Clwyd-based veterinary surgeon, Alina Grecko has been struck off by the RCVS Disciplinary Committee for obtaining a prescription-only medicine knowing that it was for human and not veterinary use.

Mrs Grecko faced two charges. 

The first was that she got a nurse colleague to order griseofulvin, a prescription-only antifungal medication, knowing that it was for human use, rather than legitimate veterinary use.

It was also alleged that she then caused a student veterinary nurse to record the order in the name of another veterinary surgeon, who was not involved in the order or prescription of the medication, and falsely record that it was for Mrs Grecko’s dog.

The second charge was that she had acted dishonestly and misleadingly, as the medication was, in fact, intended for use by her husband.

At the outset of the hearing, Mrs Grecko admitted she had asked her RVN colleague to order the medication and for her SVN colleague to record that the medication was for her dog and that doing this was dishonest and misleading.

Mrs Grecko accepted that these admitted charges amounted to serious professional misconduct.

She denied asking an SVN to record it under the name of another veterinary surgeon.

However, the Committee heard from two eye-witnesses who testified consistently that Mrs Grecko had told her SVN colleague to record the medication under another vet's name, and from another witness who testified that Mrs Grecko had made a similar admission.

It therefore found it proven that she had asked her SVN colleague to make a false record, that it was dishonest and misleading, and that together, the charges amounted to serious professional misconduct.

Paul Morris, chairing the Committee and speaking on its behalf said: “The Committee considered that Mrs Grecko’s conduct had breached her obligations as a veterinary surgeon to respect the proper protections that were in place for the control of prescription-only medications.

"She had committed a serious abuse of her position in using the fact that she could obtain medications by virtue of her profession to circumvent the protections.

"She had been prepared to involve others in the course of the conduct.

"In addition, Mrs Grecko had been prepared to engage in an attempt to conceal her actions and falsify the clinical records in the process.

“Although it was acknowledged that Mrs Grecko may have been subject to some conflicting demands, being affected by her husband’s interests and may have felt a pressure to act, the Committee considered that she had completely failed to acknowledge and respect her overriding professional responsibilities.”

The Committee considered that the offence was a serious one, taking into account the abuse of position and pre-meditated and dishonest conduct.

The Committee also took into account previous adverse findings against Mrs Grecko from 2011, which involved misconduct of a very similar nature, which meant that they could not accept her argument that she had learnt her lesson, and also meant that, in the Committee’s judgement, she presented a significant risk of further repeated errors of judgement and dishonest conduct.

Mr Morris added: “Further, the Committee considered that members of the public would be very concerned to learn that, having once been reprimanded for her previous dishonest conduct, Mrs Grecko had repeated her behaviour.

“It [the Committee] concluded that this rendered Mrs Grecko’s disgraceful conduct in a professional respect incompatible with continued registration and no lesser sanction than removal from the Register would be sufficient to protect the wider public interest in maintaining public confidence in the profession and declaring and upholding proper professional standards.”

Mrs Grecko now has 28 days from being informed of her removal from the Register to lodge an appeal.

www.rcvs.org.uk/disciplinary

The eminent equine vet, Dr Sue Dyson FRCVS, has been struck off for a series of dishonest statements and actions, including fabricating a letter from a fictitious Home Office Inspector, in order to have her research project published in an international publication.

The Disciplinary Committee heard that in 2018, when Dr Dyson was employed as Head of Clinical Orthopaedics at the Animal Health Trust (AHT), she completed a research project: ‘Influence of rider: horse body weight ratios on equine welfare and performance – a pilot study’, for which she had previously been given the go-ahead by the AHT’s Clinical Research Ethics Committee. The results of the study were then submitted to the Journal of Veterinary Behaviour: Clinical Applications and Research for publication.

After peer-reviewing the project paper at the request of Journal Editor Karen Overall, Dr Matthew Parker, a Senior Lecturer in Behavioural Pharmacology at the University of Portsmouth, was concerned by the lack of a Home Office licence and asked for details of the licence or an explanation of why the project didn’t need one, and for the paper to be re-submitted.

In reply, Dr Dyson then emailed Ms Overall saying: “We have a former Home Office Inspector on our AHT Ethical Committee and two current licence holders (Named Veterinary Surgeons) who are fully conversant with the current legislation ... I also sought informal advice from a current Inspector. All were fully aware of the protocols to be employed and gave me assurance that in their opinion Home Office approval would not be required”.

Ms Overall then asked Dr Dyson to obtain a letter from the Home Office to support this position.

On 24 December 2018, Dr Dyson sent Ms Overall a letter purportedly from a Home Office Inspector called Dr Butler who, she explained, had advised her during the planning phase of the project. In the letter, the fictitious Dr Butler confirmed that their advice was sought for the project and that in their opinion, a Home Office Licence was not required.

Ms Overall then sent the letter to Dr Parker for further review, who decided to contact Dr Martin Whiting, Head of Operations at the Home Office Animals in Science Regulation Unit (ASRU) to ask if he knew of Dr Butler.

Dr Whiting confirmed that the Home Office had no record of employing a Dr Butler as an Inspector and that they were in the process of making further inquiries into the matter.

After Dr Whiting’s reply was forwarded to Dr Dyson, she replied to him saying that she thought the studies’ procedures did not meet the criteria for the Animals (Scientific Procedures) Act 1986 (ASPA), but that this was questioned by peer reviewers.

She said that her decision to send Dr Butler’s letter was one that she would ‘eternally regret’ and that she was ‘an inherently honest person’.

She explained that she was under a huge amount of pressure in her personal and professional life and that she was ‘fully aware that [she] acted completely inappropriately and she requested the incident be overlooked’.

In March 2019, Dr Dyson sent a letter to William Reynolds, Head of the Home Office ASRU, in which she expressed remorse for writing the letter. Mr Reynolds subsequently raised a concern with the RCVS about Dr Dyson’s alleged behaviour. 

Dr Jane Downes, who chaired the Disciplinary Committee, and spoke on its behalf, said: “The Committee heard from Dr Dyson that she had no recollection of several events detailed in the charge, including writing the letter from Dr Butler and sending the email to Ms Overall which contained Dr Butler’s letter. She accepted that the letter was dishonest and that it should not have been sent. However, she also claimed that, as she could not remember writing the letter, she did not act dishonestly.

The Committee heard testimonials from several witnesses who held Dr Dyson in high regard, including colleagues from the AHT, who attested to her integrity.

However, there were many dubious claims made by Dr Dyson throughout the hearing, including that the Home Office Inspector that she referenced as ‘my friendly inspector’ was someone who could have given informed consent to a project as Dr Dyson confirmed that she had met the individual briefly, around two and a half years ago at a drinks reception.

In reaching its decisions, the Committee considered Dr Dyson’s previously impeccable character, the written and verbal testimonies from witnesses. They also considered that during the hearing, Dr Dyson explained that at the time she fabricated the letter, she was under a lot of work and personal pressures, including managing a workload amidst colleagues’ resigning or going on maternity leave and it being the anniversary of her dog having to be humanely destroyed.

However, it did not accept Dr Dyson’s claims that she had amnesia at this time, and considered that she had not owned up to her wrongdoing until it was discovered. Although Dr Dyson maintained her actions were not pre-meditated, the Committee considered that, in the case of the forged letter, a certain amount of planning and careful thought was involved. The Committee believed that Dr Dyson knew what she was doing at the time, but acknowledged she may subsequently have blanked out what she did.

The Committee found all but one of the allegations proved and confirmed that it “was satisfied that the writing and sending of that letter was the culmination of a course of dishonest conduct.”

Committee Chair Dr Downes said: “In assessing [the evidence of] Dr Dyson the Committee took into account the difficulty faced by any Respondent appearing before their Regulator and also the various interruptions occasioned by issues which had to be dealt with during her evidence. Whilst [Dr Dyson is] undoubtedly highly qualified and highly respected, the Committee nevertheless considered her evidence lacked credibility and was not reliable.”

The Committee found that Dr Dyson’s conduct had breached parts of the RCVS Code of Professional Conduct for Veterinary Surgeons and amounted to serious professional misconduct.

Dr Downes continued: “The Committee determined that it was important that a clear message be sent that this sort of behaviour is wholly inappropriate and [was] not to be tolerated. It brings discredit upon Dr Dyson and discredit upon the profession.

"For whatever reason, Dr Dyson chose not to respond to Ms Overall’s email on 30th November 2018 in an honest and straightforward way. Instead, she lied about the makeup of the AHT Ethical Committee in order to cloak her response with authority.

"She also lied about having received advice from a current Inspector for the same reason. In the Committee’s view, she made a conscious decision to provide a dishonest response. She no doubt believed that would be the end of the matter.

"When that did not work, she lied further in the email to her co-author, Andrew Hemmings, claiming to have a letter from her friendly Inspector. When that too did not work, she impersonated a Home Office Inspector in creating the ‘Dr Butler letter’.

"She then added a false declaration to the manuscript, which she subsequently submitted to the Journal along with an email containing yet further lies. That was all done in a blatant and wilful attempt to deceive Ms Overall ... into believing the contents of the correspondence to be true, that confirmation a Home Office Licence was not required had been obtained and all was therefore well with the submitted manuscript.

"There was no rush, or urgency to have the paper published and the actions were not done in a moment of panic. No doubt she had not planned the entire course of events in advance, but instead reacted to each new obstacle that came her way, but her overall course of dishonest conduct spanned over three weeks.

“The Committee was well aware of the impact and ramifications for Dr Dyson of any decision to remove her from the Register but had to weigh her interests with those of the public.

"In doing so it took account of the context and circumstances of the case, all matters of personal mitigation, as detailed above, Dr Dyson’s undoubted distinguished international career and reputation and the need to act proportionally.

"However, for all the reasons given above, the Committee was of the view that the need to uphold proper standards of conduct within the veterinary profession, together with the public interest in maintaining confidence in the profession of veterinary surgeons, meant that a period of suspension would not be sufficient and that the only appropriate and proportionate sanction in all the circumstances of this case was that of removal from the Register."

Mars Petcare UK has announced the publication of a new study showing that dogs’ immune systems change as they age meaning they will have a reduced ability to respond to infections or stress.

The study, Understanding How Dogs Age: Longitudinal Analysis of Markers of Inflammation, Immune Function, and Oxidative Stress, was published this week in the Journal of Gerontology: Biological Sciences¹. It followed 80 dogs for over 10 years, from adulthood till end of life, measuring a number of parameters to track their aging process.  

Findings included: 

• 51% increase in DNA damage. The study showed a 51% increase in 8-Hydroxydeoxyguanosine (80HDG) levels. 80HDG is a specific marker of oxidative damage to DNA.
• 30% increase in C-reactive protein (CRP). CRP levels will rise in response to inflammation, showing that aging dogs can suffer from increased levels of inflammation.
• 86% decrease in Heat Shock Proteins (HSP70). HSP70 measure ability to respond to cellular damage, and this study shows a significant decrease in this ability as dogs age. 

Mars says it is the largest prospective study to investigate aging in dogs and offers new insight into the ways in which we may be able to support dogs in their old age.

Janet Alexander, Senior Research Scientist at the Waltham Centre for Pet Nutrition and lead author of the study said: "We now know that dogs suffer from low level inflammation and cellular damage as they get older, similar to humans. The study identified multiple targets for potential therapeutic intervention to defend against or delay the impact of aging and the new insights can help us to provide more effective life stage support."

Mars has also released the results of its Aging Pets Ownership Survey², conducted last month, which found that:

• Around 1 in 5 dog owners currently own a senior dog.
• Over half of senior dog owners surveyed in the UK would value more information on how to look after their pet.
• While senior dog owners do not find caring for their pets much harder than the owners of younger dogs (29% vs 25%), 65% would value more information from their vet on how to look after their senior dog. 
• Nearly half of UK dog owners surveyed say that they find senior dogs are better behaved than younger dogs. According to new research, they may just need a little more support in their old age. 
• Most dog owners change the way they look after their dogs as they get older (76%) either by changing their food (58%) or taking them for shorter walks (54%).  
• 65% of dog owners surveyed would value more information from their vet on how to look after their senior dog. Information on nutrition (68%) and amount of exercise (57%) are the areas where they would value the most help.

References

1. Understanding How Dogs Age: Longitudinal Analysis of Markers of Inflammation, Immune Function, and Oxidative Stress, Janet E Alexander, PhD, Alison Colyer, MSc, Richard M Haydock, PhD, Michael G Hayek, PhD, JeanSoon Park, PhD;  The Journals of Gerontology: Series A, glx182, https://doi.org/10.1093/gerona/glx182. Accessed online 8/11/2017.
2. The Mars Petcare Aging Pets Ownership survey ran from 4th-12th October 2017, surveying 6,298 adults aged 18+ who owned at least one dog in their household. Respondents came from the following countries: 1,046 from the UK; 1,103 from the USA; 1,049 from Australia; 1,049 from France; 1,050 from Japan and 1,001 from Argentina. In each country, dog-owning respondents were surveyed online and drawn from a nationally representative sample of the adult population.

Zoetis has acquired Virtual Recall, a software business that helps veterinary practices improve their service offering and communication with pet owners.

Virtual Recall's products include vaccination, neutering, appointment and healthcheck reminders, customer feedback, telemedicine and post operation surveys, and healthcare advice communications. 

Jamie Brannan, Senior Vice President UK, Ireland and Nordics said: "This is an exciting opportunity for Zoetis to add a new solution for veterinarians with an innovative service that will support clinics in increasing their level of compliance, education and engagement at the pet owner level.

"As we expand our comprehensive offering across the continuum of care for veterinary clinics, Virtual Recall will enhance the level of pet owner services that can be offered to their pet owner customers in the UK, Australia and New Zealand.

“Our studies have shown that veterinary customers are keen to reduce administrative workload and find new ways to engage with pet owners. We believe that Virtual Recall will achieve that, helping to educate and improve pet owner compliance and adding financial benefits to the veterinary practice.”

Jamie Crittall, Co-founder, Virtual Recall said: “As a company we’ve always been restless – constantly looking at new ways and developing new technologies in which we can drive animal healthcare compliance. Zoetis’ thoroughly well-earned reputation for always putting their customers first – wanting them to thrive and be successful – combined with a commitment to enhance the lives of people and animals, is infectious. It is a very exciting new chapter for Virtual Recall and fellow co-founder Charlie Barton and I are thrilled to continue at the helm."

Lowestoft vet Frank Eric Ainsworth MRCVS has received a severe reprimand and warning as to future conduct from the RCVS Disciplinary Committee after being found guilty of serious professional misconduct.

The charge against Mr Ainsworth was that in July 2013, he failed to provide adequate care to Ash, a dog presented to him whilst he was working as a locum at Pinebank Veterinary Surgery in Kent.

Specifically, the charge was that having diagnosed Ash with heatstroke, Mr Ainsworth failed to admit the dog to the practice for urgent treatment, failed to transfer the dog to another practice, failed to suggest euthanasia, and failed to offer the owner, Mr McMahon, adequate treatment advice.

On presentation to Mr Ainsworth at Pinebank between 7am and 8am, Ash was collapsed and his symptoms included diarrhoea, vomiting, lethargy and a high temperature.

On being told that Ash had heatstroke and was unlikely to survive, Mr McMahon asked Mr Ainsworth whether anything could be done to save him, but was told the practice did not have the necessary treatment facilities. Mr McMahon was advised to take Ash home and use cold running water, ice packs and fans to reduce his temperature.

After Mr McMahon took Ash home and showered him in cold water, his wife telephoned Pinebank to complain. The practice receptionist, Ms Baldock, confirmed to her that there was nothing they could do.

Mrs McMahon asked if her husband could take Ash to Pinebank's out-of-hours service provider, but was told this was not an option.

Eventually, Mr McMahon took Ash to an alternative practice, Sandhole Vets, where the dog was treated by the practice owner, Mr Johnson. Mr McMahon was told that Ash was unlikely to survive and that, if there was no improvement, he should consider euthanasia. Around 45 minutes after the treatment was started, Ash suffered seizures and died shortly thereafter.

Mr Ainsworth told the Committee that he did not think Pinebank had adequate facilities to treat a dog of Ash's size for heatstroke and was unaware that it had a hosepipe and watering can. In addition, he did not believe it would be practical and effective to reduce Ash's temperature with wet towels and considered that the main priority of reducing the temperature would be best done at home.

Mr Ainsworth told the Committee that he intended to make enquiries about referring Ash to another practice once his temperature had been reduced at home. He was about to search the internet for alternative practices when he overheard his colleague's phone conversation with Mrs McMahon and assumed that Ash had been taken to another practice.

Mr Ainsworth accepted that he did not discuss euthanasia with Mr McMahon, which he said he would have done at a later stage if Ash's condition did not improve. He also accepted that he made no further enquiries of Ms Baldock and did not telephone Mr McMahon to check if Ash had gone to another practice.

Before reaching its decision the Committee considered, in detail, the testimony of a number of witnesses and experts for both the College and Mr Ainsworth. It rejected Mr Ainsworth's evidence that his treatment plan was to follow up his investigations into Ash's case or contact Mr McMahon by telephone. It concluded that, if such a plan had been in place, he would have informed Mr McMahon of his intentions.

The Committee also rejected Mr Ainsworth's evidence that he had overheard the conversation between Ms Baldock and Mrs McMahon. It said it was not credible that, if he had heard the call, that he would not have made further enquiries.

The Committee found the charges proven. For example, it concluded that Mr Ainsworth should have made further enquiries about the treatment facilities available at the practice for cooling Ash and, if he felt that they were inadequate, should have advised Mr McMahon to take the dog to another practice. It also felt it was inappropriate for Mr Ainsworth to have sent Ash home to the care of his owners while in a critical condition without first seeking the option of referral.

Furthermore, the Committee felt that Mr Ainsworth should have given Mr McMahon the full range of treatment options available, including oxygen and fluids as Ash was in a collapsed state, before he left the practice, as well as discussing euthanasia.

However, the Committee did accept, on the basis of Mr Ainsworth's clinical records, that he had given advice to Mr McMahon on how Ash could be cooled down at home, although it felt the advice could have been more detailed.

In deciding its sanction for Mr Ainsworth the Committee accepted that his actions were not motivated by indifference to animal welfare but that, on this occasion, there was a serious lapse of judgment.

The Committee also considered that this was a single incident on Mr Ainsworth's first day at the practice and that he had been confronted with an emergency situation before the practice had opened. It accepted that Mr Ainsworth had an unblemished career over the past 38 years and that he had produced character references from other veterinary surgeons attesting his integrity, skill and conscientiousness.

Judith Webb, chairing the Disciplinary Committee and speaking on its behalf, said: "The Committee has concluded that the sanction proportionate to Mr Ainsworth's conduct is one of severe reprimand and warning as to his future conduct."

She added: "The Committee considers that veterinary surgeons are required to be proactive in their duty of care and refer cases when they do not have the ability to deal with cases appropriately."

The Committee also recommended that Mr Ainsworth should undertake, in the next 12 months, continuing professional development with an emphasis on emergency and critical care and client communication.

The Committee's full findings and decision are available on the RCVS website (www.rcvs.org.uk/disciplinary).

A study published in the April edition of the Journal of Small Animal Practice has found that the Border terrier, the Lhasa apso and Staffordshire bull terrier have increased odds of Cushing’s syndrome compared with crossbreed dogs in the UK primary-practice population.

In what researchers say was the largest study of its type to date, dogs with Cushing’s syndrome were identified from the electronic patient records of practices participating in the UK VetCompass programme during 2016.

Both pre-existing and incident cases of Cushing’s syndrome during 2016 were included to estimate the one-year period prevalence.

Available demographic data for study dogs included date of birth, sex, neuter status, breed and mean lifetime bodyweight above 18 months.

Multivariable binary logistic regression modelling was used to assess the associations between risk factors and Cushing’s syndrome. 

Dr Imogen Schofield, corresponding author for the paper, said: “A total of 1527 Cushing’s syndrome cases were identified in this study, from a population of 905,544 dogs in 2016.

"The estimated one-year period prevalence for Cushing’s syndrome in dogs was 0.17% (95% confidence interval 0.05 to 0.07).

“The findings of this study provide evidence from primary-care clinical records on the epidemiology of Cushing’s syndrome which can help primary-care veterinarians during diagnosis.

"Seven breeds were associated with increased odds of Cushing’s syndrome; the Bichon frise (OR=6.17, 95% CI 4.22 to 9.00), Border terrier (5.40, 95% CI 3.66 to 7.97), miniature schnauzer (3.05, 95% CI 1.67 to 5.57), Lhasa apso (2.52, 95% CI 1.49 to 4.28), Yorkshire terrier (1.82, 95% CI 1.23 to 2.70), Staffordshire bull terrier (1.52, 95% CI 1.08 to 2.13) and Jack Russell terrier (1.50, 95% CI 1.07 to 2.08).

"Four breeds were at decreased odds of Cushing’s syndrome: the Golden retriever (0.24, 95% CI 0.06 to 0.98), Labrador retriever (0.3, 95% CI 0.17 to 0.54), Border collie (0.32, 95% CI 0.13 to 0.78) and cocker spaniel (0.44, 95% CI 0.21 to 0.90), which could help vets in practice lower their index of suspicion for Cushing’s syndrome for these breeds.

"Dogs with a bodyweight higher than their breed-sex mean had 1.44 times the odds of Cushing’s syndrome than those within their breed mean (95% CI 1.17 to 1.78), suggesting either overweight dogs or larger examples of the breed are at increased risk of this condition, or that dogs with Cushing’s syndrome gain weight.” 

Nicola Di Girolamo, Editor of JSAP, said: “When we look at risk factor analysis in previous studies, the generalisability of their findings to the general population of dogs in the UK have typically been limited due to studying dogs from referral populations or due to a lack of multivariable analysis.

"The findings of this study help to address that knowledge gap, supporting some of the risk factors previously reported, and by identifying novel associations, such as that in the Border terrier.

"Awareness of breeds with high or low risk could help to enhance the index of suspicion for veterinary surgeons working in primary-care practice where Cushing’s syndrome is predominantly diagnosed and managed.”

Reference

1. Schofield I, Brodbelt DC, Niessen SJM, Church DB, Geddes RF and O’Neill DG (2022) Frequency and risk factors for naturally occurring Cushing’s syndrome in dogs attending UK primary-care practices, 63 (4). Available at: https://onlinelibrary.wiley.com/doi/full/10.1111/jsap.13450 

Photo: BSAVA

Boehringer Ingelheim has launched NexGard Combo spot-on, billed as the first and only broad-spectrum parasiticide to treat cats for fleas, ticks, ear mites, roundworms and tapeworms.

NexGard Combo is a systemic isoxazoline-based endectocide designed specifically for cats which contains esafoxolaner, eprinomectin and praziquantel.

The new product provides one month’s protection against fleas and five week's protection against the most common tick on cats, Ixodes ricinus. It also treats the roundworms, Toxocara cati and Toxascaris leonina, hookworms, tapeworms and ear mites, against the last of which Nexgard Combo provides 97.2 to 99.9% efficacy following one treatment¹.

NexGard Combo can be used in kittens from eight weeks of age and 0.8 kg in weight, making it suitable for most kittens at first vaccination. It is available in two pack sizes: small, for kittens weighing 0.8 - 2.5kg and large, for adult cats weighing 2.5 - 7.5kg. For cats weighing 7.5kg or over, an appropriate combination of applicators should be used.

Jackie Sterratt, senior brand manager at Boehringer Ingelheim, said: “We’re excited to add to the successful NexGard range and to help vets treat more cats. We know only one in two cats is treated for fleas² and cats are only wormed on average three times per year³ despite all cats being at risk of fleas and most cats requiring monthly roundworming treatment^{2, 3}, so there is a big opportunity to increase treatment rates and compliance. As the only product on the market to treat fleas, ticks, ear mites, roundworms and tapeworms, NexGard Combo offers a simple solution for cats at risk of multiple parasites."

To support the launch Boehringer has produced a marketing package which includes a kitten support pack, client leaflets, dispensing envelope and parasite risk checker.

For further information, contact your local Boehringer Ingelheim territory manager or phone 01344 746957 (UK) or 01 291 3985 (Ireland).

References

1. Tielemans E, Prullage J, Tomoko O, et al.  Efficacy of a novel topical combination of esafoxolaner, eprinomectin and praziquantel against ear mite (Otodectes cynotis) infections in cats.  Parasite 2021:28.
2. Cooper A-R. et al. (2020). Fleas infesting cats and dogs in Great Britain; spatial distribution of infestation risk and its relation to treatment. Medical and Veterinary Entomology. Doi:10.1111/mve12462.
3. McNamara J. et al. (2018). Survey of European pet owners quantifying endoparasitic infection risk and implications for deworming recommendation. Parasite Vectors;11:571.

Carlos Egido Cortes, a Glamorgan-based practitioner, has been struck off by the RCVS Disciplinary Committee following his conviction for possession of four indecent images of children and an extreme pornographic image involving an animal and a female.

Mr Cortes had pleaded guilty to the offences in January 2017 at Cardiff Crown Court. In February 2017, he was sentenced to six months imprisonment suspended for two years with a requirement to complete unpaid work and rehabilitation activity and a victim surcharge. Following Mr Cortes’ conviction the matters were referred to the RCVS and Mr Cortes was subsequently referred to the Disciplinary Committee.

Mr Cortes did not attend at the Disciplinary Committee hearing and was not represented. The Disciplinary Committee, being satisfied that Mr Cortes had been served with the Notice of Inquiry and having considered and taken into account a number of separate factors, decided that it would be in the interests of justice to proceed with the hearing in his absence.

The Committee considered whether Mr Cortes’ convictions rendered him unfit to practise as a veterinary surgeon. Chitra Karve, chairing the Committee and speaking on its behalf, said: "The Committee has reached the conclusion that the respondent’s possession of this material which has led to his convictions was so reprehensible as to merit the description disgraceful. It considers that by possessing this material, the respondent has brought disgrace on the profession and will have undermined confidence in it. It therefore finds that the convictions have rendered the respondent unfit to practise veterinary surgery."

In considering the sanction the Committee decided that removing Mr Cortes from the Register of Veterinary Surgeons was the only available option. Ms Karve added: "The Committee has determined that the respondent’s behaviour is fundamentally incompatible with being a member of the veterinary profession. It therefore directs the Registrar to remove the respondent’s name… from the Register of Veterinary Surgeons."

The RCVS has published a new waiting room poster which details what pet owners and veterinary professionals should expect from each other.

It’s very significant because it’s the first time the College has produced material for practices that highlights the responsibilities of pet owners, as well as those of veterinary surgeons and nurses. 

As such, it should be a really useful tool to support the advice given by veterinary surgeons and nurses in practice.

In other words, don’t just stick it on the wall in some hidden part of the waiting room. Display it prominently by the reception desk, and point to it when explaining why owners need to make their own arrangements to bring the animal into the practice in emergency, for example. Or why you can’t prescribe drugs when you haven’t seen the animal for 8 years. 

The idea for the poster was first mooted by Jonathan Wray MRCVS in the forum on VetSurgeon.org, after he’d seen a similar thing produced by the French regulator for veterinary practices in France. 

VetSurgeon.org decided to produce an English version with input from vets as to what they would like a UK version of the poster to say.

On reflection, however, it was always something which would carry so much more clout if it came from the regulator, so we turned the idea over to the RCVS.

To its great credit, the College ran with the idea and had the poster designed and put through its Standards Committee. The result has now been posted to all practices in the UK, with a pdf version available to download from www.rcvs.org.uk/poster. 

The RCVS is now inviting feedback about the poster at communications@rcvs.org.uk.

If you like the poster, I really do urge you drop the College a quick line at that email address and say so. Better still - and I will probably be put on the naughty step for saying this -  cc L.Lockett@rcvs.org.uk and i.holloway@rcvs.org.uk. It was they who took the idea forward and made it happen. I think they deserve a round of applause. 

Virbac has launched Vetemex (maropitant), an antiemetic for the treatment and prevention of vomiting and nausea in cats and dogs.

Vetemex has a 56-day broached shelf life and uses benzyl alcohol as the excipient, rather than metacresol.

Virbac points to a study in which benzyl alcohol achieved a 78% reduction in pain score immediately post-injection, and a 53% reduction in pain score in the 2-minute period post-injection, compared to Metacresol¹.

Vetemex is presented in a 20ml bottle and is available from the veterinary wholesalers now.  

Claire Lewis, Product Manager at Virbac said: "Vetemex is a valuable addition to the already extensive Virbac portfolio. We are pleased to be able to offer vets this new, and more comfortable to administer, antiemetic option."

For more information on Vetemex, speak to your Virbac Territory Manager. 

Reference

1. Deckers N, Ruigrok CA, Verhoeve HP, et al. Comparison of pain response after subcutaneous injection of two maropitant formulations to beagle dogs. Veterinary Record Open 2018;5:e000262.

The RVC has published a new study which has revealed several risk factors for canine lipomas, fatty masses which because of their large size and rapid growth often cause extreme and long-term anxiety to the owners of affected dogs.

The College says that until now, veterinary research has largely ignored lipomas because they are rarely referred for specialist treatment.

For the study, the RVC identified 2765 lipoma cases from a population of 384,284 dogs in its VetCompass Programme (which collects anonymised clinical data on dogs under primary veterinary care in the UK) in 2013. 

The study found that 1 in 50 dogs are affected by lipomas each year and that Springer Spaniels, Dobermann Pinschers, Weimaraners and Labrador Retrievers are the most susceptible to lipomas (5-8% prevalence).

The study also found:

• At least one lipoma was diagnosed in 1.94% of dogs during the single year of the study.

• Individual dogs with an adult bodyweight that was equal or higher than their breed/sex average had 1.96 times the odds of lipoma.

• As dogs age, their odds of getting lipoma increase. Dogs aged between 9-12 years were over 17 times more likely to be diagnosed with lipoma compared to dogs aged 3-6 years old.

• Neutered dogs had higher risk.

• Insured dogs had 1.78 times the odds of diagnosis. 

• Purebred dogs had 1.16 times the odds compared with crossbred dogs. 

Dr Lynda Rutherford, Clinician and Lecturer in Small Animal Surgery at the RVC, said: "This paper has supported the theory that lipomas are more common in older, overweight dogs.

"This information is useful as it can be discussed with owners and used as another reason to keep pet dog’s weight under control. It also provides a useful insight into how common lipomas are within the UK dog population."

Reference

• O'NEILL, D. G., CORAH, C. H., CHURCH, D. B., BRODBELT, D. C. & RUTHERFORD, L. 2018. Lipoma in dogs under primary veterinary care in the UK: prevalence and breed associations. Canine Genetics and Epidemiology, 5, 9. https://cgejournal.biomedcentral.com/articles/10.1186/s40575-018-0065-9 

Virbac has announced the launch of Epirepress (phenobarbital) for the treatment of epilepsy in dogs, designed to make dosing and dispensing easy and accurate for practice staff and owners. 

Virbac says phenobarbital is the only medication licensed to treat both idiopathic and structural epilepsy, and that it provides clinical improvement in 85% of cases.¹ 

Epirepress is offered in the conventional 60mg tablet strength, which can be split into two or four so dosing can be tailored to the needs of individual patients. 

EpiRepress is the first epilepsy treatment to be offered in easy-to-dispense boxes of 30 tablets, removing the need for the practice team to count out tablets from larger pots – a process which can now be done without the need to handle individual tablets. Virbac says the smaller box size also makes the purchase price more manageable for clients.

Virbac has produced a range of client and marketing materials to support the use of EpiRepress, including an epilepsy diary, a folder to keep the diary and extra materials in one safe place, and a diagnostic and treatment poster for practices. 

Virbac Product Manager Sarah Dixon MRCVS said: "The prevalence of canine epilepsy means that most practices are seeing at least one case a week.²  Phenobarbital is the mainstay treatment for canine epilepsy and, in developing our product, we wanted to offer practices and owners an easier, more accurate and more cost-effective solution.¹  EpiRepress, with its divisible 60mg tablets and smaller box size, is the result and we are delighted to be able to launch it. 

"We are focused on supporting practices and owners with compliance so have also developed a novel practice support package for EpiRepress. It offers the latest guidance to both vet practices and pet owners on the diagnosis, treatment and management of this challenging disease."

References

1. Podell, M., Volk, H. A., Berendt, M., Loscher, W., Munana, K., Patterson, E. E., & Platt, S. R. (2016). 2015 ACVIM Small Animal Consensus Statement on Seizure Management in Dogs, Journal of Veterinary Internal Medicine, 30, 477-490.
2. IVETF (2015). International Veterinary Epilepsy Task Force Consensus Reports.  Available at: www.biomedcentral.com/bmcvetres/series/IVETF_consensus_reports.

Suffolk-based Dr Horia Elefterescu has been struck off by the RCVS Disciplinary Committee for dishonesty, clinical failings and poor record keeping.

The Committee heard seven charges against Dr Elefterescu. The charges were:

1. In September 2015, in relation to a male cat called Kitty Brown, he failed to undertake an adequate examination prior to surgery and that he undertook an unnecessary laparotomy.

2. In February 2016, in relation to a male cat called Storm Page, he failed to undertake an adequate clinical examination prior to anaesthesia and made dishonest or misleading entries in the clinical records stating that he had undertaken a full clinical examination.

3. In February 2016, in relation to a male cat called Sampson Page, he failed to undertake an adequate clinical examination prior to anaesthesia and made dishonest or misleading entries to the effect that he had undertaken a full clinical examination.

4. In February 2016, in relation to Tibial Plateau Levelling Osteotomy (TPLO) surgery performed on a female Bichon Frise called Lucy Allen, he failed to undertake adequate examinations into the possibility of a cranial cruciate ligament rupture or failed to record the same; performed the TPLO surgery with insufficient clinical justification; performed the surgery inadequately; failed to take steps to rectify inadequate surgery having obtained post-operative radiographs; made dishonest/ misleading entries into clinical records; and, in a letter to the RCVS on 7 August 2016, made dishonest and misleading comments.

5. In February 2016, in relation to a male cat called Kipper Morley, he failed to take and record a sufficiently detailed history; failed to undertake an adequate clinical examination; that, having noted the possibility that Kipper might have anaemia, he failed to make arrangements for urgent investigations to be undertaken; that, having decided to administer intravenous fluids to Kipper, failed to make arrangements urgently; and failed to keep clear, accurate and detailed clinical records.

6. Between September 2015 and February 2016, he failed to keep clear, accurate clinical records in relation to seven cases.

7. In February 2016, in relation to a male cat named Chino Biggs, he failed to undertake adequate clinical examination and dishonestly made entries in the clinical records saying that he had undertaken aspects of an examination when he had not done so.

Having heard evidence from complainants, witnesses (including expert witnesses) and the respondent himself the Committee determined that the facts of all the charges were proven – with the exception of part of Charge 6 regarding his keeping inadequate clinical records in relation to a male cat called Dax Parham.

The Committee then went on to consider whether the proven charges, both individually and cumulatively, amounted to serious professional misconduct. In relation to the first and fifth charges the Committee found that, while Dr Elefterescu’s conduct fell below what was expected of a professional veterinary surgeon – they did not constitute serious professional conduct.

In relation to the parts of the second, third, fourth, sixth and seventh charges that were found proven, the Committee determined that each constituted serious professional misconduct. 

In relation to these determinations, Ian Arundale, chairing the Committee and speaking on its behalf, said: "The respondent’s clinical failures… are very serious, amounting as they do to failures in the basics of animal care and resulting in suffering to the animal. They involve widespread breaches of the Code, including not only the obligation in relation to animal health and welfare… but also the specific obligations of the Code in relation to record keeping. 

"In addition to his clinical and record keeping failures the respondent has been found to have acted dishonestly. This dishonesty would have impacted upon professional colleagues and any owner who viewed the records. It has the potential to undermine public confidence in the profession. The respondent was also dishonest in a letter written in August 2017 to his regulator."

In considering Dr Elefterescu’s sanction, the Committee took into account a number of aggravating and mitigating factors.

Aggravating factors included actual and risk of injury to animals, dishonesty, recklessness, breach of client trust, repeated misconduct and limited insight into his failings.

In mitigation the Committee considered that, at the time of the misconduct, the respondent was new to the UK, he had language difficulties which resulted in communication problems, that he was unfamiliar with UK veterinary computer systems and procedures, that he is of good character, that he has taken steps to avoid a repetition of his misconduct and that there have been no subsequent complaints since the dates of the matters in the charges.

However, the Committee found that, in light of the seriousness of the charges found against him, the only sufficient sanction was to direct the Registrar to remove Dr Elefterescu’s name from the Register. 

Mr Arundale, commenting on the sanction, said: "The respondent’s misconduct involved very serious departures from the professional standards set out in the RCVS Code…. In particular, the unnecessary surgery (both the initial and revision) carried out on Lucy Allen constituted very serious harm to an animal. The Committee considers that the respondent’s lack of insight into his failings, and his wholly unjustified confidence in his abilities constitute an ongoing risk to animal welfare. In these circumstances, the Committee has determined that the only sanction which is appropriate and proportionate, in order to ensure the welfare of animals, the public interest and the reputation of the profession, is to direct the respondent’s removal from the Register."

Dr Elefterescu has 28 days in which he can lodge an appeal with the Privy Council regarding the Disciplinary Committee’s decision.