Dubbed the PICO Project, the scheme will initially run via a series of specialism-specific surveys that let respondents select individual species or topics and input the research questions they would like to see covered within Veterinary Evidence.
Knowledge will make the list of submitted questions available online for the veterinary community to answer as Knowledge Summaries (Critically Appraised Topics), which will be peer-reviewed and published in the open-access journal.
Professor Peter Cockroft, recently appointed Editor-in-chief of Veterinary Evidence, said: "The practice of evidence-based veterinary medicine is an empowering process for practicing veterinarians that enables important gaps in knowledge to be identified. It is the bridge between research and clinical practice.
"If you have a clinical question that may shape the care of a patient, Veterinary Evidence may have the best current answer or will add the question to the growing archive of important information needs."
The first survey to launch – open now – will focus on equine practice, with possible subjects ranging from the likes of husbandry or vaccination to infectious diseases.
To ask for the evidence on a particular area, choose your topic in the survey’s drop-down menus and fill in up to five related questions, preferably in Population Intervention Comparison Outcome format.
Livestock will be the focus for the next survey, due to open alongside the BCVA Congress in October. Further surveys will look at canines, felines and other specialisms.
To keep up to date with the list of PICO questions being answered or available to be answered, visit Veterinary Evidence and follow @RCVSKnowledge on Twitter.
If you wish to become an author of a Knowledge Summary for publication in the journal, contact the Managing Editor at Bridget@rcvsknowledge.org.
Participation in this year’s survey was similar to previous years with 5,235 people taking part and returning records for 15,433 horses. Most horses were kept in livery or a private yard and used for leisure and hacking and the majority within the age range of 5 to 10 years.
A broad variety of breeds were represented, including natives, thoroughbred types and warmbloods.
59% of horses were recorded as healthy and 41% with one or more health problems, compared to 62% and 38% respectively in 2016.
The top five disease syndromes recorded this year were:
Of the 5.5% of horses recorded with back problems 26% were also showing signs of lameness. While the details of the results do not confirm that the two are necessarily connected, these findings reflect the outcome of recent studies conducted by Dr Sue Dyson, Head of Clinical Orthopaedics at the Centre for Equine Studies at the Animal Health Trust.
Sue said: "It is a common observation that horses with lameness stiffen the back as a protective mechanism and develop muscle pain which may be misinterpreted as a primary back problem. We have shown objectively that abolition of lameness by diagnostic analgesia results in an immediate increase in range of motion of the back. The current data supports this close relationship between lameness and back pain."
The debate, which was described as 'robust but good-humoured', was moderated by BEVA past-President Madeleine Campbell, sole partner at Hobgoblins Equine Reproduction Centre.
Keith Chandler, former BEVA President and member of the acquisitions team at Independent Vet Care and Karl Holliman, partner and director at Cliffe Veterinary group and past chairman of XL Equine, argued for corporatisation.
Their supporting witnesses were Lesley Barwise Munro of AlNorthumbria vets which was sold to CVS in 2015 and Julian Samuelson a former managing partner of Bell Equine, which was sold to CVS earlier this year.
In the opposing corner were Andrew Harrison, a partner at Three Counties Equine Hospital and Tim Greet, who recently retired as an equine partner at Rossdales.
Their supporting witnesses were Louise Radford MRCVS, who now works in the pharmaceutical industry and Nenad Zillic, partner at the Barn Equine Surgery.
As the moderator called 'seconds out', opinion was relatively evenly divided, with 44% of the audience agreeing with the motion and 56% disagreeing.
The pro corporatisation team advocated that obvious commercial and business advantages, together with the scale and diversity of a corporate, can give vets greater potential for a more flexible career path and advancement within the industry, and a more sustainable working career in equine practice.
Karl Holliman pointed out that corporates enable greater purchasing power, better health and safety resources, improved career structure and the freedom for employed vets to focus on clinical expertise rather than becoming bogged down with practice management.
Keith Chandler went on to argue that selling to a corporate is a solution to the problem of succession planning. In a climate of unwillingness for younger vets to buy in to practice, selling allows partners to realise the value they've built up and release that equity to do something else.
This is all very well, said Tim Greet, on the anti corporatisation panel, but the good reputation the profession currently enjoys is based on service to clients and above all the animals in our care. Clinical rather than commercial elements drive practice and partners are light on their feet and can respond quickly to decisions without referring to "a ponderous corporate hierarchy".
Tim also argued that clients like continuity and the quickest way to lose them would be to send in different vets. A bespoke approach to client care was needed rather than hard targeting.
Andrew Harrison went on to suggest that the only vets who really benefit from selling out are those who have one eye on retirement. Younger partners may be able to pay off the loan they took out to buy into practice in the first place but are then likely to take a considerable drop in salary and be given a middle management job, moving from the "pilot seat into the passenger seat." He argued that young vets cannot afford to buy into practices because the industry is being "fuelled by the corporates who are falling over themselves competing to buy equine practices and squeezing out our fellow professionals."
Pro corporatisation witness Julian Samuelson maintained that since Bell Equine has been sold to CVS there has been no change to client service, no restrictions on clinical performance and that no targets have been imposed to achieve set revenues.
Anti-corporatisation witness Louise Radford made the point that big corporates could exert pressure on pharmaceutical companies to drive down prices, which would reduce their capacity to invest in research and development trials and CPD, to the ultimate detriment of the veterinary industry.
The session closed with 72% of the audience disagreeing with the motion Corporatisation is inevitable and will benefit vets and their clients.
BEVA President Jon Pycock said: "Whether we like it or not corporatisation of equine practices is on the rise. But it shouldn’t mean that the future isn’t going to be viable for independents too as there is a role for both to co-exist. Importantly, this should mean that vets and their clients will both continue to have choices."
B&W operates an integrated practice based around a multi-disciplinary referral hospital in Breadstone, Gloucestershire, with additional clinics in Cardiff, Gloucestershire and Bristol. The group employs more than 30 veterinary surgeons, including seven diploma holders, and offers a full range of services, including what it says is the most comprehensive equine imaging service in the UK.
Ian Camm, Managing Director of B&W, will continue in the role of Equine Regional Director for the South West at CVS. He said: "We are excited about life within CVS and see many opportunities for our staff both within B&W and within the wider Equine Division at CVS. We look forward to working with the CVS team to realise the potential the partnership offers to members of our team and to further developing B&W as an equine veterinary centre of excellence."
Simon Innes, Chief Executive at CVS, said: "Our Equine Division has grown rapidly over the last 18 months because we offer an ambitious and exciting vision for the future of equine practice. B&W is one of the UK’s premier equine practices and we are delighted to welcome the team to CVS and look forward to working with them to help them build an even more successful future."
The traditional method for detecting equine lameness is subjective, using expert visual evaluation of gait to identify the presence or absence and degree of asymmetries. The lame horse is described as having a disorder, defect or loss of function and this clinical diagnosis has associated welfare implications if the horse is still asked to perform.
The article explains how advanced computer technology is starting to change all this. Optic motion capture or the use of inertial measurement units (IMUs) is now enabling the detailed study and quantification of the horse’s gait; objective assessment against preset thresholds. The paper points out that while these digital systems can overcome the temporal and spatial limitations of the human eye they simply rely on one or a number of set gait parameters to decide about lameness and this can present obstacles.
Thresholds are forcibly based on a limited reference population, which doesn’t adequately reflect the millions of horses in the world. The individual environmental and mental conditions for each horse and its day-to-day gait variations are also not accounted for. On this basis to use the term ‘lame’ because a horse demonstrates a subtle gait alteration, causing it to fall below the threshold, could be inappropriate, particularly as it may not affect the horse’s welfare in any way.
Professor Celia Marr, Editor of the Equine Veterinary Journal said: "An important first step is for researchers and clinicians to start to discriminate clearly between 'asymmetry' and 'lameness' and not to use these as interchangeable terms when interpreting gait analysis data. Asymmetry is often, but not always, a hallmark of lameness, but is not a clinical term, whereas lameness is."
The epidemic of respiratory disease in early 2010 was characterised by coughing and nasal discharge.
The disease spread through the population of 77,000 Icelandic horses within weeks, leading to a self-imposed ban on their export and significant economic cost to the country.
Initially, due to the speed at which the disease had spread, a viral cause was suspected. However, investigations by researchers at the University of Iceland showed that only Streptococcus zooepidemicus was consistently recovered from coughing horses and rare fatal cases of infection. However, this bacterium is also often found in healthy horses.
The AHT and the Wellcome Trust Sanger Institute were brought in to investigate. Dr Simon Harris from the Wellcome Trust Sanger Institute said: "To identify the culprit, we sequenced the DNA from 257 samples of bacteria from diseased animals and people. This showed that one specific strain of S. zooepidemicus, called ST209, was the likely culprit, and we also found this strain in a human case of blood poisoning. This study highlights, for the first time, how DNA sequencing can be used to identify endemic strains of bacteria and distinguish them from the cause of an epidemic infection."
Iceland is free of all major equine infectious diseases thanks to the ban on the importation of horses into the country in 1882. Consequently, Icelandic horses are particularly susceptible to any new bacteria or virus that crosses the border, and so strict biosecurity regulations are in place to help protect them.
Dr. Sigríður Björnsdóttir of the MAST Icelandic Food and Veterinary Authority, used information from owners and veterinary surgeons to build an epidemiological network. This enabled her to identify an equine rehabilitation centre where horses exercised in a water treadmill. The water treadmill is thought to have provided the perfect conditions for transmitting the disease as water was splashed up and ingested. Horses would complete their rehabilitation and return home, whilst incubating the disease, taking the infection with them.
The ST209 strain of S. zooepidemicus found in Iceland has also been recovered from a coughing horse in Sweden and an abdominal abscess in a Finnish horse trainer.
Dr Andrew Waller, Head of Bacteriology at the AHT, said: "There are a couple of theories as to how the strain entered Iceland. These bacteria are able to survive outside a horse for a week or so, which means the import of contaminated equipment or clothing is the most likely route by which ST209 entered Iceland. However, this particular strain could have even infected a human who travelled to Iceland, before spreading the strain back to a horse and triggering the epidemic.
"We are delighted to have helped uncover the likely identity of the cause of this epidemic. Our investigation highlights the ability of S. zooepidemicus strains to cause disease in animals and people. We found evidence that even endemic strains of S. zooepidemicus were likely causing cases of respiratory disease in Icelandic horses, illustrating that this group of bacteria causes more clinical problems in horses than was previously thought. We hope that raising awareness of the cause of this epidemic, and the likely involvement of a water treadmill as a key factor in disease transmission, will encourage veterinarians around the world to improve disease control precautions preventing future epidemics."
Thousands of shipments of equine germinal product (semen, ova or embryos) are imported into the UK every year. It is a legal requirement for all imported equine semen to be accompanied to the place of destination (usually to the side of the mare) by an original, valid health certificate (ITAHC), issued in the country of origin.
The BEVA says that recently, consignments of equine semen have been imported without the appropriate health certificates meaning that there is no guarantee that the semen is free from the stated diseases or even that it is from the chosen stallion.
According to the Association, some well-known importing agents have been advising mare owners that these certificates are unnecessary and openly criticising veterinary surgeons who refuse to inseminate mares with uncertified imported semen.
The use of uncertified semen risks recipient mares being infected with diseases such as CEM or EVA, the potentially rapid spread of disease in breeding stock and eventual restrictions being placed on breeding premises. Recent outbreaks of Equine Infectious Anaemia (EIA) in Europe have increased the threat to the UK herd.
The personal and professional reputation of any veterinary surgeon involved with using uncertified semen is also in danger, with the RCVS likely to take a stringent line with any vets who disregard animal health laws and the high health status of British horses.
Malcolm Morley, Partner at Stable Close Equine Practice was recently placed in a difficult position with a longstanding client when semen arrived without the requisite documentation. Following a discussion between the semen importer and his client, where the client was told that Malcolm was being pedantic and that the client should find someone else to inseminate the mare, Malcolm contacted the importer saying: "We have no intention of inseminating the mare without the correct health papers. Please will you ensure that when you speak to the mare’s owner that you make it clear that you do not expect us to inseminate the mare in these circumstances and that the health papers should have been shipped with the semen."
Another BEVA member who wishes to remain anonymous said: "I have one very big client I think I may be about to lose because of my refusal to inseminate his mare without papers … (the importing stud) did not feel it worth a three hour drive to get papers done. The semen importer has made it clear to my client that (they believe) I am just being awkward."
Mark Bowen Senior Vice president of BEVA said: "Import agencies have placed additional pressure on the vets to inseminate mares without the necessary paperwork. Not only is this action illegal but places recipient mares under a direct threat from a notifiable and incurable disease. This seems particularly cavalier given the recent outbreaks of EIA across Europe."
Tullis Matson, Founder and Managing Director of Stallion AI Services said: "No one should be inseminating mares with imported semen that isn’t accompanied by the original health certificate. If the UK wants to retain its high health status and continue to utilise the international market it needs the breeding industry and the veterinary profession to use the disease controls that are currently place until such a time as we can implement more efficient system."
The BEVA says it is taking the following action:
The effect of changing diet on gastric ulceration in exercising horses and ponies following cessation of omeprazole treatment was conducted by Nanna Luthersson (Hestedoktoren, a private practice in Denmark) and Coby Bolger (Horse1 Spain), with colleagues from the University of Madrid and Glasgow, in collaboration with Spillers and the Waltham Equine Studies Group.
The study evaluated the effect of dietary change in combination with omeprazole treatment and after the cessation of treatment.
The 32 horses in this part of the trial had been diagnosed with significant equine squamous gastric disease (ESGD) and were in hard work.
On a random basis one of each pair was assigned to a specified low starch, fibre-based diet consisting of their own forage alongside a restricted starch, high fibre, high energy cube (Spillers HDF Power Cubes, which are commonly used in racing yards) and a high oil, low starch, chopped alfalfa based feed (Winergy Equilibrium Growth) and the other stayed on their original diet. All animals were scoped before, after the recommended course of omeprazole treatment and then six weeks after the omeprazole finished.
The horses in the no diet change group improved significantly with the omeprazole but when the treatment was stopped many regressed. Overall, by the end of the trial they were not significantly different to when they had started.
However, the horses in the dietary change group overall showed significantly improved ESGD scores, not only following the omeprazole treatment but also after the treatment had stopped. This showed that a change in diet was able to help maintain the beneficial effect of omeprazole even after the omeprazole was removed.
The study achieved an award in 2016 for research in horse welfare from the Fundación para la Promoción del Deporte Ecuestre, Spain.
Clare Barfoot RNutr, the research and development manager at Spillers, said: "This exciting work confirms what we suspected; that whilst appropriate dietary change can provide additional support to medical treatment for EGUS most importantly it can help maintain better gastric health post medical treatment."
Last year the British Equestrian Trade Association, in consultation with the Veterinary Medicines Directorate, introduced a new feed approval mark to help owners identify feeds suitable for horses and ponies prone to equine gastric ulcer syndrome (EGUS).
Currently six feeds in the UK carry the BETA Equine Gastric Ulceration Syndrome (EGUS) Certification Mark including Winergy Equilibrium Growth and Spillers Alfalfa Pro Fibre.
Compliance with equine medicines legislation involves the challenges of food production, equine passport and essential medicines legislation as well as the prescribing Cascade, VMD guidance and the RCVS practice standards scheme.
With these in mind, the online guidance now includes:
The BEVA says the new medicines guidance resource has already been invaluable for members working towards the new Practice Standards Scheme, such as Josh Slater from the RVC, who said: "The PSS Awards define what a high-functioning equine practice looks like. The BEVA medicines guidance documents enabled us to fulfil the PSS Awards scheme requirements for demonstrating responsible use of medicines and compliance with requirements such as Cascade prescribing and emergency treatment of horses, helping us to achieve our Outstanding rating in the PSS Awards. The resource will be very useful for all equine practices preparing for PSS inspections and continues to be an invaluable day-to-day reference source for us."
The BEVA will also be holding two equine medicine courses in October 2017, providing evidence-based updates on a range of topical issues in equine medicine. The focus will be on recent research with practical relevance and the courses are aimed at clinicians who have attained or are working towards certificate level qualifications. The first will be held in Oulton, Leeds on 10 October and the second in Oxford on 31 October.
The session will be conducted in the style of the BBC Radio 4 Moral Maze discussion programme, with panelists and witnesses arguing for and against the viewpoint corporatisation is inevitable and will benefit vets and their clients.
Moderated by Madeleine Campbell, Keith Chandler and Karl Holliman will argue for corporatisation and Andrew Harrison and Tim Greet will be against. They will call upon a series of 'witnesses' for detailed questioning before the topic is more broadly debated.
CVS, the UK’s biggest veterinary group now owns more than 410 veterinary practices, of which over 30 are specifically equine or mixed practices.
The latest equine acquisitions include Bell Equine, a one-site Equine Referral Hospital in Kent, in January 2017 and Severn Edge Veterinary Group, a mixed practice with 12 sites in Shropshire, including a six-vet dedicated equine practice, in April 2017.
One line of argument says that the commercial and business advantages of a corporate, together with their scale and diversity, can give veterinary surgeons greater potential for a more flexible career path and advancement within the industry, and a more sustainable working career in equine practice.
On the flip side, there's the removal of any opportunity to buy into ownership, reduced decision-making ability because of adherence to corporate procedures, extra paperwork, longer approval processes and an increased emphasis on the bottom line.
David Mountford, Chief Executive of BEVA said: "The auditorium is usually full to bursting for our Moral Maze sessions because they bring a broader and more engaging dimension to important topics. The statement Corporatisation of equine practices is inevitable and will benefit vets and their clients is bound to generate some stimulating and possibly heated debate."
This year's BEVA Congress will be held at Liverpool Arena Convention Centre, and anyone who registers before 3rd August will receive significantly reduced booking fees.
For more information, visit: www.beva.org.uk.
Armed with the new microscope, New Forest Equine Vets (NFEV) has started offering a mobile equine veterinary service, including expert worming advice.
The microscope captures images with a resolution of 1 micron, with a live magnification of x200 and x400 or more, which means that the practice can carry out an accurate egg count in the yard, rather than sending faecal samples off to the lab.
This, they say, allows for a more a more accurate result, because posting faeces can lead to the sample desiccating and the eggs hatching, leading to false negative results. It also allows the veterinary surgeon to give immediate advice and treatment.
Dr. Beth Robinson BVSc Cert AVP(EP) MRCVS, co-owner of NFEV, says "One of the main aims of performing worm egg counts is to identify horses shedding low numbers of eggs so that we can maintain a low number of parasites on the pasture that have not been exposed to wormers and therefore have not been placed under selection pressure for resistance. In horses shedding high numbers of eggs, worm egg count reduction tests are a useful way of assessing whether treatment has been effective."
Andrew Monk, co-founder of ioLight, said: "The product is incredibly simple to use. By using a tablet both the owner and vet can view the image and discuss treatment. We hope that more horse owners in the New Forest will use the services from NFEV to protect their animals, and that it will encourage other equine practices to purchase a microscope so they can also offer a similar high quality service. We have made a video with NFEV to demonstrate their service and encourage other equine vets to use the ioLight microscope in their own mobile clinics."
Beth added: "We are delighted to be working with ioLight and horse owners to keep their animals healthy and improve equine welfare."
The BEVA Trust is the Association’s philanthropic arm and in 2015 members decided that it should provide support for voluntary projects to help improve knowledge and welfare.
Since then volunteers have been rolling up their sleeves to help out with castration and welfare clinics in the UK and veterinary training schemes around the world.
Over the past 12 months a total of 42 vets and vet nurses have volunteered their time at seven BHS Education and Welfare Clinics throughout the UK.
They have helped microchip, passport, vaccinate and castrate horses recognised by Welfare Officers as needing help.
So far 598 horses and ponies have received passports and 302 been castrated.
The Trust has seen a further ten volunteers travel across the globe, working on projects in Cambodia, the Gambia, Honduras, Kiev, Nicaragua and the Ukraine.
BEVA President Vicki Nicholls said: "We thank all of the volunteers that make our Trust such a success, with special mention to Luke Edwards from the University of Liverpool and Alice Horne from Ddole Road Veterinary Clinic who have both volunteered at four clinics. We must also remember the good work of our industrious BEVA Council members and our excellent speakers at Congress this September, who are all volunteers."
For further information on BEVA Trust volunteer projects email lara@beva.org.uk to be added to the BEVA Trust mailing list.
The National Equine Health Survey is an online snapshot survey designed to uncover common health issues in horses, directly from horse owners themselves. Results of the survey are used to build a picture of equine health and disease in the UK and define priorities for future research, training and education.
Over the past six years the survey, in partnership with the British Equine Veterinary Association, has developed to become one of the UK’s most important endemic disease monitoring initiative. The results are referenced in leading veterinary and equestrian publications and papers and are regarded as valuable benchmarks for our general knowledge of horse health.
Blue Cross Education Officer Gemma Taylor said: "These majestic police horses have taken part in our survey and we hope that they will encourage others to follow suit and be ambassadors for horse welfare.
"The more data we can collect from the National Equine Health Survey the more robust our results will be, helping us to steer equine awareness, education and research to keep our nation’s horses healthier."
Last year survey records were returned for almost 17,000 horses, ponies, donkeys and mules and the six most notable disease syndromes identified.
To take part in the National Equine Health Survey, visit: www.bluecross.org.uk/NEHS
To find out more about Blue Cross’s rescue and rehoming work with horses and ponies visit bluecross.org.uk
The charity will be carrying out a study about the disease in collaboration with the Universities of Liverpool and Nottingham. However, because funding for research is limited, and because researchers want it to answer questions around PPID that owners and veterinary surgeons actually want to know, they are asking for your suggestions.
The AHT says that it wants to provide owners and vets with practical and applicable advice that will improve the wellbeing of their horses, based on scientific evidence. So whether that’s a question around how the disease is diagnosed, the best way to treat it or what the long term prognosis is, now is your chance to have your say.
If you own or care for a horse/pony with PPID or are a veterinary surgeon that treats them (or you have done in the past) please visit: www.aht.org.uk/PPID, to take part.
If you have any questions, contact the Project Investigator Becky Tatum by email: becky.tatum @aht.org.uk or by telephone: 01638 751000 Ext. 1241
According to the company, information on best worming strategies for foals and yearlings remains largely anecdotal, making it difficult to develop a clear plan for this age group. Zoetis veterinary surgeon Wendy Talbot has therefore reviewed the recent literature to develop an eight-point plan.
Explaining the guidance, Wendy writes:
Foals and yearlings are usually more susceptible to worms than are adult horses because they have had little chance to develop any immunity. They are more vulnerable to related diseases and tend to have higher egg shedding, which increases the risk of infection. The main parasitic culprits in the UK for foals less than six months of age are large roundworms (ascarids). In older foals and weanlings, small and large strongyles, tapeworms (and pinworms) are the main considerations.1 Yearlings may also have a second wave of large roundworm infection at 8-10 months of age.2 Any control strategy will need to take into account the individual circumstances such as stocking density, pasture management and previous disease history.
Guidelines for parasite control in foals suggest a first treatment with fenbendazole at 2-3 months of age, targeting large roundworm, followed by another treatment at 5-6 months. Alternatively, pyrantel may be considered for these doses; however, there may be resistance in some areas and foals with large adult ascarid burdens may be at higher risk of intestinal rupture when this drug is used.4 At weaning (approximately six months of age), it is advisable to perform a faecal worm egg count (FWEC) to determine if treatment for strongyles is also required; the macrocyclic lactone anthelmintics (ivermectin or moxidectin) are expected to have the highest efficacy. At 9 and 12 months of age treatment for stronglyes and a larvicidal dose for encysted stages of small strongyles (moxidectin or a 5 day course of fenbendazole) are indicated. A tapeworm treatment should be included with one of these doses.2,3
For yearlings, two methods have recently been proposed for worm control: the first involves using faecal worm egg counts (FWECs) at more frequent intervals than for adults to guide dosing for strongyles in the grazing season.1 The second suggests three baseline treatments targeting strongyles in spring, summer and late autumn, with FWECs in between to identify and treat any still shedding high numbers of eggs, up to a maximum of six treatments per year.2 Macrocyclic lactones have the highest expected efficacy against small strongyles and should form the basis of treatments; however, pyrantel can be considered for some treatments where it has been shown to have continued efficacy. Both strategies include a larvcidal treatment for encysted small redworm combined with testing or treating for tapeworm in late autumn. The inclusion of one or two doses of a macrocyclic lactone each year (usually already used for small strongyle control) should be sufficient to prevent large strongyle related disease.3
The wide differences in the circumstances of foals and yearlings, together with geographical variations in resistance patterns and a lack of consensus on best practice in this group means it is not possible to define a single approach to a worming plan. An important point to note is that FWECs may give surprising results because higher counts are generally seen in youngstock.
Eight ways to keep clients' youngstock worms controlled:
For further information on worming together with some equine specific CPD visit: https://blog.vetsupportplus.com/
Severn Edge was formed six years ago with the merger of two long-standing neighbouring practices, and now employs 135 people, including 43 veterinary surgeons.
Mrs Karyn MacKenzie, Director of CVS’ Practice Division, said: "Severn Edge is an impressive practice with an outstanding leadership team and an ambitious and exciting vision for the future which we share. We are delighted to welcome the team to CVS and look forward to working with them to help them build an even more successful future."
Dr John Brentnall BVSc MRCVS, a Director of Severn Edge, will continue in the role of CVS Regional Director. He said: "It was clear from our early discussions that CVS understood what we are trying to achieve. We have embarked on a significant investment programme, including upgrading our surgery at Madeley outside Telford, and the redevelopment of the site of an additional clinic which we have recently acquired in Craven Arms.
"In order for us to continually upgrade our clinics, provide the widest range of career opportunities for our staff and steer our practice through an increasingly competitive world, we believe that the best interests of us all lie in joining forces with CVS. It is known for its interest in equine and farm practice, as well as companion animal practice, and has a policy of significant investment in both infrastructure and staff. We believe it offers the best fit with Severn Edge."
The recommendation follows the analysis of data collected as part of the company's Talk About Laminitis disease awareness initiative, which has seen more than 47,000 horses tested for PPID since it was launched in 20121.
The data revealed that, regardless of presenting clinical signs, a horse aged 15-20 is three times more likely to have PPID compared to a horse under 10, and this risk increases with age. For example, a horse of 20-25 is six times more likely to have PPID compared to a horse under 10 and a horse that is 25-30 is 10 times more likely to have PPID.
Boehringer says that despite the high prevalence of PPID in the older horse population, the clinical signs of the disease are insidious in onset and owners may simply associate them with the ageing process.
One study demonstrated that in a single population of horses over the age of 15 only 1.6% of owners reported signs of PPID2. However, when the same group of horses were examined by a veterinary surgeon, 21% were found to have signs of the disease.
Dr Jo Ireland, veterinary surgeon at the University of Liverpool, said: "It is often difficult for owners to spot the signs of PPID as they frequently associate them with the ageing process. However, PPID is now the fifth most commonly diagnosed disease in horses in the UK3.
"We are therefore encouraging veterinary surgeons to routinely test horses over 15 years of age or those that are displaying signs of PPID with an ACTH test."
The 'Talk About Laminitis' disease awareness initiative runs from June until the end of October and aims to raise awareness of the underlying hormonal causes of laminitis – PPID and Equine Metabolic Syndrome (EMS). As part of the scheme, the laboratory fees for the blood test which detects PPID (the basal ACTH test) are free.
Redwings’ head of veterinary and care, senior veterinary surgeon Nicky Jarvis, said: "Any initiative that decreases the incidence of laminitis developing in an older equine is invaluable. Laminitis is an extremely distressing condition for both the horse and the owner and the long-term consequences can be devastating. Knowing the underlying cause is a huge help in tackling the disease and we would encourage anyone to take advantage of this offer and get their veteran checked out."
For further information about 'Talk About Laminitis', visit www.talkaboutlaminitis.co.uk or contact your local Boehringer Ingelheim account manager.
References
According to the AHT, there is undisputed evidence that owners, riders and trainers have a poor ability to recognise signs of pain seen when horses are ridden. As a result, problems are labelled as training-related, rider-related, behavioural, or deemed 'normal' for that horse because 'that’s how he’s always gone'.
This, says the AHT, means pain-related problems are often disregarded, the horse continues in work, and the problem gets progressively worse.
Dr Sue Dyson, Head of Clinical Orthopaedics at the AHT, believes it may be easier to educate riders and trainers to recognise changes in facial expression and behaviour rather than lameness. So she and her team set out to develop and test an ethogram to describe facial expressions in ridden horses and to determine whether individuals could interpret and correctly apply the ethogram consistently.
At this stage in the project, they concluded that their ethogram could reliably be used to describe facial expressions of ridden horses by people from different professional backgrounds (full paper here: http://www.journalvetbehavior.com/article/S1558-7878(16)30184-8/fulltext).
In the next stage of the project, Sue and her team sought to demonstrate that the ethogram could be used to identify lameness.
The ethogram was applied blindly by a trained analyst to photographs (n=519) of the head and neck of lame (n=76) and non-lame (n=25) horses acquired during ridden schooling-type work at both trot and canter. These included images of seven lame horses acquired before (n=30 photographs) and after diagnostic analgesia had abolished lameness (n=22 photographs).
A pain score (0-3; 0=normal, 1-3=abnormal) was applied to each feature in the ethogram, based on published descriptions of pain in horses.
A total of 27,407 facial markers were recorded, with those giving the greatest significant difference between lame and sound horses including ears back, eyes partially or fully closed, an open mouth with exposed teeth and being severely above the bit.
Pain scores were higher for lame horses than non-lame horses (p<0.001). Total pain score (p<0.05), total head position score (p<0.01), and total ear score (p<0.01) were reduced in lame horses after abolition of lameness.
Severely ‘above the bit’, twisting the head, asymmetrical position of the bit, ear position (both ears backwards, one ear backwards and one to the side, one ear backwards and one ear forwards) and eye features (exposure of the sclera, the eye partially or completely closed, muscle tension caudal to the eye, an intense stare) were the best indicators of pain.
The researchers concluded that application of the ethogram and pain score could differentiate between lame and non-lame horses. Assessment of facial expression could potentially improve recognition of pain-related gait abnormalities in ridden horses (full paper here: http://www.journalvetbehavior.com/article/S1558-7878(17)30019-9/fulltext)
Sue and her team are now working on the development of a whole horse ethogram and its application to non-lame and lame horses, to help to differentiate between manifestations of conflict behaviour, in response to the demands of the rider, and pain. They are also working towards the development of a practical tool for recognising facial expressions, similar to that of a body condition score chart, which they say could dramatically improve the health and welfare of all horses.
Photo: Signs of pain include ears back (pain score of 3), intense stare, muscle tension and mouth. Courtesy Dr Sue Tyson.
5638 events were reported spontaneously, mainly by the marketing authorisation holder (61%), with the remainder largely reported by veterinary surgeons.
Of these, 5512 were reports of adverse reactions in animals: 829 concerning suspected lack of efficacy, 4638 concerning safety. The majority of reports concerned dogs (2927), cats (1426) and cattle (386).
In dogs, medicines for the control of epilepsy were most often suspected of not having performed as expected (80 reports) whilst vaccines were most commonly reported as having failed to work (71). However, the VMD points out that in many cases, vaccination failure was attributable to other causes (such as incomplete vaccination schedule).
In cats, flea spot-on products were most likely to be reported as not having worked (21). However, there are many reasons why owners may continue to see live fleas on their animal which are unrelated to product efficacy (such as reinfestation from the environment).
Notably, the majority of efficacy reports in horses (12/19) related to euthanasia products, which the report says should serve as a reminder that alternative means of euthanasia should always be available in case the chosen method does not proceed as planned.
Of the safety reports, 59.6% involved dogs, 31% cats, 4.9% horses and 3.9% rabbits. The majority concerned vaccines (1360 reports, most commonly general signs or symptoms, such as lethargy or pyrexia), parasiticides (472 reports, most commonly lethargy, emesis, inflammation/pruritus, depending on method of administration) and inflammation control (412 cases, most commonly emesis, renal insufficiency and diarrhoea, depending on the drug type).
There were 124 reports of adverse events in humans. Of those involving veterinary professionals (about a quarter):
The VMD says that reports of needle stick injuries involving vaccines with a mineral oil adjuvant are of particular concern, because they often fail to show that the injured party has received prompt and correct treatment, either because they are themselves unaware of the necessity for swift intervention, or because they do not take the product package information leaflet with them when seeking medical treatment.
Similarly, the VMD says that incidents involving injectable tilmicosin seem to be often dismissed as just a scratch, and that if you use these products, you should make sure you are fully aware of the warnings contained in the product leaflets.
To read the full report, visit: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/608968/PhV_Annual_Review_2015_v7.pdf
The kit uses an indirect semi-quantitative IgG antibody assay which provides an easy-to-read colour change which clearly distinguishes normal IgG levels (>8mg/ml; colourless), partial FPT (4-8mg/ml; pink) and levels generally considered diagnostic of complete FPT (<4mg/ml; purple).
Vetlabs says the kit has a proven sensitivity and specificity of 97.4% and 93.6% respectively, and responds equally well with anticoagulant whole blood, serum or plasma. And with no additional equipment or refrigerated storage required, it is a true field test.
Mike Fleming, CEO of Vetlab Supplies Ltd said: "It’s not often you get to launch an equine diagnostic that’s genuinely life saving. With Fastest IgG Equine, vets can now give a clear-cut Failure of Passive Transfer (FPT) diagnosis at farms, stables or equestrian centres – and all in just 10 minutes."
According to the company, as many as 1 in 5 new-born foals can suffer some degree of IgG FPT. Foals with no antibody protection, due to complete FTP, have an estimated 75% chance of contracting debilitating or life-threatening infection. Even foals with some protection following partial FPT have only a 50% chance of resisting invaders such as Anaplasma, Giardia and Cryptosporidium.
The new-born foal’s absorption of maternal antibodies is most efficient in the first 6 to 8 hours of life, effectively ceasing after 24 to 36 hours. Veterinary surgeons and managers of equestrian facilities have only this narrow window to recognise FPT and act to save a valuable new-born from life threatening infection.
Mike added: "With Fastest Equine as part of their field kit, equine vets are equipped to diagnose and treat antibody deficient foals with life-saving colostrum, colsotrum formula substitute, or administer oral or intravenous IgG, within that critical first 24 hours."
Following last year's campaign, Merial commissioned a survey to learn more about how horse owners seek and receive information about the wider aspects of preventative healthcare, and in particular about the relationship with their veterinary practice.
In the survey of 455 horse owners, which was carried out by CMI Research, 78% said their veterinary surgeon was the most important source of information. The next most important influencers were yard managers/grooms at just 22%.
Louise Radford MRCVS from Merial said: "We wanted to learn more about client education and the opportunities for practices to get more from their client relationships, including vaccination and booster uptake. However we hadn’t estimated just how much horse owners rely on their vet for information!"
"However there appears to be a significant gap between vets as a source of information, and their client’s purchasing habits. Health plans are a great example of the potential for improved compliance, with benefits to the horse, client and practice. Yard health plans present an opportunity to increase booster uptake and also to include animals that might not otherwise be vaccinated.
"Of those horse owners and grooms surveyed who did not vaccinate some or all of their horses, their reasons included horses that never leave the yard, or are old, young, or do not interact with other horses. Yet we know that horses that don’t travel are still at risk of equine flu, as virus can travel up to a mile as an aerosol on the wind, in addition to being carried on objects such as buckets and tack.
"So as the key influencers on preventative healthcare, there is much that practices can do to further engage with clients to increase uptake of products and services, improve client loyalty, and ultimately boost the practice business."
For more information on Equine Flu Awareness Month- 2017, including client materials and video content, visit www.equinefluawareness.com
The Best UK Vets Awards are given to the practices that accumulate the largest number of positive reviews from clients on vethelpdirect.com and any-uk-vet.co.uk over the course of the year.
Penmellyn Vets achieved 839 positive ratings; 200 more than their nearest rivals, reflecting the tremendous level of engagement they have with their clients, something which also shone through in the sentiments expressed in their client reviews.
Penmellyn Vets is an independent practice owned by six veterinary surgeons, who are all based in Cornwall. They have been providing veterinary care to the pets and horses of Cornwall for over 130 years. They still cover their own out of hours’ care and their services include preventative healthcare packages for their cat and dog-owning clients, ‘LifeCare’ and ‘LifeCare+’. The latter grants clients access to unlimited vet and nurse consultations 6 days a week – something that is currently only offered by Penmellyn Vets in Cornwall.
Philip Harris, one of the partners at Penmellyn Vets said: "We are absolutely delighted to have won this award and want to say thank you to each and every one of our clients who took the time to leave a review. And my thanks to the Penmellyn staff for their hard work and commitment to providing the outstanding customer service that has been recognised by this award. I couldn’t be more proud of them. We’re an independent practice and very traditional in many ways, so I think as we’ve grown as a group, with a goal of excellence always in patient care, our values have kept us grounded and very client-centric. We look forward to celebrating the award with our team at the awards ceremony in the coming weeks."
Blacks Vets in Dudley were awarded the Silver award after receiving a very commendable 620 qualifying client reviews.
Tracey Jewkes, Managing Director, said: "We are delighted to have been awarded Silver in the Best UK Vet 2017 Award and would like to take this opportunity to send a heartfelt thank you to our wonderful clients for voting for us again this year. Our consistency at the top of this award for the past 3 years is a reflection of both the calibre and heart Team Blacks give to pets, clients and each other year after year. We could not be more proud of each and every team member here, nor could we feel more privileged to take great care of so many much loved pets in our local community."
Inglis Veterinary Hospital in Dunfermline, Scotland received 358 qualifying reviews and received the Bronze award. They also went on to win the Best Scottish Vet Award 2017.
The full list of winners is:
This year’s winners of the small category awards are:
Bell Equine is one of the leading equine hospitals and was the first practice worldwide to install a standing MRI unit for horses.
CVS says the acquisition reflects its increased focus on equine practice, with further expansion of its Equine Division planned in the UK and Europe during 2017.
Equine Director Ben Jacklin said: "The acquisition of such an outstanding hospital is an exciting step for us. Bell Equine has always been at the forefront of the equine profession, both clinically and non-clinically, and as such it is a perfect match for the Equine Division of CVS."
Julian Samuelson, former managing director of Bell Equine, will continue in the role of Clinical Director. He said: "We are delighted to be joining forces with CVS and are very much looking forward to working closely with the Group to help realise the exciting potential of its equine ambitions. We look forward to the opportunity to continue to lead the profession, both within and outside CVS."
The nine-page booklet is being distributed electronically to all BEVA members, together with a guide on spotting some of the warning signs horses may display, written by equine veterinary surgeon and behaviourist Gemma Pearson.
A report commissioned by the BEVA in 2013 indicated that an equine vet could expect to sustain between seven and eight work-related injuries that impeded them from practicing, during a 30-year working life.
Data available from the Health and Safety Executive suggests that this is a very high number of injuries compared to other civilian occupations, including those working in the construction industry, prison service and the fire brigade.
The new guide has been produced ‘by horse vets for horse vets’ with BEVA members contributing their views, experiences and suggestions to early drafts.
It provides information for those handling and involved with equine veterinary care; to make workers consider the steps that they can take to make their activities as safe as reasonably possible by assessing a situation and implementing measures to limit the risk that vets and others are exposed to.
The guide also aims to challenge prevailing attitudes and culture. It outlines how to make ‘on the spot’ or ‘mental’ risk assessments and when to stop if a procedure becomes unsafe.
The guide is accompanied by an illustrated leaflet Signs of Increased Arousal Combined with a Negative Effective State. Written by Gemma Pearson, BVMS Cert AVP (EM) MRCVS who specialises in equine behaviour and learning theory, it explains signs of increased arousal including facial expressions, stance, movement and response.
David Mountford, CEO of BEVA said: "The new guidelines have been carefully developed to ensure that they are as pertinent, pragmatic and helpful as possible for vets in practice. Hopefully they will help to make the equine veterinary workplace a little safer."
The new guides can be downloaded at: https://www.beva.org.uk/workplacesafety
The Boehringer Academy (www.boehringer-academy.co.uk) contains hundreds of hours of CPD material on equine, companion and production animals. It comprises a mixture of webinars, podcasts, short videos and downloadable documents, which can be viewed at any time. The site keeps a CPD log for each user and provides downloadable certificates.
Boehringer’s Small Animal Marketing Team Leader, Jemima Mead said: "We already have just over 15,000 vets and nurses in the UK and Ireland currently registered with the Academy.
"New and existing members are eligible to receive the Boehringer Academy colouring book. They simply have to visit www.boehringer-academy.co.uk and complete their profile. In addition, everyone completing their profile will be entered into a draw to win an iPad Pro and Apple Pencil."