The Veterinarian Magazine March 2023

TheVeterinarian

Funding for world-first malaria test in East Asia

HECS debt forgiveness needed to aid industry

Rural veterinary business Apiam is calling for HECS forgiveness to ease pressure on workforce shortages.

Apiam Managing Director Chris Richards told The Veterinarian that it is time the government took rural veterinary workforce shortages as seriously as those in health and teaching.

“The ruralveterinary workforce shortages are not going anywhere as we compete with not only the metro centres but overseas as well,” he said.

“Demand for veterinary services in the regions is booming, largely due to rising population, as well as the growing ‘humanisation’ of pets.”

To contend with the growth in demand, Richards said it is important to retain veterinary talent, not merely attract it.

East Asia’s goal of eradicating malaria by 2030 has been bolstered with more than $1.3 million in new funding for research to develop and deploy a world-first diagnostic test.

Almost $1m of the funding from the National Health and Medical Research Council (NHMRC), will be used to develop the first point-of-care rapid diagnostic test for the Plasmodium parasites which cause malaria. Further funding will assist in creation of a laboratory version of the test to be based in the Philippines, the site of recent malaria outbreaks in the East Asia region.

Malaria is transmitted to humans through the bite of an infected mosquito, with more than 200 million cases (and 620,000 deaths) worldwide each year. The tests will pinpoint if an individual has been

infected with the Plasmodium vivax parasite, and whether they are at risk of relapsing.

Ivo Mueller, Joint Division Head of the Walter and Eliza Hall Institute of Medical Research (WEHI), a world expert in the biology, epidemiology and control of P. vivax malaria, said being able to predict the chance of relapse would be a breakthrough in control of the disease.

“Malaria reinfections are the leading cause of residual transmission that continue to challenge malaria eradication efforts,” he said. “Our novel test can show whether someone has had a P. vivax infection within the last nine months. This timing is critical as most people in tropical regions are expected to relapse within nine months of a previous blood-stage infection. To page 30

“To get HECS forgiveness right, it is crucial that we instil a minimum length of time, such as fouryears, that these graduates have to complete their placements in the regions,” he said.

In a recent AVA survey, veterinary students were asked if they would consider taking a regional/rural veterinary role “within the first five years of graduation to be eligible to have part or all of your HECS debt removed?”

Despite an admittedly small sample size of around 100 students, 100 per cent of respondents said they would consider utilising such a program.

■ SAM WORRAD

Live export phase out briefing attended by AVA, VALE

AVA representatives have attended Senator Murray Watt’s briefing on the phase out of live sheep exports. Watt, the Minister for Agriculture, Fisheries and Forestry, formally announced the beginning of consultation, seeking views on a transition plan from stakeholders including the AVA.

A consultation report will be published by September next year, and an expert panel (chaired by senior public servant Phillip Glyde) will provide advice to the Minister on how the phasing out of live sheep export should occur, and when the practice should cease.

“Phasing out live sheep exports by sea is a complex issue that will impact farmers, businesses, our trading partners, and the communities that participate in the trade,” Sen Watt said in a statement.

“I am also conscious that the wider Australian community is interested in the phase out, including those that want to see animal welfare maintained and improved.”

Vets Against Live Export (VALE) haswelcomed the announcement, however the group wants a rapid cessation of live export, with spokesperson Sue Foster calling for a “phase out as soon as feasibly possible.”

Foster said she anticipates the live export industry to protest the changes and cite high standards of welfare.

“It is true that Australia does have the world’s best standards, but they are regularly breached by this industry,” she said.

“Independent observers reported breaches on 75 per cent of accompanied Middle East ship voyages.”

Foster added that several common factors are unchanging on live export voyages.

“What never changes is the inherent conditions on these ships: ship movement, To page 30

Murry Watt

Liver cells (pink) infected with a malaria parasite (green). Picture Drew Berry

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Incorporating cultural fire practices to help protect koalas

In the wake of the 2019/2020 bushfires in which an estimated three billion wildlife perished, a two-year ongoing collaborative project ledby researchers from the University of Sunshine Coast, and land custodians from the Quandamooka Yoolooburrabee Aboriginal Corporation, has shown bushfire management strategies would benefit if Aboriginal knowledge was included. Such knowledge could help mitigate the risks bushfires pose for vulnerable species such as koalas.

The study was conducted on 130 hectares in the northeast region of Queensland’s Minjerribah/North Stradbroke Island, that is home to a wide range of protected flora and fauna including a population of genetically unique koalas. The results showed no negative impacts on the densities or stress levels of the koalas after the first burn in July 2021.

Bruce Walker, a ranger with the QYAC, said cultural burns were cooler, lower, and slower than ‘hot fires’, enabling better coordination and control to encourage the regeneration of suitable native plants. The burns also controlled species like banksias and wattle, reducing the risk of fire reaching the canopy where koalas lived.

Asitha Samarawickrama, an environmental scientist with experience as a ranger, conservation and threatened species researcher,and environmental educator, and who conducted the

research for his UniSC Master of Science, said the findings were exciting.

“It’sbelieved to be the first study of Aboriginal cultural burning to mitigate the risk of wildfires on koalas, something that’s increasingly important as uncontrolled wildfires become

Health benefits of keeping pets in aged care facilities

A recent study published in the International Journal of Environmental Research and Public Health and led by researchers at the University of South Australia, explored a practical model of hosting companion animals in aged care facilities. It confirmed the health benefits of human-animal relations, ‘cannot be underestimated for residents in aged care’. The model included both foster animals and personal pets.

Study leader and co-author Janette Young, a lecturer in health sciences at UniSA, said it was morally imperative to provide older people in residential care with a supportive, healthy environment, and although many people had shared their domestic lives with other species, in residential aged care settings multi-species sharing was rare.

“Australia has one of the highest rates of pet ownership in the world. Pets help us feel happier and healthier and they can do this in different ways: we take them for walks and play with them, so they help us stay active; we feed and care for them, so they give us purpose; but most importantly they’re always there to give us unconditional love and companionship,” she said.

The Foster Cat Project was a joint venture between an animal rescue service, an aged care facility and university researchers. It aimed to develop a practical working model of companion animals which could be replicated in other facilities in line with the Ottawa Charter action areas of creating health-promoting environments. The Charter is a global health milestone that identifies

several key attributes deemed essential to wellbeing. They include peace, shelter, food, education, social justice, and sustainable resources.

The pilot program was disrupted by COVID-19 which limited access to aged care facilities, but Young said the pandemic had also presented an opportunity to gain reflective insights into the perceived barriers, enablers and tensions involved in seeking to implement pet animal inclusion in residential aged care.

“The effects of the pandemic have been felt around the globe, but the negative impact has been disproportionately great for those in residential care. As we edge into safer terrain, we can start to look at improving other aspects of aged care, and one of the most unrecognised issues of ageing is touch deprivation. Pets that are there to cuddle and pat can make all the difference to someone when they’re feeling sad or down,” she said.

The program involved two adult cats living among residents in a dedicated wing of an aged care facility, that were cared for by aselect group of trained staff and volunteers. By living with the residents, the cats helped ease residents’ loneliness, as well as relieve stress, anxiety and depression from being there to pat, talk to, care for and love – and provide that special sense of companionship.

“Positive ageing is not just about living a long life. It’s about ageing well, enjoying your older years, and having purpose and comfort in your life. Pets can provide this.”

To page 30

more frequent and severe with climate change. It showcases how cultural practices over millennia can be combined with cutting edge technology to advance science and support traditional management for conservation purposes,” he said.

The research involved counting and monitoring koalas using drones fitted with thermal cameras, and the collection of koala scats from the ground. These were analysed for hormone metabolite levels which could indicate stress.

Team supervisor Romane Cristescu, Director of Detection Dogs for Conservation, and a Research Fellow at UniSC, said Minjerribah’s koalas were genetically distinct and very healthy, and in contrast to mainland koalas showed little evidence of diseases such as chlamydia.

“After the 2019-2020 megafires showed the vulnerability of koalas living in fire-prone habitat, an obvious solution was to address the ways we manage fires to try to prevent them. This study is a first step to show that cultural burns have that potential,” she explained.

A second burn during August 2022 was successfully conducted with study and funding partner organisations WWF-Australia and the Queensland Department of Environment and Science.

There’s hope for handfish

Tasmania is home to several wildlife species that are listed as endangered or critically endangered, and the spotted handfish is one of them. Once widespread along the state’scoastal regions, the unique bottom-dwelling fish that famously uses its pectoral fins to walk along the seabed, is now found only in a few locations in or close to Hobart’s River Derwent estuary.

As part of the Handfish Conservation Project a captive breeding program was established at Melbourne’sSea Life Aquarium in 2017. It is a collaborative project that includes CSIRO, and northern Tasmania’s Seahorse World. After overcoming several obstacles, including learning how to accurately determine a handfish’s sex, the first captivebred babies - known as fry-were hatched in January 2022. This

successful breeding outcome is a world first for the species and incorporates the full cycle of courtship, fertilisation, egg laying and hatching to occur in aquarium habitats and in human care.

Lead aquarist Sam Fawke said it was a major achievement for the team, which had to replicate conditions in the wild, including temperature changes, food availability and salinity levels to encourage breeding. Although the handfish fry were raised in the facility’s nurser y aquariums and away from public view,Fawke said the small population of juveniles was now ready to go on display.

“Originally we planned on having them here as an ambassador population to educate the public. Then we successfully managed to breed them so now we’re a key part of the whole program, and they’re ready to take centre stage,” he said. To page 30

■ ANNELAYTON-BENNETT

Asitha Samarawickrama

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Giving a RATs: rapid antigen testing range increases

more quickly, eliminating the need to wait on pathology or other test results to begin treatment.

Steven Quinlan, Growth and Strategy Consultant at Touch Biotechnology believes the testing kits will make a difference in veterinary practice. “The benefits of using the animal diagnostic testing range include prioritising the animal’s wellbeing by making the testing process accurate and streamlined,” he said. “It can assist in quick and early detection and differentiation between viruses using a single sample, reducing the dependency on laboratory or any other test equipment.”

owners and veterinarians to quickly identify and treat illnesses and health issues that arise from various germs, bacteria, and viruses. Early detection of animal diseases is crucial, not only for protecting public health but also maintaining the wellbeing of our pets,” Quinlan said. “Our new FastVET Animal Diagnostic Tests for dogs, cats and cattle detect and combat multiple pathogens (viruses and other diseases) from a single sample. The range is easy to use, requires minimal training and can be administered in a clinic or hospital setting using bodily fluids like faeces, blood, plasma or serum.”

antigens from cat faecal samples or antibodies specific to FCoV in serum and plasma samples. Some kits can be used to test either cats or dogs, including one product which detects Toxoplasma gondii antibodies, and another which tests for Giardia.

Testing kits have also been developed for use with cattle, including a rapid antigen test to detect Rotavirus, Coronavirus, Escherichia coli K99, Cryptosporidium parvum and Giardia from bovine faecal samples. The product is suitable for use with cattle, calves and cows and delivers aresult in ten minutes.

Australian company Touch Biotechnology Systems has developed a new range of rapid antigen tests to provide rapid detection of a range ofzoonotic diseases in cats, dogs and cattle. Designed to detect a range of pathogens from a single sample in ten to fifteen minutes, the FastVET testing kit range launched by Touch Biotechnology Systems will enable veterinarians and other animal care professionals to obtain diagnostic information far

While rapid antigen testing was largely unheard of by the general population prior to the COVID-19 pandemic, most pet owners are now far more familiar and comfortable with the use of such tests. More significantly, coronavirus has also made the public has also become increasingly aware of the dangers posed by zoonotic infections and of the importance of protecting public health via timely diagnosis of animal diseases.

“Animal Diagnostic Testing has become pivotal in helping animal

Avian influenza on the rise

The highly pathogenic avian influenza has caused periodic outbreaks in farmed poultry and wild birds since 1996, when the HPAI strain known as the Goose Guangdong virus developed and spread from poultryto wild birds, and from wild birds to poultry. In the years since the virus has spread sporadically throughout Europe but was generally only detected during the winter months. During 2022 it was found to be infecting farmed and wild birds in summer, with seabird colonies particularly affected, and despite HPAI being highly specific to birds, several spillover events were being documented inmammals. In rare cases the virus was transmitted to humans, highlighting the zoonotic potential of the disease.

Martin Beer, head of the Institute for Diagnostic Virology at Germany’s Federal Research Institute for Animal Health, said the virus seemed to be adapting better to wild birds while the seasonality aspect appeared to be diminishing.

“In the UK, and in Germany on the coastline, we had a lot of wild birds, colony-breeding birds, dying of H5N1 viruses. These are not a single virus type – there are more than 30 genotypes worldwide now –so the situation is worrying,” he said.

Ian Brown, a visiting professor of avian virology at the UK’s University of Nottingham, and a director of the International Reference Laboratories for Avian Influenza of the World Organisation of Animal Health, and the Food and Agriculture Organisation, and who led the science response for the 2021/22 avian influenza outbreak,

said monitoring and tracking the disease was key in helping to contain the disease.

“If we find disease in poultryor kept-bird flocks then we can take action to eliminate it. How that’s done will depend on the amount of veterinary infrastructure available but traditionally infected flocks are killed quickly to minimise the spread. If the disease is controlled effectively in poultry, the interface is reduced between poultr y and wild birds, but vaccination is also increasingly being used,” he said.

The latest HPAI outbreak is believed to have occurred because of spill-over to a mink farm in Spain’s Galician region. The farm is readily accessible to mammals, rodents, and wild birds due to its open buildings and the provision of food on top of the cages. The mink farm is also where the virus is believed to have mutated, with increasing evidence of bird to mammal, and mammal to mammal transmission. This could be due to the density of the mink populations making the animals more vulnerable to transmission, given previous outbreaks have involved population colonies of both Russia’sCaspian seals and Peru’s sea lions. Animals that are more solitary, or that live in smaller populations, appear to be less susceptible although Brown said this theory had yet to be tested and a cautious approach should be adopted.

“An important point to understand is that there are a lot of infected wild birds that are sick and dying from this virus. We know animals like sea lions either share habitat and have close contact with these

The FastVET range for canines includes a testing kit to determine and differentiate between whether a dog has Canine Parvovirus, Canine Coronavirus or Giardia from a faecal sample, providing a result in about ten minutes. The feline range includes a testing kit that detects antibodies to Feline Immunodeficiency Virus and antigens of Feline Leukemia Virus from cat serum, plasma and blood samples, and another testing kit allowing for in vitro detection of Feline Coronavirus (FCoV)

Touch Biotechnology Systems has designed testing kits which are user friendly and – most significantly –provide high quality results (with a very high sensitivity of >97 per cent) in a short period of time. “Using the tests in a veterinary practice can significantly enhance the level of care provided to animals, making it an essential diagnostic tool for animal care professionals,” Quinlan said. For more information, visit touchaustralia. com.au.

■ JAI HUMEL

bird populations, or they scavenge and predate them. So, although there are a lot of sea lions, there are an awful lot of wild birds dying, so we can’texclude the possibility that sea lions are feasting on dead sea birds,” he said.

Thus far the virus has not been identified in Australia and Antarctica but the rapid spread of infection to so many different species should be considered a cause for concern given it has already reached South America with the serious biodiversity risk this could pose for Antarctica.

According to Ursula Höfle, a contract professor at Spain’s National Game and Wildlife Research Institute, the virus has been affecting species that haven’t been affectedbefore, such as large scavengers like vultures.

“It’s been wiping out entire colonies of some species, so we expect to see a huge impact on biodiversity on some populations from this virus. This is apart from the obvious risk and worry about human

infections or mammal to mammal transmission. This is the really serious part of the zoonotic. The virus is changing in many ways that we don’thave a handle on,” she said.

Although vaccination has been used in poultry for some time against several diseases and can be highly successful when part of a control program, Brown said there were practical issues that made vaccination challenging in combating this virus.

“How do you vaccinate a house full of 100,000 chickens easily, and ensure that all those birds have received vaccine? And how do you tryto make sure that the virus in the environment in the wild bird population doesn’tstill spill over into those flocks? These viruses are evolving to the point they could, potentially, escape vaccine immunity, but there’s a lot of work going on around the world, particularly in Europe, so vaccination will have an important role globally in trying to suppress this increasing problem,” he said. Topage 30

Steven Quinlan

GARNETTHALL: ANOFFICERAND AVETERINARIAN

When I first emailed Garnett Hall requesting an interview with him for The Veterinarian,Ithought I was rather busy. In addition to all my usual day to day commitments, Iwas moving into a newly built house, installing a pool and overseeing landscaping, sorting out various end of year school commitments for my children and – joy of joys – attempting to cajole various technicians into establishing our NBN connection in something vaguely resembling a timely fashion. Naturally, all of these things had to be accomplished before Christmas, and it felt like a bit of a juggle.

Around that same time, however, I began receiving aseries of emails responding to interview questions Ihad sent to Hall, and I soon discovered that he has taken busy to a whole new level, one which juggle does not even begin to cover. And, now I’m sitting happily in my new home and finally have a reliable internet service, my most recent challenge has been working out how to write a profile on someone who warned me, quite jauntily, right from the start of our correspondence: “I’ve certainly jammed a lot into my career so far, but I feel like there’s a lot more to accomplish!”

For most of his adult life, Garnett Hall has had not one, but two careers, plus a dizzying array of side hustles. He is a veterinarian by profession and an Army Reserve Infantry Officer by training, but is also a television presenter, a founder of Biotech company VetChip, a Board Member of the Royal Agricultural Society of Western Australia, an ambassador for Greyhounds as Pets, and President of the Western Australian Division of the Australian Veterinary Association. Quite obviously, it’s a lot: many threads woven into a complex picture that makes up the life of Garnett Hall. But tease out the strands, and three main threads emerge. The first is a love of animals and a passion for their welfare. The second is a belief in the importance of service to others. And the third, underpinning all these, is family.

Hall was born in Brisbane and grew up in Paddington, where his parents owned the Kookaburra Café. With characteristic modesty, he described the venue as being “fairly wellknown in Brisbane”, failing to mention that the restaurant had been frequented by everyone from sporting stars such as Wally Lewis and Tony Grieg, to global luminaries such as Taylor Swift, Katherine Hepburn, and Nirvana. (Superstars Beyoncé and Jay Z apparently opted to order delivery.) For Hall, however, the Kookaburra Café was simply the family business where he spent many of his school years working alongside his siblings.

Hall attended Brisbane Boys College from Year 5 to Year 7 before receiving a full academic scholarship to attend Brisbane Grammar School from Years 8 to 12, graduating in 2000. He tossed up studying medicine or veterinary science at the University of Queensland, and ultimately chose to become a vet upon realising he would probably need to complete an undergraduate degree prior to studying medicine. That said, by this stage his love of animals was already well established, having been fostered by his family, who had

increasingly intertwined. Upon graduating from university, he spent two years working in Dayboro as a mixed-practice vet. “Dayboro was abeautiful little dairying community just outside of Brisbane, where early morning starts to pregnancy test cattle in the dairy sheds were typical,” Hall said. “We also worked with a few small beef studs, and would undertake larger multi-day trips to extensive beef properties further afield.”

In 2008, Hall was a recipient of an Australian Cattle Vets Rural Practice Scholarship, which are presented to recently graduated veterinarians working in rural areas to enable them to further their careers in bovine practice.

Aleave of absence from Hall’s veterinary work in Dayboro was required, however, when his efforts RMC Duntroon led to him receiving a Foreign Academies Exchange Program Award. The award entitled Hall to travel to Singapore with four Regular Army Officers to observe and train with the Singapore Armed Forced Training Institute and Officer Cadet School. Upon his return, his first posting was as an Infantry Platoon Commander with the 9th Royal Queensland Regiment,

successful course which graduated approximately 40 infantry soldiers, who very highly sought after by both ARA battalions.”

Later in 2009, Hall opted to resign from his civilian veterinary role when he was offered the chance to deploy to East Timor with the 8/9th Royal Australian Regiment on Operation Astute. “This would be my first overseas deployment and was a twelve-month full-time contract, so I made the decision to leave Dayboro,” he said. “Going to East Timor was an incredible experience that allowed me to immerse myself in a culture that was very different from the life I knew back in Australia.” Aside from his Operational duties, Hall was able to use his veterinary skills working with the Task Force’s RAAF Military Working Dog detachment, whose dogs were encumbered by several tropical conditions in need of veterinary attention. “I was also able to provide

many pets. “Our family restaurant earned its name from my Dad’s love of native birds,” he said. “I grew up surrounded by dogs, birds, guinea pigs, rats, turtles and frogs, and I thought it was great. The first pet I knew was a poodle called Gulliver. He was a brilliant dog and I used to spend hours playing with him and teaching him tricks.”

Having decided upon his first career path, Hall applied himself to his veterinaryscience degree. “I had a brilliant time at the University of Queensland, back in the day when the vet school was still primarily at the St Lucia campus,” he said. “I had a great bunch of close friends, and we would often go camping on Stradbroke Island or Fraser Island over the holidays.” While still an undergraduate, Hall also embarked upon his second career: he joined the Army Reserve as an InfantryOfficer,somehow managing to fit his army training around university commitments. This decision was influenced by his father,who was a Vietnam veteran conscripted into National Service. “Dad had always spoken highly of his time with the Army and encouraged me to join for the opportunity to learn, travel and serve our country,” Hall explained. “I graduated from the part-time version of Royal Military College Duntroon in February 2006 at the lowly rank of 2nd Lieutenant,” Hall said. “I also finished the veterinary course that year, and felt ready to go and tackle the world!”

From this point, Hall’stwo seemingly disparate careers first overlapped and subsequently became

aReserve unit based in South-East Queensland. “Here I was able to consolidate my leadership skills and platoon tactics, culminating with my platoon travelling to New Zealand and winning the 2008 Exercise Tasman Reserve platoon trophy,” he said. “I thoroughly enjoyed my time with the 9th Royal Queensland Regiment, which I somehow balanced with mycivilian career,though there werealot of late nights driving back to Dayboro from Enogerra Barracks in Brisbane.”

By this stage, Hall’s performance in military circles was attracting attention from further up the ranks. In early 2009, he was asked by the Commanding Officer of the 8/9th Royal Australian Regiment (RAR), thenLieutenant Colonel Simon Stuart–who is now the Chief of Army – to run a full-time Infantry Initial Employment Course at Enoggera Barracks for three months. “The course was designed to bolster the ranks of the recently reformed 8/9th RAR and the 6th RAR, both of which were due to deploy to Afghanistan,” Hall explained.

“This was ultimately a very

veterinaryassistance as part of the Australian Contingent to the Pacific Partnership, a US-led humanitarian assistance mission providing medical, dental, optical and veterinary care to several South-East Asian nations, including East Timor.”

Hall returned to civilian life following his posting to East Timor and moved to Cairns. He got married to Sally, herself a medical doctor and a veterinarian, and they had a couple of children in quick succession, followed by a third child several years later.While in Cairns, Hall worked in veterinary practice and also as a Veterinary Policy Officer for the Australian Government Department of Agriculture, Fisheries and Forestry.

Simultaneously, he was posted to the 51st Far North Queensland Regiment (51 FNQR) as a Platoon Commander, which saw him participate in many training and Operational activities, including service with Operation Yasi Assist providing relief following the Severe Tropical Cyclone Yasi in 2011, and border protection duties with the ongoing Operation Resolute. “Operation Resolute is a whole-of-government effortprimarily involving the Australian Army and Royal Australian Navy to locate foreign fishing vessels and illegal drug smuggling operations in or near the Australian mainland,”

‘We live in an interesting world with a lot of opportunity. To me, animals are a big part of what makes our world so wonderful’.

“Whenever possible, NSAIDs should be part of an acute pain management protocol”

Hall explained. “When I was involved, this unique operation required patrols to survey isolated, inhospitable and remote parts of the Queensland coastline looking for large-scale drug crops. Information gathered was fed back to state law enforcement agencies, and officers from the Queensland Police Drug Squad and Special Emergency Response Team were on board Navy Landing Craft to provide intelligence and operational support.” For his efforts with the 51 FNQR, Hall was recognised in 2011 as Officer of the Year.

Also in 2011, Hall was awarded the Australian Defence Force Prince of Wales Award for his work with military dogs in East Timor. Receiving this award entitled him to travel to the UK, where he attended the British Equine Veterinary Association Congress in September 2011. “This is an annual even held in the United Kingdom showcasing the latest science and veterinary techniques,” Hall said. “I also visited the Royal Army Veterinary Corps in Leicestershire, which provides, trains and cares for service animals across the British Army, including several Military Working Dogs support units.”

While in the UK, Hall was also able to participate in training and ceremonial activities with other British Units, including the King’s Troop of Royal Horse Artillery,

the Household Cavalry and Queen’s Life Guard, the 101 Military Working Dog Squadron and the Defence Animal Centre.

Combining his military and civilian roles was now becoming customary for Hall, who was again able to put his skills to use on home turf in 2012 when he deployed to Western Australia’s Dampier Peninsula on the Army Aboriginal Community Assistance Program. “Alongside full-time soldiers from the Royal Australian Engineers, I set up and ran a temporary veterinary hospital in the Aboriginal communities of Lombadina and Djarindjin, providing much-needed veterinary services to the local animals.”

Strangely enough, despite having lived on the East Coast all his life, Hall soon found himself permanently based in Western Australia. Although he and Sally had planned to live in Far North Queensland for only a year, they ended up staying for five, and had a loose plan to establish a veterinary hospital on the Sunshine Coast hinterland with Hall’s brother, Max. Hall was more than a little surprised when his brother suggested they set up a practice in Perth instead, but decided to give it a go and headed west in 2015. By mid-2016, they had opened West Coast Veterinary Hospital in Forrestdale, Western Australia. “The practice services quite a large area, hence the

name,” Hall explained. “It is a unique hospital in that it is a specialist equine surgery with advance imagery, including MRI and nuclear scintigraphy, but we also treat many small animals, farm animals, and even a few zoo animals.” The hospital itself is also large, and includes stables, theatre and recovery stalls, a reproduction barn and specific areas allowing for standing surgery and lameness assessments.

“Working with family is great,” Hall said. “My brother Max and I have always been close, and running a business together is quite easy because we know each other so well.” Since its inception, West Coast Veterinary Hospital has become even more of a family affair, with Hall’s wife Sally also working there and his parents living on site. “My parents help out with the retirement-appropriate gardening and miscellaneous tasks, which they seem to really enjoy,” he said. “I also have a twin sister who doesn’t work in the business but is still a big part of our lives over here. She loves looking after the kids!” Despite being a vast distance – both geographically and professionally – from where Hall started out helping out at the Kookaburra Café, it is evident that family remains vitally important to him. “Working in the family business instilled in me the ethos that everymember of the family should pitch in to help the business and help each other,” he said. “We’ve carried the core of this message over to our clinics where we strive to create a ‘team’ mindset and focus on shared goals.”

As West Coast VeterinaryHospital became more established, that team has now grown to include ten vets and around fifty support staff. On the back of their success in Forrestdale, Hall and his brother opened a small animal clinic, Fremantle Animal Hospital, in 2020. “Fremantle Animal Hospital is much smaller than West Coast Veterinary Hospital, but it has already become partof the Fremantle community,” Hall said. One of the ways the practice has engaged the local area has been by starting a ‘Pet Friendly Freo’ campaign, which has produced an online database of cafes, restaurants and businesses in Fremantle that allow pets. The campaign not only provides animal lovers with a directory of pet friendly businesses, but also affords pet friendly businesses with the opportunity to gain exposure in their local community. Additionally, Hall has also been actively seeking change to strata and rental laws in WesternAustralia to prevent discrimination against pet owners and create more inclusive communities in areas beyond Fremantle.

Throughout this period, Hall continued his involvement with the Army Reserve, transferring to the 13th Brigade when he relocated to Perth. In 2017, in between opening West Coast and Fremantle Animal Hospitals, he was offered an ongoing

role as a part-time veterinary officer in the Australian Army, caring for the Australian Defence Force’s military working dogs.

“The role also involves the delivery oftraining to our soldiers in tactical canine casualty care,” Hall said. “It is a very niche field dealing with essential frontline care for dogs injured by bullet wounds, explosions, stabbings and other injuries peculiar to military service.” Having initially based the comprehensive first aid and trauma care training package on a course he ran for owners of pet dogs, Hall was then asked to develop another training course for drug detection dogs as well.

Hall also maintained his involvement with the Army Aboriginal Community Assistance Program, delivering veterinary services to the remote indigenous community of Jigalong in the Pilbara region in 2019, and then in 2020 deployed on Operation Bushfire Assist. “We provided much-needed veterinary assistance to the injured animals on Kangaroo Island, South Australia,” he said. “These efforts, as part of the veterinary team, were recognised with the rare and prestigious Gold level ADF Group Commendation.”

In 2020, Hall was elected President of the Western Australian Division of the Australian Veterinary Association. “The AVA plays an important role in the lives of vets and animals across the country,” he said. “Like any profession, vets face a number of issues that are best resolved collectively. Wehave some pretty severe workforce shortages at the moment which make our working conditions difficult, and this has caused several parts of WA to lose access to regular veterinary services. This then leads to potential animal welfare and biosecurity problems.” Hall believes the advocacy role of the AVA is vital to the future of the veterinary profession, and suggests changing the currently predominant workforce model may provide solutions to workforce shortages. “We need to work together to support regional practices through mechanisms such as student debt forgiveness, sponsored internships, access to continuing education and workforce relief,” he said.

One of initiatives Hall has been working on with the AVA is a proposal that has the potential to help veterinarians with their mental health and to provide much needed relief to vets working in remote communities. The proposed scheme would send “Relief Vets” to spend afew weeks in a remote practice, thereby allowing the usual vet to have a break without leaving the community devoid of veterinary services. “This has huge potential benefits for the reliever,the rural vets and the community,” Hall said. “I highly recommend volunteering or generally ‘giving back’: it helps us to maintain perspective and connections with our community.

Topage 29

The first liquid solution for hypertension

Semintra® 10 mg/mL Oral Solution for Cats is the first angiotensin receptor blocker licensed for feline hypertension. Its unique, targeted mode of action provides reliable, long-term control of blood pressure.1 And, as Semintra® is an easy to give liquid formulation, it is well accepted by cats, making administration easy.2

Pigeon post from the UK

The UK’s inflation rate seems to have peaked, from a high of over 11 per cent in October last year, it had eased back to just above 10 per cent by January this year. However, the economy is still far from recovery. The IMF predicts that the UK will be the only G7 economy to shrink during 2023; a predicament it shares with war and sanctions ravaged Russia. Widespread pay strikes by public sector workers have continued throughout the winter with transport and health services particularly badly impacted. The general economic malaise has naturally affected the veterinary profession too. A survey of 3000 veterinary employees in December 2022 by NSV Veterinary Recruitment found that 22 per cent of respondents had not received any pay rise during 2022. About a quarter of respondents had received a 6-10 per cent rise over the year, but even the most generous raises would have left employees worse off as inflation exceeded 10 per cent. The survey also found that full-time veterinarypay ranged from £39,299 –78,597 (A$ 69,500–139,000) depending on seniority and sector, veterinary nurse pay ranged from £23,227–35,091 (A$ 41,000 –62,000).

The financial squeeze on vets is corroborated by the veterinarysupport charity Vetlife which reported that requests for financial assistance had trebled in the last year Although a rule change last summer permitted vet nurses to seek monetary assistance for the first time, this alone could not account for the surge in need. Calls to the charity’shelpline (for all reasons) were up 3.3 per cent during 2022 to 3,503. There is currently no

suggestion of strike action by employed veterinarians for improved pay, though the current strike culture has considerably raised the profile of labour withdrawal. The British Veterinary Union is a branch of the second largest UK union called Unite (with over 1.4 million members). It is heavily involved in the current National Health Service strikes.

Last year saw a fall in the number of students enrolling on veterinary undergraduate courses in the UK. The Veterinary Schools Council reported there was an overall fall of 10.9 per cent in enrollments in 2022 compared to the previous year. The biggest falls came at the universities of: Bristol (46 per cent), Liverpool (39 per cent) and Glasgow (16 per cent), though increases were recorded at Nottingham (31 per cent) and Edinburgh (15 per cent) universities. Some of this reduction could

be due to current economic constraints and the return to examination-based entry after two years of grade assessments necessitated by the COVID-19 pandemic, but it does raise some concerns for a course that has enjoyed rising popularity in recent memory. Are the problems within the profession starting to filter through to the young people making their university application choices?

There’s happier news to report from the food animal sector. Antibiotic sales for use in production animals in the UK have fallen to a record low since recording began in 2014 despite the difficulties of COVID-19 and Brexit.

Veterinary Antimicrobial Resistance and Sales Surveillance (VARSS) data from 2021 showed a 55 per cent fall in sales from 62.3mg/kg over seven years to 28.3mg/kg.

Continued cooperation between farmers and vets has put the UK

ahead of most European Union nations. Increases in usage were only reported for turkey, game bird and fish production. Resistance testing results were also encouraging, of 4,507 Salmonella isolates challenged over 66 per cent were susceptible to all the antibiotics tested. E. coli resistance to the highest priority critically important antibiotics (HP-CIAs e.g. fluoroquinolones and later generation cephalosporins) was found to be generally low or absent.

On the subject of judicious prescribing the Royal College of Veterinary Surgeons has voted 20 to 3to update its guidance on the ‘under care’ question despite fierce opposition from many in the profession (see Pigeon Post Dec 2022). The new guidance, which (subject to possible reviews) is expected to come into force later this year. It states that the physical examination of an animal may not be necessary in every case for safe treatment. An examination will still be mandatory when a notifiable disease is suspected and in all but ‘exceptional circumstances’ when prescribing antimicrobials to individual or groups of non-agricultural animals. Proponents of the change see it as a natural progression bringing the advantages telemedicine into the mainstream. Opponents see it as an opportunity for remote prescribing companies to seize a sizeable chunk of veterinar y revenues and simultaneously jeop-ardize animal welfare standards. Either way it is clear that this could become a ‘watershed moment’ for the profession, one that could either widen its reach or accelerate a metamorphosis into averydifferent animal.

DO YOU HAVE SOMETHING TO SAY?

Is thereatopic you’ve wanted to tell everyone about?

Have you ever thought you would like to write a clinical review but don’t know where to start? Do you have a hobby or history that you think vets everywhere would like to learn more about? Then don’t delay – email The Veterinarian at editor@vetmag.com.au and let us know – because your words could be in the pages of next month’s issue!

Ian Neville BA(Hons) BVSc MRCVS reports from Britain.

INSEPARABLE

PEXION® is the only targeted therapy developed specifically for dogs with idiopathic epilepsy, balancing seizure control whilst preserving quality of life in patients.1,2

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“PEXION has provided a vital new tool for the treatment of epilepsy in dogs. As a neurologist, I now use it as my first choice anticonvulsant in drug-naive patients, because of its improved side effect profile over more traditional drugs, its improved hepatic safety, and its short half-life (which means I know whether it’s working fairly quickly). It is also one of the few anticonvulsants that has a sound body of evidence to support its use and it gives us one more option to use in our never-ending quest for that most elusive of things: perfect seizure control.”

– Dr Sam Long BVSc

Veterinary Referral Hospital.

Prolonged persistence of canine distemper virus RNA, and virus isolation in naturally infected shelter dogs

Canine distemper virus remains an important source of morbidity and mortality in animal shelters. RT-PCR is commonly used to aid diagnosis and has been used to monitor dogs testing positive over time to gauge the end of infectious potential. Many dogs excrete viral RNA for prolonged periods which has complicated disease management. The goal of this retrospective study was to describe the duration and characteristics of viral RNA excretion in shelter dogs with naturally occurring CDV and investigate the relationship between that viral RNA excretion and infectious potential using virus isolation data. Records from 98 different humane organizations with suspect CDV were reviewed. A total of 5920 dogs were tested with 1393; 4452; and 75 found to be positive, negative, or suspect on RT-PCR respectively. The median duration of a positive test was 34days (n = 325), and 25 per cent (82/325) of the dogs still excreting viral RNA after 62 days of monitoring. Virus isolation was performed in six dogs who were RT-PCR positive for > 60 days. Infectious virus was isolated only within the first two weeks of monitoring at or around the peak viral RNA excretion (as detected by the lowest cycle threshold) reported for each dog. Our findings suggest that peak viral RNA excretion and the days surrounding it might be used as a functional marker to gauge the end of infectious risk. Clarifying the earliest point in time when dogs testing positive for canine distemper by RT-PCR can be considered non-contagious will improve welfare and lifesaving potential of shelters by enabling recovered dogs to be cleared more quickly for live release outcomes.

Carolyn Allen1,Alexandre Ellis1,Ruibin Liang2,Ailam Lim2, Sandra Newbury1

PLoS One. 2023 Jan 20;18(1): e0280186. doi: 10.1371/journal.pone.0280186.

1Department of Medical Sciences, Shelter Medicine Program, University of Wisconsin, Madison, Wisconsin, United States of America.

2Wisconsin Veterinary Diagnostic Laboratory, Virology, University of Wisconsin, Madison, Wisconsin, United States of America. Free PMC article

Temporal lobe epilepsy in cats

In recent years there has been increased attention to the proposed entity of feline temporal lobe epilepsy (TLE). Epileptic discharges in certain parts of the temporal lobe elicit very similar semiology, which justifies grouping these epilepsies under one name. Furthermore, feline TLE patients tend to have histopathological changes within the temporal lobe, usually in the hippocampus. The initial aetiology is likely to be different but may result in hippocampal necrosis and later hippocampal sclerosis. The aim of this article was not only to summarise the clinical features and the possible aetiology, but also being work to place TLE within the veterinary epilepsy classification. Epilepsies in cats, similar to dogs, are classified based on the aetiology into idiopathic epilepsy,structural epilepsy and unknown cause. TLE seems to be outside of this classification, as it is not an aetiologic category, but a syndrome, associated with a topographic affiliation to a certain anatomical brain structure. Magnetic resonance imaging, histopathologic aspects and current medical therapeutic considerations will be summarised, and emerging surgical options are discussed.

Akos Pakozdy1,Peter Halasz2,Andrea Klang3,Borbala A Lörincz4, Martin J Schmidt5,Ursula Glantschnigg-Eisl6,Sophie Binks7 Vet J. 2023 Jan; 291:105941.doi: 10.1016/j.tvjl.2022.105941.

1University Clinic for Small Animals, University of Veterinary Medicine, Vienna, Austria. Electronic address: akos.pakozdy@vetmeduni.ac.at.

2Institute of Experimental Medicine, Budapest, Hungary.

3Institute of Pathology, University of Veterinary Medicine, Austria.

4Clinic of Diagnostic Imaging, University of Veterinary To page 30

Markers for internal neoplasia in the horse

The diagnosis of internal neoplasia in horses is challenging. Increased production of hormones physiologic for adult animals (e.g., adrenocorticotropin, norepinephrine, and erythropoietin) or typical for the foetal phase (alpha-fetoprotein, anti-Müllerian hormone, and parathyroid-hormone-related protein) might aid in tumour diagnostics. Thymidine kinase-1 and alkaline phosphatase are examples of intracellular enzymes, whose activity in the blood may increase in some neoplasia cases. Furthermore, inappropriate production of abnormal monoclonal or autologous antibodies can accompany lymphoma and multiple myeloma. Many of those tumour markers lead to clinical or laboratory changes, called paraneoplastic syndromes, such as hypercalcaemia and erythrocytosis. The interpretation of the results of the tumour marker measurements in horses is complicated due to many factors affecting the markers' concentration or activity (e.g., young age, pregnancy, and inflammation) and other diseases triggering the same changes. Moreover, the presence of paraneoplastic syndromes is inconsistent, which leads to low sensitivity of those substances as tumour markers. In conclusion, screening for neoplasia in horses is not recommended. The measurement of tumour markers should be performed only in risk groups with suspicious clinical or laboratory findings, and the results should be interpreted with caution. It is advisable to add inflammatory markers to the tumour profile or repeat the measurements.

Karolina Drozdzewska1,Heidrun Gehlen1 Vet Med Sci. 2023 Jan;9(1):132-143.doi: 10.1002/vms3.1042.

1Equine Clinic, Surgery and Radiology, Freie Universitaet Berlin, Berlin, Germany.

Free article

Latent burnout profiles of vets in Canada: Findings from a cross-sectional study

Background: Although burnout is often discussed as 'present' or 'not-present', the conceptual framework of an engagementburnout continuum is more accurate and useful. Recognition of individuals' transitional states of burnout also allows for earlier detection of issues and tailored interventions to address the full burnout spectrum.

Methods: Previously reported Maslach Burnout Inventory-Human Services Scale (MBI-HSS) data from a 2017 national survey of 1272 veterinarians across Canada were re-analysed using a latent profile analysis to classify individuals along the engagementburnout continuum.

Results: Four clusters wereidentified: engaged (10.8 per cent), ineffective (18.9 per cent), overextended (29.6 per cent) and burnout (40.7 per cent). These results indicate that most participants (89.2 per cent) had one, or a combination, of high exhaustion, high depersonalisation and low professional efficacy.

Limitations: This cross-sectional study represents data from one point in time and may be subject to response bias.

Conclusion: We discuss strategies-particularly long-term, organisational-level interventions-to promote engagement and help address workplace issues contributing to inefficacy, overextension and burnout in the veterinary profession. We also recommend MBI data be analysed via latent profiles to provide a more nuanced view of burnout, allow for earlier recognition of workplace issues and facilitate more meaningful interventions and comparisons across populations.

Andria Jones-Bitton1,Daniel Gillis2,Makenzie Peterson3, Hayley McKee4

VetRec. 2023 Jan;192(2): e2281.doi: 10.1002/vetr.2281.

1Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada. To page 30

Simon Palmer is the Managing Director of Practice Sale Search, Australia’s largest vet practice brokerage. If you’d like more information on practice sales or want to have a confidential discussion about your practice’s circumstances, email Simon Palmer at info@practicesalesearch. com.au or call 1300 282 042.

Itis no exaggeration to say that your premises lease can make a massive impact on the profitability and saleability of your veterinary practice. While many landlords will issue their tenants with a proposed lease saying that what is proposed is standard and imply that there is little to be negotiated or concerned about it is important to seek advice as not all commercial leases are created equal.

As a business owner there are many pitfalls that you will want to avoid if you want to sell your practice down the track.

Below are six important clauses toconsider carefully for any veterinary practice lease:

THE COSTS

1. Rent

Themost obvious thing to look for in a commercial lease is the cost and the frequency of payment.

2. Increase in rent over time

Commercial rent in a lease will go upevery year. In some leases this is fixed to CPI, in others it is a set percentage (usually between 3–5 per cent).

3. Outgoings

Outgoing are the costs of the premises you will be obliged to pay,

ontop of the rent. These outgoings sometimes include utility bills, such as water and electricity. Sometimes, the lease also obliges the tenant to pay strata and property management costs.

The Impact of 1–3

It seems obvious that the rent will have a direct impact upon the profitability of your practice and profit and that profit is one of the primary drivers of a business valuation.

Buyers sometimes pay less attention to the yearly percentage increase in rent and the additional expenses they will need to pay as part of their lease.

To see if a lease or rent is reasonable, and how the rent will impact upon your profit, these three need to be looked at together.

A high rent may be very reasonable if it has low increments per year and/or is inclusive of outgoings.

THE SECURITY OF TENURE

4. The length of the lease

The length of the lease gives the tenant the security of knowing that they have an exclusive space to run their business in for a period of time, without fear of needing to move.

Most commercial leases that we come across have 3 to 4 terms of between 3 to 5 years (for example,

Management

3terms of 3 would be 3+3+3 or 9years), where it is the renter’s choice of whether to renew at the end of each term.

5. Relocation or demolition clauses

These clauses are not in most leases. Where they exist, theygive the landlord the right to either relocate you to another premise (relocation),or terminate your lease if they are going to redevelop the site (demolition).

These clauses will specify the notice period you will have for relocation and termination and whether the tenant will get any kind of assistance or compensation for the inconvenience.

The Impact of 4–5

Businesses such as veterinary practices are difficult to move for two reasons:

■ the loyalty of clients/patients is often based upon geography and convenience and moving a practice can lead to patient attrition.

■ Council zoning and complex fit outs make finding a suitable space for relocation difficult and doing the relocation expensive and time consuming.

As such, practices that have a higher risk of needing To page 30

Reference: 1. APVMA number 88412. 2. De Ridder, T., Campbell, J., Burke‐Schwarz, C., et al. Randomized controlled clinical study evaluating the efficacy and safety of intratumoral treatment of canine mast cell tumors with tigilanol tiglate (EBC-46). J Vet Intern Med 2021;35(1):415-429

Dr Jane Miller Veterinarian Victoria

Liver fluke – diagnosis, treatment and control

Introduction

Liver fluke (Fasciola hepatica)affects a range of livestock and other species; it is the most important trematode of domestic ruminants. The trematode group of flatworms live in several hosts during their life cycles. Suitable hosts for F. hepatica are alpacas, cattle, deer, goats, horses, pigs and sheep, as well as a range of other species including kangaroos, rabbits, wallabies and humans.

Penny has worked extensively in private mixed practice, and in animal biosecurity and welfarefor both government and not-for-profit organisations. She manages a 212 hectare Dorper sheep breeding property in NSW,and is co-Director ofYour Hobby FarmSuccess, helping hobby farmers enjoy their lifestyle, and reap the benefitsof having healthy and happy animals.

Large numbers of sheep and cattle inAustralia graze on pastures where liver fluke is endemic; infection costs millions of dollars each year due to reduced animal productivity, stock deaths and costs of treatment and prevention. Much of the economic cost can be associated with production losses from infections that may not be apparent. Fasciolosis also results in condemnation of infected livers in abattoirs.1

The eggs hatch in wet areas on pasture when the mean daily temperature is over 10oC. The small larvae (miracidia) swim around until they find a small water snail (the intermediate host), which are lymnaeid snails. In Australia, the most common is the indigenous freswater snail L. tomentosa;it is about 6to 12 mm long and the shell has a clockwise or ‘right hand’ thread when viewed from the point to the base of the snail.

An introduced North American snail (L. columella)and an introduced snail from the Pacific area (L.viridis), which have been found in defined locations on the NSW coast, have also been identified as intermediate hosts.2

The larvae (single: miracidium) enter the snails where they develop and multiply as sporocycts, rediae and cercariae. One single miracidium

After grazing animals ingest metacercariae, the immature liver flukes are released into the small intestine, penetrating the intestinal wall as they make their way to the liver. Migration through the hepatic tissues occurs for 6to 7 weeks before the larvae enter the bile ducts to become adults. Egg production starts about 8 to 10 weeks after infection. Adult liver flukes can live for several years in the liver of infected sheep and produce between 20,000 and 50,000 eggs per day.4 In cattle, egg production declines as natural resistance to chronic infection develops.

The epidemiology of fasciolosis is influenced by the grazing habits of animals. Cattle often graze in wet marshy areas inhabited by the liver fluke snail, while sheep and goats prefer to graze away from such areas if food is available elsewhere. Long wet seasons are usually associated with

Distribution

Liver fluke is limited to higher rainfall (>600 mm per year) areas of New South Wales (NSW); especially in the south-east (the tablelands and nearby coastal regions to the east, and slopes to the west), Victoria and Tasmania, and to small areas in Queensland and South Australia.

It occurs in areas on properties where there is suitable habitat for the eggs, the intermediate host snails (Lymnea tomentosa)and the larval liver fluke, such as springs, slow-moving creeks, swampy areas, water courses, irrigated pastures and seepages (e.g. leaking water troughs). Affected properties may have a historyof liver fluke.

Epidemiology2, 3, 4

The adult liver fluke is pale brown, flat and leaf-shaped. It is 2 to 3 cm long and has tiny sharp spines that irritate the hepatic tissue of the final host. The adult liver fluke residing in the bile ducts produces eggs which pass into the intestine and are excreted in the faeces. The eggs are a golden brown colour, oval and operculated (130–150 x 65–90 µm).

hatching from a liver fluke egg can produce up to 4000 infective cysts (metacercariae).

The tiny tadpole-shaped cercariae then leave the snails, swimming until they attach to vegetation (usually grass) where they encyst again into a resistant cyst stage (metacercariae), which is the infective stage of liver fluke. When adequate moisture is present, the metacercariae will remain alive for many weeks; they can survive longer at or below 20oC. The inter-mediate host snails produce eggs throughout the year and these eggs hatch when the temperature is suitable; usually spring to late autumn. Snails can produce 3000 eggs a month and one generation of snails from egg to egg takes about one month under optimum conditions. L. tomentosa survives in drymud for at least one year, and tolerates low temperatures; it can move with and against water currents.

The larval stages of liver fluke (sporocysts, rediae) also survive in snails for long periods, and will resume development when climatic conditions improve.2

ahigher infection rate but sheep are more likely to ingest large numbers of cysts during dry periods after a wet season, when they are forced to graze in wet areas.2,3, 4

Clinical signs and diagnosis

2,3, 4 Infection with liver fluke can produce sub-acute, acute and chronic fasciolosis depending on the size of the infection and how quickly it is acquired. Disease is due to haemorrhage and hepatic damage from migrating immature liver fluke, and from damage to bile ducts and blood loss from the adult liver fluke. In NSW, acute fasciolosis is most commonly seen in sheep and usually occurs from late summer to late autumn, while chronic disease is more common in cattle mostly occurring from autumn to spring. Bottle jaw, pale gums and eye membranes, weight loss, ill-thrift and diarrhea may be reported.

The clinical signs for acute fasciolosis range from no obvious signs to death, with or without sudden weakness, colic, jaundice and anaemia.

The history may indicate the possibility of a very high but relatively short-term intake of metacercariae.

Possible ‘flukey’ area – a marshy area leading into a dam

Penny Linnett BSc (Zool Hons) BVSc

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The high intake being the result of seasonal and climatic conditions usually combined with a lack of fluke control measures. Acute fasciolosis is much less common and has been seen in dairy calves exposed to massive numbers of immature liver fluke, for example.3

For sub-acute fasciolosis, clinical signs include anaemia, ill-thrift, jaundice, and possibly death after several weeks. The burrowing liver fluke causes extensive tissue damage, which results in haemorrhage and liver failure; the outcome being severe anaemia, liver failure and death in 8 to 10 weeks.

Chronic fasciolosis is the most common form. Clinical signs develop slowly in sheep, goats and cattle and include anaemia, loss of appetite, poor milk production, weight loss, weakness, submandibular oedema (the characteristic ‘bottle jaw’), diarrhea and death. Affected cattle have rough coats, which change to a paler colour in breeds that have red coats (e.g. Herefords).3

Acomplicating factor of fasciolosis is Black disease; an acute and invariably fatal hepatic disease of sheep and cattle caused by Clostridium novyi. It can cause sudden death as a result of the C. novyi multiplying in areas of the liver damaged by migrating immature liver fluke. The damaged liver parenchyma provides the ideal environment for the germination of spores of C.novyi type B bacteria. Black disease can be prevented by prior vaccination.

Fasciolosis should always be considered when anaemia, ill-thrift, bottle-jaw and death are present in sheep and cattle. It is easy to form an opinion on what liver fluke-prone countr y looks like, but be aware of the lighter hilly/undulating country with spring-fed or seasonal creeks and dams as these water sources are often ideal liver fluke habitats.

Mature liver fluke infestation can be detected and monitored by the use of laboratorytests which detect liver fluke eggs in faecal samples. The sampling technique is generally reliable in sheep but much less so in cattle. Bulk milk and blood tests to detect immature as well as mature liver fluke infection are also available. A serological

antibody test (ELISA) is also available; it detects infection with both immature and adult liver fluke in the flock or herd situation, but it is not sensitive enough for diagnosis in individual animals. Plasma concentrations of γ-glutamyltransferase, which are increased with bile duct damage, are useful when liver flukes are in the bile ducts.

The distinctive white migration tracks through the liver from immature liver fluke activity, haemorrhage and adhesions due to fibrinous perihepatitis, can be seen on post-mortem examination. Adult liver flukes are readily seen in the bile ducts, and immature stages can be ‘squeezed’ from a cut surface.

Infection with Barber’s Pole worm (Haemonchus contortus)can be difficult to distinguish from liver fluke infestation without faecal egg testing and possibly post-mortem examination.

Treatment

Effective treatment depends on removal of the animals from the infected area and administering a suitable anthelmintic. The best prevention and control is achieved with strategic use of anthelmintics (e.g. triclabendazole) which are effective against both the immature and adult liver fluke stages but care must be exercised to avoid the development of resistance.

Prognosis post-treatment depends on the disease status of the animals, including development of secondary complications, the possibility of re-infection, and readily available food, shelter and water for more seriously affected animals.

Resistance to infection

There is no evidence of acquired resistance to F.hepatica in sheep; acute and chronic fasciolosis can occur at any age.

Cattle have a natural resistance and under normal conditions, clinical disease is only likely to occur in young cattle. Cattle that are chronically infected can recover spontaneously, and previously infected animals can partially resist re-infection. However, this resistance is only possible because of chronic fibrotic changes in the liver,so with even a small number of liver fluke present, there may be production losses.

Horses and pigs are known to be more resistant to fasciolosis than cattle or sheep.

Prevention and control

Liver fluke only occurs where the intermediate lymnaeid host snails are present and as the snail is not present in all ‘flukey’ areas, it may therefore not be present on all paddocks or properties. Consequently, an important part of prevention and control is testing for liver fluke, which can be done at the same time as the regular faecal egg test for roundworms.

Itis almost impossible to eradicate liver fluke because it is usually not practical to prevent reinfestation of pastures and animals. Good economic control can, however, beachieved through the strategic use of currently available drenches with other strategies (e.g. reducing exposure of livestock) to control exposure to the snail. Consequently, control should be seen to be preventive rather than curative.

1.Drench programs2,3,4

Ideally, a drenching program for liver fluke should be developed based on the degree of infestation, prevailing climatic conditions (rainfall pattern in the area and seasonal temperatures) and suitability of available drenches. The drenching timetable across NSW is fairly similar, with only small adjustments required in south-eastern Australia; this is because the weather pattern of the Central Tablelands is similar to that of the Southern Tablelands while the North Coast weather pattern is similar to conditions on the south coast apart, from the higher rainfall.

All drench programs will probably vary slightly from year to year, depending on temperature and rainfall patterns, with more or fewer treatments being required. For example, in south-east Australia, animals start to pick-up infective larvae in spring and this may continue through summer on irrigation properties or areas with water sources that favour snail survival. In average winters, snail numbers are significantly reduced but in mild winters, snail activity, and hence liver fluke infection, may continue unabated.

The first step in developing a suitable drench program is to determine if the animals are infected and to what extent. This is usually done by faecal egg testing or less commonly, via a blood (ELISA) test. It is possible to determine which paddocks are affected by testing animals that have only been run in aparticular paddock since the last liver fluke treatment.

For Queensland and NSW summer rainfall/tablelands and slopes, and Tasmania, three faecal egg tests per year (autumn, winter and summer) are recommended and they should be undertaken for at least two years. For Victorian winter rainfall, two tests per year (late summer and winter) are recommended for at least two years.

If all tests over the two-years are negative and the livers of dead or slaughtered sheep are free from

liver fluke pathology, it is probable that the intermediate host snails are not present and therefore, drenching for liver fluke is not required.

If the testing confirms that sheep are infected at all test times, then ongoing testing can cease and routine treatments administered tosheep that have been grazing the affected paddocks.

The following is a general guide to drenching adapted from WormBoss liver fluke control programs5 and using information from the NSW Department of Primary Industries (NSW DPI)2,4 and Victorian Department of Environmentand Primary Industries (DEPI).3

For Queensland and NSW summer rainfall areas, tablelands and slopes

Three routine treatments should be given to sheep that have been grazing affected paddocks in April–May, August–September and February.

The most important treatment is the one carried out in April–May and should be based on the flukicide, triclabendazole, which is effective against all stages of liver fluke found in the sheep. If treatments are also required in August–September and/or February, one or both of these treatments should be a flukicide other than triclabendazole (if this was used in April-May). This treatment rotation will reduce the rate of development of resistance to triclabendazole.

For Tasmania

Routine treatments should be given to sheep that have been grazing affected paddocks at the first summer drench (late January/early February). One or two more drenches may be required in early April and in May, and August/September.In areas which only have liver fluke in wet years, two drenches in late autumn and in late winter are recommended.

The most important treatment is the one carried out in April and/or May and it should be based on triclabendazol. If treatments are also required in August–September and/or February,one or both of these treatments should be a different flukicide, if triclabendazole was used in April-May.

An alternative drenching strategy may be used where only a small portion of the farm is affected – treatment either onto (before grazing) or off (after grazing) affected paddock(s), or both.

For Victorian winter rainfall

Two routine treatments given to sheep that have been grazing affected paddocks are generally recommended for February–March (before a secondary snail breeding season in autumn) and July–August (before the main breeding season of the host snail in spring). However, in extremely liver flukeprone areas and on irrigation properties, extra drenches may be required in December and April.3

For cattle, an April-May and July drench is recommended; dairy cows in liver fluke areas are often treated at drying-off.

While running water most likely limits the ability for the intermediate host of liver fluke (L. tomentosa), surrounding wet areas may be good locations for the snail to survive

Any positive liver fluke egg count is significant and means that treatment is required. If egg counts for a particular paddock are high (>2550 eggs per gram) then significant production losses could already be occurring.

As acute fasciolosis can occur in late spring and early summer in heavily infested areas and onirrigation properties, extra drenches may be required in December, and possibly April; this is when the first drench should have activity against the immature liver fluke. In other areas, significant infestation may not occur until autumn when animals graze springs in search of green pick, so a drench may not be required until then.

The most important treatment is carried out in winter and should be based on triclabendazole. If treatments are also required in February–March, this treatment should be a different flukicide. An appropriate drench program should be developed for each property and reviewed annually to take into account the temperature and rainfall pattern.

Some anthelmintic pharmacology6,7,8,9,10

Immature liver flukes in the liver parenchyma ingest mainly liver cells, which contain only a small amount of anthelmintic because plasma-protein binding limits entry of the drug into the cells.

As the liver flukes grow and migrate through the liver, they cause extensive haemorrhage and hence come into contact with anthelminticbound plasma protein. When the liver flukes reach the bile ducts, they are in the main excretory channels for the active metabolites of the fasciolicides and hence, are exposed to toxic concentrations. This may be why mature liver flukes are more susceptible than immature liver flukes to most fasciolicides.

Triclabendazole and the benzimidazoles

Triclabendazole is a member of the benzimidazole (BZ) group of parasiticides. It is often used in combination with other active ingredients such as abamectin, albendazole, fenbendazole, ivermectin and levamisole.

The BZs are broad spectrum agents with a wide margin of safety and a high degree of efficacy used to treat nematode and trematode infections. They also have limited activity against cestodes. The development of widespread resistance has decreased their use in ruminants. Metabolism and excretion of BZ compounds are more extensive in cattle than in sheep due to differences in relative rates of oxidation in the liver and reduction in the gastrointestinal tract. The systemic anthelmintic activity of most BZs, therefore, is greater in sheep than in cattle and, dose rates for cattle are often higher.

The BZs bind to nematode tubulin, which is a structural protein of microtubules, preventing its polymerisation during microtubule assembly andtherefore, disrupting cell division. The BZs also inhibit parasite fumarate reductase, an enzyme important in energy generation. Consequently, the worms become paralysed and die and/or are passed out of the body.

Triclabendazole binds to a specific ‘tubulozole’ receptor in the microtubules of liver flukes, which interferes mainly with intracellular transport in the cells.9

Pharmacology of triclabendazole9

After oral administration, triclabendazole is well absorbed from the gastrointestinal tract into the bloodstream. It is quickly metabolised (oxidised) in the liver to the sulfoxide derivative, which is also an effective flukicide, and peak plasma levelsare attained about one day after administration.

The sulfoxide derivative is further metabolized to the ineffective sulfone derivative; peak plasma levels of the sulfone are reached three days after administration. These two metabolites are usually detected in tissues and milk, whereas the

parent molecule remains almost undetectable. Both metabolites bind strongly to plasma proteins, mainly to albumin. The sulfoxide binds reversibly to albumins, and is partly released back into the liver tissues, which increases its bioavailability and efficacy.

Excretion is predominantly (>90%) through thebile and faeces, followed by urine (~2%) and milk (~1%). About half of the administered dose isexcreted six days post-treatment.

Triclabendazole has limited residual effect, protecting against re-infestations for a few days only.

Clorsulon and Nitroxynil

Clorsulon is a benzosulfonamide that works by inhibiting 3-phosphoglycerine kinase and phosphoglyceromutase, which are necessary for energy production in trematodes. It is considered a safe drug and can be used in breeding andpregnant animals. It is suitable for the treatment of immature and adult forms of liver fluke in cattle.

Nitroxynil is efficacious against late immature and mature liver fluke in cattle and sheep, but it has to be injected because bacteria in the rumen metabolize the agent and destroy its activity.

Several drugs are available to treat infected ruminants, including albendazole, clostantel, triclabendazole, clorsulon (cattle and sheep only), netobimin, oxyclozanide and rafoxanide. However, not all these actives are approved in all countries and not all are active against all stages of the liver fluke.

Salicylanilides and substituted phenols7

The fasciolicidal effects of salicylanilides (e.g. rafoxanide) in sheep depend on the length of time the drug stays in plasma. In sheep, closantel, oxyclozanide and rafoxanide have high plasma-protein binding affinity which means long half-lives of 14.5, 16.6, and 6.4 days respectively. Residues in the liver can be detected for weeks after administration. This longer persistence is associated with greater activity against immature liver flukes, but the withholding period for slaughter is also increased.

Oxyclozanide is metabolized in the liver to the anthelmintically active glucuronide and is excreted in high concentration in the bile duct, where the adult liver fluke resides.

Resistance

Resistance to triclabendazole has been reported in livestock in several countries including Argentina, Australia, Ireland, New Zealand, Spain and United Kingdom; mostly with crossresistance with albendazole. Many roundworms are resistant to benzimidazoles. In Australia, resistance of liver flukes to triclabendazole (and albendazole) in sheep was discovered in the mid-1990s and since then it has been reported in other countries and also in cattle.

Withholding periods6,7,8

Most anthelmintics have withholding periods. Of the benzimidazoles, thiabendazole is absorbed and excreted most quickly; fenbendazole, oxfendazole, and albendazole are absorbed and excreted over a longer period, which necessitates withholding periods of 8 to14 days before slaughtering for meat, and 3 to 5 days before milking for human consumption. Withholding periods are longer for bolus formulations.

2. Host snail control

It is almost impossible to eradicate the intermediate host snail from an area using either chemical or biological control(s) because:

■ the snail reproduces veryreadily

■ rapid repopulation from adjoining areas can occur

■ no product is registered for snail control i n Australia.

Improving drainage is definitely beneficial. Draining swampy areas or converting them into deeper, quickly moving water will greatly reduce the number of snails present. Broken pipes and leaking water troughs should be repaired, and earthworks undertaken to deepen shallow water and improve drainage in wet, low-lying areas. Building dams and draining wet areas will reduce snail habitats and increase the available grazing area. Regular clearing of vegetation from drainage channels will reduce silting and blockages that support the growth of snail-contaminated vegetation.

In irrigation areas, snails breed in the channels and they can be spread over the pasture during irrigation. This habitat is nearly ideal for the snail but it is difficult to change.

Changing the vegetation (e.g. planting trees) inwet areas is also an option, as the snail doesn't live in habitats which have a dense cover ofvegetation.

Use of chemicals to control snails is not recommended as they last for a long time in the environment and can kill other species, including fish.

3.Property management (e.g. fencing and grazing management)

Liver fluke-prone areas are usually confined to certain parts of a property, so fencing off these areas from livestock is the most efficient and economic way of controlling fasciolosis. Even fencing off the worst areas to prevent access by the most vulnerable animals (sheep, goats, alpacas and young cattle) is worthwhile.

Grazing management reduces the number of animals requiring a liver fluke drench. Also, more resistant cattle can be grazed on known liver fluke-prone areas as they are less likely to be affected. Rotational grazing combined with judicious anthelmintic treatment is also good management.

4. Other preventative measures include:

■ not introducing animals with liver fluke onto the property

■ quarantining and drenching all animals that come from a liver fluke area with a suitable anthelmintic, or just quarantining and drenching all animals that are coming onto the property

■ obtaining an animal health statement when purchasing stock – these are not always available but they are useful for the purchaser so that they are aware of the diseases status of the animals being provided by the vendor.

References and further information

1. Meat and Livestock Australia (2012) Liver fluke (see www.mla.com.au/Livestock production/ Animal-health-welfare-and biosecuriy/Parasites/ Identification/Liver-fluke; accessed 10 February 2014)

2. Boray, J. (2007) NSW DPI Primefact 446 Liver fluke disease in sheep and cattle. NSW Department of Primary Industries (see http://www.dpi.nsw.gov.au/data/assets/pdf file/0004/114691/liver-fluke-disease-in-sheepand-cattle.pdf; accessed 10 February 2014)

3. Campbell N.J. et al (2007) DEPI Victoria Control of liver fluke. Published: June 1995, updated February 2007 (see http://www.dpi.vic.gov.au/agriculture/pestsdiseases-and-weeds/pest-insects/liver-fluke; 10 February 2014)

4. Love, S. (2008) NSW DPI Primefact 813 Liver fluke –the basics. NSW Department of Primary Industries (see http://www.dpi.nsw.gov.au/data/assets/pdf file/0005/249116/ Liver-fluke-the-basics. pdf; accessed 10 Februar y 2014)

5. http://www.wormboss.com.au (accessed 10 February2014)

6. Merck Veterinary Manual (2012) Fasciola hepatica in ruminants (see http://www.merckmanuals.com/vet/digestive_system/fluke_ infections_in_ruminants/fasciola_hepatica

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_in_ruminants.html; accessed 10 February 2014)

7. Merck Veterinary Manual (2012) Pharmacokinetics of Anthelmintics (see http://www.merckmanuals.com/vet/pharmacology/anthelmintics/pharmacokinetics of anthelmintics.html; accessed 10 February 2014)

8. Merck Veterinary Manual (2012) Benzimidazoles (see http://www.merckmanuals. com/vet/pharmacology/anthelmintics/benzimidazoles.html; accessed 10 February 2014)

9.Parasitipedia - Triclabendazole, anthelmintic for veterinary use on cattle, sheep and goats against liver flukes (see http://parasitipedia.net/index. php?option=com_content&view=article&id=251

9&Itemid=2792; accessed 10 February 2014)

10. Webster C.R.L. (2001) Clinical Pharmacology. Teton New Media, USA (pp. 88-91)

11. Mulcahy G., et al. Liver: fasciola hepatica infestation (see http://vetstream.com/equis/Content /Disease/dis01248; accessed 10 February 2014)

Liver fluke can also infect horses11

Horses that graze in persistently wet areas or drink from creeks/rivers are at risk, especially if cattle and/or sheep share the pasture.

Horses are more resistant to liver fluke (F. hepatica and F. gigantia)than either cattle or sheep; however, younger horses are more susceptible than older ones.

Clinical signs

Clinical signs include anaemia, anorexia, ascites, colic, diarrhea, lethargy/weakness, depression, jaundice, ill-thrift and weight loss. Acute clinical signs are unlikely to be seen.

Differential diagnoses include: gastric ulcers, plant poisoning (e.g. pyrrolizidine alkaloids), chronic biliary and hepatic dysfunction, and protein losing enteropathy.

Diagnosis

Diagnosis is based on clinical signs, full blood count and biochemistry profile (e.g. hepatic enzymes such as GGT) and identification of liver fluke eggs in faecal egg tests. Fasciolosis is probably largely undiagnosed as either infections do not reach patency and/or techniques used to detect liver fluke eggs are not a routine part of the parasitological examination of equine faeces.11

Treatment and prognosis

Triclabendazole is the recommended treatment. Treatment failure may be due to lack of a specific diagnosis, resistance to flukicides, and re-infection if the horse is treated and put back onto the infected pasture.

Prognosis is good if the clinical cases are treated; some cases resolve spontaneously without treatment.

Control

It is best to avoid grazing cattle and sheep with horses in wet areas of the pasture.

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Agood location for the liver fluke intermediate host (L. tomentosa)to survive

It is best to avoid grazing cattle and sheep with horses in wet areas of the pasture

Hyperthyroidism is the most prevalent endocrine disease in cats over 10 years of age. Excess thyroid hormone comes from a single benign adenoma or more commonly bilateral adenomas on the lobes of the thyroid gland. The aetiology behind these adenomas remains incompletely understood but the population of cats impacted as a percentage continues to grow. This rise has been driven by the implementation of feline geriatric monitoring programs that provide earlier diagnosis of diseases later in life through health screening, an indication that currently some level of under diagnosis for feline hyperthyroidism may be occurring. Most cases of hyperthyroidism will be straightforward to diagnose and treat, with current treatment options available including the chemotherapy treatment, radioactive iodine, surgical thyroidectomy, topical compounded medications or tablets. The challenge in practice is that tablet medication is most often prescribed and therefore most clients must learn to regularly tablet their cat to be compliant.

The team at Norbrook recently announced the launch of Thyronorm Oral Liquid for Cats to manage feline hyperthyroidism. Michael Dhar, Norbrook’s Technical Services Manager, comments “Cats with hyperthyroidism are difficult to treat initially because of the aggressive behavioural changes that occur with the disorder Medical treatment is common as either a precursor to other options or for the lifelong management of hyperthyroidism, successfully returning cats to a euthyroid state in over 95% of cases.

Thyronorm Oral Liquid now provides Australian vets with a registered alternative to making their clients tablet a cat with hyperthyroidism”. Thyronorm oral liquid contains 5mg/mL thiamazole (also known as methimazole in the US) that inhibits the production of thyroid hormone by the thyroid gland, in a palatable liquid formulation that has an ISFM (icatcare.org) Easy to Give award.

The liquid thiamazole formulation provides an alternative to any tablet version including the human carbimazole formulation as carbimazole is a prodrug of thiamazole.

“Carbimazole is immediately converted to thiamazole by the liver which is the active molecule. It is important to recognise that the molar equivalent of carbimazole is not the same as thiamazole, so when converting doses between the two some maths needs to be done,” Dhar said. “Thyronorm also provides an alternative to the compounded topical thiamazole formulations as a registered medication that also has the benefit of reducing the possibility of accidental exposure to other pets or humans that may occur with topical medicines when prescribed.”

“The thyroid hormone has an impact on many systems within the body. These include metabolism, body temperature, blood pressure, heart rate and gastrointestinal function. Practising vets will have hyperthyroidism on their differential list for a varied set of unwell geriatric feline clinical presentations.”

There are two thyroid hormones, thyroxine (T4) and triiodothyronine (T3), these are synthetised and released from the thyroid gland under the influence of TSH (thyroid stimulating hormone). Outside the thyroid gland there is further conversion of T4 to T3 in tissues. There is a negative feedback loop from the thyroid hormones to the hypothalamus reducing TRH (thyroid releasing hormone) and the pituitarygland reducing TSH to manage blood thyroid hormone levels. The impact of the benign

adenoma in the thyroid gland is that the negative feedback loop to manage hormone levels no longer is effective. The adenoma continues to produce hormone in excess of requirements resulting in high blood levels.

Common clinical symptoms cat owners notice include:

■ Catabolic muscle wasting and weight loss PU/PD with proteinuria

■ Gastrointestinal symptoms of vomiting and diarrhoea

■ Polyphagia and increased appetite

■ Behavioural changes that include increased activity level, restlessness, agitation, or nervousness

■ Vocalisation

■ Unkempt hair coat

Clinical examination of the patient by the veterinarian may provide additional symptoms that increase the suspicion of hyperthyroidism and include:

■ Tachycardia and hypertrophic cardiomyopathy

■ Palpable goitre

■ Hypertension that may present as retinal detachment or hyphema (blood collecting within the eye)

■ Hindlimb paresis or paralysis where aortic thromboembolism is the diagnosis

Co-morbidities are common in cats that have hyperthyroidism with concurrent renal insufficiency occurring in as many as 20 per cent of cases. Tachycardia, volume overload through adrenergic stimulation and hypertension can artificially increase GFR (glomerular filtration rate) by 100 per cent when hyperthyroidism exists. “Hyperthyroidism results in renal damage through renal hypertension and glomerular sclerosis resulting in this population of cats having a higher incidence of renal disease.” Euthyroidism will limit on-going renal damage and if renal disease exists that should be managed concurrently. As renal insufficiency is present at such a high rate prior to hyperthyroid management, on-going monitoring of renal parameters when monitoring blood thyroid hormone levels is strongly recommended.

A small percentage of feline hyperthyroidism cases are a consequence of a malignant thyroid adenocarcinoma rather than the more common benign adenoma.

“If response to medical management is not resulting in the expected reduction in blood thyroid hormone levels, consider the small risk of an adenocarcinoma being present.” Adenocarcinomas develop from benign adenomas generally over an extended period of more than 3 years as a consequence of further mutations. Outcomes in the treatment and management of adenocarcinoma cases is less predictable.

Thiamazole interferes with the production of thyroid hormone through limiting thyroid peroxidase activity whose action results in the incorporation of iodine onto the thyroglobulin protein in the creation of thyroid hormone. This reaction occurs within the thyroid follicular cells with thyroglobulin concentrated in the colloid of the thyroid gland and iodine uptake selectively entering these cells from the blood. Thiamazole is a dose dependent medication in its actions and this allows vets to manage a cat’s transition to euthyroid by adjusting the dose according to laboratory total thyroid hormone tests. The goal is for total thyroid hormone to reach levels in the lower half of the laboratory’s reference range. Thiamazole does not inhibit

the effect of currently circulating thyroid hormone in the body or the release of previously produced thyroid hormone that remains within the thyroid gland. For this reason, measurement of the impact of thiamazole on reducing and normalising blood total thyroid levels should occur no sooner than 2–4 weeks after beginning medication or an alteration of dose.

“Thiamazole is a bitter tasting medication. In tablet form it needs to be covered in a casing to prevent the patient tasting the active ingredient,” Dhar said. “This creates challenges to a vet’s management plan of hyperthyroidism when minor dose adjustments are needed to reach target levels as we are either asking clients to then give two tablets or if they give a halved tablet there is the opportunity for cats to react to the bitter taste of thiamazole.”

With previous success in formulating liquid oral medications for cats the Norbrook research team were challenged by vets to create a liquid version of thiamazole. The feedback from practicing vets was that a liquid thiamazole medication would assist compliance and management plans greatly in the medical treatment of feline hyperthyroidism. The formulation created uses honey flavouring over the top of a solution that has removed the upfront bitter taste of thiamazole. He adds, “Feedback from our colleagues in the UK is to expect 70 per cent of cats will readily accept Thyronorm from the syringe after a little initial training to get them use to taste and the syringe,” Dhar said.

Thyronorm’s formulation allows dose adjustments of 1.25mg (0.25mL) to be made to ensure the dose given can more readily match the management plan resulting in blood total thyroid levels at the vet’s desired target range.

“[It] has been available in the UK for 5 years now and the positive feedback from vets on the benefits of a liquid formulation over the available tablets is overwhelming.” Asurvey of 200 practising vets was completed by Norbrook UK about the use of Thyronorm.

■ 99 per cent of vets are likely or verylikely to recommend Thyronorm.

■ 95 per cent found it successful as an alternative to tableting.

■ 84 per cent found the product easier to offer low or in-between doses.

■ 89 per cent expect Thyronorm to improve compliance compared to other options.

Thyronorm is expected to ensure the pet parent bond continues with him adding “Thyronorm has been available in the UK since 2016 and the vets have made it their number one prescription for feline hyperthyroidism. With this endorsement from our colleagues, we are sure that Australian vets and their clients will love the benefits of Thyronorm too.”

“This product was driven by vets voicing their frustrations at current therapy options, we are proud as a company to have developed and delivered Thyronorm. Wehave fielded many queries about when this product will arrive and I’m glad to say it’s here now,” Dhar said.

Thyronorm provides a simple solution to the complex problem of feline hyperthyroidism. It is the first and only registered oral liquid therapy for cats to manage hyperthyroidism in Australia.

This article was supplied by Norbrook.

There’s no need to tablet the grumpy hyperthyroid cat any more...

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Any vet feeling a bit burnt out should consider volunteering in a way that is different from their normal job, either in a different location as we are suggesting with “Relief Vets”, or perhaps in a non-veterinary capacity.”

In addition to supporting the wellbeing of veterinarians, Hall sees the AVA as having an important role in ensuring animal welfare. “I believe the AVA should be the leading voice in animal welfare conversations,” he said. “Vets care deeply for all animals, and as a group we can apply our training and knowledge to improve the lives of animals and promote the importance of the human-animal bond.”

Hall’s passion for animal welfare has also led him to take on other roles, including as a Board Member of the Royal Agricultural Society of WA. While he freely admits that his involvement was partly fuelled by fond childhood memories of attending the Ekka in Brisbane, where he loved seeing the animals even more than the showbags, and also by his later experiences as a young graduate working as the Ekka vet in 2007 and 2008, Hall’s guiding principles align closely with those of the RASWA. “I really resonate with the mission and values of RASWA, and when a friend suggested that Inominate for a position on their Council, I jumped at the chance,” he said “I believe that animals are such an important part of our lives, and Iwant to ensure we live in a society that values animals and maintains the link between people and agriculture.”

This same belief in the importance of animal-human bonds has also seen Hall become an ambassador for the Western Australian branch of Greyhounds as Pets. “I adore greyhounds! They are such friendly, goofy, loving things,” he enthused. “Greyhounds are super low maintenance and fit into many different home environments. The team at Greyhounds as Pets do a wonderful job finding them homes after their racing careers, so I am happy to do my part promoting this wonderful cause.”

Service to others underpins many of Hall’sroles – as a veterinarian, an ArmyReserve Officer, AVA division President, board member and ambassador. “Giving back to the community is important for everyone, not just vets,” he said. “The human species is capable of compassion, foresight and complex planning, and we should be using these skills to be improving the world in every way.”

Hall could easily add communication skills to his list of capabilities, particularly since he frequently combines his roles with a strong media presence to promote veterinarians’ wellbeing and animal welfare. “I enjoy promoting the importance of animals in our lives, and I’m really grateful for the opportunity to sharethese stories in any way,” he said. His earliest television appearance coincided with his time as a rural vet in Dayboro, on Channel 10’s children’s program Totally Wild.“The plan was to show a day in the life of a country vet, and I had a great time taking Pip Russell and the TV crew to see a local dairy herd, then go and worm a few camels before racing back to the clinic to perform an emergency spleen removal on a dog,” he recalled. “I’ve since found myself in front of a camera or microphone many times, usually accompanied by some sortof animal.”

While Hall cites taking a cow into Channel 9’s Perth studio as one of the highlights of his media outings, he is excited to be filming an upcoming episode of the ABC science show Catalyst. “This has always been one of my

favourite shows, and it has covered an incredibly diverse range of topics at the forefront of science and technology,” he said. “We will be looking at the role that parasites play in modern medicine, and we have found some amazing scientists who are using parasites to treat disease and improve the lives of humans.”

Technology and its intersection with veterinary practice is a subject dear to Hall’s heart, not least because he is one of the founders of biotech company VetChip. Given that animals are unable to communicate that they are running a temperature or have experienced a fluctuation in their blood pressure, for example, or where they are located if they have wandered off, Hall wanted tofind a way to use technology to give them avoice. VetChip has developed implantable biosensors for animals aimed at providing proactive monitoring systems, data analytics and disease detection. Once installed, the VetChip it can alert owners and veterinarians of any abnormal events that could indicate possible injury or illness and, when used in conjunction with VetChip’s VetTag devices, can also track an animal’s location and movements in real time.

“The concept for VetChip had been swimming

technology is extremely difficult but I feel it is vitally important to the future of animal health. If we get it right, we can really change the world.”

When Hall won the This Is Freemantle Aspire Award in 2021, therefore, he knew exactly what he would do with the scholarship funds, which must be used to assist personal and professional development by attending an overseas conference of the winner’s choice. Once international travel was possible, he immediately opted to attend the Singapore Vet Show, the largest annual veterinary conference in the Southern Hemisphere, in order to network with likeminded professionals and to showcase VetChip. “Every vet loves helping animals and owners, but the challenge that really compels me is trying to design the technology and systems that improve outcomes across the world,” Hall said.

“Monitoring individual health and detecting abnormalities is just the beginning, as we can analyse patterns of abnormalities to detect complex disease processes in individual animals or groups of animals. This technology gives us the ability to detect problems sooner, provide more effective treatments, and give owners the peace of mind that their animal’s health is being monitored in the best way possible.”

around in my head for years, and I’d written up a high-level overview of what that technology might involve and what it might be able to do,” Hall said. “But the vision was so expansive I knew I’d need to find some great co-founders.” Roping in his brother and fellow vet Max was relatively easy, but it wasn’tuntil Hall heardabout some talented electrical engineers who were interested in working on health devices that would connect to the internet that the project really took off. “After a brief phone call turned into an hour-long chat about all the possibilities, I knew I’d found the right team,” he said. “VetChip is deliberately intended to work in all mammals, and maybe other species eventually.The real-time health monitoring is going to be incredibly useful, but the potential to diagnose – or perhaps even predict – diseases is going to be a real game changer.”

Hall has set himself and the VetChip team several challenges, but one practical application that stands out for him is to create technology that will prevent dogs from dying in hot cars. “I want us to be able to determine when a dog is exposed to this situation using our VetChip’s thermometer and location services, and then to alert the owner or nearby responders to intervene before the animal suffers a slow and horrible death,” he explained. “Developing this

It is hard to resist Hall’s passion for the VetChip project and its myriad possibilities for animal health and welfare, and I sincerely hope he fulfils his aspirations. Writing about Hall’s many achievements and his varied roles providing service to animals and humans has reminded me of the old adage – that if you want to get something done, you should ask a busy person to do it. That said, Hall is quick to point out that the growth of the business and his numerous other ventures would not be possible without the support of his wife. “Basically, the only way I managed to achieve as much as I have is because Sally has been willing to give up some of her own career aspirations so that I could take on these challenges,” he said. “She is quite a clever cookie and an incredibly hard worker who not only assisted with the set-up of our clinics, but oversaw the entirefit-out and put in the majority of effort to raise our three kids while having a part-time career in medicine –and that was after completing vet school!”

Having attempted to unravel the intricate tapestrythat is Garnett Hall, I also suspect that he does not necessarily see himself as a busy person, but as someone living life to its fullest. As he himself said, “We live in an interesting world with a lot of opportunity. To me, animals are a big part of what makes our world so wonderful, and I’ve always wanted to see and experience as much of the world as possible. Being a vet has allowed me to understand not just the animal world, but also biology,medicine and disease, and the reason I love technology is that it enhances our ability to understand or improve all of these things, leading to better outcomes for animals and people everywhere.”

I, for one, am looking forward to seeing what Garnett Hall will accomplish next.

■ JAI HUMEL

Funding for world-first malaria test in East Asia

From page 1

Our test is the closest the scientific world has come to tracking and predicting these ‘hidden’ infections.”

A high-throughput laboratory version of the test would be used to confirm whether the asymptomatic underlying P.vivax infections are contributing to outbreaks, to detect areas with ongoing transmission, and to treat people with these dormant infections.

Chief Investigator Rhea Longley said this information is critical for outbreak containment. “These insights will enable us to get ahead ofthe parasite to predict where it may be silently hiding, who its next target is and when it is likely to attack,” she said.

Longley said the team hoped its findings could be used to fuel malaria eradication across East Asia.

Live export phase out briefing attended by AVA, VALE

From page 1

24-hour lighting and 90dB noise for 20 plus days, faecal ‘bedding’ and head stress,” she said.

“Even with the changes implemented since 2018, 38 out of 41voyages accompanied by inde-

There’s hope for handfish

From page 3

Although it took five years to perfect the necessary breeding environment Fawke is confident Sea Life Aquarium can successfully breed more handfish so that eventually there will be enough to enable some individuals to be released back into Tasmanian waters.

“We’ve all the right parameters in place and we know the trigger points now so we shouldn’t have any issues once these juveniles get to be adults, or if we manage to source some more adults from the wild in the future. They’re a fantastic little fish, full of character and we don’t want to lose them,” he said.

Tasmania’s equally endangered red handfish is also the subject of a recent project designed to restore the species’ habitat. With an estimated 100 adult fish left, the species is on the brink of extinction and while the red handfish breeding program has also been successful, researcher Jemina StuartSmith, a research fellow and marine ecologist at the University of Tasmania’s Institute for Marine and Antarctic Studies, said red

pendent observers have reported heat stress … the ships are not air-conditioned, and no amount of ventilation helps when the ambient conditions exceed a sheep’s heat stress threshold.”

■ SAMWORRAD

handfish were literally running out of habitat, and unless it was restored there was little point releasing captive-bred fish into the wild.

“We’re trying to restore lost habitat by translocating seaweedcovered boulders to areas that have been decimated by an increase in native urchins, and seaweed provides the necessar y structure and shelter on which handfish can lay their eggs.” she said.

Stuart-Smith described urchins as resembling garden pests eating the vegetables, and the removal of natural urchin predators like large lobsters had probably contributed to an increase in urchin numbers. Although the ‘sea-gardening’ project is still in its early stages, there are encouraging indications it is proving beneficial.

“We’re hoping to know mid-year, but we think the seaweed is surviving and, assuming we can keep on top of urchin numbers, we’ll be able to increase the amount of habitat available to the handfish. The long-term solution though is to restore a balanced ecosystem,” she said.

■ ANNELAYTON-BENNETT

Health benefits of keeping pets in aged care facilities

From page 3

Young said a significant issue now was funding because although many aged care facilities are keen to try new innovations they are limited by resources and funding, so the researchers are calling for the federal government to mandate financial support for pets in aged care to help improve the mental health and wellbeing for thousands of residents.

“We need the federal government to stand up to fund pets in aged care. Just like exercise facilities have become a core part of aged care facilities – and are proven to boost movement capabilities and

wellbeing – so too should pets be considered an essential part of aged care. It’s no longer good enough for people to simply live longer. They need to be assured of happy, healthy, and meaningful older years, and for pet-loving older people, this means including their beloved pets.”

■ ANNELAYTON-BENNETT

‘A qualitative Analysis of Management Perspectives on Seeking to Implement the Foster Cat Project in Residential Aged Care in the Context of COVID-19’ is available at doi.org/10.3390/ doi.org/10.3390/ijerph20010752.

Avian influenza on the rise

From page 5

Beer stressed the virus was now a global panzootic in birds and had reached areas in the world where this type of virus had never been seen before.

“We’re talking about a whole new continent with a lot of different bird species which have never had contact with this kind of virus. We have to follow the situation closely and be aware that this virus can occur in non-bird species. It’s a highly dynamic situation and surveillance monitoring measures are needed all over the globe,” he said.

■ ANNE LAYTON-BENNETT

Management

From page 17 to move in the future are often devalued in the eyes of buyers and the banks that lend to them.

One of the pitfalls that many business owners fall into in their final years in practice is to only negotiate a lease for the duration that they wish to practice. Any buyer of their practice (and the bank lending them money) will need a lease with options for 10 years at the point of sale to feel secure.

ABILITY TO ASSIGN

6. Assignment

Most leases will contain an assignment clause, which compels a landlord to act reasonably if the assignment of an existing lease is requested. If the new prospective tenant is someone of good character and sound financial standing, they should meet these criteria.

The Impact of 6

An assignment clause is vitally important if you ever want to sell your business. Without it, there is no obligation on your landlord to assign your lease to the buyer and, without the lease, you may find that your practice is unsellable.

Abstracts - vet burnout

From page 14

2School of Computer Science, College of Engineeringand Physical Sciences, University of Guelph, Guelph, Ontario, Canada.

3American Association of Veterinary Medical Colleges, Washington, District of Columbia, USA.

4Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Abstracts - epilepsy in cats

From page 14 Medicine Vienna, Austria.

5Department of Veterinary Clinical Sciences, Small Animal ClinicNeurosurgery, Neuroradiology and Clinical Neurology, Justus-LiebigUniversity,Germany.

6University Clinic for Small Animals, University of Veterinary Medicine, Vienna, Austria.

7Oxford Autoimmune Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.

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Ivo Mueller and Rhea Longley. Picture WEHI

CREATURE Feature Donskoycat ( Feliscatus )

TheDonskoy(alsoknown astheDonsphynxorRussian hairless)isahairlesscatbreed ofRussianorigin.Itisnot relatedtothebetter-known sphynx:theDonskoyís hairlessnessiscausedby adominantmutationofthe keratin71gene,whereas sphynxhairlessnessiscaused byarecessivemutation. Inspiteoftheirlackofa coat,Donskoyrequire frequentgrooming. PictureNickolasTitkov

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