The RCVS Disciplinary Committee has ruled that whilst the care given to a diabetic dog by Paul Roger MRCVS fell short, it did not amount to serious professional misconduct. 

Mr Roger faced three charges: that he had failed to provide adequate care, failed to communicate with the owner adequately and failed to keep adequate clinical records for Honey, a Shiih Tzu dog who, it transpired, had hypergycaemia.

At the initial consultation, Mr Roger took a blood sample which showed that there was an elevated blood glucose, an elevated white blood cell count, an elevated ALT and an elevated ALP (which Mr Roger took to be indicative of liver damage secondary to infection).

Mr Roger prescribed a cholagogue (ursodeoxycholic acid), an antibiotic (Synulox) and a diuretic (Frusemide).

In its findings of fact, the Committee found it likely that Mr Roger would have realised that Honey had a potential diabetes mellitus diagnosis with an elevated blood glucose of 28.

However, Mr Roger explained that he had believed the elevated blood glucose was due to the stress Honey had undergone in taking the blood samples.

The Committee therefore accepted that Mr Roger’s actions did not indicate a complete failure by him to notice the elevated blood glucose because he had explained he believed at the time it was due to stress.

Honey’s owner took her back to the veterinary practice that Mr Roger worked at three days later.

A different veterinary surgeon examined Honey and flagged that her blood sugar was high and that her liver was damaged.

She was taken to an alternative veterinary practice for follow-up but died later that day.

Mr Roger admitted failing to ask Honey’s owner if there was a history of diabetes mellitus, failing to take repeat blood glucose tests or carry out urine analysis or carry out additional blood tests, failing to communicate adequately with Honey’s owner about the significance of the hyperglycaemia and the options for investigation/management and failing to keep adequate clinical records in regard to Honey’s blood glucose levels.

The Committee found the admitted facts proved.

The evidence presented to the Committee included the clinical notes taken during Honey’s consultations, emails sent from Honey’s owner to the RCVS outlining the complaint, and evidence from experts in small animal veterinary practice.  

Although the Committee found some matters not proved, it did find proved that Mr Roger had failed to recognise and/or pay adequate regard to Honey’s elevated blood glucose levels, had failed to manage Honey’s hyperglycaemia either by treating it or by documenting an appropriate plan to do so and had failed to communicate adequately with Honey’s owner about the significance of her elevated glucose and the reason for it.

Having reached its decision in relation to the facts, the Committee went on to consider whether the facts it had found proved either individually or cumulatively amounted to serious professional misconduct.

Judith Way, Chairing the Committee and speaking on its behalf said: “The Committee found that the charges and particulars it had found proved did not amount to disgraceful conduct in a professional respect either individually or cumulatively.

"In its judgment, the conduct found proved fell short of the standard to be expected of a reasonably competent veterinary surgeon but not far short of the standard which is expected of the reasonably competent veterinary surgeon.”

As a result of the Committee finding that Mr Roger was not guilty of serious professional misconduct on any of the proven charges, either individually or in any combination, the hearing did not proceed further.

Northwest Surgeons has changed its name to Northwest Veterinary Specialists (NWVS), following what it describes as a significant investment into its facilities and people.

The referral centre recently extended its floor space at its base in Cheshire to support a major expansion of the services being offered, which include orthopaedic, soft tissue and spinal surgery and internal medicine; with specialist support in anaesthesia and pain management, a diabetes clinic, intensive care, cardiology, diagnostic imaging, neurology (medical and surgical) and oncology.

Liz Cousins, hospital manager at Northwest Veterinary Specialists, said: "The success of NWVS is down to the dedication of our highly skilled clinical, nursing and support teams.

"Our clinicians are well respected specialists in their chosen disciplines and it’s fantastic to be able to offer new services to pets and first opinion vets.

"The hospital is home to 88 colleagues and the change of name now reflects the growth and dedication by everyone here at Northwest Veterinary Specialists since opening in 2002."

Northwest Veterinary Specialists provides specialist veterinary services to veterinary practices in north west England and north and mid Wales.

Liz added: "At Northwest Veterinary Specialists we treat pets from as far apart as Carlisle, North Yorkshire and Staffordshire.

"The facilities are state-of-the-art, demonstrating a quality of service both for our clinicians and our clients, but most importantly the pets that we treat."

In case you missed the email last month, Novartis Animal Health has announced the launch of Atopica for Cats (cyclosporine oral solution, 100 mg/ml), a treatment for chronic allergic dermatitis.

This disease, which is apparently one of the most common reasons for pet owners to take cats to the veterinary surgeon², can be difficult to diagnose and causes itching and associated chewing and licking, skin lesions and loss of hair. Atopica for Cats is the first medication approved in the UK specifically for allergic dermatitis in cats.

Novartis says the new product provides relief from the uncomfortable and recurrent itch/scratch cycle, and the majority of improvements are seen in the first four weeks^3-5. The company also says that in clinical trials, 84 per cent of cats diagnosed with allergic dermatitis were considered to be "uncomfortable" at the start of the study⁵. After six weeks of treatment with Atopica for Cats, 78 per cent of cats were considered "comfortable" with satisfactory levels of grooming³ - a key indicator of a healthy cat. Additionally, Atopica for Cats is proven to significantly reduce unsightly and painful skin lesions and has a proven safety profile.

Anne-Laure Driscoll, Atopica Brand Manager, Novartis Animal Health UK, said: "Veterinarians and pet owners understand the discomfort and frustration of an itchy pet. We are pleased to add Atopica for Cats to our proven family of Atopica products, offering an effective treatment for cats suffering from the extreme discomfort associated with allergic dermatitis."

Developed specifically for domestic felines, Atopica for Cats is an oral solution which Novartis says is easy-to-dose and administer. In studies, approximately one-third of cats took the medicine in their food and two-thirds were dosed directly into the mouth^3,4. According to the company, the product offers a unique mode of action that specifically targets immune cells such as the T-lymphocytes involved in the allergic reaction. In this way, Atopica for Cats blocks the production of inflammatory cytokines, molecules that fuel the allergic response, breaking the recurrent itch/scratch cycle.

Dr. Keith Hnilica, DVM, MS, MBA and DACVD, and author of Small Animal Dermatology: A Color Atlas and Therapeutic Guide (3rd ed), said: "Atopica for Cats has the potential to change how our profession treats the itchy cat. For the first time ever, we have a safe, highly effective, approved treatment for cats with allergic dermatitis. And because Atopica for Cats is not a corticosteroid, I can prescribe it for long-term use without worrying about the health risks that can be associated with steroids."

References

1. Atopica for Cats is indicated for symptomatic treatment of chronic allergic dermatitis in cats in the EU, and for control of feline allergic dermatitis in the US.
2. Veterinary Practice News, April 2011: Veterinary Pet Insurance (VPI), top 10 pet medical conditions of 2010, p10.
3. Novartis data on file. Study summary CYCINT-0105.
4. Novartis data on file. Study summary CYCINT-0205.
5. Novartis data on file. Study summary NAH-07-0028.
6. Lowe AD et al. Glucocorticoids in the cat. Vet Derm, 2008, 19, 340-347

Dechra Animal Health has launched Revozyn RTU, billed as a revolutionary breakthrough for subclinical and clinical local mastitis in cows.

Revozyn RTU, which contains 400 mg/ml Penethamate hydriodide, is the first ready-to-use injectable narrow spectrum Penethamate on the UK market. It can also be used to treat relapses of old infections.

Dechra says that the intramuscular injection works by diffusing through the blood vessels and accumulating in the udder tissue and milk, treating the whole udder effectively. Apparently the new formulation also features an ion trapping mechanism that results in high Benzylpenicillin concentration in milk and udder tissue.

Revozyn RTU comes in a 50ml multi dose vial. It has a 28-day shelf life after first use and has withdrawal periods of four days for milk and 10 days for meat and offal.

Dechra Brand Manager Emma Jennings said: "The treatment and control of mastitis is one of the largest costs to any dairy farmer. It affects productivity and cow welfare and we are delighted to be able to introduce this revolutionary product.

"Revozyn RTU can change the way that clinical and subclinical mastitis in dairy cattle is treated. Its narrow spectrum of activity means that the risk of antibiotic resistance is reduced and there is no need for additional animal handling, thereby saving time and protecting user safety.

“The flexible dosing of Revozyn RTU and 28-day shelf life also make it a cost effective option for farmers".

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

David Barker MRCVS, a soft tissue surgeon at Paragon Veterinary Referrals in Wakefield, has removed a whopping 5kg tumour from a four-year-old Dalmatian called Penny. 

David, who was assisted by Dan Kenny and Kat Grzywa MsRCVS, said: “Penny presented with suspected ascites, given a large volume of peritoneal effusion. Her abdomen was very swollen and taut

“We performed a contrast-enhanced CT scan with an iodine-based contrast to help highlight the areas of the body we needed to examine and the results were startling. 

“The mass was enormous. It almost completely filled the abdomen.” 

CT images showed that the mass had originated in the right kidney, which had been displaced into the left side of the abdomen, and also compressed the rest of Penny’s internal organs.

There was no evidence of metastatic disease. 

David added: “A right ureteronephrectomy was performed and the large cystic parts of the tumour were dissected free from the omentum, the peritoneum and the retroperitoneal vasculature.

“The surgery was really difficult because the mass was so large and heavy, and it required extra surgeons to hold and manipulate the mass, while its vasculature was dissected and ligated. 

“The weight of the mass on the diaphragm also made the anaesthesia challenging but surgery went very well.

"Once the surgery was over, the weight of the mass was confirmed at nearly 5kg. 

“Penny made a good recovery from the anaesthesia, her blood renal parameters remained normal throughout her recovery, and she was discharged 48 hours later. Histopathology later confirmed the mass to be renal carcinoma.”

Fitzpatrick Referrals has carried out a world-first procedure in which an American Bulldog was fitted with a prosthetic hip and femur with a special in-growth attachment which effectively re-attaches the tendons and muscles to the artificial limb.

The procedure took place after 8 year old Roly was diagnosed with cancer in his rear hind leg earlier this year. It involved a highly complex two-hour operation, during which Dr Noel Fitzpatrick, a neuro-orthopaedic veterinary surgeon, replaced the cancerous femur bone and hip joint with a specially constructed artificial prosthesis, while re-attaching the musculature and realigning the relative position of the joint to restore perfect movement to the dog. 

The prosthesis was designed through a collaboration between Professor Gordon Blunn, Head of the Centre for Bio-Medical Engineering at UCL's Institute of Orthopaedics and Musculoskeletal Science; veterinary surgeon Noel Fitzpatrick and Jay Meswania from specialist implant manufacturer OrthoFitz.

Professor Blunn said: "What is significant about the design is the way in which it sandwiches tissue and metal together overlaying the gluteal muscles onto the top of the endoprosthetic femur - alternating tendon, synthetic Dacron mesh, tendon, synthetic Dacron mesh, tendon and finally trabecular metal - which has a honeycomb surface resembling a series of small chambers.  In this way, the hope is that the Sharpeys fibres which attach tendons of muscles to the bone will grow into the trabecular metal surface and permanently adhere to it."

"This truly remarkable achievement was made possible through the convergence of biomechanics, biology and surgical innovation," said Noel Fitzpatrick.  "We tapped into the evidence provided by the CT and MRI scanners we have in place at the practice, so that the data collected about Roly during clinical diagnosis was used to design and construct an artificial femur which exactly mirrored his original limb. It has been constructed rather like a telescope - one section fitting inside the adjoining section, so that we get maximum flexibility and traction during motion."

Noel added: "Hip replacement is common here. We do more than 50 a year, on animals as small as a cat or a Chihuahua. But this hip replacement was special, and to my knowledge, the first of its kind in the world. It's important though to emphasise that this technology must only be employed when it is in the best interests of the individual patient. It's not enough to be able to do something; it must be done for the right reason in every case without exception. It must be ethically right. It's also important to emphasise that Roly will probably not live for a normal lifetime because bone cancer generally spreads to the lungs over time in spite of chemotherapy. However, this technology is equally applicable for dogs and cats affected by trauma who will likely live longer. My job is to look after my patients as best I can and to be honest with their guardians and give them options. What I do is provide pain free functional quality of life for as long as my patient is alive. That's important and that's special, but the decision must remain with each and every individual animal owner".

According to the team, this development also has potentialy life-changing implications for human patients such as motorcycle accident victims, where a key challenge to recovery may be successfully re-attaching the kneecap tendon onto the top of the tibia in the lower leg, and injured sports players with ruptured  repairing ruptured tendons.

Click here to view the x-rays of this case in the VetSurgeon Gallery.

The Competition and Markets Authority has unveiled a package of veterinary transparency reforms that will require practices to publish prices, give written estimates and tighten complaints handling.

Although the regulator says the changes should impose only limited administrative costs, VetSurgeon.org estimates that implementation may still run to several thousand pounds for some practices.

Under the reforms, practices will need to:

• Update signage and marketing materials if part of a group to display the practice owner.
• Ensure marketing materials and signage clearly set out out-of-hours arrangements, staff qualifications and accreditations.
• Publish a standardised price list online and in-practice for consultations and a wide range of diagnostics, treatments and procedures defined by the CMA, for five standardised pet characteristic and weight categories.
• Publish prices for commonly sold flea, tick and worm products, plus a link to the VMD Register of online retailers, both online and in-practice.
• Publish full pet care plan details, including standalone prices and an explanation of any claimed cost savings.
• Submit practice information and pricing data to the RCVS for publication via an upgraded Find a Vet comparison platform.
• Provide written estimates for treatment pathways likely to cost £500 or more and update them if costs are likely to increase by 20% or £500.
• Provide itemised bills.
• Put written clinical freedom policies and processes in place.
• Give clients written information produced by the RCVS about prescriptions and buying medicines elsewhere, including via practice websites, posters and emails, and tell owners during consultations.
• Provide written prescriptions at the end of a consultation or digitally within 48 hours.
• When prescribing own-brand medicines, tell clients about the reference product alternative and identify it in writing.
• Provide additional information to owners receiving ongoing medication about their ability to request a written prescription and potential savings from buying medicines elsewhere.
• Check any out-of-hours contract to ensure notice periods do not exceed 12 months and no termination fee applies after that period.
• Offer a communal cremation service and publish clear information about cremation options and prices, including add-ons.
• Put a written complaints procedure in place, publish it and keep a complaint log.
• Take part in mediation in good faith when required.

In total, the CMA package introduces more than a dozen new operational requirements for veterinary practices.

Practices will also have to pay a new levy to the RCVS to fund its expanded role running the price comparison service, estimated at £450-£550 annually, after a £150-£250 setup charge.

Once the Order is made — currently expected in September 2026 — most of the transparency measures will need to be implemented within three months by larger veterinary groups and six months by smaller practices.

More operational changes, such as written estimates, itemised billing and the new prescription rules, follow later, with smaller practices typically given up to 12 months to comply.

The final stage will see practices submitting data to the RCVS for its upgraded Find a Vet comparison platform once the system has been built.

Prescription fees will be capped at £21 for the first medicine prescribed in a consultation and £12.50 for each additional medicine, with both figures rising annually in line with CPI, and practices will need to assess the impact on their business model.

The World Small Animal Veterinary Association has published 'Animal Welfare Global Guidelines for Companion Animal Practitioners and the Veterinary Team'.

The guidelines, launched during WSAVA World Congress 2018 in Singapore, aim to bridge differing perceptions of welfare around the world and help veterinary surgeons and nurses tackle the ethical questions and moral issues which impact welfare. 

They also offer guidance to ensure that, in addition to providing physical health advice and therapy to their patients, veterinary surgeons and nurses can advocate for their psychological, social and environmental wellbeing.

Dr Shane Ryan, incoming President of the WSAVA and former Chair of the WSAVA Animal Wellness and Welfare Committee, said: "As veterinarians, our responsibility extends far beyond the physical health of our patients. Animal welfare as a science is a new and rapidly developing discipline and veterinarians need current, evidence-based invformation to enable them to maintain the highest welfare standards and to provide knowledgeable, accurate advice for pet owners and communities.

"Our new Guidelines provide recommendations, checklists and other tools to promote optimal levels of welfare throughout the veterinary visit. They also offer guidance on increasing welfare beyond the doors of the clinic through outreach activities.

"As levels of pet ownership increase in many regions of the world, including Asia, it is essential that veterinarians champion animal welfare and the WSAVA hopes that these new Guidelines will encourage our members to adopt best practice and set the highest standards.

"I would like to thank the members of the Animal Welfare Guidelines team, who worked so hard to create them and, of course, our sponsor, Waltham, whose constant support was instrumental in enabling us to deliver them."

The Animal Welfare Global Guidelines for Companion Animal Practitioners and the Veterinary Team are available for free download at: https://bit.ly/2D3RAoc.

Boehringer Ingelheim has launched HatchPak IB H120TM NeO, a freeze-dried live attenuated virus of Bronchitis disease, H120 strain, for active immunisation of one day-old chickens in order to reduce infection with Massachusetts serotype of Infectious Bronchitis virus.

The company says that the effervescent tablet presentation was designed to significantly improve vaccination practices for poultry producers while maintaining reliable virus protection.

Boehringer says this dispensing form reduces the risk of stock solution contamination and, when compared to glass vials, the small blister packs make vaccine management safer for operators, take up less room in the fridge and reduce packaging waste by 90%.

HatchPak IB H120 NeO will be available shortly in packs of 10 tablets of 1000 doses or 10 tablets of 2000 doses.

Callum Blair, Boehringer Ingelheim Avian and Swine Brand Manager, said: "The addition of HatchPak IB H120 NeO to our NeO product portfolio is evidence of our continued investment in the poultry sector."

TVM-UK has announced the launch of the 'Corneal Focus Range', a new range of ophthalmology products for dogs, cats, horses and exotics.

The range includes:

• Fluodrop (the first fluorescein product specifically designed for veterinary use)

• Ocryl - an ocular and periocular cleanser that can also be used to reduce and prevent unsightly tear staining

• Ocular lubricants (carbomer and hyaluronic acid based)

• Clerapliq – a novel molecule to the UK veterinary market that is used to help restore and regenerate the corneal extracellular matrix

The products will be supported with a selection of materials to help vets, nurses and pet owners in the maintenance of corneal health, including diagnosis and treatment guidelines, anatomical guides, posters and client educational and treatment aids to help with compliance.

William Peel MRCVS, product manager at TVM-UK said: "Our Corneal Focus Range is an exciting way to expand on our product portfolio following the successful introduction of our ‘Anti-tox’ range.

"With ‘Anti-tox’ we successfully managed to make vets and nurses lives easier by providing education and materials alongside a great range of products to help when dealing with poisoning cases in practice. We also attempted to make clients more aware of the dangers of poisoning in pets.

"We hope to emulate this approach and success with our Corneal Focus Range – by developing a wealth of materials for vets, nurses and clients to aid them in managing and understanding ophthalmology cases – and by providing quality products."

TVM UK will be showcasing its new products and support services at the London Vet Show (stand P40) this November.

For more information, visit: http://www.tvm-uk.com/ 

Vets4Pets has unveiled its latest national TV advertising campaign, which airs for the first time during Coronation Street on ITV tonight.

The 30-second commercial was shot at five different locations around the UK and features John Davies-Riand MRCVS Vet Partner at Vets4Pets Leeds and Sarah Scott Vet Nurse Partner at Vets4Pets Kettering.

The commercial is running nationally until 28th March and forms part of a national campaign offering owners of elderly pets a discounted £25 senior pet health check with a vet and a half price bag of senior pet food.

Gill Hammond, Head of Brand Marketing said: "It was really important to us when planning this new campaign that we feature our real partners, they are at the end of the day the core of our business and the faces that our clients see when they visit us. The offer itself, focusing on senior pets is testament to our partners' and their teams' commitment to on-going pet health care."

Lee Ashton, founder of Bugler Smith, the agency behind the new ad said: "Working with Vet4Pets on this project has been a really exciting process. Having got under the skin of the brief, and carried out some initial research within Vets4Pets practices nationwide, the overwhelming and consistent theme from everyone we spoke to, was how they have a real passion for pets and making every difference they can.  

"This was key to our message, and we felt it was really important to use their best brand ambassadors (their own vets and veterinary nurses) to introduce the brand to the public, to really demonstrate in a straight forward way what makes them different to other vet practices, and we're really pleased with the outcome."

A new study, published in the latest issue of the Journal of Small Animal Practice (JSAP), has demonstrated that placement of temporary tracheostomy tubes following multi-level airway surgery for brachycephalic obstructive airway syndrome (BOAS) is helpful in managing postoperative airway obstruction and has a low mortality rate.

Outcome of temporary tracheostomy tube-placement following surgery for brachycephalic obstructive airway syndrome in 42 dogs¹ was undertaken at Dick White Referrals, UK. A retrospective case series of dogs that had a temporary tracheostomy tube placed in the post-operative period following surgery for BOAS was obtained from the referral hospital.

Of the 42 dogs, 11 had a tracheotomy tube placed electively and 31 had one placed as an emergency. The overall postoperative complication rate in the study was 95%. The minor complication rate – defined as resulting in no observable compromise of the clinical status and/or self-limiting, such as a cough - was 71%. The major complication rate – defined as resulting in discernible harm to the patient, such as cyanosis and dyspnoea - was 83%. 41/42 dogs were classified as having successful tracheostomy tube management.

Marius Stordalen, lead author of the paper said: "Contrary to what had been previously thought, this manuscript shows that in an appropriate clinical setting, temporary tracheostomy tube placement following multi-level airway surgery for brachycephalic obstructive airway syndrome carries a good prognosis for the majority of patients."

Nick Jeffery, editor of JSAP added: "Whilst overall mortality rate was low following placement of a tracheostomy tube in the postoperative period, there was a high overall complication rate. This finding demonstrates the need for continuous monitoring and intensive care for patients following placement of tracheostomy tube.”

The full article can be found in the May 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.13127 

London Vet Specialists in Belsize Park has announced that oncologist Richard Elders MVB, CertSAM, DACVIM (SAIM), DECVIM-CA (Onc), Msc (Clin Onc) has joined its team of referral specialists.

A graduate of University College Dublin, Richard started out in first opinion practice after completing an internship at the University of Glasgow.

While studying medicine, Richard researched mast cell tumours in dogs, which led to an MSc in clinical Oncology. He went on to complete a PhD on mast cell tumours at the Royal Veterinary College in 2008.

Richard works with referral oncology patients and clients two days a week at LVS and currently spends the rest of his working week as an oncology consultant for IDEXX Laboratories.

From February, Richard will also be working at Southfield Veterinary Specialists in Laindon, Essex, thereby allowing him to refer oncology patients for radiation therapy at Southfields when necessary.

Richard said: "Having never been comfortable with operating myself, working with a team of this calibre and experience in a welcoming environment within central London was very attractive. It has been a very fulfilling role for me, especially as both our team and the scope of the services we can offer continue to expand.

"Given the high standard of care offered by local vets in the area, the patients referred to LVS are often very challenging. Together with our clients’ high expectations, the service is definitely not run-of-the-mill but all the more rewarding because of that. 

"I’m looking forward to bringing my experience in both research and clinical spheres to LVS." 

Richard’s main professional interests are mast cell tumours, novel diagnostics and immunotherapeutics, but he is experienced in all aspects of veterinary oncology and can also offer advice about internal medicine cases.