Earlier this month, the government had exempted veterinary surgeries from the requirement to close their doors during the pandemic. Strictly speaking, the exemption meant that practices could carry on offering the same level of service as before, provided they followed further government guidelines on social distancing.
However, the College then advised that non-essential treatments should not be carried out until further notice, and that animals should only be seen in emergency, or if their health was likely to deteriorate as a result of inaction.
This included vaccination, where RCVS advice stated that whilst routine vaccinations were considered not urgent, there "may be scenarios where, in your professional judgement, vaccines are being given to reduce a real and imminent risk of disease; this includes in the face of an animal disease outbreak, or in a scenario where part of a vaccine course has been given and the animal may be exposed to the disease."
The updated College guidelines, issued last Thursday evening, appeared little changed, except to say that its advice concerning vaccinations is under review. Meanwhile, its new flowchart gives a very clear framework for veterinary professionals to work within, essentially leaving it to your own professional judgement to weigh up the risks.
However, the BVA went further, declaring amongst other things, that:
Vaccinations – we are now recommending that primary vaccinations and year 1 boosters in dogs and cats go ahead due to the increased risk of disease outbreak over a longer period of time, and annual leptospirosis vaccination due to the zoonotic risk. If additional component of the core vaccine is due at the same time, it should also be administered. In addition, we’re recommending rabbit vaccinations go ahead due to the seasonal disease risks. Rabies vaccinations should be carried out if required for certification reasons
.... leading to an outcry that the BVA's advice appeared to be being relaxed at precisely the point when the government is imploring the public to stay at home, and that:
To add further fuel to the flames, the British Small Animal Veterinary Association then issued a statement to the effect that it had not been consulted during the preparation of the new BVA guidelines, which BVA past President Robin Hargreaves felt was so economical with the truth that he resigned his BSAVA membership on the spot.
COMMENTAt the end of it all, there is but one simple truth for every veterinary surgeon who is working in these difficult times, and it is this: The government and the RCVS guidance gives you the freedom to exercise your professional judgement concerning whether or not an animal needs to be seen for whatever reason. Provided you can explain why you reasonably concluded that an animal should or should not be seen, that is all that matters. It trumps everything else.
This whole farago has highlighted a number of important issues in the profession, starting with the social media conspiracy theories that the new guidance came after pressure from corporate practices when as far as I can tell, it appears to have been driven by a genuine concern that that failure to vaccinate could cause significant welfare issues in the future.
That seems a reasonable argument, and very much in line with the College advice. But that in turn raises a far bigger question, which is what on earth the BVA (a voluntary membership organisation) was doing issuing what appeared to be instructions ostensibly for all members of the profession. Notwithstanding the fact that BVA recommendations have no legal weight, having all these chefs running around with different recipe books is itself a recipe for muddled communications and confusion over leadership.
In turn, that raises the even bigger question of what the BVA's role should be. Should it be snuggling up in bed with the RCVS, issuing joint edicts? Or should it instead be holding the College to account, challenging its decisions and demanding clarification where clarification is necessary. I would argue the latter. In this situation, the ONLY organisation issuing guidelines about vaccinations for practising vets should be the regulator. And it is the role of the BVA to challenge those guidelines if necessary, or to demand clarification.
Which leads me on to the next thing, which is that increasingly, members of the profession seem to demand explicit rules or guidelines to operate within. There are lots of hypotheses for why this might be true. Perhaps because we live in a more (or seemingly more) litigious world and veterinary professionals like the reassurance rules provide. Perhaps it is because the younger cohort of vets lack the self-confidence needed for decision-making. Perhaps corporatisation has a part to play, in that employees of larger organisations tend to play more by the rules. Or perhaps it is a consequence of the growth in the 'refer everything’ culture which means vets take fewer clinical risks.
Whatever the reason, it seems clear that in some cases, the RCVS tack of "you're a professional, decide for yourself" is perfectly reasonable, whereas on other occasions, such as Schedule 3, more explicit guidelines are demonstrably necessary. Once again, surely the role of the BVA as the "Voice of the profession” is not to issue its own advice, but to press the College for more explicit guidelines as necessary.
Lastly, there is the role of Facebook in all of this. Quite obviously vets are no more immune to conspiracy theories than members of the public who think that coronavirus is spread by 5G telephone masts. Sadly, the truth is usually far less exciting. However, the problem at the moment is that the growth in social media and Facebook groups has left the regulator and the representative associations on the back foot, such that it is often left to individuals from those organisations who 'happen to come across OK online' (rather than having any properly defined role) to firefight.
Photo: https://www.scientificanimations.com/wiki-images/
Two new campaigns which call on the veterinary profession to unite against the practice of homeopathy have been launched this week.
Both campaigns raise concerns about the ethics of veterinary surgeons using irrational, unscientific and ineffective remedies to treat ill animals or in place of conventional vaccinations.
The Campaign For Rational Veterinary Medicine presents the case against homeopathy on a new microsite, and asks the profession to unite around a call for the Royal College of Veterinary Surgeons to issue a public position statement that homeopathy is ineffective in animals, bringing it into line with the NHS, the findings of the British government's own review of homeopathy, and the BVA.
The campaign also asks that veterinary surgeons who prescribe homeopathic remedies be required to get owners to sign a consent form, prepared by the College, giving the College’s views on the ineffectiveness of homeopathy.
Lastly, the campaign asks that promotion or advertising of homeopathy by veterinary surgeons should abide by Advertising Standards Authority regulations and carry a statement from the College.
The Campaign for Rational Veterinary Medicine has been set up by a group of practitioners including the BSAVA Past President, Mike Jessop, Alex Gough, Martin Whitehead, Niall Taylor, Phil Hyde, Martin Atkinson and Brennen McKenzie, supported by VetSurgeon.org Editor, Arlo Guthrie. It also has the support of the noted author, academic and erstwhile dog owner, Professor Edzard Ernst.
Arlo said: "This is not just about the ethics of prescribing or tolerating the practice of prescribing water to animals that are dependent on us. There are 13m pet owning households in the UK. As well as visiting the vet, they will all be patients at some stage in their lives. So what you and the College say about homeopathy in animals has the potential to affect the choices they make for themselves too. Think how much money and false hope you could save them, and the consequent benefit to human welfare."
By complete coincidence, another campaign against veterinary homeopathy was launched last week. This one, by Danny Chambers MRCVS goes further, calling for a complete ban on the prescription of homeopathic remedies by veterinary surgeons. The petition has already gathered over 750 supporters.
Arlo said: "I think it’s important to say that the two petitions are not mutually exclusive. If you think both represent acceptable solutions, then sign both!"
Visit the Campaign for Rational Veterinary Medicine here, and sign the petition here.
Sign Danny Chambers' petition on change.org here.
Broadline was a fipronil-based parasiticide which also contained (S)-methoprene, eprinomectin and praziquantel.
NexGard Combo, on the other hand, contains esafoxolaner together with eprinomectin and praziquantel for worming.
Both products are licensed for use in cats with or at risk from mixed infestations by fleas, ticks, mites cestodes, nematodes.
There's an explainer video about NexGard Combo on the Boehringer Academy website: https://www.boehringer-academy.co.uk/
The milk withdrawal has been reduced from 108 hours to 96 hours and the dose is now 15 mg/kg for three consecutive days.
Kath Aplin, veterinary adviser for Boehringer Ingelheim Animal Health, said: "The new dosage regimen gives clearer guidance to vets and their clients; a 660kg cow should receive 10g of penethamate hydriodide (one vial) daily for three days.
Mamyzin, a lecithin coated pro-drug of benzyl penicillin, is highly lipophilic and actively concentrates in the udder, where it is capable of entering epithelial cells to achieve intracellular bacterial kill1. It provides targeted, narrow spectrum treatment for gram positive mastitis in situations where injectable therapy for mastitis is required."
Reference
Galliprant is a first in a class of drugs called piprants, or non-COX-inhibiting prostaglandin receptor antagonists (PRAs), which specifically target the EP4 receptor largely responsible for OA pain and inflammation1,3 without interfering with other prostanoids and receptors, thereby minimising the impact on gastrointestinal and kidney homeostasis.1,4
According to Elanco, the main benefit of the new drug is that it can be given in the earlier stages of the disease; from first diagnosis in fact. Speaking at the London Vet Show in 2018, Dr Kristin Kirkby Shaw, Surgeon and Rehabilitation Specialist at the Animal Surgical Clinic of Seattle, said: "…being much more targeted, it makes us feel more comfortable starting this product in an earlier stage of osteoarthritis."
In the target animal safety study, Galliprant was well-tolerated over 9 months at doses equivalent to 15 times the target dose.5 Kristen said: "I challenge anyone to think of another product that has been given in a safety study at that high of a level for that duration of time."
The efficacy of Galliprant was demonstrated in the field study at the licensed target dose of 2mg/kg body weight, with treatment success seen by owners in their dogs at home, and confirmed by vet assessment.2 Owners saw statistically significant improvements in pain severity and interference with daily activities vs placebo at days 7, 14, 21 and 28.2
For more information, visit www.galliprant.co.uk. You can also watch Dr Kristen Kirkby Shaw's London Vet Show presentation and other expert opinion here.
References:
The proposals put to Council by the Education Committee included six key recommendations for changes to CPD policy:
To change the CPD requirement – as stated in the Codes of Professional Conduct – to 35 hours per calendar year for veterinary surgeons and 15 hours in the same period for veterinary nurses, from the start of 2020. This replaces the previous requirement of 105 hours and 45 hours of CPD over a rolling three-year period for veterinary surgeons and veterinary nurses respectively.
Making the use of the new CPD platform (currently in development) for recording learning and development mandatory from 2022.
Giving veterinary surgeons and veterinary nurses who, upon renewing their registration, have confirmed their compliance with the requirement, the opportunity to download a certificate demonstrating this.
The introduction of an administration fee (which is currently yet to- be determined) that will be charged to any veterinary surgeons or veterinary nurses who continually (defined as two or more years in a row) fail to confirm their compliance with the requirement and/or fail to respond to requests from the College for their CPD records.
Changing the words of the Codes of Professional Conduct to include the fact that CPD should be ‘regular’ and ‘relevant’.
The continuation of the RCVS CPD Referral Group, which meets to consider what further steps should be taken in cases of veterinary surgeons and veterinary nurses who continually fail to comply with CPD requirements and/or respond to requests.
RCVS Council agreed, by a majority vote, to approve the above recommendations.
RCVS Council member Dr Sue Paterson (pictured right), who introduced the paper and is the incoming Chair of the Education Committee, said: "While the majority of both veterinary surgeons and veterinary nurses do recognise the importance of continuous learning and development for their professional practice, their clients and, ultimately, animal health and welfare, it’s clear that there has been a cohort of people in both professions who take a more lax view of undertaking CPD.
"The changes to our CPD policy are intended to tighten up our processes and are targeted at those who, when challenged about why they have not undertaken sufficient CPD, say that they will meet the requirement one or two years down the line as part of the rolling three-year system. The administration fee also recognises the amount of time and effort spent by staff in the College in contacting and chasing up those people who aren’t compliant.
"However, we also recognise the fact that some members of the profession may have personal circumstances that means they are unable to meet their CPD requirement in a given year – whether that’s because of parental leave or other caring responsibilities, or long-term sick leave. So we will be retaining flexibility within the system and will be considerate and compassionate when taking into account individual circumstances when considering non-compliance.
"Furthermore, in light of the fact that the majority of vets and vet nurses do meet the requirement but also often go above-and-beyond it, we also thought it would be a good idea to introduce a downloadable compliance certificate in recognition of their achievement. This could be displayed, for example, in the practice and would be particularly useful for Practice Standard Scheme assessments.
"Over the coming months we will be fine-tuning the details of these policies and will be making further decisions about how they will work in practice in due course."
Veterinary surgeons and nurses who feel they will struggle to complete their CPD requirement within a 12-month period due to personal circumstances can contact RCVS confidentially at any time to discuss their difficulties on cpd@rcvs.org.uk
For full details about the decision, you can download the RCVS Council paper at: www.rcvs.org.uk/document-library/rcvs-council-papers-13-june-2019/
The study also suggests that encouraging the idea that client-orientated behaviours make for a 'good vet' will help many vets improve their mental wellbeing.
Liz found examples of new graduates who value their client-oriented skills, such as being able to tailor clinical plans to individual clients' needs, but still couldn’t shake the feeling that a 'better vet' would offer a more academic or specialist approach to cases.
Even when they skilfully adapt a plan for an owner who is unable to afford advanced tests to find out what is causing their pet's illness, this jars with the vets' beliefs that by reaching a specific diagnosis they would be doing a better job. Thus they chronically feel like a 'bad vet', despite demonstrating high-level skills in communication and clinical problem-solving.
The paper argues that learning to form positive client relationships in difficult situations leads to vets who are more resilient and have greater mental wellbeing.
However further analysis found a clear sentiment of 'the client is the enemy' in colleagues' discussions and social media.
During a difficult case, with complex conflicting pet and pet owner needs, vets who choose to emphasise the client as difficult and unreasonable can receive temporary solace when talking to similarly-minded peers or by accessing social media. However, this thinking prevents them from developing client empathy, impacting their mental health negatively in the long-term.
Liz therefore believes everyone in the profession has a responsibility to frame the strengths of the 'good vet' as being as much about the pet owner as the pet.
Liz said: "It's really important not to think of this as a message that we must all be 'nicer' to our clients. I have heard vets say clients' limited finances or not wanting to put their pet through treatment have forced them to go against their 'professional code'. This simply isn’t true: the RCVS Code of Conduct emphasises a need to work alongside clients to problem-solve these complex situations. Animal welfare can be supported through palliative or symptomatic treatments, which may be offered after difficult negotiations with very upset pet owners. This should therefore be a skill that is celebrated, rather than being considered not 'gold standard'.
"Being able to work with a client who is highly troubled by their financial limitations or the impending loss of a pet is difficult, particularly when these anxieties manifest as anger and accusation. The social media message of the client as the enemy obstructs this skill, as it becomes easier to rant about the 'difficult client'. Unfortunately, where this becomes embedded, it prevents the career satisfaction that comes from working with clients."
Photo courtesy RVC
In his first year of what would normally have been be a four-year term, Colin served on the College’s Education Committee, PIC/DC Liaison Committee, and on the Advancement of the Professions Committee as Council Deputy Lead for the ViVet innovation programme.
VetSurgeon.org caught up with Colin, who explained: "I've never had any problem with the idea of respecting Council decisions, even those I disagree with.
"However, I questioned the interpretation of collective responsibility when I first joined Council, and was told that in the event of disagreement, it was OK for councillors to say publicly that there was a 'split vote', or 'opinions varied'.
"This new statement would mean that if I disagree with a Council decision, I would now either have to lie in public and say I supported it, or run away and hide.
There were two other aspects of the new statement which Colin was not prepared to sign up to.
The first was a new requirement that councillors "support the College’s vision".
Colin said: "People who actively disagree with the College's vision should be free to stand to join Council, and if the profession disagrees with the College's vision, they'll get elected!"
The second was a requirement for councillors to "Live the College’s values"
Colin said: "Although perhaps inline with a corporate ethos, I think it represents quite a conflict.
"The values someone lives by are a deeply personal matter, and shouldn't be imposed by the majority vote of a committee they happen to sit on - however much they may or may not be likely to align."
Colin's resignation prompted VetSurgeon.org to carry out a quick analysis of the percentage of RCVS Council meeting agenda items marked as 'Confidential' from November 2015 to June 2022, to see whether the requirement to tow the party line reflected a broader lack of transparency at the College.
In the four Council meetings from November 2015-2016, 12% of the agenda items in the Council minutes were marked 'Confidential'.
By 2022, that figure had more than doubled to 36% (see graph right).
The new RCVS 'How we work' statement can be read in full in Annex One of the June 2022 Council Papers.
For the research, being conducted by David Mills MRCVS (pictured) and VetSurgeon.org Editor Arlo Guthrie, vets are being asked to complete an eight question survey which asks how things like money, trial by social media, insurance and fear of complaint affect the way they practise.
All answers will treated as strictly confidential and data processed anonymously.
However, those who are happy to share their names will be entered into a draw for three £50 Amazon vouchers.
David said: “All practising vets are aware of the recent noise about high vet fees and the CMA investigation as well as the various competing pressures when advising owners.
"For the first time in the profession, this study will allow vets to have their say on the considerations that owners may not see or be aware of.
"Please take 5 minutes (max) of your time to complete the survey and help us build a better evidence base than the current soup of anecdote and opinion"
https://survey.alchemer.com/s3/7979966/VetSurgeon-org-Factors-influencing-the-clinical-advice-given-by-vets-to-clients
Shortlink: https://bit.ly/clinicalinfluences
The survey closes on 15th December 2024
Ms Parody faced two charges, the first of which related to her treatment of a cat named Shadow and had multiple elements:
The second charge was that her conduct in relation to all parts of the first charge was dishonest.
At the outset of the hearing Ms Parody’s counsel admitted to the majority of the elements of the first charge, although denied she had removed the microchip in order to mislead others about Shadow’s identity.
Ms Parody also admitted that her failures to inform the owner that euthanasia had not been carried out, of the treatment plan, of the removal of the microchip and that she had taken Shadow home was dishonest.
However, she denied dishonesty in relation to failing to make adequate records.
The Committee went on to consider the facts of the remaining, contested charges.
After hearing evidence from a number of witnesses, the Committee concluded that it was not proven that Dr Parody removed the microchip in order to mislead others about his identity, and that, in this respect, she had therefore not acted dishonestly.
In relation to whether Ms Parody was acting dishonestly in relation to failure to make adequate clinical records, the Committee also found this not proven.
Having determined the facts of the case, the Committee went on to consider if the proven charges amounted to serious professional misconduct.
In terms of aggravating factors, it considered that there was actual injury to an animal – albeit small and while the cat was under sedation - and that Ms Parody had engaged in conduct that was in breach of a client’s trust.
In mitigation, the Committee considered the immense pressure that Ms Parody and her colleagues in the practice were under at that time due to the coronavirus pandemic and the fact that she had acted in a way which she thought was best for Shadow’s welfare and which clouded the rest of her decision making.
Furthermore, the Committee considered this was a single isolated incident, that she took the decision without the opportunity for full reflection and the length of time since the original incident.
However, it found Ms Parody guilty of serious professional misconduct in relation to all the proven charges.
Paul Morris, chairing the Committee and speaking on its behalf, said: “However well-intentioned, Dr Parody made some serious errors of judgment with regard to her approach to Shadow and embarked upon a course of dishonest conduct, which started with her failure to inform the owner about her decision not to euthanase Shadow, was followed by her treatment of Shadow, including his castration and microchip removal, all without the consent of the owner, and ended with her taking Shadow home over Christmas, again without the owner’s consent.
"In addition, she failed to make adequate clinical records with regards to Shadow.”
The Committee then went on to consider the most appropriate sanction for Ms Parody.
It heard a large number of positive testimonials as to her character and professionalism from both clients and former and current work colleagues.
The Committee also considered further mitigating factors such as the fact she had no previous disciplinary issues, had a long and unblemished career both before and since this isolated incident, her open and frank admissions regarding some of the charges, the significant impact she displayed regarding her misconduct, and her genuine expressions of remorse and apology.
Paul Morris added: “The Committee recognises that there is a scale of seriousness of dishonesty and therefore gave careful consideration as to where Dr Parody’s dishonest conduct fell to be judged.
"The Committee was concerned with her conduct between 20 December and 31 December 2021, as found proved.
"What led to what she has admitted as dishonest behaviour, was her acting to protect the welfare of the cat.
“The Committee was confident that she most certainly did not set out to act dishonestly.
"She made an initial error of judgement and everything that followed flowed from that.
"What she went on to do was something of a panicky attempt to cover up what she had done initially, so that she could decide on how to rectify it but, the Committee was satisfied, all done with the best of intentions and in the best interests of the cat and its owner.
"She had not acted out of any personal or financial gain or malicious intent.
"She had created a mess and she was trying to sort that mess out.”
After deciding that a reprimand was the most appropriate and proportionate sanction to impose, Paul Morris concluded: “In all the, somewhat exceptional, circumstances of this case, the Committee was satisfied that a reprimand would provide adequate protection to animals, as it was satisfied Dr Parody was most unlikely to ever make such a flawed set of decisions again.
"The Committee was satisfied that Dr Parody does not represent a risk to animals going forward, indeed from the character evidence it is clear that she always puts the welfare of animals first.
"She has also shown, since this episode, that she can work under pressure and not resort to making bad decisions and thus the Committee considered the wider public interest would be served in this case by a reprimand.”
www.rcvs.org.uk/disciplinary
The association has released figures from its Voice of the Veterinary Profession survey in which 86% of 671 veterinary surgeons polled in May/June last year had treated conformation-related health problems in brachycephalic cats, such as Persians and Exotic Shorthairs.
The most common conformation-related treatments carried out by these vets were for:
Eye problems (69%)
Breathing/respiratory problems (60%)
Dental issues (45%) and
Skin problems (32%).
The survey also found that on average, 28% of the flat-faced cats vets see in their practices have had or would benefit from having treatment for conformation-related health or welfare problems.
Respondents also said that only a quarter of brachycephalic cat owners were already aware of the potential health issues and just one in twenty were aware of the additional costs associated with the breeds before choosing their pet.
BVA Senior Vice President Gudrun Ravetz said: "Everyone knows that the internet loves cat photos and videos. But as time passes we’ve noticed a growing appetite for novelty creeping in - with quirky and unusual cat breeds proving increasingly popular on social media.
"Currently the UK population of pure breed cats is very small as most cat owners opt for regular non-pedigree ‘moggies’. However, we are worried that the popularity on the internet of breeds with extreme conformation, such as the very flat-faced Persians and Exotic Shorthairs, or gene abnormalities such as cause the ears to bend forward in the Scottish Fold breed, may prompt increased demand among consumers who are unaware of the potential serious health and welfare issues associated with such breeding.
"These figures show that many, many owners are choosing pets without understanding either the possible welfare implications of their extreme features or the potential cost of treating them."
The BVA, which has been campaigning to curb the growing popularity of brachycephalic breeds of dog for some time, says it is keen to emphasise that health and welfare issues relating to extreme conformation are not limited to dogs or to brachycephaly. To that end, it will be launching a wider position statement on extreme conformation in animals later this summer.
For BVA #BreedtoBreathe campaign materials, including infographics and videos which draw attention to the serious health issues experienced by brachycephalic animals, visit: www.bva.co.uk/brachys.
Photo: Shutterstock/Piyato
Ophtocycline is licensed for the treatment of keratitis, conjunctivitis and blepharitis caused by Staphylococcus spp., Streptococcus spp., Proteus spp., and/or Pseudomonas spp.
Dechra says chlortetracycline hydrochloride works against both aerobic and anaerobic Gram-negative and Gram-positive bacteria.
The recommended dosage is four times a day for five days. The 10 mg/g ophthalmic ointment has a 14-day broached shelf life. There is a one-day withdrawal period for meat and offal.
Dechra Brand Manager Carol Morgan said: "Ophtocycline provides veterinary professionals with a targeted treatment to effectively tackle the growing and reproducing bacteria that causes these eye conditions.
"Chlortetracycline is a bacteriostatic antibiotic which interferes with bacterial protein synthesis in the rapidly growing and reproducing bacterial cell and has both time-dependent and concentration dependent effects.
"We are very pleased to be able to roll out this product to the UK market as part of our ophthalmic range alongside popular products such as Isathal."
For more information visit: www.dechra.co.uk
This new injectable fluralaner formulation is approved for the immediate and persistent killing of fleas for one year (Ctenocephalides felis and Ctenocephalides canis), from 3 days to 12 months after treatment for the ticks Ixodes ricinus, and Dermacentor reticulatus, from 4 days to 12 months after treatment for Rhipicephalus sanguineus, and from 7 days to 12 months after treatment for Ixodes hexagonus.
MSD says it will also reduce the risk of Babesia canis via transmission by Dermacentor reticulatus from day 3 after treatment for up to 12 months, and also reduces the risk of infection with Dipylidium caninum via transmission by Ctenocephalides felis for up to 12 months.
Victoria Miles, UK Companion Animal Business Unit Director, MSD Animal Health said: “Imagine not having to worry about flea and tick protection for a whole year."
Bravecto 150 mg/ml powder and solvent for suspension for injection for dogs can be administered to dogs and puppies six months of age and older.
The product is already available in France and Germany and MSD told VetSurgeon.org that stocks are expected in the UK in September, for which the company is now taking pre-orders.
Contact your MSD Account Manager for further information on pricing.
The hearing concerned an incident which took place at the VetsNow Huyton premises in Liverpool. There were two charges against Dr Rafiq. The first was that in December 2017, shortly after a litter of puppies was delivered by caesarean to a French Bulldog named Lila, she took one of the puppies away from the practice with the intention that it should not be returned to Lila’s owner and that, in doing so, she was dishonest, misleading and had not acted in the best interest of the puppy’s welfare.
Another puppy was taken away by an animal care assistant who was also working at Vets Now Huyton on the night in question.
The second charge against Dr Rafiq was that she had told her employer at VetsNow that the puppy she had taken from the practice had died in the car when she had been driving home when, in fact, the puppy was alive at that stage and, in telling her employer this, she had been dishonest and misleading.
There was one charge against Mr Perez: that he had made an entry in the clinical records for Lila that she had given birth to four live puppies when in fact she had six; that he had only discharged four of the six puppies to the owner; that he knew that his colleagues intended to remove or had removed the puppies; that he had failed to prevent the removal of the puppies and had failed to report to a colleague the removal of the puppies. The charge also stated that, in relation to the incident, Mr Perez had been dishonest, misleading, did not act in the best interests of the puppies’ welfare and failed to keep accurate clinical records.
At the outset of the hearing, Dr Rafiq admitted in full the charges against her and accepted that she had acted dishonestly. Mr Perez admitted some of the charges against him including that he had made the false clinical record, had discharged four rather than six puppies and had failed to keep accurate clinical records, however he denied any knowledge of the intention to remove puppies and denied that his conduct had been misleading or dishonest.
The Committee was not satisfied that Mr Perez knew at the time of surgery that his colleagues intended to remove the puppies and also considered there was insufficient evidence that he subsequently became aware of their removal.
As a result, the Committee found that he could not have prevented their removal or reported the matter to a colleague. However, the Committee did find that his actions were unintentionally misleading regarding the clinical records and the discharge of the incorrect number of puppies.
The Committee found all the charges against Dr Rafiq proven.
The Committee considered whether the admitted and/or proven charges against Dr Rafiq and Mr Perez amounted to serious professional misconduct.
In respect of Mr Perez, the Committee was critical of his failure to keep accurate clinical records and considered that it was his duty to know how many puppies were born and to record them accurately.
However, while the Committee concluded that Mr Perez’s conduct fell below the expected professional standards of a veterinary surgeon, it did not fall so short as to constitute serious professional misconduct. As a result, no further action was taken against Mr Perez.
In regard to Dr Rafiq, the Committee recognised her admission at the outset that her actions constituted serious professional misconduct and noted her expression of remorse.
The Committee did however have concerns regarding the evidence she gave as to her actions being motivated by animal welfare concerns. The Committee felt that such concerns should have been raised with colleagues and it found that Dr Rafiq had acted recklessly and had been dishonest both with the owner and with her colleagues.
The Committee therefore concluded that her conduct fell so far short of what would be expected of a veterinary surgeon that it constituted serious professional misconduct.
The Committee then considered the sanction against Dr Rafiq, taking into account aggravating and mitigating factors. The aggravating factors included a risk of injury to the puppies, an abuse of the client’s trust, sustained misconduct as the puppy was retained by Dr Rafiq from 2/3 December until its actual death on the night of 5 December, that the dishonesty was sustained until 7 December and that she had only demonstrated limited insight in respect of her wider professional responsibilities.
In mitigation, the Committee considered that her actions involved no financial gain, that it was a single and isolated incident, that she had no previous adverse findings, that she had demonstrated genuine remorse and that she had made admissions at an early stage.
Dr Rafiq, who was unrepresented during the hearing, also submitted evidence in mitigation including testimonials from colleagues and clients, her youth and inexperience at the time, and her remorse, among other things.
In deciding the sanction Ian Arundale, who chaired the Committee and spoke on its behalf, said: "The Committee concluded that Dr Rafiq was a competent veterinary surgeon who was very unlikely to pose a risk to animals in the future.
"However, it considered the reputation of the profession and the need to uphold standards was an important consideration that outweighed the hardship which would be suffered by Dr Rafiq by not being able to practise in her chosen profession. It considered that Dr Rafiq would be fit to return to the profession after a period of suspension.
"It therefore determined that, notwithstanding the nature and extent of the dishonesty in this case, a suspension order was a sufficiently severe sanction to maintain the reputation of the profession and to meet the wider public interest. It took into consideration the overall dishonesty, including that Dr Rafiq had been dishonest when first confronted about these matters, when deciding on the length of any suspension.
"The Committee considered the sanction of suspension was proportionate in the circumstances of this case where there was supporting evidence that Dr Rafiq was a competent and well-regarded veterinary surgeon. It considered the positive testimonial evidence given… and that she was held in high regard by her current employers who were aware of the admitted misconduct, were significant factors in deciding that a suspension order was the proportionate sanction."
The Committee determined that a six-month suspension order would be the most appropriate sanction under the circumstances and directed the Registrar to remove Dr Rafiq from the Register for this period of time.
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."
For the study the RVC used VetCompass, its pioneering technology which analyses the veterinary records of 10 million animals from 1,000 veterinary practices in the UK and is now the world’s largest research database of anonymised clinical records.
The college says this made the study the largest-ever conducted into osteoarthritis in dogs under veterinary care – covering 455,557 dogs.
The study found that:
Rottweilers are the breed most prone to osteoarthritis, with the Old English Sheepdog and Dogue de Bordeaux also being very prone to the condition.
The large population of Labrador Retrievers in the UK makes them the most commonly treated breed for osteoarthritis in the UK.
2.5% of dogs involved in the study had osteoarthritis (which would equate to a total of around 200,000 dogs in the UK).
Dogs that were above average weight for their breed were nearly 2.3 times more likely to be diagnosed with the condition.
Males dogs were 1.2 times more likely to have osteoarthritis than female dogs.
The RVC says that on average, dogs receive their first diagnosis by the age of 10.5 years. Of the dogs who are diagnosed with osteoarthritis, 75% of cases are recommended to remain on medication as a form of pain relief.
It is hoped that this research will improve diagnosis times, which will enable dogs suffering from osteoarthritis to be treated faster.
Dr Dan O’Neill, RVC Senior Lecturer and co-author said: "Breed predisposition to disease is now recognised as one of the biggest problems facing dogs. Studies of huge populations, such as this one, are giving us vital insights into breed-related health problems in dogs that would have been impossible before VetCompass. This study has enabled us to positively support changes in dog welfare."
Anderson KL, O'Neill DG, Brodbelt DC, Church DB, Meeson RL, Sargan D, et al.: Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Scientific Reports 2018,8(1):5641.
Photo: Dog hip arthritis. Richard Meeson.
Atilla was presented with the concerned owners of an eight year old Staffie at the end of August this year, having found blood in the dog’s urine. He said: "Fortunately the owners were extremely vigilant and noticed the blood. They phoned on a Sunday and arrived in the surgery as an emergency two hours later, bringing with them a urine sample. The urine was dark red and remained so when spun. I then carried out an in-house peripheral blood smear and found the Babesia piroplasms. Treatment started immediately with Imizol injections."
"Having just seen the dog two weeks later for its second injection, the lucky Staffie is thankfully doing very well. This dog was fortunate though as we were not seeing it regularly at the practice so it had not been receiving regular tick treatment. This meant it was exposed to the dangers of tick-borne diseases even though it hadn’t travelled outside the UK."
Hannah Newbury, Technical Manager at MSD Animal Health said: "This case is a reminder of the value of vets remaining vigilant to the possibility of Babesiosis being present in dogs that have not travelled outside the UK or had contact with dogs that have.
"It also highlights the need for vets to discuss parasite risk with owners to ensure that dogs are given regular tick-treatments throughout the year to reduce the risks to pets and owners.”
"As we learnt from the cases of canine Babesiosis in Essex last year, there are established populations of the tick Dermacentor reticulatus acting as vectors of the introduced pathogen Babesia which is a major concern for animal health. It also demonstrates the potential dangers from the inadvertent introduction of novel disease pathogens if vigilance and surveillance are not maintained."
The BBC has broadcast an investigation in which the RSPCA is accused of various acts of inappropriate and uncharitable behaviour towards a veterinary surgeon, a barrister, an aged pet owner and the owners of an animal sanctuary.
The accusations were broadcast on BBC Radio 4's Face the Facts, and included:
Responding to the accusations, RSPCA's Chief Executive Gavin Grant sounded by turns arrogant and defiant, dismissing accusations of harassment of vets and barristers as 'a nonsense' and saying that the idea that the police/CPS should take over prosecutions (as happens in Scotland) is 'fanciful'. When the interviewer suggested that the charity was losing its reputation as a 'helpful' organisation and becoming known as 'heavy-handed', Mr Grant seemed unapologetic, deflecting the question by talking about the values of those that founded the charity.
Rosemullion Veterinary Practice is a three-site small animal practice owned by CVS.
It has 100 members of staff and dispenses 3,584 medications in an average month.
According to an article in Companion Animal, medication errors account for 30% of all reported errors in veterinary practice1.
Errors can be prescribing errors - where the vet prescribes the incorrect medication or dosage, or dispensing errors where the incorrect medication, strength or volume is dispensed by the pharmacy team.
Some errors can ‘look or sound alike’ – where medications have similar names or packaging – making them easy to mix up.
Rosemullion conducted an initial clinical audit of entries on its VetSafe system between 1st March and 31st May 2023.
Analysis was conducted on the drugs involved, whether they were prescribing or dispensing errors or near misses, and looking for patterns of behaviour or the drugs involved.
During this time there were 29 (0.27%) near misses and 14 (0.13%) errors.
Prescribing near misses most often involved flea and worm products.
Here additional feedback from vets was that it was difficult to remember weight brackets for all products and when weight brackets were included in the drug description this made them easier to prescribe accurately.
As a consequence, the Rosemullion pharmacy team introduced the inclusion of weight brackets on all flea and worm products.
Dispensing errors and near misses were mostly related to ‘look or sound alike’, particularly in worming tablets, flea treatments and Rheumocam cat and dog.
To address this, the Rosemullion pharmacy team added extra labelling to dispensary draws and separated draws for flea and worm treatments into different weight brackets.
Rheumocam – with its similar packaging design and box sizes – was also split into separate cat and dog drawers, and drawers clearly labelled up with the version and volume to make dispensing clearer.
Feedback was also given to the drug manufacturer.
Rosemullion also held a CPD session to highlight the common errors that were occurring, to explain resulting process and systems improvements, and ask the team to take extra care with these dispensaries.
A new ‘handing out medication’ process was also created – involving checking the medication in the bag matched the on the screen notes, confirming it was for the correct animal and validating it was what the owner was expecting.
A subsequent audit was run from 1st October to 31st November 2023.
The results revealed there were no prescribing or dispensing errors (0%) and only 8 (0.13%) near misses during this time.
Alice Bell, Senior Vet and Quality Improvement Lead at Rosemullion Veterinary Practice, said: “We place patient safety at the forefront of all we do.
"We wanted to conduct this extensive audit to assess our prescribing and dispensing processes and systems.
“The methods we had in place made it easy to do the task correctly and the changes we have now put in place have made the process even safer for our clients.
"Our overall error and near miss is now at a really low number compared to our total number of medication dispenses.
“The teams have been very receptive to the improvements and the project has had a positive impact on various aspects of the practice, including on team wellbeing.”
Rosemullion Veterinary Practice’s initiative has recently been recognised with a RCVS Knowledge Highly Commended status at its 2024 awards.
Ms Hill and Wilfred Wong snatched the child from their foster carer when they arrived home from school on Anglesey.
Hill wrestled the child from the car and put them in a waiting vehicle while Wong held a knife to the foster carer’s throat before slashing one of the carer’s car tyres to stop them following.
Having made their escape, they then transferred the child into the hands of two other conspirators who had hired a car to take the child abroad.
The child was rescued four hours later when the hire car was stopped by police on the M1 in Northamptonshire.
A police investigation later concluded that the child had not been the victim of any abuse.
Ms Hill was sentenced at Caernarfon Crown Court to 19 years, 5 months, with a custodial term of 14 years and five months.
Ms Hill did not attend the RCVS disciplinary hearing as she was serving her prison sentence, and she was not represented.
In relation to the charges, the Committee was presented with the sentencing remarks from Ms Hill’s conviction at Mold Crown Court.
The judge said that Ms Hill had led the conspiracy to kidnap, and that it had caused the victim and the people responsible for their care “unspeakable misery and considerable harm”.
The judge also said that Ms Hill posed a significant risk of causing serious harm in the future.
Dr Hazel Bentall, chairing the Committee and speaking on its behalf, said: “The Committee took into account a number of aggravating features when considering the sanctions.
"In particular, the Committee considered that the conviction arose as a result of careful planning over several months and involved the use of violence.
"The Committee concluded that there were no mitigating factors apart from that Dr Hill had no previous regulatory history and that the only appropriate and proportionate sanction was that Dr Hill’s removal from the Register of veterinary surgeons be maintained.”
Dr Hill has 28 days from being notified of her removal from the Register to lodge an appeal with the Privy Council.
The Committee’s full findings can be viewed at www.rcvs.org.uk/disciplinary
David Grant MRCVS, Director of the RSPCA's Harmsworth Animal Hospital and one of the stars of the BBC's hugely successful Animal Hospital series, is to retire this month.
To mark his outstanding service, David will be presented with the prestigious Queen Victoria Gold Medal - the Society's highest meritorious award for staff and volunteers - at the RSPCA Honours awards event on 8 September. It is reserved for the most exceptional servants to the RSPCA and its cause.
The popular figure, who began his veterinary career in the late sixties working in farm practice, has looked back on his time with the RSPCA as part of the charity's latest podcast.
David said: "25 years seems like 25 weeks. It is quite scary when you look at it that way. Joining the RSPCA was the best professional decision I ever personally made in my career. I look back and I don't regret one single day."
David recounts many of the stories from his career in the podcast, such as the time he came face to face with one of the world's most venomous snakes, which was found in a box on Regent's Canal. He also looks back on the unexpected fame that followed his starring role on Animal Hospital.
He said: "It has just been tremendous fun. It hasn't felt like work.
"It has worked out that in the last 25 years I haven't had a single boring day. I've had some really exciting days. I've had the most amazing things happen, such as Animal Hospital. The only bad thing about the past 25 years is that they have gone in a flash."
The podcast is available to listen to at www.rspca.org.uk/podcast. It is also available to download from iTunes.
Photo courtesy RSPCA
Vets4Pets has announced that it is piloting a 'revolutionary' new 24/7 service at its practices in Rayleigh in Essex, Rustington in Sussex and Bournemouth in Dorset.
The company says that clients of the new 24/7 clinics will be able to have their pets seen and treated at any time by the same team, with the same level of service and at the same price as daytime treatment.
Research carried out by Vets4Pets showed that pet owners struggle to fit visits into their busy working lives, so the 24 hour practices will offer consultations up to 10:00pm and allow clients to drop pets off early in the morning, before traditional practices open.
In addition, the 24/7 clinics will see emergency and routine cases around the clock at no extra cost and will provide care for pets that need to be hospitalised overnight. Vets4Pets says that the practices are equipped with in-house surgical facilities, lab, pharmacy, digital x-ray and ultrasound, and will have a veterinary surgeon and nurse on-site at all times, so its clients will get the highest standard of care.
Clients of other practices within the group will also be able to use these facilities if their own vet feels their pet would benefit from overnight care and is within driving distance of a 24/7 practice.
Kirsty Bridger MRCVS, Joint Venture Partner at Rayleigh Vets4Pets said: “We have been telling our clients about 24/7 for the last few weeks and we have only received positive responses. The perceived increase level of service has been so well received and customers are delighted that we will be offering out of hours services with no extra charge. This is about listening to what our clients need and providing them with more convenience and excellent service however and whenever we can.”
Sally Hopson, CEO of the Vet Group said: “All of us at Vets4Pets are focused on leading innovation in the veterinary sector, and as our clients live increasingly busy lives, these 24/7 pilot practices are our way of helping them manage their hectic schedules, while also ensuring that pets in need of urgent treatment can be seen at any time. We are very excited about the potential of our 24/7 practices and our ability to offer customers extended quality, service and convenience of veterinary care.”
VetSurgeon.org asked Vets4Pets some questions about the new 24/7 practices:
VetSurgeon: Is V4P going to offer an OOH referral service to other practices?V4P: As this is a pilot, initially Rayleigh will only be offering this service to other practices within the VetGroup. However, once we understand more about how the model works, we may open the service to other practices, particularly in areas where there are few or no other options for them to outsource OOH cover.
VetSurgeon: How is V4P able to offer OOH consultations at the same price as daytime consults?V4P: At Vets4Pets we care about offering our clients the best service we can. We believe that it's important that clients can access veterinary care at all times of the day or night without prohibitive surcharges. The 24/7 business model is built around this concept. This is clearly a significant change from the traditional way of thinking about out of hours care within the industry and we think clients and their pets will benefit.
VetSurgeon: How will it affect the quality of life of the vets & nurses working at the practices?V4P: We have thought carefully about the rotas that the vets and nurses will be working. We've looked at best practice within the veterinary industry and in other industries which work around the clock and we have developed guidelines based on these benchmarks which will then be flexed depending on the requirements of each individual team.
VetSurgeon: Does V4P think others will follow?V4P: We hope this is something that will expand across our own group once we've completed the initial pilot phase. We believe it's the right thing to do for our clients and for their pets. This is a new way of thinking about out of hours care and we're lucky to be able to work with forward thinking Joint Venture Partners who are putting their clients at the centre of their thinking. If others follow the model, that can only be a good thing for pet owners and for pets.
VetSurgeon: Does this threaten Vets Now?V4P: We work with Vets Now in many of our practices and we hope to continue to have a positive working relationship in the future. VetsNow have a different and well established business model. Our objective is simply to offer our clients and their pets the best levels of care that we can by being able to provide them with the same level of service at the same price at any time of day or night.
Bravecto Plus contains fluralaner (280 mg/ml), an ectoparasiticide which provides systemic activity against ticks (lxodes ricinus) and fleas (Ctenocephalides felis), and moxidectin (14 mg/ml), an endoparasiticide which provides systemic activity against a range of internal worms, including heartworm (Dirofilaria immitis), intestinal roundworm and hookworm.
Bravecto Plus is applied topically using the "Twist'n'Use" pipette. Once applied, the product kills ticks and fleas for 12 weeks, while also treating intestinal roundworm and hookworm and preventing heartworm disease for eight weeks.
Bravecto Plus can also be used as part of a treatment strategy for flea allergy dermatitis.
Bravecto was first launched in 2014 as a chewable tablet for dogs. In 2016 Bravecto spot-on was launched as a topical solution for dogs and cats. More than 80 million doses of Bravecto have been sold in 72 countries since 2014.
Amanda Melvin, marketing manager, at MSD Animal Health, said: "We are pleased to introduce the latest innovation in feline parasite protection to the Bravecto family."
For more information, refer to the summary of product characteristics or contact your MSD account manager.
A German Shepherd bitch is making an impressive recovery from serious burns, after treatment with manuka honey impregnated dressings.
'Lady' sustained her injuries after being trapped in a blazing house in Cornwall, as reported by the BBC. She has since been under the care of Amanda Manley at the Cornwall Animal Hospital, who has been using Activon Tulle Manuka honey impregnated dressings to treat the wounds.
Amanda said: "I'd like to say it was all down to the manuka honey, although it's difficult to make a scientific judgement without a control in place. Nevertheless I am very impressed with the results and will definitely use honey again in a similar situation"
Rachel Fuller, Product Manager for Activon (medical grade manuka honey dressings) at Dechra Veterinary Products said: "In human medicine, manuka honey has become popular as a result of its antibacterial and healing properties. All honey has a degree of effectiveness, but the unique properties of manuka honey make it by far the most effective for use on wounds. It is now gaining recognition among veterinary professionals, which has led to the introduction of honey-based wound management systems for animal care".
According to Dechra, Manuka honey has been shown to be effective against over 70 strains of bacteria commonly found in wounds, including MRSA1. It also has an osmotic effect which draws fluid from a wound bed and helps to remove slough and debride necrotic tissue that can harbour bacteria and impede wound healing2. It protects the wound bed and provides a moist wound healing environment3 and the water soluble antioxidants provide favourable conditions that help to promote granulation and epithelialisation, thus faster healing. There is a rapid reduction in odour when honey is applied to a malodorous wound and it also acts as an anti-inflammatory, which therefore reduces pain.
The Cornwall Animal Hospital is a registered charity which exists to provide affordable pet care to those on a low income. It has provided all Lady's treatment at cost, including the Activon dressings, which have since been replaced by Dechra as a gesture of support.
Photographs of the case at initial examination, post debridement / pre-treatment and post treatment are in the galleries.
References
VetSurgeon.org visited a random selection of stands in the commercial exhibition at BSAVA Congress, and asked: "What's new and exciting?"
Here's what they said: