The Veterinarian Magazine February 2024

TheVeterinarian ■ February 2024

■ www.theveterinarian.com.au

Humans can identify chicken moods, research says ON THE INSIDE

3 NEWS Impact of fire on koalas

The estimated 100 million chickens in Australia might be able to make their feelings known, after a University of Queensland study found humans can tell if chickens are excited or displeased, just by the sound of their clucks.

The study used recordings of the noises chickens made when they anticipated a reward, such as food, which researchers labelled the ‘food’ call, or the ‘fast cluck’, and a second set of recordings made when a reward was withheld, which they called the ‘whine’ and ‘gakel’ calls.

Participants in the survey were

played the recordings to see if they could tell the context of the chicken sounds, and whether various demographics and levels of experience with chickens affected their correct identification.

Joerg Henning from UQ’s School of Veterinary Science said the findings were significant.

“We found 69 per cent of all participants could correctly tell if a chicken sounded excited or displeased,” Henning said.

“This is a remarkable result and further strengthens evidence that humans have the ability to perceive

the emotional context of vocalisations made by different species. It provides confidence that people involved in chicken husbandry can identify the emotional state of the birds they look after, even if they don’t have prior experience.”

Henning hopes that future research will expand on the findings, potentially developing into artificially intelligent based detection systems to monitor vocalisations in chickens to assist in monitoring the welfare of farmed birds.

Steve Jeffries and Melissa McEwen

From 17 January, potential registrants of veterinary medicines can have their products reviewed by Australian and United Kingdom regulators at the same time, to facilitate speedier registration.

The Australian Pesticides and Veterinary Medicines Authority (APVMA) and United Kingdom ■ www.theveterinarian.com.au

NEWS Seals fussy about their food

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■ JULIA GARDINER

Anthrax outbreak Speedier medicine review is expected for Australia and UK confirmed on Veterinary Medicines Directorate (VMD) have developed the United Kingdom–Australia Regulatory Cooperation: Guidance on Veterinary Medicines Simultaneous Reviews, which will serve as the foundation for simultaneous reviews of veterinary medicines submissions by both agencies.

Besides cutting the time it will take to register the medicines, the move will also have financial benefits to project teams, by providing access to two major markets upon approval.

APVMA Acting Chief Executive Officer, Melissa McEwen, said the guidance represents an important step forward.

“This exciting new approach can reduce the burden and provides the opportunity for a single project team to work on the application, in line with common assessment timeframes,” McEwen said. To page 30

5

NEWS Genomic influence

cattle property

An anthrax outbreak has been confirmed on a cattle property northeast of Shepparton, Victoria, prompting swift action from Agriculture Victoria. The property is quarantined, and measures are underway to manage the situation.

Anthrax, caused by spore-forming bacteria in soil, poses a significant threat to livestock, resulting in rapid fatalities. Agriculture Victoria has disposed of affected animals and is vaccinating remaining cattle.

Cameron Bell, Victoria's Deputy Chief Veterinary Officer, commended early reporting by the property owner and veterinarian, facilitating rapid response. Quarantine measures and disinfection protocols are in place to contain the outbreak.

Efforts to limit anthrax spread include on-site incineration of carcasses. To page 30

10 A DAY IN THE LIFE Jackie Campbell EAGLE POST

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News

Study illustrates impact of fire on koalas A study led by University of Adelaide researchers has uncovered some of the impacts to koalas following the 2019–20 Black Summer bushfires, during which more than three billion animals, including significant numbers of koalas, were estimated to have been killed or displaced.

Beyond obvious injuries such a burnt fur, the researchers found that significant burns to the pads of their feet left koalas unable to escape the fires, or climb trees, important to their feeding and sleeping habits, as well as protection from predators.

Natasha Speight, from the University of Adelaide’s School of Animal and Veterinary Sciences unit, who spearheaded the research, explained the importance of the findings.

“By understanding the extent of the burns of the skin in the footpads, as well as furred regions of the body, koalas can be assessed for their likelihood for rehabilitation and release, or if the prognosis is poor,” Speight said.

“Compounding the effect of burns on the health of the koalas, a high likelihood of lung damage due to smoke inhalation has

also been found by this study, and this is an important additional consideration for veterinarians triaging rescued koalas.”

Following the bushfires, the conservation status of koalas in Australia was upgraded from vulnerable to endangered in NSW, QLD and the ACT, where the fires destroyed 3.5 million hectares of koala habitat and caused an estimated population decline of 7.2 per cent in the subsequent year.

A NSW government report on koala populations and habitats in NSW, released in 2020, found that without intervention to protect habitat and address all other threats, the koala will become extinct in New South Wales before 2050.

The University of Adelaide research hopes to provide resources to assist in the event of future bushfires.

“These … can then be used by the government, wildlife carers and veterinarians to assess the prognosis for koalas that have injuries due to bushfires, as well as aid coordination of bushfire response efforts,” Speight said.

■ JULIA GARDINER

Millions of pets can’t be wrong! ‘Forever’ chemicals widespread More than 37,000 responses were collected as part of the first-ever Victorian pet census, the results of which will be used by the Government to better support pet and their owners, as well as the animal welfare sector.

Animal Welfare Victoria (AWV), a dedicated public service group within the Department of Energy, Environment and Climate Action, is responsible for bringing together aspects of domestic animal and animal welfare research, policy, legislation, education and compliance; however previous data regarding pet and companion animal ownership in Victoria proved insufficient for their work, leading to the commission of the pet census.

The census results estimate over half of adults in Victoria are the owners of an estimated 4.3m pets across the state, with the survey providing a greater understanding of the unique needs of a variety of animal species to help close the current knowledge gap on pet welfare and owner priorities.

Dogs were found to account for 41 per cent of Victorian pets, about half of which were bought from breeders, with popular breeds including cavoodle, labrador, greyhound, border

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collie, and golden retriever. Cats made up 24 per cent of pets counted in the survey, with most cat owners adopting their pets from an animal or rescue shelter.

While the Census also highlighted the positive impact of pets on the lives of Victorians, with an overwhelming 98 per cent attesting to benefits of pet ownership, awareness, understanding and perceived importance of the legal requirements around pet ownership was low compared to other aspects of pet ownership surveyed.

While 91 per cent of cat owners felt it was important for them to meet legal responsibilities, perceived importance was much lower for other pet types (ranging from six per cent among insect owners to 77 per cent for among dog owners).

Respondents were generally more likely to be aware of laws relating to their own pets than the laws relevant to the broader pet industry, such as requirements around breeding.

Veterinary services were the most common service used for all types of pets, particularly among dogs (with 92 per cent having used veterinary services in the last year), cats (78 per cent), small mammals (69 per cent) and large mammals (65 per cent). To page 30

in Tasmanian environment

Results of a study published recently in the journal Science of the Total Environment have found that per- and polyfluoroalkyl (PFAS) substances are present in the nesting soils and blood of Tasmania’s little penguin populations (Eudyptula minor).

Little penguins forage and breed along Tasmania’s coastlines which makes them vulnerable to the increasing urbanisation of this large group of chemicals that are commonly used in fire-fighting foams, non-stick cookware, cosmetics and sunscreens, and fast-food packaging.

Lead author Melanie Wells, a PhD candidate at the University of Tasmania’s School of Natural Sciences, and Institute of Marine and Antarctic Studies, said PFAS are referred to as ‘forever chemicals’ due to their stability within the environment.

“They can transport long distances through natural processes and are resistant to degradation.

Bioavailable PFAS enter food chains and bioaccumulate in predators. We found PFAS

concentrations were positively associated with increased urbanisation around penguin colonies, detecting PFAS in 100 per cent of the samples collected from Burnie and Hobart’s Derwent Estuary,” she said.

Researchers detected 14 different PFAS homologous in nesting soils, blood and abandoned eggs of little penguins, with Perfluorooctanesulfonic acid (PFOS) being the most prevalent PFAS, detected in 76 per cent of the soil samples collected from penguin nests, and in just over 82 per cent of the 45 blood samples.

Oceans absorb and hold PFAS and many other pollutants that resist degradation which then enter surface waters and sediments through run-off and natural atmospheric processes, accumulating over time in the food chain.

“We explored the association of PFAS concentrations to several little penguin health parameters, and found an effect on circulating total plasma proteins, haematocrit or ‘packed cell volume’, and genotoxicity. To page 30

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News

pledges $230,000 Seals fussy about their food Victoria to wildlife rehabilitation Although conservation efforts have ensured the southern elephant seal (Mirounga leonina) is no longer considered endangered, a recent study published in the journal Marine Ecology Progress Series and led by researchers from the University of New South Wales, has found that particular dietary preferences of male elephant seals could present another challenge for the survival of the species.

According to Andrea Cormack, lead author of the study and a PhD candidate at UNSW’s School of Biological, Earth & Environmental Sciences, male elephant seals are extremely picky eaters, with each having a favourite food, be it fish, squid species, crustaceans or octopus.

“They could have the pick of the buffet, yet each male southern elephant seal eats a lot of the same food which is just a fraction of what’s on offer,” she said.

Researchers analysed whisker samples from 31 male southern elephant seals from the Western Antarctic Peninsula. The whiskers hold chemical clues about the food each seal consumed in the past year, providing an extensive picture of each individual animal’s diet.

“These guys are out in the water foraging for months, and then fasting for two to three months on land during breeding season, so it’s hard to gather a lot of information about their diet through study methods like stomach analysis. But by analysing hard tissues that store an inert chemical record of what they’ve eaten, we can start putting together the pieces about their eating habits,” Cormack explained.

Nearly all male seals were found to be specialists with individuals consistently eating the same food items over time with little variation in diet.

Most could be considered extreme specialists, feeding on less than 20 per cent of their population’s

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range of food types. Only one seal in the sample was a generalist and had chosen to eat a broad diet of various food sources.

The scientists found variation between individuals strongly correlated with their body size with the heaviest seals preferring larger energy-dense prey such as big squid. Reasons for this could be fluctuations in seasonal and yearly food availability, or gape size which could dictate ideal prey.

“We know from previous studies that individuals will often return each year to the same feeding grounds in search of their favourite foods, but

we need more studies to be confident about exactly what’s driving specialisation and how it impacts breeding success,” Cormack said.

The southern elephant seal’s habitat on the Western Antarctic Peninsula is a region experiencing the greatest changes from ocean warming. Fears climate-driven shifts in the Southern Ocean could alter krill availability, impacting the seal’s ability to feed on its favourite foods further up the food chain.

Emerging pathogens like deadly avian flu strains also threaten seal populations. To page 30

The Victorian Government recently announced the recipients of the latest round of its Wildlife Rehabilitation Grants program.

The much-needed grants support wildlife shelter operators and foster carers with up to $3,000 in funding, with this round providing a total of $230,000 to support 102 wildlife organisations, including 34 wildlife shelter operators.

Successful applicants provide a wide range of services, including Moonshadow Flying Fox Rescue and Rehabilitation Centre which received funds to build a predator proof aviary for microbats and a pond for water birds, and South Oakleigh Wildlife Shelter will purchase new possum and bat nest boxes.

Red Box Wildlife Shelter will receive funding to build a shelter for kangaroo rehabilitation while Outlook Rd Shelter can now build two flight enclosures, a wombat enclosure and essential feed and milk formula.

With much of the state’s animal rescue operations carried out by volunteers, who have been calling for government assistance, the Government has also released the Victorian Wildlife Rehabilitation Guidelines – a comprehensive resource to enhance the welfare of Victoria’s sick, injured and orphaned wildlife.

The guidelines were developed by the Department of Energy, Environment and Climate Action (DEECA), Zoos Victoria, members of the wildlife rehabilitator community and experienced wildlife veterinarians around Australia.

They cover education in current best practice in wildlife rehabilitation, instructions on the administration of basic first aid and the provision of health care following veterinary instruction, and information on species appropriate housing and nutrition. To page 30

FEBRUARY 2024 TheVeterinarian 5

News

Plumbing the genomic influence Qld floods displace

Following the population decline of the Tasmanian devil (Sarcophilus harrisii) in the wild, due to the spread of the lethal facial tumour disease that has ravaged the species since its emergence in the mid-1990s, a study published recently in Nature Ecology & Evolution has found that the absence of the island state’s top order predator has influenced the evolutionary genetics of Tasmania’s spotted-tail quoll populations (Dasyurus maculatus).

Quolls are a less dominant terrestrial predator in Tasmania, but an international study involving scientists from the University of Tasmania, Griffith University and Washington State University found quoll behaviour altered when there was less competition for food as devil populations declined. The findings parallel the results of similar studies involving other top predators globally, that have shown there can be cascading ecological effects when predator species are removed from the ecosystem. One of them is a reduction in competition

that enables increased activity in an ecosystem’s subordinate mid-range mesopredators.

Over 15 years genome marker data was collected from 345 quolls across 15 generations to look for evidence of genetic variation and natural selection associated with differences in DFTD prevalence and geographical location.

The scientists found in areas where DFTD was impacting the devil population, there was evidence of less movement of genes between quoll populations, and more differences across geographically separated quoll populations in genes specifically related to muscle development, movement and feeding behaviour.

Co-author Menna Jones, Professor of Biological Sciences and marsupial carnivore expert from the School of Natural Sciences at UTAS, said the activity of the spotted-tail quoll shifted significantly in the regions where Tasmanian devils had severely reduced numbers.

“Quolls have shifted their peak-time activity, from pre-dawn to avoid devils, to early evening with low devils when most prey are active, and hunting is the best. We found that with fewer devils, quolls are benefiting from more carrion and are spending more time feeding at carcasses,” she said.

With less competition and more food, the need for quolls to move around as much or as far also lessened. Changing evolutionary pressure on their physical performance associated with escaping from devils, and the fertility of the quoll populations, was also being affected by declining devil numbers.

The study used the “community landscape genomics” approach that the research team hopes will be used more broadly to enable greater understanding of the evolutionary consequences of predator declines around the world.

■ ANNE LAYTON-BENNETT

Upping the ante on illegal wildlife trafficking The illegal trafficking of Australia’s wildlife is now increasingly being associated with organised crime. Offences have included the export of bird eggs, using the international mail system to attempt to send 100 native species, including 30 live reptiles like blue tongue and pink tongued skinks hidden among children’s toys. But the introduction of world leading technology, developed in partnership by Taronga Conservation Society and the University of New South Wales, University of Technology Sydney, and the Australian Nuclear Science and Technology Organisation, and able to detect if native reptiles have been bred in captivity or taken from the wild, is hoped to curb the escalating illegal trade.

Tanya Plibersek, Federal Minister for the Environment and Water, said wildlife crime was a threat for many species already at risk of extinction. She cited the example of a single poaching event potentially able to drive the critically endangered Cape Melville leaf-tailed gecko to extinction in the wild.

“We have to stamp out this terrible trade which sees our native animals captured in the Aussie outback, bound and gagged, and sent overseas to be sold. It’s why the government has boosted efforts to combat crime here and overseas, using some of the best minds and technology available,” she said.

The federal government’s specialist Environmental Crime Section has led the country’s effort to detect and disrupt wildlife crime.

State governments have also boosted efforts to combat wildlife crime more rapidly and effectively, designed to also help improve the care of species at the centre of these schemes.

Phoebe Meagher, Taronga’s Wildlife Conservation Officer, said teams recently 6 TheVeterinarian FEBRUARY 2024

Picture Conrad Hoskin

established in Sydney and Melbourne enabled them to join forces with the Taronga Conservation Society of Australia, a facility that is uniquely positioned with the tools and expertise to work with industry partners to combat the illegal wildlife trade.

“We’ve seen an increase in smuggled wildlife, with animals often in a poor welfare state.

Collaborating to embed science in national processes to improve conservation outcomes is so rewarding and motivates us to continue to find new ways to apply science to protect wildlife,” Meagher said.

When smuggled wildlife are detected at Australia’s borders using Rapiscan Systems scanners, Environmental Crime staff take the seized parcels to Taronga to be unboxed.

Once there, the animals receive health checks and, where possible, are rehomed.

Between September and December last year over 100 seized reptiles were cared for by the Taronga team. To page 30

animals, impact breeding season Recent flooding in Queensland has led to warnings the rain has displaced animals and will impact their breeding cycles in coming months.

Displaced animals will seek shelter and food in their new territories, with snakes, crocodiles, cane toads, crown-of-thorns starfish and venomous jellyfish being likely species to be impacted by the rain.

Snakes are the most likely to have an impact on domestic animals, with one snake catcher reporting an increase in call-outs for incidents involving snakes and pets since the floods.

“Snakes are not the bad guy. They are just doing what comes naturally to them but it's certainly something people should consider if they have a small dog,” Dan Rumsey said.

“They're not thinking, 'Oh this is perfect. This is a backyard'. They're just trying to find somewhere to take shelter.” To page 30

Seal ‘bomb’ use denied Despite the Aquaculture Stewardship Council’s September 2022 decision to no longer permit the use of seal crackers, or ‘bombs’ in its Salmon Standard, these acoustic underwater deterrent devices continued to be legal in Tasmania under the state government’s Seal Management Framework.

Designed to deter seals from damaging farmed salmon pens, numerous studies have found these acoustic harassment and deterrent devices cause hearing loss, bone fractures, soft tissue burns, and other physical trauma, not only to seals but also to other marine mammals like dolphins, porpoises and whales.

Tasmanian seafood company Tassal has been under fire from conservation and animal welfare groups due to a continued use of seal crackers at its leases, with reports of 1006 ADDs being used between December 2022 and November 2023.

A request by Tassal to the ASC in late 2023 to allow the permanent use of ADDs and AHDs was recently refused, a decision welcomed by animal welfare groups.

In a statement posted on its website the ASC said: ‘The Variance Request has been technically reviewed by the Standard VR Committee, formed by ASC staff and members of the Technical Advisory Group. Following the review and taking into account stakeholder feedback, ASC has refused the VR to allow the use of seal crackers, under the circumstances proposed, in Tassal’s eight ASC certified salmon farms.’

In claiming the ASC’s decision was a win for wildlife, Tasmanian Greens leader Rosalie Woodruff said it showed how ‘appalling’ Tassal’s behaviour had been since no other country used explosives as a method to deter wildlife.

“Tassal has used vast numbers of explosives and lead shot pellets on Australian fur seals for years, without authorisation from the ASC. The industrial fish-farming business model is built on exploiting Tasmania’s waterways and the impacts on the marine environment are extreme with seals killed and maimed,” Woodruff said.

Tasmania’s Primary Industries Minister, Jo Palmer said the decision was, ‘a matter for the ASC’, but under the state government’s Seal Management Framework, the crackers could still be used, but only as a last resort.

“If other measures have failed, there’s an opportunity for [salmon companies] to use seal crackers, but only at that time,” she said.

■ ANNE LAYTON-BENNETT ■ www.theveterinarian.com.au

News

Understanding why biodiversity matters Global biodiversity loss is now widely recognised as a serious issue, with at least one million animal, fungal and plant species potentially at risk of extinction within a few decades, according to a study published recently in the journal PLOS ONE. Researchers from Queensland’s James Cook University, and the Musée National d’Histoire Naturelle in Luxembourg analysed 14,669 European plant and animal species and found significant factors driving species decline included changes in agricultural land use and the overexploitation of biological resources.

In his recently published book Why Biodiversity Matters, ecologist Nigel Dudley also focuses on the importance of biodiversity protection, and the need for a careful rethink on conservation approaches. Dudley, who has worked with WWF International and UNESCO, and is an industry fellow at the University of Queensland’s School of Earth and Environmental Sciences, said the failure of some governments to respect biodiversity rights threatens the survival of many species and the future of the planet.

Although the authors of both the journal article and the book acknowledge the efforts being made by many governments and non-profit organisations to reduce the loss of biodiversity, both publications stated measures too often lacked a comprehensive understanding of the threats to different species in different locations and were too closely linked to economic benefits for humans, which limited their success.

In the European study the researchers found approximately one-fifth of the terrestrial, freshwater and marine species assessed were threatened with extinction - a number that exceeds the assumed extinction risk claims the Intergovernmental Platform on Biodiversity and

Ecosystem Services made recently. As well as changes in agricultural practices and associated habitat loss, the study’s results showed biodiversity loss was also due to overharvesting, pollution, and residential and commercial development.

Dudley’s book is both a call to action and a manifesto for policymakers and other influencers to ensure a balance is achieved between economic development and ecosystem survival, as well as recognising the rights of humans and the biodiversity rights of individual animals.

“It’s not that the ecosystem services are unimportant, far from it. But there has been a tendency for the utilitarian and economic values of wild plants and animals to dominate discussion to the exclusion of the basic rights that species have to live their natural evolutionary span,” he said.

The book discusses how three important ethical issues – human rights, animal rights and biodiversity rights – interact and sometimes clash. An example is the emotive but complex issue of hunting in relation to biodiversity.

Although Dudley personally abhors the practice, he said the decline in hunting in Germany had led to damaging wild boar levels, while in Scotland the deer populations, that are maintained for hunting purposes, have laid bare the country’s woodlands.

“Culling a population of non-native rabbits on an island to protect a unique species of plant doesn’t make sense from the perspective of animal rights but it does in terms of biodiversity rights. Conservationists haven’t always got the right balance, particularly when it comes to human rights,” he said.

Authors of the PLOS ONE study concluded that financial investment in activities detrimental

Nigel Dudley

to biodiversity far outstripped biodiversityfriendly investments, and to avoid and mitigate the impact of major threats to biodiversity urgent action was needed. Their research also showed a doubling of the extinction threat for European plant and animal species compared to the number IPBES assumed were at risk.

“Biodiversity is the foundation that underpins food security, human well-being and wealth generation, and to secure a future for Europeans, greener agriculture and fishing policies, and a rapid phasing out of incentives detrimental to biodiversity in agriculture, forestry, fisheries and energy production will be required.”

■ ANNE LAYTON-BENNETT References ‘A multi-taxon analysis of European Red Lists reveals major threats to biodiversity’ doi.org/10.1371/ journal.pone.0293083 Why Biodiversity Matters by Nigel Dudley (Routledge, 2023) ISBN: 9780367365202 (pbk)

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Eagle Post

Advice to young and old graduates An article appeared recently in the Veterinary shifts gradually toward a profound intolerance Clinics of North America Small Animal Practice toward discomfort?

Medical educators speak of once-routine entitled “Top Veterinary Practice Issues that Negatively Affect Culture, Retention, and aspects of training now being considered Performance.” It is a must-read for new harmful. Threats to mental health include graduates and older graduates hiring young vets. encroachments on time away from the hospital.

To attract and retain talented veterinarians, Educators are told to only include positive employers must create a great work environ- feedback in the written record, leaving trainees ment that fosters community and friendships. without the constructive criticism they need According to the 2020 Census of Veterinarians to succeed. A new social capital has emerged, and 2022 American Veterinary Medical challenging traditional hierarchies that had Association Report of the Economic State of the previously elevated trainees with intellectual and Veterinary Profession, veterinarians are leaving emotional fortitude to manage acute and evolvthe profession due to poor work culture. ing illness. In the new order, people who speak Poor work culture was the reason for 47% of those thinking of leaving. Almost one-third of new graduates change employers in their first year of working. Employees must feel valued and believe they are making a meaningful contribution to their work to make a difference.

Young graduates place a high value on work-life balance. They seek a more balanced life than their parents. It is a defining feature of Generation Z and millennials. Unfortunately, older veterinarians may perceive young grad-uates as lazy or not committed to their work, but good practices mentor and support young vets. A friend, a veterinary innovator in Boston, would always celebrate his employees’ professional achievements, such as work anniversaries, accomplishments, team milestones, and cultural holidays. As he says, “We work hard and we party hard.”

While the advice about where to work is good, new graduates must consider whether veterinary medicine is a job or a calling. Millennials and Gen Z often think their job is just a job.

Unhealthy work environments make it hard to give your all, and new graduates may want to get out. A way to do that is by saying, “This is a job.

I no longer have an emotional connection to this. I will do what is needed to keep my job. And then, I will clock out at 6 pm. and return home to recover from any trauma experienced during the day.” If everyone is not in “This is a job. agreement with this thinking, then the veterinarian who wants to clock out on I no longer have an emotional time will seem to be a slacker who is there for the wrong reasons. Everyone connection to this. I will do must agree on signout and departure what is needed to keep my job. times. It ensures I can leave at 7 a.m. the next day or whenever the shift ends.

And then, I will clock out at Leaving when your team is working hard 6pm and return home to and staying late doesn't feel good.

People need to feel like they’re part of recover from any trauma a hardworking group of people, which experienced during the day.” is exactly what medicine is all about. It is challenging for people used to working hard to work less intentionally.

Veterinary medicine is harder than other jobs. out about the unjust training demands are And that is what many graduates signed up for – highly regarded. While most trainees strive for they want to do the hard work because they excellence, a vocal minority can set the tone and believe in what they are doing. If you believe shape perceptions for the majority. When a your work is just a job, working hard is pointless. grievance is expressed in a group chat, consenThe individual will think the practice is manipu- sus about potentially traumatizing effects quickly lating them so they can work harder for it, and it solidifies, according to a colleague who runs can profit and benefit. It is true given the trend a successful internal medicine residency. of many veterinary practices becoming corpo- The moral overtones of this framing made it rate. The question becomes, how do you set a successful strategy. Her authority dissolved. expectations around discomfort as the culture “It becomes unconscionable not to comply,” www.theveterinarian.com.au

she says. "Then you are oppressing them.”

A surgeon colleague told me about a conference focused on the toxic aspects of medicine, which has perpetrated racism and misogyny.

Recognition of the immorality of the structures and people perpetuating such oppression is long overdue. But when every ill feeling is labeled trauma, “distinguishing among harms of varying magnitudes becomes difficult, as does targeting interventions to root out problems. Recently, a presenter showed slides from the division's Twitter account: awards won, research grants received, US News and World Report rankings.

The alleged cultural problem is that trainees who work hard, are burned out, and already worry about their future are being harmed by hearing about others' successes. Many

participants shared the same thoughts. My colleague suggested celebrating excellence, clarifying that the tweets were a marketing tool, not an existential threat to trainee well-being.

But before she could, a resident commented that leadership would probably "gaslight everyone" by saying precisely that. My colleague described her responsibility and commitment to creating a safe space to her executive coach. The coach responded, “Did you feel comfortable speaking?”

She said no. The coach retorted, “Then it's not a safe space.”

New veterinarians in an internship, residency or new job may think that the mental, physical, and spiritual health is the organization's or collective space's responsibility. Instead, in medicine, discomfort is an essential part of the human experience and a prerequisite for learning. While we should avoid violence and oppression, we should not avoid discomfort.

Encouraging the ability to distinguish between the two is a form of emotional maturity that we should foster.

FEBRUARY 2024 TheVeterinarian 9

F O E F I L E H T N I Y A D L A L E B P M A C E I JACK

PALLIATIVE CARE VET

T

his month, A Day in the Life heads to Queensland, where veterinarian Jackie Campbell owns and runs a growing business, Sunset Vets, which works exclusively with veterinary patients requiring palliative care and euthanasia services. While Campbell and her head office team are based on the Sunshine Coast, Sunset Vets also offers end of life care in Melbourne, Canberra, Sydney, Brisbane and the Gold Coast. She was kind enough to find time in her busy schedule to chat with The Veterinarian about what constitutes a typical day for her.

Campbell is an early riser, who begins her day at around 5:00am. “I’m lucky enough to live in a pretty beautiful part of the Sunshine Coast, so a good day starts with a really quick swim or a jog if I can squeeze it in, but I don’t always manage it,” she said. She then trawls through emails over breakfast and is generally in the office by 8:00am to assist the care team. “At Sunset, we support a large team of vets who provide this special type of care right across the country,” Campbell said. “As one of the first companies to really try and dedicate all we do to palliative care, it’s been an interesting journey.”

Following her graduation from the University of Queensland’s vet program in 2006, Campbell became interested in understanding and treating patients with chronic pain early in her career.

“I dabbled in rehab and sports medicine with some courses through the Canine Rehabilitation Institute and have also done some basic training in acupuncture as a modality,” she said. In 2014, she travelled to the UK to complete her Diploma of Canine Myofunctional Therapy and followed this in 2016 with training in the US where she became the first Australian veterinarian to obtain certification in Animal Hospice and Palliative Care through the International Association for Animal Hospice and Palliative Care (IAAHPC). With the aim of providing more supportive and better directed palliative care in Australia, Campbell started Sunset Vets in 2014. Since then, she and her team have delivered professional and personalised services to clients whose pets are approaching the end of their lives while also offering a valuable and much-needed alternative to veterinarians wishing to refer end of life cases on.

The nature of Campbell’s work tends to involve seeing patients towards the latter part of the day and into the evening, which allows her time in the morning to work with her head office staff.

She also uses this time to support any new vets joining Sunset Vets, discuss cases with vets on the road or with referring practices, and to prepare for lectures or other commitments she may have.

When she begins her consulting hours at around 10:00am or 11:00am, many of these are conducted in clients’ homes. “This means a drive to see the client, which I actually love–it gives me an opportunity to catch up on phone calls, or just absorb the scenery and listen to music,” Campbell said. “On a busy day our team will see four to five clients per day, and we allow about an hour in the home for each consultation, depending on what support they need.”

Palliative care cases often require quite a lot of preparation, particularly as Campbell must work through all the referral notes and previous case histories for the pet. She then combines this knowledge with information collated by the Sunset Vets care team, who have tried to gain an understanding of all the relevant factors affecting both the patient and the client. “We take into account things like why the client is seeking support, what we can do to help them understand their pet’s prognosis, and what fears and concerns we need to address to ensure the best outcome for the patient,” she said. “Palliative care work in general is not that different from routine veterinary care, but we do focus really specifically on comfort-focused outcomes and ■ www.theveterinarian.com.au

spend much more time talking with owners about their goals for care, their limits, and their caregiver burden.”

Campbell is quick to point out that in a couple of crucial ways, palliative care also differs quite significantly from regular veterinary practice.

“Patientwise, it’s all about pain and symptom control, so we’re often fairly aggressive in our treatment plans, and I’m much braver with what I’ll recommend in the palliative setting than what I would otherwise do in primary care,” she said. “In many ways, however, it’s also a type of slower paced medicine: we create the environment where we have fewer time constraints than in clinic life, which allows for more planning. In this way we hope we can avoid crisis points for our palliative patients.”

Euthanasia home visits also constitute a large portion of Campbell’s case load. Pet owners who access end-of-life services have often had them recommended by Sunset Vets’ referrer clinics, or they are clients who know they would prefer to be in their home rather than a clinical setting to bid farewell to their beloved pet.

“The stakes are pretty high with these sorts of visits,” Campbell said. “Again, there is lots of prep work ahead of the visits, and we work closely with the cremation teams at the end of the appointment to ensure the pet and family are all well looked after. We are such a relationship focused business.”

Campbell is up front about the toll both palliative and end of life care can take on a veterinarian, and identifies the emotional weight of the work as being one of the most challenging aspects of her role. She recognises that vets have been involved with palliative care for generations but is equally cognisant of what she describes as “an evolving expectation of care” from pet owners. Consequently, Campbell is committed to pushing some of the accepted boundaries as she does her best to support the welfare needs of pets at end stages. “As a profession, I think we need to be constantly curious and learning about how we can do better,” she said. “We are so often faced with ethical challenges in end-of-life cases, but we have very few accepted frameworks for how we approach these case decisions. As I reflect on how far we have advanced our diagnostics and treatment options, it’s in contrast to how we’ve developed our palliative care skills – I believe there’s a bit of a gap.”

Veterinarians, in Campbell’s opinion, need to have an industry-wide conversation about end-of-life care, answering the sorts of questions she comes up against in everyday practice. For example, what is the best course of action to ■ www.theveterinarian.com.au

take when a patient is suffering with poor quality of life, but the owner is not ready to say goodbye? Or, how is it best to manage tricky cases where owners have religious objections to euthanasia? “These questions are definitely challenging,” she said. “But it’s also kind of fun to be at the forefront of the challenge, making incremental improvements to our standards of care.”

Given her willingness to identify and tackle challenges in her chosen field, it is unsurprising that Campbell also finds many aspects of her work rewarding. “Getting on top of a patient’s pain and seeing that transition happen – that will always feel great,” she said. “Equally, providing euthanasia for a pet who needed it can

also be rewarding. There’s a feeling that you’re absolutely alleviating pain or distress, and that the day has therefore been a good one.”

As the Sunset Vets team has expanded, Campbell has also found a sense of satisfaction in helping her team. “I’ve realised that a lot of my joy these days comes not just from helping our clients, but from helping other vets to find their own love of this work,” she said. “Our vets come from all kinds of backgrounds and career stages, and I know some of them would have left the profession had they not found this style of practice, so it’s pretty rewarding to see them flourish and reconnect with the joy of vetting through joining the Sunset team.”

While Campbell aims to finish her work tasks by 6:00pm and loves to have an evening jog if she has not managed to exercise that morning, she has a range of other commitments that help her balance the potential emotional toll of her day. She is involved in the Pets in the Park program, having founded the Brisbane chapter of the group, which delivers preventative health care to the pets of people experiencing homelessness. She is also the Australian representative for the IAAHPC, and is involved on several of their committees, including the education committee. To top it off, in 2017 Campbell founded the Australian Veterinary Palliative Care Advisory Council (AVPCAC) to promote the advancement of palliative veterinary medicine in Australia, and has also launched the Sunset Grief program, which provides access to free counselling sessions for people experiencing grief resulting from pet loss.

Sadly, Campbell herself is recently bereaved, so as we conclude this Day in the Life column with our usual Creature Questions, we take the opportunity to extend our sincere condolences to Jackie upon the passing of her own beloved cat Jemima.

Do you currently have any pets?

I am actually currently pet-less and it’s definitely not a natural state of being. I grew up with dogs, cats and horses so it’s unusual to be without an animal in the home, having recently lived my own palliative care journey with a much-loved cat. My cat’s story was the very stereotypical vet story – a stray in the clinic I worked at, she became my very first cat spey when I was a vet student (thanks to my epic boss Stephen Lindores for letting me scrub in, picking up the surgical pieces, and then letting me take her home when no one else would).

She moved with me through vet school, across the country through all my vet jobs and survived to a respectable 21 years of age, teaching me so much about palliative case management in her final years. Personality wise, this cat was also intent on ensuring she was an ‘only child’ her whole life. I remember multiple attempts at introducing other clinic strays, and she would not have a bar of it, so she ruled the house right till the end.

What is your favourite animal?

Can anyone seriously answer this question?!

I’m not sure I have a favourite. As a kid I was gifted an ‘adopted’ rhino from my parents who recognised my animal loving gene early. They paid a contribution to an African conservancy for many years on my behalf and I’ve loved rhinos ever since, maybe I am happy to settle on that as an answer. That said, it’s pretty hard to overlook so many of our incredible Australian native wildlife species as favourites.

If you could transform into any animal, what would you be and why?

Well, with the quality of life of our cats and dogs here in Australia, I feel like life would be pretty comfortable being either of those things.

If we’re going for something more exotic, though, I’d definitely be something that lived in an alpine environment. Give me mountains and snowy vistas! Perhaps I’d be a snow leopard?

If you or any of your colleagues would like to access more information about Sunset Vets, particularly if you would like to know more about supporting your patients, training and education for clinics, or accessing their free grief program for your clients, please get in touch at www.sunsetvets.com.au.

Also, if you are interested in connecting with other vets and would like to learn more about palliative care, you can find the Australian Veterinary Palliative Care Advisory Council website at www.avpcac.com – it is free for veterinarians to join.

■ JAI HUMEL FEBRUARY 2024 TheVeterinarian 11

Management

Why buy the practice premises?

Every vet practice has a premises to operate out of that they either lease from the premises owner or own themselves.

Occasionally, a practice owner that is leasing is given the opportunity to buy their premises at a reasonable/fair price…

If you, as a business owner, have this opportunity: What are the relevant considerations that you should take into account?

■ Why should you buy when you can rent?

■

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.

1. Capital growth through paying your rent As a practice owner, you are already paying rent to someone else – if you buy the premises and put that rent towards premises interest repayments, you would be able to a get the capital growth through the increased premises value over time.

2. Asset diversification A lot of business owners would like to build some assets outside of their home and business.

Commercial real estate can be a good asset class to diversify into especially if you have a chance to buy commercial real estate with a solid tenant.

3. Practice renovation costs improve capital When you are renting and you pay money to renovate, that renovation will either need to be undone at the end of the premises lease or it will improve the value of the landlord’s asset.

However, if you own the real estate and you pay money to renovate, the renovation should improve the value of both your business and your premises, such that both assets are increasing in value.

4. Security of tenure Security of tenure is perhaps the best reason for a veterinarian to buy their own real estate.

What is security of tenure?

Simply put, it is your assurance of the legal right to continue using the space that your business is in. While it is possible to get security of tenure by leasing premises…even the longest leases are usually not as long as a long career as a veterinarian.

Poor security of tenure can compromise the value of your practice in multiple ways.

4a. A veterinary practice isn’t the type of business that is easily moved The further you need to move a client base, the greater the practice attrition if your practice becomes less ‘convenient’ for them to get to.

If your lease ends and you need to relocate, veterinary practices aren’t easily moved when you compare them to other businesses. You aren’t just talking about tables, chairs and a sign on the door, like an accountant or law firm.

If a veterinary practice is moving to a new premises, you will usually need special council permissions and radiation licenses for the new premises, organisation of council waste removal, non-standard fit-out, radiation shielding and plumbing.

4b. Existing client goodwill attached to the location As much as all veterinarians want to think that they are irreplaceable in their clients' eyes, there are usually clients in any practice who are only coming back because it is close to where they live or their work, their children’s school, the train station, etc. The percentage of client goodwill attached to the location varies from practice to practice, but it is usually significant, and needing to move a practice’s location, therefore, will usually result in some client attrition.

4c. New client goodwill attached to the location New clients come to a practice for many reasons. One of the reasons why a new client may choose your practice over others is that, when they had a veterinary issue, they remembered seeing your sign or passing your practice when they were in the area.

The percentage of new clients received by this method will vary from practice to practice. Those in a prominent street front will usually get more business this way than a veterinary practice in a suite in a commercial building. Moving a veterinary practice will also mean a loss in community familiarity associated with that location, and could therefore mean a loss of new clients.

4d. Selling a practice with poor security of tenure is hard When the time comes to sell your practice, good security of tenure reinforces the value of your goodwill and practice as a whole.

DO YOU HAVE SOMETHING TO SAY? Is there a topic 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!

12 TheVeterinarian FEBRUARY 2024

■ www.theveterinarian.com.au

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Even though they can’t speak, diagnosing and managing their pain and inflammation doesn’t need to be difficult.

WE’RE ALWAYS READY TO HELP Please speak with your Boehringer Ingelheim Territory Manager today about how we can assist you with pain and mobility solutions.

PAIN, INFLAMMATION AND MOBILITY SOLUTIONS. ONE TRUSTED SOURCE.

METACAM is a registered trademark of Boehringer Ingelheim Vetmedica GmbH. Previcox is a registered trademark of Boehringer Ingelheim Group.

Boehringer Ingelheim Animal Health Australia Pty. Ltd., ABN 53 071 187 285. Level 1, 78 Waterloo Road, North Ryde, NSW 2113 Australia. Toll free: 1800 808 691. ©2021 Boehringer Ingelheim Animal Health. All rights reserved. PET-0169-2021

■ EDITED BY JENI HOOD BSc (Hons) BVMS PhD

Abstracts

Access to veterinary care: evaluating working definitions, barriers, and implications for animal welfare Humans have a moral obligation to meet the physical and mental needs of the animals in their care. This requires access to resources such as veterinary care, which is integral to achieving animal welfare.

However, "access" to veterinary care is not always homogenous across communities and currently lacks a consistent definition.

The objectives of this scoping review were to (1) understand how "access" to veterinary care has been defined in the literature, (2) map a broad list of potential barriers that may influence access to veterinary care, and (3) identify how access to care impacts the welfare of companion and livestock animals. The literature search yielded a total of 1,044 publications, 77 of which were relevant to our inclusion criteria, and were published between 2002 and 2022.

Studies were most frequently conducted in the United States (n=17) and Canada (n=11). Publications defining access to veterinary care (n=10) or discussing its impacts on animal welfare (n=13) were minimal. However, barriers to accessing veterinary care were thoroughly discussed in the literature (n=69) and were categorized into ten themes according to common challenges and keywords, with financial limitations (n=57), geographic location (n=35), and limited personnel/equipment (n=32) being the most frequently reported.

The results of this scoping review informed our proposed definition of access to veterinary care. Additionally, our findings identified a need to further investigate several understudied barriers relating to access to care (i.e., veterinarian-client relationship, client identity) and to better understand how they potentially affect animal welfare outcomes.

Kayla Pasteur1, Alessia Diana1, Jane Kinkus Yatcilla2, Shanis Barnard1, Candace C Croney3 Front Vet Sci. 2024 Jan 18:11: 1335410.doi: 10.3389/fvets.2024.1335410.

1Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, IN, United States.

2Purdue University Libraries, Purdue University, West Lafayette, IN, United States.

3Center for Animal Welfare Science, Departments of Comparative Pathobiology and Animal Science, Purdue University, West Lafayette, IN, United States.

Physical stress and musculoskeletal complaints of veterinarians – a narrative review Introduction: Veterinarians have high physical workloads. The aim of this narrative review is to evaluate the literature on typical physical workloads, such as lifting/carrying and forced position (during surgery) and predictors of injuries. The health complaints of veterinarians were also examined.

Methods: Diverse databases were used. Prevalence rates of total workloads (also including surgery), health complaints, musculoskeletal discomfort, and predictors of injury, musculoskeletal disorders, and precaution awareness were examined.

Results: Thirteen studies were included. The most prevalent injury was animal attacks (9–84 per cent). Working in large and mixed practice types were predictors of injuries or musculoskeletal disorders (e.g., shoulder, lower back, head/neck) compared to other types of practice.

Conclusion: The study findings presented here clearly show a high need for intervention to minimize and prevent occupational risks. Ergonomic working conditions and occupational safety training can reduce the risk of musculoskeletal disorders.

Beatrice Thielmann1, Robert Pohl2, Irina Böckelmann2 Appl Ergon. 2024 Feb:115: 104180.doi: 10.1016/j.apergo.2023.104180.

1&2Institute of Occupational Medicine, Medical Faculty, Otto-von-Guericke-University, Leipziger Str. 44, (Building 20), 39120, Magdeburg, Germany. Electronic address: beatrice.thielmann@med.ovgu.de.

14 TheVeterinarian FEBRUARY 2024

Alternatives to conventional antibiotics for the prevention and treatment of commonly occurring diseases in feedlot cattle Antibiotic-resistant bacteria are a problem in human medicine.

The development of antibiotic resistance in bacteria in feedlot cattle could have negative effects on their health and welfare and there is a theoretical possibility of transmission of antibioticresistant bacteria from food animals to humans. Alternatives to conventional antibiotics in feedlot health management could reduce the selective pressure for the development of antibiotic resistance. This review assesses the evidence supporting potential alternatives to conventional antibiotics in the prevention and treatment of diseases in feedlot cattle, including nitric oxide, plant extracts, supplemental yeast or yeast products, bacterial probiotics, organic acids, bacteriophages and non-specific immunostimulants. Further research is warranted with lactate utilising bacteria, the organic acid malate, bacteriophages and the non-specific immunostimulants β-1,3 glucan and those based on pox viruses. However, none of the alternatives to conventional antibiotics investigated in this review have sufficient supporting evidence to date to justify their use with feedlot cattle.

Frequently, statistically weak results and studies without negative controls are cited as support for similar studies. The health and welfare of feedlot cattle are dependent on the use of products that have robust supporting data to ensure efficacy and to avoid adverse outcomes.

PMV Cusack1 2 Aust Vet J. 2024 Jan 24.doi: 10.1111/avj.13314.

1Australian Livestock Production Services, Cowra, New South Wales, 2794, Australia.

2School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2678, Australia.

An RNA replicon system to investigate promising inhibitors of feline coronavirus FIPV is of great significance in the cat population around the world, causing 0.3 per cent-1.4 per cent of feline deaths in veterinary practices (2). As there are neither effective preventive measures nor approved treatment options available, there is an urgent need to identify antiviral drugs against FIPV. Our FCoV replicon system provides a valuable tool for drug discovery in vitro. Due to the lack of cell culture systems for serotype I FCoVs (the serotype most prevalent in the feline population) (2), a different system is needed to study these viruses. A viral replicon system is a valuable tool for studying FCoVs. Overall, our results demonstrate the utility of the serotype I feline coronavirus replicon system for antiviral screening as well as to study this virus in general. We propose several compounds representing promising candidates for future clinical trials and ultimately with the potential to save cats suffering from FIP. Kimberly Schmied1 2, Rosina Ehmann3, Claudia Kristen-Burmann3, Nadine Ebert1 2, Güliz Tuba Barut1 2, Lea Almeida1 2, Jenna N Kelly1 2 4 5, Lisa Thomann1 2, Hanspeter Stalder1 2, Reto Lang1 2 6, Gergely Tekes3, Volker Thiel1 2 4 5 J Virol. 2024 Jan 18: e0121623.doi: 10.1128/jvi.01216-23.

1Institute of Virology and Immunology (IVI), Bern and Mittelhäusern, Switzerland.

2Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.

3Institute of Virology, Justus Liebig University Giessen, Giessen, Germany.

4Multidisciplinary Center for Infectious Diseases (MCID), University of Bern, Bern, Switzerland.

5European Virus Bioinformatics Center (EVBC), Jena, Germany.

6Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland.

Free article

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RECOMMENDED BY SPECIALISTS “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 PhD DipECVN, Veterinary Referral Hospital. *If you are registering with Animal Health Academy for the first time, please use access code: myAcademy For more information, please contact Boehringer Ingelheim Animal Health on 1800 808 691 References: 1. Bhatti, SFM, et al. (2015) International Veterinary Epilepsy Task Force consensus proposal: medical treatment of canine epilepsy in Europe. BMC Vet Res.;11:176. 2. Tipold A, et al. (2015) Clinical efficacy and safety of imepitoin in comparison with phenobarbital for the control of idiopathic epilepsy in dogs. J Vet Pharmacol Ther.;38(2):160-168.

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Advertorial

Diagnostic Imaging for Small Animal and Mixed Practices Textbook quality images: more clarity, better diagnosis, improved outcomes!

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X-Ray: RAD-X DR CX4A 703C

Canon CXDI 703C DR Panel – 35x43cm Includes the panel, charger and two batteries

RAD-X DR CX4A In-Clinic DR System Ideal small animal system for in clinic use, this system captures and displays images in seconds.

Unique RAD-X multi-frequency image processing algorithms create crystal-clear images like those seen in textbooks. The software is quick, easy, and simple to use, and the system is incredibly forgiving.

DICOM 3.0 connectivity mean you can send to any DICOM destination, including the industryleading RocketPACS cloud system.

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‘My best mate when it comes to vet toys is our new GE Versana ultrasound.

I’d wanted one for some time and it finally arrived a few months back – now I have to fight the other vets to get use of it. The image quality is just so much better than we had before!’

Paula Williams, WestVETS Anstead Small Animal and Equine Hospital.

What’s driving that image quality Paula praises?

■ Colour, Power and PW Doppler included as

standard

■ Coded Harmonic Imaging enables high reso-

lution even at deep penetration Real-time Speckle Reduction Imaging (SRIHD) reduces noise and enhance true tissue detail ■ CrossXBeam™ enhances your ability to visualise tissue interfaces and differentiate borders ■ Whizz Real-time Optimization constantly optimises image quality as you scan ■

Even better, it comes with all the support and service you need to get the most out of your ultrasound imaging.

Here you can see vets Amy Spark and Maddie Garnache of Selwood House Vet and Cat Hotel in Leura getting practical training when their system was installed.

Ultrasound: GE Versana Active The imaging capability of a console in a handcarried, lightweight package means you can diagnose patients on premises or remotely as required. Vets love it!

16 TheVeterinarian FEBRUARY 2024

Radincon include an on-site visit with every installation. A GE applications specialist configures your Versana Active and trains you in how to use it. For this visit Andrew Wilmot even brought his dog Ruby along to act as a test patient!

Every system also comes with the following support – at no extra charge: ■ One-year on-site warranty ■ Remote access available for GE service technicians to diagnose issues and fix where possible ■ 24-7-365 support from Radincon’s Australian team Quality Equipment backed by Quality Service and Support All equipment wears out and breaks down sometimes – you don’t need that happening to you in a busy vet practice. Using quality systems from Radincon means you may never face this challenge. But if you do, you’ll have friendly, helpful support just a phone call away.

We had equipment from somewhere else originally, but we chose Radincon for the quality of the equipment and because of their reputation.

The after sales service is amazing. We call on Sundays or after hours and we always get help. I remember one weekend Alex was on his way out to attend a wedding, but he stopped and took the time to help us out.

Christine Kidd and Pauline Gaven of Manly Road 24 Hr Veterinary Hospital.

Expanding or upgrading your diagnostic imaging capability?

Call Radincon on 1300 721 734.

■ www.theveterinarian.com.au

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See product label for full claim details and directions for use. For more information contact Boehringer Ingelheim Customer Care on 1800 808 691. Boehringer Ingelheim Animal Health Australia Pty Ltd. Level 1, 78 Waterloo Road, North Ryde NSW 2113. ABN 53 071 187 285. ®NEXGARD SPECTRA is a registered trademark of the Boehringer Ingelheim Group. All rights reserved. PET-0072-2023

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News from across the network Latest updates from Australia’s largest specialty and emergency network

NSW Meet Dr Filipe Espinheira LMV, DACVO, Registered Specialist in Veterinary Ophthalmology

Animal Referral Hospital (ARH) Homebush is pleased to introduce its new ophthalmology service with Dr Filipe. With over 14 years of extensive experience, Dr Filipe has worked as a faculty member in Comparative Ophthalmology at leading US universities including Cornell University College of Veterinary Medicine. His professional interests include intraocular surgery, glaucoma, advanced imaging of the eye and ophthalmology of exotic and wild animals. Dr Filipe will be based at ARH Homebush Mon – Thurs, joining its large team of medicine, surgical, emergency and critical care vets. He will also be consulting at ARH Gosford and ARH Minchinbury once a month.

For enquiries or referrals contact (02) 9758 8666.

New extended hours at ARH Minchinbury

In response to the growing needs of the local community, Animal Referral Hospital (ARH) Minchinbury has extended its emergency opening hours to include Sundays. ARH Minchinbury is now open Monday to Friday, 8am to 12am midnight and on Sundays, 8am to 5pm. For enquiries or referrals contact (02) 8610 3400.

VIC Minimally invasive urinary procedures at Veterinary Referral Hospital (VRH)

VRH Dandenong is excited to announce the availability of cutting-edge, minimally invasive urinary procedures, in conjunction with existing essential imaging and cystoscopy services. These minimally invasive procedures reduce morbidity associated with surgical alternatives and enable diagnosis and treatment within a single procedure, often conducted on an outpatient basis. Procedures include fluoroscopy-based imaging, ectopic ureter laser ablation, and ureteral and urethral stenting. This service is led by Dr Matt Munro, DVM, DACVIM (SAIM) Board Certified and Registered Small Animal Internal Medicine Specialist. Dr Matt welcomes vets to contact him via email at medicine@vrh247.com.au for referrals or free case advice.

SA Summer alert! Bee venom desensitisation at Adelaide Veterinary Specialist & Referral Centre (AVSARC)

Do you have a patient who has suffered an anaphylactic reaction from bee or wasp stings? They may be a suitable candidate for a desensitisation treatment with Dr. Andrew Carter BVSc (Hons), Diploma in Veterinary Dermatology. Helping to mitigate the risk of severe reactions, this treatment has not been readily available in Adelaide until now. The patient undergoes an intradermal test with bee or wasp venom to confirm a diagnosis, followed by a tailored inpatient or outpatient desensitisation program.

For enquiries or referrals contact AVSARC on (08) 8132 0533.

QLD Now open! Animal Emergency Centre (AEC) Kedron

We are pleased to announce AEC Kedron has re-opened. As a dedicated pet emergency and critical care facility, AEC Kedron serves the needs of the Kedron community and neighbouring areas. The team works closely with general practice vets to provide after-hours vet care for patients. AEC Kedron is open 24 hours on weekends and public holidays, and from 5pm to 8am on Monday, Thursday and Friday.

For enquiries or referrals contact (07) 3350 1333.

Animal Referral & Emergency Network is Australia’s largest specialty and emergency network, with over 20+ locations nationwide.

The network operates as an extension of local veterinary practices, offering clinical excellence and professional advice in specialist cases and emergencies.

Learn more at www.emergencyvet.com.au

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Wellness

Nurturing balance: A guide to work-life harmony for veterinarians In the fast-paced world of veterinary medicine, the pursuit of balance between professional duties and personal well-being often feels like a delicate dance. As dedicated caregivers to our animal companions, veterinarians face unique challenges in maintaining a healthy work-life balance. Long hours, demanding caseloads, and emotional intensity can take a toll on our mental and physical health if left unchecked. However, with mindful attention and proactive strategies, it's possible to cultivate harmony between our professional responsibilities and personal lives.

The challenge of work-life balance in veterinary medicine Veterinary medicine is a calling -a profession driven by passion and compassion. Yet, the very qualities that draw us to this noble field can sometimes blur the boundaries between work and personal life. The demands of emergency cases, surgery schedules, and client emergencies often spill over into our personal time, leaving little room for rest and rejuvenation.

Studies have shown that veterinarians experience higher levels of stress, burnout, and compassion fatigue compared to professionals in many other fields. According to a recent survey by the American Veterinary Medical Association (AVMA), nearly 60 per cent of veterinarians report experiencing burnout, with factors such as long working hours, emotional

demands, and work-related stress contributing to their exhaustion.

Strategies for achieving work-life balance 1. Establish boundaries: Setting clear boundaries between work and personal life is essential for maintaining balance. Define specific work hours and designate time for self-care, family, and hobbies.

Communicate your boundaries to colleagues and clients and prioritise activities that nourish your well-being outside of work.

2. Practice mindful time management: Efficient time management is key to preventing work from encroaching on personal time. Prioritize tasks based on urgency and importance, and delegate responsibilities when necessary.

Utilize tools such as scheduling apps and to-do lists to stay organized and focused.

3. Cultivate self-care practices: Investing in self-care is not selfish -- it's essential for sustaining your well-being and effectiveness as a veterinarian.

Prioritise activities that replenish your energy and reduce stress, such as exercise, meditation, hobbies, and spending time in nature. Remember, self-care is not a luxury; it's a necessity for longevity in your career.

4. Foster supportive relationships: Nurturing strong connections with

colleagues, friends, and loved ones provides invaluable support during challenging times. Lean on your veterinary community for guidance, empathy, and camaraderie. Cultivate open communication with your support network and seek help when needed.

5. Embrace flexibility: Flexibility is a hallmark of resilience in veterinary medicine. Embrace adaptability in your schedule and mindset, allowing for unexpected changes and challenges. Be willing to adjust your plans and priorities as needed to maintain equilibrium in both your professional and personal life.

The benefits of work-life balance Prioritizing work-life balance is not only essential for our own well-being but also enhances our effectiveness as veterinarians. Research has shown that veterinarians who prioritize selfcare and maintain healthy boundaries experience higher job satisfaction, lower levels of burnout, and greater resilience in the face of adversity.

A study published in the Journal of Veterinary Medical Education found that veterinarians who engaged in regular self-care practices, such as exercise and mindfulness, reported lower levels of stress and emotional exhaustion. By investing in our own well-being, we can better serve our patients, clients, and veterinary teams with compassion and competence.

Conclusion: nurturing harmony in veterinary medicine Achieving work-life balance is an ongoing journey -- a dynamic interplay of self-awareness, resilience, and intentional action. As veterinarians, we are committed to the well-being of our animal patients, but it's equally important to prioritize our own health and happiness. By implementing practical strategies for managing workload and stress, fostering supportive relationships, and embracing flexibility, we can cultivate a sense of harmony between our professional responsibilities and personal lives.

Let us remember that our capacity to care for others is deeply intertwined with our ability to care for ourselves.

As we navigate the challenges and joys of veterinary medicine, may we embrace the pursuit of balance with compassion, courage, and grace.

References 1. American Veterinary Medical Association (AVMA). (2023). “WellBeing and Mental Health Study: Understanding and Addressing Veterinarian Well-Being.” Retrieved from [link] 2. Shanafelt, T. D., et al. (2015). “Career Fit and Burnout Among Academic Faculty.” JAMA, 313(10), 1025–1033.doi: 10.1001/jama.2014.18509 3. Singh, S. M. (2020). “The Effect of Self-Care Strategies on Stress Among Veterinary Professionals.” Journal of Veterinary Medical Education, 47(4), 388–396. doi:10.3138/jvme.2018-0103 FEBRUARY 2024 TheVeterinarian 19

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Clinical Review

Snakes: an envenomation update

Naomi Hansen BVSc MACVSc graduated from Queensland University in 1997.

She worked in mixed animal practice in Queensland after graduation, before moving to Canberra to work for John Aspley Davis at Kippax Veterinary Hospital. She has completed a residency in emergency and critical care at Melbourne University and was a resident in the same field at the Pennsylvania University Veterinary Hospital in the US. She is Veterinary Emergency & Critical Care in Sippy Downs, Qld. Hansen is a member of the Emergency and Critical Care Chapter of the ACVS.

■ www.theveterinarian.com.au

Australia is home to some of the most venomous snakes in the world with the snakes known to be more active in the summer months (October to May). Retrospective human data suggests that 54% snake bites occurred around the victims’ home which makes their pets very susceptible.

In Australia approximately 550 people per year are admitted to a public hospital following a snake bite, of these people, an average of two will die from the bite or associated

complications. The brown snake has been implicated in the majority of these deaths (23/35 deaths from snake envenomation between 2000 and 2016 were attributed to brown snake envenomation).

The species more commonly associated with severe snake envenomation in domestic animals across Australia are the brown snake (Pseudonaja sp.), tiger snake (Notechis scutatus) and red-bellied black snake (Pseudechis porphyricus). This list is not exclusive and there are other snakes that

have been associated with morbidity and mortality in domestic animal species but they are less commonly reported. These ‘other’ snakes include the death adder (Acanthophis sp.), copperhead (Austrelap sp.), eastern small eyed sake (Cryptophis nigrescens), white lipped snake (Drysdalia coronoides), black whip snake (Demansia sp.), king brown snake (Pseudechis australis: note this is a member of the black snake family), spotted black snake (Pseudechis guttatus), Taipan (Oxyuranus scutellatus).

FEBRUARY 2024 TheVeterinarian 21

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Clinical Review These ‘other’ snake species are less documented and for some (death adder and taipan) a specific antivenom is required. Tiger-brown antivenom is recommended for copperhead, eastern small eyed snake, white lipped snake and spotted black snake. Tiger-brown or CSL black snake antivenom is recommended for king brown envenomation.

Snake identification Correct snake identification is essential to the correct management of snake envenomation In veterinary practice, we often assume the species of the offending snake on the basis of geographical location and results of preliminary testing (i.e. PCV/TP, coagulation times, CK and AST).

This preliminary assumption is justified for two reasons: ■ Most snake envenomation patients are started with a vial of polyvalent (tiger-brown) antivenom.

■ The SVDK can take 30 minutes to return a result, this is a long time in an unstable patient.

BUT veterinarians should be more diligent in the use of snake venom detection kits (SVDKs), especially if there is clinical support for systemic envenomation and antivenom administration is required. Correct identification of the snake involved allows us to target our therapy with a monovalent antivenom.

SVDKs are considered 100% specific (i.e. a positive result is positive) but the sample timing and test technique may result in a false negative.

The reliability of the SVDK depends on the sample source and time lapse since the bite: Venom (bite site or fang): The most reliable sample source Urine: The protein binding of venom varies with the snake species so false negatives can occur if the urine concentration of venom is low (more likely to provide a positive response within 12h of envenomation) o Cats: may record a false negative result in the initial 5 hour period following envenomation Blood: Read the directions carefully when testing blood (more likely to provide a positive response within 4 hours of envenomation Knowledge of the offending snake species allows for better case management through: ■ Administration of the appropriate antivenom ■ Prediction of the clinical progression ■ Prediction of potential complications SVDKs (Elisa test) can accurately identify the type of snake in 30 minutes of a bite Clinical progression The differential diagnosis for snake envenomation includes all forms of lower motor neurone paralysis/paresis (i.e. Tetrotoxins, tick intoxication, polyradiculoneuritis, organophosphate or carbonate intoxication, thromboembolic disease and meningitis/myelitis).

To differentiate these potential diagnoses from snake enveomation: the clinical onset of snake envenomation is generally acute, the progression rapid and is commonly accompanied by a coagulopathy.

Many of the clinical signs observed in human snake envenomation patients can be applied to domestic animals and will assist in the early detection of systemic envenomation: <1 hr Headache, irritability, photophobia, nausea, vomiting, diarrhoea, confusion, coagulation abnormalities +/- hypotension and loss of consciousness (collapse). Collapse and vomiting may occur within minutes of a bite followed by an apparent ‘recovery’.

A period of apparent recovery may be observed within 30 minutes of the bite, preceding the progression of clinical signs ■ www.theveterinarian.com.au

1-3 hr Cranial nerve paralysis (dilated pupils, salivation and respiratory distress), abdominal pain, haemoglobinuria, hypertension, tachycardia, haemorrhage >3 hr Flaccid limb and respiratory muscle paralysis leading to respiratory failure, peripheral circulatory failure (pallor and cyanosis), myoglobinuria and death.

Muscle destruction (myolysis) is associated with muscle tenderness and predisposes kidney failure.

The rate of progression is variable and depends on the patient body size, physiological status, snake venom potency and the dose of venom delivered.

Brown snake envenomation has been associated with an acute deterioration and death from severe cardiac depression (within 5 minutes of the onset of clinical signs) Toxic components of snake venom 1. Neurotoxin Neurotoxins act at the neuromuscular junction (NMJ) causing a progressive paralysis.

The initial effects of a neurotoxin appear 2-4 hours post envenomation (time taken for the venom to travel to the NMJ and attach) Post-synaptic neurotoxins (tiger, brown, taipan and death adder) block neuromuscular transmission by occupying the acetylcholine receptors at the motor endplate (this is reversible with antivenom) Pre-synaptic neurotoxins (tiger, brown, taipan and rough scaled snake) block acetylcholine release and their onset is delayed 30-60 minutes (this is reversible with antivenom) Mydriasis and slow pupillary light responses Complete paralysis may take from 3-18 hours.

Upper respiratory dyspnea may occur before respiratory paralysis from paralysis of the tongue and pharynx. These patients often require intubation +/- temporary tracheostomy and may require a period of ventilatory support.

Antivenom: Severe pre-synaptic paralysis (tiger snake, taipan and rough scaled snake) will not be reversed by antivenom BUT post-synaptic paralysis (death adder) may be reversed by antivenom 2. Pro-coagulant Pro-coagulants act as prothrombin activators (fibrinogen consumption).

The clotting mechanism is activated by the conversion of prothrombin is converted to thrombin and fibrinogen converted to fibrin Rapid defibrination or fibrinogen depletion (< 30 minutes) results in a clinical coagulopathy in the presence of normal platelet numbers and function (prolongation of both PT and aPTT) Fortunately, fibrinogen levels are rapidly restored (within 3-4 hours), this means that an improvement (they do not need to be ‘normal’ merely improving) in fibrinogen or PT when tested 4-6 hours after administration of anti-venom supports neutralisation of the pro-coagulant effect and resolution of the coagulopathy.

Restoration of the consumed coagulation factors may take upto 24 hours sequential in clinc coagulation tests maybe prolonged for this period and there is no benefit from additional antivenom provided fibrinogen and PT levels are showing improvement at 4-6h.

IF the fibrinogen is persistently low when tested 4-6 hours after anti-venom administration there is indication for administration of more anti-venom.

Coagulopathies associated with tiger snake envenomation may resolve spontaneously (12-18 hours) Fibrinogen, FDP and D-dimer levels will facilitate identification of fibrinogen consumption and differentiate a defibrination coagulopathy from an anticoagulant coagulopathy (unfortunately these tests are not always available) Antivenom: Antivenom is the only effective treatment for this coagulopathy (several vials may be required).

Allow at least three (4-6) hours to lapse before deciding if more antivenom is required (a drop in fibrinogen

after this period or progressive prolongation of PT suggests the need for further antivenom treatment) 3. Anticoagulant Rapid reversible coagulopathy without defibrination.

FDP and D-dimer negative.

Antivenom: is the only effective treatment and the response is rapid.

4. Nephrotoxin There are NO isolated nephrotoxins in Australian snake venom BUT secondary kidney damage from Australian snake envenomation does occur.

Kidney damage is believed secondary to the following mechanisms: ■ hypotension ■ myolysis ■ coagulopathy 5. Myotoxin Myotoxins bind to the muscle fibres causing progressive destruction of the muscle cells.

The myolysis may take several hours to become clinically evident (creatinine kinase (CK) elevation and myoglobinuria) The muscle damage cannot be reversed but the progression can be attenuated by antivenom administration Patients show signs of progressive muscle weakness and pain Muscle weakness must be differentiated from a flaccid neuropathy on neurological examination.

Clinical complications: Secondary renal failure, hyperkalaemia and hypocalcaemia.

Antivenom: Rapid resolution of clinical signs (weakness and pain) and a fall in CK (the halflife CK is 3-6h and AST 12 hours) Medical management of snake bite Critically ill patients The initial approach to all critically ill patients is as easy as ABC … snake envenomation patients are no exception: THERAPEUTIC AIM: Maximise oxygen delivery to the tissues (maximise oxygen uptake, oxygen carrying and oxygen delivery).

1. Airway and Breathing: Neurotoxins may cause upper airway paralysis before respiratory paralysis, these patients will improve with intubation and may require a temporary tracheostomy.

Chronic dyspnea from a functional upper airway obstruction predisposes laryngeal oedema and pulmonary oedema, complicating recovery Airway support Aim for a sPO2 >92-93% (FiO22 21%) and pCO2 35-40 mmHg The ‘cut off’ values for ventilatory support are sPO2<60 mmHg (FiO2 21%) and/or pCO2 >60 mmHg Serial sampling will allow early identification of ventilatory and/or respiratory failure (sPO2 trending down and/or the pCO2 trending up)

Early identification and management of respiratory and/or ventilatory complications will minimise future complications.

Intubate and ventilate with 100% oxygen if ventilatory or airway failure is evident on presentation.

2. Circulation: Patients may present in shock (poor pulses, tachyarrhythmia, pale mucous membranes and hypotension) and require intravenous fluid resuscitation.

Hypotension and renal hypoperfusion will contribute to renal failure post treatment. Rapid volume resuscitation from shock is essential.

FEBRUARY 2024 TheVeterinarian 23

Clinical Review Systemic envenomation patients should be connected to an ECG and monitored continuously until they are stable. ECG monitoring will assist in the early detection of arrhythmias associated with envenomation, electrolyte disturbances and/or antivenom reactions.

Table 1. Canine and feline blood parameters

Brown snake envenomation is reported to cause cardiac arrest in humans.

Prior to initiating an intravenous fluid resuscitation regimen collect 2-3 mL whole blood and record the following baseline blood values (blood, except coagulation study sample, can be collected from the peripheral catheter): 1. Packed cell volume (%) and total protein (g/dL) 2. FRESH blood smear (platelet evaluation) 3. Serum colour 4. Serum glucose (mMol/L) 5. ACT (seconds) or PT/aPTT (seconds) 6. Lactate (mMol/L) 7. Electrolytes (Na+, K+, Cl-) 8. +/- CPK, BUN, Creatinine, blood gas and acid/base values Collect another 2-3 mL of ‘pre treatment’ blood and store it appropriately for the following tests: CBC (EDTA tube), serum biochemistry (Lithium Heparin or Clot tube), FDP/D-dimer and/or fibrinogen levels. ● Blood may be collected via the peripheral catheter or

saphenous vein (avoid using the jugular or cephalic veins for sampling in coagulopathic patients).

If possible collect a ‘pre treatment’ urine sample (SVDK, USG, urine colour, dipstick and microscopic evaluation for casts). ● Voided or catheterised samples are preferred (avoid cystocentesis in coagulopathic patients) ● Repeat urine sampling may be required to monitor renal function. In paretic patients it may be beneficial to place a sterile indwelling urinary catheter at this time. ● In acute envenomations a repeat urine sample may be required to positively identify the snake species via a SVDK, iff a false negative is recorded initially.

The frequency of subsequent testing (blood and urine) is determined by the results of the initial testing and the patient’s progress.

The snake venom detection kit (SVDK) ■ Sampling: The best sample for testing is a swab from the bite site ● Urine is a useful alternative but false negatives can occur (especially within the first 5 hours in cats ● Blood may be used (read directions carefully) ● If a dead snake is available a swab from the fangs may yield an accurate result The SVKD is 100% specific (a positive result is a positive result) but false negative results can occur as a result of sample timing and testing technique.

Rules of intravenous catheter placement Placement of an intravenous catheter is essential in the management of systemic snake envenomation ■ The following rules apply when placing an intravenous catheter: 1. ‘Three strikes and you are out’ let another staff member have a go!

2. The vein order for peripheral catheter placement: ■ cephalic veins ➸ lateral/medial saphenous veins ➸ jugular veins 3. On all veins, start distally and work proximally along the vein 4. A peripheral cut down should only be attempted by an experienced staff member and only if necessary (remember to maintain sterility and bandage appropriately to avoid phlebosis)

■ www.theveterinarian.com.au

Severe coagulation disturbances, electrolyte abnormalities and muscle damage leading to acute renal failure are likely

3. Fluid resuscitation or rescue phase: Snake bite patients with acute systemic envenomation may present in circulatory ‘shock’, these patients require volume resuscitation as soon as possible.

Recently, fluid resuscitation techniques have been reviewed as the health of the endothelial glycocalyx can be affected by the rate at which fluid resuscitation is undertaken (i.e. the volume of fluid infused and time over which that infusion is actioned).

The type of crystalloid utilised for fluid resuscitation has also been under review with a trend away from 0.9%NaCl toward Hartmanns.

Fluid resuscitation or rescue: ● Hartmanns: Bolus therapy 10-20ml/kg (dogs) upto 90ml/kg/h and 5-7ml/kg (Cats) upto 60ml/kg/h Monitor these patient’s q 10-15 minutes and reduce their fluid rate as they start to respond (HR, RR, thoracic auscultation, pulse quality and mentation) Be careful not to overload them with fluids Patients that present in circulatory shock have a reduced capacity to perfuse their gastrointestinal tract, lungs, kidneys and brain. Rapid correction of their perfusion status is essential to minimise post treatment complications like renal failure, gastrointestinal ulceration and ARDs

Snake envenomation patients are in the ‘high risk’ category for DIC Monitoring intravenous fluid resuscitation is similar for all critical patients: Blood Pressure: Record a baseline blood pressure (mmHg) and resuscitate to a MAP of 80-100 mmHg (do not over resuscitate) Heart rate/Respiratory rate: Thoracic auscultation q 10-15 minutes during fluid resuscitation will assist in the early detection of a patient’s response and prevent over resuscitation.

Resuscitate to a physiologically appropriate heart rate and cease resuscitation if pulmonary ‘crackles’ are audible Oxygenation: Oxygen supplementation is indicated during resuscitation to maximise delivery to the tissues. Hyper or hypoventilation post envenomation will contribute to tissue hypoxia and acidemia. Supplement to a sPO2 of >95%, in severe cases this may require intubation and ventilation on 100% oxygen.

Pulse rate and character: Pulse character provides a crude evaluation of blood pressure.

A reduction in pulse rate accompanied by an improvement in pulse character supports a favourable response to fluid resuscitation.

Packed cell volume/Total protein: Record a baseline PCV and TP, if either or both FEBRUARY 2024 TheVeterinarian 25

Clinical Review of these are low monitor them q30-60 minutes as they will DROP during fluid resuscitation.

ECG: Continuous ECG monitoring will assist in the early detection of atrial or ventricular arrhythmias.

Lactate (if available): The serum lactate value is valuable indicator of perfusion. Adjunct or alternate to serial BP monitoring may be the implementation of a resuscitation regimen that ceases when the patients serum lactate is < 2.0 mMol/L Do not over resuscitate snake envenomation patients as they may be renally compromised and may not be able to ‘deal’ with high volumes of intravenous fluids 4. Antivenom: The appropriate antivenom should be administered as soon as signs of enveno-mation are observed. Identification is often unreliable and snake venom detection kits (SVDK) should be used but if unavailable use Tiger snake antivenom in Tasmania, tiger and brown snake antivenom in Victoria and poly-valent antivenom in other states.

The amount of antivenom required depends on the amount of venom injected (the size of the snake, the number of strikes, the effectiveness of the strike and the fullness of the venom glands) Antivenoms are prepared from horse serum (containing no more than 170 mg/mL equine plasma protein) The risk of anaphylaxis is low (<1% in human literature but increases with prior exposure to horses, equine tetanus vaccines and a general allergic history) Recent studies suggest more than one ampoule is required to neutralize the procoagulant effects of brown and tiger snakes and we routinely start with two vials in severe envenomations.

Antivenoms should be administered slowly (over 30-60 minutes) diluted in an isotonic intravenous fluid Premedication: Not routinely used in veterinary patients Serum sickness: Fever, rash, aching joints, renal impairment and a generalised lymphadenopathy that occurs in 10% people treated with polyvalent antivenoms (up to 14 days post treatment) Medical management of human envenomations advocates intravenous adrenaline only for life threatening hypotension or anaphylaxis (its use has been associated with cerebral haemorrhage). Human literature suggests adrenaline, antihistamines and corticosteroids be administered only in the event of a clinical reaction 5. Analgesia and sedation Opioid analgesia is advised ● Buprenorphine 0.01-0.02mg/kg q8h (SC/IV/IM) ● Methadone 0.2-0.3mg/kg q4-6h (SC/IV/IM) ● Fentanyl as a CRI Snake envenomation can be very painful and we have been using combination CRI therapy to manage pain (i.e. Fentanyl/Lignocaine/ Ketamine) in patients that are clinically uncomfortable Monitoring the snake envenomation patient post treatment 1. Blood tests: Monitor PCV/TS, Platelets, Serum colour, ACT, Glucose, Electrolytes, CPK, BUN, Creatinine, Acid/base and blood gas status q6-12h 2. ECG: Continuous monitoring is indicated until the patient is stable 3. sPO2: Monitor q2-4 until the patient is weaned off oxygen supplementation 4. BP: Monitor for hypotension q2-4 until the patient is stable Management of hypotension: Volume expansion (HTS and/or colloids) Vasopressors (iff the patient is normovolemic and ECG and BP monitoring is available) 5. Urine output: Monitor q4 until CPK stars to decline (the half life of CPK is 3.5 hours) 6. Urine composition: Dipstick and microscopic evaluation ■ www.theveterinarian.com.au

Anti-venom The number of units of neutralising capacity and ampoule volume varies between snake species

Death adder venom: Paralysis (post synaptic neurotoxin) ■ Indications for treatment: Paralysis ■ Paralysis starts with ptosis, spreads to the

Administration: 1. Dilute antivenom up to 1 in 10 in an isotonic crystalloid (Saline, Hartmans or Dextrose) 2. Rate: 1 vial over 15-30 minutes 3.Have adrenaline on standby in case of a reaction

cranial nerves to peripheral muscles and may cause respiratory paralysis within 6 hours if untreated ■ The use of anticholinesterases (eg.

Neostigmine) may assist in management of post synaptic paralysis (more Ach available at NMJ may overcome blockade)

Brown snake venom:

Taipan venom:

Defibrination coagulopathy (pro coagulant effects) ■ Indicators for antivenom treatment:

coagulopathy and/or nephrotoxicty ■ There is a risk of cardiotoxicity (collapse, ■ ■

■ ■

arrhythmias and cardiac arrest) Avoid hypertension (risk of haemorrhage) Platelets are not affected but platelet consumption and thrombocytopaenia have been observed following brown snake envenomation FFP is contraindicated until all circulating venom is neutralised Large amounts of antivenom (Humans: 2-6 vials) may be required to reverse the defibrination coagulopathy (allow 4 hours before deciding to administer more antivenom and do not be guided by the PT/aPTT as these parameters may take 12 hours or longer to resolve)

A retrospective survey published in March 1998 (Australian Veterinary Journal) raises a few issues pertaining to the veterinary management of domestic animal snake envenomation: Few venom detection kits were used prior to the administration of antivenom Many domestic animals are treated with antivenom on the basis of geographical location and snake distribution Dogs are more sensitive to venom than cats (lethal dose tiger snake venom 0.1 mg/kg cats and 0.03 mg/kg dogs)✛ The severity of a patients presentation has an impact on the decision to treat There are a variety of ancillary therapeutics instigated in the management of both cat and dog envenomations ✛ Barr SC. Clinical features therapy and epidemiology of tiger snake bite in dogs and cats.

Aust Vet J 1984; 61:208-212 i MA Johnston et al. Successful recuscitation after cardiac arrest following massive brown snake envenomation. MJA Dec 2002; 17:646-649 * Tiger snake antivenom is a cheaper option for these species of black snake

Paralysis (pre and post synaptic neurotoxin) Myolysis Defibrination coagulopathy (pro coagulant) ■ Systemic envenomation is common post bite

so antivenom is indicated in all Taipan bite patients ■ The paralysis and coagulopathy may be profound ■ Large amounts of antivenom (Humans: 3-8 vials) may be required to reverse the defibrination coagulopathy Respiratory paralysis may occur within 2-4 hours of bite and complete defibrination within 1 hour of bite

Black snake venom: Myolysis Coagulopathy (anticoagulant) ■ Indicators for antivenom treatment:

Myolysis ■ Myolysis predisposes secondary renal

failure and hyperkalaemia ■ Anticoagulant coagulopathy (prolonged

bleeding time with a normal fibrinogen and no FDPs) ■ Paralysis is of little clinical significance ■ One vial of antivenom is usually sufficient

Tiger snake venom: Paralysis (presynaptic paralysis) Myolysis Defibrination coagulopathy (pro coagulant effects) ■ Most tiger snake bites result in systemic

envenomation ■ The paralysis appears to affect the

head (ocular, facial and glossopharyngeal muscles) before the respiratory muscles ■ Presynaptic paralysis is NOT reversed by antivenom so early treatment (before onset of major paralysis) is indicated ■ Myolysis predisposes secondary renal failure and hyperkalaemia ■ Defibrination coagulopathy may spontaneously resolve (15-18 hours after envenomation)

Anti-venom

Applicable snake species

Brown snake

All species from the Pseudonaja genus: Western brown snake, common brown snake, peninsula brown snake, Ingram’s brown snake, speckled brown snake, dugite.

Black snake

All species from the Pseudechis genus: Mulga snake, spotted black snake, Collett’s snake, Butler’s snake, red-bellied black snake, Papuan black snake.

Tiger snake

All species of the Notechis genus: common tiger snake, western tiger snake, peninsula tiger snake, Krefft’s tiger snake, Tasmanian and King Island tiger snake, Chapel Island tiger snake Some species of black snakes*: Red-bellied black snake, Collett’s snake, spotted black snake Some copperheads (Austrelaps species): Lowland copperhead, highland copperhead, pygmy copperhead Some broad headed snakes (Hoplocephalus species): Stephen’s banded snake, broad-headed snake, pale-headed snake) Rough-scaled snake Maybe of some value in treating sea snake envenomation

Death Adder

All species from the Acanthophis genus: Common death adder, northern death adder, desert death adder

Taipan

All species from the Oxyuranus genus: Irian Jaya taipan, coastal taipan, inland taipan, Papuan taipan

Polyvalent

All Australia’s dangerous snakes

FEBRUARY 2024

TheVeterinarian 27

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Animal emergency centre Kedron has reopened The Animal Emergency Centre (AEC) Kedron is excited to announce it has reopened its doors after a two-year hiatus. Part of the Animal Referral & Emergency Network (AREN), AEC Kedron is one of 23 specialty and emergency sites located across Australia and one of six locations in Queensland.

Led by Taylor Argent BVSc (Hons), who brings six years of emergency experience to the team, previously working as a Clinical Coordinator in Canberra before joining AEC Kedron. Dr Argent's team provides dedicated emergency and critical care to the pets of Kedron alongside the surrounding general practices.

“I'm extremely excited to be leading the team at AEC Kedron,” Argent said. “The opportunity to offer our patients gold standard care, perform many diagnostics in-house and provide an exceptional experience to our patients and clients,” “Being part of the Animal Referral & Emergency Network (AREN) and Greencross Pet Wellness Company means I can draw on some of the best practice techniques that our sister sites have developed without the need for many trials and tribulations,” “I am looking forward to sharing my experience and learning from my peers across the AREN network, collaborating to help create a positive workplace culture that, in-turn enhances the delivery of exceptional patient care.”

AEC Kedron will be open 24 hours on weekends and public holidays. Monday, Thursday and Friday it will be open from 5pm–8am with the intention to be open seven days in the coming months.

AEC Kedron's highly trained and dedicated team of vets and nurses provide a range of emergency and critical care services including: ■ Stabilisation and monitoring of critical patients ■ Surgery ■ X-ray

L to R - Taylor Argent, Kelly Hodge, Emily Walchshofer, Britney Gwynne ■ ■ ■ ■

Ultrasound In-house pathology and diagnostics Intensive care and hospitalisation Endoscopy (coming soon).

Equipped with state-of-the-art facilities, AEC Kedron is prepared to handle a wide range of pet emergencies from trauma and toxic exposures through to severe medical/endocrine disorders and surgical interventions.

Free liver health webinar PureANIMAL will be hosting their first FREE webinar on Dysfunction, detox and dysbiosis: an integrative approach to liver health. Don’t miss the opportunity to join Nicole Rous and Matthew Muir in this fireside chat on how to improve liver health in this thought-provoking webinar.

“We understand emergencies can happen at any time. It's our aim to be there for our clients and our patients when they need us the most,” Argent said.

Located within the same building as Petbarn, AEC Kedron is only a few blocks from Chermside Shopping Centre.

For further information visit www.emergencyvet. com.au/our-network/aec-home/aec-kedron.html

The webinar will be on February 29 at 7pm AEDST. If you are unable to attend, don’t worry, the webinar will be available on demand, but you still need to register.

Learn more about the presenters Nicole Rous BVSc (Hons), BS (Hons) MANZCVS (Anim.Reprod.) www.shytiger.com.au Nicole Rous holds a Bachelor of Science (Honours), a Bachelor of Veterinary Science (Honours) and gained her Membership with the Australian and New Zealand College of Veterinary Scientists in Animal Reproduction. In 2020 she started her own business, Shy Tiger, which provides all-natural plant-based health support for dogs. Nicole also works at and owns Mont Albert Veterinary Surgery and is a member of the College of Integrative Veterinary Therapies.

Matthew Muir BVSc BVetBiol (Hons) MRCVS www.allnaturalvetcare.com Matthew Muir obtained a degree in Veterinary Science and Veterinary Biology (Honours) from Charles Sturt University. He is the clinical director at All Natural Vet Care, a holistic and integrative veterinary clinic in Sydney's Inner West and he is also the co-founder of Lyka Pet Food, a subscription which provides balanced fresh meals for dogs.

Want a sneak peek? Visit vimeo.com/902811798/f0c24fad85 Want to register? Visit my.demio.com/ref/80rRbTdG8AKd7BjT Correction - In the December 2023 issue of The Veterinarian, the story ‘A Day in the Life of Andrew Breed’ listed the acronym for bovine spongiform encephalopathy as BCE rather than BSE. We apologise for the error.

■ www.theveterinarian.com.au

FEBRUARY 2024

TheVeterinarian 29

News

Speedier medicine review is expected for Australia and UK From page 1

“The guidance supports the APVMA and VMD’s shared aim of expanding access to treatment options for animals and helping food producers stay competitive globally.

The legislative and regulatory frameworks and technical guidelines of both countries will remain in place.

Vigilance is urged, especially during wet weather when bacteria can multiply.

Anthrax can affect humans handling infected animals, so precautions are advised.

Prompt reporting of unexplained livestock deaths is crucial. For further information or to report suspicions, contact Emergency Animal Disease Watch Hotline on 1800 675 888.

Millions of pets can’t be wrong!

From page 3

Pet owners mainly relied on the internet for information to help look after their pet, including search engines (69 per cent) and online forums (33 per cent), as well as advice from veterinary clinics and hospitals (44 per cent).

The Acting Minister for Agriculture Harriet Shing said the census highlighted the importance of pets to their owners.

“The immense love and

care Victorians have for our pets is reflected in the numerous responses to our first Pet Census, highlighting the vital role pets play in the lives of Victorians,” Shing said.

“The Census data will empower us to better cater to a diverse range of pet owners in our community, ensuring quality support and services for every pet, regardless of species.”

■ JULIA GARDINER

PO Box 6130 West Gosford NSW 2250 Tel: 0432 575 877 Publisher - James Martin Email: james.martin@vetmag.com.au From page 3

These results indicate a detectable reduction to general health as a result of PFAS exposure, and possible evidence for diseases although more research is needed to verify this, and to understand the pathways of exposure and possible point sources of PFAS pollution around Tasmania,” Wells said.

The chemicals pose a real risk to biological life, especially to marine predators like seabirds, seals and dolphins. They are also a risk for human health through the consumption of seafood exposed to PFAS. With the increase in coastal urbanisation and thus further encroachment on wildlife habitats, there is a greater need for more ecotoxicology studies, both to understand the impact of human activities on vulnerable wildlife populations, and more informed management decisions can be made for their protection.

“The persistent nature of these pollutants makes it critical that we focus our efforts on eliminating them from our environment,” Wells said.

The study was carried out in collaboration with ADE Consulting Group and the National Measurement Institute. It was supported with funding from the Australian Academy of Science, the Ecological Society of Australia, the Wildlife Disease Association of Australasia and the Australasian Seabird Group.

Victoria pledges $230,000 to wildlife rehabilitation

From page 5

From page 5

■ ANNE LAYTON-BENNETT

Andrea Cormack

Qld floods displace animals, impact breeding season From page 6

The impact of rain on the environment is likely to lead to a spike in the breeding cycle of some animals, with parts of the environment more productive after the rain.

“It supports more insects, which then supports the things eating insects, which then supports snakes [and] predatory birds,” Christina Zdenek, from the University of Queensland, said.

Stagnant water after a 30 TheVeterinarian FEBRUARY 2024

flood also provides an ideal breeding ground for mosquitos, which increases the risk of mosquito-borne diseases, including Ross River and Barmah Forest viruses. Pets can also be impacted, with heartworm disease spread through mosquito bites.

Queensland Health recommends covering entrances to the home with insect screens and draining any areas where water has accumulated.

■ JULIA GARDINER

Editorial Advisory Board Thomas Donnelly BVSc DipVP DipACLAM Nicholas Kannegieter BVSc DipVetClinStud PhD FACVSc David Lidbetter BVSc MVS FACVSc DipECVS Dip ACVS Angus Martin BVSc Mary Porter BVSc (Hons) MACVSc Jeffrey Smith BVSc FACVSc Dip ACVO David Vella BSc BVSc (Hons) DABVP Designer - Anne Norrell Email: annenorrelldesign@gmail.com To have your say, email editor@vetmag.com.au Printed by Newstyle Printing 41 Manchester St, Mile End SA 5031 Post Print Approved PP255003/06488 All material in The Veterinarian is subject to copyright and must not be reproduced wholly or in part without the written permission of the Editor.

Views expressed in The Veterinarian are not necessarily those of The Veterinarian or Sydney Magazine Publishers Pty Ltd. Subscriptions - Clem Martin Tel: 02 9487 6627 Email: clem.martin@vetmag.com.au

■ ANNE LAYTON-BENNETT

Seals fussy about their food Although there is now a solid foundation of evidence about how the individual diets of male southern elephant seals can vary, Cormack said increasing the sample size to include groups of seals from other colonies from around the Southern Ocean could help improve a greater understanding of the species’ dietary specialisation.

“It would be great to do more longitudinal-type studies to continue building our knowledge of male southern elephant seal specialisation and its impacts,” she said.

TheVeterinarian Sydney Magazine Publishers Pty Ltd ACN 102752787 ISSN 1447-9768

Picture Jaslyn Allnutt

■ JULIA GARDINER

Anthrax outbreak confirmed on cattle property From page 1

‘Forever’ chemicals widespread in Tasmanian environment

The Minister for Environment, Steve Dimopoulos acknowledged the importance of the grants to the wildlife rescue sector.

“Victoria’s wildlife shelters and foster carers do such important work to help rehabilitate injured and orphaned native animals so that they can be released back into the wild,” Dimopoulos said.

“These grants are about supporting and recognising our dedicated volunteers who

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selflessly give their time and expertise to help sick, injured and orphaned wildlife.

New Zealand $105 (AUD) 1 Year $160 (AUD) 2 Years $210 (AUD) 3 Years USA/Canada (airmail) $135 UK/Europe (airmail) $135 .

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■ JULIA GARDINER

Upping the ante on illegal wildlife trafficking From page 7

As the hand-held scanner technology develops it is hoped the exact location where wild-caught lizards are taken from can be pinpointed so they can be returned to their homes.

“We’re determined to better protect our precious native plants and animals so they can be enjoyed by our kids and grandkids. This is just one part of doing this, on top of the $500 million the government is investing in projects to protect native species and tackle invasive pests,” Plibersek said.

Picture Conrad Hoskin

■ ANNE LAYTON-BENNETT ■ www.theveterinarian.com.au

Great crested grebe (Podiceps cristatus) Describe by Carl Linnaeus in 1758 as Colymbus cristatus, this water bird is now of the type species of the genus Podiceps, erected by the English naturalist John Latham in 1787. The birds are characterised by their distinctive black and white plumage, and their elaborately synchronised courtship dances . Picture Wikipedia

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