What do you do on a What can the profession Are you au fait with changes What do you hope to find normal Sunday? learn from the military? to the pet travel scheme? in your Christmas stocking? – page 26 – page 30 – page 32 – page 55
Science, innovation, and precision
DECEMBER 2011 Volume 43 Number 10 Changes called for in way RCVS functions “THE Royal College should urgently IT and a building project. The report was challenging, and and head of finance review its protocols for the agreement produced by a review team chaired by transparent governance.” supported this of business plans and project Professor Bill McKelvey – assisted by The group was also recommendation. However specifications, the processes for sign- two Privy Council-appointed members of very concerned that a the council has failed, for off of those plans, the procedures for the council, Richard Davis and Judith formal internal audit whatever reasons, to act on tendering and agreement of Webb – whose remit was “to look at all function did not exist in that recommendation.” contracts, and the methodology for aspects that relate to the RCVS the College, and therefore The group reported that, timeous reporting of progress, budgeting and expenditure processes and appropriate benchmarking with the building project, it against agreed milestones, to officers to propose lessons that should be of procedures and had been unable to and to council. This should include a learned”. practices was not regularly determine where ultimate review of written authorisation limits The report said the College should undertaken through responsibility lay for for expenditure at all levels.” carefully consider the pivotal role of the independent external Dr Jerry Davies. agreement of plans, These are among the principal treasurer in ensuring not only financial assessment. contracts and budgets. findings of the McKelvey Report on the accountability, but also in ensuring that “Without such assessment we are A further recommendation was that recent “over-spends” at the College on best practice standards are regularly unclear as to how members of the the College should give due reviewed across all College operations Council can satisfy themselves with consideration to the co-option and RCVS registrar through internal audit and external regard to ensuring best practice across appointment of non-elected members of benchmarking of business processes. the College’s various statutory and council through a defined skills matrix leaving “The skills set required for the business functions.” The report calls for approach. THE treasurer should be formally reviewed an audit and risk committee, fully The RCVS president, Dr Jerry registrar and and the appointment process should take independent of the finance and planning Davies, commented: “That such a review secretary of due consideration of these skills portfolio, to be formed. was required is regretted … the the RCVS, requirements,” it said. recommendations will be a very helpful Jane Hern, The report criticised the planning Failure to act addition to the work that is currently is standing and resources committee (PRC) for “We understand (from anecdotal underway to ensure corporate down this acting as both a finance and general accounts) that a similar recommendation governance is fit for purpose and, in month after purposes committee and as a quasi audit was made some years ago following a particular, that the management of 15 years in committee. similar investigation of an overspend on capital projects within the College is the position. “In our view this is entirely a buildings project, and that the registrar optimised.” At the RCVS council meeting last inappropriate and does not reflect best month, the president, Dr Jerry Davies, governance practice. It became clear to Mercury 4 Feline CKD 16 Parasites 32 said the College had been fortunate in us that the planning and resources Cross-words 6 Orthopaedics 19 Book reviews 41 having Jane’s wisdom and guidance. He committee did not interrogate projects in Viewpoint 8 Dermatology 22 Livestock pages 42 added that a recruitment process for a detail, received post-hoc information, and new registrar would begin “once the at times exhibited a ‘them and us’ culture Latest products 9 Critical care 24 Equine pages 50 role has been defined”. RCVS Council 10 Events 29 Business and finance 55 which was not conducive to open, IN THIS ISSUE headache? Get RoboVet Relief! “MAY WE WISH YOU ALL A VERY HAPPY FESTIVE PERIOD AND PROSPEROUS 2012!”
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Symposium on Trees, one of the organisers of the practices, we will challenge them,” Roly production of poor-quality low value event. Owers, chief executive of World Horse foals was the root cause of many health antimicrobial “Speakers will review the scientific Welfare (WHW), told a conference on and welfare problems. “Purchase prices evidence base to inform a rational equine welfare in London last month. are decreasing and costs of keep resistance debate, focusing on the sources of “Our support for equestrian sports increasing, which are going to lead to THE RCVS, together with the Royal antimicrobial resistance in animals and is a matter of principle and goes right to increasing welfare problems.” College of Physicians and the Royal humans, and the flow of resistance the heart of what World Horse Welfare College of Pathologists and in between them and the environment.” is about,” Mr Owers said. “So long as Award for young association with the Health Protection The symposium will consider the we accept a heavy burden of Agency, is to hold a one-day symposium rapidly-growing importance of responsibility on our shoulders for their poultry vets on antimicrobial resistance in London antimicrobial use and misuse globally, welfare, and give their welfare priority THE World Veterinary Poultry next March. the impact of travel and the historical over all other considerations, we believe Association (WVPA) and Pfizer Animal Called Antimicrobial resistance in human outcomes of previous restrictions. that involving horses in sport is right Health Global Poultry are introducing a and veterinary medicine – one health, one and mutually beneficial. global award for poultry veterinarians problem?, the symposium will be held on Equine welfare “Horse welfare in sport is so high in aged under 35. 15th March at the Royal College of part because welfare organisations like The WVPA Young Veterinarian of Physicians. standards praised us have made it our business to work the Year 2012 award will be presented at “The aim is to bring medical and “WE are proud to play a role to ensure with sport regulators to help them reach Poultry Focus Asia in Bangkok in veterinary scientists and leading sport horses enjoy welfare standards these standards.” February 2012. The winner will receive practitioners together to discuss among the highest in the world; The event featured WHW’s $US5,000 towards travel and antimicrobial resistance, in the spirit of however, the sport industry also president, the Princess Royal, the accommodation expenses for attending ‘one medicine’,” says Professor Sandy understands that wherever we find bad Minister for Sport and the Olympics, an international scientific/technical or Hugh Robertson, and speakers such as CPD meeting of his or her choice. Dr Jonathan Pycock, who gave a Entries close on 31st December and Internet pharmacies presentation on Overbreeding in the equine can be made only via the website, Geoff Watson of Hyperdrug.com writes: industry. He said that the issue that over- www.wvpa-award.com. As “one of the enemy”, in other words a registered UK pharmacy with an internet site offering veterinary products, we found your article Internet pharmacies: Veterinary Practice is an independent monthly opportunity or threat? [November issue, page 3] interesting. publication for members of the veterinary Unfortunately the same old allegations were trotted out once again including profession in the UK. It is mailed free to all internet security, repeat prescription abuse, unauthorised veterinary medicinal veterinary surgeons in practice and is available on products, competent recipients, reporting of suspected adverse reactions, etc. subscription (£36 a year) to others interested. If anyone has any evidence that any of these abuses have ever taken place then it is disappointing that they seem to have failed to report them to the Editorial and Advertising and Published pharmacy regulator, the General Pharmaceutical Council. However many of the websites loosely referred to as “internet pharmacies” design: subscriptions: monthly by are nothing of the sort and include some referred to in pharmacy circles as Editor: David Ritchie, JCA Media Group Ltd VP Publishing Ltd “virtual vets”, sometimes even making illegal use of the restricted title BA, HonAssocRCVS Lion Lane, Needham 30 Diamond Ridge, (editor@veterinary- Market, Suffolk, IP6 8NT Camberley, Surrey “pharmacy”. practice.com) GU15 4LD There has been an accreditation scheme for many years for pharmacy Contact: websites and most if not all legitimate UK pharmacies trading on the internet Editorial consultant: Ian Giffard Contact: display the GPhC green cross logo to provide easy verification of their status by John Tandy, BVSc, ([email protected]) or 01276 686654 (tel) a link to the regulator. MRCVS Sam Compton 01276 63307 (fax) ([email protected]) editor@veterinary- CLARIFICATION Design: Simon Wyatt 01449 720881 practice.com In the report on the launch of Veraflox (Bayer) on page 36 of the last issue, there was a statement from Dr Joy Olsen, Bayer’s global veterinary services manager, that this was the first fluoroquinolone to be registered for the Follow us on Twitter at vpeditor VP treatment of periodontal disease. We have been asked to make clear that this Visit our website at www.veterinary-practice.com applies only to dogs – it is not licensed for this use in cats. PUBLISHING LTD
CORRECTION © VP Publishing Ltd (2011): no part of this publication An error occurred in the chart of canine communications signals which may be reproduced in any form (except for review appeared with the article by Anne-Marie Svendsen-Aylott and Hanne Grice purposes) without the express permission of the editor. on pages 30 and 32 of the October issue. A corrected version is reproduced Printed by Buxton Press, Buxton, Derbyshire in full on page 12 of this issue. Veterinary Practice apologises for the error. 4 COMMENT VP DECEMBER 2011 Why don’t we heed the warnings – and change? AS a small boy, I was always taught foreign holidays possible but set the nation to join the dots to hold doors open for ladies and a pattern for boom and bust on a truly in their own way, the only myriad of other actions which would continental scale. way that people can all indicate the quality of my Not only have we, as individuals, co-exist is if all are upbringing, in an age where an overt been offered an endless vista of easy sufficiently display of consideration for others credit but our respective governments successful not to was not only expected but required. have followed our lead. notice or care That, of course, was a very long In just the same way that our about the cracks time ago and so much has changed families cannot exist at the level many in the wall. since then. Consideration for others of us choose, without borrowing to When success seems to be left to professional agencies fund the excess, neither can our is revealed to be both a now, preferably ones where a modest governments and, if one looks behind little more than smoke short-term donation can salve the collective the hype and bombast of Brussels, the and mirrors and when the credit tap is solution and a long-term conscience. introduction of a secondary and turned off, disaster comes about plan for our current disaster and, like all Intriguingly, while some ladies of a apparently unifying layer of government remarkably rapidly. As I write this, team games, we have to stick it out until more mature disposition still appreciate should have signalled from the outset Europe is wrangling about who can or the final whistle even if the Greek the door being held open for them, will come to the rescue of Italy which, national sport is tax evasion and even if so many either don’t notice or following on the sequential bail-out of life for women in Berlusconi’s Italy has simply steam through regardless. THE MERCURY COLUMN Ireland, Portugal and Greece, looks as if taken a retrograde step by 10 years or Many of a younger generation in which a guest columnist takes it may be next in line. more. actively dislike the gesture and the temperature of the profession – Until recently, Italy was the world’s appear to miss the point and the world around fifth largest economy and reality tells us In the same boat completely; it isn’t about equality, it that there is not enough cash sloshing There is some comfort in the fact that is about consideration. Clearly, a lot around to carry on like this. If we think much of the rest of the world is in the has changed. that this was barely affordable for the about it, what do Denmark and Greece same boat, notably the US, and Perhaps the rot set in much further wealthy nations let alone those who have in common other progressively both back. When, after the First World War, watched enviously from the sidelines. than their currency? Pet owners have Russia and China are the class system dissolved in the nascent There is a certain irony in that those The same could be said having difficulties, but at realisation that one could no longer who brought the miracle expansion for any two nations in found many other some stage China will expect those who had served and given about have themselves created the the European ways to care for want its money back and their lives in the trenches, alongside the disaster which has now brought it low. Community whether their pets with perhaps sooner than we ruling class, to be disdainfully returned Rather like Brussels, the management of they be Italy and minimal help think. to the Downton Abbey existence of the banks have long believed their own Ireland, Spain and from us but we For me, there are masters and servants, things began to PR and rapidly lost sight of the kind of Estonia or Poland and strong parallels in this change. financial probity which required Luxembourg. plough on story with the way in accountability and the need for one regardless, which small animal Retail explosion senior person to check a junior person’s Steeped in building bigger veterinary practice has Then, after the Second World War, work. tradition and flashier evolved. The business rationing and the slow escape from In a tsunami of concerns about Many of us would businesses case that half the privation served to unify the nation in a equality and the rights of individuals, concede that the population will have pets sense of collective opportunism which our 21st century culture has become concept was right at the without very which they must care for was, in turn, fuelled by the instant obsessed with certain issues and blinded time if the necessary much with our help is looking communication of film and radio, then about others. measures of financial commitment to creaky. Pet owners have television which showed us all what probity applied to both actively engaging found many other ways wonders we could have if only we could Little cohesion the individual with the pet to care for their pets afford it. Hey presto, in the 1950s, along All this is symptomatic of change in an governments and the with minimal help from came credit cards and, in a retail environment where there is little overarching European owner. us but we plough on explosion, the modern-day consumer cohesion. Union itself but few, if regardless, building was born. Rightly or wrongly, a political or any, of us spent much time looking at bigger and flashier businesses without The rest is history but none of us social dictatorship ensures that everyone the controls put in place by the banks. very much commitment to actively would be where we are now without the sees things the same way but where Europe is part of the First World engaging with the pet owner. US style of credit provision that not democracy and the forces of equality and every participating nation has a We’re really good at passive only made new cars, kitchens and provide a loose backdrop for each culture of its own that is steeped in engagement; we wait here all day, open tradition and establishment. For those all hours, for the pets to come flocking Ferret information on website of us who grew up in the world of in. WILDPRO, run by the Wildlife Information Network, has a new “volume” establishment, its reliability, The Pfizer Performance Index (once on ferrets. Called Ferrets: Health and Management, it was developed following dependability and strength was FDI) tells us that not only are they not research carried out across UK institutions which run animal welfare courses. legendary and could safely be taken for doing that, the attrition in footfall The information on www.wildlifeinformation.org covers diseases, differential granted but, in the latter day case of the continues in a steady downward curve diagnoses and treatment, husbandry and management. banks and their complicit relationship as it has done for almost 20 years, but The new feature was launched at the London Vet Show on the Supreme with governments, establishment simply we don’t heed the warnings and we Petfoods’ stand. provided a platform for daylight don’t make plans to deal with what’s Professor Sharon Redrobe, life science director at Twycross Zoo – East robbery hidden behind a veil of coming. Midland Zoological Society and one of the key people behind the project, respectability which fooled us all. Clearly Maybe we don’t think it could says it provides a great “one stop shop” for up to date information on ferrets. a great deal has changed. happen to a vet? After all, we’re part of The real issue is that we need to find the establishment, aren’t we? EaseFlex Chews NOW AVAILABLE for cats!
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THE TASTY WAY TO SOOTHE STIFF JOINTS AND MAINTAIN MOBILITY Science is improved understanding EFC.01/03/11 6 CROSS-WORDS VP DECEMBER 2011 Getting the best from the reps MANY months ago a good friend cut! though. time he’d arrived, had a cup of coffee and local drug rep told me he was Working-up a case was something JP. Nowadays maybe things have gone and answered a few phone calls, it was retiring. The following year he was that vets generally just read about in a little too far the other way, where in time for the first client appointment and still hanging on in there but he has the Vet Record and nobody else in the some larger surgeries practice all you got was nothing for a one-hour finally parked his rep-mobile for the surgery ever got to read the Record in managers, sometimes from a non- journey to the middle of nowhere. last time, put away the last pack of case they found a better job in the veterinary background, are the first Despite the practice being a major local samples, attended his umpteenth back! port of call for drug company reps. player, it just wasn’t worth the effort of and last BSAVA congress and Three-legged dogs and cats were This doesn’t seem like progress making the visit for what you got out of become a youngish age pensioner. more commonplace back in the 70s when vets deliberately distance it and the vet concerned was only Before his synapses completely and 80s and long-term supportive themselves from new science and creating more pressure for himself, a fossilise I thought it would be a good therapy was just not available. technology, for whatever reason. lose-lose result for both parties.” idea to tap him up for some inside Obviously, proportionately just as Drug companies have possibly information on the repping and Big- many animals were euthanased back brought this situation upon themselves n I can imagine how annoying that must have Pharma scene, and also for some then as today, but they were a whole lot by adopting an American-style detail been. I remember a company vet travelling three informed comment on the veterinary younger. calling plan. Company sales and hours (our local rep had invited her) to speak to profession, which I can then pass on to Back in the 80s the companion marketing departments seem to have our practice for an hour on a subject. I rounded you all. got it into their heads that more visits up our staff to listen to her, as usual like He GARETH CROSS mean more business. herding cats, and felt the need to pass on how worked has been talking to a company One senior manager in our much effort some people on your side of the roughly the rep who recently retired after 30 company inspired new reps at a sales industry go to see us lot in practice. same patch years of visiting practices and meeting with a quote I have never JP. Vets should try and be realistic for roughly attending veterinary events, to forgotten, “Look after the call rate and about timing and think about questions the same get his views on how things have the business will look after itself.” you want to ask reps/company vets. company changed Now if you’re selling a commodity Generally, industry reps probably want (give or take that involves seeing mainly support staff to give practices more than practices the odd merger and name change) for animal side often ran as second fiddle to keep the shelves full, then that may might expect, both in terms of deals 30 years. Few people will have visited to the large animal business and open be correct, but in my experience there is and support. and re-visited the same group of surgeries were squeezed into time slots a threshold for the number of calls you practices over a 30-year period and that suited farm visits. can make before you start wasting You’ll never know what witnessed the changes. As a rep I called on practices at the people’s precious time. you’re missing out on... He has attended more veterinary time it was most convenient to call, This will vary according to the Dig your heels in and play hard to get congresses and CPD functions than is which was usually very early or late and relationship you have with a practice and most reps will just leave you out in good for his liver and has been a well- occasionally I would see a practice at and the amount of business done, but the cold and you’ll never know what known fixture of the local veterinary lunchtime, when it was off to the pub the pot is spoiled by the combined call you’re missing out on. scene. He will have a unique and for something that stuck to the ribs all pressure that companies exert on larger Alternatively, there are reps who’ll informed viewpoint of how things afternoon. practices. give you the earth on a first visit: when have changed (and what hasn’t). What Of course there are they first call on your has got better and what worse. The senior partners ruled the fewer companies calling Treat companies practice you should be So this month and next month’s roost... due to mergers, but this much the same concerned! If you were Cross-words forms the first of an Senior partners were the only staff you is offset by reps being trying to sell a “me-too” occasional series. I put to him a series ever really got to see and this hierarchy confined to smaller areas and approach product, or one where six of questions and comments on e-mail often ruled the roost with assistants with higher call rates them fairly, then months after launch the and below are his replies (slightly keeping a very low profile. CPD required and the try to make warehouse is still full to edited for clarity by myself). meetings in practice were unheard of introduction of several unbiased the ceiling with short- So sit back and enjoy the ramblings and leaving a data sheet for anyone species-specific reps dated stock, then you’d of the old bugger who has, incidently, other than the boss was often regarded working for the same business be giving it away as asked to remain anonymous. Let’s just as pot stirring. company. decisions so that well! call him JP. I was reminded recently by the I can’t blame the best Treat companies nurse concerned of an incident where practices trying to deflect products and much the same and n So, JP, how have things broadly changed I suggested to a senior partner that the this pressure, but there practice support approach them fairly, since you started out working in the veterinary HVN sat in on a discussion about what are simple ways that you, then try to make industry? would later prove to be a world-leading in practice, can separate shine through. unbiased business JP. I look back and wonder! It’s small animal product. the chaff from the grain. decisions so that the amazing how 30 years passes and you The look of sheer bewilderment on best products and practice support just adapt to changes without really his face at the mere suggestion was Request a limit on the shine through. taking stock of how different things priceless. She told me that that was the number of visits... Just keeping the door shut against are today compared to those “good old first time a nurse in that practice had Start perhaps by contacting the companies and individuals that you days”. ever been involved in a product companies concerned and requesting a don’t happen to deal with at the Looking at it from a pet’s discussion.” limit on the number of visits allowed by moment might be seriously perspective, just imagine the fear and your practice, maybe one vet handicapping your business: you have dread they must have felt being n It is certainly a different world out there appointment every three months, but everything to gain by listening and dragged into a cold, damp, converted from the secretive and cosy chats with the make sure you keep your side of the interacting in a positive way. Also garage with newspaper on the floor partner. Many reps now offer “lunch and deal if possible by making the avoid point scoring with drug reps, and the smell of ether in the air. learn” meetings complete with the obligatory appointment at a mutually convenient it’s a no-win activity. If the pets weren’t terrified, then CPD certificate. The buying and deals may be time. n Next month we look deep into the the owners probably were! Because up to the partners still but in all the non- I can remember one practice murky world of pricing drugs, the that’s what so many one-man-band corporate practices I have worked in all the principal who would book joys of congresses and advice for surgeries were like way back then. It vets have been able to order or request specific appointments at a branch for 8.45am anyone thinking of crossing over was cut and dried stuff as well, mainly items. I imagine that’s not always the case now when his surgery started at 9am. By the from practice to industry. 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Sharing passions, shaping futures 8 VIEWPOINT VP DECEMBER 2011 A fresh opportunity for well-meaning busybodies THE EU declaration calling for appears at first sight to be saying and By rights there should by mandatory identification and doing all the right things and for the now be no pit bulls left in registration of every dog in Europe right reasons. “Animals are sentient the country but there they has received wide acclaim from beings and the EU and member states are on every street corner veterinary and welfare organisations must pay full regard to the welfare for all to see. across the UK. requirements of animals,” it says. Well If the authorities can’t On the face of it, one can see why yes, I wouldn’t disagree with that but it enforce the sterilisation of a this would be welcomed but at the risk doesn’t tell us anything new does it? few pit bulls, then what hope of being branded a sour puss I shall The declaration “calls on the is there of enforcing the declare that I am not quite so member states to adopt comprehensive sterilisation of goodness knows enamoured by the idea as everyone else dog population management strategies how many other dogs? apparently is. Not that I want the Government to Complete PERISCOPE have that sort of power over me harmonisation enforced by continues the series of reflections on anyway. The Government already police authorities have already spent legislation is not necessarily issues of current concern knows far too much about me and millions of pounds on the kennelling of a good thing in my everybody else as far as I’m concerned confiscated pit bulls: to what effect? opinion. Let us not forget and I’ve no desire for them to know Will they be forced to do the same for that the single currency seemed a great which include measures such as dog how many dogs I own or have a say in Yorkies and Labs and hairy mongrels if idea back in the day but I presume control … and sterilisation as necessary whether or not I can be trusted to the owners are in breach of the law? there are plenty of countries who now to control the number of unwanted breed with them. What if the owners refuse to pay the wish they’d never heard of the euro, dogs.” How on earth would it all work? fine? Will their dogs be permanently much less signed up to it. And now I’m starting to get a bit Who is going to decide whether I confiscated and fostered out to another How that particular crisis eventually twitchy. Not just a little bit twitchy but should be permitted to breed from my home? What if the new home isn’t as plays out is not yet certain but I suspect very twitchy indeed. Remember the dogs anyway? What qualifications could good as the one they’ve been that we are not out of the woods and Dangerous Dogs Act? I happen to be they possibly have that would make confiscated from? may not yet even be travelling in the one of the few people who agree with them capable of making such a right direction. the sentiments behind it but no one can judgement? Who is going to pay for the Jumping on a bandwagon The EU declaration on dogs pretend it’s been a rip-roaring success. enforcement? You and me presumably! Well, there are enough questions there At best I foresee a few well- to last a good long while and I suspect meaning busybodies who will want me that those who came out with the EU to attend dog-care evening sessions in declaration have considered few if any much the same way as we all dutifully of them. attended parenting classes. I also suspect that many of those My worst nightmare is the spawning who have given their unequivocal of a whole army of jobsworths (or support to the declaration have rather worse still, animal welfare enforcers in jumped on the bandwagon without uniform) who feel entitled to blunder considering the consequences. into our homes to see whether we have We still, for the time being at least, an unauthorised litter of puppies live in a free country. We should be hidden away under the stairs. educated and persuaded to look after our dogs and other pets to the best of Where will it end? our ability just as we should be And where will it all end? Presumably, persuaded to look after our children. once all the dogs are ticked off and But we should be permitted to make accounted for they will turn their our own mistakes, to learn from them attention to cats, rabbits, guinea pigs and deal with the consequences, and anything else they think they might without the interference of the state be able to catalogue. demanding that we do this or that. And who is to draw up the criteria Yes of course there will be some on which to judge if I look after my children and some dogs that suffer as a dogs in a responsible way? After all, I result of this laissez-faire approach and don’t give mine a kiss and a cuddle each that is when the state will have a clear night before tucking them into bed but duty to step in and protect those who I know some people who do and who cannot protect themselves. think that anything less constitutes But surely that is a better approach gross cruelty. than the state laying down draconian Are we going to have to pay for the rules that must be followed regardless, privilege of registering our dogs and if in a guilty until proven innocent so how much? What will be the scenario. penalties for failing to comply? Will the An Englishman’s home is his castle dogs be confiscated regardless of and he should be allowed to fill it with whether they are well cared for? Will dogs if he so desires without anyone they have to go into kennels at public poking their nose in. Only if he fails to expense until the courts decide what to look after them should the state declare do with them? an interest and until then it should very It is my understanding that some much mind its own damn business. VP DECEMBER 2011 PRODUCTS 9
Single-shot vaccine applied, the product is active in 30 practices who trialled it during the seconds and effective for up to 48 summer,” the firm says. for pigs hours. Using the latest content management MSD Animal Health has received Rob Watkins, managing director of software, the internet portal gives marketing authorisation in the EU for Invicta, said, “The majority of UK practices access to a range of template Porcilis M Hyo ID Once, the first hospitals and the Blood Transfusion articles and appropriate supporting single-shot vaccine against Mycoplasma Service already use Chloraprep and we images. Articles can be used verbatim or, hyopneumoniae (M. hyo) infection in pigs are pleased to make this available under where appropriate, edited to be specific for intradermal administration. the provisions of the cascade.” to the individual practice needs. The product is indicated for the In addition, practices choosing to do coincides with the creation of Royal active immunisation of finishing pigs to their own writing can upload and Canin’s DermAlliance campaign, which Practice newsletter reduce pulmonary lesions and the securely store their articles and images. is aimed at improving skin care decrease in daily weight gain during the Ned Flaxman, director of innovation knowledge in general veterinary practice. system finishing period due to infection caused PFIZER Animal Health’s Vet Support+ at Pfizer who heads up the Vet The campaign includes free CPD by M. Hyo. has launched PressRoom, an online Support+ business services, says the webinars, a training roadshow, case The new vaccine, says the firm, practice newsletter system. system is so simple to use that just about study collaborations and competitions differs from the existing Porcilis M Hyo “Providing a range of content to any member of the practice team could to win skin disease reference materials. in that it comes as a single-shot practices wishing to produce client be empowered to produce the draft Gudi Stuttard, the company’s (whereas the existing vaccine is available communications which are appealing, practice newsletter. veterinary support manager, said, “The as a two-shot vaccine), and it is engaging and informative, the service Practices interested in a trial should large volume of skin cases we see in approved for use as an intradermal has already proved popular with contact [email protected]. general practice necessitates a certain administration (whereas the existing level of expertise in small animal vaccine is approved for use as an dermatology and we believe our new intramuscular administration). New group offers array of services Skin Care range, coupled with the CARELINE4VETS is a new company formed by three firms which aims to creation of our DermAlliance provide specialist services to veterinary professionals. NSAID range educational campaign, will help promote The three – Lockharts Solicitors, RA Accountants and Demco – will offer increased greater clarity in an often confusing help on legal matters, finance, taxation, telecommunications, marketing, IT, clinical area.” NORBROOK has launched Loxicom premises and recruitment, and intend to link with other service providers in The diets are available for adult dog, (meloxicam) Injection for Cattle, Pigs various fields. adult small dog and junior small dog. and Horses. Assistance will also be offered on matters uch as dispute resolution, The new product is indicated for the partenership issues and employment law. treatment of a range of conditions New bottle sizes Based in Wembley, the firm says it will be able “to cut the costs of including pneumonia, acute mastitis and strategic service provisions calf scour in cattle, swine locomotor introduced by introducing vets to MERIAL Animal Health has launched diseases such as lameness and MMA high-calibre specialist two new bottle sizes of its Zactran syndrome, acute and chronic musculo- service providers”. antibiotic which is licensed for the skeletal disorders and equine colic. The photo shows the treatment and prevention of bovine founders (from left): respiratory disease. Andrew Lockhart, Riz Antibiotic for cattle There are now 100ml and 250ml Akhtar and Linda and sheep polypropylene bottles and a 50ml bottle. Demetriou. ANIMALCARE has introduced Details are on the Tilmodil Distributor for website (tilmicosin www.careline4vets.org. 300mg/ml human product INVICTA Animal Health has been solution for appointed as exclusive veterinary injection), a fast- ‘Fresh thinking’ at ‘think tank’ distributor in the UK for Chloraprep, a acting, long- “NEW challenges require fresh number of practices are now licensed human product for cutaneous acting, semi- thinking.” This was the platform for a competing with one another for a fair antisepsis, prior to invasive procedures. synthetic “think tank” event held recently by slice of a shrinking veterinary cake. According to the company, macrolide TVS, which presented delegates with “We will focus on how practices Chloraprep (2% chlorhexidine and 70% antibiotic, new ideas, a strategy or “script” for can create their own ‘shared value’ by isopropyl alcohol) is a single use, easy to indicated for the growth and the opportunity to discuss working more closely with one apply, sterile system, available in a treatment of ways of finding solutions to today’s another, suppliers, insurers and animal variety of sizes and in clear and tinted pneumonia in veterinary challenges. advocates in the local community, in versions to enhance the visibility of the cattle and sheep, “Economic gloom and doom is order to grow the size of the cake in area requiring antisepsis, for instance foul in the foot in cattle, footrot and contagious,” said Ashley Gray, which everyone has a share.” prior to surgery. mastitis in sheep. managing director of TVS (Total Vet The event was sponsored by The sterile solution is maintained in Presented in 50ml multi-dose vials, it Solutions). “The new reality for many Novartis and TVS plans to hold a glass ampoule is administered as a single, low volume UK vet practices around the country is further “think tanks” during 2012. inside a subcutaneous injection. that they are now faced not only with To register interest in the events, protective outer a more competitive market but one contact Kat Dunn on case and, to with cash flow problems … and a [email protected]. Canine diets for skin prevent care contamination, the patented ROYAL Canin has introduced the Skin design ensures Care range of dermatological diets users don’t come designed, says the firm, for the into contact nutritional support of skin function in with either the dogs with dermatosis unrelated to food contents or the intolerance or allergy. patient’s skin. The launch of the new range Once 10 RCVS VP DECEMBER 2011 Much to discuss by expanded council THE November meeting of council heated to tropical levels) and awaited Student fees and social experience in veterinary education to is very much the start of a new the arrival of the new president and responsibility the job. term. Freshly elected members take officers. The council had overwhelmingly their seats for the first time (well OK With a huge agenda I settled in for adopted a resolution tabled by myself Governance review group there weren’t any of them – the long haul and was pleasantly to establish a working party into the This group expressed concern about Professor Sandy Trees had sent an surprised by the uncustomary efficiency effects of raised tuition fees on the fact that there is no limit on the apology) and new appointees from with which the council conducted its recruitment to the profession and the number of occasions a member of the universities make their first public business. effects this might have on social council may stand for re-election – with appearance. As usual things got off to a sombre diversity within it. The officers were a few members sitting for extended Of note was the introduction of start as a minute’s tasked to investigate this. A lengthy and periods of time (sometimes over a two new detailed report had been prepared by decade). There is no limit in the VSA places on the RICHARD STEPHENSON the head of education but overall the but the group suggested that the council for an elected member of the RCVS officers had concluded that at present council could adopt a “convention” Nottingham council, provides his recollections the matter was best left with the EPSC limiting the numbers of terms. University, of the deliberations at the latest who would review the situation This had been discussed at the swelling the council meeting – and the mass of annually. planning and resources committee documents to be considered ranks of the The final report produced is in fact meeting but was rejected. I must admit solemnly a very detailed document teeming with to having changed my mind on the black-gowned councillors to 42 silence was observed to commemorate useful information and I was pleased to subject. (although four were absent). The those members of the College who had be able to welcome it. I was assured by Initially I felt that a convention November meeting is also the first departed this life since the last meeting. the chairman, Professor Stuart Reid, should be adopted in the code of occasion on which the new president Glasgow graduates like me were that he would make sure that the practice to limit the terms of office of chairs a meeting and it is always particularly sad to read the obituary situation was reviewed annually and the members but having talked this through interesting to see if he or she is able to circulated for Professor Bill Jarrett president confirmed that this would be with colleagues I am convinced that it is give the debate some direction or if whose work dominated that institution a standing item on the agenda. a democratic process and we shouldn’t things will get a bit ragged as usual. for so many years. I recommend that anyone interested restrict the choice of the voters. If they The build-up to each council Then it was down to business. in the subject looks the paper up on the don’t want a candidate after “x” many meeting is always hectic with papers The president paid tribute to the College website – there is an enormous times, they don’t need to vote for him arriving, reports to be considered, retiring registrar (who was not present gap between what the press has or her! weighty consultation documents to due to a prior appointment); he pointed reported and the reality of the situation. The Group had also suggested that peruse, and streams of e-mails clogging out that she had overseen many the council should form a small up the “inbox” – but the run-up to this changes at the College and taken the Complaints resolution management board of no greater than meeting was like none that I have institution forward. The assistant working party 12 to discharge most of its function. encountered before. registrar was standing (or sitting) in for The suggestion here is that the College This was liable to be more effective On the Saturday prior we received her and would answer any legal should develop a mediation service to than the whole council meeting three confidential copies of the McKelvey questions as required. assist in the resolution of complaints times per year – a sentiment with which report into the “overspends”; we had between members of the public and it is difficult to disagree. already had a copy of the equally The budget the profession where those complaints confidential “past presidents plus two” It was announced that the RCVS was are not deemed to be sufficiently Future of RCVS awarding report into the committee structure of heading towards a small £26,000 serious to warrant disciplinary action. body (veterinary nursing) the RCVS to be read in conjunction surplus on the year’s operations out of The College already uses its PIC It has been decided that the RCVS with McKelvey. a total budget of almost £8 million. investigators to visit and discuss should cease to be the awarding body In addition there was the Once again, despite a freeze in problems with both complainants and for the VN qualification. This will “performance protocol” and the new retention fees, income was above respondent vets and frequently these eliminate any potential conflict of draft Guide to Professional Conduct, both budget due to increasing numbers of visits result in a resolution of the interest between the RCVS being both extremely important matters in their members. complaint: even when they don’t the regulator (setting the standards and own right. If that was not enough there There were a number of questions complainants are usually satisfied that monitoring them) and also being the was also the VNC decision for the from Mr Partridge regarding the VN they have been listened to. awarding body (i.e. the body being RCVS to stop being an awarding body. department budget and its relationship The working party recommended regulated). All this was in addition to the normal to the awarding body. The situation that wider consultation was desirable workload of the council. seems to me to be very complex, made and that a pilot study was necessary The advisory committee The big bombshell, however, was more so by the imminent separation of before proceeding further. This was The new chairman, Clare Tapsfield- delivered on the Friday before the the awarding body from the RCVS. approved without debate. Wright, introduced the report. She meeting when the Mark Elliott asked declared that there were no “shrinking College received the why staffing levels at Disciplinary violets” on her resignation of the the College were committee committee, that debate registrar, who is leaving increasing (doubled The council approved had been “robust” and us at the end of the since his first term): changes to the she was modelling her year to pursue other was it necessary? Peter membership of the chairing style on Anne interests after 15 years Jinman (senior vice- disciplinary committee Robinson! at Belgravia House. president) replied that after the resignation for There were still It had already been the demands on the personal reasons (illness ongoing concerns decided to start the staff were increasing all of husband) of the about lay TB testing meeting at 9am rather the time. Government chairman, Caroline but lines of than the more required responses to Freedman. communication had convenient 10am and consultations and legal Professor Peter Lees opened up with so it was some slightly processes that were was elected without DEFRA. Dr Bertie bleary-eyed councillors The RCVS president, Dr Jerry simple 10 years ago had debate and I’m sure will Clare Tapsfield-Wright, who Ellis said that there who crowded into the Davies, who chaired the become much more bring a steady pair of chairs the advisory should be a level chamber (as usual meeting. complex. hands and years of committee. playing field and if this VP DECEMBER 2011 RCVS 11 was no longer to be considered an act members with genuine ‘We are the due to the ongoing Currently four individuals are of veterinary surgery, then the clinical competence masters of controversy surrounding being or have been investigated and certification of tests shouldn’t be problems and should unintended the overspends – with two cases of lay people posing as considered to be veterinary result in the more efficient loopholes.’ some members taking veterinary nurses have been reported. certification. management of problem the highly unusual step The senior investigator had been to A new protocol was submitted for veterinary surgeons. It will – Dr Bertie Ellis of voting against their Hungary and Slovakia to check the consultation. This “clinical performance now go to the wider adoption. integrity of two names on the register. protocol” is the follow-on to the earlier public for consultation. The debate this time was perhaps The case reported was somewhat “health protocol” and develops an less heated but was not helped by humorous: it concerned an aggrieved alternative means to the disciplinary New Guide still under some references in the minutes to a client who objected vociferously to committee for dealing with cases where development question that had been asked at the paying for a “free” T4 test on her cat. members are being shown to fall far This is a much shorter document than AGM concerning the pay levels of No amount of explanation has below what are considered to be the current Guide to Professional Conduct senior staff at the College. satisfied her and she still feels reasonable standards of clinical and none the worse for that. outraged that the vet charged for a competence. I was disappointed that we have Preliminary investigation “free” test. The College receives numbers of backed away from expecting UK vets to committee Well you simply can’t win them all! complaints every year frequently be able to communicate in English It was reported that the Health I do recall a similar complaint in my concerning the same individual (except possibly in Wales) with a Protocol was already being effective practice concerning an invoice veterinary surgeons. Often, taken as an watered down statement about with four veterinary surgeons worded, “humanely destroy horse with individual case the complaint, although adequate communication skills. currently being helped via the scheme; a free bullet”, necessitating a change fairly bad, does not cross the higher one had now been released from the to a more tactful invoice text. threshold of being serious professional Education and specialisation protocol having made satisfactory Once again the committee misconduct. committee progress and two members were being highlighted the dangers of Baytril The question for the PIC is often: Main item here was the specialisation assessed currently. overdoses in cats which result in when do multiple similar cases become working party report, the most It is not a soft option but a permanent blindness. I have been cumulatively serious professional important recommendation being a constructive one. surprised how often this crops up in misconduct? In some cases it is clearly second tier of practitioner between the Two further cases had been complaints to the College and it’s identifiable that a small number of GP and the specialist, possibly known referred to the DC and there are now certainly one to watch out for in individuals are accidents waiting to as an “advanced practitioner”. eight awaiting a hearing. There had practice. happen and currently the RCVS often The committee had also decided to been 22 announced visits and six After a brief report on the work waits until a serious infringement of continue to insist on an English unannounced visits between June and of the disciplinary committee, council animal welfare occurs before being able language requirement for all entrants to October. had concluded its business by 11.20am to take action (often despite the the statutory examination. The College continues to assist (record time) and then went into individual concerned receiving frequent Bertie Ellis delivered a lengthy and police and trading standards in private session from which we were “advice” from the PIC). humorous oration on why he felt that enforcing breaches of the VSA. not finally to emerge until 4.30pm! The protocol would enable the PIC exemptions to the English language test to ask members to give undertakings to should be allowed – his daughter the College to rectify clinical qualified in Grenada and has VETARK deficiencies such as by doing extra subsequently had to take the English PROFESSIONAL CPD, appointing a mentor or refraining language test along with other similar from certain types of practice. English-speaking UK citizens. Council Failure to give undertakings could was unmoved but I look forward to Special products for special pets either result in the case(s) being referred Bertie’s next contribution on the to the DC or such refusal being put on subject. Seeing ex-battery birds? file potentially to be used in evidence if - look at our New range for domestic poultry a problem should subsequently be Planning and resources reported to the RCVS. committee In my view the protocol is a good The council has had some difficulty thing. It would enable the RCVS to with approving the minutes of this exercise a more pastoral approach to committee on the last two occasions Call for council candidates NOMINATIONS are now open for candidates wishing to stand in the 2012 RCVS Council and RCVS Veterinary Nurses Council elections. Six seats on the RCVS council and two on the VN council are due to be Plus a complete filled in the 2012 elections. Those elected will take their seats on RCVS Day next July, to serve four-year terms, and will be expected to spend at least six to eight days a year attending council meetings, working parties and sub- committees (a loss-of-earnings allowance is available). All prospective candidates need to provide the signatures and registered/listed addresses of two proposers, and should also submit a short biography, manifesto and photograph for inclusion in the RCVS News Extra election specials. Nobody may nominate more than one candidate, and no current member of the RCVS council or VN council may make a nomination. Nominations must be made in writing on the prescribed form and general nutritional support received by the registrar on or before the closing date of 31st January 2012. products Full details and guidance notes for both elections will be available on the RCVS website. Contact us Nomination forms and candidate information forms for RCVS council www.vetark.co.uk may be requested from Gabi Braun (020 7222 0761 or e: [email protected] [email protected]) and those for VN council from Annette Amato t: 44(0)1962-844316 (020 7202 0713 or [email protected]). 12 COMMUNICATIONS VP DECEMBER 2011
Communication signals from the dog – and our interpretation of what they mean as well as what a human would mean if he or she were using the same body language.
Area Specific What to look for Possible meaning for dog Human body language meaning Face Ears – position Neutral, relaxed, in the “I am feeling relaxed” N/A middle (see Figure 1) Flattened back (see Figure 2) “I am unsure”, “feeling a bit uneasy”, “get N/A that finger out of my bum!” Upright and forward ‘What’s that?!’ N/A Aeroplane wings “Too much, too much – can’t cope!” N/A Eyes Wide, dilated pupils, possibly “Really stressed here...” “I like what I see” or “Woah! What was that!”, “Back off!’ (pupil constricts again when red conjunctiva startle is over and we perceive it as being something negative) Soft, neutral (see Figure 1) “Chill-time.” The same Squinting “I am friendly.” “I don’t like you”, “I am angry” Blinking “I am unsure” The same Looking away (see Figure 2) “Feeling a little pressured here – please “I am thinking about what you just said’ or “I am not here” (e.g. on trains) back off?” Blocking the eyes with a Rarely seen “I just heard something negative that I don’t like or am upset about” hand or by closing them Direct stare “Take one step closer and talk to my “I like you’ or with squinty eyes “I don’t like you” teeth!” Whale eye – seeing the white “Back away from my stick/bone”, “I am “I am suspicious of you/don’t trust you” of the eye watching you – sneakily” Mouth Loose, relaxed, hanging “Happy and relaxed!” Full lips – “Relaxed and comfortable” Tight mouth and forward “I am warning you! Not happy here! Back Lips progressively disappearing – “More and more uncomfortable” commissures it off ” Stretched back to show “Too much going on – I am stressed”, The smile – “I am happy and want to share it” molars – open on horizontal “Don’t want to fight but will if I have to” axis, possible growling Open on the vertical axis “I am confident to fight and I will if I Nothing similar with incisors and canines have to” showing, possible growling Yawning “Slightly uneasy here – a bit “Too much information”, “Too little sleep” uncomfortable...” Licking lips or nose “Not sure about stuff – a bit uneasy – be “I am unsure’ – also seen with hand-pacifying gestures. nice to me, please” Muzzle twitch – showing “Back off! Give me space – you too, Nothing similar only canines unilaterally doc!” Body Weight Forward, maybe coming into “I am challenging youuu” “I like you” or “I am getting aggressive” distribution your personal space Neutral “I am OK, you’re OK, we’re OK” The same Back “Very unsure – don’t like this – where The same are you putting that thermometer??” Shifting “Ohh – not sure about this, edgy here!” The same or “Want to leave” Body posture Standing tall “I am BIIGGG and don’t you forget it!” The same Bottom tucked under “No, you can’t smell my bottom, please Nothing similar don’t hurt me” Play bowing “Let’s just be silly – no reason to fight!” Nothing similar Turning away “Oh – not too sure about that, let me just “I am irritated”, “I disagree with you” or “Desperate to leave” move away a bit” Crouching “Please don’t punish me! I am just like a The same puppy!!” Creeping back “Uh-oh – want to get out of here” The same Paw lift “Let’s be friends?” Handshake... An error occurred in this chart Hair Shedding “Whoa! Too much! Stress city...” Nothing similar which appeared with the Pilo-erection on back of “I am alert”, “Ready for action” Nothing similar article by Anne-Marie neck and above tail or along Svendsen-Aylott and Hanne entire spine Grice on pages 30 and 32 of Breathing rate Respiratory rate 16-20 breaths “Relaxed, all is good” Slow respiration – relaxed the October issue. The per minute corrected version is included Panting “Too stressful! I am really worried here! “I am terrified!” here. Veterinar y Practice Don’t like this.” apologises for the error. Tail Angle Neutral – horizontal from “Everything’s OK” Nothing similar the spine Tail tucked under “No, not sharing information – not too Nothing similar sure, don’t want you to know too much about me” 45 degree angle up “What’s that!”, “What just happened?” Nothing similar 90 degree to curling over “OK, bring it on!! I mean business here” Nothing similar Degree of Loose and soft with wide, “I love you so much! Talk to me, touch Slow, calm movements – “I am relaxed and friendly” stiffness and wavy movements, bum me, love you, love you, love you!!” speed possibly included Intermediate with some “What’s that – who is that over there?” Faster, slightly jerky movements – “I am a bit stressed/annoyed” firmness, possibly slight quiver, mostly still Rigid, very still “I am warning you ... bite imminent” Stiff and still – “Ready for action – whatever it is” Rigid, helicopter tail “Arghh! Get away from me, get away Explosive motion – “Coming in for the attack” from me! Warning you!” VP DECEMBER 2011 COMMUNICATIONS 13 Leader v. manager: why does it make a difference? THE business world is full of develops at a measured pace. Nicely On the contrary, it managers. So are practices – but and very much in control, seen from a encourages everyone to has the time come to re-evaluate senior management perspective. pull together and analyse what you do and consider whether Within smaller businesses, most of their options in order to it would be better to upgrade to the above tasks may fall to one or two think of the best way leadership? And what exactly is the people. The pace is often hectic with forward. difference between managing little time to consider next steps, so people and leading them? the focus easily becomes the task in How does it make a Have a think for a second: do you front of them – and the next one – difference? consider True leadership takes yourself a ANNE-MARIE courage. Courage to trust manager? Or SVENDSEN-AYLOTT and believe in the people do you explains the difference between around you, to believe that even those in the practice. It changes the consider management and leadership and “problem” people may have a role and atmosphere into one of positive, yourself a how the latter can move that they are only a problem, because enthusiastic participation. It leader? practices much further into you have not yet found them. encourages smiles, laughter, focus and And if excellence The only truly “problem” people in determination. you said no to strongly-led businesses It makes the both those questions, is there really and the one after that. are those who do not True leadership practice a place where nowhere in your life where you take Managers may unwittingly end up believe in the vision. ignites the people people work together the lead? Where others follow your categorising employees in their heads Because they are in the in the practice. It towards a common example because they respect you? as “doing their job with no problems” wrong place and will be changes the goal, drawing on each and “problem people that are causing happier somewhere else atmosphere into other’s strengths – Management upsets” – e.g. impeding the smooth with a vision that suits whatever they are – Traditional management has a heavy flow of running the practice. And so them better. one of positive, and using that focus on ticking the boxes for all the people can become yet another task to True, inspirational enthusiastic common goal to tasks that need to be done in any be solved/dealt with/seen leadership comes from participation. It benchmark all their business. to/addressed. within. It requires that encourages actions. Sales targets have to be met, so you know yourself, True leadership staff receive training to help them Leadership your values and your smiles, laughter, makes managers of achieve the tasks more efficiently. Leadership, on the other hand, is all weaknesses. That you focus and everyone else, because There is a long-term business about direction. It is about knowing understand exactly determination. it changes the focus development plan that senior exactly where you want to go and what your vision is and and the responsibility management hold tight to their chest – believing so firmly in that vision that why it is so powerful to you – because into an individual one where everyone after all, what is the point in sharing it you are happy to share it with if it isn’t powerful to you there will be understands what tasks need to be until they know exactly what tasks they everyone around you. no drive to help you share it with done – and where they understand need their people to do? And it is about that vision being others. why they need to be done. Serious considerations around powerful enough and congruent And with no drive – there can be Leadership does not make perfect. competitors and marketing are enough with who you are that you no spark in the people around you, no But it does take us much further into assigned to specific groups that have inspire the people around you to want activation of their internal motivations, excellence. the knowledge and the specific skills to to go with you, to want to come up and no free-flowing innovative True leadership has to start work on these particular tasks. with the solutions and the innovative thinking on their behalf. somewhere. Do you have the courage All in all, the business gets done, thinking that will make that vision True leadership ignites the people to step up to the plate? the boxes get ticked and everything come true. Leadership is all about Anne-Marie Svendsen Aylott trained people. About understanding as a veterinarian and ran her own people to the point where it is veterinary practice in Copenhagen, easy to establish what needs to Denmark, for seven years. She then be done – and to then hand it spent nine years with Hill’s Pet over to others and let them get Nutrition working with sales, brand on with it in the way that they marketing, professional relations and identify is the best possible. training. She has trained in both Leadership requires a light personal performance coaching and corporate and executive coaching in hand on the reins. It requires addition to being a certified NLP letting go of information Master Practitioner, and works as a control, because in order for business performance coach with a people to truly work effectively range of companies from small sole and with enthusiasm, they need traders to global corporations. She to know what is happening, runs Purple Cat Performance Coaching and they need to have access to and can be contacted at all the information they can. [email protected] Adversity does not bring The most effective way to encourage people to go in the direction you want them to go is (website down a practice with www.purplecatcoaching.com). through leading by example. leadership. 14 CPD VP DECEMBER 2011 Thirty ways to misdiagnose without realising you are doing it COGNITIVE errors make a n biases. unbiased scientists significant contribution to Making good medical decisions is dealing accurately with misdiagnoses particularly in extremely difficult if you are already the information in front Figure 1. highly complex and dynamic “hard-wired” not to collect good data of us and never deviating situations from best practice or making an understanding of how the clinician’s such as CHRIS WHIPP error. To challenge this somewhat mind works and from that comes the emergency discusses ‘cognitive dispositions utopian view was to potentially open opportunity to consciously train and medicine or to respond’ and ways to improve ourselves to a world of develop our cognitive where medical decision making in angst about subjects There is a range skills. pressures of practice – and how to take the that it was thought we of reflective Neuroscience has time first steps forward could not change. activities such as demonstrated that many preclude However, keeping a of the taken-for-granted adequate time for reflection. (failures of developments in the “habits of thinking” are Cognitive Dispositions to perception), process it inexpertly last 15 to 20 years now “learning log” or not fixed but are Respond (CDRs) are a subset of (failed heuristics) or disregard it provide us with a more completing available to be trained cognitive errors that relate to: anyway (biases). optimistic view of “critical and retrained by those n failures of perception; The tendency in the past has been what is possible and incident” prepared to do so. n failed heuristics; for us to assume that we are all how we might achieve summaries ... In her 2003 article, it. Crosskerry brought Chris Whipp, BVetMed, MSc(VetGP), MRCVS, graduated from the RVC in 1979 and which can together more than 30 in his 32 years as a veterinary surgeon has spent 10 years as an educational Improving encourage a CDRs associated with researcher and seven as a professional and executive coach. He currently splits his understanding more analytical the diagnostic process; time between first opinion clinical practice, providing work-based learning Cognitive psychology approach to an abridged list is given programmes through Middlesex University, professional coaching and the “BEVME – has generated an ever in Table 1. A Dialogue” initiative. He can be contacted at [email protected]. improving your work. Development as a VP DECEMBER 2011 CPD 15
Table 1. Cognitive Dispositions to Respond (CDRs) that may lead to diagnostic error. self-responsible professional involves a number of steps (Figure. 1); this Aggregate Bias Denial that aggregated data applies to individuals leading to errors of commission or omission. article aims to raise awareness of Anchoring Tendency to lock onto salient features in the patient’s initial presentation too early in the diagnostic process, CDRs and to provide those prepared may be severely compounded by the confirmation bias. to take it, the opportunity to take the Ascertainment bias Thinking shaped by prior expectation such as stereotyping first steps forward. Availability Disposition to judge things as being more likely if they come readily to mind. The first step is to raise awareness Base-rate neglect Tendency to ignore the true prevalence of a disease, either inflating or reducing its base-rate, and distorting of CDRs in general and specifically Bayesian reasoning. to those which are most common Commission bias Tendency toward action rather than inaction, more likely in over-confident clinicians. within oneself. This can be done in a variety of ways. Confirmation bias Tendency to look for confirming evidence to support a diagnosis rather than look for disconfirming evidence to refute it. Raise your awareness and Diagnosis Diagnostic labels tending to become stickier and stickier until other possibilities become excluded. knowledge momentum Just reading about the CDRs in Feedback sanction A form of ignorance trap and time-delay trap with diagnostic errors either never being discovered or poor Table 1 will raise your awareness and feedback systems preventing important information getting to the decision maker. knowledge; you may well recognise Framing effect How a clinician sees things may be strongly influenced by the way in which the problem is framed. some as more obvious in yourself Fundamental Tendency to be judgmental and blame patients for their illnesses (dispositional causes) rather than examine the than others. attribution error circumstances (situational factors) that might have been responsible. Alternatively, there is a range of Gambler’s fallacy This fallacy is the belief that if a coin is tossed 10 times and is heads each time, the 11th toss has a greater reflective activities such as keeping a chance of being tails; e.g. the pre-test probability that a patient will have a particular diagnosis might be “learning log” or completing “critical influenced by preceding but independent events. incident” summaries, particularly for events that do not go as expected, Gender bias Tendency to believe that gender is a determining factor in the probability of diagnosis of a particular disease which can encourage a more when no such pathophysiological basis exists. analytical approach to your work. Hindsight bias: Knowing the outcome may profoundly influence the perception of past events and prevent a realistic appraisal The second step is to take of what actually occurred. responsibility for the CDRs you Multiple A multiplicity of options on a differential diagnosis may lead to significant conflict and uncertainty. Reverting identify. This is simple but not all alternatives bias to a smaller subset may help but may then result in inadequate consideration of other possibilities. that easy in that you will be seeking Omission bias The tendency toward inaction and rooted in the principle of nonmaleficence. Omission biases typically to change what are probably deeply outnumber commission biases. ingrained habits of which you are Order effects Information transfer is a U-function: we tend to remember the beginning part (primacy effect) or the end probably only partially aware. (recency effect). Primacy effect may be augmented by anchoring. You might best work with your Outcome bias The tendency to opt for diagnostic decisions that will lead to good outcomes, a form of value bias in that peers or perhaps a clinical coach or clinicians may express a stronger likelihood in their decision-making for what they hope will happen rather than mentor here. Once you have developed an for what might actually happen. awareness and taken responsibility, it Overconfidence Universal tendency to believe we know more than we do, reflects a tendency to act on incomplete information, is possible to further develop bias intuitions, or hunches with too much faith placed in opinion instead of carefully gathered evidence. metacognitive (thinking about Frequency Tendency in equivocal or ambiguous presentations to opt for a benign diagnosis on the basis that it is thinking) skills, to come to recognise gambling significantly more likely than a serious one. Diametrically opposed to the base-rate neglect CDR. incongruity, ambiguity, atypical Posterior Occurs when a physician’s estimate for the likelihood of disease is unduly influenced by what has gone on presentations, and instances when probability error before for a particular patient. Opposite of the Gambler’s fallacy data are not fitting together and then Premature closure A powerful CDR accounting for a high proportion of missed diagnoses, the tendency to apply premature apply cognitive forcing strategies. closure to the decision-making process, accepting a diagnosis before it has been fully verified. These introduce a specific, Representativeness The representativeness heuristic drives the diagnostician toward looking for prototypical manifestations of conscious “debiasing” step that restraint disease when restraining decision-making along these pattern-recognition lines leads to atypical variants being monitors your own decision-making missed. process. Search satisfying Reflects the universal tendency to call off a search once something is found, comorbidities, etc., therefore being We can now dissect and missed. analyse... Sutton’s slip The diagnostic strategy of going for the obvious is referred to as Sutton’s law, the slip occurs when possibilities Of course, expert clinicians have been other than the obvious are not given sufficient consideration. behaving in this way for decades before Sunk costs Entrapment CDR where the more a clinician invests in a particular diagnosis, the less likely they may be to “metacognition” was first described in release it and consider alternatives. Time, money or ego may be the investment. the 1970s but usually via a tacit path. Triage cueing The triage process is particularly prone to a number of CDR that then influence subsequent management. The advantage now is that we can, Unpacking Failure to elicit all relevant information (unpacking) in establishing a differential diagnosis may result in in an explicit way, dissect, analyse, and principle significant possibilities being missed. Likely to occur when history giving is blocked or history taking is limited. gain an understanding of what goes Vertical line failure Routine, repetitive tasks often lead to thinking in silos – predictable, orthodox styles that emphasise economy, into expertise in clinical decision efficacy, and utility. Though often rewarded, the approach carries the inherent penalty of inflexibility. making. Visceral bias The influence of affective sources of error on decision-making has been widely underestimated. Visceral By knowing more about this, it also allows us to train students and arousal leads to poor decisions inexperienced clinicians in Yin-Yang out Patients subjected to exhaustive and unavailing diagnostic investigations are said to have been worked up the metacognitive skills, shortening and Yin-Yang. The Yin-Yang out is the tendency to believe that nothing further can be done to throw light on the easing their path to expertise. situation, the physician is let out of further diagnostic effort. If you would like to know more on the subject or would like to join a free of cognitive errors in diagnosis and BEVME – A Dialogue webinar on the subject, please e-mail strategies to minimise them. Acad Med is a UK practitioner-led initiative to bring together stakeholders from all aspects [email protected]. 78 (8): 775-780. and stages in veterinary education to encourage and foster “best evidence” practice and provide constructive solutions to existing challenges for all. The Crosskerry P. (2003) Cognitive forcing resources of the community are freely available to all. References strategies in clinical decision making. Register an interest at www.surveymonkey.com/s/BEVME. Crosskerry, P. (2003) The importance Ann Emerg Med 41: 110-120. 16 FELINE VP DECEMBER 2011 The approach to and management of feline chronic kidney disease – part 2 THIS is the second article on feline by feeding moist foods, adding water to by adding an intestinal phosphate Metabolic acidosis is common chronic kidney disease (CKD). Part I the food, providing a water fountain and binder. Feline maintenance diets are particularly late in the course of CKD. covered the approach to the cat with offering broths made from poaching high in phosphate due to their high Maintaining normal hydration and CKD and this article will focus on fish or chicken (avoid salty broths and protein content and the administration feeding feline prescription renal diets the long-term management of these milk) can help improve hydration. of a phosphate binder to a maintenance (which are non-acidifying) will help patients. If these measures are insufficient, diet is rarely adequate to achieve the prevent acidosis. Oral potassium citrate Before commencing treatment, it is some owners are prepared to administer target serum phosphate concentrations. or sodium bicarbonate can be important to obtain baseline clinical, 75-100ml of a balanced electrolyte Several phosphate binders are administered if additional treatment is haematological and biochemical solution subcutaneously 2-3 times a available on the veterinary market needed; however, this is not often information about the patient (see part week. This is relatively inexpensive, is including lanthanum (Renalzin, Bayer) necessary. 1) to enable and calcium carbonate containing agents the ALIX McBREARTY (Ipakitine, Vétoquinol). Phosphate Proteinuria development in the concluding part of this binders must be administered with every Proteinuria (urine protein-to-creatinine of an series, discusses the long-term meal as they act by binding dietary ratio >0.4) can lead to progression of individualised management of CKD patients and phosphate and reducing its absorption renal disease as filtered proteins are treatment explains how affected cats can in the intestines. renotoxic. This has been identified as a survive for many years with a plan. As Calcium containing phosphate risk factor for mortality in feline CKD good quality of life discussed in binders should be avoided in patients patients (Syme et al, 2006). part 1, with hypercalcaemia and those receiving Treatment of cats with IRIS stage 2- determining the underlying cause of well tolerated by many cats and can be a vitamin D. 4 CKD and proteinuria is therefore CKD can be difficult in these cats; successful way of maintaining hydration. As hyperphosphataemic cats have advised and involves: avoiding excessive however, treatment of the underlying Nausea and vomiting are not increased total body phosphate, blood dietary protein, the administration of cause, if found, may slow further uncommon in cats with CKD and phosphate levels take time to normalise angiotensin converting enzyme progression of the disease. contribute to dehydration, inappetance after the institution of treatment and inhibitors (ACEi) and controlling The specific treatment will depend and weight loss. H2 antagonists such as serum levels should therefore be hypertension. on the diagnosed disease (e.g. renal famotidine, ranitidine or cimetidine can monitored no more often than monthly. The administration of ACEi to cats lymphoma, pyelonephritis, be used to treat hypergastrinaemia Hypokalaemia is relatively common with CKD has been shown to nephrolithiasis) and is beyond the scope which contributes to uremic gastritis. in stage II and III CKD and can significantly reduce proteinuria and of this article; however, the importance Anti-emetics such as metoclopramide contribute to lethargy, weakness, reduce the number of cats progressing of specific treatment cannot be over- (Emeprid, Ceva; Vomend, Eurovet), inappetance, weight loss and from IRIS stage II/III disease to stage emphasised. chlorpromazine and maropitant may polyuria/polydipsia as well as causing IV disease (Mizutani et al, 2006). Once any active renal disease has also be used. the more classic signs of generalised Systemic hypertension (present in been recognised and treated muscle weakness and cervical about 20% of cats with CKD) can appropriately, the goals of CKD Anorexia ventroflexion in severe cases. result in ocular, cerebral and management are to: prevent and/or Anorexia can be a major problem in Hypokalaemia can also adversely cardiovascular pathology as well as treat the complications of decreased cats with CKD and is often affect renal function. Feeding progression of renal disease. ACEi kidney function, thereby improving the multifactorial. Feeding warmed food, prescription renal diets which are non- alone are not very effective anti- clinical signs, slow progression of the hand-feeding, offering foods of acidifying and supplemented with hypertensive agents in cats; however, disease and treat any concomitant different textures and adding flavour potassium can be sufficient to prevent amlodipine is usually effective. unrelated conditions. enhancers such as tuna juice or brewer’s or correct hypokalaemia in mild cases. In some cases, both drugs are As CKD is almost invariably a yeast can all help. In some cases appetite In cats in which this is insufficient necessary. Although the optimal end- progressive disease, it is important to stimulants such as cyproheptidine, and/or those with generalised muscle point for antihypertensive therapy has monitor the patient over time and make mirtazapine or anabolic steroids are weakness, supplementation with oral not been established in cats, blood treatment changes as the disease needed. potassium gluconate/citrate or pressure monitoring of hypertensive progresses. Placement of an oesophagostomy supplementation of cats should initially be performed every Dehydration is common in cats with or gastrotomy tube may be considered subcutaneous/intravenous fluids with 1-2 weeks with a suggested goal of CKD and can result in reduced appetite, to deliver additional food, water and potassium chloride may be necessary. <150/95mmHg generally advised. lethargy, weakness and constipation, as medications in some cases, although this Patients on intravenous potassium Anaemia can contribute to lethargy well as predisposing to acute kidney will not be suitable for all cats or their supplementation should undergo and inappetance as well as potentially injury which can lead to disease owners. monitoring of their serum electrolytes causing disease progression due to renal progression. Increasing oral water intake Hyperphosphataemia affects about at least daily. Initially, patients started on hypoxia. Anaemia in cats with CKD can 60% of cats with CKD and although it oral potassium supplements will need be due to a variety of underlying causes Alix McBrearty, BVMS(hons), CertSAM, is unlikely to cause clinical signs, it has serum potassium measurement every 1- and more than one cause likely exists in MRCVS, completed her veterinary been shown to significantly reduce 2 weeks, to enable appropriate dose many cases. degree in Glasgow in 2002. After two years in small animal practice she survival time (Boyd et al, 2008). Target adjustment. Treatments to consider in these moved to Suffolk to complete a serum phosphorus concentrations have rotating internship at the Animal been suggested for different Table 1. Suggested serum phosphorus concentration targets according Health Trust. She returned to Glasgow International Renal Interest Society to the stage of CKD*. in 2005 where she did her residency in (IRIS) stages of CKD (see Table 1). It IRIS stage Serum creatinine Target serum phosphate small animal internal medicine. She is should be noted that these targets fall concentration (µmol/L) concentration (mmol/L) working towards her European below the upper limit of the reference Stage 2 140-249 1.1-1.5 College of Veterinary Internal ranges of many laboratories. Stage 3 250-439 1.1-1.6 Medicine Diploma. Alix sees internal Hyperphosphataemia is treated Stage 4 >440 1.1-1.9 medicine referral cases at the Vets initially by dietary phosphate restriction Now Hospital in Glasgow and has a * From: Elliott, J., Brown, S. A., Cowgill, L. D. et al (2006) Phosphatemia management (i.e. feeding a prescription renal diet) particular interest in feline medicine. in the treatment of chronic kidney disease. Louisville, Kentucky: Vétoquinol. and if this is insufficient after 4-8 weeks, VP DECEMBER 2011 FELINE 17
patients include gastro-protectants (to this is the single most effective therefore not be detected without urine treatment of chronic renal insufficiency in treat gastrointestinal blood loss due to treatment for feline CKD (Plantinga et culture. cats. J Vet Intern Med 20: 1,074-1,079. uraemic gastritis), B vitamin al, 2005; Elliott et al, 2000; Ross et al, Feline CKD is typically a slowly Barber, P. and Elliott, J. (1998) Feline supplementation, ferrous sulphate (to 2006). progressive disease and sudden patient chronic renal failure: calcium homeostasis treat iron deficiency caused by decreased A diet change to a prescription deterioration may suggest the in 80 cases diagnosed between 1992 and intake and increased loss) and kidney diet is the initial treatment of development of another disease or an 1995. J Small Anim Pract 39: 108-116. recombinant erythropoietin therapy (to choice in cats with IRIS stage 2-4 CKD. episode of acute-on-chronic disease. Polzin, D. J., Ross S. and Osborne, C. A. treat relative erythropoietin deficiency). Without a doubt, changing the diet can Such patients should therefore undergo (2008) Calcitriol. In: Bonagura, J. D., ed. Erythropoietin administration is not be difficult in cats, particularly in those investigations to try and identify Current Veterinary Therapy XIV. without risk and can result in iron with CKD, and this process should not conditions which may be treatable and Philadelphia: Saunders Elsevier. deficiency, hypertension, polycythaemia be rushed. Feeding a prescription renal reversible, enabling the cat to return to Plantinga, E. A., Everts, H., Kastelein, A. and the production of anti- diet should not be started when cats are its previously stable state. M. and Beynen, A. C. (2005) Retrospective erythropoietin antibodies. It is usually acutely ill and hospitalised. Although feline chronic renal study of the survival of cats with acquired reserved for the treatment of cats in Diets should be introduced disease is an incurable and usually chronic renal insufficiency offered which all other causes of anaemia have gradually over a period of at least seven progressive condition, medical different commercial diets. Vet Rec 157: been excluded or treated, that are days and often 3-4 weeks and it can be management combined with regular 185-187. symptomatic and that have a PCV helpful to offer both the old and new monitoring and appropriate treatment Elliott, J., Rawlings, J. M., Markwell, P. J. <20%. diets side-by-side. modification enables cats to survive and Barber, P. J. (2000) Survival of cats Hyperparathyroidism was present in The temperature, texture and many years after the initial diagnosis with naturally occurring chronic renal 84% of cats with CKD in one study formulation of food may all be with a good quality of life. failure: effect of dietary management. J (Barber and Elliot, 1998) and a relative important and some cats will accept Small Anim Pract 41: 235-242. or absolute deficiency of calcitriol is one brand or flavour but not others. References Ross, S. J., Osborne, C. A., Kirk, C. A., believed to play a key role in the Introduction of a renal diet is likely to Boyd, L. M., Langston, C., Thompson, K., Lowry, S. R., Koehler, L.A, and Polzin, D. development of renal secondary be easier earlier in the course of the Zivin, K. and Imanishi, M. (2008) Survival J. (2006) Clinical evaluation of dietary hyperparathyroidism. disease. in cats with naturally occurring chronic modifications for treatment of It is important for owners to kidney disease (2000-2002). J Vet Intern spontaneous chronic renal disease in cats. J Parathyroid hormone understand the significant benefits of Med 22: 1,111-1,117. Am Vet Med Assoc 229: 949-957. Parathyroid hormone is thought to act renal diets not only to decrease Syme, H. M., Markwell, P. J., Pfeiffer, D. as a uraemic toxin and may also cause mortality but also to decrease the and Elliott, J. (2006) Survival of cats with Further reading lethargy, weakness, anorexia and frequency of uraemic episodes and naturally occurring chronic renal failure is Kidder, A. C. and Chew, D. J. (2009) immunodeficiency among other wide- therefore improve quality of life. related to severity of proteinuria. J Vet Treatment options for hyperphosphatemia ranging systemic effects. In addition, Without the understanding of owners, Intern Med 20: 528-535. in feline CKD: what’s out there? J Feline calcitriol may also have important renal a successful transition to a prescription Mizutani, H., Koyama, H., Watanabe, T., Med Surg 11: 913-924. effects unrelated to parathyroid diet is less likely to be successful. Kitagawa, H., Nakano, M., Kajiwara, K. Polzin, D. J. (2011) Chronic kidney disease hormone. Having started appropriate and King, J. N. (2006) Evaluation of the in small animals. Vet Clin North Am Small There have been anecdotal treatment, it is essential to institute a clinical efficacy of benazepril in the Anim Pract 41: 15-30. suggestions that calcitriol therapy may plan for regular monitoring. This is improve the quality of life of cats with important to: assess whether the CKD; however, a randomised management of previously diagnosed Rare tiger captured in Russia controlled clinical trial of cats with complications is adequate, gauge disease A RARE Amur tiger has been captured in a remote area of Russia by an stage 2-4 CKD did not show any progression, monitor for the international research team searching for the even rarer Amur leopard. evidence of altered mortality, improved development of new complications, Capture and examination of the male tiger is being claimed as a major appetite or quality of life with and provide client support. success. Data are expected to provide invaluable information to protect the treatment (Polzin et al, 2008). At this The frequency of monitoring will existing wild leopard population and contribute to a ground-breaking long time, good evidence for the treatment depend on the stage of disease and term project: an Amur leopard reintroduction scheme. of cats with CKD with calcitriol is severity of concurrent problems. It is Dr John Lewis, co-founder and director of Wildlife Vets International lacking. likely to be frequent initially (every 1-2 (WVI), who was with the team in far eastern Russia, said: ‘We need to catch, Many of the above complications weeks) and then may be reduced to assess and radio collar tigers as well as leopards if we are to discover how can be addressed simultaneously by every 3 to 12 months thereafter, they co-exist. Tigers are present in the proposed leopard reintroduction area feeding a prescription renal diet (see providing the patient is stable. and we must know the risks for any leopards released there. Infectious Table 2). Although these diets are often In addition to collecting a history diseases affecting tigers can equally affect leopards so health screening has more expensive than maintenance feline and performing a full physical major conservation relevance for both animals.’ diets, currently available evidence from examination, re-check examinations will The tiger, one of only about 450 remaining, was anesthetised for published clinical trials suggests that include blood pressure and ocular examination and released with a GPS tracking collar. Table 2. Beneficial modifications to typical examinations, blood The multi-organisation team undertook a two-month programme to track feline prescription renal diets. sampling for haematology the elusive, solitary and nocturnal Amur leopard before temperatures dropped and biochemistry below -20ºC. Modification* Complication addressed (including phosphorus, The project is part of a wider long-term effort to assess the health of wild Phosphate restricted Hyperphosphataemia calcium and electrolytes) and captive leopards and their prey base in the wild. The ultimate aim is to Protein restricted Uraemia and urine sample provide comprehensive disease screening of both wild and captive Amur Potassium supplemented Hypokalaemia collection for urinalysis leopards so a second population can be safely released into the wild. B vitamin supplemented Anaemia (including urine protein- WVI, which was formed by a group of zoo and wildlife vets in 2004 to Non-acidifying Metabolic acidosis to-creatinine ratio) and give conservation workers the veterinary support and skills they need and to Palatable Anorexia, inappetance culture. reverse the decline of some of High caloric density Weight loss Twenty per cent of the world’s most endangered Supplemented with omega-3 cats with CKD suffer animals, says it needs to raise polyunsaturated fatty acids from a urinary tract £25,000 a year to continue its Supplemented with infection at some point in Amur leopard project support. their disease and this can n anti-oxidants The photo shows the result in pyelonephritis * Note: Not all of these dietary modifications have been anaesthetised tiger being and disease progression. examined by Dr John Lewis examined individually in cats with CKD and been These infections are often proven to be effective. 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I=:BDHIH:A:8I>K:CH6>9;DG9D 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. 2011. All rights reserved. VP DECEMBER 2011 ORTHOPAEDICS 19 Conservative management of canine osteoarthritis – part 3 TREATMENT of OA should story is not so clear cut as to label the first NSAID was actually having an may be suffering, on the other, there is incorporate not only treatment of COX 1 “all good” and COX 2 “all effect when the replacement NSAID a risk that the norm simply shifts to a pain, but an attempt to limit bad”, there is increasing evidence that appears to have no effect at all on their new protocol. dysfunction for as long as possible, significantly more COX 2 has been animal’s pain. Where it used to be long-term to limit the frustration of the found in the synovium of OA affected Side effects of NSAIDs are well NSAIDs and glucosamine/chondroitin patient from having its resources hips than normal joints in dogs.15,16 documented, and include gastric (or prednoleucotropin, or restricted, and to limit the guilt felt COX 2 is also implicated in the irritation and ulceration, kidney failure glucocorticoids, where NSAIDs did by the owners from having to limit development of central sensitisation and hepatotoxicity. Whilst caution is not work) the new “formula” may these sensible in the face of any become NSAIDs, plus tramadol plus resources gastrointestinal disturbance if its origin gabapentin. and SAMANTHA LINDLEY is not known, it is probably true to say Although there is no proof of the continues her series on canine OA administer with a discussion of the need for that NSAIDs are withdrawn too often efficacy of these for the treatment of medication a dynamic approach to treatment in response to vomiting and diarrhoea. pain and suffering in dogs with OA, about which and a look at analgesia – the first Unless there are signs of gastric the impression is that they have had a they feel in the A, B, C, D, E checklist ulceration (which would obviously significant effect on the welfare of ambivalent. indicate treatment in its own right), it is patients suffering from pain arising Above all, the approach must be and inhibition of probably wise to withdraw the NSAID from a variety of sources. However, dynamic and, where possible, proactive. COX 2 has been shown to decrease whilst the problem is present, and then that does not mean that no Carmichael describes an approach central sensitisation.16 reintroduce it when the signs are circumspection is required in their use; that fits these requirements.14 The The administration of a COX 2 resolved. excessive use of these medications will straightforward A, B, C, D, E inhibiting NSAID is now taking on a One side effect from NSAIDs that result in owners perceiving that their mnemonic provides an instant checklist further potential importance for the is not much discussed is nausea. It is pets are being “doped up” and, of for practitioners in the treatment of patient: it should specifically target the not known whether there is a course, the more sedating drugs used, OA: inflammatory process in affected joints connection between nausea and gastric the more likely it will be that an A = Analgesia; and it should decrease central ulceration caused by NSAIDs, or individual will be sedated. Dullness and B = Bodyweight; sensitisation, therefore having an whether nausea is a risk factor for sedation will complicate continued C = Control (i.e. control of impact on chronic pain states. From ulceration. However, nausea itself is a assessment of the pain and suffering. complications and of comfort, and the evidence that if central sensitisation highly unpleasant experience, and giving the owner a sense of control. It is decreased, peripheral disease and replacing pain with nausea is not likely Analgesics employed in also stands for common sense. To inflammation are reduced,7 it may be to improve the animal’s well-being. multimodal analgesia paraphrase Carmichael: “If the dog is hypothesised that COX 2 inhibiting Signs of nausea include an increase Tramadol hydrochloride running about freely and happily and NSAIDs may actually help to treat the in grass or plant eating (pica is also This is often thought of as an opiate, the only thing it cannot do is get in the disease by treating the pain. possible), an increase in lip licking, but has only weak opiate activity, car, then the dog needs a ramp and not Each NSAID has a different excessive yawning and stretching binding at µ-receptors, and also a hip replacement”.); profile, differing pharmacokinetics and, (although the latter may also indicate interacting with both noradrenergic and D = Disease modification; therefore, it is not surprising that on abdominal pain/low back pain), serotonergic systems, as well as having E = Exercise. occasion, different individuals respond inappetence and general dullness of other central effects. Serotonin and Carmichael and Lindley have differently to a variety of NSAIDs. demeanour, with or without vomiting. noradrenaline are neurotransmitters consolidated this approach in the Pet Sometimes this varying response is These signs should be checked for by involved in two of the descending Arthritis Counsellor Training course: in terms of side effects, and sometimes questioning the owner at each inhibitory pain pathways that are in terms of apparent efficacy. Some consultation. essential in controlling and inhibiting A = Analgesia individuals appear to respond the response to painful stimuli. NSAIDs are the first line of approach predictably and adversely to all Multimodal analgesia It is important to remember that for dogs with OA. NSAIDs, as it is NSAIDs, and some only to one. It is Pain is modulated at various sites in the tramadol is not classed as an anti- well known, act partly by decreasing claimed that some patients no longer nervous system and, at its simplest, inflammatory and, if one suspects that prostaglandin synthesis by inhibiting have a benefit from a given NSAID multimodal analgesia exploits the active inflammation is present, then an the enzyme cyclo-oxygenase (COX) after a while (so-called “tolerance”), different actions of different analgesics anti-inflammatory should be used, which occurs in two forms: COX 1, and a change to another NSAID may to maximise the effect on pain, and except when contraindicated. However, the so-called constitutive COX, and elicit an improved response. minimise the overall amount of each there is some evidence that central COX 2 which is induced during cell It is possible that the patient may analgesic. inhibition of pro-inflammatory injury and inflammation. always have been likely to respond Whether an animal needs analgesia cytokines may occur with the use of The general trend in veterinary better to the alternative drug and that additional to NSAIDs will depend on tramadol, and, with increasing evidence pharmaceuticals is towards preferential its condition was simply getting worse, the assessment of its suffering. It is not that the inhibition of central COX 2 inhibition since, although the such that the first no longer provided a given that all animals need multiple sensitisation leads to a reduction in sufficient analgesia. Without reliable analgesics, nor that all patients with OA peripheral disease, this view may Samantha Lindley, BVSc MRCVS, and consistent pain scoring, it would be will need analgesics all of the time, change. qualified at Bristol in 1988. She is impossible to say whether this effect is hence the need for frequent re- Tramadol is best used where the currently involved with the Pain Clinic real or just due to the vagaries of evaluation and adaptation of the patient is suffering (this distinction was and Behaviour Service at the Glasgow chronic pain, individual response to individual approach. made in part 2); in short, where the veterinary school and the Pain Clinic at NSAIDs, and/or the progression of There are many unlicensed pain affects its mood and demeanour. Broadleys Veterinary Hospital, Stirling. OA. analgesics in common use for pain in Although tramadol may have an effect Her areas of clinical interest are the There appears to be no logical small animals. On one hand, it is on lameness, it is not unusual to see assessment and management of mechanism by which such “tolerance” reassuring to know that there is that the dog just limps more happily, chronic pain, behaviour problems and of these drugs occurs. It is also not recognition that NSAIDs are not i.e. one may use a different outcome their clinical causes. infrequent that the owner realises that always enough and that many animals measure when treating with tramadol. 20 ORTHOPAEDICS VP DECEMBER 2011 Since the drug is not licensed for tramadol and NSAIDs. use in animals, a comprehensive list of side effects and contraindications is not Paracetamol available. Side effects seen include An NSAID, with no gastric activity, sedation, dullness, vomiting, nausea, paracetamol can be safely used when diarrhoea and, specifically, dysphoria. It there is gastric ulceration, and is associated with lowering seizure alongside other NSAIDs and threshold in man, but this does not glucocorticoids. The disadvantage of appear to be a problem in dogs, where- this drug is that it is not a very potent Figure 7. Underwater treadmills are as seizures have been reported in cats. analgesic when used on its own. increasingly employed as part of the The dose commonly used is 2- In humans, it is reported to be treatment of OA in dogs. 5mg/kg bid-tid, although starting at the more potent in combination with other Figure 6. Acupuncture appears to be useful for pain relief in OA. lower dose range often has an effect analgesics than when used alone. Its regarding the assessment of any and will limit side effects. The drug licensed combination contains codeine physical therapy (including appears to be highly stable and can be and, for that reason, should really be circumstances. Side effects of acupuncture), that are outside the remit used in its powder form or dispensed avoided with tramadol, in case the amitryptline include transient vomiting of this article, as well as simpler into gel capsules for dosing smaller patient is particularly sensitive to the and diarrhoea, sedation, and reasons regarding funding, that are dogs. Additionally, it appears to be safe opiate activity of both. It is occasionally, changes in behaviour limiting progress in these fields. to use with NSAIDs. It would be wise contraindicated in liver dysfunction. (disinhibition). Meanwhile, combinations of to keep the doses to a minimum in The recommended dose is 10mg/kg therapies including cryotherapy (for either renal or hepatic dysfunction. bid. Acupuncture acute inflammation) and the Tramadol should not be used with Acupuncture is being used increasingly application of heat (when acute other serotonergic drugs such as Amantadine in the treatment of OA pain in humans inflammation has resolved); range of clomipramine, amitryptline or Amantadine is an NMDA receptor and animals (Figure 6). There are now motion exercises; hydrotherapies, monoamine oxidase inhibitors, because antagonist that is reportedly useful for systematic reviews to support the use including swimming and underwater of the potential danger of causing controlling canine OA pain. However, of acupuncture in OA of the human treadmill walking (Figure 7); electrical serotonin syndrome. it appears to be most useful in this knee, but there are few useful studies in nerve stimulation, and active exercise, regard alongside an NSAID or opiate, the canine field. appear to be the most helpful in Gabapentin although there are anecdotal reports of Currently, acupuncture should be rehabilitating, or palliating, patients This is classed as an anti-convulsant success in its treatment of neuropathic thought of as primarily providing pain with OA. and was first licensed for neuropathic pain as a sole agent. relief, rather than an anti-inflammatory Exercises include sit-to-stands pain in humans. Neuropathic pain It would be indicated in action, although there is an emerging (Figures 8a, b,c), “dancing”, shaking involves the nervous tissue directly, uncontrolled OA pain, where there is suggestion that the treatment of pain hands, step climbing and lead walking. such as nerve root irritation, foraminal evidence of central sensitisation, and may modify disease. Until this is more Such exercises may be best designed stensois, or cord compression, but is where gabapentin/tramadol is not firmly grounded, it is sensible to use and demonstrated by a qualified also used to mean the effects of central tolerated or not working. Side effects acupuncture as an adjunct to treat OA, physiotherapist, although the simpler sensitisation and central disinhibition, are sedation and vomiting/diarrhoea. rather than a sole treatment if an active strategies can be easily learned and where the patient experiences Recommended doses are 2-4mg/kg sid. inflammatory process is suspected. demonstrated. widespread pain, not necessarily Acupuncture triggers and enhances Beware of forcing or encouraging attributable to any pathology or Amitryptline potent analgesic pathways in the body animals with severe pain to engage in correlated with its severity. Amitryptline is a tricyclic anti- via the stimulation of (primarily) A such activities without the benefit of The latter can be relevant in OA depressant (TCA) which is an effective delta (or Type II and III) fibres in skin sufficient analgesia. pain and should be picked up during analgesic for both neuropathic and and muscle. This stimulation causes examination and initial assessment (or nocioceptive pain in humans, when inhibition of C fibre pain in the dorsal 14. Carmichael, S. (2005) Putting of course may occur as the disease used at lower doses than for emotional horn and release of theory into practice – best progresses). Gabapentin is therefore disorders. However, it has not been beta-endorphins, practice management for indicated when allodynia and assessed in canine OA. noradrenaline and osteoarthritis. 9th Annual hyperalgesia are present or where the It has been dubbed a multimodal serotonin, amongst Symposium, Geneva. pain and suffering are not being analgesic on its own because of its other 15. Lascelles, B. D., King, controlled by other means. widespread actions via descending neurotransmitters, S., Roe, S. et al (2009) There are various theories as to inhibitory pain control, regulation of from the brain.17 Expression and activity of how this drug works; the most sleep, anxiolysis, and antihistamine COX-1 and 2 and 5-LOX commonly quoted is that it blocks effects. It has more noradrenergic Physiotherapy in joint tissues from dogs calcium channels, thereby decreasing activity than other TCAs and therefore Physiotherapy is Figures 8a, 8b and 8c. Sit-to- with naturally occurring the excitability of nerve cells, slowing is considered superior to them for pain increasingly used in stands are among the many coxofemoral joint transmission, but there may also be relief in humans. The SSRIs (specific small animals for a simple physiotherapy osteoarthritis. The Journal some noradrenergic effects via serotonin reuptake inhibitors such as wide range of exercises that can be helpful of Orthopaedic Research 27 descending inhibition. fluoxetine) have not been found at all problems. Like for dogs with OA. (9): 1,204-1,208. Side effects reported include useful for analgesia. acupuncture it is an 16. Veiga, A. P., Duarte. I. sedation, vomiting and diarrhoea, Amitryptline requires competent emerging field in D. G., Marcelo, N. A. et al excessive drinking (short lived), itch (at hepatic and renal function for veterinary medicine, (2004) Prevention by higher doses), but specifically, ataxia elimination. In humans it causes drying with limited research celecoxib of secondary with stumbling and tripping, assumed of the mucous membranes and to demonstrate hyperalgesia induced by to be associated with feelings of therefore should perhaps be used with efficacy in the formalin in rats. Life dizziness reported by human patients. caution in KCS. It is dysrhythmogenic veterinary species. Sciences 75: 2,807-2,817. Gabapentin is partially metabolised in overdose and should be used with However, it should be 17. Bowsher, D. (1998) by the liver and eliminated by the extreme caution in patients with remembered that lack Mechanisms of kidneys in the dog, so minimal dosing dysrhythmias. of evidence of acupuncture. In: Filshie J, is wise where there is renal or hepatic Because of these cautions, it tends efficacy is not White A, editors. Medical dysfunction. The recommended to be used less frequently than evidence of lack of Acupuncture: A Western dosages are 5-10mg/kg bid, starting tramadol and gabapentin, although efficacy. scientific approach. Churchill low and increasing if necessary. It time and experience may also inhibit Additionally, there Livingstone, Edinburgh: appears to be safe to use alongside the use of these in certain are complex reasons pp69-82. VP DECEMBER 2011 CANINE 21 Canine neutering: legal aspects THE legal aspects of removal of permitted when it is necessary for (BPH), testicular tumours, perianal Norwegian Veterinary Forensic body parts to improve or change a animal welfare reasons or other tumours and inguinal hernias or Council (VFC), which is an advisory dog’s exterior is generally agreed specific reasons.” chryptorchidism and, sometimes, body to the Food Safety Authority upon as not allowed in Europe. Hence, neutering, which involves unwanted elimination. In most (FSA) concerning issues in general Hence, docking of tails and ear the surgical removal of the gonads in behaviour-related cases, owners veterinary practice (Animal Health cropping are no longer permitted in healthy dogs, is generally not consult their veterinarian due to Personnel Act), liability cases and most European countries, and permitted. All aspects of the animal’s concerns over aggressive dogs or dogs client complaints, and the Animal some countries have banned welfare situation should go into the that display hypersexual behaviour. Welfare Act, has received some input docked dogs from participating in decision whether or not to neuter the on neutering practices among shows and some (Norway) even in dog. Guide dogs for the blind and The future veterinarians in Norway. field trials. other special utility dogs are exceptions There seems to be a growing Recently a case has been brought In Denmark and some other from the prohibition to neuter under motivation among Norwegian small before the VFC concerning the countries, docking is allowed in “other specific reasons”. animal veterinarians towards practice of a veterinarian neutering a hunting dogs encouraging dog owners to litter of puppies at eight weeks before of certain Professor WENCHE neuter/spay their dog. They argue that they were sold and transferred to new breeds and FARSTAD spaying/neutering is legal and owners. The question asked by the castration is in the second of our three part- common practice abroad, and that FSA is whether this practice is in allowed. series on neutering practices there are obvious health benefits from accordance with the current AWA. Castration of across Europe, discusses the castration. This is an interesting question dogs must be different legal standpoints in the Non-breeding females are much since the Act’s requirement that every carried out by various countries less often spayed for other reasons case should be discussed with the an authorised than medical, whereas male behaviour dog’s owner relating to an individual veterinarian. In Sweden, castration was Serious behaviour problems may problems are more often used as an animal’s welfare may be difficult to made exempt from the prohibition to now be considered acceptable grounds argument for surgical castration. New fulfil in this case. remove body parts in 1988, hence for castration, but still the veterinarians drugs, such as GnRH-agonist implants It appears that across-the-board neutering is allowed under the Swedish have to justify neutering in every (e.g. deslorelin), which down regulate recommendations for neutering all pet Animal Protection Act individual case. Thus, the role of the testicular and ovarian function, entered dogs do not appear to be [djurskyddslagen (1988:534) §§10/11] veterinarian is co-operative according the Norwegian market professionally founded. and its regulations 1988:539. Norway to the intentions of the Animal in 2009 and may It appears that This is a principle that has taken a slightly different approach. Welfare Act. Alternatives to surgical provide an option for across-the-board should be mirrored in Neutering of dogs (male or female) neutering should be discussed between owners who are the laws and was explicitly prohibited in Norway by client and the professional, but the hesitant towards recommendations regulations on the former Animal Protection Act veterinarian makes an informed surgery. for neutering all neutering in dogs and (dyrevernloven, 1974). decision on how to solve the problem. pet dogs do not in small animal clinical This was subject to medical Hence, the veterinarian and the Early castration – appear to be practice. conditions related to the gonads owner decide together whether special professionally (ovaries or testicles), accessory sex castration would be an option to considerations References glands or uterus, and it was agreed that improve the dog’s behaviour to such Then there is the issue founded. Von Heimendahl, A. certain established disease conditions an extent that it may continue living in of early castration or (2011) Neutering in the would allow for neutering under the the household. paediatric castration, i.e. neutering UK and Europe. Veterinary Practice 43 law, but prevention of those were not. puppies while still at the breeder’s, a (9): 24-25. In this scenario, neutering could not be Spaying females practice that may be common in some Kristiansen, V. et al (2011) Personal justified unless there was an The main medical indication for countries or states with a large communication. established medical condition. spaying females is pyometra or other population of unwanted dogs or a Ru, G., Terracinim B. and Glickman, L. The prohibition to neuter dogs was uterine disease. In some cases it is stray dog problem (e.g. USA). T. (1998) Host-related risk factors for not changed in the newly implemented carried out as a preventive measure The traditional castration age of canine osteosarcoma. Vet J 156: 31-39. Animal Welfare Act (dyrvelferdsloven, against mammary tumours in breeds at six months or younger appears to Cooley, D. M., Beranek, B. C., 2009) but the wording changed slightly. increased risk (e.g. Cocker Spaniels, predispose dogs to health risks that Schlittler, D. L., Glickman, N. W., The animal’s welfare is more clearly von Heimendahl, 2011). could otherwise be avoided by waiting Glickman, L. T. and Waters, D. J. considered in this new Act which is Results from a randomised until the dog is mature. (2002) Endogenous gonadal hormone executed by the Norwegian Food prospective clinical study on effect of Spay/neuter before one year of exposure and bone sarcoma risk. Safety Authority: spaying on the development of age is associated with a significantly Cancer Epidemiol Biomarkers Prev 11 (11): www.mattilsynet.no/english/animal_w existing canine mammary tumours in increased risk of osteosarcoma (Ru et 1,434-1,440. elfare (English translation). Norway have indicated that females al,1998; Cooley et with well-established benign tumours al, 2002). In many Medical and surgical benefit from spaying. cases the treatment Relapse risk in dogs with benign veterinary medical “Surgical procedures or removal of mammary tumours treated surgically literature supports body parts must not be carried out was reduced by 50% when the female the notion that unless there is a justifiable reason to was ovariohysterctomised (Kristiansen long-term health do so out of consideration for the et al, unpublished data). risks and benefits animal’s health.” And further: “The of spay/neuter removal of horns and castration is Neutering males will vary between Common indications for neutering dogs of different Professor Wenche Farstad, DVM, PhD, males include: aggressive behaviour ages, by gender DipECAR, is in the Department of towards other dogs or humans; and life situation Production Animal Clinical Sciences, hyperactivity, hyper-sexuality towards of the dog and its The traditional castration age of six months or younger Norwegian School of Veterinary dogs, objects or humans; and medical owners. appears to predispose dogs to health risks that could Science, Adamstuen, Oslo, Norway. conditions including prostate disease The otherwise be avoided by waiting until the dog is mature. 22 DERMATOLOGY VP DECEMBER 2011 Getting to grips with atopic dermatitis THIS series will look first at the manner. Adjunctive treatment includes eight dogs already on treatment with skin barrier and global Additionally, in human atopic antibiotics and antifungals, strict flea allergen-specific immunotherapy management of atopic dermatitis; patients, a mutation in the gene control, diet trials, antihistamines, and/or pentoxyfilline, during a 12- later articles will discuss the encoding for filaggrin (filament shampoos, and fatty acid week treatment period, their canine management of Malassezia aggregating protein) have been supplementation. atopic dermatitis extent and severity dermatitis; pruritus; the role of identified. Intradermal and serological tests index (CADESI) scores were steroids; and are both recommended as useful to measured before and after treatment, shampoo FILIPPO DE BELLIS identify environmental triggers in and the total clinical score therapy. begins a three-part series on the view of pursuing allergen specific progressively decreased, in association latest thinking and technology immunotherapy. with an improvement in clinical signs. Skin available to practitioners to Interestingly, there is no evidence The change in the scores for barrier in diagnose, treat and manage the that anti-inflammatory therapy excoriations and erythema was the atopic most common skin problems interferes with allergen specific most dramatic. dermatitis immunotherapy; therefore this can be Because the only change in The pathogenesis of atopic dermatitis In the canine counterpart the used during the induction phase, treatment over the 12 weeks was the (AD) is considered multifaceted due to presence and role of filaggrin before any improvement is seen from addition of the topical spot-on the action of genetic and mutation has not been clearly the vaccine. therapy, these results may suggest that environmental factors. Classically, AD elucidated. Although more research is Control of localised pruritus can topical lipids may play a role in the is thought to be caused by a genetic clearly needed, there is increasing, be successfully achieved by use of reduction of inflammation. Repair of defect in the immune system, leading albeit preliminary evidence, to support topical glucocorticoids and tacrolimus epidermal barrier function to a hypersensitivity to normal a role for skin barrier dysfunction in and more generalised manifestations presumably leads to the reduction in environmental allergens. canine AD. benefit from systemic glucocorticoids, inflammation seen in this study. Newer theories propose that a to be started as for acute flare, with These findings are encouraging, defect in the skin barrier has an Global management of the aim of achieving a low-dose but double-blinded placebo-controlled important role in the pathogenesis. In atopic dermatitis alternate-day dosage, and with or cross-over studies are needed for healthy individuals skin offers an Management of canine AD usually ciclosporin. This should be started on further confirmation. effective barrier function against involves a combination of therapeutic a daily basis and then, upon clinical bacteria, viruses, parasites and modalities. In a recent paper, the signs, reduced gradually. References allergens, such as house dust mites, options were divided into two Essential fatty acids, Chinese Shimada, K., Yoon, J. S., Yoshihara, T. forage mites and pollens. categories: treating acute herbs and antihistamines are J. S., Iwasaki, T. and Nishifuji, K. Genetic defects in skin lipids and manifestations and treating chronic recognised as useful steroids, sparing (2009) Increased transepidermal water proteins create a barrier defect, causing cases. drugs in the long term. Bathing with loss and decreased ceramide content increased entry of the allergens into Currently recognised causes of non-irritating, anti-seborrheic or in lesional and non-lesional skin of the body, stimulating an immune flares of canine AD include fleas, antimicrobial shampoos is also dogs with atopic dermatitis. Veterinary response. food and environmental (e.g. house believed to be beneficial, albeit not Dermatology 20 (5-6): 541-546. dust mites, pollens) allergens; other recommendable as a sole therapy. Marsella, R., Olivry, T. and Carlotti, Building blocks ectoparasites, such as Cheyletiella or It is tempting to speculate that D. N. (2011) International Task Force The skin can be described as a bricks Sarcoptes, can also contribute to addressing the skin barrier defects on Canine Atopic Dermatitis: Current and mortar structure, with epithelial increase pruritus. could produce a beneficial effect. In evidence of skin barrier dysfunction cells making up the bricks and In addition to addressing these one human study, the application of a in human and canine atopic extracellular lipids and proteins making factors, where infections are present, topical moisturiser containing dermatitis. Veterinary Dermatology 22 up the mortar. it is recommended that they are ceramides produced dramatic (3): 239-248. Both human and canine patients treated topically or systemically, improvement in clinical scores after Olivry, T., DeBoer, D., Favrot, C. et al with AD have been shown to have according to the clinical signs. three and six weeks of treatment. (2010) Treatment of canine atopic abnormalities and deficiencies in the When pruritus is not complicated In dogs with AD, topical dermatitis: 2010 clinical practice intercellular lipid barrier, showing in by infections, glucocorticoids should application of a lipid preparation was guidelines from the International Task particular difference in the way the be used, including topical (e.g. shown to be effective in re- Force on Canine Atopic Dermatitis. lipids are formed and organised. hydrocorticosne aceponate spray) or establishing a normal skin structure. Veterinary Dermatology 21 (3): 233-248. Lipids are produced by the systemic (prednisone or In atopic dogs it is difficult to Piekutowska, A., Pin, D., Rème, C. A., epithelial cells into structures called methylprednisolone at anti- demonstrate the clinical efficacy of Gatto, H. and Haftek, M. (2008) lamellar bodies. The lamellar bodies inflammatory doses) formulations, this skin lipid complex spot-on Effects of a topically applied are extruded into the extracellular according to the clinical signs and treatment in clinical practice, because preparation of epidermal lipids on space and form organised stacks called lesions’ distribution. topical lipid applications are not used the stratum corneum barrier of atopic lamellae, which help prevent water loss Medications that are not suitable as monotherapy. dogs. Journal of Comparative Pathology and allergen penetration. for management of acute flares These formulations are intended 138 (4): 197-203. Ceramides are a type of lipid that include antihistamines (they would to be used as adjunct therapies in Fujimura, M., Nakatsuji, Y., Fujiwara, makes up a large portion of the not have had the time to block combination with other anti- S., Rème, C. A. and Gatto, H. (2011) lamellae. Dogs with AD have a skin histamine receptors before their inflammatory drugs, antimicrobial Spot-on skin lipid complex as an deficiency of ceramides and their occupation by histamine released in drugs, and immunotherapy as part of adjunct therapy in dogs with atopic lamellae are arranged in a disorderly early allergic reactions), essential fatty the global approach to the dermatitis: an open pilot study. acids (they take too long to be management of canine AD. Veterinary Medicine International 281846. Filippo De Bellis, DVM, CertVD, DipECVD, MRCVS, European Specialist incorporated into the cells’ In a recent study, conducted on E-pub 2011 Sept 29. in Veterinary Dermatology, graduated membrane) and ciclosporin (due to its from the University of Bari (Italy) in delayed therapeutic benefit). Win a spa pampering day... In the management of chronic 2001. After spending two years Virbac Animal Health is offering readers the chance to win a skin working in a small animal and equine cases, the mainstay of treatment is pampering session at a top spa – with chocolates for five runners-up – practice in Italy, he moved to the UK allergen-specific immunotherapy, each month for this and the next two months. and now works at Vets Now Referrals, topical, systemic (low-dose alternate- Details of the competition are on page 36 in this issue; closing date the Animal Health Trust and Southern day oral) glucocorticoids, and for this first competition is 12th January 2012. Counties Veterinary Specialists. ciclosporin. Introducing a revolution in the nutritional management of severe dietary allergy In some dogs, adverse food reaction is so severe that the body will react even to hydrolysed diets The protein in our Anallergenic diet is unique. A state of the art process produces a stable protein source composed exclusively of free amino acids and very low molecular weight oligopeptides. Now, the management of severe dietary allergy in dogs is more achievable. For more information about the Royal Canin DermAlliance range please contact your Veterinary Business Manager. www.royalcanin.co.uk / www.royalcanin.ie 24 EMERGENCY AND CRITICAL CARE VP DECEMBER 2011 A LOOK THROUGH THE output. Ultrasonography revealed variations in the results obtained with the and carprofen. There was no significant RECENT LITERATURE abnormalities in the liver suggestive of two methods which could be critical difference in the effects of the two Use of intravenous lipid liver lobe torsion. Each rabbit underwent when interpreting blood glucose agents, suggesting that either NSAID emulsion as an antidote in surgery in which the diagnosis was measurements or selecting a glucometer may be deleterious in dogs with veterinary toxicology confirmed and the affected lobe resected. for an intensive care setting and for extracellular fluid volume depletion or Alberto Fernandez and others, Cape Prompt diagnosis and hepatectomy is precise glycaemic control in critically ill when receiving frusemide treatment. Cod Veterinary Specialists, recommended and appears to be dogs. International Journal of Applied Research in Massachusetts associated with an excellent prognosis. American Journal of Veterinary Research 72 Veterinary Medicine 9 (2): 130-137. Intravenous lipid emulsion (ILE) has Journal of the American Veterinary Medical (9): 1,204-1,208. been suggested as an antidote in toxicity Association 238 (9): 1,176-1,183. Tussive syncopy in a pug with incidents involving local anaesthetic Restoring a functioning airway lung lobe torsion agents and other lipophilic compounds. Tube feeding in dogs with in the stabilisation of John A. Davies and others, Small It may be particularly valuable when the severe acute pancreatitis emergency patients Animal Medicine and Surgery, clinician is faced with cardiopulmonary Caroline Mansfield and others, Nadja Sigrist, University of Bern Overland Park, Kansas arrest and unsuccessful cerebral Murdoch University, Western Irrespective of the underlying cause, Torsion of a lung lobe at its hilus is a rare resuscitation. However, evidence for Australia patients with respiratory distress should but life-threatening condition in dogs using ILE in both human and veterinary Acute pancreatitis is a cause of high be regarded as emergencies, as the initial and cats. The common presenting signs medicine is limited and based mainly on mortality in dogs and surviving patients treatment may determine prognosis and include dyspnoea, tachypnoea, lethargy, data from experimental animals. require intensive treatment and survival. The author describes a strategy anorexia, pyrexia, cough and vomiting. The authors review current literature hospitalisation. There is evidence that the for localising the cause of the respiratory The authors report a case in a three-year- on ILE with a view to drawing up gut plays a role in amplifying systemic problem at a time when key diagnostic old spayed female pug in which the main guidelines on its applications in inflammation in this condition and procedures may be impossible or feature was multiple episodes of acute veterinary practice. They conclude that providing intraluminal nutrition may counterproductive. Once the cause has collapse preceded by coughing and the method appears to provide a safe decrease inflammation in experimental been identified, the clinical team may gagging. They describe the diagnosis and therapy for veterinary patients presenting models. The authors assess the effects of then introduce supportive measures such successful surgical management of this with certain toxicoses. Evidence of enteral nutrition delivered proximal to as oxygen supplementation, stress-free case, involving the first reported incident adverse events associated with this the pylorus. In eight dogs with severe handling or analgesia, as well as a more of tussive syncopy secondary to lung intervention appears both limited and acute pancreatitis they found that early specific therapy for the underlying lobe torsion. anecdotal. However, standard enteral nutrition was well tolerated and condition. Canadian Veterinary Journal 52 (6): 650- resuscitation protocols should be resulted in fewer complications than European Journal of Companion Animal 660. exhausted before considering this parenteral nutrition. Practice 21 (1): 13-21. therapy and the potential side effects Journal of Veterinary Internal Medicine 25 [Originally published in Kleintierpraxis 55 Feline anaesthetic deaths in should be considered. (3): 419-425. (2): 85-96] veterinary practice Journal of Veterinary Emergency and Critical David Brodbelt, Royal Veterinary Care 21 (4): 309-320. Comparison of five blood Omentalisation of a College, London typing methods for the feline caudalmediastinal abscess in a Anaesthetic deaths involving feline Computed tomography AB blood group system dog patients are a rare event but they are analysis of brain infarction in Mayank Seth and others, University Alastair Franklin and others, known to occur more frequently than canine patients of Pennsylvania Veterinary Specialist Centre, North with human or canine patients. The Amanda Paul and others, Murdoch The feline AB blood group system is Ryde, New South Wales author reviews studies on the frequency University, Western Australia clinically important because of the A two-year-old German short-haired of such incidents in cats, estimated at Cerebrovascular accidents were potential risks of acute haemolytic pointer presented with acute onset about 0.11%, and also identifies potential considered uncommon in dogs until transfusion reactions and neonatal lethargy, pyrexia and tachypnoea. risk factors. Patient health status, age, relatively recently but through the wider isoerythrolysis. There are a number of Radiography and ultrasound detected a weight and procedure type and urgency availability of advanced imaging different typing methods available and mass caudal to the heart which was have each been linked to the risk of modalities, they are now recognised more the authors compare the ease of use and identified as a caudal mediastinal abscess serious complications. Endotracheal frequently. The authors review the accuracy of five tests in 490 samples, following a fine needle biopsy. This intubation and fluid therapy also increase clinical features of eight cases of acute including a high proportion with type B abscess was managed surgically by the odds but this finding may reflect onset neurological signs in spaniel-type or AB blood, anaemia and auto- median sternotomy, abscess content higher risk techniques. dogs in which brain infarction was agglutination cases. They state that evacuation and omentalisation of the Topics in Companion Animal Medicine 25 (4): confirmed using computed tomography. current laboratory and in-clinic methods abscess cavity via the diaphragm. 189-194. They conclude that CT scanning is provide simple and accurate typing of Although surgical management of particularly sensitive for detecting feline blood groups with few mediastinal abscesses has been reported Evaluation of a serum haemorrhagic infarction, but may under- discrepancies. However, retyping using previously, this appears to be the first biomarker as a diagnostic and represent ischaemic and lacunar laboratory methods after using in clinic report of treatment involving prognostic indicator in sepsis infarctions when compared with tests is recommended. omentalisation. Amy DeClue and others, University magnetic resonance imaging. American Journal of Veterinary Research 72 Australian Veterinary Journal 89 (6): 217- of Missouri Australian Veterinary Journal 88 (10): 374- (2): 203-209. 220. Sepsis is associated with severe morbidity 380. and frequent fatalities in affected dogs. Effect of haematocrit on the Ibuprofen and carprofen in Differentiating between true sepsis and Hepactectomy as a treatment accuracy of blood glucose euvolaemic and volume- non-infectious forms of systemic for liver lobe torsion in measurements in dogs depleted dogs inflammatory response syndrome domestic rabbits Amanda Paul and others, Murdoch Kathryn Surdyk and others, (NSIRS) can be clinically challenging. Natasha Stanke and others, Angell University, Western Australia University of Georgia, Athens The authors compare levels of a Animal Medical Center, Boston, In human medicine, the performance of Impaired renal function is one of the potentially useful diagnostic biomarker Massachusetts blood glucose measuring devices is main adverse events associated with the serum NT-pCNP in serum from dogs Liver lobe torsions are unusual in any known to be affected by the proportion use of Cycloxygenase inhibitor non- with sepsis, NSIRS and healthy animals. species and four cases in rabbits in quick of red blood cells in the sample. steroidal anti-inflammatory drugs. The They found that this peptide is a succession at a single centre was Greyhounds are known to have naturally authors investigate the effects of promising biomarker for some forms of considered surprising. They were high haematocrit levels and so the experimental volume depletion as a result sepsis but a poor indicator in those cases presented over a two-year period with authors investigated the effects of of frusemide administration on the renal involving septic peritonitis. non-specific clinical signs including haematocrit on readings from two point- activity of non-selective and preferential Journal of Veterinary Internal Medicine 25 anorexia, lethargy and decreased faecal of-care analysers. They found significant Cox-2 inhibiting agents, i.e. ibuprofen (3): 453-459. relax it’s a genuine Swann-Morton When they rely on you - we know you can All medical devices are CE marked FM 73368 in accordance with the Medical rely on us for the accuracy and precision Device Directive (93/42/EEC) you demand time after time. 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I’ll the PDSA in Dunkirk Road ... it’s a (4) five-year-old Boxer who is on fluids take Liz with me, one of our current lovely clear autumn morning. I for haemorrhagic gastroenteritis. “cutting edge” trainees. wave hello/goodbye to the PDSA Spent about half an hour checking 12.15pm. All packed for the house call. ACA who is just finishing his the in-patients and treatment plans. It’s a sunny Sunday and a nice day for overnight shift. 9.50am. Next consult – one-year-old a drive up the M1, at least. Thank I tuck my dog Abe into his usual Labrador cross-bred who developed goodness for sat nav. The 16-year-old kennel – he’s got a fresh knuckle bone acute diarrhoea at 3am. He’s very dog has haematuria and is a bit from my favourite butcher to keep him quiet, not his usual Labrador self. IV dehydrated. Bladder seems a bit amused today. It’s a bit of a thickened on palpation but no masses boring life for him when I’m AVA FIRTH are obvious. Will start him on working long shifts but he gets of Vets Now in Nottingham antibiotics and recommend they take out whenever someone has a describes the variety of the dog and a urine sample to their little break. I change into scrubs, challenges faced on one day in an own vet soon. say good morning to the night inner-city out-of-hours practice 2.30pm. Arrived back at the clinic shift and boil the kettle for a cup from house call. One of our vets is Figure 3. Soot in nasal oxygen of tea all round. trying to pass a urinary catheter on a catheter. 8am. My shift officially starts. We’ve fluids, basic labs plus abdominal rads male cat that had been catheterised got a one-hour overlap with me and to rule out GI foreign body... all clear, two days ago at its regular vet and is the night vet who is due to go home at so he gets to sleep in a kennel all day. again straining to urinate. It’s a weird 9am. 10.05am. House call request for one – the cat had pulled out its first 8.15am. First client arrives ... an euthanasia on a collapsed 13-year-old urinary catheter and the penis is now elderly lady had rung at 6am because dog ... turns out she is eligible for pointing dorsally instead of ventrally her dog has developed bloody PDSA treatment so she will bring the (Figure 1). diarrhoea. Dog has had diarrhoea for dog here. We can only get a catheter in 5cm, three days but now there’s blood in it. 10.35am. Another house call request to the level of the pubic bone. The owner had to round up friends for a 16-year-old dog who is urinating Contrast radiography doesn’t show a for transport so has come in at 8am blood. Discussed options with them, urethral tear and the contrast material Figure 4. Enlarged pale kidney at with a very very cute five-year-old Jack they will think about it and ring back. does pass through into the bladder. We post-mortem. Russell Terrier who is bouncing 11am. 17-year-old cat arrives, has suture the catheter in as far as it will around the exam room but actually developed acute vestibular signs this go and perform cystocentesis on the 6pm. Shift is officially over. Steph’s doesn’t mind being examined and gives morning, cannot stand up. Is already cat. Offered the owners immediate back on deck and is taking the me doggy kisses! on meds for cardiac and referral but they consultations. But I’ve still got three My secret trick with little dogs is to renal disease. It might Telephone call declined. cases to write up and a post-mortem to sit down and put them on my lap. do all right with some from owner of a 4.30pm. Smoke do. Faecal sample brought in by owner is supportive care for a dog who ate a inhalation dog has Wrote up notes on the dachshund: mustard-brown soft faeces with blobs few days but owners been off oxygen for he’s been on a morphine/lidocaine/ of bloody mucus around it. Dog has request euthanasia. bunch of acorns the last four hours. Is ketamine infusion and we’ve finally got been routinely wormed. Let’s call it 11.30am. Owners of yesterday and eating, drinking, him to a dose where he’s pain-free and colitis, switch to metronidazole. the inpatient cat with now has looking good. Blood alert. I’m still suspicious of peritonitis 8.55am. Time to take a hand-over subcutaneous oedema diarrhoea. At gases are unchanged but can’t prove it yet. from night vet, Steph Brien. have arrived for least, they think from four hours ago – Post-mortem exam on the cat with Fortunately I helped to admit all of discussion. Our work- yay! She has superficial subcutaneous oedema: liver was the current in-patients yesterday so I up shows proteinuria, he ate some burns along her back grossly enlarged and slightly pale. already know the background: (1) 10- hypoalbuminaemia, acorns. (Figure 2) but it’s Kidneys were moderately enlarged and month-old Dachshund who was normal liver enzymes. time to send her home pale (Figure 4), with pale tissue transferred for post-op care after Top differentials are protein-losing – well, to their temporary home. She infiltrating about 50% of the cortex gastrotomy and two enterotomies for nephropathy, pyelonephritis, renal will rest better with her family. (Figure 5). I need to do some removal of assorted foreign bodies; (2) neoplasia. None of them easy to fix. Instructed the owners re coupage ... cytology on the tissue samples but I’m 11-year-old German Shepherd that Owner is an elderly lady on a budget. they are dedicated owners and I am betting on renal lymphoma. was in a house fire on Friday She elects euthanasia and I ask for confident they’ll get it done. 9pm. Out the door finally ... me and afternoon and is battling smoke permission to perform a post-mortem. I show them the black soot that is the dog home to bed. Nothing died inhalation; (3) four-year-old MN cat Permission granted. inside the nasal oxygen catheter today that shouldn’t have. That makes 11.45am. House call request people (Figure 3) to get it across to them it a good day. phoned back – yes they would like a how much material is inside house call. Fortunately we have a of her lungs. second vet who started at 11am so 5.30pm. Telephone call from owner of a dog who ate a bunch of acorns yesterday and now has diarrhoea. At least, they think he ate some acorns. Must have been a Labrador, acorns don’t taste very Figure 1. Cat penis rotated dorsally. Figure 2. Superficial burns. good! Figure 5. Kidney with infiltrates. VP DECEMBER 2011 WILDLIFE 27 Tragedy in Turtleville... AS a small animal practitioner in threatened, while the Wood turtle and log is something Canada, on a typical work day I Spotted turtle are endangered. residents of treat dogs and cats. My inherent Limited information is available on Canada once took fondness for exotic and wildlife Painted turtles, so they have not yet for granted. species has allowed me to also care been listed. And although many people Populations are for pocket pets and rehabilitate are familiar with Red-Ear Sliders, these declining and wildlife, such as squirrels, raccoons, are non-native species that have been biologists fear that and birds. introduced via the pet trade, and most species of In six years of practising, I have uneducated owners no longer turtles may had very few opportunities to treat committing themselves to their care in ultimately injured reptiles. My passion for wildlife captivity often release them into local disappear from our conservation recently led me to enrol wetlands. province if change in a workshop for caregivers on turtles, Ontario is fortunate to have a isn’t implemented. Figure 1. Turtles at risk in the where trauma and rehabilitation community-based conservation Road mortality from moving cars poses Province of Ontario. techniques were practised. The program called the Ontario Turtle Tally significant threats to turtles, and most workshop turtles hit by vehicles are nesting provided a Dr ERIKA SULLIVAN females (Figure 2). thorough is concerned about declining Likewise, habitat destruction of introduction numbers of turtles and believes wetlands crucial to species survival is a to basic that as humans are mostly to reality of expanding urban populations. blame, it seems sensible that chelonian Global factors such as pollution, illegal they should be part of the Figure 3. Anaesthetic intubation care, as well collection of wild species for sale in solution technique on a cadaver turtle. as highlighted the pet industry, and predation as food the by other species are threatening turtles importance of conserving the cold- that records where turtles survive, what abroad. blooded reptiles that habituate the threatens their population, and where Comparative species medicine is wetlands that I call home. the habitat that sustains them is found fascinating. As veterinarians, we are Turtles are one of the oldest four- for their rehabilitation and survival. able to learn the anatomic and legged animals inhabiting the planet Such efforts, along with rehabilitation physiologic differences amongst species today. They first appeared in the fossil and release, local and global education, and apply such knowledge towards record of the Triassic period dating and partnering with other organisations their care. Turtles differ from mammals back 220 million years, and have are steadily implementing change for in many ways. Figure 4. Temporary fracture fixation adapted to a remarkable variety of future turtle populations. of an injured turtle’s shell utilising environments. Turtles are very active during Ecotherms medical tape, cement-glue, and art- Our ecosystem relies on them. nesting season, which occurs in spring Turtles are ectotherms, relying on their supply-store hooks and wires. Native turtle species are a necessary and early summer in Ontario. In early environment for body temperature, part of the ecology of wetlands, months, turtles are in search of nesting and have slow metabolic rates. can be collected from gravid females including fauna. They help control grounds, and sandy, gravel-covered Their respiratory system allows for and incubated, so that the hatchlings plant life by incorporating it as part of roadsides are prime locations for a breath-holding reflex, which enables can be later released. their diet. They eat invertebrate and digging. them to dive under water, while With a few simple acts of vertebrate animals and are themselves In later months, hatchlings emerge switching to anaerobic respiration, and kindness, anyone can help raise food for fish, snakes, birds and from nesting sites and begin their poses significant challenges to awareness to the threats affecting mammals. search for hibernation sites. Turtles anaesthesia when treating them in turtles. Sadly, globally turtles are among the may also be seen crossing roadways hospital (Figure 3). They lack a As a pedestrian, simply moving an world’s most endangered vertebrates, looking for food, mates, or to lay their diaphragm and cannot cough uninjured turtle out of harm’s way in with more than 300 species worldwide eggs. effectively, and their trachea is short the direction that it was heading may existing and almost half of these The sight of a turtle basking on a with complete tracheal rings, similar to save its life. To avoid risk of bite threatened by extinction. If we don’t birds. wounds from species such as intervene now, the subsequent loss of Their heart possesses three snapping turtles, using a shovel, car biodiversity and degradation of chambers, and their venous blood mat, or by attempting to have it ecosystems will pose significant threats drains from the pelvic limb into the clamp down on a branch to drag it to our future. kidney to form the renal portal system. off the roadway may facilitate The province of Ontario is home The anatomic distribution of their handling. to eight native species of turtles, which organs, specifically having lungs It is important that we never are listed according to their level of located directly under their carapace, remove a turtle from its home threat for existence (Figure 1). Noted makes them more susceptible to territory. Each turtle saved will make on the special concern list are the respiratory trauma after shell fractures. a difference, as less than 1% of eggs Snapping turtle and Northern Map Species differences aside, however, naturally survive to adulthood, so turtle. The Spiny Soft-shell, Stinkpot our approach to treating an injured every turtle’s ability to reproduce is (Musk) turtle, and Blanding’s turtle are turtle is similar to that of others, crucial. where an initial assessment, Globally, animal caregivers should Erika Sullivan, DVM, is a veterinarian in stabilisation including fluid therapy, contact wildlife rehabilitation centres small animal practice in Toronto. Her pain management, temporary fixation for information on similar primary interests include medicine and of fractures (Figure 4), and organisations and projects in their surgery of feline and exotic animal rehabilitation measures such as region. species, geriatric medicine and Figure 2. Motor vehicular accidents feeding-tube placement and wound We all share the planet, and since acupuncture. She is passionate about are the leading cause of turtle management, are possible. humans are mostly to blame for the promoting wildlife conservation and trauma, and can lead to extensive Even if a deceased turtle is decline in turtle populations, it only learning first-hand about the threats to carapace (shell) damage, as is shown presented for care, species seems sensible that we play an active species native to Canada. in this victim. preservation is made possible, as eggs role in being part of the solution! 28 EVENTS VP DECEMBER 2011 MAJOR veterinary and veterinary- www.vcf.org.uk (150th anniversary of the Royal 24th-28th July related events planned in the UK Netherlands Veterinary Association) 7th World Congress of Veterinary and overseas in 2012 include: 29th February-1st March RAI Exhibition and Conference Centre, Dermatology 1st ISFM [International Society of Amsterdam Vancouver Convention Centre, Vancouver, 14th-18th January Feline Medicine] International www.voorjaarsdagen.org Canada The North American Veterinary Congress www.vetdermvancouver.com Conference The Langham Hotel, Hong Kong 11th-15th April Orlando, Florida, USA www.isfm.net/conferences 55th Annual Congress of the BSAVA 4th-7th August www.tnavc.org with WSAVA and FECAVA American Veterinary Medical 1st-3rd March International Convention Centre (ICC) and Association Convention 26th-28th January 2nd World Veterinary Cancer National Indoor Arena (NIA), San Diego, California VPMA Congress 2012 Congress Birmingham www.avmaconvention.org Chesford Grange Hotel, Kenilworth Pullman Paris Bercy, Paris, France www.bsava.org www.vpma.co.uk www.worldveterinarycancer.org 20th-24th August 24th-25th April 13th ISVEE Conference: International 1st-4th February 15th-18th March 63rd Annual Conference of the Symposium on Veterinary 5th European College of Equine AAHA [American Animal Hospital Association for Veterinary Teaching & Epidemiology and Economics Internal Medicine Congress Association] Denver 2012 Research Work (AVT&RW) Maastricht Congress Centre, Maastricht, The Surgeons’ Hall, Edinburgh Colorado Convention Center, Denver, University of Nottingham Netherlands www.eceim.info Colorado www.avtrw.co.uk http://ecvph.org www.aahanet.org 17th-19th February 10th-11th May 26th August-1st September Veterinary Christian Fellowship 23rd-24th March Pig Veterinary Society Spring Meeting 16th International Veterinary Radiology Southern Conference Spring meeting of the Association of The Village Hotel, Solihull, West Midlands Association Meeting & EVDI Wycliffe Centre, Horsleys Green, Bucks. Veterinary Anaesthetists www.pigvetsoc.org.uk [European Veterinary Diagnostic www.vcf.org.uk Davos, Switzerland Imaging] Annual Meeting www.ava.eu.com 17th-20th May Bursa, Turkey 19th-23rd February SPVS Olympic Congress 2012 http://kongre.4yon.org or 84th Annual Western Veterinary 28th-30th March London Hilton Riverside, Docklands, www.evdi.org Conference Society for Veterinary Epidemiology London Mandalay Bay Resort and Casino, Las and Preventive Medicine Annual www.spvs.org.uk 29th August-1st September Vegas, Nevada Meeting 2012 38th Annual IVAS [International www.wvc.org Glasgow 21st-23rd May Veterinary Acupuncture Society] www.svepm.org.uk Sheep Veterinary Society Spring Congress 24th-26th February Meeting Radisson Blu Hotel and Spa, Galway, Veterinary Christian Fellowship 5th-7th April Harrogate, North Yorkshire Ireland Northern Conference European Veterinary Conference – www.sheepvetsoc.org.uk www.ivas.org Wigton, Cumbria Voorjaarsdagen 24th-27th May 12th-15th September ECVO [European College of BEVA Congress 2012 Two-day seminar on HR Veterinary Ophthalmologists] International Convention Centre, Birmingham Conference 2012 www.beva.org.uk issues at 2012 VPMA Congress Centre, Trieste, Italy http://ecvo.co/ 8th-12th September congress in January 18th International Veterinary THERE is to be a masterclass in recruitment, training and performance 3rd-7th June Emergency and Critical Care management at the annual VPMA congress in January. XXVII World Buiatrics Congress Symposium Sheila Roe Grosdidier and Mark Opperman, both of VMC Inc., a Lisbon Congress Centre, Lisbon, Portugal Grand Hyatt, San Antonio, Texas veterinary practice management firm, will be travelling from the US shortly www.wbc-2012.com www.veccs.org after giving talks at the North American Veterinary Conference (NAVC), to present a two-day seminar for the VPMA on what practice managers and 13th-14th June 23rd-27th September owners need to know to take their HR procedures to the next level. VET Trust Conference 2012 WCVA 2012: 11th World Congress of The sessions will cover the changing labour market, the latest recruitment Stirling Management Centre, Scotland Veterinary Anaesthesiology interview techniques, training plans, optimising team performance, developing www.vettrust.co.uk Cape Town International Convention Centre, financial compensation packages and implementing change. The final session Cape Town, South Africa will discuss ways to capitalise on opportunities and how to “future-proof ” the 15th-17th June www.wcva2012.com practice. 11th Congress of the European Sheila Grosdidier has been named the Speaker of the Year by the NAVC Veterinary Emergency and Critical 28th-29th September three times and has spoken at over 200 Care Society BVA Congress 2012 conferences globally; Mark Opperman has a Barcelona, Spain Venue not yet announced VHMA Lifetime Achievement Award and www.eveccs.org www.bva.co.uk has also previously been awarded Speaker of the Year by the NAVC. 13th-17th June 12th-13th October There will be two other lecture/seminar ISFM [International Society of Feline BVHA [British Veterinary Hospitals streams throughout the congress as well as Medicine] European Congress Association] Congress and AGM the usual full social programme. Budapest, Hungary Venue not yet announced The congress will take place for the www.isfm.net/conferences www.bvha.org.uk second year running at the four-star Chesford Grange Hotel near Kenilworth in 6th July 18th-21st October Warwickshire from 26th to 28th January. RCVS Day (including RCVS AGM) Southern European Veterinary Details are on www.vpmacongress.co.uk. Royal College of Physicians, Regent’s Park, Conference Prospective delegates can register on line London Barcelona, Spain and non-members are welcome. www.rcvs.org.uk www.sevc.info VP DECEMBER 2011 EVENTS 29 Faith in learning and the consult room THANK God it’s Monday. work in the field of serving our clients use of key performance indicators and at the beginning of a consultation Why do you go to work? What, and patients. developing links from the care in the when a great deal can be achieved how and why do you do your work? We have a privilege to work in such consulting room to the business and through proactive listening, taking time What is your work ethic? a noble profession in which we have qualitative indicators of performance. to gather the case history and client The Veterinary Christian Fellowship responsibilities of stewardship for This helped to illustrate which are concerns, and the results are more (VCF) is a relatively small organisation ethics, care, example, leadership, the most important approaches and effective medicine with better time in terms of numbers of members in money management and working with questions to ask clients in following up management. the veterinary profession, but it has real costs, connecting through cases, from a surgical operation such The vet-client consultation is a relevance to its membership and to the communicating with the emotional and as cruciate ligament surgery in the dog very complex process, and lots of wider veterinary community. practical needs of our clients and for an example which does have both things happen and have to be dealt The VCF decided to hold the first patients. We have the choice of short-term and long-term implications with in what is usually a 10-minute of a series of CPD meetings built on working purposefully and authentically. for the patient. time scale, or in some cases a 15- looking at what the Bible has to say Being embarrassed about what the minute period allocation. The skills about work, practice charges is a feeling that was needed are also complex and and exploring Dr PAUL MANNING explored in quite a few discussions, challenging, but the tools and evidence some topics reports on a recent meeting indicating a concern in this area from illustrated in real ways how these can that organised by the Veterinary the delegates, so it was interesting to be recognised, learned and improved. practitioners Christian Fellowship to look at hear that the discipline of following up a There was a great deal in this day are involved what the Bible says about work case of cruciate surgery which the vet of value to Christians and non and other aspects of our lives in for a large may have referred for a £4,000 Christians, vets, practice managers and part of their operation was not rigorously followed others involved in delivering care working lives. The first of these Choices and challenges up afterwards, but may be as a result of where people interact. Vet students meetings was held in a delightful venue So we do have choices to make, the greater understanding and would also find this very helpful as in Milton Keynes at the Cricket clinical decisions to make, and for appreciation of these issues from this consulting is a major part of most Pavilion with beautiful scenery and many practitioners we are day. practising vets’ days at work. surroundings, ideal facilities, communicating with these challenges The principles of consultation Acquiring a greater understanding refreshments and lunch. for at least half of our working lives. skills were illustrated with the use of of the complex interactions of ethics, After we had all arrived and I engaged the delegates in a structures in models of consultations business, people and clinical issues introduced ourselves, Brian Aldridge mixture of presentation, video so that the value of this professional here can be of significant benefit. (VCF president) started off the day demonstrations of live consultations, activity could be appreciated. Indeed, consultation skills are a unique with prayer, followed by some and interactive discussion during the It is challenging to be faced with selling point for the clinician, and are a interesting study of what the Bible has day about the skills we use and need in the issues of value for money when set of skills that cannot be delegated. to say about work. Work is what God the consulting room. doing such noble and valuable work, has called us to do for His Kingdom. The theme “From death to new but veterinary practice has always been Challenges and responses God is a worker who never tires. In life” reflected the various types of a business with bills to pay to sustain In Paul’s letter to the Thessalonians (2 our work we should be thinking about consultation, starting with the business and the service provided. Thessalonians 3: 6-15) we are warned what, how and why we do is a bereavement, through medical and against idleness. reflection of the glory of God because surgical consultations to the Relevance of the teaching We are told that some among us God has created us and given us this excitement of the new-born puppy or The Bible says a great deal about are idle busybodies, but we are responsibility after making us in his kitten and vaccination. money, and also about care and commanded to set an example and image. Handouts included biblical communication, e.g.: the parable of treat these busybodies as brothers and Brian discussed some of the references from Brian, and the the talents – use your money and skills to discipline them whilst we never tire complexities of the work ethic with PowerPoint presentation from me, wisely; the parable of the widow’s mite of doing what is right. reference to the Bible. Issues included together with a handout on – although this lady gave just a tiny Our focus should be sharp in our the divine mandate of work: God is a consultation models and some visual coin, she had given of herself because delivery of care through our worker and man also is a worker, aids for use in the consulting room that was all she had; the parable of the consultations. All our work is in vain if finding creativity, fruitfulness, meeting illustrating, for example, the effective shrewd manager – do good things and it is not for the Lord (Ecclesiastes). We his and his family needs and the needs dental recommendation. make friends whilst on earth, because have a wonderful mission in our of others through work, and finding Reflection was encouraged as much earthly people have great difficulty workplaces. protection from distractions. more than simply navel gazing, but understanding the ways of a higher Challenges in the workplace The greatest commandment is, needs to include a wide-ranging and purpose. include resourcing and explaining and “You shall have no other gods before in-depth review of “What is going on Among other examples: “A good integrating the business with caring me.” In working out our daily lives, here in the consultation?” man cares for his animals, but the through the consultations. work, ethics and morality, living in the The presentations and discussions kindest acts of the wicked are cruel” – Some clients refuse to pay for what fear of God is a challenge to us as we were designed to provide tools to use Proverbs 12: 10; “A good name is are reasonable demands for services together with an evidence base to more desirable than great riches: to be provided, and not all practice team Paul Manning MA, VetMB, encourage and stimulate reflection so esteemed is better than silver or gold” members play their part with the same MSc(VetGP), DProf, MRCVS, that the learning outcomes for the – Proverbs 22: 1; “He who answers strong motivation and commitment. graduated from Cambridge in 1979 delegates could be achieved and before listening, that is his folly and his Veterinary care is what vets and has been in practice for over 30 transported back home with them. shame” – Proverbs 18: 13. uniquely provide, and whether that is years. He reports that he has found Tools included in practice Modern research has shown that in small animal, farm or equine many blessings and also challenges in discussions about consultation skills there is a “golden minute” of listening practice, the vet has the important role being a vet with a faith. He has and communication aided and duty to use the clinical and non- researched professional development by a flip chart, video clinical skills wisely and effectively. and consultation skills through a recording of live Brian encouraged everyone to Masters and a Doctorate, and works consultations using reflect on how they could use the full-time in the small animal hospital practice he founded in 1986 in constructive critique, the learning from the day to practise their Newport Pagnell, Bucks. use of consultation faith and work together for the glory models and rating tools, of the Lord. 30 EVENTS VP DECEMBER 2011 What can the profession learn from the way the military works? IT came as a complete surprise commander knows his people, has is being adopted across all areas of when Major General Arthur more than a passing relationship with the company. Denaro spoke of the comparison them and is there to support them Sean Gilgallon and Helen between the troops under his whenever they need it. He said he felt Wiseman from CVS reported on a command during the Iraq war and that the CVS policy of local survey recently conducted amongst the running of practices owned by community practices was far more 750 CVS staff to try to establish how the CVS Group. effective than globally managing a stress was impacting the lives of its The General had been invited to single brand. employees and what we could do give the keynote speech at the end of His speech came at the end of the about it. The usual issues, common in the latest two-day annual CVS conference, which was generously most businesses, included lack of Lucy Rose from AVC Oakley receives the CVS vet of the year award from conference and there was more than supported by MSD Animal Health clarity in direction, poor Tim Davies, veterinary director of one sceptic doubting how his and Bayer, along with Petplan and, for communication and lack of CVS. experiences could relate to the the awards ceremony, Menarini, encouragement. veterinary profession. Warrens, NVS, PPI and Photon. The “mindfulness” approach, Indeed, at the start of his Earlier, the veterinary and nursing based on Mark Leonard’s work, will presentation be phased in across the company in he talked BRIAN POUND the coming months. The success of about the corporate development director this initiative is regarded as crucial to experiences of CVS, reports on the group’s enable the teams to work effectively of his distant latest conference where speakers together and to achieve the levels of relatives in discussed matters ranging from motivation necessary to achieve the Somme military strategy to workplace success. and other stress notorious Celebrating success battles. groups had attended a technical This conference, now in its seventh But all became clear when he got lecture on ophthalmology, provided year, with 300 delegates, celebrated onto the subject of delegation and by James Oliver, and a presentation the success of many staff with an Dani North from the Village Animal operation. CVS owns over 225 by Joy Howell on the subject of awards evening. These awards Hospital receives the CVS practice practices spread throughout the UK identifying feline CKD. recognised the manager of the year award from (plus six veterinary labs and a pet The managerial As the General practice of the year, Simon Innes, CEO of CVS. crematorium). staff, both from the said, you must vet of the year, nurse n Other award winners were: Each one retains its own identity practices and from the of the year and practice of the year – AVC Oakley; trust your men, nurse of the year – Louise O’Dwyer and is encouraged to maintain its support team had heard receptionist/practice trust the of Pet Medics; special achievement traditional values. It is the company’s about “Adding value”, manager of the year. award – Sarah Warren of Mildmay. intention that the staff at each presented by Bobbie adequacy of their All had been location regard themselves as part of Flight, and the social training and trust nominated by their of inviting the whole of the 2,300 the local team and not responsible to media from Robin them to achieve colleagues and voted CVS workforce. But he was sure the some greater power. Houghton of Egg Box their goal. They on by their peers. good spirit that prevailed was a Marketing. A final award for reflection of the care and compassion Make own decisions All the other did not need to special achievement that the CVS staff have for their This is where the comparison came in sessions concentrated be checked on completed the awards clients, their patients and their with the Army. It was a surprise to on team-working and every five ceremony and was colleagues. He added: “Although there most of the delegates attending the motivation with minutes and presented to Sarah is lots more to do, we are definitely conference, who in the main had no inspirational speakers neither did they Warren for her efforts heading in the right direction.” military experience, that each unit was such as Callum Blair in not only gaining her This final point was crystallised by left to make its own decisions about and Michael Ealand, an need to be told certificate in two presentations, one by Bev Panto how best to achieve the set goals. Anglo-Australian who what to do. dermatology whilst and one by Sarah Warren. There was no “high” command spends much of his time working full time but instructing them to conquer a local visiting and helping Australian also for setting up clinics across Dedicated mentors ridge or bluff. The men were well practices. multiple CVS practices to provide her Bev explained the progress she had trained, knew what had to be done services well beyond her host practice. made under the CVS new graduates but were then left to do it in the ‘Mindfulness’ training CEO Simon Innes, in scheme which had enabled her to safest and most effective way One of the subjects discussed at the commenting on the conference, said grow in skills rapidly in her first year possible. meeting was a new initiative what a pleasure it was for him to see and gain a broad level of experience As the General said, developed by CVS under so many professional and competent quickly through the use of dedicated you must trust your the auspices of the people participating enthusiastically in mentors. men, trust the adequacy health and safety and all the sessions. She even told the story of one of their training and HR teams in conjunction He made the point that seeing occasion when she had to face a trust them to achieve with Mark Leonard from these folks on a regular basis becomes tricky surgical procedure. She called their goal. Oxford University where even more difficult as the business her “mentor” for advice who They did not need a new method of grows so this conference gives him reassured her that she could cope. to be checked on every “mindfulness” training and the other managers a chance to But part way through the five minutes and neither has been developed. meet many more people and share proceedings she found her standing at did they need to be told Designed to help thoughts and ideas. her shoulder dressed in her evening what to do. people cope with the best (en route to dinner) just to give He also remarked stresses of the working Heading in right direction her the confidence that she really about how a good Mark Leonard. environment, the system His only regret was the impracticality could do it. VP DECEMBER 2011 EVENTS 31 An unforgettable experience for all who attended... THE WSAVA congress is a entirely appropriate in this the 250th celebration of all that is right with year of our profession and one which the international veterinary has seen the eradication of rinderpest profession. Vets from many nations from the globe. Achievements such as enjoy each other’s company, these show the power of the medical The congress ends – with Andrew exchanging ideas, sharing and veterinary professions working organises basic CPD across the Ash on the left of the front row, two technology and working together in together. region on topics such as “how to along from David Wadsworth, a co-operation for the benefit of all. The next challenge for OIE is perform a consultation” or urine former president of both the BSAVA and WSAVA. This spirit of togetherness and co- rabies, which takes an estimated 55,000 analysis. Every penny is well spent. operation was exemplified at lives, more than 40% of victims being The most striking thing about the sports TV (not easy to find) and a WSAVA/FSAVA/KAHA in Jeju, South under 15 years old. This may prove Asian vets that I met at this congress coach organised for transport. Korea, when 3,500 participants from difficult – the biggest source of human was their total enthusiasm for the I would estimate about 60 to 80 around the world (mainly Asia) infection is transmission from stray profession and craving for of us arrived to watch the game, only gathered for the 51st WSAVA. dogs, a reservoir of infection. Here, the knowledge. They simply soak it up. to discover that Korean TV had Jeju is an island of 550,000 worldwide veterinary profession can chosen to delay the match so as to inhabitants, a special self-governing have a huge Expensive education show highlights of the Korean grand province of In Korea, parents would expect to prix from earlier in the day. This is South Korea, ANDREW ASH pay 50-60% of their income on where the co-operation came in. president of the BSAVA, records located in the his impressions of a memorable educating their children through The non-English speaking bar South Korean WSAVA congress – with a little school and university – so perhaps staff and the Australian with the lap Strait, close to rugby thrown in for good this hunger for knowledge is top, without a word understood the province measure – on the South Korean understandable. between them, managed to set up a of Jeollanam- island of Jeju So, what of the Gecko bar and all feed to show the live game from the do. What was this international sharing and co- bar’s wi-fi, via the lap top, to the TV once an agricultural and fishing impact with vaccination programmes, operation? This screen. economy is evolving into a tourist controlling and identifying dogs, as well congress’s scientific ...a fantastic It was a hugely destination: the island has been short- as border controls and education. programme had some atmosphere and successful congress listed as a contender to be one of the These points were well made by serious competition, at great spirit with a fantastic new seven wonders of the world, as both Tomoko Ishibashi in her plenary least for sports fans in against the atmosphere and great well as being a UNESCO heritage site. lecture and Bernard Vallat, OIE the shape of the spirit against the The event was wonderfully director general in his videoed Rugby World Cup, the backdrop of a backdrop of a organised by the local committee and acceptance speech at the opening semi-finals of which beautiful island beautiful island and a what they may have lacked in ceremony. were played over the and a warm, warm, welcoming experience of organising events such as middle two days of welcoming people. It was an this, they made up for with collective Aiming for consistency the congress. people. unforgettable enthusiasm and dedication. In Jeju, it is The OIE is also turning its attention to Arriving at the experience for said that the camphor tree, Nocknamu, undergraduate veterinary education BSAVA stand with delegates and characterises the traits of Jeju people, with the aim that one day, standards England already on their way home accompanying people alike. shown by their diligence, practicality can be raised consistently. in disgrace, working the week with a I am very grateful to WSAVA and and endurance in adversity. I found it telling that Tomoko Welshman and positioned next to the the tireless organisers who put The congress involved some 250 Ishibashi identified lack of training New Zealanders, I knew I would together this unique event. lectures including the WSAVA award rather than resources as being the have to “man up”. n There were 1,500 vets and a total lectures and the WSAVA One Health limiting factor when it comes to disease A few parallels were quickly of 3,500 participants; the majority of award which was presented to the OIE control. Without an effective veterinary drawn between incomplete exhibition delegates were (925) from Korea and (Office International des Epizooties or profession, the control of disease such stand (which had been delayed by other countries with significant World Organization for Animal as rabies will never be achieved. customs) and the “non arrival” of numbers were Taiwan (98), Japan Health). Attending congresses overseas is England’s team at the World Cup. (89), Malaysia, China, Hong Kong This new One Health award is also a chance to network and I was The second semi-final clash between and Thailand. Speakers from the UK fortunate to meet the All Blacks and Australia was included Kathy Clarke, Dr Cecilia Lawson Cairns, a eagerly awaited, a bar located with Gorrel and Professor Michael Day. Scotsman and an RVC graduate who Preparing for the next congress has been working Andrew Ash writes: “My time at Jeju put into focus BSAVA’s hosting of the with tireless energy world congress in 2012, and made me determined to offer a congress that at and enthusiasm to once demonstrates our commitment to scientific excellence and our support for help educate vets in one another. Southern Africa. “Jeju reminded me of the two I am proud to say reasons why I love this profession – that the majority of the work and the people – and this is the funding that he what we will be celebrating next April Kate Ash, Andrew Ash and John Williams (the BSAVA receives via WSAVA in Birmingham when we expect more congress chairman) take some time away from the comes from the than 8,000 professionals to join us for congress to watch a little world cup rugby. BSAVA. He another record-breaking year.” 32 PARASITES VP DECEMBER 2011 Parasite control critical in keeping diseases out of UK VETERINARY practices are being The new rules are primarily designed to Erin Morgan asked by ESCCAP UK to provide protect humans, says DEFRA. (University of Bristol) feedback on their experiences There is concern that explained that one of At the meeting on parasites (from following the changes to the parasite harmonisation of the pet travel scheme the students had calculated that it left): Liz Abbott, Eric Morgan, control rules and regulations that across Europe will increase the disease would take the blood content of 21 Maggie Fisher, John Helps, Faith are expected to come into force on risks for the UK. It is recommended people to satisfy the nutritional Smith, Balazs Toth, Jackie Barber and 1st January 2012. The organisation that pets, before leaving the UK, are requirements of a human vampire. Anna Judson. can be contacted via treated for ticks and tapeworms with Moving on to tapeworms (Echinococcus [email protected] or via the treatment options on their return. The multilocularis), fox faeces contain millions (castor bean tick) is a common tick in website www.esccapuk.org.uk. number of animals going into of eggs. The urbanisation of foxes the UK and other countries and I. A meeting at Bristol of some 40 quarantine will drop. DEFRA offers a greater risk to the suburb canisuga (British dog tick) and I. hexgonus veterinary surgeons and nurses learned recognises that there is a real risk that dwellers than to country dwellers. (Western Europe) is observed on dogs that there will no longer be mandatory there will be confusion about the need Traditionally the surveillance of and cats. tick treatment and mandatory for treatment in various locations. foxes has been carried out by Overseas the brown dog tick tapeworm treatment is to gamekeepers but this work now needs Rhipicephalus sanguineus transmits be confirmed. Pet owners to be carried out in towns and cities. babesiosis. Dermacentor reticulatus has will have greater VETERINARY PRACTICE The fox is the definitive host with voles been recorded on dogs in Wales for responsibility and will need reports on a recent meeting called to being predated by foxes as the some years but is now known to inhabit to understand that parasite discuss the changes being made to the Pet intermediate host. south-east England. control is critical in Travel Scheme and their likely effects It is important to control The ticks typically attach to long preventing exotic parasites tapeworms in dogs. There is a 98% grass and bracken and hook into the and vector-borne diseases chance that dogs who visit endemic coat of warm-blooded animals where entering the UK. Europe for two weeks without they feed on blood. Diseases are Liz Abbott and Maggie Fisher of Thinking about rabies treatment will transferred from earlier ESCCAP UK (European Scientific John Helps of MSD Animal Health introduce Echinococcus. Of 3,534 dogs feeding sessions from Counsel Companion Animal Parasites) explained that here in the UK we will examined in the animal to animal and introduced the topic and explained the need to think more about rabies in the Parasite on the animal to man. Deer are activities of the organisation, which is future. move UK, 810 (14.9%) often found with tick funded by commercial companies and Throughout the EU wildlife is the The parasite is had ticks, infestation and the has branches in European countries. A main risk vector whereas domestic and travelling westwards although many increase in deer numbers film of the presentations is available on stray dogs are recognised risks in other from Eastern Europe. were small and may account for a rise in the web at www.keyskill.com. areas. Dog bites account for 99% of Praziquantel kills adult relatively risk from ticks in many human cases of rabies. The latent worms and daily doses areas. Background period from bite to disease is 3-8 weeks of albendazole will unengorged and An increase in animal Dr Balazs Toth from the AHVLA in dogs and up to 12 months in suppress the slow would go movements out of and ([email protected]) outlined humans. growing cysts. unnoticed by into the UK will increase the background that since 2000 750,000 From the bite wound the Lyssavirus Screening faecal owners. the risk of dogs and cats pets have been involved in the pet travels at 10cm per day before entering samples is a risk to being presented at travel scheme with about 100,000 pets the brain and is replicated in the spinal operators. surgeries with vector- going abroad each year. cord. The closer the bite wound to the Ticks and tick-borne diseases were borne diseases, according to Jackie The existing rules for citizens of brain, the shorter the incubation period highlighted by Faith Smith of the Barber of Liverpool University, who the EU require the pet to be with more rapid onset in children veterinary parasitology and ecology highlighted the difficulties of treatment microchipped, vaccinated, blood because they are often bitten around group at the University of Bristol. Ticks for leishmaniasis (protozoa) and sampled, six months wait and then the head. are found on dogs in each month of dirofilariosis (heartworm). Advice to issued with a passport certificate. This In the EU 700 bats have been the year but ticks have optimal activity prevent these diseases is essential. will be changed to the pet being identified with EBLV-1 and six rare at 17-20°C and survive for three to Leishmania infantum is transmitted in microchipped, vaccinated, 21-day wait Daubenton’s bats with EBLV-2 have eight years. Mediterranean countries by and then issued with a passport and been identified in the UK. Four human Two to three thousand eggs are laid phlebotomine sandflies. Humans are free to travel. cases of rabies infection have been that develop into six-legged larvae that infected by the sandflies, not from Full details of listed countries where confirmed in Europe. become eight-legged nymphs and then dogs. This is a disease of “tatty” dogs the rules apply and the rules for other A programme of vaccination in the eight-legged adults. With warmer, with a long incubation period of countries are on the DEFRA website. Serengetti has realised a dramatic drop wetter winters more ticks are found months eventually leading to death. in human cases, a dramatic drop further north in Europe. in dog cases and the return of Of 3,534 dogs examined African wild dogs that were in the UK, 810 (14.9%) previously wiped out. Further had ticks, although many information about this work is were small and relatively being collated and will be unengorged and would go published in Veterinary Practice. It unnoticed by owners. is feared that the new pet travel It is believed that only rules will encourage more dogs a quarter of the cases of to be brought into the UK with Lyme disease (Borrelia an increased risk of rabies. A burgdorferi) in humans (953 one-dose vaccination provides in 2010) are reported each adequate protection in most year and more sensitive dogs. means of diagnosis are Rabies pathogenesis (provided by John Helps of Laura Yeadon with information on ESCCAP. In consideration of bats, sought. Ixodes ricinus MSD Animal Health). 34 WELFARE VP DECEMBER 2011 Many pet owners ‘still don’t understand’ “IMPROVED animal welfare The “preventers” group contains health and welfare they don’t see the need cannot be achieved by constantly all of those whom veterinary and find out if the for it. So how can they preaching to the converted. The practitioners would regard as their pet-owning public are be persuaded that they profession must find a way to bonded clients. But it also includes aware of what they are mistaken? “We can contact those pet owners who those who may seek veterinary care should do. write any number of don’t understand their but have no great loyalty to any one “It is clear that articles and try to get responsibilities to their animal and practice, and those who will buy flea there is a significant them published in never visit a veterinary practice,” and worming products from other population who don’t newspapers and says NOAH’s chief executive, Phil sources, such as pet shops. understand what is magazines but they will Sketchley. Mr Sketchley argues that from a expected of them. It be mainly read by This is the main message from welfare viewpoint it is largely is no good throwing people who are already the latest survey on pet owners’ irrelevant where the pet owner goes the Animal Welfare interested in this attitudes towards the health and for preventive treatments, as long as Act at these people. NOAH’s Phil Sketchley. subject. But that doesn’t welfare of their animals, a repeat of a they receive good advice. Issuing threats is not mean efforts to educate study conducted four years ago. Pet shop staff trained as Suitably the way to do it, we need to these people are pointless,” he says. Vets and the broader animal Qualified Persons are much more communicate the benefits of Since the first survey in 2007, health industry can take some likely to provide that service than the properly addressing the needs of NOAH launched its Pet Health satisfaction from the strong friends and family of the client, or their animals.” Information website as a source of commitment to preventive healthcare internet websites of unknown Mr Sketchley suggests that all pet unbiased, independent information on shown by many respondents in these provenance, he points out. owners probably believe they are all species. difficult economic times, he says. looking after their animals well and But some trends were Concentrate efforts would resent being told that they are Keep on trying... disappointing: the survey has It is the “non-preventers” group on not. He suspects that the root of the The new survey showed a satisfying confirmed the existence of a large which all those with an interest in problem is that most “non large number of pet owners have used population of pet owners who don’t promoting animal health should be preventers” have not grown up with the site, including many people who provide the pets with basic protection concentrating their efforts. pets and have not absorbed the wouldn’t read those information against disease – and the recession Veterinarians, NOAH’s member necessary lessons as children. sources traditionally targeted by vets has made them even less likely to companies and all those providing Obviously, the goal should be to and the animal health industry. But care. pet care advice must take on the educate these pet owners before they there are still tens, possibly hundreds, The NOAH study divides the pet- challenge presented by people like buy their animals but in many cases of thousands of pet owners who owning population into two groups – those in this group in the survey, one they are bought on impulse or in haven’t got the message, he says. “preventers” and “non-preventers”, third of whom never visit a vet, Mr situations where parents cave in to The only solution is to keep on according to whether they have Sketchley says. “pester power” from their children. trying and this has to be a shared arranged for their animals to receive “We didn’t commission the survey Too often such owners will acquire responsibility. “No one has a magic vaccinations or wormers during the because we want to sell more pets that are unsuitable for their wand – there are only limited past two years. medicines, it was to promote better particular situation and it would be resources available for this sort of better if they could be persuaded communications work and so we have CHANGES TO PETS – from previous page against getting an animal in the first to work together.” Oral treatment over months is Prevention of insect bites is place, he says. He urges all practices and available, is expensive and may provide essential with insecticides plus companies to support initiatives like clinical improvement but does not preventive medication. If a dog has Don’t see the need... National Pet Week. He recalls a recent eliminate the parasite. previously been to an at-risk area, it is One of the key insights from the visit to a veterinary practice which has advised to test for microfilaria. survey was the finding that many opened up the building for Keep dogs indoors The Virbac Canileish vaccine is “non-preventers” don’t see the need presentations on different veterinary Most cases in dogs in the UK are where available abroad but the third dose for vaccinations because they haven’t services – surgery, nutrition, grooming the dog has lived abroad, for example needs to be given in the UK and a heard of anybody whose pet has and skin care, laboratory science, etc. where the owner has a holiday home. preventive dose for animals going back experienced that particular disease. “I was interested to see that the Sandflies are silent (unlike mosquitoes) abroad. Mr Sketchley compares this practice had taken pains to highlight and are active from dusk ’til dawn. Anna Judson of Camlar Vets in response to those who insisted that the investment it has made in the The advice is not to have the dog Welshpool and Maggie Fisher vets and the animal health industry equipment needed to look after with you outside in the evening or to proposed the need for a “pet travel had exaggerated the threat to livestock clients’ animals. That is one of the sleep outside. There is no vaccine so champion” within veterinary practices from bluetongue, rather than praising issues we face. repellents and insecticides including to run pet travel clinics and to generate the effectiveness of the vaccination collars are essential. newsletters and reminders to pet campaign. Challenge for the profession Collars need to be applied at least owners. Unlike the bluetongue virus, there “We are lucky to have the NHS in one week before going to an at-risk Owners are likely to need advice on is clear evidence that parvovirus is still this country but it means people have area and need to be removed before the pet travel rules for their particular present in Britain. Regrettably, it may no idea of the real costs of swimming to protect aquatic life. travel areas. only be when there is a local outbreak healthcare. Even when they have to Renewal is normally required every 5-6 A range of leaflets and other and they are sitting in a crowded pay a prescription charge that is only months. resources are freely available from veterinary practice waiting room to £7.40, which is less than half the real Heartworm (Dirofilaria immitis) is Laura Yeadon at ESCCAP. Within the have their dog vaccinated that these cost of a typical medicine.” spread from mosquito bites with an website, guidelines for treatment and people will acknowledge that they He adds: “In the survey, even the incubation period of several months control are available and a search by can’t rely on other pet owners in ‘preventers’ were complaining about before clinical signs. country and parasite with parasite maintaining herd immunity to protect how expensive they think veterinary Treatment is difficult and expensive distribution maps will be useful. their own unvaccinated pets, he says. care is. It is a challenge for the whole with complete rest and hospitalisation The site has a pet owner and a Mr Sketchley doubts whether there of the profession to engage with including therapy for ongoing heart professional section. Anyone with are any pet owners who would their clients – and those who should failure. Surgery may be required to ideas for better advising pet owners is deliberately set out to give their pet a be their clients – to show them that it remove the worms. invited to contact ESCCAP. poor standard of care – it is just that is value, not price, that matters.” Vexatious complaints Paperless registration of VEXATIOUS complaints, or spiteful complaints, are a sufficiently well- recognised occurrence to be recognised in law in our country. I am sure you all microchips now available have spent hours pacifying irate pet owners who later admit they over-reacted AVID, which manages the UK effective. greatly. PETtrac database for microchipped The firm hopes this will encourage Reasons given for such over-reaction include that pets are helpless (being pets, has launched an enhanced veterinary practices and rescue centres unable to complain themselves), or that the owner lives alone and relied on the registration service on its website, to use a paperless system when companionship of the pet, or that the owner considers the pet a human designed, it says, to make registration registering microchips. companion, quick, easy, efficient and highly As part of the system, all etc., etc. Dr MARTIN BRIGGS microchips registered are checked to of Newlands Veterinary Clinic, These Directory of rescue ensure they are valid numbers and that “reasons” Cape Town, wrote this piece for the South African Veterinary organisations they were sold to the organisation allow the pet Medicine Journal earlier this year registering them, and the built-in owner to and believes it will be of interest on website postcode software has been improved temporarily to UK readers MIRANDA Luck, a veterinary nurse to be able to re-use more details, so and artificially who has spent the last 18 months that registering a litter will take less raise the value collating data on all UK organisations time. of the pet in their eyes and fire off a complaint at you, or to the Veterinary involved in animal rescue and rehoming, Customers with supporting Council. This tendency to over-react has been recognised at Parliamentary level reports that her Rescue Review website practice management systems can to the extent that vexatious complaints are legislated against in the Animals (www.RescueReview. co.uk) now register microchips directly from their Protection Act no. 71 of 1962. includes a directory listing over 2,000 software using VetXML and VetEnvoy. If you Google this, you will see that Section 9 relates to “vexatious rescue organisations. For details contact AVID on 0800 complaints” and stipulates that “if the court is satisfied that any person or body The directory is searchable by 652 7977 or e-mail [email protected]. has without reasonable cause and vexatiously lodged the complaint that led to postcode, species or such trial, it may award costs including attorney and client costs on the region. magistrate’s court scales against such person or body”. The aim, she says, Empathy in dealing with such complaints as well as the passage of time assist is to improve animal in settling the matter and the pet owner often realises their anger is misdirected. rehoming and to However, occasionally a complainant needs to be made aware that their determine the success complaint is indeed spiteful or “vexatious”. of the efforts made It would only be fair if similar retribution, as is provided for in the Animal’s by those involved in Protection Act, is available in our veterinary law as well. Only when over-reacting rescue/rehoming and wishes all readers a very pet owners are made to cough up for wasting everyone’s time will these folk adoption by think twice about being vexatious. gathering and happy Christmas and a n Reprinted with permission of the South African Veterinary Medicine Journal (VetMed) collating numbers of peaceful and prosperous 2012 Journal Feb/Mar 2011. animals processed. 36 WELFARE VP DECEMBER 2011 Exposing compassion fatigue COMPASSION fatigue is not a new n Bottled-up emotions. When you lack making it more difficult to stay on task loving and caring people suffer from topic in veterinary medicine: it has the space, time, or inclination to release or complete your tasks. compassion fatigue – the very people been talked about before. Yet how your emotions, you stuff them down n Prone to accidents. Your diverted who are so vital to the animal-care field many of us today would admit that until you are all filled up. Eventually you mental energy increases the risk of (Figley and Roop, 2006). we suffer from compassion fatigue? will burst, and this may be in your making mistakes, both medical and The first step is to understand and Whether you are the family workplace or your home, making physical. accept the emotional strain that is part veterinarian who is now saying innocent bystanders the victims. When you clock out at the end of of our career. We must recognise the goodbye to puppies and kittens you n Impulse to rescue anyone (or the day or shift, your compassion toll it takes on us daily, yet also first met 10 or 15 years earlier when anything) in need. Those of us who fatigue isn’t left behind in your locker. It recognise our great potential to you entered the profession, or you are have a house full of rescued pets can follows you home, and affects your overcome or minimise its effects. the emergency clinic technician who certainly relate to this impulse. It can relationships with your We understand and must say goodbye to many patients all happen in our spouse or partner, accept that sadness and in one day children and friends, The first step is to pain are a part of our after barely KATHERINE DOBBS and ultimately understand and job. We begin to getting to introduces a new series looking decreases your overall accept the understand that our know their at how ‘mental fatigue’ can quality of life. feelings of anger, affect the way we work and emotional strain families, or These are just a depression, and sadness other aspects of our lives, the that is part of our you are the signs to look for, and the need to few of the ways that career. We must are best dealt with if we front office learn how to cope with it compassion fatigue recognise them and allow team member affects us at home: recognise the toll them to wash over and at a specialty n withdrawn, it takes on us past us. We recognise our practice who faces the brunt of personal lives as well, when we attract n decreased interest in daily, yet also incredible potential to emotional eruptions from clients day in those who are needy and whom we feel intimacy, recognise our help animals. We ARE and day out, we are all susceptible. we can help. n mistrust, changing the world! Experts agree that the more you n Isolation from others. You may feel n isolation from great potential to (Fakkema, 1991). know about compassion fatigue, the yourself drawing back from people at friends, overcome or What can we do better prepared you are to recognise it work or at home, wanting to be alone in n impact on parenting, minimise its about compassion and cope with its effects. Compassion the midst of your negative swirl of n projection of anger effects. fatigue, aside from is defined as a deep awareness of the emotions. This walls off those who or blame, leaving the profession suffering of another, coupled with the want to help, even if they could. n intolerance. and giving up the careers wish to relieve it (Figley and Roop, n Sadness and apathy. It may be easy We chose this career because we are we love? We have to fight back, on a 2006). for you to recognise when you feel sad, compassionate, caring people. personal level, and an organisational Fatigue is defined as the mental but less obvious and more dangerous Unfortunately, that also makes us more level. We can make a difference, in our weariness resulting from exertion that can be apathy. This is particularly true in susceptible to compassion fatigue. If we lives as well as the lives of pets and is associated with attending to the the professional setting, when you may had no compassion, we would not have families. emotional and physical pain of others no longer be able to deliver the to worry about the fatigue. More to come next month in this (Figley and Roop, 2006). Combined empathetic client service and team Only compassionate, empathic, series on compassion fatigue… together, compassion fatigue has been support that is so necessary in our called the hurt of the heart (Ogilvie, profession. 2006). n Need to voice excessive complaints Win a spa pampering session Let’s look at symptoms of about management and co-workers. Whilst your clients are enjoying the best in skin care, how about you? compassion fatigue so we can Displaced emotions can result in anger Virbac Animal Health is offering readers the chance to win a skin recognise the condition when it may be or dissatisfaction that manifests itself pampering session at a top spa, worth £200. And if a spa day isn’t your thing, staring back at us from the mirror: through complaints about those around what better way to earn brownie points and treat that special loved one by you. This can put your career or giving her (or him) the gift of your winning vouchers! Five runners-up will each receive a box of luxury chocolates to indulge in. Katherine Dobbs, RVT, CVPM, PHR, position at risk as well. All you have to do is correctly answer the following three questions and e- began as a registered veterinary n Lack of interest in self-care practices. technician in 1992. In 2006 she You may know what you need to do to mail your answers to [email protected]. Put “Veterinary Practice Spa became a Certified Veterinary Practice take care of yourself, but you lack the Competition No. 1” in the subject line, and include your name and contact Manager (CVPM) through the interest or motivation to really do those telephone number in the e-mail. Veterinary Hospital Managers things. These are typically the things that 1. In acute flares, when pruritus is not Association (VHMA). Also in 2006 she could help us the most in fighting complicated by infections, what should be founded the Veterinary Emergency compassion fatigue! used for treatment? 2. Why are essential fatty acids not suitable and Specialty Practice Association n Recurring nightmare and flashbacks. for management of acute flares? (VESPA). In 2008, she created If you’re having bad dreams about InterFace Veterinary HR Systems; 3. In the management of chronic cases of work, or reliving particularly bad became a Professional in Human AD, what are the mainstays of treatment? Resources (PHR) in June 2008, and a moments or events while awake, this Closing date for receipt of entries for Compassion Fatigue Specialist in 2009. could be a sure sign that you are competition No. 1 is midnight on 12th January 2012. Entries received after She has been published in various reaching your limit. this date and time will not be included in the draw. The first correct entry professional journals in the United n Persistent physical ailments. You drawn at random will receive a voucher worth £200 for a pampering session States and Canada, and has published may have nagging ailments that don’t at a Champney’s resort of his or her choice. Five runners-up will each receive two books through AAHA Press. ever seem to disappear. They may not a box of luxury chocolates worth £10. Katherine was voted the 82nd Annual be enough to keep you home from A full list of the terms and conditions is available from Western Veterinary Conference work, but they make it more difficult to [email protected]. Practice Management Continuing get through the work day. Educator of the Year in 2010. She can n Virbac would also be pleased to hear of any Cortavance success stories n Difficulty concentrating, mentally be contacted at readers may have. If you would like to share them, please include details tired. Carrying all of that emotional [email protected]. in your entry e-mail. baggage can wear you out mentally, VP DECEMBER 2011 BEHAVIOUR 37 Empathy, patience and ‘people skills’ needed “REALLY your job is dealing with the ability to listen to whatever is said, said life was easy? owners,” commented a delegate no matter how infuriating or during a break at a recent distressing, in a totally non-judgmental First opinion vets bear an behaviour meeting. Never a truer manner, no amount of knowledge or awesome responsibility statement was made. range of other skills will count. Before we get there, however, we do The most common reason for Often people make mistakes and sometimes have a problem. arranging a behaviour consultation can animals pay the price, but that’s life. Responsible companion animal be summed up in a single word: And unless we can accept this without behaviourists work only on veterinary “desperation”. Statements like “There any negative comment – in modern referral, and as veterinarians we would is nothing left to try” and “We’re at parlance perhaps “get over it and never see a behaviour case without the the end of our tether” frequently move on” – we are no good to first opinion colleague’s full appear in pre-consultation anyone. This can be challenging. knowledge and consent. Therefore, questionnaires, leaving little doubt Not uncommonly, in the welfare what happens initially is crucially No matter what mistakes owners have made, non-judgmental about the terminal nature of these interests of the animals one might feel important. attitudes are necessary in both the situations. Admittedly some clients say inclined to bang heads together but if What if someone who has veterinary surgery and behaviour “We want him/her to be happy” but that becomes obvious our chances of struggled with it for years finally consultation. that doesn’t mean they haven’t also helping at all may plucks up the courage to raise their reached crisis pet’s behavioural issue only to meet point. FRANCESCA RICCOMINI with disapproval or, worse still, clearly discusses the qualities needed by It should stated blame? both veterinary surgeons and never be behaviour counsellors, including They may be able to stand their assumed, the need for non-judgemental ground and insist they get help, but however, that attitudes, if consultations are to what if they are not? Quite possibly clients whose succeed the first and last chance for us patience has collectively to help this animal is lost. finally frazzled will not do their well evaporate completely. They may soldier on with damndest to consistently and So no matter how unrealistic, compromised lifestyles and effectively implement a behaviour unfair or just plain stupid people have relationships until Fate intervenes but programme once diagnosis is made, all been, we simply must maintain an they may also now throw in the towel contributing factors identified and attitude of unconditional positive and simply give up their pet. potential remedial measures agreed. regard. We are, after all, quite possibly it could also sabotage our one chance More often than not they will the one remaining advocate an animal An effective collective to reach out to people who are swiftly work their socks off. They have so has or the single ally of the only effort is needed reaching the bottom of the slippery much to lose and few, if any, owners household member who still values Clearly then, despite the supreme slope that ends in relinquishment or are going to set aside time and pay the pet and wants to carry on with it. effort and strength of character often euthanasia. fees (the excess if insured) unless they needed, for first opinion vets bland In this context, therefore, care about their pets and want to Enlisting the support of expressions and non-judgemental whatever our role, dealing sensitively make a success of their relationship. disenchanted owners is attitudes are also the order of the day. and well with people is not an But by the time we see them, they challenging but necessary It is never appropriate to tell owners optional extra. Rather, it is an are in a bit of a state to say the least. It’s never easy trying to win everyone “it is their fault”, as boldly stated on a essential requirement without which They are stressed, upset, frustrated over – an essential requirement if a clinical history I recently saw. none of us is going to be an effective and often, as clearly articulated, “at programme to resolve the problems is It may be true, and saying so may advocate for the troubled animals breaking point”. to have any chance of success. momentarily make us feel better, but under our care. Many also feel complete failures It may well stretch almost to and are embarrassed because other breaking point one’s hard-learned people seem to do so well at this pet- skills, powers of active listening and Entrepreneurial award finalist ELVINA Pittaway of Broad Lane Vets of owning lark. So yes, this being a ability to charm, smile and keep silent Coventry has been named among the finalists in “make or break” situation, in the face of immense provocation. this year’s NatWest Everywoman Awards, which tremendous patience plus sensitive Maturity and a wealth of life are given to honour British entrepreneurial handling is absolutely essential – and experiences can be helpful but success. that’s before we come to the troubled “people skills” are definitely needed if She has been nominated for the Demeter and troublesome dog, cat, rabbit or we are to be any use to the animals we Award for the most inspiring businesswoman parrot! want to help. And without doubt, we aged between 26 and 35. The winners are to be must like people. announced in London on 7th December Listening non-judgmentally After all, despite their apparent Miss Pittaway, who graduated from is crucial culpability in messing up their pets or Liverpool in 2000, acquired Broad Lane Vets, This highlights one of the essential failing to act well when life does that the practice in which she worked, and has skills of counselling, whatever the for them, people are the essential expanded it into two successful clinics. species it aims to help. Empathy is, of conduit through which we can effect According to the award organisers, “Having assessed the considerable course, hugely important, but without change. financial risk and commitment, Elvina proceeded to use her savings, secure a Without them on board, no matter bank loan and remortgage her home in order to fulfil her ambition. Broad how well-qualified and highly- Francesca Riccomini, BSc(Hons), Lane Vets was a respected community veterinary practice, but Elvina’s vision BVetMed, CCAB, MRCVS, motivated to do a good job we are, we enabled her to take the business to the next level... In little over three years, DipAS(CABC), is a certified clinical remain essentially useless. Our aims Elvina has grown her team from 21 to 30 staff, has purchased a new branch animal behaviourist, a member of the will remain unfulfilled and the animals surgery, entirely renovating the premises, and has upheld new client figures Association of Pet Behaviour we are dedicated to serve will struggle thanks to her passion for customer care.” Counsellors and the Feline Advisory on with compromised welfare in n The NatWest Everywoman Awards were founded in 2003 “to showcase the Bureau’s Expert Panel. She also lectures unsatisfactory conditions. and writes extensively on companion variety of female business role models, celebrating their success and inspiring OK it’s hard, but as counsellors we animal behaviour. future generations of entrepreneurs”. For details see www.everywoman.com. know it must be done – anyway, who 38 INTERVIEW VP DECEMBER 2011 Growth based on new range of generics IT may seem a long way from forward and wanted to look at more animals. school teacher to managing simple business structure. We are a relatively small company director of an animal health As part of the new management but we have a relatively large office business, but that’s the path that team we were tasked to find an staff because of the database that we Stephen Wildridge’s career has independent future for the then Genus run for Identichip and other brands of taken. Animalcare Division of which pet identification microchips. We have The man who now heads one of Animalcare was a part. So Genus almost 20 people dedicated to running the UK’s fastest growing veterinary concentrated on animal genetics and this database. companies, Animalcare, began his we looked at developing the animal At present we are under- working life as a teacher of A-level health division. warehoused and over-officed; our base physics, chemistry and games but, as From the start it was clear that is over 30 years old and we’re looking he jokingly puts it, finding that he had Animalcare was a good business but for the right place to move to. become allergic to children, in 1979 he by 2003 it had lost its way and there Hopefully within the next six months turned to the applied life sciences, wasn’t a good idea on what it could do we will move: staying in the York area joining first Albright and Wilson, then or what it should do. but in a place better suited to what we moving on to May and Baker, part of From the very start we established want to do. Stephen Wildridge. Rhone Poulenc. Mr Wildridge spent 16 JA. Just how big is the business? in Europe. years with that company, JOHN ALBOROUGH SW. We turn over about £12 million a Equally we looked for partners for chats with Stephen Wildridge, the MD of 10 of them overseas in a year and we have approximately 54 example in Germany, France and one of the country’s fastest growing variety of roles in various veterinary supply companies employees, though not all of them are Benelux, who were looking for parts of the world, full-time. We have six local ladies who distribution for their products in the including Brazil, France input the registration forms for the UK and so we have a quid pro quo in and Canada before being seconded to a strategy of growth for Animalcare microchips into our database as home- working with those companies. the World Bank for a year in based on the development of a new work. Not only do we have distribution Washington DC, helping the bank range of generic veterinary medicines. On the distribution side, we have agreements with our European establish policy on pesticides and This was so successful that between 14 sales reps in the UK, a marketing partners, we also have development genetically-modified crops in 2005 and 2008, as Genus divested team of four, customer services team agreements. We jointly develop developing countries. itself of its non-core business of three and four products, then they From there he joined Monsanto as including all the other businesses of its warehouse people. ...we launched six take the products for director of business development for animal health division, Animlacre was new products last their markets and we its global wheat team based in retained. JA. Do you have year and have the take them for ours. Brussels, looking firstly at GM wheat However, as Genus Group sought partnerships with other capability of This not only in Europe before being to pay down debt companies? reduces our costs and appointed general ...after averaging following its SW. In 2003 we laid launching as many risk, it also means our manager of Monsanto’s more than 95 acquisition of Sygen in out our strategic plan again this year. capabilities to develop agriculture business in flights a year in January 2008 we were for the business. We and introduce new northern Europe and the previous five acquired or merged, if did a thorough analysis of our veterinary medicines are much bigger then director of years, it became you will, with Ritchey strengths and capabilities and the than you might expect for a small UK business development plc, and the group was market opportunities that were company. for EMEA – Europe, clear I needed to renamed as Animalcare present. In real terms we are able to be in Middle East and Africa. see more of my Group plc and the In very simple terms we looked at the process of developing and And then, he says, family”. combined businesses whether we wanted to be in pet foods, registering three new generic products “after averaging more floated on the AIM diagnostics, nutrition, veterinary at any one time. than 95 flights a year in stock market in equipment and medicines and we Since it takes around three years the previous five years, it became clear London. decided that generic veterinary from first concept to first sales, that I needed to see more of my family”. Initally I continued as MD of medicines was the way forward for us. means we should be able to launch So on 1st April 2003 he joined Animalcare Ltd and became CEO of The cost and time and expertise perhaps two new products each year. Animalcare, then part of the Genus the group in April 2010; after further required means that developing a As a result of our joint Group, as managing director. The firm rationalisation, the Animalcare Group brand new veterinary medicine is a development and distribution is based in Dunnington, York, just 20 is now entirely a veterinary supplies world-wide game. programme with our European miles from where he was born in the business. With the harmonisation that has partners, we launched six new small coal-mining village of Since 2003 Animalcare has been gone on with regulatory systems in products last year and have the Featherstone. working towards being essentially a Europe, however, developing a generic capability of launching as many again sales and marketing company which medicine means you can actually this year. That’s far and above what we JA. Who, or what, is Animalcare? supplies professional goods and develop and register your product for could do on our own. SW. It’s a company that has been services to vets and the UK market and It is unlikely that there is any other around since 1988. It was the specialist other veterinary with a little extra effort company in the UK which will have products division of the Vet Drug professionals. and cost it’s applicable introduced as many new products in Company that was established by a Our focus is on in the whole of the UK either last year or this. group of Yorkshire vets in about 1956 companion animals Europe. It becomes and eventually bought by the Genus and our development potentially a pan- JA. Do you contract out your Group in a hostile takeover in 1997. in the future will be on European venture. manufacture? It would be fair to say that the old companion animal In 2003 we set out SW. Yes, the quip is, “We make VDC businesses struggled under medicines. We do make to find partners who nothing but money.” We manufacture Genus and by the time I joined in and sell large animal wanted to distribute nothing within Animalcare. We 2003 Genus wasn’t sure what it wanted products and that our new generic contract out formulation development, to do with the businesses and its sector is important to medicines that we had stability testing and development shareholders and investors were saying us but our focus is developed for the UK studies and manufacturing. that conglomerates weren’t the way mainly on companion Torben Orskov. in their home markets With the exception of the product VP DECEMBER 2011 INTERVIEW 39 development management, sales and JA. What is your view on the current trying to hold our own with our old products based on our IP and that marketing, we act as a “virtual” state of the market? products. could be formulation or more likely company for many aspects of the SW. Neither the companion animal I think we will grow quicker than molecules new to the veterinary business process. segment nor the livestock segment is the market overall as we have done for market. So when you ask the immune from the world around us. several years. Because of our new question, “Why should the vet buy JA. If a vet in practice has a query or The livestock segment is driven more product pipeline, I think we will from us?”, we believe we will have a concern about an Animalcare by economic factors affecting continue this trend for the next few even more reasons in the future. product, who provides technical agriculture which are somewhat years. assistance? detached from the direct effects of JA. And your family? SW. That is an area the recession and JA. And the next stage? SW. I have two grown-up children, a where we have always We have seen credit crunch that we SW. Our next steps will be to take son and daughter. My son is in his been and still are very some elective are now seeing our development away from simple final year of a history degree and is much a regular business. treatments that affecting the generics into what we call “enhanced unsure of which direction his career As with most small companion animal generics” – older veterinary products will take while my daughter is a vet companies, we have a might have been segment. where we have been able to apply who qualified from Glasgow in 2008. number of people who done two or three But this segment new technology to improve their She practised for a couple of years are experienced and years ago now not is quite resilient and utility and sometimes clinical but is now back at university studying multi-talented across the being done. will resist its effect performance. to become an MD on a path that I board. more than some areas The next phase will be to develop think is leading to research. Our director of sales, of the economy. Kevin O’Brien, for example, has been We have seen some elective Applications sought for animal welfare in the business for over 20 years and treatments that might have been done has a vast practical knowledge and two or three years ago now not being student scholarships experience. done. Clients may not keep up as THE Universities Federation for Animal Welfare (UFAW) is inviting Torben Orskov, who heads our closely as they might wish with, for applications for its 2012 Animal Welfare Student Scholarships. technical department and regulatory example, the vaccination regime for The aim of the scheme is to enable students to pursue their interests in department, is a veterinary surgeon their pets. animal welfare science by providing opportunities to undertake research in who has many years of experience When the family pet dies, it may this field or other, for example educational, projects. from being in practice and each of not be replaced quite as quickly as in Projects must be relevant to improving the welfare of farm, laboratory, our two product managers has been in recent years. But when the upturn companion, zoo or free-living wild animals whose welfare is compromised by the business for over 20 years, so they comes I believe that the market will human factors, and may be carried out within the UK or overseas. Successful have the knowledge and capabilities to respond rapidly. applicants will receive up to £1,600 to cover subsistence and project expenses. give technical recommendations on I also believe Animalcare will Further information and application forms can be obtained at the UFAW our products within the legislative continue to do well as we are website www.ufaw.org.uk, “grants and awards page”. Closing date for framework of the industry. introducing new products and not just applications is 28th February 2012. THEATRE Two stories aired again on the big screen JOHN Le Carré’s super spy, George but I did feel that, unusually, I enjoyed (writing as Hergé) have delighted some rearrangement of the plot but it is Smiley, must be the most fascinating the film far more for knowing the story children and adults for over 80 years well done and I could go with it. fictional secret agent of all and yet he already due to the movie’s limited time since the reporter’s first comic book The story is delicately handled and has featured only uncommonly on for detail of plot and characterisation adventure, TinTin in the Land of the Soviets, the TinTin anoraks amongst us could screen. compared to that which could be in 1930. delight in the various homages to the Smiley’s most famous adventure, achieved in the longer television series. There have been two main television canon that are sprinkled throughout the Tinker, Tailor, Soldier, Spy, was adapted for This view was confirmed for me adaptations of the books, the better one story, perhaps the best being when an television by the BBC in the 1980s at being the very faithful Canadian/French important clue is scrawled on a copy of a time when its Cold War setting was Dr COLIN ROBERTS production by Ellipse and Nelvana that Le Petit Vingtième, the children’s still of immediate relevance, the has been to see both Tinker, Tailor... presented 21 of the 23 complete newspaper supplement in which TinTin seven-part series first airing around and the first in the TinTin trilogy adventures (a 24th, TinTin and Alph-Art, first appeared. the time of the unmasking of and found both of them to be better remained uncompleted when Hergé died Performance capture is seen at its Anthony Blunt as the fifth of the than expected, with much to enjoy in 1983). TinTin has had a few outings best in this movie, carrying the beloved infamous “Cambridge Spies”. on the big screen but none so far has style of animation just the right degree The series was a big hit if somewhat when my son, who has not seen the BBC exactly set the world on fire. towards real life without losing the charm controversial on account of its complex version, said that he had enjoyed the The Adventures of TinTin: The Secret of of the original. TinTin translates into this plot. A superb cast featured Alec movie but had wanted to know much the Unicorn represents the latest cinematic format perfectly and if the faces of Guinness as Smiley, Michael Jayston, Ian more about the protagonists. incarnation for the intrepid reporter. Captain Haddock and Snowy (TinTin’s Richardson, Beryl Reid and Hywel Some stories are so long that a single Directed by Stephen Spielberg, produced faithful fox terrier, in case there is anyone Bennett, to name but a few. movie cannot do justice to them, and this by Peter Jackson (Lord of the Rings) and who does not know) did not look quite This is a truly hard act to follow and is probably one. Tinker, Tailor is a good adapted for screen by a team of British right for me, I was able to forgive this in I was only persuaded to give the new big movie and it is worth seeing, but if you writers, including the outstanding Steven the overall quality of the presentation. screen version of the story a chance in want the fuller picture, watch the BBC Moffat (Dr Who, Sherlock, Coupling), this TinTin... is in good hands with the knowledge that it was directed by version. The movie boasts a strong cast, “performance capture” 3D film boasts a director Stephen Spielberg who was Tomas Alfredson, whose stunning Let the including Gary Oldman, Colin Firth, strong pedigree and combines three of apparently once described by Hergé as Right One In I rate as the best vampire John Hurt and Mark Strong. the original comic stories, The Crab with the only person who could do TinTin movie ever. Oldman is very good as Smiley, a the Golden Claws, The Secret of the Unicorn justice on screen. Alfredson captures a real sense of difficult character to play; he is so and Red Rackham’s Treasure. This film should delight old fans mid-seventies Britain and the story is, of different to the typical screen spy. I went prepared for disappointment, as well as newcomers to these course, riveting. As a fan of the BBC However, it must be said that whilst but from the charming animated credits, wonderful stories. Fortunately, this production, when I watched the movie I Oldman is excellent as Smiley, in the TV featuring a beautifully appropriate theme first offering is planned to be the first felt that I was revisiting old friends and version, Guinness was Smiley. by John Williams, through to the very of a trilogy: the anorak looks set for a seeing them from a different view point The TinTin stories of Georges Rémi end I was captivated. Of course, there is good airing. 40 NEWS VP DECEMBER 2011 New chairman for parasites such as ticks, worms, fleas and BVA AWF mites and also a display of foreign bodies ingested by pets. DR Tiffany Hemming has been elected There was an ultrasound room, a as the new chairman of the British dental hygiene room and a diagnostic Veterinary Association Animal Welfare room with x-ray display, while the prep Foundation (BVA AWF). area was converted into Teddy Hospital After graduating, Dr Hemming where small children’s teddies were worked in mixed practice before treated. The final room included completing her doctorate in displays from the practice’s chosen epidemiology at the University of charities: Cats Protection and Dogs Guelph in Canada. She joined the Trust. New equine clinic Territorial Army as a Veterinary Officer Tilly Morgan, head receptionist, who opened at in 1997, transferring to the Regular co-ordinated the event, said the practice Army in 2000. was delighted with the feedback from Breadstone She has been employed in several the public. “We were particularly glad to B&W Equine Group, which runs four different roles all over the world, has see several new clients who signed up clinics in Wales and the south-west of commanded a medical squadron for two on the day!” she added. England, has opened a new equine years and deployed with them to n National Pet Month 2012 will take clinic at Breadstone in Gloucestershire. Afghanistan in 2009-10. place from 7th April to 7th May; see The facility, which cost over £2.2 internal medicine. Holding the rank of Lieutenant- www.nationalpetmonth.org.uk for more million to build and equip, is said by the The new clinic, located on a four- Colonel, Dr Hemming is currently details. group to be one of Europe’s most acre site at Breadstone, has state-of-the- employed in a policy position in advanced diagnostic and surgical art diagnostics and advanced laboratory Whitehall. Her particular interests within Equine vet of the centres. facilities, housing the only equine MRI animal welfare science are working The group was created in 2008, scanner in the area as well as a CT animals and educating owners about year selected following a merger between Willesley scanner and scintigraphy unit. improving the welfare of their animals. CHRIS Pearce from the Barn Equine Equine Clinic and Bushy Equine Vets, There are five examination rooms, Surgery in Wimborne, Dorset, has won and has 23 veterinary surgeons, two knock down boxes, and custom- NPM 2011 event the annual including RCVS and European made orthopaedic and colic theatres, Petplan recognised specialists in surgery, adult and neonatal intensive care suites winner Equine Vet orthopaedics, diagnostic imaging and and separate isolation units. THE Old Golfhouse Veterinary Group, of the Year based in Watton, Norfolk, has won Award, Awards’ gala dinner in London last impact on horses’ welfare, comfort and National Pet Month’s “Best 2011 presented month. longevity, as well as his understanding of Veterinary Event” award. at the There were more than 185 the importance of horses to their The practice held an open day in Animal nominations and the judges said they owners and the support and empathy he April which included a tour of the Health were particularly impressed with Mr demonstrates when working with their practice through a series of themed Trust Pearce’s “pioneering work in advancing horses”. rooms, including a room showing Equestrian equine dentistry, which will have a real The other finalists for this award were Dr Catherine McGowan from the University of Liverpool and Ross Syme from Avondale Veterinary Group in Prof. Bedford installed as ISVO president South Lanarkshire. PETER Bedford, emeritus professor 60s and 70s into a discipline which He added that during his two-year of veterinary ophthalmology at the had penetrated the four corners of the term of office he intended to VMA introducing RVC, was installed as the new world and had seen the formation of introduce an international exchange president of the International Society specialty colleges in both North and scheme to help ophthalmologists award for PR of Veterinary Ophthalmology at the South America, Europe and now Asia. attend centres of excellence to THE Veterinary Marketing society‘s recent conference in Jeju, Ophthalmology had given him further their specific interests in the Association (VMA) is adding a new Korea, prior to the WSAVA congress. considerable personal professional subject. award for PR to its annual advertising He took over from Dr Akihito satisfaction and the wonderful The conference in Jeju was a joint awards. Saito, an eminent Japanese veterinary opportunity to teach the subject in meeting organised by the ISVO and The aim, says the event organiser, ophthalmologist known for his work over 30 countries. the AiSVO and the subject areas Claire Edmunds, is to recognise the on keratoconjunctivitis sicca and When he was first appointed at included research into canine value that media and public relations instrumental in the recent formation the RVC, the lectureship was in head glaucoma, dry eye and vision and the can add to the marketing mix. of both the Asian Society (AiSVO) and neck surgery and he was allowed clinical topics discussed were cataract It will be awarded to the company and the Asian College (AiCVO) of to include some ophthalmology in the surgery, feline corneal disease and or veterinary practice that has Veterinary Ophthalmology. curriculum only because eyes were in injectable anaesthesia. delivered the most innovative PR Professor Bedford said that during the head. The ISVO co-ordinates and campaign during 2011, as judged by a his 40-year career in veterinary In those days his cataract surgery promotes fellowship amongst panel of industry professionals. ophthalmology he had seen the was shoe-horned in between laryngeal veterinary ophthalmologists This can be a single event or subject rapidly grow from a speciality tiebacks in the horse, soft palate worldwide. Its quarterly journal The article, or a sustained campaign over a practised by a privileged few in the resection in brachycephalic dogs and Globe can be downloaded free by given period. sinus trephination in cats. anyone with an interest in The winner and two highly But ophthalmology had ophthalmology and its biannual commended entries will be announced evolved and current conference can be attended again free at the VMA Awards on 9th March interest in the by those attending the host WSAVA 2012 at Shakespeare’s UnderGlobe development of the congress. Theatre in London. The deadline for subject was witnessed by The next meeting is in New entries is 27th January. the number and Zealand in 2013. Further information and ticket enthusiasm of the n The photograph shows the application forms are available at the delegates attending the handover of the presidency from Dr VMA’s website, www.vma.org.uk, or by conference, he said. Saito (left) to Professor Bedford. calling 0844 561 6157. VP DECEMBER 2011 BOOKS 41 A complete Any area of interest chosen to date become a bit rusty. textbook on by this reviewer has revealed a plethora The book is just over 430 pages of well-presented, highly relevant long and well-illustrated with colour reproduction – with information. The editors have done an photos on most pages. Text is broken impressive statistics outstanding job ensuring minimal up into boxes with headings like: repetition of material, despite the Diagnostic Approach, Treatment, massive number of authors involved. What if it Doesn’t Get Better?, When EQUINE REPRODUCTION Of course, with such a complicated Should I Refer?”, and, in a welcome Second edition: two volumes (plus subject with so many interactions, but unusual for a textbook box: “The DVD) some overlap of subjects does occur. Low Cost Option”. Edited by Angus O. McKinnon, The line illustrations, tables and The three authors/editors include a Edward L. Squires, Wendy E. Vaala figures are generally very clear. The recently retired GP as well as and Dickson D. D. Varner photographs in the text are academics and the book reflects that 3,132pp.; £266.95; Wiley-Blackwell reproduced in black and white, but experience. It’s the sort of book many there is a CD with all the images in vets would like to write on retirement! This book certainly has an impressive colour included. The downfall of the book is set of statistics: four editors of Uniquely, as far as the reviewer is obviously it has to be slightly eclectic. worldwide renown, aware, all proceeds due to But it’s a great one for pointing you in nuthatch, not the rare lesser/greater 250 authors, two editors and contributors the right direction and describing the spotted or pied woozlesnatcher. volumes, 3,288 pages, have been allocated, by common things that are so common, This book also covers common 325 chapters and a CD common agreement, to and giving clear and well-illustrated clinical syndromes not usually dealt with 713 full colour equine reproductive treatment options for these. with well at university, such as cat bite illustrations ensure that research. When you are a newly minted vet, abscess, whelping and euthanasia you get plenty for your Overall, the book is of it is good to have a book that focuses (including doing it alone). money! excellent quality and well on these things. An analogy would be If I was in final year or new in my It is without doubt worth the rather a novice bird watcher: you don’t want first job, I’d be out buying this now a complete textbook expensive price tag. The to go out on your first bird-watching (and at £39.99 it’s good value); then, regarding all aspects of editors’ assertion in the trip with a two volume encyclopaedia when a few months into it, possibly reproduction preface that “the new of every bird ever seen in the UK. back it up with something like knowledge in the horse edition is an accurate You want a nice, pocket-size Saunders’ Manual of Small Animal from both an historical and current reflection of the current level of colourful book with lots of photos Practice. But you’d need to have banked viewpoint. This gargantuan tome knowledge in equine reproduction” is and pointers as to habitat and season, your first pay cheque to buy that. This encompasses everything that can wholly justifiable. I would also echo and 95% of the birds you see will be book may help you survive long potentially be seen on any breeding the question posed in the next in it. That bird upside down on your enough to do so. operation regardless of the size of the sentence, “Only time will tell how long peanut feeder is almost certainly a – Gareth Cross enterprise or breed of horse involved. the information remains current.” Whether working on a large For now, with no question, this thoroughbred stud farm or looking book is the best chance we have of after a single pony mare on an being up-to-date and knowledgeable individual owner’s premises, this book about all aspects of equine will ensure you have any and all reproduction, thereby able to serve information you may need in one well that most noble and unique of place. To ensure this completeness of animals, the horse. approach, the sections on the stallion, – Dr Jonathan Pycock the neonate, older foal and the yearling have been massively expanded from the first edition. Good value book Problems unique to the pregnant mare are covered in detail and covering reproductive surgeries for the mare ‘competencies’ for and stallion are thoroughly dealt with. As would be expected from the new graduates editors, assisted reproductive techniques are gone into in enormous 100 TOP CONSULTATIONS IN detail. SMALL ANIMAL GENERAL The chapter authors have been PRACTICE drawn from all parts of the world and By Peter Hill, Sheena Warman and all disciplines including equine Geoff Shawcross practitioners, university faculty 432pp.; £39.99; Wiley-Blackwell instructors and academics. Without exception, every author has drawn This book has been created to help heavily from recent literature from all vets grapple with clinical problems that sources ensuring exposure to fall under the remit of “day one information in journals not frequently competencies”. As such, its core encountered by the majority of readers will be undergraduates, recent practitioners. graduates and those returning to The intended audience is not only practice after a break. veterinarians, but also animal scientists, It would also be useful to the large reproductive physiologists, students animal practitioner covering the odd and breeders. There is information, consulting shift and the very-part-time both basic and applied, on any topic small animal vet. Also experienced needed for equine reproduction practitioners will find it a refreshing practice. review of areas where they have 42 LIVESTOCK VP DECEMBER 2011 ROUND-UP OF Surgical repair of sacral against respiratory pathogens Prevalence of major enteric fractures in heifers David McClary and others, Elanco pathogens in dairy calves RECENT PAPERS Tanja Schmid and others, Animal Health with diarrhoea PUBLISHED ON University of Zurich Mannheimia haemolytica and Pasteurella Matthew Izzo and others, Sacral fractures may occur in cattle multocida are two of the main University of Sydney ASPECTS OF through various forms of trauma but pathogens associated with respiratory Infectious diarrhoea is the main cause BOVINE MEDICINE are uncommon and there are few disease in calves. of morbidity and mortality in neonatal reports on their successful treatment. The authors investigate the dairy calves throughout the world. The AND SURGERY The authors describe a surgical minimum inhibitory concentrations condition may occur through single or procedure used in three heifers with of the macrolide antimicrobial multiple infections with a range of Effects of early per rectum deformation of the tail head and tail tilmicosin against isolates of both viral, protozoal and bacterial pregnancy diagnosis on paralysis. A narrow locking organisms in vitro and compare these pathogens. reproductive success in compression plate was placed on the results with those from clinical The authors investigate the cattle spinous process of the fifth sacral and treatments of calves with bovine pathogens found on 84 Australian Juan Romano and others, Texas the first coccygeal vertebra. respiratory disease. dairy or dairy-beef units. Their A&M University In each animal the procedure They found that isolates of findings confirm that most outbreaks Pregnancy diagnosis using the resulted in a significant improvement timicosin-resistant M. haemolytica and of calf diarrhoea are caused by palpation per rectum technique is one in tail movement and a reduced risk of P. multocida were recovered only rarely multiple agents. of the most common procedures faecal fouling. Later they were able to and there was no association between Rotavirus and Cryptosporidium carried out in farm practice. Early calve successfully without assistance. MICs for tilmicosin and treatment parvum were the organisms found most detection of non-pregnant cattle can Veterinary Surgery 40 (3): 374-378. response. frequently on dairy units while help improve the reproductive Journal of the American Veterinary Salmonella sp. and rotavirus were more performance of the herd but there is Efficacy of preventive Medical Association 239 (1): 129-135. common on dairy-beef operations. conflicting data on the effects of this measures against bovine Australian Veterinary Journal 89 (5): 167- process on the ability of cattle to respiratory disease Detection of bacteriuria and 173. retain the embryo. Jared Taylor and others, Oklahoma bacteraemia in newborn The authors investigate whether State University calves by a catalase-based Effects of mycotoxins on the incidence of early pregnancy Bovine respiratory disease is the most urine test liver function in dairy cattle losses is affected by palpation costly condition in North American Didier Raboisson and others, Olga Averkieva, Kemin Europa nv., procedures involving one or two beef cattle and, despite extensive University of Toulouse, France Herentals, Belgium membrane slips. research, there is little understanding Septicaemia is common in calves Reports on the impact of mycotoxins The overall pregnancy losses in of effective preventive measures. during their first few days of life but in dairy cattle have tended to focus on 928 healthy cattle between days 31 and The authors review evidence on can be difficult to diagnose on the their effects on milk production. 60 of gestation were 14.1%. the results of strategies such as basis of clinical signs while blood In many cases, however, milk Embryonic pregnancy losses were nutritional manipulation, vaccination culture can be slow and costly. production, including milk fat and highest in the control group while and antimicrobial use. The authors report a trial of the protein content, are not greatly foetal pregnancy losses were highest in The latter is one option shown to Uriscreen test, which measures urine affected by dietary mycotoxins. But the group in which two foetal have clear benefits but concerns over catalase activity, in detecting most of these toxins are capable of membrane slips were performed. costs and the potential overuse of bacteriuria and bacteraemia in calves causing liver damage and this may be a So pregnancy diagnosis with one antimicrobials may preclude its wider with experimental E. coli infections. cause of significant problems in high- or two foetal membrane slips during uptake. Bacteraemia was detected in all the producing cows that are more per rectum palpation in early gestation Investigating the reasons for the calves inoculated with E. coli but in vulnerable to physiological stress. does not increase pregnancy losses in variability in the findings of BRD none of the healthy controls. There The author describes the likely dairy cattle. research may help provide better was good correlation with the results effects of the most commonly Journal of the American Veterinary mitigation strategies. of bacterial culture in inoculated encountered mycotoxins and warns of Medical Association 239 (5): 668-673. Canadian Veterinary Journal 51 (12): calves. the dangers of synergistic interactions 1,351-1,359. Journal of Veterinary Internal Medicine between multiple agents. In vitro activity of gallium 24 (6): 1,532-1,536. Cattle Practice 19 (1): 3-8. nitrate against Assessment of foetal well- Mycobacterium avium subsp. being by ultrasonography Clinical features in 32 cases Avoiding injection site paratuberculosis Sebastien Buczinski and others, of doxycycline overdose in reactions in cattle receiving Marie-Eve Fecteau and others, University of Montreal calves multivalent clostridial University of Pennsylvania Utrasonographic assessments of foetal Mounir Brihoum and others, vaccines Johne’s disease, or paratuberculosis, is well-being have been described in University of Liège, Belgium Amelia Woolums and others, an economically important enteric humans, horses and sheep and these Reports from a number of countries University of Georgia, Athens infection caused by M. avium subsp. procedures are considered to have have described incidents of sudden Clostridial vaccines are effective in paratuberculosis. Most infections occur potential value in monitoring high-risk death in calves given the semi- preventing potentially fatal conditions in calves soon after birth through pregnancies in cattle. synthetic broad spectrum tetracycline caused by the various pathogens of contact with an infected adult. The authors compare the doxycycline to treat respiratory the Clostridium genus but they can also The authors investigate the ultrasonography findings in cattle with disease. be responsible for painful and potential value of gallium nitrate normal pregnancies, in sick cows with The authors examine the medical unsightly reactions at the injection site. treatment in preventing growth of possibly compromised pregnancies and records from 32 cases in which calves The authors compare the the pathogen in vitro. The agent was in those carrying cloned foetuses. showed adverse effects after receiving cutaneous responses to standard found to inhibit the growth of all 10 Their findings suggest that high doses of the drug. Their subcutaneous and needle-free MAP isolates tested from four transabdominal ultrasonographic findings corroborate those from transdermal injection methods in a different species. assessment of foetal well-being may earlier reports of doxycycline group of yearling beef cattle. There were variations in serve as a useful tool for evaluating overdose in calves. But in addition to Transdermal vaccination produced susceptibility but this agent does progress in bovine pregnancies. evidence of renal and liver toxicity serum antibody titres similar to those show promise as a prophylactic Canadian Veterinary Journal 52 (2): 136- missing from earlier reports, they also achieved with conventional treatment in preventing transmission 141. highlight signs involving myocardial inoculations but produced significantly during the neonatal period. and striated muscle. smaller injection site reactions. American Journal of Veterinary Research Comparison of in vitro and in Journal of Veterinary Internal Medicine American Journal of Veterinary Research 72 (9): 1,243-1,246. vivo effects of tilmicosin 24 (5): 1,203-1,210. 72 (8): 1,124-1,129. 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For further information please visit www.noah.co.uk/responsible 44 LIVESTOCK VP DECEMBER 2011 Keeping up to date with developments in bovine mastitis Speakers at the British Mastitis THE 2011 British Mastitis Morten Dam Rasmussen (Aarhus presented. The detection of mastitis Conference (from left): Mark Burnell, Conference, at the home of University, Denmark) discussed the pathogens by real time PCR compared Martin Green, Nick Cobb, Brian Worcester rugby, attracted some 120 relationship between teat preparation, to bacteriology, from clinical (n101) Pocknee, John Cook, Morten Dam delegates including about a third the lag time before milking units are and subclinical (n100) milk samples Rasmussen, Anja Rothkamp, Jon from veterinary practice. A breadth attached and the milking performance. collected from farms in the Reader, Chris Hudson and Elizabeth of corporate attendees with He highlighted that pre-milking Netherlands, was discussed by Anja Berry. pharmaceutical, hygiene and teat preparation is not essential to a Rothkamp (Gmbh Diagnostics). walls, adhesion factors on bacterial cell machinery interests mingled with high milk production but does PCR targets specific bacteria rather walls and slime pseudocapsules. advisers, academics and dairy influence milk quality, udder health than identification of plate growth The vaccines have limited ability to industry representatives. and milking performance. With with bacteriology. Generally about prevent infections but enhance the All would have found the content stripping to detect clinical mastitis, the 30% of milk samples record no spontaneous cure rate and reduce the of interest. On the face of it, after 23 hand of the milker risks the spread of growth. In the study 13 samples number of chronically infected cows years of such conferences, it could be bacteria between quarters and cows so showed no growth with bacteriology that go on to become clinically supposed that there was little new to gloves are important and cleanliness, but all recorded pathogens with PCR. infected. A reduction in coagulase say but the expectation bar is with a need for clean and dry teats on It is thought that the bacteria were negative Staph. infections has been continually either growth inhibited or dead, due to recorded. being raised RICHARD GARD antibiotic therapy, or affected by the and it is the reports on the 2011 British cow’s immune response. Vaccine trial detail that is Mastitis Conference and finds Eleven mastitis-causing bacteria or A UK trial of a vaccine containing now being that, even after 23 years of these groups are detectable by PCR. Overall Slime Associated Antigenic Complex conferences, there is still a very interrogated PCR detected over 80% of the plus J5 is currently ongoing (HIPRA). great deal about the subject to rather than be discussed pathogens detected by bacteriology Further research overseas involves a the principles. with fewer Staphylococcci species recombinant TRAP (target of The use being identified but a larger number of RNA111 activating protein). of a hand-held fluorescent adenosine cluster attachment. minor and major pathogens. Expectations are for a decrease in cell triphosphate analyser was presented by It is the method of cleaning the Is therapy for the cow indicated by count and an increase in milk yield. Judith Roberts and Matthew Haslam teats, rather than the use of chemicals, a culture negative but a PCR positive Despite great activity, an effective (Leonard and May Farm Vets) and that will affect the rate of new result? Antibiotic sensitivity testing is vaccine for Strep. uberis is unlikely to be won the best poster competition. This infections. Pre-milking teat preparation not available from a PCR sample. The available in the UK for some time. tool is being used to assess hygiene on may lower the number of clinical relevance of detecting more Experience in practice (Startvacc, dairy farms, from swabs, and has environmental cases of mastitis but pathogens by PCR still needs to be HIPRA UK) injecting all milking cows particular application with Bactosan increase the number of cases caused evaluated but application of the every three months has shown the problems and to evaluate the efficacy by cow-dependent bacteria. The use of technology is progressing. need for standard operating of pre-milking teat disinfection. the term “cow-dependent bacteria” Jon Reader (Synergy Farm Health) procedures and calendar reminders, The visual demonstration has been may be useful in discussions with outlined his understanding and particularly to make sure that heifers shown to be an excellent aid to engage herdsmen rather than the term experience with mastitis vaccines. One are vaccinated. Heifers are vaccinated with farmers in tackling cleanliness “contagious”. of the recognised problems is to either after entering the herd or issues. Further details about the 3M develop a successful vaccine that does beforehand depending on the mastitis Clean Trace Surface ATP Test are Milk ejection not trigger a cell-mediated response. situation on farm. Bacteriology is seen available from 3M. Studies have shown that milk ejection An increase in white blood cells risks as vital to monitor and direct vaccine Other posters from developed may occur with peak lactation cows at milk of unsaleable quality. use. projects included: Bacterial migration unit attachment, whereas late lactation A further concern is that if a Farmer expectation is mainly to through the teat canal related to liner cows require stimulation at least 30 specific pathogen is targeted by the combat clinical mastitis and a action (Forbes and Gehm, AHVLA); seconds prior to attachment. The start vaccine, other opportunistic pathogens reduction of 1.5 cases per month in a Strategies to reduce milking duration of milk ejection is due to the amount may colonise the udder so that 200-cow herd is required to justify the of individual cows (Edwards and Jago, of cisternal milk in the udder. Cows eliminating one source of infection cost. This is only achieved where an DairyNZ); Monitor the level of with a low udder fill have milk stored leads to a different mastitis chronic high cell count cows to avoid mainly in the alveoli and not available problem. The key to penalties (Hanks, VEERU and Watson, to the milking machine. success will be a thorough Wood Vet Group); Mastitis For late lactation and low fill cows, understanding of the bacteriology and qPCR – myths and increasing the lag time before unit disease on a particular dairy realities (Bradley, QMMS Ltd and application decreased the machine on unit. Biggs, Vale Vet Centre); Association time, regardless of the time spent on E. coli vaccines (J5) between herd size and somatic cell pre-milking stimulation. enhance the ability of white count for Irish and UK dairy herds Consistent attachment 60 to 90 blood cells to destroy (Archer et al, University of seconds after the beginning of teat bacteria. Vaccinated cows Nottingham). preparation can improve milk yield. It become infected but have a Details of the posters and content is important to apply teat preparation lower rate of development of the presentations are within the in a consistent manner in order to milk of clinical mastitis and the proceedings available from The Dairy cows gently and quickly. Cows respond duration of clinical Group ([email protected]). to a good routine with short machine infection is reduced. Staph. The Conference was jointly organised on times, excellent teat condition and aureus vaccines target by The Dairy Group and the proper milk out. virulence factors including Judith Roberts, Elizabeth Berry and Matt Haslam University of Nottingham. Four research updates were proteins in bacterial cell with the best poster award. VP DECEMBER 2011 LIVESTOCK 45 effective overall mastitis management disease involving multiple strategies, a review of the past, present and Clean teats (deep sand in the plan is in place. Application of the recording of health and fitness traits future. The figures for sales of cubicles), test the milking parlour 3-4 DairyCo Mastitis Plan is considered to combined with genetic evaluations is a lactating cow intramammaries have times per year, attention to detail and be an important requirement. realistic option. Success is slowed by fallen to 1,298kg in 2009 but it is above all doing the simple things well The influence of genetics on lack of recording of clinical mastitis individual cow use that causes were emphasised. mastitis was presented by John Cook and steps to improve this will be contamination. An important part of the (Genus Breeding) and with hundreds welcomed. MSD set up a workshop in 2011 to management struucture is the vet and of genes involved in mastitis Preliminary results of a large discuss the issues of use and misuse Mark Burnell (Synergy Farm Health) resistance, the identification of single retrospective study looking at mastitis with milk failures and some incidents explained his approach to mastitis in genes to be targeted is challenging. and infertility were discussed by Chris were recognised human error, where large herds. His view is that no vet is Ongoing selection for mastitis Hudson (University of Nottingham). others remain unexplained. indispensable, no vet knows it all and resilience can be more successful by The data set consisted of 2,338,025 no vet suits every farmer. measuring traits such as cell count and two-day risk periods from 39,590 Communication needed A team approach is adopted with clinical mastitis. lactations and 21,068 cows. Analysis of Further discussions within the UK each herd and communication between High Immune Response this data indicates that a case of National Mastitis Panel have indicated all involved is highly important. The Technology (HIR) is being applied to clinical mastitis close to a risk period is the need for communication and vet is a health adviser, not a health identify and select individuals with associated with a major reduction in education about the responsible use of manager, and the people involved are higher breeding values for immune probability of a pregnancy occurring. medicines. Also a need to understand interested and are often very well response traits. Individuals are classed The greatest effect is when clinical the science behind antimicrobials and informed. If someone is asked to do as high (H), average (A) or low (L) mastitis occurs one to seven days resistance is considered essential. something they should understand the immune responsiveness. before a risk period. This may be due The unpredictable element is the reasons. to management decisions not to serve emotions and fears of the public, Data are collated at the practice Complex disease where oestrus is observed after clinical reflected by the politicians. The whole and discussed on farm. Protocols are High antibody and high cell-mediated mastitis or to a suppressive effect on industry is urged to work together to developed for everything and posters immune response animals are sought. ovulation or expression of oestrus. ensure that antibiotics are used are put up in appropriate locations. A calf identified as a high immune Early lactation mastitis may have correctly and responsibly. Review dates (often six monthly) responder will generally maintain that little effect on fertility as cows will not Nick Cobb (JF Cobb & Sons) are stated, which keeps the topic alive. classification as a mature cow. be served anyway. Work is ongoing to manages three dairy herds in Dorset Each farm has a vet and a vet buddy. Studies have shown that 15% of a explore the relative importance of with 800, 610 and 400 cows. Clinical The buddy is aware of all procedures, herd are H. This is not enough to udder health compared to other mastitis ranges from 18/100 cows to aims and ambitions so that there is no allow annual replacements but the influences on overall reproductive 45 and 47 cases. The aim is to achieve drop in activity due to a lack of avoidance of mating with undesirable performance. 20 cases of mastitis per 100 cows or veterinary involvement. Mark made the outcomes is available through There has been much debate about less, to maintain current milk quality point that operating the veterinary role computerised mating programmes. the use of antimicrobials and Jennifer and to increase milk sales from the with large herds is not the role for a Although mastitis is a complex O’Connor (MSD Animal Health) gave current total of 20 million litres. vet with a large ego. Treat right the first time! - Easy, Convenient Increase farm productivity with easy and convenient treatments! Prescribe Closamectin Pour on as your & Effective Farmers no stress Fluke, Worm and External Parasite treatment at housing. Fluke, Worm & External Parasite treatment Please read the product data sheet and seek advice before use. The dosing programme should be established by a veterinary surgeon or suitably qualified person. Manufactured and distributed in NI by: Norbrook Laboratories Ltd, Station Works, Newry, w Co. Down, BT35 6JP. Distributed in GB by: Norbrook Laboratories (GB) Ltd, 1 Saxon Way East, Oakley Hay Industrial Estate, Corby NN18 9EX. Distributed in ROI by: Norbrook Laboratories (Ireland) Ltd, Rossmore Industrial Estate, Monaghan, County Monaghan. Legal Category: POM-VPS. ROI: LM. Closamectin Pour on Solution for Cattle contains 0.5%w/v Ivermectin and 20%w/v Closantel. 46 LIVESTOCK VP DECEMBER 2011 Reducing antibiotic resistance on farm ANTIMICROBIAL resistance is and need to use diagnostic evidence to is one thing that is currently a hot topic for discussion support their use, only to know that a certain, and that is but do we have enough science- serious proactive and collaborative we need to protect based evidence to defend current management approach is essential here the availability of working practices? This was the in the UK. different antibiotic Professor Seamus Fanning (UCD), main theme of a panel meeting Prescription practices differ across classes for use in animals. John Fishwick (BCVA) and Profesor recently hosted by Vétoquinol and Europe, and Britain does not want to “Minimising the preventive use of David Barrett (University of Bristol) chaired by Professor David Barrett be a scapegoat for the Dutch veal antimicrobials is one of the at the panel meeting. from the University of Bristol. industry.” recommendations. The use of Key academic and clinical experts From a clinician’s perspective, Dr medicines should not be a substitute emphasised the time pressure on the took part in a debate to coincide with Tim Potter from Westpoint Veterinary for biosecurity and good farm industry with respect to EU legislation. the launch of the new antibiotic Forcyl, Group spoke about the issues management.” “As a leading member state, for which the company is advocating surrounding science and practice. consumers, retailers and the the controlled use by a single, short- “Commercial reality dictates and more Responsibilities government really need to understand acting Unfortunately, animal use of antibiotics the high standards that are already in injection for LOUISE RADFORD has been and still is an easy excuse for place on UK farms and the extent of the treatment of Vetbrief reports on a recent antimicrobial resistance (AMR) in veterinary involvement. They also of bovine meeting which focused on how to human medicine. There are definitely need to understand the pressures on respiratory reduce on-farm antimicrobial practical difficulties that exist with the industry before imposing new disease (BRD) resistance and the need for regards to preventing AMR,” policy.” in calves. science-based and defensible commented John Fishwick, the BCVA In his closing remarks, Professor Forcyl protocols president. “We must engage with the David Barrett reiterated this message contains profession and create and the need for marbofloxacin, which is administered often than not it is not practical to some evidence-based industry collaboration. by intramuscular injection at 10mg/kg. investigate every disease situation ahead guidelines to use on “The profession needs Dr Henry Giboin described how this of prescribing an antibiotic. However, farm if we are to responsible and newly licensed optimal dose maximises more drug susceptibility testing would defend the current defensible protocols that the bactericidal effect against BRD improve our understanding of the status quo.” are science-based to pathogens. “Forcyl was designed with amount of AMR already present on a Crucially, these prevent new policy targeted but sustainable therapy in farm. The problem is, how can we important messages being driven by politics mind. The aim is to treat affected differentiate treatment failure from need to be transferred alone.” animals early to achieve clinical efficacy resistance when the disease itself can across the whole Professor Barrett and pathogen eradication. By not affect the pharmacokinetics and industry. Catherine will also be chairing the treating too long, you minimise pharmacodynamics of drugs?” Mclaughlin, animal BCVA medicines course resistance amongst commensal flora,” health and welfare on the subject later this he said. Back to basics adviser for the NFU, John Fitzgerald. year. The RUMA and the BVA guidelines on Industry collaboration the responsible use of antibiotics are European Parliament seeks phasing out RUMA is the national body in charge now well-established; however, Dr of the responsible use of antibiotics Potter also suggested a “back to of antibiotics in farm animals while EU and John Fitzgerald, who recently basics” approach: funds research into homoeopathy retired from the VMD, will soon 1. health plans should be referred to at THE European Parliament has backed the phasing out of antibiotics in farm become its secretary general. “As it regular intervals; animals for disease prevention in order, it is claimed, to ensure such stands at the moment, we all need to 2. vaccine use and good husbandry treatments remain effective for humans. work together to reduce antimicrobial should be encouraged; The Parliament’s “Resolution on the Public Health Threat of resistance (AMR) on farm. That 3. weight measurements taken – Antimicrobial Resistance” calls on the European Commission to phase out includes farmers, vets and estimates vary enormously; the prophylactic use of antibiotics in livestock farming, calling instead for pharmaceutical companies alike,” he 4. treatment protocols should be disease prevention through good hygiene, housing and animal husbandry, as commented. present and adhered to; well as strict biosecurity measures. It has recommended the use of antibiotics “We all appreciate how these 5. record keeping – prescription details as a “last resort” in exceptional, preferably individual, circumstances. products provide economic benefits to and volumes to be kept for five years; This development follows news that the EU is investing £1.8 million in a farmers and health benefits to both 6. antibiotic use in accordance with the pilot research project to examine the effectiveness of homoeopathic humans and animals. However, we product SPC only; treatments on farm animals and looking at how homoeopathy may be able to witness what is happening in Holland 7. on-farm compliance – build farmer reduce the use of antibiotics in treating livestock. where vets have to reduce antibiotic attitudes into protocol. Geoff Johnson, who graduated as a vet from Cambridge in 1987 and now usage by 50% over the next two years The BVA guidelines highlight that a runs a homoeopathic veterinary surgery in Taunton, Somerset, says he is in prophylactic approach to the use of favour of using homeopathic treatments on animals. “Homoeopathy is an antibiotics for the treatment of BRD Louise Radford, BVetMed, CertVR, invaluable tool on the farm, used by many farmers in the UK together with MRCVS, MCIM, who graduated from should be kept to a minimum and only conventional treatment to reduce reliance on antibiotics. I’ve seen first-hand the RVC in 1988, runs Vetbrief, an used where older calves are actually how effective homoeopathy has been in treating sick animals. animal health consultancy which physically in contact with disease. “Some say homoeopathy is just the placebo effect, but if that is the case, specialises in providing tailored Records listing outcomes should always why have I seen it work so effectively for cows and other animals?” marketing solutions for livestock be kept. n Veterinary Practice will welcome readers’ views on these issues; please send to businesses. She can be contacted at “The regulations will definitely [email protected]. [email protected] by 8th December. change,” said Mr Fitzgerald, “but there ‘Bimamix is a very easy to use preparation. I know that once I have treated my calves with it, my mind can rest that they are in goods hands’ Herd Manager Home Farm LTD, Newtownards, Co. Down Bimamix ‘Bimamix is the first treatment I RTU Calf Scour Treatment reach for when faced with a Available in 250ml and 1 Litre diarrhoeic calf’ Claire Ferris local vet to Home Farm LTD., Millisle, Newtownards, Co. Down WE’VE GOT YOUR REAR COVERED Bimamix contains: Dont let calf scour cost you and your clients Neomycin 2.5% w/v, Sulphadiazine 15% w/v and Use Bimamix calf scour treatment at the first sight of scour 10.5% Kaolin POM-V Bimeda® , Bryn Cefni Business Park Llangefni, Anglesey LL77 7XA Tel: 0800 526769 www.bimeda.co.uk Pig vets urged to sign up to vets can support the scheme, see injury in cob and pony breeds, compared to other www.pighealth.org.uk. breeds. Horses used competitively also had a higher national scheme risk of injury, VETERINARY surgeons have been urged to High percentage of horses Although most of the injuries recorded occurred promote a “top five” of farm services that will be during turnout, 11% occurred in the stable, with available to pig farmers signing up to BPEX’s new suffer injuries most of the injuries affecting the head or eye. national pig health scheme at their “Two Tonne A RESEARCH project funded by The Horse Trust Sow” Focus on Health conferences. has found that 40% of horses had suffered a ‘Breakthrough’ in diagnosis The Pig Health Improvement Project (PHIP) traumatic injury within the past year. Only 13% of became a national scheme in July following regional injuries occurred during ridden exercise, while 62% of canine lymphoma projects in Yorkshire, East Anglia and the East occurred while the horse was turned out in the field. A NEW kit for the diagnosis of lymphoma was Midlands. The research, which has been accepted for launched at the Veterinary Cancer Society’s annual “The PHIP takes a publication by the Equine Veterinary Journal, was conference in New Mexico last month. collaborative, action- carried out by Rosie Owen, who is currently working Developed by PetScreen (www.pet-screen.com) orientated approach to as The Horse Trust’s Clinical Scholar in Equine in the UK, the product is described as a significant reducing the incidence Orthopaedics at the University of Liverpool. breakthrough in the diagnosis of canine lymphoma of disease in pig herds to ensure the long-term The results were obtained through analysing the with the major benefit being that it is able to sustainability of pig farming. The role of vets in responses from 652 randomly selected horse owners differentiate between patients with lymphadenopathy delivering the scheme is key,” says BPEX’s vet from north-west England, Midlands and North due to lymphoma and lymphadenopathy due to project manager, Helen Clarke. Wales, all of whom had a horse aged 15 years or other ailments such as lymphoid hyperplasia. “We need to achieve a high level of uptake – and younger. Owners sought veterinary treatment for PetScreen Ltd and Tridelta Development Ltd are looking to achieve sign-up from farms that 47% of the injuries reported, while the remainder have announced that they are to jointly develop, together represent at least 90% of sows nationally. were treated by the owner or a friend, or required no manufacture and market a range of veterinary cancer And that’s why we are keen for farmers to take treatment. diagnostic kits under the banner of Tri-Screen advantage of these five services that deliver benefits Ms Owen identified a number of factors that (www.tri-screen.net). at farm level,” she adds. were associated with an increased risk of injury. For PetScreen has established the first reference The services consist of: free BPHS abattoir example, horses that had been owned for a shorter laboratory offering the advanced lymphoma blood reports, which are useful for vets and pig producers period of time were found to be significantly more test (ALBT) utilising the Tri-Screen canine in identifying sub-clinical disease; access to local at risk of injury. lymphoma assay kit. The kit is now available to health mapping, which raises awareness about any The research also found that horses turned out enable laboratories to offer the test world-wide. pig health-related concerns in a farm’s locality; a within larger groups were at an increased risk of By enlisting the support of vets in the UK and bespoke biosecurity action plan which vets will injury. This is probably due to there being a larger USA, the assay has been tested on 194 canine develop with farmers, using a questionnaire to assess hierarchy with multiple horses competing for patients with lymphoma, benign lymphoid biosecurity on their units; and disease testing which dominance. However, she found that the risk of hyperplasia and other diseases with similar farmers can access with the help of their vet; along injury reduced when additional feeding areas were presentation to lymphoma as well as healthy dogs, with BPEX regional support. provided in the field. and, says PetScreen, “achieved excellent levels of Sign-up is free for producers. To find out how Other findings included the lower incidence of high performance, reproducibility and objectivity”. 48 LIVESTOCK VP DECEMBER 2011 Goats: from diarrhoea to foot rot... ONE of the difficulties for goat veterinary surgeon may ask the owner related to colostrum. Weaned kids have glycol starts at the first sign of the doe keepers and veterinary surgeons is for a signed acceptance of the risk. problems often associated with over- not eating concentrates and termination the lack of specific information In food animals a minimum of 28 eating and the third group are the of pregnancy with dexamethasone is an about the diseases that afflict and days meat withdrawal and seven days adults. Tapeworms cause little problem option. the therapies that are available for milk withdrawal must be applied. If in goats and coccidiosis requires species Other problems include the high goats. these withdrawal periods for a identification rather than numbers as demand for calcium with lactation and The simple statement that goats are particular product are greater in other half of the coccidia are non- foetal development (hypocalcaemia), not sheep was echoed around the latest species, then the lengthier requirement pathogenic. dystocia (ring womb), uterine torsion meeting of the Goat Veterinary Society applies. Use of a product must only be A full discussion of alimentary (rare), uterine rupture on manipulation at Ludlow Racecourse last month. The for indications that are authorised in disease will be published in the Goat and artery rupture. discussion was at times heated, but other species. If a vaccine has no Veterinary Journal, including PGE, cud always polite, and the enthusiasm for all withdrawal period in other species, then dropping (listeriosis), anaemia Lameness problem that is goat-related very much in that also applies with the goat. (FAMACHA chart), bloat, wire, Three speakers presented a evidence. In Romania there are 231 products enterotoxaemia, hypersalivation (foreign comprehensive account of goat The chairman, Dr Tony Andrews, that have a market authorisation for body from browsing hedges), ulceration lameness, which stimulated in-depth introduced and linked the topics. The goats with 800,000 goats recorded for and ruptures. discussion. discussions flowed between The particular problems of Ben Duston (Cumbria) summarised the experienced speakers anthelmintic resistance in goats were that lameness leads to difficulty with and the delegates and the VETERINARY PRACTICE presented by Professor Neil Sargison of walking, compromises welfare, reduces most urgent interventions reports on the wide-ranging proceedings Edinburgh University. Although goats productivity and profitability and for the chairman were to of the latest meeting of the Goat and sheep are hosts to the same undermines staff morale. Prevention is keep time with refreshment Veterinary Society parasites, goats are browsers, able to essential with measure, benchmark, periods and lunch. handle toxins better and metabolise record and control. John Matthews, veterinary surgeon the country. Portugal has 98 products anthelmintics very rapidly. Lameness can also be indicative of and goat keeper, shared his experience with 500,000 goats and Ireland 17 Multiple anthelmintic resistance was other underlying problems and should of the geriatric goat. These are retired products with 8,000 goats. The UK has first recorded in sheep in 2001, with 22 not be allowed to persist. milking goats, pygmy goats or castrated four such products and 100,000 goats. flocks now diagnosed in the EU, There are 33,000 milking goats in males. Most are kept as pets and have a A medicine must have an MRL whereas multiple resistance in goats was the UK, many in herds of 1,000 goats life span of 16 to 18 years. established in food-producing animals. recognised in 1992. Sheep and goats do plus. Kathleen Weilkopolska (York) In practice, there is no distinction A new Eudrapharm website contains not absorb and metabolise drugs in the described their whole farm approach to between a pet or a food-producing an EU-wide list of products and details same way and sheep dose rates cannot control lameness in a large herd of animal. Milk production declines with are also available in the NOAH be extrapolated for goats. 2,500 milkers and followers, with age and so does buck fertility but compendium. In future new products Parasites have the ability to develop minimal lame goats. female fertility continues throughout may have limited marketing resistance rapidly and repeated dosing Strategic measures include avoiding life. Nutrition is always a consideration authorisations, so it is important to be and underdosing are implicated. It is contact with sheep, avoid goats walking when considering disease in goats. aware of changes if the cascade is to be not easy to accurately calculate the outside across yards, have concrete Older goats are less resistant to accurately applied. correct individual dose and deliver it to floors in pens and passages with adverse weather, become fussy eaters sheep flocks. proper drainage, take good care of and may need individual pens, as they Recognising signs The SCOPS system (Sustainable feet, design all pens to avoid injury and are less able to compete for food with An appeal came from David Harwood Control of Parasites) includes pasture use plenty of bedding every day. Wet younger animals. Arthritis is common (AHVLA) for owners to be able to and flock management to reduce areas (e.g. around water troughs) are and leads to impaired movement and recognise clinical signs and to know exposure and trials in France of a avoided. lameness. when to call in the vet. In addressing a programme of computerised checking Foot trimming takes place three Dental problems lead to loss of diagnostic approach to alimentary tract of liveweights, as a trigger for therapy, times a year. If an animal is treatable it body condition and increased tooth disorders, he urged goat keepers not to is proving successful in sheep. Regular is treated, if not culled. Exercise is sensitivity to cold water restricts leave it too late. monitoring of parasites is important important and the milking goats walk feeding. The teeth slant further forward A good history is important and and a low level of parasite resistance is to the feed troughs and walk to the with age and full examination of molars vets will need to be aware of general able to be accommodated by producers. parlour. requires sedation. Excessive points on goat-keeping conditions as well as A fat doe is fat in the abdomen Rose Grogano-Thomas and Kat teeth need to be filed to prevent conducting a clinical examination. For rather than across the back. Less space Bazeley discussed whether the new damage to the inside of the cheeks. laboratory samples, faeces are preferred is available in the abdomen for the work on foot rot in sheep could be As chronic laminitis is common, it to swabs, whether from the live animal rumen and so the animal eats less, extrapolated to goats. Antibiotic is important to check the depth as well or on post mortem. metabolises the fat, produces ketones treatment of flocks was considered as the shape of the hoof and non- Diarrhoea in goats differs with age. leading to twin lamb disease. Margit unacceptable in milking goats and the steroidal anti-inflammatories are well Pre-weaned milk-fed kids are likely to Groenevelt of the University of Bristol increase in foot rot through trimming received by goats. Pregnant does in suffer from an infectious source, with identified problems around parturition of flocks on pasture had little particular need exercise and uterine E. coli only relevant in the first seven and advised to “avoid fat goats”. relevance to goats kept on concrete. tumours are quite common. Many goat days of life, or dietary issues often Treatment with oral propylene Hygienic care when trimming was keepers appreciate a full veterinary discussed with differences between service for their much-valued animals. goats kept on grass or in yards Due to the lack of licensed showing different control products for goats, the veterinary requirements. The room concluded surgeon would be left with water for that information is not directly injection, teat dips and the means for transferable from sheep to goats and euthanasia so the cascade has to be there was a suspicion that goat regularly applied. Nick Clayton keepers value their specificity. provided an update on the cascade n The next meeting of the Goat system and pointed out that the The photo shows (from left): Kat Bazeley, Margit Groenevelt, David Harwood, Veterinary Society will be on 10th product must be prescribed by a vet Rose Grogano-Thomas, Ben Duston, Kathleen Weilkopolska, John Matthews, May 2012 at Taunton; details from and is used at the owner’s risk. A Nick Clayton and Tony Andrews. Nick Clayton: [email protected]. VP DECEMBER 2011 CONSERVATION 49 Putting up boxes for returning species MANY years ago we were lucky This small flock in our hedge was constantly as they flicked their tails and enough to have a tree sparrow mixed in amongst house sparrows bobbed around on the rocks. After all nesting in one of the tit boxes in which made it easy to compare the the rain we’ve had of late, the river our back garden. Since then they two. The tree sparrows were slightly was running high and fast but the seem to have disappeared, not smaller and all together more refined dippers were still plunging beneath the surprising perhaps when one looking with a smaller, less bulky bill. surface in their search for food. considers that the UK population They were searching the hedge for They would disappear for 10 or 15 suffered a decline in seconds and then emerge again onto a numbers of over 90% rock, (their plumage tinder dry) and between 1970 and 2008. VETERINARY PRACTICE start their chattering again. Now though, recent conservation correspondent, is delighted Reflecting on how much pleasure I breeding bird surveys to see tree sparrows back in the hedge get from seeing birds in the area of birds that won’t be returning to suggest that numbers may along his drive around where I live, I decided to take a mainland Europe next spring. have started to rise, good look at the BirdLife International When one considers the enormous news indeed if that is website, www.birdlife.org. pressure on birds from habitat loss maintained for the tree sparrow is now insects and berries and I watched them and climate change, the additional a comparatively rare bird in Britain. for 10 minutes or so. Songbirds trapped losses suffered purely to provide I was therefore delighted the other Knowing that they are around has One of the news items that caught my songbird “delicacies” for the relatively morning when looking out of our raised my hopes that they might nest eye concerned the huge number of wealthy appears outrageous. kitchen window to see a flock of some here again next spring so I’m going to migrating songbirds that are trapped There is much work to be done in five or six tree sparrows in the hedge put up some more boxes this winter in Cyprus each autumn to supply the not only legislating against such along our drive. with large enough holes for them. I’m restaurant trade. practices but also in enforcing the Though superficially similar to a also going to keep a close watch for BirdLife Cyprus has been legislation. It also demonstrates how male house sparrow, tree sparrows are them on the bird table over the weeks monitoring this illegal trapping for crucial it is to pursue conservation easily identified by their chestnut- and months ahead. several years and estimates that almost efforts across international coloured head and nape (this is grey in Out for a walk with the dogs today one and a half million songbirds have boundaries when considering the the male house sparrow), and white we saw several dippers down by the been caught and killed with mist nets protection needed by birds and cheeks and collar with a black cheek river. I had never realised how vocal or bird lime during September and animals that migrate over long spot. And unlike house sparrows, both they are until today. October 2011. That’s a lot of birds on distances and through different sexes have a similar plumage. The ones we saw were calling one small island and represents a lot countries. CLIENTS The Bohemian smallholder GILBERT Huppy is warming his boycotting commercialism. This way gleams a tassel of mittened fingers above the toaster in young Thomas, she’s in corner of red tinsel. Gilbert his caravan. field.” spins the goat round By the bucket sink, a needle-free Bloody hippy, thinks Tom, as they to show the surprise Christmas tree is garnished with dusty hopskotch their way through the oil – ta-da! – two tiered decorations, and the sparkle-free tinsel drums and car tyres. Free love, CND tails, one blonde smothering the damp walls confirms it: and a meat-free and hairy, the other Gilbert hasn’t a less glittery bothered to VICKI BROWN version of the oral change his continues her series on client tassel. “Out at both Christmas behaviour, under the heading: ends. It’s gone right decor in the ‘Psychotic clients: the mad, the through her. Cost caravan’s four bad and the dangerous to know’, two hundred to get decades. with a special Christmas edition... her de-Christmassed Leaning last year. What’ll it around the rusted door, Tom Hornwell diet of nuts, berries and twigs. be…?” VetMB’s nose is charged with the scent Blinking vegetarians shouldn’t be Tom gnaws his “Blinking vegetarians shouldn’t be of burnt offerings from bygone years. allowed to keep livestock. lower lip. “I’m allowed to keep livestock.” “It’s Doris again,” Gilbert says, Doris the Golden Guernsey is afraid the ex-lap blinking. “She’s only gone and eaten chewing a tractor tyre and turns a face goat charge jumped up last week. It’s a tinsel. Christmas tinsel. Does it every full of blithe unconcern, hayseeds hundred and thirty-seven twenty-three Gilbert clumps his knees together December.” He chews on a black trembling in her beard. per stomach. That’s five hundred and in a frisson of joy. “Turkey gets a wedge of toast, glasses bobbing on the “See?” Gilbert parts her jaws. forty-eight pounds ninety-two pence. reprieve.” He hauls himself from his bridge of his nose. “Her way of Between the horseshoes of milky teeth Plus VAT.” muddy bed, pulls a crust from Doris’s “Man.” Gilbert plumps down in mouth and puts it in his own. Canine help for heart patients the mud, glasses misting. “Can’t stump “This’ll learn you, Doris my love. that.” He pushes his toast into Doris’s You’ll look very elegant on Christmas DOGS Trust has teamed up with cardiac rehabilitation experts at Harefield mouth. Then his beard parts in a platter. This year, Doris – you’re Hospital to help patients in their final phase of coronary recovery. The smile. “Got it! I know how to stop the dinner.” programme, Hounds Help Hearts, is said to encourage post-coronary patients to bugger eating Christmas again.” walk dogs as part of their recovery. “Thank God,” thinks Tom. A This is a work of fiction. Any resemblance to Dogs Trust is also urging GPs throughout the UK to prescribe a daily seasonal epiphany. Forty years down persons living or dead is coincidental. The opinions dose of dog with The Dog Prescription after research highlighted the health the road and Gilbert Huppy’s finally expressed are those of the characters and should benefits of dog ownership for both children and adults. worked out he needs to take down the not be confused with those of the author. 50 EQUINE VP DECEMBER 2011 Five CPD streams at an exhausting world congress YOUNGER colleagues and walked round a magnificent fort and on pastures. veterinary students, in fact climbed high up in a mausoleum. Then There were many Professors Paddy Dixon and Tim specifically students, are used to the girls went shopping for silk. Luckily other great speakers. I wish I could Greet (in the centre of the photo) attending lectures from 9am until the bazaar had a cool, comfortable sofa have attended them all but sadly so look on with some concern at a 5pm for five days a week and then so I enjoyed a snooze. I think they often the topics and speakers clashed display by dancing horses. working in the evenings. Old guys were shopping for so long that a better and I had some very difficult decisions like me, or should I say more term was a sleep! to take. As always I learnt a large the magnificent setting of the gala mature colleagues, find a four-day The main CPD had five streams amount from Dennis Brooks on dinner was extremely memorable. congress starting at 8.30am and and covered an extremely wide variety ophthalmology and Sue Dyson’s However, they ended in good time so I ending at 6.45pm very hard work. of topics. Timing was good and clinical lameness case reviews were was not late to bed. I must be getting I am writing this report at the synchronised and so moving from magnificent. I could listen for hours to old! airport exhausted, waiting for my flight stream to stream was not a problem. Ed Robinson on respiratory problems. Professional learning is not just home from last month’s World Equine Everything was in English. Kate Savage stepped in wonderfully at about improving one’s clinical ability Veterinary the last minute to give some cardiology but also about improving the real Association GRAHAM DUNCANSON lectures. clinical output from one’s practice. The Congress, but has been out and about The most memorable lecture of all, welfare lectures put this into extremely accumulating CPD hours: this however, was Jean-Marie Denoix’s live perspective for me. I hope when I pleased that I report covers his recent trip to demonstration of ultrasound. He kept return to my daily practice I will be made the India for four lengthy days at the us all enthralled by his skill and thinking more of the welfare of the World Equine Veterinary effort to Association congress... expertise. Actually scanning the stifle horse and less about my personal come. of an unsedated horse in a lecture hall standing with the client. India is an is mind-blowing, particularly as the I also hope that I will spend more extremely hospitable country. The I felt very humbled by speakers ultrasonographic pictures were shown time listening to my clients and less people of Hyderabad pride themselves from India, Mali, Thailand, South on two big screens. time repeating my on their friendliness. I was staying a Africa, Brazil and many European dogmatic opinions. So mile from the Novotel which housed countries all lecturing in a foreign Reflections many problems in the conference centre venue. This was tongue for them. The lectures I Real learning is very equine practice in the ideal as the daily ride in an auto attended given by colleagues from the difficult to quantify UK are caused by the rickshaw costing only 50p gave me a UK and the USA were in the minority. after such an event. horses being overweight. taste of adventure every morning. In I can never go to an equine There is no doubt that I will only be able to reality, I had a daily adrenaline rush as congress and miss any lectures on learning is consolidated help these animals by the roads in Hyderabad are chaotic. dentistry. Paddy Dixon did not by the small discussions quietly working with my There is no road-rage, it is just how disappoint me. His lectures were held over coffee at the clients. They will never they are. excellent and right up to date. I was breaks and I definitely change their feeding My accommodation was the delighted to attend Derek learnt more than I have regimes as a result of a equivalent to a B&B although curry for Knottenbelt’s dermatology lectures done at other didactic lecture from Professor Derek breakfast was a little daunting! Dinner which are delivered in a style that not conferences. One me. Knottenbelt, one of the at night was only £1.50 so I saved a only allows me to learn but also are reason was that the stars of the congress. hatful of money. In fact, including the great entertainment. trade exhibition was Other CPD air fare, the cost of this conference was I appreciated the very well- very limited. I had no time to attend but there was very similar to a BEVA congress. organised dermatology lectures by I understand this was mainly on other learning available. There was a Annette Petersen. I hope BEVA can account of the high cost of renting the two-day series of equine lectures for Top-rate centre persuade her to come to the UK to area. However, it did mean than I spent lay personnel which I understand from The actual conference centre was top- share her extensive knowledge. The little time looking at shiny instruments one of my South African colleagues rate. It was certainly as good as any dermatology sessions were in the same and elaborate medicine claims and a lot was well worthwhile. other I have been to. I had a swim stream as the welfare lectures, which I more time networking with other There was also a two-day small every lunchtime to help keep myself found very interesting as so many veterinarians from all over the world. animal programme which seemed to be awake for the after lunch lectures. This countries were represented as well as Talking with colleagues after a well attended. I imagine the single-day was an added bonus. India. lecture and listening to their views session run by the FEI was very I arrived a day early. My excuse was greatly enhances my learning and pertinent with the 2012 Olympics less so I could get over the jet-lag but I had Helping equines and people seems to make the original lecture and than a year away. a great day out with some very close There is a large amount of work being my few notes much more memorable. friends from South Africa. We were done world-wide to help not only the All the proceedings were given to Relevance of the CPD in India not on any organised tour but we had equines, particularly donkeys, but also delegates on a disc, which was Equines in Norfolk account for 75% an excellent taxi-driver and a guide to help the people who own them and excellent. This is particularly helpful of my work. All of the lectures on book. We went to a town buffalo dairy, need them. when flying as the massive paper Graham Duncanson, BVSc, There is no doubt that the majority proceedings would have been very MSc(VetGP), DProf, FRCVS, qualified of equines in the developing world are heavy. at Bristol in 1966. He spent eight years looked after by children. Without their Another factor which increased my as a Government veterinary officer in donkey, the hard task of carrying, take-home learning was the very Kenya where he was primarily water, wood, food, etc., would make friendly informal social part of the engaged in disease control. He their lives a complete drudgery. congress. I did not spend my evenings returned to Norfolk in 1975 to work as The genuine welfare work being at massive formal dinners drinking too a general practitioner in a medium- carried out is a far cry from some of much and so I was much fresher in the sized practice and has been there ever the rescue centres in the UK which do morning to attend to the lectures. I since as a large animal/equine not rehabilitate the horses which come really enjoyed the Indian horses A happy group of South African practitioner. delegates at the WEVA congress. under their care but just herd them up dancing at the welcoming evening and VP DECEMBER 2011 EQUINE 51 Getting to grips with equine dentistry THE level of learning by a delegate gave us excellent lectures with good examination of a depends not only on the delegate notes. The other three lecturers took us horse, making a plan but also on the CPD provider. The through all the other aspects of equine for the dental organiser of the course, the dentistry which we required to make it procedures to be lecturers, the demonstrators, the a very balanced course. The only sad carried out, and then facilities and the notes are all vital to omission was the absence of Nicole Du the delegates as a enhance the delegate’s learning. Toit who is now working back in her group do the I was in the happy position at the home country, South Africa. She would dentistry. These are two-day British Equine Veterinary have provided a useful lecture on privately-owned A practical session in progress. Association “Modern Equine Dentistry donkey’s teeth. However, delegates who horses so a full dental chart is the median patella ligament in equines Course” for veterinary surgeons held want to learn more about donkeys can completed. with upward fixation of the patella. I on 14th and 15th of October at hopefully attend the full day’s course on We discuss the full range of think it took me five or six before I Langford, of being a learner and a this species planned for 12th January sedation options. It is amazing how was 100% happy with the procedure. demonstrator. run by Vetswest. these differ between clinicians. All the Looking at other professions BEVA has a very good track record Although there was no specific regimes in the main seem equally as might be helpful. When the RAF for providing excellent effective. The only consistent feature teaches a pilot to fly a fixed wing CPD. This is is the examination of the horse, aircraft, most of the best pilots go particularly evident GRAHAM DUNCANSON particularly the heart before the solo within four to six hours. also attended a BEVA course on dentistry – with this annual sedation is given. in a dual role – and explains that modern equine attendance at CPD meetings does not Gone are the days of didactic Profession’s problem dentistry course. necessarily equate with learning teaching. This is group learning at its If a trainee has not gone solo within Modern is definitely best. I am sure all the delegates learn 12 hours, that person is told that a the correct adjective from these sessions by the large flying career is not open to him (or as this course is continually updated. lecture on health and safety aspects of number of e-mails I receive after the her). It took me eleven-and-a-half I can vouch for that having lectured equine dentistry, this subject was course. hours to go solo. Can I reflect that I at the first course for equine dentistry covered in many of the lectures. I am confident that the learning of am a slow learner or have got poor to be held at Bristol in the summer of My one concern is the fact that the delegates is only the tip of the hand/eye co-ordination? 1996. For a Bristol graduate it is very 50% of the lecturers are suffering iceberg. By the way the delegates talk The veterinary profession has a reassuring to arrive this October to find damage to their shoulders as a direct and my own experience in our practice problem. Should individuals or massive building work in progress. result of the repetitive strain of equine in Norfolk, the delegates will be taking practices be asked to document their Bristol is an ideal venue with very dentistry. This is unacceptable for not home their learning to their success rates for certain surgical good facilities for the delegates. Henry only younger members of the colleagues. procedures or even all surgical Tremaine is a top course organiser, profession but also for more It is vital that even if only one procedures? having learnt the ropes from the experienced colleagues. member of the practice in the main Or should individuals or practices legendary Paddy Dixon many years ago. carries out equine dentistry, that the just have to show evidence that they are There are rumours that Paddy will Preventing injury practice has a unified approach to the carrying out clinical audits or show that not be organising the advanced course I am sure the use of sedation helps to work. they have standard operating in 2012 so we all hope that Henry will prevent injury and all the lecturers and When I analysed all the dental procedures in place to monitor their take on this task. There is a serious the delegates agreed that 100% sedation charts over a 10-year period from success rates? amount of work involved but hopefully must be the ultimate goal when treating Westover for my fellowship, it was The RCVS practice tier scheme Henry will be able to allocate the time a horse’s teeth. This, however, is not the very apparent that in 1998 I carried goes some way to do this. The required. only answer. I am not alone in thinking out the vast majority of the dental professional development phase (PDP) Henry was not only the organiser that motorised dentistry may well procedures. However, in 2007 the quite rightly does not require candidates but also the main lecturer, covering a remove some of the repetitive strain distribution of charts was much more to give their success rates, only to show very wide area of dentistry from but might also bring on other more equal between the five of us. Could that they have satisfied their mentor anatomy, radiography to surgery. He insidious injuries. BEVA council is well this be a reason why I haven’t got that they are competent. Certainly aware of the problems but solutions are damaged shoulders? attendance at the “New Graduate WEVA – from previous page not obvious. It is difficult to analyse why small Dentistry Course” run by Pete Ramzan dentistry, dermatology, ophthalmology, The delegates and lecturers broke group learning is successful. Naturally at Newmarket with the help of the respiratory problems, cardiology and off the course on Saturday morning to the practical element of actually BEVA Trust, must count highly when lameness have a direct usage for this watch the rugby world cup. It is a real performing a task lends itself to being completing the PDP. work. concern that veterinary surgeons memorable. However, I do not agree To sum up, the BEVA modern I never felt during the four days of carrying out full-time equine dentistry with the argument that doing such equine dentistry course creates a the conference that such a technique, may have a working life expectancy as and such a task is like riding a bicycle. marvellous opportunity for reflective such a diagnostic test or the usage of short as international rugby players. I Many tasks do remain in my learning and serves as a model for other such a piece of equipment was not count myself very lucky to be still memory like manually pregnancy CPD. relevant to my daily working life. carrying out equine dentistry at 67. diagnosing cows or castrating colts, It is hoped that equine practitioners India was good fun. I have a big That does not stop me worrying about even after months of not performing will not be plagued with injuries as a thank you to Tim Greet, last year’s the younger generations of veterinary them. Is it a numbers thing? result of their work with horses’ WEVA president, for bringing the surgeons. Reflecting on mouths. Equally, I congress to my attention. The learning The afternoon sessions were such tasks is hope that no equine was worthwhile and I would practical and this is how the BEVA difficult as I practitioners will be thoroughly recommend to any equine dentistry course differs from most cannot recall injured in the practitioner the next World Equine other equine CPD meetings. It is in this how many I had Equine SKI-PD Veterinary Association meeting practical element where I switch from performed planned for 8th to scheduled to be held in Budapest, a being a learner to being a teacher. Do I? before they were 12th January 2012 at great city, in the autumn of 2013. In reality I learn and can reflect on second nature to Ischgl in Austria I hope to go but having ridden a what each group of five practitioners me. I can reflect which Henry horse back from Budapest to Calais tells me. Each of the six groups spends on other tasks, Tremaine is five years ago, I think I will go by air. an hour with me discussing the oral e.g. sectioning organising. 52 EQUINE VP DECEMBER 2011 A TRICK IN EVERY TRADE... PROFESSOR Leo Jeffcott of the drug use in competition. detection times to assist veterinarians University of Sydney chaired the Medication control comes up treating horses prior to competition. Friday afternoon session at the against an inherent conflict of This is backed up by the provision of BEVA congress on “Lameness: interests. On the one hand, the FEI pre-competition elective testing. medicating/treating the wants clean sport where horses Physical rapping of jumping competition horse”. compete on their intrinsic merit and horses has been banned for many Professor Leo Jeffcott addressing the In his paper on the historical competition is safe and fair to all. years but it has been superseded by congress. perspective, he described the changes This gives priority to the welfare of chemical irritants applied to the in attitude that have evolved during the horse. On the other hand, owners forelegs. These show up on thermal The European Horserace the 43 years that he has been a listed and trainers want to win. imaging, but it was hard to prove the Scientific Liaison Committee event veterinarian for the Federation The year 2004 was a watershed intention behind the practice. (EHSLC) was established in 1992 to Equestre Internationale (FEI). with 4.8% of horses tested giving The FEI has, however, adopted a promote international harmonisation In the beginning, there were no positive results, robust protocol which allows for and get relevant information to systems for detection and disqualification of any trainers through their veterinary medication MARION McCULLAGH horse found to be hypersensitive surgeons. This gave rise to the control. It presents the third of her reports without having to establish the concepts of “detection times” and an took until the on the September congress of the precise cause of the hypersensitivity. internationally recognised “screening mid-1970s British Equine Veterinary Overall, the FEI has made great limit”. for the FEI Association, covering the sessions strides in establishing a genuinely The horse is allowed to have a on lameness and drug testing to publish a clean sport and making the residue of drug that has been judged list of regulations effective and to have no effect on its performance. “forbidden substances” and it was with four positives at the Athens understandable for everyone Analysis is so refined that an absolute not until 1981 that “anti- Olympics and two gold medals taken involved. zero is impractical. (Details of these inflammatory substances, other than away. (The most popular illegal drugs matters are available on the EHSLC phenylbutazone (PBZ)” were are non-steroidal anti-inflammatories, Drug testing rationale website.) outlawed. sedatives and corticosteroids.) Lynn Hillyer, of the Department of Samples are taken on the raceday, PBZ was permitted at a level up This situation led to a major Equine Science and Welfare of the usually after the race, but they are to 4mcg/ml; this was reduced to up review of the MCP. The Prohibited British Horseracing Authority (BHA), also increasingly being taken “out of to 2mcg/ml but the drug was not Substance List was split into “banned explained the “Rationale and competition” from the horses in banned altogether until 1993. In the substances” and “controlled practicalities of drug testing”. Drug normal training, sometimes in 1970s and 80s medication control still medication substances”. testing has been an integral part of response to suspicion of wrongdoing suffered from lack of structure. It racing since Daniel Dawson was but also to establish whether the drug was based on the protocols used in Emergency intervention executed in 1812 for doping horses in clearance patterns differ in sick racing, with the principle of zero Although drugs must not influence Newmarket with arsenic. horses under treatment when tolerance: that is, any detectable level performance, intervention is The BHA insists that horses must compared with the healthy horses of banned drug was forbidden. permitted in emergency, under the race free from the effect of drugs, used experimentally to establish the The Horse Forensic Laboratory in control of the official veterinarians. both to protect the horses and their data. Newmarket carried out the testing This Emergency Therapeutic Use jockeys and to maintain the The pattern of testing has but uncertainty concerning the Exemption allows emergency confidence of the betting public. become more refined with “planned validity of collection of blood and treatment of minor conditions, the Nowadays, broken rules result in unpredictability”, which is a favourite urine samples let to many successful declaration of altrenogest (Regumate) fines and disqualifications but there is tool of regulators, being applied to legal challenges which undermined given to mares and authorisation to a big emphasis on keeping trainers racing. Racing authorities are doing effective drug control. veterinarians to give non-banned and veterinarians informed so that their best to work with trainers and It took until 1990 for the substances such as rehydration fluids. they can act without breaking the veterinarians to avoid unintentional establishment of the Medication Application for elective testing to rules. It is an ever-changing scene as rule breaking but there is no Control Programme (MCP) and the make sure that medication used laboratory analysis becomes tolerance for those who cheat. appointment of a proactive before competition has been cleared increasingly refined, regulators and There may be a “trick in every medication sub-committee to control from the horse’s system is also analysts are in constant dialogue and trade” but the racing authorities are covered. methods and standards are exchanged making every effort to keep racing BEVA president At present, the FEI is operating a internationally. fair for the benefit of horses, jockeys CleanSport programme. This aims to Broadly, drugs are either there to and the whole industry. keep equestrian sport drug free and dope, to alter performance so improve both the welfare of maliciously, or to treat disease, but horses and the public’s perception of the boundaries are blurred and the the sport. So far it has achieved a reality is very complex. There is a good reduction in the number of competitive edge: a veterinarian can horses testing positive with the 2004 say “no” and keep medication within figure of 4.8% down to 1% in 2009. the prescribed limits or he can be The post-Athens Equine Anti- persuaded to push the boundaries. Pictured at the congress – (from left) Doping and Controlled Medication When there are multiple vets above: Peter Green, Michael Crane Regulations spell out the implications working in a yard with a bewildered and Dr Joe Collins; below: Andy of doping and controlled medication trainer trying to keep his owners Durham, Dr Catherine McGowan and making it much clearer to the people happy, reality can be uncomfortable. Alexandra Dugdale. Ben Mayes, a partner at Mayes and involved. The new Prohibited The trainer is responsible for Scrine equine veterinary practice, Substance List is comprehensive and recording medication. In principle, succeeded Deidre Carson as it is under continual review as new medication should be given to aid president of the BEVA during the substances are constantly appearing. recovery from injury rather than as a congress. Keith Chandler is now The FEI has published a substitute for rest. In practice, most president-elect with Paul Jepson as Prohibited Substance Database which infringements of the rules involve junior vice-president. is available to anyone and a list of therapeutic medications. One-year accredited modular coursesleadingto www.improvecpd.com General Practitioner Certificate qualifications Courses start DiagnosticImaging GPCert(DI) *NEW FORMAT! November 2011 Endoscopy and Endosurgery GPCert(Endo) Emergency Medicineand Surgery GPCert(EM&S) Ophthalmology GPCert(Ophthal) ExoticAnimal Practice GPCert(ExAP) Feline Practice GPCert(FelP) Small Animal Practice GPCert(SAP) * Business and ProfessionalStudies GPCert(B&PS) * *Gain credits towards theCertAVPwith thesecourses! Call us on 01793 759159 for abrochure, or go to www.improvecpd.co.uk to see the full range and book. 54 ON THE ROAD VP DECEMBER 2011 A vehicle that could prove a favourite with businesses I SOMETIMES wonder whether remarkably capable VW Passat there was a particularly friendly Bluemotion Estate. I haven’t told him milkman in my neighbourhood in yet but I am rather jealous of this the early part of 1987. The reason infinitely more practical, efficient and for me saying so is that this is the comfortable mode of transport only logical reason why my brother compared to my noisebox on wheels. and I are so remarkably different in VW has clearly decided to push mean that CO2 emissions drop to a AT A GLANCE so many aspects of life. technology to the limit when designing highly tax-efficient and appealing Model tested: VW Passat Estate He is the yin to my yang, the the Bluemotion range. It combines a 116g/km. It is for this reason that I Bluemotion 1.6 TDI Robson to my Green. He is the sensible variety of tweaks to the engine set-up, fully expect the Bluemotion Passat to Price as tested: £22,470 one with the settled family life, savings and can be applied to any VW model to be a firm favourite within many in the bank and beers in the fridge. I create the cleanest and most fuel- company car policies in the near future. Power output: 105 PS am the wayward one who just manages efficient car in the line-up. The only potential downside to this is Top speed: 120mph to scrape by each month and never has I have already driven the highly that they may become a rather 0-62mph: 12.5 seconds anything in ubiquitous sight when driving up and Fuel economy: 64.2mpg on the house, ROBBIE TIFFIN down Britain’s motorways. combined cycle aside from tries out the VW Passat As you can imagine, performance CO2 emissions: 116g/km some stale Bluemotion Estate and finds it to was not at the forefront of the Rating: +++++/5 biscuits, for be a brilliantly sensible and designer’s mind with the Bluemotion when guests remarkably capable vehicle with Passat. The model I tested covers 0- comfortable and prestigious but you pop round. highly tax-efficient and appealing 62mph in a sluggish 12.5 seconds and would also need to sell your wife on the He knows CO2 emissions the top end poke is nothing that will get black market to cover the fuel costs. how to wire a the juices flowing. However, the The only potential downside is the plug and possesses a pair of sensible impressive Polo Bluemotion and was 250Nm of torque on offer does pull fairly substantial price tag that shoes, whereas my DIY skills are intrigued to know how the practical well enough to make motorway driving accompanies this car. The Bluemotion probably on a par with those of a estate version would perform on a an effortless experience and between 50 technology adds another £1,000 to the goldfish and I don’t own a single item week-long road test. and 80mph the engine does everything cost of the more basic Passat S, of sensible clothing. Fashion over Engineering enthusiasts may wish to you would ever need it meaning the model I function has long been my mantra know that the estate version uses the to do. ...it really is the drove was priced at just although this clearly doesn’t do me too same modified 105bhp 1.6-litre TDI I am also pleased to Captain Sensible under £22,500. This is a many favours when left shivering in the engine as the four-door saloon but with report that the of modern serious amount of stands for a winter rugby game. the addition of lengthened gear ratios soundproofing is motoring and, money for anybody to to improve cruising capabilities. excellent with minimal pricing aside, is consider parting with, Clear differences Special dynamic spoilers have been road or engine noise although in return you These differences are also clearly added underneath the engine space to entering the driving nigh on are rewarded with one of evident in our choice of car. When not improve airflow and the ride height has cabin. Those with impossible to the most capable cars reviewing cars for this publication I been lowered to give a more sleek and cursory regard for their find fault with currently on sale. choose to drive a faintly ridiculous aerodynamic appearance. driving licence may also The new Passat white hot-hatch that is about as be interested to know that the Bluemotion really is the Captain functional as a chocolate teapot. I can Staggering range maximum speed has been raised by Sensible of modern motoring and, barely fit my gawky frame into the These tweaks certainly pay off in terms 3mph to 120mph. pricing aside, is nigh on impossible to cramped interior and the boot space of the performance statistics as fuel The 1,731-litre boot space is find fault with. For this reason I can’t has similar dimensions to Posh Spice’s efficiency is a hefty 64.2mpg on the nothing short of immense and would help but to award it five stars. However, stomach. Bluemotion version. This provides a easily swallow up a litter of Labrador knowing my brother doesn’t receive this On the flip side, and without taking truly staggering range of 800-plus puppies and Barbour’s entire collection publication and therefore won’t see this my advice, my brother has just decided miles. of sensible jackets. glowing appraisal, I will tell him that I to invest in the car featured in this very I can personally vouch for this after Standard features include climate thought it was absolutely awful and he article: the brilliantly sensible and yet being astonished to see that a seven- control, a multi-function steering wheel, would be much better off with a gaudy hour round trip only stop/start functionality, bluetooth, hot hatch instead. used just over a third DAB radio and iPod connection, Brotherly love hey! of a tank of fuel. For meaning it is as well- those doing serious equipped as many mileages each year luxury executive this presents a highly saloons. If someone appealing option, told me I had to especially when the drive to Scotland and attractive finance back tomorrow, then arrangements I would be really currently offered by hard pushed to name VW are factored into a better car to travel the equation. in. Sure a Range The Bluemotion Rover might be amendments also marginally more THE MANAGEMENT PAGES n What do you want for Christmas? n What can you do if you are left a pet in a will? n Have you mapped out your area? n Are you clear on the distinction between "value" and "growth" investments? What would you or your practice hope to find in your Christmas stockings? CHRISTMAS comes but once a year and with a use the Kindle App on their smartphone or iPad or couple of weeks to go before the festive season they use a Kindle reader, they just love the ability to takes over, Veterinary Practice takes its now hold countless books on one device free from the annual look at the “must have” gadgets that weight of heavy books. every vet At the end of should place ADAM BERNSTEIN September, Amazon Sonos. on their 2011 takes a look at some of the latest launched two new Sonos encapsulates a Christmas gadgets – from sound systems to Kindles in the US, both set of products that list. satnavs, phones and cameras – of which will be in the connect to your home or that would make great presents – UK soon – the Kindle practice network. The Amazon and some might even be useful in Touch and Kindle Fire. network then becomes the practice Kindle The former, an update the conduit to stream Amazon’s to the existing product, audio either from tracks Kindle is four years old now and it has is a black-and-white touch screen device that comes held on a local hard drive, revolutionised reading; some have even said that it’s with 3G and/or wi-fi. internet radio or from helped to contribute to the decline of the traditional The Fire, on the other hand, is an Android wi-fi- subscription services such bookshop; however, that’s a debate for another day. only tablet device with a 7-inch colour touch screen; as Napster. But whether readers being based on Android it can do far more than read It really is a plug-and- books as Amazon tries to make it its iPad. play system that is Both products lack the physical keyboard that the incredibly modular; one hub can allow audio to be previous Kindle possessed, but the touch screens played independently in up to 32 rooms at the same beat that and offer a larger viewing area instead. Pick time – that’s up to 32 different choices of audio one up – you’ll rarely go back to a printed book. being played at once. Alternatively, zones can also be Price: Kindle Touch – from $99; Kindle Fire – created – at home or in the practice – so users can from $199. UK prices TBC. group rooms together to play the same audio. n www.amazon.com It’s not the cheapest way of listening to audio, but it works well and it’s simple to use as it’s Sonos controlled via a dedicated handset or via an app; The playing of audio – music for most – has there are versions for the iPod, iPhone, Mac, PC or Kindle Fire (left) and changed so much in the last 30 years as we’ve Android device. the Kindle Touch. progressed from the Walkman, CD player and Put one on your Christmas list: it’ll blow you Minidisk to the iPod. But whilst the iPod is still with away. Adam Bernstein, BSc(Hons) is a freelance writer on us, when it comes to playing audio out loud, Price: Starter set-up around £590. business, financial and industrial topics. streaming is the way to go and the best for this is a n www.sonos.com "! *)('&%$#)"%!) ( % ( % " %)(& " " #( % )" %" " ( #" % &% &'# %##" ) ( ( %('!' % (# (& #% ( &%#) % #" %''% " % # ''%# %%%#"%( ( % #) Companion The best pet careers Carevets 56 BUSINESS & FINANCE VP DECEMBER 2011 Each time CoPilot Interestingly, Live calculates a route, Nikon lists it it will, where possible, as top of the give three options to consumer choose from. It also range. features speed limit and However, speed camera many notifications whilst also reviewers allowing users to set have placed just how far over the it squarely in limit they want to go the before being warned. professional Unlike some rivals, range of it includes true postcode navigation and photo Nikon navigation based on the GPS co-ordinates of a products. photo taken on (say) an iPhone. CoPilot Live does Either way, offer extra paid-for services including traffic its results are iPhone 4S updates, to allow for automatic re-routing, and stunning, The iPhone 5 isn’t here and won’t be for some local fuel prices notification. especially in time. However, Apple’s iPhone 4S is with us – but The bottom line? A satnav won’t beat local low light is it worth buying? knowledge, but CoPilot Live comes quite close. levels where Well the answer is “it depends”. The Price: £29.99 UK and Ireland, £59.99 Western a flash would announcement of the 4S underwhelmed the Apple Europe. wreck a picture or cannot be used. world because of the unofficial hype and because n www.copilotlive.com/uk/ It’s quite simple to use – considering it’s an it wasn’t radically different. It’s almost identical in SLR – and access to most features are a button form to the iPhone 4 – shape, size and so on – but Nikon D7000 press away. Further, its 16.2 MP sensor also it is different. A picture is worth a thousand words and with the records HD video. There is too much to say about The 4S features a better camera (8MP instead advent of digital imaging, photography has never the D7000 in such a short space on the page, but of 5MP); it shoots video in 1,080p HD; is faster been easier. However, getting good results depends take a look at www.kenrockwell.com/ because of its dual core processor; can download not only on the photographer but also the nikon/d7000.htm – it’s a plain English review that mobile data faster if the mobile network allows; equipment. So the last item to add to this year’s list glows. features Bluetooth 4.0; has a better antenna set-up; is the Nikon D7000 digital SLR. Price: Body only from £777; with lens from possesses a longer-lasting battery and also comes Being an SLR it’s not a pocket-sized compact £943. in 16GB, 32GB and 64GB capacities. camera, but it does offer the flexibility of being n www.europe-nikon.com/en_GB/product/ It also features Siri, an app to allow the user to able to change lenses and use a decent flashgun. digital-cameras/slr/consumer/d7000 speak to the iPhone normally and ask questions such as “Will it be cold in London tomorrow?” with sensible answers being returned. Hardware aside, most of the software features, Charity day raises over £4,700 apart from Siri, are available in IOS 5 that anyone CAVE Veterinary Specialists, of West Buckland, near Wellington in Somerset, held a charity CPD day in with an iPhone 3GS or 4 can download free. September. So the answer to the question really revolves Held in the practice’s recently opened premises, veterinary surgeons and veterinary nurses were around whether someone is looking to upgrade an offered a choice of presentations from experts around the UK. More than 250 people attended the day iPhone 4 or get a first iPhone – and that comes and a total of over £4,700 was raised. down to cost. Either way, the 4S is an object of The money has been donated to Plymouth-based Nowzad Dogs, a charity that rescues stray, desire. abandoned and injured animals in Afghanistan and helps train local vets. Price: SIM free – from £499. From the Pen Farthing, founder and chairman of the charity, said, “The amount of money raised for Nowzad is networks – variable. absolutely awesome and is so appreciated. The funds will go to updating and stocking our small but n www.apple.com/uk essential clinic that currently is in constant demand. Slowly but surely, with the support of fantastic people like those at Cave Specialists, Nowzad is making a difference for our four-legged buddies in CoPilot Live Afghanistan with no voice but ours.” ALK has just launched the latest version of its Su Hoddinott, a veterinary nurse at successful CoPilot Live app for Android and Quantock Veterinary Hospital in Bridgwater iPhone and it’s very good. said it was a great day: “Good food, useful With a redesigned interface, map and functions, it’s lectures and a very well organised event from now much easier to use. what looks like a good team.” CoPilot Live offers navigation for pedestrians, Tom Cave, owner and partner at Cave cars, bikes as well as motorbikes – further, once Veterinary Specialists, added, “We are so very routes have been calculated they can be dragged grateful to all our staff and the superb around on the map for fine-tuning. speakers who gave up their time to support this charitable event. It was a fascinating day, we had vets and nurses attend from all over the country and some superb trade exhibitors who also helped support us. “I am sure that the money raised will be put to great use by Nowzad Dogs and we wish them good luck with their valuable work in the future. We are already planning to do something similar next year!” n The photo shows Tom Cave (in the blue) and Pen Farthing (on right with the dog) and staff at Cave Veterinary Specialists. VP DECEMBER 2011 BUSINESS & FINANCE 57 What can you do if you are left a surplus funds would belong to the that clients named the correct pet in a will? practice. Similarly, if the pet is left to “recipient” for a pet in their will – i.e. the individual vet, any surplus cash they may set the service up under MY previous article, in the October the practice’s fees. Whether these fees would belong to that vet. their usual trading name of the edition of Veterinary Practice, are reasonable from the deceased Another query which was raised practice, or a separate commercial discussed the options available to owner’s estate point of view is the was whether vets could provide a vehicle. In addition, practices may pet owners when thinking how to responsibility of the executor. service to look after pets until they can change their legal status and may include their pets in their wills. If the vet is asked to put a pet be re-homed, perhaps convert from a sole Whilst this was written from the down on an owner’s demise, then using a legacy? In If a pet owner has practitioner to a perspective of a pet owner, the whether or not to take this action will theory they could do named a partnership or to an question has arisen as to what vets depend on how the will is worded. If this, but there are veterinary LLP. The practice must should do, in their professional there is no specific gift to the vet or some issues to practice in his or be able to give clear capacity, if they are left a pet by one of the practice, it will be the executor’s or consider. advice to its clients to their clients. personal representative’s responsibility They will have to her will, then the avoid any problems As with take on the risk that practice is able to later on. many things SOPHIE ENDERSBY the legacy may either take the pet and There is also the of a legal follows up her previous article on be insufficient, and so the legacy even if practical issue of space nature, the pets and wills with a discussion of they will need to the legacy to consider. For answer how practices and individual eventually fund it, or example, the practice depends on a veterinary surgeons can handle too much, but could exceeds the will have to think about number of such bequests perhaps fund those lifetime of the what it will do if it factors. pets that were not left animal. ends up with too many If a client has merely given a verbal to give those instructions and he or he with sufficient money. pets. It should be made request to a local veterinary practice to will then become a client of the vet. It is, of course, impossible to know clear to the pet owner that the pet look after a pet once they are no If there is a specific gift of the pet how long the pet will live or what may need to be put down if the longer alive, there is no binding in a will to a vet with a request to put treatment it will require and so it will animal can not be re homed. obligation. the animal down (and it can only ever depend on whether the veterinary If you have any questions or need If the practice or indeed the be a request as the vet then becomes practice feels such a service is further information regarding any of individual vet wishes to take the animal the owner), the decision is up to the commercially viable. these issues, please contact the author and house it, then they can do so, but vet as he or she then owns the animal. The practice would have to ensure at [email protected]. they do so freely and without being Under the Animal Welfare Act able to request any financial 2006, all that is required is that the recompense. destruction of the animal must be in If they decide not to take the an appropriate and humane way. animal, then the pet is left to the executors or the personal Incentive representatives of the deceased client Some pet owners may specify in their for them to deal with. will a named individual to take the It should be pointed out that if a animal, which could be coupled with a pet is left by its owner to the executors cash gift, firstly as an incentive to take of the will to deal with, and the the pet and also to use the money for executors request a practice to take the pet’s keep. care of the animal, the executors then The recipient can refuse the animal become a client of the practice and but if he or she chooses to accept it would be contractually obliged to settle (and the cash), that person has to also accept the risk that the funds may not Sophie Endersby is partner and head be sufficient to house, feed and look VetSurgeon.org & VetNurse.co.uk has featured of the private client team at BPE after the pet for the rest of its days. nearly 60,000 jobs to date, and what is more it is solicitors LLP, St James House, St James If a pet owner has named a Square, Cheltenham, Glos. GL50 3PR; veterinary practice in his or her will, telephone 01242 248222, e-mail then the practice is able to take the pet [email protected]; website and the legacy even if the legacy www.bpe.co.uk. exceeds the lifetime of the animal. Any Manchester law firm to offer advice service to veterinary practices DAVIS Blank Furniss, a Manchester-based law firm, has launched a department geared towards the healthcare sector, including vets, doctors and It’s free to place your vacancy. Simply dentists. log on on to www.vetsurgeon.org and The department, headed up by Sonio Singh, will deal with such matters as www.vetnurse.uk. acquisitions and disposals, restructuring, property and development If you are looking for a job there are matters/premises management, partnership advice/corporate governance and plenty to choose from. If you are VetNurse VetSurgeon employment advice. .co.uk .org The firm reports that it has extensive experience in this market and seeking someone new, why not add already acts for a variety of SME and institutional healthcare clients yours today! For details, see www.dbf-law.co.uk/healthcare_sector/. 58 BUSINESS & FINANCE VP DECEMBER 2011 MAPPING OUT THE FUTURE “RUNNING a successful total number of pets within your pet ownership is an veterinary practice, how hard can it practice geography) and qualitative (pet industry first. With be? Surely it’s a simple case of owners’ attitudes to veterinary care) incredibly powerful supply and demand; there are sick measures. and informative and injured pets and only a vet can By establishing what your market content, it treat them. Sounds like the perfect potential is, you will be able to gain a demonstrates business to me,” said a well- better understanding of the demand where, on a meaning but ill-informed former within a given geographical region and geographical map, industry associate. ensure your services match the needs the stronger pet- If only it were that straightforward. of that pet-owning population. owning sectors of There will the community are always be sick BAL BAINS based, as well as animals who of Pfizer’s Vet Support+ team, their purchasing require discusses ways in which practices habits regarding veterinary can assess their market potential, pet insurance and treatment, but and the value of ‘client mapping’ premium or the fact that and ‘socio-demographic profiling’ economy pet food. rescue centres This enables a are at full capacity whilst the ever- By knowing deeper insight into growing pet accessories market is what makes owners “tick”, you will be the buying currently valued at over £600 million1 able to select your strategies for behaviours of pet just goes to show that owners view growth in a more structured, effective owners and their pets in vastly different ways and and ultimately profitable way. That therefore the that client behaviour cannot always be might mean the provision of extra demand for various taken for granted. services, a review of the fee structure, services in If we use the latest figure from the targeted marketing at key different regions of Performance Index – that suggests at demographics, or the impact of a new the UK. best only 49.5% of pets visiting a vet branch on your current client base. For a practice practice will be vaccinated2 – even that undertakes an Experian report in the article, “market potential” is those owners who profess to care for Simple method through Vet Support+, the findings surely the more strategic and their pet do so in a very different way Client mapping and socio- can be both surprising and potentially rewarding way to view your from what would be considered best demographic profiling provides a enlightening in equal measure. By business. By knowing where your practice by vets. simple way to better understand your pinpointing on a map your competitor current and future clients are and their As any practice owner looking to client base and identify your market practices, locating your clients and pet-owning behaviours, it is possible to develop a clear market position for his share of the pet-owning population their density by postcode, and increase your practice’s opportunity or her practice to attract pet owners within your locality. understanding how far your clients with the local pet-owning community and subsequently grow the business This can be achieved by using the travel through accurate drive-time through targeted marketing and will tell you, establishing where the data within your practice management analysis (not just an “as the crow flies” matching the development and owners are, and understanding their system coupled with your own view), a practice can see at a glance positioning of the services provided behavioural profiles, can be akin to knowledge and experience. It’s possible where the threats and opportunities by the practice to the needs of your searching for the proverbial needle in a to ascertain your practice’s market may lie. clients. haystack, especially if they are not potential by reviewing the geographical already clients. region you cover, how many pet Detailed analysis 1. Pet Accessories Market – UK 2011- However, for a practice looking to owners you “guesstimate” are in that Overlaid against this with the Mosaic 2015, AMA Research. provide the very best veterinary care region and their “style” of pet Profiling is a detailed analysis of your 2. Pfizer Index, July 2011. and at the same time generating a fair ownership. clients and their profit, it must first understand its A more scientific method of socio-economic Case study “market potential”. Market potential is establishing market potential employed status and a Practice A’s management team felt that the four-site a combination of quantitative (the by many other industries is Experian’s propensity for pet business had no clear strategy and with various Mosaic UK model which classifies all ownership for the competitors in the region, thought they might be losing Bal Bains is a graduate in mathematics consumers in the UK by allocating population as a their edge and were considering lowering prices to remain from Imperial College London and them to one of 67 types and 15 whole. Overall, competitive. received executive management groups. The groups and types in these this mapping will Unsure of what the market potential was and keen to training from Cranfield School of profiles paint a rich picture of UK enable a practice make informed decisions, they decided to run an Management. He has also studied for consumers in terms of their socio- to appreciate an MBA from WBS, University of Experian report with Vet Support+. The report which economic and socio-cultural behaviour. where the greatest used the practice’s own PMS data as well as the propensity Warwick, and participated in the Vet Support+ has taken this potential for extensive in-house training programme for pet ownership content, gave the management team a established model and given it growth exists and at Pfizer Business Consulting. He few pleasant surprises. started his management consulting additional relevance to the veterinary where the best It showed that there was good penetration in the career with Lane, Clark & Peacock, and industry by overlaying proprietary opportunities lie. affluent areas of the region, far more so than they had went on to work for Standard research into the propensity of pet Recognising previously realised and that clients were travelling from Chartered, General Electric, General ownership to each of the types and that the veterinary much further afield. Motors and DHL, gaining a wealth of groups already identified in Mosaic. industry is so Armed with this knowledge the team was able to international business consulting and From “Rural Solitude” and much more make decisions confidently about pricing strategies, commercial experience over 20 years “Terraced Melting Pot” to “Active complex than the service provision and the value of targeting new regions across Europe, the Middle East and Retirement”, all will have a different simple supply and Africa specialising in strategy, with different offers, but more importantly, avoiding the propensity to own a pet and different demand previous strategy of trying, unsuccessfully, to be all things marketing, operations and resource attitudes to pet care. relationship management. to all people and at a lower price. This research into propensity for mentioned earlier VP DECEMBER 2011 BUSINESS & FINANCE 59 Investment styles and techniques - 2 HAVING come up with the central to value investing is that of Growth at a Reasonable Price Utility companies snappy title “Investment Styles “margin of safety”. This simply (GARP) strategy looks for companies For this reason, dividends are more and Techniques – 1” for my last means that you buy at a sufficient that have both good growth potential prominent in certain industries. Utility article, I set out to provide some discount to allow some room for and are currently trading at an companies, for example, have explanation of the terminology error in your estimation of value. attractive price. historically paid good dividends. used to describe the various types Despite the different methodologies, A common There are many of approach employed by fund it all comes back to trying to buy misconception is that In recent years companies with strong managers. something for less than it is worth. GARP investors hold many astute dividend records, one of This time I have really tried to An alternative method, known as a portfolio with equal investors have the best examples being push the inspiration boat out with the growth investing, is also favoured by amounts of both made sizeable Johnson & Johnson, the title! some investors. The concept involves value and growth sums from US pharmaceuticals As indicated previously, in this researching and stocks. However, firm. From 1963 to piece I will GARP investors purchasing stock 2004, Johnson & look at the GORDON NICOLL identify stocks on an in fledgling Johnson increased its continues his series explaining distinctions individual basis, dividend every year. different types of investment companies and between with a look at the distinctions selecting those that watching them If an investor had “value” and between ‘value’ and ‘growth’ demonstrate both grow into huge purchased the stock in “growth” investments and how the two characteristics. 1963, the dividend yield investment, approaches can be combined multi-national on the initial shares how the two Does a business empires. would have grown approaches are sometimes combined investing in companies in the belief company’s ability approximately 12% and the significance of a company’s that their profits and share prices will to pay dividends matter? annually (Source: Bloomberg, July ability to pay dividends. beat the market over a long period. Yes. Some fund managers employ a 2011). At its simplest level, the idea is to technique known as How do value and growth buy an acorn and then sit back and “income investing”. As investment differ? watch it grow into a giant oak. In the name suggests, this These terms refer to the overarching recent years many astute investors strategy focuses on the strategies that a manager may adopt have made sizeable sums from income from the when choosing companies to invest purchasing stock in fledgling underlying investments in. Value investing is a strategy of companies and watching them grow (in the form of selecting stocks that trade for less into huge multi-national business dividends or interest than their intrinsic value. empires. payments) to enhance Value investors actively seek returns over the long companies that they consider the Humble beginnings term. market has undervalued, believing Perhaps the best example of the ideal Income investors that the market over-reacts to both company for a growth investor is generally focus on good and bad news resulting in stock Microsoft. From humble beginnings older, more established price movements that do not in 1976, Bill Gates has grown his companies that tend correspond with a company’s long- business empire into the world’s most not to be in rapidly term fundamentals. successful computer company. expanding industries. The result is an opportunity for Taking Microsoft as an example, These companies value investors to profit by buying from March 1986 the stock has grown balance the need to when the price is deflated. by 25,005%. Or to put it another way, reinvest their earnings The big problem for value if you’d invested £5,000 in 1986 it back into the company investors is calculating the intrinsic would be worth a staggering to fund growth and value, as this assumption is very £1,382,900 today (Source: Bloomberg. expansion plans with subjective. Although the current value Data to 7th July 2011). paying out the earnings of a company’s assets can be However, once companies reach a in dividends as a calculated, the wider value including certain size and capture the majority reward for loyal future profitability is a matter of of the market share, their shareholders. opinion, rather than fact. characteristics change. With little Two investors can be given the room left for growth but strong exact same information and place a balance sheets gained through years different value on a company. of solid, consistent results, they begin to demonstrate different traits. Margin of safety Again, taking Microsoft as an Professional business support For this reason, another concept example, it could be argued that it for veterinary practices now behaves in a similar way to a utility stock: lower volatility and For further information or to discuss From starting or acquiring your first practice, any aspect of financial planning, consistent dividend distributions. contact the author, a founder member Growth investors, therefore, tend through developmental growth, to exit of The Ellis McComb Partnership, 3 to invest more frequently, looking for planning and sale we can help you Mortimer Street, Birkenhead, Wirral, companies that have the potential for every step of the way. CH41 5EU; telephone 0151 650 good growth over the medium-term. 6520, e-mail [email protected]; website www.ellismccomb.co.uk. The Do fund managers use both Ellis McComb Partnership is an strategies at the same time? appointed representative of St James’s Yes. Sometimes considered a hybrid Place Wealth Management plc. of both growth and value investing, a