The Webinar Gazette - October 2021 by thewebinarvet

OCT OB E R 2 0 2 1

The

Webinar Gazette

WHAT’S INSIDE: Speaker of the Month

Diagnostic Dilemma

BVA

AHP

David’s reviews

Vet Exhibition

Introduction from

Anthony Chadwick Well September was a funny month! I needed an eye operation for my glaucoma, a viscocanulostomy. I went back to the hospital today and they are pleased with progress and I’m now heading down to London to catch the Eurostar to Belgium to see my daughter for the first time in 2 years. I’m really looking forward to seeing her. The pandemic and lockdown has been difficult for so many people in so many different ways but it has, hopefully, made us appreciate life more. I hope you are keeping well.

1. P lant trees when new members join or locums sign up on our payroll service

I’ve spent a lot of time over the last few months thinking about the challenges that the veterinary profession and the wider world face. Practices are very busy; many still seeing clients outside or separate from their animals; there are workforce shortages caused by Brexit and the pandemic; more animals have been taken on during the pandemic and may now be given up again. It’s a tough situation and you have my profound sympathy.

One of our podcasters, Richard Scott from the Eden Project has donated 10 packs of seed from my local Rimrose Valley meadow for those practices who are considering planting a wildflower meadow at work. Your actions as leaders of your communities are noticed by people who may follow your example. I’d love to see some more beautiful meadows blooming next summer because of your commitment now. Email anthony@thewebinarvet.com if you are up for it and the first 10 will receive some seeds. It’s worth listening to Richard’s podcast or please ask my advice. I’ve learnt a lot this year also consulting on my wife’s rewilding project at her primary school.

This has been compounded by Brexit shortages in our supermarkets, shortage of CO2 and other problems. I’ve also spent the summer speaking to lots of clever people about the environment in our Regenerative podcast series. These people have inspired me to continue with all The Webinar Vet does

2. O ffset our carbon via the EcoOffset service 3. Provide webinars so that people can save travel miles to the benefit of the planet- probably over 10,000,000 miles since inception 4. Plant a wildflower meadow at work 5. G et the word out there with our regeneration podcast

COP26 is happening in early November and I am going to be there to see how we vets can make a difference. We have a key role to play and I see the degradation of the environment as a real existential threat! Within all the difficulties that we face in the profession at the moment it is easy to lose sight of bigger problems in the world like

the climate emergency. Please do email your local MP and encourage him to put pressure on our government to not only host but also to lead the debate on climate change. It really is a critical time. On 5th October 8pm BST, I will be hosting a book club discussion on “Rebirding” by Benedict Macdonald. The UK is one of the most nature deprived nations in Europe and yet it could be so much better with more vision from our leaders and environmental charities as well as a little less tidiness in our gardens and roadside verges. I’d love to see as many debating this very important topic https://us02web.zoom.us/j/84410444867 I also wanted to give a big shoutout to this month’s top CPDers who between them completed 269 hours. • Valeria Vastano • Drew Poh • Monica Guerrero-Mendez • Courtney Perry • Lauren Johnston Finally, I’ve been so impressed with everything that vets and nurses are doing in these difficult times. We are looking for a weekly Simply Vet hero. This week I picked Catherine Tapp for her heroic piece of eye surgery that was recently front-page news in the Vet Times. After my own eye surgery, I empathised with the dog. Well done Catherine! A block of ethically sourced is winging its way to you!

Speaker of the month

James McMurrough CertAVP certificate in Veterinary Cardiology

James graduated from the University of Bristol in 2008 and took a position in a busy out-of-hours and referral practice the same year. He gained the CertAVP(Small Animal Medicine) in 2012, and has just finished his second CertAVP certificate in Veterinary Cardiology. James currently works at Vets Now Referrals in Manchester dealing with referral internal medicine, oncology and cardiology cases. His particular areas of interest are cardiorespiratory diseases and gastroenterology. https://www.thewebinarvet.com/speaker/james-mcmurrough https://www.thewebinarvet.com/shop/sotm-october2021

Use Code for discount off James’ webinars: SOTMOCT

Diagnostic Dilemma: Classification of Brain Neoplasms

Sandra Dawson, Veterinary Pathologist at NationWide Laboratories (BSc BVMS FRCPath MRCVS) I am very much looking forward to learning more about neuropathology in the BSVP Autumn Meeting. Working primarily in the front line of first opinion histopathology in companion animals, neuropathology doesn’t take up a huge section of my case work and so I am extremely grateful to BSVP and the wider networking opportunities I have through my veterinary pathology colleagues to learn more about this particular area of pathology and to discuss the occasional case that crosses my desk. A search through my most recent caseload has revealed an interesting primary brain tumour in an 8-year-old female cross breed dog. This was described as a meningeal mass at level of medulla oblongata. In this case I described the lesion as a meningothelial meningioma, atypical grade 2 but I found the classification tricky for several reasons. The classification of neurological tumours in animal appears to closely follow the human classification system and for many neoplastic conditions in domestic animals this seems to work well but I am wondering if we have enough data from our domestic species to validate this? In this case I received seven small, fragmented pieces of tissue measuring between 5 and 13 mm. They demonstrated some necrosis and there were no other

normal anatomical landmarks. This, coupled with the limited clinical history of a “meningeal mass at the level of the medulla oblongata”, made it difficult for me to orientate the lesion and correlate the clinical information with my histological findings Finally, I did offer some immunohistochemistry with a panel of three antibodies to include vimentin which is expressed meningiomas, pancytokeratin which would highlight epithelial tumours, particularly if there is concern about metastatic carcinoma and GFAP which is expressed in astrocytomas. Unfortunately, the client did not proceed with the panel. I suspect the diagnosis of a neoplastic lesion was all that was necessary for their decision-making process, but this leads to frustration for me in the knowledge that I am not quite sure if my histological suspicions were correct and I have learned nothing for my next case. I am very much looking forward to finding out if the participants have the same diagnostic dilemmas and if the speakers have any helpful tips and advice in dealing with such cases. Thanks again to the Webinar Vet for facilitating the meeting and allowing us to hear such an esteemed group of experts in this field through the wonders of the online meeting!

The Pet Food Manufacturers’ Association and The Webinar Vet present: Pet Obesity Awareness Day – Virtual Event Taking place online on Wednesday 13th October 2021 PFMA and The Webinar Vet are excited to present this FREE CPD event day which will explore the growing problem of pet obesity and the ways in which vets and vet nurses can help to tackle it head-on. An excellent panel of expert speakers has been confirmed including Professor Alex German and Georgia Woods-Lee from the University of Liverpool, Professor Thomas Webb from the Psychology Department of Sheffield University and John Chitty, Co-Director of a small animal / exotics practice in Andover. Presentations will cover the range of pet species and will provide practical tools and guidance on how best to tackle pet obesity and how to communicate with pet owners on this delicate subject. Nicole Paley, PFMA Deputy Chief Executive, advises: “We are delighted to be working with The Webinar Vet to address pet obesity. As it is National Pet Obesity Awareness Day, we want to put the spotlight on this complex issue and encourage vets and vet nurses to join us.” For more information and registration, please visit: www.thewebinarvet.com/pages/pfma-pet-obesity-awareness-day Bespoke sponsorship packages for the event are still available starting from £500 up to £5,000. More information is available here: National Obesity Awareness Day Event: Sponsorship Packages - YouTube With thanks to our sponsors:

Platinum sponsors

Gold sponsor

Veterinary forensics, the link and professional responsibility: What you need to know about animal welfare casework. Friday 10 December, 9am to 4.30pm. FREE for BVA Members with coupon code, £35+VAT for non-members Book your place through The Webinar Vet now. New one-day virtual conference for vets lifts the lid on animal welfare casework and veterinary forensics The British Veterinary Association (BVA) and Scottish SPCA are joining forces to offer vets a day of virtual and interactive learning about veterinary forensics and how they can best use their skills to support animal welfare investigations. Those attending the one-day virtual conference, which is free to BVA members, will hear from experienced vets and animal welfare experts on how to approach animal welfare investigations, and participate in virtual workshops on presenting evidence. Delegates will also gain insights into how to spot possible links between animal abuse and domestic violence. The conference on 10 December kicks off with an interactive session giving an introduction to veterinary forensics and casework, led by Scottish SPCA Chief Veterinary Officer Ian Futter and Gilly Mendes Ferreira, Head of Education, Policy and Research. Delegates will then hear from the RSPCA’s Senior Clinician Vanessa Whitfield and David Martin, Group Animal Welfare Adviser at IVC Evidensia on how to report cases of suspected animal cruelty and neglect, and what vets’ obligations are under the law. Delegates in the afternoon can enjoy a presentation delivered by Paula Boyden from the Links Group and Professor Jo Williams from the University of Edinburgh on the latest research into recognising nonaccidental injury, followed by a session led by Vetlife’s Dr Rosie Allister considering approaches to managing psychological challenges in emotionally demanding work. Romain Pizzi, BVA’s Scottish Branch President, is co-chairing the day alongside Ian Futter, Chief Veterinary Officer at the Scottish SPCA. He said: “We’re delighted to be teaming up with the Scottish SPCA to give vets a comprehensive lowdown on what is a complex and crucial area of work. The day’s speakers offer a wealth of expertise and experience on veterinary forensics and animal welfare casework, which will leave delegates well equipped with the skills and means to support animal welfare investigations in the best way they can.

“Importantly, sessions will also be giving advice on how to spot possible links between animal abuse and domestic violence, as well as tips on how to protect your own well-being when carrying out this vital but often emotionally demanding work. I highly recommend that members book their free place for what will be an insightful and informative day.” Ian Futter said: “Sadly a large number of the animals that come into our care are as a result of cruelty or neglect. In order to secure successful convictions we need veterinary professionals to feel confident giving evidence. “Our conference aims to highlight the importance of veterinary input in these cases. By working together with enforcement agencies, like the Scottish SPCA, the veterinary profession can help fight animal cruelty in Scotland. “We want to build confidence around being involved in animal cruelty cases, particularly for those who are newly qualified in the field. Our conference aims to remove any doubt about the process and showcase the reality of being a professional witness in animal cruelty cases.” BVA members can look on their BVA Member Dashboard under ‘My Discounts’ for their BVA coupon code for a free place. View the full programme and book your spot.

This event is kindly sponsored by

Petplan® is proud to have been working with the veterinary profession and animal charities for over 40 years to help improve the welfare of animals. We provide unrivalled support and training for animal charity staff and volunteers and in 2020 we gave over £4.7million to animal charities who work in partnership with us to help support the work of rescue centres

What is safe for dogs to chew? Canine chew-related tooth fractures

For a number of years, the link between hard chews or toys and tooth fractures in canines has been a concern for veterinarians and veterinary dental specialists. Tooth fractures are commonly seen in practice with a reported prevalence of 25-27 percent,1-7 and occur most frequently in functionally important teeth with a role in prehension and chewing (i.e. canines and carnassials).1, 5-8 Tooth fractures can be extremely painful and can often lead to further complications, such as abscesses and infections. However, a lack of formal research has meant dental specialists have been unable to quantify the risk hard chews or toys could pose to dogs. A new study, conducted by the University of Pennsylvania and supported by Mars Petcare, has investigated the forces that are required for tooth fractures to occur.

“Fractured teeth are one of the most common cases we see referred to us and often these are caused by products which are too hard. To help owners understand the risk these chews and toys pose, vets need to really help owners understand what is safe for their dog to chew on.” Norman Johnston BVM&S, FAVD, Dipl.AVDC, Dipl.EVDC, FRCVS

Clinical findings The fracture limits of maxillary fourth premolar teeth were tested via an axial compression test on 24 teeth. The mean maximum load (± SD) sustained by the tested teeth at the point of fracture was 1,281 N (± 403 N) at a mean impact angle (± SD) 59.7° of (+/- 5.2°). This establishes a clinically relevant pattern of fracture of maxillary fourth premolar teeth under angled compression at forces within the maximum chewing capability of the average domestic dog.

Tooth “slab” fracture © Lisa Milella

About the author

Prof. Alex Reiter Dipl. Tzt., Dr. med. vet., Dipl. AVDC, EVDC Dr. Reiter is Professor and Chief of Dentistry and Oral Surgery at the University of Pennsylvania’s small animal teaching hospital. He is also a diplomate of the American Veterinary Dental College (AVDC) and European Veterinary Dental College (EVDC).

The most common fracture type that occurred among all samples was a complicated crown fracture (n=12), followed by an uncomplicated crown fracture (n=6). There was no statistically significant correlation between dog age, weight or impact angle and the maximum load applied before fracture.

Significance The findings of the study provides robust evidence that chewing objects of a hard

consistency presents a high-risk for dogs fracturing their teeth.

Chew toys and treats that fail to yield below the maximum load of 1,281 N should be considered to be a risk of fracturing maxillary fourth premolar teeth. Dogs routinely exposed to hard treats and toys that do not yield significantly below this point might be at increased risk of fracture of maxillary fourth premolar teeth as a result of overexertion during chewing.

What can veterinarians do? Chews and toys are an important part of an effective canine oral care regime, however pet owners need to be made aware of what is safe for their dog to chew. Until an industry standard is introduced, veterinarians and practice staff play an important role in education around textural safety.

Despite their prevalence in clinical practice, slab fractures can often be missed due to their difficulty to diagnose via conscious examination. In addition, many owners may not immediately notice if their dog is suffering from a fractured tooth, however this does not mean that the dog is not in pain. Remember to check for these fractures as part of a routine dental check. Fractured teeth with pulp exposure can be root filled or extracted, but should never be left.

References 1. Golden AL, Stoller N, Harvey CE. A survey of oral and dental diseases in dogs anesthetized at a veterinary hospital. J Am Anim Hosp Assoc 1982; 18: 891-899. 2. Le Brech C, Hamel L, Le Nihouuannen JC, et al. Epidemiological study of canine teeth fractures in military dogs. J Vet Dent 1997; 14: 51-55, 1997. 3. Hamp SE, Olsson SE, Farso-Madsen K, et al. A macroscopic and radiologic investigation of dental diseases of the dog. Vet Radiol 1984; 25: 86-92. 4. Venturini. Retrospective study of 3055 pets referred to Odontovet® (veterinary dental center) during 44 months. Dissertação (Mestre Em Medicina Veterinária), Faculdade De Medicina Veterinária E Zootecnia, Universidade De São Paulo 2006; 35-37. 5. Gioso MA, Lopes FM, Ferro DG, et al. Oral fractures in dogs of Brazil - a retrospective study. J Vet Dent 2005; 22: 86-90. 6. Butkovic V, Simpraga M, Sehic M, et al. Dental diseases of dogs: a retrospective study of radiological data. Acta Vet Brno 2001; 70: 203-208. 7. Capik I, Ledecky V, Sevcik A. Tooth fracture evaluation and endodontic treatment in dogs. Acta Vet Brno 2000; 69: 115-122. 8. Soukup JW, Mulherin BL, Snyder CJ. Prevalence and nature of dentoalveolar injuries among patients with maxillofacial fractures. J Small Anim Pract 2013;54:9-14.

Meet the team

Kathryn Bell, CEO Tell us a little bit about yourself?

How long have you worked at TWV?

Any goals for 2022?

Hello my name is Kathryn, I live by the beach in Crosby, just outside of city centre Liverpool. I love being busy, whether that’s spending time with my lovely family and friends or being at work. I will always have at least ten lists on the go and to keep life and work on track, and love feeling productive. I also love getting outside getting my steps in, and travelling the world, although it’s proving difficult at the moment! I’m a HUGE Liverpool FC fan, coming from a dedicated family of reds, and get to Anfield as much as I can. I am fascinated by people, their motivations, supporting their development, and helping them to achieve their goals.

I’ve been a part of this company for just under a decade, helping to take us from a team of 3 to 30 and one brand to 5, through growth and acquisitions, all of which supporting our vision to become the veterinary marketplace. I’ve sat on our Board for the last six years too. When I think back to January 2012 and the start of my Web Vet journey, our community and membership base was tiny, and we were very much a UK based online CPD company. I’m very proud of the global brand we’ve become, and I can’t wait to see what the future holds as it really does feel like now we’ve got our team in place we’re just getting started!

At TWV we spend a lot of time at the start of the year looking at our vision and values and for the first time ever we’ve started to align our purposes, and passions to the UN Development Goals. Some of the team are extremely passionate about sustainability and we’re doing some great initiatives in that space which I’d love to build on in 2022. Another main passion in the organization, particularly for myself, is gender equality, and we’ve got some big goals and initiatives that will play a huge focus for 2022. Keeping a focus on work-life integration and getting that right will be an ongoing goal for me too!

What is your role at TWV?

Favourite thing about the company?

If you weren’t in this role what else would you be doing? (not TWV)

Up until April 2021 I was always heavily involved in the operational aspects of TWV, primarily running the day-to-day ops, marketing, and tech teams. As the team has grown and Anthony Chadwick our founder decided he wanted to focus on the recruitment side of Alpha Vet, I was asked to become Acting CEO of the business which is the role I’m so thrilled to be doing currently.

I love that our vision and values are the guiding force behind everything that we do. I love that we consider ourselves to be a community more so than a company, and most importantly I love that everything we do is to support people in the profession, their careers, and their families.

Absolutely still a role that involves supporting people. I’m so passionate about people, diversity and business transformation and believe the three are so interlinked. If people feel supported and empowered, and can truly be themselves at work, that’s when growth and transformation happens!

Simply Vets Referral Scheme – Make £100 Per Referral! Here at Simply Vets we have created a new referral scheme; all you have to do is refer a friend to Simply Vets and once they complete 5 shifts via the Simply Vets Payroll service you get £100! It really is that simple, just put us in touch with a locum vet or nurse and after the 5 shifts we’ll pay you £100. You don’t have to be part of Simply Vets or even part of the veterinary industry to qualify for the referral payment! The locum doesn’t have to come with a contract or booked shifts either - the recruitment team at Simply Vets are experts in finding locum roles across the UK. You might now be wondering, ‘Why Simply Vets?’. Of course, we think we are great, but take a lot at the 5 points below that we think set us apart from our competitors.

Increase your take-home pay

Access to our jobs board

Unlike many umbrella and payroll companies, we do not charge to submit a timesheet or levy a monthly fee. We also don’t charge you for Employer’s National Insurance, the result is a much higher takehome pay!

Fancy finding something yourself? Also fine - take a look at our jobs board for over 100 locum roles currently available across the country. If the dates aren’t quite right but you like the practice - get in touch with us directly and we can arrange alternative dates at that practice!

Free CPD Membership

Invitations to Locum Events/Webinars

Our sister company, The Webinar Vet, offers all Simply Vets Locums a free membership if you complete 10 shifts per month via the Simply Vets payroll service - a saving of £500 per year for you!

We want our locums to be the most confident in the world, so we like to ensure they are up to date with all the latest techniques and practices with our Simply Vets webinars. They are run live in the evening with our experts, so you have a chance to ask any questions alongside watching their presentation.

Introductions to practices The recruitment team at Simply Vets are experienced in finding exactly the right role for you. With contacts all over the UK, just let them know your preferences and watch the opportunities roll in!

The first CAT Handling Gloves which REALLY work! It will be hard to forget the moment I was allowed to witness 2 nurses restraining a cat with just a towel..

Followed by their use as protection against bites and scratches of a much wider range of species.

The sound was eerie and gave me the distinct feeling that something was about to explode!

From big lizards to small crocs, and from bats to even small sharks!

And in reality I wasn’t far of, as the cat really did not like what was happening.

Eventually what triggered our interest in the veterinary scene; the handling of tiger cubs at Chester Zoo!

The furry creature eventually had its injection administered and after the second round of a seemingly ongoing wrestling match it was safely placed back into its enclosure.

Although not puncture proof, the specialist fabric we use in our gloves is highly puncture & needle stick resistant (level 5)

That first time was quite an experience.. and I can only say; a BIG respect to the nurses, as they clearly made the best of a daunting situation. I was told that the alternative methods of (useless) gloves or a crush cage (even the name sounds scary) were not preferred, for a variety of seemingly valid reasons. And after some in-depth research it became clear that being scratched and bitten was merely considered to be an occupational hazard. Which to me really says something about the wonderful people who fulfil this important position at the frontline. Had it been an occupation not involving animals, but instead; ‘working with machinery’, then it would most likely be an entirely different situation.. It was crystal clear to me that our ‘Venom Defender’ animal handling gloves would make a huge difference! As by then we had already been successfully providing our gloves to handlers of dangerous reptiles and animals at zoos around the world for approximately 7 years. And thus testing had been done in the most extreme circumstances imaginable. At first against the bites of venomous snakes, hence the brand name; ‘Venom Defender’!

We actually managed to utilise 3(!) layers in the make up to achieve the ultimate protection, whilst they still are extremely comfortable to wear! Furthermore, after learning how off-putting ‘dirty’ and ‘bloody’ gloves can be, we ensured that they can be washed in a washing machine, and dry in less than 6 hours. And indeed, since our launch in the veterinary scene, we have had a great response. After extensive testing the PDSA charity ordered one pair for each of their hospitals. And the RSPCA which, after they conducted their trials, ordered the gloves specifically for the rescues of feral and difficult to handle cats. Buying Venom Defender gloves for your practise can be considered a worthwhile investment, as they dramatically reduce downtime, staff shortages, lasting injuries and/or worse. They very quickly pay for themselves! And as you cannot give a monetary value to the increase in animal welfare and significant reduction in stress to your staff, these gloves could even be considered to be; ‘PRICELESS’ I invite you to watch my ‘Webinar Vet’ presentation and visit our website. Clem Kouijzer

Useful links.. Website 1-2-1 Animal Handling Products; www.1-2-1.com

Promo video; https://www.youtube. com/watch?v=Q93gn-PzSr8&t=1s

Brochure; https://1-2-1.com/images/ brochures/venom-defender-glovescats-brochure.pdf

Website Snake Professional; https://snakeprofessional.com/

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David’s reviews

Point of care terminal pro-B-type natriueric peptide assay to screen apparently healthy cats for cardiac disease in general practice Ta-Li Lu, Etienne Coté and others Journal of Veterinary Internal Medicine First published 16 May 2021 (Open Access) This article follows on from the webinar by James McMurrough that I have summarised in this month’s webinar newsletter. It is multi -author, and mainly from colleagues from the Cardiospecial Veterinary Hospital in Taipei, Taiwan. Etienne Coté is at the Atlantic Veterinary College on Prince Edward Island in Canada. Point of care N-terminal natriuretic peptide (NT-proBNP) ELISA test has been evaluated for screening cats for cardiac disease in the referral practice setting, but less is known about its use in general veterinary practice. The objective of this study was to evaluate the diagnostic utility of the above test in cats seen in primary care practice. Two hundred and seventeen apparently healthy cats from twenty-one practices were enrolled. Veterinarians at their general practices performed cardiac auscultation and NY proBNP Elisa tests. After enrollment the cats were evaluated at a cardiology referral veterinary hospital. This entailed cardiac auscultation and echocardiographic diagnosis. Results were interpreted based on whether cats had normal or abnormal echocardiographic findings. The results were as follows: The point of care ELISA test differentiated cats in the abnormal group from those in the normal group with a sensitivity of 43% and a specificity of 96%. In cats with a heart

murmur the corresponding values were 71% and 92% respectively.

University of Tennessee Veterinary School.

In conclusion the authors state that: -

Veterinary Clinics of North America

In apparently healthy cats a positive test is associated with heart disease warranting an echocardiogram, but negative results do not reliably exclude heart disease. The results suggest that the test is not an effective screening test for apparently healthy cats seen in primary care practice. Its performance is improved when it is used only in cats that have a heart murmur The September 2021 edition of Veterinary Clinics of North America: Small Animal Practice is entitled ‘Effective Communication in Veterinary Practice’. This topic revisits an earlier one on the same subject in 2007. Clearly time for an update as currently veterinary students in AVMA accredited veterinary schools around the world are graduating with training in the use of core skills such as effective listening, open-ended questions, expression of empathy and the use of non-verbal communication. There are many useful and interesting topics in this edition. Following on from the webinar by Tasha Walsh, which I summarised in this month’s newsletter, I was interested in the article by Adesola Odunayo and Zenithosn Y Ng. Both authors are from the small animal department of the

Valuing Diversity in the Team Volume 51 Issue 5 September 2021 pages 1009-1040 The key points as stated by these authors are: • Diversity is a term used to describe individual and group/social differences (e.g. life experiences, personality types, socioeconomic status, class and gender) • Diversity is about creating a culture and practices that recognise, respect and celebrate those differences • Veterinary practices that are diverse serve a diverse clientele, inspire creativity and foster innovation • Diversity should be valued among team members. This involves continuous lifelong learning as individuals and as a team Other articles in this edition include amongst others Veterinary Clinical Ethics and Patient Care Dilemmas, Compassion Fatigue: Understanding Empathy, Challenges in Intercultural Communication and Suicide Warning Signs and What to do. This last one is a sombre topic but is approached in a sensitive way by the

authors. I have mentioned it here because it is very informative and adds information from the webinar by Tasha Walsh, which I have reviewed and thoroughly recommended. Suicide warning signs and what to do Veterinary Clinics of North America Volume 51 Issue 5 September 2021 Pages 1053-1060 Christine Moutier MD and Maggie G Mortali MPH Both authors are medically qualified and associated with the American Foundation for Suicide prevention. Christine Moutier is the Chief Medical Officer of the Foundation. Key points in this article as stated in the abstract are that: • Suicide is a complex health outcome with multiple intersecting risk and protective factors • Critical to suicide prevention is helping the person connect with hope and reasons for living while at the same time helping them feel less connected to reasons for wanting to die • Key features of suicide prevention initiatives for veterinary professionals include reducing stigma associated with mental health distress and help seeking, improving access to peer or social support and to health care, and making judicious changes related to access to lethal means in the professional work setting In the introduction the statistics for suicide in the United States are that in 2019 more than 47,000 Americans died of this cause. It is a major public health problem worldwide with approximately 800,000 deaths per year. For vets research has shown that the suicide rate is higher than that of the general population. This statement is backed up by a 2019 study that demonstrated that in the United States of America between 1979-2015 male vets were 2.1 times and female vets 3.5 times as likely to die by suicide compared to gender matched controls in the general population. During the era of the pandemic attitudes to mental health care have been opening up tremendously, and science demonstrates that suicide, although complex, is a health issue and generally preventable cause of death. Therefore implementing steps to prevent suicide among veterinary professionals can drive down the suicide rate and save lives. This excellent and comprehensively researched article describes biological, psychological, social and environmental risk factors in detail. Suicide warning signs are divided into talk, behaviour, and mood, and with each one there is a list of important features. The final part of the article is entitled ‘What you can do’ and contains a lot of practical advice for all of us.

From the 16th – 18th September, THE Vet Exhibition hosted the 32nd European Veterinary Dermatology Congress, including the Royal Canin pre-congress symposium on the 15th September 2021. Between the 15th – 18th September alone, THE Vet Exhibition had a phenomenal virtual footfall of 13,322 visits taking the total visits since launching over 40,000! The commercial exhibition will remain open until the 31st December 2021 to all ticket holders so we do encourage all participants to continue visiting our fantastic exhibitors and sponsors! For now, take a sneak peak into each of the exhibitor stands! Gold Sponsors

Silver Sponsors

Bronze Sponsors

Digital Exhibitors

THE Vet Exhibition will also be welcoming a new exhibitor from next month so watch this space for more information!

I’d encourage anyone who wants to learn more about THE Vet Exhibition to book in a private demo and I would love to virtually show you around! Stephanie, THE Vet Exhibition Show Manager

WEBINAR

MANAGING AGGRESSION IN RABBITS GUEN BRADBURY MA VetMB MRCVS

WEBINAR

Guen Bradbury qualified from Cambridge Vet School in 2011 and has had a varied and very interesting career since then. Of particular interest for this veterinary webinar she has written a textbook ‘Behavioural problems in rabbits: a clinical approach’, runs a teleconsultancy to help rabbit owners, vets and vet nurses, is the veterinary adviser for RWAF’s ‘Rabbiting on Magazine’, an Honorary Fellow of the University of Edinburgh and lectures at the Cambridge University veterinary course. She is also an Innovation Consultant, working for Innovia Technology. It is worth googling that aspect of her work! The aims of the webinar are as follows enabling you to understand: • Why rabbits show aggressive behaviour • Why this behaviour should be reduced •H ow rabbits show aggressive behaviour • How to differentiate different types of behaviour • How to reduce aggressive rabbit behaviour Rabbit aggression is divided into between rabbits and to counteract predation. Some reasons are listed including resource protection, pain, fear, frustration, maternal care and territorial Generally in the wild rabbits don’t show aggression between themselves. In domesticity they do and when it occurs it indicates bad animal welfare, and shows acute stress. A very good line diagram takes you through the various stages of aggression from subtle signs through to fighting, chasing and biting. The constant need of exhibiting aggressive behaviour, such as that seen commonly in domesticity, inevitably induces chronic stress clinical manifestations leading to inactivity, stereotypes, and a lack of self –care, amongst others. Aggressive behaviour escalates as shown in another diagram reinforcing earlier information. It begins with withdrawal, threat, chase, bite and fight, and this is followed by a couple of videos demonstrating rabbit aggressive behaviour. I was impressed by the fortitude of the rabbit owners with protective boots on, while their rabbit circled them searching for a place to inflict a bite. I was also quite surprised by the statistics that 13% of rabbit owners experience regular aggression by their pet, and astonishingly 24% have been bitten at least once.

Some rabbits may naturally act more aggressively. For example, inter rabbit aggression is more commonly seen with unfamiliar rabbits, unneutered males, rabbits in pain and rabbits in single sex pairs. Rabbit aggression to people tends to occur especially in rabbits that are picked up, rabbits housed alone, rabbits in pain and in female rabbits or neutered males. Differentiating the causes in individual rabbits requires, just as in any routing veterinary consultation, on the signalment, history, clinical examination and specifically a behavioural examination. In order to understand the principles of reducing aggressive behaviour we are introduced to the ABC model of behaviour comprising Antecedent, Behaviour and Consequence. In rabbits the A is the stressor, B is the aggressive response and C is the owner (or companion rabbit) response. We are asked whether we can change the stressor in the environment, change the behaviour or change the response.

I was looking forward to watching this webinar for two reasons. First, because I have heard Gayle speak before and I expected a very easy to assimilate educational webinar, and secondly because the subject was one I know absolutely nothing about having been mainly in small animal practice

An example of changing the environment is ensuring that there is a join between the main accommodation and the exercise area avoiding the need to pick up the rabbit in order to facilitate moving to an exercise area. Rabbits, perhaps unsurprisingly are particularly averse to being picked up. A very neat explanation underlying this compares the development of human infants (plenty of hand contact) with rabbits, (no hands). Hands are, as a result, very threatening to rabbits. For changing behaviour we are introduced to the concepts of desensitisation and counter conditioning. This is very well and logically explained with some examples of their use. The final part of the webinar deals with the reduction of aggression in specific situations. These are summarised with examples: • Fear • Pain

GUEN BRADBURY MA VetMB MRCVS

• Territorial • Food related. This is an excellent webinar, very clearly explained throughout and leaves you with a good foundation in rabbit behaviour and wanting to know more. It is thoroughly recommended for all with an interest in rabbits.

WEBINAR

CATIOMYOPATHIES: AN UPDATE ON FELINE HEART DISEASE A Bristol 2008 graduate, James started his professional career in a busy out-of –hours and referral practice. He has achieved RCVS advanced practitioner status with two CertAVP certificates in small animal medicine, and just recently in veterinary cardiology. He works at Vets now Referrals in Manchester. This veterinary webinar is specifically aimed at first opinion vets and nurses with the aim of updating knowledge of feline cardiac disease as follows: • Overview of common cardiomyopathies • How to screen for occult cardiomyopathies • How to diagnose feline congestive heart failure (CHF) • How to treat feline CHF • Use of thrombotics in feline heart disease

He begins by outlining the main cardiomyopathy types and their underlying causes, while emphasising that they are common and a significant cause of mortality. Hypertrophic cardiomyopathy (HCM) has a prevalence of 15% in the general population and 29% in older cats. Of these 23% will progress to cardiac related death due to congestive heart failure, (CHF) arterial thromboembolism, (ATE) or arrhythmias. Certain breeds at risk are listed and ultrasound images demonstrate the diagnostic features. Restrictive cardiomyopathy (RCM) can be seen in endocardial or myocardial forms and is more common in older cats. There is often marked bi-atrial enlargement (an excellent ultrasound image shows this) and the condition has a poorer prognosis. Dilated cardiomyopathy (DCM) is uncommon and can be associated with nutritional deficiency or as an end stage of other cardiomyopathies.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is rare and there is an ultrasound video depicting this cardiac disease. The recent ACVIM consensus statement on staging cardiomyopathies is outlined. This is A –predisposed B1-low risk B2 –higher risk C –current/previous CHF or ATE and D =refractory CHF. A suggested protocol for the screening for occult cardiomyopathy (stage B1/B2) involves history (normal) physical examination, blood tests and echocardiography but not radiography, which has no value. Although genetic testing may be of some value with specific breeds, the most useful blood test is the Quantitative NTproBNP. This is a biomarker for cardiomegaly and can be useful when echocardiography is not available. There is a snap version of this that can be performed on plasma or pleural effusions. It enables discrimination between cardiac and noncardiac causes of respiratory distress where

WEBINAR The webinar is an excellent review of feline heart disease with up to date references, superb ultrasound images, many of which are in video format, and will be of great value for students, nurses and vets in primary care practice. a point of care ultrasound is not available. There is a very good summary of the diagnosis of congestive heart failure. There are relevant statistics for heart rate, breathing rate and a surprise (for me at least) that a rectal temperature less than 37.5 degrees C is very suggestive. The previously mentioned blood test is useful, and also blood pressure measurements and an ECG. Most important is a point of care ultrasound. According to James this can be performed in primary care to improve diagnosis after appropriate training. I would expect that one of the results of this webinar will be a strong desire to access ultrasound training, particularly by young colleagues I suspectand a request for the practice to acquire an ultrasound machine if not already available. Point of care ultrasound can assess for left atrial cardiomegaly, assess the type of cardiomyopathy and assess for the presence of B lines, pleural effusion and pericardial effusion. The ultrasound image of B lines is particularly impressive. General advice follows on the use of ultrasound in the investigation of feline heart cases, noting that it is the only way to definitively diagnose feline cardiomyopathies and is the best way to give an accurate prognosis. No drugs are proven to delay CHF in cats, There is however a discussion around the usefulness or otherwise of atenolol, and thrombolytics (dealt with later in the webinar). These are advised for those cats at risk of developing ATE. The treatment of CHF is divided into the emergency case and outpatient care. Emergency treatment emphasises oxygen supplementation, anti-anxiety drugs, thoracocentesis, (if required), furosemide and monitoring of renal values, potassium levels, blood pressure, respiratory rate, urine output and body weight.

The mainstay of outpatient treatment is furosemide, although torasemide according to a recent publication cited in the webinar, may be an improvement. Other drugs mentioned here are pimobendan, ace inhibitors and spironolactone. Of these drugs the possible advantages of pimobendan are discussed in more detail. James makes an important point of the risk of polypharmacy (particularly with cats) is of owners finding management too difficult. An interesting and easy way for owners to monitor progress is to note the respiratory rate of their cat when it is sleeping. A respiratory rate of less than 30 breaths per minute suggests good control. Breaths per minute of more than 30/minute indicates possible pulmonary oedema and anything over 40/minute should prompt advice to attend the clinic. The final slide of this webinar deals with the use of anti-thrombotics to prevent ATE. Mentioned here are aspirin, clopidogrel (stated to be superior to aspirin according to the FAT Cat study) and Rivaroxaban, which has been evaluated in the SUPER CAT study. The webinar is an excellent review of feline heart disease with up to date references, superb ultrasound images, many of which are in video format, and will be of great value for students, nurses and vets in primary care practice.

JAMES MCMURROUGH BVSc CERT AVP (SAM/VC) MRCVS

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WEBINAR

ADVANCES IN INVESTIGATION AND TREATMENT OF NECK PAIN IN THE HORSE Rachel, like most equine specialists I suspect, decided on her career path quite early after graduation following three years in mixed practice in the south west of England. She began her exclusively equine career at Liphook Equine Hospital followed by equine practice in Norfolk, and a further three years at Liphook before undertaking a residency at her alma mater, the RVC. During this time she achieved a certificate in equine orthopaedics, a Masters in Veterinary Medicine, and became a diplomate of the European College of Equine Surgery. After a year in Yorkshire she returned to Liphook Equine Hospital in the summer of 2017. It’s an excellent CV, making her very well qualified to deliver this veterinary webinar on neck pain in horses.

Clinical signs of neck pain are listed including fixed low head carriage, difficulty eating and a reduced range of movement. Subtle signs are reduced performance, unwilling to work on the bit, forelimb gait deficits/tripping and behavioural changes.

The content of the webinar is as follows: -

A series of very high quality radiographs in various projections demonstrates the value of this procedure. Scintigraphy is considered fairly insensitive for the cervical spine but does have some use in investigating poor performance. Ultrasound also has its usesfor example to guide joint injection, assess joint margins and thickened joint capsules. However computed tomography is the modality that has significantly enhanced understanding of neck conditions. The procedure is performed under a short general anesthetic, using wide bore gantries enabling imaging of the entire neck in most horses. A photograph of a horse in the CT scanner is extraordinary and even more so is the collection of CT images that follows. Myelography in lateral and transverse views are shown. Over the last few years at Liphook Equine Hospital approximately 70 horses have had CT scans of the neck. This has improved understanding of conditions such as cervical vertebral malformation (CVM/Wobblers syndrome) and articular process joint (APJ) arthropathy.

• Relevant anatomy • Clinical signs and clinical examination • Diagnostic imaging • Pathological conditions and imaging examples • Treatment options The first thing that struck me from the first photographs of a horse grazing is the extraordinary range of movement required of the neck. Small wonder things go wrong. Neck and spinal pain is very common in people and many of us, (of a certain age!), may have personal experience of this adding to the comparative interest. Some very well constructed line diagrams revise the anatomy of the seven cervical vertebrae. Of note is that Atlas (C1) and Axis C2) are highly modified for the large range of movement required. Particular emphasis is also made of the articular process joints with the use of diagrams and post mortem material.

Cervical imaging follows a well-described, thorough clinical examination. This consists of: • Radiography • Scintigraphy • Ultrasound • CT • Myelography

WEBINAR

The webinar is a pleasure to watch delivered by a colleague very much on top of her subject and well presented with some fantastic images.

The full list of conditions described is as follows: • Articular process joint osteochondrosis • Articular process joint osteoarthritis including radiculopathy, APJ fragments and loose bodies • Cervical osteomyelitis • Cervical subluxations/fractures • Nuchal ligament desmitis, nuchal bursitis • Morphological variations • Intervertebral disc disease and cervical neoplasia This section contains many images of quality CT scans, some clinical cases with their relevant history, and post mortem cases. The final part of this excellent webinar discusses treatment options, beginning with conservative management of neck pain and the various drugs that may be of use. Ultrasound guided intra-articular injection with triamcinolone acetonide (total dose 18 mg) is described in addition to physical therapies. There is a short discussion on perineural injection, which at Liphook has only been performed in a few cases. Surgical options exist and they are briefly described. Cervical Vertebral Stabilisation has been reported (reference cited) to induce bony regression of arthritic APJs 12 months post surgery. The procedure is technically demanding and expensive with associated risks to the horse but offers an additional option.

Rachel summarises her final thoughts: • The diagnosis of neck pain can be challenging therefore maximise the clinical value of diagnostic imaging, including advanced imaging where possible •A PJ medication can be very effective in selected cases • Surgical options exist-but: •G reater understanding of the underlying disease processes is needed •O ther avenues require investigation such as neuropathic pain and myofascial dysfunction. The webinar is a pleasure to watch delivered by a colleague very much on top of her subject and well presented with some fantastic images. It is thoroughly recommended to all with equine interests but also I suggest to all those interested in orthopaedics from a comparative point of view.

Rachel Tucker

BSc B.Vet.Med M.Vet.Med Cert AVP (ESO) Dip ECVS MRCVS LIPHOOK EQUINE HOSPITAL

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