Virtual Veterinary Specialists and The Webinar Vet have launched a series of free webinars to support vets in practice with the triage and management of emergency and urgent cases during the pandemic.

The webinars will be given by RCVS Specialists from Virtual Veterinary Specialists and recorded so that you and your team can watch them at your convenience, either from your practice or at home.

The first webinar in the series ‘Is Cancer an Emergency’ by Dr Clare Knottenbelt, RCVS Specialist in Small Animal Medicine and VVS Oncology Consultant. 

Nuala Summerfield, Founder and Director of VVS said: "We are really excited about this first webinar and anticipate that it will be a very popular topic!"

The webinar can be viewed here https://www.thewebinarvet.com/webinar/veterinary-care-in-the-face-of-covid-19-is-cancer-an-emergency

Email: admin@vvs.vet or visit https://vvs.vet/covid-19/ to register interest in the series or see VVS's other free coronavirus resources.

Idexx Laboratories has produced a SARS-CoV-2 (COVID-19) RealPCR test for pets.

The company says it has made the test available in response to customer demand and growing evidence that in rare cases pets living with COVID-19-positive humans can be at risk of infection.

The test will be available to veterinary surgeons in North America this week and will roll out across most of the world in the coming weeks, via the company's worldwide network of laboratories.

Jay Mazelsky, President and Chief Executive Officer of Idexx Laboratories said: "We have continued to monitor the rapidly evolving public health crisis worldwide, paying special attention to the effects on pets.

"While there is currently no evidence that dogs or cats play a role in transmitting the disease to humans, it became clear offering the test was the right thing to do when we saw clinical evidence that pets—especially cats and ferrets—can in rare cases be at risk for infection. And, we heard from our customers around the globe that veterinarians needed a testing option."

Idexx recommends the test is used when three specific criteria are met: 

• Pet is living in a household with a human who has COVID-19 or has tested positive for the virus
• Pet has already been tested for more common infections, that a veterinarian has ruled out
• Pet (especially cats and ferrets) is showing clinical signs consistent with COVID-19

Idexx says leading health authorities agree with the company that transmission of the SARS-CoV-2 virus is primarily person-to-person and advise against testing asymptomatic pets. Since mid-February, the company has tested over 5,000 specimens for the virus, from cats, dogs, and horses with respiratory symptoms in 17 countries. To date, it has found no positive results, suggesting that dogs and cats living with infected people generally remain uninfected, except in rare and isolated cases. 

For information about the Idexx SARS-CoV-2 (COVID-19) RealPCR Test for pets, visit idexx.com/covid19-pet-test.

Southfields Veterinary Specialists has appointed Xavier Navarro-Cubas, an RCVS and EBVS specialist in small animal cardiology, as its new head of cardiology. 

Xavier (pictured right), who graduated from Cardenal-Herrera University in Valencia, Spain, in January 2006, has joined Southfields from the Royal Veterinary College, where he was working on the high profile Mitral Valve Repair Programme.

Xavier moved to the UK in 2009 to specialise in cardiology, first spending two years in Scotland where he completed a general and a cardiology internship at the Universities of Glasgow and Edinburgh, before beginning a cardiology residency at the University of Liverpool which he completed in March 2016.

He then continued at the University of Liverpool as a lecturer in cardiology for 16 months, before becoming a cardiology clinician at the Royal Veterinary College.

Henry L'Eplattenier, clinical director at Southfields, said: “We’re extremely pleased to welcome Xavier to Southfields and look forward to him progressing his career with us.

“He’s a very talented cardiologist who brings with him a wealth of expertise and experience which makes him a very valuable addition to our world-class team.”

Xavier said: “The move to Southfields is a wonderful opportunity for me and I’m really energised and motivated for the challenge ahead.

“This is one of the leading veterinary referral centres in the UK and it is set to become even better when we move into a new, purpose-built building boasting the finest facilities and most up-to-date equipment.

For more information, visit www.southfields.co.uk.

MSD Animal Health has added to its library of online CPD resources to help farm vets communicate with clients remotely and provide technical training content when working from home. 

The training material includes a range of new downloadable marketing resources for vets and SQPs to help maintain communications with their farmer customer base while face-to-face contact opportunities are restricted. They include a newsletter and social media and farmer engagement tools for various dairy, beef and sheep disease management issues.

Vets can also access new BRD management content highlighting the benefit of immunity-led disease prevention and ultrasound scanning of calf lungs. You can also view a range of practical ‘how to’ videos, as well as five different webinar recordings explaining ways to collaborate more effectively with farmers over youngstock rearing issues. The content is based on implementing MSD Animal Health’s versatile calf health checklist engagement tool, which facilitates an audit-based approach to assessing and improving current on-farm management practices.

MSD says it has another two webinars in the pipeline, which will be released in the weeks ahead: ‘Immunology’ with Professor James Roth and ‘Salmonella’ with Katrina Henderson from SAC.

To access all the training content, visit: https://www.msd-animal-health-hub.co.uk

The RCVS has announced the recipients of this year’s Honours and Awards. 

The Queen’s Medal - the highest honour that the RCVS can bestow upon an individual veterinary surgeon - was given to Dr Mary Stewart MRCVS, a retired academic who spent most of her career at the University of Glasgow where she was responsible for the development of the modern vet school.

Dr Stewart was nominated by Professor Stuart Reid, the Principal of the Royal Veterinary College and former Dean of the Glasgow Veterinary School. In his nomination he said: “Mary Stewart is one of the unsung heroes of the veterinary profession. A veterinarian graduating from Cornell in 1949, Mary has been MRCVS since 1951 and without doubt has been one of the major influencers of ethical approaches in the vet-client-patient environment and, in particular, the impact of euthanasia on both owners and attending veterinarians. Conducting nearly all her professional career in the UK, the vast majority at the University of Glasgow, Mary was of the generation selected by Sir William Weipers to create the modern school at Glasgow, an institution in which Mary played a pivotal role that would have reach nationally and internationally.”

The Inspiration Award is given to vets or nurses to recognise their ability to inspire and enthuse others consistently throughout his or her career. This year, it has been awarded to Dr Freda Scott-Park MRCVS. Freda is a former president of both the British Veterinary Association (BVA) and the British Small Animal Veterinary Association (BSAVA) as well as the current coordinator of the Highlands & Islands Veterinary Services Scheme and a campaigner for identifying the links between animal and other forms of abuse through The Links Group.

The Impact Award is given to vets and nurses who have recently made a considerable impact that has affected the profession at large, animal health or welfare, or public health. This year two Impact Awards have been bestowed. The first is to Dr Rosie Allister MRCVS, a leading campaigner and researcher for and about veterinary mental health, as well as a veterinary educator, the manager of the Vetlife Helpline and a member of the RCVS Mind Matters Initiative Taskforce.

The second Impact Award recipient is Hannah Capon MRCVS, the co-founder and director of Canine Arthritis Management (CAM), a self-funded social enterprise that provides advice to both other veterinary professionals and animal owners on the treatment and management of arthritis in dogs.

This year the RCVS is also awarding three Honorary Associateships, bestowed upon those who are not veterinary surgeons or veterinary nurses but who are making a considerable impact in the veterinary sphere, whether in the field of campaigning, charities, research, politics or journalism, for example.

This year’s first Honorary Associate is Professor Maureen Bain, Professor of Comparative Anatomy and Histology at the University of Glasgow’s Institute of Biodiversity, Animal Health & Comparative Medicine, and an Associate of Glasgow Vet School who has dedicated her career to research on improving the quality and safety of eggs for human consumption.

The second Honorary Associate is Mike Flynn, the Chief Superintended of the Scottish Society for the Prevention of Cruelty to Animals (SSPCA), for his collaborative work with the veterinary profession in areas such as the illegal puppy trade and the Links Group.

The third and final Honorary Associate is Professor Roberto La Ragione, the Deputy Head of the Surrey Vet School where he is also Professor of Veterinary Microbiology and Pathology and Head of the Department of Pathology and Infectious Diseases. Professor La Ragione was nominated for his contribution to veterinary education and research.

RCVS President Niall Connell (pictured right) said: “My hearty congratulations to all of this year’s award winners. Once again, it was a very strong field of people who have made and are making an indelible impact on veterinary science, the professions, animal health and welfare, food safety, public health, and plenty more besides."

Normally RCVS Awards & Honours are presented at Royal College Day in July. However, due to the coronavirus pandemic, the 2020 awards ceremony will instead be part of the proceedings of a combined Royal College Day and Fellowship Day, which will take at the Royal Institution on 2 October 2020. This event may be subject to cancellation and postponement depending on the latest Government advice and restrictions on the prevention of transmission of coronavirus.

A joint statement issued by the RCVS and the BVA with updated guidance for the professions about working during the coronavirus pandemic has led to an outcry on social media and highlighted flaws in the structure of the veterinary profession. 

Earlier this month, the government had exempted veterinary surgeries from the requirement to close their doors during the pandemic. Strictly speaking, the exemption meant that practices could carry on offering the same level of service as before, provided they followed further government guidelines on social distancing.

However, the College then advised that non-essential treatments should not be carried out until further notice, and that animals should only be seen in emergency, or if their health was likely to deteriorate as a result of inaction.

This included vaccination, where RCVS advice stated that whilst routine vaccinations were considered not urgent, there "may be scenarios where, in your professional judgement, vaccines are being given to reduce a real and imminent risk of disease; this includes in the face of an animal disease outbreak, or in a scenario where part of a vaccine course has been given and the animal may be exposed to the disease." 

The updated College guidelines, issued last Thursday evening, appeared little changed, except to say that its advice concerning vaccinations is under review. Meanwhile, its new flowchart gives a very clear framework for veterinary professionals to work within, essentially leaving it to your own professional judgement to weigh up the risks.

However, the BVA went further, declaring amongst other things, that:

Vaccinations – we are now recommending that primary vaccinations and year 1 boosters in dogs and cats go ahead due to the increased risk of disease outbreak over a longer period of time, and annual leptospirosis vaccination due to the zoonotic risk. If additional component of the core vaccine is due at the same time, it should also be administered. In addition, we’re recommending rabbit vaccinations go ahead due to the seasonal disease risks. Rabies vaccinations should be carried out if required for certification reasons

.... leading to an outcry that the BVA's advice appeared to be being relaxed at precisely the point when the government is imploring the public to stay at home, and that:

• it must have been the result of pressure from corporate veterinary businesses which are taking a severe financial hit from the loss of vaccination sales,
• that it would lead to veterinary surgeons being forced by their (probably corporate) employers to work when they believe it is wrong to do so,
• that it would put unnecessary strain on practices that are struggling to look after urgent case with reduced staff,
• that it would lead to pressure from the public to carry out non-essential vaccinations,
• that it would cause Vesuvius to erupt and the oceans to boil.

To add further fuel to the flames, the British Small Animal Veterinary Association then issued a statement to the effect that it had not been consulted during the preparation of the new BVA guidelines, which BVA past President Robin Hargreaves felt was so economical with the truth that he resigned his BSAVA membership on the spot.

COMMENT
At the end of it all, there is but one simple truth for every veterinary surgeon who is working in these difficult times, and it is this: The government and the RCVS guidance gives you the freedom to exercise your professional judgement concerning whether or not an animal needs to be seen for whatever reason. Provided you can explain why you reasonably concluded that an animal should or should not be seen, that is all that matters. It trumps everything else.  

This whole farago has highlighted a number of important issues in the profession, starting with the social media conspiracy theories that the new guidance came after pressure from corporate practices when as far as I can tell, it appears to have been driven by a genuine concern that that failure to vaccinate could cause significant welfare issues in the future.

That seems a reasonable argument, and very much in line with the College advice. But that in turn raises a far bigger question, which is what on earth the BVA (a voluntary membership organisation) was doing issuing what appeared to be instructions ostensibly for all members of the profession. Notwithstanding the fact that BVA recommendations have no legal weight, having all these chefs running around with different recipe books is itself a recipe for muddled communications and confusion over leadership.

In turn, that raises the even bigger question of what the BVA's role should be. Should it be snuggling up in bed with the RCVS, issuing joint edicts? Or should it instead be holding the College to account, challenging its decisions and demanding clarification where clarification is necessary. I would argue the latter. In this situation, the ONLY organisation issuing guidelines about vaccinations for practising vets should be the regulator. And it is the role of the BVA to challenge those guidelines if necessary, or to demand clarification.

Which leads me on to the next thing, which is that increasingly, members of the profession seem to demand explicit rules or guidelines to operate within. There are lots of hypotheses for why this might be true. Perhaps because we live in a more (or seemingly more) litigious world and veterinary professionals like the reassurance rules provide. Perhaps it is because the younger cohort of vets lack the self-confidence needed for decision-making. Perhaps corporatisation has a part to play, in that employees of larger organisations tend to play more by the rules. Or perhaps it is a consequence of the growth in the 'refer everything’ culture which means vets take fewer clinical risks.  

Whatever the reason, it seems clear that in some cases, the RCVS tack of "you're a professional, decide for yourself" is perfectly reasonable, whereas on other occasions, such as Schedule 3, more explicit guidelines are demonstrably necessary. Once again, surely the role of the BVA as the "Voice of the profession” is not to issue its own advice, but to press the College for more explicit guidelines as necessary.

Lastly, there is the role of Facebook in all of this. Quite obviously vets are no more immune to conspiracy theories than members of the public who think that coronavirus is spread by 5G telephone masts. Sadly, the truth is usually far less exciting. However, the problem at the moment is that the growth in social media and Facebook groups has left the regulator and the representative associations on the back foot, such that it is often left to individuals from those organisations who 'happen to come across OK online' (rather than having any properly defined role) to firefight.

Photo: https://www.scientificanimations.com/wiki-images/

The BSAVA has put together a collection of resources on anaesthesia to support the veterinary profession during the coronavirus pandemic.

The BSAVA Library Collection, which is freely available until the end of June 2020, includes resources relating to total intravenous anaesthesia (TIVA) and anaesthetic monitoring in addition to a new guidance document on the administration of anaesthetics during the pandemic, which has been endorsed by the Association of Veterinary Anaesthetists (AVA).

Kerry Woodhouse, author of the guidance document, said: “In line with RCVS recommendations to promote safe practice and social distancing, anaesthesia for routine procedures should be stopped during the current restrictions relating to the COVID-19 pandemic. There will however remain a need for anaesthetics for emergency and urgent procedures on welfare grounds. This guidance document provides practical information on administering anaesthesia while conserving oxygen supplies."

BSAVA President, Sue Paterson added: “The potential prioritisation of oxygen cylinders into human medicines means that we must be ready and able to revert back to using some more basic anaesthetic techniques. BSAVA is pleased to be able to support the profession during these challenging times through the provision of up-to-date guidance and resources to address these concerns.”

The new  Anaesthesia Resources collection can be found here: https://www.bsavalibrary.com/content/update 

The Association is also reassuring the profession that there is no indication of a shortage of medical gases.

In preparation for an escalation of coronavirus cases, BOC has been building stocks of medical gases to ensure its supply chain is in the best position to respond to customer requirements.

BOC has also implemented a ‘Full for Empty’ supply of all medical cylinder gases and customers with medical oxygen are being encouraged to manage their cylinders in an effective manner and ensure that empty cylinders are available promptly for collection. The company has also increased the frequency of deliveries and collections to help with cylinder turnover.

Customers are being asked to be vigilant and ensure that medical gas cylinders are kept as secure as possible to deter potential misuse or theft.

BSAVA understands that if a practice is closed for the foreseeable future, BOC will collect cylinders free of charge.  

For further information, call BOC’s Customer Information Centre on 0800 111 333 or visit https://www.boconline.co.uk/shop/en/uk/customer-information 

For more BSAVA resources relating to coronavirus, visit https://www.bsava.com/adviceforCOVID19 

Ceva Animal Health has reformulated and relaunched Allevinix, its flunixin-based NSAID for cattle, pigs and horses.

The product was one of eight NSAIDS that had been suspended following a European ruling that an excipient, diethanolamine, may pose a risk to human health.  

Allevinix is licensed for both intravenous (I/V) and intramuscular (I/M) administration over one to three days in cattle. It has a dose rate of 4ml per 100kg liveweight in cattle, and milk withdrawal times of 24 hours after I/V injection and 36 hours after I/M injection.

Ceva says Allevinix reaches peak plasma levels (CMax) approximately 30 minutes following I/M injection. It is available in 100ml and 250ml vials. 

Peter Keyte, ruminant business unit manager at Ceva Animal Health, said: "Allevinix is the only flunixin licensed for both intramuscular and intravenous administration in cattle and provides both vets and farmers with a cost-effective, fast-acting and versatile NSAID that is a useful addition to the range of NSAID options available."

For more information, contact your Ceva account manager, email cevauk@ceva.com or call the ruminant marketing department at Ceva on 01494 781510.

Animalcare has launched The PAC (Practice Assistance Centre), a new online resource for the veterinary profession.

The PAC offers pain scale apps for dogs, cats and rabbits, a library of downloadable resources and multiple webinars released via the Animalcare Learning Alliance.

Animalcare Product Manager Kai Crawshaw said: “The PAC serves as a one-stop-shop for a wide range of resources, available in digital form and printed form if required. Whether you’re looking to offer clients educational materials on a particular clinical topic; refresh your own knowledge or take some online CPD via one of our webinars. The PAC will prove a useful and easily accessible tool for veterinary teams.

“In light of the current changes to the industry, having a fully-functional digital platform like this to provide to our customers is now more important than ever. We hope that The PAC can be enjoyed anytime, anywhere; no matter what your current circumstance is.

He added: “We would also like to extend our support and thanks to the many veterinary teams right across the UK, which are working so hard to deliver much-needed services in the challenging conditions posed by the COVID-19 pandemic.”

The PAC can be accessed here www.the-pac.co.uk.

XLVets, the cooperative of independent practices, has decided to share its resources with independent practices that are not currently members.

XLVets has called on experts in people development, legal, IT and HR, as well as its practice owners, managers and team leaders to develop a package of coronavirus resources. The package includes guidance and best practice, tips offered by XLVets members, expert guidance in the use of technology to support home workers, access to the XLVets Thriving in Practice wellbeing initiative and more. 

To access the resources at www.xlvets.co.uk without charge or obligation, email admin@xlvets.co.uk.

Colm McGinn (pictured right), from XLVets said: "We are very good at working together to develop solutions for problems and supporting each other. This is a national challenge and while our members have faced some difficult decisions, they've been able to share that decision-making process with their peers, calling on them for ideas, guidance and support.

"It's a big ask for just one or two partners to interpret the guidance in a rapidly changing environment and to stay informed about advice from regulatory bodies and associations. We've all benefited from sharing knowledge and it's lifted some of the pressure that comes from taking individual action, while still having freedom to do what's right for your own practice and people. I can't think of a better time for us to share our learning and resources for the greater good."

For more information, visit: https://www.xlvets.co.uk/the-boss. 

A new study, published in the latest issue of the Journal of Small Animal Practice (JSAP), found that relying on total calcium concentrations alone to diagnose dogs with ionised hypercalcaemia may result in misclassification in around one third of dogs.

Investigation of the relationship between ionised and total calcium in dogs with ionised hypercalcaemia¹ was undertaken by Tørnqvist-Johnsen et al. at the Hospital for Small Animals, University of Edinburgh, UK.

Initially, a normal reference interval for ionised calcium, total calcium and albumin, serum and plasma biochemistry was established by analysing samples from 351 healthy adult dogs.

After establishing a reference interval for ionised calcium, the laboratory’s database was searched for adult dogs with ionised hypercalcaemia that had attended the university small animal hospital between 2012 and 2017, a time frame when the same sample handling protocols and instrumentation was in use. The hospital records were searched for patient information and the biochemical parameters statistically analysed.

Of 63 dogs identified with ionised hypercalcaemia, 23 did not have a total hypercalcaemia (37%). 16 of these 23 dogs (70%) had albumin within the reference interval. To summarise the key findings; using total calcium, one third of patients with ionised hypercalcaemia were not identified. There was also no significant relationship between albumin and total calcium in these cases.

Camilla Tørnqvist-Johnsen, lead author of the paper, said: "Hypercalcaemia is a very important clinical abnormality, often revealing severe underlying disease in dogs who do not get idiopathic hypercalcaemia. This study reveals the true importance of doing an ionised calcium measurement when evaluating calcaemic status."

Nick Jeffery, Editor of JSAP said: "This study demonstrates that, if relying on total calcium alone, more than one third of dogs with ionised hypercalcaemia will be classified as normocalcaemic. Furthermore, the study demonstrates that the discordance between ionised and total calcium cannot be routinely explained by a low protein-bound component.

"Whilst reference intervals are key in clinical practice to determine whether a result is an outlier from 95% of a healthy population, it is not inevitable that a patient with an outlying biochemical test result has a clinically relevant disease."

The full article can be found in the April issue of the Journal of Small Animal Practice which is free for BSAVA members. It can also be read online here: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13109 

Reference

1. C. Tørnqvist-Johnsen, T. Schnabel, A. G. Gow, J. Del-Pozo, E. Milne, V. Macklin, C. Fisher, I. Handel and R. J. Mellanby (2020) Investigation of the relationship between ionised and total calcium in dogs with ionised hypercalcaemia. Journal of Small Animal Practice, 61 (4). Available at: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13109    

The RCVS has announced that veterinary surgeons will be able to spread the cost of their annual renewal fees over the course of the calendar year to mitigate against the financial consequences of the coronavirus pandemic.

The measures agreed by RCVS Council will allow UK-practising members to spread the cost of renewal over three instalments: paying 50% of the full cost by 30th April, 25% by 30th September, and the remaining 25% by 31st December.

Kit Sturgess, Treasurer, said: “We recognise that most veterinary businesses will be seeing a downtown during the coronavirus (COVID-19) lockdown, especially as veterinary practices reduce their workloads to emergency-only procedures or those that can be classed as urgent. Furthermore, we understand that many individual veterinary surgeons will no longer be working, and that this will cause financial difficulties for many vets and their families.

"We appreciate that this is a very difficult time for the profession, and as part of our compassionate approach to regulation we wanted to do our bit to help people manage the difficult financial consequences of the coronavirus crisis, and to help them to return to work as soon as Government advice allows. While fees for veterinary nurses are not due until the end of the year, we will keep the impact of the coronavirus pandemic under review on an ongoing basis.”

Any UK-practising member wishing to switch to the payment-by-instalments system should cancel their existing Direct Debits immediately (the College has already temporarily deferred these direct debits for around 10-14 days to allow time for them to be cancelled).

The College says that any member who does not pay the first instalment of 50% of the total fee by the end of April will need to pay the full amount in one instalment by the end of May. Should they then fail to make this payment, the College would then have to remove their name from the Register.

Those who pay the initial 50% instalment but fail to pay one or both of the subsequent 25% instalments will be moved to the non-practising Register for up to one year. This would mean that they could transfer back to the UK-practising Register without incurring a restoration fee. However, they would no longer legally be entitled to practise as a veterinary surgeon while on the non-practising Register until they had paid the retention fee in full and been transferred back to the UK-practising Register.

RCVS Council also agreed that the higher fee that usually applies for late payments, ie those made between 1 May and 30 May, will not be applied to any category of membership this year.

Members can opt to move to the new arrangements or continue with full payment. Details of how to pay under the new arrangements will be sent to members shortly. Any member who has already paid their fee in full and would like to switch to the payment-by-instalments mechanism should contact the College on refunds@rcvs.org.uk.

Further details about the scheme are available in a detailed Frequently Asked Questions guide via www.rcvs.org.uk/coronavirus.

COMMENT
It has been argued that at a time when many veterinary surgeons have lost a significant part of their livelihood, the College should have gone further and reduced the renewal fees, at least for the period of time that vets' earning ability is compromised. I'm not qualified to judge whether the College could have afforded that, and a spokesman would only say: "...we have to work within the framework of the legislation and the statutory instrument and, given this, the measures that RCVS Council has put in place is a reasonable outcome and will assist veterinary surgeons who may be struggling during these very tough times."