Andreea Maria Bacaintan was convicted by the Bucharest Court of Law in October 2017 of bribing a professor during her final year at university in order to pass an examination, a charge to which she had pleaded guilty.
Miss Bacaintan was fined and sentenced to a period of one year and four months' imprisonment, suspended for two years, with requirements for supervision and unpaid community service work. The case against Miss Bacaintan was that this conviction renders her unfit to practise veterinary surgery.
However, the Committee also heard and accepted that Miss Bacaintan had been the victim of a dishonest scheme perpetrated by members of staff at the University to extort money from students before they would let them pass the exam.
At the outset of the hearing the respondent admitted the facts as contained in the charge and that her conviction rendered her unfit to practise veterinary surgery. However, notwithstanding Miss Bacaintan’s acceptance that she was unfit, the issue of whether or not she was fit to practice remained one for the Committee’s judgement.
The Committee considered whether or not Miss Bacaintan’s conduct amounted to serious professional misconduct. In coming to its decision, the Committee took into account the submissions it had heard from Nicole Curtis, acting for the College, and from Miss Bacaintan, who represented herself.
Ms Curtis submitted that the nature and circumstances of the offence, which involved an element of dishonesty and which led to the conviction, were such as to render Miss Bacaintan unfit to practise as a veterinary surgeon in the UK. Miss Bacaintan’s conduct was also liable to have a seriously detrimental effect on the reputation of the profession, as it undermined the examination system.
The Committee also considered the mitigating factors associated with the conviction, namely that this was a single, isolated incident and that Miss Bacaintan was clearly the victim of a dishonest scheme perpetrated by staff at the University.
Considering both the aggravating and mitigating factors, the Committee was satisfied that Miss Bacaintan’s conduct fell far below the standard expected of a Registered Veterinary Surgeon.
The Committee then considered what sanction to impose on Miss Bacaintan. In doing so it took into account some of the written testimonials submitted on her behalf. The Committee was satisfied that Miss Bacaintan understood the magnitude of what she had done and was highly unlikely to repeat her dishonest behaviour.
Speaking on behalf of the Committee, Ian Green said: "This was a truly exceptional case where, whilst she had been dishonest, which the Committee in no way condoned, she had felt compelled to act in this way. The Committee was persuaded that Miss Bacaintan had herself been the victim of a corrupt system and had acted out of desperation in the final stages of her degree and with the genuine fear that if she did not “play the game” she would not graduate, thereby throwing away six years of hard work.
"It was notable that she did not succumb to the corrupt scheme until the third time of trying to pass this exam. It was clear from the evidence that she was not alone in paying up to try and pass this exam and that at least 30 and possibly many more students had done the same thing."
In such circumstances and with the significant mitigation, the Committee decided that the appropriate and proportionate sanction was to reprimand Miss Bacaintan and to warn her about her future conduct.
Based on the reported facts, what I'd like to know is why the DC even reprimanded a veterinary surgeon who was clearly being extorted herself, and what action was taken against the University staff?
Discuss here.
The Committee’s full facts and findings can be found at www.rcvs.org.uk/disciplinary
Virbac has launched Pronefra, a palatable phosphate-binder to aid with the management of chronic kidney disease (CKD) in cats and dogs.
The company says that managing blood phosphate levels is regarded as one of the most important aspects of managing CKD, with various studies showing the benefits of restricting phosphate in the diet1,2. The company also points to a study which shows that Pronefra, which contains two intestinal phosphate binders: calcium carbonate and magnesium carbonate, can significantly decrease serum phosphate levels3.
In addition, Pronefra also contains:
Virbac is at pains to stress that palatability has been a focus of Pronefra's development as it is an essential attribute for a product aimed at often inappetant animals.
Pronefra is presented in a liquid formulation for ease of use and should be mixed with food or given orally (it can be syringed) at meal times.
Virbac is providing a practice pack of support materials to practices, including a pet health recording book for clients to aid in compliance and other educational tools for vets, nurses and clients.
Simon Boulton MRCVS, Marketing Manager for Companion Animals, said: "CKD causes a vicious circle of deterioration but good management can increase both the quality of life and life expectancy of affected animals.
"We are delighted to launch Pronefra in the UK, following a 'sell-out' launch in mainland Europe, as a new option to aid in the management of CKD."
References
Mr Fioletti was found guilty of the murder of Stephanie Hodgkinson at Bournemouth Crown Court in January, and was sentenced to life imprisonment with a minimum 15 years.
The hearing for Dr Fioletti took place on Thursday 6 June, with the Committee deciding to proceed in his absence after Dr Fioletti said in correspondence that he did not want to attend the hearing nor be otherwise represented.
The Committee found the facts of the case proven by the certificate of conviction and went on to consider whether the conviction rendered Dr Fioletti unfit to practise as a veterinary surgeon.
Aggravating factors in terms of fitness to practise included the fact that it was an offence involving violence and loss of life and the injuries caused by Dr Fioletti to Ms Hodgkinson.
The sentencing remarks, which were cited during the disciplinary hearing, also made clear the devastating impact that Dr Fioletti’s actions had on Ms Hodgkinson’s family, including her two young children.
Paul Morris, chairing the Committee and speaking on its behalf, said: “The Committee considers that, when consideration is given to the ferocity of the attack on Ms Hodgkinson and the number of stab wounds she suffered, when taken together with the finding by the sentencing judge, who presided over the trial, that the respondent “represent[ed] a significant danger to any female with whom you find yourself in a relationship”, members of the public would find it abhorrent for a veterinary surgeon to have acted in this way and would be concerned at the risk the respondent posed to some members of the public.
“This Committee considers that the offence of murder is so inherently deplorable and shocking that it must constitute conduct falling far short of that to be expected of a member of the profession; and is certainly liable to bring the profession into serious disrepute and undermine public confidence in the profession.”
The Committee then went on to consider the most appropriate and proportionate sanction for Dr Fioletti.
In terms of the aggravating factors in this case, Mr Morris said: “The misconduct in this case relates to a savage, sustained and ferocious attack with a weapon on a defenceless woman in her own home.
"His victim trusted him to be in her home.
"He knew that she was the mother of two young sons, of whom she had custody, and to whom he knew she was devoted.
"He would have known that the effect of his attack on her would have devastating consequences for her sons and her other close relatives – and it did.
"This conduct constitutes disgraceful conduct of the most egregious and reprehensible kind.
“The Committee also considers that the misconduct raises serious concerns about the reputation of the profession in the eyes of right-thinking members of the public.
"This was abusive and controlling conduct of the worst kind and conduct of which the respondent had been guilty of in past relationships, as the sentencing judge found.
"Such acts by their very nature run contrary to the very essence of the practice of the profession of veterinary surgery, which is intended to protect and enhance the welfare and well-being of animals and of work colleagues.”
In mitigation the Committee noted that Dr Fioletti had no previous criminal history and had a hitherto unblemished career as a veterinary surgeon.
The Committee found that only complete removal from the Register was appropriate in this case.
Paul added: “The Committee has reached the conclusion that the respondent’s behaviour is fundamentally incompatible with being a veterinary surgeon.
"The respondent’s behaviour was so serious that removal of professional status and the rights and privileges accorded to that status is considered to be the only means of protecting the wider public interest and of maintaining confidence in the profession.”
The Committee expressed its condolences to the family of Stephanie Hodgkinson for their incalculable loss.
https://www.rcvs.org.uk/concerns/disciplinary-hearings
Apovomin is effective after a single injection, with results in two to fifteen minutes.
Apovomin has the active substance apomorphine hydrochloride hemihydrate 3 mg (equivalent to apomorphine 2.56 mg). It is being marketed in 5 ml vials. It has a three-year shelf life and lasts for up to 28 days once broached.
Dechra Brand Manager Claire Morgan said: “Unfortunately there are many everyday substances that are toxic to dogs once ingested and time is of the essence when dogs have swallowed something that is poisonous to them.
“It is vital that veterinary professionals have access to a safe and effective treatment like Apovomin that they know they can rely on when dealing with cases like this.
“Apovomin offers a cost effective and successful treatment for accidental poisoning that will be an important tool for veterinary professionals in day-to-day practice.”
For more information visit www.dechra.co.uk.
The RCVS Disciplinary Committee has struck off Suffolk vet Oliver Fraser Lown after finding him guilty of five separate charges relating to the possession of extreme animal pornography and sexual activity with animals.
Mr Lown, who graduated from Szent Istvan University in Hungary and has stated that he has never practised in the UK, did not attend the Disciplinary Committee hearing but was represented by Mr Jo Cooper, a solicitor-advocate. He was accused of five charges of disgraceful conduct in a professional respect:
On the first day of the hearing, the respondent made an application to the Disciplinary Committee that the hearing should be held in private on the basis that any publicity about the case 'would offend public morality' due to the nature of the allegations and because the respondent's father suffers from ill-health, which could be adversely affected by any publicity. The Committee rejected the application on the grounds that the nature of the allegations was already in the public domain and that public justice in the context of professional regulation outweighed the private concerns of the respondent regarding his father.
On the second day of the hearing, the respondent made an application to adjourn charges 2 - 5 on the basis that he had already admitted, and received a conditional discharge, for the first charge and would, therefore, not oppose removal from the Register and an undertaking never to re-apply. The respondent also argued that the original decision of the College to register him in July 2013 was flawed because it was unfair to admit him, in awareness of his conditional discharge, apparently for the purpose of taking disciplinary proceedings against him. He also referred to the Crown Prosecution Service's decision not to prosecute him in respect of charge 4.
This application was dismissed by the Disciplinary Committee on the grounds of the gravity of charges 2 - 5 and the fact that the respondent chose to apply to join the Register and had been advised to seek legal advice regarding his conditional discharge beforehand. Furthermore, the Disciplinary Committee heard that there was no error at the time of his registration because the conditional discharge was not a conviction and therefore, under the Veterinary Surgeons Act, there was no option to refuse registration.
The respondent then made a final application to have the case adjourned on the grounds that new documentation he had received the previous day regarding his registration had led his lawyers to conclude that the decision to register him may have been unlawful. However, the Disciplinary Committee said that, in its understanding, the RCVS Registrar had no option but to register Mr Lown. The Disciplinary Committee then dismissed the application on the grounds that any challenge of the validity of registration could and should have been made within the three month time limit for judicial review and that no significant new documentation about Mr Lown's registration had come to light that could reasonably be said to have triggered a judicial review and warrant an adjournment. It also again highlighted the gravity of the charges.
The Disciplinary Committee then heard evidence in relation to charges 2 -5, including that of two officers from North Yorkshire Police who took part in the original investigation, who the Committee found to be credible and reliable witnesses, and, after reviewing the evidence, found that all four charges were proven.
The Committee then considered the appropriate sanction for Mr Lown, and took into account a number of aggravating factors including the risk of injury to animals, premeditated misconduct, sexual misconduct, misconduct sustained or repeated over a period of time and his lack of insight into the offences or his overall conduct.
Professor Noreen Burrows, chairing the Disciplinary Committee and speaking on its behalf, said: "In these circumstances, the Committee has no doubt that the respondent's conduct was of the utmost seriousness. The material found in possession of the respondent and his own conduct in charge 4 involved the abuse of animals and a total lack of respect for their welfare. In the judgement of the Committee each of the charges individually amounts to disgraceful conduct and the charges certainly amount to disgraceful conduct when taken cumulatively."
In order to safeguard animal welfare, maintain public confidence in the profession and uphold proper standards of conduct, the Disciplinary Committee directed the Registrar to remove Mr Lown's name from the Register.
The Committee's full findings and decision are available on the RCVS website (www.rcvs.org.uk/disciplinary).
More on this story: http://www.bbc.co.uk/news/uk-england-suffolk-28524348
The campaign – Cats deserve pain relief too – has been prompted by a recent study1 which revealed that perioperative analgesia following neutering was only given to 33% of cats compared with 75% of dogs, a statistic which ISFM says it is very keen to change.
The campaign, which includes a free webinar for veterinary professionals, highlights the reasons many cats are not receiving postoperative analgesia, and aims to encourage practices to review their policies on prescribing analgesics for routine neutering procedures.
ISFM says it already encourages the routine assessment and treatment of pain in cats. However, recognition of pain is not always straightforward and the perception that cats experience less pain than dogs with neutering may largely reflect different behavioural responses to pain between the two species rather than genuine differences in the experience of pain.
The charity says that physiologically, it makes sense that both species are likely to feel pain for several days after a surgical procedure and studies have shown that cats do show behavioural changes indicative of pain for 3 days or more after neutering.2 However we also know that cats are less demonstrative and less likely to show overt signs of pain such as vocalisation.
Additional reasons why cats receive less analgesia post-operatively than dogs, may include the following:
According to the WSAVA pain management guidelines,4 the use of preventative/multimodal analgesia, along with careful tissue handling and adherence to good surgical principles is strongly recommended.
The guidelines additionally suggest that analgesia following castration or ovariohysterectomy/ovariectomy may be required for up to 3 days after surgery using non-steroidal anti-inflammatory drugs.
As part of this awareness campaign, ISFM, supported by Boehringer Ingelheim is running a free webinar on Wednesday 31st August at 8.00pm.
David Yates (Manchester RSPCA) and Jo Murrell (Reader in Veterinary Anaesthesia, Bristol University, UK) will be on hand to discuss, 'Neutering in practice: are your anaesthesia, analgesia and surgical protocols up to scratch?'
To register for the free webinar, go to: http://icatcare.org/learn/webinars and for further information about the campaign, visit: http://icatcare.org/campaigns/cats-deserve-pain-relief-too.
Alstoe Animal Health has launched a cat pain score chart to help veterinary surgeons make decisions about analgesic protocols.
The company says that one of the most common questions it is asked about its injectable opiate, Vetergesic, is: 'when is it okay to use more?' The answer is usually: 'do you think the case needs more?', but this new behaviour-based pain scoring system for cats - which was developed with leading anaesthetists - should help practices to assess the patient's condition. Dr. Ian Ryder from Alstoe said: "It is designed as a one-off assessment, which can be repeated as required."
The Vetergesic Composite Pain Scale for Cats is now available in a wipe-clean plastic board format and also as a downloadable pdf for practices to assist in making the decision when it is the right time to use some more analgesic.
The Vetergesic Composite Pain Scale for Cats is available as part of a one-hour educational presentation which can be delivered at the practice. For further information or to arrange a visit, contact Alstoe on 01347 878606 or info@alstoe.co.uk
At the start of the hearing the RCVS applied for it to take place in the absence of Mr Dobson, who had failed to respond when informed about the hearing. The application was granted by the DC on the basis that Mr Dobson, by refusing to respond to communications from the College – including by letter, telephone and email – had voluntarily waived his right to attend.
There were three sets of charges against Mr Dobson. The first charge was in June 2018, while he was not on the Register of Veterinary Surgeons, Mr Dobson had carried out an equine pre-purchase examination (PPE) and used the postnominals MRCVS to sign the associated PPE certificate and covering letter.
The Committee found this charge proven after it was presented with evidence of the certificate and covering letter alongside the fact that Mr Dobson had been removed from the Register on 1 June 2018 for non-payment of the annual renewal fee needed to remain on the RCVS Register. He was only restored to the Register upon paying his outstanding fee in late November 2018.
The second charge was that Mr Dobson did not have any professional indemnity insurance (or PII) or other equivalent arrangements in between June 2018 and August 2020. He also failed to provide adequate details of his PII when requested by the RCVS.
The Committee was presented with evidence that Mr Dobson had failed to confirm that he had PII arrangements or other equivalent arrangements in place prior to August 2020 and that he had failed to respond to numerous requests for evidence from the College. On this basis the Committee found the charges proven.
The third and final charge was that Mr Dobson had failed to respond to numerous requests from the RCVS, including: failing to provide written comments on concerns relating to the equine PPE; failing to provide written comments on the concern that he had carried out the PPE and used the postnominals MRCVS while not on the Register; failing to provide details of his continuing professional development (CPD) for the previous three years; and failing to provide copies of his Day Book and/or Controlled Drugs Register. All elements of this charge were found proven when the Committee was presented with evidence of numerous attempts to contact him that went unacknowledged and unanswered.
Regarding the first charge, the Committee recognised that Mr Dobson had not intentionally allowed his registration with the College to expire and that it was down to administrative error. However, it also considered that he had not responded to or taken action upon receiving numerous reminders to pay his fees. It considered that Mr Dobson had therefore acted recklessly in not only allowing his registration to expire but in continuing to practise veterinary surgery while not registered, a criminal act in contravention of the Veterinary Surgeons Act. The Committee therefore found that the first charge amounted to serious professional misconduct.
The Committee also found that the remaining charges constituted serious professional misconduct.
Cerys Jones, chairing the Committee and speaking on its behalf said: "The respondent demonstrated a pattern of behaviour in not responding, which was sustained and persistent. He asked for extensions of time but did not make good on his assurances that he would provide information. Due to the length of time during which the respondent failed to comply with the requests, as well as the proliferation of issues in respect of which he did not comply, the Committee was of the view that he demonstrated a wilful disregard of the role of the RCVS and the regulatory processes. This was particularly serious in light of the reliance which the RCVS places upon its members to cooperate with providing it with information relating to their professional practice which is relevant to the RCVS’s regulation of the profession.
"There was no harm caused to animals or the public, and the Committee acknowledged that practice circumstances have been made more difficult in general by the Covid-19 pandemic. However… the respondent’s failures to comply were serious and undermined the functions of the RCVS. The Committee was satisfied that the respondent’s failures fell so far below what was expected as to amount to serious professional misconduct."
Having found that all the charges amounted to serious professional misconduct the Committee then considered the most appropriate sanction for Mr Dobson. In terms of aggravating factors, the Committee considered Mr Dobson’s recklessness in failing to renew his registration and practising while it was lapsed, his pattern of not responding to the RCVS, the fact that financial gain was obtained as a result of misconduct, a wilful disregard to the RCVS and regulation, and limited evidence of insight. In mitigation the Committee considered Mr Dobson’s previous good character, a long and otherwise unblemished career, the fact that no animals were harmed and increased demands on time and processes due to Covid-19.
However, taking all of the information into account, the Committee decided that removal from the Register was the appropriate and proportionate sanction due to the sustained and prolonged nature of the misconduct.
Cerys Jones said: “The respondent demonstrated a wilful disregard of the role of the RCVS and the regulatory processes by way of his disgraceful conduct. In addition, his lack of engagement with the hearing process indicates to the Committee that he is not engaging with his regulator and, along with the limited insight and lack of remediation with respect to the disgraceful conduct, this demonstrates a lack of insight into the seriousness of his actions or their consequences.”
In a letter to Danny, RCVS President Christopher Tufnell wrote:
"As the regulator of the veterinary profession, we place an emphasis on the importance of evidence-based veterinary medicine. We therefore recommend that there should be a cautious approach to homeopathy for animals and that normal evidential standards should be applied to complementary treatments."
Danny said: "A cautious approach? What, like this claim by the BAHVS that homeopathy cures cancer?. Or would you say that this claim on national TV represents a cautious approach?
"Talking about homeopathy and normal evidential standards in the same breath is oxymoronic. If you apply normal evidential standards to homeopathy, it is completely ineffective and should not therefore be used in animals."
Mr Tufnell wrote: "We believe it is also essential that such treatments, until they can be proved, are complementary rather than 'alternative' and that they are therefore used alongside conventional treatment."
Danny said: "This argument makes sense whilst evidence-gathering for new treatment modalities. Homeopathy, however, has been with us since 1796. In that time, there has been no good evidence that homeopathy is effective for any condition. Against that, we now have the benefit of an increasing body of meta analyses that show it isn’t. How much more evidence does the RCVS require?"
Mr Tufnell wrote: "Whatever views there may be within the veterinary profession, it is clear that there is a demand from some clients for complementary therapies for their animals."
Danny said: "That may be true, but client demand is not an argument for prescribing medicines shown not to work. Nor should ill-informed client demand trump animal welfare"
Mr Tufnell added: "It is better that they [clients] should seek advice from a veterinary surgeon - who is qualified to make a diagnosis, and can be held to account for the treatment given - rather than turning to a practitioner who does not have veterinary training."
Danny said: "It makes no difference to the animal's suffering whether effective treatment is withheld by a layperson or a qualified vet. At what point do we trust the clinical judgement of vets who subscribe to this magical thinking? In the case of hyperthyroidism in a cat, at what point do we trust them to start giving proper treatment? Maybe when the T4 levels reach a certain number? Or when renal failure kicks in? Or when the cat loses a certain percentage of its body weight?"
Finally, Mr Tufnell wrote: "homeopathy is currently accepted by society and recognised by UK medicines legislation and does not, in itself, cause harm to animals."
Danny said: "I'm not sure how it is possible to claim homeopathy is 'accepted by society'. What constitutes 'societal acceptance'? The NHS says that: 'The ideas that underpin homeopathy are not accepted by mainstream science, and are not consistent with long-accepted principles on the way that the physical world works'; the Australian Government says: 'Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious.' Clearly homeopathy is far from being accepted by society.
"Even if it was, the argument that we should prescribe medicines because they are 'societally accepted' is no different to the argument that we should do so because there is 'consumer demand.' Both are plainly wrong. Presumably the RCVS wouldn't approve of veterinary surgeons prescribing antibiotics just because there is 'consumer demand', or because they are 'societally accepted'.
As to the veterinary medicines regulations, homeopathic remedies were ‘grandfathered’ and have not had to prove efficacy to become authorised. So their recognition by UK medicines legislation is meaningless.
"Lastly, homeopathy does, in itself, cause harm to animals when given ahead of, or in place of proven treatments."
At the same time as Danny was running his petition for banning homeopathy, the Campaign For Rational Veterinary Medicine has been running a petition which instead asks that the RCVS takes steps to allow animal owners to make a more informed decision, thereby limiting the harm that homeopathy causes animals.
This petition, which is for the veterinary profession only, has so far gathered over 400 signatures, and the campaign organisers are now inviting anyone who signed the petition to ban homeopathy to consider signing this one as a pragmatic alternative.
Pfizer Animal Health has launched Dexdomitor, a new, advanced form of the popular sedative /analgesic Domitor (medetomidine).
According to Pfizer, Dexdomitor contains only the right-handed enantiomer (dexmeditomidine) which is responsible for the beneficial pharmacological effects of the meditomidine molecule. By removing the left-handed enantiomer (levomedetomidine) from the original racemic mixture the same sedative and analgesic effects can be achieved with a lower metabolic load, less potential for interaction with other drugs and half the active substance.
According to Dr Jo Murrell, Senior lecturer in veterinary anaesthesia in Bristol Vet School, the use of dexmedetomidine has a number of advantages in terms of veterinary use:
"Because dexmedetomidine had to undergo a lot of safety studies to get market authorisation in humans, we have a huge amount of cardiovascular data about the effects of dexmedetomidine in dogs,” she said. “That means we know very precisely the effects of dexmedetomidine on cardiac output, on organ blood flow and the changes in blood flow to vital organs such as the heart and brain."
Dr Murrell recommends that vets who are currently using Domitor should consider switching to Dexdomitor when it becomes available.
"You won’t notice any disadvantages as a result of the switch, but you may well notice that the effects of dexmedetomidine are more reliable compared to medetomidine, and you may notice some benefits in terms of recovery from anaesthetic combinations."
Corneal ulceration is a condition that affects up to 0.8% of cats and dogs in the UK1.
It can have a number of causes such as trauma, foreign bodies or underlying ocular pathology such as tear film insufficiency.
Helen Harrison MRCVS, Veterinary Advisor at TVM, said: "Keratomalacia, or corneal melting, may develop as a complication of an existing corneal ulcer due to the uncontrolled action of proteolytic enzymes.
"This can lead to corneal perforation and permanent loss of vision.
"Management of keratomalacia requires prompt and aggressive medical treatment to arrest corneal destruction.
"Anti-collagenases, anti-microbials and analgesia are the mainstay of medical therapy, with surgical intervention also indicated for cases requiring tectonic support.
"In addition, certain patients (such as brachycephalic breeds) are more at risk of keratomalacia occurring, therefore anti-collagenases should be considered pre-emptively as part of the treatment plan."
Stromease, which TVM says is the first and only licensed product of its type, contains the active ingredient N-acetylcysteine.
It does not require any prior preparation or special storage.
Presented in a 5ml bottle, Stromease has a three-year unopened shelf-life.
The licensed dose is two drops into the affected eye(s) 3-4 times daily.
Will Peel, TVM’s product manager said: "Traditionally vets have had to rely on ‘home-made’ anti-collagenase preparations which can be time-consuming to prepare, difficult to store correctly and inconvenient to use.
Stromease is a licensed, anti-collagenase treatment option for corneal ulcers dogs and cats, presented in a user-friendly format."
For more information visit: www.tvm-uk.com/cornealfocusrange or ask your territory manager.
Reference
RCVS Registrar, Eleanor Ferguson said: "Changes to the chapter of the supporting guidance to the Code of Professional Conduct titled ‘Miscellaneous procedures: legal and ethical considerations’, specifically in regards to surgical artificial insemination in dogs, were discussed at a meeting of the Standards Committee on 30 January 2019.
"The proposed changes to the guidance were to clarify that surgical artificial insemination (AI) in dogs is prohibited by animal welfare legislation – specifically the Animal Welfare Act 2006, which prohibits mutilations. Prohibited procedures are defined as those which interfere with sensitive tissue or bone structure. Surgical AI in dogs is not one of the exemptions permitted within the Mutilations (Permitted Procedures) (England) Regulations 2007.
"Due to an unfortunate oversight, the guidance had not been updated following this legislative change, although, in the interim, the guidance still made it clear that surgical AI in dogs was unlikely to be in the animal’s best interests and could only be carried out and justified in very limited circumstances and for exceptional reasons.
"However, we apologise for the oversight, and as soon as the College was made aware that the guidance on surgical AI did not conform exactly with the legislation and regulations, a paper was prepared for the Standards Committee to consider as soon as possible and update the guidance accordingly.
"As always, if any members of the profession or the public have any questions about any aspect of our Code of Professional Conduct and supporting guidance, they are welcome to contact our Standards and Advice Team on advice@rcvs.org.uk."
The company says the new method, which was developed with Professor Ian Ramsey at the University of Glasgow, has been introduced following recent studies that showed a lack of correlation between ACTH stimulation test results and the clinical status of dogs treated with Vetoryl 1,2
Craig Sankey, Brand Manager at Dechra Veterinary Products, said: "Vetoryl is a medicine that will normally deliver major clinical benefits to a patient with canine Cushing's syndrome but finding a stable, long-term dosing regimen can be hard if ACTH stimulation tests return varying results.
"Pre-Vetoryl Cortisol monitoring is a reliable alternative to traditional ACTH stimulation tests for several reasons. It predicts clinical signs better, gives more consistent results, is less expensive and is easier to perform.
"Our online guide gives veterinary professionals a detailed insight into how they can integrate PVC into their treatment plans and the benefits it can bring to their patients and practice."
Information about Pre-Vetoryl Cortisol monitoring is now available at www.dechra.co.uk/prevetorylcortisol, together with other resources for patients on Vetoryl.
Dechra also hosts a website for owners whose pets have been prescribed Vetoryl: www.canine-cushings.co.uk.
In total Mr Hendrie Smith had faced eight charges against him, all of which related to him undertaking the euthanasia of a German Shepherd named Bouncer during a home visit in January 2017.
The charges alleged that when John Hendrie Smith undertook the euthanasia of Bouncer he had:
1. failed to ensure he was sufficiently prepared for the euthanasia in that he failed to attend the visit with a muzzle and failed to attend with any sedative and the means of administering sedative;
2. failed to delay the euthanasia until he was in possession of the above items;
3. undertook the euthanasia by means of an injection without first sedating Bouncer;
4. failed to provide Bouncer’s owner with an adequate explanation of the procedure. Including:
a. failing to explain that the procedure involved an attempt at injection directly into the heart;
b. failing to explain that an injection into the heart without sedation is (except in extreme circumstances) not an accepted means of euthanasia;
c. wrongly stated that Bouncer would not feel the injection;
d. failed to provide an explanation of the risks;
e. failed to explain the risks and signs of narcotic excitement;
f. failed to explain the risks of injection into the heart without sedation;
5. failed to obtain Bouncer’s owner’s informed consent for the procedure;
6. failed to make any clinical records in respect of the procedure;
7. provided inadequate veterinary care to Bouncer and caused him unnecessary suffering; and
8. failed to communicate with Bouncer’s owner.
Having considered evidence about the case from Bouncer’s owner, his owner’s former partner, two expert witnesses and Mr Hendrie Smith, the Committee found all of the charges against Mr Hendrie Smith proven, with the exception of charge 4(e) on the grounds that there was insufficient evidence against him on this particular charge.
In considering whether the charges that were found proven amounted to serious professional misconduct, the Committee heard further evidence from the College’s two expert witnesses, and submissions from both the College and Mr Hendrie Smith. Having considered the evidence and submissions, the Committee concluded that in relation to each of the charges found proven, Mr Hendrie Smith’s conduct had fallen far below that which was to be expected from a veterinary surgeon and was therefore serious professional misconduct.
The Committee went on to consider what sanction was appropriate following its earlier findings against Mr Hendrie Smith. The Committee took into account a number of mitigating and aggravating factors. In mitigation the Committee considered that this was a single, isolated incident and that Mr Hendrie Smith had been a practising veterinary surgeon for 65 years and had an otherwise unblemished career with no adverse professional findings against him. It also took into account testimonials from professional colleagues, clients and his local community.
However, the Committee also considered the aggravating factors which included actual injury and unnecessary suffering to an animal, a blatant disregard of the systems that regulate the veterinary profession including the RCVS Code of Professional Conduct and its supporting guidance relating to euthanasia, informed consent, preventing unnecessary suffering and working within one’s area of competence.
In explaining its decision to direct his removal from the Register of Veterinary Surgeons, the Committee noted Mr Hendrie Smith’s lack of insight into his behaviour, which included denying that he was at fault, challenging several of the Committee’s findings and disputing that an intracardiac injection into the heart of a dog without administering sedation or anaesthesia was wholly unacceptable, despite expert opinion to the contrary.
Chitra Karve, chairing the Committee and speaking on its behalf, said: "The respondent, in his oral evidence, admitted that he was not really a small animal vet, and had not been dealing regularly with small animals for a significant period of time. His specialisation in recent years was with large farm animals. The Committee considered that the respondent had, and still has, no concept of the difficulties now recognised as inherent in the procedure he performed, or the risks of pain and suffering it posed to the animal."
She added: "The Committee has found that the respondent’s conduct in attempting an intracardiac injection without prior sedation or anaesthesia caused appalling pain and suffering to Bouncer, as evidenced by his screaming, and was wholly unnecessary. The respondent accepted that he had a sedative in his car, but chose not to postpone attempted euthanasia so that he could sedate his patient first.
"The respondent explained in his oral evidence that he had, in the past, euthanased over 200 dogs by intracardiac injection without sedation or anaesthesia. The Committee concludes that this was the respondent’s customary method of euthanasia, and he did not understand why it was wholly unacceptable for a reasonably competent veterinary surgeon to carry out euthanasia in this way. Given his lack of insight, the Committee considers that there is a risk that, if the respondent were to be asked to euthanase a dog in the future, he would be likely to use his customary method, and thereby cause injury and suffering to another animal."
In determining the sanction the Committee decided that, because there had been a serious departure from the professional standards set out in the Code, serious harm was caused and there was a serious risk of harm to animals in the future, that removing Mr Hendrie Smith from the Register was the only means of protecting animals and the wider public interest.
Mr Hendrie Smith has 28 days from being informed of the Committee’s decision to make an appeal to the Privy Council.
Dr Botes faced a total of nine charges against him, relating to performing (or recommending) inappropriate total hip replacements on five dogs without adequate investigation and without getting informed consent from the owners.
One of the charges also related to a failure to keep adequate, clear and detailed clinical records in relation to the five dogs.
Dr Botes denied the first two charges which were later dismissed because the owner did not attend the hearing and counsels agreed that it would not be in the public interest to pursue them.
Dr Botes admitted the other seven charges and that they amounted to serious professional misconduct, and they were therefore found proven by the Committee.
In considering whether the charges amounted to serious professional misconduct, the Committee considered an expert report from Professor John Innes, RCVS Specialist in Small Animal Surgery (Orthopaedics) and Mr Midgley, RCVS Advanced Practitioner (Small Animal Orthopaedics).
Ian Arundale, Chair of the Committee, said: “In coming to its decisions, the Committee took into account Professor Innes’ opinions that it was not reasonable for Dr Botes to have carried out the THR without sufficient investigation into Kilo’s pain; that the THR undertaken in respect of Sora was not in the animal’s best interests; and that it was ‘entirely unnecessary’ to recommend the THR in respect of Penny.
"In addition, the Committee has found that both THRs performed in respect of Daisy were not in her best interests.
"Thus, in the Committee’s view, Dr Botes’ actions and omissions did not ensure the animals’ health and welfare.”
The Committee took into account that the THRs in question were a source of financial gain, that Dr Botes’ conduct was repeated over a considerable period of time and that he was in an increased position of trust and responsibility because of perceived expertise in small animal orthopaedics and its education.
However, the Committee took into account, as a mitigating factor, that Dr Botes has indicated some insight into some aspects of the charges in his written communications to the College, in his witness statement dated 29 December 2021, and in his admissions at the start of this inquiry.
The Committee then considered what would be an appropriate and proportionate sanction, hearing from several character witnesses including Dr Midgely, who was put forward as Dr Botes’ proposed supervisor if the committee agreed to a postponement with undertakings.
When making their decision, the Committee took into account the fact that Dr Botes had been suspended from the Register in 2008 for six months for serious professional misconduct over the care of a dog that had been involved in a road traffic accident.
The Committee considered a postponement of judgment with undertakings, which was submitted by Dr Botes’ counsel.
However, the Committee took the view that a postponement would not be appropriate because the failings were not in limited aspects of practice but were wide-ranging, covering the fundamental requirements of any veterinary surgeon.
In the Committee’s view, this would mean nothing less than direct supervision, where Dr Botes’ practice was directly monitored on a day-to-day basis would be sufficient to protect animals, clients, and to uphold the wider public interest.
It would be impracticable to formulate undertakings capable of effectively addressing these issues.
The Committee also noted that the disgraceful conduct was serious and there was a pattern of sustained and persistent misconduct.
The Committee therefore did not believe that no further action, a reprimand or a warning were appropriate or proportionate outcomes.
The Committee also considered whether suspension was appropriate but concluded that there was a real risk of repetition of the behaviours outlined in the charges, and so the Committee was unable to conclude that Dr Botes would be fit to return to practice after a period of suspension.
The Committee therefore decided to direct that Dr Botes should be removed from the Register indefinitely.
In coming to this decision, the Committee carefully applied the principle of proportionality and took into account the impact of such a sanction on Dr Botes both professionally and financially, and took into account his witness statement in this regard.
Ian Arundale added: “In light of the gravity of the conduct, and all of the factors taken into account, any lesser sanction would lack a deterrent effect and would undermine public confidence in the profession and the regulatory process.
"Removal was the only appropriate and proportionate sanction.”
Dr Botes has 28 days from being notified of his 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
Virbac says there is mounting evidence of a growing change in the attitude of pet owners towards permanent castration, that research has shown that 25% of pet owners are concerned or very concerned that neutering could be harmful for their dog1. The permanency of surgery has been cited as the reason why 67% of owners with entire male dogs have not yet opted for the procedure2.
Hence the campaign to raise awareness of Suprelorin, the company's reversible alternative to surgical castration, which uses visual metaphors to explain that there is: 'more than one way to crack a nut'.
The video is also broadcast on the campaign website: www.morethanoneway.co.uk.
Veterinary practices are invited to participate in the campaign by contacting their Virbac Territory Manager to order waiting room and client materials, or to book a Suprelorin lunch meeting for their practice.
Suprelorin Product Manager Claire Lewis said: "Pet owner attitudes are definitely changing so by offering a choice when it comes to castration, veterinary practices have the opportunity to not only increase their overall castration rate, but also enhance their relationship with their clients."
Davies says pulmonic stenosis is one of the most common congenital heart defects in dogs. In most cases it is caused by a malformation of the pulmonic valve with fusion of the leaflets (type A stenosis) or with the presence of rudimentary valves accompanied by hypoplasia of the annulus (type B stenosis).
Dogs with severe stenosis are at risk of sudden death, heart failure and have a decreased survival time in comparison to normal dogs.
Minimally invasive catheter based procedures (balloon valvuloplasty) have become the treatment of choice for valvular pulmonic stenosis, with good results in most but not all cases. French Bulldogs are predisposed to the condition and tend to not respond to valvuloplasty as well as other dogs.1
In this case, the dog was first referred to Pedro Oliveira, RCVS and European Veterinary Specialist in Small Animal Cardiology at Davies, for treatment of severe pulmonic stenosis.
An echocardiogram confirmed the presence of a type B stenosis accompanied by marked right ventricular hypertrophy and also an atrial septal defect.
A standard balloon valvuloplasty procedure was performed without complications and the dog initially showed improvement (click image right to enlarge). Soon after, however, she began to suffer episodes of weakness and collapse and was readmitted.
An echocardiogram showed that the right ventricular obstruction had worsened.
Pedro said: "Re-stenosis has been reported in up to 16% of cases following balloon valvuloplasty and in this case it was suspected to be due to the formation of scar tissue in the valve leaflets. The pressures inside the right side of the heart were now higher than left allowing blood to flow through the atrial septal defect from the right to the left atrium directly without receiving oxygen from the lungs.
"Whenever Gracie got excited or tried to exercise she would go 'blue' from lack of oxygen and collapse. In fact her quality of life was so poor that euthanasia was suggested at that point. For this reason we decided we should attempt this novel procedure. The only other option would have been open-chest surgery (patch graft) but this held a higher risk of complications during the anaesthesia and even death. Also, the cost of surgery would have been higher than this new option."
Pedro performed the procedure with fellow Davies cardiologist, Jose Matos, while Antonia Mavropoulou guided them using transoesophageal echocardiography.
Under a general anaesthetic the heart structure was assessed using transoesophageal echocardiography and angiography to choose the correct size of the stent for Gracie.
An 8mm wide and 4cm long stainless steel catheter tightly mounted on a balloon was chosen.
This was then positioned across the pulmonic valve and the balloon was expanded forcing the stent to open up to its full size (figure 2B). There was an immediate and significant improvement of blood flow through the stent (figure 2C), the patient recovered well and she was discharged four days later.
Re-examination after three months showed improved flow across the stent and a reversal of the right to left shunting across the atrial septal defect. Gracie stopped experiencing episodes of collapse or cyanosis and is now able to exercise and lead a more normal life.
Pedro said: "This technique has been used in very few cases in the whole world and to the best of our knowledge this is the first time it has been used in the UK.
"It is more technically challenging and costly than a standard ballooning although it may provide an effective, safe, and cheaper alternative to patch graft surgery. In this particular case we feel it made an important difference in terms of quality of life and prognosis for Gracie.
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/
The practice's dentistry and oral surgery team, led by Peter Southerden, has now carried out its first two successful reconstructions using the technique, following oral tumour resection.
Use of patient-specific implants (PSI) for jaw reconstruction is a new technique, which provides an alternative to bone regenerative techniques. Both techniques can be used in cases which have had significant jaw resection or need reconstructive surgery after a trauma.
Peter said: "To my knowledge, using this technique to create patient-specific implants for rostral mandibular reconstruction following bilateral rostral mandibulectomy has not been reported in dogs before.
"The reconstructive surgery involves taking pre and post-operative CT scans of the affected area and sending them to a specialist human medical PSI design company, which then uses 3D titanium printing technology to recreate the missing bone.
"In our first two cases, both dogs are doing really well. The feedback we’ve received from owners suggests their dogs have gained significant benefit from the jaw reconstruction process."
Peter is one of three dentistry and oral surgery clinicians at Eastcott alongside Andrew Perry and resident Ingrid Tundo, with a second resident due to join in 2019.
The team caters for dentistry cases including periodontology, endodontics, orthodontics and restorative dentistry, to complex cases including oral tumours, traumatic injuries and congenital issues such as cleft palates.
Peter added: "There aren’t many people with specialist qualifications in this field, possibly only six in the UK and we are the only team working with the backup of a multi-disciplinary referral hospital.
"Having a team of three, soon to be four, is unusual and means we have a big caseload and see a wide range of different cases. We are very keen on developing new techniques such the ones we have already introduced."
For more information about Eastcott Referrals, visit www.eastcottreferrals.co.uk.
Henry Schein said in a statement on Friday that it had sold the business in order to focus on its dental and medical markets and pursue new investment opportunities.
Covetrus says it will be using the experience, technology and global scale of the merged companies to provide veterinary practices with a more comprehensive set of integrated services and technology solutions, and tools to strengthen client relationships and grow their practice.
Covetrus launched on Nasdaq last Friday, when President and Chief Executive Officer Benjamin Shaw, said: "Today marks an important new chapter in the world of veterinary medicine, as we launch Covetrus as a new company listed on Nasdaq.
"We look forward to strengthening our customer relationships and expanding our veterinary practice partnerships worldwide as we bring more comprehensive and powerful solutions to market to meet their evolving needs and improve health and financial outcomes."
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
According to the company, Prinocate contains the same combination of Moxidectin and Imidacloprid as Advocate. In dogs it is licensed for the treatment and prevention of Angiostrongylus vasorum (lungworm); for the treatment and prevention of fleas and also for lice, mites, heartworm and roundworms. In cats, the licence covers fleas, mites, roundworm and heart worm.
Prinocate is offered in six presentations to suit all weight ranges and in packs of three pipettes, to suit most pet health plans. Each pipette is individually wrapped for ease of use and dispensing.
Krka’s National Veterinary Sales Manager Will Ridgway, said: "Prinocate offers practices and pet owners the reassurance of tried and trusted actives moxidectin and imidacloprid, the reliability of spot-on delivery and the affordability that Krka customers have come to expect.
"Its launch, hot on the heels of Selehold, and added to our wormers Milprazon and Anthelmin, means that Krka now offers an attractive, reliable and affordable parasite control range and, during its launch period, we are offering one free pack of Prinocate for every five purchased.”
He added: “As Angiostrongylus vasorum is one of the main parasites of concern in practice today, to mark the launch of Prinocate, we’re delighted to be offering a free webinar with Ian Wright during which he will explore how A.vasorum has managed to spread so successfully and the most effective preventative protocol to offer your clients.”
The webinar takes place on Tuesday, 2nd June 2020 at 8:00pm. To register, visit: https://tinyurl.com/avasorum
The RCVS Disciplinary Committee has struck off the Register a veterinary surgeon who delayed attending a dog that had been run over at a farm, causing her to suffer unnecessarily.
Following a two-day hearing, the Disciplinary Committee found Munhuwepasi Chikosi guilty of unreasonably delaying attending Mitzi, a fourteen-and-a-half-year-old Labrador cross, and of unnecessarily causing her to remain in pain and suffering for at least an hour.
On 9 September 2011, Mr Chikosi had been working as a locum veterinary surgeon at the Vets Now out-of-hours emergency service in Barton-le-Clay, Bedford, when Mitzi's owner telephoned him to say that his dog was severely injured and to request a home visit for the purpose of euthanasia.
At Mr Chikosi's request, the owner attempted to bring Mitzi into the practice using a blanket. However, it was not possible to get Mitzi into a Land Rover, and she uncharacteristically bit the owner's son, so her owner called the practice again.
Mr Chikosi repeated the request to bring the dog in, saying that he was unable to leave the practice because he was looking after other animals, but that he could possibly organise another veterinary surgeon to visit "probably within the next hour or two".
The Committee considered Mr Chikosi's actions in context of the RCVS Guide to Professional Conduct 2011, which listed a number of factors for veterinary surgeons to consider when deciding whether to attend an animal away from the practice premises.
These included the likely treatment needed, the possibility of the animal being safely conveyed to the veterinary surgery, the health status of the animal and ability of the owner to manage the animal's pain until veterinary attention could be sought during normal hours, and travelling time for the veterinary surgeon.
However, the Committee found Mr Chikosi had made no enquiries to determine whether Mitzi was in a fit condition to be moved, and offered no advice as to how her condition could be alleviated whilst waiting for the home visit. Further, his advice that Mitzi should be moved on a blanket was wrong, as she may have had an injured back.
The Committee concluded that, from the outset, Mr Chikosi took the stance that he was unable to leave the practice because he was the only veterinary surgeon present.
However, the Committee noted, from the information available, that there were only three in-patients, no critical cases and a qualified veterinary nurse was present. The Committee found there was no good reason why he should not have attended the farm, which was only 10 to 15 minutes' drive away.
The Committee said that, by the time Mitzi's owner called a second time, it was clear that the out-of-hours service was experiencing difficulty finding a second veterinary surgeon but, instead of going to the farm himself, Mr Chikosi waited another hour until the second veterinary surgeon arrived at the out-of-hours service.
Professor Peter Lees, chairing and speaking on behalf of the Committee said: "The Committee is satisfied that the delay caused Mitzi unnecessary suffering, which was evidenced by her uncharacteristically biting [her owner's] son. [Her owner] had recognised the severity of the injuries and the need for euthanasia as soon as was practicable. [Mr Chikosi's] failure to attend a seriously injured dog promptly in the circumstances described falls far short of the conduct to be expected of a reasonably competent veterinary surgeon."
He directed that Mr Chikosi's name be struck off the Register.
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: