Vet's Hub Volume 1 Number3

U Veterinary burnout: Causes and solutions U CPD webinar: Protecting kidney function in cats

Volume 1 | No. 3

U Itchy horses? Solutions beyond the scratches

Earn CPD points

From science to solutions in veterinary care

Informed consent: What exactly do I need to disclose?

Vet’s Hub

Contents

Volume 1 | No. 3 EDITORIAL EDITOR: René Bosman René.Bosman@media24.com SUB EDITOR: Gill Abrahams LAYOUT & DESIGN: Allison McCallum ADVERTISING KEY ACCOUNT MANAGER Cindy Riederer | 082 492 0229 Cindy.Riederer@media24.com DISTRIBUTION & SUBSCRIPTIONS Rae Morrison Rae.Morrison@media24.com PUBLISHING TEAM General Manager: Dev Naidoo Head of Content & Digital Strategy: Varushka Padayachi Production Manager: Angela Silver Group Art Director: David Kyslinger MEDIA24 MEDIA CEO: Minette Ferreira CFO: Luxolo Dywili MEDIA24 CORPORATE CEO MEDIA24: Raj Lalbahadur CFO MEDIA24: Nelmarie Beyers B2B JOHANNESBURG OFFICE Building 13, The Woodlands Office Park, 20 Woodlands Drive, Woodmead, Sandton PO Box 784698, Sandton 2146 Tel: +27 11 867 6111 Published by Media24 B2B www.medicalacademic.co.za PRINTING Printed by Novus Print, Cape Town Cover photograph: Getty Images/GlobalP

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Editor’s note: From burnout to biodiversity: Connecting care across every level

News: Burnout among veterinarians: Understanding the crisis and strategies to cope

Vet’s Nursing Corner: Key domains of veterinary nurse contributions

Medicolegal: Informed consent: What exactly do I need to disclose?

Practice Management: What you need to consider when running a successful veterinary practice – Part 2

Health awareness: Not just old bones: Rethinking canine osteoarthritis

Infectious diseases: Rabies: A preventable but persistent global threat

Companion animals: Treating inflammation first: Are we rethinking canine otitis externa?

Nutrition of ageing cats: Understanding the unique needs of senior felines Cat-astrophe averted: Evidence-based diabetes management in cats CPD activity: Protecting kidney function in cats: Preserving companionship from diagnosis to longevity

Livestock: Itchy horses?

Solutions beyond the scratches Spring flush syndrome in cattle: Managing the risks of rapid pasture transition

32

Wildside: South Africa’s biodiversity plan puts farms, livelihoods and nature at the centre

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Vet’s Hub

Editor’s Note

Volume 1 | No. 3

From burnout to biodiversity: Connecting care across every level

Welcome to issue 3 of Vet’s Hub, where we explore veterinary medicine beyond the consulting room. This edition spans the wellbeing of veterinary professionals, advances in clinical practice, effective practice management, One Health and the broader role of the profession in protecting biodiversity.

The mental wellbeing of the veterinary profession: Burnout

accurate staging and nutritional intervention to preserve kidney

is not a personal weakness but a recognised occupational risk

function and improve quality of life.

affecting veterinarians worldwide. In this issue, we examine

Marking Itchy Pet Awareness Month, we examine allergic skin

the factors driving burnout and explore practical strategies to

disease in horses, exploring the latest understanding of insect

help veterinary professionals build resilience and safeguard

bite hypersensitivity and equine atopic dermatitis. Advances in

their wellbeing.

veterinary dermatology continue to improve our understanding

Veterinary medicine has always been a team effort, and

of the complex interactions between genetics, immune function

veterinary nurses are central to that success. Their contribution

and skin barrier integrity, enabling more targeted, evidence-based

extends well beyond clinical support to infection prevention,

treatment strategies.

antimicrobial stewardship, public education, disaster response

Prevention remains a recurring theme throughout this

and animal welfare. Together, veterinarians and veterinary

issue. As World Rabies Awareness Day approaches, we revisit

nurses embody the principles of One Health, recognising the

one of the world’s most preventable, yet persistent zoonotic

interconnected health of animals, people and the environment.

diseases and the collective responsibility required to eliminate

Outstanding veterinary care depends not only on clinical

human deaths.

expertise but also on communication, leadership and efficient

Finally, we broaden our perspective to South Africa’s

practice management. In our Medicolegal feature, Dr Cornelia

remarkable natural heritage. The draft National Biodiversity

Els reminds us that informed consent is far more than a

Strategy and Action Plan reminds us that conservation extends

signed document – it is an ongoing conversation built on trust,

well beyond protected areas, recognising biodiversity as living

transparency and shared decision-making.

infrastructure that supports healthy ecosystems, resilient

Marianne van Wyk continues her practice management series, highlighting how exceptional patient care, outstanding client

communities and sustainable livelihoods.

Whether your passion lies in companion animals, equine

service and effective stock control form the foundations of a

practice, livestock, wildlife or practice leadership, we hope

successful veterinary practice.

this edition provides practical insights, fresh perspectives and

This issue also brings together a diverse range of clinical

inspiration for your daily work. Thank you for being part of the

topics across companion animals and equine medicine. Dr

Vet’s Hub community. We hope these pages leave you better

Myra Rose Marais explores evidence-based management of

informed, better connected

canine otitis externa, questioning whether every case requires

and ready to embrace

antibiotic or antifungal therapy and reinforcing the importance of

the opportunities and

antimicrobial stewardship.

challenges ahead. U

Dr Angeliki Kaldelis summarises the latest Royal Canin Veterinary Academy insights into the changing nutritional needs of ageing cats, while we examine the latest International Cat Care consensus guideline on feline diabetes, emphasising early diagnosis, structured management and long-term caregiver engagement.

We also revisit highlights from our inaugural CPD-accredited Vet’s Hub webinar, where Dr Melanie Wergin discussed chronic kidney disease, underscoring the importance of early detection,

Renè Bosman

Writer & Editor

Vet’s Hub

News

Volume 1 | No. 3

Burnout among veterinarians The veterinary profession faces a critical challenge: Burnout. Long hours, emotional strain, financial pressures, and difficult client interactions contribute to stress and drive veterinary professionals from the field. This harms not only their well-being but also patient care and workplace morale. Research highlights the concerning mental state of veterinarians, with studies finding high rates of burnout, compassion fatigue, and burden transfer (stress from client challenges). Early-career and female veterinarians are most vulnerable. Several studies explore interventions to improve veterinary well-being.1 Burnout is not simply feeling tired or stressed at the end of

The consequences extend beyond the individual. Burnout is

a long shift – it is a psychological syndrome rooted in prolonged

strongly associated with increased rates of depression, anxiety,

exposure to chronic interpersonal job stressors. It is characterised

compassion fatigue, and suicide risk. In a study of practising

by three distinct and measurable dimensions: Exhaustion,

veterinarians in Spain, 36.9% were classified as experiencing

cynicism, and reduced professional efficacy. 2

high emotional exhaustion, 33.3% as high in cynicism, and 19.8%

Exhaustion reflects the overwhelming depletion of physical and

reported a formal diagnosis of anxiety or depression.4 A further

emotional energy. Cynicism – sometimes called depersonalisation

31.9% felt they needed professional mental health treatment but had

or disengagement – describes a detached, negative, or indifferent

not been diagnosed – suggesting a significant gap between need

attitude toward work, colleagues, and patients.2

and access. Concerningly, 19.1% reported using benzodiazepines,

Reduced professional efficacy refers to a growing sense of incompetence and failure to achieve meaningful outcomes.

Importantly, burnout is not synonymous with depression, though

with ~50% doing so without a prescription, underscoring the depth of untreated psychological distress in the profession.4 The suicide risk among veterinarians is particularly sobering. In

the two are closely interrelated and can mutually reinforce one

the United States, veterinarians die by suicide at a rate 3.9 times

another. Burnout is fundamentally situational and occupational

higher than the general population, while British veterinarians face

in nature, arising from structural mismatches between a worker

~4 times the national average suicide rate. Female veterinarians in

and their work environment rather than from individual character

the United States face a 3.4-fold increased risk compared to the

weakness or personal failing. 2

general female population. The ready availability of euthanasia

These structural mismatches are best understood through the Areas of Worklife model, which identifies six key domains in which

drugs is a compounding factor, increasing suicide risk fourfold in this professional group. 3

imbalance drives burnout: Workload, control, reward, community, fairness, and values. When chronic demands outpace available

Who is most at risk?

resources – as is common in veterinary practice – the resulting

Not all veterinary professionals are equally vulnerable. Research

resource loss creates a cascade of exhaustion, disengagement,

consistently identifies early-career veterinarians and female

and ultimately departure from the profession.

practitioners as the groups at greatest risk of burnout and

2

Social relationships at work play a particularly critical role.

Burnout is contagious, spreading through teams when left

its consequences.4 In the Spanish study of registered veterinarians, younger

unaddressed, and poor supervisory support, unresolved conflict,

practitioners and those with one- to 10- years of professional

and workplace incivility all significantly accelerate its progression. 2

experience reported significantly higher levels of emotional exhaustion and cynicism. Those with >10-years of experience

The scale of the crisis in veterinary medicine

reported greater professional efficacy and higher self-compassion –

The data on burnout in veterinary medicine is alarming. About 49%

psychological vulnerability that warrants targeted support.4

suggesting that the early career period is a window of particular

of American veterinarians report high burnout, while 86% of British

Female veterinarians consistently face higher burnout scores

veterinary professionals reported emotional exhaustion in a 2021

across multiple domains. In the Spanish sample – where 72.3% of

survey. In Australia, 61% of veterinarians scored high on validated

respondents were female, reflecting the increasingly feminised nature

burnout measures, and among American small-animal practitioners –

of the profession – women showed higher exhaustion and cynicism

a group with particularly heavy exposure to euthanasia decisions and

tendencies and lower self-compassion on several subscales.3

emotionally distressed clients – the figure reaches 74%.3 Veterinary students and interns are equally at risk: 70% of

Heavy student debt, which averages ~R2.5m (US$150 000) for new graduates in the United States and is associated with

American veterinary students reported burnout symptoms in

2.5 times greater stress in early-career veterinarians, further

2023, and 77% of American veterinary interns reported burnout

compounds this burden. Rural practitioners, equine and zoo

before graduation. These are not isolated or regional findings,

veterinarians, and veterinary technicians also face an increased

burnout rates consistently fall between 55% and 74% across roles,

risk, reflecting the diverse and often isolated conditions in which

specialties, and countries worldwide.

many veterinary professionals work.3

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Vet’s Hub

News

The protective role of self-compassion Emerging evidence points to self-compassion as a significant and measurable protective factor against burnout. Self-compassion encompasses three interlocking elements: Self-kindness (treating oneself with the same care one would offer a friend in distress), common humanity (recognising that suffering and imperfection are universal rather than isolating experiences), and mindfulness (observing distressing thoughts without over-identification or suppression).4 In the Spanish veterinary study, self-compassion showed a strong inverse correlation with emotional exhaustion (Spearman’s p = −0.567) and a significant negative correlation with cynicism (p = −0.368), confirming its role as a meaningful buffer against the core dimensions of burnout.4 Veterinarians with lower self-compassion were more likely to engage in self-judgment, feel isolated in their struggles, and over-identify with workrelated failures – all of which accelerate the burnout trajectory.

Perfectionism, common among high-achieving professionals, acts as a particular vulnerability, as it undermines the self-kindness component of self-compassion and drives individuals toward unsustainable standards.4 Critically, self-compassion is not a fixed trait. It can be cultivated through deliberate practice, making it a viable target for both personal development and structured

Volume 1 | No. 3

100 practices and reduced staff turnover by 28%, while Employee Assistance Programme access within US veterinary school programmes achieved a 45% reduction in student burnout.3 The evidence also supports addressing access-to-means risk, particularly the availability of euthanasia drugs. Strengthening safe storage protocols and offering structured debriefing after ethically traumatic events – such as difficult euthanasias or highconflict client interactions – can meaningfully reduce both acute and cumulative psychological harm. These provisions should be standard components of workplace safety planning in veterinary settings.2,3

Building a culture of wellbeing in veterinary practice Perhaps the most important systemic shift required is cultural.

Burnout thrives in environments where help-seeking is stigmatised, suffering is normalised as an inevitable professional rite of passage, and workload concerns are dismissed as individual weakness rather than systemic failures. Changing this requires visible leadership commitment to mental health, routine and non-judgemental checkins, anti-stigma campaigns, and the explicit integration of wellbeing metrics into practice performance standards.2 Veterinary education must also take greater responsibility for equipping students and graduates with the psychological tools

wellness interventions in veterinary education and workplaces.4

they need before they reach crisis point. This means embedding

Strategies for coping: Individual and organisational interventions

skills into veterinary curricula – rather than treating them as

Addressing burnout effectively requires a dual approach: supporting the individual while simultaneously reforming the structural conditions that create and sustain burnout. Individuallevel strategies are valuable and measurable. 2 Mindfulness and resilience training have demonstrated significant outcomes in veterinary populations. A United Kingdom Royal College of Veterinary Surgeons mindfulness pilot involving 500 veterinarians lowered depression scores by 35%, and resilience workshops in New Zealand reached 1200 participants and reduced suicidal ideation by 22%.3 Peer support programmes are equally promising – the Not One More Vet initiative in the United States has reached >15 000 veterinarians and reported a 55% improvement in wellbeing scores among participants. Digital tools and wellness applications have also demonstrated utility, with 78% of veterinarians using mindfulness-based apps reporting meaningful reductions in stress.3 At the organisational level – which research argues must take priority, given that burnout is primarily a situational and systemic phenomenon – the most impactful interventions target root causes directly. These include workload reduction, enforcement of reasonable working hours, improved staffing ratios, streamlined administrative burden, equitable reward structures, and clear confidential pathways for reporting distress without career penalty.3 The American Veterinary Medical Association wellbeing programme, in which 63% of participating practitioners reduced burnout levels by 25%, demonstrates the scalability of structured workplace wellness investment. Canadian wellness grants funded

self-compassion training, mental health literacy, and wellness afterthoughts or optional extras.4 Universities and professional bodies should develop clear, accessible psychological support services and ensure that early-career veterinarians – the most vulnerable group – are proactively connected to these resources from the moment they enter the profession.4

Conclusion Burnout among veterinarians is a systemic crisis with serious individual, professional, and public health consequences. It is not inevitable, and it is not the result of personal weakness. It arises from sustained structural mismatches between the exceptional demands of veterinary work and the resources, support, and recognition available to those who perform it. Addressing it effectively requires honest acknowledgement of the scale of the problem, sustained investment in both individual coping strategies and organisational reform, and a cultural shift that places veterinary wellbeing at the centre – not the periphery – of professional practice.

Help at hand The South African Veterinary Association’s Stress Management Hotline is available to support members experiencing personal or emotional challenges by providing access to professional counselling and advice. The hotline offers compassionate support for issues such as anxiety, depression, anger, grief, loneliness, and fear, and can assist with referrals to appropriate professionals when additional care or guidance is needed. To find out more, go to https://www.sava.co.za/sava-stress-management-hotline/ References available on request. U

FUEL EXTRAORDINARY

HIGH-QUALITY ANIMAL PROTEINS TO SUPPORT LEAN MUSCLE MASS Reg. No. V15465, V15467, V23641. (Act 36/1947)

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Vet’s Hub

Vet’s Nursing Corner

Volume 1 | No. 3

Key domains of veterinary nurse contributions The image of the veterinary nurse as a behind-the-scenes assistant – handing instruments to the veterinarian, comforting anxious animals in the waiting room, updating patient records – is giving way to something far more expansive. Across Europe and globally, veterinary nurses are increasingly recognised as frontline actors in the protection of human, animal, and environmental health. Their evolving role positions them not merely as clinical support staff, but as essential contributors to what is now widely referred to as the One Health framework: The recognition that the health of people, animals, and the planet are inextricably linked.

For much of it s history, veterinary nursing has been practised

matured considerably. University-trained veterinary nurses –

in the shadow of the veterinary profession – essential in practice,

as distinct from those trained through shorter vocational

invisible in policy. That is changing. Driven by the growing

programmes – now graduate with competencies that include

complexity of animal care, the rising prominence of zoonotic

infection prevention, biosecurity planning, zoonosis surveillance,

disease, antimicrobial resistance, and climate-related health

behavioural medicine, and client education in public health. They

threats, veterinary nurses have assumed responsibilities that

are, the authors argue, among the most underrecognised assets

extend well beyond the consulting room.

in the global health system.

A landmark European perspective paper by Ferrinho et al substantive contributions to One Health, spanning infection

Infection control and antimicrobial stewardship

control, antimicrobial stewardship, animal welfare, disaster

Among the most clinically critical of their evolving responsibilities

response, public education, environmental monitoring, and more.

is the role veterinary nurses play in infection prevention and

identified 10 distinct domains in which veterinary nurses make

This breadth of contribution reflects a profession that has

control (IPC). In practice settings, they implement and monitor IPC protocols, advise on biosecurity measures, and educate both clients and colleagues on the risks of zoonotic transmission. Their proximity to animals – and to the people who own them – makes them natural sentinels for the early detection of unusual illness patterns that may signal emerging infectious threats.

Closely related is their growing role in antimicrobial stewardship (AMS). Veterinary nurses administer antibiotics, monitor treatment compliance, educate owners on appropriate antimicrobial use, and advise on the safe disposal of medications to prevent environmental contamination. In doing so, they sit at the intersection of clinical care and public health in one of the most pressing global health challenges of our time:

Vet’s Hub

Vet’s Nursing Corner

Volume 1 | No. 3

The increase of antimicrobial resistance. Despite this, systematic

gaps in many training programmes, with insufficient coverage of

inclusion of veterinary nurses in national AMS frameworks

zoonoses, biosecurity, public health, and behavioural science. In

remains limited – a gap that the authors identify as a significant

addition, structured career pathways to specialisation – typically

missed opportunity.

available only after four to six years of practice – exist in some systems but are far from universal.

Welfare, behaviour, and safeguarding The expanding scope of veterinary nursing also encompasses animal welfare and behavioural medicine. Veterinary nurses increasingly conduct behavioural assessments, identify early warning signs of distress or aggression, and implement welfarefocused interventions that prevent abandonment, reduce community risk, and improve quality of life for animals and their owners alike. This is not incidental to their clinical role – it is central to it, as behavioural problems represent one of the most common reasons animals are relinquished or euthanased.

Perhaps less expected, but equally important, is the safeguarding dimension of veterinary nursing. Research has

Veterinary nurses are essential contributors to the One Health framework – the recognition that the health of people, animals, and the planet are inextricably linked.”

– Ferrinho et al.

(One Health, 2025)

established strong links between animal abuse and domestic violence – a phenomenon sometimes called the ‘link’. Veterinary nurses, through their regular and trusted contact with pet owners,

The path forward

are well positioned to identify unexplained or recurrent injuries in

Ferrinho et al’s central argument is both clear and urgent:

animals that may signal abuse in the household.

veterinary nurses must be formally recognised, better educated, and meaningfully integrated into One Health policy and practice

Disaster response and community resilience

if the global health community is to respond effectively to

In an era of increasing climate instability, the disaster response

resistance, climate change, and food insecurity.

the interconnected threats of zoonotic disease, antimicrobial

capabilities of veterinary nurses have taken on new urgency.

This will require harmonised education standards across

During floods, earthquakes, pandemics, and other crises,

countries, legally defined scopes of practice, inclusion in national

veterinary nurses contribute to triage, sheltering, and the

and regional AMS and surveillance frameworks, and stronger

reunification of displaced animals with their owners. They help

professional representation in policy forums.

maintain the health of livestock on which communities depend

Professional bodies such as the British Veterinary Nursing

for food and economic stability, and they provide practical and

Association and the European Veterinary Nurses and Technicians

psychosocial support for families whose animals are central to

Association have made important strides in advocacy, but

their livelihoods and wellbeing.

formal inclusion of veterinary nurses in decision-making

This capacity for community resilience extends also to

processes – in outbreak preparedness, public health policy, and

environmental health monitoring. Veterinary nurses who work

education reform – remains insufficient. Investment in research to

with livestock, wildlife, or food-producing animals are positioned

systematically document the contributions of veterinary nurses

to recognise and report environmental hazards – contaminated

will be essential to sustain the case for their integration.

water sources, vector risk, the effects of heat stress – and to collect samples that support broader surveillance. As climate

Conclusion

change continues to alter the distribution of disease vectors

The role of the veterinary nurse is no longer – if it ever truly was –

and the vulnerability of both animal and human populations, this

confined to the clinic. It extends into communities, households,

environmental intelligence function grows ever more important.

food systems, emergency shelters, and the environmental monitoring networks on which early disease detection depends.

An uneven landscape: education and regulation

University-trained veterinary nurses are, as Ferrinho and

Despite the breadth and importance of their contributions, the

One Health actors working today. Realising their full potential will

profession of veterinary nursing remains strikingly uneven in its

require systemic changes to education, regulation, and policy.

recognition and structure across the globe. This heterogeneity

The rewards, in terms of improved health outcomes for animals,

has real consequences. Where legal recognition is absent or

humans, and the environment alike, will be substantial.

colleagues compellingly argue, among the most underrecognised

poorly defined, veterinary nurses are confined to subordinate technical roles, limiting their ability to contribute meaningfully to

Reference

public health, surveillance, or policy processes.

Ferrinho R, Afonso AM, Ferrinho P. Veterinary nurses at the forefront of one health: European perspectives. One Health, 2025. U

These structural constraints are compounded by curricular

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Medicolegal

Volume 1 | No. 3

Dr Cornelia Els, Consultant, Veterinary Defence Association

Informed consent:

What exactly do I need to disclose?

Did the client really understand what they agreed to? It is a question that comes up in almost every complaint file that crosses my desk – and it is rarely about whether consent was obtained. It’s about whether it was informed.

Informed consent is not a form. It is not a signature. It is a conversation, and if that conversation did not happen properly, the signature at the bottom of the page wouldn’t save you.

It is 7h30, and the waiting room is full. Bella, a nine-year-

A rough number given in passing, and a treatment decision made

old Yorkie, is dropped off for her third dental in three years by

mid-procedure on the vet’s own judgment, both skip the one thing

her owner’s wife – she practically knows the drill by now. The

that actually matters – telling the client and letting them decide.

receptionist checks her in, pulls up last year’s consent form,

Variations on this theme show up constantly. Rosie’s owner

updates the date, and has her sign before rushing off to work. The

could not be reached when the vet found a mass far worse than

vet, mid-consult with another patient, glances at the form on the

the scans suggested and had to decide alone whether to proceed.

way to theatre. It looks the same as always, so she does not stop

Tumble’s family expected a full recovery and got a permanent

to check it.

head tilt instead – a ‘successful’ surgery that did not look like what

By the time Bella’s dental is done that afternoon, she

they had pictured. Duke’s owner had her phone off in a meeting.

has developed a jaw fracture during extraction – rare, but not

The practice tried her three times over twenty minutes before the

impossible in a small-breed dog with advanced periodontal

vet made the call alone, in theatre, and Duke never woke up.

disease. Her owner’s husband, collecting her that evening, is

It is the same pattern in almost every consent complaint that

furious: Nobody told him this could happen. The vet is confident

crosses my desk: Decisions made for the client instead of with

it was mentioned ‘last time’. But the consent form says nothing

them, and a gap between what was actually discussed and what

about fracture risk, does not reflect any breed- or age-specific

is on paper.

discussion, and was filled in by a receptionist who has never been in theatre.

What ‘informed’ actually means

A few weeks later, Max, a young Boerboel, is booked in for a

Consent is only valid if the client had enough information to make

lump removal. His owner’s wife calls ahead. The receptionist, mid-

a real choice. In practice, that means a reasonable client – not a

call with another client waiting, ducks into theatre and asks the vet

veterinarian, not a specialist, an ordinary pet or livestock owner –

for a rough number, then writes it on the form as the quote. On

needs to understand:

the table, the vet finds a second, larger mass nearby and removes

U What you are proposing to do, in plain terms.

that one too, reasoning any owner would obviously want it dealt

U Why – the diagnosis or suspected diagnosis prompting

with in the same trip. Max’s owner, collecting him that afternoon, is billed for two removals he only consented to one of – and hears about the second mass for the first time at the till.

He is not wrong to feel like the decision was made without him.

the procedure.

U The material risks involved, including the ones that are rare but serious.

U The reasonable alternatives, including doing nothing.

Vet’s Hub

Medicolegal

Volume 1 | No. 3

U The likely cost, and what happens if complications push that cost up.

U The prognosis – with and without treatment.

writing, that costs may change if the clinical picture does – and the treating vet should be the one confirming that has been said, before the procedure, not explaining it after the invoice.

If a client cannot repeat this back to you in their own words, they probably were not informed. That is the standard a court or the

Practical steps that hold up

South African Veterinary Council (SAVC) will apply after the fact,

Document the discussion in your clinical notes, not just the signed

however good your intentions were at the time.

form – what was explained, what alternatives were offered, and how the client responded.

The word that trips vets up: ‘Material’

U Use the consent form to support the conversation, not replace

You do not need to disclose every conceivable risk – that is

it. For higher-risk or costly procedures, build in a brief pause

neither possible nor useful, and it can overwhelm a client into

before signature so the client is not rushed.

decision paralysis. What you need to disclose is what is material:

U Where a client declines a recommended option, record that

Risks that are either common, or rare but severe, or specifically

too – informed consent includes the right to informed refusal.

relevant to this particular animal, this particular procedure, this

U Revisit consent if the clinical picture changes intraoperatively in

particular client.

A rare but severe complication still needs mentioning, even

ways the client did not anticipate.

U Treat consent as occasion-specific, not indefinite – a

if it is unlikely. A client with a nervous breed, a geriatric patient,

returning patient like Bella does not come with standing

or a known drug sensitivity changes what is material for that

consent attached.

consultation. Materiality is assessed from the client’s perspective, not yours – would this client, with this animal, have wanted to know? The consent form is evidence that a conversation happened. It is not a substitute for the conversation.

Where consent forms go wrong I regularly see disciplinary and civil matters where the paperwork looks fine on its face but falls apart under scrutiny. Common failure points: U Generic forms treated as sufficient. A blanket ‘I consent to treatment’ line does not discharge the duty if the specific risks of this procedure were never actually discussed.

U No record of the discussion itself. If the consult notes do not reflect what was disclosed, you are relying on memory – yours, months or years later, against a client who says they were never told.

U Consent taken from the wrong person. Verify you are dealing with the animal’s owner or someone with authority

The bottom line

to consent on their behalf, particularly in boarding, referral, or

Informed consent protects the client’s right to decide what

multi-owner situations.

happens to their animal – and it protects you, but only if it

U Estimates or consent detail filled in by reception, not the vet.

is genuine. A signed form backed by a real, documented

If non-clinical staff assist with the paperwork or a quote, the

conversation is a strong defence. A signed form standing alone is

treating vet still needs to confirm what was actually disclosed,

not. If you are ever unsure whether you have disclosed enough,

before signature.

ask yourself what a reasonable client, in this specific situation,

U Handwriting and figures not corroborated. Cost estimates and

would have wanted to know before saying yes. If in doubt, tell

options discussed on the form should match what is in your

them. As for Bella and Max – a two-minute conversation, at

clinical notes. Discrepancies between the two are one of the

the right moment, would have closed both gaps. That is the

first things scrutinised in a complaint.

whole exercise, really: not more paperwork, just making sure the

U Consent obtained too late. Consent given as the animal is already being wheeled into theatre, under time pressure,

paperwork reflects a conversation that actually happened, with the person who is actually deciding.

is vulnerable to challenge – particularly for elective or non-

Dr Cornelia Els is a dual-qualified veterinarian and attorney,

urgent procedures.

and a consultant to the Veterinary Defence Association,

U If reception is taking bookings, quotes, or intake details, the estimate needs a standing caveat, said out loud and put in

where she advises on SAVC disciplinary matters, professional liability, and legal risk in veterinary practice. U

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Practice management

Volume 1 | No. 3

What you need to consider when running a

successful veterinary practice – Part 2 Mari an

ne

v

an Wy

k

In Part 2 of this three-part series, Marianne van Wyk, CEO of Vetmaster Online, explores several essential areas that every veterinary practice should prioritise to remain competitive, efficient and patient-focused in modern veterinary medicine.

A well-managed veterinary practice not only improves

customer service and effective operational systems all play a

patient outcomes but also enhances client satisfaction, staff

vital role.

retention and long-term profitability. In today’s competitive veterinary industry, success depends on much more than

Below are three key areas that every modern veterinary practice should focus on.

excellent clinical skills. Efficient management, exceptional

1. Deliver outstanding patient care The health and welfare of every patient should always be your highest priority. Consistently providing excellent veterinary care builds trust, strengthens your reputation and encourages long-term client loyalty.

Successful practices should: U Follow current veterinary best practices and treatment protocols.

U Invest in modern diagnostic and medical equipment.

U Maintain accurate, complete and secure patient records using a reliable veterinary practice management system.

U Encourage continuous professional development for veterinarians, veterinary nurses and support staff.

U Promote preventative healthcare through vaccinations, parasite control, nutrition counselling and routine wellness examinations.

U Exceptional patient care remains the foundation of every successful veterinary practice.

Vet’s Hub Volume 1 | No. 3

2. Provide exceptional customer service Today’s pet owners expect clear communication, empathy and professionalism throughout every stage of their visit.

Successful practices: U Clearly explain diagnoses and treatment options.

U Discuss costs before treatment begins to avoid misunderstandings.

U Keep clients informed while their pets are hospitalised or undergoing surgery.

U Follow up after major procedures to monitor recovery.

U Make courtesy calls after consultations or treatments to check on the patient’s progress and demonstrate genuine care.

Excellent customer service is often what distinguishes one practice from another. Never underestimate the power of word-ofmouth marketing. A delighted client may recommend your practice to friends and family, while one poor experience can discourage several potential clients. Every interaction is an opportunity to build trust and strengthen your reputation.

3. Maintain effective stock control Poor inventory management can significantly reduce profitability and negatively impact patient care.

Best practices include: U Monitor stock levels daily.

U Set minimum and maximum stock quantities.

U Track medication expiry dates. Perform regular stock takes (weekly).

U Reduce expired, damaged and obsolete stock.

U Closely monitor high-value pharmaceuticals and controlled medicines.

U Follow the first in, first out (FIFO) principle to minimise wastage.

U Keep the drug register accurate and up to date to ensure regulatory compliance.

U Avoid purchasing excessive quantities simply because products are on special from suppliers.

U Do every week ghost stock taking – nobody knows what product will be in line for stock staking at what moment.

An effective inventory management system helps reduce waste, improve cash flow and ensures that essential medications and products are always available when patients need them.

If you missed Part 1, click on the link https://www.vetshub. co.za/what-you-need-toconsider-when-runninga-successful-veterinarypractice/ or scan the QR code to catch up and stay tuned for Part 3, where we’ll explore practical strategies to grow your practice, improve profitability and future-proof your veterinary business. U

Practice management

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Health awareness

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Not just old bones:

Rethinking canine osteoarthritis

Save the Date Animal Pain Awareness Month September

OA is more than wear and tear Canine osteoarthritis (OA) is a progressive degenerative joint disease driven by mechanical, genetic, metabolic, and traumatic factors that disrupt joint homeostasis across cartilage, bone, and synovial structures.

It causes structural changes such as cartilage loss, subchondral bone sclerosis, osteophyte formation, and synovial inflammation, leading to pain, reduced mobility, and impaired quality of life (QoL), without systemic illness in most cases.1

Silent pain, visible impact Diagnosis is clinical, supported by imaging and sometimes synovial fluid analysis. Joint pain is the dominant sign, often presenting as lameness, stiffness, or reduced activity. Physical findings may include crepitus, effusion, muscle atrophy, fibrosis, and restricted movement, though these are not OA-specific and must be differentiated from immune-mediated or other joint diseases. Radiographic changes typically confirm later-stage disease.2

References Budsberg SC. Canine Osteoarthritis: Understanding the etiology, clinical presentation, and diagnosis. DVM360. [Internet]. Available at: https://www. dvm360.com/view/canine-osteoarthritis-understanding-etiology-clinicalpresentation-and-diagnosis 2. Cachon T, Frykman O, Innes JF, et al. The COAST Development Group’s international consensus guidelines for the treatment of canine osteoarthritis.

Front Vet Sci, 2023.

3. Anderson KL, Zulch H, O’Neill DG, et al. Risk Factors for Canine Osteoarthritis and Its Predisposing Arthropathies: A Systematic Review. Front Vet Sci, 2020.

1.

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Practice pearls 1.

2.

3.

4.

5.

OA is an active inflammatory disease process – not simply ‘wear and tear’ – and early intervention changes long-term outcomes.

Radiographic severity does not always correlate with pain levels, clinical signs and owner observations remain central to assessment.

Weight management is one of the most effective OA interventions, with even modest weight loss improving mobility and comfort.

Multimodal therapy works best: Combine NSAIDs, rehabilitation, nutrition, exercise modification, and environmental support throughout disease progression.

Breakthrough pain in advanced OA requires rapid reassessment and short-term escalation strategies, including hospital-based analgesia when necessary.

Who is at risk?

OA is multifactorial, shaped by genetics, conformation, obesity, environment, and age.

Large breeds (Labradors, German Shepherds, Rottweilers) are predisposed to hip, elbow, and cruciate disease, while small breeds (Chihuahuas, Pomeranians) are prone to patellar luxation.

Obesity is a key modifiable risk factor, increasing joint load and accelerating degeneration. Rapid growth, overfeeding, and neuter status may further increase risk.3

COASTeR: A staged roadmap for care The COASTeR framework guides stage-based OA management, prioritising early intervention and lifelong monitoring.2 Stage 0-1: Risk-based prevention, weight control, education, exercise optimisation.

Stage 2: Mild OA – introduce nutrition support, omega-3s, activity modification.

Stage 3: Moderate OA – multi-modal therapy, NSAIDs, more frequent reassessment.

Stage 4: Severe OA – intensive pain control, mobility aids, multidisciplinary care, and end-of-life planning.

Multimodal care is key Breakthrough pain needs rapid action Severe pain episodes may occur at any stage, especially Stage 4 OA. Hospital-based interventions include ketamine and lidocaine infusions, with opioids used in acute crisis situations. These are short-term stabilisation tools, not long-term solutions. Palliative care planning, caregiver education, and mobility aids are critical in advanced disease.2

OA management is lifelong and multimodal, combining lifestyle, pharmacologic, and supportive therapies. Nonsteroidal antiinflammatory drugs (NSAIDs) are recommended as first-line oral therapy but require monitoring for adverse effects. Injectable therapies and adjunct analgesics are added in progressive disease stages. Rehabilitation, weight management, and environmental modifications are essential across all stages.1,2

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Health awareness

Volume 1 | No. 3

Rabies: A preventable but persistent global threat

Save the Date World Rabies Awareness Day 28 September Theme: Stronger together

Rabies is one of the world’s deadliest zoonotic diseases, with an almost 100% fatality rate once clinical symptoms develop. Despite being entirely preventable, rabies still causes ~59 000 human deaths annually, predominantly in Africa and Asia, where limited healthcare infrastructure and inadequate access to vaccines continue to perpetuate infection cycles.1

Domestic dogs are responsible for 99% of human rabies

particularly vulnerable due to poor access to healthcare and

cases globally, making canine vaccination the cornerstone

inconsistent canine vaccination coverage.1,2

of disease prevention and elimination strategies. Children are

Effective prevention depends on both pre-exposure

disproportionately affected, accounting for ~40% of rabies deaths

prophylaxis (PrEP) for high-risk groups and rapid post-exposure

because of their frequent contact with animals and increased

prophylaxis (PEP) following suspected exposure. PEP includes

vulnerability following bites.1

immediate wound washing, rabies vaccination, and where

Rabies is caused by a neurotropic virus transmitted primarily through the saliva of infected animals via bites, scratches, or contamination of broken skin and mucosal surfaces.

Following infection, the virus attacks the central nervous system, resulting in progressive encephalitis and death. 2 Clinical disease occurs in two forms: Furious rabies, characterised by agitation, hydrophobia, hypersalivation, and hallucinations, and paralytic rabies, which presents with progressive weakness and paralysis. Initial symptoms are nonspecific and include fever, headache, nausea, and discomfort at the wound site before neurological deterioration rapidly develops. Survival after symptom onset remains exceptionally rare. 2 South Africa continues to face endemic rabies, with domestic dogs serving as the principal reservoir for human infection. Wildlife species such as jackals may also contribute to transmission. Rural communities remain

indicated, rabies immunoglobulin administration. When initiated before symptom onset, PEP is virtually 100% effective.3

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Crash course: South African puppy and kitten vaccination guidelines According to the guidelines available on the South African Veterinary Council website, vaccination is essential not only for individual pets, but also for maintaining ‘herd immunity’ and reducing outbreaks of infectious diseases such as canine parvovirus and feline panleukopenia.4 For puppies, the core vaccines are canine parvovirus, canine distemper virus, canine adenovirus, and rabies. The guidelines recommend starting vaccinations at six-weeks of age because South Africa experiences high levels of parvovirus infection and poor herd immunity.4 Puppies should receive core vaccines at six-, nine-, and 12-weeks of age, with some veterinarians recommending an additional booster at 16-weeks because maternal antibodies may interfere with vaccine years depending on lifestyle and risk. Cats living in multi-cat

effectiveness until that age. 4

households or catteries are considered higher risk and may require

Rabies vaccination is legally required from 12-weeks of age,

more frequent vaccination.4

followed by a booster between four- months and one-year of

The guidelines also recognise the value of serological testing

age, and thereafter every three-years. In high-risk environments such as breeding kennels and shelters, vaccination may begin as

to measure immunity and avoid unnecessary vaccination.

early as four-weeks using approved high-titer vaccines.

Testing may help determine whether an animal still has protective

4

Optional but highly recommended non-core vaccines include

immunity, especially before administering additional boosters.

parainfluenza and Bordetella bronchiseptica, especially for

Overall, the South African vaccination guidelines aim to balance

dogs exposed to kennels, shows, travel, or boarding facilities.

scientific evidence, local disease pressures, legal requirements,

Leptospirosis vaccination may also be considered where

and practical realities to improve the health and protection of

risk exists, although evidence of the disease in South Africa

puppies and kittens.4

remains limited.4

Conclusion

The guidelines stress that maternal antibodies transferred through colostrum can interfere with vaccination in young puppies

Rabies is a major yet preventable public health threat, particularly

and kittens. Because antibody levels vary between littermates,

in developing countries such as South Africa where canine

multiple vaccinations are necessary to ensure protection.

transmission continues to place vulnerable communities at risk.

Completing the vaccine series is considered critical, as stopping

Strengthening vaccination coverage in domestic dogs and cats

too early is one of the most common causes of vaccine failure.

is essential to reducing disease transmission and protecting both

4

For kittens, the core vaccines are feline panleukopenia

animal and human health. Public awareness, responsible pet

virus, feline herpesvirus-1, feline calicivirus, and rabies. Initial

ownership, routine veterinary care, and rapid access to post-

vaccinations are recommended at six-, nine-, and 12-weeks of

exposure prophylaxis are critical components of rabies prevention.

age, with a possible additional booster at 16-weeks if required.

Adherence to South African vaccination guidelines, together

Rabies vaccination is administered from 12-weeks onward,

with improved community education and healthcare access, can

with revaccination depending on travel requirements and

significantly reduce rabies-related deaths and contribute toward

risk exposure.4

the global goal of eliminating dog-mediated human rabies.

The guidelines strongly recommend feline leukaemia virus (FeLV) vaccination in young cats, even though it is internationally

References

classified as non-core, because of its importance in protecting

1.

kittens from severe disease. FeLV vaccination begins at eightto nine-weeks with a second dose three- weeks later. Other non-core vaccines for cats include Bordetella bronchiseptica and Chlamydia felis, mainly for cats in shelters, breeding catteries, or multi-cat households.4 A booster vaccination is recommended at six-months to oneyear of age for both puppies and kittens to protect animals that may not have responded fully to earlier vaccinations. Thereafter, core vaccines in dogs are generally recommended every threeyears, while cats may receive boosters annually or every three-

World Organization for Animal Health. Rabies. 2026 [Internet].

Available at: https://www.woah.org/en/disease/rabies/ 2. National Institute of Communicable Diseases. Rabies Update.

2026 [Internet]. Available at: https://www.nicd.ac.za/rabiesupdates/ 3. National Institute of Communicable Diseases. 2025 [Internet].

Available at: https://www.nicd.ac.za/rabies-prevention-andvaccine-update-chirorab-now-available-in-south-africa/ 4. De Cramer K. Dog and cat vaccination guidelines for South Africa (2019) – Evidence. Available at: https://www.sava.co.za/ wp-content/uploads/2015/10/DOG-AND-CAT-VACCINATIONGUIDELINES-FOR-SOUTH-AFRICA-2019-EVIDENCE-rev-3-DeCramer-002.docx U

Vet’s Hub

Companion animals

Volume 1 | No. 3 Dr Myra Rose Marais, deputy head generalist department at Fourways Veterinary Hospital

Treating inflammation first: Are we rethinking canine otitis externa?

Skin disease remains one of the most common and frustrating conditions encountered in small animal practice, driving veterinarians, owners and patients alike to exhaustion. Despite this, dermatology is still often considered ‘bread and butter’ medicine within general practice. Once the primary underlying condition is identified and controlled, many patients are still left battling one particularly frustrating problem: Otitis externa, specifically erythemato-ceruminous otitis externa.

For many veterinarians, the sight of an erythematous,

This concept is particularly interesting in chronic allergic

uncomfortable ear immediately triggers a familiar treatment

patients. Many veterinarians will recognise the ‘recurrent ear dog’ –

pathway – topical combination products containing antibiotics,

the patient repeatedly treated with various combination products,

antifungals and corticosteroids. However, recent studies and

only to re-present several weeks later with another flare.

discussions within the dermatology field suggest that perhaps this reflexive approach deserves reconsideration.

While infection certainly plays an important role in some cases, it is often the underlying allergic or inflammatory disease

As antimicrobial stewardship (AMS) becomes an increasingly

process that remains insufficiently controlled. Identifying and

important conversation in veterinary medicine, growing attention

managing the primary disease remains of utmost importance.

has been placed on whether every mild otitis case truly requires

Cost is another important consideration. Managing chronic

antibiotic or antifungal therapy.

skin and ear disease can become financially taxing for owners,

Recent literature, including work highlighted by Virbac,

particularly in patients requiring repeated treatment courses.

has explored the use of topical corticosteroid-only therapy in

This raises the question of whether chronic intermittent use of

selected cases. These findings challenge us to reconsider the role

topical corticosteroids (CS), alongside improved owner education

inflammation itself plays in the development and perpetuation of

and long-term management strategies, may offer a more cost-

otitis externa.

effective and practical approach in selected cases of chronic otitis externa.

Inflammation versus infection in chronic cases

The importance of careful case selection

In many patients, particularly allergic dogs, inflammation is often

Importantly, the idea of steroid-only therapy does not suggest

the primary driver of disease. Secondary microbial or yeast

abandoning diagnostics, overlooking infection, or avoiding further

overgrowth may be relatively mild – or even incidental – in early

investigation into the primary underlying cause. Cytology remains

presentations. In these cases, effectively reducing inflammation

an essential part of the otitis work-up and plays a critical role in

may help restore the normal ear canal environment and improve

determining appropriate case selection.

clinical signs without the immediate need for combination therapy.

Suppurative otitis, severe microbial overgrowth, painful

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ulcerative ears, rod infections, significant biofilm formation, or

can still challenge long-standing habits and assumptions within

suspected ruptured tympanic membranes would clearly not be

general practice. It will certainly be interesting to see how future

appropriate candidates for CS-only management. Rather, this

studies continue to shape our approach to managing canine otitis

discussion highlights the importance of approaching otitis externa

externa in the years ahead. U

thoughtfully and individually, instead of reflexively reaching for triple-therapy products in every case.

Practice pearls 1.

Long-term management and antimicrobial stewardship As general practitioners, we are uniquely positioned to influence AMS through our everyday prescribing habits. Even small shifts

2.

in how we assess and manage common conditions such as otitis externa may contribute meaningfully to reducing unnecessary antimicrobial exposure over time.

3.

At the same time, this evolving approach reinforces something many clinicians managing chronic dermatology patients already appreciate: Successful long-term otitis management rarely relies on treating infection alone. Identifying

4.

and controlling the primary cause – whether allergic dermatitis, conformational disease, endocrine disease, or another underlying pathology – remains the cornerstone of preventing recurrence.

Dermatology continues to evolve rapidly, and conversations such as these remind us that even very common conditions

5.

Cytology remains essential when assessing otitis externa and should guide treatment selection rather than relying on reflexive prescribing habits.

In allergic dogs, inflammation may be the primary disease driver long before significant bacterial or yeast overgrowth develops.

Recurrent otitis cases often require better longterm control of underlying allergic or inflammatory disease, not repeated antimicrobial therapy alone.

CS-only therapy may be appropriate in carefully selected erythemato-ceruminous otitis cases with minimal microbial involvement.

AMS in general practice starts with thoughtful case selection and avoiding unnecessary antibiotic exposure in mild ear disease.

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Volume 1 | No. 3

Nutrition of ageing cats:

Understanding the unique needs of senior felines

In this article, Dr Angeliki Kaldelis, Scientific Communications manager South Africa at Royal Canin, summarises key insights from the Royal Canin Veterinary Academy on the evolving nutritional needs of ageing cats. The original article, Nutrition of Ageing Cats, written by Lori Prantil and Becca Leung (2024) explores how age-related changes in digestion, appetite, hydration, muscle maintenance, and disease risk influence dietary requirements, while highlighting practical nutritional strategies to support healthy ageing, maintain quality of life, and promote longevity in senior and super senior cats.

As cats age, their nutritional requirements evolve, reflecting

food intake and nutrient utilisation. Sarcopenia, the age-related

changes in their physiology, metabolism, and health status. While

loss of muscle mass independent of disease, also contributes to

life stages for cats have only recently been clearly defined, with

these challenges.

organisations such as the American Animal Hospital Association

Given these factors, senior cats often require diets with higher

and the International Society of Feline Medicine providing slightly

caloric density and enhanced digestibility to maintain body weight

differing categorisations, there remains a notable gap in specific

and muscle condition. Regular monitoring of body weight, body

nutritional guidelines tailored for senior cats. This lack of formal

condition score, and muscle condition score is essential to tailor

guidance presents a challenge, especially as the population of

dietary adjustments appropriately. Feeding strategies may include

senior and super senior cats grows.

offering foods with varied aromas and flavors and serving meals at optimal temperatures to stimulate appetite.

Decline in digestive efficiency One of the most significant changes observed in ageing cats

Hydration – another concern

is a decline in digestive efficiency. Research indicates that up

Hydration is another concern in ageing cats. Older cats may

to one-third of senior cats experience reduced fat digestibility,

experience a decreased thirst drive, reduced mobility, or underlying

and approximately 20% show diminished protein digestion. This

diseases that predispose them to dehydration. However, clinical

reduction in nutrient absorption contributes to common clinical

signs of dehydration can be subtle or inconsistent, making

observations such as weight loss, decreased lean body mass,

proactive encouragement of water intake vital.

and a decline in muscle condition scores.

Providing fresh, clean water is fundamental, but incorporating

These changes may be partly due to a negative nitrogen

dietary moisture through wet food can be especially beneficial.

balance resulting from insufficient protein digestion. Importantly,

This approach not only supports hydration but also aids cats

current protein intake recommendations, which aim to maintain

with dental disease, which affects over half of senior cats and can

nitrogen balance, may not be adequate to preserve muscle mass

make chewing dry kibble painful.

in older cats. Beyond digestive changes, sensory decline – such

Wet diets are also advantageous in managing conditions

as diminished smell and taste – can reduce appetite and food

like CKD and urinary tract diseases. However, because wet

interest, further complicating nutritional management.

food has lower caloric density, it is important to ensure that cats

Additionally, diseases prevalent in older cats, including

consume sufficient quantities to meet their energy needs. For cats

hyperthyroidism, chronic kidney disease (CKD), lymphoma, and

struggling to consume adequate volumes, a combination of wet

diabetes, as well as medication side effects, can negatively impact

and dry food may be necessary.

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Nutritional protein requirements in senior cats is nuanced

inorganic phosphates and maintaining an appropriate calcium-

While we know some older cats have reduced protein digestibility,

to-phosphorus ratio is advisable to support kidney health in

it is unclear what protein level should be recommended for healthy

ageing cats. However, because protein and organic phosphorus

older cats. While CKD is a common diagnosis in older cats, there

levels often correlate in pet foods, balancing high protein intake

is insufficient evidence to support lowering protein intake in all

with low phosphorus content can be challenging, especially in

ageing cats as a preventive measure against CKD.

maintenance diets.

In fact, reducing protein prematurely may exacerbate

Consequently, avoiding diets with high levels of soluble

Vitamins and minerals remain essential for all life stages, but

sarcopenia, given cats’ status as obligate carnivores with

ageing cats may face additional challenges in absorbing fat-

inherently high protein requirements. Therefore, protein restriction

soluble vitamins due to decreased fat digestibility. Although data

should be reserved for cats with diagnosed renal disease rather

on deficiencies in older cats are limited, inadequate absorption

than applied broadly to healthy seniors.

combined with poor diet quality or intake could lead to deficiencies.

Antioxidant vitamins such as vitamin E and beta-carotene

Healthy ageing in cats starts with nutrition tailored to changing digestion, hydration, muscle maintenance, and cognitive and joint health needs

have shown potential benefits in promoting longevity. Watersoluble vitamins like vitamin B12 may require supplementation in cases of increased urinary loss or malabsorption.

Fish oils, fuzzy memories, and the quest for nine good lives Degenerative joint disease (DJD) is prevalent in senior cats, with radiographic evidence found in >90% of cats older than 14-years.

Among various supplements studied, eicosapentaenoic acid and

Fat intake also warrants careful consideration. Since fat

docosahexaenoic acid, omega-3 fatty acids commonly found in

provides more calories per gram than protein or carbohydrates,

fish or algal oil, have demonstrated the most consistent benefits.

reduced fat digestibility in senior cats can contribute to unintended

Supplementation with these fatty acids has been associated with

weight loss. For cats losing weight without underlying disease,

improved activity levels, reduced stiffness, and enhanced quality

diets higher in fat, alongside improved protein and carbohydrate

of life.

digestibility, may help maintain body condition.

Conversely, overweight or obese senior cats – who represent

Cognitive decline is increasingly recognised in ageing cats, with a significant proportion of owners reporting behavioural

a significant proportion of the feline population – may benefit

changes consistent with cognitive dysfunction. While some

from lower-fat diets to support weight loss and reduce the risk of

supplements, such as S-adenosyl-l-methionine, show promise,

associated health problems.

evidence for others like melatonin, L-theanine, and medium-chain

Carbohydrates, although not essential nutrients for cats, play

triglycerides remains inconclusive. Emerging research targeting the

a supportive role in balancing dietary energy and sparing protein

gut-brain axis, including the use of prebiotics and probiotics, holds

from being used as an energy source. Cooked carbohydrates are

potential for future interventions.

readily digestible and can provide glucose, reducing the need for gluconeogenesis from protein. Importantly, there is no evidence

Conclusion

linking digestible carbohydrates to obesity or diabetes in cats.

In conclusion, while many commercial diets and supplements

Dietary fiber, particularly fermentable fibers like beet pulp and

are marketed for senior cats, the scientific understanding of their

fructo-oligosaccharides, supports intestinal health by promoting

specific nutritional needs remains incomplete. Ageing cats represent

beneficial microbiota and producing short-chain fatty acids. In

a diverse group with varying health statuses, making individualised

senior dogs, increased dietary fiber has been shown to reduce

dietary assessment and management essential. Regular

intestinal ammonia, which may have implications for cats with

monitoring of body weight, body condition, muscle condition, and

CKD or hepatic encephalopathy. However, fiber also lowers

hydration status, combined with evidence-based adjustments

caloric density and can affect palatability, so its inclusion must be

to diet composition, can help support healthy aging. As research

balanced carefully.

advances, more precise nutritional

Mineral content, especially concerning phosphorus and

recommendations will emerge,

the calcium-to-phosphorus ratio, is a critical area of focus.

enabling better care for our senior

Recent studies have demonstrated that diets high in inorganic

feline companions.

phosphorus, particularly with calcium-to-phosphorus ratios below

For the full article with

1:1, can induce renal changes in healthy cats. Inorganic phosphorus

references please visit: https://

causes a dose-dependent increase in plasma phosphorus

academy.royalcanin.com/en/

concentrations, which is more pronounced than with organic

veterinary/nutrition-of-aging-

phosphorus sources.

cats U

EASY

ENRIC

EAT & D TO

EST IG

D IN EPA HE

HA &D

RGY RIC NE

H

E

Every year matters for healthy ageing

Reg. No. V23337, V23334, V25139 (Act 36/1947)

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Cat-astrophe averted:

Evidence-based diabetes management in cats In late 2025, International Cat Care (iCatCare) published a consensus guideline offering comprehensive recommendations for the diagnosis, treatment, and long-term management of feline diabetes. As the second most common endocrine disorder in cats after hyperthyroidism, diabetes mellitus represents a growing clinical challenge requiring structured assessment, ongoing monitoring, and sustained caregiver engagement.¹ The guideline strongly emphasises a multidisciplinary approach,

such as chronic kidney disease or pancreatitis may obscure

where veterinary professionals and caregivers work collaboratively

classical presentations. Cats with HST may also exhibit subtle soft

to optimise outcomes, recognising that successful long-term control

tissue enlargement rather than obvious phenotypic changes.¹

depends on coordination rather than isolated clinical intervention.¹

More severe cases may present with diabetic ketoacidosis (DKA), while chronic hyperglycaemia can result in diabetic

Epidemiology and risk profile

neuropathy, often manifesting as a plantigrade stance. The

Feline diabetes affects ~0.5% of the general cat population,

heterogeneity of clinical presentation highlights the importance of

equating to roughly one in 200-250 cats, with prevalence

thorough assessment and tailored diagnostic evaluation.¹

increasing in parallel with rising obesity rates. Age remains the strongest risk factor, with most affected cats older than six years

Diagnosis and the ALIVE Framework

and a mean age at diagnosis of around 10-years, peaking between

Diagnosis relies on clinical signs supported by biochemical

nine- and 13-years. Diabetes in younger cats is uncommon.1,2

evidence of persistent hyperglycaemia. Home monitoring,

Obesity is a major modifiable risk factor, increasing the likelihood

continuous glucose monitoring (CGM), and urine dipstick testing

of diabetes by three- to fivefold. More than 40% of cats aged five-

using naturally voided samples can help distinguish stress

to 11-years are overweight, underscoring the expanding metabolic

hyperglycaemia from true diabetes.¹

disease burden in companion animals. Neutered cats are nearly

The ALIVE diagnostic criteria define two pathways:

twice as likely to develop diabetes, while males have a 1.5-fold

In the first pathway, diabetes is diagnosed when a random

increased risk compared with females.1,2 Genetic predisposition

blood glucose ≥15mmol/l is present alongside classic clinical

may also play a role, particularly in Burmese cats. Environmental

signs, with no alternative explanation, or in the context of a

and lifestyle contributors, including indoor confinement, reduced

hyperglycaemic crisis. At least one additional criterion is required,

physical activity, and high-calorie diets, further amplify risk.

such as elevated glycated proteins (eg fructosamine) or repeated

1,2

glucosuria from home-collected urine samples taken at least two

Pathophysiology and disease classification Feline diabetes shares similarities with human diabetes and is

days post-stress.¹ The second pathway applies to blood glucose levels between

broadly classified as insulin-dependent (type 1 diabetes [T1DM])

7-15mmol/l and requires at least two supporting criteria, including

or non-insulin-dependent (type 2 diabetes [T2DM]). True T1DM,

clinical signs, elevated glycated proteins, or repeated glucosuria.¹

caused by immune-mediated beta-cell destruction, is rare in cats.¹

Early diagnosis improves outcomes and increases the

T2DM accounts for ~75%-80% of cases and is characterised

likelihood of diabetic remission, defined as at least four weeks

by insulin resistance combined with impaired insulin secretion.

without exogenous insulin and absence of clinical signs.

Contributing mechanisms include islet amyloid deposition,

Remission significantly improves quality of life (QoL) and may be

glucotoxicity from chronic hyperglycaemia, pancreatitis, and other

more likely when underlying causes such as HST are addressed.¹

pancreatic insults or neoplasia.¹ Secondary diabetes comprises around 20%-25% of cases,

Principles of individualised management

most commonly associated with hypersomatotropism (HST).

Management must be tailored to the individual patient, particularly

HST involves chronic excess growth hormone secretion and is

where concurrent disease is present. Cats with anorexia,

now recognised in approximately 20%-30% of diabetic cats. Many

dehydration, or systemic compromise may require urgent

affected cats lack overt acromegalic features such as enlarged

stabilisation, including DKA protocols.¹ A comprehensive baseline

paws, facial bone changes, or organomegaly, making HST a

assessment should include body weight, ideal body weight,

frequently underdiagnosed driver of insulin resistance.

body condition score, muscle condition score, dietary history,

1,2

medication review, and identification of comorbidities.¹

Clinical presentation Typical clinical signs include polyuria, polydipsia, polyphagia with

Insulin therapy as the foundation of care

concurrent weight loss, and lethargy. However, comorbid conditions

Insulin remains the cornerstone of feline diabetes management.

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Volume 1 | No. 3

It directly addresses hyperglycaemia, reduces glucotoxicity, and

SGLT2i are most appropriate for clinically stable (‘happy’)

supports recovery of beta-cell function – critical for achieving

diabetic cats and require careful pre-treatment screening,

remission in T2DM. Its benefits extend beyond glycaemic control,

including ketone assessment and evaluation for concurrent

including improvement in clinical signs, prevention of DKA, and

endocrinopathies. The highest risk period for euglycaemic diabetic

increased likelihood of remission.¹

ketoacidosis (eDKA) is within the first two-weeks of therapy.¹

Insulin types and pharmacokinetics

fructosamine levels, and CGM data, as urine glucose becomes

Insulin preparations fall into two categories:

unreliable due to drug mechanism. Adverse effects include

1.

Suspensions (eg porcine lente, NPH, protamine zinc insulin)

gastrointestinal (GI) signs, dehydration, and rarely eDKA, which

require resuspension before administration. Their absorption

requires immediate discontinuation and supportive care.¹

Long-term monitoring focuses on clinical signs, body weight,

is variable, with intermediate duration of action and twice-daily dosing commonly required. Incorrect mixing can lead to dosing

GLP-1RA emerging adjunct therapy

inconsistencies and poor control.¹

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) enhance

2. Solutions (eg insulin glargine U100/U300 and degludec)

glucose-dependent insulin secretion, suppress glucagon, slow

offer more predictable pharmacokinetics and do not require

gastric emptying, and reduce appetite. These effects make them

resuspension. Glargine U300 provides a stable basal profile, while

theoretically beneficial in obese or insulin-resistant cats.¹

degludec, despite its ultra-long human action, behaves as a 12-

Limited studies, mainly with exenatide, show modest

hour insulin in cats and is not suitable for once-daily dosing.¹

improvements in glycaemic control and reduced insulin requirements when used adjunctively. However, GLP-1RAs have not demonstrated

Practical administration considerations

remission as monotherapy. They may be useful in selected

Insulin timing does not need to be strictly synchronised with

overweight cats but should be avoided or used cautiously in those

meals, particularly with basal or long-acting formulations. Cats on

with GI disease due to potential appetite suppression and nausea.¹

low-carbohydrate diets experience minimal postprandial glucose variation, allowing flexible dosing schedules.¹

Integrated approach to care Effective feline diabetes management requires a multimodal

Insulin selection

strategy combining insulin or SGLT2is, dietary modification,

Choice of insulin depends on multiple factors: Residual beta-cell

weight management, and regular monitoring. Early

function, comorbid disease (such as pancreatitis or renal disease),

diagnosis and identification of underlying conditions such as

caregiver compliance, cost, and availability. Some evidence

hypersomatotropism significantly improve outcomes and increase

suggests glargine formulations may improve remission rates,

remission potential. Adjunct therapies such as GLP-1RAs may

although data remain limited.¹

provide additional metabolic benefits in carefully selected cases but remain secondary to established treatment modalities.¹

Monitoring and dose adjustment Monitoring is essential to optimise therapy and detect remission

Conclusion

early. Blood glucose measurements remain central, while

Feline diabetes management has evolved into a precision-based,

fructosamine provides intermediate-term glycaemic assessment.

individualised discipline. The iCatCare consensus underscores the

CGM offers the most detailed metabolic profiling and is particularly

importance of early diagnosis, structured monitoring, and flexible

useful in unstable or insulin-resistant cases.¹ Clinical parameters –

treatment strategies that integrate pharmacological, nutritional, and

appetite, weight, hydration, and behaviour – remain equally

lifestyle interventions. Insulin remains foundational, while newer agents

important. Dose adjustments should be gradual, typically in one-

such as SGLT2i and GLP-1RA expand therapeutic possibilities.

unit increments, with emphasis on avoiding hypoglycaemia and

Ultimately, successful management depends on collaboration between

preserving quality of life. Remission should be considered when

clinicians and caregivers, careful attention to comorbid disease, and a

cats maintain euglycaemia and clinical stability for at least four

sustained focus on quality of life. When applied thoughtfully, evidence-

weeks without insulin.¹

based interventions not only control disease but significantly increase the likelihood of remission and long-term metabolic stability.

SGLT2 inhibitors a new insulinindependent option

References

Sodium-glucose cotransporter-2 inhibitors (SGLT2i) provide an

1.

insulin-independent mechanism for glucose control by increasing urinary glucose excretion. They act at the proximal renal tubule by blocking SGLT2-mediated glucose reabsorption.¹ Clinical studies of velagliflozin and bexagliflozin demonstrate glycaemic control in 80%-90% of treated cats, with comparable outcomes to porcine lente insulin and no reported clinical hypoglycaemia.¹

Taylor S, Cannon M, Niessen S, et al. iCatCare 2025 consensus guidelines on the diagnosis and management of diabetes mellitus in cats. Journal of Feline Medicine and Surgery, 2025.

2. Herrtage ME. New Strategies in the Management of Feline Diabetes Mellitus. World Small Animal Veterinary Association World Congress Proceedings. 2009 [Internet]. Available at: https://www.vin.com/apputil/content/defaultadv1.aspx?pId= 11290&catId=33314&id=4252689&ind=147&objTypeID=17 U

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Vet’s Hub

CPD activity

Volume 1 | No. 3

Protecting kidney function in cats: Preserving companionship from diagnosis to longevity Chronic kidney disease (CKD) is one of the most common chronic diseases in cats and the leading cause of death in geriatric felines. During this webinar, Dr Melanie Wergin highlighted the importance of early diagnosis, accurate staging and timely intervention to preserve kidney function, improve quality of life (QoL) and extend survival.

CKD affects an estimated 2%-20% of cats, with prevalence

progression by about 1.5 years.

increasing markedly with age. Around 80% of cats >15-years

ACE inhibitors are recommended for cats with proteinuria and/

are affected. The disease is multifactorial, with recognised risk

or hypertension to reduce RAAS activation and preserve

factors including breed predisposition (Scottish Fold, Maine Coon,

renal function.

Persian and Abyssinian), male sex, lean body condition, poor

Dr Wergin also discussed supportive therapy using SUC,

dental health, inherited polycystic kidney disease, hypertension,

comprising solidago virgaurea, ubiquinone (coenzyme Q10) and

cardiovascular disease, chronic infections and nephrotoxic

coenzyme preparations. These compounds possess anti-

medications such as non-steroidal anti-inflammatory drugs.

inflammatory and antioxidant properties that may reduce fibrosis,

Although the initiating cause is often unknown, CKD progresses

support mitochondrial function and protect remaining nephrons.

through irreversible nephron loss, chronic inflammation and

An observational multicentre study comparing SUC with

fibrosis, resulting in a continuous decline in renal function.

benazepril in cats with IRIS stage 2 and 3 CKD found comparable

A key driver of disease progression is activation of the

renal outcomes, while cats receiving SUC experienced

renin-angiotensin-aldosterone system (RAAS), which promotes

improvements in creatinine concentrations, appetite, activity,

vasoconstriction, proteinuria, hypertension and further nephron

grooming and overall quality of life. Approximately 70% of stage

damage. Because cats possess substantial renal reserve, serum

3 cats improved sufficiently to move into stage 2. The findings

creatinine does not typically increase until ~70%-75% of kidney

also suggested that treatment should be continued at least twice

function has been lost, meaning many cats remain clinically

weekly to maintain clinical benefit.

normal during the early stages of disease.

A clinical case demonstrated similar improvements following

Clinical signs depend on disease severity. Cats in International

rehydration, renal diet and SUC therapy, with reductions in creatinine

Renal Interest Society (IRIS) stage 1 are often asymptomatic and

and phosphate concentrations, improved urine concentrating ability

identified only through routine screening, while those in stages 2

and a marked improvement in the cat’s overall condition.

and 3 commonly present with increased thirst and urination, poor appetite, vomiting, weight loss, lethargy and reduced grooming. Dr

Conclusion

Wergin recommended annual kidney screening from six years of

Dr Wergin concluded that although CKD is progressive and

age to facilitate earlier diagnosis and improve long-term outcomes.

irreversible, early diagnosis, routine screening, nutritional

Diagnosis relies on serum creatinine and symmetric

intervention, appropriate management of proteinuria and

dimethylarginine (SDMA), which detects declining renal function

hypertension, and supportive therapies can significantly slow

earlier than creatinine and is less influenced by muscle mass.

disease progression, preserve renal function and improve both

Additional assessment should include urinalysis, urine culture,

survival and QoL for affected cats.

urine protein-to-creatinine ratio, blood pressure measurement and

This webinar is currently

renal ultrasonography. These investigations form part of the IRIS

undergoing CPD accreditation.

staging system, which guides prognosis and treatment.

You can still watch the replay and

Management focuses on slowing disease progression

earn points. Click here to watch

and maintaining quality of life. Rehydration is essential before

the replay or scan the QR code.

interpreting renal biomarkers, while nutritional management

Once you have watched the video,

remains a cornerstone of therapy. Commercial renal diets

please send your full names and

restricted in protein and phosphorus have been shown to slow

council registration number to

CKD progression by approximately 43% and delay disease

rene.bosman@media24.com. U

Vet’s Hub

Livestock

Volume 1 | No. 3 Article reviewed by Dr Sue Murray

Save the Date

Itchy horses?

Solutions beyond the scratches

Itchy Pet Awareness Month August

Horse allergies present a significant clinical challenge in equine practice, affecting both animal welfare and performance. Advances in veterinary dermatology have shed light on the complex mechanisms underlying allergic skin conditions, particularly insect bite hypersensitivity (IBH) and equine atopic dermatitis (EAD). Effective management requires an integrated understanding of genetic predisposition, immune dysregulation, and skin barrier dysfunction, enabling veterinarians to implement evidence-based therapeutic strategies.1,2 Dr Rosanna Marsella, a leading researcher in veterinary

and recurrent skin lesions. It often affects multiple body regions

dermatology at the University of Florida (United States), has

and persists year-round. Pathophysiology involves an overactive

provided critical insights into equine skin barrier function. Her work

immune response to environmental allergens such as dust mites,

highlights parallels between allergic skin conditions in horses

pollens, and moulds, leading to immunoglobulin E (IgE)-mediated

and atopic dermatitis (AD) in humans and canines, particularly

inflammation and barrier disruption. 2,5

the disruption of lipid lamellae in the stratum corneum. These structural changes compromise the barrier, facilitating allergen penetration and triggering inflammatory responses.1,3 Recognising the central role of the skin barrier has shifted

Sniffing out allergies: Getting the diagnosis right Accurate diagnosis underpins effective treatment. Veterinary

therapeutic strategies toward not only controlling immune

evaluation should include:

responses but also restoring barrier integrity. In practice, this

U Clinical assessment: Pattern, distribution, and seasonality of

translates to treatment plans that incorporate environmental

pruritus and lesions. 2,6

management, pharmacologic therapy, topical interventions,

U Exclusion of differential diagnoses: Parasitic infestations,

dietary modulation, and emerging biologic therapies.1,2,5,6

bacterial or fungal infections, contact dermatitis, and food hypersensitivities. 2,5

Itch happens: Common equine allergies

U Allergy testing: Intradermal testing or serum IgE assessment

IBH and EAD represent the two most common allergic skin

can guide allergen-specific interventions but should be

conditions encountered in equine practice. 2,5,6,7,8

interpreted alongside clinical findings. 2

Insect bite hypersensitivity IBH, also called ‘sweet itch’, is the most prevalent equine allergic

Taming the itch: A multifaceted approach to equine allergy management

condition and a seasonal hypersensitivity reaction to the saliva of biting

Management of equine allergies is multifaceted, integrating

insects, primarily Culicoides species pluralis. Lesions predominantly

environmental, pharmacologic, dietary, topical, and immunologic

affect the mane, tail base, ears, and ventral body. Molecular studies in

interventions. Veterinary practitioners should tailor strategies to

affected horses demonstrate upregulation of IgE, histamine receptors

individual horses, considering disease severity, seasonal variation,

(HR) (HRH2/HRH4), thymic stromal lymphopoietin, interleukin-33

and owner adherence.1,6,7

(IL-33), and IL-31 receptor alpha, indicating that immune activation is closely linked to skin barrier dysfunction. Effective clinical management

Environmental management

requires strategies that address both the allergic response and the

Environmental modification remains the cornerstone of

underlying barrier impairment.6,7,8

allergy control:2,6 U Stabling practices: Horses should be stabled during peak

Equine AD EAD is a chronic, inflammatory condition characterised by pruritus

insect activity (dawn and dusk).

U Protective equipment: Fly sheets, masks, and

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Volume 1 | No. 3

U Shampoos and conditioners: Oatmeal, aloe vera, and ceramide-enriched formulations soothe inflamed skin, reduce pruritus, and restore lipid balance.

U Barrier creams and emollients: These help maintain moisture, protect disrupted skin, and limit allergen penetration.

U Antimicrobial topicals: In cases with secondary bacterial overgrowth, targeted topical antimicrobials can complement systemic therapy while preserving microbiome diversity.

Next-gen relief: Targeted therapies tackling equine itch IL-31 pathway inhibitors IL-31 is a central mediator of pruritus in equine allergic conditions. Pharmacologic modulation of this pathway, such as with oclacitinib (currently approved in dogs), shows promise in reducing itch severity and improving blankets help reduce insect exposure and subsequent

patient comfort. Early veterinary trials suggest potential off-label

hypersensitivity reactions.

applications in horses, though larger studies are required to

U Repellents: Topical or spray formulations may reduce biting

establish safety and dosing.1,8,11

insect exposure, though efficacy varies.

U Pasture management: Limiting standing water and

Barrier restoration agents

maintaining grass at an optimal height reduces insect

Research is increasingly focused on interventions that restore

breeding sites.

lipid integrity and ceramide production in allergic skin. By directly

U Dust and mould control: Ensuring dry, well-ventilated

targeting the underlying barrier dysfunction, these therapies

stables and hay storage minimises exposure to

may reduce allergen penetration and the severity of immune-

environmental allergens.

mediated reactions. 8

Pharmacologic therapy Glucocorticoids

Immunotherapy

Systemic glucocorticoids remain the most effective agents for

approach, particularly for horses with well-characterised triggers.

acute relief of pruritus and inflammation. Oral prednisolone or

Allergen-specific immunotherapy aims to desensitise the immune

dexamethasone can provide rapid improvement, but long-term

system over time. Veterinary protocols typically involve gradual

therapy requires careful monitoring for adverse effects, including

introduction and ongoing monitoring. While requiring long-term

laminitis, immunosuppression, and metabolic disturbances.

commitment, immunotherapy can provide sustainable relief and

Veterinarians should consider tapering protocols and adjunctive

reduce dependence on pharmacologic agents. 2,12

Allergen-specific immunotherapy offers a disease-modifying

therapies to minimise systemic exposure.

5

Microbiome-based interventions Antihistamines

Emerging data indicate that restoring microbial balance may

Oral antihistamines have limited efficacy in horses but may serve

support skin barrier function and mitigate allergic responses.

as adjuncts to glucocorticoid therapy. Clinical response is variable,

Approaches may include prebiotics, probiotics, or topical

and practitioners should set realistic expectations with owners

treatments that enhance microbial diversity, representing a

regarding their modest benefits.

complementary strategy to traditional therapies.1,9

5

Dietary omega-3 fatty acids, particularly from fish oil, exert anti-

Practical considerations in clinical management

inflammatory effects and support barrier function. Integrating

Veterinarians should adopt a multimodal, individualised approach

these supplements can reduce the severity of pruritus and

to equine allergies:2,5,6

enhance skin health over time.

U Severity-based protocols: Mild, seasonal cases may

Omega-3 fatty acid supplementation

7,10

respond to environmental modifications and topical therapies

Topical therapies

alone, while chronic or severe cases often require systemic

Topical interventions can provide symptomatic relief and aid

pharmacologic intervention.5,6

barrier restoration:

9,10

U Monitoring and adjustment: Regular follow-up allows

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Livestock

Volume 1 | No. 3

allergic skin may yield agents that restore barrier function and

1. Prioritise the skin barrier

reduce allergen sensitivity.

Disrupted lipid lamellae and barrier dysfunction are central to equine allergic skin disease. Therapeutic strategies should not only target immune-mediated inflammation but also focus on restoring barrier integrity through topical formulations, emollients, and dietary lipid support.1,3,8

2. Environmental management is key Environmental modification remains the cornerstone of allergy control. Stabling horses during peak insect activity, using protective fly gear, managing pastures, and reducing dust/mold exposure can significantly reduce allergen and insect contact, especially for IBH. 2,6

3. Tailor pharmacologic therapy Systemic glucocorticoids remain the most effective symptomatic therapy but require careful monitoring for adverse effects.

Antihistamines may be adjunctive, while omega-3 supplementation can support barrier function and reduce inflammation.5,7,10

4. Consider targeted and emerging therapies IL-31 pathway inhibitors, barrier restoration agents, and microbiome-based interventions represent promising strategies to address pruritus and allergic inflammation. Early adoption in clinical practice should be guided by patient response and ongoing research.1,8,9,11

5. Immunotherapy offers long-term benefits Allergen-specific immunotherapy can desensitise the horse’s immune system and provide sustainable relief. While requiring longterm commitment, it may reduce reliance on systemic medications and improve quality of life for chronic allergy patients.2,12 practitioners to assess treatment efficacy, adjust medications, and monitor for side effects.5 U Owner education: Owners play a critical role in implementing environmental control measures, administering medications, and observing for early signs of flare-ups. Clear communication improves compliance and clinical outcomes. 2

Future directions Several research avenues are critical to advancing equine allergy management.1,3,4,8,9 U Functional assessments: Evaluating transepidermal water loss, skin hydration, and pH can guide treatment efficacy.

U Genetic studies: Understanding filaggrin and other barrier protein polymorphisms may enable personalised therapeutic approaches.

U Microbiome research: Comprehensive studies on dysbiosis during flares may inform novel microbiomebased therapies.

U Targeted lipid interventions: Clarifying lipid metabolism in

Conclusion Equine allergies reflect a complex interplay between genetic predisposition, immune dysregulation, and skin barrier compromise.

Veterinary management requires a multifaceted strategy combining environmental modification, pharmacologic therapy, topical care, emerging biologics, and immunotherapy. Emphasis on barrier restoration, microbiome balance, and cytokine-targeted interventions represents a paradigm shift from purely symptomatic control to disease-modifying approaches. Veterinarians equipped with an understanding of these mechanisms are better positioned to improve clinical outcomes, reduce pruritus, prevent secondary complications, and enhance the quality of life for affected horses.

References Marsella R. Skin barrier function in normal and allergic horses. Vet Sci, 2025, 12(2), 91. Available at: https://doi.org/10.3390/vetsci12020091.

2. NextMune. Atopic dermatitis in horses: diagnosis and management [Internet]. NextMune; 2024 [cited 2025]. Available at: https://nextmune. com/en-us/vet/equine/allergy/atopy.

3. Discepolo DR, Gaare E, Handlos G, Perry EB. Fluctuations in equine cutaneous pH and transepidermal water loss with time of day and ambient conditions. J Equine Vet Sci, 2024 Sep;140:105140. doi: 10.1016/j. jevs.2024.105140. Epub 2024 Jun 29. PMID: 38950715.

4. My Pet Nutritionist. Can genes result in poor skin function? The role of filaggrin in skin barrier integrity [Internet]. 2021 [cited 2025]. Available from: https://mypetnutritionist.com/post/can-genes-result-in-poorskin-function/ 5. Littlewood J. Equine atopic dermatitis: latest on diagnosis and management [Internet]. Vet Times; 2022 [cited 2025]. Available from: https://www.vettimes.com/clinical/equine/equine-atopic-dermatitislatest-on-diagnosis-and-management-cpdeqpreventive.

6. Young A and Finno C. Insect bite hypersensitivity in horses [Internet]. UC Davis CEH; 2022 [cited 2025]. Available from: https:// ceh.vetmed.ucdavis.edu/health-topics/insect-bite-hypersensitivity.

7. Bazay C. Skin allergies in horses: causes, symptoms and treatment [Internet]. Mad Barn; 2025 [cited 2025]. Available from: https://madbarn. ca/skin-allergies-in-horses/ 8. Jebbawi F, Chemnitzer A, Dietrich M, et al. Cytokines and chemokines skin gene expression in correlation with immune cells in blood and severity in equine insect bite hypersensitivity. Front Immunol, 2024 Jul 15;15:1414891. doi: 10.3389/fimmu.2024.1414891. PMID: 39076967; PMCID: PMC11284025.

9. Rodrigues Hoffmann A. The cutaneous ecosystem: the roles of the skin microbiome in health and its association with inflammatory skin conditions in humans and animals. Vet Dermatol, 2017 Feb;28(1):60-e15. doi: 10.1111/vde.12408. PMID: 28133874.

10. Eaton S. Management of Equine Dermatological Allergies: A Review of Conventional and Complementary Therapies. Am J Trad Chin Vet Med, 1.

2024, 19(2):51-66. https://doi.org/10.59565/001c.121506.

Marsella R, White S, Fadok VA, et al. Equine allergic skin diseases: Clinical consensus guidelines of the World Association for Veterinary Dermatology. Veterinary Dermatology, 2023. https://doi.org/10.1111/ vde.13168.

12. Veterinary Practice. Atopic dermatitis in dogs, cats and horses: comparative immunotherapy approaches [Internet]. Vet Practice; 2021 [cited 2024]. Available from: https://www.veterinary-practice.com/article/ atopic-dermatitis-in-dogs-cats-and-horses. U 11.

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Livestock

Volume 1 | No. 3

Spring flush syndrome in cattle: Managing the risks of rapid pasture transition With spring approaching in South Africa, cattle farmers face one of the most dangerous seasonal transitions on the farming calendar. ‘Spring flush syndrome’ is not a single disease. It refers to two common and deadly metabolic emergencies that affect cattle grazing on fast-growing, young spring grass: Grass tetany and frothy bloat. Both are triggered by the sudden dietary changes that happen when herds eat highly digestible, lush, new forage.1,2,3,4

After months on dry winter rations – balanced mixes of dry

magnesium absorption. Cattle on lush grass pastures are also more

forage, grains, and co-products – cattle are turned out onto green

likely to develop metabolic alkalosis (urine pH >8.5), which reduces

pasture. This rapid shift from a controlled, dry diet to lush spring grass

the supply of ionised calcium and magnesium, compounding the risk

places enormous stress on the rumen and on the animal’s metabolic

of both hypomagnesaemia and hypocalcaemia.2

system. The new forage is characterised by three challenging

The clinical signs are dramatic and often appear without

properties: low dry matter (often <20%), excessively high protein

warning. Affected cows exhibit hyperexcitability – sudden head-

coupled with moderate energy, and very low fibre content.1

throwing, loud bellowing, and erratic galloping. Muscular spasms

Lush spring grass can frequently be <25% dry matter, meaning

are common, and in severe cases, seizures occur. During seizures,

a lactating 600kg cow may need to consume up to 62.6kg of

cows may display paddling motions, chomping jaws, frothy

fresh grass daily just to meet energy requirements – more than

salivation, and eyelid fluttering. In extreme situations, respiratory

the rumen can physically hold at roughly 45.4-56.7kg.1

distress sets in, potentially leading to collapse and death. Clinical

The cow simply cannot eat enough to sustain herself. At the same time, the protein content of rapidly growing grass frequently exceeds the animal’s requirements while energy remains

signs can cause death within four hours, and a rapid rise in body temperature may follow a tetanic event. 2 Treatment must be immediate. Clinical cases require

inadequate. When rumen microbes face excess protein without

intravenous (IV) magnesium (2-4g), or subcutaneous injection

sufficient energy, deamination occurs: protein is broken down

of 200-400ml of 25% magnesium sulfate. A standard course

into ammonia, which crosses into the bloodstream, is converted

involves slow IV injection of 400ml of 40% calcium borogluconate

to urea by the liver, and excreted in urine. This protein-energy

and 50ml of 25% magnesium sulfate, since hypocalcaemia

imbalance is not merely an inefficiency – it is a direct precursor to

frequently accompanies hypomagnesaemia. However, animals in

both grass tetany and frothy bloat.

coma typically fail treatment, and stimulation during treatment can

1

trigger lethal seizures. 2

Grass tetany: The silent killer Grass tetany, or hypomagnesemia, occurs when the body’s

Frothy bloat: The rumen under pressure

absorption of dietary magnesium is insufficient to meet the demands

The conditions described in the studies – low fibre, high protein,

of lactation (~120mg per kilogram of milk) and maintenance (3mg

and rapid passage rates in lush spring forage – are precisely the

per kilogram of body weight). Unlike calcium, magnesium cannot

factors that predispose cattle to frothy bloat. When cattle graze

be reabsorbed from bone reserves to compensate for a transient deficiency, making cattle entirely dependent on daily dietary intake.

immature, low-fibre pasture, the rumen cannot maintain normal 2

Spring pasture creates the perfect storm. Fast-growing

motility and gas eructation. A stable foam forms that traps fermentation gases, leading to life-threatening rumen distension.

grasses contain high nitrogen levels (ranging from 4.2% to 6.3%,

Meteer observed that the low fibre content of immature

equivalent to 26%-39% crude protein), which leads to elevated

forages results in very high passage rates and unsatisfied cattle –

ammonium ion concentrations in the rumen, raising ruminal pH

cows appear hungry despite being knee-deep in green grass.1

and directly decreasing magnesium bioavailability.

2

The high potassium content of lush spring forage further hinders

The solution is straightforward: supplementing with palatable dry baled forage that is low or moderate in protein (not alfalfa hay)

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Livestock

Volume 1 | No. 3

can help address both the dry matter deficit and the fibre shortage.

and improved antioxidant status compared to those on grass-

Supplementing with grains – though not exceeding 0.5% of body

only pasture, suggesting that diverse swards may help buffer the

weight – or grazing only the top third of the grass plant can also

metabolic extremes of spring flush.4

help restore balance.1

Comprehensive training of farm workers to recognise early warning signs – changes in behaviour, appetite, or milk

Management and prevention

production – is essential for timely intervention. Regular blood and

Prevention of grass tetany centres on ensuring adequate

urine testing for magnesium and metabolic parameters can detect

magnesium intake before and during high-risk periods.

subclinical deficiency before it becomes a clinical emergency. 2

Supplementation with high-magnesium mineral feed should begin

Conclusion

at least 30 days before calving. 2 Cows need ~113g of a mineral mixture containing 12%

Spring flush syndrome demands respect. The transition from

magnesium daily. Magnesium oxide (MgO) can be added to

dry winter feed to lush spring pasture is not a single event but

grains, though its bitter taste requires mixing with palatable

a process requiring careful management. Supplementing with

ingredients such as molasses and concentrate.

magnesium, providing dry fibre alongside pasture, avoiding excess

2

During dangerous periods, 60gr of magnesium oxide can

potassium fertilisation, and considering energy supplementation

be supplemented daily. Magnesium can also be delivered by

and forage diversification are all evidence-based strategies that

spreading MgO powder (500g per cow) on hay or spraying a

protect herds. With preparation and vigilance, South African cattle

2% magnesium sulfate solution on pasture every one- to two-

farmers can harness the nutritional benefits of spring growth

weeks – though if rainfall >40-50mm within two- to three-days,

without falling victim to its hidden dangers.

the treatment must be repeated.

2

Pasture management is equally critical. Fertilisation should follow soil testing, and excessive potassium fertiliser should be avoided, as high potassium in lush spring forage directly hinders magnesium absorption. Providing dry hay or limiting grazing time to two- to three-hours per day slows food passage through the digestive tract and promotes magnesium absorption. 2 Energy supplementation during spring grazing can also help address the protein-energy imbalance. Research showed that supplementing grazing dairy cows with high moisture maize lowered milk and plasma urea concentrations by 0.72mmol/l and 0.76mmol/l respectively, compared to cracked wheat, indicating better nitrogen utilisation and a more balanced rumen environment.3 Pasture diversification also matters: Cows grazing legume and forb-based pastures showed lower beta-hydroxybutyric acid

References Meteer WT. Mitigating the Challenges of Grazing Lush, Spring Forages. [Internet]. Available at: https://uknowledge.uky.edu/cgi/ viewcontent.cgi?article=1147&context=ky_grazing 2. Kang D, Lungu SE, Danso F, et al. Animal health and nutrition: metabolic disorders in cattle and improvement strategies. Front Vet Sci, 2025.

3. Merino VM, Leichtle L, Balocchi OA, et al. Metabolic and Productive Response and Grazing Behavior of Lactating Dairy Cows Supplemented with High Moisture Maize or Cracked Wheat Grazing at Two Herbage Allowances in Spring. Animals (Basel).

2021.

4. Ford HR, Busato S, Trevisi E, et al. Effects of Pasture Type on Metabolism, Liver and Kidney Function, Antioxidant Status, and Plant Secondary Compounds in Plasma of Grazing, Jersey Dairy Cattle During Mid-lactation. Front Anim Sci, 2021. U 1.

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Wildside

Volume 1 | No. 3

South Africa’s biodiversity plan puts farms, livelihoods and nature at the centre

South Africa’s biodiversity is not a luxury reserved for national parks. It is living infrastructure behind productive land, reliable water, food, jobs and rural livelihoods. The country is one of the world’s megadiverse nations, contains three of the 36 global biodiversity hotspots and has almost 1000 distinct ecosystem types across terrestrial, freshwater, estuarine and marine environments.

More than 20 000 indigenous plant species occur here, with

The warning from the 2025 assessment

60.5% found nowhere else on Earth. The country has identified

The National Biodiversity Assessment 2025 provides a clear

263 terrestrial Key Biodiversity Areas, while its 3 000 km coastline

picture of the country’s ecological condition. Almost half (48%)

links rocky shores, beaches, estuaries, kelp forests, coral reefs

of South Africa’s ecosystem types are threatened. Estuaries,

and deep-sea habitats. More than 13 000 marine species have

rivers and wetlands are the most threatened and least protected,

been recorded. Around 290 functional estuaries support diverse

a serious concern in a country where water security is inseparable

life and help protect coastal communities from extreme weather.

from functioning catchments and wetlands. Around 16% of

South Africa now has 32 Ramsar sites (important wetlands

assessed plant species and 10% of assessed animal species are

protected under an international treaty).

threatened. Freshwater fish face especially high risk (66%), as do

This natural wealth is working wealth. Indigenous plants and harvested marine species contribute to food and livelihoods.

cartilaginous fish (42%).

The assessment also introduces a genetic warning: 58%

Savannas and grasslands support rangelands and crop

of assessed populations are below the effective size required

agriculture, while strategic water source areas provide 50% of the

for long-term genetic health. A population with too little genetic

nation’s water from only 10% of its land area.

diversity is less able to withstand disease, drought or changing

The draft National Biodiversity Strategy and Action Plan

conditions. For agriculture, this is a reminder of the value of

(NBSAP) 2026-2035 therefore matters well beyond the

indigenous genetic resources, crop wild relatives, landraces and

conservation sector. It is South Africa’s third NBSAP and its latest

locally adapted livestock systems.

vehicle for meeting responsibilities under the Convention on

Protected areas have expanded. In 2025, protected and

Biological Diversity (CBD), ratified in 1995. Its question is practical:

conserved areas covered ~17% of South Africa’s terrestrial area

How can South Africa conserve the systems on which people

and 15% of its marine territory. Biodiversity stewardship was central

depend while sharing biodiversity’s benefits fairly?

to meeting and exceeding terrestrial protected-area targets by

South Africa’s biodiversity is more than a conservation priority. It is the natural capital that underpins our economy, wellbeing and future resilience.

2020, showing what can be achieved when private and communal landholders are partners in conservation. Yet rivers and wetlands remain poorly protected, and a percentage on a map does not by itself guarantee ecological health.

The pressures are familiar to farmers and rural communities. Land conversion for croplands, grazing, plantation forestry, settlements and mining removes habitat. Overgrazing reduces vegetation cover, accelerates soil erosion and sends damaging effects downstream.

Dams, abstraction and altered river flows affect estuaries.

Vet’s Hub

Wildside

Volume 1 | No. 3

Invasive alien plants consume water and increase fuel

Biodiversity: An inclusive, transformed society living in harmony

loads, while non-native predatory fish disrupt rivers. Acid mine

with nature, where biodiversity conservation and sustainable use

drainage, industrial and urban effluent, agricultural return flows and

ensure healthy ecosystems, with improved benefits that are fairly

stormwater runoff further degrade aquatic environments.

and equitably shared for present and future generations.

These are not separate problems. Degraded soil means less

Its impact is expressed simply as ‘Thriving People and

productive grazing and greater vulnerability to drought. A damaged

Nature’. The strategy aligns with the Kunming-Montreal Global

wetland stores and filters less water, while a cleared or invaded

Biodiversity Framework adopted by CBD Parties in 2022, while

catchment can increase flood risk and reduce dry-season flows.

reflecting South Africa’s water scarcity, land degradation, rural

Declining ecosystem resilience eventually becomes a direct cost to farming, livestock production, households and local economies.

What the previous plans teach us South Africa’s first NBSAP, published in 2005, was built on the National Spatial Biodiversity Assessment of 2004. Of its 122 activities, 54% were fully or substantially achieved. It strengthened institutional coordination and contributed to provincial spatial

Protecting biodiversity requires action far beyond protected areas, with every sector playing a role in securing South Africa’s natural heritage

biodiversity plans and the first National Biodiversity Framework.

But it also showed that mainstreaming biodiversity into other sectors takes longer than expected and depends on opportunities outside the direct control of the biodiversity sector.

The second NBSAP, covering 2015-2025, delivered significant

poverty, diverse farming sector and need for transformation.

The action plan is organised into 12 thematic areas: Mainstreaming, restoration and invasive alien species, ecosystem and species conservation, human-wildlife coexistence,

gains. Terrestrial protected-area targets were met or exceeded

sustainable use and the biodiversity economy, pollution and

by 2020, largely through biodiversity stewardship, and marine

waste, ecological infrastructure and climate resilience, access

protection increased dramatically from less than 0.5% to 5.4%.

and benefit sharing, biosafety and biotechnology, means of

Technical capacity also improved, including an integrated national

implementation, and knowledge, participation and inclusion.

ecosystem map and natural-capital accounting for protected areas and strategic water source areas.

Progress was uneven. Only five of 22 strategic outcomes were

This recognises that conservation cannot be delivered by protected areas alone. Biodiversity must influence spatial planning, agriculture, water management, mining, infrastructure, urban

fully achieved - 14 remained in progress and three had unknown

development and private-sector decisions, supported by restoration,

status, largely because monitoring was lacking. Although nominal

compliance, finance, research and meaningful participation.

expenditure increased, inflation reduced its real purchasing power.

The lesson is to set achievable outcomes, assign

From pressure to practical response

responsibility, publish progress and measure whether conditions

The plan’s response to habitat loss includes biodiversity-inclusive

improve – not merely whether activities were listed.

spatial planning and better management of protected areas.

Restoration is an ecological and livelihood opportunity. Rangeland

A plan for ‘Thriving People and Nature’

initiatives promoting rotational grazing, native vegetation recovery

The 2026-2036 draft NBSAP adopts the vision of the White

and community governance offer a model for livestock areas.

Paper on the Conservation and Sustainable Use of South Africa’s

Invasive alien species management is paired with restoration rather than treated as a once-off clearing exercise.

Priority catchments and strategic water source areas can benefit twice: Habitat recovers, while water security and climate resilience improve. The plan also links ecological infrastructure to ecosystem-based adaptation and nature-based solutions. Healthy wetlands, rivers and riparian zones regulate water flows, buffer floods and droughts, protect infrastructure and sustain livelihoods.

Pollution has its own thematic area for the first time.

That is significant because agricultural nutrient runoff, pesticides, failing wastewater systems, mining legacies and illegal dumping cannot be solved by conservation agencies working in isolation. The draft calls for stronger baselines, accountability, compliance monitoring, enforcement and remediation of contaminated sites.

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Wildside

Farmers are part of this solution through responsible soil, nutrient

Volume 1 | No. 3

hunting, harvesting, hiking and cultural uses. Traditional medicines

and water management, but they also need reliable municipal

and indigenous products connect natural resources to rural

services and fair, consistent regulation upstream and downstream.

enterprises and livelihoods.

Climate change increases urgency. Prolonged drought in the

The draft plan places sustainable use at the centre of this

arid west contributes to species declines, while extreme weather

opportunity. Its intention is not to extract more until resources

affects coastal and estuarine systems.

are depleted, but to build legal, well-regulated and inclusive value

Climate change also amplifies other pressures by interacting

chains. Enterprise development should create space for rural

with invasive species, altered fire regimes and habitat degradation.

communities and designated groups, while better permitting,

Maintaining connected, functioning ecosystems is therefore a

traceability, compliance and enforcement protect the biological

form of risk management for agriculture and rural communities,

foundation of the economy. When people receive meaningful

not an alternative to development.

benefits from well-managed biodiversity, they have a stronger stake in protecting it.

Healthy ecosystems provide clean water, food security, climate resilience and sustainable livelihoods, making biodiversity an investment in our collective future

Access and benefit sharing is particularly important for farmers, communities and traditional knowledge holders. The plan proposes stronger systems for sharing monetary and nonmonetary benefits arising from genetic resources and associated knowledge. It also recognises the importance of securing indigenous genetic resources, crop wild relatives and domestic landraces in gene banks and community seed banks – an investment in future food security as much as in conservation.

Implementation will decide the outcome

The marine evidence is equally sobering.

The largest risk is that the third NBSAP becomes another

The number of species evaluated in South Africa’s marine fishery

statement of good intentions. Biodiversity investment remains

resources report grew from 22 in 2008 to 65 in 2025, reflecting

heavily dependent on the public sector and accounts for less than

improved monitoring. Yet depleted or heavily depleted stocks

1% of the consolidated government budget. Nominal expenditure

accounted for 31% of monitored resources in 2025. Sustainable

rose from R15.25 billion in 2016 to R20.14 billion in 2024, but real

use, science-based management, bycatch reduction and support

purchasing power fell from R14.31 billion to R12.9 billion. The draft

for customary and small-scale fishers are essential if coastal

calls for domestic resources, international climate finance and

livelihoods are to endure.

private-sector contributions, with an access goal of $8 billion annually and greater use of innovative finance.

Growing the biodiversity economy fairly

It also proposes outcome-oriented indicators aligned with

South Africa already has a substantial biodiversity economy.

the Kunming-Montreal Global Biodiversity Framework. This

Biodiversity-based tourism contributed R27.7 billion in direct GDP

means asking whether ecosystems are recovering, extinction

and supported more than 90 000 positions in 2019. The wider

risk is falling, water-related ecological infrastructure is functioning,

biodiversity economy includes fishing, aquaculture, ecotourism,

resource use is sustainable and benefits are reaching rights holders. Monitoring must be regular, public and useful to decision-makers.

For South Africa’s farmers, livestock producers and rural communities, the stakes are concrete: soil that stays on the land, water that remains available, rangelands that recover, fisheries that support families and biodiversity-based enterprises that share value fairly. The draft NBSAP’s strongest idea is that these outcomes are connected. Thriving nature is the foundation that allows people, farms and rural economies to thrive.

Reference Department of Forestry, Fishery and the Environment.

South Africa National Biodiversity Strategy and Action Plan 2026-2035. 2026 [Internet]. Available at: https:// www.dffe.gov.za/sites/default/files/docs/strategy. framework/biodiversity/draft.nbsap202636.pdf U

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