful introduction to neurosurgery – particularly smart feature of this text on osteoarthritis and the approaches to in practice that is what practitioners are with a good synopsis of physiotherapy relates to the surface anatomy its diagnosis, treatment and actually doing. – and a useful review of neurological photographs. A weak point for many management. The beauty of this book, which has emergencies. Behavioural problems are of us, the strategically placed clips in It has a great evidence base with an been well-researched, is that it provides VP vol42 07_August 2010 24/08/2010 13:48 Page 9

SEPTEMBER 2010 VETERINARY PRACTICE BOOKS 9

a concise resource of the current state the sheet may not be what you want. editors are from the USA but Dick Vet of the art from which further research But that’s a small problem. graduate Simon Platt, now an associate Attractive volumes and development, and improvement of Most practices will surely use the professor at the University of Georgia, for dog and cat the delivery of care by practitioners, electronic version rather than the will be a name familiar to British can potentially be moved forward. printed one, because the files can be readers. The book is in English (the owners TWO books which practices might It is a book that is needed to bring downloaded into practice computers American variety) but the CD-ROM has consider adding to their the evidence together in one place, and and personalised to the extent that notes everything in Spanish as well. merchandising shelves were to help to encourage more focused for individual clients can be added in a The sections are: Procedures and published earlier this year: The Cat thinking and dialogue on this very box at the foot of each sheet. The CD- techniques (from limb amputation to Expert by Rebecca Watson (former important subject, particularly in small ROM also has 100 images that can be urine protein assays in dogs); editor of The Cat magazine) and The animal practice. I would recommend used to explain diseases and procedures. Cardiovascular system; Respiratory Dog Expert by Karen Bush (author of this book for small animal It’s American – Dr Morgan, who is system; Neurolgic system; Digestive other books on dogs). practitioners, researchers, and students a diplomate in both internal medicine system; Endocrine system; Urinary The project consultant on both of the RCVS CertAVP. and ophthalmology, hails from Smoky system; Reproductive system; was Dr D. G. Hessayon and they are – Dr Paul R. Manning Mountain Veterinary services in Hemolymphatic system; Immune in the “Expert” book range Walland, Tennessee – so some of the system; Musculoskeletel system; published by Transworld Publishers. leaflets don’t apply in the UK but the Dermatologic system; Diseases of the Both have 128 well-illustrated pages vast majority are relevant. All 19 section eye; Diseases of the ear; Infectious Educational tools and are priced at £7.99. diseases; Behavioural disorders; A lot of useful information is Nutritional disorders; Toxicology; to help clients packed into each, with sections Environmental disorders (covering covering selection of the “right” SMALL ANIMAL PRACTICE burns, electrical cord injury, heat animal; creating an ideal CLIENT HANDOUTS prostration, shock, and venomous snake environment; feeding and exercise; By Rhea V. Morgan bites). spotting when something is wrong 496pp. (plus CD-ROM); £61.99; Dr Morgan states in the preface and how best to help – and good Saunders Elsevier that, “We hope these educational tools advice about vets and pet insurance. will make it easier for clients to Curiously there are four pages on What a remarkable publication this is. It understand their pet’s medical problem, first aid in the dog book but none in consists of handouts for clients on 450 the rationale behind your the cat one diseases, tests and procedures, with each recommendations, and the potential Many in the profession will not handout in two sections, the first outcomes.” agree with everything presented but covering “Basic information”, the Well worth having – and practice there’s nothing major and clients second “Treatment and follow up”. staff, vets included, can learn plenty could find them both appealing and Each page is perforated so it can easily from it. informative. – VP be removed, but what is on the back of – VP

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10 CPD VETERINARY PRACTICE SEPTEMBER 2010 Can communication skills be taught? THERE is very little doubt as to So how can individuals improve techniques. These are why members of the practice team their communication skills? Although it usually carried out in small should improve their communication is not a personality trait, these skills are groups and generally skills: better compliance, more still linked to self-esteem, individual style speaking one learner effective consultations for the client and our own perception of good undertakes a consultation and animal, reduced complaints and communication. The methods used to or interaction with a improved animal welfare are to teach this subject, therefore, need to simulated client/team name but a few. produce an effective and long-lasting member while the others Having ascertained why change in behaviour. observe. communication skills are important, it is Medical research has demonstrated Participants engage in now an established fact that that didactic teaching methods may be feedback about the communication skills are a series of stimulating, promote thinking and interaction, rehearse learned skills that can be taught with the understanding of communication but if alternative approaches or same intensity as other clinical subjects. not supplemented with other teaching specific skills and perhaps Are you sure your client is paying close attention Of course, methods are unlikely to try again in part or in full. and absorbing all your words of wisdom? individuals wanting to lead to sustained The order of feedback is engage in this process MARINA BAXTER changes in behaviour crucial and is usually elicited from the into the equation since replaying the will begin from communications when applying these learner followed by others in the group, whole tape or even sections of the different starting training co-ordinator skills in practice. the simulated client and finally the recording adds considerably to the positions but for the at the VDS, The use of trigger facilitator. length of the session. majority of individuals introduces various tapes, demonstrations, The role and skill of the facilitator is Despite the potential difficulties, who have some helpful techniques workshops, discussions a key component in the process if video recording remains an extremely experience and and exercises are more learners are not to feel vulnerable and valuable tool and can also be used in the knowledge of likely to engage remain keen to participate and engage in clinic setting. The camera should be communication there is participants but are still feedback. It is also imperative that the placed as unobtrusively as possible but always something that can be added to removed from altering how we facilitator ensures that delegates use should allow at least a three-quarter the toolbox. communicate. descriptive feedback methods, otherwise body shot of both the client and After all, the acquisition of good the process may become judgemental member of the practice team. communication skills has no ceiling in Experiential and non constructive. In addition, the Permission should also be obtained achievement because of the inherent Alternatively, the practice team may educational role players are trained to from clients before embarking on this complexity of the subject. consider experiential learning give feedback in three ways: in role but route. in a neutral position, in role but still in Feedback can be carried out on a the emotion, and out of role. one-to-one basis but analysis of tapes in OTITIS EXTERNA IN DOGS AND CATS This type of training can also be a small group with a trained facilitator is recorded visually and there is no doubt probably more effective unless the that this provides a gold standard as it learner has very different needs from enables a more detailed analysis of the the rest of the practice team. interaction. Simulated clients are also beneficial in this setting as they can recreate the Watching taped encounter. This allows learners to Using this technique means that the rehearse and practise new skills and take learner engaging with the client has an on board feedback from the client, opportunity to look at his or her own which is often not possible in a real performance before feeding back to the encounter. group, which is not practical when using The immediate benefits to both the “fishbowl” technique. Not being seasoned and new members of the able to watch oneself can also lead to practice team are clear but longer term individuals being highly critical about benefits can also accrue, making it a their own performance. highly efficient and fun method of The downside comes in terms of enhancing and updating communication ® expense and time. There is considerable skills. Surolan capital outlay for televisions, cameras After all, communicating effectively and microphones. Facilitators need to with your clients is probably one of the Power through synergy be au fait with the technology, otherwise most profitable transactions individuals ineptitude can interfere with the training are likely to embark on. Proven first-line efficacy against: ■ Gram+ ■ Gram- ■ Yeasts ■ Fungi session.The VDS Time Communicationsalso needs to be factored Training Team is running a New GCP field study results1 are in: series of seminars in 2011: NEW STUDY Team Approach ■ Clinical improvement in 97% of cases n Wednesday 16th February at the Marriott Newcastle Hotel, North Brunton ■ Conclusion: Surolan highly effective against n study isolates Tuesday 5th April at the Sheffield Park Hotel, Sheffield n Wednesday 4th May at the Hilton Hotel, Coventry First-line every time Managing Difficult Situations n Wednesday 2nd February at the Daresbury Park Hotel, Warrington n Tuesday 1st March at the Horwood House Hotel, Milton Keynes Use medicines responsibly www.noah.co.uk/responsible n Wednesday 6th April at the Belfry Hotel, Nottingham Further information available from: Janssen Animal Health, 50-100 Holmers Farm Way, High Wycombe, Bucks HP12 4EG, UK. Tel: +44 (0)1494 567555 Fax: +44 (0)1494 567556 Email: [email protected] For details, contact Marina Baxter, CT Co-ordinator, c/o The Veterinary Legal category POM-V Each ml of Surolan contains 23 mg miconazole nitrate, 5,500 i.u. polymyxin B sulphate and 5 mg prednisolone acetate. Surolan is a licensed trademark. www.janssenanimalhealth.com Defence Society Ltd, 4 Haig Court, Parkgate Estate, Knutsford, Cheshire WA16 Reference 1. Engelen, M et al. Effectiveness of an otic product containing miconazole, polymyxin B and prednisolone in the treatment of canine otitis externa: Multi-site field trial in the US and Canada. Intern J Appl Res Vet Med 8, No 1, 2010 8XZ; telephone 01565 652737, fax 01565 751079, e-mail [email protected]. VP vol42 07_August 2010 24/08/2010 13:48 Page 11

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12 MUSINGS VETERINARY PRACTICE SEPTEMBER 2010 ‘It’s a bad case of sesquipedalianism, I’m afraid, Mrs Jones’ “When I use a word,” said Humpty This, for the avid dictionary enthusiast, something he Dumpty, “it means exactly what I want it to is the lexicographical equivalent of the would be mean – neither more nor less.” – Lewis world record, the Holy Grail, the last unlikely to have Carroll frontier, and is in its own way no mean time to do feat. himself during THE English are renowned, it Presumably he must be a very the year, as one would seem, for their eccentricity, good speed reader, for to get through suspects he and nowhere more so than when it the whole thing in a 12-month period survived on comes to their favourite is apparently equivalent to snack foods and pastimes and digesting a Grisham caffeine-rich hobbies. novel each day, and he drinks) and Some, of course, would have faced indeed may find are more unusual than some daunting words himself to be in others – the person along the way. a cagamosis (an unhappy marriage), words and phrases, to the detriment who makes a scale Indeed, the certainly at the end of the year if not and puzzlement of our clients. model of the Tower dictionary statistics are at the start of his project. Why not utilise more words with of London entirely in themselves fairly fewer syllables, they say? Why say from used jam jar lids, daunting. Did you Ardent logophile craniomaxillary or pneumococcidiosis, the man who amasses know that the OED His efforts would, I suspect, be cholangiohepatic or neurofibromatous when each and every version EWAN McNEILL runs to 20 volumes enough to daunt even the most ardent you could use something a little of the game of continues his series on and almost 22,000 logophile (lover of words) and whilst simpler, even if it means taking a bit Monopoly (there’s the theme “When I pages, and – with the this term could be applied to him, it is longer to say it, and which more reputed to be more rule the world” with a help of 59 million more likely that he is in fact suffering people might understand? than 1,500 different look at how we can words – contains from logolatry, which is a veneration or But, of course, what we’re trying editions) or the very, increase our definitions for excessive regard for words. to do is to avoid circumlocution (using very sad individual vocabularies approximately 300,000 One does suspect that getting many words where fewer would do), who collects entries which are stuck next to him during a long coach although there is always the sneaking catalogues and labels illustrated by 2.5 journey could become a trifle wearing, suspicion that if one employs words different types of barbed million quotations? and perhaps we could that no one else wire. Our hero will have encountered accuse him of ploitering We’re often understands, it confers It would seem, however, that we 430 different meanings for the word (working for little membership of some have stiff competition from at least set, and struggled through the 400 purpose) although any accused of elite club and bestows one American, the man who, for a pages that define anything and cruciverbalist (a lover of speaking in on the user the hobby, reads dictionaries. A puzzling everything beginning with “un”. But crossword puzzles) technical terms appearance of choice for any bookworm, you may there will be some advantages as well. might, if not envying and polysyllabic superiority and even argue – no plot, no characters (except, He will have emerged from his reading him, at least envy his words and mysticism. a pedant would contest, for the letters as something of an expert on knowledge. These people are themselves of course), no exciting Shakespeare (and in particular Hamlet, However, thanks to phrases, to the known as sesquipedalians dialogue and definitely no dramatic as the OED contains 1,600 quotes his efforts – or more detriment and – which is no more ending – they always just fizzle out on from this one play alone) and will have accurately the puzzlement of than saying they like the last page with something like zyxt wrestled with the longest word in the newspaper article our clients. using long words –and (which in an old Kent dialect means dictionary – pneumonoultra- describing his Why not utilise presumably they suffer “to see”). microscopicsilicovolcanoconiosois (it’s not a achievements – I now from sesquipedalianism. hyphenated word normally but the realise that my dislike of more words with This condition may be Unabridged lines here are not long enough to practising the piano as a fewer syllables, seen as a blessing or a Our man featured in a recent accommodate it!) – which apparently youngster was simply they say? curse, but there is, newspaper article because he had just describes a form of respiratory misodoctakleidism, that my however, the finished reading his latest reference disease, but above all he will have children are absolute experts in advantage that by using elongated, book which had taken him rather appropriated a whole new vocabulary. expalpating, which is simply obtaining scientific or obscure words (or even longer than usual – a whole year, to be things through flattery (“Nice tie, Dad; better, words that are all three exact, because it was the Oxford English Interesting words by the way, could you drop me and my together) we can dress up unpleasant Dictionary, the unabridged version. Presumably, having noted down every friends at the shopping centre this messages by describing them in a way word that he found interesting or morning and lend me another that sounds more technical and Ewan McNeill, BVMS, CertVR, MRCVS, novel during his perusal of the book, tenner?”) and that my grandfather’s impressive. qualified from Glasgow in 1984. He worked in mixed practice for five years he can now casually scatter into his rather unkempt appearance was at least in the Midlands before settling in conversations utterances such as apricity in part due to the fact that he was an ‘Your dog has steatopygia...’ Nottingham where he is joint principal (the warmth of winter sunshine) and autotonsorialist (basically, he used to cut So the next time I see a dog with a of the Castle Veterinary Centre. He lant (the action of adding urine to beer his own hair). weight problem, I can tell the owners was president of the Society of – which somehow makes it stronger), that their pet is suffering from Practising Veterinary Surgeons in although he might require the ability to Few understand... steatopygia (a fat posterior) rather than 2006-07. He has lectured on steer conversations down certain paths Now, it’s not a million miles from just saying he’s overweight; and I will veterinary radiography at a veterinary to use them effectively, or at least in using hippopotomonstrosesquipedalians now rather grandly inform an owner nursing college and also occasionally context. (long words) that few understand the that instead of giving her cat an enema teaches at the veterinary school in He may also have come to envy language vets employ in their daily I will perform an emunction, (which may Nottingham. He is also a consultant for the talents of a deipnosophist (a person lives. We’re often accused of speaking also allow me to charge more for the Anval. skilled in the art of dining – in technical terms and polysyllabic privilege of doing so). VP vol42 07_August 2010 24/08/2010 13:48 Page 13

SEPTEMBER 2010 VETERINARY PRACTICE MUSINGS 13

I am now even familiar with the about a subject in an attempt to is known as onomatomania. OED as being likely to make a hugely impressive word acnestis (the impress. And lastly, we will all be aware that mistake)? Unless you happen to be part of an animal’s back that the We can also use lesser-known at various times in our professional dealing with an amateur lexicographer, animal can’t reach to scratch) and will words as a reason and explanation for career we may find ourselves in an you may find that you’ve impressed be looking to drop it our actions; did you acutely difficult or embarrassing your client so much that they have casually into my next ...we will all be know that lalochezia is position with regard to a clinical case; mistaken your polysyllabic confession consultation on Monday aware that at to use foul or obscene fear not, for one can simply announce as a diagnosis and go away feeling morning. various times in language to relieve that we are in fact involved with a hugely impressed. This technique of our professional stress or ease pain? kankedort (a word which simply means So when I rule the world I am demonstrating bon mots And I thought that any awkward situation). giving serious thought to introducing can usefully be extended career we may when that horse One possible kankedort is when to the veterinary undergraduate to work colleagues as find ourselves in kicked me I was just we find ourselves dealing with a syllabus a compulsory module that well, so that when one’s an acutely swearing mindlessly. gossypiboma, which is a surgical sponge requires students to study, in depth, partner refuses to move difficult or Then there’s the inadvertently left inside a patient the complete, unabridged OED, and with the times and embarrassing instance when one during surgery, a situation that always for two main reasons. update his cruciate really is stuck for a requires delicate handling but at least Firstly, confined in their phrontistery repair technique or position with word; when we, for may sound impressive when discussing (place of study) they’ll spend so much antibiotic therapeutics regard to a those of us who have it with the VDS or a defence lawyer. time reading through the multiple he can be accused of clinical case; fear passed the first flush Another possibility is where the volumes that they will have less time to being a mumpsimus not, for one can of youth, have what is hapless vet has managed to totally miss become gambrinous (full of beer) or instead of rather simply announce sometimes described a blindingly obvious diagnosis for suffer the trauma of abligurition boringly calling him a as a grey-haired some days or even weeks; we can (excessive spending on food or, more stick-in-the-mud who that we are in fact moment, where we are perhaps try and claim to those around likely, drink) or indeed fall into the trap refuses to admit that he involved with a left mentally grappling us that this problem has arisen for all of cacoethes (any bad habit or urge), all is wrong. kankedort... to haul a word from sorts of reasons, but inwardly we have of which are of course absonant the darkest recesses of to confess that it’s come about purely (abhorrent). Ultracrepidarianism our befuddled mind. as a result of our own ignotism (a And secondly, they’ll be ready to Beware, however, of the vet or nurse Perhaps we can regain some mistake made from ignorance). start their professional careers able to who thinks he or she knows it all and credibility by telling our companions Can I suggest that when the penny communicate with clients and offers opinions on matters beyond we have lethologica (that assumes, of finally drops we can, to spare our colleagues alike in a manner that is at their field of knowledge: this is a course, that we can remember it) and, blushes and divert attention from once doctiloquent (learned), breviloquent classic situation of ultracrepidarianism having perhaps garnered some ourselves, announce to the owner that (to the point), suaviloquent (pleasant in and indeed the user may be a sympathy from our listeners, go on to we have finally realised that what we manner) and, of course, absolutely philosophunculist – someone who explain that the feeling of vexation are dealing with is something known straightforward (that’s planiloquent to pretends to know more than they do which follows this brief memory loss as a hamartithia (which is defined in the you and me). Three methods of giving equine pain relief

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14 EVENTS VETERINARY PRACTICE SEPTEMBER 2010

ECC congress in Harrogate Congress is to be held from 27th to [email protected]. Non- and 1st July 2011 at the Historic in November 29th January at Chesford Grange members are welcome. Dockyard, Portsmouth. It is seeking THE annual Vets Now Emergency and Hotel, a four-star manor house hotel contributions and expressions of Critical Care (ECC) Congress will be with 17 acres of grounds in Lectures on allergic skin interest in attending. held on 11th and 12th November at its Kenilworth, Warks. disease The aim of the symposium, which usual venue: the Majestic Hotel, Following the AGM and pre- AVACTA Animal Health is to run a marks the HSA’s centenary, is to present Harrogate. congress dinner on Thursday 27th, the further series of evening lectures by and discuss recent scientific and There is a welcome evening get- congress opens with three streams, Professor Richard Halliwell on allergic technical advances in the humane together on Wednesday 10th which run during Friday and Saturday. skin disease. slaughter of farmed animals, the uptake November when the annual MAD Stream 1 is for new starters who are Entitled “Diagnosis, management and application of these advances (Made-A-Difference) awards will be thinking about going into partnership and treatment of allergic skin disease in around the world, and their relevance to presented. or opening a practice for the first time; the dog and cat”, the events will take current farming methods; to help The clinical programme on the stream 2 is for experienced practice place on: 15th September at the identify future priorities and consider Thursday and Friday has a total of over managers and principals who need to Colchester Ramada Hotel; 16th how these may be tackled; and to 40 hours of CPD. look ahead to marketplace trends and September at the Marriott Hotel, provide a forum for sharing information More than 40 companies are taking to stimulate new thinking; and stream 3 Peterborough; 29th September at the and experiences. part in the commercial exhibition. The combines personal development on Heathrow/Windsor Marriott in Langley, Speakers already committed include social programme includes a Friday and team development on Berks.; and 30th September at the Dr Temple Grandin of Colorado State Hollywood-style dinner on the Saturday delivered by a business and Glasgow veterinary school. University, Dr Andrea Gavinelli of the Thursday night entertained by a live life coach. All events start with a hot food European Commission and Jia Zili, band, The Magnets. Delegates will be able to move buffet at 7pm and end at about 9.30. director of the Beijing Chaoyang Anhua The full programme is on the between streams as they wish or follow The evening comprises two hours of Animal Product Safety Research website www.vets-now.com and the stream that best meets their needs. certificated CPD, is open to both vets Institute. registration can be completed on-line. The speakers include leading and nurses and costs £20 (plus VAT) The HSA would like to hear from consultants, industry experts and vets per person. those who would like to contribute an Three streams at VPMA who have built up their own practices To book, use the form on oral or poster presentation on any congress in January from scratch. www.animal-allergy.com or call 0800 aspect of the humane slaughter of THE 2011 Veterinary Practice For the first time in some years 8494 550. livestock, or who are interested in Management Association (VPMA) there will be a commercial exhibition. attending. The social programme includes a Symposium next June on Details of how to submit a Veterinary Practice welcomes banquet on Friday. welfare at slaughter presentation abstract can be seen on the information on future events for Delegates can register or request THE Humane Slaughter Association HSA website (www.hsa.org.uk) along inclusion in these columns. Please note further information about the congress (HSA) is to hold an international with further information about the that copy closes on the 14th of each by calling 01727 859259 or by sending symposium on Recent advances in the symposium; or contact Heather Barker month for the following month’s issue. an e-mail to welfare of livestock at slaughter on 30th June at the HSA, e-mail [email protected]. VP vol42 07_August 2010 24/08/2010 13:48 Page 15

SEPTEMBER 2010 VETERINARY PRACTICE EVENTS 15

Pet Smile Month again The association reports that a SEPTEMBER is, once again, Pet Smile number of the workshop sessions – Month (PSM) when participating including Ultrasound for nurses, Canine practices carry out free dental checks as aggression and Physiotherapy part of a campaign to promote dental techniques – are already sold out. health in pets. The BVNA is introducing a new Nominations wanted for Pet “Pet Smile Month is all about scanning system and all delegates will relieving pain and suffering in pets and have a barcode printed on their Insurance Advisor Award educating owners on the importance of conference badge so that they can be PETPLAN is calling for nominations for this year’s Petplan Pet dental care for pets,” says Bob Partridge, scanned into lectures, enabling the Insurance Advisor Award, in association with Veterinary Practice. the founder of PSM. “It also highlights BVNA to provide evidence of This award recognises the hard work and dedication that Pet the caring nature of the profession and attendance at each lecture that a Insurance Advisors (PIAs) do to highlight the importance of insurance provides practices with an opportunity delegate attends for CPD purposes. to pet owners so that they are protected financially. You can nominate to promote the n For details see www.bvna.org.uk. range of services a PIA at your practice by visiting www.petplan.co.uk/pia. they offer.” Cardiology seminar Pet owners often look to vet nurses to help understand veterinary PSM is CEVA Animal Health is hosting a free procedures and for advice about treatment and medication but supported by cardiology seminar in Milton Keynes on increasingly they also look for advice about insurance, and that is why Petosan, Genitrix, Wednesday 29th September featuring it is important that a formally trained member of staff is available to Ceva, Kruuse, Mike Martin, an RCVS specialist in answer customer queries when it comes to pet insurance. NVS, Centaur, veterinary cardiology. Petplan works with over 4,000 veterinary surgeries throughout the Dunlops, VSSCo and IGP, with Kruuse Entitled Therapy of adult congestive UK to promote pet insurance. These are Appointed Representative donating an iM3 42-12 dental scaler as a heart failure in dogs: a practitioner’s guide, the (AR) practices who receive training and certification to speak about prize for the best waiting room display. seminar will provide up-to-date specific insurance policies. The PIA scheme is an extension of this: n For more information, go to the vet information on the treatment of AR practice staff can train to become a dedicated Pet Insurance area on www.petsmile.org. acquired heart failure in practice. Start Advisor by registering on www.petplan.co.uk/pia. time is 8pm with a finger buffet and Becoming a PIA allows you to earn valuable CPD points whilst London Vet Show in October refreshments available from 7.15pm. developing transferable skills such as confidently promoting products THE organisers of the London Vet n To book e-mail and handling client objections. Show (LVS), to be held in London [email protected]. Fiona Andrew, a veterinary nurse at Tay Valley Veterinary Centre in Olympia’s National Hall on 22nd and Perth who won the Petplan Pet Insurance Advisor Award 2009, 23rd October, report that Dr Rick Equine nutrition workshop highlights the benefits of the scheme. LeCouteur from the University of THE fifth European workshop on “When pet owners are thinking about their pet’s future, they need to California will be the leading equine nutrition is to be held at the consider pet insurance. An insured pet owner can explore the full range international speaker at the event, Royal Agricultural College in Cirencester of veterinary diagnostics and treatment should their pet fall ill or be focusing on neurosurgery in small from 21st to 23rd September. injured. Encouraging owners to invest in pet insurance early on in their animal veterinary practices. The theme of the meeting, pet’s life can ensure a stress-free future. The PIA scheme offers good His research interests include brain organised by the British Equestrian advice about the basics of insurance which are easy to understand for tumours and neuromuscular disease Trade Association, is the impact of with over 30 years experience in small nutrition on health and welfare of the vet nurses. This information can then be simply conveyed to clients.” animal neurosurgery working in horse, with the aim of facilitating Petplan marketing manager, Alison Andrew, says, “At Petplan we Australia, America and Europe. His discussion between equine nutrition are proud to recognise the dedication and hard work that Pet subjects at the event will include scientists and to create a bridge between Insurance Advisors put in to give their customers informed and up-to- neurological examinations and the use scientists, practitioners and the horse date advice. So please get your nominations in!” and misuse of glucocorticoids. industry. To nominate your dedicated PIA for Petplan’s PIA Award, please A third clinical lecture stream is n For details see www.ewen.vet.ed.ac.uk. visit petplan.co.uk/pia. The PIA of the Year will receive a new laptop being introduced and will include and the practice will receive £100 in vouchers. speakers such as Alex German, Susan Abuse in people and animals Nominations close on 12th September and the nominees will be North, Danielle Gunn-Moore, Simon PATHOLOGY of abuse in animals and judged by industry professionals. The winner will be announced at the Girling and David Church. The clinical humans is the subject of a meeting to be annual BVNA congress on 9th October. programme is being arranged by the held at the Royal College of z For more information about the PIA scheme please visit RVC. Pathologists in London on 13th January www.petplan.co.uk/pia. The business lecture programme next year. will also be running again with speakers The symposium will discuss trauma such as Alison Lambert of Onswitch, in humans and animals with special Dr Mark Johnston of Vetstream and reference to non-accidental injuries. Alan Robinson of Vet Focus. Similarities and differences will be The LVS, organised by Closerstill explored. Media Healthcare, was launched last The meeting is aimed at medical and year when it attracted 1,977 delegates veterinary pathologists, paediatricians and over 100 exhibitors and clinicians and is also expected to be By the middle of last month, more of interest to medical clinicians, than 1,800 delegates had booked and practising veterinary surgeons, police over 200 companies had reserved officers and members of animal welfare exhibition space. and child protection organisations. n Details are on Speakers include Professor John www.londonvetshow.co.uk. Cooper and Mrs Margaret Cooper, Dr John Clark, Dr David Bailey, Dr Nursing congress next month Stephen Leadbetter, Dr Linda Teebay, THE 2010 congress of the British Paula Boyden, Dr Heather Piper and Dr Veterinary Association (BVNA) is to be Fiona McEwen. Petplan PIA 2009 (from left): zoologist and wildlife photographer Mark held from 8th to 10th October at the n Details are on Carwardine, Petplan business developer Howard Brown, PIA winner Fiona Kettering Conference Centre. www.rcpath.org/conferences. Andrew and the then president of the BNVA, Bonny Millar. VP vol42 07_August 2010 24/08/2010 13:49 Page 16

16 VIEWPOINT VETERINARY PRACTICE SEPTEMBER 2010 Time to consider how private veterinary practice is structured THERE has been much hand- latter by a qualified veterinary nurse. of us to do our utmost to wringing since that Panorama Both instances appeared ugly and act in a calm, measured, programme went out on TV and I unprofessional but if one assumes that respectful and, dare I say, believe that some of the individuals they were the worst cases of animal professional manner. “featured” on the screen have been treatment in all the months of But let us not forget that called to account by their employers. undercover filming that took place, then we are all human and although This is right and proper; when I think that the profession can take the animals concerned in the someone is accused of wrongdoing some comfort from that fact. aforementioned cases experienced a they should account for It implies that there degree of physical and/or mental pain, their actions and a could have been hour there was no suggestion that they had clamps down hard on any proven decision can then be PERISCOPE after hour of film suffered any long-term effects. cases of fraudulent activity. That will made as to the continues the series showing vets and Let’s turn now to the matter of punish the guilty and hopefully appropriate course of of reflections on issues nurses behaving in a recommending inappropriate persuade those of somewhat “flaky” action. However, the of current concern very caring manner if procedures (e.g. a follow-up MRI scan professional integrity to think again. kind of threats to an the intention had been at huge expense for a dog with Much more though, we need to individual’s safety that to make a balanced secondary lung tumours already consider how private veterinary have reportedly occurred as a result of programme – which it clearly was not. diagnosed on x-ray); and the apparently practice is structured and in many the screening have no place in resolving dishonest act of splitting up a client’s cases stop trying to be all things to all any of the issues raised. Rewarding – but frustrating... bill into several separate ailments in men and all animals, particularly in Moving on now that the dust has Working in veterinary practice can be order to maximise a heavily populated settled, it is perhaps a good time to very rewarding but it can also be claim on pet insurance. Perhaps we need urban and suburban look at what was portrayed in a more frustrating. Animals don’t always co- This appeared to me to start thinking areas. balanced way and try and tease out operate fully with what we want to do nothing more than whether it really Perhaps we need what it really tells us about the to them and I have to say there have profiteering and has no is in the animals’ to start thinking profession. been times when vicious cats and dogs place in a profession whether it really is in So what were the main issues? have genuinely scared me. where the mutual trust best interests for the animals’ best Looking from the animal care I would also add that there are a between client and vet is just about every interests for just perspective there were two things that I, handful of occasions when I’ve not paramount. In such vet to offer a about every vet to and I suspect most of the viewing been particularly proud of the actions cases one can only complete medical offer a complete public, found disturbing. The first was I’ve thought it necessary to take in squirm and say that the and surgical medical and surgical the issue of the two unqualified nurses order to get the job done. perpetrators deserve all service. trying to insert an intravenous cannula Looking back I don’t think that I that they get. service. Why don’t some into a dog’s front leg. would have wanted an undercover The problem, of (more) instead start camera filming me and then putting it course, is that pieces of kit like MRI offering more of a primary Two-fold problem on show without giving me the scanners cost an absolute fortune and care/minor surgical intervention The problem here was two-fold. Firstly, opportunity to put what happened into have to be used frequently in order to scenario with referral on to the why were inadequately trained some sort of context. justify their existence. practice up the road for more major personnel asked to carry out the I am not condoning, excusing, or interventions? procedure in the first place? And, why defending such action, merely trying to Great temptation That way those practices with was the supervision and/or the offer a rational explanation of how it The temptation to use them whenever expensive equipment will get a higher instructions given so inadequate that can come about. When we get bitten or possible (and not just when they are throughput of cases that really merit those persons concerned did not know scratched we can get angry. If an genuinely needed) must be very great such interventions and there will be when it was time to desist and ask for animal pulls its leg away before all the – particularly in the current world of far less temptation to use them purely more qualified assistance? anaesthetic has been injected, it can practice where there is still very little because they have to somehow be In my experience, look messy and differentiation between most first and paid for. even in the busiest ...if one assumes incompetent and we second opinion veterinary practices We should not beat ourselves up practices, there is always that they were might say inappropriate (high-powered referral practices as a profession because of this time for a vet or qualified the worst cases things. excepted). programme. Instead, let’s see it as an veterinary nurse to of animal Of course, good Everybody is clamouring to do opportunity to reorganise the intervene in such sedation and competent anything and everything which means profession into something a little bit circumstances and indeed treatment in all restraint can help there is a lot of underused kit out more fitting for the 21st century but it is their duty to do so. I the months of minimise such instances there which somehow has to be paid which still retains its deserved think it is very hard to undercover but those of us who for. reputation as one of the most caring come up with any defence filming that took have worked in small What is the answer? Certainly a and trustworthy professions in the to what appeared to place, then I animal practice for any strict disciplinary process which world. occur. length of time will have The second issue was think that the experienced events that In case you missed the broadcast, here is an extract from the BBC’s website: that of the inappropriate profession can we would rather forget. “Panorama sent a reporter undercover for nine months to work as a trainee at one handling of the semi- take some Our reaction to of the country’s largest veterinary chains. Alex Lee worked at Medivet, with an anaesthetised cat and the comfort from such events is the key estimated annual turnover of £20m, and found evidence of both questionable bills Shar Pei dog, the former I issue here and it is up and unqualified junior staff performing medical procedures.” The hour-long programme was shown on BBC1 on 22nd July. believe by a vet and the that fact. to each and every one VP vol42 07_August 2010 24/08/2010 13:49 Page 17

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18 YOUNG GRADUATES VETERINARY PRACTICE SEPTEMBER 2010 Wake me up when September ends... A DEFICIENCY of ideas for the just how much we had both developed. benefit clinical decisions in the future. have followed my “new graduate” title and indeed the content of this Twelve months ago we were And as difficult as they are at the series and I will continue to write of article led me to tune in to my discussing, “Were we taught to use this time, complications make you a better the stories I come across but feel the newly-installed Sky HD and the medication or that medication for this vet as you learn to deal with the time has come to pass that mantle to classic film American Pie for (common) condition?” compared to unexpected, which makes you refer someone younger, fresher and inspiration. now where the topics are, “I have back to underlying physiology, anatomy hopefully not much better looking than The fact that this was exhausted all the and pathology in order to cope with me! marketed as a classic common conditions the encountered complication. It was Einstein who said that “the made me feel, at the and have followed only source of knowledge is tender age of 24, past these steps and Develop continuously experience” and I wish all of the recent my prime. This was wonder if you have Experiences good and bad help you ’10 graduates the best of luck in their accentuated by having any other ideas from improve and develop to continuously first few weeks and months in practice the opening scenes your experience,” and, raise the bar of your standard of developing that experience. interrupted by a friend “In your experience...” practice – what makes you a good vet In the same way I look forward to of mine who was These changes is your ability to take things hard when developing in the same way I have seeking advice during show that in the last it doesn’t go right as it shows you care. done in the first 12 months for the rest his first night on call 12 months we have I am told it affects you less as you of my career. reminding me that I RICHARD SANDERSON seen so much and grow older but still always affects you. And from one great philosopher to was no longer a new concludes his series on learned so much as a When it doesn’t, it is surely time to another in Oz from American Pie: “After graduate; the adapting to life result. I was speaking retire from the profession! this everything is going to be emergence of the outside university with to one of the I would like to thank all those who different.” recent cohort of 2010 a look back on his first receptionists in my graduates making me, year in practice new workplace today a 2009 graduate, no who was describing a PRIZEWINNERS longer the newest age cow with the n John Auld of Aspinall, Auld & Stevenson in Quedgeley, Glos., has won the of the profession. symptoms of August-bag. She was able first prize in Vétoquinol’s recent Ipakitine competition. The competition Just prior to tuning in for some to describe the signs the farmer had involved answering three questions on the diagnosis of a cat with chronic renal inspiration I was sorting out the given her and associate these with the insufficiency. Mr Auld won £500 worth of vouchers. paperwork for enrolment onto the condition and had already got the The second prize of £300 worth of vouchers went to CertAVP programme, having medication out that she thought I Caroline Webber of Highcroft Vet Group in Whitchurch, completed my PDP a few months ago. might want. Bristol; Rebecca Bates of MM Leggett Vets in Anstey, I was discussing the programme and Everything she said was absolutely Leicester, received the third prize of £200 worth of details with a fellow ’09 graduate friend correct and this shows just how much vouchers. of mine who is also enrolling and experience can teach us all and how n Tania Parsons, a final-year student at Liverpool, won specifically we were looking at the much we get from being in the cases’ this year’s Dechra Veterinary Products Dermatology request for our CPD record. environment. Prize, which is awarded to the student who has displayed Part of the CPD can be self- She was mindful to point out that the greatest aptitude for veterinary dermatology. certified clinical discussion limited to a she knew she was not a vet and that of Tania received Debenhams vouchers to the value of John Auld. maximum 10 hours per annum, a course clinical decisions are the £450. She has since graduated with distinction and has joined Alfold Veterinary figure we were both confident we had exclusive domain of us, but in my Surgery in Cranleigh, Surrey, as a veterinary assistant. exceeded in these first 12 months in opinion quality experienced support n Robert Newcombe, a senior veterinary surgeon at the PDSA Plymouth PetAid practice just speaking to each other staff, which I am lucky to have had in Hospital, has won a £50 Marks & Spencer gift voucher in the recent survey about difficult cases: long-standing my time in practice, can be worth their carried out on vetsurgeon.org by Swann-Morton. medical cases more suitable to be weight in gold, especially in those early The company reports that over 57% of respondents stated that they had approached by Gregory House and his stages of your career. always used Swann-Morton blades but had a low awareness of the website at team, unique surgical challenges, and www.swann-morton.com and the fact that there was a dedicated Veterinary complex herd health problems, to Underpinning knowledge section. name just a view. This is evident in everyday practice as n Five veterinary surgeons have won a Selekt cattle As I continued to write this article whilst all we do is based on our under- pump worth £240 for their practices. Vétoquinol to the backdrop of American Pie I was pinning knowledge from our offered the opportunity to win the pumps in return reminded of the progression of each continuing education (university, PDP, for a short case study on their experiences with of the characters through each sequel CPD), every decision we make is based Marbocyl 10% when treating acute mastitis. developing and progressing from their on the clinical experience of ourselves The winners were: Tom Henderson (pictured) of experiences; and from that drew and our colleagues within our practice Beacon Vet Centre in Aspatria, Cumbria; Ben parallels to us as a year group of 2009 and further afield; the advent of Sapsford of Tithe Barn Vet Centre in Kirkby graduates. mobile telephones, internet and Lonsdale; Tracey Taylor of Oakhill Vet Centre in The discussion with one of my mobile-internet making keeping in Preston, Lancs.; John Moore from Co. Westmeath; fellow ’09 graduates earlier in the touch much easier. and Gerard Lahart from Ballinasloe in Co. Galway. evening focused on some rather And in these short 12 months it is The company reports that the five case studies complex and involved cases and I only when talking to fellow ’09 showed a clinical cure rate of between 75 and 100% looked back to think what we were graduates and comparing to discussions when treating up to five cows in herds of between discussing 12 months ago and realised with friends who are recent ’10 100 and 160 with Marbocyl 10%. graduates that it becomes apparent that Richard O. Sanderson, BVSc, MRCVS, we have seen and done more than we FRONT-OF-HOUSE AWARDS JUDGING IN PROGRESS graduated from Liverpool in 2009. probably appreciate. Judging is now in progress of the entries received in the 2010 Front-of-House After a year in mixed practice in It is grounding still that you then Awards being run by Veterinary Practice in association with Royal Canin. The Shropshire he moved to Staffordshire discuss cases with more experienced organisers wish to the thank the many practices which entered for the time and where he is again in mixed practice. He members of the profession within the trouble they took. Judging should be completed by early October and the results can be contacted on practice or referral centres and realise [email protected] will be announced as soon as possible afterwards. just how much further experience will VP vol42 07_August 2010 24/08/2010 13:49 Page 19

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20 CARDIOLOGY VETERINARY PRACTICE SEPTEMBER 2010

also describe a step-by-step protocol European Journal of Companion Animal Through the literature for performing pericardiocentesis in Practice 18 (2): 145-148. companion animal practice. (reprinted from Pratiques Medicale et Clinical and post mortem findings eight years or over. The authors Veterinary Medicine 105 (5): 218-226. Chirurgicale de l’Animal de Compagnie 42 in dogs with chronic congestive propose annual screening by Holter (3): 123-130) heart failure examination for all dobermanns starting Increased cardiac troponins in Torkel Falk and others, University of at two years old. serum from a cow with tricuspid Innervation of the mitral valve Copenhagen Journal of Veterinary Internal Medicine 24 endocarditis and its association with valvular Intra-myocardial arterial narrowing, (3): 533-538. Sebastien Buczinski and Anne- disease in dogs along with myocardial fibrosis and Marie Belanger, University of Geoff Culshaw and others, atrophy, are common findings in dogs Mutations associated with Montreal University of Edinburgh with naturally occurring congestive hypertrophic cardiomyopathy in Bacterial endocarditis is a common Anatomical studies in several species, heart failure. Arterial narrowing has Maine coon cats condition in cattle, which present with including humans, have shown that the been linked to myxomatous mitral valve Gerhard Wess and others, Ludwig signs of a chronic infectious process, tissues of the heart valves have a nerve disease but little is known about the Maximillians University, Munich undulating fever and a heart murmur supply which appears to have a role in clinical significance of these lesions. Hypertrophic cardiomyopathy is the but normally without specific signs of valve function. If the same is true in The authors sought to correlate most common inheritable heart disease cardiac disease. The authors describe dogs then it is possible that changes in defined pathological findings with the in cats and two specific mutations in the first indication that raised troponins, innervation plays some part in the clinical features, including the results of the myosin binding protein gene have reliable biomarkers for heart disease in development of mitral valve disease. echocardiography and electrocardio- been identified as the cause of the humans, are also useful indicators of The authors examined tissue from 11 graphy scans, in 58 dogs. Detailed post condition in the Maine coon breed. The disease in this species. The patient was dogs of varying ages. Nerve fibres were mortem examinations showed that authors investigated the prevalence of a three-year-old Holstein in which present in the valves of all dogs but arterial narrowing significantly the A31P and the A74T mutations in transthoracic echocardiography showed innervation declined with age. All dogs correlated with fibrosis and with 83 Maine coon and 68 cats of other thickening of the tricuspid valve. Its over five years had some signs of mitral fractional shortening, an indicator of breeds. Their findings show that serum cardiac tropinin 1 level was valve changes which preceded the loss systolic function. The fibrosis grade currently available tests for these two raised at 3.52ng/ml. of nerve fibres. correlated with survival time. This study polymorphisms are of limited clinical Canadian Veterinary Journal 51 (2): 195- American Journal of Veterinary Research 71 supports the hypothesis that chronic value as the mutations have a low 197. (2): 194-202. congestive heart failure in dogs is penetrance and even homozygous cats affected by several factors including can remain healthy. Cardiogenic arterial thrombo- Effects of lidocaine on mitral valve degeneration, myocardial Journal of Veterinary Internal Medicine 24 embolism causing non- cardiovascular function in atrophy and fibrosis, and by (3): 527-532. ambulatory tetraparesis in a cat isoflurane anaesthesia in horses arteriosclerosis. Danielle Bowles and others, Alex Valverde and others, The Veterinary Journal 185 (1): 68-74. Assessment of spironolactone Veterinary Specialist Group, University of Guelph dosage needed to treat canine Auckland, New Zealand Injectible anaesthetic agents such as Electrical cardioversion of congestive heart failure Arterial thrombo-embolism is a lidocaine may reduce the amount of sustained tachycardia in three Jerome Guyonnet and others, Ceva common consequence of cardiac isoflurane anaesthetic needed during boxers Animal Health, Libourne, France disease in cats and will usually cause equine surgery but may have unwanted Robert Prosek, University of Florida Spironolactone is a useful drug in paralysis or paresis affecting only the cardiac effects and also influence Boxer dogs are predisposed to treating congestive heart failure through hindlimbs. The authors describe what recovery. The authors compare the ventricular arrhythmias and sudden its effects in blocking the hormone they believe to be the first case of effects on cardiovascular function and death. Electrical cardioversion using a aldosterone, resulting in increased tetraparesis secondary to heart disease quality of recovery of lidocaine given biphasic defibrillator is a common excretion of sodium in the urine and in a cat. The one-year-old oriental had alone or in combination with procedure in human cardiac cases and decreased potassium losses. It has been sudden onset flaccid paralysis and medetomidine. Their findings show was used by the author in treating three used empirically in veterinary patients vocalisation. An echocardiogram that a constant rate infusion of boxers with sustained ventricular without specific data on its revealed severe restrictive lidocaine and medetomidine did not tachycardia. After the failure of pharmacokinetic and pharmacodynamic cardiomyopathy and spontaneous adversely affect cardiovascular function pharmacological cardioversion, the properties. The authors measured the echogenic contrast. Clinical findings and produced a smoother recovery three were treated with equipment effects of spironolactone at different suggested multi-site thrombo-embolic than lidocaine on its own. delivering 30 J of energy during the doses in blocking endogenous disease, which was confirmed post Equine Veterinary Journal 42 (3): 192- peak of the QRS complex. One case aldosterone in beagles. They conclude mortem. 199. required a second procedure but the that 2mg/kg bodyweight once daily is Journal of Feline Medicine and Surgery 12 results and follow-up show that the an appropriate management dose. (2): 144-150. Comparison of ventricular treatment was safe and effective. Journal of Veterinary Pharmacology and function in small, medium and Journal of the American Veterinary Medical Therapeutics 33 (3): 260-267. Mitral valve disease in a large large dogs Association 236 (5): 554-557. breed dog Hiroshi Takano and others, Azabu Recognising and treating Eric Bomassi, Cordeliers Veterinary University, Japan Age prevalence of dilated pericardial disease in companion Hospital, Meaux, France Two dimensional speckle-tracking cardiomyopathy in dobermann animals Mitral endocardiosis is a chronic echocardiography is a novel technique pinschers Mark Olcott and Meg Sleeper, degenerative disease of the mitral that provides a non-invasive, angle Gerhard Wess and others, Ludwig Animal Emergency & Critical Care valvular apparatus. The condition is independent method for assessing left Maximillians University, Munich Center, Leesburg, Virginia usually observed in aged male dogs of ventricular systolic function. The Dilated cardiomyopathy in dobermann Pericardial disease is an uncommon but small breeds but it does also occur in authors used this technology to pinschers appears to be an autosomal potentially life-threatening condition in larger breeds. The author describes a compare left ventricular contraction inherited disease for which the specific cats and dogs. The clinical signs can be case in a 13-year-old saluki which profiles in different dog breeds. They mutation has not yet been identified. easily overlooked or mistaken for other presented with lethargy and difficulty found that several systolic indices were Data on the age-related prevalence of disease processes. Successful treatment breathing. The clinical, radiographic and decreased in large breed dogs the disease would help in developing depends on rapidly diagnosing and echocardiographic findings are compared with small and medium- screening programmes and so the managing cardiac tamponade and so described and these show a different sized animals but say this should not authors carried out 775 examinations of preventing the development of elevated pattern of valvular insufficiency to that be interpreted as a sign of decreased 412 animals. The cumulative prevalence intrapericardial pressure. The authors described in small dogs. Further studies systolic function. was 58.2%, ranging from 3.3% in one- discuss the aetiology, diagnosis and may confirm whether the underlying American Journal of Veterinary Research to two-year-olds to 44.1% in those aged treatment of pericardial disease. They disease processes are different. 71 (4): 421-427. VP vol42 07_August 2010 24/08/2010 13:49 Page 21 Nelio®...tailor-made benazepril

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1. Gfk data January 2010 2. King JN & Font A (2002) Effect of benazepril in chronic renal insufficiency in cats: Interim results from the Benric clinical trial WSAVA Congress 3. The Bench Study Group (1999) The effect of benazepril on survival times and clinical signs of dogs with congestive heart failure: Results of a multicenter, prospective, randomized, double-blinded, placebo-controlled, long-term clinical trial Journal of Veterinary Cardiology 1 (1) pp 7-18 Science is improved understanding

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Advertorial Two New Publications Discuss the Use and Benefi ts of Spironolactone in Dogs Fraser Broadfoot BVetMed GPCert(SAP) MRCVS

This article summarises two new publications that discuss the clinical benefi ts of giving spironolactone (Prilactone®, CEVA Animal Health) as part of fi rst-line therapy to dogs with congestive heart failure caused by mitral valve disease.

Effi cacy of Spironolactone on Survival in Dogs with Naturally-occurring Aldosterone receptor antagonists – how cardiovascular actions may Mitral Regurgitation Caused by Myxomatous Mitral Valve Disease. explain their benefi cial effects in heart failure. Bernay, F., Bland, J.M., Häggström, J., Baduel, L., Combes, B., Lopez, A., Kaltsatos, Ovaert P., Elliott J., Bernay F., Guillot E., Bardon T. (2010), Journal of Veterinary V. (2010), Journal of Veterinary Internal Medicine. In Press. Pharmacology and Therapeutic. In Press.

The aim of this study was to determine the clinical effi cacy of spironolactone This paper summarises the mode of action of spironolactone which, as an for dogs with mitral valve disease when added as part of fi rst-line congestive aldosterone antagonist, has traditionally been classifi ed only as a potassium- heart failure therapy. 212 dogs were enrolled onto the study and were sparing diuretic. However it has now been discovered that aldosterone plays randomised, under double blind conditions, to receive either spironolactone a pivotal role in many other pathogenic processes involved in the progression or placebo. All dogs also received an ACE inhibitor and other authorised of heart failure, including myocardial fi brosis, see fi gure 2. treatments included furosemide, digoxin and L-carnitine. The study was continued for 15 months and the following end-points were recorded:

• death or euthanasia due to heart failure (mortality) • severe worsening of heart failure (morbidity), defi ned as the need to introduce an unauthorised cardiac therapy or to increase the dose of furosemide over 10mg/kg/day to prevent life-threatening oedema

By the end of this period, 10.8% of dogs in the spironolactone group reached the end-point (death, euthanasia and severe worsening) versus 25.5% of dogs in the placebo group. This represents a 55% reduction in the risk of cardiac morbidity-mortality (p = 0.017), see fi gure 1, and an even greater 69% reduction in the risk of mortality (p = 0.0071).

Figure 2: Myocardial subendocardial and interstitial fi brosis; areas of fi brosis (collagen) are coloured in blue. Photo. I. Raymond-Letron National Veterinary School of Toulouse, France.

In human patients, the development of myocardial fi brosis has been shown to cause abnormal myocardial stiffness, leading to ventricular diastolic and systolic dysfunction and ultimately to progression of heart failure. In recent studies, Falk et al. (2006/2007) showed that dogs with congestive heart failure had signifi cantly more myocardial fi brosis than control dogs and the higher the degree of fi brosis then the shorter the survival time.

Aldosterone antagonists, such as spironolactone, help to prevent myocardial fi brosis and this helps to explain their marked benefi cial effects on reducing the risk of mortality in dogs and people with heart failure. Figure 1: Survival curve for dogs receiving spironolactone (Prilactone®) versus those receiving placebo (end point = death/euthanasia and severe worsening due to cardiac disease)

These results were highly statistically signifi cant and support the use of For further information about how Prilactone® can be incorporated into your Prilactone® as part of fi rst-line therapy for the treatment of dogs with heart failure treatment regimes, please contact Fraser Broadfoot MRCVS by congestive heart failure caused by mitral valve disease. telephone on 01494 781510 or by email at [email protected].

Other references Falk, T., Jönsson, L., Olsen, L.H., Pedersen, H.D. (2006), Arteriosclerotic changes in myocardium, lung and kidney in dogs with chronic congestive heart failure and myxomatous valve disease, Cardiovascular Pathology, 15, p185- 193. Falk, T., Jönsson, L., Olsen, L.H., Tarnow, I., Pedersen, H.D. (2007), Correlation of cardiac pathology and clinical fi ndings in dogs with naturally occurring congestive heart failure. Abstract. Proceedings of the 17th annual ECVIM congress. Budapest Hungary, September 13th -15th. Abstract 23.

09:08 VP vol42 07_August 2010 24/08/2010 13:49 Page 23

SEPTEMBER 2010 VETERINARY PRACTICE CARDIOLOGY 23 Building up a knowledge base LISTENING to the dog’s chest, the clinical research in which he believes “But even if it turns out to be the whistling murmur of early mitral studies can be broadly classified into best thing since sliced bread in cardiac valve disease is clearly apparent. But two categories: “top up” and “top disease diagnosis, it won’t do much to lots of small dogs have audible down” research. raise the overall standard of veterinary murmurs with no clinical relevance. The former includes research into care in this country if there are only 10 So will this one go on to develop advanced imaging methods such as the people who have access to the severe disease – or will it expire as a promising new technique of 3D equipment and know how to use it.” result of other causes, long before echocardiography or novel MRI-guided So the efforts of Adrian and his its valve function interventional research team have focused on degenerates enough procedures. Such developing the sort of tests that can to become life- methods are developed easily be adapted for use in a typical threatening? by those at the top of practice laboratory. They have been For general the pyramid of looking at the value of biochemical practitioners, the expertise in any markers, such as natriuretic peptides absence of any reliable talks to Adrian particular discipline including N-terminal pro-BNP, which Adrian Boswood. prognostic indicators is Boswood at the Royal and will mainly be used have already been shown to have probably the most Veterinary College by their peers. potential in monitoring human cardiac there is evidence for an earlier onset frustrating aspect of about his work on The techniques will patients. and more rapid progression than in dealing with many mitral valve disease make those people “What we want is a test, or more other breeds. common heart and other heart who are already expert likely a sequence of tests, which will The team has recently published the conditions, according to problems in their discipline even help us to stratify our patients into first of what they hope will be many veterinary cardiologist better but they are different risk groups and to treat them scientific papers generated by this Adrian Boswood. unlikely to be of accordingly.” project. “The longer that you study a So the goal of his research at the immediate benefit to less experienced disease, the more accurate will be the Royal Veterinary College is to build up clinicians working to develop their skills Better understanding needed picture that you build up of how it a knowledge base which will allow in general practice, he points out. But to underpin this work, there is a behaves. The study is currently colleagues to identify and focus their “Top down research would include need for a better understanding of the supported by the Pet Plan Charitable attention on those patients that will the studies that will create the evidence natural history of the disease. Adrian Trust and the grant has another 12 benefit most from careful monitoring to show which therapy is best, and at points out that most studies on months to run. When that finishes we and appropriate treatment. what particular stage in the conditions like mitral valve disease are will be very keen to secure further Professor Boswood works at the development of the disease it should be conducted retrospectively or as cross- funding to continue this work.” Queen Mother Hospital for Animals, given. It also includes the studies which sectional studies, in which researchers home to the largest assembly of talent will produce reliable diagnostic and will usually see the animal only once. Lead investigator in the field of veterinary cardiology in prognostic tests that can be used in Neither gives an opportunity to observe As well as providing practitioners with a the country. In addition to Adrian general practice, which is something how the disease progresses in that better understanding of how the himself, there are three other holders of that we don’t always have at the particular individual animal. disease may progress in different the European diploma in that particular moment, even for some of the So for the past five years, with the patient groups, Adrian’s research discipline: David Connolly, Virginia commonest conditions that we see.” help of two PhD students, he has been interests focus increasingly on Luis Fuentes and Simon Dennis. following a cohort of dogs at the treatments for this very common So there will always be a diplomate Developing techniques Beaumont Animals’ Hospital and the condition. on duty at the hospital to oversee the Both these types of research are Blue Cross in Victoria. These dogs Although many different medical work of the clinical students and the important. “It is important,” he says, undergo a full examination every six therapies have been tested in canine two cardiology residents in the “to develop techniques like 3D months. To date, around 200 dogs have mitral valve disease prior to the onset department. echocardiography. Unlike CT, for been recruited, some have since died as of heart failure, there is no unequivocal Those clinicians have access to all example, this method can be performed a result of their cardiac disease or evidence that any one of them the latest technologies – in a fully conscious animal, which is unrelated conditions but there are many improves outcomes for patients. echocardiography, fluoroscopy, CT and important when you are looking at the that remain from the original sample. So Adrian has been appointed as MRI – when dealing with the difficult effects of a disease which would be These dogs are from a wide range the lead investigator for a major study cases which present at the hospital as altered if you have to use general of breeds but around a third are being supported by a multi-national secondary or tertiary referrals. The anaesthesia or even sedation. Cavalier King Charles spaniels, in which animal health company. The study is a same hospital runs an out-of-hours’ good example of the increasingly global emergency service for about 20 local nature of veterinary research and it is practices and a first opinion practice at hoped that it will involve about 36 the Beaumont hospital in Camden researchers on four continents. Town. When it is completed the study may help to provide unequivocal evidence of Routine cases the benefits of treatment, something This creates the steady stream of that is still relatively uncommon in any routine cases needed to ensure that branch of medicine. students are properly prepared for the Veterinary scientists around the sort of caseload that they will face on world are also looking into the genetic graduation. But it also provides the factors that determine the progression clinical material needed for Adrian’s of a disease in which very few other clinical research projects. predisposing factors have been A 1989 graduate of the Cambridge identified to date. school, Adrian spent a year in mixed Jens Häggström, a Swedish practice before being accepted on the veterinarian from the University of RVC’s intern programme and has Uppsala and someone with whom remained there ever since. During that A right parasternal long axis echocardiographic view demonstrating a large Adrian regularly collaborates, is leading time he has developed a theory about mitral regurgitation jet. an investigation to try and identify VP vol42 07_August 2010 24/08/2010 13:49 Page 24

24 CARDIOLOGY VETERINARY PRACTICE SEPTEMBER 2010 Mitral valve disease in practice THE diagnosis and treatment of Dr Patteson started by emphasising then this may suggest that congestive echocardiography. mitral valve disease was the title of the importance of the clinical heart failure is on its way. Radiography is a useful way of this fascinating evening talk in examination in assessing these patients. Other signs that may indicate assessing heart size, the Worcester, which was Mitral valve disease is a congestive heart failure include exercise presence/degree of pulmonary oedema given by cardiology progressive condition intolerance and breathlessness. Dr and the presence of concurrent specialist Dr Mark and many dogs will Patteson likened the lungs to a sponge respiratory disease. Signs that may be Patteson and have a heart murmur that, in the normal situation, quickly noted include a large left atrium (which sponsored by Ceva for 3-4 years before springs back. However, in a dog with can cause tracheal elevation) and Animal Health. the signs of congestive heart failure and pulmonary pulmonary oedema, which often Mitral valve disease congestive heart oedema, the lungs “absorb” the fluid, appears as a “fuzzy” interstitial pattern is more common in failure (CHF) begin. making them stiff and slower to return on the peri-hilar (dorsocaudal) region small breed dogs such Routinely to normal. This results in rapid, of the caudal lung fields. as Cavalier King recording the shallow breathing (tachypnoea). The Buchanan Vertebral Heart Charles Spaniels, respiratory rate at rest Coughing is easily observed by Scale can be a useful way of assessing although large breed JULIE HUTTON (ideally when least owners and can be caused, for and monitoring heart size over time. dogs can also be went to a CPD stressed such as on example, by atrial enlargement pushing Most dogs with CHF have a score of affected. meeting to learn the floor before up on the airways (harsh cough) or 12 or more. The mitral valve about the diagnosis putting the dog up severe pulmonary oedema (soft cough). connects the left and treatment of this onto the table), the It is important, however, to Measure the atrium atrium and ventricle condition heart rate, the differentiate whether the cough is Echocardiography was also discussed and should close and strength of the apex caused by heart failure or respiratory by Dr Patteson who explained that “if prevent the backflow of beat and the murmur disease as, for example, a dog coughing you only measure one parameter, blood into the left atrium during grade/intensity can help to assess due to respiratory disease may have an measure the size of the atrium”. This is systole. With mitral valve disease, whether the disease is worsening and incidental heart murmur. because, as a rule, the larger the atrium, however, the valve becomes thickened the stage at which therapy is required. In addition to clinical examination, the worse the prognosis and if, for and unable to form a proper seal. Although stress in the veterinary Dr Patteson described other diagnostic example, a dog is coughing but has a Blood, therefore, shoots back from the clinic can cause an increase in heart tests which can also help to determine normal left atrial size, then this rules high-pressure left ventricle into the rate, if the heart rate in the clinic is the presence of congestive heart failure out congestive heart failure as the cause. low-pressure left atrium, creating a left monitored over time and increases, for and monitor disease progression, in Left atrial size can be measured apical pan-systolic murmur. example, from 110bpm to 140bpm, particular radiography and using a right parasternal long-axis view by comparing its size to the size of the from page 23 particular condition. cats until it reaches a fairly advanced aorta (left atrial:aortic ratio). The ratio specific genes which may underlie the The disease is probably stage. should be <1.6:1 but is often >2:1 in rapid disease progression seen in CKC multifactorial with many different genes So Adrian’s colleague, Virginia Luis congestive heart failure cases. spaniels. interacting with environmental and Fuentes, is trying to assemble the same When treating mitral valve disease, With the completion of a first draft other factors. Moreover, there is strong type of basic data on disease Dr Patteson explained that there is of the canine genome, many veterinary evidence to suggest that valvular progression in cats that they have been currently no evidence that any teams are looking to define the genetic degeneration is a normal consequence gathering in dogs. She is examining cats treatments are beneficial during the basis of a huge range of diseases, with of ageing in a large percentage of the in rehoming centres for evidence of asymptomatic period, regardless of a view to developing gene tests. Is it canine population and so it may be cardiac disease with routine whether cardiomegaly is present. possible that this approach will work in tricky to define exactly when this echocardiography and other screening He therefore reserves treatment for mitral valve disease? Adrian cautions becomes abnormal. tests and hopes to follow a cohort of symptomatic patients in heart failure that it seems unlikely that there will be But he is not without hope that cats to monitor disease progression. where he has a pragmatic approach, simple answers to preventing this genetic tests will have some impact on With such a growing emphasis on explaining that there are two reasons to the overall prevalence of cardiac comparative data, is there anything that use a drug for treating heart failure: disease. Single gene defects have been veterinary science can offer to aid improving quality of life and shown to have a role in an increasing understanding of cardiac disease in improving survival. number of veterinary conditions such humans, conditions that in the long run Firstly, Dr Patteson stated that the as dilated cardiomyopathy in some are likely to prove fatal for up to a third diuretic furosemide is mandatory for dobermanns and hypertrophic of the readers of this publication? treating the congestion that cardiomyopathy in Maine coon cats. Adrian notes that obstructive accompanies heart failure. It is coronary vascular disease, the most important, however, to try and get Cats different from dogs common cause of heart failure in down to the lowest possible dose as The latter is one of the few cardiac human patients, is extremely rare in side-effects of furosemide may include conditions in feline patients to be companion animals. But the differences electrolyte imbalances (for example, reasonably well characterised. The between man and beast in the clinical hypokalaemia) and activation of the clinical picture for heart disease in feline picture of heart disease have started to renin-angiotensin-aldosterone system patients is very different from that of blur. (RAAS). dogs, with conditions affecting the “As we have got better at dealing In addition to furosemide, Dr cardiac muscle being much more with some heart diseases in the Patteson explained that three other common than valvular disease. human population, people are living complementary drugs (spironolactone, Cat owners are unlikely to notice longer and they are starting to pimobendan and ACE inhibitors) have any significant changes in their pet’s develop other forms of cardiac evidence-based indications for the ability to exercise and as heart murmurs disease which were less obvious treatment of symptomatic heart failure are a less consistent manifestation of before. Certainly, degenerative valve heart disease in this species, their disease is becoming much more Julie Hutton, BVetMed, MRCVS, attending vets may not detect anything common in human patients and so qualified from the RVC in 2001 and sinister during a routine examination. there will probably be growing works in a small animal practice in For these and other reasons, most interest in the comparative aspects of Stourbridge, with a particular interest Adrian Boswood at work. cardiac disease is apparently silent in this sort of condition. in veterinary acupuncture. VP vol42 07_August 2010 24/08/2010 13:49 Page 25

A STITCH IN TIME SAVES LIVES

lived on average 91% longer FACT

®

†Plus furosemide as required. *Dogs treated with Vetmedin† had a median survival** of 267 days compared with 140 days for dogs receiving benazepril†1. **Survival was defined as the composite endpoint of cardiac death, euthanasia due to heart failure or treatment failure. Reference 1. Häggström J et al. Effect of pimobendan or benazepril hydrochloride on survival times in dogs with congestive heart failure caused by naturally occurring myxomatous mitral valve disease: The QUEST study. J Vet Intern Med; Vol 22:1124-1135, 2008. Vetmedin contains pimobendan. Prescription only medicine. Further information is available on request from Boehringer Ingelheim Vetmedica, Bracknell, RG12 8YS, UK. Tel: +44(0)1344 746959. E-mail: [email protected]. www.vetmedin.co.uk. Date of preparation 01/10. AHD6245. VP vol42 07_August 2010 24/08/2010 13:49 Page 26

ative Portfolio nov In n A

t en m fo ge r Pain Mana

For further information please contact Pfi zer Animal Health, Walton Oaks, Tadworth, Surrey KT20 7NS Trocoxil® contains mavacoxib, Rimadyl® contains carprofen, Torbugesic® contains butorphanol and benzethonium chloride. All these products are POM-V Use medicines responsibly (www.noah.co.uk/responsible).

AH481/10 VP vol42 07_August 2010 24/08/2010 13:50 Page 27

SEPTEMBER 2010 VETERINARY PRACTICE CARDIOLOGY EQUIPMENT 27

spironolactone is actually a very weak diuretic and should be classified as an aldosterone receptor antagonist (ARA). French company During heart failure, aldosterone levels are increased and cause a number of harmful effects, including launches a portable myocardial and vascular fibrosis. Spironolactone helps to protect against these harmful effects and has been veterinary shown to improve outcomes in heart failure patients. In human patients with heart ultrasound device failure, for example, a large study demonstrated that the addition of ECM of France has developed frequency probes (convex, micro-convex or spironolactone to standard therapy Eaxago, a mobile veterinary linear) for reproductive and gynaecological (which included an ACE inhibitor and ultrasound device which is said applications, furosemide) resulted in a 30% to be suitable for use with which can also Dr Mark Patteson. reduction in the risk of mortality. horses and pets. be used for caused by mitral valve disease. Similarly, a recently published study “Its small size, light weight tendon and ACE Inhibitors have a variety of in dogs with heart failure caused by and extended battery life make muscular- beneficial properties and a number of mitral valve disease demonstrated that it an ideal tool for field skeletal studies (for example, the COVE study the addition of Prilactone as part of diagnoses, as well as for use in examinations. and the BENCH study) demonstrate standard first-line therapy caused a veterinary practices,” the firm n ECM, which that their addition makes dogs feel dramatic 55% reduction in the risk of states. is better and live longer. Similarly, the cardiovascular mortality/morbidity as The product is said to be headquartered QUEST study demonstrated that the well as improvements in clinical signs. four to five times as light as a in Angoulême, addition of pimobendan (Vetmedin, To conclude, Dr Patteson explained standard scanner – it weighs in south- Boehringer) significantly improves that, once dogs develop heart failure 3,250g, including the battery. It western survival time thanks to a number of caused by mitral valve disease, the is powered by an France, The new scanner being beneficial effects, including its action as condition will inevitably deteriorate and, interchangeable battery, which develops and carried and opened for use. a positive inotrope by increasing the despite therapy, the survival for dogs is has a lifetime of 4.5 hours, and manufactures sensitivity of contractile proteins to often less than one year. However, an 8.4-inch screen. specialist calcium. advances in diagnosis and treatment Ultrasound images and veterinary-science Spironolactone (Prilactone, Ceva) now mean that, more than ever, we can video sequences can be saved devices, with the was then discussed in further detail. Dr extend and give affected dogs an directly to the device’s memory. support of Patteson explained that, despite excellent quality of life in their final The scanner has multiple Noveko, its historically being classified as a diuretic, months. connectivity points, for Canadian partner. connecting to a larger screen, a Further Cardiac referral service printer or a USB stick information is The product is supplied available on www. DVS (Davies Veterinary Specialists) runs a comprehensive diagnostic and with a wide range of variable agroscan.com. treatment service in cardiology, led by Dr Nat Whitley and Dr Clive Elwood. The department benefits from leading edge facilities and equipment enabling the team to deal with complex as well as straightforward cases of congenital and acquired heart, lung and chest disease in dogs and cats. Typical cases include dogs or cats with a heart murmur or arrhythmia and animals showing symptoms such as coughing, laboured breathing, exercise intolerance or episodes of collapse/fainting. Some patients are seen under various breed schemes for assessment for heart disease prior to potential breeding. The range of services includes: n Interpretation of thoracic radiographs and ECGs, sent in by veterinary Scans of a horse pastern at distal third and a tendon; and (below) a pregnant colleagues, with advice on management, or prior to referral. mare at 26 days. n Echocardiography (cardiac ultrasound) with spectral and colour flow Doppler: state-of-the-art imaging as part of the normal investigation of heart disease along with conventional chest x-rays and ECG recording. n Holter (24-hour ECG) monitoring to investigate collapse and manage cardiac dysrhythmias. n Artificial pacemaker treatment for symptomatic bradyarrhythmias (slow arrhythmias, e.g. complete heart block). n Drainage of pericardial effusions, sometimes followed by thoracoscopic pericardectomy. n Surgical treatment of certain congenital cardiac defects, including closure of patent ductus arteriosus. n Bronchoscopic investigation of chronic airway disease and chronic coughing and for removal of inhaled foreign bodies. Many patients are admitted just for the day for investigations, which will often also include blood tests. Sedation is sometimes required for x-rays but general anaesthesia is only usually needed for procedures such as bronchoscopy. Patients with heart failure or serious arrhythmias requiring close monitoring may be admitted for several days for treatment. For further information visit www.vetspecialists.co.uk. VP vol42 07_August 2010 24/08/2010 13:50 Page 28

28 CANINE VETERINARY PRACTICE SEPTEMBER 2010 The prostatic conditions, their diagnosis and management 1. Benign prostatic cell, thereby inhibiting the binding of approached hypertrophy/hyperplasia (BPH) dihydro-testosterone to the receptor. It through a caudal In most cases, BPH does not cause any therefore has a rapid onset of action. It midline clinical signs. Only if the prostate is so is given at a dose of 0.25-0.5mg/kg coeliotomy and enlarged that it compresses the colon SID for 7 days and has an effect for periprostatic fat and interferes with defaecation are dogs about six months. is carefully usually presented to the veterinarian. dissected from Other clinical signs frequently 2. Prostatitis the prostate. The include hemorrhagic discharge from the Clinical signs associated with bacterial prostatic vascular urethra. On rectal examination, the prostatitis include depression, painful supply, prostate is found to be enlarged, rectal palpation, fever, straining to hypogastric and symmetrical and painless. Ultrasound urinate or defaecate and a stiff-legged pelvic nerves are examination usually gait. Occasionally in found on the reveals an enlarged breeding male dogs the dorsal aspect of Figure 1. Omentalisation – intra-operative photograph of a prostate with loss of only sign of prostatic the prostate and prostatic abscess. After the prostatic abscess has been the normal bacterial infection may should be opened, drained and flushed with copious amounts of saline, homogeneous be poor semen quality preserved. an instrument is passed through openings in either side of the abscess in order to pull the omentum into the abscess and fix appearance. leading to sterility. It is now it there. Treatment is Definitive diagnosis is recognised that required in patients made by cytological properties of the omentum including the urethra, placement of a urinary with clinical signs of examination and secretion of an angiogenic factor and catheter before or during surgery is prostatic disease. The quantitative isolation immune and phagocytic functions can highly recommended. In addition, the treatment of choice is of bacteria from be used in the surgical treatment of catheter can be attached to a closed surgical castration. A Dr HENRY prostatic fluid obtained prostatic diseases such as abscesses. urine collection bag, allowing the 50% reduction of the L’EPLATTENIER by ejaculation or Intracapsular omentalisation is the bladder to remain empty for the size of the prostate concludes his two- prostatic massage. treatment of choice for prostatic duration of the procedure. can be expected within part review of the Normal prostatic fluid abscessation. three weeks. prostate with a should contain less Bilateral stab incisions are made in 4. Prostatic and para-prostatic Alternatively, chemical discussion of the than 10,000 bacteria the lateral aspects of the prostate (see cysts castration is possible.1 various conditions per ml.1 Figure 1). Pus is removed from the Clinical signs include tenesmus or A variety of Treatment of abscess cavities by suction to minimise dysuria. Ultrasonography is the imaging pharmaceutical agents bacterial prostatitis abdominal contamination. All abscess technique of choice for recognising have been tested in dogs, including involves antimicrobial therapy and cavities are broken down by digital anechoic cystic lesions.1-3 delmadinone acetate (Tardak, 1-2 castration or anti-androgen therapy. exploration. Omentum is then packed Retention cysts and para-prostatic mg/kg SQ, repeated after 8 days if no Antibiotic therapy should be based on in the cavities, passed around the cysts should be drained surgically. Very response), medroxyprogesterone acetate sensitivity of the isolated bacteria and urethra and fixed to the capsule of the large cysts may be partially resected. (Depo-promone, 3 mg/kg SQ twice at on the ability of the antibiotic to reach prostatic abscess.2 Castration should be Omentum is fixed to the remaining cyst 4 week interval) and megestrol acetate therapeutic concentrations on prostatic performed at the same time as surgical to avoid recurrence.2 Castration is also (Minipil, 0.55 mg/kg PO for 4 weeks). parenchyma. treatment of the prostatic abscess. recommended in dogs with cystic The synthetic steroid finasteride Permeability of the blood-prostate prostatic disease. (5á-reductase inhibitor), which is used barrier for a given antimicrobial agent Preparation for prostatic surgery effectively for the treatment of BPH in depends on its lipid solubility and Anaesthesia 5. Prostatic squamous metaplasia humans, has also successfully been used ability to diffuse along a pH gradient. As the prostate is located in the caudal Clinical signs are related to the to induce prostate atrophy in dogs Trimethoprim-sulfa, chloramphenicol abdomen, dogs undergoing prostatic enlargement of the prostate and are without decreasing sperm quality or and enrofloxacin are known to reach surgery are good candidates for peri- similar to the ones described for BPH libido (Proscar, 5mg per dog between prostatic parenchyma in therapeutic operative analgesia using epidural and the condition may also be 10 and 50 kg every 24 hours). concentrations and are effective in anaesthesia. Opioids are preferred over associated with cystic changes. In More recently Ozasterone acetate treating most bacterial infections of the local anaesthetics because of the lower addition, the dogs may show signs of (Ypozane ) has been licensed for the prostate.1 risk of causing urinary retention feminisation related to hyper- treatment of BPH in dogs. It blocks the postoperatively. oestrogenism (attraction for other uptake of testosterone by prostate cells 3. Prostatic abscess males, development of mammary and blocks the androgen receptor in the Clinical signs of prostatic abscess are Urinary catheter similar to prostatitis. Definitive Cysts and Henry L’Eplattenier, DrMedVet, PhD, diagnosis is made on ultrasound abscesses can DipECVS, MRCVS, grew up in the examination, which allows the typical greatly alter the French-speaking part of Switzerland. fluid-filled cavities of the abscessed gross appearance He studied at Bern University and trained as a small animal surgeon at prostate to be recognised. In severe of the prostate Zurich University. He obtained a PhD cases, dogs with prostatic abscess, and the surgeon from Utrecht University last year for peritonitis and septicemia may show may find it his research on prostate cancer in signs of septic shock.2 difficult to dogs and is now a director and head Prostatic abscesses should be identify normal of surgery at VRCC, Veterinary considered relative emergencies and anatomical Referrals, in Laindon, Essex. He can should be treated surgically in addition structures. In be contacted on to antimicrobial therapy described for order to identify Figure 2. Intra-abdominal chryptorchid testicle with an [email protected]. bacterial prostatitis. The prostate is the location of oestrogen-producing Sertoli cell tumour. VP vol42 07_August 2010 24/08/2010 13:50 Page 29

Ypozane tablet size Weight of dog Tablets to be given daily Treatment duration Treatment frequency 1.875 mg 3 - 7.5 kg 3.75 mg 7.5 - 15 kg 1 TABLET 7 DAYS Every 6 months 7.5 mg 15 - 30 kg 15 mg 30 - 60 kg

POM-V *Johnston, S. D. , Kamolpatana, K., Root-Kustritz, M. V. and Johnston, G. R. (2000) Prostatic disorders of the dog. Journal of Animal Reproductive Science 60-61(2):405-15. **Albouy, M. Treatment of benign prostatic hyperplasia with Osaterone acetate tablets. Proceedings of the 31st WSAVA congress 2006, 831-832. For further information please contact Virbac on tel: 01359 243243 e-mail: [email protected] VP vol42 07_August 2010 24/08/2010 13:50 Page 30

30 CANINE VETERINARY PRACTICE SEPTEMBER 2010

glands). examination of a fine needle aspirate illumination of the target organ with treatment with intraluminal stents can Diagnosis is made by cytological of the prostate performed under light of a determined wave length. The be effective in improving quality of life examination of cells obtained by fine ultrasound guidance. light is absorbed by the photosensitiser for several months.8 needle aspiration biopsy or by Due to the high metastatic rate of causing photochemical mechanisms collection of prostatic fluid. prostate carcinoma, both local and leading to tissue necrosis.5,6 1. Johnston, S.D., Kamolpatana, K., Root- Treatment of squamous metaplasia systemic treatment are necessary to No effective chemotherapeutic Kustritz, M. V. and Johnston, G. R. (2000) of the prostate involves castration and control the disease. Radical protocol is available for the systemic Anim Reprod Sci 60-61: 405-415. removal of the tumour-producing prostatectomy in dogs with prostatic treatment of PCA in dogs. COX-2 is 2. White, R. A. S. (2000) Clin Tech in Small oestrogens (see Figure 2). Additional disease is associated with a high expressed in various types of canine An Pract 15 (1): 46-51. surgical treatment of prostatic cysts incidence of peri-operative mortality cancer including PCA, and is thought 3. Dorfmann, M., Barsanti, J. (1995) Comp may also be necessary in some cases. and post-operative incontinence and is to play a role in carcinogenesis. This is Cont Educ 17 (6): 791-810. therefore not an acceptable treatment supported by evidence that treatment 4. L’Eplattenier, H. F., van Nimwegen, S. A., 6. Prostatic neoplasia option for dogs with prostatic with COX-2 inhibitors may be van Sluijs, F. J. and Kirpensteijn, J. (2006) Canine PCA has a higher incidence in carcinoma. beneficial in the management of Vet Surg 35: 406-411. castrated individuals than in intact Various techniques for partial or certain tumours in dogs. 5. Lucroy, M. D., Bowles, M. H., Higbee, R. males and it differs from human PCA subtotal prostatectomy have been Although it has been shown that G., Blaik, M. A., Ritchey, J. W. and Ridgway, in that it cannot be treated by described. Partial prostatectomy can be COX-2 is expressed in canine PCA7, T. D. (2003) J Vet Intern Med 17: 235-237. androgen ablation therapy. In this useful as a symptomatic treatment of the effect of NSAIDs on the clinical 6. L’Eplattenier, H. F., Klem, B., Teske, E., respect, canine PCA resembles the late the disease by decreasing the size of outcome of dogs with PCA has not van Sluijs, F. J., van Nimwegen, S. A. and stage of PCA in humans, also called the prostate and reducing faecal been extensively investigated. Despite Kirpensteijn, J. (2008) Vet J 178: 202-207. androgen-independent PCA. straining.4 this, treatment with a selective COX-2 7. L’Eplattenier, H. F., Lai, C. L., van den PCA should always be considered Photodynamic therapy (PDT) has inhibitor such as meloxicam or Ham, R., Mol, J., van Sluijs, F. and Teske, E. with a high degree of suspicion in also been used for the local control of firocoxib is generally recommended. (2007) J Vet Intern Med 21: 776-782. castrated dogs showing signs of prostate carcinoma in dogs. PDT For dogs with severe stranguria or 8. Weisse, C., Berent, A., Todd, K., Clifford, prostatic disease. The diagnosis is combines the administration of a urethral obstruction caused by C. and Solomon, J. (2006) J Am Vet Med usually made by cytological photosensitiser and the subsequent neoplasms of the prostate, palliative Assoc 229: 226-234. CPD Lectures on oral care problems FOLLOWING the success of the become more enthusiastic about since practice benefitting from the 09 lecture Improving Periodontal Health lecture working in practice, because you see so series is Bishop’s Stortford Veterinary tour last year, the British Veterinary many dental cases and a wide range of Hospital. According to Rosemary Dental Association has announced a dental problems.” Cowper, the practical take-home further six lectures. However, for Mr Stephens, oral care messages delivered at the event have Speakers include Norman Johnston, problems are still all too common. “We considerably improved the quality of a former president of the European see mouths that need attention day in advice to owners. Veterinary Dental College, dentist John day out. I find that a lot of clients aren’t “We’ve always been very proactive Robinson and Lisa Milella, president of confident at opening their pets’ mouths with clients and run items such as the BVDA. This year sees the content or simply don’t think to do so. This, puppy parties, but the event also helped extended to include resorptive lesions, coupled with the fact that cats and dogs us to improve our preventive oral care fractured teeth and dental radiography do not demonstrate oral pain in the advice to pet owners. with greater emphasis on feline oral same way we do, means that clients are “We now fully appreciate the Norman Johnston demonstrating. care. often not aware that their pet is importance of consistent daily oral forms we have been able to educate our Lisa Milella, believes that the 2009 suffering. care. For example, in the past we clients on the reasons why improved series delivered tangible benefits for “The lecture tour not only covered advised weekly brushing, whereas now oral care is important. However, there is practices that attended. the basics of periodontal disease but we recommend daily brushing to also a direct benefit to the practice as “For many vets and VNs, dentistry also provided useful guidelines on how owners.” we now sell a range of oral care makes up a significant part of to improve our dental service for our Ms Cowper also says that oral care products and even specialist foods,” consultations and surgery, yet often clients. I took home the importance of now takes a more prominent role concludes Ms Cowper. training falls far short of what’s dental charting and, as a practice, we throughout the practice. “At puppy Another delegate of the 2009 series required in order to take a more are now more thorough with our dental parties we have started giving was Buttercross Veterinary Centre’s proactive role in this important area for recordings. demonstrations on finger brushing, and Dane Atkin. What struck him was the clients and the business,” says Lisa. “Further to regular post dental also emphasise the importance of severity of chronic gingivostomatitis “We know from the feedback from checks, we now also offer free dental chewing. We want our clients to and periodontal disease that some dogs the 2009 seminars that the lectures examinations six months after any understand that oral care is by far best experience. offer practical help and solutions to dental procedure. This gives an started at an early age. “During one presentation the point vets and VNs in delivering oral care opportunity to see whether the was made about the improvement to advice to owners. Oral care gets little preventive measures that we have Refreshers human oral health by the introduction coverage at vet school and therefore it’s demonstrated, like tooth brushing and “Also, following treatment for any oral of nylon toothbrushes. It made me no surprise that vets and VNs enter the mouth washing, have been effective and condition, we give cat and dog owners a realise that something similar is needed profession with only a basic to check refresher on oral management including in pet oral care and that we needed to understanding of pet oral health,” she whether our tips on brushing techniques and other re-think our approach,” he notes. adds. clients are oral care measures. Otherwise the What Mr Atkin and his team did Delegate Michael Stephens of confident and positive benefits of the treatment are following the lecture was to look at Ewell Veterinary Centre says he happy with soon lost.” how they address oral care with clients. overlooked dentistry whilst studying. performing For the practice Ms Cowper says it “We’ve changed much of our “There wasn’t a great emphasis on those doesn’t just mean a more appreciative procedures, particularly post-treatment the teaching of dentistry at college, but preventive client base. “Owners’ knowledge of after scaling. We now ensure that all it also wasn’t as interesting to me (or to measures,” he oral care is generally quite poor. clients are aware of the need for post- my friends) as many of the other notes. Through learning more about treatment ‘preventive’ oral care, clinical subjects. It’s an area I have only Lisa Milella. Another periodontal disease and how plaque especially brushing.” VP vol42 07_August 2010 24/08/2010 13:50 Page 31 ?aTeT]cX^] XbP_aX^aXch

Introducing the new Partners in Prevention Programme: Along with our comprehensive range of vaccines and parasiticides you can now access a new range of support tools designed to help pet owners understand the benefi ts of a tailored prevention plan for their pets. C^VTcWTafTRP] \PZTXcWP__T]

Contact your local representative for more information on the benefits Pfizer can bring to your practice

PFIZER ANIMAL HEALTH Walton Oaks, Tadworth, KT20 7NS AH330/10 VP vol42 07_August 2010 24/08/2010 13:50 Page 32

Noticed the difference?

The more you look for differences between NSAIDs, the more you will see. PREVICOX® was the first coxib developed exclusively for dogs and is still the most COX-2 selective NSAID for the treatment of canine OA. Discover the PREVICOX difference for yourself.

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PREVICOX® chewable tablets for dogs contain 57mg or 227mg firocoxib. PREVICOX® is a registered trademark of Merial Ltd. Further information is available from: Merial Animal Health Ltd, CM19 5TG. UK:POM-V IE: POM © Merial Ltd. 2010. All rights reserved. VP vol42 07_August 2010 24/08/2010 13:50 Page 33

SEPTEMBER 2010 VETERINARY PRACTICE TRAINING 33 Managing your training and development in practice

PRESSURES on practice have that are designed to help tackle some happy members of the team. The roadshow on interactions in become increasingly apparent and of these issues. Graduates often say that they the consulting room is designed to real in the past year, and The roadshow for might have thought they were provide practical learning and take- some industries have young graduates is reasonably well equipped to deal with home points for the clinical team of reported 70 designed to help both the pressures in their first job, but the vets providing a framework for the graduates chasing graduates and their realities are frequently more development of the skills found to be every job. employers to challenging than they expected. This necessary in the delivery of best The veterinary proactively work roadshow is designed to help provide clinical practice and financial business is certainly together to kickstart support in this area, and to encourage performance. not escaping a young careers. The everyone involved. This has been an area of great significant amount of pressures on The roadshow on clinical audit is importance for many years, but these pressures, which graduates and their designed to provide assistance to increasingly so today, and now we have are brought into focus employers have practices working on practical ways of some practical expertise and tools with by clients questioning PAUL MANNING increased with the improving clinical outcomes by which to learn and apply these skills professional advice gives details of a new need to achieve carrying out clinical audits which help for the benefit of our patients, clients and bills, amongst series of roadshows higher levels of to both ensure that protocols are and businesses. other things, including on dealing with the performance, which implemented and further developed to The times we live in require a challenge to the pressures of adds to the challenge ensure the best possible delivery of innovation and positive activity in all footfall through professional life in the first three to 12 best practice for as many patients as of these areas of practice. E-mail and practices. months. possible. telephone support from experienced Vet Learning has Effective early and The issues are really important to practitioners for 30 days after these arranged three roadshows this autumn continuing support is critically the patient, client, team, and the roadshows is a valuable benefit to help important to build those clinical and business. Clinical audit is a recognised delegates make the most of their Paul R. Manning, MA, VetMB, non clinical skills which enable the part of the RCVS Veterinary Hospital learning and put it into practice. MSc(VetGP), DProf, MRCVS, is a graduates to develop their confidence (Tier 3) standard, and is under review For further information, see the director of Vet Learning Ltd. and competence in their ability to do for other tiers. This will be valuable for advertisement in this issue or e-mail the job and become effective and veterinary practitioners and nurses. [email protected]. MEDICINES Few changes likely to affect veterinary surgeons in the 2010 regulations IN a recent (and totally unscientific) pharmacists and veterinarians. regarding variations to national authorisations, retailers of feedingstuffs straw poll of a number of veterinary n Introduction of controls on internet authorisations) and associated fee and SQP premises. surgeons in practice, not one was able retailing of veterinary medicinal changes. n Reduction of fees for some to provide any details of the VMDs products with an associated fee. n Removal of the “5% rule” permitting categories of wholesale dealers’ proposals for changes to the Veterinary n Implementation of Article 8 of EU the supply of products between authorisations. Medicines Regulations this year. Regulation 767/2009 on the placing on retailers. n Application of a below inflation Not one person said the market and use of n Introduction of a procedure and fee increase to existing fees. he or she was feed. for giving formal advice as to whether n Application of a below inflation intending to make any n Revision of the a product requires a Marketing increase in the Graded Annual Fee as comments on the exemptions relating to Authorisation. a percentage of industry turnover. proposals – “that’s up animals kept on n Introduction of a procedure and fee Comments can be made to the to the BVA” was a domestic premises – to change the distribution category for VMD by 10th September and the common response – looks at this year’s ceiling on weight of a centralised product. new regulations are expected to come and hardly anyone proposals for the VMR medicated n Change to the method of recharging into force on 1st December. could recall what feedingstuffs that can travel and subsistence costs for The first item, removing changes had been made be manufactured from inspections of UK sites. permission for antimicrobials to be last year. As it happens none of the the premixture. n Correction of the fees for inspections advertised to farmers, represents a u- changes proposed will have much n Revision of the exemptions relating relating to more than one authorisation. turn by the VMD which allowed impact upon the vast majority of vets to animals kept on domestic premises n Introduction of a waiver for fees for POM-Vs to be advertised to farmers in practice. – extension to veterinary surgeons and variations to remove or reduce animal because they were “professional A summary of the changes on pharmacists of the derogation allowing testing. keepers of animals”. which the VMD is currently consulting registered SQP retailers to supply n Correction of the fees for The VMD now believes that is on the VMD’s website; it reads: premixtures and medicated feed decentralised extensions applying to advertising to farmers of these Summary of the proposed changes intended for domestic use without the multiple species where the UK is products, particularly new ones, could to VMRs: additional need to be approved as a reference member state. lead to pressure being put on n Remove permission for antimicrobial distributor. n Introduction of a fee to assess veterinary surgeons to prescribe them veterinary medicinal products to be n Simplification of the procedure for equivalence data for parallel imports. and this could in turn hasten the advertised to farmers. variations to national marketing n Removal of the additional fees for development of resistance. n Allow dispensing of prescriptions authorisations (implementation of late payment of annual fees for Strangely, the VMD has produced from EEA veterinarians by UK Commission Regulation 1234/09 marketing no evidence to support this. VP vol42 07_August 2010 24/08/2010 13:50 Page 34

34 PRODUCTS VETERINARY PRACTICE SEPTEMBER 2010

Anti-inflammatory launched toxaemia in pigs. for the treatment of enrofloxacin- tract, respiratory tract, urogenital tract, CEVA Animal Health has introduced A single injection is required when sensitive bacterial infections in large secondary wound infections and otitis the anti-inflammatory Meloxidyl used in combination with suitable anti- breeds of dog. externa. (meloxicam). It is indicated for the infectives. One tablet will treat a dog management of respiratory disease, weighing 50kg. Random access analyser mastitis and diarrhoea in cattle and Treatment for large dogs The tablets have a wide range of QUANTUM Vet Diagnostics (a non-infectious locomotor disorders BAYER Animal Health has introduced indications in companion animals, division of Woodley Equipment) has and puerperal septicaemia and a new 250mg Baytril Flavour Tablet including infections of the alimentary introduced a new random access analyser. It comes with a full maintenance and reagent package. It can carry out 150 tests an hour; up to 240 samples can be programmed at one time; and there is automatic pre-dilution. For details, e-mail [email protected] or call 01798 813659.

Latest workwear brochure GRAHAME Gardner has published its new brochure with details of its various ranges of workwear. To order a copy call 0116 255 6326 or e-mail [email protected]. Details of the firm’s product range and services are also on the website www.grahamegardner.co.uk.

Mastitis tracker service NMR is launching a new mastitis tracker service in September and will demonstrate it at the Dairy Event at the NEC on 7th and 8th September. The tracker allows mastitis-causing pathogens to be identified in preserved milk samples as part of routine cow management and integrates the results with the NMR cell count records. “We have offered producers a service for identifying pathogens in the past but it has involved plate culture techniques that require fresh milk samples. But there is always a risk of contamination in fresh samples which in turn hinders the accuracy of results,” says NMR group business development manager, Hannah Pearse. “Now that we can replace this technique and use preserved samples – and provide far more accurate results – we can take mastitis control in our herds to a much higher level. “The big breakthrough is PCR (polymerase chain reaction) technology for identifying pathogens that uses preserved milk samples. PCR measures the amount of DNA for each specific pathogen and it can detect many more mastitis pathogens and far more accurately than has been possible in the past.” PCR testing on milk recording samples is new to the UK but is already part of integrated services in

ART3078 North America and Scandinavia where mastitis management in dairy herds is           considered to be more advanced, the          
 
   firm states.
 
      
Cost is £13 or £14 (plus VAT) per Epiphen® 30mg Tablets contain 30mg of phenobarbital, Epiphen® 60mg Tablets contain 60mg of phenobarbital, Epiphen® Solution contains 4% phenobarbital. For use in the control of epilepsy in dogs. POM-V.*Terms and conditions apply test depending on volumes tested. Further information is available on request from: For details, contact NMR customer Vetoquinol UK Limited, Vetoquinol House, Great Slade, Buckingham Industrial Park, Buckingham, MK18 1PA. Tel: 01280 814500 Fax: 01280 825460 Email: offi [email protected] Website: www.vetoquinol.co.uk services on 0844 7255567 or e-mail [email protected]. september 11/8/10 15:35 Page 1

Sep tember 2010 J.A.K Update

Veterinary AnaeSorber

We are pleased to introduce our NEW Purfect Veterinary AnaeSorber. An easy and convenient NEW way of scavenging organic waste anaesthetic gases. • Contains activated carbon BUY 6 FOR £13.45 each • Adsorbs 200g of organic waste anaesthetic agent such as isoflurane, halothane and sevoflurane A SAVING OF £9.00*

• Not suitable for use with N2O • Approximate maximum constant use - 20 hours • Discard when weight reaches 1400g • Dispose by controlled incineration

01-1645 Veterinary AnaeSorber £14.95

E L Endotracheal Tube Rack B A L II W A O V N A

Convenient storage for up to 17 endotracheal tubes from 3 to 11 mm. DICKIES • Arranged by size for quick access in an emergency SAVE • Manufactured powder coated mild steel SCRUB SUITS • Attaches easily to a wall £10 • Horizontal design holds tube securely in place whilst stocks last Contact us for details 01-1440 Endotracheal Tube Rack Was £25.00 £15.00

BAG’EM Scented Biodegradable Waste Bags Ticks E Due to warmer winters there is now no L definite tick season. Ticks can be active at • Scented B A temperatures as low as 3.5°C. They use • Biodegradable L II W plant debris to shelter in during cold • Easy tie handles A O weather. On warmer days during the V N • 50 waste bags per pack A winter the temperature can be sufficient for them to seek a host. ECO- The O'Tom Tick Twister FR The best and safest way to remove ticks without B IE I N O DL leaving the mouthparts of the tick planted in the D Y skin. Thus reducing the risk of infection. EG RADABLE NEW 02-2635 •Quick, painless and easy to use Silicon Handle 02-2630 DESIGN •Avoids compression of the tick Tick Remover Tick Remover •Reduces risk of infection 20 pack 20 pack •Leaves no tick mouth parts in the skin 02-3150 BAG’EM Scented Biodegradable Waste Bags (50) £0.54 £45.00 £40.00

VETin4m Summer Issue PACKED WITH NEW PRODUCTS, SPECIAL OFFERS AND A CHANCE TO WIN A £150 ACTIVITY VOUCHER If you have not received your copy or would like more FREE copies for your practice please call us on 01347 878697

J.A.K Marketing Limited Telephone 01347 878697 Fax 01347 878308 Email [email protected] www.jakmarketing.co.uk september 11/8/10 15:35 Page 2

Infusion and Drainage Products Animal Paw Covers Animal paw covers, with a reinforced Founded and run by a veterinary surgeon, Infusion Concepts design foot pad for added protection and and supply a wide range of quality infusion sets, extension lines, caps comfort. and valves, connectors, catheters, drainage, needle-free and critical • Water-resistant neoprene body care products for the veterinary profession. • Velcro securing strap • A top quality range NOW • Full back-up on all products IN • Informative user guides STOCK

• Advice on product application and suitability 02-0790 Small 55mm (l) x 60mm (w) £2.10 02-0785 Medium 60mm (l) x 70mm (w) £2.10 • Problem-solving advisory service 02-0780 Large 80mm (l) x 75mm (w) £2.10 02-0775 X Large 90mm (l) x 90mm (w) £2.10 02-0770 XX Large 95mm (l) x 100mm (w) £2.10 Jugular Catheters We supply a wide range of single, double and triple lumen jugular catheters. • Soft tipped catheters for placement by Purfect Washable Kennel Liner ‘Seldinger’ technique • Polyurethane material softens further in blood An ideal under pad for use in kennels and cages. This washable stream pad comes with a waterproof undersheet to prevent fluid strike • Single handed guide-wire operation through and can be washed and re-used, saving you money. • Supplied as complete kit with all items • Able to hold up to 2000ml of fluid necessary for placement • Additional suture bridge supplied for security • Quick drying due to its single layer of absorbent fabric • Supplied with Latex Free Injection Caps • Machine washable up to 200 times Infusion & Transfer Sets • Economical at under 10p per use We supply a range of products to meet your • Dimensions: 70 x 90cm needs for equine fluid therapy. • Y-spiral giving sets 02-3950 Washable Kennel Liner (1) £11.95 • Wide bore and Hi Flo sets • Bag-to-bag transfer sets • End extensions for easier disconnection Littmann Classic II SE Littmann Master • Intravenous catheters • Central Venous catheter kits Classic II • Stainless steel chestpiece End Extensions • Single lumen tubing • Stainless steel chestpiece End extensions allow simple patient • Floating diaphragm ensures high • Deep bell increases low frequency disconnection. Our range now includes two acoustic sensitivity sounds extensions with needle-free access for • Floating diaphragm ensures improved safety and ease of use. consistent acoustical response • Hi Flo for maximum flow rate • Needle-free standard – needle-free luer • Kink-proof with needle-free luer and Y-port Wound Drainage We stock a wide range of PVC and 100% silicone wound drains and closed collection systems for your drainage needs. • Silicone drains (including Jackson Pratt) • Silicone grenades • PVC grenades with redon drains • Passive & active collection sets 07-1545 Black £52.97 07-1570 Black £61.88 07-1520 Grey £52.97 07-1560 £61.88 Chest Drainage Caribbean Blue 07-1530 Navy Blue £52.97 07-1555 Burgundy £61.88 Our unique needle-free trochar chest drain range allows simple placement, ease of 07-1515 Caribbean Blue £52.97 07-1565 Navy Blue £61.88 maintenance and the ultimate in patient 07-1525 Hunter Green £52.97 safety. • One-piece connection 07-1495 Burgundy £52.97 Littmann Accessories • Needle-free valve for secure closure & easy access Littmann Classic II • Connects to our range of valves and Paediatric collection systems • Available in all sizes to 28 Fr

J.A.K Marketing offer the full range of Infusion 07-1535 Black £57.66 07-1685 Littmann Name Tag £5.06 Concepts products. For more informaton call 07-1500 Caribbean Blue £57.66 07-0815 Littmann Ear Nibs Soft £5.30 01347 878697 or email [email protected] 07-1505 Raspberry £57.66 07-0600 Binaural Tubing £24.81

Telephone: 01347 878697 Email: [email protected] Web: www.jakmarketing.co.uk september 11/8/10 15:35 Page 3

G1B Veterinary Pulse Oximeter Affordable monitoring for all patient types. At last a pulse oximeter designed for veterinary application. ONLY • Unique digital SP02 technology • Rapid, accurate and stable £190 • Anti-movement recognition • Bright visual LED numerals PURCHASE A • Built-in memory card • Up-load data for analysis or printing G1B PULSE OXIMETER • Quick and easy user operation AND RECEIVE A J.A.K MARKETING • Re-chargeable desktop pod £50 MONEY OFF VOUCHER* Terms and conditions apply, please see back of voucher

13-1265 G1B Veterinary Pulse Oximeter £190.00

13-1295 Replacement Veterinary SP02 Sensor £77.00

Veterinary Monitor G3H Veterinary Monitor G3D A balanced patient monitor manufactured Take control of your patient’s vital signs with three application modes: with this affordable compact monitor, monitoring, diagnosis and operating. manufactured with your core duties in mind: monitoring, diagnosis and Offered in an advanced streamline design operating. - portable, compact and lightweight. Offered in an advanced streamline design • Easy read 8.4” Screen - portable, compact and lightweight. • Intelligent audio visual alarm • 72 hour data storage • Easy read 12.1” screen • 7 waveform display • Intelligent audio visual alarm • Suitable for all patient sizes • 72 hour data storage • Uses friendly menu structure and • 8 waveform display rotary dial • Suitable for all patient sizes • User friendly menu Standard configuration includes: Standard configuration includes: ECG, HR, PR, SP02, OxyCRG diagram, ST analysis, Arrhythmia analysis, RESP*2 (RA-LL impedence and nasal cavity, NIBP (with ETC02 (sidestream), ECG, HR, PR, SP02, OxyCRG diagram, ST venous punch), Temp*2 (surface and rectal), Drug dose analysis, Arrhythmia analysis, RESP*2. SAVE calculation. (RA-LL impedence and nasal cavity, NIBP (with touniquet NEW function), Temp*2 (surface and recal), Drug dose calculation. Optional extras: (PLEASE SPECIFY AT TIME OF ORDERING) £250 Printer option Optional extras: (PLEASE SPECIFY AT TIME OF ORDERING) Invasive Blood Pressure Function Printer option Invasive Blood Pressure Function

13-1260 Veterinary Monitor G3H £995.00 13-1280 Veterinary Monitor G3D c/w sidestream List £2245.00 £1995.00 13-1275 Printer Option List £150.00 £100.00 13-1275 Printer Option List £150.00 £100.00 13-1300 Invasive Blood Pressure Function £290.00 13-1300 Invasive Blood Pressure Function £290.00

QUACKS will be sent out with every order Visit us at Stand 82-83 at the BVNA Congress Bring your QUACKS for your chance to win!

Aztec Trolley - Black Padded Surgeons Stool Drugs Cabinet

Ideal for a wide range of Black padded seat, easy to Size : 600 x 450 x instruments and equipment. clean and height adjustable gas 250mm Lightweight and easy to clean. strut 57 to 82cm. Mounted on (24” x 18” x 10”) Offers accessories tray and five spoke chrome mobile base. Manufactured in steel five drawers. Chrome gas strut. and finished in white 30 (w) x 92 (h) x 37 (d)cm powder coat. Fitted with full length stainless steel piano hinge. NOW 7 lever security lock. AVAILABLE Two removable shelves. Back drilled for wall IN BLACK mounting.

10-2205 Aztec Trolley - Black £80.00 10-1600 Padded Surgeons Stool £76.50 10-0760 Drugs Cabinet £194.61

Telephone: 01347 878697 Email: [email protected] Web: www.jakmarketing.co.uk september 11/8/10 15:36 Page 4

StatSpin® VT with RT12 Microtube Rotor Blood, urine, haematocrits and other routine spins in two minutes. • Fast - separates in a fraction of the time required by other centrifuges ... quality serum or plasma in 30 - 90 seconds • Quiet - operates without vibration and with virtually no noise or heat build-up SAVE £50 • Versatile - instantly adaptable to blood separations, urine sediments, microhematocrits and other routine applications NOW ONLY • Safe - cover interlock system, meets international safety standards £852.00 • Pre programmed run cycles simplifies operation

07-2460 Centrifuge StatSpin VT with RT12 Microtube Rotor Was £902.00 £852.00 07-2535 StatSpin® Micro Hematorcrit Rotor RH12 (no reader) £123.00

We can supply a wide range of StatSpin Products, please contact us for details on 01347 878697

J.A.K Marketing are proud to be appointed distributor of StatSpin® products, we are now able to supply the full range and provide after sales and servicing support

This agreement compliments the current portfolio of products that we service and repair Clippers • Microscopes • Centrifuges • Digital Scales

Please contact us if you are unable to find your particular item listed. We are committed to meeting all your service requirements

StatSpin® Vet-Tubes

General Features Specific Features Tough, plastic tube - Ideal for centrifuging and Vet-Tube S & SG posting samples. • Clotting agent for serum PLASMA • Available with and without separation gel (for serum Post compliant - Polypropylene, 3-part tube with use brown • Reduces slide failures with dry chemistry cap tube) leak-proof screw cap. WHOLE analysers BLOOD GEL Improves sample quality - Unique additives Vet-Tube P & PG GEL GEL BLOOD enhance accuracy of test. • Li-Heparin anticoagulant for plasma biochemistry and exotics haematology Unique, convenient I.D. system - Colour coded cap • Allows immediate centrifuging and testing and unique Vet I.D. label. VET TUBE BEFORE AFTER • Available with & without separation gel CENTRIFUGING CENTRIFUGING

Competitively priced - Excellent value for money. Vet-Tube E for Haematology • EDTA anticoagulant in LIQUID form enhances Separation gel - Once centrifuged, layers remain mixing separated. Serum/plasma transfer optional; either leave on or pour off. Prevents glycolysis. • Reduces risk of clotting No need for FI. Oxalate tube. • Reduces platelet clumping • Improves differential WBC counting Code Description Quantity Lid Colour Price 07-2615 Vet Tube P Li Hep 1.3ml 100 Orange £22.00 07-2610 Vet Tube PG Li Hep + Gel 1.1ml 100 Green £28.50 07-2605 Vet Tube S Plain 1.3ml 100 Clear £22.00 07-2600 Vet Tube SG Plain + Gel 1.1ml 100 Brown £28.50 07-2590 Vet Tube E EDTA (liquid) 1.3ml 100 Red £22.00 NEW 07-2585 Sodium Citrate 1.3ml 25 Green £7.13 07-2595 Microcentrifuge Tubes 500 £14.00

All prices are exclusive of VAT. There may also be a small carriage charge on some equipment. Terms and conditions apply. J.A.K Marketing reserves the right to withdraw any of the offers stated within at any time. All offers end 30 September 2010. Discounts apply to products alone and does not include delivery charges. We reserve the right to amend prices/specifications without prior notice. Errors and omission excepted. VP vol42 07_August 2010 24/08/2010 14:53 Page 39

SEPTEMBER 2010 VETERINARY PRACTICE CONSERVATION 39 Three beaver families in Scotland doing rather well I HAVE spoken before about the have at least one young kit each, reintroduction of species into the thought at the time of writing to be UK, in particular the red kite and about eight weeks old. That they are great bustard. The sea eagle is breeding during only their second another example and all three birds summer in the wild suggests that the be successful then it may be that further forestry in Scotland and northern can be considered to have been environment is suiting them very well reintroductions in Scotland and perhaps England to support a population of successfully re- and that further success England too are likely to take place just some 450 lynx which would help introduced. over the five-year trial as they have in some 25 control the ever So far the story A Veterinary Practice period will almost countries across Europe. It is estimated expanding deer just covers birds and correspondent is certainly materialise. If the beaver project that there is population. Attacks although there are encouraged by the Already the is a success there could be on sheep would be many examples of changes to the attempts to bring back enough forestry “manageable” and the reintroduction of in Scotland and alien mammal species beavers and looks environment that some of the other size of lynx means having colonised this forward to more beavers are likely to keystone species we have northern England that they pose green and pleasant species returning bring to the area are lost, with the lynx being to support a virtually no threat to land – grey squirrels, apparent with thinning perhaps one of the prime population of humans. mink, muntjac deer to of the woodland candidates. Whilst The establishment name just a few – the purposeful re- around their home or lodge creating a previously thought to some 450 lynx of the beaver could introduction of a mammal species naturally coppiced area of dappled have died out 4,000 years which would help be just the start of that man has previously brought to sunlight with glades and trees of varying ago, recent evidence is control the ever exciting times ahead. extinction in the UK has only just size. that it survived into expanding deer n The photo of the beaver been started. Two families have constructed their mediaeval times and was population. lodge was taken by Miller- I say purposeful because although own lodges rather than using the eventually exterminated NPS Photo and of the there are now areas of Britain seemingly artificial ones provided, and one of by man. swimming beaver by J. alive with wild boar, these are the result these families has built a significant dam It is estimated that there is enough Schmidt-NPS Photo. of escapees or sporadic releases rather which has created a new area of wetland than a deliberate effort to re-establish being colonised by a range of other them. The reintroduction I am referring invertebrate and vertebrate species. to is, of course, that of the European This change in the environment is The success of beaver. one of the things that conservationists ® Beavers were once widespread are most excited about and for which PERLOQUAN throughout Britain but were hunted to those opposed to the scheme have most In the words of the owners extinction some 400 years ago. Last concern. Those in opposition worry year, after much heated debate it has about the effect that dams may have on

to be said, three beaver families (11 flooding in the area and how fish stocks ® The Files: PERLOQUAN animals in total) were released at a trial might be affected along with the Case studies site in the Knapdale forest in Argyll, perceived damage that the beavers do to Scotland. How have they fared since? trees. Putting the jump into Ginny! Generally speaking rather well We all know how dogs love to run and play, and maintaining healthy joints is important in keeping them mobile for longer. although one of the families did Very selective Catherine Dixon, a veterinary nurse from Whiston, near ® on her two-year-old disappear in somewhat murky Conservationists, on the other hand, Liverpool, is using the nutritional supplement, PERLOQUAN Border Collie, Ginny, to ensure that her joints are looked after due to all the strenuous circumstances which included the sound point to the fact that beavers are very exercise she does. of unauthorised gunshot. It is selective in their tree felling and are “Like most Collies, Ginny loves running around and particularly enjoys going for speculated that local opposition may natural woodland “managers”, walks in a pack with my mother’s two dogs, a Border Collie and a Lurcher/Terrier cross, who are really active and involved in flyball. The cross-breed is so fast that she’s have been behind this but another instinctively, through centuries of been crowned the second fastest cross-breed in England! ® breeding pair were released in the spring evolution, producing a forest edge of “I was concerned that all the exercise would affect Ginny when she was older, so I’d of this year to replenish the stocks. widely diverse tree sizes and habitats been giving her cod liver oil in her food. This has now been replaced by PERLOQUAN which has had a dramatic effect. Ginny has the same energy as always and is as It seems now though that the stocks and “managing” water levels to the great active as ever, but she now has an edge on the cross-breed who she loves to race may already be self-replenishing with benefit of a host of other species such when she is off the lead. She is more fluid in her movements the day after a long walk and there is also a noticeable difference in her coat which is amazingly shiny the recent news that two family groups as water birds, otters, amphibians and and soft. Other people have even started commenting on it, which makes us really invertebrates. proud of her. ® to be very easy to use and, being a veterinary nurse, I am “I’ve found PERLOQUAN ® and would definitely Beavers also have a extremely happy with PERLOQUAN recommend it to clients.” habit of moving on ® PERLOQUAN can be given as a treat or added to a pet’s from one place to food. It is available in an 800 g pack with a convenient measuring scoop. another as they access ®, new food sources so For further information on PERLOQUAN please contact your local veterinary practice. that the landscape they create is in a constant state of flux and For more success stories by dog owners who use PERLOQUAN® go to therefore attractive to TM PERLOQUAN® is an easy-to-administer nutritional supplement specially formulated to help maintain different species at healthy joints and associated tissues. For more information please contact Janssen Animal Health, a division of Janssen-Cilag Ltd, 50-100 Holmers Farm Way, High Wycombe, Bucks HP12 4EG, UK. different times. Tel: +44 (0)1494 567555 Fax: +44 (0)1494 567556 Email: [email protected] Caring for your life’s companions If the trial proves to www.janssenanimalhealth.com VP vol42 07_August 2010 24/08/2010 14:53 Page 40

40 WELFARE VETERINARY PRACTICE SEPTEMBER 2010

Veterinary surgeons, animal welfare scientists and others attended the These showed that calves that sucked from hill breeding flocks and fattened- Universities Federation for Animal Welfare (UFAW) symposium in York at the from their dams or through an up on lowland farms. Animals with end of June to hear about the latest advances in welfare science, and artificial teat fell asleep more quickly lost tags need to be given new ones particularly developments in improved methods for assessing health and and spent more time in the initial non- although the absence of a tag doesn’t welfare in domestic species. John Bonner picks out some of the highlights. rapid eye movement phase of sleep necessarily preclude them entering the than those animals that drank from a food chain. Eye temperature as an stress in a faster heart rate and raised bucket. Her studies have shown that salivary cortisol levels. So in further In addition, calves kept in pairs watching the animals in the lairage is indicator of horse tests she compared the eye have longer periods of sleep than of limited value in detecting potentially welfare temperatures of horses that showed those housed on their own and calves painful lesions, which may only be CHANGES in the surface temperature behavioural signs of distress when lying on rubber mats had less apparent post mortem. These were of the eye could provide a simple, fast clipped against those of animals that fragmented sleep than those settling classified according to type and and non-invasive method for assessing were considered to be more relaxed. down on bare concrete floors. severity of the lesions. Nearly 900 the welfare of horses, according to Surprisingly, there was little Dr Hanninen said her work has carcases from 51 farms were examined Kelly Burton, a PhD student at difference in the eye temperature and attracted interest from the Finnish and lesions were found in 16% of Nottingham Trent University, who salivary cortisol responses of the two dairy industry which recognises the cases with a high incidence of medium described her studies using infra-red groups. It seems that horses that potential importance of good quality grade inflammation and suppurative cameras to detect increases in radiant appear relaxed when subject to the sleep as a measure of good welfare. It lesions. heat as a result of stress. stress of handling will still experience may also have subtle effects on the Older animals with double tags She said the temperature of a a surge in the production of stress economic efficiency of a calf-rearing were six times more likely to have horse’s eye may go up by 8 or 9 hormones. enterprise as it is known that growth these lesions than lambs slaughtered at degrees at the same time that its skin “These results show that the hormones are secreted in phases of an age when only single tags were surface actually cools as blood is horses do find clipping to be aversive non-REM sleep. required. More than 90% of the tags diverted to the muscles as part of the but either they have been trained not Further studies will look at the were of the plastic loop type, the “fight or flight” response. to respond or habituation is masking effects of aversive management cheapest but one which previous Thermographic cameras were the behavioural but not the procedures like disbudding on the studies have also shown to be the most originally developed for military physiological signs of distress,” she subsequent sleeping patterns of calves likely design to cause ear injuries such purposes but have attracted interest explained. and on the patterns of sleep in older as bleeding and inflammation. from animal welfare researchers as an animals. One area to be investigated is Further studies will try to identify alternative to methods like heart rate the interaction between cycles of sleep the specific risk factors associated with monitoring and blood cortisol Lack of sleep affects and rumination in dairy cows. the more severe forms of injury, with measurements, which may themselves productivity of “During REM sleep the rumen is a view to developing guidelines on best cause the animal to become stressed. atonic. So it has been suggested that practice. One thing is already clear that Improved methods for measuring livestock this is one of the factors that has the competence of those responsible stress would be useful as many aspects Lack of adequate sleep may affect contributed to the short cycles of for fitting the tags is crucial in avoiding of domestication, such as transport, both the welfare and productivity of sleep that are seen in cattle, because injury as there is large variation training and confinement in a stable farm livestock, Laura Hanninen from the cow has to wake up and burp between different units in the away from its herd-mates are potential the University of Helsinki told the before it can start ruminating again.” incidence of injuries. causes of chronic stress. meeting. “So it may be better to invest in In her investigation, Ms Burton Studies in humans and laboratory training rather than double tagging if assessed the response to coat clipping, animals have shown that sleep is Ear infections in sheep we want to be able to trace the a routine husbandry procedure which essential for maintaining good health increase after tagging movements of animals across Britain appears to cause acute stress in some with a wide range of physiological Incidents of painful ear infections in and Europe,” she suggested. horses, who object both to the noise effects. So if the duration or quality of sheep have increased in the wake of and the sensation of the clippers on sleep is insufficient then this will have legislation requiring tagging of both their skin. detrimental effects on the individual’s ears to improve traceability of animals Free-range or battery: The test horses were given a sham social behaviour, immune function, etc. through the food chain, according to what difference? clipping session lasting 10 minutes. Currently, very little is known research at the Glasgow veterinary Laying hens are just as likely to suffer This is a longer duration stimulus than about the role of sleep in the lives of school. serious welfare problems when housed has been used in previous studies farm animal species but she described Cintia Silva, a postgraduate student under free-range conditions as they are assessing this technology to identify her work in developing and validating in the school’s department of in intensive battery production stress – and this may account for the lightweight, non-invasive technology veterinary public health, has been systems, researchers at Bristol bigger temperature changes seen in for making ambulatory carrying out ante- and post-mortem veterinary school have discovered. this study, she suggested. electroencephalogram recordings to examinations of sheep at abattoirs to Anna Davies, a postgraduate The measurements were made with monitor sleeping behaviour in cattle. assess the welfare impact of the student in the animal welfare and the camera 150cm away from the Overall, the patterns of brain European directive 92/102/EC on the behaviour group, described a study horse’s head according to a standard activity and sleeping behaviour are identification and registration of food looking at spent hens in the run-up to protocol. similar in all species of mammals and animals. depopulation at around 72 weeks of In a pilot study, the increase in the birds. But the amount of time devoted Those rules require that sheep age. surface temperature of the eye after to sleep will vary with carnivorous born in the UK after 11th January She pointed out that many of the five minutes of “clipping” correlated species able to enjoy much longer 2008 should be tagged in each ear or welfare issues of most concern to well with the traditional measures of periods of sleep than prey species, identified with a combination of tag consumers, animal welfarists and the which will typically spend about two and a tattoo, except in those animals industry are cumulative and so they are hours asleep a day taken in short intended for slaughter within the UK best measured at the end of the birds’ bursts. before the age of 12 months. working lives. It must be remembered, The only functional differences are She points out that the size and however, that the findings may seen in marine mammals and birds in structure of the UK sheep industry underestimate the severity of welfare flight, which are able to shut down one will mean that the legislation has a problems if birds with more obvious hemisphere at a time. potentially greater effect on welfare injuries are culled or die earlier in the Preliminary studies using the here than in other EU states. The production cycle. technology have looked at the effects country has 32 million sheep, more Miss Davies and her colleagues Thermographic image of a horse of different management practices on than any other member state, and a captured 50 birds each from 25 free- shown by Kelly Burton. the sleep patterns of dairy calves. high proportion of lambs are sent range layer flocks throughout the UK VP vol42 07_August 2010 24/08/2010 14:53 Page 41

Clearing the way to a fl ea-free environment.

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42 WELFARE VETERINARY PRACTICE SEPTEMBER 2010

and examined them for various injuries slaughter. Changes in the activation huge numbers of dogs at great which would indicate poor welfare. levels of several hundred genes were expense and with detrimental effects They found that nearly half the birds identified by comparison with samples on their welfare, said Eugenia Natoli, had plumage damage, over 30% had from chickens slaughtered on the farm. who works at a dog shelter in the peck injuries around the vent, while Her results showed that 153 genes Lazio region around Rome. 20% had vent prolapses and more than were upregulated (or activated) by the She described a study into the 60% had potentially painful injuries to time the chickens reached the slaughter impact of Italian National Law 281/91 the keel bone. line, including many genes associated which also requires the registration of It is a concern that many of the with energy metabolism and the owned dogs and neutering more serious injuries, like keel bone immune response. These reflect programmes for any dogs brought into fractures and prolapses, are unlikely to changes at the genetic level which municipal shelters. Apart from Austria be spotted during the sort of cursory match known physiological responses and some regions of Spain, Italy is the inspections that the birds would to stress and food deprivation. only European country to operate a undergo in a normal production Meanwhile, another 233 genes were no-culling policy for strays but because system. The injuries are only apparent if down-regulated as the birds’ the rules have not been properly the birds are held individually and metabolism adapted to the depletion of enforced the intended welfare benefits The UFAW 2010 Wild Animal examined closely. glycogen reserves in the liver by have not materialised. Welfare Award was presented to She pointed out that this high mobilising alternative energy resources. In the Lazio region there are 47 the Food and Environment prevalence of injuries occurred in hens A second phase of the study looked shelters but these are all full and house Research Agency (Dr Julie Lane, from six different genetic strains and at the effects of chronic stress during many animals that are likely to spend Vicky Jackson, Anne Hudson and kept in several different types of the rearing phase as a result of the pain their whole lives behind bars. The Matt Brash) in collaboration with housing system. “So we must ask caused by foot pad dermatitis. network is very successful in finding the University of York (Dr Pat ourselves if the modern laying hen is Significant changes were also detectable new owners for the strays, rehoming Coulson) for their new “Wild robust enough for the conditions in in the pattern of gene expression of about 1,000 a year, but there are about mammal and bird training which they are kept and whether we these lame birds compared with their 1,500 dogs entering the system. course”, which provides training should be looking at selectively healthy flock-mates. Consequently, the costs of looking after for researchers aimed at breeding healthier birds,” she said. Ms Sherlock said her findings the dogs has spiralled, reaching €7 improving best practice in the Keel fractures are seen much more confirmed what is already known about million a year, excluding those expenses capture, handling, marking and frequently in these free-ranging birds the effects of stress from behavioural relating to veterinary treatment. release of wild animals used in than in those kept confined in battery and biochemical studies. “This Dr Natoli described a study such research. The photo shows cages. This would appear to be the technique can provide a useful tool to looking at behavioural and Dr Lane receiving the award from penalty paid for allowing birds to follow find out more about the underlying physiological parameters in dogs that Dr James Kirkwood, UFAW’s chief their instincts in seeking out high-level mechanisms that lead to the changes we are long-term inmates at eight regional executive and scientific director. perches, as they probably are caused by observe as a result of stress in things shelters. She found there was little the birds colliding with these structures. like growth rate and the immune correlation between some of the But it must be remembered that system.” behaviours that are reckoned to be battery cages cause their own welfare While the technology can indicators of canine stress, such as problems which are likely to be just as potentially provide objective evidence vocalising, panting and lip-licking, with severe, she said. on the causes of welfare problems, it the biochemical findings from blood may also help to improve the economic cortisol and blood antioxidant levels. performance of the poultry industry. However, other behavioural features Stress causes changes She pointed out that stress and did appear to be reliable signs of stress in broilers before injury during harvesting and transport and poor welfare such as aggression are probably responsible for 75% of and stereotypic movements. slaughter the 3 million birds a year which are Aggression was most common in PDSA senior veterinary surgeon Stress experienced by broiler chickens dead on arrival at the abattoir. Although those shelters with the highest Sean Wensley received the UFAW before slaughter causes physiological this is only a very small proportion of proportion of unneutered dogs but Companion Animal Welfare award changes that can be detected at the the 800 million broilers slaughtered high stocking densities alone did not from James Kirkwood for a project most fundamental level, producing each year in the UK, it still represents seem to be a problem. One positive he carried out with colleagues variation in the expression of genes an economic drain on the industry. indicator of high welfare was the Elaine Pendelbury and Tim associated with key metabolic pathways, frequency that dogs were taken out for Browning. They set up Your Right according to RVC researcher Louise walks by volunteer workers at the Pet – a web-based tool designed Sherlock. Stray dog legislation shelters, she noted. to help prospective pet owners Ms Sherlock is a postgraduate Dr Natoli believes the evidence not working in Italy choose the right pet for their student in the school’s Centre for Legislation introduced in Italy to that long-term incarceration results in lifestyle and circumstances. The Animal Welfare and is using micro- protect the welfare of stray dogs has poor welfare is sufficiently strong to site (www.your-right-pet.org.uk) assay technology as a tool for assessing had quite the opposite effect and require a review of the national gives information about the five the effects of stress in intensive rearing should be scrapped, an Italian legislation on stray dogs. welfare needs and practical systems. veterinary surgeon told the meeting. “We have decided in Italy that it is guidance on how these can be met This technology is used widely in Rules introduced in 1991 require better for dogs to receive life for commonly kept companion investigations into human diseases and local authorities to capture stray dogs imprisonment than capital punishment. animals – helping to prevent the increasingly as a tool for welfare and keep them in shelters where no So it is our ethical duty to guarantee suffering that can be caused by research. It consists of an array of animal should be euthanased unless it that the welfare of these animals is inappropriate pet choice. thousands of DNA oglionucleotides is found to be vicious or terminally ill. adequate.” which can detect complementary DNA But far from sequences in a tissue sample. eliminating the In her study she analysed liver stray problem, 2009 proceedings published THE proceedings of the international symposium run by UFAW last June samples of broilers after they had been the legislation under the title Darwinian selection, selective breeding and the welfare of animals, have exposed to a series of potentially has done been published as a supplement to Animal Welfare, the federation’s journal. stressful events that form part of the nothing to Copies are available at £20 within the UK and Europe and £30 further afield normal production process – food reduce stray from UFAW at The Old School, Bewhouse Hill, Whtahampstead, Herts. AL4 withdrawn for many hours, capture, numbers while 8AN; telephone 01582 831818, e-mail [email protected]. transport, shackling, stunning and Eugenia Natoli. locking away VP vol42 07_August 2010 25/08/2010 11:59 Page 43

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Further information available from Boehringer Ingelheim Vetmedica, Bracknell, Berkshire, RG12 8YS, UK. Tel: +44(0)1344 746959. Email: [email protected]. Date of preparation: September 09. AHD 6137 VP vol42 07_August 2010 24/08/2010 14:54 Page 45

SEPTEMBER 2010 VETERINARY PRACTICE EQUINE 45

Based on their findings, the authors viable supplemental option for Equine Veterinary Education 22 (6): 281- Round-up propose a dose of 5mg/kg given pre- treating burn injuries, with no 286. Efficacy of using stored breeding with two further doses at 36 apparent adverse effects. colostrum to establish passive to 48 hours post-breeding as a rational Equine Veterinary Education 22 (2): 67- Adrenocorticotrophic hormone immunity in at risk foals preventive strategy against common 72. as a biomarker for pituitary Laura Nath and others, University bacterial strains associated with dysfunction of Melbourne endometritis. Ciprofloxacin and moxifloxacin Zuo-Yen Lee and others, Pegasus Failure of transfer of passive immunity Journal of Veterinary Pharmacology and concentrations following topical Equine Diagnostics Ltd, in foals can lead to an increased risk of Therapeutics 33 (3): 287-294. ocular administration Nottingham neonatal infection, bacteraemia and Alison Clode and others, North Pituitary pars intermedia dysfunction death. So it is recommended that foals Use of a modified Vinsot Carolina State University is a common disorder in elderly horses are given stored colostrum if they are technique for partial Ulcerative corneal disease is a common which may eventually progress to perceived to be vulnerable to FTPI due phallectomy in standing horses problem in equine practice requiring laminitis. Elevated plasma to a failure to suck or because their Carolyn Arnold and others, Texas aggressive therapy with suitable topical adrenocorticotrophic hormone dam is found to produce poor quality A&M University antimicrobial agents. The authors (ACTH) levels are associated with the colostrum. Phallectomy procedures may be compare the ocular penetration and condition and the authors describe a The authors assessed the benefits necessary in male horses affected by a systemic absorption of 0.3% study measuring changes in hormone of this intervention in a cohort of number of conditions including ciprofloxacin and 0.5% moxifloxacin levels in horses with pituitary disease 232 thoroughbred foals. Pre-suckle chronic paraphimosis, carcinoma and in healthy equine eyes. Anterior and matched controls. In both groups, colostrum was collected from mares priapism. The authors describe a chamber paracentesis and blood ACTH concentrations were and analysed to determine its colostral technique for penile amputation in the samples were taken up to 25 hours significantly higher in autumn and refractive index. Foals from dams standing horse. This was carried out in after the final dose. These showed that winter than in spring and summer. which produced colostrum with a CRI 11 cases and found to be technically moxifloxacin penetrated better into the Such seasonal variation must be taken below 20% were given stored, frozen easy, well tolerated by the patient and aqueous humor and may be a more into account in assessing the results of material by nasogastric tube on four with minimal post-operative suitable option in treating deep corneal any assay. occasions within six hours of birth. complications in the form of two lesions than ciprofloxacin. The Veterinary Journal 185 (1): 58-61. Analyses of serum IgG incidents of mild urine scalding. The American Journal of Veterinary Research concentrations confirm that treatment technique is effective in those horses 71 (5): 564-569. Surgical correction of with stored colostrums is effective in which, for medical or economic rectovaginal fistulas in mares preventing FTPI in at-risk foals but reasons, are unsuitable candidates for Cytokine mRNA expression in and their subsequent fertility some were still vulnerable even after general anaesthesia. horses with exercise-induced Sarah Jalim and Angus McKinnon, consuming colostrum with adequate Journal of the American Veterinary pulmonary haemorrhage Goulburn Valley Equine Hospital, CRI values. Medical Association 237 (1): 82-86. Montague Saulez and others, Victoria Journal of the American Veterinary University of Pretoria A rectovaginal fistula is a relatively Medical Association 236 (10): 1,085- Antimicrobial delivery by Exercise-induced pulmonary common injury sustained during 1,090. intrasynovial catheterisation to haemorrhage occurs in up to 75% of foaling and may also arise as a result treat septic arthritis thoroughbreds undergoing strenuous of unsuccessful surgical repair of a Assessing recovery from Allison Stewart and others, exercise. Inflammation in the airways perineal laceration. The authors inhalation anaesthesia in horses University of Illinois is likely to be accompanied by the evaluate the effects of surgical repair Karine Portier and others, Septic arthritis and tenosynovitis are production of inflammatory of this lesion on the subsequent University of Lyon, France potentially lethal problems occurring mediators which, the authors fertility of 28 mares. Five mares were Recovery is a high-risk period during secondary to trauma and joint hypothesise, may be detectable in covered during the same cycle as the equine anaesthesia with 32% of the infections in horses. Irreversible bronchiolar lavage fluid at levels surgery with all five conceiving and all overall mortality occurring in this damage to the articular cartilage may which correlate with the severity of but one carrying to term. These time. Several scoring systems have occur within 24 hours of the initial EIPH. After racing at sea level, findings suggest that it is not been developed in attempts to assess injury and so early aggressive therapy interleukin-6 expression was indeed necessary to delay breeding until the risk and compare the effects of is warranted. The authors describe a associated with more severe cases of next season in mares surgically treated different drugs on recovery quality. technique for delivering broad- bleeding. Racing at altitude resulted in for rectovaginal fistulas. The authors describe the use of an spectrum antibiotics to the joint via an higher expression of both IL-6 and Australian Veterinary Journal 88 (6): 211- objective scoring system based on intrasynovial catheter. The method tumour necrosis factor. 214. recovery descriptors involving two was used in 38 cases of synovial American Journal of Veterinary Research alternatives, such as the presence or trauma and/or infection. The 71 (4): 447-453. Primary epitheliotropic absence of shivering, and compare the prognosis for survival was very good intestinal T-cell lymphoma as a results to those of a conventional and 43% of cases returned to riding. Multiple-drug resistant cause of diarrhoea in a horse visual analogue scale measure. They Australian Veterinary Journal 88 (4): 115- Acinetobacter baumannii Macarena Sanz and others, suggest that the new method is a 123. bronchopneumonia in a colt Washington State University useful tool for further studies. Jonna Jokisalo and others, A 25-year-old Appaloosa gelding was Veterinary Anaesthesia and Analgesia 37 Shockwave therapy in treating a University College Dublin evaluated for chronic weight loss of (10): 329-336. burn injury on a horse Acinetobacter baumannii is an two months duration and diarrhoea Jenny Johnson and others, Oakhill opportunistic pathogen which has been which had been occurring for one Enrofloxacin therapy in Shockwave, Calabasas, California shown to be developing multiple drug week. On clinical examination, a preventing equine endometritis Healing in horses with burn injuries resistance with increasing regularity. diagnosis of protein-losing Claudia Gonzalez and others, may be slow and require careful Such strains have been found to cause enteropathy was made and the animal National University of Buenos management to prevent infection. wound infections in small animal was euthanased. Post mortem, a Aires Studies of burns in human patients patients and the authors describe an histological analysis revealed Enrofloxacin is often used empirically have suggested that shockwave incident in a colt. This had been treated neoplastic lymphocytes infiltrating the to prevent uterine infections in mares therapy may aid the process of re- for a presumed enterocolitis before mucosa of the large and small and improve the productivity of epithelialisation of partial thickness developing chronic lower respiratory intestine. Immunohistochemistry was commercial embryo transfer units. lesions. The authors describe using tract disease. A percutaneous positive for the CD3 T-cell marker, a The authors studied the uterine this method in a horse which transtracheal wash revealed an A. finding consistent with a diagnosis of distribution of this drug and its main sustained extensive burns to its back baumannii infection which was epitheliotropic T-cell lymphoma. metabolite, ciprofloxacin, following in a trailer fire. Their findings suggest successfully treated with marbofloxacin Canadian Veterinary Journal 51 (5): 522- intravenous administration in mares. that shockwave therapy may be a following sensitivity tests. 524. VP vol42 07_August 2010 24/08/2010 14:54 Page 46

46 EQUINE VETERINARY PRACTICE SEPTEMBER 2010 How can nutrition support rest, recuperation and re-introduction of exercise? A PERIOD of rest and back into work, is significantly supplement the ration if energy is likely to be relatively low, it must recuperation is almost inevitable reduced in comparison to that of requirements demand. This is have a higher micronutrient density during a horse or pony’s career, horses in full work. However, care particularly relevant for horses or than a feed designed for maintenance irrespective of whether we are should be taken to account for the ponies that are at risk from equine or low work. Most traditional coarse discussing a top-flight potential increased energy demands of rhabdomyolysis, where box rest and a mixes and cubes require a daily intake performance horse, or simply a severe trauma or stress in high starch diet is a risky combination of about 500g per 100kg bodyweight hard-working pony club pony. recuperating horses. There are no (Valberg and McKenzie, 2005). to ensure adequate provision of Horses and ponies may require a specific figures regarding this in micronutrients and so the use of a period of recuperation that includes horses, but in human patients with Harnessing the anti- broad-spectrum vitamin and mineral complete box rest for major fractures, basal inflammatory potential of fatty supplement, or a feed balancer a variety of reasons, energy requirement is acids product should additionally be for example surgery reported to be There is evidence to suggest that an considered. following an increased by 20-25% increased omega 3:6 fatty acid ratio in Adequate provision of antioxidant orthopaedic issue or (Jensen et al., 1982). the diet is beneficial during rest and micronutrients and vitamins such as colic, or due to recovery from injury or disease in selenium, vitamin C and vitamin E is systemic disease or Forage is horses (Manhart et al., 2009; essential to support immune function viral challenge. multifunctional Woodward et al., 2007). Whilst and to curb the deleterious effects of Laminitis is another for recuperation inflammation is a functional free radicals that are synonymous common reason for a Adequate forage component of the repair process, it with inflammation. prolonged period of intake is probably the needs to be carefully managed. box rest, especially in Dr CATHERINE most important Stabled horses usually have a Protein intake must promote ponies. DUNNETT aspect of a ration for higher intake of omega 6 fatty acids, quality and not just quantity Rest and discusses the feed rest and recuperation which in comparison to their omega 3 Repair of tissue is associated with an recuperation poses a requirements of and when the level of counterparts are characteristically pro- increased rate of cellular turnover and particular nutritional horses at special times exercise increases in inflammatory. Omega 3 fatty acids, therefore an increased requirement challenge and some those horses being which can be found in grass, linseed for amino acids from dietary protein. major changes to the reintroduced to meal, tuna oil and some algae, give During recovery from injury or diet may be required during the exercise training. rise to a number of anti-inflammatory disease, protein quality and pre-caecal period of box rest, but also once the Multiple forms of good quality mediators such as prostaglandins and digestibility should ideally be high, horse or pony is brought back into hay or haylage that has a low mould cytokines. However, the omega 6 fatty particularly where the functionality of work. burden is essential to help maintain acid ã-linolenic acid (GLA), of which the small intestine is compromised The focus of the diet for a horse both digestive and respiratory the algae Spirulina is a rich source, is due to surgical resection following or pony on box rest as well as those function, but also to effectively satisfy also reputed to exhibit anti- colic. However, the protein quality that are being re-introduced back into the need for occupational therapy inflammatory effects (Collaa et al., and digestibility offered by many low exercise training should be: (Goodwin et al., 2007). The 2004). energy feeds, which are traditionally n to provide an adequate but not prevalence of stereotypic behaviours used for horses during rest and excessive intake of energy; such as windsucking and wood Strategies to maximise pre-caecal recuperation, may be inadequate to n to provide a suitable profile of chewing is higher in horses that are digestion are beneficial optimally support this process. macro and micronutrients to support fed inadequate amounts of forage Concentrate feeds should be kept In addition, the pre-caecal tissue repair, digestive function, coupled with low fibre high starch small and fed on a little and often digestibility of protein from forage is muscle function, immunity and concentrate feeds (Nicol, 1999). basis to maximise the digestion of generally low and so in order to respiratory health; During this period, horses will both starch and protein pre-caecally. provide an optimum balance of n to maintain overall condition and also benefit from a shift in the main This will limit the detrimental effect amino acids to support the repair limit muscle wastage; and source of energy away from high of starch reaching the hindgut on the process as well as muscle protein n to minimise behavioural problems starch containing cereals, which can microbial balance. As horses can only turnover, provision must be made associated with box rest and a general contribute to excitability and utilise amino acids absorbed in the through the concentrate feed. lack of activity. stereotypic behaviour, towards feeds small intestine, high pre-caecal protein Feed ingredients such as soya and Energy or caloric intake in box- with a higher digestible fibre content. digestibility is vital. whey have traditionally been fed, but rested horses, as well as those coming Oil can also be used to As the intake of concentrate feed new ingredients such as the blue-

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SEPTEMBER 2010 VETERINARY PRACTICE EQUINE 47

green algae Spirulina also provide a surprisingly, therefore, the Naturforsch 59C: 55-59. glutamine status in the equine at rest, rich source of quality protein with requirement for glutamine increases Goodwin, D., Davidson, H. P. B. and during exercise and following viral high pre-caecal digestibility. in situations of trauma or sepsis. In Harris, P. (2007) Responses of horses challenge. Equine Veterinary Journal horses, plasma glutamine is reduced offered a choice between stables Supplement 30: 612-616. Key amino acids involved in following viral challenge (Routledge et containing single or multiple forages. Valberg, S. and McKenzie E. C. repair processes al., 1999) and glutamine status can be Veterinary Record 160: 548-551. (2005) Muscle disorders: untying the There are a number of amino acids, improved through supplementation Harris, R. C., Harris, P. A., Routledge, knots through nutrition. In: Pagan, J. e.g. arginine, ornithine, glutamine and of the diet with glutamine-rich feed N. B., Naylor, J. R. and Wilson, A. M. D. (ed.) Advances in Equine Nutrition leucine, that are reported to have a ingredients (Harris et al., 2006). (2006) Plasma glutamine III. Nottingham University Press, beneficial effect on recovery Leucine is a branch chain amino concentrations in the horse following Nottingham. pp473-488. processes in athletes (Pasquale, 2008) acid that is reputed to limit muscle feeding and oral glutamine Woodward, A. D., Nielsen, B. D., and which are therefore of relevance wastage that occurs during prolonged supplementation. Equine Veterinary O’Connor, C. I., Skelly, C. D., Webel, to sports injury and disease in horses. periods of inactivity by retaining the Journal Supplement: 637-642. S. K. and Orth, M. W. (2007) Arginine, an amino acid reputed normal rate of protein synthesis. Jensen, J. E., Jensen, T. G., Smith, T. Supplementation of dietary long- to function in a number of ways to In summary, horses that are K., Johnston, D. A. and Dudrick, S. J. chain polyunsaturated omega-3 fatty speed repair from injury: undergoing a period of rest and (1982) Nutrition in orthopaedic acids high in docosahexaenoic acid n promotes insulin release and IGF recuperation, or that are being surgery. Journal of Joint and Bone (DHA) increases plasma DHA action – these are anabolic hormones reintroduced back into work, will Surgery 64: 1,263-1,272. concentration and may increase trot that stimulate protein synthesis and benefit from a high intake of forage, Manhart, D. R., Scott, B. D., Gibbs, P. stride lengths in horses. Equine and collagen deposition; coupled with a low starch and high G., Coverdale, J. A., Eller, E. M., Comparative Exercise Physiology 4: 71-78. n stimulates nitric oxide production, fibre concentrate feed with an Honnas, C. M. and Hood, D. M. Dr Catherine Dunnett has a which increases blood flow to enhanced micronutrient content. (2009) Markers of Inflammation in background in biological sciences with affected areas and activates In addition, supplementary feeds Arthritic Horses Fed Omega-3 Fatty many years of experience of scientific macrophages involved in tissue clean that offer a superior source of Acids. The Professional Animal Scientist research, primarily at the Animal up; protein of high quality and 25: 155-160. Health Trust, where she undertook her n promotes the conversion of digestibility to improve targeted Nicol, C. (1999) Understanding PhD, combining nutrition with exercise ornithine to proline required for amino acid delivery may also be equine stereotypies. Equine Veterinary physiology. Catherine worked as a collagen synthesis. beneficial. Journal Supplement 30: 20-25. nutritionist and product manager for a Ornithine is the major metabolite Pasquale, M. G. D. (2008) Amino leading horse feed manufacturer and of argenine that is reputed to References acids and proteins for the athlete: the now runs her own consultancy promote wound healing. Collaa, L. M., Bertolina, T.E. and anabolic edge: CRC Press, Boca business, Independent Equine Glutamine is an amino acid that is Costab, J. A. V. (2004) Fatty acids Raton, Florida. Nutrition, that provides a combination of nutritional support and analysis, essential for the metabolism of profile of Spirulina platensis grown Routledge, N. B., Harris, R. C., product development and evaluation, rapidly turning over cells, such as under different temperatures and Harris, P. A., Naylor, J. R. and as well as educational services. lymphocytes and enterocytes. Not nitrogen concentrations. Z. Roberts, C. A. (1999) Plasma

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48 EQUINE VETERINARY PRACTICE SEPTEMBER 2010 NSAID usage and welfare THE FEI Congress on Non-Steroidal supersede national law, and that anyone Dominik Anti-Inflammatory Drug Usage and participating in the sport in any of the Burger, president Medication in the Equine Athlete, held nine countries must note that national of the in Lausanne, Switzerland, last month laws prohibit, or may prohibit, the use Veterinary attracted more than 200 delegates from of NSAIDs. Commissions of 29 countries, bringing together up-to- Lynn Hillyer, of the British Horse the Breeding date scientific data as well as non- Racing Authority, explained that the Associations for scientific aspects of NSAID usage. Racing Authorities of Europe, Hong Swiss sport The event demonstrated, says the Kong, North and South Africa, horses, spoke on FEI, that this is a debate that cannot Australasia, Asia and the Middle East the breeding be viewed purely from a scientific (except Saudi Arabia) rule that horses perspective. He Dr Martial Saugy, Professor Tim perspective and that ethical values and must not race under the effects of any concluded that the issue would benefit Greet (a former president of both legal issues also have to be taken into drugs, but acknowledge that from a pluralistic ethical analysis based the BEVA and BVA), Frank Kemperman, Brough Scott and Chris account. medication is necessary – off the not just on the welfare of horse and Hudson discuss the use of NSAIDs in Following the mainly science-based racetrack – to ensure a horse’s physical rider but also on regional and global competition. presentations, FEI general counsel Lisa well-being. public values like integrity, equity, Lazarus outlined details from nine “In other words, medication should justice, duties and responsibility. possible repercussions of reintroducing European countries that prohibit or be an aid to recovery, not a tool to Steve Maynard, laboratory director NSAIDs in competition. may prohibit the use of NSAIDs enable a horse that should be resting at Horseracing Forensic Laboratory FEI veterinary director Graeme under national law. and recuperating to race or train,” she Sport Science, said that quantitative Cooke, stressed the importance of In light of the legal issues, Ms said. analysis, applied to determine the keeping the debate alive between now Lazarus stated that the FEI has two Stephen Schumacher, chief exact level of a substance being and the vote on in-competition use of options: either abandon any proposed administrator of the Equine Drugs and present in the body, is significantly NSAIDs at the FEI general assembly change in the treatment of NSAIDs, Medications Programme of the United more costly than qualitative analysis in November. maintaining the status quo that NSAIDs States Equestrian Federation (USEF), carried out to detect the presence of a “There is no doubt that both sides cannot be administered to sport horses stated that the USEF Equine Drugs substance. of the Atlantic and the rest of the during FEI competition anywhere in and Medications Rules allow NSAIDs The public perception of world have the same clear goal in mind: the world; or permit the use of usage with quantitative restrictions. equestrian sports, sponsors and the that the welfare of the horse is really NSAIDs at appropriate levels as far as “We believe that the welfare of our media perspective were all aired in a paramount to whatever we do,” he the FEI and its members are horses is not put into jeopardy with the panel discussion, when British said. concerned, but make it clear to all judicious use of NSAIDs and their use journalist Brough Scott asked some n Videos of the event are on the participants that the FEI’s rules do not may in fact be beneficial,” he said. hard-hitting questions about the FEI YouTube Channel.

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SEPTEMBER 2010 VETERINARY PRACTICE EQUINE 49 Survey aims to uncover perceptions of horse welfare WORLD Horse Welfare (WHW) has “People often do not realise the launched the Great British Horse scale of equine abuse which still exists Survey 2010. The charity is asking in the UK,” she said. “Britain certainly everyone with an interest in horses to has a reputation as a nation of horse take part, making it the biggest survey lovers, but with an increasing number of its kind ever undertaken. of abuse cases, it seems we are in With questions on a range of danger of tarnishing it. This survey is issues, including practical problems a great opportunity for those people facing those looking after horses and who love and enjoy horses to offer general perceptions of welfare their views about what they think are standards, the aim is to create the most the most pressing issues facing the complete picture of the equine equine community.” community ever held in Britain. Pippa Funnell, a trustee of WHW, Unacceptable is urging all those involved in the Roly Owers, the charity’s chief equine community, in any capacity, to executive, said: “Despite the 2006 go online and have their say at Animal Welfare Act which makes www.horsesurvey.co.uk. owners accountable for the welfare of their animals, we are still dealing with Blood transfusion an unacceptably high number of equine cruelty cases. saves foal “This shows there is a lot still to be done to eliminate horse suffering in the UK. “The Great British Horse Survey will enable us to gain an in-depth insight into the overall state and perceptions of horse welfare issues in the UK today, and complement the tireless work our field officers carry out on the ground every day. “Ultimately it is about supporting our commitment to tackle the root causes of welfare abuse in the UK, and to achieve this we need to When veterinary surgeons at Pool galvanise everyone who has an interest   House Equine Clinic in LichÆ eld were in horses to complete this important called to a seriously ill four-day-old survey.”    foal they immediately recognised The survey finishes on 30th that it urgently required a blood November 2010. Everyone who takes   transfusion. It was very dull, sleepy, part will be entered into a draw to win     depressed and had stopped feeding, a place on the 2011 Canadian and was diagnosed with neonatal Wilderness Challenge Ride. VetSurgeon.org & VetNurse.co.uk has featured isoerythrolysis. The foal was taken to the veterinary clinic and a donor nearly 60,000 jobs to date, and what is more it is horse had to be found quickly. The Hot branding to be Blue Cross had a 1-year-old gelding banned in Scotland on standby after being placed on loan by the charity to Richard THE BVA and BEVA have expressed Stephenson, who treats the homeless delight at the announcement from the horses at the Blue Cross equine Scottish Government that the hot  centre in nearby Rolleston-on-Dove. branding of horses and ponies will be   In just over an hour, three litres of banned in Scotland. blood were collected into plastic  The announcement follows a bags containing anticoagulant. As 
consultation by the Scottish each half-litre bag was Æ lled it was immediately transfused into the foal Government driven by BVA and BEVA policies calling for a full ban last year. It’s free to place your vacancy. Simply and, says Mr Stephenson, HThe log on on to www.vetsurgeon.org and effect was like a miracle. The foal Professor Bill Reilly, president of went from collapsed and lethargic to the BVA, said it was a very important www.vetnurse.uk. lively and energetic in less than an decision for the welfare of horses and If you are looking for a job there are hour. By the end of the transfusion ponies. plenty to choose from. If you are VetNurse VetSurgeon we had to sedate him to keep him “We are delighted that the Scottish seeking someone new, why not add .co.uk .org stillJ The foal was closely monitored Government has made this decision yours today! over the next 10 days and went on to and hope that the rest of the UK make a full recovery. follows.” VP vol42 07_August 2010 24/08/2010 14:54 Page 50

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SEPTEMBER 2010 VETERINARY PRACTICE PRACTICE PROFILE 51 Milestone marks start of new era DAVIES Veterinary Specialists says, both bureaucracy and research (DVS), one of the largest private responsibilities conflicted with The new ownership team (from left): Dr Jerry Davies, small animal referral hospitals in hospital referral services and his job Richard Whitelock, Dr Clive Elwood, Dr Nat Whitley Europe, is celebrating 12 years in satisfaction. and Mike Thomas; at right is Dr David Gould. business this year with a raft of Believing there to be a big changes. potential market for the provision of fracture repair; and the correction of oncology A new managing private referral limb deformities. Accurate diagnosis is services. director and board of services, he set up aided by 45-minute consultations, and Procedures directors have been practice in barns on on-site access to x-ray, ultrasound, include appointed, the the Manor Farm MRI and CT scans. The team is surgery to corporate logo has Business Park in the headed by Richard Whitelock and the ear, nose been “refreshed”, the visits one of the hamlet of Higham David Thomson and includes two and throat, twice-yearly newsletter country’s biggest Gobion – the second other clinicians and one resident. cardiothoracic, hepatic, has been given a new referral practices and part of the name The internal medicine service is gastrointestinal, urogenital, look and the practice hears how things are coming from the led by Nat Whitley with four other reconstructive and oncological website has been changing Gobion family which specialists and one resident. The team surgeries. redesigned. took up residence accepts cases with clinical problems The diagnostic imaging service is The business was there soon after the ranging from vomiting to diarrhoea, led by Francisco Llabres-Diaz and actually founded in 1995 as Veterinary Norman conquest in 1066 – on the polyuria/polydipsia, malaise, weight supported by four imagers (three Radiology Ltd by Dr Jerry Davies and Hertfordshire-Bedfordshire border. loss, hormonal disorders, anaemia and specialists, including Dr Davies). his wife Olivia; it subsequently became Over the past 12 years, the practice fever, as well as congenital and Facilities include three radiography Davies White and then Davies has taken over more buildings on the acquired heart, lung and chest disease suites, two mobile fluoroscopy units, Veterinary Specialists in 1998. site, fitting them out to its own where the cause is not obviously including one for intra-operative and Dr Davies formed the practice specification. cancer and where the immediate interventional therapy use with digital after spending many years working at These buildings house a management of the case is not subtraction technology, and two the Royal Veterinary College where, he spectacular reception and waiting area, surgical. colour-flow Doppler ultrasound offices, clinical areas and wards, a The neurology team is led by machines which allow cardiac, lecture theatre and Laurent Garosi and abdominal, orthopaedic, ocular and spacious staff includes two other oncological examinations. facilities. DVS, specialists and a which treats dogs resident. The team (90%) and cats sees a wide range (10%) specialises in of presentations most disciplines including loss of including orthopaedics, neurology, limb function (ranging from ataxia to internal medicine, oncology, paralysis), seizures, spinal pain, loss of ophthalmology and soft tissue surgery nerve function and muscle diseases. and claims to offer a broader range of The oncology service combines services than most other private the expertise of the oncologist referral practices, using a multi- (Shirley van Lelyveld), imagers and disciplinary approach to case surgeons and is concerned with cancer management. diagnosis through various diagnostic The veterinary surgeons’ office in tests including imaging and tissue one of the elegant barns. “Show me a Wide range of conditions sampling, and cancer treatment tidy desk and I’ll show you someone The orthopaedic team deals with a through drug therapy, surgery and who is not busy enough!” says Dr wide range of conditions; the typical radiation therapy. Elwood. Below: part of the spacious caseload includes the investigation and Surgical procedures in the reception/waiting area which has treatment of all forms of lameness; ophthalmology service include separate areas for canine and feline patients. the management of trauma and phacoemulsification, lens luxation surgery, entropion and facelift surgery, as well as electroretinography (ERG) The new MD, Dr Clive Elwood, at his and diagnostic work-up for blindness. desk; and (below) performing upper David Gould heads this department gastrointestinal endoscopy on a and is supported by Leonburger. another specialist and a resident. The soft tissue department’s four surgeons include three specialists, led by Ronan Doyle. This service accepts the full spectrum of general surgery cases and also supplies support for the medicine and

 VP vol42 07_August 2010 24/08/2010 14:54 Page 52

52 PRACTICE PROFILE VETERINARY PRACTICE SEPTEMBER 2010

an opportunity to European specialists further develop and and seven are cement the specialists in training. relationship with their The specialists referring veterinary are supported by surgeons and are, house officers, who therefore, a key are newly-qualified marketing tool. veterinary surgeons, The practice usually with a short produces a six- period of first monthly newsletter opinion practice that is circulated to its experience, and who referring practice base stay for about a year Soft tissue surgeon Ronan Doyle examining an airway; and other veterinary before moving on. and (below): Richard Whitelock, orthopaedic surgeon, surgeons across the The house operating. UK. This allows officers, who are all veterinary surgeons to accommodated on keep up-to-date with site, rotate between events at DVS and various specialist Nurse Mary Richards, managing in the CT room. also provides an sub-disciplines and opportunity to discuss are responsible for providing care at cases. best practice and new nights and weekends. These positions Dr Davies, who in July took up the techniques. frequently lead to specialist training post of junior vice-president of the The practice sees positions in universities in the UK, RCVS, is now chairman of the the newsletter as an Europe and USA. company and the newly constituted important link Many of the senior nurses have ownership structure comprises between itself and the obtained the RCVS Diploma in Richard Whitelock as deputy wider veterinary Advanced Veterinary Nursing. They managing director, Mike Thomas as community. rotate between wards, diagnostics and finance director, with Drs David The practice can carry out The practice website, theatre; each of these areas has two Gould and Nat Whitley as percutaneous ultrasound-guided biopsy www.vetspecialists.co.uk, acts as a permanent nursing supervisors in shareholder/directors. Dr Laurent of lesions and organs; it also has its direct advertisement to pet owners and charge of nursing resources. Garosi and David Thomson remain as own MRI scanner, which was the first a reference source for prospective directors. of its kind to be installed in the UK, clients and referring veterinary Hand-over Commenting on the changes, Dr and in December 2007 a GE CT surgeons. It currently receives about Earlier this year, Dr Davies stepped Davies said he was proud of what the scanner was commissioned. 205,000 visits a month. down from the day-to-day running of practice had achieved and he The imaging department works the practice and handed over the role expressed confidence that the new with other areas within the hospital Facilities of managing director to Dr Clive management structure would maintain providing and interpreting images as The practice has 11 consulting rooms, Elwood, an RCVS and European the practice ethos and bring fresh well as providing a rapid radiographic including two ophthalmology specialist in small animal medicine, ideas that will ensure DVS stays at the reporting service for other veterinary examination rooms; six wards, who continues to handle some of the forefront of veterinary specialist practices. including an intensive care unit, a internal medicine and cardiology practice. Anaesthesia and intensive care is separate cat ward and an isolation provided by four clinicians (two unit. These can house up to 80 Link between chemotherapy agents used specialists), led by Louise Clark. patients at a time. The intensive care unit (ICU) is equipped with a in animals and thyroid cancers in people BRETT Cordes of Scottsdale, Arizona, had been a practising veterinary CPD courses defibrillator, an assisted ventilation surgeon for nearly a decade when he was diagnosed with thyroid cancer at the DVS runs monthly seminars and CPD unit and monitoring equipment for age of 35. courses in its on-site lecture theatre. blood gas, arterial blood pressure, One of the first questions his doctor asked him after he gave him the The courses are aimed at referring venous pressure and ECG. There are diagnosis was whether he handled chemotherapy agents and he said there veterinary surgeons and their nurses five theatres which are supported by a appeared to be a link between these agents and thyroid cancers. Mr Cordes, who wish to get a better understanding sterile supplies unit with two built-in who is now healthy four years after his diagnosis and treatment, said the of advanced veterinary practice. hospital autoclaves. doctor’s comment changed his life. “I quit my practice and made it my The courses also provide DVS with The diagnostic facilities are passion to improve oncology safety for vets.” equipped to perform video- Noting that animal oncology “has exploded within the last decade” as the endoscopic examinations of the body cost of drugs has come down dramatically, he estimates that about 4,000 systems, emergency blood analysis, general practices in the USA administer a few doses a month, often with no electrocardiography, electromyography, special precautions in place. “I used to dump the drugs down the sink, and electroretinography, invasive and non- they would stain the sink red for four days,” he said. “And I wasn’t the only invasive blood pressure measurement; one doing it.” in addition, numerous tissue sampling He didn’t use specialised protective gear or take other measures to keep procedures are available as required. himself or his workplace from becoming contaminated. The in-house laboratory handles a Now he advises others on how to stay safe. He recently co-authored a range of “patient-side” tests as well as paper for the National Institute for Occupational Safety and Health, and he emergency blood and urine tests, also helps market a specialised closed-system device that contains spray when clotting screens, cytology and vials are punctured. urinalysis. The potential risk extends to pet owners, too, he said, because of the DVS has more than 130 staff and length of time the drugs persist in the environment. If someone brings their its approval as a specialist training dog in for treatment, and the dog is later throwing up at home, the people in centre allows in-house development of the house are potentially being exposed. Co-workers at practices, such as staff to the highest level. nurses, cleaners and maintenance staff, could also be at risk. “Education is a A German shepherd dog in the ICU Of the 30 clinicians, 18 are RCVS- huge issue,” he said. “A lot of people still don’t believe it’s a problem.” following seizures. recognised specialists, three are VP vol42 07_August 2010 25/08/2010 12:00 Page 53

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54 LIVESTOCK VETERINARY PRACTICE SEPTEMBER 2010 Are practices doing enough about infectious disease in cattle? COMPLAINTS have been made, by drawn in many directions. on a daily basis. No doubt a client of members of committees and Here is someone who has had his one practice finds it easier to have organisations, that veterinary ear bent by various committee members samples analysed than clients of another practices are not doing enough representing the spectrum of cattle practice. about infectious diseases in cattle. production. Our conversation has CPD is being arranged and at the These rumblings do not appear to prompted some thoughts and aspects end of each meeting a performance be based on detailed that the profession may sheet is completed and most speakers information or surveys wish to consider. are awarded over three-quarters of the but a general feeling Sitting in a tray on available points. This reviews the ability that more needs to be a desk is a collection of of the speaker to put across the done. So, any ideas sample bottles labelled technical content but it is more difficult how the activities of up and about to be to know whether the information was veterinary surgeons used by dairy clients able to be used to improve disease levels and veterinary for their quarterly on farm. practices can better assessment of the bulk How about a “vets of the year” match the needs of milk. Every dairy herd award for the veterinary practice that cattle keepers? in the practice has milk achieves the lowest levels of disease on Before raising the RICHARD GARD samples interrogated their clients’ farms, after investigation? issue of training in talks to BCVA and the results It would appear that you have to Keith Cutler. veterinary schools and president Keith recorded. Is this the investigate, otherwise nobody has the difficulties for new Cutler about the need norm for all practices? disease because it hasn’t been looked for reduce disease?” would it be the practice graduates to develop for more effective Deepest Wiltshire or, if it has been looked for, it hasn’t that is up country or would it be a the sort of herd health communication with does not have the been recorded. This topic begins to neighbour? The technician side of the planning that is seen as colleagues and clients greatest density of become more and more complex. brain would probably look to work with the way forward, there dairy herds but there Education is a big issue and the the best and the business developer side is a concern over are over 1,200 cattle programmes for next year are already in maybe wants to assess the competition. Government policy. Detail upon detail herds in the county so the beef train. Clearly, cattle keepers are It seems timely to consider a world will be emerging over coming weeks but programmes would represent an becoming more knowledgeable and less without substantial income from TB some cattle practices have already lost opportunity. Within the practice there prepared to suffer avoidable loss. testing and a world where more is to be their role with TB testing. is interest in developments with beef demanded from clients. A battle for It is said that if the change of policy suckler herds and one can imagine the Who most needs the education? viable work may be one of the was introduced over a year or so then extensive grazing available on The dog-and-stick farmer is still the salt outcomes. Another could be greater co- the practices would have time to Salisbury Plain. The local landscape of the earth and even if he doesn’t use operation between vets so that groups develop further initiatives to occupy determines the farming and the the vet until the last resort, his levels of of neighbouring farmers address the cattle expertise. This might benefit the vetting. stockmanship skills may not be matched local disease issues. farmers and allow vets the time to deal Immediately it is apparent that an by staff on the bigger units, so it with infectious disease prevention and answer to the question “Why aren’t vets appears unreasonable to think of the Healthy management of an area control, without four days a week of doing more?” is not going to be small farm as a reservoir of disease may be way forward testing. However, change has arrived in effectively answered by looking at one waiting to afflict the bigger units. A probable level of future days and weeks and veterinary surgeon veterinary practice. Maybe it is time to Who, therefore, needs the education: understanding is whether cattle herds lay-offs are anticipated. find out exactly what is going on. the farmer, the vet, or the farmer with can control infectious disease by relying At technical meetings there is often the vet? There could be an increase in on their own resources. By its very Troubles never come singly... talk of intervention levels. So, how complementary veterinary skills and nature the term infectious indicates a Troubles never seem to come singly and many client’s herds within a practice are farmer skills developing together in the spreading of infection and time after the needs of the farmer clients have to routinely monitored for infectious same course. time talks highlight breakdowns because be addressed so that there are fewer disease by analysis of samples? Is a third Keith admitted that there were of cattle mixing due to gaps in hedges, disease build-ups this coming winter. an acceptable level, or double that or topics that the practice members felt or bull sharing, or water course Partners and managers may need to put treble? could be better delivered by someone contamination. TB in a box to be dealt with as best as from outside the practice. These Instead of hoping for the ideal possible and concentrate on whether Why do some practices have “specialists” are invited to address a farm, with double fencing and a more can be done to reduce infectious higher figures than others? group of clients but they tend not to be managed environment, one reality is diseases that include Johne’s, BVD, IBR, Once a level is seen as practical and sought from neighbouring practices. that neighbour activities undermine mastitis and lameness. worthwhile, is it reasonable to question Someone from a hundred miles or the will to invest fully in health Infertility may be considered a why some practices have higher figures so perhaps, because, and here there is a programmes. Healthy management of consequence of other disease but for than others? Does a 90% testing level slight coyness in the response, the an area could be the next big idea. herd performance all else hinges on the indicate greater disease control or are competitive nature of modern If local veterinary surgeons are availability of replacements, controlled the vets promoting testing to cover a veterinary cattle practice is the elephant prepared to share their expertise and calving, and milk in the tank as lack of confidence in diagnosis or in the room. Not defined perhaps, not work towards a common goal, would requested by the dairy. disease management? accurately stated but something to the uptake of veterinary services to In order to understand the issues The thoughts that start to swim consider. control disease increase rapidly? In better, I tracked down the president of around begin to uncover some of the This aspect of the competitive some districts this may be easier than the British Cattle Veterinary Association difficulties and it is likely that practice business of veterinary medicine may be others but if the viability of practice to his practice in Salisbury. You may management, as well as veterinary one of the drivers to perform better in is threatened there may be an think that close to home would be an expertise, plays a part. the eyes of clients. If you ask yourself opportunity to do what you do obvious place to meet up, but Keith Some multiple branch large animal the question, “Where would I like to better, to expand and communicate Cutler is a busy chap and seems to be practices have vans collecting samples work for a week to learn more ways to effectively with colleagues and clients. VP vol42 07_August 2010 24/08/2010 14:54 Page 55

SEPTEMBER 2010 VETERINARY PRACTICE LIVESTOCK 55 ‘Government should do Coccidiosis only those things which in calves and only Government can do’ lambs: new THE Public Bodies Reform Bill is soon to be robust, credible and efficient science base”. presented. This is the vehicle to obtain the It will not have escaped attention that the necessary approvals to carry out the abolitions and Animal Health Agency and the Veterinary website dissolutions of DEFRA’s arm’s length bodies. Laboratories Agency are to be merged with “as There are 90 such bodies, some are now part of little disruption to staff and customers as what the Government does as a matter of course possible”. New structures and ways of working, provides and others are now no longer necessary. That is the with full integration of the two agencies, are to be view of the Secretary of State for the Environment, in place by the autumn. Caroline Spelman, as explained in various The stated overview is that “in resource- information online proclamations, and included the statement constrained times, the merger will enable the which is the headline of this report. agencies to create more efficient ways PROFESSOR Mike Taylor recently reported on The objectives are laid down and of working, reduce the cost and key findings from an expert workshop on bovine include: “I am committed to bureaucracy needed to manage the coccidiosis held at the First European Buiatrics increasing the transparency and interfaces between these agencies, Conference and facilitated by Janssen Animal accountability of DEFRA’s public DEFRA and the devolved Health. bodies and to reducing their number administrations, and their The workshop identified potential problems in and costs.” There is a “sustainability customers”. hear about changes diagnosis and highlighted new approaches to agenda” across the whole of It is apparent that no section of planned or already in treatment. Now a new website is being launched Government that is not to be the population is to be left to progress at DEFRA by Janssen that provides a wealth of information delegated to an external body. wallow in their present comfort on the topic of coccidiosis in calves and lambs: It has been announced that: zone and more is to follow in the www.takingcareofcoccidiosis.com. • Funding will be withdrawn from the Sustainable name of economics. Following the fine of £160 The site builds on the findings of the expert Development Commission. million by the European Commission over the forum and looks at all of the areas that the • The Royal Commission on Environmental farm subsidies issue, DEFRA ministers will experts focused on as being especially Pollution to be abolished. probably be anxious to show Europe that they have problematic including immunity, sources of • The Agricultural Wages Board, the 15 Agricultural a tight hold on management and performance. infection, risk factors, prevention and treatment. Wages Committees, the 16 Agricultural Dwelling In the meantime there will be a number of The end result provides a substantial on-line House Committees and the Committee on committee members looking for alternative activity, resource for veterinary professionals, SQPs and Agricultural Valuation to be abolished. existing members will be wondering how their farmers. • The Commons Commissioners and the Inland involvement can be justified and funded, and Arriving at a diagnosis of coccidiosis is not Waterways Advisory Council to be abolished. DEFRA staff will be just wondering. always straightforward, says the firm. It must be It is a time for clear direction. It is probably supported by history and clinical signs, as well as time to make up your mind which of the support Leaner and stronger... evidence of pathogenic species of the Eimeria The intention is “to make DEFRA a leaner, services from Government are essential and write parasite. stronger department, with a renewed and clearer to the Minister. If you wait for a committee to give focus on its key priorities and a simplified structure guidance, their minds may be elsewhere and, as Explanations on sampling for delivering those priorities, underpinned by a they say, “a week is a long time in politics”. Interpretation of oocyte counts can be particularly difficult and results have to be viewed Obituary in the context of the farm situation. The site contains explanations about the Dennis S. Papworth timing of sampling and how that can impact THE death was announced of Dennis Papworth, OBE, MSc, FRSC, FIBiol, FRSM, on the anniversary of upon the results. The Battle of Britain. He was 89. Treatment has traditionally relied on fluid Dennis was the first secretary of AHTAG which later changed its name to AMTRA. therapy and the use of sulphonamide drugs but A kind and generous man, Dennis saw war service at the earliest permissible age when he volunteered recommendations on the use of more recently for a flying commission in the Royal Navy. During latter training at Worthy Down his colleagues included introduced treatments such as diclazuril focus on Ralph Richardson and Laurence Olivier. They were often met by Vivian Leigh, the then wife of Laurence single-dose treatments administered 14 days after Olivier, at Winchester station, who plied them drinks on the journey! a stress factor – such as moving to a higher risk In 1941 he was appointed to front-line fighter squadrons on Hurricane aircraft in North Africa. He was environment, weaning or transportation. later transferred to Ceylon to help fight off the Japanese attacks on that island. Much later in the war he The various treatment strategies, including was Flight Commander to 885 Squadron, flying Spitfires to cover for the D-Day landings. He subsequently prophylactic and metaphylactic approaches, are joined the aircraft carrier HMS Ruler and saw action off Sakishima Gunto and Okinawa and survived described and this is likely to be of particular several kamikaze attacks. interest to those who have experienced problems After the war, when he left with the rank of Naval Commander, he resumed his career in chemistry with coccidiosis in the past and want to avoid and human physiology at Liverpool University and gained a Masters Degree in Biochemistry. He later recurrence on an individual farm. joined the CVL specialising in toxicology. When he left the Ministry of Agriculture he was head of the Janssen adds that for those looking to update Pesticides Safety Division. their knowledge, seeking a tool that explains the In “retirement” he remained very active in his role of chairman, then president, of the Radon Council disease in greater depth or just searching for which he helped form in 1990. specific information that helps in their own Dennis retained an interest in both aviation and railways right until his death. He was comfortable with individual situation or with interpretation of a people irrespective of their status and had the rare ability of being able to interface with young and old difficult case, www.takingcareofcoccidiosis.com alike. He will be greatly missed by all his friends and former colleagues. – JCA promises to be a valuable resource. VP vol42 07_August 2010 24/08/2010 14:54 Page 56

56 NEWS VETERINARY PRACTICE SEPTEMBER 2010

RCVS seeks health of a veterinary surgeon must also Thirsk, North Yorkshire. James Roadnight, who has over 14 comments on draft take steps to ensure that animals are not “Since graduating last year I have years’ experience in working in specialist put at risk and that the interests of the often turned to the internet for recruitment within professional and health protocol public, including those of their information but found that Google high-integrity industries. THE RCVS is calling for comment on a colleagues, are protected. would often return pages with “your vet “There comes a time in some vets new draft health protocol which aims to A similar protocol is to be will be able to advise you of the best or vet nurses’ careers when they can deal compassionately with veterinary introduced for Registered Veterinary treatment” – which isn’t overly helpful want a change from working in practice surgeons who have health problems, Nurses when the equivalent disciplinary when you are the vet! There is loads of and would like to move their skills to such as alcohol or drug addiction or system comes into force next year. useful content on the internet but it is industry or academia. And we can help mental health issues, while continuing to The draft protocol, together with often hard to find, so I thought, why with this transition,” he said. protect the public interest. recommended changes to the RCVS not bring it together in one place? “Similarly, companies and According to independent legal Guide to Professional Conduct to support “I then set about finding friends institutions have a need to recruit advice sought by the College, such an the change, is available online with the necessary skills, contacting a personnel and will benefit from working approach is appropriate and necessary in (www.rcvs.org.uk/healthprotocol). host of companies and researching with an agency that specialises only in order for the RCVS to fulfil its Comments are requested by 8th resources to start putting the site this sector and should therefore have regulatory responsibilities – similar October. The comments will be together. the strongest candidates available. systems exist within other regulators. considered by the advisory committee “Thanks go to all the companies “We have a database of over 8,000 “At present, where veterinary and then by RCVS Council at its and organisations which have offered specialists that include veterinary surgeons suffer from health problems meeting in November. their support. “Any further assistance surgeons and nurses, veterinary that affect their fitness to practise, they Comments should be sent to Simon from companies or individuals is managers, animal health technicians and may be referred to a formal and public Wiklund, advisory manager, on gratefully received as the aim is to make sales/account managers. This database disciplinary committee inquiry and [email protected]. VetGrad.co.uk as useful as possible for is growing by over 100 new candidates stopped from practising. But it is existing and future veterinary per month which is essential to ensure recognised that this is not always in the graduates.” that our clients have access to the latest public interest, which could be Website for new talent available.” protected by a more compassionate graduates launched RIG Animal Health Recruit reports approach, involving medical help, Recruitment that it is a member of and works within workplace supervision and continued by new graduate agency expands into the guidelines of the Recruitment and practice, subject to conditions,” says the VetGrad.co.uk, described as a new Employment Confederation. RCVS president, Peter Jinman. website for recently graduated vets, was industry The draft protocol has been launched on 1st August. THE Recruitment Investment Group Surgery closed after developed by the RCVS preliminary The brainchild of Thomas Rees, (RIG) has established a new recruitment investigation (PIC) and advisory who graduated from Cambridge last agency to specialise in the supply of accident committees. It formalises and builds on year, the website “aims to be a ‘one stop skilled professionals to the veterinary A PRACTICE in Lincoln has lost the steps taken by the PIC in the past to shop’ for veterinary graduates looking animal health market. use of its surgery for nearly two months help veterinary surgeons to recover for content on the internet; bringing Currently, agencies concentrate on after it was damaged in a freak accident. from health problems affecting fitness together valuable resources in one easily recruiting veterinary surgeons and LincVet was left “unsafe” and in to practise, without referral to the accessible place”. nurses into veterinary practices, but the need of extensive work after an elderly disciplinary committee. Some of those Access is free and aimed at vets newly formed RIG Animal Health driver managed to wedge his car into veterinary surgeons also receive help during their first five years after Recruit will be working in the the corner of the waiting room and a from the Veterinary Benevolent Fund’s graduation. It has information on “industry” side of the profession to stone wall. Veterinary Surgeons’ Health Support resources, links to free and chargeable provide a permanent and temporary After the smash on 9th July, the Programme. CPD courses, jobs, useful links (e.g. to recruitment service in areas such as surgery was unable to open for business The protocol encourages anyone the RCVS-PDP sign in page), as well as sales, technical product, academia, and as part of the structure had to be pulled coming into contact with veterinary a welfare section (“Why Bother?”), laboratory work. down and rebuilt. A further five weeks surgeons – including other veterinary news, competitions and short The new company is headed up by work was expected to follow. surgeons, veterinary nurses, members of educational articles. practice staff, clients and healthcare It is also developing a library of professionals – who have concerns step-by-step guides to common LETTER about a veterinary surgeon’s health to procedures carried out by recent report those concerns to the RCVS as graduates which will feature in the Where did domestic cats come from? soon as is reasonably practicable. “How To” section. Dear Sir, Veterinary surgeons and veterinary Mr Rees says he got the idea during I read with dismay another “cat expert” propounding that domestic cats (Felis nurses who are concerned about the a busy weekend on call as a mixed vet in catus) descend from African forebears (“Beware the fair-weather feline”, Vet. Practice August issue, page 45). This is quite simply not the case. Current evidence1,2 shows that domestic CPD Workshops 2010 cats descend from Eurasian lineages, perhaps with a migration to and from Trent Park Campus the Americas over the Bering land bridge. The African cats share common Middlesex University London N14 4YZ ancestors with domestic cats, but are not themselves domestic cats’ ancestors. experience the difference 10am—5pm As the author is probably aware, extant felidae occupy a surprising range Switch on the power for of niches, from arid plains to jungles and snowy mountains. I fully support the opinion that all cats should be able to choose their environment and that improved clinical outcomes we, as their owners and vets, should facilitate that as far as possible. “New Graduates Survival Guide - Thriving in the early years” Yours faithfully, 26th October MICHAEL DOUBE, BPhil, BVSc, PhD, MRCVS, “Clinical Effectiveness - Skills to improve both clinical and financial results” Research Associate, Department of Bioengineering, 23rd September Imperial College London, South Kensington Campus, London SW7 2AZ.

“Consulting Room - Next steps to improving consulting skills and performance” 1. Johnson, W. E. et al. (2006) The late Miocene radiation of modern Felidae: 25th November a genetic assessment. Science 311: 73-77. 2. Driscoll, C. A. et al. (2007) The Near Eastern Origin of Cat Domestication. Also, six months Science 317: 519-523. ahead of schedule due to demand, now recruiting for next • Francesca Riccomini, who wrote the article in question, notes that she has CertAVP(A&B’s, B’s & VetGP) group www.vetlearning.co.uk never claimed to a be “cat expert” and is happy to stand corrected. VP vol42 07_August 2010 24/08/2010 14:55 Page 57

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58 THEATRE VETERINARY PRACTICE SEPTEMBER 2010 On the trail of the fictional detective THE fictional character most have played both Holmes and Watson. Morstan, being frequently portrayed in film is Sir Seeing Brett as Holmes was like portrayed in Arthur Conan Doyle’s great watching the character step off the ways far too detective, Sherlock Holmes, some pages exactly as one imagined him, a different from 75 actors having played him in rare occurrence, one of few other their original movies. modern examples being Sir Alec forms for my Holmes’ fans (and here I must Guinness’ tremendous renderings of liking. admit to being even more of a John Le Carré’s George Smiley. Nevertheless, fundamentalist than I am as a Brett’s portrayal is sublime, subtle I found “Trekkie”) are divided as to whose yet energetic, capturing the enigma of Downey’s portrayal has been the definitive one. Holmes perfectly. He was accompanied character likeable Many older film fans still regard Basil by two Watsons, initially David Burke as long as I Rathbone’s version, first in movies, took the role and he was followed by thought of him later on radio, as the epitome of Edward Hardwicke; it is impossible to as an ace Holmes. choose between them. Victorian Benedict Cumberbatch (left) as To hold this Just as Brett detective but not as Holmes, and the Sherlock Holmes with Martin opinion I can only captured Holmes, story was fun although not Freeman as Dr Watson in the BBC believe that they have Dr COLIN ROBERTS both actors outstanding, the most interesting part series. never read any of the was more than personified the true being the sub-plot that obviously leads books, for not only pleasantly surprised Watson, an intelligent to a sequel. I did, however, find Law’s deductive reasoning and the clever use was Rathbone’s by the compelling man of great integrity, Watson unconvincing and the bickering of texting are wonderful. Holmes an insipid BBC portrayal of solid and brave, the relationship between this Holmes and Martin Freeman, whose praise I pastiche of the great modern-day Sherlock kind of man that you Watson irritating. have sung before, follows beautifully in man, but Nigel Bruce’s would want by your the tradition of the Watsons of Burke appalling interpretation side in times of danger, Interesting project and Hardwicke and is a superb foil for of Watson as a bumbling buffoon was rather than Bruce’s bumbling fool Recently, the BBC screened its three- Cumberbatch. even more inaccurate. These films are whom, given a chance, one would part Sherlock and this is an altogether The three stories do not to be avoided, however much your shoot before one’s adversary. more interesting project. The fact that specifically follow Conan Doyle’s, but grannie tells you she loved them. Jeremy Brett’s Holmes can still be it was set in the present day alarmed again key characters are there, seen on satellite TV and the me and to be honest, I only watched it intriguingly presented for our time, Stunning performance collection is available on DVD: I urge because of the involvement of Stephen whilst references to the original canon To see Holmes as I am sure Conan you to try it. More recently, though, Moffat (Dr Who, Coupling, Press Gang) are charming, occasionally subtle, and Doyle envisaged him, we must turn to we have seen Holmes return both to who created it with Mark Gatiss (who fun to spot. the small screen and Jeremy Brett’s film and to television in new appears as Mycroft Holmes), but I was Watching the final episode, I stunning performance in the Granada manifestations. more than pleasantly surprised. could not remember the last time that TV series first aired between 1984 and The Sherlock of these stories is not I found a television programme so 1994. Victorian setting the Holmes of the books, but he is a compelling. The ending gave us a Brett was an actor of the highest The 2009 movie, Sherlock Holmes, character whom one could believe totally unexpected cliff-hanger that, it quality who was taken from us far too directed by Guy Ritchie, starring Holmes might have been had he lived a is to be hoped, indicates a second early, by which time he had appeared in Robert Downey Junior as Holmes with little over a century later. series soon. 41 of the 60 stories; it is sad that he Jude Law as Watson, kept the Victorian The excellent Benedict In the meantime, if you missed was unable to complete the canon. setting, but changed far too much for it Cumberbatch has the enigmatic quality Sherlock, or even if you didn’t, it is Brett also played Watson on stage, to feel like a real Holmes story to me, so important for a successful Holmes due to be released on DVD at about opposite Charlton Heston as Holmes, with two of the famous supporting and the imaginative, graphic manner in the time that this issue of Veterinary making him one of only three actors to characters, Irene Adler and Mary which the viewer is shown his Practice falls through your letterbox. Scientists report discovery of mechanism of avian influenza virus circulation and transmission A TEAM of American and Italian scientists has bodies. They found that a progressive virus “sticking” additional sampling methods could be necessary to reported the discovery of a previously unknown on feathers occurs because AIV-contaminated waters detect AIVs on birds’ bodies. mechanism of avian influenza virus circulation and interact with the preen oil gland secretion. The results suggest that a preened body surface transmission in nature. Since waterbirds spread preen oil over their own could be the common denominator that explains The team, led by Mauro Delogu, a virologist at or other birds’ plumage, it is easily understandable how AIV infection occurs in different taxonomic the Veterinary Faculty of the Bologna University, and how these preening activities could facilitate the groups of aquatic birds and future studies are needed researchers from the Istituto Superiore di Sanità, diffusion of the viruses in nature. The discovery, to determine the common uropygial component that Istituto Zooprofilattico Sperimentale della Lombardia adds Mauro Delogu, has also important could promote interaction with AIVs in all aquatic e dell’Emilia and St Jude Children’s Research Hospital implications in the surveillance of avian influenza bird species. Studies to reproduce the preening- in Memphis, Tennessee, have discovered a new way viruses. mediated AIV infection mechanism in the animal of avian influenza transmission. model are in progress. The study, which is said to offer new insights into Escaping detection The researchers add that the discovery opens a ecology, surveillance and prevention strategies of Virus on feathers could escape detection by the door to explain the highly pathogenic H5N1 avian influenza viruses (AIVs), may ultimately be current surveillance strategies which assay the virus circulation and persistence in Eurasia, as well as important in the fight against influenza. secreted in the cloacal and tracheal samples only. the only recorded human case of fatal infection The researchers found that the preen oil gland Lack of detection of these viruses may greatly passed from wild birds in February 2006. All secretions, by which all aquatic birds make their complicate surveillance and rapid responses to new infected humans were involved in defeathering of feathers waterproof, support a natural mechanism virus emergence and spread. For this reason, the dead wild swans after a massive die-off of these that concentrates AIVs from water onto birds’ researchers say, in routine surveillance programmes aquatic birds occurred in Azerbaijan. VP vol42 07_August 2010 24/08/2010 14:55 Page 59

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60 ON THE ROAD VETERINARY PRACTICE SEPTEMBER 2010 A stylish yet affordable means of open-air motoring IT’S a hard life being a motoring automotive equivalent of Jordan – awful journalist. No, really it is. I have to look at and listen to and incredibly already taken part in a number of embarrassing to wake up to each professions during my relatively morning. to fulfil the desire of owning an out- small number of years on earth and Perhaps I have just been unlucky and-out sports car. Instead, people want AT A GLANCE never have I been subjected to so with the people I have come into an elegant and luxurious cruiser that Model tested: much spite and vitriol contact with as I can’t they can enjoy the summer months of Audi A5 Cabriolet 2.0 Litre TFSI SE as I have been when see any reason as to sunshine in. On the road price: £33,040 writing about cars for why the A5 Cabriolet After all, there’s no point in driving Fuel economy: 41.5 mpg (combined a living. could be considered as too quickly if you are aiming to be cycle) Take this week, for an outwardly grandiose noticed. With this in mind, in terms of example, during which form of motoring. It is sheer “pose factor”, when fitted with Tank range: 603 miles I have had the pleasure by no means a Ferrari the right spec the A5 Cabriolet could be 0-60 mph: 7.5 seconds of reviewing the car or Lamborghini and, to considered one of the most stylish Top Speed: 150 mph you see pictured – the me, is a discrete yet “normal” cars of the year and the OVERALL: ++++/5 new Audi A5 highly desirable option design team at Audi should be lauded Cabriolet. My test when looking to tick for creating something that is issue of practicality, it should also be period just managed to ROBBIE TIFFIN the open-air motoring understated yet, at the same time, quite noted that there is genuine space for up coincide with a semi- tries out the Audi A5 box without breaking flash – a very impressive feat indeed. to four adults and because some of the tropical heat wave in Cabriolet and is taken the bank in the It also goes without saying that Audi boot space is occupied by the electric Great Britain so I felt aback by the process. really does put a high premium on the hood mechanism, just their soft and somewhat obliged to reactions of other It also will avoid quality and build of its cars and the A5 squishy luggage. partake in a spot of motorists the need for your Cabriolet is no exception. The interior However, any ladies with a open-air motoring and colleagues to think that was tactile and discrete, desirable yet not predisposition for “going commando” fully test the Audi’s you are trying to make up ostentatious. The on-board technology, should be warned that getting out credentials as an open-air cruiser. Bad for a deficiency in the trouser such as the brilliant bluetooth phone through the two-door only aperture can idea. department. system, worked seamlessly, so much so be somewhat problematic when the So far, and this is only the fifth day The model tested was the entry-level that even my technophobic father was roof is up. of my week-long test period, I have petrol version which featured Audi’s able to work it. All in all, I really enjoyed my time been subjected to at least three brilliant 2.0-litre TFSi petrol engine, with the A5 Cabriolet. For those expletive-laden tirades about what a which is also used in the new VW Golf Wind deflector looking for a stylish yet affordable poser I am driving around in my GTi. With regards to engine choice, My only real gripes were that the means of open-air motoring, you would sunglasses with the roof down. there are a number of options to steering was a little incommunicative be hard-pressed to find a more capable “Get out of the way you flash so choose from. There is also a 2.0 litre and the suspension a little too firm, car. The 2.0 litre turbocharged petrol and so (I’ll give you poetic licence to fill diesel unit, a 3.2-litre FSI V6, a 3.0-litre given any pretention to wafting along engine I tested combined strong in the gaps),” was the latest one which TDI or, for those wanting to go the without a care in the world. performance with very reasonable emanated from the mouth of a very whole hog, a supercharged 325bhp V6 The female population, or running costs. irate and heavily tattooed man driving in the form of the S5 cabriolet. Premiership footballers, might also As always with an Audi, the interior his Hyundai Getz a good two inches Personally, I would choose the fast complain that it’s rather draughty when was a very classy affair and the from my rear bumper. yet frugal TDI V6 which manages the you don’t have the wind deflector in equipment provided as standard is likely I duly obliged and let him through, 0-60 sprint in a respectable 6.4 seconds, place and this does no favours for one’s to be all that you will ever need, choosing to refrain from returning the has a 154mph top speed (which, let’s be perfectly coiffed barnet. However, the especially if you upgrade to the SE trim compliment as he passed. Perhaps this honest, is more than enough) and, most wind deflector is really simple to erect level. My only advice to you would be to was due to fact that the neck tattoos importantly, averages over 40mpg even and, with it in place, normal put the roof up if you happen to pass a were a good indication that this chap when fitted with Audi’s excellent conversation can be enjoyed at the legal heavily tattooed man driving a Hyundai would be highly skilled in the art of Quattro 4x4 system. limit with just a cosmetic ruffling of the Getz on the A46 near Stratford upon pugilism or perhaps, in the same way we That being said, the 2.0 litre turbo hair. Avon. Failing that, you could always are told not to pass comment on petrol model I tested can also be On the plus side, if it starts to rain invest in some ear plugs. Grandad’s wet patch, it goes without considered a highly attractive and when you’re on the saying that the Hyundai Getz is the affordable option and might make a lot move, you can raise of sense for those or lower the fabric wishing to avoid hood at speeds up the sacrilege of to 30mph. This owning an oil- makes the A5 burning sports Cabriolet highly cabriolet. practical for UK However, drivers, where whilst I appreciate extended periods of that, to many, sunshine are about performance is as rare as an important, my appearance by feeling is that no George W. Bush on one buys an A5 Mastermind. Cabriolet in order Whilst on the VP vol42 07_August 2010 24/08/2010 14:55 Page 61

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62 TRAVEL VETERINARY PRACTICE SEPTEMBER 2010 A knight goes in search of dragons

VETERINARY cryptozoology is a Hatching a plan by searching everyone with the most demanding profession, I was And that’s when it struck me! The what appeared courage necessary forced to admit, as I reflected on Welsh Red Dragon has its home to be all of to ascend high up my unfortunate series of failures range right here in the British Isles, Wales’ its jagged edge. to date. and Y Ddraig Goch is a mountains, I Additionally, My attempts to study these rarest cryptozoological species that not even would have an the mountain was of creatures – whom, indeed, are the least observant of veterinarians excellent chance kind that day. The considered by mainstream biologists could possibly miss! They are, after of locating the vicious winds that not to exist – had taken me to Loch all, exceedingly large, inhabit massive Welsh Red threaten to tear Ness, the Alps (repeatedly), and to rocky nests on mountain-tops, and are Dragon. smaller hikers Mediterranean islands. coloured bright red. Given that some of our climbing from the ridge were reduced to the I’d journeyed to some To top it off would be at night, I might even mildest puffs, and the sleet I recalled of the murkiest they’re associated encounter some sleeping Y Ddraig from previous exercises in “fun” here corners of Ireland, with intermittent Goch, which was the recommended was remarkably absent. As we and even to darkest smoke plumes – way to conduct dental (or indeed, any) emerged from the mist, a silent, London. Yet my which should be easy dragon examinations. Being naturally untouched world was revealed, bathed deficiencies were not to spot at a distance, cautious, however, I decided to pack in the golden glow of dawn. The due to lack of given our increasingly earplugs, lest they prematurely pinnacle of Mt Snowdon rose from dedication, in clear, summer skies. awakened. the clouds ahead, and our knife-edge attempting to fulfil Obviously I In times past their pained shrieks pathway appeared warm and inviting. the continuing needed to thoroughly have been known to kill animals, Soon, we revelled in education obligations ANDREW KNIGHT search the Welsh cause women to miscarry, and plants unaccustomed solitude on the summit of my chosen heads for the mountains, and in to become barren; and unlike certain of Mt Snowdon, at 3,560 feet. Within speciality. mountains of Wales in particular, Snowdonia, team-mates, I had not acclimatised hours it would be visited by I had endured his continuing quest where most of Wales’ myself with heavy-metal via walkman, thousands, but at dawn the world – island beaches and to become the first supposedly-mythical whilst everyone else was attempting and, apparently, the absent dragons – alpine ski fields registered specialist creatures have been to sleep in our youth hostel dorm. slumbered quietly somewhere far without complaint in veterinary reported. below. when, like any cryptzoology Unfortunately, The knife-edged ridge Glittering in the depths was the conscientious (DipCrypt) however, this was And so it was that our ragged, sleep- legendary Lake Llydaw, home to the veterinarian, all I where things started deprived band gathered at the feared Afanc, a kind of demigod of really wanted was to do to become complicated. ungodly hour of 4am in Pen-y-Pass, the rains. Thankfully, he appeared to was work. My bank accounts had It turned out that there were 15 Snowdonia. After meeting our fearless be holidaying abroad. Somewhere in similarly sacrificed, incurring appalling “proper” mountains in Snowdonia mountain guides from Lupine his dark pool apparently lies (although, I trust, fully deductible) and any of them could prove to be Adventure Co-operative, we headed Excalibur, where the dying King costs, funding such essential the mountain(s) I needed. And hectic off into the pre-dawn gloom. Arthur threw it before his body was scholastic trips. plans involving a series of essential Far too soon the edge of Crib carried away by the ladies of this Unfortunately, whilst I’ve not yet scholastic trips to Mediterranean Goch loomed sinisterly through the haunted lake. In one of the been able to convince my veterinary islands and the Alps had left me with mist. Fortunately, however, the surrounding caves his knights are still employers of the virtues of similarly little time to spare. improving daylight combined with believed to remain sleeping, awaiting sacrificing toward my education, this Fortuitously, however, the fear of public humiliation to infuse the call to arise once more to the was not for lack of repeated attempts. Extreme Vegan Sporting Association defence of the realm. And yet, my earnest efforts had all was running its “Vegan 15 Peaks come to naught! Challenge” around that time. The aim The Glyderrau range The closest I had come to actually was to showcase vegan fitness, and to Our long descent toward the valley encountering any of the reclusive demonstrate just how much fun the hamlet of Nant Peris was enlightened creatures I sought had been a large vegan lifestyle can be, whilst fund- by a lone cyclist, pushing his bike all pile of very old bones in London’s raising for a bunch of very worthy the way up Mt Snowdon. It was Natural History Museum, and a animal charities. refreshing to briefly feel relatively spooky moment in its College of Fortunately, as a vegan I was able sane. Psychic Studies, whilst researching to secure a place, and the expedition From the valley a brutal ascent of phantom animals, and courses on did indeed sound like fun. We would around 3,100 feet led us to the animal communication and intuitive attempt to climb all 15 of Wales’ heights of the Glyderrau mountain imaging. 3,000 foot peaks in the same day, range, which took nearly nine hours Yet, it is precisely because hiking around 43km whilst ascending to cross. En route we admired the veterinary cryptozoology is so some 4,000 metres. And to reach the awesome Castle of the Winds, a spiny demanding, that persistence is so start point of the official route on Mt mass of rock rising some 200 feet important. Defeat is not an option for Snowdon – Wales’ highest summit – into the sky, and posed for photos any cryptozoologist worth his or her we would first have to climb Crib upon the Cantilever, a carefully salt. Perhaps I just needed a change of Goch, Wales’ most feared knife-edged balanced slab that appears precarious approach, and a species a little easier ridge, in the pre-dawn darkness. but has withstood the elements for to find. Something somewhat larger Unfortunately, gripping the ridge thousands of years. and a bit more obvious, perhaps. might prove a bit problematic, I carefully scanned the because I’d recently broken my arm in surrounding skies for smoke plumes, a misadventure involving two bicycles, but they remained frustratingly blue. Andrew Knight, BVMS, MRCVS, an one blonde triathlete, and a lot of Indeed, global warming appeared to Australian veterinarian based in London traffic. But my sense of have provided one of the hottest London, has been seeking novel The author on Carnedd Ugain (with career and CPD options. balance has always been good and, Welsh days on record. The sun beat besides, the important thing was that Mt Snowdon in the background). down mercilessly as we climbed the VP vol42 07_August 2010 24/08/2010 14:55 Page 63

SEPTEMBER 2010 VETERINARY PRACTICE TRAVEL 63

rocky, dusty slopes, and soon we were sleeping before rotating onto this navigational episode all running low on water. shift, were fresh and keen, but we we had even Unfortunately, one of our team heavily outnumbered them and forced staggered onto one had flown in from a country close to them to slow down. Cliffs, rocks and of them twice. And the North Pole and after bravely endless mountains followed in an yet, not a single battling nausea for a prolonged period increasingly bleary haze. Although dragon had we whilst completing the toughest part of one mountain did appear oddly found! Perplexed, I the course, he nobly withdrew, to familiar, and certain rock piles in the rechecked my avoid slowing the team. dusk caused excitement, unfortunately cryptozoological For the rest of us the notorious the dragons remained determinedly texts, whilst sheer summit of Tryfan loomed absent. carbohydrate re- ahead. The spiny nest of rocks atop As the landscape succumbed to loading with a large its jagged precipices appeared perfect darkness, we admired shards of quantity of truffles. for dragons, and so I keenly strove golden light from the setting sun, Soon enough, an for the summit. Unfortunately, piercing the purple evening clouds. obvious flaw was however, all we encountered there Gaps in the silken mist revealed the revealed in my plans. were two tall rocky pillars named twinkling lights of towns far below, In mediaeval times, Adam and Eve, and a bunch of stretching across the plains of Wales dragons marauding sensible-looking day climbers. to a distant, half-imagined sea. Far across Britain were Agile as a gazelle, a team-mate above, a glittering swathe of stars was lured to large pits of jumped from Eve to Adam. Feigning strewn across a velvety night sky. mead, and after pain in my arm, I declined his A staggering run allowed us to alcohol-induced invitation to follow. Any fall would complete the official course in 17 slumbers were last for a very long time, and we were hours 30 minutes, after which an captured and on a schedule. increasingly delirious six mile descent humanely (or Navigating Crib Goch’s ridge (photo by Lupine After descending what seemed a to the cars awaited us, followed by a inhumanely, Adventures). mile we finally reached Lake Ogwen, nightmare journey along winding depending on your where our supply car waited with mountain roads at a particularly perspective) relocated to Wales. The However, one does not succeed in the wonderful supplies of water and undesirable hour of the morning. solution, therefore, was clear. All I demanding world of veterinary food. For those with the necessary needed to do was to retrace my steps, cryptozoology without both sacrifice intestinal fortitude it was also an The absence of mead whilst prominently displaying a and dedication. I am therefore opportunity to examine one’s feet. We had run, climbed and sizeable quantity of dragon-quality resolved to carry out my plan at the Next, we climbed 2,300 feet up determinedly staggered onto every mead. next suitable opportunity. And at least the Carneddau mountain range. Our one of Wales’ mountain summits. Beverage of such quality would such scholastic expenses should be guides, who we suspect had been Due to a certain unfortunate doubtless be exorbitantly expensive. fully deductible.

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VETERINARY PRACTICE SEPTEMBER 2010

THIS MONTH: n Review your property costs n Ten tips for a healthier business n National minimum wages go up in October n Setting up a flexible benefits scheme n Are you familiar with NEST?

Could you make savings in property costs? AS the second largest cost after staff, property property rather than moving at the end of the term, out there – if only to use as a negotiating tool! plays an important role in business. With the or exercising a break. Where there is no natural break in your current recession far from behind us, and the full If the location is good then think about lease, landlords may still be willing to negotiate mid- implications of the country’s deficit yet to renewing, but on lower rental terms or perhaps with term to secure, for example, a longer term even if spread into the wider economy, cost savings will a contribution of capital from your landlord to for a lower average rental and revised letting terms. still be high on the agenda for all improve the fabric of the building or So consider reducing the amount of rented space businesses moving forward. for better internal fit out. It is also the business uses and generating extra income by This article outlines a number of an ideal time to address the issue of sub-letting part to another occupier. Whether or not options for tenants and landlords to dilapidations and agree a reduction this is possible will depend on existing lease terms. consider in the quest to further in reinstatement obligations. However, landlords may prefer to consent to such an reduce their property costs. Research shows that many arrangement where it secures the viability of an businesses could use just half the existing tenant and avoids a potential insolvency. Opportunities for tenants space they currently occupy. Again, The opportunity to rent a small area where there If you are a tenant, now is a good if you are coming to the end of are existing facilities is often attractive to a smaller time to ask for better terms on your your lease or thinking about start-up business and can be done on flexible terms lease. If you are coming to the end exercising a break clause, can you so that you can expand back into that space should of a lease or have the option to ADELE McDERMOTT reorganise your business to operate demand increase again. serve a break notice, or are due a says it is a mistake to out of a smaller space reducing rent, An area of expense that often gets overlooked is rent review, think about negotiating assume that property business rates and other overheads? service charges. Often these just arrive as invoices hard on renewal terms. Landlords costs are fixed and Space, particularly within office from the landlord, without any questioning of how do not want empty property on unalterable – and they buildings, may be only 50%-60% the expenses have been incurred. Look at the service their hands, particularly older should be reviewed used on any given day because of charge clauses and get hold of the last few years’ properties that are harder to let in holidays, sickness, meetings off-site records and accounts. Look for unusual increases in the current market. and the increase in “hot-desking” and any particular costs and management fees – are they Since the abolition of empty property business home working. reasonable? Can they be challenged? rates relief, most landlords benefit from only three Equally, up to 15% of floor space can be taken months grace for non-industrial premises and six up by filing and storage. Off-site storage can often Opportunities for property owners months for industrial premises before having to pay be found at substantially lower rates than main office If you own your building and have not sold and the full amount of business rates. It is better for a rents with electronic storage reducing costs even leased it back in the boom times, you have further landlord to have a tenant paying a lower rent than no further, reducing your carbon footprint and limiting flexibility. You could sell or let out part. tenant plus a business rates bill on top. the need for travel. Even on a lower rental this may produce a This is an ideal opportunity to re-gear a lease to Relocation itself may not seem immediately significant cost saving if you don’t have to pick up your current business strategy. Much can be achieved attractive given the disruption and additional costs, the rates bill. There may also be additional savings by simply agreeing to remain in occupation of your but there will be plenty of landlords willing to offer on security and insurance, which could be recharged Adele McDermott is partner in the Commercial incentives which may go a long way to meeting those to a tenant. Property Department of Beswicks Solicitors LLP: costs and providing better accommodation for the Obviously you will be competing with the rest of [email protected]. business in the long run. It is worth seeing what is the market but it could provide extra income. Your Right opportunity - Right location - Right now! Where do you want your new surgery?

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SEPTEMBER 2010 VETERINARY PRACTICE BUSINESS & FINANCE 65

building may possibly have a greater value as an will do this for you. It is important, however, to mitigate your outgoings? It may be possible to avoid alternative use and it may be useful to get some choose a reputable agent who is professionally paying empty property rates, or at least reduce your specialist advice as to your options. qualified and who will provide detailed information liability. Again, check your rating assessment. Business rates are often the third highest cost for as to the likely costs involved. If your rateable value for 2010 is significantly small businesses after rent and staff costs. Non Remember that a reduction in your rateable higher than for 2005, then you may be entitled to domestic rates are a tax on the right to use and value will not necessarily equate to a reduction in some transitional relief. Check with the Valuation occupy commercial property and are the amount of rates payable. This is Office Agency that you are receiving all allowances based on rental values. Remember that because there are other reliefs and and reliefs. Rateable values in England and a reduction in exemptions for which you may If your property is a listed building it will receive Wales are set independently by the your rateable qualify before coming to the correct the full exemption from empty property rates. Valuation Office Agency every five calculation of your rates bill. If you are entitled to small business rate relief years and the current values have just value will not In England, small businesses are then you might consider re-occupying the property, been set, effective from 1st April 2010 necessarily generally entitled to small business as empty properties do not qualify for the relief and but based on a rental valuation date of equate to a rate relief if they occupy one the rates payable by a ratepayer who qualifies may be 1st April 2008 when rents were at their reduction in the property and the rateable value of less than the rates payable on an empty property. peak. In Scotland, business rates are amount of rates their premises is less than £18,000 dealt with by Scottish Assessors; in (£25,500 in London). The Welsh Deal with your energy efficiecy Northern Ireland, the next revaluation payable. Assembly funds its own small Now may be the time to really deal with your is not due until 2015. business rates relief scheme. energy efficiency. Heating and hot water used in You can check your business rating online on the Northern Ireland has a hardship relief scheme. your building can amount to half of all your VOA website www.voa.gov.uk. If you are unhappy After its last budget, the previous government energy costs. Installing an energy efficient heating with the rating assigned to your premises, you may announced a temporary increase in the level of and hot water system, having it regularly serviced have grounds to appeal if, for example: small business rate relief so that eligible ratepayers and operating it effectively so that it is set to turn n you think the new rateable value is incorrect; pay no rates on properties with rateable values up to off when it is not needed, will save you money. n if any part of your property has become exempt £6,000 with a tapered relief of between 100% and As the government is keen to impress upon us, from liability; 0% for properties with values between £6,001 and it will also reduce your carbon footprint and help n there has been a material change of circumstances £12,000. combat climate change. There is help including 0% which might affect value, such as a change of use, a The new levels of relief were to be available for business loans and carbon surveys available for change to its physical state or a change in the 12 months from 1st October 2010 and are being businesses from organisations such as the Carbon locality. kept by the Coalition Government. If you think you Trust to go “green”. See www.carbontrustco.uk for may be eligible, you should contact your local more information. Appealing your rateable value authority to seek advice as to what to do to make a The key message is to not assume that the You can choose to appeal your rateable value direct claim. property costs are fixed and unalterable. With a with the Valuation Office Agency, and it’s free. If you have already moved out of your premises little time and effort it’s quite possible to make Alternatively, there are many rating agencies which and they are empty, is there anything you can do to changes that will help your bottom line.

The top dog.

Do your professional fees reflect the true costs of the services you provide or are they based on guesswork?

In these tough economic times it’s vital that your professional fees cover all your costs Call and meet your profit goals. After all, your financial success depends on the fees you 0845 4747 445 FREE copy charge. However, identifying and calculating all the cost components of every fee is for your a surpringly complex task and one that few practices have attempted. Fortunately, of our booklet technology can cut it down to a manageable size and greatly simplify the process. 10 Proven Recession- RxWorks Performance Pack will help you determine the true costs of your fee components and, by Busting Strategies applying the desired profit margins, calculate prices. It is one of an exciting range of add-on modules for Veterinary that are available with the latest release of RxWorks – Rx4. Practices Other Rx4 modules handle patient recalls, deliver automatic SMS text messages, help boost healthcare compliance, generate forms and letters, integrate laboratory equipment and manage electronic ordering. Modules can be added at any time to create a practice management system tailored to suit each practice’s individual needs. For an obligation-free discussion with one of our practice advisors to discover how Rx4 and Performance Pack could help put your practice on a more profitable footing, call 0845 4747 445 or email [email protected]

RxWorks Ltd Unit 14, Kingfisher Court, Hambridge Lane, Newbury, Berkshire RG14 6SJ Tel: 0845 4747 445 Fax: 0845 280 2626 Email: [email protected] Web: www.rxworks.com VP vol42 07_August 2010 24/08/2010 14:55 Page 66

66 BUSINESS & FINANCE VETERINARY PRACTICE SEPTEMBER 2010

communication must not only be during the consult. We must remember Ten tips for a healthier business that owners do receive a huge amount EVERYBODY talks about the twice before spending any money, it is communicate the plan to the whole of information in the short period of economic crisis and how it is fundamental that client satisfaction is team. time that a consult usually lasts. affecting their business. The maximum, they must see the added Lastly, employees must have Besides, they do have loads of veterinary profession is no stranger value that we offer with our services. empathy and identify with their distraction, starting with their pets. That to it. It is important to admit that They should notice that when buying a businesses. Huge companies have is why we must have tools ready for the there is a problem and help is bag of food in our shop, it is not just closed despite everybody doing their most common things (for example: if needed: this is always the first step some biscuits, but it has professional job right. Circumstances do change and we want the owners to use parasitic to overcome any nutritional advice what at some point was acceptable (to treatment regularly, we should provide crisis. associated. work 37 hours and get paid for 40), them with an information sheet that On the following Communication is may not be acceptable under the talks about the flea cycle or diseases lines I will try to give key and the whole current climate. The whole team needs carried by ticks...). some ideas, from the team has to be to know the situation and give that Another useful tool is the regular many that can be involved. Investing extra bit. informative campaigns which give a thought, to face this information in the The key to giving your best is dynamic and modern image to the crisis with the best team so they also motivation and this requires a decent clinic, as well as making our clients tools. understand the need salary, information, time off... We need more faithful to us and educating them. Let´s start by for communication to know what really motivates our They can contribute, too, the formation understanding what are will always bring employees to help them to be fulfilled and motivation of our team. the goals of any IGNACIO MÉRIDA ISLA benefits, and even as people. This will ensure they Besides, as a secondary effect, more business. These goals looks at what more nowadays. continue working for us for longer, and educated clients will spend more money can be summarised as practices can do in It is clear that the longer they stay, the more they as they will be more likely to use more the following: order to not just companies do need to identify themselves with our business. services. Campaigns can be combined • produce benefits; survive but prosper produce benefits to The more they identify, the harder with discounts or promotions that help • client satisfaction; in the current ensure their survival. they will work to prevent it from failing, with the motivation. • keep employees economic climate It is necessary to as the failure will not only be of their happy. remember that company but of themselves. 3. Use of new technologies These three goals are because of inflation, we We have to remember that In the era of communication, with as important as each other and, need to increase revenue yearly just to everybody was doing the right thing internet, mobile phones, etc., we cannot especially in these times of crisis, every keep even, so we need to plan ahead at during the initial (and only) trip of the look the other way. We need to use all single tool at hand must be applied so the beginning of the year how we are Titanic, the band was playing music, the the resources to communicate with our they are fulfilled at 110%. going to achieve this increase, use waiters serving drinks, engineers clients. Using e-mails is cheap and In a time when clients do think assessment mechanisms and checking the machines ... and despite all allows us a regular contact. It can be that, the ship sank. used to forward those informative In this case there was a leadership campaigns, as well as vaccine or problem – whoever took the decision worming reminders. Take our about the speed. This can also be Setting up the system will cost applied to our clinic: we need to money, but it is a small investment if meditate well on the decisions we make. we compare it with how much a passion further We cannot change strategy each month traditional mailing costs. because the results are not the expected Using a technology that most of us ones, but choose wisely in the first have in our phones, like “bluetooth”, Veterinary Affairs Manager place. proximity marketing can be achieved in Attractive salary plus a great benefits package Once the goals for the clinic are our waiting rooms, or share our wi-fi including a generous car allowance understood, let’s see how can we make with the clients to make waiting times Based at home them come true. less boring. At Purina, we’re passionately committed to helping pets enjoy happier, 1. Be proactive 4. Re-visit your relationship with healthier and longer lives. As one of the world’s leading pet care companies, we are pioneers in the scientific advancement of pet nutrition, Our clients are out there (I hope suppliers creating products that make a real difference to pets’ lives. nobody has met a client who walked in During this period of a drop in Millions worldwide look to us for the very latest advances in quality, taste the clinic saying that he or she could consumption, we must limit the and nutrition. And as one of our Veterinary Affairs Managers, they’ll be not feed their pet and they put it expenses, and an important part of the looking to you too. An influential and inspirational ambassador, you’ll down); and they are delaying their visits expenses in a veterinary clinic are those promote Purina’s product innovations to audiences at all levels – including and consuming less. products we buy from our suppliers, veterinary academics, key practitioners, industry trade associations and We need to get out there and find from the vaccines and drugs to food welfare organisations. them, we need to stop hiding in our and accessories. For that, the best thing As a qualified vet, experienced with small animals, and with some previous clinics, waiting for the pets to get sick, to do is a retrospective study of what commercial experience in industry, your proven ability nutritionally and and focus more on prevention. we spent in the past, and use this data commercially will enable you to have the opportunity to truly shape and grow this new role. Prevention is more than vaccination to negotiate future orders. To apply please visit www.nestlecareers.co.uk or email your CV and and parasitic treatment, it is also There are shopping groups or a covering letter to [email protected] preventive neutering, regular blood tests distribution companies that will allow Closing date: 26th September 2010. in chronic or elderly patients... We need, you to avoid some middle men, hence then, to educate the owners and this they can offer you a better price. cannot be done without our next point – communication. Ignacio Mérida Isla, MBA, DVM, MRCVS, qualified in Spain in 2000. In 2. Communicate information 2007 he started his own consulting Vets, as with any other service company, Assis Veterinary Business providers, have the moral duty to Advisers; he can be contacted by e- Good Food, Good Life mail at [email protected]; website educate our clients. Communication is www.assisvba.com. our best ally on this mission. This VP vol42 07_August 2010 24/08/2010 14:55 Page 67

SEPTEMBER 2010 VETERINARY PRACTICE 67 Looking for a Remember that lab companies do not good leader as it helps to motivate the offer the same price to someone who team. new job? buys 100 vaccines as the one who buys 10,000. 8. Be a leader Let us help you As a leader, it is important to be an 5. Design an annual plan example. You need to be the first to We have a It is clear that if you are travelling accept changes and be flexible. A good abroad, the normal thing is not only to leader not only listens to the team, but dedicated team decide the destination, but also how to also communicates with it. get there, where to stay, local currency... It is better if the employees know ready to find jobs A plan is elaborated. that the reason to work harder is not so Our clinic is like a continuous trip, that you can go on holidays to a far for you which means that we need to do a away country, but in these crisis times periodic plan, based on our business the revenue has decreased and they plan. In this way, we will use the need to work harder so everybody gets appropriate tools, for example to paid and there are no personnel increase the number of clients opting reductions. for preventive surgeries, or increase the revenue by increasing the percentage of 9. Seek for synergies sales of food. Everybody is facing the same economic Qualified Vets needed in the UK This plan needs to be agreed and it situation so perhaps it is about time to must take account of the current think about that collaboration that so
Nationwide coverage situation, the goal and the tools to far did not seem to be working. One of achieve it. We need to review that our the best options to increase revenue is
Practice and commercial positions goals are being achieved and if it is not the possibility of offering more the case, find out how to get back to services. It is very expensive for a single
Confidential service the right path. practice to hire a cardiologist to improve the revenue, but one can be 6. Review your finances hired among several clinics, working We need to start by checking our one day in each. The same can be said rig finances and where we spend the about an ultrasound machine, which Call 01392 314070, money. If we do not know where the can be very small and portable, allowing money is spent, how are we going to practices to share the expenses. Every or visit www.rigvets.co.uk know where to save it? Use the tools in collaboration (or even association) will your hand (from a computer to a help to reduce costs. simple pen and paper – both are equally useful) and check on every penny you 10. Ask for help have spent. Once you know, you will Every change involves an effort, and a know if you can save some money rare commodity in the veterinary (change your electricity provider, your profession, time, even with a low phone company...). economic cost. Besides, a pair of fresh Veterinary The same can be done for the eyes can always help to bring a new revenue. Check where the money is point of view. coming from so you learn which areas There are companies and people of your business need to be improved. which can help you to make those Equipment Working to the plan will allow us to decisions and to elaborate that plan that decide where to invest the marketing is going to benefit your business so money, for example. much, or develop those information campaigns or give you the tools to Finance 7. Listen to the team check your finances... You never know where the next good idea may be coming from. On the To summarise, there is no magic If you’re a high rate tax payer, regular meetings with our team, it is formula to face the crisis, but we can important that everybody gives their use the various tools at our disposal to Performance Finance points of view and ideas to improve the deal with it. It is difficult to win the is renowned for it’s ability current situation. lottery, but if you do not buy a ticket it At the end of the day, everybody is almost impossible. to offset tax working in the clinic is in the same As Albert Einstein said: “It is crazy crisis together. It is important to listen to do the same thing over and over actively, it is another requirement of a again and expect a different outcome.” ‘Full’ IT package for practices NOVA IT Solutions of Maidstone in Kent reports that it can now provide www.performancefinance.co.uk veterinary practices with a full IT package, from consumables to servers, with remote back-up and seven-day-a-week computer support. Give us a call today on Features include e-mail reminders of appointments booked through t : 01536 52 96 96 Customer Relationship Management (CRM) software, newsletters via online marketing to an opt-in list of customers and clients, and smart phone access to e-mails. The system enables authorised staff to link to their desktop computers remotely to access client or pet data, as well as via hand-held, online devices. For details see www.nova-itsolutions.com or call 0800 019 4525. VP vol42 07_August 2010 24/08/2010 14:55 Page 68

68 BUSINESS & FINANCE VETERINARY PRACTICE SEPTEMBER 2010 National minimum wages rise next month THE Government has changed the at the Employment Tribunal. The working to all employees and reveals culture will be in the best position to categories for the national Council appealed. that of the 1,167 respondents who sustain morale and retain top talent. minimum wage and increased the The EAT upheld the ET’s decision took part, 47% named flexible working rates, which will take that D had been unfairly as their most important benefit, with Equality Act 2010: update on effect from 1st dismissed on the basis bonuses in second place, preferred by commencement dates October 2010. that the Council had 19% of respondents. The Government Equalities Office The new hourly made no attempt to Benefits of less significance were had, in June, removed references to rates will be: standard investigate properly or paid time off to do social or the commencement date of the adult rate (workers “engage with” D’s humanitarian work, exposure to majority of the Equality Act 2010 aged 21 and over) – explanation that his advanced networking or social from its website. It has now updated £5.93 (rising from conduct was a result activities and paid training and its site to state that the government £5.80); development of his medical development. “…is currently considering how the rate (workers aged condition and The research found that the different provisions will be between 18 and 20) – consequently they did employees were clear about what they commenced so that the Act is £4.92 (rising from GARETH EDWARDS not have reasonable wanted. Half of those interviewed implemented in an effective and £4.83); and young provides a round-up grounds for their would prefer to be self-employed while proportionate way. workers rate (workers of some important belief that D was almost a third would like to be “In the meantime, the Government aged under 18 but employment issues guilty of gross employed by a business whose values Equalities Office continues to work on above the compulsory misconduct. match their own. the basis of the previously announced school age who are The EAT also It would appear that companies timetable, which envisaged not apprentices) – upheld the ET’s order that are in a position to adapt to the commencement of the Act’s core £3.64 (rising from £3.57). that D should be re-instated to his increasingly popular flexible-working provisions in October 2010.” Importantly, the Government has position with the Council. extended the adult standard rate to 21 New rights for self-employed year olds from 1st October 2010. The Employee and excessive internet qualifying age up until that date is 22. use include maternity leave There are consequences for An Employment Tribunal has awarded SELF-employed workers and their partners will enjoy better social protection – employers who fail to pay their staff almost £40,000 to an accountant including the right to maternity leave for the first time – under new legislation the NMW. Recently, a Manchester dismissed for “excessive use of the endorsed by EU governments. optician who paid his staff up to 40% internet”. The Directive on self-employed workers and assisting spouses repeals and less than their entitlement was Mr Innes’ bosses at Scottish and replaces an earlier law (Directive 86/613/EEC) and improves the social successfully prosecuted under the Southern Energy claimed that he had protection rights of millions of women in the labour market, boosting female National Minimum Wage Act 1998 been spending a “ridiculous amount of entrepreneurship. At present, women represent only one in three and was fined £3,696. time” using the internet for personal entrepreneurs. purposes during working hours, The legislation, agreed with the European Parliament on 18th May and Misconduct must be properly alleging that he reached 27,500 website endorsed by EU Member States, will provide equivalent access to maternity investigated prior to dismissal hits. He was dismissed for breaching leave as for employees, but on a voluntary basis. At EU level, this is the first An employee who was caught viewing the firm’s internet policy. time a maternity allowance has been granted to self-employed workers. pornographic material whilst at work The ET ruled that his dismissal The new rules are expected to promote entrepreneurship in general and was held to have been unfairly was unfair because the decision to among women in particular. There is a currently a major gender gap in this dismissed by the Employment Appeal dismiss was based on a report on his area – only 30% of entrepreneurs in Europe are women. Tribunal due to his employer’s failure internet use that the company had “no Finally, the provision on social protection for assisting spouses and life to investigate the employee’s defence idea” how to interpret. Managers partners is also a considerable improvement from the 1986 Directive. They will that his conduct was a result of a should have obtained advice from the have the right to social security coverage (such as pensions) on an equal basis hypoglycaemic episode. IT department on the data within the as formal self-employed workers. In The City of Edinburgh Council report before dismissing Mr Innes, EU countries have two years to introduce it into national law. v. Dickinson, D, who suffered from given the seriousness of that decision. n http://ec.europa.eu/social/BlobServlet?docId=608&langId=en. diabetes, was employed as a The Tribunal was unequivocal in its community learning and development decision that the dismissal was unfair. worker based in a school. D was It is understood that Scottish and New guide explains the caught viewing images of a “serious Southern Energy is considering an different types of telephone pornographic nature” on his computer appeal. but claimed that he had no recollection The decision highlights the numbers now in use of the incident and that this out-of- importance of employers OFCOM has issued a guide to call The guide also explains about 08 character behaviour must have resulted implementing a comprehensive e-mail charges for those struggling with the numbers, ranging from 0800 numbers from a hypoglycaemic episode. and internet usage policy for staff. A different types of phone numbers in – which are free to call from a landline At the time, D’s diabetes was not policy needs to be clear, precise and use today. – to 0843, 0844 and 0845 numbers, as properly controlled due to him being accessible to staff and sufficient The guide looks at some of the well as 0870 numbers. Finally, the prescribed with the wrong strength training should be provided on its common numbers in use, what they guide will tell you how much you can insulin. D’s explanation was not provisions. Staff also need to be made are used for and how much it costs to expect to pay if you call the more accepted by the Council and he was aware of the repercussions of failing call them from a BT landline. expensive 0871/2/3 numbers and summarily dismissed for gross to comply with its terms. The guide gives detail on geographic premium rate 090 numbers. misconduct. D brought proceedings numbers – numbers beginning 01 or 02 The prices in the guide are based against the Council for unfair dismissal Your flexible friend – as well as 03 numbers, which many on the cost of calls from a BT landline and disability discrimination and won A survey by PricewaterhouseCoopers organisations now use as an alternative and other providers’ prices may vary. reveals that employees value flexible to more expensive 08 numbers. There’s Calls from mobiles will almost always Gareth Edwards is a partner in the working more than performance- also information on 030 numbers – be higher and you should check the employment team at Veale related bonuses. The survey follows used by not for profit organisations – costs of calls with your provider. Wasbrough Vizards. the new government’s proposals to and 07 mobile numbers and 070 n www.ofcom.org.uk/files/ [email protected]. extend the right to request flexible personal numbers 2010/01/numbering.pdf. VP vol42 07_August 2010 24/08/2010 14:55 Page 69

SEPTEMBER 2010 VETERINARY PRACTICE BUSINESS & FINANCE 69 Setting up a flexible benefits scheme EMPLOYEE rewards are about employers of all sizes. These may number of specialist benefit providers BENEFITS TO THE BUSINESS attracting, retaining and motivating include tax and national insurance and employees can be provided with n Assists recruitment and retention your people. Any size of savings, such as those achieved by access to a wide range of discounts n Administration is simplified organisation will have a wide offering certain benefits through salary and offers from leading brands and n Create savings, particularly in variety of individuals with different sacrifice, for example pension retailers, via a dedicated website. National Insurance ages, lifestyles and hence different contributions, child care vouchers, These may range from leisure and n Keep a cap on payroll costs motivations. health screening and bike loans. shopping, eating out, entertainment, n Target expenditure at benefits that Offering flexible benefits may offer The employer has the ability to insurance to travel attract/retain employees a number of control costs so if the and gifts, as well as Benefit choices n Budget for future attractions for large provision of some of seasonal can sometimes be expenditure and smaller employers the benefits increased promotions and linked with n Further communication alike who often face in price, the employee one-off deals. working of benefits package the difficult task of may be required to The benefit n Complement existing providing benefits to pay the extra cost of provider will arrangements benefit arrangements employees in a cost- these price rises. usually charge the such as enhanced effective manner. This Employers can target employer a flexible working, BENEFITS FOR is a way to offer the spend on benefits minimum fee or if or the option to EMPLOYEES rewards that can that employees value. there are many buy or sell n Choice of benefits to benefit everyone in a In designing employees, a fixed suit personal diverse workforce and MARILYN MARTIN benefits, these will be cost per head, holiday. circumstances also ensure that the looks at ways in which influenced by the making it easy to n Better rewards are fully employers can actual profile of the budget for. If communicated communication/improved value appreciated, as they provide benefits for employees: for effectively, employees save money n Create savings, particularly in have been self- staff in a cost- example, dental, and the employer can be associated National Insurance selected. effective manner health screening and with top brands, thereby n Benefit from discounted group The idea of travel cover will be distinguishing themselves in the rates negotiated by the company flexible benefits is more attractive than present market as employers to work n Avoid duplication of benefits simple. That is to focus expenditure on perhaps life assurance for younger for. those areas where it will achieve staff members and smaller employers A successful benefits plan relies n Please note that that this advice is for maximum value and this is by letting can often offer a more flexible range on the interactions of design, access guidance only and individuals should take employees choose the benefits that of benefits to enable them to compete and communication, so in summary their own professional advice before matter most to them. Such schemes with larger employers in the attraction these are: making any decisions based thereon. are also sometimes known as “cafeteria of staff. benefits”. Employees are given a Employees usually value their flexible benefits budget so they can ability to tailor pay and benefits to suit “buy” the benefits they want. their personal circumstances and this is People at different stages in their particularly useful to attract employees careers want different things. One with particular skills, if there are person may place a higher value on a specific skill shortages. lower cost benefit than on a more The principle is that the employees expensive perk. Employees can choose have an allowance to spend on various their own benefits from a set menu, flexible options on top of their core which may include choosing or benefits. Benefit choices can rejecting certain benefits as well as sometimes be linked with working upgrading certain benefits in exchange arrangements such as enhanced for others, normally within specific flexible working, or the option to buy limitations. or sell holiday. In an acquisition or In this way you can attract and merger of practices, it is important to retain a variety of personnel within a harmonise the benefits and integrate fixed budget that the employer sets. It packages between the two parties. is usual in most flexible benefit As some of the flexibility can schemes that employees make their create savings, particularly national selections only once a year. This eases insurance, employers can use these administration. savings to offer additional benefits, so Schemes can, however, make keeping a cap on their payroll costs, exceptions for “lifestyle events” such but providing for and empowering as promotion, marriage, divorce or the their employees. birth of a child. Employers can take a It will be necessary to review building block approach, i.e. they don’t existing benefits and there are a need to implement the system in one number of organisations, PKF among go; they can choose a basic version them, that can provide this service and initially, with an option of building up assist in the design of a suitable over time to give greater freedom and scheme, to include draft paperwork, to build confidence in the idea. etc., to fully communicate with the There are potential benefits for staff. This may be integrated into an employee savings scheme. Marilyn Martin is a partner at PKF (UK) An employee saving scheme is LLP. telephone 01473 320700, e-mail another way for employers to reward [email protected]; website employees without increasing salaries. www.pkf.co.uk. These schemes are available through a VP vol42 07_August 2010 24/08/2010 14:55 Page 70

70 BUSINESS & FINANCE VETERINARY PRACTICE SEPTEMBER 2010 National Employment Savings Trust (NEST) IN December 2006, the cost pension scheme, NEST will be employers throughout an individual’s Government published a White introduced as part of the workplace working life. Table 2. The time-scales. Paper outlining its workplace pension reforms and will have the The self-employed and single Number of PAYE Staging pension reforms, including following key features: person directors are not eligible for staff date proposals for NEST (the National 1. Governance auto-enrolment but will be able to 50,000+ Q4 2012 Employment Savings Trust) – NEST will be a trust-based join NEST. 10,000-49,999 Q1 2013 previously called Personal occupational pension scheme. It will 4. Opting out 4,000-9,999 Q2 2013 Accounts. be regulated in the same way as Employers will need to automatically These reforms aim existing trust-based enrol their eligible workers into a 1,250-3,999 Q3 2013 to increase the defined contribution qualifying pension scheme and make 500-1,249 Q4 2013 amounts people save schemes. contributions to it. Workers will be 250-499 Q1 2014 for their retirement in 2. Charges able to opt-out of their employer’s 90-249 Q2 2014 order to supplement NEST will provide scheme if they choose not to 50-89 Q3 2014 their pension income. people with access to participate. However, the government <50 Q3 2014- It is clearly apparent a simple, low-cost is likely to make this process rather that the state pension pension scheme. The labour intensive in order to prevent Q1 2016 cannot be relied upon charges are expected people from opting-out immediately New employers Q1 2016- to fund one’s to be: and procrastinating yet further about Q3 2016 retirement in its n a 2% charge on the how they will provide a replacement entirety. ANDREW NEALE value of each income in retirement. enrol all eligible employees in a At around £100 outlines the new contribution to cover Workers who give notice during qualifying pension scheme and make per week it is hardly pension scheme which NEST’s start-up the formal opt-out period will be put contributions to their plan. enough to cover the is due to come into costs; back in the position they would have It is therefore imperative that grocery bills, let alone effect in 2012 n an annual been in if they had not become business owners are made aware of provide people with management charge members in the first place, which may these proposed changes to pension all the income they of 0.3% of the value include a refund of any contributions legislation and start to identify the will require once they stop working of the fund. Whilst this is taken following automatic enrolment. impact these changes will have on for a living. significantly less than most 5. Transfers their business. As the government’s flagship occupational stakeholder or group Transfers into and out of NEST will Ideally, they should consult their proposal under pensions reform, the personal pension plans, the fund not be allowed (except in specific independent financial adviser or NEST scheme, due to come into range and flexibility of the contract limited circumstances). This will be accountant to talk through the effect from 2012, will put in place will be severely limited as a result. reviewed in 2017. possible implications of this and the pension provision for millions of low This may lead to a number of firms 6. Contribution limits various options available to them. to moderate earners who are not choosing to implement their own There will be an annual contribution Will their existing scheme allow currently saving for their retirement arrangements, that comply to NEST limit of £3,600 (in 2005 earnings’ the business to meet the requirements and will have wide-ranging effects legislation, rather than using the terms) into NEST. This will be up- of the legislation or does a suitable across every field of business. Government’s standard NEST rated by earnings year on year and the contingency plan need to be devised? There is a lot to be gained by compliant scheme. limit will be reviewed in 2017. It is also worth considering the starting to prepare now and ensure 3. Investment choice However, individuals should be aware administration requirements of the appropriate provisions are put in Workers will be automatically enrolled that they will still be eligible to legislation and ensuring it is place before the legislation takes into the default fund but there is contribute to other pension compliant with the government’s effect. To provide an indication of likely to be a choice of other arrangements alongside NEST if they requirements. Additional staff what will be required, employers will investment funds, which may include so wish and the NEST scheme need resource of systems may be required be obliged to auto-enrol new and options such as social, environmental not be their only source of pension as a result. existing employees into a personal and ethical investments. Those not funding. n The author can be contacted at: “defined contribution” plan (i.e. wishing to make an investment choice Allchurch Bailey Wealth, 93 High contribution levels for employee and will stay in the default fund, although Summary Street, Evesham, Worcs. WR11 employer are set at outset) unless they it is clear that the fund range will be From sometime between 2012 and 4DU; telephone 01386 442597, opt out and, from October 2017, a somewhat limited in order to keep to 2016 (dependent on the size of the e-mail minimum employer contribution of the low-cost charging structure. business from largest to smallest), [email protected]; 3% of salary will be required. Some firms, as a duty of care to employers will have to automatically website www.abwealth.co.uk. Details of how the contribution their employees, may wish to levels (both employee and employer) implement their own private HMRC launches free ‘toolkits’ to help with will be structured, as well as other key arrangements that offer greater features of the proposed legislation, investment flexibility whilst still tax returns can be seen in Table 1. complying with NEST criteria. SIX free “toolkits” to help taxpayers and their agents avoid common errors The time-scales are shown in However, this is likely to come at an when filing returns for 2009-10 have been published by HM Revenue & Table 2. additional cost to the members. Customs. Anyone who joins NEST will be The toolkits, which are downloadable from the website Key features of NEST schemes able to continue to save in the scheme www.hmrc.gov.uk/agents/prereturn-support-agents.htm, cover capital gains tax As a new form of simple and low- even after they leave the workplace or for land and buildings, marginal small companies’ relief, private and personal move to an expenditure (income tax self-assessment), trusts and estates, capital gains tax for Table 1. The contribution levels. employer that does trust and estates (supplement) and capital allowances for plant and machinery. Employer Employee Tax relief not use NEST. The toolkits are free and taxpayers do not have to use them, but they are Up to 10/2016 1% 0.8% 0.2% Therefore, the packed with helpful information including checklists, links to online guidance 10/2016- 10/2017 2% 2.4% 0.6% individual policies and examples of frequent errors and how to avoid them. The toolkits provide evidence of good working practice and reasonable care 10/2017 onwards 3% 4% 1% created within n Contributions will be based on total PAYE earnings between NEST will be highly and will help, says HMRC, to ensure that tax returns are completed correctly £5,035 and £33,540, increased in line with National Average portable and can be from the beginning.region. It is expected to be seen by over five million Earnings, from tax year 2006-07. transported between people. VP vol42 07_August 2010 24/08/2010 14:55 Page 71

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