The effect of changing diet on gastric ulceration in exercising horses and ponies following cessation of omeprazole treatment was conducted by Nanna Luthersson (Hestedoktoren, a private practice in Denmark) and Coby Bolger (Horse1 Spain), with colleagues from the University of Madrid and Glasgow, in collaboration with Spillers and the Waltham Equine Studies Group.
The study evaluated the effect of dietary change in combination with omeprazole treatment and after the cessation of treatment.
The 32 horses in this part of the trial had been diagnosed with significant equine squamous gastric disease (ESGD) and were in hard work.
On a random basis one of each pair was assigned to a specified low starch, fibre-based diet consisting of their own forage alongside a restricted starch, high fibre, high energy cube (Spillers HDF Power Cubes, which are commonly used in racing yards) and a high oil, low starch, chopped alfalfa based feed (Winergy Equilibrium Growth) and the other stayed on their original diet. All animals were scoped before, after the recommended course of omeprazole treatment and then six weeks after the omeprazole finished.
The horses in the no diet change group improved significantly with the omeprazole but when the treatment was stopped many regressed. Overall, by the end of the trial they were not significantly different to when they had started.
However, the horses in the dietary change group overall showed significantly improved ESGD scores, not only following the omeprazole treatment but also after the treatment had stopped. This showed that a change in diet was able to help maintain the beneficial effect of omeprazole even after the omeprazole was removed.
The study achieved an award in 2016 for research in horse welfare from the Fundación para la Promoción del Deporte Ecuestre, Spain.
Clare Barfoot RNutr, the research and development manager at Spillers, said: "This exciting work confirms what we suspected; that whilst appropriate dietary change can provide additional support to medical treatment for EGUS most importantly it can help maintain better gastric health post medical treatment."
Last year the British Equestrian Trade Association, in consultation with the Veterinary Medicines Directorate, introduced a new feed approval mark to help owners identify feeds suitable for horses and ponies prone to equine gastric ulcer syndrome (EGUS).
Currently six feeds in the UK carry the BETA Equine Gastric Ulceration Syndrome (EGUS) Certification Mark including Winergy Equilibrium Growth and Spillers Alfalfa Pro Fibre.
The College says that until now, veterinary research has largely ignored lipomas because they are rarely referred for specialist treatment.
For the study, the RVC identified 2765 lipoma cases from a population of 384,284 dogs in its VetCompass Programme (which collects anonymised clinical data on dogs under primary veterinary care in the UK) in 2013.
The study found that 1 in 50 dogs are affected by lipomas each year and that Springer Spaniels, Dobermann Pinschers, Weimaraners and Labrador Retrievers are the most susceptible to lipomas (5-8% prevalence).
The study also found:
At least one lipoma was diagnosed in 1.94% of dogs during the single year of the study.
Individual dogs with an adult bodyweight that was equal or higher than their breed/sex average had 1.96 times the odds of lipoma.
As dogs age, their odds of getting lipoma increase. Dogs aged between 9-12 years were over 17 times more likely to be diagnosed with lipoma compared to dogs aged 3-6 years old.
Neutered dogs had higher risk.
Insured dogs had 1.78 times the odds of diagnosis.
Purebred dogs had 1.16 times the odds compared with crossbred dogs.
Dr Lynda Rutherford, Clinician and Lecturer in Small Animal Surgery at the RVC, said: "This paper has supported the theory that lipomas are more common in older, overweight dogs.
"This information is useful as it can be discussed with owners and used as another reason to keep pet dog’s weight under control. It also provides a useful insight into how common lipomas are within the UK dog population."
Reference
O'NEILL, D. G., CORAH, C. H., CHURCH, D. B., BRODBELT, D. C. & RUTHERFORD, L. 2018. Lipoma in dogs under primary veterinary care in the UK: prevalence and breed associations. Canine Genetics and Epidemiology, 5, 9. https://cgejournal.biomedcentral.com/articles/10.1186/s40575-018-0065-9
The company says that so far, it has had no cases of flu reported in horses vaccinated with Equip F or Equip FT in the UK. However, it cautions that in the present flu outbreak it is not clear if any of the current influenza vaccines will provide complete clinical protection against the mutated strain.
In addition, Zoetis highlights that:
Equip F and Equip FT are both indicated for reduction in clinical signs caused by Equine Influenza, including Florida Clade 1 strains.
Cross protection has been demonstrated by virulent challenge for representative strains of Florida Clade 1 (Paillot et al 20081, Bryant et al 20102) and Clade 2 (Paillot et al 20153).
Vaccination with Equip F stimulated a flu specific cell-mediated immune response to a Clade 1 strain which was detectable for up to one year after the third vaccination in primary course (Paillot et al 20153).
Zoetis says it is confident that the Equip range continues to be effective against its licensed indications.
If you have further questions about the vaccines, ring 0845 300 8034 and choose option 1 to speak to Zoetis' technical team.
References
The response offers further evidence concerning the CMA’s potential concerns, and says that voluntary measures relating to transparency of fees and ownership could be introduced before the conclusion of a market investigation.
The BVA has formed a working group to develop guidance on transparency, client choice and the value of veterinary care to support companion animal practices.
British Veterinary Association President Anna Judson, said: “We’re keen to see healthy competition and consumer choice and we recognise that some of the areas identified by the CMA would benefit from further scrutiny.
"We are already taking steps to support vet practices by developing guidance for the profession in relation to transparency of fees, transparency of ownership, prescribing and dispensing of veterinary medicines, and contextualised care.
“However, we are extremely disappointed to see the suggestion in the CMA’s report, as well as in subsequent media reporting, that veterinary professionals might prey on owners’ desire to do the best for their pets by using these circumstances as a “strategy” to promote more sophisticated or expensive treatment.
"Vets enter this high-pressure profession out of genuine care for animals and will always prioritise their health and welfare."
“We also have significant concerns about the suggestion that practices might be mandated to provide information to clients about quality or outcome-related measures.
"We do not see primary concerns about the quality of veterinary treatment and we believe such a requirement would not meaningfully support consumer choice.
"Instead, it would be extremely challenging to deliver and could significantly exacerbate many of the complex issues faced by our members, who are already under significant pressure.
There will be a panel discussion about the CMA investigation at BVA Live this year.
https://bvalive.vetshow.com
COMMENT
There are lots of good points made in this latest response to the CMA, if no more than a nod to the real issue here: which is the often eye-watering cost of modern veterinary care.
But it is hugely disappointing to see the BVA (and others) berating the CMA and the media for suggesting that vets might prey on owners' desire to do the best for their pet, rather than asking WHY people think that, and how can the profession regain trust.
That, surely, is the starting point here: for the profession to stop feeling sorry for itself, and instead think how it can change to meet the needs of its customers and dispel their perception of being taken for a ride.
The CMA investigation is a bit of a red herring: the price of veterinary care is not going to be significantly changed by displaying the prices for a few standard procedures on practice websites, with greater transparency over practice ownership or with slightly cheaper prescriptions, all of which is just tinkering.
The biggest influence on the size of the client's bill is not marketplace competition, it's the vet's recommendation.
Paul Manktelow, Chief Vet at the Blue Cross has already hit the nail square on the head when he called on the profession to practise pragmatic medicine.
The BVA now alludes to this with talk in its response of 'contextualised care' - a concept which allows practitioners to offer pragmatic medicine (aka what people can afford, rather than 'gold standard'), without the judgement that it is inherently associated with.
The benefits of 'contextualised care' are well explained by Ruth Serlin at VDS Training here.
That's great, but will it be enough?
Perhaps not, because whilst someone might be happy to walk out of the car showroom with a Dacia Sandero knowing they cannot afford a Bentley, they may be less happy to accept the Dacia level of care for their beloved pet, when they watched 'Supervet' only the night before.
If that's true, then pragmatic medicine will have to be combined with all sorts of other measures, such as reviewing and reducing the cost of regulation, questioning the value of diagnostics and changing to a less 'referall' (sic) culture.
The new spot on, which is complementary to the Bravecto dog chew, is the only one to provide 12 week protection for both fleas and ticks, including Rhipicephalus sanguineus.
The company highlights research it carried out which showed that the convenience of Bravecto's 12 week flea and tick killing treatment improves compliance over monthly alternatives1.
The new product means practices now have more choice if they prefer to offer a spot-on or clients find compliance easier to achieve with a spot-on rather than a chew.
Amanda Melvin, Marketing Manager at MSD Animal Health said: "Our research has shown that convenience is the key to improving compliance and successfully eradicating fleas and ticks. By offering a new formulation of a 12 week treatment, Bravecto Spot-on for dogs further increases the opportunity.
"It improves the choice for vets and pet owners depending on the client’s lifestyle and type of dog.
"This new innovation also offers vets the opportunity to raise the topic of fleas and ticks with clients that have been more reluctant to use existing products.”
The applicator for Bravecto Spot-on for dogs has been designed so there is no need to remove a loose cap and no sharp edges that can scratch the pet's skin.
The launch is also supported by a range of materials for veterinary surgeons, nurses and pet owners, including information guides, a quick-fact flip book, waiting room materials, Bravecto 3+1 card and post-prescription client leaflets.
For more information, contact your MSD Account Manager.
'The Vet' branded surgeries were registered to Quality Pet Care Ltd which was initially acquired by CVS Group plc in August 2021.
The acquisition makes The Pet Vet not only the largest independent family-owned practice by number of sites (12) in the UK, but also the only one with a national presence.
The newly acquired surgeries are in Warrington, Portsmouth, Southampton, Bristol, Nottingham, Liverpool and Morden and Waltham Forest in London.
The Pet Vet already operates three surgeries in South Yorkshire (Barnsley, Rotherham and Doncaster) and in 2021 opened a 5,500 sq ft surgery on a retail park in Lincoln.
The Pet Vet is under the sole ownership of Rob Jones MRCVS (pictured right with Managing Director, Mel Fuller), who graduated from Bristol in 1987.
Rob practised in companion animal care in London and Australia before opening the first The Pet Vet surgery in Doncaster in 2011.
The practice now has nearly 100 employees, including 24 full time vets, and an annual turnover of over £6m.
Earlier this year, The Pet Vet secured £3.1m from alternative lender ThinCats to fund its growth plan.
A extra cash injection then allowed the family-owned independent to snap up The Vet when it came up for sale in April 2022.
Rob said: "With nearly 70% of the veterinary practice market by revenue already in the ownership of major corporations, a fact of which most consumers are still completely unaware, this is a real opportunity for us as a family business to make a positive difference for pet owners.
"Our acquisition of The Vet will allow us to further advance in-house provision, giving our vets more variety and stimulation in their working day and even greater opportunities for professional development."
RSA Insurance Group, which underwrites pet insurance on behalf of MORE TH>N, Tesco Bank, M&S, John Lewis, Argos and Homebase, has clarified recently announced changes to its policy conditions concerning cases which need to be referred for specialist treatment.
In a letter dated 22nd May, which was sent to practices in the Midlands and the NW, the company said:
"With effect from the 25th May 2015, if you need to refer a pet under any of the above Brands to a specialist or referral vet, and the visit is not in response to an emergency, then our customer / your Client can contact us on the relevant number below before any appointment is made. We will then agree which of our preferred specialist or referral practices our customer should go to, dependant (sic) on the individual circumstance relating to the claim. If our customer does not get in touch with us or we have not agreed to the visit, then this could result in our customer suffering a financial impact. This amount will be in addition to the policy excess."
Speaking to VetSurgeon.org, Keith Maxwell, Head of Pet Claims at RSA said: "What we're saying to the primary practices is that we want to speak to our customers before they go to a referral vet. We want to engage with our customers to let them know that we have referral vets who we are starting to work with across those specific regions. We are not saying to customers that you have to use those referral vets and if you don't, we won't provide cover."
This appeared to contradict a statement that a member of VetSurgeon.org had received from John Lewis earlier which said: “If you decided to go to a specialist that wasn’t approved by us, we wouldn’t cover the costs." Keith said: "That is not correct."
Clarifying the financial impact referred to in the company's letter to veterinary practices, Keith said: "In terms of any sort of financial impact on the customer, if we think about the level of benefit that a customer will have under their insurance policy, they will have a maximum cash benefit. If a customer goes to one specific referral vet and the cost of treatment is extremely high, and they have a choice of going to a referral vet that we have been interacting with to get a like for like treatment, the cost will be lower, the financial impact on the customer will be that the overall benefit available to them will be eroded at a faster rate."
He added: "The other thing I would say is that certain customers under our policies will have a policy excess which will be on a percentage basis. Now if you think about a higher cost treatment which will incur a percentage excess, it will be a higher amount the customer will have to pay, as opposed to going to a referral vet where they can get the exact same high quality treatment, but the overall cost will be lower; they will pay a lower excess. So we are not saying we are going to penalise a customer. There are other financial consequences i.e. eroding benefit or having to pay a greater amount of excess."
Whilst RSA appears not to be removing the freedom of choice over referrals, there remains the potential for a conflict of interest when a primary practitioner recommends treatment at a centre they believe to be the most suitable for the case, and the client then rings the insurer only to be advised to use an alternative, primarily for reasons of cost. Keith said: "What I would say is that we are at the start of a journey. We've selected a small part of the country. We are very much in a 'test and learn' phase. As we have selected referral vets, we have gone through obviously quite a lengthy process of engaging with referral vets, looking at specialism, looking at their accreditation, looking at their capability, their skill, equipment within their practices, what their areas of specialism are, so we are building up this view. It does come down to we want to learn from this. We want to engage with our customers. We want to offer our customers choice. We want to make sure that our customers will not be receiving an inferior service or inferior treatment or level of specialism in any specific way."
VetSurgeon.org asked how RSA has selected its preferred referral practices, and how others can join its network. Keith said: "When we started this journey, we made contact with a significant number of referral vets across the country. Some referral vets just said point blank 'No, we don't want to talk to you'. Others said 'Yes, we'd like to come and have some discussions'. So we took those forward and then we took the referral vets through a benchmarking process based on a full list of criteria, and within RSA we have veterinary expertise helping us along that journey, so we're not just doing this on our own. We are very much an open door to interacting and liaising with referral vets."
Keith concluded by saying: "We are focused on our customers here. We are focused on making sure that pet insurance is sustainable in the long term, both for our customers and for vets across the country."
Virbac says phenobarbital is the only medication licensed to treat both idiopathic and structural epilepsy, and that it provides clinical improvement in 85% of cases.1
Epirepress is offered in the conventional 60mg tablet strength, which can be split into two or four so dosing can be tailored to the needs of individual patients.
EpiRepress is the first epilepsy treatment to be offered in easy-to-dispense boxes of 30 tablets, removing the need for the practice team to count out tablets from larger pots – a process which can now be done without the need to handle individual tablets. Virbac says the smaller box size also makes the purchase price more manageable for clients.
Virbac has produced a range of client and marketing materials to support the use of EpiRepress, including an epilepsy diary, a folder to keep the diary and extra materials in one safe place, and a diagnostic and treatment poster for practices.
Virbac Product Manager Sarah Dixon MRCVS said: "The prevalence of canine epilepsy means that most practices are seeing at least one case a week.2 Phenobarbital is the mainstay treatment for canine epilepsy and, in developing our product, we wanted to offer practices and owners an easier, more accurate and more cost-effective solution.1 EpiRepress, with its divisible 60mg tablets and smaller box size, is the result and we are delighted to be able to launch it.
"We are focused on supporting practices and owners with compliance so have also developed a novel practice support package for EpiRepress. It offers the latest guidance to both vet practices and pet owners on the diagnosis, treatment and management of this challenging disease."
By way of example, Emma highlights syringomyelia (SM) and mitral valve disease (MVD) in Cavalier King Charles Spaniels, two diseases which cause considerable suffering and which could be significantly reduced with selective breeding.
Following the uproar caused by the Pedigree Dogs Exposed programme in 2008, a voluntary BVA/Kennel Club SM screening programme was introduced in 2012. However, Emma says that in the time since then, during which 20,429 CKCS puppies have been registered with the Kennel Club, only 331 have been scanned.
She points out that there is still no official heart scheme in the UK, despite the Kennel Club promising at a meeting at the House of Lords in 2008 that they would introduce one.
Meanwhile, Sweden, Belgium, the Netherlands and Denmark have introduced mandatory heart testing schemes for CKCS, and the latest figures from Denmark apparently show there has been a 73% reduction in heart disease.
Back in the UK, this year's Crufts Best of Breed Cavalier sired his first litter untested when he was only 9 months old, against the recommendations of the MVD Breeding Protocol.
Emma said: "It's all very well single vets like me saying 'I'm bloody sick of this', but I don't know how we can change it unless the Kennel Club does something."
Responding in Veterinary Times, the Kennel Club’s secretary Caroline Kisko blamed the veterinary profession for the lack of progress with a heart testing scheme, saying: "The KC has been committed to developing a new heart scheme in the UK for many years but, unfortunately, the veterinary profession has been unable to agree testing protocols."
Emma said: "It is typical of the KC to blame the veterinary profession. It beggars belief to say a heart scheme is too complicated when many other countries have them already in place. At the very least the KC could insist on the well-accepted MVD breeding protocol being followed for Cavaliers. It would be a start. If we never do anything because it’s not perfect, how will we ever evolve change? Looks like us vets will just have to continue to pick up the pieces while dogs carry on dying.”
Long-time Cavalier health campaigner Margaret Carter has a petition on change.org calling for compulsory SM and MVD screening. It has amassed over 27,000 signatures. She said: "It [the Kennel Club] has been talking about a heart scheme for years. It has the know-how and power to not only create a scheme but insist breeders use it. While the Kennel Club prefers to placate its most important customers – breeders - more and more Cavalier puppies are being born to suffer from inherited disease.
"Its Assured Breeders’ Scheme (ABS) is almost meaningless for Cavaliers because the only health test required is for eyes: a token nod to health when the breed is plagued by conditions as horrific as SM and MVD.
"And with so few recorded Cavalier health tests because of the absence of a heart scheme and the breeder boycott of the official SM scheme, the KC’s Mate Select tool is rendered pretty useless too.
Margaret added: "We are very grateful to Emma Milne for voicing so powerfully the situation regarding Cavalier health, however unpalatable the truth might be to some. I’d ask all vets to follow Emma’s lead in writing to the KC and their professional bodies demanding action."
Photograph: Bailey Cooper
The ten-programme series stars Cat Henstridge MRCVS, a Midlands-based locum, Cheryl Lucas MRCVS, a Vets4Pets JVP from Essex, Bristol-based James Greenwood MRCVS and Rory Cowlam MRCVS from London.
The documentary follows a wide selection of patients and conditions, from routine stuff like lump removal from a dog and dental work on a cat, through to more obscure things like an obstructed python and surgery on a goldfish.
Cat said: "I am hoping the profession will like it. It definitely features the realistic side of the job!"
To watch the show on iPlayer, visit: http://www.bbc.co.uk/cbbc/shows/the-pets-factor
Centaur will continue to operate its warehouse in Castle Cary, Somerset; the new facility will allow the company to bolster its services to customers throughout Northern England, North Wales and Scotland.
AmerisourceBergen says the new Midlands facility will hold more than 13,000 products and be licensed for the wholesale distribution of veterinary and human medicines. The facility will use a state-of-the-art warehouse management software to provide efficient and accurate order fulfillment and improve the visibility of products in the supply chain.
Brian Topper, Managing Director of AmerisourceBergen Animal Health U.K. said: "Our expanded presence and capabilities in the U.K. is a reflection of the demand for high-quality solutions, and we’re growing to best meet our customers’ needs.
"Practices of all sizes rely on us to provide them with timely access to the products they need on a daily basis. With broader scope and capacity, we’ll be able to go beyond our best-in-class services and provide an unmatched customer experience by delivering critical products to practices in a more efficient and consistent manner than ever before."
The company says that the new warehouse will create more capacity at its Somerset warehouse and put the company in a positive inventory position to buffer against any business continuity challenges that may occur – ensuring that practices and their patients continue to have access to vital products.
Lisa Derbyshire, Director of Operations & Supply Chain at Centaur Services said: "As the industry moves forward, we want to ensure our customers have access to high-quality infrastructure that maximizes product safety and improves operational efficiency. Adding critical resources and upgraded service offerings, like our new distribution center in the Midlands, enables us to be at the forefront of distribution while continuing to provide the excellent service that our customers have come to know and expect from Centaur."
Mr Garcia had pleaded guilty of harassment at Nottingham Magistrates Court last September and was sentenced to six weeks’ imprisonment, suspended for 12 months. The magistrates also imposed a restraining order and ordered Mr Garcia to pay compensation and costs as well as a surcharge to fund victim services.
The harassment conviction related to incidents between 30 September 2016 and 27 December 2016 in which Mr Garcia engaged in conduct that amounted to harassment towards a woman including sending offensive text messages, visiting her place of work, attempting to contact her through social media, going to her home address and driving past her home address.
At the outset of the disciplinary hearing Mr Garcia admitted the College's charge against him and that his conviction rendered him unfit to practise veterinary surgery.
Following cross-examination of Mr Garcia on the facts of the case and having considered representation from his counsel, the Disciplinary Committee found that Mr Garcia’s conduct leading to conviction and the conviction itself rendered him unfit to practise as a veterinary surgeon.
Mehmuda Mian, chairing the Committee and speaking on its behalf, said: "It was a serious conviction as demonstrated by the sentence imposed and by the nature of the harassment. It brought distress on [the victim] and will have damaged the reputation of the veterinary profession. The respondent was right to accept that this was the case."
Turning to the sanction for Mr Garcia the Committee considered a number of aggravating factors in his case including the distress caused to the victim as some of the text messages could be interpreted as threats to harm; the fact that Mr Garcia had continued to contact the victim after receiving a warning from the police; the fact he visited her place of work; that there was a sexual element to some of the messages he sent to the victim; and that the pattern of behaviour was sustained over three months and only ended with his arrest. It also considered that his behaviour was contrary to the Code of Professional Conduct and its supporting guidance’s advice on professional and appropriate use of social media.
The Committee also considered mitigating factors such as the fact that, during the period of his conduct, there was a family illness and bereavement; that he admitted the charges before the magistrates and the Committee; that ‘social ineptitude’ was a factor and that he did not recognise the rejection he received from the victim; testimonials as to his capabilities as a veterinary surgeon; and insight into his behaviour as well as taking steps to avoid its repetition.
Ms Mian concluded: "The Committee has determined to suspend the respondent’s registration for a period of five months. This sanction reflects the seriousness of the conviction and the concerns expressed by the Committee in this determination. It will send a message to the respondent and to the profession that conduct such as this is unacceptable. It will afford an opportunity to the respondent to reflect further on his behaviour."
Mr Garcia will have 28 days from the end of the hearing to appeal against the Committee’s decision.
The Committee’s full findings and decision are available at: www.rcvs.org.uk/disciplinary
Led by the RVC’s VetCompass Programme, researchers say the study1 was the largest exploration of cherry eye in dogs in the world.
The research team followed the anonymised veterinary health records of 905,553 dogs for a year and identified that 0.20% (1,802 dogs) were affected by this condition.
Certain breeds showed showed significantly high proportions of dogs with cherry eye, including: Neapolitan Mastiffs (4.9%), English Bulldogs (4.8%), Lhasa Apsos (1.6%) and American Cocker Spaniels (1.5%).
Importantly, say the researchers, some popular designer breeds of flat-faced dogs were also hugely affected, such as the Puggle (Pug x Beagle) (2.1%) and Jug (Jack Russell Terrier x Pug) (1.2%), suggesting the recent craze for designer crossbreeds does not eliminate health issues associated with the parental pure breeds.
Overall, brachycephalic breeds had 6.9 times the risk of cherry eye compared with dogs with medium skull length, with the Neapolitan Mastiff at the top of the league table with a risk factor of x34.
Other findings from the study included:
Dr Dan O’Neill, Associate Professor in Companion Animal Epidemiology at the RVC and lead author of the paper, said: “Given that humans designed dog breeds in the first place, we all carry a heavy responsibility to constantly improve our designs to breed away from poor health for these dogs.
"The hugely increased risks of cherry eye in popular flat-faced breeds such as English Bulldogs suggests that we have some way to go before we can consider many flat-faced breeds as designed for optimal health.
"The findings from this study will hopefully help prospective owners make better informed choices when purchasing a dog. We urge all would-be dog owners to follow advice from the UK Brachycephalic Working Group to ‘stop and think before buying a flat-faced dog’.”
The RCVS DC has directed that a Wirral-based veterinary surgeon should be removed from the Register after finding that he had treated clients badly, kept inadequate clinical records, was dishonest in dealing with the RCVS, and that animals in his care were placed at risk.
At the end of the five-day hearing, the Committee found that Ian Beveridge, of the Daryl Veterinary Centre, Heswall, was guilty of charges relating to two separate cases: one concerning a crossbred bitch named Holly, who belonged to Mr and Mrs Flanagan and was treated in February 2011; and the other, a cat called Blu, belonging to Ms Simpson and treated in March 2010.
On the morning of 23 February 2011, Holly was admitted to the Daryl Veterinary Centre in a collapsed state with a swollen abdomen. The Committee found a proper assessment should have led Mr Beveridge to perform an abdominocentesis at the practice, the results of which, in view of the practice and its facilities, would inevitably have led to Holly immediately being referred elsewhere. However, the Committee heard that Mr Beveridge simply placed her on a heat pad for observation until about midday, something it considered no reasonably competent veterinary surgeon in general practice would have done. The Committee also found that, on more than one occasion, Mr Beveridge had refused to discuss referral with Mrs Flanagan, and this amounted to failing to treat her with courtesy and respect as required by the RCVS Guide to Professional Conduct 2010, which applied at that time. Holly was ultimately referred elsewhere and survived. The Committee also found the records of Holly's admission to be completely inadequate.
Blu was presented on 22 March 2010 in a collapsed state by Mr Taylor, Ms Simpson's former partner with whom the cat lived. The Committee found that Mr Taylor was told that the cat would be kept on a heat pad, that no other treatment or diagnosis was discussed, and that the possibility of euthanasia was not raised. Having been unable to contact Mr Beveridge that evening, Ms Simpson went to the practice the following morning, intending that her cat be discharged and taken elsewhere. However, the Committee found, when Mr Beveridge eventually fetched Blu, who had died, he blocked Mrs Simpson's exit from the consulting room, saying words to the effect that had she been a better owner, none of this would have happened.
Mr Beveridge also sent to the College clinical records for Blu detailing a blood sample taken at 19.00 on 22 March, and subcutaneous fluids administered during that night. The Committee found this to contain deliberately false information in order to cast a better light on his management of Blu and that he was dishonest; the document was essentially a fabrication to enhance his own interests.
In reaching its decision, the Committee said that it made allowances for the fact that Mr Beveridge operated in first-opinion practice at a basic level. Notwithstanding this, however, it found him guilty of a very serious failure of care to both patients, which gave rise to serious risks to their safety and welfare.
Professor Peter Lees, chairing and speaking on behalf of the Committee said: "On each occasion [Mr Beveridge] treated the owners with a lack of courtesy and respect and made the difficult and distressing circumstances in which they found themselves much worse than they need have been. The Committee takes a very serious view of his attempt to prevent Ms Simpson leaving the consulting room with Blu, and of the unjust and upsetting way in which he sought to blame her for the animal's death. He showed her no consideration at all. Likewise his refusal to contemplate referral for Holly until compelled by Mrs Flanagan to do so and his persistent refusal to engage with her about this at all was, in the Committee's view, reprehensible."
The Committee directed Mr Beveridge's name should be removed from the Register.
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.
In what researchers say was the largest study of its type to date, dogs with Cushing’s syndrome were identified from the electronic patient records of practices participating in the UK VetCompass programme during 2016.
Both pre-existing and incident cases of Cushing’s syndrome during 2016 were included to estimate the one-year period prevalence.
Available demographic data for study dogs included date of birth, sex, neuter status, breed and mean lifetime bodyweight above 18 months.
Multivariable binary logistic regression modelling was used to assess the associations between risk factors and Cushing’s syndrome.
Dr Imogen Schofield, corresponding author for the paper, said: “A total of 1527 Cushing’s syndrome cases were identified in this study, from a population of 905,544 dogs in 2016.
"The estimated one-year period prevalence for Cushing’s syndrome in dogs was 0.17% (95% confidence interval 0.05 to 0.07).
“The findings of this study provide evidence from primary-care clinical records on the epidemiology of Cushing’s syndrome which can help primary-care veterinarians during diagnosis.
"Seven breeds were associated with increased odds of Cushing’s syndrome; the Bichon frise (OR=6.17, 95% CI 4.22 to 9.00), Border terrier (5.40, 95% CI 3.66 to 7.97), miniature schnauzer (3.05, 95% CI 1.67 to 5.57), Lhasa apso (2.52, 95% CI 1.49 to 4.28), Yorkshire terrier (1.82, 95% CI 1.23 to 2.70), Staffordshire bull terrier (1.52, 95% CI 1.08 to 2.13) and Jack Russell terrier (1.50, 95% CI 1.07 to 2.08).
"Four breeds were at decreased odds of Cushing’s syndrome: the Golden retriever (0.24, 95% CI 0.06 to 0.98), Labrador retriever (0.3, 95% CI 0.17 to 0.54), Border collie (0.32, 95% CI 0.13 to 0.78) and cocker spaniel (0.44, 95% CI 0.21 to 0.90), which could help vets in practice lower their index of suspicion for Cushing’s syndrome for these breeds.
"Dogs with a bodyweight higher than their breed-sex mean had 1.44 times the odds of Cushing’s syndrome than those within their breed mean (95% CI 1.17 to 1.78), suggesting either overweight dogs or larger examples of the breed are at increased risk of this condition, or that dogs with Cushing’s syndrome gain weight.”
Nicola Di Girolamo, Editor of JSAP, said: “When we look at risk factor analysis in previous studies, the generalisability of their findings to the general population of dogs in the UK have typically been limited due to studying dogs from referral populations or due to a lack of multivariable analysis.
"The findings of this study help to address that knowledge gap, supporting some of the risk factors previously reported, and by identifying novel associations, such as that in the Border terrier.
"Awareness of breeds with high or low risk could help to enhance the index of suspicion for veterinary surgeons working in primary-care practice where Cushing’s syndrome is predominantly diagnosed and managed.”
Photo: BSAVA
IDEXX Laboratories has unveiled the Angio Detect Test, a world-first diagnostic test which allows veterinary surgeons to detect the lungworm Angiostrongylus vasorum in clinic, with almost immediate results.
Until now, vets have had to rely on the Baermann method to detect A. vasorum, which can present with varied and confusing clinical symptoms. However, the Baermann test has had limited use because it requires faecal samples from the same dog to be collected on three successive days, and the results can be compromised by the intermittent shedding of larvae. IDEXX says this leads many experts to believe that A. vasorum is widely under-diagnosed.
The Angio Detect Test works by detecting an A. vasorum specific antigen in the animal's blood. The test can be used in-clinic using a serum or plasma sample and returns results within 15 minutes. Depending on results, you can offer a licensed treatment or talk about a preventative treatment regime and refer the client to a source of further information, such as lungworm.co.uk.
IDEXX suggests that because the test is inexpensive, it can be used for the diagnosis of A. vasorum suspect dogs and in those with non-specific signs. Indeed, in market research1, 94% of veterinary surgeons said they would use the test in dogs presenting with A. vasorum signs.
In endemic areas, it can be considered as an additional pre-surgical measure to avoid complications associated with coagulopathy.
This test comes at a time when concern about A. vasorum has been growing. A survey of 150 veterinary practices across the UK in January 2013 recorded a total of 952 suspected cases (157 laboratory confirmed), with 81 deaths thought to have been caused by the parasite2. The Angio Detect Test should help to improve the picture, as confirmed cases are logged onto incidence maps so vets can check prevalence in their area.
Ian Wright from the European Scientific Counsel Companion Animal Parasites (ESCCAP) said: "In recent years, there has been spread of the A. vasorum parasite across the UK with cases now being reported as far north as Scotland. It was initially thought this may be due to increased reporting rather than genuine spread, but this pattern in the UK has been mirrored in many other countries and would appear to represent a true emergence of disease. Although the cause of this spread is not known for certain, increasing slug and snail numbers combined with increased pet movement and urbanisation of foxes are all likely to have played a significant part. These factors make A. vasorum a year round rather than seasonal threat.
"Any new diagnostic test that can quickly confirm a case of lungworm is a fantastic development and will help save dogs' lives and give us even greater insight into the extent of the spread of the parasite."
Graham Bilbrough, veterinary surgeon and European medical affairs manager for IDEXX Laboratories, said: "Up until now, testing methods have been time consuming to the client and costly, so the launch of the Angio Detect Test, together with recognition of clinical signs and early treatment will really help to prevent A. vasorum related fatalities in dogs. We also know that some dogs have subclinical angiostrongylosis, and this new test will help uncover this hidden problem before the surgical blade makes a cut. Difficulties in diagnosis have also meant that the full prevalence of A. vasorum in the UK has been relatively unknown. This test will allow veterinary surgeons to quickly identify the parasite and treat it if found. They shouldn't forget that other dogs in the household and the area are also at particular risk from the parasite."
The Angio Detect Test is available now in the UK, and will be launched in other European countries later this year. For more information on the test, visit www.idexx.co.uk/angio or speak to your IDEXX sales representative. For further information and free CPD on A. vasorum and other parasites, visit www.jungleforvets.co.uk or speak to your Bayer territory manager.
Suitable for both puppies and adult dogs, Eradia is presented in a bottle with an award-winning1 'All-In-One Smart Cap' which stops the person administering the product from coming into contact with the solution, is child proof and offers flexible dosing options.
Available in 30ml and 100ml bottles to cater for all dogs, Eradia can be administered either directly into the mouth or on to food.
Virbac says that Eradia has been shown to be accepted by 100% of dogs2, thereby alleviating any possible problems administering metronidazole.
For more information, contact your Virbac Territory Manager.
Equine glandular gastric disease is a complex syndrome that is distinct from gastric ulceration. A number of studies now indicate that it is an inflammatory gastritis, predominantly at the gastric outflow, which has different causes and risk factors from gastric ulcers. As such, medication effective in treating gastric ulceration may be less effective for this specific condition.
The clinical signs of EGGD are diverse and non-specific and may be mild or recurrent. They may include changes in temperament, changes in rideability, unexplained weight loss, reduced appetite or cutaneous sensitivity manifesting as biting of the flanks or resentment of girthing, grooming, leg aids or rugging. Recommendations for reducing the prevalence of disease, based on putative risk factors, include providing rest days from work, maximising turn-out, minimising management changes and other potential stress factors and minimising changes in equine companions and human carers.
The new guidelines have been published by a group of equine medicine specialists, based on a review of published and unpublished evidence. The intention is to provide veterinary practitioners with up-to-date guidance on risk factors, diagnosis, treatment, dietary management and prevention of EGGD.
David Rendle, an internal medicine specialist at Rainbow Equine Hospital in North Yorkshire who chaired the group and is a consultant editor of UK Vet: Equine said: "Our findings challenge long-standing dogma on EGGD, a condition about which there is currently very little advice available to vets and horse owners. It is becoming increasingly clear that the distinction between disease of the squamous and glandular mucosa is important clinically and the group felt that updated guidance may help to improve management of EGGD in practice."
Provision of evidence based clinical guidelines should enable practitioners to adopt more standardised and logical approaches and base EGGD management decisions on the most current data.
Professor Josh Slater, Professor of Equine Clinical Studies at the Royal Veterinary College said: "Clinical guidelines are commonly used in human health care and have been shown to improve clinical outcomes by condensing data from large numbers of research publications and promoting rapid adoption into clinical practice. These new guidelines represent a step forward in the management of this complex condition by combining a consensus of expert opinion with the best available current clinical research and evidence."
Mark Bowen, Professor of veterinary internal medicine at the University of Nottingham who is based at Oakham Veterinary Hospital said: "Whilst the panel hasn’t come up with miracle cures there was universal agreement that new treatment options have to be integrated in a logical and responsible manner."
"Our understanding of this condition is in its infancy but we hope that the summary document, which also highlights the gaps in our knowledge, will provide a useful framework for vets to follow and will be a stimulus for future research."
The guidelines can be found here: https://www.magonlinelibrary.com/doi/full/10.12968/ukve.2018.2.S1.3
Photo: Marked multi-focal depressed haemorrhagic and fibrinosuppurative lesions
The Canadian company highlights research which showed that the biggest challenge UK veterinary clinics face is the volume of pets (57%), followed by being overbooked (50%) and unable to take on new patients1.
In addition, earlier research has shown that 37%2 of vets are “actively” thinking about quitting, with 80%3 of the UK profession leaving to get a better work-life balance.
Hence the company offers a service through which UK practices can divert non-urgent calls to Vetster, to relieve some of the pressure.
Vetster says the most common cases treated by its veterinary surgeons are dermatology, gastrointestinal, respiratory, urinary tract, ophthalmology and musculoskeletal issues.
By diverting these cases to UK-licensed vets online, Vetster says it aims to relieve the pressure on clinics so that they can better serve pets in need of surgery, immunisations, bloodwork and other clinical treatments.
Mark Bordo, CEO and coFounder of Vetster said: “We are experiencing a global crisis in pet care exacerbated by the pandemic.
“Veterinarians are facing tremendous pressure to provide services to millions of pet owners.
"Vetster’s virtual care platform connects pet owners with licensed UK veterinarians to provide support when their clinic is closed, to answer a non-urgent question, and to improve the health outcomes of their pet and help ensure owners can care for their animals.”
Veterinary surgeons in search of a better work life balance can also join Vetster to create a virtual care practice that provides teletriage and addresses non-urgent issues.
Mark added: “Veterinarians are able to incorporate a new modality of practice to improve their work-life-balance, serve pet owners outside of a clinic environment, and hopefully practice for longer avoiding burnout and stress associated with this much-needed profession.”
Vetster is not available as a white label service at this time, and VetSurgeon.org understands that when it is clear an online consultation requires hands-on care, the owner is referred to the local practice on the platform, which may or may not be their normal practice.
Vets interested in offering consultations through Vetster can visit: https://vetster.com/en-gb/for-vets
Veterinary practices that are interested in having Vetster provide OOH support to clients, can visit: https://vetster.com/en-ca/for-vet-clinics
Animalcare has launched Buprecare into the UK and Ireland veterinary markets. Buprecare (POM-V) is a veterinary licensed analgesic, containing buprenorphine, for use in dogs and cats. It is licensed for post-operative analgesia in dogs and cats, and potentiation of the sedative effect of centrally acting agents in dogs.
This is the second major product the company has introduced in the last 18 months as Animalcare continues to grow its portfolio of veterinary products with the launch of an ACE inhibitor Benazecare (benazepril hydrochloride) earlier in 2007.
To complement the product launch, Animalcare is offering an ampoule breaker to help practice staff to open ampoules safely, together with a practice support package, containing pain scoring pads to aid in the assessment of pain of patients and judging of adequate analgesia requirements. In addition a dosing table and poster detailing common behavioural changes that can be associated with pain are available. Buprecare 0.3mg/ml is available in 1ml ampoules, in cartons of 5 ampoules.
Stephen Wildridge, Managing Director of Animalcare Ltd. said: "We have a very exciting time ahead with the launches of several new pharmaceutical products over the next twelve months, and the proposed expansion of our business into the major European veterinary markets."
Please contact your Animalcare representative, or ring 01904 487687 for more details.
The patient-side test identifies urinary tract infection (UTI) and the best antibiotics to treat the condition, with the results produced in minutes.
Test and Treat says the new test means that vets will no longer have to treat empirically while a urine sample is sent to an external laboratory. Nor will you have to risk delaying treatment until the results are received.
In addition, the company says that the test will help support the responsible use of antibiotics, which is particularly important given that Enterococci strains identified in canine urinary infections have been found to be resistant to three or more antimicrobials1.
U-treat is a two-part test. The first part of the test detects the presence of a urinary infection. The second part of the test looks at antibiotic susceptibility, showing the best choice of antibiotic and identifying those that won't work due to antimicrobial resistance.
Using the principles of bioluminescence, U-Treat removes host cell ATP before lysing bacterial cell walls to release bacterial ATP, which is then detected using a luminometer. The initial detection of infection test takes five minutes and the susceptibility test takes 30 minutes.
Clinical evaluation of the test in cats and dogs was carried out at University of Tennessee in conjunction with Prof. David Bemis of Cornell University. The company says U-Treat demonstrated high levels of sensitivity (97.1%) and specificity (92%), compared to lab tests.
The test is currently validated for use in dogs and cats and is being investigated for use in horses. While the test will launch first in the veterinary world, it also has scope to cross over into human medicine where there is potential to use it in general practice, paediatric and geriatric care.
Ron Turner, CEO and Scientific Director of Test and Treat said: "We've already sent our first orders to the US and have being talking at veterinary conferences about the technology - so we know vets are keen to get access to this new diagnostic test. Fast, reliable and accurate results mean that it's easier to put together a rational treatment plan that they can be very confident will work because they have the evidence."
Test and Treat is based near Newmarket in Suffolk and orders for the test are now being taken from veterinary practices in the UK. Full training will be given and the desk-top equipment (incubator, luminometer and reader) required to run the test can be supplied.
The company, which has attracted government enterprise funding, is also interested in hearing from veterinary surgeons who might be interested in investing in the technology and helping to expand its use.
To place an order, contact James Turner, General Manager on 01638 501974, email: jamest@tandtreat.com or visit http://www.tandtreat.com.
The first change has been made to paragraph 1.6 which now advises general practitioners to check whether the vet they are referring a case to is on the RCVS Specialist or Advanced Practitioner list, explaining the difference to the client and what sets them apart from other vets who might be prepared to accept a referral.
Also, practitioners who accept a referral should provide information to the referrer about the experience and status of those likely to be responsible for the case.
The guidance about conflicts of interest in paragraph 1.7 has also been amended such that referring surgeons should tell clients if they are referring their case to a practice owned by the same group.
There is new guidance about how vets and nurses talk about referral practitioners, with the new advice being to focus on accepted terms such as 'RCVS Specialist' and 'RCVS Advanced Practitioner', and avoid more general terms like 'referral surgeon' or 'consultant' to avoid confusion or implying that individuals hold more qualifications than they do.
Lastly, there is new guidance that vets may only use the name 'Specialist' in the name of their practice where there is genuine and meaningful involvement, and oversight, in case management by at least one RCVS specialist in all disciplines where any clinical services are offered under the business name.
https://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/referrals-and-second-opinions/
The OIE represents 178 Member countries and territories with international surveillance programmes that monitor antigenic drift among equine influenza viruses, and its Expert Surveillance Panel (ESP) for EIV makes annual recommendations for the composition of equine vaccines.
ProteqFlu, manufactured by Merial Animal Health, is currently the only vaccine in Europe to meet these recommendations.
Brand manager Dr Clare Turnbull said: "These recommendations, which have been in place since 2011, call for the inclusion of both Florida Clade 1 and 2 strains; as these are representative of the EIV strains that competing horses encounter globally.
"Although all licensed vaccinations should give clinical protection to individuals when challenged with a heterologous strain, mathematical modelling demonstrates that when scaled up to population level, this mis-match between challenge strain and vaccine strain significantly increases the risk of an epidemic occurring."
The FEI imposes mandatory equine influenza vaccination for horses competing under their jurisdiction to improve equine welfare by reducing clinical disease in individuals; but also because of the financial losses that an outbreak could have on the equine sport industry.
Göran Akerstrom, veterinary director of the FEI said: "The FEI has been a part of a Public Private Partnership with OIE for many years and we admire the work that they do in disease surveillance and global animal health.
"We stand behind their recommendations on vaccination for equine influenza and recommend our athletes to discuss these with their veterinary surgeons when considering their vaccination schedules."
For further information on FEI vaccination requirements visit https://inside.fei.org/node/3289