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The patient-side test identifies urinary tract infection (UTI) and the best antibiotics to treat the condition, with the results produced in minutes.
Test and Treat says the new test means that vets will no longer have to treat empirically while a urine sample is sent to an external laboratory. Nor will you have to risk delaying treatment until the results are received.
In addition, the company says that the test will help support the responsible use of antibiotics, which is particularly important given that Enterococci strains identified in canine urinary infections have been found to be resistant to three or more antimicrobials1.
U-treat is a two-part test. The first part of the test detects the presence of a urinary infection. The second part of the test looks at antibiotic susceptibility, showing the best choice of antibiotic and identifying those that won't work due to antimicrobial resistance.
Using the principles of bioluminescence, U-Treat removes host cell ATP before lysing bacterial cell walls to release bacterial ATP, which is then detected using a luminometer. The initial detection of infection test takes five minutes and the susceptibility test takes 30 minutes.
Clinical evaluation of the test in cats and dogs was carried out at University of Tennessee in conjunction with Prof. David Bemis of Cornell University. The company says U-Treat demonstrated high levels of sensitivity (97.1%) and specificity (92%), compared to lab tests.
The test is currently validated for use in dogs and cats and is being investigated for use in horses. While the test will launch first in the veterinary world, it also has scope to cross over into human medicine where there is potential to use it in general practice, paediatric and geriatric care.
Ron Turner, CEO and Scientific Director of Test and Treat said: "We've already sent our first orders to the US and have being talking at veterinary conferences about the technology - so we know vets are keen to get access to this new diagnostic test. Fast, reliable and accurate results mean that it's easier to put together a rational treatment plan that they can be very confident will work because they have the evidence."
Test and Treat is based near Newmarket in Suffolk and orders for the test are now being taken from veterinary practices in the UK. Full training will be given and the desk-top equipment (incubator, luminometer and reader) required to run the test can be supplied.
The company, which has attracted government enterprise funding, is also interested in hearing from veterinary surgeons who might be interested in investing in the technology and helping to expand its use.
To place an order, contact James Turner, General Manager on 01638 501974, email: jamest@tandtreat.com or visit http://www.tandtreat.com.
Reference
The group reports that over 150 veterinary professionals have registered on its website and pledged their support.
The campaigners say they've been astonished with the response and believe the dozens of practices that have received legal letters and signed up so far could just be the tip of the iceberg.
Since the story first came to light, VetSurgeon.org understands IVC has sent follow-up letters to a number of practices saying it has decided to offer a stay of execution and extend the deadline to comply until the 31st December 2025, before it considers taking further legal action.
However, the campaigners estimate that to rebrand so many ‘Pet Health Clubs’ will cost £250,000 and £350,000 in total, so they have now appointed an intellectual property lawyer to provide specialist advice on whether such a common term can be protected with a word mark.
Alex Green of Broadway Vets said: “Initially we set up We Are Spartacus to bring all the affected practices together to support each other, and while we’ve done this, we’ve also brought the wider veterinary community together who want to stand up to IVC Evidensia and the ridiculous word mark.
“Lots of practices have had a ‘Pet Health Club’ for more than 10 years and the majority of those that have come forward were using the term long before IVC registered its word mark in 2019, so it’s clearly an issue that people feel very passionate about, especially when it’s likely to cost each practice a significant amount of money and time to rebrand.
“We’ve been overwhelmed by the number of people who have registered to support us, especially those that aren’t affected but who want to stand shoulder to shoulder with us against such an unnecessary and underhand way of doing business.
"However, there are still several practices that are affected that we haven’t heard from, and we’d urge them to come and join us now.
“We’re also keen to hear from those that received initial letters and haven’t yet had a follow-up offering a stay of execution until the end of the year.
"Whilst we’re delighted that IVC has extended their deadline, it does not resolve the fact that their threats are unacceptable when every practice in the country provides animal, or ‘pet’, healthcare, or ‘health’, in a community-based service, or ‘club’.
“They don’t need to fight or worry about this on their own and we’re stronger as a collective, especially when it comes to pooling resources and expertise.
"We’ve already appointed a specialist IP lawyer to advise us, and the view is that given the extensive prior use of ‘Pet Health Club,’ it would be crazy to allow this to escalate to court when it can be amicably resolved.
“It’s also come to light that IVC has even registered ‘It’s not what we do, it’s why we do it’ which does rather sum it all up.
Spartacus just wants to know why IVC is doing what it’s doing.”
www.wearespartacus.co.uk
When the Newmarket-based veterinary and scientific research charity launched the test, it was believed that one in twenty Petit Basset Griffon Vendeen puppies would grow up to be affected by POAG.
Three years later, through responsible breeders using the DNA test, the AHT says there have been NO affected puppies in the UK reported to The Kennel Club.
The AHT says the test results demonstrate how appropriate DNA testing can lead to the immediate disappearance of a recessive disease, improving the health and wellbeing of countless dogs and their families.
One breeder who has seen first-hand the benefits of this DNA test is Viv Phillips, who said: "As the breeder who first announced I had a dog affected by POAG I was delighted to work with the AHT and Prof Peter Bedford for 18 years in the research into this disease. I know how tough it is to not be able to avoid your dog going blind at a relatively young age. When the AHT discovered the DNA mutation in November 2014 which was subsequently launched at Crufts in 2015 it was the most wonderful result.
"I tested the PBGVs I still had, including their older parents, and was able to ascertain that puppies I had bred were either at no risk of going blind or sadly carried the gene and therefore treatment could be started to prolong their eyesight. Since this time I have bred 12 puppies and I am delighted that I know they will not be affected as a result of using the DNA test.
"Worldwide approximately 1800 Petit Basset Griffon Vendeen have been tested, and in the UK no puppies have been recorded as affected in the last three years. It is not a numerically large breed and if we can continue to spread the word worldwide and convince breeders to test their breeding stock, we can - with the help of the AHT - look forward to eliminating this awful disease completely."
Dr Cathryn Mellersh, Head of Canine Genetics at the AHT, said: "Years of work went into developing this DNA test which makes it even more rewarding to see it used so well to stop these lovely dogs from going blind. Glaucoma is a very debilitating and painful disease and some dogs have to their eyes removed as a result.
"We are studying glaucoma, and many other blinding diseases, in lots of dog breeds. These mutations can also affect cross bred as well as purebred dogs, so as the popularity of cross bred dogs continues to rise, DNA health testing is more important than ever to make sure you’re breeding, or buying, puppies that are going to have the very best start in life. Great things can be achieved through genetic research and as humans suffer many of the same diseases as dogs, there is always the possibility that our research is going to help human medicine as well. Unfortunately research is expensive and we always need more funding to be able to continue to maintain and expand our research of inherited diseases, including more complex diseases, such as epilepsy."
The Statutory Membership Examination must be taken by all individuals educated outside of the UK whose veterinary qualification is not recognised by the RCVS. Passing the exam allows them to join the UK Register, and practice as a veterinary surgeon in the UK.
The exam has existed in its current format for over 30 years, and the review was implemented to ensure the examination remains fit for purpose, and sits in line with international best-practice and the College’s current Day-one Competences.
The College says the review was also designed to make sure it is using the most appropriate means of assessment methods, to best prepare candidates for success, and to ensure candidates can work in the UK to the best of their ability.
The written examination will now consist of two parts; a clinical Multiple Choice Question (MCQ) paper (in a single best answer clinical vignette format) and an open book examination, which will be used to ascertain the candidate’s knowledge of the RCVS Code of Professional Conduct.
The Clinical, Practical Examination will now exist in the form of a multi-dimensional Objective Structured Clinical Examination (OSCE). This examination is set to measure a range of clinical, technical and professional skills including clinical reasoning, communication, professionalism, and ethical awareness. Following a tender process, Glasgow Veterinary School has been awarded the contract to host the OSCE examination for five years from 2019 to 2023.
RCVS Examinations Manager, Victoria Hedges, said: "The review of the Statutory Membership Examination has provided us with the opportunity to ensure that we continue to test the skills and knowledge needed to work effectively in a veterinary practice in the UK in a robust manner, and bring it in line with the final year examinations delivered at UK vet schools. In designing the examination, the RCVS has considered international best practice, in addition to approaches to regulatory examinations within both the veterinary and medical sectors."
A comprehensive handbook regarding this new examination will be available on the Statutory Membership Examination section of the RCVS website (www.rcvs.org.uk/statutory-membership-exam) shortly.
If you have any questions, please get in contact with Examinations Manager, Victoria Hedges: v.hedges@rcvs.org.uk
According to the study1, which looked at Chihuahuas treated in first opinion practice, ownership in the UK has increased over five-fold in the past decade from 1.0% of all puppies born in 2005 to 5.4% in 2016.
However, the study also found the breed was particularly susceptible to a number of health issues, including: dental disease (13.5%), obesity (5.9%) and retained baby teeth (5.7%).
Compared with other dogs, Chihuahuas were also more prone to aggression (4.2%), slipping kneecap (4.0%) and retained testicles (3.9%).
Other findings included:
Dan O’Neill, senior lecturer at the RVC and author of the paper, said: "Chihuahuas are an old breed but the recent craze for them can cause some real welfare issues for this tiny dog. There is increasing evidence that unscrupulous breeders and dealers both inside and outside the UK are cashing in on this trend by making a lot of money but with little regard for the welfare of these puppies and breeding bitches."
Camilla Pegram, VetCompass epidemiologist at the RVC and co-author of the paper said: "Dental disease and retained baby teeth should be recognised as important health concerns for Chihuahuas, with preventative care for dental disease a key topic for discussion between vets and owners. In addition, many of the common or predisposed disorders, such as dental disease, retained baby teeth, sliding kneecap and retained testicle(s), often require surgical intervention. The Chihuahua’s small size increases its anaesthetic risk. Obesity has many detrimental effects, including increased anaesthetic risk, and aggression makes them challenging patients and pets, therefore nutrition, lifestyle and behaviour are also key areas for veterinary-owner discussions."
The full paper is open access: https://doi.org/10.1186/s12917-020-2258-1.
Reference:
The effect of changing diet on gastric ulceration in exercising horses and ponies following cessation of omeprazole treatment was conducted by Nanna Luthersson (Hestedoktoren, a private practice in Denmark) and Coby Bolger (Horse1 Spain), with colleagues from the University of Madrid and Glasgow, in collaboration with Spillers and the Waltham Equine Studies Group.
The study evaluated the effect of dietary change in combination with omeprazole treatment and after the cessation of treatment.
The 32 horses in this part of the trial had been diagnosed with significant equine squamous gastric disease (ESGD) and were in hard work.
On a random basis one of each pair was assigned to a specified low starch, fibre-based diet consisting of their own forage alongside a restricted starch, high fibre, high energy cube (Spillers HDF Power Cubes, which are commonly used in racing yards) and a high oil, low starch, chopped alfalfa based feed (Winergy Equilibrium Growth) and the other stayed on their original diet. All animals were scoped before, after the recommended course of omeprazole treatment and then six weeks after the omeprazole finished.
The horses in the no diet change group improved significantly with the omeprazole but when the treatment was stopped many regressed. Overall, by the end of the trial they were not significantly different to when they had started.
However, the horses in the dietary change group overall showed significantly improved ESGD scores, not only following the omeprazole treatment but also after the treatment had stopped. This showed that a change in diet was able to help maintain the beneficial effect of omeprazole even after the omeprazole was removed.
The study achieved an award in 2016 for research in horse welfare from the Fundación para la Promoción del Deporte Ecuestre, Spain.
Clare Barfoot RNutr, the research and development manager at Spillers, said: "This exciting work confirms what we suspected; that whilst appropriate dietary change can provide additional support to medical treatment for EGUS most importantly it can help maintain better gastric health post medical treatment."
Last year the British Equestrian Trade Association, in consultation with the Veterinary Medicines Directorate, introduced a new feed approval mark to help owners identify feeds suitable for horses and ponies prone to equine gastric ulcer syndrome (EGUS).
Currently six feeds in the UK carry the BETA Equine Gastric Ulceration Syndrome (EGUS) Certification Mark including Winergy Equilibrium Growth and Spillers Alfalfa Pro Fibre.
The VetSurgeon Expert Forums were originally designed to overcome the weaknesses inherent in other social media platforms like Facebook, such as the lack of accountability, transparency and provenance for the clinical information and opinions being shared.
However it is hoped that the new resource will prove to be especially helpful to general practitioners who find themselves working in isolation because of the coronavirus pandemic.
For them, advice from some of the leading experts in the country could prove a real lifeline.
To use the new Expert Help forums, login and visit VetSurgeon.org/experts (under ‘Forums’ in the main navigation). Alternatively, navigate to the relevant area under ‘Interests’ and go from there.
Type your question in brief, then add any further detail in the box beneath.
Your question is then emailed to a number of experts in the relevant field, who’ll reply when they are able.
All questions are added to a knowledgebank which other members of the profession can read and refer to, but only you, the question author and the experts can reply.
This means you can be assured of a friendly, helpful and knowledgeable reply and it won’t get drowned in a sea of ‘me too’ posts.
Importantly, you can see the provenance for all advice given in the Expert Forums: click the name of the expert to read their full professional profile and qualifications.
There’s also a red ‘Claim CPD’ button at the top of the thread. Use that to claim your question as CPD, or just to keep a record of your questions and the answers (which you can later review in your profile).
Once you have had your answer(s), you must click ‘Verify Answer’ under any that you feel have answered your question. This adds the referral practitioner’s logo and gives them points on a leaderboard of most active and helpful experts. So it’s a nice way to say 'thank you' for their time and effort.
The expert forums are being rolled out, discipline by discipline, over the coming weeks.
Anaesthesia and Pain Management is now live, with experts like Jo Murrell from Highcroft Referrals, Dan Holden from County Vet Clinic, Gwen Covey-Crump, and Carl Bradbrook from Anderson Moores answering questions.
In Cardiology, we have the ever-helpful Dave Dickson from HeartVets and Roger Wilkinson joined by Chris Linney from Willows, Mike Holgate, Mark Patteson from HeartVets, and Nuala Summerfield from Virtual Veterinary Specialists.
In Dentistry, we have Peter Southerden from Eastcott, Norman Johnston from DentalVets, Evelyn Barbour-Hill, Bob Partridge from VetDentist and Rob Davis from Moreton Hall all there to lend a hand.
You'd be hard-pushed to find a more helpful, friendly or more knowledgable bunch of people, so do make the most of this new resource. Remember, there is no such thing as a stupid question, and posting it here adds it to a knowledgebank for everyone else and allows both you and the expert to claim CPD time.
Post your question here!
If you are an expert in one of the veterinary disciplines on VetSurgeon and would like to contribute to an expert forum, please first watch this explanatory video for referral practitioners and then contact: support@vetsurgeon.org.
Suitable for both puppies and adult dogs, Eradia is presented in a bottle with an award-winning1 'All-In-One Smart Cap' which stops the person administering the product from coming into contact with the solution, is child proof and offers flexible dosing options.
Available in 30ml and 100ml bottles to cater for all dogs, Eradia can be administered either directly into the mouth or on to food.
Virbac says that Eradia has been shown to be accepted by 100% of dogs2, thereby alleviating any possible problems administering metronidazole.
For more information, contact your Virbac Territory Manager.
References
Mrs Mullen faced four charges against her.
The first was that she failed to provide information to her clients about her practice OOH provision.
She was also charged with discharging a Labrador, called Cleo, that was unfit to be discharged following spay surgery, with an inadequate abdominal dressing and inadequate information given to the dog's owners regarding complications from surgery, the risk of post-operative haemorrhage and arrangements for out-of-hours care, as well as failing to make adequate clinical records.
The third charge alleged that she had failed to obtain informed consent for anaesthesia/ surgery performed on an English Bulldog, called Boycie, from his owners, failed to ensure the dog had adequate monitoring whilst recovering from anaesthesia, failed to offer an adequate range of overnight care for the dog, left the dog alone overnight when it was not in a fit condition to be left, failed to provide information to its owners on post-operative care at home and out-of-hours emergency arrangements, and failed to make adequate clinical records relating to its treatment.
Finally, she was charged with failing to have Professional Indemnity Insurance (PII) or equivalent arrangements in place or failing to provide details of it, failing to respond to requests regarding her continuing professional development records and failing to respond adequately to reasonable requests from the College for details and documents regarding her treatment of the two dogs.
Mrs Mullen indicated to the RCVS before the hearing that she would not be engaging with the disciplinary process.
The Disciplinary Committee therefore granted the RCVS permission to proceed in her absence on the basis that Mrs Mullen had made it clear that her absence from proceedings was deliberate and voluntary, that there was no indication she would attend any future hearing if it was adjourned and that the charges were of sufficient seriousness that it was in the interests of animal welfare to proceed with them.
The Committee heard evidence from a number of witnesses including the animals’ owners, an expert veterinary witness and College staff.
In the evidence, the Committee heard that the Labrador had died while undergoing treatment at another veterinary practice from complications arising from blood loss following Mrs Mullen’s surgery.
The Committee also heard that the English Bulldog had suffered brain damage and had lost its sight due to post-operative hypoxia, although it had otherwise recovered.
Having heard all the evidence, the Committee found all the charges against Mrs Mullen proven.
The Committee then went on to consider whether the proven charges amounted to serious professional misconduct.
In doing so it considered the aggravating factors, including that there was actual injury to animals, that the misconduct was sustained and repeated over a period of time, that the conduct directly contravened advice issued by the RCVS, and the blatant disregard of the RCVS’s regulatory role.
It also considered that Mrs Mullen had previously been suspended from the Register by the Disciplinary Committee for two months in April 2017 for failing to have Professional Indemnity Insurance arrangements in place.
It considered that there were no mitigating factors in the case and accordingly found serious professional misconduct in relation to all the proven charges.
The Committee then considered what the most appropriate sanction would be.
Judith Way, chairing the Committee and speaking on its behalf, said: “Animal welfare lies at the heart of the veterinary profession.
"The Committee considers that [Mrs Mullen’s] treatment of Cleo and Boycie constitutes a breach of this fundamental tenet of the profession.
"Other serious findings of disgraceful conduct against [Mrs Mullen] are her failure to provide informed consent, failure to provide details about out-of-hours cover, failure to have in place Professional Indemnity Insurance (PII), continuing professional development (CPD), and failure to respond to the College’s request for information.”
The Committee considered that the conduct was so serious that the only means of protecting animal health and welfare and public confidence in the profession was to direct the Registrar to remove Mrs Mullen’s name from the Register of Veterinary Surgeons.
Judith added: “The Committee considers that [Mrs Mullen] has displayed a persistent lack of insight into the seriousness of her actions or their consequences.
"The Committee considers that [Mrs Mullen’s] conduct raises serious clinical concerns, shows disregard of obligations in relation to out-of-hours care, indicates deficiencies in making decisions, demonstrates an obstructive attitude to her regulator and creates a potential risk to patients.
"She has not engaged with the regulator, she has not demonstrated insight into her misconduct, has learned nothing from her previous suspension in relation to PII, and has done nothing to remediate her disgraceful conduct.
"There is no evidence that [Mrs Mullen} has complied with any of her obligations in relation to CPD."
“In the view of the Committee, if [Mrs Mullen] were permitted to remain on the Register, there would be a serious risk of harm to animals. She has demonstrated a reckless disregard for the obligations of a registered veterinary surgeon.”
Mrs Mullen has 28 days from being informed of the Committee’s decision to lodge an appeal with the Privy Council.
First out of the stalls was Vet AI, a company founded in 2017 by Paul Hallett and Robert Dawson MRCVS, which announced last November that it had filed patents for artificial intelligence technology to deploy in giving online consultations through its newly-launched app: Joii.
More recently, a Swedish company called FirstVet has announced the UK launch of a consultation service it has offered in the Scandinavian countries for a few years now.
All three companies charge £20 for an online consultation with a veterinary surgeon.
All of these services are currently limited in what they can offer pet owners here in the UK, because veterinary surgeons are not allowed to prescribe medicines without having physically examined the patient. FirstVet says that in Sweden, similar rules apply, except that under current guidance, antiparasiticides and feline contraceptives can be prescribed remotely.
This means that for the moment at least, online consultations in the UK can only advise pet owners whether they do or do not need to see a veterinary surgeon in person, or recommend OTC treatments, such as flea control.
Personally, I'm not convinced that it's worth £20 for the privilege of asking a vet whether or not my pet needs to see a vet, although to be fair, Joii includes a free symptom checker to differentiate between those cases that need directing to see a vet in person, and those that would benefit from the online consultation. Also, if a case needs to be referred to another vet after a consultation, Joii refunds the consultation fee.
Nevertheless I think I'd just ring my normal practice and ask. But that's just me. Perhaps others will see a value in the immediacy of the online service, or that it entails less commitment.
FirstVet does, however, have another string to its bow. It has been busy forging relationships with insurers to fund the majority of its consultations. The insured owner gets a free consultation subsidised by the insurance company; if the animal requires treatment, the owner is referred to their normal vet, unless they don't have one, in which case the referral is to the nearest practice which can help.
That seems to make all sorts of sense for insured clients. It really adds value to the insurance policy, to be told you'll have access to free, immediate online veterinary consultations. Almost certainly it will mean pet owners seeking veterinary advice sooner than they might otherwise have done. For the insurer, that in turn might mean earlier diagnosis and therefore cheaper treatment. One assumes it also translates into cost-savings for the insurer by dealing with certain queries without needing a trip to the practice.
Still, the really big prize here for remote consultation companies will come if and when the regulations allow remote prescribing. Not necessarily because they'll make a mark up on the sale of prescription drugs, though of course they will, but because suddenly the proposition to the pet owner is that the consultation can, in many cases, offer more convenient and cheaper treatment than if they had to visit a practice in person.
The problem with that, however, is that the £20 remote consultation may carry a greater risk of misdiagnosis. It may mean that the preventative approach to veterinary medicine goes out of the window, at least until remote monitoring technology catches up. There is also a risk that these new limited service providers will take the bread and butter consultations from bricks and mortar practices, consultations that may have been to some degree subsidising care for other patients. These are all the sorts of things that were hotly debated at RCVS Council last November.
Nevertheless, Vet AI is unashamedly pushing for remote prescribing rules to be relaxed. Founder Robert Dawson MRCVS said: "I think that the ease and reduced cost of access to veterinary advice and medicines will have a positive impact on animal welfare. I also think that it will free up vets' time to see the cases they really need to see.
"But in truth, what I think is not the point. The whole debate at the moment is characterised by members of the profession saying what they think will happen as a result of remote prescribing. What we actually need is some evidence. I'd really like to see some movement from the College on this, for a limited number of treatments like parasiticides, before the end of the year."
As Robert says, the debate is characterised by a lack of evidence. But there is, of course, another way that online consultations could really add value to the client/vet relationship without any of these problems, and that is as an adjunct to the service offered by bricks and mortar practices.
Bricks and mortar practices can already prescribe medicines to animals under their care without physically seeing the animal on every occasion. Furthermore, there are a number of situations where a remote consultation could save both the practice and pet owner time and money. For example, post-operative follow-up consultations.
However, none of the existing providers I've spoken to plan to offer a 'white label' solution. So, if I owned a practice, I tell you what, I'd be looking into online consultation software right now. It is already possible, of course, to offer online consultations via things like Skype. But better still would be a system that allowed clients to schedule an online appointment with their normal vet, perhaps slotted in between their face-to-face consultations. As opposed to the existing online providers, you wouldn't need to refund money if a physical consultation was needed, just - perhaps - set it against the later consultation. You could also offer annual plans to include a certain number of online consultations. You could have online triage consultations carried out by veterinary nurses.
There are lots of possibilities. But if you're a bricks and mortar practice, one thing is for sure, the time to look into all this is now. You could do worse than to start here: https://www.vetsurgeon.org/news/b/veterinary-news/archive/2019/01/15/now-all-vet-practices-can-offer-remote-consultations.aspx
The company says that Anallergenic can be used as the elimination diet of choice when working up dermatosis cases. Nutrient intolerance can be determined by feeding the extensively hydrolysed elimination diet for six to eight weeks followed by reintroduction of the pet’s original diet.
For cases where a nutrient intolerance is proven, Royal Canin says Hypoallergenic should be used for long-term nutritional management, although some refractory cases may need to remain on Anallergenic.
Anallergenic has been formulated with feather protein hydrolysate, starch instead of whole cereals and a combination of ingredients to help reduce water loss through the skin and strengthen the barrier effect of the skin.
John O’Connor, Veterinary Marketing Manager at Royal Canin, said: "When a nutrient intolerance is suspected, the cat’s diet should be changed to Anallergenic without any food transition. Dermatosis is complex to understand and identifying the underlying cause can be challenging. Managing cats with dermatosis requires a long-term commitment and it is essential for vets to use nutrition as part of their work up.
"The lower the allergenic potential of the diet, the more reliable the results¹ and nutritional management with Anallergenic can be continued for the cat’s lifetime. With the new, highly palatable² Feline Anallergenic diet, Royal Canin offers the complete nutritional approach to dermatosis."
Alongside the new diet, Royal Canin has produced a range of owner education materials, including a leaflet with top tips and a video about nutrient intolerances to raise awareness of the condition and the importance of owners seeking veterinary advice. The new materials are available via your Royal Canin Veterinary Business Manager.
For more information, visit royalcanin.co.uk/skin
Centaur will continue to operate its warehouse in Castle Cary, Somerset; the new facility will allow the company to bolster its services to customers throughout Northern England, North Wales and Scotland.
AmerisourceBergen says the new Midlands facility will hold more than 13,000 products and be licensed for the wholesale distribution of veterinary and human medicines. The facility will use a state-of-the-art warehouse management software to provide efficient and accurate order fulfillment and improve the visibility of products in the supply chain.
Brian Topper, Managing Director of AmerisourceBergen Animal Health U.K. said: "Our expanded presence and capabilities in the U.K. is a reflection of the demand for high-quality solutions, and we’re growing to best meet our customers’ needs.
"Practices of all sizes rely on us to provide them with timely access to the products they need on a daily basis. With broader scope and capacity, we’ll be able to go beyond our best-in-class services and provide an unmatched customer experience by delivering critical products to practices in a more efficient and consistent manner than ever before."
The company says that the new warehouse will create more capacity at its Somerset warehouse and put the company in a positive inventory position to buffer against any business continuity challenges that may occur – ensuring that practices and their patients continue to have access to vital products.
Lisa Derbyshire, Director of Operations & Supply Chain at Centaur Services said: "As the industry moves forward, we want to ensure our customers have access to high-quality infrastructure that maximizes product safety and improves operational efficiency. Adding critical resources and upgraded service offerings, like our new distribution center in the Midlands, enables us to be at the forefront of distribution while continuing to provide the excellent service that our customers have come to know and expect from Centaur."
Online veterinary pharmacy Vet-Medic has announced the results of a survey which showed that veterinary practices are charging pet owners 100% more than online pharmacies for well-known drugs.
The survey compared the prices charged by veterinary practices, online pharmacies, pet superstores, supermarkets and veterinary medicine suppliers. Amongst other things, it found a six-pack of Frontline for cats available online for £16.33, vs £38.95 in practice. Optimmune was available for £23.86, compared to a practice in North London selling it for £59.81.
Andrew Evans, Managing Director of Vet-Medic said: "This research offers huge insight into the pricing structures of pet medication. When we commissioned the research to help us keep our own pricing competitive, we made an assumption that online shopping should come out cheaper but were staggered by how much."
He added: "Not many pet owners are aware that vets are obliged, in most circumstances, to provide them with a prescription when asked. How and where the prescription medicine is purchased is actually the owners' choice."
The BVA responded to the survey yesterday. President-Elect Harvey Locke said: "The Vet-Medic claim that veterinary practices are over-inflating the price of veterinary medicines is an unfair accusation.
"Veterinary practices will mark up the cost of the medicines they supply in order to cover the costs of keeping and dispensing them. This includes having trained staff available, buying the necessary equipment, and storage facilities that are governed by strict rules, and covering the cost of wasted medicines that have a short shelf life.
"Online pharmacies have similar overheads but are able to buy in much larger quantities than the average veterinary practice due to the much higher volumes sold. Many of the internet prices revealed in the survey are around the same cost as veterinary practices can buy the medicines from wholesalers suggesting that some of the internet companies are sourcing cheaper drugs abroad.
"As with many products buying online can be cheaper and consumers have a choice. Many pet owners choose to use the veterinary practice pharmacy because a lot of advice and assistance is available, including demonstrations on how to administer the treatments.
"Vet-Medic's assertion that pet owners don't know that they can obtain a prescription from their veterinary surgeon is also false. Over 50% of UK practices are registered under the RCVS Practice Standards Scheme. One of the conditions of the scheme is that a notice must be displayed in the waiting room informing clients that prescriptions are available on request, the price of a prescription, and the price list of the top ten medicines that the practice has dispensed in the last three month period.
"It's important to remember that under the law veterinary practices are not allowed to fix the price of medicines. As they are independent businesses this means that it is up to each practice to charge according to their own circumstances to cover their individual overheads."
By way of example, Emma highlights syringomyelia (SM) and mitral valve disease (MVD) in Cavalier King Charles Spaniels, two diseases which cause considerable suffering and which could be significantly reduced with selective breeding.
Following the uproar caused by the Pedigree Dogs Exposed programme in 2008, a voluntary BVA/Kennel Club SM screening programme was introduced in 2012. However, Emma says that in the time since then, during which 20,429 CKCS puppies have been registered with the Kennel Club, only 331 have been scanned.
She points out that there is still no official heart scheme in the UK, despite the Kennel Club promising at a meeting at the House of Lords in 2008 that they would introduce one.
Meanwhile, Sweden, Belgium, the Netherlands and Denmark have introduced mandatory heart testing schemes for CKCS, and the latest figures from Denmark apparently show there has been a 73% reduction in heart disease.
Back in the UK, this year's Crufts Best of Breed Cavalier sired his first litter untested when he was only 9 months old, against the recommendations of the MVD Breeding Protocol.
Emma said: "It's all very well single vets like me saying 'I'm bloody sick of this', but I don't know how we can change it unless the Kennel Club does something."
Responding in Veterinary Times, the Kennel Club’s secretary Caroline Kisko blamed the veterinary profession for the lack of progress with a heart testing scheme, saying: "The KC has been committed to developing a new heart scheme in the UK for many years but, unfortunately, the veterinary profession has been unable to agree testing protocols."
Emma said: "It is typical of the KC to blame the veterinary profession. It beggars belief to say a heart scheme is too complicated when many other countries have them already in place. At the very least the KC could insist on the well-accepted MVD breeding protocol being followed for Cavaliers. It would be a start. If we never do anything because it’s not perfect, how will we ever evolve change? Looks like us vets will just have to continue to pick up the pieces while dogs carry on dying.”
Long-time Cavalier health campaigner Margaret Carter has a petition on change.org calling for compulsory SM and MVD screening. It has amassed over 27,000 signatures. She said: "It [the Kennel Club] has been talking about a heart scheme for years. It has the know-how and power to not only create a scheme but insist breeders use it. While the Kennel Club prefers to placate its most important customers – breeders - more and more Cavalier puppies are being born to suffer from inherited disease.
"Its Assured Breeders’ Scheme (ABS) is almost meaningless for Cavaliers because the only health test required is for eyes: a token nod to health when the breed is plagued by conditions as horrific as SM and MVD.
"And with so few recorded Cavalier health tests because of the absence of a heart scheme and the breeder boycott of the official SM scheme, the KC’s Mate Select tool is rendered pretty useless too.
Margaret added: "We are very grateful to Emma Milne for voicing so powerfully the situation regarding Cavalier health, however unpalatable the truth might be to some. I’d ask all vets to follow Emma’s lead in writing to the KC and their professional bodies demanding action."
Photograph: Bailey Cooper
Vetsonic has launched Otimectin vet, an ivermectin-based topical preparation for the treatment of Otodectes cynotis infections in cats.
The new product offers a once-weekly dosing alternative to traditional ear mite treatments, which commonly require twice daily administration over 7 to 21 days.
Presented as a gel in a 10g tube complete with application spout, Otimectin vet is a 1 mg/g ivermectin preparation. It does not contain an antibiotic or steroids.
The Allium species includes onions, garlic, and their relatives. All members of the Allium family are poisonous to cats and dogs and even minimal amounts can be dangerous. For example, a 5kg cat would only need to ingest 1-2 garlic cloves to show clinical signs. Poisoning causes haemolytic anaemia with treatment being supportive, as there is no antidote. In severe cases blood transfusions may be required.
Powdered versions of these plants are more concentrated and are often used in gravy and stuffing in the traditional Christmas dinner, so toxicity can occur much more easily.
Will Peel, Product Manager at TVM UK said: "Alliums are toxic to animals and as there is no antidote it’s important that veterinary staff are fully prepared and are able to react quickly and provide the best care possible.
"Our focus is on helping veterinary staff prepare for all eventualities so we hope that these new guidelines will prove beneficial."
The guidelines can be downloaded for free from https://www.tvm-uk.com/vet-resource-library/.
The OIE represents 178 Member countries and territories with international surveillance programmes that monitor antigenic drift among equine influenza viruses, and its Expert Surveillance Panel (ESP) for EIV makes annual recommendations for the composition of equine vaccines.
ProteqFlu, manufactured by Merial Animal Health, is currently the only vaccine in Europe to meet these recommendations.
Brand manager Dr Clare Turnbull said: "These recommendations, which have been in place since 2011, call for the inclusion of both Florida Clade 1 and 2 strains; as these are representative of the EIV strains that competing horses encounter globally.
"Although all licensed vaccinations should give clinical protection to individuals when challenged with a heterologous strain, mathematical modelling demonstrates that when scaled up to population level, this mis-match between challenge strain and vaccine strain significantly increases the risk of an epidemic occurring."
The FEI imposes mandatory equine influenza vaccination for horses competing under their jurisdiction to improve equine welfare by reducing clinical disease in individuals; but also because of the financial losses that an outbreak could have on the equine sport industry.
Göran Akerstrom, veterinary director of the FEI said: "The FEI has been a part of a Public Private Partnership with OIE for many years and we admire the work that they do in disease surveillance and global animal health.
"We stand behind their recommendations on vaccination for equine influenza and recommend our athletes to discuss these with their veterinary surgeons when considering their vaccination schedules."
For further information on FEI vaccination requirements visit https://inside.fei.org/node/3289
Mr Chaney was charged with stealing Trazadone and Metacam from the Hampstead practice he worked at, and of unlawfully possessing Trazadone and Metacam. He was also charged with unlawfully administering Butorphanol to a dog and failing to record the administration of the drug in the dogs records. He was also charged with making and deleting false entries into the clinical records of his own dog to the effect that it had been seen by a vet at the practice and that Metacam had been prescribed. The final charge was that his conduct over the false records was dishonest and misleading.
The Committee heard that Mr Chaney’s conduct in relation to the first two charges was discovered when, in July 2018, the Department for Environment Food & Rural Affairs (Defra), accompanied by police officers, executed a warrant (for unrelated matters) on the property where he lived. During the course of the search, police officers found Metacam and Trazadone in Mr Chaney’s bedroom which did not seem to have a prescription and so Defra officers launched an investigation.
During the course of this investigation, a Defra investigator was also provided with a video and messages that indicated Mr Chaney had unlawfully administered Butorphanol to a Husky dog in frustration with the animal as it was being too noisy.
The Committee heard that, in November 2018, Mr Chaney accepted a police caution in relation to his possession of Trazadone and Metacam, and the unlawful administration of Butorphanol. The Committee also heard that following the police attending his property and finding the medicines, Mr Chaney went on to create false records at the practice in relation to the examination of his dog in order to justify his unlawful possession of the drugs.
The Committee found all the charges against Mr Chaney proven.
The Committee then went on to consider if the charges, taken both individually and in totality, amounted to disgraceful conduct in a professional capacity.
Judith Way, chairing the Committee and speaking on its behalf, said: "The Committee had no doubt that administering a sedative to an animal that required prescription by a veterinary surgeon and then failing to record it in the clinical record with the resultant risk to the animal’s welfare due to lack of knowledge of the administration fell far below the expected standard.
"The Committee also considered that possession of prescription only medicines by a registered veterinary nurse, without the sanction of law, having stolen the same from a practice also fell far below the expected standard.
“The Committee also considered that tampering with the clinical record for a dog, in order to create a misleading impression and in doing so dishonestly, was conduct which fell far below the expected standard.
“Taken as a whole, the Committee considered that Mr Chaney’s conduct had fallen far below the expected standard.”
The Committee therefore found him guilty of disgraceful conduct in a professional capacity in relation to all seven charges.
It next went on to consider what sanction, if any, to impose taking into account the aggravating and mitigating factors.
In considering the aggravating factors, the Committee took into account that Mr Chaney’s conduct had presented a risk of injury to the animal and that much of his conduct was pre-meditated. It also considered that Mr Chaney’s conduct involved a breach of trust to both the practice where he was employed and the owner of the Husky, and it was also an abuse of position in gaining access to and stealing medication. Lastly, because the charges related to two separate incidents, there was a common thread in Mr Chaney disregarding rules on veterinary medicines.
In mitigation, the Committee considered that Mr Chaney had reflected on and gained some insight into his behaviour, and acknowledged he had made admissions at the outset of the hearing, including apologising for and showing regret about aspects of his conduct.
However, the Committee did not believe he had addressed his understanding of the effect that this conduct had on the risk to animals, the standards of the profession or the maintenance of public confidence in the profession. In mitigation the Committee also considered a number of positive character references and his previous good character.
Judith Way said: “The Committee determined that it would not be sufficient in the circumstances of the case, to satisfy the public interest to suspend the Respondent’s registration. In its view this case involved a serious departure from identified professional standards. The disregard had been deliberate, in relation to ignoring legislation in respect of prescription-only medication and dishonesty in stealing medication.
"There was evidence of attitudinal issues in relation to that behaviour and insufficient evidence of the development of insight. The dishonesty in relation to the clinical record relating to dog O [his own dog] had been an attempt to conceal earlier dishonesty relating to the theft of the medication. In administering the Butorphanol to dog L [the Husky], Mr Chaney had been putting his own interests in quieting the dog ahead of the dog’s interests, which would have required checking with a veterinary surgeon as to appropriate steps.
"The Committee acknowledged that, by directing removal, there would likely be professional reputational damage to Mr Chaney and possible financial loss. However, in the view of the Committee the requirements of the public interest outweighed these factors.”
Accordingly, the Registrar of the RCVS was directed to remove Mr Chaney’s name from the Register of Veterinary Nurses.
Full details can be found here: https://www.rcvs.org.uk/concerns/disciplinary-hearings/
The buy-out was led by Professor Nick Bacon, Clinical Director, Dr Laurent Findji, Senior Clinician, Dr Jonathan Bray and Dr Gerard McLauchlan, who will collectively take the hospital forward with the financial backing of a small team of external investors.
Professor Noel Fitzpatrick will continue to lead Fitzpatrick Referrals Orthopaedics and Neurology and Fitzpatrick Referrals Institute for the Restoration of Skeletal Tissue which are both based in Eashing, Surrey.
Fitzpatrick Referrals Oncology and Soft Tissue is rebranding as AURA Veterinary, continuing to focus on animal oncology, soft tissue surgery, interventional radiology and internal medicine.
Under the new management team, AURA Veterinary says it has plans to invest in its team, equipment, scientific innovation and research.
Noel said: “I am proud of everything and everyone who has been part of the journey over the last seven years.
"It is a world-class hospital with an unrivalled team and the foundation we have built together is incredible.
"The time is now right for the team to embark on the next part of their journey - allowing me to also go forward and focus my passion, energy and time at Fitzpatrick Referrals Orthopaedics and Neurology and lead that team into its exciting new phase.”
Nick Bacon, Clinical Director, said: “It was a wonderful opportunity to be involved with a hospital like this from the very beginning, and it’s exciting to be part of its new chapter.
"Laurent and I are hugely grateful to Noel for his vision in creating the hospital, which is unparalleled in the level of care, skill and innovation our team can provide for our patients.
"We look forward to the growth and success of AURA Veterinary.”
Photo: Dr Gerard McLauchlan (standing, back left, in darker scrubs), Professor Nick Bacon, Clinical Director (sitting, front left), Dr Jonathan Bray, (sitting, right), Dr Laurent Findji, Senior Clinician (standing, far right)
Mr Shillabeer faced five charges which largely related to his alleged prescription of contra-indicated NSAIDs and corticosteroids.
He was also charged with prescribing frusemide to a pregnant dog when there was no evidence of a benefit of so doing.
He was also charged with performing inadequate spay surgery.
Mr Shillabeer did not admit to any of the charges, engaged with the College and responded to all requests for information, as well as being present in-person at the hearing.
He made an application to the Committee to dispose of the matter by way of adjournment, subject to the Committee accepting his written undertaking to remove his name from the Register and never to apply to be restored to the Register.
In support of his application, Mr Shillabeer’s legal counsel referred to his client’s witness statement, which set out that he had previously attempted to sell his practice but had been unsuccessful and that he had since closed it.
His legal counsel also asked the Committee to consider the fact that Mr Shillabeer is almost 85 years old and has had an unblemished 60-year career, has had no previous disciplinary findings against him, had put his practice up for sale and made efforts to guide his previous clients to ensure continuity of care elsewhere, and that he deeply regrets anything he has done, which has failed to protect the welfare of animals, or has caused concern or upset to his clients and fellow members of the profession.
Mr Shillabeer's counsel also asked the Committee to take into consideration that his undertakings would have the effect of protecting the welfare of animals and uphold the reputation of the profession as Mr Shillabeer is no longer in practice.
He stated it would be not proportionate, or in the public interest, for there to be a lengthy contested hearing resulting in substantial costs for both the RCVS and Mr Shillabeer.
The College’s legal representative stated that the RCVS did not oppose the application, and that it took a neutral stance.
She highlighted that Mr Shillabeer’s removal from the Register, together with his undertaking never to apply for restoration, would go far beyond anything the Committee could direct by way of sanction after a full enquiry, that Mr Shillabeer retired from practice on 23 July 2024 and does not intend to return, that a full enquiry would take a significant amount of time and expense, that the complainant supports the case being dealt with in the manner proposed by Mr Shillabeer, and that there are no previous findings against Mr Shillabeer.
Paul Morris, chairing the Committee and speaking on its behalf, said: “Taking into account the undertaking never to practice again, in conjunction with all of the circumstances and context set out, the Committee considered that by allowing the application, such an outcome would be sufficient to uphold the public interest, confidence in the profession and the RCVS as regulator, and protect the welfare of animals.
“As a result of all the factors set out, the Committee decided that this is not a case in which the public interest or the welfare of animals demands that there be a full hearing.
“Taking into account proportionality and weighing in the balance all the circumstances of the case, the interests of justice, the public interest, the need to uphold proper standards of conduct and performance, and the need to protect the welfare of animals, the Committee decided to grant the respondent’s application.”
Mr Shillabeer was removed from the Register with immediate effect.
https://www.rcvs.org.uk/concerns/disciplinary-hearings/
The motion was introduced by Kate Richards MRCVS, Chair of the RCVS Standards committee, who explained that it'd been driven by three things, namely: the Vet Futures Initiative, the RCVS Strategic Plan signed off by Council in 2017 and the RCVS telemedicine consultation that took place earlier this year.
The latter of these showed that 69% of vets opposed the idea of prescribing without a physical exam, which rather beggars the question why it's being discussed at all. However, as Kate explained, when asked whether certain types of products could be remotely prescribed, the answer was more equivocal: 52% of vets said "yes".
Kate also explained that over the last two years, there had been a number of good quality discussions at Standards Committee and Council, but that decision-making had been "hampered by a paucity of evidence on the opportunities, risks and benefits of telemedicine to animals and the public".
The full wording of motion was: "Council is invited to consider the recommendation of Standards Committee to conduct a limited and time-bound trial to assess the benefits and risks of allowing the remote prescription of POM-V (excluding opiates, sedatives and potentially also critically important antibiotics) where there has been no physical examination."
However, in order for the trial to take place, it would be necessary to make a temporary change to the Supporting Guidance of the Code of Professional Conduct concerning the definition of "Under his care" (Ed's note. C'mon RCVS, isn’t that a bit anachronistic? Both your CEO and your President are now "her". "Under Care" would do it.), adding the words in italics to para 4.1: "A veterinary surgeon cannot usually have an animal under his or her care if there has been no physical examination; consequently a veterinary surgeon should not treat an animal or prescribe POM-V medicines via the Internet alone, other than in circumstance where a telemedicine service is a part of the RCVS telemedicine trial".
In the best interests of animal welfare
Amanda Boag (MRCVS, Vets Now, RCVS President) then reminded everyone that: "RCVS Council needs to act in the best interest of animal welfare and the public, and whilst sustainability of veterinary services is important, it isn't our role to promote anything novel or to protect traditional models."
Really? Strikes me that the sustainability of veterinary services isn’t just "important", it's an essential part of ensuring good animal welfare. Surely, therefore, it most certainly is the role of Council to protect traditional business models or, for that matter, to promote novel methods if (and I stress "if") doing so protects or enhances animal welfare.
Don’t confuse telemedicine with remote prescribing
Jo Dyer (MRCVS, small animal locum, Devon) opened by pointing out that this is not about telemedicine per se. Telemedicine has been going on since the invention of the telephone in the late 1800s, supplemented over the last 20 years or so by photography and video sent over the internet. Telemedicine does not, in and of itself, require a change in regulation.
What this is about, she explained, is the much narrower act of remote prescribing without physically examining the animal, something which would require the profession to redefine "under his care", which in turn "makes up the foundation of what forms the relationship with the owner and the animal in order that we can safeguard the use of medicines, safeguard the animals under our care and safeguard our clients."
No evidence remote prescribing increases access to veterinary services
Jo argued that the only reason Council should be considering the prescription of medicines without a physical examination would be if it were in the interests of animal welfare. And yet, she said, there is no evidence to support this idea.
Some have suggested that it could increase access to veterinary care. However, Jo said she had been unable to find any evidence to support this idea either. Not just in the veterinary profession, but in the medical profession in the Western and the developing world.
Jo also noted that the trial proposal was to use commercial organisations which have a financial interest in a positive outcome, which would render the results biased and unreliable.
She then raised the issue of antimicrobial resistance, highlighting the use of cytology and culture sensitivity to make sure the right antibiotics are used. Remote prescribing, she said, would be a retrograde step, even if only non-critical antibiotics could be prescribed remotely.
Spawning a new class of limited service provider
Next she highlighted the impact of the trial on 24-7 cover. Under the proposal, "Those under a trial would be required to actively support clients in identifying a veterinary practice that could physically see their animal in both routine and emergency situations."
As Jo pointed out, this would by definition mean that any veterinary surgeon, not just those practising telemedicine, could set themselves up as a limited service provider and refer all cases they didn’t want to see (whether OOH or not) to a local practice. This, she argued, should only happen after a proper debate, and not be just the unintended side-effect of regulation change to allow remote prescribing.
In fact, there is evidence that this is exactly what is happening in human medicine. Only the following evening, the BBC aired Diagnosis on Demand: The Computer Will See You Now, a documentary about telemedicine and artificial intelligence in human medicine. It should be required watching for all RCVS Councillors.
The programme makers visited GP at Hand, a telemedicine business based on the Lillie Road in Fulham, London that has been formed in partnership with Babylon. Coincidentally just up the road from where I used to live, it's a pretty nondescript sort of a place, but now home to the fastest-growing GP surgery in the UK. Since late 2017, it has amassed a staggering 30,000 clients from across London, virtually none of whom will ever visit the place. The problem is that GP at Hand has skimmed away fee-paying clients from across the capital that had in effect been helping to subsidise local care elsewhere.
More information needed for such an important decision
Jo concluded by saying that a decision of this magnitude, particularly when it seems to go against the wishes of the majority of the profession, demands checks to ensure no conflicts of interest, legal advice and wider consultation with organisations such as the VMD, Defra, the BVA and its subdivisions and the VDS. Therefore, she would propose a new motion to delay the decision until more information is made available.
Chris Barker (MRCVS, small animal practice, Cumbria) was up next. He felt that the RCVS consultation was very effective and gave a good picture of what veterinary surgeons see as the risks inherent in remote prescribing. However, he felt that the analysis has been marshalled to suit an agenda and minimises the concerns of general practitioners.
Fragmentation and multiple consultants leading to a loss of responsibility
The trial, he said, will lead to fragmentation of veterinary provision and send the message to the public that it is quite OK to go to more than one vet for advice and treatment, and that will lead to confusion and the loss of individual responsibility for the veterinary care of an animal that exists today.
An inspection with no history: not a proper examination.
Chris argued that the act of prescribing demands a physical examination, but that a video consultation could only ever be an inspection. He also highlighted the importance of patient histories and argued that the immediacy of telemedicine simply doesn’t allow a practitioner to get the patient history from another vet.
Chris also argued that the profession is not structured to allow for clients to consult multiple veterinary service providers simultaneously: once a client leaves his practice, he has a duty under GDPR to expunge much of their records, and he for one didn’t much care for the idea of re-registering a client at 2:00am.
Some of the issues Chris raised may of course be solved by technology in the foreseeable future. GDPR already calls for data portability, presumably it will not be long before owners expect the same data portability for their animals' clinical histories.
Who wants clients who only ever call when telemedicine has failed?
Still, his overall point was an important one: whether or not there will be vets out there who are happy to pick up and see failed telemedicine cases at 3:00am in the morning from people who are not clients of their practice and who don’t otherwise contribute financially to the business.
90% of vets say remote prescription is high risk or inappropriate
Lastly, Chris drew attention to a question in the RCVS consultation which asked respondents what risk they thought there would be in a remote consultation when the consulting vet did not know the owner, did not know the animal and does not know the situation in which the animal is kept: "90% of responding veterinary professionals either chose it as high risk or simply not appropriate at all. I know of no better body of people than practitioners in Britain to understand the welfare and the risk to the welfare of animals."
The risk of misdiagnosis
Martin Peaty (MRCVS, equine practitioner, Wiltshire) spoke next, highlighting the risk he saw to animal welfare from misdiagnosis. He drew attention to concerns raised by the Quality Care Commission in human medicine, in particular that there is no access to the long term medical records of the patient, and the risk of misdiagnosis: "And that’s in human patients who can fluently articulate their symptoms", he said, "I think we should be much more cautious in exercising care before allowing remote diagnosis and prescription."
Martin's point seemed especially apposite in the light of an article which appeared in The Times two days later: 'NHS app 'no match for trip to the GP', in which Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs expressed concerns about online consultation systems, particularly for vulnerable groups, such as children.
Remote prescribing demands that vets sacrifice principles
Martin also outlined the three principles which underpin current practice: physically examining the animal, considering its history and providing 24 hour care, the latter in part in case of a reaction to a prescribed medicine.
"These proposals ask us to sacrifice these principles for telemedicine businesses whilst for good reason they remain in place for other veterinary practices. I think that is hypocritical. I think it is wrong."
Not enough follow-up
Sue Paterson (MRCVS, a referral specialist who offers a dermatology telemedicine service to the profession and the public, Merseyside) jumped in next. She was unashamedly enthusiastic about the benefits of telemedicine, in particular how it allows practitioners to engage with the public and make veterinary advice more accessible, not to mention because: "I am sick to death of people coming into consults when they have been on Facebook or they’ve been on to talk to Dr Google."
However, despite her enthusiasm and despite finding that users of her service do not want antibiotics, just advice, help and reassurance from people they trust, Sue was still against the idea of remote prescription: "I don’t want to prescribe because I can't follow those cases up, because I can’t maintain the level of client care that I think is really important, so for me, I would not want to see this change to the code."
We won’t know what we missed, or the consequences of what we missed
Caroline Allen (MRCVS, charity veterinary director, London) said the biggest issue for her is that without a physical examination, she won’t ever know what she missed (the heart murmur, the goitre, the subtle muscle wastage), or for that matter, the animal welfare consequences of what she missed.
As others had done, Caroline highlighted the importance of getting a weight every time and how difficult it is for clients to measure accurately.
Lastly, she made the thought-provoking point that allowing the remote prescription of drugs without a physical examination would risk legitimising Dr Google in the eyes of the public. After all, if no veterinary physical exam is needed, surely owners can just look it up on the internet for themselves?
In defence of the RCVS
At this point in the discussion, RCVS CEO Lizzie Lockett addressed the suggestion that the whole process of investigating and voting on telemedicine was being driven by hidden agendas, something she absolutely and eloquently rejected. She explained that sure, some parties had been more engaged in the whole process than others, but emphatically denied there had been any influence. Council, she said, had asked Standards to investigate and develop a proposal, which it had done diligently. Now it is down to Council to decide whether the proposal stands or falls; the College exists to implement the decision.
RCVS Vice President, Professor Stephen May went further, saying that many present would be aware that he'd been a vocal critic of the way that a number of other regulators in modern society push things out to court for decisions, rather than taking decisions collectively and then sticking by them. "I’m really proud that we are discussing this and I’m really pleased that this is up to us how we move things forward in the interest of animal health and welfare and supporting the public in that."
The need for a more nuanced, less polarised debate
However, he said he was worried about the way the debate was being polarised into a yes or no when he felt the profession should thinking about how it should adapt to the changing circumstances, thinking about cases which are amenable to a distant relationship and in what context that is appropriate, taking into account the risks.
Remote prescription is already happening, illegally
Melissa Donald (MRCVS, small animal practice, Scotland) questioned whether telemedicine and remote prescription is what the public wants. She said that remote prescription is already happening, illegally from abroad, and that the College needs to have a more robust response than "it’s not our problem". She therefore recommended a further period of consultation, particularly with public focus groups, and internet research to see how much remote prescription is already happening.
Vets are professionals
Tim Walker (Lay) said he was struck by the need to assemble better evidence. He felt there needs to be more thought given to the transference of responsibility for cases between a telemedicine provider and a traditional practitioner. Tim also felt that the definition of "under his care" will almost certainly need to be rethought in the not-too-distant future, because the idea of a patient being under the care of just one practitioner is starting to look dated; in the human sphere, patients are looked after by teams of people.
Tim highlighted the approach he said is taken by the GMC, which obliges doctors to be able to demonstrate that they have done sufficient due diligence to prescribe, not that they can simply do so automatically under certain circumstances. That, he said, is what professionalism should be about.
Taking the lead
Mark Castle (Lay) said he thought that the public was looking for a choice, that technology is constantly throwing up new opportunities, and he expected that in the future more and more will be able to be done remotely, so he wanted the RCVS to take the lead in this area.
Lucy Goodwin (MRCVS, BSAVA Head of Education) was positive about the idea of conducting a time-limited, controlled trial: "We say we want evidence, so let’s go and collect it", but had a number of reservations. Not least of these was the fact that the participants in any trial would be on best behaviour, so it may not be able to extrapolate the numbers to the profession at large. Beyond that, she was also concerned that the scope of the trial should be better defined, in particular which categories of drug could be included within it.
Vets don't want a trial of telemedicine
Mandisa Greene said that whilst she is positive about telemedicine as it had been described, and not averse to a trial, she didn’t see the point in a trial when the people who actually do the prescribing don’t want it.
A voice in favour
Chris Tufnell (Past President) began by declaring that he consults to the Affordable Pet Care Company which is shortly to launch a telemedicine service, although he said the service would be unaffected by the decision being taken by Council. He was also at pains to stress that he hadn’t had any other fingers in this particular pie, in particular that he hadn’t been to any of the Standards Committee meetings or presented to them, or been involved in formulating the proposed trial.
Whether you agree or disagree with Chris, it was at least good to hear someone speaking in favour of the motion. Chris opened by arguing that veterinary surgeons are good at making decisions based on imperfect information: "Client histories, as we know, are of variable quality. We make decisions daily on whether we are happy with the information we get from the practice lab or whether we need to send the sample to a reference lab. When I started in practice, practice lab machines were routinely described as random number generators."
"We make decisions on a daily basis on what the limitations of our abilities are. It’s called professional judgement and what we are proposing here is actually a test of our definition of 'in our care'. We’re talking about testing the possibility of making remote prescriptions. The responsibilities around prescribing won’t change, and those responsibilities include the responsible use of antibiotics."
Chris then argued that all the motion was calling for is a trial of something that unlike, for example, deregulating advertising and practice ownership, is not going to give a slice of the consultation fee to non-vets. He also pointed out that people will always be able to highlight cases that would be completely unsuitable for remote prescribing, but that this is not about replacing the consulting room.
Filling the void
What it is about, he said, is removing barriers to care; filling the vacuum between a concerned owner, and the £60 - £100+ they’ll be charged for a consultation. It’s a vacuum that is currently filled by the 'free' (except it's not) phone advice given out by practices, by Facebook and by Dr. Google.
He then pointed to an example from the US, where 83% of people who visited https://www.whiskerdocs.com for pet advice and thought their problem was suitable for home treatment, were in fact wrong and ended up being instructed to visit their veterinary practice. This, he said, could lead to better productivity in practice.
Could telemedicine help retention?
Telemedicine, he said, could also provide a role for people thinking of leaving practice, which is potentially an important factor at a time when retention is proving such an issue.
Evidence-gathering, clinical freedom and professional judgement
Like others, Chris argued that the trial is about putting the RCVS at the forefront of progression in our increasingly digitised society, at a time when remote information from wearables is going to become more and more common. In summary, he said: "This trial is about an evidence-based profession looking for evidence, it’s about clinical freedom and it’s about putting professional judgement in the hands of the professionals."
A two-tier service
Lynne Hill (Past President) said her main concern is about having to redefine "under his care" and how remote prescribing via telemedicine would lead to a two-tier level of care, which she thought would be wrong.
She also highlighted that the College had debated the definition of "under his care" in relation to farm animal practice, where some farmers have multiple vets, some of which offer herd health care and nothing else. Deregulating to account for this has, she said, been responsible for the demise of farm animal practice. Quite simply there are less vets around to see animals.
Show me the money
Lynn also noted the altruistic nature of the debate thus far, and reminded everyone that this is really about business and making money. The companies that are set up to provide telemedicine and possibly take part in the trial will not be in it for the welfare of animals, but to make money.
She also scoffed at the idea that telemedicine and remote prescribing will mean the 10% of people who do not currently have a vet are "now going to get madly involved in telemedicine." The reason they don’t have a vet at the moment, she said, is because they don’t want to pay. Telemedicine doesn’t change that.
Lastly, as others had done, she highlighted the difference between human medicine, where patients can describe their symptoms, and veterinary medicine, where they can’t.
Leadership is about taking the right decision, not jumping on the bandwagon
"Leadership is not always about jumping on the bandwagon and going forward because something is out there. Leadership is actually about looking and deciding and making the right decision."
The disingenuous antimicrobial argument
Dave Leicester (MRCVS) was up next, arguing that it would be wrong to say that a body of professionals can be trusted to make decisions about animal welfare, but not about prescribing. He also felt it was a little disingenuous to do a lot of hand-wringing over antimicrobials when, as a profession: "We’ve managed to make a 3rd generation cephalosporin the most prescribed antibiotic in cats."
Finally, Dave made the point that in his 15-year experience working for OOH emergency service providers, they’d managed to work very successfully without access to patient medical histories.
Setting veterinary standards
Claire McLaughlin (Lay) reiterated that the role of the RCVS is to set veterinary standards, something it can’t very well do without knowing what is going on in practice, and finding out how these things work in practice. “We need to be in a process which takes us to able to set those standards. Whether the trial that is proposed is the right trial or not, we can’t just say no, it’s fine as it is because people will work within their professional competence. As Eleanor [RCVS Registrar] will tell you, they don’t work within their professional competence because they come before disciplinary committee all the time. I think we would be remiss if we didn’t start a process now or continue this process in a way that allows us to set appropriate standards.”
Colonel Neil Smith (MRCVS, Chief Veterinary Office for the Army) began by declaring that he provides telemedicine services for animals in disparate parts of the world as part of his day job, but these animals are very much under care and there is an existing relationship with patients. He is also involved with the provision of limited veterinary services for homeless people via StreetVet, a charity which has had to form relationships with practices that can cover the 125 hours per week when it is not present.
Lowering veterinary standards
Neil explained that his "massive" concern with the proposal lies in particular with the part that says: "Given the limited nature of the service that can be provided by telemedicine alone, however, it is proposed that those under a trial would be required to actively support clients in identifying a veterinary practice that could physically see their animal in both routine and emergency situations."
This, he said, would lower veterinary standards, if all somebody providing telemedicine has to do is point people in the direction of a practice.
For that reason, Neil said, he could not support the proposal as is, and would instead recommend that it goes back to Standards and is then brought back at the next council meeting with a clearer idea of what the trial is all about.
Accessible care
Caroline Allen then jumped in again, saying that whilst she agreed with the idea that more data is needed, she also thought that telemedicine and remote prescription is being driven by the issue of accessible care, and it is that, in fact, which needs to be investigated and understood and debated first.
The digital age
Past President Professor Stuart Reid highlighted that the veterinary students of today live their lives in the digital environment and their world will be very different from ours. The same goes for pet owners. He reiterated that as the regulator, the RCVS needs to be ahead of the game, and that if this is what the public wants, then it has to find a way of regulating it.
Stuart finished by saying that he felt conflicted about the vote; that he had significant problems with the proposal and is not entirely sure that a trial is the right thing, but: "In the referendum we're about to have, I want to say yes but I want to see what the deal is as well." He added: "I didn't vote out by the way, in case this gets back to my employers, but I do think we have to think very carefully about throwing the baby out with the bathwater here."
Pressure to prescribe
Martin Peaty then recounted how at a Vivet Conference last year, a provider of telemedicine (which he thought was Babylon) explained that doctors on its system were retained on the basis of a post-consultation customer satisfaction survey. That, he thought, would make it difficult for practitioners not to prescribe things when they know it will affect their job.
David Bray (Lay), said he believed the telemedicine and remote prescribing will come and it will become more common to have pets treated by multiple vets, so he was fully supportive of a trial.
When it came to the vote ...
Guessing at which way the people who spoke might have voted, it seemed as though there were probably enough councillors with sufficient reservations about the motion, which would have given the go ahead for the trial, for it to be voted down.
That said, the overall sentiment in the room seemed to be that the discussion about the regulation of telemedicine and remote prescription needs to continue, and not get kicked into the long grass simply because of a disagreement over the proposed trial.
At this point, Jo Dyer and others stepped in to argue that the decision to proceed with the trial should not be made until the issues raised in the debate had been addressed. There was then a lot of going backwards and forwards, discussing whether this would need a new motion, which is not allowed under Council rules, or whether the existing motion could be amended, which is allowed.
In the end, the decision was taken to hold two votes, the first being to refer the issue back to the Standards Committee which was carried by 18 to 12, with one abstention.
The second vote was:
"Council is invited to consider the recommendation of Standards Committee to prepare and develop a proposal for a time-bound and limited trial to assess the benefits and risks of allowing the remote prescription of POM-V with appropriate stakeholder engagement and with consideration of the issues that we've discussed today and the detail on them, including 24/7 care and classes of drugs, especially antimicrobials. So we are asking for the detail on that to be worked up on the basis that it will at some time come back to Council."
The second vote was carried by 21 to 8 with 3 abstentions.
In other words, the trial will not now go ahead unless Standards can develop a new proposal which addresses the concerns raised by Council.
VetSurgeon Conclusion
Looked at solely in terms of its impact on animal welfare, this debate seems to come down to one question, which is whether more animals will benefit from easier, cheaper access to veterinary services available via telemedicine and remote prescription than will suffer as a result of misdiagnoses and missed diagnoses that will surely be the inevitable consequence of veterinary surgeons working only from the more limited, and potentially inaccurate or even false information they will get from a video consultation.
For sure, more wearables are coming, and they will overcome some of the problems caused by the fact that animal patients cannot describe their symptoms. Doubtless someone will also invent a set of weighing scales that makes it possible for owners to do the job reliably accurately. Patient histories will surely become more portable. But these things are not with us just yet.
In any event, it is not just about the immediate impact on the quality of care delivered to patients. The way the trial has been framed thus far takes us in the direction of a two-tier profession. What happens if more veterinary surgeons prefer, or make a better living from working from the comfort of their own home without the added responsibility that comes with providing the physical care. Who’ll do the ‘real' vetting?
If you look at the popularity of human telemedicine, the 30,000 patients who have signed up for telemedicine at the small practice in the Lillie Road in London, it seems obvious that patients want the convenience of consulting online, without having to schlep to the practice and find a parking space. It also seems self evident that if online consultations are offered at a lower price point, it will inevitably lead to more pet owners availing themselves of veterinary advice, though as Lynn Hill said, it’s unlikely to cause a mad rush whilst Dr Google is still free.
Perhaps, though, there is another valid way to solve this conundrum. Rather than rushing headlong into a trial that could irrevocably change the very nature of the profession, how about establishing some pragmatic ground rules from the outset. For example, that unless by unanimous agreement of Council in the future, telemedicine should only be allowed as an extension of the service offered by existing bricks and mortar practices to their existing clients.
When it comes to remote prescribing, surely the safest way to regulate it (if you’re going to allow it at all) is to do so on a drug-by-drug basis. Perhaps trial it with the endo- and ecto-parasticides for existing clients of existing practices. Find out whether the convenience of the online consultation leads to higher standards of parasite control for greater numbers of pets. If it doesn’t, then ditch it. Either way, it doesn't preclude trying another category of drug.
That’s my tuppence worth, for what it’s worth, which probably isn’t quite tuppence!
Equip EHV 1,4 is licensed for the active immunisation of horses to reduce clinical signs due to infection with Equine Herpesvirus 1 and 4 and to reduce abortion caused by EHV-1 infection.
Zoetis says it has already communicated directly with veterinary surgeons to inform them that Equip Rotavirus will be out of stock from the end of November 2017 until mid-2018.
During this time an imported vaccine for Rotavirus, will be available to provide an interim solution until supply is restored.
Practices wanting to buy the alternative imported Rotavirus vaccine will need to apply to the VMD for a Special Treatment Certificate (STC).
The company says it acknowledges the concern and frustration this causes its customers and wants to reassure the equine community that it is working diligently to restore the supply of Equip Rotavirus as soon as possible.
For more information, contact your Zoetis account manager or Zoetis technical team.
In the study1, records from a large commercial diagnostic laboratory were searched for canine skin masses submitted for histopathology from dogs aged between 0-12 months from practices based in the UK and Europe.
For each case, data on the breed, age and sex of the dog, the body location of the sample, and the diagnosis made by the original reporting histopathologist were recorded.
For the purposes of the study, masses were included which were cystic, hyperplastic or neoplastic, but not inflammatory.
Submissions of samples from the eyes, anal glands and nails were excluded and only MCTs submissions that were cutaneous were included.
Risk factor analysis using multivariable binary logistic regression modelling was carried out for skin masses with at least 30 submissions.
Professor Ken Smith, corresponding author for the paper, said: “A total of 2553 submissions for a skin mass were included in the study.
"Across all the skin masses, the majority (94.3%) were neoplastic in nature.
"Of the neoplastic lesions, 98.5% were considered benign.
"Almost all of the benign neoplastic lesions were of round cell origin (94.0%), whereas most of the non-neoplastic lesions were derived from the epithelium (93.8%).
“The most common histopathological diagnoses for skin masses were histiocytoma (86.6%), papilloma (3.5%), dermoid cyst (3.3%), follicular cyst (1.7%) and MCT (1.4%).
"Multivariable analysis revealed that Labrador retrievers, Boxers and Golden retrievers had reduced odds of histiocytoma compared to crossbreed dogs.
"Male neutered dogs had lower odds of dermoid cyst compared with female entire animals.
"Dogs aged 9 to 12 months had significantly higher odds of follicular cyst compared with dogs aged under 6 months, whilst dogs aged over 6 months showed significantly higher odds of MCT than dogs under 6 months of age.”
Nicola Di Girolamo, Editor of JSAP, said: “Retrospective studies that include a large number of cases such as this one are an invaluable resource for clinicians working in any setting.
"The findings of this study corroborate those of previous research, suggesting that a skin mass in a young dog is very likely to be a histiocytoma.
"However, the risk factor analysis in this paper identified a number of different predilections to those previously recognised, indicating a need for continued research in this area.”
The full article can be found in the January issue of the Journal of Small Animal Practice and can be read online here: https://onlinelibrary.wiley.com/doi/full/10.1111/jsap.13418
The news comes only weeks after the RCVS announced conditional accreditation of the school's veterinary degree for a further year whilst further improvements could be made, having previously identified ‘wide-ranging concerns’.
The RCVS responded to the news with the following statement:
"We were very sorry to learn that Cambridge University’s Council of the School of Biological Sciences has decided to recommend to the University’s General Board that veterinary education at Cambridge should cease and, as ever, our first thoughts are with the students and staff team at the veterinary department, who will be affected directly by this news.
“As we reported on 25 November 2025, in light of the significant progress made by the vet department at Cambridge over the past 12 months towards meeting our accreditation standards, our Education Committee decided to grant conditional accreditation of the Cambridge veterinary degree programme for a further year to allow time for remaining improvements to be made.
“As stated, we appreciate the considerable efforts and hard work that the staff team at the vet department had put into rectifying many of the issues identified in the 2024 accreditation event, for taking on board the constructive advice that was given and working together to make many of the necessary improvements.'
“We had collaborated with the team within the vet department on putting together an action plan and timeline for meeting the 20 remaining recommendations, and we hoped that the department would continue on its current trajectory towards meeting our accreditation standards.
“The visitation panel noted the considerable efforts the department staff had made to make improvements in a relatively short timeframe, and the staff’s commitment to improving the remaining issues was clear. We also understood from discussions during the visitation that the department had the full and ongoing support of the School of Biological Sciences and wider University.
“In light of the School Council’s recent recommendation, however, we know that this will be a very upsetting and uncertain time for the vet department staff team and students, so we stand ready to offer as much support as we are able over the coming months.”
The BVA has also responded, it's President Dr. Rob Williams MRCVS saying: “When we met with senior leadership at Cambridge University back in June, we secured reassurances that they remained committed to the long-term future of the vet school.
"It’s therefore deeply concerning to hear that once again the future of Cambridge Vet School is in doubt.
"Working with students, alumni and staff, we’re seeking clarity on the situation and will make the case for its veterinary medicine degree course to continue."
A final decision will be made by the university's general board in January.