The researchers say that when veterinary surgeons give advice to clients with the aim of changing their behaviour - such as encouraging them to feed their pet differently - they often speak in a directive style, which is driven by a paternalistic-type relationship.
This, they say, reduces a client’s sense of emotional connection to their vet, whilst limiting their personal choice and self-direction in the decision-making process. This consultation method, combined with its conflict with these basic motivational drives, may contribute to why low uptake of veterinary recommendations are reported throughout the profession.
One solution could be the use of evidence-based communication approaches that have been tried and tested in the medical profession.
Alison Bard, PhD researcher at the School of Veterinary Sciences, said: "Veterinarians are working hard to connect with their clients and promote the health of animals in their care, but being a veterinarian is not just about communicating science and methodology. Communication must also inspire motivation, prompt action and boost confidence for an animal carer to put veterinary advice into practice.
"The problem our research identified is that the perceived role of the veterinarian - to provide advice and solutions – leads to a personal communication style that leaves little room for empathy or client input. This style comes at a high cost for client engagement with advice, as we know from wider research that relational interaction and active participation of clients is essential for inspiring a change in behaviour. For the typical veterinarian, this may be surprising, as the clinical accuracy and relevance of advice has traditionally (and intuitively) been the focus of advisory services."
The research team believes a shift in veterinary surgeons' perceptions of advisory consultations is needed to improve the uptake of advice.
Alison added: "As a profession, veterinarians can benefit from recognising that behaviour change is incredibly complex. Being provided with the ‘right’ advice is not always enough for clients to put veterinary recommendations into action, especially where disease management is complicated and clients have mixed feelings over treatment options. How information is communicated in these cases affects client outcomes, meaning the difference between a motivated and unmotivated client can - in fact - be shaped by the veterinarian."
The research team hopes that this study will help veterinary surgeons think differently about their consultations by encouraging them to consider how their communication may be influencing client motivation and behaviour. As a result, they hope veterinarians will think carefully before using labels like ‘unmotivated’ or ‘resistant to advice’, and instead explore whether their clients are perhaps just in need of emotional support, personal choice or a sense of self-confidence to truly engage with veterinary recommendations.
This call for change in the veterinary profession is already underway as a result of the VetFutures project, launched in 2015. This project called for a change in veterinary consultation style: away from a hierarchical model with the veterinary surgeon as the expert passing on instruction, to a model centred on partnership to create empowered and motivated clients.
Bristol’s research will inform this focus of the VetFutures project, and this study provides further evidence about the consequences of paternalistic communication on motivation and behaviour change in veterinary clients.
Dr Kristen Reyher, Senior Lecturer in Farm Animal Science, said: "This paper is one element of an exciting research project that will help inform and support our evolving veterinary profession. I’m confident that change can be achieved with the help of ongoing research. Our interdisciplinary work is focused on whether Motivational Interviewing - an evidence-based communication method that fosters a mutualistic approach to conversations on behaviour change - can deliver the advances VetFutures imagine for our colleagues of the future.
"We look forward to providing further evidence to contribute to a professional shift that will enhance the experience and wellbeing of veterinarians, clients and the animals in their care."
Reference
A vet from Texas hit the headlines this weekend after allegedly killing a feral cat with a bow and arrow and then posting photographs and bragging about it on Facebook.
According to various news reports, Kristen Lindsey DVM's post quickly went viral, and one of two Facebook pages set up in response - Justice for Cat Murdered By Kristen Lindsey - has already attracted over 35,000 likes. There are also petitions to revoke her license on thepetitionsite.com and change.org which have each gathered around 18,000 signatures thus far.
Sky News reports that Ms Lindsey was quickly fired by her employer, the Washington Animal Clinic, which issued a statement on Facebook.
The veterinary clinic's website and Facebook page are both currently unavailable.
The range comprises four products: Calm, Seb, Pyo and Care. All four contain a new active ingredient derived from Ophiopogon japonicus called ophytrium, which Ceva says has been shown to strengthen the mechanical skin barrier1, restore the balance of protective microbial flora2 and sooth the skin1.
The new range consists of both shampoo and mousse formulations: Douxo S3 Calm is designed to sooth itchy, irritated skin while maintaining the skin barrier. Douxo S3 Pyo contains ophytrium and chlorhexidine at 3% which is both antibacterial and antifungal. Douxo S3 Seb contains ophytrium and seboliance and includes an extract from the peel of pomegranate. Ceva says it has an anti-odour action and will help with oily or flaky skin. Lastly, Douxo S3 Care (available as a shampoo only) contains ophytrium and is designed for regular use and maintenance.
The products are all free from soap, parabens, sulphates, phthalates, colourants and nanoparticles. A new, hypoallergenic ‘summertime’ fragrance has been added to the range which pet owners apparently liken to coconut and vanilla.
The Douxo S3 range comes in eye-catching packaging with a pump that can be used with one hand, an ergonomic bottle designed to be easy to grip, even with wet hands, and a visibility line so you can see the remaining quantity of the product.
Dr Melanie Rougier, corporate marketing manager at Ceva, said: “Our new range is the result of over 10 years of clients’ experience with Douxo and a robust programme of market research with four specific studies that included more than 2,000 vets and pet owners and represented over eight months of contact with pet owners. This has allowed us to gain a thorough understanding of our clients’ needs, in terms of performance, formulas, fragrance and ergonomic packaging."
Andrew Fullerton BVSc (Hons) MRCVS, product manager for Douxo at Ceva, added: "The new Douxo S3 range has been developed following extensive market research and field studies to ensure that the shampoos and mousses are not only innovative and effective, but that they are also safe and easy-to-use."
Dr Tim Nuttall BSc BVSc CertVD PhD CBiol MSB MRCVS, RCVS Specialist in Veterinary Dermatology and Senior Lecturer in Veterinary Dermatology at The Royal (Dick) School of Veterinary Studies at the University of Edinburgh, said: "I like that the performance has been proven on a basic science screening level and innovative skin model and then moving on to the in-field trials. This is what we would like to see from topical products."
Douxo S3 shampoo and mousses will automatically replace the current Douxo products via veterinary wholesalers and Ceva says it is working to convert other products in the Douxo range to S3.
For further information, contact cevauk@ceva.com, your local territory manager or visit https://www.douxo.com/uk/Pet-Skin-Care/douxo-s3.
References
In the study titled 'Staphylococcal bacterial contamination of portable electronic devices in a large veterinary hospital1', samples were taken from the screen and any button of PEDs (such as mobile phones and tablets) of staff working directly with feline and canine patients. Hospital staff were asked to complete a questionnaire to ascertain the frequency of PED use and the frequency and method of PED cleaning.
The aim of the study was to determine the prevalence of Staphylococcal contamination of PEDs in a veterinary hospital, and to identify the source and determine the pathogenesis of any cultured strains.
Positive cultures were tested for resistance to oxacillin and vancomycin using a Kirby-Bauer disc diffusion test and then by using a broth microdilution test to EUCAST guidelines and breakpoints. PCR was used to specifically genotype the isolated staphylococci.
Georgia Vinall, corresponding author for the paper, said: “Useable swab samples were taken from 47 devices. Staphylococcus spp. were cultured from 68% of PEDs with a median of 10 colonies grown per device. Vancomycin-resistant Staphylococcus spp. were found on 36% of devices, whilst oxacillin-resistant Staphylococcus spp. were cultured from 2% of devices. DNA sequencing identified three Staphylococcus species; S. capitis, S. epidermidis and S. hominis which are most likely associated with humans as either sources or transmission vectors."
“The results of the survey indicate that 96% of staff had a PED which they used in the hospital environment, of which 85% use their device every day. Despite the high usage of PEDS in the hospital environment, only 6% of staff cleaned their device daily, with 33% of staff cleaning their PED less than weekly. Furthermore, only 54% of staff cleaned their device with a disinfectant."
Nicola Di Girolamo, Editor of JSAP said: "This study demonstrates that PEDs may become contaminated with potentially pathogenic microorganisms. Although this specific study did not focus on transmission of these microorganisms, and therefore it is unclear what are the clinical implications of this finding, it seems prudent to develop appropriate protocols for cleaning of PEDs in veterinary hospitals."
The full article can be found in the April issue of the Journal of Small Animal Practice and can be read online here: https://onlinelibrary.wiley.com/doi/10.1111/jsap.13289.
The consultation invited members of the professions to explain how they currently understand and interpret Schedule 3 in practice, how it could be clarified and how it might be amended to bolster the veterinary nursing profession.
11,625 people responded to the consultation, the highest number that has ever responded to an RCVS consultation. 6,873 were veterinary nurses (around 35% of the profession and including 1,665 student veterinary nurses) and 4,752 were veterinary surgeons (around 21% of the profession).
The report on the consultation, which is published today by the Institute for Employment Studies, found that 92% of veterinary nurses and 71% of veterinary surgeons think veterinary nurses should be able to undertake additional areas of work.
However, neither vets nor nurses seem to have an especially good understanding of the current scope of Schedule 3 and how it applies in practice, rating their personal understanding at 5.6 and 6.7 out of 10 respectively.
When asked what prevented the full utilisation of veterinary nurses, the majority of both vet and vet nurse respondents highlighted a lack of understanding of what tasks can be delegated under Schedule 3, with around 60% of veterinary surgeons also admitting that they are not good at delegating.
61% of veterinary nurses and 50% of veterinary surgeons thought that the RCVS gives sufficient support and advice about Schedule 3, though the relatively poor level of understanding amongst veterinary surgeons in particular suggests more needs to be done.
In corresponding comments both veterinary nurses and veterinary surgeons said they would like more clarity, especially around 'grey areas' such as the meaning of the term 'minor surgery', as well as further communication from the College about Schedule 3 and for more training for veterinary nurses to ensure they have the competence and the confidence to carry out delegated procedures.
Liz Cox, Chair of RCVS Veterinary Nurses Council, said: "Thank you to all those who responded to the consultation in such large numbers and who shared their views on this topic. The consultation grew out of the government’s suggestion that we review Schedule 3 as a means of bolstering the VN profession, and from the VN Futures project last year, when Schedule 3 was identified as an area where there could be some additional work to clarify the rules around delegation to veterinary nurses.
"There was a clear consensus that veterinary nurses could do more in their role and under Schedule 3 and so we will be feeding the findings back to the RCVS Legislation Working Party, which will be looking, in the round, at possible changes to the framework of veterinary legislation, including how it applies to veterinary nurses and other paraprofessionals.
"In terms of the understanding of Schedule 3 and how it applies in practice it is clear that we need to do some further work to clarify the rules and develop guidance to assist both veterinary nurses and veterinary surgeons in exercising their professional judgement in respect to delegation, for example, through case studies and other examples."
Looking at the tasks currently performed by veterinary nurses, the survey found the five most commonly performed are: clinical cleaning (92%), administration of medicines by subcutaneous injection (91%), administration of medication (90%), monitoring of anaesthesia (86.5%) and administration of medicines by intramuscular injection (86%).
The consultation also found that the majority of veterinary nurses are involved in clinics aimed at educating animal owners on various different aspects of animal health and welfare. The most common include puppy/kitten care (66.5% of respondents), nutrition (65% of respondents), general check-ups (62.5% of respondents) and dental care clinics (57% of respondents).
Post-survey interviews with 10 veterinary nurses and 10 veterinary surgeons found a number of recurring themes, including: limited career paths for veterinary nurses; poor pay for VNs relative to their training and complexity of work; lack of recognition and appreciation for the VN role; enthusiasm for advanced practitioner and specialist status for VNs; and difficulty recruiting experienced VNs.
The College says the results of the consultation will now be considered by the RCVS Schedule 3 and Legislation Working Parties, which are reviewing the efficacy of the current Veterinary Surgeons Act and whether changes need to be made to bring the legislative framework for the profession up-to-date, including consideration of the part played by allied professions like veterinary nurses in the veterinary team.
The full report can be downloaded here.
Harrison Family Vets opened its first practice earlier this month in Woodley, Reading, in a £350,000 investment that created eight jobs.
The plan is for the next practice to open later this summer in the Midlands, before the group expands north towards the end of the year. The group is now searching for further properties across the north and south of England, with plans to open 75 practices by the end of the decade.
Tim joined his dad's practice in 1995 as General Manager. He later co-founded Vets4Pets in 2001 before joining Mars Inc. to head the overseas growth of Banfield, then the world’s largest veterinary practice. He then rejoined the family business to grow it further, until it was acquired by IVC Evidensia in 2018.
Alongside Tim is operations director, Kristie Faulkner who also worked at White Cross Vets until it was acquired by IVC, whereupon she became regional operations manager, overseeing more than 200 of the IVC's practices across the South East of England.
Between 2012 and 2018, White Cross Vets was repeatedly named as one of the UK’s best employers and a truly extraordinary place to work. The company secured a place in the prestigious ‘Top 100 Sunday Times Best Small Companies to Work For’ league table for seven consecutive years, as well as being the inaugural SPVS Wellbeing Award Winners.
Tim said: “The whole ethos at Harrison Family Vets is about fostering a culture within our team that sets us apart and differentiates our practice from all others. Every individual’s strengths and personality traits will contribute to what we do, in a family-orientated environment. Our culture is about looking after people. Focus on attracting the very best people and then look after them as much as possible. A successful practice with a fabulous reputation amongst the profession and amongst clients is what automatically follows.
“Our state-of-the-art clinics boast extensive facilities including on-site laboratories, full x-ray suites, operating theatres, ultrasonography and separate dog and cat wards that have been carefully designed with mood lighting, aromas and music to offer a calming atmosphere.
We’ve also worked hard to create a customer experience that’s more akin to an Apple store, than a traditional veterinary practice. We don’t have a reception desk and instead, our front of house team have the autonomy to freely interact with our clients and their pets.
Our waiting areas feature bespoke pods, which give clients their own space and offer pets privacy, thus shielding them from the stresses of facing other pets in a traditional waiting room. Each pod also has its own tablet where clients can update their details, sign up to our Total Wellness Plan or even order fresh and healthy dog food from Butternut Box.
“Everyone wants to know why we want to start another veterinary group now. For Kristie and I the timing is perfect as there is a clear void to fill. The people-focused independent practice is becoming a thing of the past and is what the profession is yearning for. This will attract the very best team members which in turn will provide a superior client and pet experience.
"Creating a successful business and building a fantastic team is incredibly exciting and we genuinely believe Harrison Family Vets can become the most innovative, forward-looking and caring practice, as well as the employer of choice for vets and nurses, in the UK.”
VetSurgeon.org wishes Tim and Kristie all the very best luck in the world with their new venture, although one suspects that they won't need to rely on luck. White Cross under his direction was consistently doing extraordinary things to foster what seemed to be a remarkably good working environment. If they can come close to repeating the formula, or improving on it, they must be on to a winner.
The British Association of Homeopathic Veterinary Surgeons is claiming that: "owners can now be confident homeopathic medicines can be effective for common canine and feline conditions in many animals, following a recently published clinical study."
In what the BAHVS says was the largest-ever study of its type, the Clinical Outcomes survey has identified a number of clinical conditions in dogs and cats that homeopathic veterinary surgeons believe may be promising targets for future research in veterinary homeopathy.
In the study, twenty-one homeopathic vets in the UK recorded data from their patients over a 12-month period, and collected information from a total of 1500 dogs and 400 cats. The most frequently treated feline conditions overall were dermatitis, renal failure, overgrooming, arthritis and hyperthyroidism. The most commonly recorded canine conditions were dermatitis, arthritis, pyoderma, colitis and fear. By owners' assessments, a moderate or major improvement was reported overall for 68% of dogs and 63% of cats.
The authors of the study concluded that a programme of controlled research in homeopathy for frequently-treated feline and canine conditions is clearly indicated.
John Alborough, co-publisher of VetSurgeon.org said: "I also find that if I shove toenail clippings up my bottom, it totally cures my indigestion."
ReferenceMathie RT, Baitson ES, Hansen L, Elliott MF, Hoare J. Homeopathic prescribing for chronic conditions in feline and canine veterinary practice. Homeopathy 2010; 99: 243-248.
MSD says the new chip is compliant with ISO standards, has proven temperature accuracy1 and as yet is the only microchip on the market that combines identification and temperature monitoring.
The HomeAgain Thermochip has been designed to work for the lifetime of the pet, and it's being launched alongside the HomeAgain Pet Recovery Database, which is free of charge.
Michael Morrow BSc BVSc MRCVS, Director of St Vincents Veterinary Surgery in Wokingham, has been involved in trials of the new chip. He said: ''The launch of HomeAgain Thermochip is a real game-changer in the market.
“We have been trialling the Thermochip for some time and it’s now our default option to measure temperature.
"It’s incredibly useful in everyday practice, particularly when it comes to fractious cats or extremely nervous dogs, and it improves efficiency in consultations.
"We also use the Thermochip extensively during anaesthetic and post operative monitoring – with minimal handling.
“Reassuringly, we’ve never had any issues with the microchip reader or with the chip migrating to other parts of an animal’s body so it’s very reliable.”
In addition to the benefit of being able to measure temperature in a non-invasive way, MSD points to recent studies which suggest that a pet’s ‘normal’ temperature is not a specific number, rather a range of values that depend on numerous factors such as the time of day, the site of measurement, sex, breed, size, age, activity and stress levels2.
The HomeAgain Thermochip makes it easier to take multiple temperature readings easily over time, thereby establishing a pet’s individual temperature range.
For animal identification, the microchip works in much the same way as other microchips.
Once the owner registers their pet’s microchip with a recovery database, their animal – in theory – can be traced if lost.
The reality is often different, because owners' contact details are frequently out of date, making it difficult to reunite pets.
MSD says it aims to have the most comprehensive reunification platform, with a database which:
For more information, visit: homeagain.co.uk
The study was part of the RVC’s VetCompass programme which include anonymised veterinary information from over eight million UK dogs. From this pool, a random sample of 22,333 dogs were followed for a year, identifying all health issues that were diagnosed during this time.
The study is one of the largest ever studies to explore the anonymised health records from veterinary surgeries and report on the most common disorders in dogs. The study also looked at whether the health of dogs varied by age, sex and whether the dogs were neutered.
The main findings were:
Dr Dan O’Neill, Senior Lecturer, Companion Animal Epidemiology at the RVC and lead author of the paper, said: "This study shows that it is really important for owners to develop strong habits of caring for their dog’s teeth, ears and weight, right from the time they first acquire a puppy.
"This study shows interesting and strong correlations between human and canine healthcare: the need for good dental and bodyweight maintenance. Given how closely the lives of humans and dogs are intertwined, this should be no surprise really; we often share the same food and exercise. Owners should work closely with their vet to plan appropriate dental and weight care programmes at each visit to their veterinary clinic.”
Hannah James, Health Research Manager at the Kennel Club, and co-author of the paper, said: "As dog owners, the key priority is keeping our pets healthy and happy, but it can be difficult to put into context the most common problems that affect our canine counterparts and which areas we need to pay particular attention to in order to maintain this. These findings help us establish these key areas, and where we as owners, vets and organisational bodies can work towards to improve the day-to-day life of our beloved companions."
O'Neill, D.G., James, H., Church, D.B., Brodbelt, D.C. and Pegram, C. (2021) 'Prevalence of commonly diagnosed disorders in UK dogs under primary veterinary care: results and applications', BMC Veterinary Research.
Photo: Uwe Gelle
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
The practice, which has nine clinicians (including three RCVS Recognised Specialists), eleven RVNs, two human-trained cardiac physiologists and a dedicated referral administrator is the first referral practice in the UK to become an EOT.
Dave Dickson, a director alongside Jo Harris, said: "The decision to transition the clinical side of the business into employee ownership was led by the core values of the team and the desire to preserve our independence as a referral service.
"In an industry dominated by corporate acquisitions, with business models increasingly focused on keeping referral offerings within the corporate groups and limiting choice for clients, we felt it was crucial to chart a different course.
"We have a very bonded and supportive team, working together to continuously improve and evolve, where the ideas of every team member are important and all roles are equally appreciated.
"We feel that employee ownership aligns perfectly with this ethos.
Jo Harris added: “By involving all our employees in the ownership of the business, we aim to foster a culture of engagement and collaboration.
"This new structure ensures that every team member has a stake in the success of the business and a voice in how it operates.
"We believe this will not only enhance our service quality but also promote sustainable growth and innovation.
"The transition to employee ownership is not just a change in structure; it is a reaffirmation of our values and a pledge to our patients, clients, and partners that we will continue to strive for excellence in every aspect of our work.”
https://heartvets.co.uk
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 Codes of Professional Conduct for both veterinary surgeons and veterinary nurses stress the need for effective communication with clients and ensuring that informed consent is obtained and documented before treatments or procedures are carried out.
At its January meeting RCVS Standards Committee approved changes to chapter 11 (‘Communication and consent’) of the supporting guidance to the Codes to provide further advice to the professions on matters that should be discussed with clients to ensure informed consent is gained, provide clarification on who can gain consent for a procedure and give some additional guidance on consent forms.
Nick Oldham, Standards and Advisory Manager at the RCVS, said: "We hope that this updated guidance is more accessible, readable and will aid members of the profession in developing a more comprehensive approach to gaining informed consent for treatments and procedures and therefore reduce the risk of miscommunication and misunderstanding which can lead to concerns being raised by clients.
"For example, we have updated our guidance to encourage veterinary surgeons to consider discussing a number of additional factors with a client before obtaining consent. This includes the nature, purpose and benefits of any treatment or procedures, the likely outcomes including potential risks, financial estimates, informing the client when other treatments may have available and checking that the client understands what they are agreeing to rather than assuming the client understands both the potential financial outlay and possible side effects.
"Furthermore, there is now additional guidance for veterinary surgeons on who should be seeking consent. While ordinarily it is expected that the veterinary surgeon undertaking the procedure or providing treatment is responsible for obtaining the client’s consent we know that this is not always practical.
"Therefore we clarify that the responsibility of obtaining consent can be delegated to another veterinary surgeon and, failing that, a registered veterinary nurse or student veterinary nurse could obtain consent provided that they are suitably trained, have sufficient knowledge of the proposed procedure or treatment and understand the risks involved.
"The RCVS Standards and Advice Team is also in the process of producing a series of fictional case studies based on informed consent issues encountered by the College’s Preliminary Investigation Committee which we hope will further help the profession."
The updated supporting guidance can be found in full at www.rcvs.org.uk/consent
The Code of Professional Conduct and its supporting guidance can also be downloaded as an app for smartphones and tablets at www.rcvs.org.uk/codeapp
Members of the profession seeking confidential advice on matters relating to professional conduct can contact the Standards and Advice Team on 020 7202 0789 or advice@rcvs.org.uk
The College first became aware that confidential information had been leaked earlier this year after the Veterinary Record made the decision to publish details.
The College says it then provided a number of informal opportunities for the person leaking the information to come forward and discuss the reasons for their actions, but nobody stepped forward.
A Council member then made a formal complaint about the leak, which triggered the complaints policy set out in the College’s Code of Conduct for Council Members and instigated the investigation.
The investigation was run independently of the RCVS by an external specialist consultancy, and coordinated by a legal assessor.
Initially, the investigators were asked to focus on a single leak, but following a number of further leaks over ensuing months, it became necessary to widen the scope and depth of the investigation.
The investigators’ report concluded that there had been several separate and deliberate leaks of confidential information by a current or former Council member over an extended period.
However, they were not able to identify who specifically was responsible for the leaks, and because nobody admitted it, no further action under the complaints policy of the Code of Conduct for Council Members was appropriate.
The investigators concluded that the leaks were not the result of poor understanding of College or Council processes, but a deliberate decision to provide confidential information to third parties.
Council members have therefore agreed to review existing training requirements and mechanisms for handling confidential information and to explore in more detail the potential motivation of the person or people who leaked the information, together with the underlying culture of Council that might have influenced their behaviour.
RCVS President Mandisa Greene, said: “There is no denying this is a sad day for the College, and for RCVS Council in particular. As Council members of our professions’ regulatory body, we must maintain the very highest standards of probity and integrity if we are to maintain the trust and confidence of our professional colleagues. In the same way, we must subject ourselves to the same level of scrutiny and investigation if these values and behaviours are ever called into question.
“That someone chose to breach the trust placed in them by their peers is extremely disappointing, especially when they were given every opportunity to come forward to discuss their concerns, and avoid the College having to launch a formal investigation.
"Our default position during Council meetings is to hold as many discussions as possible in public session to ensure Council’s decisions are as open and transparent as possible – something that we will continue to increase as much as possible. Like any organisation, however, there may be a small number of issues that need to be discussed in closed session – for example, those still at concept stage prior to any decision being made public or put out for consultation, or those containing personal or commercially sensitive data.
"I sincerely hope that all of us on Council can learn from this unfortunate and unnecessary episode. We must rebuild and maintain sufficient confidence in each other, and in our processes, that, even if we disagree on certain matters, it is always best to do so in a direct, upfront and honest manner."
16 clinics are affected by the investigation, namely Penrose Veterinary Group Limited, Kevin Castle (Pet Care) Ltd, Swayne & Partners Ltd, Treforest Veterinary Clinic Ltd, Mercer & Hughes Limited, Swaffham Veterinary Centre Limited, Anglesey Pet Clinic Ltd, Chiltern Equine Clinic.
It's not the first time, of course, that the CMA has intervened in the veterinary profession.
Earlier this year, it investigated the acquisition of Quality Pet Care (trading as The Vet) by CVS, and then Vet Partners' acquisition of Goddards, which led to CVS selling The Vet and Vet Partners selling eight of the 47 Goddards sites to Linnaeus.
An IVC spokesperson said: “IVC Evidensia is working closely with the CMA and engaging constructively with this review."
Leading equine veterinary surgeon Ian Wright has been setting a legal precedent this week, as the Court of Appeal ruled that his ex-wife could not expect him to continue to fund her lifestyle and that she should earn her own living.
Ian, an RCVS Specialist in Equine Surgery and a partner at the Newmarket Equine Hospital, divorced his wife Tracey in 2008 after 11 years of marriage. As part of the settlement, Mrs Wright was given a £450,000 house and Mr Wright was ordered to pay £75,000 per annum, which included £33,200 spousal maintenance.
Last year, Mr Wright, 59, went to the High Court to ask for a reduction in maintenance, arguing that it was unfair to expect him to continue to fund his ex-wife indefinitely, even after he retired at 65, when she made no effort to find a job and support herself.
The case was heard by Judge Lynn Roberts, who agreed there was no reason why Mrs Wright had not worked in the six years since her divorce and said she had been: "evasive on the subject of her own earning capacity".
Mrs Wright challenged the decision in the Court of Appeal this week, where Lord Justice Pitchford rejected her fight to have her future maintenance reinstated, saying: "There is a general expectation that, once children are in year two, mothers can begin part time work and make a financial contribution" and: "The time had come to recognize that, at the time of his retirement, the husband should not be paying spousal maintenance".
Speaking to The Times, Mei-Ling McNab, a partner at Brachers law, said: "This landmark decision provides some much needed clarity and will be a game-changer for future big-ticket divorce cases. The ruling confirms that mothers with children aged over seven should have financial responsibility to support themselves."
According to the authors, Miniature Schnauzers positively shone in their averageness in this study, because they were not commonly affected by any specific breed-related health problems.
In other words, the illnesses suffered by Miniature Schnauzers are just the common or garden things like dental disease, obesity, anal sac impaction, vomiting and ear infection, which can affect all dogs.
The study, which the authors say was the largest ever study of the breed, analysed 3,857 Miniature Schnauzers from a population of over 450,000 dogs across the UK. Its findings were that:
The average lifespan of Miniature Schnauzers was 11.7 years, which is similar to the average of 12.0 years for dogs overall.
The average adult bodyweight of Miniature Schnauzers was 10kg. Males on average were heavier than female breeds (11kg vs 9kg).
The most common disorder affecting the breed was dental disease (affecting 17.4% Miniature Schnauzers). This is similar to that of other similarly-sized breeds such as the Cavalier King Charles Spaniel (15.2%) and Border Terrier (17.6%).
Female Miniature Schnauzers are more likely to have dental disease, obesity/overweight and heart murmur. However, males are more prone to diarrhoea and claw injury.
The most common causes of death were neoplasia (14.7%), collapse (13.3%), mass-associated disorder (10.7%) and brain disorder (10.7%).
Dr Dan O’Neill, Senior Lecturer in Companion Animal Epidemiology at the RVC and Vet Compass researcher, said: "To do their best for their dogs, owners need to know what aspects of their dog’s health are the most important to protect. Thankfully, we now have the data to identify these: owners of Miniature Schnauzers and also dogs overall should pay special attention to dental care, weight management, anal sac issues and making sure their dogs eat a healthy diet."
"Based on VetCompass Programme data, the Miniature Schnauzer is currently Britain’s most average dog from the breeds that we have studied to date. Extreme breeds such as flat-faced, long-backed or teacup-sized dogs may currently be in vogue but we need to move away from extremes and towards the healthier middle-ground."
Dr Alex Gough of Independent Vet Care and co-author added: "Although a number of diseases were identified in the current study that affect Miniature Schnauzers, the commons ones did not occur more frequently in this breed than in others studied. Many popular breeds are prone to life-threatening and distressing conditions related to their breeding. Our study suggests that the Miniature Schnauzer should be considered as a relatively healthy breed, which can help owners make a decision when acquiring a new dog."
Bill Lambert, Senior Health and Welfare Manager at the Kennel Club, said: "The Kennel Club currently recognises 221 different breeds and registering these breeds with the Kennel Club provides opportunities for data to be collected so that it can contribute to high quality and large scale research, such as this study by the Royal Veterinary College.
'It is vitally important that this type of research is carried out so that breed specific information is gathered and can be made available to owners to help ensure their dogs are kept as fit and healthy as possible.
'The Miniature Schnauzer is a popular breed in the UK so being the ‘most average dog’ in terms of health, and having no breed specific health problems, is actually a good quality and is very welcome news.”
ITV's Tonight programme broadcast last night portrayed a veterinary profession in which overcharging is commonplace.
Researchers for the programme took three healthy animals (a cat, a dog and a rabbit) to a number of different vets, telling them that the animals were off their food. The advice they were given varied. In the case of the rabbit from no treatment necessary, to dental work under general anaesthetic.
TV vet Marc Abraham then looked at each animal and told viewers that the correct advice in each case would have been the least expensive.
The programme also highlighted the substantial savings that pet owners can make by buying drugs online, and questioned whether the penalty meted out to a vet that had committed malpractice was sufficient (the vet had been struck off for 14 months, where presenter Jonathan Maitland argued it should have been for life).
Veterinary business consultant Mark Moran said: "So often, vets rely to a large degree on what owners are telling them, and the degree to which they insist the animal is ill, or off its food, will affect the advice and treatment given. Marc Abraham had the luxury of being presented three animals that he knew to be perfectly fit and well."
However he agreed wholeheartedly with the response from RCVS President Jill Nute this morning, that the thing both vets and pet owners need to learn from the programme is "the importance of communicating with each other".
Mark said: "It's a question of managing people's expectations. There'll always be a variance in the advice being given, but being up-front and open will help mitigate the risk of being accused of overcharging".
Click here to watch the programme. Click here to read the reactions to Marc Abrahams' blog
The updated guidance follows a public campaign known as ‘Tuk’s Law’, which was started after a healthy dog by that name was euthanased despite its microchip being dually registered with a rehoming centre as a 'rescue backup'.
In response, the RCVS and the BVA agreed that more should be done to prevent occasions where a dog might be needlessly put to sleep, but voiced concerns that a legislative approach could undermine a vet’s clinical judgement, unfairly involve veterinary surgeons in ownership disputes or potential criminality, and leave vets unfairly exposed to financial sanctions.
In consultation with Defra, the RCVS and BVA therefore jointly agreed to strengthen the Code of Professional Conduct as follows:
Chapter 8 (para 8.9)
There may be circumstances where a request is made by a client for the destruction of a dog, where in the clinical/professional judgement of the veterinary surgeon destruction of the dog is not necessary, for instance where there are no health or welfare reasons for the dog to be euthanised.
In these circumstances, before carrying out the request for euthanasia the veterinary surgeon should scan the dog for a microchip and check the relevant database if a microchip is found.
Chapter (paras 29.25 -29.27)
Clients may have a contract with the shelter from which they acquired the dog such that it can be returned to that shelter, and that it may be appropriate to discuss this with them prior to euthanasia. Alternatively, there may be another individual willing to take responsibility for the dog (who may be named on the microchip database), and this may also be discussed with the client.
The updated guidance supports existing best practice in terms of discussing alternatives to euthanasia with clients, and give vets flexibility where, in their professional judgment, scanning is not appropriate; this might be if scanning would itself cause a welfare problem, or where a vulnerable client might be involved.
The RCVS Standards Committee says it recognised the difficulties experienced by veterinary surgeons in dealing with the current microchip database system, but felt that introducing these provisions into the guidance was a more proportionate response than the alternative of legislation with substantial fines.
BVA Senior Vice President Dr Daniella Dos Santos MRCVS said: “One of the most important jobs as a vet is having those difficult conversations with clients about euthanasia where we talk through all the options that are in the animal’s best interests. But where the vet doesn’t consider that euthanasia is necessary, the new guidance clearly sets out the steps we need to take. We support this constructive approach that addresses the campaigners’ concerns without undermining veterinary judgement.”
Dechra Veterinary Products has launched free online Fluid Therapy Calculators to help veterinary staff calculate their patients' fluid requirements.
There are two versions available, small animal and equine. Both are available as an online tool or as a download to your desktop (note that to get hold of the desktop version, you need to try out the online calculator first).
For small animals, there are three options available. The M1/M2/M3 Plan calculates simple multiplications of the maintenance rate, while the Comprehensive Plan calculates fluid required to provide maintenance requirements, correct dehydration or replace ongoing losses. The third option, the Simple Rate Calculator, is a tool for calculating resuscitation fluid rates and can also be used for large animals. The Equine Plan calculates fluid requirements and infusion rates for both adult horses and foals.
Dechra says it has launched the calculators as the next component of its Vetivex Fluid support package. Along with the Fluids Knowledge Programme, this initiative aims to help veterinary staff across the UK to deliver effective fluid therapy.
Larry King, Product Manager at Dechra, said: "The calculators are a quick and easy reference tool for today's busy vet. You simply fill in the body weight and animal type, key in a few details and you have an instant but very accurate fluid rate calculated for you. It saves time and effort and ensures the animal is given the correct amount of fluid. The more effective the fluid therapy regime the faster the animal recovers."
The free Fluid Therapy Calculator is just one of a number of tools Dechra uses to support its Vetivex range of fluids. There is a range of downloadable reference documents, charts and guides available on the website http://www.fluidtherapy.co.uk/ including the Fluid Knowledge Programme and a full CPD Programme focused on effective fluid therapy.
Dechra Veterinary Products has announced that it is to relaunch Fuciderm Gel, the topical skin product used to treat surface pyoderma in dogs, as Isaderm.
Isaderm contains fusidic acid, which Dechra says is highly effective against the bacteria Staphylococcus pseudintermedius, and the steroid betamethasone, which is both an anti-inflammatory and anti-pruritic.
Available as a white translucent gel in 15 g and 30 g tubes, Isaderm is a topical treatment which can be applied directly and stays on the affected area - the base of Isaderm is a carbomer gel which maintains contact on skin and wet lesions.
Dechra Dermatology Brand Manager Roger Brown said: "Fuciderm is one of our most popular products. As part of an international Dechra rebranding programme the name will now be Isaderm® but veterinary professionals can be assured that the only thing about the product that has changed is the name.
"This treatment was the subject of a multi-centre UK trial* comparing treatment of surface pyoderma with the gel or systemic therapy, and the gel product was shown to be as effective as systemic therapy."
For further information, visit www.dechra.co.uk
Virtual Vet Derms has been set up to be able to give advice to veterinary surgeons on any aspect of skin or ear disease whether it is allergy, otitis media, cutaneous neoplasia or endocrine-based in any species, including dogs, cats, small furries, exotic pets including raptors, birds and reptiles, horses, camelids, zoo and farm animals.
Sue, herself an RCVS Recognised Specialist in Veterinary Dermatology, is supported by a team of veterinary dermatology colleagues as well as veterinary specialists in exotic medicine, internal medicine (including endocrinology) and consultants with expertise in oncology.
Sue said: "We recognise that not every veterinarian has got access to a local dermatology specialist and that not all clients can or want to travel to a referral centre. The aim of the service is to formalise the advice that dermatology clinicians give to veterinary surgeons to allow them to get detailed help to manage difficult or challenging dermatology cases within their own practice."
The service has been set up under the RCVS Vivet initiative, is approved by all of the major insurance companies and supported with Veterinary Defence Society Insurance cover.
Virtual Vet Derms offers support in a range of ways.
Quick questionsShort questions that veterinary surgeons can submit via the online form on the Virtual Vet Derms website that just require a brief reply. This may be a dose of a drug, a parasite you want identifying, or the interpretation of a blood sample such as an ACTH stimulation test.
Veterinary reportsVeterinary surgeons can use online request forms on the Virtual Vet Derms web site to submit a brief history of the animal and the problem and some good quality photos of the skin condition. There is also the ability to upload histopathology reports, blood samples and any other pertinent information. A detailed written report is sent back to the vet within 48 hours which will describe clinical signs, differential diagnoses, recommended diagnostic tests and treatment option where appropriate. Where possible, Virtual Vet Derms aims to pass the advice request to the nearest dermatologist but vets can ask for advice from any of its specialists.
Telemedicine consultationsFor new cases or for cases where initial advice has been sought, in the client's own primary care veterinary practice via the internet. The Virtual Vets Derms specialist can consult with the owner to provide even more specific advice and support. After each teleconsultation the Virtual Vet Derms specialist will produce a report in the same format as the veterinary report to allow the primary care veterinary surgeon to continue to manage the case more effectively.
Face to face consultationsCan also be arranged via the owner’s vet at the specialist's own practice if there is the need for more specialist investigation that may not be available in the primary care veterinary surgery. In these cases, the specialist will take on the direct care of the case and work with the owner and vet on the best course of action.
General advice Also possible if the vet wishes to direct an owner straight to Virtual Vet Derms.
For more information, visit: https://virtualvetderms.com
Paragon is being built by the Linnaeus Group, which says the new centre will be one of the largest and best-equipped in the UK when it opens its doors early in the New Year.
The new centre follows the Linnaeus Group's acquisition of Dewsbury-based Calder Vets last year.
Calder Vets' existing referral teams, together with two ophthalmologists from its Mirfield branch, will be transferring to Paragon. Meanwhile, Calder Vets will move to solely first-opinion work.
Currently nearing the end of construction, the centre will have eight consulting rooms, five operating theatres, MRI and CT scanners, intensive care facilities along with an all-digital imaging department.
A total of up to 80 staff will be employed at Paragon, including up to 18 referral vets and 32 veterinary nurses.
Specialist services will include cardiology, neurology, ophthalmology and orthopaedic and soft tissue surgery.
Positions currently available include a diagnostic imager, internal medicine specialist, neurology specialist, oncology specialist and an ophthalmologist, as well as various nursing posts.
Ian Monteith, managing director of Paragon, said: "We are looking for the best possible people who not only have the right skills and experience, but who will also fit into the ethos we want to create at Paragon.
"It is a significant and exciting opportunity for motivated, high calibre people to help shape something that has a very bright future for both the industry and for their own careers.
"Our philosophy is very much one of friendly cooperation between all members of staff, creating a pleasant, supportive and good-humoured atmosphere."
For details of the vacancies currently on offer at Paragon, visit www.paragonreferrals.co.uk/en-GB/careers
It is thought that the main reason for the cutbacks is a shortage of veterinary surgeons caused by Brexit, which is making it both harder and more expensive to recruit.
The company has given an undertaking that the joint venture partners of the practices it offers to buy back will not be expected to repay outstanding borrowings to any parties and Pets at Home will settle any liabilities for third party bank loans and leases on behalf of the JVP.
Chief Executive Peter Pritchard said: "Since becoming the Group CEO in May, I have had the opportunity to take stock of the wider group and shape my view of our future.
"What I have found fills me with confidence. Pets at Home is a healthy business and customers are loving what we do; responding to our price repositioning, investment in digital and the amazing service delivered by our vet partners. We have the ability to offer almost everything a pet owner needs, giving us opportunities our competitors simply don't have. Which is why my vision is to develop a complete pet care company, uniting our retail and vet businesses.
"Reviewing our Vet Group has been a priority. I recognise we have grown at pace and more recently, have seen the pressure that rising costs and our fees are placing on this young business. We will need to recalibrate the business to deliver more measured growth, whilst maintaining our plan to generate significant cash profits.
"We are focused on maximising our unique assets and delivering a plan for sustainable cashflow and profit growth. Given the success of the changes we have made in Retail, I'm confident we can do this."
Oxidative stress is an imbalance of free radicals and antioxidants which can lead to cell and tissue damage, impacting the health and performance of cattle.1 Virbac says the trace minerals in Multimin are essential structural components of antioxidant enzymes which are required to neutralise free radicals and combat oxidative stress.2,3
Multimin, which comes in a 100ml PET bottle, contains zinc, copper, manganese and selenium. It is designed to be administered during or before periods of high demand in dairy and beef cattle, such as breeding, calving, weaning and vaccination. After injection, it reaches peak levels in the blood after 8 hours4,5 and the liver after 24 hours.4,5
Virbac says Multimin has been proven in 24 peer-reviewed papers and field trials of more than 6,000 cattle, and that it offers a fast, simple and accurate way to top up essential trace minerals at times of high demand, to help improve cattle health and performance.
Lynda Maris, Virbac Large Animal Product Manager said: "Trace mineral requirements are currently primarily provided through the diet and various forms of oral supplementation. However, reduced oral intake, poor absorption from the rumen and antagonism from other minerals means that during periods of high demand, even in apparently well supplemented animals, a trace mineral gap can occur between the trace minerals required for optimum health and performance versus those available."
Lynda added: "Multimin is a great addition to the Virbac Large Animal range. It represents an exciting new opportunity for vets to strengthen their herd health plans, boost practice revenue and help to further reduce antibiotic usage."
For more information, speak to your Virbac Territory Manager or visit the Virbac stand at the BCVA Congress, 17th – 19th October.