The Veterinarian Magazine November 2022

TheVeterinarian

Hip-hop inspires Indigenous communities on animal health

Lions’ escape prompts zoo review

The escape of five lions escape through a six-foot fence at Taronga Zoo is the subject of an ongoing internal review, the Sydney facility said.

The incident took place on the morning of November 1, and veterinarians and keepers report that all lions are doing well.

Patrons present at the zoo as part of the ‘Roar and Snore’ package (which included an overnight stay) were evacuated to safe zones.

Engineering advice established that clamps that join wire cables failed, creating a gap in the fence that the lions passed through.

In a prepared statement, the zoo added the failure enabled a “lacing cable which connects the fence mesh to a tension cable to unravel.”

The spokesperson said the preliminary review recommended the engagement of an independent tensile-structure engineer to provide advice on the failure and repair.

Animal Management in Rural and Remote Indigenous Communities (AMRRIC) is utilising the storytelling power of hip hop music to inspire Indigenous communities about animal health with the launch of the Dog Mob Cat Crew educational music video.

Featuring the deadly talents of local children from the remote Indigenous community of Finke (Aputula) - a place of dog dreaming, the Dog Mob Cat Crew hip-hop music video promotes responsible pet ownership to highlight how this leads to strong animals, strong health, and strong communities.

Creating the video was based on community centred creative practice which represents the intersection of collaboration, innovation, community, and culture.

AMRRIC enlisted the skills of award-winning music video producer Dion Brownfield from Grand

“The Dog Mob Cat Crew music video is super special because it was driven by the community and showcases the beautiful and incredibly talented Finke mob, and their language and sacred country. You can literally feel the excitement and the energy through the performance,” Brownfield said.

“Dogs are special, and they are important part of families and communities. They need love, care, shelter, food, and water. Dogs, like people, need to be cared for when they are sick or injured. We hope this video will remind communities to be responsible pet owners because healthy animals mean healthy communities.”

Grand Trine Creative visited the Finke (Aputula) community and were hosted by Finke School, To page 30

Abducted vet released in Chad

A French-Australian veterinarian who was taken hostage in the north central African nation of Chad has been freed.

Jerome Hugonot was reportedly abducted at gunpoint on October 28 while working for the Sahara Conservation Fund (SCF), according to a spokesperson for Chad's government.

A joint operation by Chadian and French security forces secured Hugonot’s release on October 30, which was announced on the Twitter account of Chad’s interim president, Mahamat Idriss Deby.

“I am delighted with this happy ending,” Deby said. The French foreign ministry also announced Hugonot’s release in a statement.

Hugonot was released in Tibetsi in an area

bordering Libya and Niger, AFP reports.

The SCF issued a statement which advised that Hugonot was healthy and safe.

“SaharaConservation would like to thank all those who participated in the release process and in particular the Chadian and French Authorities who mobilised massively to free him,” the statement said.

The SCF works to conserve the wildlife of the Sahara and bordering Sahelian grasslands “together with the diverse landscapes required for [the] survival of the region’s embattled fauna and flora”, the organisation’s website states.

The demands of the abductors are unclear.

■ SAM WORRAD

“The ongoing review also found that while inside their exhibit, the lions played and interacted with the fence for approximately 20 minutes before four cubs, and, later, adult male Ato, were able to breach it,” the zoo statement said.

“Lioness Maya and one cub chose to remain in the exhibit.”

According to the zoo, Maya and the cub who chose to remain in the exhibit were called back into their dens by keepers, and the emergency response including staff in multiple vehicles was established to monitor and control the escape.

“The four other cubs and adult male lion appeared to remain calm and investigated the other side of the main containment fence, remaining within metres of their exhibit, before actively trying to find their way back under the fence,” the statement said.

The zoo said two of the cubs explored beyond a secondary fence within the zoo, one cub made its own way back into the exhibit, and the final cub was tranquilised and returned to the dens.

The lions will remain in an outdoor, back-of-house holding area pending specialist advice.

■ SAM WORRAD

Trine Creative who works with well-known Indigenous hip-hop artists including Baker Boy and Dallas Woods.

Picture Taronga Zoo

Finke school students take a break during a big day of music video filming

Call out for citizens scientists: where did all the Christmas beetles go?

Every summer, after waiting underground all year, Christmas beetles emerge at around – you guessed it – Christmas time. And every year, also around Christmas time, Tanya Latty, a Research and Teaching Fellow in Entomology in the University of Sydney’s School of Life and Environmental Sciences, gets asked the same question: Where did all the Christmas beetles go?

“It’s a funny question, because we can’t answer it,” Latty said. “We don’t even really know if the Christmas beetles are gone, which sounds really strange. But as scientists, what we really need is data.” As a result, Latty and her collaborators are requesting the help of citizen scientists to report sightings of Christmas beetles to see if the as-yet unsubstantiated reports of their declining numbers are accurate.

“People seem to remember Christmas Beetles being in really high numbers when they were kids, often in the 1980s and before, but I’ve been inAustralia for fifteen years now and I don’t think I’ve ever seen large amounts of Christmas Beetles,” Latty said. “We have a strong feeling that something has happened, and we’re working with Chris Reid, the Principal Research Scientist in Entomology and Arachnology at the Australian Museum, who is Australia’s expert on Christmas beetles, and he also thinks they’ve gone down in numbers, but we don’t have the data. Without the data, there’slittle we can do.”

The Christmas Beetle Project is a joint initiative ofthe University of Sydney and Invertebrates Australia, a new conservation foundation aimed at giving invertebrates – which constitute more than 90 per cent of animal life – a conservation voice. Participants sign up to the program online (please see the link below) and download a free app called iNaturalist which enables them to photograph Christmas beetles and report their discoveries.

“There are actually 35 species of Christmas beetle in Australia,” Latty explained. “It’s possible that some species are declining and others are fine, but if we don’t have that information we can’t even say: OK, this is the species that is in trouble; we need to do something.” Fortunately, the iNaturalist app not only enables citizen scientists to report beetle sightings, but it is also attempts to identify the species that has been photographed. The app employs a machine

Even more importantly, because the photos citizen scientists upload have location and time metadata embedded in them, the reported sightings constitute reasonably high quality evidence for the Christmas Beetle Project’s data set. “We can’t do anything about the past – that data wasn’t collected, unfortunately – but we can start tracking now,” Latty said. She and her collaborators are hopeful that by looking at the data that is collected they will be able to determine which of the 35 species appear to be in decline, or whether particular regions have especially high or low numbers of Christmas beetles.

“Once we have the data, we can be much more targeted in our responses. We don’t have the manpower to go and survey all of Australia, but if we can get everyday folks on board, we can hopefully acquire the data set we would never be able to get on our own.” Latty said. “Assuming that we find some species are in lower numbers than we would have expected, the first thing we would do is go to look for them and figure out where they are, and then we can start more targeted research to figure out what they need.”

learning algorithm, which means the more data is collected via iNaturalist, the better the platform is at identifying specific species. “With the Christmas Beetle Project, we go through and check all of the sightings and to make sure things are what we think they are and to ensure people got the identifications correct,” Latty said. “It cuts down our workload, because iNaturalist is pretty good at getting pretty close to the right species, there’s only a few species that they are likely to mix up.”

Even without data, Latty is able to make an educated guess about the main factors likely to be impacting Christmas Beetle numbers. “We know that most species of Christmas Beetle larvae feed on native grass roots, so most likely the big driver of declines would be habitat loss due to things like bushfires, housing developments, and agriculture,” she said. “If that was the case, we could start looking at restoration strategies to see how we could include more native grasses so we have more food for baby Christmas Beetles.”

Insecticides may also be responsible for species decline, particularly since Christmas Beetle larvae are often mistaken from other types of scarab larvae. To page 30

iM3 Vet-Exam Pro

Upgrade Options

• As new x-rays are captured they are automatically saved in the background with no interruption to the user.

• The Surface Quality Check feature scans the image plates for damage and scratches, and recommends when the image plate should be replaced.

• Full DICOM compliance allows easy export of data to remote applications.

• Improved connectivity to the iM3 CR7 Vet or DR7 for seamless workflow.

iM3 Vet Exam Pro now comes as standard with all new iM3 CR7 Vet Dental X-ray Scanner purchases. Upgrades are also available to older users of Vet-Exam Plus and Vet-Exam Intra. Prices vary depending on the age of your CR7 scanner, please contact iM3 directly for more information.

iM3 is thrilled to present iM3 VetExam Pro, the new, fast, simple, reliable and modern veterinary dental x-ray software that pairs perfectly with the iM3 CR7 Vet. Not just an update, but brand-new software, iM3 Vet-Exam Pro has been built for modern operating systems such as Windows 10/11. Capture & viewRange

The integrated capture and viewer allows for immediate comparison between newly acquired x-rays and older images already held in iM3 Vet-Exam Pro.

The newly refined and improved toolbox was designed to be intuitive. Zooming, mirroring, correcting, filtering and annotating, along with the more advanced features of iM3 Vet Exam Pro.

Growth in Gippsland: a regional recipe for success

Gippsland Vet Hospital in Maffra, Victoria is now Australia’s largest regional veterinary clinic. Following amajor extension, Gippsland Vet Hospital has doubled in size and can now offer patients a range of CT, hydrotherapy and physiotherapy services that would rival many metropolitan veterinary hospitals. In the past twelve months, the practice has also welcomed eight new vets, bringing the total veterinary staff at the hospital to fifteen.

Duncan Runciman, Senior Veterinarian at Maffra, is justifiably proud of the burgeoning practice and its staff, particularly as the expansion comes just six months after the opening of the nearby Sale Veterinary Centre which, like Gippsland Vet Hospital, is operated by Apiam Animal Health. Having worked in Maffra for over twenty years, Runciman has witnessed the growth and development of the business firsthand. “We’ve been here for a long time,” he said. “The Maffra vets were well known as a dairy practice, which is why I first went there. It was about 90 per cent dairy and 10 per cent companion animal when I started, and since then we’ve been able to grow our companion animal practice and develop it over the years.”

Pivoting towards servicing companion animals in a regional area has been a large part of Gippsland Vet Hospital’ssuccess, with 70 per cent of their caseload now devoted to companion animal care. “What we’ve found is that regional areas are full of companion animals, and the sector is probably underserviced because regional Australia is full of cow and horse practices,” Runciman said. “There has also been a lot of movement of people

into regional areas, and in this part of Victoria we have seen a lot of retirees move here with their pets. They expect the same level of veterinary medicine and care for their animals as they would for their children.”

The newly expanded Gippsland Vet Hospital not only provides the high-quality services pet owners have come to expect, but Runciman also believes attending their clinic allows for better outcomes for patients in the region.

of the day we became vets because we want that bond and to follow things up with our patients, so if you can see it from start to finish it’s really quite positive for our staff.”

Operating an after-hours clinic –and being able to staff it adequately –is another part of the practice’s success. “A lot of practices can’t sustain an after-hours service, which means more and more people can’t access veterinary services,” Runciman said. “We’ve been able to grow our staff in the past couple

he said. “We offer vets the chance to follow their passion and develop their skills in any area they want to go, and we really want to develop our vets, so they feel rewarded. If they choose to leave us, they leave better than they were when they started with us, and if they stay, they are offering all sorts of services they couldn’t previously.”

Encouraging personal development for veterinarians has the flow on effect of diversifying the types of work available to them. “We offer lots of different kinds of work –cattle work, equine work, plus two small animal clinics – so there’s a great range of things to do,” Runciman said. “We have an equine surgical specialist on board, a canine reproductive specialist in the making, someone with a very keen interest in greyhound medicine and surgery, so as a result ofthat you start needing upskilling in ultrasound and endoscopy and CT and that keeps driving your business forward. We’ve also been able to attract a lot of referrals by developing our medical and surgical services.”

“We still find that some people are happy to travel to Melbourne for veterinary care, but if you take your animal to a specialist centre a fair distance away you want to get your animal home again as soon as possible, and as a result some owners end up bringing their animals home prematurely,” he said. “We offer a local service and the animals can stay and get appropriate postoperative care. That gives you a better relationship with the client and the patient, because you see the whole case through, and at the end

of years and keep the after-hours clinicopen. Traditionally, we keep hearing about how hard it is to attract people to regional and rural Australia, but we’ve been able to grow our numbers and still have people knocking on the door to come and work with us.”

Runciman attributes Gippsland Vet Hospital’s ability to attract and retain new staff to three main factors: culture, personal development, and diversity. “I put our growth primarily down to our culture and our focus on vet development,”

When asked what the best thing is about being a vet in Maffra, Runciman could easily say it’s the newly expanded state of the art hospital he works in, but he returns instead to encouraging the vets he works with. “We don’t want to hold them back,” he said. “We really promote the idea of trying and developing yourself so that people see themselves succeeding in the industry in five years, in ten years, and beyond.” Judging from recent results, it sounds like a recipe for success.

■ JAI HUMEL

Whyalla VeterinaryClinic switches to electric vehicles

It has become obvious over the last few years that internal combustion engine vehicles (ICE cars) that run on petrol and diesel are rapidly becoming obsolete and anew cleaner, more efficient technology is emerging, the Electric Vehicle or EV.

Economics

Cost is a major driving force for change and with the rising cost of fossil fuels (Diesel or Petrol), this leaves us in a precarious position with our ability in Australia to transportpeople and goods.

Currently 90% of Australia’s fuel comes from overseas and the war in Ukraine and cutbacks in Middle East production have shown us that whilst they do not affect usdirectly,the flow on effects in the fuel supply chain do, resulting in higher prices.

We can break out of this cycle.

Australia has the potential to produce enough solar energy to power all our energy needs, and we have the raw materials to build the batteries to store it, to that we can end our reliance of fossil fuels and the high costs associated with them. All that is lacking

is the planning and political will.

ICE cars also requirefar more maintenance than EV’s, so their service costs are much higher and with many times more moving parts, the life span of an ICE car is a lot less than an EV. In addition, ICE vehicles are about to become stranded assets, where they will be prematurely written off with a substantial financial loss to the owners. It makes sense to reduce our transport costs now and change our vehicles to EV’s.

Pollution and pets

ICE cars use a lot of toxic chemicals that can be detrimental to our pets. Petroleum can cause skin irritation and poisoning if ingested. Radiator fluid containing ethylene glycol is attractive to dogs and if ingested causes kidney failure.

ICE vehicle exhaust gas emissions contain acocktail of toxins that arepoisonous to our pets and the environment we live in

■ Carbon dioxide (CO2) is a potent greenhouse gas leading to climate change.

■ Nitrogen oxides (NO2) is released from burning fuels and contributes to smog.

Carbon Monoxide (CO) is highly toxic to animals.

■ Sulfur dioxide (SO2) forms corrosive acids.

■ Hydrocarbons (HC) from fuel.

■ Benzene(C6H6) from unburnt fuel causes cancer.

■ Particulates: Soot from exhaust damages lungs.

Even worse for Australia, the lack of emissions standards will lead to automotive manufacturers dumping polluting vehicles in Australia, that they can’t sell in other countries because of their higher emissions standards.

The time is right to protect our patients and our environment by switching to zero emission electric vehicles. It has been an interesting journey away from our traditional vehicle suppliers, Toyota, and Honda, who no longer make products relevant to our transportneeds to the new electric vehicle manufacturers, Tesla and BYD.

Andrew Melville-Smith, Whyalla Veterinary Clinic, Whyalla, SA.

PROVEN RESULTS FOR OVER 1 MILLION PATIENTS

Discover the most innovative therapeutic device for every creature, great or small. Companion® offers a fast, drug-free, non-surgical and non-invasive pain relief solution for your patients across acute to chronic injuries, wounds and arthritis.

Companion® therapy lasers are designed to provide you with the right dose of laser energy for every condition, every patient, every time.

Protocols are built on years of clinical research to provide you with confidence and consistency.

CTS-DUO

0.5 - 25 Watts

Companion’s premium therapy laser

• Patient tracker

• Intuitive interface

• Perfect Protocol™

• SmartCoat® technology

• Species-specific protocols

• Enhanced treatment protocols

• Built-in videos

CTX-IQ

0.5 - 15 Watts

Companion’s flagship therapy laser

• Patient tracker

• Intuitive interface

• Perfect Protocol™

• SmartCoat® technology

• Species-specific protocols

• Built-in videos

• Battery operation

CTX

0.5 - 15 Watts

Superior outcomes, affordable entry point

• Intuitive interface

• Perfect Protocol™

• SmartCoat® technology

• Species-specific protocols

• Built-in videos

• Battery operation

DISCOVER

Visit the Companion® Discovery Hub to access clinical information, videos and educational webinars.

Successful Symposium returns

After a three-year absence due to the pandemic, the return of Australia’s largest event of its kind, the Greencross National Clinical Symposium has concluded.

The annual event, previously only open to Greencross Vets and staff, but now open to all industry professionals, attracted more than 1000 attendees with thousands more participating remotey.

Held at the Novotel Twin Waters and Sunshine Coast Convention Centre, on October 22–23, the event provided industry-leading education opportunities for vets, nurses, practice managers and veterinary leaders, a chance to form new working relationships, gain Continued

Education CE points and to engage with a range of suppliers and sponsors.

Significantly, the event allowed veterinary professionals the chance to meet up for the first time in three years, and balance incredible learning and education with a dose of networking, socialising, and fun.

“There’s so many fantastic sessions with so many people you can talk to and I think Greencross Vets is making such a difference,” Natasha Wilks, who presented on the importance of positive leadership in practice, said.

“One of the great things about symposium is that you can get such a large number of people together in the same place and communicate somuch more effectively having this event and because the network is so big, particularly at emergency clinics around the country, it’s a great way of getting this information out there really quickly,” neurologist and speaker Sam Long said.

Vision Australia’s Rolf Geerling, who attended as a partner of the Petbarn Foundation, the Greencross Pet Wellness Company’s inhouse charity, described his experience with the Greencross Vets Program when his seeing-eye-dog required veterinary care. “They’ve been there every step of the way, with encouragement when things aren’tgoing well. I can’t thank them enough. They are my family. They are my heroes.”

Support animals: what’s in a name?

For many people today animals play a much more important role than as a much-loved companion. Many provide crucial emotional and physical support for people as assistance or therapy animals, but the terminology used to define their importance in this capacity is confusing, and the variations in definitions used to describe their role can also have legal implications internationally.

A study published recently in the journal Animals examined the roles and training support animals received before differences were defined and standardised titles created that could be adopted in many of the world’s regions.

Lead author Tiffani Howell, a researcher at La Trobe University’s School of Psychology and Public Health, said that inconsistent titles had created confusion with most people unable to distinguish the difference between an assistance animal, therapy animal or emotional support animal because people used these terms differently.

“It’s important to have clearly defined terms because there can be legal implications in some cases. Some animals working in support roles have ‘public access’, which means their handler can take them toplaces that are typically offlimits to animals. But not all animals in support roles have these access rights so it’simportant to beable to quickly and easily distinguish which animals can, for example, enter a café with

their owner, and which ones can’t,” she said.

The collaborative study involved over 100 researchers, practitioners, and end users of animal-based supports from across the world. The team created working definitions for nine terms: assistance animal; companion animal; educational/school support animal; emotional support animal; facility animal; service animal; skilled companion animal; therapy animal and visiting/visitation animal –ultimately recommending phasing out the terms “skilled companion animal” and “service animal” given their similarity to other terms.

The given title can also affect funding as some government organisations provide financial support for certain types of working animals, but not for others, yet with animal-support roles evolving so quickly Howell said an update on the terminology being used, one that included an international focus, was necessaryfor industry, researchers, and the beneficiaries of this type of animal support.

“The types of work that animals can do to benefit humans are growing so quickly it can be difficult to keep pace with what’s happening on the ground,” Howell said, adding that further research was warranted to investigate the implications of the proposed definitions in different parts of the world.

ANNELAYTON BENNETT

An attendee highlight was a ‘Music Across The Decades’-themed party, featuring live music and food stalls and an array of music artist costumes.

“It’s an honour to be part of such a momentous event, surrounded by some of the brightest and most dedicated veterinary professionals under one roof for the first time since the pandemic,” Michelle Kellaway,Chief Operating Officer of Greencross Vets said. “Our teams around the country were finally able to come together to share knowledge, network and celebrate our profession. To see so many smiling and engaged faces, given the challenges of the past few years, was nothing short of amazing.”

To access 80+ lectures on demand, 10 live webinars, multiple Q&A sessions, and a virtual exhibition, visit 2022.greencrossvets-symposium.com.

Angela Frimberger:

This is the message veterinarian and climate change advocate Angela Frimberger wants to communicate to pet owners and veterinary professionals across Australia – and to Australians generally. As a founding Board member and current Deputy Chair of Vets for Climate Action, founder of Climate Vets and current Chair and Treasurer of Energy Forever Inc, Frimberger not only practices what she preaches, but encourages others to do the same.

Having witnessed the acceleration of climate change and impact of environmental problems such as habitat destruction and rapidly accumulating plastic waste, Frimberger spends much of her time advocating for sustainable environmental change within the veterinary profession. “I’ve realised the best thing I can do as a vet for the health and welfare of all animals is to work towards mitigation of problems caused by climate change,” Frimberger said. “Most of my work now is volunteering in these three organisations.”

Energy Forever Inc is based in her local area, the Port Macquarie-Hastings region of NSW (Birpai Country), Vets for Climate Action is an Australian organisation, and Climate Vets –being a blog and network of animal health professionals concerned about climate change – has global reach.

Having grown up in the north-eastern United States, in the “apple orchards and snowfields” region of central Connecticut (as opposed to the “posh suburbs of New York City” part),

Frimberger’s connection with the natural world was forged early and easily. She was raised on a small hobby farm beside a lake, with a strip of forest going up the local mountain. With the benefit of hindsight, Frimberger now recognises her upbringing was “downright magical” but, like most children, she simply saw it as normal at the time. “I had the freedom to range around through woods and fields alone or on my horse, westerntrail riding or just bareback,” she said.

“In the winter, when we went outside to play, we basically lived on ice skates or headed up to the local ski slopes. And in summer,it was either water skiing, canoeing, hanging out on the farm or wandering around in the forest, communing with the animals, plants and fungi.”

Similarly, Frimberger’s decision to become a veterinarian was also easy. “I can’t remember seriously entertaining any other option than being avet,” she said. “It wasn’t a decision as such, just the natural progression of who I was. Being a vet is the centrepoint of my passion for animals and the natural world, and my love of science.” In the United States, a bachelor’s degree in another field of study is required prior to entering veterinary school, so Frimberger made another “obvious choice” and opted to attain a Bachelor of Science in Biology at the University of Connecticut before completing four years of veterinary school at the University of Pennsylvania.

The variety of different types of work available to vets appealed to Frimberger, who was keen to pursue a career that offered her flexibility.

Not surprisingly,her favourite subject as an undergraduate was comparative anatomy. “The comparative aspect teaches us so much about the paths of evolution and the connections between different groups of creatures,” she said. “It illustrates the web of life, which I find endlessly fascinating.”

Frimberger also made sure she took advantage of opportunities that lay beyond what she had already experienced, such as participating in a summer program in aquatic animal medicine called Aquavet while at the University of Pennsylvania. “That experience was a highlight for me, and greatly increased my appreciation for natural ecosystems and the animals that live there, and my concernabout human impacts on them,” she said. Once she had graduated and began working in general practice, Frimberger continued

aveterinary voice for climate change

her association with marine animals, volunteering atMystic Marinelife Aquarium (in the same town of Mystic featured in the 1998 film Mystic Pizza)on her days off.

While Frimberger loved the patients and clients she encountered working in general practice and enjoyed learning more about the practical side of being a veterinarian, the cases which resonated with her most strongly were those involving patients with cancer. As a result, she decided to pursue further study in the field, and was fortunate to gain acceptance into an oncology residency program at Tufts University in Massachusetts. “The aspects of oncology that attracted me most were (and still are) the fascinating biology, which I’d started studying during my undergraduate years, the intricacy and intellectual challenge of the clinical work, and the sense of working against the odds,” she said. “Best of all, however,are the close, long-term relationships you build with the clients and patients.”

AtTufts, Frimberger made many connections inthe oncology department and also built a number of other long-term relationships, most notably with her futurehusband and business partner, Tony Moore, and with her mentor, Dr Susan Cotter, who she described as “ pioneer in veterinaryoncology and virology, and a quiet trailblazer for women in our profession.”

Both of these people encouraged her to pursue further studies after her oncology residency, and Frimberger chose to follow a comparative medicine path to the Massachusetts Cancer Center,where she undertook a fellowship in bone marrow biology and transplantation under the mentorship of Dr Peter Quesenberry. “As partof my work there, we developed a submyeloablative bone marrow transplantation

Thomas in 2021. The practice afforded Frimberger the opportunity to experience “the empathy for and attachment to our animal patients and their people”, which she described as being both the most enjoyable and the most challenging aspects of being a veterinarian, or two sides of the same coin. “The richest rewards come when that dog who was so scared on his first visit comes bouncing in for his regular chemo treatment and gives you a big smile, or when a family thanks you for giving their Princess back her joy in life,” she said. “But the same attachment brings vets our biggest challenges. People often think that oncology must be emotionally difficult because our patients die, and it is hard sometimes, but oncology is usually incredibly emotionally rewarding.” Frimberger pointed out that veterinary oncologists can extend the survival of and sometimes even curepatients, but even when such outcomes are not possible, they are still able to provide benefits to patients by improving the animal’squality of life or by making the end of their life easier.“The challenge for all vets is that because of our emotional attachment to our patients we tend to over-empathise and end up giving too much of ourselves –occasionally at the expense of our own health,” she said. “As a profession, we need to get much better at valuing and caring for the carers –sometimes including ourselves.”

During the time she was running Veterinary Oncology Consultants, Frimberger became increasingly concerned about climate change and other environmental impacts. “I think that climate change is the most pressing environmental threat currently, because it’s the most all-encompassing,”

In 2014, Frimberger was trained as a Climate Reality Leader by the Climate Reality Project and the Australian Conservation Foundation and started becoming more active in climate advocacy and education. Two years later, she joined Energy Forever Inc and founded Climate Vets, and in 2019 she was delighted to be involved when Dr Jeannet Kessels founded Vets for Climate Action. Frimberger’s involvement with all three organisations enables her to call for action on climate change at local, national and international levels, and to network with similarly concerned groups and individuals around the world.

protocol for dogs with lymphoma, that was offered clinically through the oncology clinic at Tufts,” Frimberger said. “We eventually published improved outcomes for dogs with lymphoma, without the toxicity that had plagued other transplant attempts in dogs.”

In 2003, Frimberger and her husband made the decision to relocate to Australia, where they founded and ran Veterinary Oncology Consultants in Lake Innes NSW (Birpai Country). They operated the practice for 18 years, offering specialist oncology support to patients of veterinarians around the country and overseas, before handing over the reins to Dr Penny

she said. “Climate change is caused by the emission of greenhouse gases such as carbon dioxide, methane and others, which trap excess heat energy in the earth’s atmosphere instead of letting it escape into space. We are already seeing the impacts of this extra heat on animals –companion, sporting, livestock and wild – as well as on people and infrastructure, in the form of terrestrial and underwater heat waves and morecommon and severe events such as droughts, floods and fires. But we are still not seeing enough response to help prevent it getting worse by reducing emission of greenhouse gases.”

“Energy Forever is a Port Macquarie-Hastings community owned renewable energy project,” Frimberger said. “Weraise funds through donations, sponsorships and grants to purchase solar energy systems for the roofs of other community organisations in our area, and we channel the proceeds from the clean electricity into other sustainability projects in the community.” Recent recipients of energy systems provided by Energy Forever include the St Agnes Early Education Centre in Port Macquarie and the Birpai Local Aboriginal Land Council. Energy Forever Inc also encourages local organisations to apply for their grants program, which are aimed at providing sustainable alternatives or upgrades, education and equipment to support awide variety of stakeholders in their community. For example, grants might be approved to supply energy efficient lighting for a sports field, to provide training to low-income households in energy efficiency, to obtain tools for a furniture recycling workshop or Men’s Shed, or to support locally grown food initiatives.

Vets for Climate Action is a national organisation aimed at supporting veterinarians, vet nurses, animal care professionals and animal lovers to act on climate change. “The veterinary profession uses a lot of energy and chemicals

“If you love an animal, climate change is an issue for you.”

and generates a lot of waste, and while many vet teams want to become more environmentally sustainable, it can be difficult to prioritise when there are so many other challenges,” Frimberger said. “We know veterinary staff are overworked, and we want to make it easy and fun for vets to make a positive impact on climate through providing resources, support and connections across our profession.” Now boasting over 1,500 members, Vets for Climate Action helps veterinary professionals to reduce emissions within their own sector by updating work practices to eliminate pollution, to educate those around them (including suppliers, clients and local communities) about the impacts of climate change on the planet generally and on animals specifically, and to work with industryand governments at all levels on behalf of animals to advocate for climate-friendly policies, particularly in the areas of animal health, welfare and production.

Early in 2023, Vets for Climate Action is launching its Climate Care Program, a new CPD program designed to empower busy vet teams take the lead on environmental sustainability in realistic and workable ways. “The program supports participants to become 'Climate Champions' who work with their team to implement changes that improve environmental sustainability,” Frimberger said. “They learn about key aspects of sustainability in veterinary practice, and how improving in these areas helps conserve precious natural resources, reduce pollution and – most pressingly – mitigate climate change.It involves an introductory module and six content based modules, addressing topics including water, waste, energy, drugs and chemicals, and procurement.” A pilot round involving 21 clinics across the country recently concluded,with results currently being collected and evaluated, with some “really encouraging preliminary outcomes”. Veterinary practices wishing to get involved in the Climate Care Program when it launches in 2023 can access more information and register their interest at www.vfca.org.au/climatecare. The program is open to participants around Australia.

Aside from joining Vets for Climate Action orparticipating in the Climate Care Program, Frimberger says there are plenty of options for veterinary professionals to become more involved in living and working more sustainably, such as joining industry specific Facebook groups such as Veterinarians Concerned About Climate Science Denial, The Sustainable Vet Nurse and Sustainability Advocacy in Veterinary Education. “There is so much going on and I’m so inspired and encouraged that we can work on this important problem within our wonderful veterinary profession,” she said. “At the end of 2020, the World Veterinary Association released aposition statement on what it describes as the Global Climate Change Emergency. Over the last two years, the Australian Veterinary Association has worked with Vets for Climate Action to greatly increase the sustainability content in its CPD streams, and vets can access

agreat deal of information there. In the UK, VetSustain is a fantastic organisation to help veterinary professionals be a leading force for sustainability, and other organisations are starting to form around the world.”

On the international front, Frimberger herself has been blogging about climate action and creating a network of veterinary professionals at Climate Vets (www.climatevets.net) since 2016. “It’s a point of connection for vets all over the world to be in touch with each other on the subject of climate change,” she said. “It was easy for me to find ways – like Energy Forever – to be active on climate in mylocal community, but I really wanted to do something specifically involving and mobilising the veterinary profession to create change.” Frimberger blogs about all manner of climate connected topics, such as animal extinctions and the impact of bushfires and other extreme weather events brought about by climate change, and links veterinaryprofessionals to webinars and other content they may find useful when advocating for change. “Adaptation and resilience have become more prominent in public discourse, but we should still be doing much more – everything possible – to mitigate

the amount and source of electricity for heating or cooling the areas where the pet lives, and the climate impact of their grooming and veterinary care.”

climate change,” Frimberger said. “Adaptation mostly centres around the needs of humans, and doesn’t generally solve the problem for animals, especially large wild ecosystems such as coral reefs.”

Frimberger is also keen to communicate the importance of mitigating climate change to pet owners, and encourages veterinarians and vet nurses to do the same. “To help reduce the severity of climate change in the coming years, pet owners can take some steps to reduce the climate impact of their pet,” she said. The main considerations she cites for pet owners to be aware of revolve around what their pet eats, how big it is, and whether it is adapted to the prevailing weather where it lives. “Most analyses point to food as being the biggest component of the climate impact of pets,” Frimberger said. “This is most pronounced with carnivorous pets, because of the greenhouse gas emissions associated with animal agriculture for meat. Obviously, the bigger an animal is the more food it will eat and the more waste it will produce, so owning a fox terrier is more environmentally friendly than aNewfoundland, but there are many other aspects of pet ownership that can also have significant environmental impacts. These include toys and accessories, waste disposal,

In addition, Frimberger encourages pet owners to choose breeds responsibly – not only for environmental reasons, but also for the pet’s comfort and general health and welfare. “Choosing a species and breed suited to where you live will use less electricity to maintain the pet’s quarters and will also reduce their risk of thermal stress,” she explained. “If you live a hot part of the country, for example, it doesn’t make sense to choose an arctic breed like a Norwegian elkhound, and conversely if they live in very cold areas an Italian greyhound isn’t likely to be very comfortable.” Frimberger also recommends keeping pets – most specifically cats – indoors to prevent them from hunting native wildlife. “I personally recommend cats should be kept 100% indoors, or with access to an enclosed outdoor exercise area,” she said. “This is safer and healthier for the cat and the human family – reducing the risk of parasites, infections, sunlight-related cancers, and trauma from cars and fighting – as well as better for the wildlife.” More generally, Frimberger highlighted the importance for pet owners, veterinary professionals and the general public to choose their energy sources wisely, particularly given the biggest source of greenhouse gas emissions do not come from animals, but from the production and burning of fossil fuels for electricity,transportation and industry. “The most valuable choices we can make to reduce the climate change problem are to choose 100% green energy and, if possible, to use electric vehicles charged from renewable power sources, and to make climate-friendly financial choices about where we bank and what we invest in,” she said. “Most importantly of all, we need to ask our elected representatives to enact the most climate-positive policies – meaning the strongest, fastest emissions reduction policies possible –to help protect ourselves, pets and all animals from the worst impacts of climate change.”

When asked what the future holds for her, Frimberger reiterated her commitment to encouraging all animal lovers recognise the importance of environmental issues that affect them and their pets. She does appreciate being able to help run her family’s non-veterinary business – an escape room in Port Macquarie –and admitted “it’s great to have something abit more light-hearted going on, and it’s a wonderful creative outlet.” Ultimately, however, Frimberger sees herself continuing to work as an advocate for climate change within the veterinary profession. “I would really love to see the day when we’ve got our pollution under control and we don’t have to work so hard on environmental issues because everyone understands the importance of the problem; and governments, business and industry, and private citizens areall doing the right thing,” she said. “If you love an animal, climate change is an issue for you.”

■ JAI HUMEL

“I think that climate change is the most pressing environmental threat currently, because it’s the most all-encompassing.”

Eagle Post

Artificial Intelligence to read radiographs

Two of the biggest owners of veterinary hospitals in the world have started using artificial intelligence (AI) for reading radiographs. It suggests that the adoption of AI may be approaching a turning point. Mars Inc. owns over 2,500 veterinary practices worldwide and employs AI to interpret radiographs atabout 60 hospitals and clinics. The AI was developed in-house by Antech and is being trialed in European practices and North America. IVC Evidensia, which owns over 2,300 hospitals in Europe and Canada, ended testing an AI product developed by the American company SignalPET. The product is already present in many of Evidensia's Canadian practices, and aUK rollout is expected to be complete in one year and in Europe in two years.

The software tools use AI to read

radiographs and provide an interpretation (not a diagnosis) in minutes. Veterinarians enter the program by signing into a website and paying about $10 for an interpretation. Other companies offering the technology to veterinarians include the California-based Vetology (vetology.ai) and MetronMind (www.metronmind.com).

AIis used to clarify radiographs in human medicine, primarily at academic institutions. However, it is not common in hospitals because there are stricter regulatoryhurdles than in veterinary medicine. Autonomous radiology devices are much debated. The Radiological Society of North America and The American College of Radiology published a joint letter in 2020 after aFood and Drug Administration (FDA) workshop on artificial intelligence in medical imaging, saying

that autonomous AI was not ready for clinical use. Up to now, they said, AI programs were unreliable and often did not work as well on groups of patients not in the original environments in which they were built. However, one product has been released for autonomous use in humans: an AI tool called ChestLink developed by Oxipit ( https://www.pr.com/pressrelease/858165 ) for studying chest radiographs was approved by European regulators in March 2022. Despite concerns by MD radiologists, adoption appears to be occurring rapidly with veterinarians. That rise has been fueled by alack of veterinary radiology specialists, particularly in academia. The American College of Veterinary Radiology has recognised the shortage.

AI tools are developed with deep learning -- machine learning methods built on artificial neural networks with representation learning. Deep learning imitates how humans gain certain types of knowledge, which “teaches” the AI to identify abnormalities in radiographs that may indicate disease. It involves supplying the AI with numerous radiographic images. Reviews by radiologists and user feedback refine the process. Mars developed its AI technology with the help of Antech's 123 radiologists. The AI trained on atrove of images stored for twenty years by VCA, the US veterinary business it acquired in 2017. Mars used about twelve million VCA images to prepare the AI.

Veterinarians typically submit radiographs in five to 10 per cent of cases for a radiologist's opinion. By offering general practitioners an inexpensive, quick analytical tool, AI technology could introduce more pet owners to radiology.It potentially could prompt some owners to seek ?specialists in evaluating initial AI-based findings.

Before making SignalPET available, Evidensia trialed it at 22 practices in the UK for up to twelve weeks. Evidensia measured performance indicators such as the product's accuracy,its effect on clinical care, and how pleased veterinarians and pet owners were with its performance. Evidensia's analysis showed 95 per cent accuracy -based on identifying what is normal or abnormal in a radiograph -which pairs with the accuracy level claimed by its developer. The use of SignalPET at trial practices triggered an increase in using other diagnostic tools, such as ultrasound and endoscopy Animal patients

spent less time in hospital, and repeat visits fell, suggesting SignalPET encouraged more targeted care, leading to better clinical outcomes. Veterinarians were impressed: 95 per cent of the practitioners at the 22 trial practices said they approved of the product, while the remaining 5 per cent said they had not used it long enough to be sure.

Manufacturers assert that their claims of accuracy are backed by scientific research. Two recent papers from the Animal Medical Center in NY (doi.org/10.1111/vru.13062) and Tufts Cummings School of Veterinary Medicine In Massachusetts (doi.org/10.1148/ryai.202020 0029) found AI software technology had an accuracy rate of 92 per cent and 89 per cent respectively. The authors of these papers supported using AI software screening to assist with short-term decision-making when a radiologist is unavailable. More publications on AI will appear in the future. The field of machine learning and AI in imaging is rapidly expanding. In 2020, the journal “Radiology: Artificial Intelligence” published a “Checklist for authors and reviewers on artificial intelligence in medical imaging (CLAIM)” (doi.org/10. 1148/ryai.2020200029). This journal started in January 2019, highlighting the emerging applications of AI in diagnostic imaging across multiple disciplines.

Product developers acknowledge the limitations of AI at present. The quality of radiographs shown to the AI from general practitioners may not always be as high as the radiograph quality from specialists. Image quality depends on patient positioning, lighting levels, and the presence or absence of impedi ments. AI software can look at a well-positioned, well-taken radiograph and tell whether it is a heart or lung image abnormality, but to make a diagnosis, it must match the clinical signs. The AI does not know, for example, if an animal is vomiting, has diarrhea, or coughing. That is why a veterinarian will still be needed to make a diagnosis.

Radiologists and scientists involved in developing AI to read radi ographs stress that education of the end user is critical. The AI is not a mechanical radiologist but a machine that conducts a diagnostic test. Therefore, veterinarians must understand what it can and cannot do.

Will AI make radiologists redundant? It is doubtful, as listing radiographic findings or detecting abnormalities is one thing but interpreting the findings and their importance is where radiologists are critical.

Thomas Donnelly, BVSc, DipVP, DipACLAM reports from the US.

Claire Adams

Dr Claire Adams

Dr Claire Adams

Dr Henry Jones

Dr Henry Jones

Dr Henry Jones

Dr Claire Adams

Dr Henry Jones

Dr

Jones

Impact of pet dog or cat exposure during childhood on mental illness during adolescence: a cohort study

Background: Inour prior study of 643 children, ages 4-11 years, children with pet dogs had lower anxiety scores than children without pet dogs. This follow-up study examines whether exposure to pet dogs or cats during childhood reduces the risk of adolescent mental health (MH) disorders.

Methods: Using a retrospective cohort study design, we merged our prior study database with electronic medical record (EMR) data to create an analytic database. Common MH diagnoses (anxiety, depression, ADHD) occurring from the time of prior study enrolment to 10/27/21 were identified using ICD-9 and ICD-10 codes. We used proportional hazards regression to compare time to MH diagnoses, between youths with and without pets. From 4/1/20 to 10/27/21, parents and youth in the prior study were interviewed about the amount of time the youth was exposed to a pet and how attached s/he was to the pet. Exposure included having a pet dog at baseline, cumulative exposure to a pet dog or cat during follow-up, and level of pet attachment. The main outcomes were anxiety diagnosis, any MH diagnosis, and MH diagnosis associated with a psychotropic prescription.

Results: EMRreview identified 571 youths with mean age of 14 years (range 11-19), 53 per cent were male, 58 per cent had a pet dog at baseline. During follow-up (mean of 7.8 years), 191 children received aMH diagnosis: 99 were diagnosed with anxiety (52 per cent), 61 with ADHD (32 per cent), 21 with depression (11 per cent), 10 with combined MH diagnoses (5 per cent). After adjusting for significant confounders, having a pet dog at baseline was associated with lower risk of any MH diagnosis (HR = 0.74, p = .04) but not for anxiety or MH diagnosis with a psychotropic prescription. Among the 241 (42 per cent) youths contacted for follow-up, parent-reported cumulative exposure to pet dogs was borderline negatively associated with occurrence of any MH diagnosis (HR = 0.74, p = .06). Cumulative exposure to the most attached pet (dog or cat) was negatively associated with anxiety diagnosis (HR = 0.57, p = .006) and any MHdiagnosis (HR = 0.64, p = .013).

Conclusion: Cumulative exposure to a highly attached pet dog or cat is associated with reduced risk of adolescent MH disorders.

Anne Gadomski1,Melissa B Scribani2,Nancy Tallman3,Nicole Krupa4, Paul Jenkins5,Lawrence S Wissow6

BMC Pediatr. 2022 Oct 5;22(1): 572.doi: 10.1186/s12887-022-03636-0.

1Research Institute, Bassett Medical Center , Cooperstown, NY, USA. anne.gadomski@bassett.org.

2Data Analyst, Center for Biostatistics, Bassett Research Institute, Cooperstown, NY, USA.

3Bassett Research Institute, Bassett Medical Center, Cooperstown, United States.

4Data Manager, Center for Biostatistics, Bassett Research Institute, Cooperstown, NY, USA.

5Center for Biostatistics, Bassett Research Institute, Cooperstown, NY, USA.

6Vice Chair for Child and Adolescent Psychiatry, Division Chief, Child Psychiatry and Behavioral Medicine, Department of Psychiatry, University of Washington, Seattle, WA, USA.

Free PMC article

Advances in the pharmaceutical treatment options for canine osteoarthritis

Canine osteoarthritis is a significant cause of pain in many dogs and can therefore compromise animal welfare. As the understanding of the biology and pain mechanisms underpinning osteoarthritis grows, so do the number of treatments available to manage it. Over the last decade, there have been a number of advances in the pharmaceutical treatment options available for dogs with osteoarthritis, as well as an increasing number of clinical trials investigating the efficacy of pre-existing treatments. This review aims to examine the current evidence behind pharmaceutical treatment options for canine osteoarthritis, including non-steroidal anti-inflammatory drugs, piprants, monoclonal antibodies, adjunctive analgesics, structure modifying To page 30

rethink our health system

Future threats require an integrated approach to the health of humans, animals and the environment

The emergence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) has clearly demonstrated our global vulnerability to emerging infectious diseases. Zoonoses --diseases that transmit from vertebrate animals to humans --are twice as likely to be implicated as emerging diseases than non-zoonoses.1Such diseases have been increasingly linked to wildlife, which are a source of infection for humans and domestic animals,2with viral spillover driven by human-induced changes in land use, agricultural intensification, and wildlife exploitation, among other things.3Sadly, warnings from experts about the dangers of unsustainable development and its impact on natural systems remained largely unheeded by politicians and policymakers.3 (Opening paragraph).

Sandra G Steele1,Jenny-Ann LML Toribio2,Siobhan M Mor3,4 Med J Aust. 2022 October 24. doi: 10.5694/mja2.51733.

1University of Melbourne, Melbourne, VIC

2University of Sydney, Sydney, NSW

3Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Neston, United Kingdom

4International Livestock Research Institute, Ethiopia, Addis Ababa, Ethiopia

Free article

Aims: To collect baseline data from New Zealand sheep farmers on techniques for docking and castrating lambs, their perceptions of the level of pain lambs experience following these procedures, and their opinions about the use of pain relief.

Methods: From a voluntary cross-sectional survey of New Zealand sheep farmers, descriptive statistics wereprovided for quantitative study variables. Thematic analysis was performed on the free-text comments. Univariable logistic regression was used to assess factors associated with farmers indicating they would consider using a device allowing administration of pain relief simultaneously with castration and tail docking.

Results: There were 432 survey responses containing sufficiently complete data for analysis. Of the 340 individuals (77.5 per cent) always or sometime performing castration of ram lambs, 242 (72.2 per cent) used rubber rings for complete castration, 23 (6.9 per cent) used the shortscrotum method for cryptorchid castration, and 75 (22.4 per cent) used a combination of both methods. Of the 423 individuals (97.9 per cent) who indicated that they always or sometimes performed tail docking, 245 (57.9 per cent) used a hot iron only,148 (35.0 per cent) used a rubber ring only, 26 (5.8 per cent) used both methods, 3 (0.7 per cent) used a surgical knife, and 1 (0.2 per cent) provided no response. Less than 2 per cent of respondents always or sometimes used pain relief for these procedures. Of the 432 respondents, 139 (32.2 per cent) and 180 (41.7 per cent) strongly agreed that castration and tail docking do not cause sufficient pain to warrant using pain relief, respectively. Time and cost were identified as major barriers to providing pain relief. In the unadjusted logistic regression analyses, respondents who were female, had high levels of education, had been farming < 20 years, who believed lambs experienced high levels of pain following the procedures, and who believed pain lasted longer than 6 hours, weremore likely to indicate willingness to use pain control devices.

Conclusion and clinical relevance: Our results suggest very few New Zealand sheep farmers currently provide lambs with pain To page 30

Practices and opinions of New Zealand sheep farmers towards pain management in lambs during castration and/or tail docking

Avision of a One Health system for Australia: on the need to

Vet corporate confidential

In May 2000, a relatively unknown chef called Anthony Bourdain decided that he was going to change careers and not run kitchens in New York City anymore. Asafinal goodbye to his previous career, he wrote a book revealing some things that he felt restaurant patrons should know. The book was called “Kitchen Confidential”; it would become a worldwide best seller and launch his second career as a famous food and travel journalist.

Having recently said goodbye to almost a decade working in Operations and Acquisitions for one of the larger dental corporates in Australia, I was recently at a similar juncture in my career, and there are some things that I think practice vendors should know about corporate acquisition.

Over the last decade, I would have spoken to and visited close to a thousand practices wanting to sell and had my hand in the actual purchase of close to a hundred. Being involved with that many practices and transactions, I saw many put their best foot forward in terms of presentation and negotiation, and get the best possible offer that we could have given them… Unfortunately,I also saw many practices that could have done better for themselves, if only they had known what to look for and how best to deal with us.

Now that I have left the world of corporate acquisitions and jumped over to selling practices, I can share with you my top 5 secrets about how corporate acquisition works and how vendors can get a better result for themselves.

1. Competition gets better results If you’re thinking about selling your practice and you find a corporate is interested in buying it (or they find you) … get another opinion. Vendors who only spoke to the dental corporate I worked for, who didn’t speak to other buyers, were less knowledgeable about what they could ask for and had less leverage in negotiations than those who did.

2. Don’t just listen and talk to the loudest voice in the room Corporates change over time. Aggregators come into and exit the marketplace.

Vets may know the publicly listed vet aggregators; they and the larger, older corporates are lucky, in that they are high profile and spend a significant amount of money getting their name out there. However, don’t make the mistake of thinking that these are the only buyers out there.

There are some smaller vet acquirers that the general public don’t know about, because they are smaller, newer, more localised to a geographical area and/or don’t spend the same on advertising. These other corporates put great deals forward and can compete

with any of the bigger corporates on price and terms. Many vendors let themselves down by only talking to “the usual suspects” or “the loudest voice in the room” in aggregation, rather than finding the less known, but better-fit suitor.Seek out the best possible suitor, not just the one with the biggest profile.

3.Most vets don’t know what Corporates want or offer Ifyou know what your best potential buyer is looking for, and what they are willing to pay for other practices like you, you can ensure that you take steps to make yourself more attractive and can present yourself in the best possible way.

There are a lot of preconceived ideas about what vet corporates are looking for and what they will pay for a practice. Many vets have heard half stories from friends or colleagues and think they know what a corporate will pay for a practice when, in reality, there has never been a one-size-fits-all offer from all corporates at all times:

■ Each corporate would give a better price and terms for practices they found more attractive or strategically important.

■ What each corporate finds attractive or strategically important has changed and evolved over time. Different corporates have placed different strategic importance on different criteria over the years.

■ What corporates consider too risky changes over time as well.

Knowledge of the buyers, their appetites for acquisition and what is important to them, can help you position your practice. Do some investigation or talk to a practice broker (Practice Sale Search) and find out what they are looking for and what they can offer. Don’t lump them all into the same basket and assume that they are all looking for the same thing and will pay the same amount. This assumption could mean that you miss out on getting a better offer.

4. It is not as hard as you think for an owner-operator buyer to compete with a corporate Many Vendors think that it’simpossible for an owner-operator to compete with a corporate for good practices, because the corporates have deeper pockets and can afford to pay more. Often, vendors don’t seek out owner-operator buyers and just stick to seeking interest from Corporates, which is how the Corporates like it. In reality, owneroperator buyers can absolutely compete with Corporates for some practices:

a. They can compete on terms Corporates generally don’t buy practices that allow vendors to exit

quickly or pay 100% upfront or without future targets. What is the opportunity cost to the vendors of the time and stress that come along with these terms? Some vendors will accept less money to get fewer post-sale terms.

b. You can compete on compatibility Many vendors prefer the idea of selling to a person, rather than a company. They prefer knowing the ethics and clinical ability of the clinician who will take over from them when they leave. If they are going to stay in the practice, they like the idea of having an owner onsite who they can talk to about clients, staff and problems, rather than needing to call a “head office” inanother state.

c. Corporates don’t put as much weight on lifestyle or ‘new’ equipment in a practice

If you renovated your facility within the past 1-3 years and expect a corporate to pay more for it, think again.

If you generated the same revenue and profit in 4 days that another practice did in 5, acorporate would value them the same.

…However,aprivate buyer might see extra value in these attributes.

5. Understand your targets

If you are thinking about selling to a corporate, like the price they are giving you, but don’t COMPLETELY understand how they calculated your post-sale profit target, STOP! Make sure you get clarity before proceeding.

Don’t let a big, shiny headline purchase price woo you into signing on to an offer that has a post-sale target calculated in a way that you don’t understand.

You will need to be able to maintain this target to get the full sale price that they are offering. You need to understand not just how they calculated it, but also, as importantly,feel confident that you will be able to replicate it!

In my experience, missing targets due to a vendor’spoor understanding of them is way too common, and the #1 reason for disharmony in vet practices that have been sold to corporates.

Conclusion

It is not uncommon for a vet practice owner to feel overwhelmed or unprepared when negotiating the sale of their practice with a corporate.After all, it isn’t a level playing field with you on one side (often selling a business for the first time) negotiating against someone who has done this a hundred times before. How do you ensure that you don’tshort-change yourself in the biggest deal of your life? If only you had someone on your side who had also done the transaction ahundred times before and knew the moving parts as well as the corporates did…

Lisa Singh has been a National Account Manager at Practice Sale Search for three years, covering northern NSW and South East Queensland. Before becoming a practice broker, Lisa held roles as both Regional Manager and Acquisitions Manager at a major dental corporate aggregator. email Lisa Singh atinfo@practice salesearch.com.au or call 1300 282 042.

wildlife tourism wildlife tourism

More so than any other species, humans experience the biophilia effect – a desire to interact or commune with other forms of life in nature. It is an innate urge to connect with all living things and explains the popularity of wildlife tourism. To observe a great ape feeding in the jungles of Rwanda or a lion prowling the African veld are thrilling, and often transformative, encounters. It can lead to greater awareness of the challenges facing wildlife globally and inspire conservation efforts from ordinary individuals. But the urge to connect with wild creatures can have dire consequences for the animals we seek to relate to. A recent study by World Animal Protection found that 75 per cent of wildlife tourist attractions have a negative impact on wild animals. Animals can be forcibly removed from their habitats, drugged, beaten into submission or made to perform abnormal acts –all for the sake of a wildlife encounter. But with greater awareness of the impact we can have on the lives of wild animals we can all learn to be responsible wildlife tourists and contribute to their conservation and welfare.

Keep your distance Elephant rides, tiger selfies, captive dolphin swims and any interaction where you can touch a wild animal should ring warning bells. Almost all of these animals have been treated cruelly - elephants are beaten to break their spirits, tigers are drugged so people can take selfies with them. In SE Asia, the slow loris is apopular photo prop but these nocturnal creatures suffer in bright daylight and most have had their teeth removed. In South America, the brown sloth becomes so stressed from frequent handling for tourist selfies that most die within six months of capture.

Elephant washing has replaced elephant riding as a sustainable activity however,to allow this close contact with a human, the

wild animal has undergone the same process of beating and subjugation to break its spirit and render it handleable.

Only support venues, attractions and operators that observe wildlife from a distance.

Choose sanctuaries wisely

In developing countries, the term ‘sanctuary’ is often used loosely to describe any venue that houses wildlife. Sanctuaries house animals rescued from both the illegal and legal wildlife trade but it is an unregulated industry and not all sanctuaries prioritise the welfare of the animals in their care. Some rescue groups front thriving black market businesses such as the orphan lion cubs in South Africa that are taken from their mothers and hand-reared so tourists can cuddle and feed them. Once they are too big to handle they become prey for the canned hunting industry, where trophy hunters pay to kill these semi-tamed animals.

Knowing what to look for and the right questions to ask can help you choose ethical venues.

Do the animals look healthy and comfortable? Is there enough space for them to move freely and to display their natural behaviours? Are they given enrichment and mental stimulation? Do they have shelter from the weather? Are the enclosures clean? What are they fed? Do they have access to veterinary care? Does the sanctuary have a strict no-contact policy?

Any venue that encourages the capture of wild animals or hands-on interactions is suspect. Captive animal breeding programs, unless of endangered species and by reputable organizations, should also be viewed with suspicion. Animals bred in captivity can’t be released to the wild so they are being bred for human entertainment or for their meat or body parts.

The rise in voluntourism has seen sanctuaries and rescues invite paying volunteers to help

HEALTH Y S KI N COM ES FROM WITHI N

The ROYAL CANIN ® Skin Support diet is scientifically formulated to help assist dogs suffering from atopy and skin disease.

Scan here to discover our online scientific and medical journal library

support and feed the animals in their care. These programs bring in much needed revenue to offset food and medical bills for the animals but before you volunteer check the credentials, testimonials and reviews of these groups.

Watch what you eat

Sampling local delicacies is part of the travel experience but choose which delicacies to try. Local bush meat is meat from wild animals and it’s likely you’ll find it on the menu in Asia, Central and South America and Africa. It’s often hunted illegally, killed inhumanely and prepared under unhygienic conditions. And over-hunting of bush meat can disturb the local ecosystem.

Fins are harvested from live sharks to make shark fin soup. Live snakes are drowned in alcohol to make snake wine. Crocodiles on the menu in Cambodia are kept in small pits where they bite and kill each other while waiting to grace the table.

In SE Asia, civets are confined to small cages and force fed coffee beans. Kopi Luwak, made from civet dung, is the world’s most expensive coffee. But in the process, these nocturnal creatures are displayed in daytime cafes and fed to high-wired obesity on a diet comprised solely of coffee beans.

Monkey brains, dog meat, guinea pigs, crocs, bat meat….maybe travel vegetarian.

Don’t feed the wildlife

There’s no excuse for feeding wildlife. Apart from feeding inappropriate foods, there is a real danger of transmitting diseases to our primate cousins. Colds, flu, tuberculosis and other respiratory diseases can easily be transmitted with close contact. When animals become habituated to expecting food from tourists they modify their foraging behavior and can become dependent on humans for food. This can affect their health due to poor food choices and can alter their social and breeding interactions. And if they don’t get the expected food, they can become aggressive. Wild bears in Canada have been culled for just this behaviour. In Bali, tourists have been bailed up by teeth-baring macaques. These clever monkeys have now learned to steal items from tourists to barter back for food.

Not all tour operators areequal Many wildlife encounters areonly possible through organized trips or tours but not all tour operators supportethical and sustainable operations. When selecting a tour,do your research.

Look for operators that help supportlocal communities in the region. An injection of

tourist dollars directly into the communities ensures the local villagers see wildlife as a precious commodity to protect and treasure. Sumatra is a prime example of how wildlife tourism can create well-paid, sustainable jobs for locals. The Sumatran Rangers who patrol the Leuser Ecosystem protecting wildlife in the rainforest jungle were once hunting and killing these animals for meat, land and resources.

Counter culture

Cultural traditions are not always animal friendly. Even if an activity is considered part ofacountry’s cultural heritage it doesn’t excuse animal cruelty. If you pay to attend a cock-fight, bull-fight, dog-fight or any event that involves animal cruelty you are supporting and maintaining that industry.

Consider traditions that aren’t as immediately obvious as dancing bears, circus animals and

Souvenir pitfalls

Items from endangered species that are commonly for sale as holiday souvenirs include ivory, tortoiseshell, reptile skins, furs and some corals and seashells. Despite the ban on ivory trading, 30,000 elephants are still poached each year for their tusks.

Before buying anything made from animal products consider the impact on that species. Is it too rare to wear? Clothing and jewelry are prime areas for exploitation. In Central and South America, tortoiseshell combs and glasses are made from the shell of the critically endangered Hawksbill sea turtle. Coral harvested for earrings and jewelry might be beautiful but coral is the basis of entire ecosystems. Once harvested it takes decades to grow back, and its loss has devastating effects on the fish and other species it supports.

Instead of animal products, choose locallymade trinkets and souvenirs that leave wildlife in the wild. In the end, photographs and memories are the best souvenirs of all.

Who to call

People seek out wildlife experiences because they love animals.

If you witness abuse, cruelty or poor animal treatment, speak up. Being a voice for the voiceless is something we can all do and raises awareness about animal welfare and conservation.

If you don’tfeel comfortable speaking directly to the venue, operator,restaurant owner or market vendor, post your experience on social media. Reviews are seen by these operators and can sway future behaviour. Even better,reportsuspect activities to organisations such as World Animal Protection, World Wildlife Fund and TRAFFIC.

any animal used for entertainment. In Africa, witchdoctor’s lotions and potions often contain animal parts. In SE Asia, shun traditional medicines made from wildlife. These are often from endangered animals. For example, tiger’s penis and rhino horn are considered to be powerful aphrodisiacs. In traditional Chinese medicine, bear bile is touted as a cure-all for everything from colds to cancer. But to obtain the bile, bears are kept in horrific conditions, confined to tiny cages for years, their gallbladders repeatedly stabbed for the precious fluid.

Even a tradition as seemingly innocuous as abirdsinging contest has a dark side. In SE Asia, wild birds, prized for the songs they sing, areillegally trapped, caged and sold at local markets. Demand for these popular songbirds has resulted in a frenzy of illegal trapping, extinction of some species and forests falling silent as they disappear from the trees.

Be prepared beforeyou travel. The Wildlife Witness app can be downloaded onto a smart phone. It was developed by the Taronga Conservation Society in partnership with TRAFFIC (the wildlife trade monitoring network). If you suspect live animal trafficking or see body parts such as rhino horn or pangolin scales you can take a photo on your phone, pin the location, and send the data to TRAFFIC.

Your dollar counts

Like it or not, the tourist dollar has a major impact on animals and wildlife across the world. By taking a little moretime and effort to research operators, sanctuaries, venues and experiences, and being mindful where those dollars go, you can contribute to the wellbeing and welfare of the amazing wildlife and animals you long to connect with.

Penny Linnett BSc (Zool Hons) BVSc

MPhil MANZCVS

Penny has worked extensively in private mixed practice, and in animal biosecurity and welfare for both government and not-for-profit organisations.

She manages a 212 hectare Dorper sheep breeding property in NSW, and is co-Director ofYour Hobby Farm Success, helping hobby farmers enjoy their lifestyle, and reap the benefitsof having healthy and happy animals.

Pharmacology of local anaesthetics

Introduction to pain and local anaesthetics drugs

The term ‘pain’ is used to describe the sensation in conscious patients, but the sensation is referred to as ‘nociception’ in anaesthetised patients since a cognitive response, which is prevented by use of an anaesthetic agent, is necessary to define pain. One definition of pain is ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage’ (IASP, 2020).

Pain is regarded as being a complex, multidimensional experience with sensory and affective elements. Several theories have been proposed to describe and/or explain the physiological mechanisms underlying pain perception but to date, no single theory has been able to exclusively incorporate all the aspects of pain perception. The four most influential theories of pain perception include Specificity, Intensity, Pattern and Gate Control. In 1968, Melzack and Casey described pain as “multi-dimensional, where the dimensions are not independent but rather interactive, and the dimensions include sensory-discriminative, affective-motivational and cognitive-evaluate components”.

In humans, the five most common types of pain are acute pain, chronic pain, neuropathic pain, nociceptive pain, and radicular pain. Common ways to describe pain are sharp, aching, stabbing, dull, radiating, throbbing, cramping, and burning.

Determining the most likely pain mechanism(s) is important during the clinical examination as this can serve as a guide to determine the most appropriate treatment(s) for a patient. Determined factors in humans that can alter pain and pain perception include biomedical, behavioural (also known as psychosocial), social and economic, and work-related.

For example, nociceptive pain is associated with the activation of peripheral receptive terminals of primary afferent neurons in response to noxious chemical (inflammatory), mechanical or ischemic stimuli. Whereas peripheral neuropathic pain may be caused by a primary lesion or dysfunction in the peripheral nervous system, and it involves numerous pathophysiological mechanisms associated with altered nerve functioning and responsiveness. These mechanisms include hyperexcitability and abnormal impulse generation and mechanical, thermal, and chemical sensitivity.

While there is no gold standard by which to assess pain, there are many scoring methods available based on behavioural and physiological variables to help the clinician in assessing the patient.

Therefore, effective relief of pain (analgesia) is a vital cornerstone of appropriate supportive care for animals experiencing pain. A variety of pharmacological agents are available for the treatment/alleviation of pain such as anti-inflammatory drugs, opioids, and local anaesthetic drugs. The local anaesthetic drugs are unique in that their analgesic effects are produced following local/regional administration rather than systemic administration.

Local anaesthetic drugs used in local and regional blockade can completely block the transmission of nociceptive impulses, decreasing both intraoperative nociception and postoperative pain, while decreasing the potential incidence of adverse effects that can be associated with systemic boluses ofdrugs. This is recognised as a very specific and powerful role in the nociceptive pathway as blockade of pain signals has a more profound impact than does modulation of pain signals alone. In one study, for example, dogs receiving local blocks following a thoracotomy had lower pain scores than those receiving systemic opioids (Conzemius, Brockman, King, &Perkowski, 1994).

Inaddition, local anaesthetics can decrease the incidence of intermediate duration pain (defined as being present for several days or a few weeks) and chronic pain (defined as being present for months to years). Local anaesthetic drugs also have other beneficial effects such as antiinflammatory and anti-metastatic ones.

Numerous local and regional blocks have been proven safe and effective in small and large animals for a wide variety of minor and major surgical procedures. Whether or not sedation is used as adjunct will depend on the procedure, and the species, temperament, and health of the animal patient. There are many advantages of using local analgesia, including avoiding the dangers associated with casting and prolonged recumbency, and expensive equipment is not needed.

Introduction

Cocaine is regarded as the archetypical ester, being the only naturally occurring local anaesthetic drug. It was isolated from the leaves of a South American plant called Erythroxylum coca and was first introduced into surgery in 1884. Synthetic substitutes have used for many years.

Procaine, the first synthetic ester local anaesthetic, was introduced in the early 1900s, and largely replaced cocaine as a local analgesic. As an aside, when procaine is combined with adrenaline hydrochloride solution, it is ten times less toxic than cocaine. The introduction of the amide local anaesthetic lidocaine in 1948 was said to be ‘transformative’, as lidocaine reputedly became quickly used for all forms of regional anaesthesia.

Local anaesthetic drugs work by binding to the · subunit of the voltagegated sodium (Na+) channels, preventing the generation and conduction of nerve impulses (also called action potentials), without causing unconsciousness. They do not alter the resting transmembrane potential and have little effect on the threshold potential. In addition, local anaesthetic drugs can bind to, and inhibit, cardiac

sodium channels as well as binding topotassium and calcium channels, and G-protein-coupled receptors. This means that local anaesthetics affect not only nerve fibres but all types of excitable tissue including skeletal muscle, smooth muscle, and cardiac muscle. Side effects occur when the drugs enter the systemic circulation, and include cardiovascular, respiratory, and central nervous effects. Allergic reactions have been seen, albeit rarely, with the ester-based local anaesthetic drugs.

Therefore, depending on the nerve and the area innervated, autonomic nervous system blockade, anaesthesia, and/or skeletal muscle paralysis can result from the use of a local anaesthetic agent. In contrast, the general anaesthetics make the patient unconscious and hyporeflexic, while providing alevel of analgesia at the same time.

Local anaesthetic drugs can block all nerves which means their action is not limited to just the desired sensory block but also cause motor loss. However, nerve fibres have different susceptibilities to local anaesthetic blockade based on their size (nerve diameter) and presence and/or absence of myelin. These factors all contribute to the ‘selective’ or ‘differential’ blockade of nerves, which was first described in 1929.

Onset of clinical effect/s usually occurs after 15 minutes after administration of the local anaesthetic drug and, depending on the compound used, may last from 45 minutes to several hours. When using local anaesthetics for surgery, it is recommended that some form of sedation also be used concurrently.

There are several factors which can influence the activity of a local anaesthetic drug including structural modifications (which alter the physiochemical characteristics of a local anaesthetic), with speed of onset, potency and duration of action depending on the pKa, lipid solubility and protein binding of the compound used. The site of injection also influences activity of the local anaesthetic, with the most rapid onset but the shortest duration occurring following spinal or subcutaneous administration of the drug. The longest latencies and durations are observed following brachial plexus block.

As the dose of a local anaesthetic drug is increased, the probability and duration of satisfactory anaesthesia increase, and the time to onset of action is shortened. The dosage can be increased by administering either a larger volume or a more concentrated solution.

Vasoconstrictors, usually epinephrine (5 µg/mL or 1:200,000), are sometimes included in local anaesthetic solutions to decrease the rate of vascular absorption, allowing more of the anaesthetic molecules to reach the nerve membrane. This improves the depth and duration of anaesthesia. However, the extent of this effect depends on the local anaesthetic agent used and the site of injection. Generally, epinephrine significantly extends the duration of both infiltration anaesthesia and peripheral nerve blocks.

The so-called ‘birth’ of local and regional anaesthesia dates from 1884, when Carl Koller and Joseph Gartner reported success at producing topical anaesthesia of the eye in the, rabbit, dog and human using cocaine.

Treating urinary incontinence in dogs is easy with PROIN®

✔ Clinically proven for urinary incontinence in female and male dogs

✔ High dose formulation for increased efficacy in female and male dogs

✔ Easy dosing flavoured chewable tablets – dogs like them

✔ Dogs lose weight when on PROIN treatment

✔ No issues in switching dogs from other treatments to PROIN Chewable Tablets

✔ Scored tablets for dosing accuracy

✔ 50mg tablets, in bottles of 60.

Insummary, epinephrine and other α1-agonists increase the duration of the local anaesthetic largely by prolonging and increasing intraneural concentrations of local anaesthetics. Blood flow is briefly decreased and the nerve block will persist after the α1-adrenergic effect on blood flow has dissipated. Other additions to the local anaesthetic agent include clonidine, dexamethasone, sodium bicarbonate, opioids, and hyaluronidase.

1.How local anaesthetics affect nerve impulses

Action potentials (nerve impulses) result from differences in the intracellular and extracellular concentrations of primarily sodium (Na+) and potassium ions (K+) and the permeability of the cell membrane to these ions. This concentration difference is maintained by the plasma membrane Na+/K+-ATPase pump, which pumps 3Na+ out of the cell through Na+-gated channels inthe cell membrane, for every 2K+ pumped into the cell. This gives a resting potential (i.e. the voltage between the inside and outside of the cell) of -70mV.

The entry of large amounts of Na+ results in transient depolarisation of the cell as the membrane potential becomes positive. The action potential is terminated by the closure of Na+ channels and the opening of slow K+channels that allow K+ to escape from the cell (repolarisation). The Na+/K+-ATPase pump then re-establishes the normal concentration difference of Na+ and K+ across the cell membrane (the resting membrane potential).

Action potentials self-propagate along the entire nerve fibre (from a dendrite, down the axon to the neuron) to convey information within the nervous system. Conduction is much faster in myelinated nerves compared with unmyelinated nerves. In unmyelinated nerves, a flow of current is developed from the depolarised segment into the resting segment while in myelinated nerves, action potentials are generated only at nodes of Ranvier (appear to jump from node to node).

Local anaesthetics interfere with nerve impulse conduction from the receptor to the cerebral cortex and render a region insensitive to painful stimuli. More specifically, they block the depolarisation-induced opening of voltagesensitive Na+ channels in the nerve cell (axonal) membrane and raise the threshold at which an action potential can be generated, thereby blocking the conduction of action potentials in nerve fibres. The opening of K+ channels is also inhibited.

The small myelinated pain fibres are the first to be blocked, as they are generally more susceptible to the action of the local anaesthetics, followed by the fibres that control sensations such as temperature (cold), touch and pressure. The large myelinated motor nerves are last to be blocked. Nerves that are repetitively stimulatedare more sensitive to the use of local anaesthetics than are resting nerves. Recovery of nerve conduction occurs spontaneously when the concentration of the local anaesthetic drug decreases at the site.

Specific drugs can contribute to differential blockade with bupivacaine (at a concentration of 0.125%) reported to have more sensory blockade than motor blockade. Ropivacaine and levobupivacaine and liposome-encapsulated bupivacaine cause less motor blockade than does regular bupivacaine.

2. Chemical characteristics

Local anaesthetic drugs are water-soluble salts of lipid-soluble alkaloids. They have three structural components which are a hydrophobic aromatic substituted benzene ring linked by an intermediate bond to a hydrophilic tertiary amine. The intermediate bond is either an ester or an amide, which differentiates the two clinicallyimportant groups of local anaesthetic agents: the ester-linked (e.g. benzocaine, procaine and tetracaine) and the amide-linked (e.g. bupivacaine, lidocaine, mepivacaine and prilocaine).

Increasing the length of carbon chains attached to either the aromatic ring, amide linkage or the tertiary amine offers higher lipid solubility, potency, and increased duration of action. Esters are generally unstable in solution and more fast acting than the amide-based local anaesthetic drugs. Allergic reactions attributable touse of an ester are more common than for the amides, and it is thought that the para-aminobenzoic acid (PABA) is responsible for allergic reactions following intradermal tetracaine, for example.

Local anaesthetics are weak bases (pKa 7.5 to 9.0) and exist in solution as both ionised and non-ionised (also known as ‘unionised’) forms, with the relative proportions depending on the pH of the solution and the dissociation constant (pKa) of the drug (the pKa = the pH at which 50 per cent of the drug is ionised and 50 per cent is non-ionised). The lower the pKa of the drug, the greater the amount present in the non-ionised form at physiological pH, the more rapid the penetration of the nerve cell membraneand the faster the onset of action.

Local anaesthetics are mainly ionised (though not completely) in tissue and it is only the nonionised molecules that can penetrate the nerve.

Subcutaneous administration of a local anaesthetic drug is often painful in conscious patients due in part to the acidic nature (hydrochloride salt) of the solution. When sodium bicarbonate is added to the solution, pain is decreased, and onset of action is more rapid.

3. Pharmacokinetics

The speed of onset of action of a local anaesthetic drug is determined by the effect of pKa on the number of lipid soluble molecules at the cell membrane. It is the unionised lipid soluble molecules that can move easily and therefore, can more rapidly cross into the cell. The pKa of the drug dictates the proportion of molecules that are in an unionised lipid-soluble state.

Increased lipid solubility may cause slower onset of action since the injected drug will have more uptake into the lipid tissues. In this case, the local anaesthetic drug is slowly released, which slows the onset of action and prolongs the duration of action. Hence, lipid solubility and protein binding are related.

Specific comments on potency and duration Potency is described as the number of molecules needed to produce a pharmacologic effect, and is based on lipid solubility,with increased solubility equating to increased potency.Properties such as pKa, lipid solubility and protein binding are inherent to each drug and determined by the drug’s chemical structure.

The nerve-blocking potency of local anaesthetics increases with increasing molecular weight and increasing lipid solubility.The larger, more lipophilic local anaesthetic drugs permeate nerve membranes more readily and bind sodium channels with greater affinity. Etidocaine and bupivacaine have greater lipid solubility and potency than do lidocaine and mepivacaine.

The more lipid-soluble local anaesthetics are relatively water insoluble, highly protein bound in blood, less readily removed by the bloodstream from nerve membranes, and more slowly “washed out” from isolated nerves in vitro Hence, increased lipid solubility is associated with increased protein binding in blood, increased potency, and longer duration of action. The extent and duration of local anaesthesia can be correlated with the local anaesthesia content (concentration) of nerves in animal experiments. In animals, nerve blocks of greater depth and longer duration arise from the use of smaller volumes of a more concentrated local anaesthetic drug, compared with larger volumes of a less-concentrated local anaesthetic drug.

Absorption

The absorption (and speed of onset of action) is dependent on the site of injection, rate of injection, dosage and vasoactivity of the local anaesthetic drug that is injected. Typically, intrapleural block is associated with the highest absorption while subcutaneous infiltration is associated with the least absorption. The order ofpeak plasma concentration after a single dose is intrapleural > intercostal > lumbar epidural >brachial plexus > subcutaneous > sciatic > femoral.

Drugs with a pKa close to the body’s pH of 7.4 have a rapid onset of action. Lidocaine with a pKa (7.9) near physiologic pH (7.4) has a fast onset of action compared with bupivacaine and ropivacaine (pKa 8.1).

Two important points:

■ lipid solubility is directly proportional to potency and the duration of action

■ potency is reduced in acidic tissues (e.g. infected tissues) where an increased number of local anaesthetic (weak bases) molecules will remain in the unionised state and the onset of action may be slower.

Distribution

Local anaesthetic drugs that are esters are less protein bound than are the amide local anaesthetic drugs. Tissue distribution tends to be proportional to the tissue/blood partition coefficient of the local anaesthetic, and the mass and perfusion of the tissue itself.

■ the degree of protein binding determines the duration of action

■ adrenaline prolongs the duration of action; vasoconstriction limits systemic absorption, which is related to the vascularity at the injection site

■ local ischaemia may delay healing.

Metabolism and clearance

The ester-based local anaesthetic drugs undergo rapid hydrolysis in plasma by pseudo cholinesterase (and to a lesser extent the liver) to the metabolite para-aminobenzoic acid (PABA) which is known to cause allergic reactions in susceptible individuals. Plasma halflife varies from less than 1 minute (e.g. chloroprocaine) to 8 minutes (e.g. tetracaine) and is prolonged in the presence of atypical cholinesterase. Cocaine, unlike other esters, undergoes hepatic hydrolysis followed by renal excretion. In the liver,amide local anaesthetics undergo aromatic hydroxylation, amide hydrolysis and N-dealkylation.

Amides are metabolised primarily by the hepatic CP-450 enzyme system. Metabolism is much slower than plasma hydrolysis which means that amide local anaesthetic drugs are more prone to accumulation in the presence of hepatic dysfunction or reduced hepatic blood flow. Ropivacaine, for example, is extensively metabolised so it is not recommended for patients with hepatic dysfunction. Prilocaine, in contrast, undergoes metabolism in the lungs.

Amides have very low allergic potential themselves, and any observed reaction may be caused by an additive such as the stabilising agent methylparaben. Response to vasoconstrictor adjuvants have been mistaken for an allergic reaction.

The esters have a longer duration of activity when given into the epidural space as they are protected from degradation.

Elimination

■ almost entirely by the kidneys

■ excretion in acidic urine is greater because of increased ionisation.

Clearance values and elimination half-times for amide local anaesthetics represent mainly hepatic metabolism because renal excretion of unchanged drug is minimal. Accumulation of metabolites may occur in renal failure.

Lidocaine has a high hepatic extraction ratio: clearance is dependent on hepatic blood flow and is relatively unaltered by changes in hepatic enzyme activity. Owing to the efficiency of the drug in dissociating from plasma proteins, entering the hepatocyte and undergoing metabolism, the rate limiting step is hepatic perfusion. This is important in critical illnesses, particularly in those states of low cardiac output and reduced hepatic blood flow.

Transfer across the placenta

The rate and degree of diffusion of the local anaesthetics, which are weak bases, across the placenta depends on three factors: degree of protein binding, pKa, and maternal and foetal pH. They have relatively low degrees of ionization at physiological pH.

Highly protein-bound agents diffuse poorly across the placenta. Bupivacaine is highly protein bound (95 per cent) and has an umbilical vein/maternal arterial ratio of 0.3. This contrasts with lidocaine (70 per cent) with a ratio of 0.5–0.7. The higher protein binding of the highly lipid soluble bupivacaine and ropivacaine, compared with that of lidocaine (less lipid soluble and has a lower degree of protein binding), likelyaccounts for their lower foetal blood levels. Lidocaine does also cross the placenta.

Foetal acidosis produces higher foetalto-maternal drug ratios because binding of hydrogen ions to the nonionized form causes trapping of the local anaesthetic in the foetal circulation. The exception to this is chloroprocaine, which has the least placental transfer because it is rapidly broken down by plasma cholinesterase in the maternal circulation.

When labour is prolonged, acidosis in the foetus can result in accumulation of local anaesthetic in the foetus by ‘ion trapping’. Ion trapping occurs when the decreased pH in the foetus produces an increased proportion of ionised drug which is then unable to cross the placenta. However,the ester local anaesthetics do not cross the placenta in significant amounts due to rapid hydrolysis.

The use of adjuvants

Adjuvants may be used with local anaesthetic drugs to prolong the duration of local nerve blockade, and the potential risk of systemic toxicity can be reduced. These include opioids, alpha-2 agonists, adrenaline, clonidine, keta mine, dexamethasone, and midazolam. Other than adrenaline, there is no clear and solid evidence for adding adjuvants to peripherally administered local anaesthetics. Combining a vasoconstrictor drug with a local anaesthetic drug, delays absorption of the latter from the injection site.

For perineural injection, buprenorphine combined with a local anaesthetic, or medetomidine combined with a local anaesthetic are clinically effective.

4. Adverse Effects

Apart from the Na+ channels, local anaesthetics can bind to many other targets. These include voltage-gated potassium and calcium channels, KATP (ATP sensitive potassium) channels, enzymes, N-methyl-D-aspartate receptors, β -adrenergic receptors, G-protein-mediated modulation of potassium and calcium channels, and nicotinic acetylcholine receptors. Binding to any one or all of these other sites can also contribute to toxic/allergic side effects.

True immunologic reactions following local anaesthetic administration are, however,rare. True anaphylaxis is more common with the ester local anaesthetics that are metabolised directly to PABA than to other local anaesthetics. Some human patients have been shown to react to the preservatives, such as methylparaben, that are part of the formulation with the active compound. Toxicity caused by local anaesthetics to the nerves themselves, and other tissues, occurs in a time, concentration, and drug-dependent manner. Possible cellular mechanisms involved

include the intrinsic caspase, phosphoinositide 3-kinase and mitogen-activated protein kinase pathways.

The incidence of systemic toxicity in animals is not documented but it has been estimated to bevery low. The incidence of systemic toxicity in humans has been estimated to be in the range 0.01 to 0.075 per cent.

All local anaesthetics have the potential to induce systemic toxicity, which is usually seen as convulsions followed by cardiac arrest. Most side effects occur after accidental intravenous administration, especially after a rapid bolus of an excessive dose of local anaesthetic. Clinical signs for central nervous system involvement are excitement, seizures, skeletal muscle twitching andrespiratory depression; and for the cardiovascular system, hypotension, hypertension, decreased conduction rate and myocardial contractility, collapse. For the cardiovascular system, clinical signs usually occur at higher plasma concentrations than those associated with the central nervous system. Arrhythmias can be resistant to treatment, leading to loss of cardiac function and patient death.

Cardiovascular system adverse effects are more commonly associated with bupivacaine overdose, due to the higher lipophilicity of bupivacaine and longer duration of sodium channel blockade when compared with other local anaesthetic drugs. Intravenous boluses of bupivacaine can induce hypotension or cardiovascular collapse, which can be fatal, secondaryto blockade of the myocardial conduction system.

Other clinical effects:

■ Anaphylaxis is very rare and is primarily associated with the ester compounds (e.g. procaine) and drugs containing methylparaben as a preservative. Lidocaine, ropivacaine, mepivacaine and bupivacaine, including liposomeencapsulated bupivacaine, are amides.

■ Methaemoglobinaemia is also rare. It is primarily associated with benzocaine administration in cats and rabbits, but it may also occur following prilocaine administration.

■ Local tissue irritation - accidental intravascular injection can occur with any nerve block; ideally,aspiration should be used to determine correct needle placement prior to local anaesthetic drug injections.

■ Nerve damage and specific injection site-related adverse effects can occur.

■ Infections from administration of local anaesthetic drugs are highly unlikely to arise because local anaesthetics have a mild antimicrobial effect. However, micro-organisms can spread along the needle tract when infected tissues are infiltrated.

During the 1980s, it was reported that 2-chloroprocaine occasionally produced cauda equina syndrome, adhesive arachnoiditis, anterior spinal artery syndrome, and other non-specified forms of permanent neurologic injury,following accidental intrathecal injection. At the time, the 2-chloroprocaine was formulated with sodium metabisulfite at a relatively acid pH and disodium ethylenediaminetetraacetate (EDTA) both of which have since been shown to cause localized neurodegenerative changes in spinal nerve roots. The published cases reporting permanent neurologic injury were generally associated with inadvertent intrathecal injection of an epidural dose, which resulted in a significant overdose. An equivalent spinal block can be achieved with 10 per cent of the epidural dose.

More recently, 2-chloroprocaine has been (and is) used as a substitute for lidocaine in human spinal anaesthesia. Due to its low potential for systemic toxicity, the most common application for chloroprocaine is in obstetrics, where it provides rapid onset epidural anaesthesia when urgent or emergency caesarean delivery is indicated. Large doses of chloroprocaine can be administered in this situation because of the low potential for maternal and foetal toxicity.

The United States Food and Drug Administration recently approved a preservative-free formulation of chloroprocaine to provide spinal anaesthesia for adults undergoing short-duration lower extremity and abdominal surgery.

5. Treatment of local anaesthetic toxicity Treatment of adverse local anaesthetic related reactions depends on their severity. Usually mild reactions will resolve spontaneously and do not require intervention. Seizures should be managed by maintaining a patent airway and by providing oxygen. Intravenous midazolam (0.05–0.10 mg/kg) or propofol (0.5–1.5 mg/kg) oraparalytic dose of succinylcholine (0.5–1 mg/kg), followed by ventilation with bag and mask (or tracheal intubation), may be required.

Cardiovascular depression can be treated by the infusion of intravenous fluids and vasopressors (phenylephrine 0.5–5 g/kg/minute, norepinephrine 0.02–0.2 µg/kg/minute, or vasopressin 40 µg IV). If myocardial failure is present, epinephrine (1–5 µg/kg IV bolus or smaller, incremental doses of epinephrine initially) may be required.

Inadvertent intravenous injections of lipophilic drugs (bupivacaine is the most lipophilic) can be managed by the lipid rescue protocol to sequester the lipid soluble drug until it can be cleared. In lipid rescue, a 20% lipid emulsion is infused intravenously; the lipid antidotes act as a sink within the intravascular space, sequestering lipophilic local anaesthetic drugs away from their site of action within body tissues.

Additional cardioprotective effects are thought possible secondaryto the lipid acting at the cellular level. By increasing the intracellular fatty acid content – the energy substrate for mitochondrial respiration – this counteracts the blockade on adenosine triphosphate synthesis, which occurs secondarily to carnitine acylcarnitine translocate inhibition. The, increased cardiac myocyte calcium levels improves contractility.

Intravenous lipid emulsion (ILE; recommended to not exceed 8ml/kg/day) persists for some hours within the circulatory system and works well with the half-life of bupivacaine, which is highly lipophilic (logP 3.64), with a pKa of 8.1 and is highly protein bound (95 per cent).

As a rule, the total infiltrative dose of lidocaine should be < 8 mg/kg in dogs and <4mg/kg in cats, while the dose of bupivacaine should be < 2 mg/kg in both dogs and cats.

6. Additional actions

Local anaesthetics also have additional actions to that of local analgesia. These include antiinflammatoryeffects (mediated by a variety of mechanisms) whereby they decrease polymorphonuclear leukocyte adherence, migration, and accumulation at the site of inflammation, altering macrophage and monocyte function. In laboratorystudies, high concentrations of local anaesthetics have anti-bacterial effects. However, systemic concentrations during regional or local anaesthesia are low, so a theoretical risk of increased susceptibility to infection therefore exists.

Local anaesthetics may also:

■ Reduce cancer recurrence (anti-metastatic effects) by attenuating the stress response. Surgery, for example, is associated with an initial proinflammatory phase followed by a period of immunosuppression; the antitumour activity of natural killer cells and CD8 T cells are inhibited, and protumour effects of regulatory T cells and type 2 T helper cells are promoted. They also reduce pain (through regional local anaesthesia techniques) which in turn reduces usage of opioid and other volatile drugs, both of which, may negatively influence the immune system. They reportedly have a direct anti-tumour effect.

Dr Jane Miller Veterinarian Victoria

However, in vivo data and information to support the latter is limited.

■ Reduce neuropathic pain – intravenous lignocaine, for example, reduces spontaneous pain, allodynia, and hyperalgesia.

■ Help manage acute postsurgical and postoperative ileus after colorectal surgery - intravenous lidocaine is used in humans to manage acute postsurgical pain and reduce postoperative ileus after colorectal surgery. Lidocaine may reduce the potential for ileus in horses after general anaesthesia and is commonly used as an adjunct in colic surgery.

6. Techniques of local anaesthesia

There are numerous effective local and regional blocks available for use in small and large animals with route of administration and choice of drug depending on the clinical situation. As it is beyond the scope of this paper to describe in any detail all therapeutic uses for the local anaesthetics, only a brief list is presented here.

a) Topical anaesthesia (e.g. lidocaine has a fast onset of action and a duration of action of 1 to 2 hours. It is metabolized by the hepatic CP-450 system by N-demethylation and excreted in the urine).

b) Infiltrative (e.g. for suturing a laceration).

c)Surface anaesthesia (e.g. benzocaine is a water-soluble ester type agent used for surface anaesthesia of non-inflamed tissues; proparacaine is a topical corneal and conjunctival surface anaesthetic agent with minimal tissue irritation).

d)Peripheral nerve blocks (e.g. mepivacaineproperties are similar to lidocaine; equipotent with a slightly longer duration of action).

e)Epidural (spinal anaesthesia, e.g. bupivacaine intermediate onset of action of 20 to 30 minutes but has a long duration of action [4.5 to 10 hours]).

f) Neurolytic anaesthesia (e.g. ethyl alcohol). g)Regional anaesthesia. h) Intra-articular (e.g. bupivacaine).

Topical capsaicin is widely used in humans to treat diabetic neuropathy, neuralgia associated with herpes-virus infection, and osteoarthritis. Capsaicin is the active component found in chilli peppers. It binds to the TRPV1 receptor on nonmyelinated primary afferent nerve fibres, and with repeat application, desensitisation occurs due to the degeneration of these pain fibres, leading to hypoalgesia. Reinnervation occurs when the capsaicin is discontinued.

7. Mixing local anaesthetics

It is possible to combine local anaesthetics but the physiochemical properties of all the possible mixtures are not well known or characterised. So the decision to do so rests with the clinician. The mixture of 2.5% lidocaine and 2.5% prilocaine in an oil/water emulsion has a lower melting point than separate local anaesthetics and allows for a higher concentration of local anaesthetic to be used. This combination, known as EMLA cream, has been used to decrease venepuncture pain in children.

Selected references

1. Auroy Y et al Major complications of regional anesthesia in France: The SOS Regional Anesthesia Hotline Service. Available at pubmed.ncbi.nlm.nih.gov/12411815/

2. Conzemius MG, Brockman DJ, King LG, & Perkowski SZ (1994) Analgesia in dogs after intercostal thoracotomy - a clinical-trial comparing intravenous buprenorphine and interpleural bupivacaine. VeterinarySurgery,23(4), 291-298.

3. Grubb T & Lobprise H (2020) Local and regional anaesthesia in dogs and cats. Overview of concepts and drugs (Part 1). Available at onlinelibrary.wiley.com/doi/full/10.1002/ vms3.219

4. IASP (2020) www.iasp-pain.org/publications/iasp-news/iasp-announces-revised-definition-of-pain/

specific local anaesthetic drug information

5. Ilkiw J (2001) Local anaesthesia and local anaesthetic techniques. WSAVA 2001.vin.com/ VINDBPub/SearchPB/Proceedings? PR05000/PR00013.htm (accessed October 2007).

6. Johnson SM, Saint John BE, & Dine AP.Local anaesthetics as antimicrobial agents: a review.Available at pubmed.ncbi.nlm.nih.gov/ 18426354/

7. Melzack R and Casey KL (1968) Sensory, Motivational, and Central Control Determinants of Pain - A New Conceptual Model. In: The Skin Senses Proceedings of the First International Symposium on the Skin Senses Held at The

Florida State University in Tallahassee, Florida. Compiled and Edited by D R. Kenshalo, Published by Charles C Thomas, USA

8. Taylor A and McLeod G (2020) Basic pharmacology of local anaesthetics. Available at www.bjaed.org/article/S2058-5349(19)30152-0/ fulltext#relatedArticles

9. Webster CRL (2001) Clinical Pharmacology. Teton NewMedia, Wyoming, USA. pp. 22-23. 10.www.nysora.com/topics/pharmacology/ clinical-pharmacology-local-anesthetics/)

11 . www.physio-pedia.com/Pain_Mechanisms 12.www.openanesthesia.org/placental_ transfer_local_anesthetics/

Some

Bravecto Spot-On for Dogs has been granted a permit (PER90837) by the Australian Pesticides and Veterinary Medicine Authority (APVMA) to allow minor use in wombats for the control of sarcoptic mange. Sarcoptic mange causes significant animal welfare and conservation concerns, especially for barenosed wombats living in Australia. Bravecto, together with WIRES Wildlife Rescue have teamed up to assist wombat welfare by distributing Bravecto Spot-On for Dogs treatment to volunteers around Australia to combat the disease.

Itis recorded that sarcoptic mange affects 150 species of wild mammals around the world, making it one of the most widespread of parasitic diseases affecting wildlife, domestic animals and humans. Wombats suffer the worst form of mange disease – commonly known as crusted mange – that causes a slow, painful death if left untreated. It caused by a

tiny parasitic mite that burrows into the skin of an animal, commonly known as scabies inhumans.

The introduction of this permit (PER90837) provides a breakthrough in managing the disease and conserving the wellbeing and welfare of wombats living in Australia.

Bravecto bolsters wombat survival Zoetis Teatseal recycling helps farmers fight plastic waste

“Sarcoptic mange causes some of the most extreme animal suffering I have ever seen,” Scott Carver, Disease Ecologist at the University of Tasmania said. “Wombats that become infected gradually decline over approximately three months until they become so weakened that they die from opportunistic infections. Sarcoptic mange is an important animal welfare issue as it can limit the size of populations and cause declines that wipe out wombats in some areas.”

“The WIRES Rescue Office has recorded a doubling of wombat rescues over the past five years,” Kristie Newton of WIRES said. “It is estimated mange is present in 90 per cent of wombat populations.1 The faster wombats receive treatment for this horrendous disease, the higher their chance of survival, which is why spreading awareness is so important.”

Fluralaner, the active ingredient in the product, effectively controls mange in wombats. It has been shown to resolve skin lesions in a wombat with mange in one to three treatments. Research suggests it is well tolerated and effective.2

“This permit means that we are now able to treat more wombats, ending their suffering and potentially saving their lives. This longlasting treatment breaks the life cycle of a mite which gives us a great opportunity to perform strategic population-wide treatments. To page 30

Animal health business Zoetis is working with Australian dairy farmers and veterinarians to contribute to a greener environment and help local communities. Zoetis has partnered with TerraCycle to launch a recycling initiative for dairyfarmers in an effort to keep plastic waste out of landfill. The innovative recycling initiative sees the plastic syringes melted down, pelletised, and this raw material can be made into new items such as garden beds, watering cans and outdoor furniture.

TerraCycle is a much-awarded waste management company operating across 20 countries. It partners with leading consumer product companies, retailers, and cities to recycle products and packages that would otherwise end up in landfill.

The recycling program supports the recycling of empty Teatseal syringe packaging. To page 30

Hip-hop inspires Indigenous communities on animal health

From page 1

where, students and staff explored the themes around being a responsible pet owner, and then wrote and recorded the song and music video toshare the important messages in their own words.

“The result is a deadly track that will make you wanna get your claws out, flex your fur and start to purr!” Brownfield said.

AMRRIC collaborate with many stakeholders within and outside the classroom, – from STEM projects

to community events, and initiatives such as this music video – to raise awareness of animal health in rural and remote Indigenous communities.

“By showcasing the talent and hard work of the children involved in the project, AMRRIC are thrilled to launch this music video as part of rebranding our education work under the Dog Mob Cat Crew,” AMRRIC Education Officer Michelle Hayes said.

“Our education program covers both community and school-based

projects and as this video demonstrates, we are always working to explore different ways to engage young people and promote responsible pet ownership across remote communities. We are thankful to our supporters and collaborating communities for making these wonderful projects possible.”

To view the video, visit www.amrric.org/ news/view/hip-hop-music-videoi nspires-indigenous-communitieson-animal-health/

Call out for citizens scientists: where did all the Christmas beetles go?

From page 3

Latty suggested the possibility that Christmas Beetle larvae may be accidentally treated with insecticides as it is quite difficult to differentiate them from other species. She also pointed out that the lawns we tend to plant in Australia are not usually native grasses, which may also be impacting Christmas Beetles’ ability to survive. “When we have data, we can also focus on specific regions and

species so restoration can occur,” Latty said. “We can create targeted campaigns aimed at restoring habitat, or reducing the use of insecticides, or encouraging people to consider native alternatives to traditional lawns.”

In the meantime, Latty hopes citizen scientists mobilise across Australia to help the Christmas Beetle Project. “I would love it if this was something everyone did around Christmas time,” she said. “Go out

Bravecto bolsters wombat survival

From page 29

This is the best chance we have had yet in abolishing mange in localised populations,” Newton said.

As the largest wildlife rescue organisation in Australia, WIRES volunteers are in paddocks and scaling riverbanks daily fighting the disease. Together with WIRES, Bravecto is ensuring that volunteers have access to Spot-On for Dogs to assist them in saving wombats lives as well as making a significant dent in disease prevalence.

For moreinformation, visit www.wires. org.au

References

1. WHA Fact sheet: Sarcoptic mange in Australian wildlife: https://static1.squarespace.com/ static/5d0991e19ea6e200018bdb37 /t/5d1066d97afa9100012a8682/ 1561356001140/Sarcoptic-Mangein-Australian-Wildlife-May-20172.0.pdf

2. Wilkinson et al. Fluralaner as a novel treatment for sarcoptic mange in the bare-nosed wombat (Vombatus ursinus): safety, pharmacokinetics, efficacy, and practicable use. Parasites Vectors (2021) 14:18.

Zoetis Teatseal recycling helps farmers fight waste

From page 29

Teatseal is a non-antibiotic product used to prevent mastitis infections during the dry-off period. The preventative treatment is administered using a plastic syringe that is not recyclable in kerbside bins and, depending on herd numbers, the amount of plastic generated per farm can be significant.

Zoetis have partnered with a number of veterinaryclinics across Australia to provide places where farmers can return used syringes. When dropped at their local participating clinic – there are currently 100 participating clinics – used syringes are placed in a recycling box. Australia produces around 8000 tonnes of waste farm plastics ayear, but only a small percentage are currently recycled. In the last three years, the Australian Federal Government has strengthened its commitment to ensure the Australian agriculture sector is contributing to global sustainable development goals.

“This is the first time we’ve run a scheme like this in Australia, following the tremendous success of a similar program implemented

by Zoetis in New Zealand,” Lance Williams, Zoetis Senior Vice President and Cluster Lead Australia and New Zealand, said.

“Whilst we have only recently launched this initiative in Australia, we’ve been impressed by the enthusiasm and uptake from veterinary clinics and dairyfarmers wanting to participate in this program.”

Since launch, the Teatseal recycling initiative has returned more than 495kgs of plastic. Zoetis plans to build on that volume and demonstrate its commitment to achieving carbon neutrality across the company by 2030.

Jean Bailliard, General Manager of TerraCycle ANZ said the new partnership demonstrates even more ways communities can reduce their environmental impact.

“Teatseal is made from a mix of plastics that can’t go in kerbside recycling. Through our new partnership with Zoetis, we’re able to provide farmers and veterinarians with solutions to divert these plastics from landfills so they can be repurposed.”

For further information visit www.zoetis.com.au.

and take pictures of Christmas Beetles and send them in!”

You can sign up to the Christmas Beetle Project here: https://university-comms.sydney.edu.au/survey. p hp?sid=30092&name=registeryour-interest-in-becoming-a-citizenscientist&fbclid=IwAR3GFSS094bQ BLO0xtcEyk3YHgGAQIJx7JbxGkSk R_MkgNOIQ8iZ7oLZ93M

■ JAI HUMEL

Abstracts - canine osteoarthritis

From page 14

structure modifying osteoarthritis drugs and regenerative therapies. C Pyee1,N Brunigess2,M Pefferss#1,E Comerfordd#1 J Small Anim Pract. 2022 Oct;63(10):721-738.doi: 10.1111/jsap.13495.

1Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, William HenryDuncan Building, 6 West Derby Street, Liverpool, L7 8TX, UK.

2University of Liverpool Small Animal Teaching Hospital, University of Liverpool, Leahurst Campus, Chester High Road, Neston, CH64 7TE, UK. #Contributed equally.

Abstracts - sheep farmers

From page 14

relief following tail docking or castration. This is likely due to the perception that the procedures are not painful enough to warrant pain relief, and concern over time and cost. This highlights the need to educate farmers about lamb pain and distress following tail docking and castration, and its negative impact on animal welfare. Farmers also need pain relief techniques and tools that can be administered simultaneously with these procedures to save time and labour cost.

KKongaraa1,R Corner-Thomass2, S Brueree1,K Lawrencee1,M C Gatess1

NZ Vet J.2022 Oct 12; 1-27.doi: 10.1080/00480169.2022.2135626.

1School of Veterinar y Science, Massey University, Palmerston North, New Zealand.

2School of Agriculture and Environment, Massey University, Palmerston North, New Zealand.

TheVeterinarian

Sydney Magazine Publishers Pty Ltd ACN 102752787 ISSN 1447-9768

PO Box 305 Millthorpe NSW 2798

Tel: 02 9487 6627

Director - Clem Martin Email: clem.martin@vetmag.com.au

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

Editor - Luke Martin Tel: 0418 698 228

Email: luke.martin@vetmag.com.au

National Sales Manager

James Martin Tel: 0432 575 877

Email: james.martin@vetmag.com.au

Designer - Anne Norrell

Email: annenorrelldesign@gmail.com

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 orSydney Magazine Publishers Pty Ltd.

Subscriptions - Clem Martin Tel: 02 9487 6627

Email: clem.martin@vetmag.com.au

Phone

www.theveterinarian.com.au

Subscriptions

Australia

$93.50 for 1 Year $138.60 for 2 Years $182.60 for 3 Years

New Zealand

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

*All rates arequoted in Australian dollars

The first liquid solution for hypertension

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

References: 1. Glaus, T.M., et al. (2019) Efficacy of long‐term oral telmisartan treatment in cats with hypertension: results of a prospective European clinical trial. JVetInternMed, 33(2), 413-422. 2. Zimmering, T. et al. (2015) Effect of Semintra® and owner observations on quality of life in cats with Chronic Kidney Disease - update on cat owner feedback (“EASY Programme”). Poster presentation at SEVC 2015, Barcelona. Boehringer Ingelheim Animal Health Australia Pty. Ltd. Level 1, 78 Waterloo Road, North Ryde, NSW 2113. Semintra® is a registered trademark of Boehringer Ingelheim Vetmedica GmbH – used under licence.