The RCVS Disciplinary Committee has reprimanded Gloucestershire veterinary surgeon Adele Lewis for failing to pass on information about a horse’s clinical history to a potential buyer during a pre-purchase examination.
Ms Lewis, the sole principal of the Cotswold Equine Clinic in Lechlade, Gloucestershire, carried out the examination of a pony called Luke on 13 February 2014. Luke was owned by Mrs Booth who was a long-established client of Ms Lewis, both at her previous practice, Bourton Vale, and at her current practice. The examination was carried out on behalf of the prospective purchaser, Mrs Grieve.
Upon examination Ms Lewis certified that, in her opinion, Luke’s veterinary history did not increase the risk of purchase.
Following the purchase of Luke, Mrs Grieve attempted to obtain insurance for Luke and found out from a pet insurance company that a claim had been made by Mrs Booth in September 2013. She subsequently found out that, following concerns expressed by Mrs Booth and her trainer about Luke’s movement and their wanting an expert opinion, Ms Lewis had referred him to Dr Kold, a Specialist in Equine Orthopaedics, in September 2013. Dr Kold had diagnosed Luke with lameness and had given him intra-articular medication. Luke had also had a follow-up appointment with Dr Kold about four weeks later in October 2013.
The Disciplinary Committee hearing commenced on Tuesday 13 October 2015. At the outset, Ms Lewis admitted several parts of the charges (charge A and charge B) against her. In regards to charge A, she admitted that she had failed to inform Mrs Grieve that, when she examined Luke on 24 September 2013, his then owner Mrs Booth had complained firstly that Luke was “not tracking up and going forward” and, secondly, that he had improved significantly when put on a Phenylbutazone trial. She also admitted that she had referred him to Dr Kold for a poor performance investigation and that she ought to have informed Mrs Grieve of these matters.
In regards to charge B, she admitted that she completed a Certificate of Veterinary Examination in which she had declared that Luke’s veterinary history did not increase the risk of purchase and allowed the vendor’s declaration to include assertions that there had been no previous lameness and no intra-articular medication given in the last 12 months. Ms Lewis admitted that she ought to have known that her declaration that Luke’s veterinary history did not increase the risk of purchase was incorrect.
However, Ms Lewis denied being aware that Dr Kold had diagnosed lameness, administered an intra-articular corticosteroid to Luke and examined and noted a problem with his breathing, including upper airway disease and possible lower airway disease. Furthermore, she denied dishonesty in regards to both the charges against her and in relation to vendor declarations made on the Certificate of Veterinary Examination regarding previous lameness and intra-articular medication.
During the course of the hearing, Ms Lewis told the Committee that she had not received the reports about the two consultations by Dr Kold (despite their having been sent to her by letter and, with respect to the second report, also by email) and that she was therefore unaware of his findings when she carried out the pre-purchase examination. She also stated that she had not been informed of these by Mrs Booth. During her evidence, Ms Lewis also admitted having entered inaccurate information on a veterinary report to assist with an insurance claim.
The Committee did not find Ms Lewis to be an impressive witness citing the fact that her “explanations as to her practice showed a worrying absence of probity in the completion of veterinary reports for the purposes of insurance claims, and an absence of any effective practice management, consistent with acceptable practice.”
However, the Committee felt it did not have the evidence to conclude that Ms Lewis had acted dishonestly during the pre-purchase examination. It cited the fact that her actions, when informed by the purchaser Mrs Grieve of Dr Kold’s examination, did not appear to be those of someone trying to cover their tracks.
In regards to charge A, the Committee also found that the “apparently chaotic manner in which Ms Lewis ran her practice, and her own opinion that the pony was sound, would appear to have led her to wrongly disregard these matters from disclosure.”
In making its decision on her conduct and sanction, the Committee said that Ms Lewis’ failure to fully communicate to Mrs Grieve all the relevant information about Luke’s veterinary history fell far short of the conduct expected from a veterinary surgeon. It also cited the utmost importance of a complete and accurate certification process, as made clear in the RCVS Code of Professional Conduct and the Twelve Principles of Certification.
Chitra Karve, chairing the Committee and speaking on its behalf, said: “The Committee continues to emphasise the importance of maintaining the integrity of veterinary certification in any aspect of practice. Mrs Grieve told this Committee that if she had been fully informed about Luke’s veterinary history she would not have purchased the pony. It is clear from the evidence that it affected Mrs Grieve’s ability to insure the pony. Ms Lewis has accepted that the information about Luke’s veterinary history, not having been disclosed, was capable of affecting the risk of purchase. The public are entitled to rely upon veterinary surgeons providing complete and accurate information, when certificates and reports are prepared.”
In mitigation, the Committee paid regard to Ms Lewis’ inexperience at running her own practice and found no issue with her competence or clinical ability as a veterinary surgeon. It concluded that she had acted out of character and that there was no financial motivation for her actions. It also found it “highly relevant that the facts admitted and found proved related to a single pre-purchase examination.”
It also noted that Ms Lewis has now put in place a practice management system and has shown insight into her actions, by taking active steps to better comply with her obligations under the Code of Professional Conduct. She had also made early admissions of guilt and made a full apology to both Mrs Grieve and the RCVS both at the outset of the hearing, and in her evidence.
Chitra Karve added: “Having had the opportunity of observing her demeanour at this hearing, the Committee believes that it is unlikely that she will repeat her conduct.... The Committee has concluded that an appropriate and proportionate response in this case is to reprimand Ms Lewis.”
Moral Maze, a debate held by members at the British Equine Veterinary Association (BEVA) Congress earlier this month, has concluded that equine practice needs to adapt to accommodate family life.
92% of voters agreed with the motion: Equine practice needs to change to become more compatible with family life.
BEVA says the result may reflect in part the changing demographics of the profession, with females now accounting for 76% of new graduate intakes.
Traditionally vets have worked together in practices, able to share resources and expertise as well as the out-of-hours rota. Until recently, men from the Baby Boomer Generation dominated the profession and many vets focused their efforts on work at the expense of their family. However, as Generation Y takes hold and more females are joining equine practice, there are different personal expectations with many vets now wanting greater commitment to family life and a better work-life balance.
The session took the form of a moral maze debate, chaired by Malcolm Morley, in which expert witnesses were challenged by informed interrogators. The proposers contended that it is possible to achieve a good work-life balance as an effective vet in a successful equine practice by working smarter, not harder and adopting a flexible approach.
Carolyne Crowe, veterinary coach and mentor, said: “Choosing to be an equine vet shouldn’t go hand in hand with giving up the rest of your life. Allowing flexibility within job roles should result in more engagement, productivity and thus economic benefit for the practice.”
Job share that included a proportionate allocation of the out-of-hours rota, was cited as a tenable solution for those juggling maternity leave and parenthood. The consistency of attending vets so often demanded by clients could be achieved by introducing two vets of equal calibre to the client, from the outset. Members of the audience outlined successful examples of job sharing and the consensus was that the turnover generated by part time, job share employees was often higher than their full time equivalents.
Mark Bowen, President of BEVA, said: “I’m not surprised that 92% of voters supported the motion, given the fact that the recent Vet Futures survey has shown a high rate of job dissatisfaction in equine practice. It reiterates the importance of moving with the times to evaluate the needs of working parents and make the equine veterinary workplace more adaptable to family life.”
BEVA is already working on various projects to help address and support the needs of members who are striving for a better work-life balance. CPD on personal effectiveness, covering work-life balance and time management is scheduled for the New Year. Further information on other initiatives will be released towards the end of the year.
The debate can be viewed online for free at beva.org.uk in the webinar tab.
Mark Bowen, Associate Professor at The University of Nottingham, has been appointed as President of the British Equine Veterinary Association (BEVA) for 2015/16.
Mark will take over the role from Andrew Harrison at the end of BEVA Congress on 12th September. Vicki Nicholls, Veterinary Assistant at Wright and Morten Vets, Cheshire becomes President Elect.
He said: "BEVA’s strengths lie in its members, who are committed to the welfare of the horse and the advancement of clinical practice. With new benefits for members, a new website, a new role for the BEVA Trust and the highest quality of education, BEVA is now an even more forceful and effective voice for the equine profession, both internally and externally.
"Whilst the profession attempts to shape its future for the next 15 years, we must continue to support the innovative individuals in the profession who look ‘outside the box’ and make sure that the future of our profession, the next generation of veterinary surgeons, does not become restricted by dogma and tradition; that they too can replicate the level of innovation seen in equine practice over the last 50 years.
"It is vital that we continue to strengthen our relationships with the British Horseracing Authority and contribute to the development of a funding body to replace the Horserace Betting Levy Board. Our relationship with the BVA, the regulation of allied professionals, the rescheduling of ketamine, the new EU animal health regulations and EU medicines regulations, even the role of Europe, are key areas where BEVA will make veterinary voices heard for the benefit of equine welfare.
"Lastly, employment and retention of veterinary graduates in the profession is a cause of concern to us all. Over the next year we will enhance the Internship Awareness Programme and provide support and mentoring for the younger members of the profession. BEVA council is full of individuals committed to working on your behalf and I am looking forward to working alongside them all for the benefit of us all."
Zoetis has announced the introduction of Equimidine solution in a 50% larger plastic bottle.
The company says the new 15ml multi-dose presentation, now in plastic rather than glass, offers greater safety, as well as cost-saving advantages to practices.
Equimidine, containing 10mg/ml detomidine hydrochloride and methyl parahydroxybenzoate 1 mg/ml as a preservative, is a clear solution for intravenous injection. It has sedative and analgesic properties and is indicated for use either alone or in combination with butorphanol to facilitate the handling of horses for clinical examinations, minor surgical procedures and other manipulations. It can also be used with ketamine for short duration general anaesthesia for surgical procedures such as castration.
According to the company, the new 15ml plastic bottle is more cost-effective per dose than the old 10ml glass vial. It is also safer to use as the bottle is less likely to break if accidentally dropped. The multi-dose facility involves a tightly fitted rubber bung through which a sterile needle can be inserted to withdraw each dose.
Penny McCann, Equine Product Manager, Zoetis UK Ltd, said: "The new presentation provides practical benefits for vets and the larger bottle size means the product is now even more cost-effective."
For more information, speak to your Zoetis Account Manager, refer to the SPC or contact Zoetis Customer Support on 0845 3008034.
Blue Cross has announced the results from its National Equine Health Survey (NEHS) which show that lameness is three times more likely to be caused by conditions such as osteoarthritis in the limb rather than problems in the foot.
Blue Cross runs NEHS in May each year, in partnership with the British Equine Veterinary Association (BEVA). It is sponsored by SPILLERS and Zoetis and supported by the UK’s leading equestrian organisations and charities. This year saw a 35% increase in participation compared to 2014, with survey records returned for almost 15,000 horses, ponies, donkeys and mules.
The charity says that whilst of course the horse’s foot is fundamental to soundness and performance, NEHS results have shown consistently that limb lameness, as opposed to foot lameness, is in fact the biggest syndrome affecting horses.
In the latest survey, conducted in May, a total of 18% were recorded as lame. 13.5% of these were recorded as suffering with lameness such as osteoarthritis, also known as degenerative joint disease (13.9% in 2014 and 14.8% in 2013).
Meanwhile foot lameness was recorded in 4.5% of returns, a similar figure to previous years.
Josh Slater from the Royal Veterinary College, who is member of BEVA’s Health & Medicines Committee and analysed the NEHS data, said: “NEHS is now producing important evidence that is replacing subjective opinion. While the lameness figures were initially surprising, given that the foot has been generally regarded as the main problem area, the fact that these figures have remained consistent over the past three years gives constructive credibility to the data. Our findings will help owner vigilance with day-to-day healthcare as well as help prioritise on areas for future veterinary education and research.”
The six most notable disease syndromes identified in the 2015 National Equine Health Survey were:
23.2% of horses were reported as being overweight with a Body Condition Score of 3.5-5, continuing the upward trend seen in previous years (16.9% in 2014 and 7.8% in 2013). Next year’s survey will explore links between obesity and the possible associated rise of obesity-related diseases such as equine metabolic syndrome (which was reported in 2.4% of 2015 returns) and laminitis.
The survey also enables participants to report on any health problems not covered in the survey questions, giving them a chance to shape future survey subjects.
Gemma Taylor, Education Officer at Blue Cross explains: “This year 11% of our free text answers mentioned gastric ulcers giving a valuable insight into the prevalence gastric ulcer syndrome in the principally leisure horse NEHS population. As a result we will be adding new questions to the 2016 survey to help us find out more.”
The 2015 NEHS survey results are now available from http://www.bluecross.org.uk/nehs2015results. To register for next year’s survey, visit www.bluecross.org.uk/nehs
Scientists from the Animal Health Trust, the Wellcome Trust Sanger Institute and the University of St. Andrews have pinpointed the genes which allow the bacteria responsible for strangles to thrive, thereby paving the way for the development of a vaccine.
In the study, which the researchers say was the largest of its kind, 224 samples of Streptococcus equi (S. equi) were procured from horses around the globe to try and find a common bacterial ancestor from which modern strains would have developed. Despite the disease first being described in 1251, the researchers were surprised at the genetic similarity of the samples and identified a total population replacement at the 19th or early 20th century. This corresponds to a period when horses from around the world were brought together in global conflicts including World War I, where an estimated eight million horses died on the battlefield.
Dr Simon Harris from the Wellcome Trust Sanger Institute said: “The mobilisation and mixing of horses in conflicts such as WWI provided perfect conditions for S. equi to thrive. This combined with high mortality rates among the horses and their replacement with young susceptible horses could explain what we see around the world today".
While loss of diversity could be considered detrimental to bacterial populations, S. equi still infects more than 20,000 horses in the UK alone each year. Its success, researchers believe, is due to its ability to persist in some horses for years after they have recovered from strangles, where the bug can evolve to evade the horse’s immune system.
Dr Andrew Waller, Head of Bacteriology at the Animal Health Trust said: “The data we have gathered in this study has enabled us to pinpoint the genes that help the bacteria to persist, spread and thrive in the horse population. This research provides an unprecedented opportunity to reduce the impact of and prevent strangles in future generations of horses.”
The AHT says that the ability of S. equi to adapt to living in a persistent state within its host and still infect new horses mirrors the situation with HIV and the bacteria that causes tuberculosis in humans. Dr Matthew Holden from the Wellcome Trust Sanger Institute and the University of St Andrews said: “Unravelling the complex population dynamics of S. equi sheds new light on the balancing act between acute and persistent infection that is going on in many pathogens. Not only does this collection of whole-genome sequences for S. equi offer hope for an effective strangles vaccine, it also provides us with a useful model for understanding persistent infection in humans.”
Researchers at the Animal Health Trust are appealing for information from veterinary surgeons who have seen recent Eosinophilic Keratitis (EK) conditions, an emerging issue in UK equine ophthalmology.
The AHT says that despite the increased awareness of EK worldwide, the aetiopathogenesis of the disease remains poorly understood and probably underdiagnosed. The charity is looking to define the pathogenesis and determine why some horses are particularly susceptible to this condition, in particular looking for epidemiological links, environmental factors and parasitic infestation.
Many of the clinical signs of EK are non-specific and similar to other corneal conditions such as blepharospasm, chemosis, conjunctival hyperaemia, epiphora or perilesional oedema. More specific signs include caseous mucoid discharge and white/yellow plaques often localised in the peripheral cornea. The degree of pain varies and concurrent ulceration is almost always present. Conjunctivitis may also occur in association with the keratitis or as a unique disease entity.
EK can have variable clinical presentations, from a thick caseous accumulation to a more superficial plaque of “ground-glass” appearance. They may present as chronic non-healing ulcers that respond quickly to the use of topical steroids and/or ciclosporin, or present with marked ocular discomfort and require superficial keratectomy to resolve the condition.
Two different corneal locations are classically (though not exclusively) involved in EK, the medial perilimbal cornea, often under the third eyelid, or the lateral perilimbal cornea, which may progress axially towards the central cornea.
The charity is also providing free cytology tests for corneal scrapes to help vets diagnose EK earlier, thereby avoiding secondary complications that can lead to permanent visionary impairment.
If you have seen cases that have either been diagnosed as or that you suspect to be Eosinophilic Keratitis this year, contact Sonia Gonzalez-Medina on 01638 751000 Ext: 1203 or sonia.gonzalez-medina@aht.org.uk.
For more information and to download a copy of the submission form to accompany samples, visit www.aht.org.uk/EKstudy.
Dechra Veterinary Products has launched TAF Spray (thiamphenicol), a next generation antibiotic wound spray for superficial wound infections in horses, cattle, goats, sheep and pigs.
Dechra says TAF Spray can also be used to treat infections of the claw and hoof in cattle, goats and sheep such as foot rot, interdigital dermatitis and digital dermatitis.
TAF Spray is the only licensed wound spray for horses and has a zero day meat withdrawal period for horses, cattle, goats, sheep, and 14 days for pigs.
Dechra is also highlighting the fact that TAF Spray is the only golden yellow coloured product of its kind on the market, allowing treatment areas to be distinguished clearly.
Brand Manager Emma Jennings said: “Dechra has developed TAF Spray in direct response to the research we conducted among farmers".
The research1 showed that 51% of the veterinary surgeons had used an antibiotic spray for the treatment of digital dermatitis – an infection that 92% of farmers had experienced in their livestock in the past 12 months.
Emma added: "Thiamphenicol is a highly effective antibiotic. With the brightly coloured spray format making it distinguishable from other treatments and a can that is able to be used in upright and inverted positions, we are sure that TAF Spray will become a popular product among veterinary professionals.”
TAF Spray comes in a 150ml can with a 360-degree nozzle which allows wounds to be targeted at any angle.
For further information about Dechra’s antibiotic portfolio, visit www.dechra.co.uk
Reference
Langford Veterinary Services, a fully owned subsidiary of the University of Bristol, has announced the opening of a new standing equine magnetic resonance imaging (MRI) facility at the university's equine centre.
The equine MRI facility completes the diagnostic imaging facilities in the School, which include a 16-slice CT scanner for small animals and standing horses, digital radiography, high-resolution fluoroscopy, diagnostic ultrasound, echocardiography and scintigraphy with a high-resolution 1.5 tesla MRI scanner, available seven days a week.
Evita Busschers, Senior Teaching Fellow and orthopaedic surgeon in the equine centre, said: “We are very grateful to the Trustees of the Alborada Trust and the Langford Trust who have provided generous support for the MRI facility. The new imaging facility will enable us to provide an even better and more complete service for our equine patients and completes the diagnostic imaging facilities available at the centre.
“Equine MRI offers the ability to image soft tissue structures and identify soft tissue injuries that cannot be demonstrated with other diagnostic imaging modalities and therefore has major additional value in providing a diagnosis and prognosis in lameness evaluations.”
Miles Littlewort, a trustee from the Alborada Trust added: “Donating the money is the easy bit but ensuring that it has been used where it should be and that it has made the necessary difference is much more challenging. We are so pleased to have had the opportunity to support the Langford Trust and their work to improve animal health and welfare. We are delighted to have attended the opening, to meet the clinicians who will use the magnificent facility and to learn about the clinical research which gives all veterinary surgeons evidence-based information to enhance diagnosis and treatment for all patients.”
Boehringer Ingelheim has launched Care and Connect a free online PPID aftercare service for horse owners, designed to help veterinary practices monitor their PPID case load and streamline the case management process.
The new service is part of Boehringer's 'Talk About Laminitis (TAL)' Awareness campaign.
The company says that PPID is the sixth most frequently encountered disease syndrome affecting equids in the UK1, and the new service should help engage owners and vets post diagnosis, thereby maximising treatment success.
Liz Barrett, equine business manager at Boehringer, said: “PPID is a progressive disease, so it is vital that veterinary surgeons remain at the centre of care, and that horses are monitored carefully following their initial diagnosis. However we recognise the high administrative demand associated with this, and TAL Care and Connect has been designed to reduce this as much as possible.”
TAL Care and Connect will be offered automatically to horse owners who take advantage of this year’s free* ACTH testing scheme, which will be available from July to November. Equine practices can also offer this aftercare service to all owners of previously diagnosed PPID cases.
Owners who join TAL Care and Connect will be able to set up a profile for their horse which allows all their ACTH results to be stored in one place. They will then receive the relevant reminders for follow-up ACTH testing which will make it easier for vets to monitor their patient’s progress over time.
In addition, owners can download an independently-written PPID information pack. Edited by Prof. Catherine McGowan with contributions from Dr Jo Ireland, Prof. Andy Durham, David Rendle and Dr Teresa Hollands, the pack includes advice on monitoring and follow-up ACTH tests, feeding, general care of the PPID patient and the link between laminitis and PPID.
Talk About Laminitis is supported by Redwings, The British Horse Society and World Horse Welfare, and will run from July until the end of October 2015. Horse owners can find out more and obtain their free ACTH voucher code at www.talkaboutlaminitis.co.uk.
For further information contact your local Boehringer territory manager or visit www.talkaboutlaminitis.co.uk.
*Cost of laboratory test
References
The Society for Practising Veterinary Surgeons (SPVS) has published its 2015 Fee Survey, which has revealed an increasing divergence between fees charged for routine and unroutine procedures in small animal practice.
SPVS says that small animal practices accounted for the largest proportion of responses to its survey, and that 75.9% of them had increased their fees during the last 12 months. When comparing a 'bundle' price comprising a kitten vaccination course, puppy vaccination course, cat spay, dog spay and consultation, the increase was 4.09%. However SPVS notes that this increase may be artificially low, as it relates to the sort of procedures that are regularly quoted and may therefore be constrained by the marketplace.
Perhaps more revealingly, whilst routine procedures such as vaccination had risen 3.3%, non routine procedures had risen by considerably more: pyometras were up 15.6%, cat dentals were up 17.5% and out-of-hours callouts were up 18.6%.
Equine fees showed an overall drop of 3.5% on the bundle price comprising initial routine examination, five-stage PPE, routine dental examination and float, a colic examination and the cost of sedation / waiting. Although many of the individual equine procedures showed a fee decrease, 79% of equine practices reported that they had increased fees over the past year. The largest decrease in equine fees was for sedating a horse and waiting while the horse was clipped or treated by an equine dental technician, with the fee charged being 12.5% less than last year and ranging from £12.50 to £93.82. Conversely, conducting an ultrasound scan of a mare for pregnancy had increased by 17.3% and ranged from £20 to £62.36.
For large animal vets, the fees are more tightly constrained by the commercial realities of farming and the range of fees quoted tends to be lower. This year, the overall price rise for the bundle of fees comprising routine calving, foot trimming, elective Caesarean and hourly rates for fertility work and herd health schemes was 4.1%. However, only 47.8% of large animal practices reported an increase in fees charged over the last twelve months. The largest increase reported was for paring the hind feet of a cow without sedation, which was up 24.4% and ranged in price from £19 to £70, while issuing a prescription to a farm animal client had decreased by 1.6% and ranged in price from 0 to £48.
Nick Stuart, SPVS president said: "We all know the industry is facing real challenges and this is reflected in the fee survey, with equine practices in particular decreasing many of their prices on last year. However the survey also shows that the fees vets charge vary widely, particularly in the small animal sector. While some of this can be accounted for by differing overheads, it does provide a fascinating insight into the various financial models that exist and challenges practice owners to review how they construct their fees. It also suggests that there is scope for practices to grow their profitability and understanding the market will help them with this.
"We have a new benchmarking service from Veterinary Insights that will help practices to set more accurate fee levels and we will be developing our fee survey further so that it dovetails with this service. I would urge practices to join SPVS and access the invaluable data we produce to help them grow their businesses."
For more information, a copy of the survey, or to join SPVS visit www.spvs.org.uk
Zoetis has announced the launch of Contacera (meloxicam) 15mg/ml oral suspension, a non-steriodal anti-inflammatory preparation for horses.
According to the company, meloxicam has been shown to hold advantages over Phenylbutazone for the alleviation of musculoskeletal inflammation and pain in horses over six weeks of age1,2,3,4.
Contacera can be mixed with food or syringed directly into the mouth to ensure compliance. It is available in 100ml or 250ml bottles, with a measuring dose syringe and a syringe adaptor. Contacera solution for injection is also available.
Penny McCann, Equine Product Manager, Zoetis UK Ltd, said: "Contacera is an exciting addition to our NSAID portfolio. Due to the potential clinical advantages of Meloxicam, Contacera gives vets an important additional option for NSAID management. It is a logical fit with the other products in our range and benefits from a choice of presentations."
For further information, contact your Zoetis Account Manager, visit www.zoetis.co.uk, or ring Zoetis' Customer Support: 0845 3008034
Ceva Animal Health has highlighted a new study which revealed that the use of the opioid buprenorphine, the active ingredient in Vetergesic, before equine elective general anaesthesia and surgery resulted in better post-operative analgesia than butorphanol, without causing further physiological disruption than is normally expected of general anaesthesia in horses.
The prospective, randomised and blinded multicentre study, conducted by Dr Polly Taylor VetMB MA PhD DVA DipECVAA MRCA MRCVS, an RCVS Specialist in Veterinary Anaesthesia, compared the degree of post-operative pain and physiological variables in horses following premedication with either buprenorphine or butorphanol in a general clinical setting. The study included 89 healthy adult horses from six UK equine veterinary clinics admitted for routine elective surgical procedures.
Ceva says that butorphanol is often used in equine procedures due to familiarity and its value for enhancing alpha2-induced sedation, but that it is probably the least effective opioid as an analgesic. There is also a common perception that butorphanol has less impact on locomotor stimulation and depression of intestinal motility than other opioids. This is likely to have contributed to the almost exclusive use of NSAIDs to manage pain in the post-operative period.
To view the full study, visit http://onlinelibrary.wiley.com/doi/10.1111/evj.12442/abstract. For details on Ceva's analgesic product range, email analgesics-group@ceva.com or call 01494 781510.
Wiley has announced the joint online publication of a special issue of 22 ophthalmology papers from Equine Veterinary Journal, Equine Veterinary Education and Veterinary Ophthalmology.
Clinical equine ophthalmology: The current state of the art brings together papers on some of the most significant advances in equine clinical ophthalmology into a single issue to make them more readily available to a wider audience. The issue contains information of direct relevance to all sectors of the veterinary profession from general practitioners and specialists to researchers, surgeons and students, covering common diseases, surgical procedures and outcomes.
The new publication was devised and compiled by a panel of guest editors comprising Mary Lassaline, member of the Veterinary Ophthalmology Editorial board and Veterinary Ophthalmologist in the Department of Surgical and Radiological Sciences at UC-Davis School of Veterinary Medicine, California, David A. Wilkie, Editor of Veterinary Ophthalmology and Professor at Veterinary Clinical Sciences Comparative Ophthalmology Ohio State University, Tim Mair, Editor of Equine Veterinary Education based at Bell Equine Veterinary Clinic, Kent and Celia M Marr, Editor of Equine Veterinary Journal, based at Rossdales, Newmarket.Mary Lassaline said: "The goal was to provide broad access to the most current information applicable to every stratum of the equine veterinary profession. Subsequently, a salient feature is that many of the papers included are collaborations between veterinary ophthalmologists with a special interest in horses, equine practitioners with a special interest in ophthalmology, private practitioners and those in academia, and academicians from different institutions."
Subjects covered include seven papers on new approaches to the diagnosis and treatment of ulcerative and non-ulcerative keratitis in the horse. There are three articles on novel approaches to corneal surgery and a further three on corneal neoplasia. Six papers provide valuable data regarding long-term outcomes following surgical intervention for Equine Recurrent Uveitis (ERU), glaucoma, and cataracts. Finally, three articles present new information regarding retinal and orbital disease.
Professor Celia Marr, Editor of the Equine Veterinary Journal said: "The key purpose of the EVJ is to disseminate information to help the enhancement of specialist knowledge at every level of the veterinary profession. By collating the most important and up-to-date ophthalmology research into one easy resource the new special issue does exactly that."The ophthalmology special issue is available free online at: http://bit.ly/1bi0RG0
Bayer Animal Health has launched Remend Wound Spray Gel for cats, dogs and horses.
The new gel contains Remend's structurally modified hyaluronic acid (HA). Bayer says it provides a matrix for cellular events that occur during the proliferative phase of the healing process, which has been shown to enhance healing1, and can promote rapid wound closure
Georgie Hollis BSc from www.vetwoundlibrary.com said: "Managing wounds can be challenging in veterinary practice; the progression of wound healing can be influenced by many factors, and selecting an appropriate product to apply should be based on the needs of the individual wound. A product that provides a moist healing environment and support of the proliferative phase ensures that cellular activity is optimised, helping to improve healing times and minimise scar tissue."
Bayer says Remend Wound Spray Gel is designed for use as part of the overall management of wounds; additional measures such as lavage, debridement and control of infection are equally important, as is giving consideration to any secondary factors that may delay healing if not addressed. The product aims to achieve greater compliance amongst owners by providing an effective management option that is easy to apply. A single application may be sufficient to enhance wound closure in fresh uncomplicated wounds; however more complex wounds may require multiple applications in order to accelerate closure.
For more information, visit: www.vetcentre.bayer.co.uk
Merial Animal Health has announced that it has purchased the the anti-inflammatory treatment for lameness in horses, Hyonate® (sodium hyaluronate), from Bayer.
Merial's equine marketing and technical manager, Louise Radford MRCVS said: "Hyonate is an established treatment of lameness in horses due to non-infectious inflammation of joints, using both intra-articular (IA) and intravenous (IV) injection.
"The beneficial effects of HA supplementation are attributable to the anti-inflammatory effects, improvement in viscoelastic properties of the synovial fluid, and interaction with the synovial membrane affecting pain transmission and joint metabolism¹."
For more information telephone Customer Support on 0870 6000123 or contact your local Merial Equine Specialist.
81% of equine worming strategies are not effective in fight against resistance, because owners are not conducting an adequate level of faecal egg counts (FEC), according to a survey carried out by Countrywide, the supplier of equestrian products.
The company surveyed nearly 1,000 horse owners in collaboration with Westgate Laboratories, Norbrook and BW Equine Vets and found that 47% have never conducted an FEC test.
When asked about their current approach to worming, 59% of respondents said they worm at set times of the year with only 31% conducting regular FEC tests.
Mark Hawkins, SQP at Countrywide, said: "With worms becoming resistant to some worming drugs, simply dosing all horses with routine wormers is not adequate. A targeted approach, which considers each horse as an individual, is needed."
Gillian Booth owner at Westgate Laboratories said: "The results show that the majority of horse owners are not updating their worming practice to match the increase in resistance and improvement in testing technology. Previous worming practices have led to the resistance problems we now have so it is vital that there is change."
The survey found that veterinary surgeons and in store advisors are vital to promote change - 65% of respondents actively seek advice from their vet and Suitably Qualified Person (SQP) for worming and general health care.
Mark added: “A huge 99% of people worm their horse at least once a year; despite this 38% of horse owners do not know an accurate weight of their horse. Considering inaccurate dosing plays a large role with the increase in resistance this figure is very concerning. If you do need to treat, accurate dosing is essential.”
The survey found that 86% of respondents had wormed for tapeworm, making it the most wormed for parasite. Despite this, only 6% of horse owners had conducted a saliva test for tapeworm, and only 8% had conducted the more established ELISA blood test through their vet to prove the need for this worming dose.
For a full breakdown of the survey results, visit: www.countrywidefarmers.co.uk/wormingsurvey.
Leading equine veterinary surgeon Ian Wright has been setting a legal precedent this week, as the Court of Appeal ruled that his ex-wife could not expect him to continue to fund her lifestyle and that she should earn her own living.
Ian, an RCVS Specialist in Equine Surgery and a partner at the Newmarket Equine Hospital, divorced his wife Tracey in 2008 after 11 years of marriage. As part of the settlement, Mrs Wright was given a £450,000 house and Mr Wright was ordered to pay £75,000 per annum, which included £33,200 spousal maintenance.
Last year, Mr Wright, 59, went to the High Court to ask for a reduction in maintenance, arguing that it was unfair to expect him to continue to fund his ex-wife indefinitely, even after he retired at 65, when she made no effort to find a job and support herself.
The case was heard by Judge Lynn Roberts, who agreed there was no reason why Mrs Wright had not worked in the six years since her divorce and said she had been: "evasive on the subject of her own earning capacity".
Mrs Wright challenged the decision in the Court of Appeal this week, where Lord Justice Pitchford rejected her fight to have her future maintenance reinstated, saying: "There is a general expectation that, once children are in year two, mothers can begin part time work and make a financial contribution" and: "The time had come to recognize that, at the time of his retirement, the husband should not be paying spousal maintenance".
Speaking to The Times, Mei-Ling McNab, a partner at Brachers law, said: "This landmark decision provides some much needed clarity and will be a game-changer for future big-ticket divorce cases. The ruling confirms that mothers with children aged over seven should have financial responsibility to support themselves."
The British Equine Veterinary Association (BEVA) is urging veterinary surgeons to be on the lookout for outbreaks of Atypical Myopathy (AM) this spring.
Atypical Myopathy is a serious muscle disease found in the UK and Northern Europe. It is linked to horses eating the seeds from trees in the Acer family, including sycamore and box elder. There were more than five times as many cases of AM last autumn than in the previous year and experts have warned that the disease tends to occur more frequently in the spring following an autumn surge, possibly because of the growth of seedlings. The prognosis is poor, with survival rates of less than 25%. Early diagnosis is essential to give the best chance of survival.
Horses that develop AM are usually kept on sparse pastures, near trees from Acer pleudoplatanus (sycamore) or Acer negundo (box elder, pictured right) that shed seeds containing the toxin hypoglycin A. They are often not fed any supplementary hay or feed and may be driven to browse on an accumulation of dead leaves, dead wood and trees in or around the pasture but sometimes well-fed animals are affected. While the tree seeds may not be directly palatable, horses on poor quality grazing may ingest considerable numbers of them.
The clinical signs of AM may include muscle weakness or stiffness, colic-like symptoms, laboured breathing, dark red-brown urine, recumbency or even sudden death. Often the disease will present as an outbreak. Confirmation of diagnosis is by a blood or urine test. The toxin directly targets aerobic energy metabolism so therapy should be targeted at promoting glucose metabolism and provided fluid dieresis.
Preventative advice for horse owners includes:
Professor Celia Marr, Partner at Rossdales, Newmarket, European Specialist in Equine Internal Medicine and Editor of Equine Veterinary Journal said: "New, collaborative research, instigated last year between the University of Liege, the Irish Equine Centre and the Animal Health Trust should shed more light on the characteristics of the disease in this country. Once we know more about the specific causes we should be able to make more positive progress with prevention strategies."
BEVA has provided free online access to two articles from the journal of Equine Veterinary Education on the disease for all vets to help them address the threat.
Volume 25, Issue 5, pages 264-270, May 2013
Management of cases suffering from atypical myopathy: Interpretations of descriptive, epidemiological and pathophysiological findings. Part 1: First aid, cardiovascular, nutritional and digestive care (pages 264-270) G. van Galen and D -M Votion.
Volume 25, Issue 6, pages 308-314, June 2013
Management of cases suffering from atypical myopathy: Interpretations of descriptive, epidemiological and pathophysiological findings. Part 2: Muscular, urinary, respiratory and hepatic care, and inflammatory/infectious status (pages 308-314) G van Galen and D - M Votion.
The Animal Health Trust is appealing to veterinary surgeons and nurses to encourage clients who keep their horses on premises that have been affected by Equine Grass Sickness to sign up to the second year of its nationwide EGS vaccine trial.
Equine Grass Sickness (EGS) occurs predominantly in Europe, with Britain experiencing the highest incidence worldwide. In 2014, 59 cases of EGS were reported through the EGS Surveillance Scheme, but it is likely that this represents only a fraction of cases occurring annually throughout Britain.
Almost all cases of EGS occur in horses with access to grazing. The AHT says there is growing scientific evidence to suggest that the disease may be caused by the bacterium Clostridium botulinum type C, commonly found within soil and capable of producing neurotoxins to which horses are particularly sensitive. EGS occurs when a combination of risk factors trigger the production of these toxins within the horse's intestinal tract, causing damage to the nervous system and paralysis of the gut.
As similar equine diseases such as tetanus and botulism can be prevented by vaccination, it is theoretically possible that a vaccine could prevent EGS. To this end the AHT, in collaboration with the Universities of Edinburgh, Liverpool and Surrey launched the EGS field vaccine trial in 2014 in order to establish whether a vaccine could indeed be effective in reducing the risk of the disease. The trial is funded by a number of sources including Neogen Corporation; Animal Welfare Foundation; Horserace Betting Levy Board; Racing Foundation; Moredun Foundation Equine Grass Sickness Fund; Hong Kong Jockey Club; The British Horse Society and the EB Moller Charitable Trust.
Now entering its second year, the EGS vaccine trial involves enrolled horses and ponies receiving either a course of the C. botulinum type C toxoid vaccine or an inactive placebo, as well as an annual booster. The incidence of EGS is monitored throughout the trial to determine the efficacy of the vaccine, and enrolled horses and ponies are closely monitored through regular follow-ups for the duration of the trial.
With 60% of EGS cases occurring during April - June, the highest risk season for EGS is fast approaching. The AHT is appealing to owners who keep their horses on premises that have had at least one case of EGS in the past three years to enrol their horse in the vaccine trial and provide an invaluable contribution to this pioneering research prior to these high risk months. Veterinary practices with clients who fit this description are asked to help the recruitment process by encouraging suitable cases to sign up to the trial.
Dr Jo Ireland, the AHT's Equine Grass Sickness Research Co-ordinator, said: "We have been delighted with the overwhelmingly positive response to the EGS vaccine trial and many owners have welcomed the chance to be a part of such important research. We don't want any eligible horse owners to miss out on the opportunity to contribute towards a potential breakthrough in the prevention of EGS, so we are encouraging more owners to enrol their horses on the trial this year."
To find out more about the vaccine trial or how clients can enrol horses and ponies, visit the AHT's dedicated EGS website www.equinegrasssickness.co.uk or email equinegrasssickness@aht.org.uk.
MSD Animal Health's equine division has launched a new series of materials to support its Keeping Britain's Horses Healthy Campaign.
For veterinary practices, there's a Vet Reception Pack designed to help receptionists educate owners why they should vaccinate and the benefits of preventive healthcare.
For yards, there are posters giving guidance and advice on prevention of Infectious Respiratory Disease and the steps which should be taken to control a potential outbreak. They can be tailor made for an individual yard.
Peter Young, MSD Animal Health Equine Business Manager said: "Our first wave of support materials focused very much on equine vets and owners - helping raise awareness of the importance of preventive healthcare and driving owners towards vets for advice. This phase of materials helps support yard owners and receptionists, aiming to fill some of those communications gaps where advice and guidelines on individual horse's vaccination requirements and yard protocols can play a vital role in preventing the spread of disease and controlling outbreaks."
Keeping Britain's Horses Healthy is a national campaign to educate horse owners on endemic infectious disease, vaccination, herd immunity and the importance of preventative healthcare. It includes a range of educational materials for veterinary surgeries and direct to owners. The campaign is supported by a national PR, advertising and social media programme, together with a dedicated website www.healthyhorses.co.uk. The website, aimed at driving owners back to their veterinary practices, includes a vet finder, exclusively for equine practices, and healthcare information.
For full details of the launch programme, talk to your account manager, call 01908 685685 or visit www.healthyhorses.co.uk.
Ceva Animal Health has announced that Vetergesic (buprenorphine), its long-lasting analgesic, is now back in stock and on special offer with the rest of the company's analgesic product range.
The company says it has appointed a new, dedicated Vetergesic manufacturing site and increased stock-holding facilities in order to guarantee a continuous long-term supply of the product, which is available in a 10ml vial for use in dogs, cats and horses and a 1ml single dose preparation for cats and dogs.
At the same time, Ceva has launched a spring offer on its entire analgesic product range, which runs till the end of April. For every two packs of Vetergesic, Carprodyl F or Dolagis purchased, veterinary practices will receive one pack free and for every four packs of Meloxidyl purchased, practices will receive one pack free. In addition, practices will be able to take advantage of ongoing rebates through the new CevaSave Rebate Programme.
For further information, contact your local Ceva territory manager, email analgesics-group@ceva.com or call 01494 781510.
The Waltham Equine Studies Group has announced the results of two pieces of research designed to improve understanding of the best nutritional support for older horses, whether they are healthy or diagnosed with Pituitary Pars Intermedia Dysfunction (PPID or Cushing's).
The first study: A comparison of nutrient digestibility between adult and aged horses, conducted by the Department of Large Animal clinical Sciences and Animal Science, Michigan State University and The Waltham Equine Studies Group, confirmed (in contrast to earlier work) that there was no difference in digestibility between healthy adult and aged horses when fed a variety of common equine diets.1
In the second study: Characterisation of the faecal bacterial community in adult and elderly horses fed a high fibre high oil or high starch diet, the Institute of Biological Environmental and Rural Sciences, Aberystwyth University, The Waltham Equine Studies Group and Michigan State University used the same horses as the previous study but this time looked at their gut microflora. The results showed that although no significant differences in individual species of bacteria were found, ageing was, however, associated with a reduction in bacterial diversity. This, say the authors, may in part explain why older animals can be at increased risk of intestinal disturbances.2
An abstract that summarised part of the Waltham Equine Studies Group's work on the effect of additional supplementation on aged horses with and without PPID was presented at the 2nd Dorothy Havermeyer Geriatric Workshop in the USA last November.3 This work, carried out in conjunction with Dr Amanda Adams at the University of Kentucky showed that age is key in influencing inflammation and metabolism rather than whether the horse is PPID positive or not.
Professor Pat Harris, head of the Waltham Equine Studies Group, said: "For the parameters we monitored, the research showed that it is being old that is the issue, rather than having PPID."
Clare Barfoot RNutr and the research and development manager at Spillers said: “This should give us a better understanding of the effects of diet and age on metabolism in order to determine optimal nutrition for the senior horse. Preliminary work suggests that this new research may change the way we think of feeding the older horse. Waltham’s work continues to ensure that Spillers feeds remain at the forefront of equine nutrition, for the better health of horses everywhere.”
John Kenward MRCVS, a director of Maidstone practice Pet Emergency Treatment Services, has been given a conditional discharge for allowing an employee to X-ray her own foot after a horse stamped on it.
Maidstone Magistrates heard that the employee, a 25 year-old vet and equine intern, was afraid the foot was broken and she might be unable to do that evening's on-call duty.
As a result, she rang Mr Kenward. As they were both concerned she could be held up in hospital A&E, Mr Kenward suggested she use the in-house X-ray kit. He gave her the settings to use and she carried out the test, which showed no break so she continued to work as normal.
Another director, who acts as Radiation Protection Supervisor, later noticed a human image on the digital processor. This led him to notify other practice board members of his intention to interview staff about the suspected breach of site radiation safety policy. He was immediately told by Mr Kenward not to discipline the vet intern as he had suggested that she use the X-ray.
As a result the Health and Safety Executive was contacted and an investigation confirmed a breach of radiation regulations.
Although the vet intern, from Maidstone, was the only person present during the X-ray exposure, she did not wear a personal dosemeter during the procedure.
However, HSE told the court that Mr Kenward was fully aware that the rules of the practice clearly stated nobody should be placed within the beam of the X-ray machine.
Mr Kenward was ordered to pay £1,296 in costs after admitting a breach of the Health and Safety at Work etc Act 1974.
After the hearing, HSE inspector Rob Hassell said: "Any vet practice using ionising radiation for medical exposures must ensure that the X-ray equipment is properly maintained and that the requirements of the Ionising Radiations Regulations are complied with. The view of HSE and the Department of Health is that it is highly unlikely that all these conditions can be met by a veterinary practice.
"It follows therefore that X-rays must not be taken of human beings at practices. We are aware that the X-raying of people may not be unique to this particular practice so I hope others will take note that HSE is prepared to prosecute if such breaches come to light."
Dechra Veterinary Products has launched a new 50 ml bottle of its rapid acting dissociative anaesthetic licensed for cats, dogs and horses, Anesketin.
Anesketin solution for injection, containing Ketamine 100 mg/ml, is indicated for induction of anaesthesia.
Dechra Brand Manager Craig Sankey said: "Anesketin has proved to be a very popular product in our range due to its versatility. It can be used in combination with appropriate sedatives and analgesics in cats, dogs and horses for induction of anaesthesia.
"As it does not require any special temperature storage conditions it makes it a very portable product for vets on the move."
He added: "We are very pleased to be able to add the larger Anesketin product to our wide range of analgesics and sedatives. This demonstrates our commitment to offering high quality products that support vets in small animal and equine practice."
Dechra says the product can also be used as a sole agent for restraint and minor surgical procedures where muscle relaxation is not required in cats.
Anesketin is also available in 10 ml vials. For further information, visit www.dechra.co.uk