The essential publication for BSAVA membersThe essential publication for BSAVA members

companionFEBRUARY 2013

Intracranial disease in a Hungarian Vizsla

How To…Approach non-healing superfi cial corneal ulcers P12

SAVSNETThe next step

P4

Nurses and AnaesthesiaResults of consultation P6

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Clinical evaluati on of a pre-ti ed ligati ng loop for liver biopsy and parti al liver lobectomyThe authors found that the pre-ti ed ligati ng loop is a versati le and safe method for liver biopsy or lobectomy – though alternati ve methods of haemostasis should always be available.

Doxorubicin/piroxicam combinati on for transiti onal cell carcinoma in dogsDoxorubicin/piroxicam combinati on therapy is well tolerated in dogs with TCC although PFS, OS, and biological response rates appear modest. The combinati on with surgery appears to off er a survival advantage – however, this may refl ect tumour locati on and volume.

Two methods of gastric decompression for management of gastric dilatati on-volvulusThe authors found that both orogastric tubing and gastric trocarizati on are associated with low complicati on rates. Trocarizati on had a higher success rate and lower failure rate.

Effi cacy of hypofracti onated radiotherapy for nasal tumors in dogsThe results suggest that hypofracti onated radiotherapy could be a viable opti on for the treatment of nasal tumours in dogs

companion is published monthly by the British Small Animal Veterinary Association, Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL2 2AB. This magazine is a member-only benefi t. Veterinary schools interested in receiving companion should email companion@bsava.com. We welcome all comments and ideas for future articles.

Tel: 01452 726700Email: companion@bsava.com

Web: www.bsava.com

ISSN: 2041-2487

Editorial BoardEditor – Mark Goodfellow MA VetMB CertVR DSAM DipECVIM-CA MRCVSCPD Editor – Simon Tappin MA VetMB CertSAM DipECVIM-CA MRCVSPast President – Andrew Ash BVetMed CertSAM MBA MRCVS

■ CPD Editorial TeamPatricia Ibarrola DVM DSAM DipECVIM-CA MRCVSTony Ryan MVB CertSAS DipECVS MRCVSLucy McMahon BVetMed (Hons) DipACVIM MRCVSDan Batchelor BVSc PhD DSAM DipECVIM-CA MRCVSEleanor Raffan BVM&S CertSAM DipECVIM-CA MRCVS

■ Features Editorial TeamAndrew Fullerton BVSc (Hons) MRCVSMathew Hennessey BVSc MRCVS

■ Design and ProductionBSAVA Headquarters, Woodrow House

No part of this publication may be reproduced in any form without written permission of the publisher. Views expressed within this publication do not necessarily represent those of the Editor or the British Small Animal Veterinary Association.

For future issues, unsolicited features, particularly Clinical Conundrums, are welcomed and guidelines for authors are available on request; while the publishers will take every care of material received no responsibility can be accepted for any loss or damage incurred.

BSAVA is committed to reducing the environmental impact of its publications wherever possible and companion is printed on paper made from sustainable resources and can be recycled. When you have finished with this edition please recycle it in your kerbside collection or local recycling point. Members can access the online archive of companion at www.bsava.com .

3 BSAVA NewsLatest from your Association

4–5 SAVSNETThe next stage

6–7 Nursing & Anaesthesia ConsultationYour comments reviewed

8–11 Clinical ConundrumA case of intracranial disease in a Hungarian Vizsla

12–16 How To…Approach non-healing superficial corneal ulcers

17 Congress SocialBig comedy talent for Congress Party Night

18–19 Slow eatersHow to get the anorexic tortoise eating

20–21 Tortoise partiesThe benefits of pre- and post-hibernation meetings

22–25 BSAVA Congress Affiliate MeetingsOffering even more CPD for those with special interests

27 PetSaversLatest fundraising and funding news

28–29 WSAVA NewsThe World Small Animal Veterinary Association

30–31 The companion InterviewDr Ruth Cromie

33 Focus On…An invitation to BSAVA Scottish Congress 2013

34–35 CPD DiaryWhat’s on in your area

Additional stock photography:www.dreamstime.com© Brianguest; © Cynoclub; © Ivan Kmit; © Michael Flippo

www.stockfreeimages.com© Brett Critchley; © Colicaranica; © Vichaya Kiatying-angsulee

SPECIAL ISSUE OF EJCAP NOW AVAILABLE

Don’t forget that as a BSAVA member you are enti tled to free online access to EJCAP – register at www.fecava.org/EJCAP to access the latest issue.

www.fecava.org/EJCAP to access the

What’s in JSAP this month?

Here are just a few of the topics that will feature in your February issue:

that are not candidates for conventi onal multi fracti onated radiotherapy.

Quality of canine spermatozoa retrieved by percutaneous epididymal sperm aspirati onIn case of ejaculati on failure due to pathological conditi ons in dogs, the collecti on of spermatozoa from the cauda of the epididymis could be an opti on for providing gametes for assisted reproducti ve technologies.

Curett age and diathermy: a treatment for feline nasal acti nic dysplasia and superfi cial squamous cell carcinomaThis study suggests that curett age and diathermy is an eff ecti ve treatment for feline acti nic dysplasia and for superfi cial squamous cell carcinoma involving less than 50% of the nasal planum. Curett age and diathermy is an easily mastered technique, requiring minimal equipment.

Log on to www.bsava.com to access the JSAP archive online. ■

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Important reminderPractice badge deadlineThe deadline for Practice Badge registrations for Congress is 6 March. This registration is an excellent way to send as many people from your practice as possible. It provides a four day registration with access to the science (vet or nurse) and exhibition allowing you to send four different people – one per day. Purchase of this registration is a privilege of membership. If you have any questions email congress@bsava.com or to book visit www.bsava.com/congress. ■

TodayWEDNESDAY

March

Supporting Southern Africa CPDWe recently reported a donation from

BSAVA toward the WSAVA CPD initiatives taking place in Southern Africa. The money has been put to

good work, as Jill Maddison, Chair of WSAVA’s CE committee, told us recently: “2012 was a very good year for WSAVA CE in Southern Africa. Four meetings were run for veterinary surgeons from Mozambique and Swaziland, Botswana, Zambia, and Kenya.

“All of the £10,000 BSAVA donation was spent on CE activities – none was spent on administration. WSAVA is very grateful for the increased support from BSAVA – the major sponsor and the level of support is seminal to the success of the programme. Without the increased support in 2012, the final meeting of the year in Kenya, which was arranged at short notice, would not have been possible.”

Dr Ndurumo M Steven who attended the course in Nairobi wrote to say: “Please accept my sincere gratitude for Saturday’s course on Small Animal Surgery. I am a vet in charge of over 500 working dogs in East Africa and the insights and training imparted will go a long way in improving my surgical skill and decision making in terms of diagnosing surgical conditions.” ■Special EJCAP issue on

diagnostic imagingA special issue of the online European Journal of Companion

Animal Practitioners (EJCAP) focused on diagnostic imaging is available now.

In the issue, several European experts present their ‘tips and tricks’ on radiographic, arthroscopic and ultrasound examination of selected joints and abdominal organs. It also provides an insight into the newer tools of CT and MRI to show how these can help to diagnose some more elusive conditions.

As the official organ of the Federation of European Companion Animal Veterinary Associations (FECAVA), it is exclusively available to FECAVA members – that means BSAVA members.

Registration is easy: interested practitioners should simply go to www.fecava.org/ejcap and follow the instructions. Once registered and logged in, all EJCAP online and previous print volumes of EJCAP can be accessed directly. ■

Scientific Policy Officer Sally Everitt attended a meeting at the BVA in December which covered a wide range of

issues relating to the breeding and the sale of dogs.

Subjects raised included puppy farming and the increasing number of puppies coming from abroad, as well as the feasibility of banning sales of puppies from pet shops and introducing controls on Internet sales.

There was also discussion about consumer expectations when buying a puppy which may often be driven by convenience and choice rather than the health and welfare of the puppy. The use of puppy contracts, such as those produced by the RSPCA/BVA-AWF and the Kennel Club Assured Breeders Scheme were

also discussed and it was suggested that these should become mandatory although this is unlikely to happen unless a single format can be agreed.

It was also acknowledged that much of the burden for dealing with problems of irresponsible breeding falls on charities and volunteer organisations.

If you have any comments or experiences regarding puppy contracts please email Sally Everitt (s.everitt@bsava.com). ■

BSAVA attends canine welfare meeting

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The Small Animal Veterinary Surveillance Network, SAVSNET, was established in 2008 by a team of veterinary scientists at the University of Liverpool, with the aim of monitoring the disease status of the vet-visiting small animal population in the UK. In a successful pilot scheme, lasting three years, the researchers were not only able to demonstrate the feasibility and validity of the data collection methods but also provided information on common reasons for consultation and antimicrobial prescribing

SAVSNET the next stage

BSAVA and the University of Liverpool have now entered into a partnership to take SAVSNET forward to the next stage, where it will be able to provide surveillance data to the profession,

research scientists, the public and policy makers.SAVSNET Ltd has been set up as a charity with

clear objectives:

1. To advance the education of the public in general (and particularly amongst scientists) on the subject of diseases of small animals, their diagnosis and management, and to promote research for the public benefit in all aspects of that subject and to publish the useful results.

2. To promote humane behaviour towards animals by providing appropriate education to the public in matters pertaining to animal welfare and the prevention of suffering among animals.

3. To advance the education of the general public in areas relating to human disease and its relationship to animal disease, for example zoonotic disease and antimicrobial resistance, as a result of research carried out on animal disease.

SurveillanceSurveillance is the ongoing measurement, collection, collation, analysis, interpretation and timely dissemination of health-related data, essential for describing disease occurrence and for the planning, implementation and evaluation of disease control measures.

Surveillance is already carried out in human medicine, and the farm animal sector as well as for diseases in horses and wildlife. However, there is currently no coordinated small animal surveillance in the UK.

SAVSNET aims to provide information on the frequency of diseases in the small animal vet-visiting population through two parallel surveillance projects.

Project 1: Laboratory dataProject 1 will involve the recruitment and collection of quarterly data from participating commercial diagnostic labs. The aim of this project is to develop a consortium of diagnostic laboratories from across the UK, similar to the system established for equine disease by the Animal Health Trust/Defra/British Equine Veterinary Association. Data from each participating laboratory will be collected and collated centrally. It is hoped that this system will provide insight into the current disease status of the small animal population in the UK, identify temporal and geographic trends in specific disease diagnosis, and allow us to identify the emergence of new strains or new diseases.

Project 2: Practice dataProject 2 will involve data collection from veterinary practitioners at the end of each consultation, using their existing practice management computer systems. It captures four types of data from consultations in participating veterinary practices:

■ Routine signalment information such as species, age, breed and sex

■ The reason why the animal was presented to the vet (clinical text field)

■ Treatment prescribed and dispensed, including dose and route of administration

■ Syndromic information on each animal (captured by means of a simple questionnaire appended at the end of consultations).

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The collection of syndromic information will be built into the existing practice computer system, allowing SAVSNET to collect information about particular conditions ranging from specific diagnoses to broad disease syndromes. This is achieved by activating a short series of questions at the end of the consultation. In order to minimise the workload of individual vets the first question will determine whether the consultation is relevant to the subject under investigation and therefore whether the subsequent questions (usually 4 or 5) are applicable.

The intention is for SAVSNET to collect data that will enable it to:

■ Monitor disease trends over time and highlight appropriate interventions

■ Identify populations at risk and monitor treatments and outcomes

■ Provide data resources for academics and others ■ Improve general public awareness of small animal

diseases and prevention ■ Provide a route to clinical benchmarking for vets in

small animal practice.

Summarised reports of the data collected will be provided on the SAVSNET website. They will include:

■ Publically available information in the form of maps and charts providing information about the incidence of disease

■ Benchmarking data for contributing practices (password-protected to ensure practice anonymity)

■ Anonymised summaries of benchmarking data for BSAVA members.

Possible areas for surveillance in Project 11. Endemic diseases which we currently vaccinate

against, e.g. distemper, parvovirus, leptospirosis, cat ’flu, myxomatosis, VHD. Providing information on the occurrence of these diseases will provide evidence for practitioners on disease and the need for vaccination as well as possibly providing information on vaccination failures.

2. Exotic and emerging diseases such as those considered endemic in Europe which may enter or have recently entered the UK as a result of travelling pets. Information on any increase in the incidence of these diseases will be important for veterinary surgeons in practice to alert them to previously rare diseases and enable them to provide clients with advice on preventive healthcare if the incidence of these diseases increases. Infections that could be considered in this category are:

a. Lyme disease (Borrelia burgdorferi)b. Erlichiac. Babesiad. Leishmaniae. Dirofilaria immitisf. Angiostrongylus vasorum

3. Antimicrobial resistance – this is topical and important, so monitoring the sensitivity profile of some common (e.g. Pseudomonas) and important (e.g. MRSA/MRSP) microorganisms through laboratory submissions would be useful both for practitioners and policy makers.

Possible areas for surveillance Project 2 include:1. Mortality data: age, breed, medical cause of

death / euthanasia2. Poisoning/Toxicity cases – looking at age,

breed, toxin, level of treatment and outcome3. Preventive healthcare – e.g. was worming/

parasite control/weight/dental hygiene discussed? Was product/service purchased?

4. Postoperative complications – type of operation, type of complication. ■

SAVSNET AT CONGRESS

SAVSNET will be on stand 104 in the NIA at BSAVA Congress 2013. Come and meet the staff and researchers and discuss how you can get involved. If you have any questi ons in the mean ti me you can contact Suzanna Reynolds, SAVSNET Project Manager, on savsnet@liverpool.ac.uk or visit www.savsnet.co.uk.

YOUR CHANCE TO HAVE YOUR SAY

■ What conditi ons would you like to see covered by SAVSNET?

■ Would you be prepared to parti cipate in SAVSNET?   Yes   No

■ Your role in the Practi ce

■ Practi ce management system

■ Contact details

Please send this form to Sally Everitt , Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL2 2AB or email s.everitt @bsava.com

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Review of nursing & anaesthesia consultation

The consultation at the end of last year was prompted by a motion in the Scottish Parliament which proposed that “like humans,

animals should only receive care from extensively-trained staff, and calls on veterinary surgeries to only use registered veterinary nurses to monitor anaesthetised animals” (John Finnie, August 9th), and the RCVS review of its current guidance.

We received 112 responses including 71 from veterinary surgeons and 37 from veterinary nurses.

Who is monitoring anaesthesia in veterinary practice?The results (Table 1) indicate that Registered and Listed Veterinary Nurses are monitoring the majority of anaesthetic in the practices covered by this survey. The variation in results reflects the staff employed in a particular practice, with seven respondents stating that they worked in practices which did not employ an RVN. These practices used a combination of student veterinary nurses and lay staff involved in nursing duties to monitor anaesthesia.

Interestingly, of the four respondents who reported sometimes using lay staff not normally involved in nursing duties to monitor anaesthesia, all employed qualified nursing staff, suggesting that this

may have been necessary to cover times when the qualified staff were unavailable, as indicated in this comment from a veterinary surgeon:

“We have advertised for an RVN for 4 weeks in the Veterinary Times without a single applicant. We are offering above average pay in a busy happy team. Unfortunately there is now a complete dearth of VNs probably as a result of the training process being too much of an onerous paper-chase. We have had no option but to employ 2 unqualified nurses and train them in-house as necessary.”

How much responsibility should the veterinary nurse have?We also asked whether veterinary nurses should be allowed to alter vaporiser settings without authorisation from the veterinary surgeon.

This question was answered by 111 respondents: 89 respondents said yes including 53/71 (77%) vets and 33/37 (89%) of nurses. Several respondents answered with provisos about the veterinary surgeon retaining primary responsibility and having confidence in the individual nurse, as indicated in the quote below from a veterinary surgeon:“Yes, but the Vet should be responsible for the anaesthetic and satisfied that the

nurse is competent to act with this degree of autonomy. The buck should stop with the vet and the nurse should be acting for the vet.”

Several veterinary nurses indicated that they were already taking on this responsibility, as indicated in the following response:

“Yes, because in practice we have more experience altering the vaporiser equipment and animals’ response.”

20 respondents said no, including 3 nurses. One respondent went on to say that this is because veterinary inhalation anaesthetics are classified as POM-V. Another replied:

“No, the act of varying anaesthesia needs the input from the vet, unless the nurse is anaesthesia qualified.”

We also asked if qualified veterinary nurses should be allowed to induce anaesthesia.

In total 61 said no to this question, including 48/71 (68%) vets and 13/37 (35%) nurses, while 39 respondents 15/71 (21%) vets and 22/37 (59%) nurses said yes. However, 12 of those that answered yes added a proviso to their answer, for example that there should be a veterinary surgeon present, that the patient had been graded as low risk (American Society of Anaesthesiologists (ASA) Grade 1 or 2 (Table 2)), that this should only apply to drugs given intramuscularly and not incrementally, or that the nurse had undertaken further training.

Training for lay staff and qualified veterinary nursesWe asked respondents if they would encourage lay staff to undertake the City & Guilds Level 2 Certificate in assisting veterinary surgeons with anaesthesia and sedation and monitoring animal patients developed by SPVS and the College of Animal Welfare.

Although the majority of respondents replied no to this question, veterinary surgeons were equally divided in their responses, with 33 replying yes, 33 replying no and 3 undecided.

In the October issue of companion we asked for your views on the role of the veterinary nurse in monitoring and maintaining anaesthesia. Sally Everitt, BSAVA Scientific Policy Officer, reports

Blank Always Usually Sometimes Never

Registered Veterinary Nurse 6 46 45 11 4

Listed Veterinary Nurse 49 14 9 12 28

Student Veterinary Nurse 26 6 21 48 11

Lay staff involved in nursing duties 19 6 4 38 45

Lay staff not normally involved in nursing duties 36 0 0 4 72

Table 1: Who assists the Veterinary Surgeon in monitoring anaesthesia in your practice?

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ASA scale

Physical descripti on Veterinary pati ent examples

1 Normal pati ent with no disease Healthy pati ent for ovariohysterectomy or castrati on

2 Pati ent with mild systemic disease that does not limit normal functi on

Controlled diabetes mellitus, mild cardiac valve insuffi ciency

3 Pati ent with severe systemic disease that limits normal functi on

Uncontrolled diabetes mellitus, symptomati c heart disease

4 Pati ent with severe systemic disease that is a constant threat to life

Sepsis, organ failure, heart failure

5 Pati ent that is moribund and not expected to survive >24 hours with or without surgery

Shock, multi ple-organ failure, severe trauma

E Describes pati ent as an emergency Gastric dilatati on–volvulus, respiratory distress

Table 2: American Society of Anesthesiologists (ASA) scale of physical status

Physical descripti on Veterinary pati ent examples

Normal pati ent with no disease Healthy pati ent for ovariohysterectomy or castrati on

Pati ent with mild systemic disease that does not limit normal functi on

Controlled diabetes mellitus, mild cardiac valve insuffi ciency

Pati ent with severe systemic disease that Uncontrolled diabetes mellitus,

Nurses on the other hand were more clearly opposed, with 29 replying no, 10 replying yes and 3 undecided.

Those who would not encourage lay staff to undertake this course focused on the level of training, as indicated in these quotes, the first from a vet, the second from an RVN:

“No. Without an understanding of the anatomy, physiology and pharmacology involved, this would put staff and patients at risk.”

“No, I would not. Lay staff should not be undertaking such a serious role without adequate training. Anaesthesia is often complicated by many medical factors which require someone with a complete education to understand. Anaesthesia is not something that can simply be separated out of the nursing profession without adversely affecting the outcome for our patients.”

In contrast, the respondents were almost unanimous in their support for further training in anaesthesia for qualified veterinary nurses, 63 (89%) vets and 37 (100%) of nurses supporting this proposal, giving reasons such as those below :

“I have been a nurse for over 25 years and still find anaesthesia difficult sometimes. I would like to see a stand-alone anaesthesia

qualification above and beyond the VN syllabus. It is not a level 2 qualification.”

“Yes, as this field is always progressing. New research, techniques and drugs are always being developed. Nurses have an obligation to keep up-to-date with this new information.”

ConclusionsThis consultation has collected the views of veterinary surgeons and nurses from a wide range of different practices and the responses do, to some extent, reflect the variation in small animal veterinary practice in the UK both in terms of staffing and caseload. Both veterinary surgeons and qualified veterinary nurses are aware of the need to recognise the qualification and role of the qualified veterinary nurse, although not all practices have sufficient qualified nurses for them to monitor all anaesthetic episodes.

The position of student veterinary nurses in monitoring anaesthesia is also controversial as many practices rely on student veterinary nurses to do this:“We could not function if student nurses were banned from monitoring. I suspect the number of training places would also drop dramatically. It should be the vet-in-charge’s decision whether a student

BSAVA VETERINARY NURSE MERIT AWARD

The BSAVA Veterinary Nurse Merit Awards provide short structured CPD programmes. Each programme consists of a two-day course and a follow-up one-day practi cal a couple of months later, two webinars, and an online assessment.All those who complete the programme and assessment sati sfactorily will receive a certi fi cate and badge. The programmes are not a formally accredited qualifi cati on, but the awards provide recogniti on of interest and experti se in a parti cular fi eld. It is expected that nurses would renew their award with a short refresher course every 5 years.The BSAVA Veterinary Nurse Merit Award programmes are very competi ti vely priced, at just over £400 plus VAT for BSAVA Veterinary Nurse e-Members. This includes registrati on for both the initi al two-day course and the follow-up one-day course a couple of months later, access to both webinars (live and recorded) and the online assessment. Non-members have to pay the full price of £720 plus VAT.The fi rst group of students completed the anaesthesia course in autumn 2012; provided there is suffi cient demand the course will be re-run in 2013. For further details or to express an interest in att ending the course please contact Jane Greenwood – j.greenwood@bsava.com.

(or any) nurse is competent to monitor and adjust anaesthesia. We carry out suitable and sufficient training on the job, which is separate from the official VN training”.

Further training in anaesthesia for qualified veterinary nurses, such as the BSAVA Nurse Merit Award in Anaesthesia and Analgesia, while professionally rewarding, may only be appropriate and relevant if the nurse is in a practice where she will be able to use her skills.

If you have any further comments relevant to this consultation please email Sally Everitt at s.everitt@bsava.com. ■

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Clinical conundrum

Alex Gough, SAMSoc committee member invites companion readers to consider a case of intracranial disease in a Hungarian Vizsla

Case presentationA 4-year-old neutered male Hungarian Vizsla presented with a 7-day history of progressive neurological signs, including stumbling, bumping into objects, not coming when called, leaning to the left, aimless pacing in both directions and disorientation. The dog was fully vaccinated and there was no history of foreign travel.

Heart rate was 120 beats per minute, with a regular rhythm. Body temperature was 38.2°C. Blood pressure was 150 mmHg. Hydration status was normal. There was some mild pain on flexion of the neck to the left. Ophthalmological examination was within normal limits. No abnormalities were seen on examination of the external ear canals. There was no evidence of Horner’s syndrome. No other physical abnormalities were detected. Neurological examination findings are summarised in Table 1.

What is your problem list?■■ Obtundation and disorientation■■ Head tilt to the right■■ Vestibular ataxia■■ Hemiparesis on the left with proprioceptive deficits■■ Neck pain

What is your neurolocalisation?The presence of head tilt implies vestibular disease, which may be peripheral or central. It is important to differentiate between central and peripheral vestibular disease since the differential diagnoses, treatments and prognoses vary greatly between these two forms of the disease. Table 2 lists findings that can be used to differentiate central from peripheral vestibular disease. In this case a head tilt with reduced conscious proprioception is suggestive of central vestibular disease.

If the lesion is in the brainstem, the head tilt should be towards the side of the lesion and proprioceptive deficits will be ipsilateral. Paradoxical vestibular syndrome describes a head tilt opposite to the side of a cerebellar lesion. In this case, if the lesion were on the left then the presence of a head tilt to the right would be consistent with paradoxical vestibular disease. However, pure cerebellar lesions do not cause proprioceptive deficits.

mentati on Mildly obtunded and disorientated, with compulsive pacing

Posture Head ti lt to the right

Gait Vesti bular ataxia and left -sided hemiparesis

ambulatory? Yes

Postural reacti ons Reduced/delayed hopping, hemiwalking and paw placing reacti ons in left pelvic and thoracic limbs

urinary functi on Normal

Cutaneous trunci refl ex

Normal

segmental spinal refl exes

Withdrawal intact in all four limbs, patellar refl ex intact, perineal refl ex intact

Cranial nerves No abnormaliti es detected. No positi onal nystagmus could be induced

Palpati on Normal muscle tone and size; Neck pain was elicited on manipulati on

table 1: neurological examination

table 2: differentiating central from peripheral vestibular disease– = rarely associated; + = sometimes associated

Central Peripheral

History of oti ti s externa

+ +

History of ototoxins – ++

Conscious propriocepti ve defi cits

++ –

Head ti lt ++ ++

Spontaneous nystagmus

+ ++

Positi onal nystagmus ++ –

Verti cal nystagmus ++ –

Rotatory nystagmus + +

Heart rate was 120 beats per minute, with a regular rhythm. Body temperature was 38.2°C. Blood pressure was 150 mmHg. Hydration status was normal. There was some mild pain on flexion of the neck to the left. Ophthalmological examination was within normal limits. No abnormalities were seen on examination of the external ear canals. There was no evidence of Horner’s syndrome. No other physical abnormalities were detected. Neurological examination findings are

conscious proprioception is suggestive of central vestibular disease.

If the lesion is in the brainstem, the head tilt should be towards the side of the lesion and proprioceptive deficits will be ipsilateral. Paradoxical vestibular syndrome describes a head tilt opposite to the side of a cerebellar lesion. In this case, if the lesion were on the left then the presence of a head tilt to the right would be consistent with paradoxical vestibular disease. However, pure cerebellar lesions do not cause proprioceptive deficits.

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Delayed placing reactions can be caused by deficits in the forebrain (cerebrum and thalamus), brainstem, spinal cord and peripheral nervous system. As the spinal reflexes were normal, peripheral nervous system involvement is unlikely.

Changes in mentation, such as obtundation and disorientation, can be associated with forebrain disease. Neck pain can be due to disease of the cervical spine, or referred pain from intracranial disease. The neurolocalisation therefore is most likely to be multifocal intracranial disease.

Can the disease be further characterised by its time course and presentation?It can be useful to characterise a neurological case according to the following aspects:

1. Onset2. Clinical course3. Pain4. Lateralisation5. Neurological localisation

The characterisation of this disease is therefore:

1. Subacute onset2. Progressive3. Painful4. Right-sided head tilt, left-sided proprioceptive

deficits5. Multifocal intracranial disease

What are your differential diagnoses, and which are most likely at this stage?The DAMNIT-V classification of diseases, (Degenerative; Anomalous; Metabolic; Nutritional; Neoplastic; Infectious; Inflammatory; Idiopathic; Traumatic; Toxic; Vascular) is useful in formulating differential diagnosis lists in neurological cases.

The most important differential diagnoses in this case are:

■■ Anomalous: e.g. hydrocephalus■■ Metabolic: hepatic encephalopathy, uraemic

encephalopathy, electrolye/acid–base disorders■■ Neoplastic: e.g. lymphoma, metastatic neoplasia

■■ Immune-mediated: meningoencephalitis of unknown origin

■■ Infectious: toxoplasmosis, neosporosis, canine distemper virus

Subacute, deteriorating, lateralising/asymmetrical brain disease with associated cervical hyperaesthesia makes an inflammatory/infectious disease process likely. The multifocal nature of the signs mean that neoplasia such as lymphoma or metastatic malignancies are also possible. Degenerative, anomalous and nutritional conditions are unlikely given the age and time course, but some anomalous conditions such as hydrocephalus can remain compensated for some time, then decompensate abruptly, for example with minor, unnoticed trauma.

The breed is not typically affected by hydrocephalus. There is no history of trauma, and the lateralisation of the signs makes a metabolic condition directly causing the neurological signs unlikely.

What initial screening tests would be useful in this case?Routine haematology, biochemistry bile acid stimulation and urinalysis were performed to look for possible metabolic diseases causing the clinical signs, and to screen for concurrent disease. These were unremarkable.

What imaging modality would you choose in this case?MRI is the imaging modality of choice for the brain. This helps demonstrate space-occupying lesions such as solid neoplasms, and will often show evidence of inflammation. MRI scans (Figures 1 and 2) showed multifocal hyperintensities on T2 weighted and FLAIR series throughout the right forebrain and right brainstem.

The cerebellum was grossly unaffected. There was shift of the midline from right to left, consistent with a mass effect, but no discrete mass was seen. There was a patchy contrast uptake on T1 scans post gadolinium through the forebrain and brainstem. This is consistent with breakdown of the blood–brain barrier or an increase in vascularity, which can be associated with inflammation/infection and neoplasia.

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Clinical conundrum

Parameter result reference range

WBC 22/µl <5

RBC 0 0

CSF protein 40.3 mg/dl <25

100 cell diff erenti al: 93 lymphoid cells, 7 monocytoid–macrophage cells

table 3: Cerebrospinal fluid analysis

Figure 2: t1 weighted transverse mri scan of the brain showing patchy contrast uptake (arrows) in the right forebrain. a mid line shift from right to left is clearly visible, demonstrating a mass effect

What further tests would you perform at this stage?Cerebrospinal fluid analysis is often important to make a diagnosis in cases of suspected inflammatory brain disease. It is useful to perform MRI prior to CSF analysis, however, to screen for conditions which might make CSF collection unsafe, such as herniation of the cerebellum through the foramen magnum.

CSF analysis from a cisternal puncture showed a moderate mixed lymphoid and monocytoid–macrophage leucocytosis (see Table 3), with elevated protein level.

Figure 1: t2 weighted transverse mri scan of the brain showing diffuse hyperintensity in the right forebrain

What is your most likely diagnosis from these findings and what other diseases would you test for at this stage?The MRI and CSF findings are suggestive of multifocal disease that may be inflammatory or neoplastic in character. Lymphoma cannot be completely excluded on this CSF finding, but the presence of monocyte–macrophages makes this less likely; ultimately, response to treatment in this case ruled out lymphoma.

A PARR test (PCR for Antigen Receptor Rearrangements), which helps determine whether lymphocytes are derived from one single clone (as in lymphoma) or many (reactive disease) could be performed, but the results take some weeks to be received and so the test was not performed in this case.

Serology tests for Toxoplasma and Neospora were negative in this case, as was PCR on the CSF for distemper. Retesting to check for rising titres of antibodies to Toxoplasma and Neospora could be useful, but as the disease was already at least 7 days into its course, and there was no antibody response at all at this stage, this was not performed.

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Contribute a CliniCal Conundrum

If you have an unusual or interesting case that you would like to share with your colleagues, please submit photographs and brief history, with relevant questions and a short but comprehensive explanation, in no more than 1500 words to companion@bsava.comAll submissions will be peer-reviewed.

aCknowledgements

Thanks to Kate Murphy and Holger Volk for comments on the text.

Present a case report at BSAVA Congress SAMSoc meeting

Do you have an interesting or unusual small animal medicine case that you think might be suitable as an oral presentation? SAMSoc is currently inviting submissions for its annual case report session during the pre-BSAVA satellite meeting on 3 April 2013.

Suitable cases should have interesting discussion points but need not be so unusual that they would be considered publishable. Three or four case reports will be selected by the SAMSoc committee for presentation at the meeting (presentation duration will be confirmed nearer the time). Successful selection entitles the author to free registration for the satellite meeting. At the end of the session the audience will vote by ballot for their favourite case report. Prizes (kindly donated by Vétoquinol) will then be awarded:

■■ 1st place: £300■■ 2nd place: £150■■ 3rd place: £50

Abstracts should be written in Microsoft Word using Times Roman 12-point font. The first line should contain the title in capitals; the second line all authors; the third the institution(s) the author(s) are affiliated with; followed by the actual abstract starting as a new paragraph. The print must be black, and the abstract should be no more than 500 words in length (including title, author names and institutions). The line spacing should be 1.5. A single diagram, figure or table can be included.

Deadline for submission of abstracts is midnight on 17 February 2013. Abstracts should be submitted electronically to kit@vetfreedom.com

The most likely diagnosis was granulomatous meningoencephalitis, but this requires histological confirmation, and other inflammatory brain diseases are possible, so this case may be more correctly classified as a meningoencephalitis of unknown origin (MUO).

What treatment would you recommend for this case?Immunosuppression is the mainstay of treatment in cases of MUO, prednisolone, with or without other immunosuppressive drugs, being most commonly given. Although there are a number of studies demonstrating the treatment of MUO with different immunosuppressive drugs, no direct comparison has been made, so it is unclear whether one regime is superior. In this case prednisolone was prescribed at a dose of 2 mg/kg twice daily by mouth for 7 days, followed by a slowly decreasing dose over a 6-month period.

Cytarabine (cytosine arabinoside) 50 mg/m2 was given subcutaneously, twice daily for 2 days, repeated every 3 weeks for the first 6 weeks. Cytarabine is commonly used in the treatment of inflammatory CNS disease, due to its penetration of the blood–brain barrier. Cytarabine is a cytotoxic drug and precautions in dosing, handling and administration must be strictly followed.

How long should treatment be continued?It is not clear whether these cases generally require life long immunosuppressive treatment, or whether therapy can be withdrawn. This case showed a marked improvement on treatment, with all neurological signs resolving over 7 days. Therapy was discontinued after 6 months, and no further treatment has been required in the following 2 years for this condition. ■

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How to approach non-healing superficial corneal ulcers

Corneal ulcers are commonly encountered in general practice. While most ulcers heal within a few days some fail to do so for an extended period of time, sometimes many

months. Corneal ulcers may fail to heal for a variety of reasons. The following article explains the approach and management of non‑healing corneal ulcers.

Corneal ulcers can be classified depending on their depth, as ulceration can be a surface or stromal defect of the cornea. The cornea consists of three layers: the surface epithelium with its basement membrane, the corneal stroma, and the endothelium with its basement membrane (Descemet’s membrane). An ulcer is classified as superficial if only the surface epithelium is lost (Figure 1).

The epithelium is a thin protective layer (making up only about 10% of the corneal thickness) that prevents bacterial invasion of the underlying stroma and is well innervated. It has very little mechanical strength, thus the simple loss of the corneal epithelium does not threaten the integrity of the globe. However, if an ulcer also affects the corneal stroma (about 90% of the corneal thickness) the mechanical strength of the cornea can become compromised, depending on the extent of the lesion.

If a lesion results in the full thickness loss of stromal tissue only the single‑layered corneal

Claudia Busse of the Animal Health Trust helps us look at this problem the right way

Figure 1: A 7-year-old Boxer with a 5-week history of superficial corneal ulceration. Note the lack of corneal vascularisation from the limbus Table 1: Criteria to identify a non-healing ulcer

1. The ulcer has been present for more than two weeks.2. Underlying causes or factors that might delay healing

have been excluded, such as:a. Dry eye (remember to check the tear producti on

in the fellow eye too, as a subclinical dry eye might otherwise be missed)

b. Mechanical trauma (entropion, lid tumours, extra lashes: disti chiasis, ectopic cilia – turn the lid margin out, most ectopic cilia sit in the central upper eyelid, they can be diffi cult to fi nd if they are not pigmented)

c. Foreign bodyd. An incomplete blink; this can occur due to

conformati onal issues (brachycephalic breeds), paresis or paralysis of the eyelids or protrusion of the globe.

3. The ulcer has loose epithelial edges. This is demonstrated with a fl uorescein test. As the dye runs under the loose epithelium and extends further than the ulcer margin outlined by the epithelium (Figures 2 and 3). Make sure you fl ush excess fl uorescein dye immediately to avoid false positi ve results as the dye enters the stroma.

4. The ulcer does not extend into the stroma (the convex contour of the corneal surface remains present).

5. There is no apparent infi ltrati on of the corneal stroma. The cornea tends to have a mild bluish ti nt due to oedema, however there should not be white or yellow densiti es in the stroma.

endothelium and Descemet’s membrane remain. In this case, the ulcer is called a descemetocele. Corneal endothelium and Descement’s membrane have very little to no mechanical strength and rupture of the globe is highly likely without adequate surgical intervention.

The healing of corneal ulcers varies depending on their depth. Superficial ulcers should heal within seven to ten days, the length of time needed for the epithelium to renew itself. This is true for the majority of superficial corneal ulcers and these are classified as uncomplicated ulcers.

If corneal healing is delayed then a complicated ulcer is present. It is essential to re‑assess the patient for underlying causes of the ulceration. Ongoing mechanical trauma caused by lid malformations, an incomplete blink, abnormally placed lashes (distichiasis, ectopic cilia), foreign body material, inadequate tear production (keratoconjunctivitis sicca), etc. have to be excluded.

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Note that the tear production should always be measured in both eyes as subclinical dry eye is easily missed if the ulcer results in a temporarily increased tear production in the affected eye. The normal tear production in an ulcerated eye is expected to exceed the normal range of the Schirmer tear test (15–25 mm/minute).

Deep (or stromal) corneal ulceration either results from a severe initial trauma (e.g. cat scratch injury) or is due to degradation of the stromal collagen by collagenases. These enzymes can be produced by bacterial and fungal organisms as well as the body’s own cells, particularly neutrophils, but also corneal epithelial cells and fibroblasts. Bacterial involvement should be suspected in cases of stromal ulceration.

The non-healing ulcerAn ulcer should only be considered as a true non‑healing ulcer if it is superficial and all potential underlying causes have been excluded (Table 1). These ulcers fail to heal due to inadequate adhesion between the corneal epithelium and stroma. The underlying cause is still not fully understood, but a variety of theories attempt to explain the lack of adhesion between the tissues. Abnormalities of the epithelial basal cells and basement membrane, a reduced number of adhesion complexes, a change in the superficial stroma, modified innervation and a lack of growth factors have all been reported. In the ophthalmic literature these ulcers are referred to as Spontaneous Chronic Corneal Epithelial Defects (SCCEDs), but other names like Boxer ulcer or indolent

Figure 2: The same dog as in Figure 1 after fluorescein staining of the cornea. Note how the fluorescein distributes under the epithelium indicating the poor adhesion between epithelium and stroma

Figure 3: A 13-year-old dog with non-healing ulcer following fluorescein staining of the cornea. Note how the fluorescein also extends under the epithelium delineating its loose edges. The prominent corneal oedema of the ageing cornea is likely to contribute to the ulceration

ulcer are still frequently used. SCCEDs usually occur in middle‑aged dogs.

The condition can occur in any breed and a predisposition is described in the Boxer. Presenting signs include a varying degree of ocular discomfort (excessive tear production, blepharospasm, enophthalmos). Loose epithelial edges adjacent to the ulcer margin, indicating the insufficient connection between epithelium and stroma, are a classical feature of the condition (Figures 1, 2 and 3). Patients often present with a reflex uveitis indicated by a slightly miotic pupil, which is easiest to diagnose using distant direct ophthalmoscopy. Other ocular abnormalities are generally absent.

After identifying a non‑healing ulcer it is important to counsel and educate the owner. Healing of non‑healing ulcers can take weeks to months even with adequate treatment. A treatment plan should address the following three points:

■■ Prevention of a secondary bacterial infection■■ Pain relief■■ Encouraging healing.

Prevention of secondary bacterial infectionPrevention of bacterial infection is achieved using topical broad‑spectrum antibiotics such as fucidic acid, chloramphenicol or a triple antibiotic combination (neomycin, polymyxin B and bacitracin). Ointments are usually given two to three times daily while drops are given four times daily.

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How to approach non-healing superfi cial corneal ulcers

Pain reliefPain relief is provided with atropine eye drops to relax the ciliary muscle spasm (successful if pupil becomes dilated, a single application is usually enough), as well as systemic non‑steroidal anti‑inflammatories. Remember to use as little topical medication as possible as preservatives (components of most eye drops) can delay healing. Topical steroidal or non‑steroidal anti‑inflammatories should also be avoided for the same reason.

Encouraging healingHealing of the ulcer is encouraged by removing the loose epithelium and debriding the superficial stroma following the administration of a local anaesthetic. The initial debridement can be performed with a clean cotton bud or ophthalmic stick swab (Figure 4). Make sure you use several cotton buds as they become less effective when wet. Gently rub the loose epithelium off by following the direction of the ulcer margin. This usually leads to a dramatic increase in ulcer size and can sometimes affect the entire cornea (Figure 5 and 6).

Note that gentle debridement is not able to remove healthy and well adhered corneal epithelium. The healing rate after debridement alone is thought to be around 60% within two weeks time. To increase the healing rate to 80% within two weeks a keratotomy can be performed (Figure 7).

A keratotomy stimulates the superficial stroma and encourages the adhesion between new epithelium and the stroma. The most commonly performed technique is a grid keratotomy; however punctate keratotomies as well as corneal burrs are also successfully used. When performing a grid keratotomy ensure that the patient is well restrained; sedation or general anesthesia may be indicated.

Figure 5: The same eye as in Figure 4 following the debridement. Note the increased size of the superficial ulcer

Figure 6: The same eye as in Figure 3 following debridement. Note the increased size of the superficial ulcer

Figure 4: Performing debridement of the ulcer shown in Figures 1 and 2 using cotton buds

Start by applying a topical anaesthetic and wait for it to work (approximately 5 minutes). Then remove the loose epithelium using cotton buds. The grid keratotomy itself is performed with a 21 gauge needle. Use the needle with its bevel up. Avoid turning it on its side as this results in a knife‑like effect that results in deep cuts and potentially uncontrolled damage to the corneal stroma. Use the tip of the needle to draw a grid into the superficial stroma (Figure 8). This must be done gently so that it is just visible after flushing the ocular surface. Avoid deep cuts that result in gaping of the corneal tissue.

Note that the more prominent the grid the more damage to the corneal stroma occurs and scarring will occur. The use of burrs has increased over the last few years. This technique allows very gentle debridement of the superficial stroma and results in less corneal scarring than a grid keratotomy (Figure 9). Following the procedure, flush the ocular surface with 1 in 50 povidone solution to prevent infection.

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Figure 7: A schematic illustration of a grid keratotomy. (A) The superficial ulcer. (B) Fluorescein staining helps to illustrate the loose epithelium. (C) Debridement of the loose epithelium usually leads to a significant increase of the superficial ulcer. (D) Gentle use of a needle to draw a grid into the superficial stroma (keratotomy). (E) The finished result. Note how the grid extends slightly over the edges of the adhered epithelium

D

E

C

BA

Figure 8: The same eye as in figures 1, 2, 4 and 5 following grid keratomy

Figure 9: Using a purpose-designed diamond ophthalmic burr for the debridement of the epithelium and superficial stroma is becoming more and more popular in veterinary ophthalmology

Debridement and keratotomy can be repeated several times depending on the progress of the ulcer, but at least 10–14 days should be left between treatments to give the cornea time to heal. Should the ulcer not improve after two or three treatment intervals a superficial keratectomy can be performed. This involves the removal of the most superficial layers of the stroma by performing a superficial lamellar keratectomy. This procedure requires an operating microscope and special instruments, and is better left to the specialist ophthalmologist.

Potential complicationsComplications of non‑healing corneal ulcerations include a secondary bacterial infection or a sterile corneal melt as well as excess granulation tissue formation. Bacterial infection and sterile corneal melt both result in infiltration of the cornea and loss of stromal tissue. Corneal melt results in yellowish (infiltrated) stromal tissue that appears soft and jelly-like. Melting corneal tissue has hardly any mechanical strength.

To identify a bacterial infection, corneal swabs for culture and cytology should be taken. The swab should be submitted for culture and sensitivity and the smear for cytology can be stained immediately using Diff‑Quik or Gram‑staining to give a quicker answer as to the presence of bacteria that may be involved in the melting process.

The treatment of the bacterial infection and prevention of further melting of the cornea should be the main objectives in these patients. To prevent progression of the melt undiluted autologous or

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How to approach non-healing superfi cial corneal ulcers

Table 2: How to avoid the most common mistakes made when dealing with a non-healing ulcer

1. Give the ulcer enough ti me to heal, leave at least 10–14 days between treatments that encourage healing (debridement, keratotomy).

2. Never perform a grid keratotomy in a cat as it is likely to cause a corneal sequestrum that will then have to be removed surgically.

3. Never perform a grid keratotomy in a stromal corneal ulcer (stromal ulcers are defi ned by a loss of stromal ti ssue and impairs the normal convex surface of the cornea, even a very subtle indentati on has to be taken very seriously as it might indicate a corneal melt, see above).

4. Do not overuse atropine eye drops: atropine should be given to eff ect and one drop is usually suffi cient to dilate the pupil. Its use should be avoided in pati ents with low tear producti on or glaucoma.

5. Non-healing ulcers are usually not infected, therefore:a. Use a broad-spectrum anti bioti c to prevent infecti onb. Anti bioti cs should only be swapped if there is a

concern about secondary infecti on (development of purulent discharge, or white or yellow discolorati on of the cornea)

c. Use the anti bioti c only as oft en as needed (4x daily for drops; 2–3x daily for ointment), avoid too much topical medicati on as the preservati ves in it might delay healing

heterologous serum can be used to inhibit the collagenases that destroy the corneal collagen. Should the ulcer reach more than 50% of the corneal depth, surgical intervention should be discussed.

Another common complication is the formation of excess granulation tissue. This is often the result of excessive debridement and resultant dramatic vascularisation of the cornea. This can be very alarming for the owner and is sometimes the reason for referral (Figure 10). When presented with this problem you should initially perform a fluorescein test to check if the corneal ulcer has actually healed or is still present. If the ulcer is healed and the cornea does not stain with fluorescein, no treatment is required. Topical cyclosporine eye ointment or steroids can be used to encourage regression of the blood vessels. If ulceration is still present, extensive loose epithelial edges are often present, too. It seems that the vascular change in the stroma also prevents an adhesion of the epithelium. The treatment should be amended and topical cyclosporine eye ointment can help to reduce the corneal neovascularisation and therefore encourage an adhesion between epithelium and stroma. Severe corneal neovascularisation is a prognostic factor, indicating that significant scarring of the cornea will occur. Re‑organisation of the cornea takes several months and the transparency of the tissue may still improve over time. Again cyclosporine eye ointment can encourage regression of the corneal neovascularisation and prevent or reduce corneal pigmentation.

Feline non-healing ulcersWhen dealing with non‑healing ulcers in the cat the identification of the condition is the same as in dogs (see Table 1). However in most patients the initial involvement of Feline Herpes Virus 1 (FHV-1) has to be suspected. If FHV-1 is identified then the addition of topical or systemic antiviral medication can speed up the healing process in these patients. While loose epithelial edges should also be debrided in cats a keratotomy is contraindicated as it entails a high risk of corneal sequestrum formation, a condition that requires surgical management.

ConclusionWith logical exclusion of potential underlying causes of ulceration and appropriate treatment, most ulcers will eventually heal; however the owner should be made aware that SCCEDs have the potential to recur and may affect the same as well as the fellow eye in the future. ■

Figure 10: Prominent vascularisation following a long-standing healing process of a non-healing ulcer. This is particularly common after too frequent or aggressive debridement, or trauma to the cornea

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Congress · 4–7 APRIL 2013

Big comedy talent

BSAVA Congress is renowned for its Saturday Party Night, having played host to a variety of top comedy acts such as Michael McIntyre and Jason Manford, along with popular

music acts like Olly Murs and Scouting for Girls. Following in this rich tradition, BSAVA is delighted to announce its top-drawer comedy talent for 2013 and hope that you will join us Birmingham for a night of laughter and dancing.

Headline funny manOur Comedy Club headliner is Alan Davies. He is one of the UK’s best known actors and comedians, having stared in the BBC hit series Jonathan Creek for an incredible 13 years. Indeed, Alan has enjoyed a hugely varied acting career with credits including Lewis, Hotel Babylon, Bob and Rose and The Brief.

Of course in recent years Alan has become a mainstay of the long-running comedy trivia quiz show QI, where he is an ever-present and much maligned team member. After a brief hiatus, Alan returned to the comedy circuit in 2012 with his hit tour ‘Life is Pain’ and we are proud to be welcoming him to BSAVA Congress.

More laughsSupporting Alan will be the exciting and emerging talent that is Chris Ramsey, who is currently on his sell-out tour of ‘Feeling Lucky’, the follow-up to his Foster’s Edinburgh Comedy Award-Nominated ‘Offermation’. Chris has recently been starring in BBC Two’s brand-new sitcom Hebburn, alongside Vic Reeves, and is a regular face on Celebrity Juice, Never Mind The Buzzcocks and 8 Out of 10 Cats.

Mister MCThe compère for the evening will be Rhodri Rhys, whose act combines sharp wit and observation with a natural geniality. His material is broad and colourful, drawing on his own experiences in his unusual path to a comedy career, while deftly seaming in religion, business, sport and history. Rhodri has been the subject of a number of TV and radio programmes in Welsh, Czech and English (S4C, TV Nova, BBC Wales) and has done comedy gigs in Warsaw, Moscow, New York, Budapest, Prague and Bahrain. n

Coming to the Party?

You can either order your Party Night ticket at the same time as you register, or you can add it in afterwards – email congress@bsava.com or call 01452 726700 if you have any questions. It is sometimes possible to buy tickets at the event from the Birmingham box office, but those who’ve been disappointed in recent years will testify that the event is often sold out very quickly, so book in advance to secure your place.

for Congress Party Night

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Congress · 4–7 APRIL 2013

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Slow eaters

Tortoises are famous for taking their time over most things that they do. But if a pet tortoise is slow to regain its appetite after emerging from its winter hibernation, that may not be through its

own choice.Delegates attending Congress will be told that

post-hibernation anorexia is a common condition in pet tortoises living in British conditions far away from their preferred Mediterranean or tropical climates. Kevin Eatwell, an RCVS-recognised specialist in exotic animal and wildlife medicine, will explain the causes of the problem, how to recognise the key clinical signs and what can be done to get the animal eating again.

Noticing the signsKevin, a lecturer at the University of Edinburgh veterinary school, will show that temperature and hydration levels are crucial in bringing ectothermic creatures like the tortoise out of their winter torpor but pet owners may not appreciate just how important they are.

“Anorexia after hibernation is a huge problem. But many cases are dealt with at home by their owners and do not see a vet until the anorexia becomes prolonged,” Kevin explains.

“A tortoise should be feeding and drinking within a week of coming out of hibernation. However the temperatures in the UK lead to the tortoise being sluggish for too long a period as they are too cold. So many owners will expect their tortoise not to eat for quite some time after hibernation before seeking veterinary advice,” he says.

Once the owners appreciate that their pet is not eating they will become understandably concerned. “Many tortoises may not be ill per se but just cold and dehydrated. When the weather warms up they are able to compensate fully. Others that continue to be anorexic may have an underlying illness such as liver, reproductive or kidney disease and these, of course, do need to see a vet urgently,” he warns.

Proper careUnder appropriate conditions individuals of the most commonly kept tortoise species Testudo graeca and T. hermanni will live for up to 50 years. Yet a failure by the owners either to deal with the underlying management problems or to seek advice from their veterinary practice can certainly reduce a pet’s life expectancy.

“Anorexia can be fatal due to metabolic disturbances and dehydration. Renal and liver disease are likely consequences of prolonged anorexia and dehydration, as they are likely to lead to hepatic lipidosis and renal gout.”

When presented with an anorexic tortoise, the first step is to get a full history to understand how the animal has been managed over its hibernation period. If the information is limited, then the clinician will have to rely solely on their own assessment of the animal’s condition.

Kevin warns against placing too much faith in the weight ratios that may appear in older textbooks to indicate the extent of the animal’s weight loss. These were originally created from measurements of wild tortoises of

Congress speaker, Kevin Eatwell, to reveal how to get the anorexic tortoise eating

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BSAVA MANUAL OF REPTILES, 2nd editi on

Edited by: Simon Girling and Paul Raiti

Repti le medicine has become signifi cantly more sophisti cated, especially in the areas of anaesthesia, diagnosis, nutriti on, surgery and therapeuti cs. This editi on provides the same high standards of relevant informati on as the original Manual, with the important additi on of superb full-colour photographs throughout.

Member price: £59.00Non-member price: £89.00

Buy online at www.bsava.com

Congress · 4–7 APRIL 2013

Edited by: Simon Girling and Paul Raiti

Repti le medicine has become signifi cantly more sophisti cated, especially in the areas of anaesthesia, diagnosis, nutriti on, surgery and therapeuti cs. This editi on provides the same high standards of relevant informati on as the original Manual, with the important additi on of superb full-colour photographs throughout.

Member price: £59.00Non-member price: £89.00

Buy online at www.bsava.com

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KEVIN AT CONGRESS

Friday 5 April

■ 13.50–14.40, Hyatt BallroomNursing the exoti c pati ent: introducti on to nursing repti les

■ 14.50–15.35, Hyatt BallroomNursing the exoti c pati ent: repti le criti cal care

Saturday 6 April

■ 9.25–10.10, Hall 5 ICCGetti ng to grips with repti les: the repti le consult

■ 11.05–11.50, Hall 5 ICCGetti ng to grips with repti les: approach to post-hibernati on anorexia in chelonians

■ 12.00–12.45, Hall 5 ICCGetti ng to grips with repti les: approach to repti le dermatology

■ 14.05–14.50, Hall 5 ICCGetti ng to grips with repti les: reproducti ve disease in chelonians

■ 16.50–17.35, Hall 10Pain management: recognising and controlling pain in repti les

two species and can be misleading when examining captive-bred animals.

“It also does not take into account pathological processes that will make the tortoise weigh more such as coelomic ascites, egg carriage or fatty liver. A full health check in combination with weight records for that tortoise is advised alongside the use of a ratio if the owner or vet wishes to use one.” Tortoise parties can perform a useful function – see the article that follows on pages 20–21.

In his presentation, Kevin will highlight the influence of adequate rehydration in helping a tortoise regain its appetite. He will show how blood samples and urinary pH and specific gravity measurements will show the extent of the patient’s fluid imbalance and give a much clearer insight into its condition. He will also explain how to introduce an oesophagostomy tube in those severe dehydrated animals that fail to respond to more basic treatment.

Fortunately, those cases are likely to be in a minority. “Ideally, anorexic tortoises should be warmed up and bathed in shallow water to allow them to warm up and rehydrate immediately after hibernation. The main problem is getting the information out to owners and ensuring they have a suitable set-up to do this at home, while waiting for the UK weather to warm up enough for it to occur spontaneously.” ■

Editor’s note: Readers are also directed to How To Approach the Anorexic Tortoise by John Chitty in July 2012 companion

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Tortoise parties

Tortoise parties provide many benefits to the practice, the client and the patient. As well as being great fun for all, there are several key advantages to running tortoise parties.

An opportunity for the patient to have a clinical examination prior to hibernation can be very beneficial. The patient is weighed and an assessment made of general overall body condition. At this stage, any concerns over poor body condition or ill health can be raised and action taken as necessary, preventing the patient from entering hibernation in a less than optimal condition.

Similarly, a clinical examination after hibernation can prove just as useful. Signs of illness or anorexia following hibernation are not always immediately obvious to owners. A clinical examination at this stage can therefore provide information on general health and condition prior to the owner noticing signs of illness, and will facilitate prompt treatment if required.

Due to a high percentage of tortoises carrying a worm burden, de-worming can be carried out at the tortoise party. For larger tortoises such as the Sulcata we carry out a faecal examination in the first instance to establish whether worms are present.

UltrasonographyCarrying out an ultrasound scan of all female tortoises during the tortoise party can provide information on their reproductive status. The presence of eggs or follicles are of interest.

If eggs are present on ultrasound scanning it is advisable to radiograph the patient to ascertain the number of eggs present and whether the eggs are normal and intact. At this stage, the author’s clinic advises induction of egg laying to relieve the egg burden, and to ensure that the weight estimations are accurate. If the eggs are abnormal or damaged surgery is preferred over induction of egg laying.

Some older lone females can carry a large number of follicles that do not progress to eggs. In these cases, the option to pair the female with a male to induce ovulation may be taken, or it may be decided to carry out elective ovariectomy if the follicles are static and do not progress over several scans.

Good for ownersThe tortoise party provides clients with an opportunity to meet other tortoise owners, to share experiences and ideas, and often to discuss potential tortoise breeding. In grouping a large number of clients together for the tortoise party, we are able to offer a reduction on the usual examination and ultrasound scan fees. Providing a reduction in costs helps to encourage clients to take advantage of the tortoise party, and will ensure client and patient numbers make the event viable. Grouping clients together makes it very convenient to us as a practice, as well as relieving the strain on the appointment system of fitting in more than 200 checks twice yearly!

The scan is included in the check price and is essentially free. This is compensated for by the increased pick-up rate of problems and is of huge benefit in training us all to use the scanner.

RVN Laura Smith of Anton Vets in Hampshire talks about the benefits of pre- and post-hibernation tortoise parties, and offers some tips gained from running her own meetings in the spring and autumn

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One benefit to the practice of running a tortoise party, that must not be underestimated, is the reinforcement of the bond between client and practice. Also, for new members of the veterinary team, attending the tortoise party can provide valuable experience of clinical examinations and the reasoning behind ultrasound scanning in female tortoises, as well as routine husbandry.

Organisation of tortoise partiesTortoise parties are only for well tortoises; no sick tortoise should be examined due to the risk of spreading infection.

Our clinic offers tortoise parties to all of the clients on their database: whether they are experienced owners or first-time tortoise keepers the health check and scan (if appropriate), and de-worming are available for all.

The whole family is encouraged to attend, with the aim of providing information and advice to all of those involved in the tortoise’s care and husbandry.

Village halls, community centres and other venues can all be used for holding tortoise parties. Large practice waiting rooms can also be considered, however the timing of the party must be planned well to ensure the party is held during a quiet time, and catering can be quite a challenge in practice.

In our experience, village halls work incredibly well. Taking clients and patients out of the clinic setting helps to make the experience less formal, and clients seem more inclined to ask questions.

The duration of the party can be as long or as short as desired, with the content dictating how much time is required.

Our practice sends an invitation through the post to all tortoise owners, and also advertises on the practice website, Facebook and Twitter pages. Once owners have responded to the invitation, a rough timescale is devised and owners planning to attend are given a time to arrive (this prevents all arriving at once!).

What is discussedInformal interactions are encouraged, with owners asking questions while their tortoise is being examined. There is no set script to follow when

examining the tortoise with the client, as each case is discussed as per its individual requirements. A large proportion of the conversation centres around the husbandry and general care of the client’s tortoise.

Client support materialAs a ‘green’ practice, all of our client support material is linked to our website. Clients are encouraged to look at our website for fact sheets and husbandry information, as well as Frequently Asked Questions relating to a variety of topics.

A stock of appropriate supplementation, such as vitamins, is taken to the tortoise party so that clients can stock up on whatever they require.

With good organisation, advertising and lots of tea and coffee on the day (for clients and practice staff), tortoise parties have many benefits to the client, patient and also the practice. n

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22 | companion

Congress ·4–7APRIL2013

On the Wednesday of Congress BSAVA sponsors meetings for its Affiliate Groups, offering even more CPD for those with special interests. For full details and registration to the affiliated group meetings you need to contact the organisation directly, contact details below

BSAVA Congress affiliate meetings

Association of Veterinary Soft Tissue SurgeonsVenue: Hall 7, ICCWebsite: www.avsts.org.ukContact: Alison Young – avstsadmin@fsmail.net

The AVSTS is thriving, and welcomes all vets and nurses involved with canine and feline soft tissue surgery cases. We aim to provide a thought-provoking discussion forum at our two annual meetings.

The spring meeting in Birmingham during BSAVA Congress traditionally covers ‘What’s new and hot?’ and in 2013 we have a commanding line-up of international speakers including: Karen Tobias, editor of the new surgical bible Tobias and Johnston; Sheila Crispin, chairman of the BVA Advisory Council on the Welfare Issues of Dog Breeding; Alex Reiter, Service Chief of Dentistry and Oral Surgery at the University of Pennsylvania; and David Vail, Professor of Oncology at the University of Wisconsin-Madison.

Our autumn meetings, held on a non-half-term Friday-Saturday, allow a theme to be explored with greater depth and breadth, and benefit from inclusion of the comparative aspects from human surgery, as well as from fine food, wine, and laughter. See website for further details and for how to join our happy society.

British Association of Veterinary Emergency and Critical CareVenue: The Crompton Room, Austin CourtWebsite: www.bavecc.org.ukContact: Toby Birch – secretary@bavecc.org.uk

BAVECC is a group of veterinary surgeons and nurses who have a common interest in emergency and critical care (ECC) topics. The group consists of university clinicians, emergency vets, nurses and general practitioners with a special interest in ECC. BAVECC will bring nationally and internationally recognised speakers to their BSAVA Congress meeting. One lecture is traditionally delivered by a criticalist from a human ICU/ECC department.

The topic this year is anupdate on treating the trauma patient. All vets and nurses with a special interest in ECC are invited to attend the meeting either just out of interest or to get further involved in the development of ECC in the UK. Visit the website or contact the Secretary for more information on membership of BAVECC and course registration.

British Association of Veterinary OphthalmologistsVenue: The Kingston Theatre and Waterside Room,

Austin CourtWebsite: www.bravo.org.ukContact: Claudia Hartley – secretary@bravo.org.uk

BrAVO is an internationally recognised friendly BSAVA Affiliated Group, consisting of around 200 members from all corners of the United Kingdom, as well as some European and Australian members. We are a sociable group and are always looking to welcome new members to our meetings, whether they have just an interest in ophthalmology or work as full time veterinary ophthalmologists.

BrAVO organises two meetings each year, with state of the art lectures covering all aspects of veterinary and human ophthalmology, aiming to educate both at practitioner and specialist level. Our spring meeting is a one-day BSAVA Congress meeting and includes both local and international speakers. The winter meeting is a

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Congress · 4–7 APRIL 2013

British Veterinary Behaviour Association (formerly the CABTSG)Venue: Hall 8a, ICCWebsite: www.bvba.org.ukContact: Jaqi Bunn – bvba@btinternet.com

The BVBA invites you to attend their annual study day on the 3 April 2013. The topic this year is ‘Pain and Quality of Life Assessment in Relation to the Behaviour Patient’.

Assessing quality of life and pain in veterinary behaviour patients is frequently difficult and yet it is an essential part of the consultation process. Pain may cause or at least contribute to the behaviours presented to a practitioner and decision making will be influenced by the practitioner’s belief as to what the quality of life of the patient is likely to be within its current and future environment. For these reasons the BVBA has invited experts in this field to address the meeting with talks ranging from the state of the science of the development and validation of assessment scales, to the practical application of the principles of pain and quality of life assessment with specific reference to the behaviour patient.

Invited speakers are all considered leaders in this field and include Professor Xavier Manteca, Prof Jacqueline Reid and Samantha Lindley. In addition the programme will include a range of presentations on other aspects of domestic animal behaviour selected from abstracts submitted.

two-day weekend meeting that is held in locations around the country, usually in the first half of November. Again we include international speakers, and usually a medical speaker for a comparative view in humans.

Members are kept informed of all our meetings, enjoy discounts on text books and journal subscriptions, have access to proceedings from the meetings as well as eligibility to apply for one of two travel scholarships to a value of £1000 per year. Additionally we have a range of companies exhibit their products with us each year, making it an ideal place to explore the current ophthalmic equipment on the market. The main speaker for our spring meeting will be Dr Gillian J. McLellan on glaucoma and tonometry.

British Veterinary Dental AssociationVenue: Lodges 1 and 2, Austin CourtWebsite: www.bvda.co.ukContact: Helen Hyde – secretary@bvda.co.uk

For the BSAVA Congress meeting this year the British Veterinary Dental Association will be having its usual Scientific Day. This will start with Alex Reiter from the University of Pennsylvania, USA, giving two major presentations: Advanced Periodontal Surgery in dogs, including a review of lateral sliding flaps for gingival defect repair; and Surgical Root Canal Therapy in cats and dogs, giving a step by step guide to apicectomy and retrograde filling.

There will also be presentations on how to make effective dental impressions so that crowns may be made, and a guide to dental extraction techniques in the horse. Case reports will cover exotics and rabbits. There will be a Q&A session to enable delegates to question the speakers and clarify viewpoints.

Refreshments and lunch will be provided and commercial exhibitors will be present all day to help you with your dentistry equipment needs. Delegates may feel free to bring photos and radiographs of cases they may wish colleagues present to give advice on – there will always be a committee member available during coffee breaks to help answer any questions. BVDA members are invited to stay for the AGM during the scientific meeting.

British Veterinary Dermatology Study GroupVenue: Hall 10, ICCWebsite: www.bvdsg.org.ukContact: Filippo De Bellis – treasurer@bvdsg.org.uk

The BVDSG holds two annual meetings – a day meeting prior to BSAVA Congress in April, and a weekend meeting usually in November. Both meetings attract eminent speakers from home and abroad, covering all aspects of veterinary and human dermatology. Members also have an opportunity to present their own work and findings at each meeting in the form of abstracts or short communications.

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24 | companion

Congress · 4–7 APRIL 2013

British Veterinary Zoological SoceityVenue: Hall 9, ICCWebsite: www.bvzs.orgContact: Victoria Roberts – editor@bvzs.org

The seventh BVZS satellite meeting provides BSAVA delegates and small animal practitioners in general practice the opportunity to undertake world class continuing professional development in non-domestic species medicine and surgery. The programme for the day complements and expands the exotic pet content in the main Congress allowing further development of your skills and understanding. We are again utilising a deeper understanding of exotics, presented by experienced and specialist veterinarians. Each lecture will be around an hour and a quarter in length, followed by time for questions and discussion.

The presentations will address the approach to cases seen in small zoo contract work or whilst developing an exotic pet caseload and so will be directly relevant to BSAVA and BVZS members.

Speakers include Neil Forbes on avian soft tissue surgery, Anna Meredith on how rabbit nutrition affects health and behaviour, Natalie Wissink on the care, diagnostics and common conditions of unusual small mammals, and John Chitty on the care of anorexic tortoises.

International Society of Feline MedicineVenue: Hall 5, ICCWebsite: www.isfm.net/conferencesContact: Amanda Dennant – conferences@fabcats.org

The ISFM provides a feline focus for the veterinary profession worldwide. The high quality of speakers and practical emphasis of all ISFM events has been a formula for success and usually attracts capacity audiences. Aimed at the feline-oriented practitioner, this year’s ISFM BSAVA Congress symposium

The BSAVA Congress event will be an interactive meeting entitled: Interactive Cases: Therapeutic Dilemmas in Dermatology. The BVSDG has secured Dunbar Gram and Kirstin Bergvall as the international speakers.

The British Veterinary Orthopaedic AssociationVenue: Hilton Birmingham Metropole Hotel, NECWebsite: www.bvoa.org.ukContact: Kamila Guilliard – k.guilliard@yahoo.com

Following the success and popularity of the new location for last year’s Spring meeting, the BVOA event will again be held in the Hilton Metropole, near Birmingham International Airport. Expect the best mix of international and national experts discussing current options in cruciate surgery, the role of the meniscus and much more. See the website for more information.

British and Irish Division of the European Association of Veterinary Diagnostic ImagingVenue: The Telford Room and Lodge 3, Austin CourtWebsite: www.eavdi.orgContact: Andrew Parry (General) –

andrew.parry@willows.uk.net Helen Renfrew (Membership) – Helenrenfrew@yahoo.co.uk

The EAVDI is open to any veterinary surgeon, student, radiographer or nurse with an interest in veterinary diagnostic imaging. The division organises two regular meetings each year: one meeting in Birmingham, on the Wednesday prior to BSAVA Congress, and a further two-day meeting in the following October or November.

This year, following the success of last year’s event, the division will host a satellite meeting on thoracic imaging. This will include a lecture on interpretation of thoracic radiographs given by Ruth Dennis from the Animal Health Trust, how to perform and interpret non cardiac thoracic ultrasound by Allison Zwingenberger, visiting from the University of California, Davis, and current concepts from a human thoracic imaging perspective by Dr Amanda James from Heartlands Hospital, Birmingham, amongst other interesting topics. The meeting will also have a fun film reading session with cases to test your skills.

Prices are deliberately kept low to encourage new members:

EAVDI member: £100.00Non EAVDI member: £120.00Resident: £80.00

BSAVA Congress affiliate meetings

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Congress · 4–7 APRIL 2013

‘Practical analgesia and anaesthesia for cats’, held jointly with the Association of Veterinary Anaesthetists, is likely prove as popular as ever.

Pain assessment, analgesia in routine and difficult situations, NSAID therapy, long-term pain management, sedation for the fractious as well as the compromised cat and anaesthesia for the old, the cardiorespiratory patient and in trauma situations, will all be discussed. The itinerary includes well respected speakers Liz Leece (Dick White Referrals), Sheilah Robertson (American Veterinary Medical Association), Polly Taylor (freelance consultant in anaesthesia), Sally Polson (University of Liverpool), Nicki Grint and Pamela Murison (both from the University of Bristol) and Matt Gurney (Northwest Surgeons, UK).

ISFM publishes the only peer-reviewed feline veterinary journal, the Journal of Feline Medicine and Surgery, holds an annual European veterinary congress (attended by delegates from over 30 different countries) and, this year, will be hosting the World Feline Veterinary Congress in Barcelona (June 26-30) in conjunction with the American Association of Feline Practitioners and GEMFE (ISFM’s Spanish National Partner) under the theme ‘Paediatrics and geriatrics’. Early booking is advised for all ISFM events.

■■ Canine diabetes – the role of inflammation and autoimmunity and its clinical relevance (Dr Lucy Davidson, University of Oxford)

■■ Canine liver disease – the role of viruses and the immune system (Dr Nick Bexfield, University of Cambridge).

The programme this year also includes a case report competition with a £300 cash prize open to everyone. The meeting is still ONLY £95 and this includes course notes and lunch. To book your place please contact Yvonne McGrotty. To submit a case report for consideration for inclusion in the programme (maximum 500 words; closing date for submissions 17 February 2013) please contact kit@vetfreedom.com.

Veterinary Cardiovascular SocietyVenue: Hall 11, ICCWebsite: www.bsavaportal.com/vcsContact: Jan Cormie – treasurer@vcs–vet.co.uk

The VCS BSAVA Congress meeting will focus on methods for measuring the size of the left atrium (arguably the most important echocardiographic measurement made), aspects of arrhythmias, including a panel discussion and some new thoughts on cardiac medications. Our speaker is Mark Rishniw. The meeting will have a practical approach to common issues encountered in General Practice. Please visit our website for access to the full programme and for registration.

Fees: Members £125, non-members £150 (includes lunch and proceedings) before 17 March; after this date members £150, non–members £175 (last date for registration is 25 March).

Membership of the Veterinary Cardiovascular Society is open to any veterinary surgeon or nurse from the UK and abroad with a special interest in cardiology. Annual VCS membership is £20 (standing order), £25 (if paid online or by cheque).

The society holds two meetings a year, a one day BSAVA Congress Spring and a two day Autumn meeting, usually in Loughborough in November (8–9 November 2013). We also offer travel grants annually to younger VCS members to help them attend ECVIM or ACVIM as well as a recently introduced cardiology research grant. ■

Small Animal Medicine SocietyVenue: Hall 8b, ICCWebsite: www.samsoc.org.ukContact: Yvonne McGrotty – samsoc@vetsurgeon.org

or telephone 01412 377676

Members of SAMSoc include specialist internists and general practitioners from the UK and abroad who share a passion and enthusiasm for small animal medicine. New members are always welcome. The society hosts a meeting every year at BSAVA Congress and this is suitable for everybody with an interest in small animal medicine. This year the day will include the following exciting sessions:

■■ Acute phase proteins in dogs and cats (Rory Bell, University of Glasgow)

■■ Inflammatory bowel disease: Attractive phenotype seeks permissive genotype! (Prof Kenny Simpson, Cornell University, USA)

■■ Human inflammatory bowel disease (Prof Yash Mahida, University of Nottingham)

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For more information or to book your coursewww.bsava.com

Learn@Lunch webinarsThese regular monthly lunchtime (1–2 pm) webinars are FREE to BSAVA members – just book your place through the website in order to attend. The topics will be clinically relevant, and particularly aimed at vets and nurses in first opinion practice. There will be separate webinar programmes for vets and for nurses

This is a valuable MEMBER BENEFIT

Coming soon… ■ Vomiting and regurgitation in the dog –

webinar for vets, 16 January ■ How to tell if your patients are in pain –

webinar for nurses, 23 January ■ Cruciate disease: which technique when –

webinar for vets, 13 February ■ Theatre practice – webinar for

nurses, 20 February

All prices are inclusive of VAT.

Practical approach to the diagnostic and management issues in cats with kidney disease19 FebruaryBringing the busy practitioner up to date with the issues in diagnosis and treatment, focusing on the main disease presentationsSPEAKER

Jonathan Elliott

VENUE

Hilton London Stansted Airport

FEES

BSAVA Member: £233.00Non BSAVA Member: £350.00

This won’t hurt a bit: simple, safe and effective physiotherapy and rehabilitation2 MayThis course will give you knowledge and skills which you will be able to apply to patients in your practice, supplementing the medical and surgical skills you already use

SPEAKER

Brian Sharp

VENUE

Dogs Trust, Haresfield

FEES

BSAVA Member: £338.00Non BSAVA Member: £507.00

A clinical dissection of brain disease in dogs and cats5 MarchA day of superb CPD with an engaging expert – with the option to add quad biking to your experience

SPEAKER

Pete Smith

VENUE

Wild Park Derbyshire, Brailsford DE6 3BN

FEES

WITH QUAD BIKING

BSAVA Member: £250.00Non BSAVA Member: £375.00COURSE ONLY

BSAVA Member: £200.00Non BSAVA Member: £300.00

26 CE Advert February.indd 26 18/01/2013 11:15

companion | 27

Calling for funding applications

PetSavers invites applications for a Masters Degree by Research (MDR) grant

A project will be considered by PetSavers to constitute ‘companion animal clinical research’ if it largely meets each of the following criteria in the reasonable opinion of a majority of the Committee:

■ The study involves only naturally occurring disease in small animals; there must be no experimental or artificial induction of disease

■ The anticipated results of the study will result in a change in diagnosis or management of small animal disease

■ The study is supervised by people with veterinary clinical skills and knowledge

■ Any interventions on animals (including obtaining samples) would be considered part of normal veterinary practice

■ The applicant must state how the results will directly benefit cats, dogs or other companion animals. If the benefit is not direct, they must suggest the number of further steps (and at what cost) they believe it will take before a benefit becomes apparent.

What funding is available?PetSavers will fund, for a period of one year, the following costs up to a maximum in aggregate of £35,000 (but subject to the individual limitations set out below):

a. Postgraduate student stipend (currently £15,000–£18,000)

b. Payment of University feesc. Equipment and consumables (up to

£10,000 including VAT) depending on the nature of the project.

GuidelinesTerms and conditions and application forms can be found at www.bsava.com/PetSavers/Grants.

Alternatively, please contact PetSavers on 01452 726723 or email info@petsavers.org.uk. Written enquiries should be sent to Gemma White, BSAVA, Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL2 2AB.

The deadline for MDR applications is 16 August 2013, with the final vote to be taken in March 2014. ■

Each year PetSavers funds numerous research projects designed to advance our knowledge of conditions affecting

small animals and with potential to relieve illness and suffering. In 2012, PetSavers awarded its very first MDR grant to Gina Pinchbeck of the University of Liverpool for her project entitled ‘Prevalence and risk factors for extended-spectrum beta-lactamase producing bacteria in companion animals’.

What is an MDR?The PetSavers MDR (a recognised degree at Masters level) will fund a postgraduate student to work full time on a specific research project, with or without attendance at some short courses (e.g. statistics, thesis presentation) depending on the nature of the project.

DEADLINE FOR CLINICAL RESEARCH PROJECTS (CRP)

Aft er introducing the new Masters Degree by Research (MDR) grant in 2012, the decision was taken to alternate the deadlines for applicati ons with the CRPs.Derek Att ride, Chair of the PetSavers Grants Awarding Committ ee, explains, “The reason for the shift was to award the MDR in March rather than September so that the MDR start date would fi t in bett er with the academic calendar. This gives the universiti es ti me to recruit a Masters student for a September/October start date in line with the academic year.” Applicati ons for the next round of CRP applicati ons will be March 2014, with the fi nal vote    taken in August 2014. Please check the PetSavers secti on of the BSAVA website for      specifi c dates for CRP applicati ons which will be updated nearer the ti me.

applications

in bett er with the academic calendar. This gives the universiti es ti me to recruit a Masters student for a September/October start date in line with the academic year.” Applicati ons for the next round of CRP applicati ons will be March 2014, with the fi nal vote    taken in August 2014. Please check the PetSavers secti on of the BSAVA website for      specifi c dates for CRP applicati ons which will be updated nearer the ti me.

27 PetSavers.indd 27 18/01/2013 11:16

28 | companion

The AWWC was formed in 2009 to help make welfare issues an everyday consideration for small animal practitioners. Dr Karyl Hurley explains more about the role of this committee

COMMITTEE FOCUS: THE WSAVA–WALTHAM ANIMALWELLNESS AND WELFARE COMMITTEE

Committee mission statement

The role of the Animal Wellness and Welfare Committee (AWWC) is to make welfare issues an everyday consideration for small animal

practitioners and to ensure that the WSAVA becomes a proactive and respected partner within international welfare circles, providing an opinion that balances compassion with science and practical needs.

The AWWC was formed in 2009 thanks primarily to the efforts of Drs Roger Clarke of Australia and Ray Butcher, a UK-based vet, who have dedicated their careers to advancing animal welfare and had the foresight to ensure that animal welfare was enshrined as one of the WSAVA’s four key ‘pillars’. The AWWC works closely with other WSAVA committees in delivering its goals, in particular the CE Committee

WHO SITS ON THE AWWC?

■ Dr Jolle Kirpensteijn (Acti ng President of WSAVA and Co-chair)

■ Dr Michael MoyerPast President of the American Animal Hospital Associati on

■ Dr Karyl J HurleyDVM, DipACVIM, DipECVIM-CAGlobal Scienti fi c Aff airs, Mars Petcare

■ Dr John Rossi VMDMBe (Master of Bioethics)Postdoctoral Research Fellow, Bioethics, Drexel University School of Public Health, USA

■ Dr John M RawlingsBSc MSc PhDGlobal Science, Welfare and Ethics Advisor, WALTHAM Centre for Pet Nutriti on, UK

■ Dr Nienke EndenburgPhD, Assistant Professor, Department of Animals in Science & Society, Faculty of Veterinary Medicine, Utrecht

For further informati on contact Karyl J Hurley tel: +1 908 619 1044; email: karyl.hurley@eff em.com

and the One Health Committee.The committee brings a great deal of

global expertise and experience which can collectively help to support veterinarians all around the world as they strive to increase levels of small animal welfare and wellness. Perhaps the biggest challenge faced by the committee is reaching out to those veterinarians who could most benefit from the support available – we want to work in partnership with all veterinarians to achieve our goals.

Understanding what the key problems are for veterinarians as they work to improve welfare and wellness, and getting to grips with what we can most usefully provide in terms of support, is the absolute priority for the AWWC. The research we have already conducted (see opposite) has given us a useful starting point but it’s not complete and we ask more members to get involved and give us their ideas.

Should we, for instance, explore providing fellowships in shelter medicine or other training opportunities for students with an interest in animal welfare? What further CE in this area would be most helpful and in what form? We’re also interested to know what veterinarians globally ‘sign up’ to when they qualify, so we’ll be reviewing the oaths we all swear to see how different they are. Please get involved and share your ideas! ■

KEY GOALS:

■ To promote advances in animal welfare and wellness around the world through enhanced veterinary care

■ To work with other committ ees within the WSAVA to provide the resources – informati on, CE, toolkits, etc. – to facilitate these advances

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In February 2012, the AWWC issued an online survey to WSAVA member associations to help it start to develop a global picture of the key issues

surrounding small animal welfare globally.While more data are needed to make

the results more comprehensive, the committee intends to use the initial findings to help prioritise activities into 2013.

Key findingsWhen asked to select from a list of issues, the one regarded as most important was zoonoses, followed closely by shelters and re-homing centres (with reference to their welfare and euthanasia policies) and animal behaviour (aggressive dogs, etc). A large majority of respondents (81.4%) said that veterinarians in their country would value access to CE on small animal welfare. The following topics were identified as priorities:

■ Nutrition ■ Shelter welfare ■ Euthanasia ■ Breeding practice

■ Pain management ■ Stray and feral animals ■ Political animal welfare issues ■ Canine, feline and exotic species welfare.

When asked how this CE should best be provided, the largest proportion of respondents (75.9%) preferred CE conferences in their region. Access to a central resource for educational materials was also rated highly (53.7%) while WSAVA

What vets think aboutwelfare

Last year the WSAVA’s Animal Wellness and Welfare Committee issued an online survey to help develop a global picture of the key issues surrounding small animal welfare. Here are some of its key findings

More to do at WSAVA World Congress 2013 in AucklandGOLF DAYSGolf acti viti es have been arranged on Monday 4 and Tuesday 5 March 2013 to allow you ti me to get a round or two in prior to the Congress. We are pleased to off er golf day packages at category A courses The Grange and Muriwai Golf Club which include green fees, souvenir gift pack, transfers, tour guide, commentary and golf playing partners (if required). Please visit the social functi ons page at www.wsava2013.org for more informati on.

Accompanying PersonsMorning tea will be held on Wednesday 6 March for accompanying persons who are joining delegates in Auckland. A comprehensive programme for accompanying persons will be published on the Congress website soon.

If you have any queries about the arrangements for the Congress please contact us by emailing wsava@tcc.co.nz.

More to do at WSAVA World Congress 2013 in Auckland

Congress lecture streams were suggested by almost half (48.1%).

67.2% of respondents felt it would be helpful for the WSAVA to organise visits in association with Congresses to sites of interest related to small animal welfare. More than half (59.1%) said that they would be interested in participating in voluntary activity programmes with rabies clinics and animal shelters, while passive visits to animal facilities were also suggested by 40.9% of respondents.

In a similar vein, more than half (58.2%) of respondents said they would interested in applying for competitive educational grants for student internships in animal welfare that would require the provision of opportunities such as spay/neuter clinics, rescue experience or shelter work.

When asked if their national organisation had any documents in English that could be shared within the WSAVA, over a quarter (26.9%) said they had. Almost half (46.3%) of respondents also indicated that their country has an equivalent of a ‘veterinarian’s oath’ which could be shared with the AWWC for comparison purposes, while 47.8% said that there were organisations/programmes in place in their country which could serve as models for intervention in particular areas of animal welfare. ■

© Leung Cho Pan | Dreamstime.com

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30 | companion

Dr Ruth Cromie was brought up on the coast of rural Northumberland which accounts for her love of eider ducks and big landscapes. Ruth gained a BSc in Biology and PhD in veterinary microbiology from the University of London in 1985 and 1991, respectively. She is currently Head of Wildlife Health at the Wildfowl & Wetlands Trust (WWT) but has worked on a range of wildlife health and welfare research jobs involving various taxa such as waterbirds, raptors and marsupials in UK and overseas. She has never ever been bored in her career and feels blessed to have been able to: perform lion lymphocyte transformation tests, pipette elephant semen, feed 1000s of wild whooper swans, quest for geese in Greenlandic tundra, search Kenyan sewage works for viruses, and both train and learn from passionate conservationists from around the world.

the companion

interview

bird species were confusing the results sheet and, regardless of palatability, the food items next to the window with me looming there were untouched – early lessons in defining your hypothesis clearly and designing your experiment properly.

How did you begin your career?A small advert in the New Scientist directed me to a PhD to develop a vaccine for avian tuberculosis that took me to WWT and into wildlife health. Although Mycobacterium avium remains my adversary, I respect it and owe it a lot for setting me off into a fascinating career.

What jobs have you done?I’ve done a range of mainly research jobs working on health and welfare, including: investigation of mycobacterioses in marsupials in the Smithsonian Institution’s National Zoological Park, Washington DC; studying avian immunology at Hong Kong University; and investigating welfare and conservation aspects of raptors in captivity at the Durrell Institute of Conservation and Ecology, Canterbury. Occasionally I’ve strayed into other conservation work, such as designing an education exhibit at the National Birds of Prey Centre, Gloucestershire, or tropical forest surveys in Trinidad.

What are you doing now?I work now for the Wildfowl & Wetlands Trust as Head of Wildlife Health, with responsibilities for some of the health care for the captive animals but mainly working

Dr Ruth Cromie

QTell us about how you got interested in science

AI think growing up in the countryside, particularly being on the coast, really sparked (or

nurtured) my love of animals and wildlife, and my first pair of binoculars was more memorable than my first bike. I was always keen to get close to wildlife and was particularly intrigued by dead things... any

seal washed up on the beach, or a dead deer in the woods warranted near daily trips to watch their decomposition... As for science, I think an inquiring mind began very early on. I remember at a young age conducting an experiment ‘on what birds eat’ in my back yard, placing small piles of breadcrumbs/sultanas/apples/crumbled pink wafer biscuits etc. and recording the results from the kitchen window. It wasn’t long before it dawned on me that different

30-31 Interview February.indd 30 18/01/2013 11:18

companion | 31

…you can get an awful lot done with teams of

straightforward people…

on a range of research, surveillance, advocacy, policy and capacity-building aspects of health in wetlands. Recent projects have included a lot of work on avian influenza and lead poisoning. I also teach on a number of courses, which I find thoroughly rewarding; the conservation benefits feel much more tangible than writing a research paper.

How did you come to be at the WWT?My first working experience at WWT was as part of my PhD studies, which was a joint WWT/Middlesex Hospital Medical School project. Having left WWT and worked on other jobs, in 1997 I was delighted to accept an invitation to return. The job is wide-ranging, fascinating and challenging. WWT is a truly special place to work, my colleagues are some of the greatest in the world, and to sit at my desk with a stunning wetland reserve just beyond my window makes me feel very privileged. I occasionally feel guilty for having not moved on to another job but it would have to be very special indeed to lure me away.

What are the main challenges facing the vets working at WWT?Being involved in the health management of the only captive population of critically endangered spoon-billed sandpipers is taking nerves of steel! These diminutive enigmatic waders are crashing towards extinction in the wild at a terrifying rate and in our recently established captive population every single bird is invaluable. However, with such tiny birds, of which we know so little, diagnoses and treatment options are very complex. Thank goodness our great animal carers make the lives of us in the animal health team easy by caring for them so well and preventing problems.

Tell us about the Ramsar Convention on WetlandsThe Ramsar Convention on Wetlands is a multilateral environmental agreement which promotes “wise use” of wetlands,

recognising their fundamental importance to life on earth whether wild, domestic or human. It’s appropriate then that this convention has championed the One Health approach to managing wetlands, as this recognises the complex interactions between the health of people, livestock and wildlife in these habitats and advocates an approach to health based on maintaining a healthy well-functioning ecosystem. It was a privilege to work on this area for the Convention and a Resolution on taking an ecosystem approach to health was adopted at this year’s Conference of Parties in Romania in July; 162 countries signing up to what you and your colleagues have written, requesting positive action is very exciting – possibly the most significant achievement of my career.

What is your greatest fear in terms of conservation and wildlife welfare?My greatest fear is that, despite the many environmental problems to address, as a society we don’t act quickly enough in response to what we learn. As a result, we’re leaving a poorer and more contaminated planet for future generations. That sounds a bit melodramatic but, to give an example, WWT has been trying to address the problem of lead poisoning in waterbirds since the 1980s. We’ve recently published a paper which analyses post-mortem data from wild birds going back 40 years. Roughly 10% of wildfowl died of lead poisoning by ingesting spent lead gunshot. This figure may be high but it’s not new news – poisoning from lead shot has long been known as a significant cause of death for waterbirds, raptors and even gamebirds. What is depressing is that despite introduction of laws to restrict its use more than a decade ago, there has been no measureable reduction in lead-related mortality rate. Lead kills wild birds. It affects domestic animals too, if they are exposed to it. It puts human health at risk, for vulnerable groups such as children and those regularly eating

game shot with lead. It’s perfect for applying those One Health principles because we can take preventive measures by only shooting with non-toxic shot, which is widely available.

Who has been the biggest influence on your career?I don’t think there is a single person but I have been immensely lucky to work with a number of people who gave me great opportunities and taught me. The training of Dr David Higgins of Hong Kong University in avian immunology in my early career is appreciated to this day. Similarly, Dr Richard (Dick) Montali of Smithsonian Institution went to some lengths to employ me; he is such a great veterinary pathologist and he taught me a great deal. I’ve also learnt a massive amount from Martin Brown, WWT’s Animal Health Officer; he is a wise, vastly experienced colleague and friend, whom I admire greatly.

Which living person do you most admire, and why?This might sound a bit parochial but Dave Paynter, Reserve Manager at Slimbridge. He’s immensely capable and knowledgeable, yet if he doesn’t know something he’s honest about it. He’s a great leader or team player, keen to share his passion for wildlife and treats everyone the same, and is always cheerful, positive and helpful. A delight to be with! Imagine if everyone you worked with shared these qualities – wouldn’t we get a lot done and wouldn’t it be fun!

What single thing would improve the quality of your life?Knowing that there is serious political will to value and look after wildlife. Less hot air, more action.

What is the most important lesson life has taught you?Be a nice person who is easy to work with – you can get an awful lot done with teams of straightforward people. ■

30-31 Interview February.indd 31 18/01/2013 11:18

For more information or to orderwww.bsava.comBSAVA reserves the right to alter prices where necessary without prior notice.

companion offer of the monthExclusive offer for companion readers – call BSAVA on 01452 726700 and quote ‘companion offer – Dentistry’

New edition includes DVDBSAVA Manual of Canine and FelineNeurology4th editionThe latest edition of this best-selling Manual is fully updated to cover all the latest advances in the field. Structured in the same practical way as the previous edition, the new edition includes new chapters on neurological genetic disease testing and counselling, adjunctive therapies, and the importance of providing adequate nutritional support to neurological patients.

An accompanying DVD-ROM contains more than 100 videos relating to clinical presentation, examination and diagnosis.

Got this in your practice library?BSAVA Manual of Canine and FelineEndoscopy and EndosurgeryA practical guide for general practitioners wishing to use minimally invasive techniques.

■ Flexible and rigid endoscopy ■ Instrumentation ■ Principles and basic techniques

WHAT THEY SAY“…a well-writt en, concise and useful guide for veterinary practi ti oners interested in starti ng out in the fi eld of endoscopy...” JOURNAL OF SMALL ANIMAL PRACTICE

BSAVA PublicationsCOMMUNICATING VETERINARY KNOWLEDGE

Extra 20% discount off member priceBSAVA Manual of Canine and FelineDentistry3rd editionWHAT THEY SAY

“...an excellent additi on for a veterinary student or a general practi ti oner who desires a greater understanding of anatomy, periodontal disease and oral extracti ons...” AUSTRALIAN VETERINARY JOURNAL

Offer is available to BSAVA members only. Ends 28 February 2013. Free P&P on telephone orders for UK and Eire delivery, online rates of P&P apply for overseas orders.

companion offer:  £45.00  £36.00Price to non-members: £70.00

BSAVA Member Price: £55.00Price to non-members: £89.00

BSAVA Member Price: £49.00Price to non-members: £75.00

On offer while stocks lastBSAVA Manual ofRabbit Medicine and Surgery2nd editionThis popular Manual reflects the increased understanding of rabbit health and disease. This edition includes:

■ Nursing care ■ Cardiovascular disorders

BSAVA Member Price: £49.00  £35.00Price to non-members: £75.00 £55.00

Note: BSAVA Manual of Rabbit Surgery, Dentistry and Imaging due 2013; BSAVA Manual of Rabbit Medicine due 2014

WHAT THEY SAY“...provides a large amount of informati on you will require on a daily basis...” JOURNAL OF SMALL ANIMAL PRACTICE

■ Dentistry ■ Diagnostic imaging

32 Publications Advert February.indd 32 18/01/2013 11:19

companion | 33

PROGRAMME HIGHLIGHTS

Nurses

WOUND MANAGEMENT – Kathryn Pratschke ■ Session one:

– Types of wounds seen in veterinary pati ents – Initi al wound management

■ Session two: – Primary contact dressings available: when and how to use – ‘New’ methods of wound management including maggots, honey and

silver dressings – Sub-atmospheric pressure therapy (VAC): when to advise specialist treatment

■ Session three: – Wound management case studies

CLINICAL PATHOLOGY – Hayley Henning ■ Session one: Blood smears, staining and cell identi fi cati on

A lecture-based session concentrati ng on the technique of producing a blood smear of diagnosti c quality. Staining technique using Diff -Quik, and theoreti cal instructi on on cell identi fi cati on

■ Session two: Practi cal urinalysis, microscopy and crystal identi fi cati onA lecture-based session concentrati ng on techniques to examine urine samples. The session includes practi cal instructi on on microscopy, staining technique using Sedi-stain, and theoreti cal instructi on on crystal, cast and cell identi fi cati on

■ Session three: Skin and hair sampling, including parasite identi fi cati onA theoreti cal and case study-based session, with some practi cal identi fi cati on of parasites. The session involves theoreti cal instructi on on diff erent skin and hair sampling techniques, when they would be used, and what could be diagnosed in the in-house laboratory

Vets

CARDIOLOGY – Ruth Willis ■ Session one: Chest radiography: indicati ons and radiographic interpretati on ■ Session two: Cardiology pharmacy: which drug for when ■ Session three: ECG and holter monitoring

NEUROLOGY – Annett e Wessman ■ Session one: Seizures, tremors and twitches ■ Session two: Neurological case management (with video footage) ■ Session three: Feline neurology

Aft ernoon Seminars

■ Joint surgery (interacti ve) – Nacho Calvo

■ The acute abdomen (interacti ve) – Kathryn Pratschke

■ Dog behaviour – Sarah Heath ■ Cat behaviour – Sarah Heath ■ ECGs for nurses – Yolanda Marti nez ■ First opinion physiotherapy for nurses

– Gillian Calvo ■ Urinary tract surgery – Sam Woods

■ Pyrexia of unknown origin (interacti ve) – Nicki Reed

■ Diseases of the travelling pet – Alix McBrearty

■ Mammary oncology – Jo Morris ■ Introducti on to clinical coaching in

practi ce – Allison Smith ■ Anaestheti c emergencies

– Fiona Strachan

Please note, the programme is subject to minor changes. Please visit www.bsava.com or email b.dales@bsava.com for further informati on and updates

EARLY BIRD 31 MAY

Vet Stream

■ BSAVA Member Weekend Rate: £150 ■ BSAVA Member Day Rate: £90 ■ Non Member Weekend Rate: £254.50 ■ Non Member Day Rate: £152.70 ■ Students/1st Year Qualifi ed Weekend Rate: £125 ■ Students/1st Year Qualifi ed Day Rate: £75

Nurse Stream

■ BSAVA Member Weekend Rate: £110 ■ BSAVA Member Day Rate: £66 ■ Non Member Weekend Rate: £130 ■ Non Member Day Rate: £78 ■ Students/1st Year Qualifi ed Weekend Rate: £125 ■ Students/1st Year Qualifi ed Day Rate: £75

Social

■ Gala Dinner – £25 for delegates – £50 for non delegates

■ Friday CPD/Buff et – £5 for delegates – £20 for non delegates

PROGRAMME HIGHLIGHTSOn behalf of the BSAVA Scottish Region I would like to invite you to a packed weekend of superb CPD, socialising and ceilidh dancing. We have worked hard to put

together a range of topics, delivered by excellent speakers at a great venue, and now that we have released our programme for the weekend it’s time to mark the date on your calendar and book your place at www.bsava.com/scottishcongress.

Thanks to the ongoing support of our sponsors, we have been able to make this year’s Scottish Congress even better value for money, with BSAVA Vet Member prices starting at just £150 for the whole weekend, along with excellent day delegate rates. Take advantage of the Early Bird offer (available until 31 May) or come and see us on the Scottish BSAVA stand at BSAVA Congress in Birmingham (4–7 April) for a special registration offer and to meet the team and join us in eating some delicious Scottish tablet. ■

Graeme Eckford, Chair of Scottish Congress, invites you to the ever-popular BSAVA Scottish Congress this Summer at the Edinburgh Conference Centre, 30 August – 1 September

2013

33 Focus On.indd 33 21/01/2013 09:52

34 | companion

CPD diary

LUNCHTIME WEbINar

Wednesday 13 February 13:00–14:00Cruciate disease: which technique whenSpeaker: Sorrel Langley-HobbsOnlineDetails from administration@bsava.com

LUNCHTIME WEbINar

Wednesday 20 February 13:00–14:00Theatre practiceSpeaker: Alison YoungOnlineDetails from administration@bsava.com

EVENING WEbINar

Thursday 7 February 20:00–21:00Case presentations: systemic disease and the eyeSpeaker: David GouldOnlineDetails from administration@bsava.com

February 2013Day MEETING – EasT aNGLIa rEGIoN

sunday 3 FebruaryHot topics in feline medicine: an interactive day of case-based lecturesSpeaker: Kerry SimpsonAnimal Health Trust, Newmarket, SuffolkDetails from eastanglia.region@bsava.com

EVENING MEETING – WEsT MIDLaND rEGIoN

Tuesday 5 Februaryreptiles: handling and husbandry – hands on with lizards, snakes and cheloniansSpeaker: Sarah PelletAnimal Care Department, Solihull College, Blossomfield Road, Solihull B91 1SBDetails from westmidlands@bsava.com

EVENING MEETING – soUTH WEsT rEGIoN

Tuesday 5 Februarysave that last breath for another day: dealing with a respiratory emergencySpeaker: Dan LewisThe Devon Hotel, Matford, Exeter EX2 8XUDetails from southwestregion@bsava.com

EVENING MEETING – NorTH EasT rEGIoN

Wednesday 6 FebruaryCat dentalsSpeaker: Bob PartridgeIDEXX Laboratories Wetherby, Grange House, Sandbeck Way, Wetherby, West Yorkshire LS22 7DNDetails from northeastregion@bsava.com

EVENING MEETING – NorTH WEsT rEGIoN

Tuesday 19 FebruaryImmunologySpeaker: Nat WhitleyHoliday Inn, ChesterDetails from northwestregion@bsava.com

Day MEETING – soUTH WEsT rEGIoN

Thursday 21 FebruaryImmune-mediated and haematological diseaseSpeaker: Nat WhitleyKendleshire Golf Club, Henfield Road, Coalpit Heath, Bristol, Avon BS36 2TGDetails from southwestregion@bsava.com

EVENING MEETING – sCoTTIsH rEGIoN

Thursday 21 FebruaryUrinary soft tissue surgerySpeaker: Richard CoeHoliday Inn, Westhill, AberdeenDetails from scottishregion@bsava.com

EVENING MEETING – EasT MIDLaNDs rEGIoN

Tuesday 12 FebruaryExploratory laparotomy: a guided tourSpeaker: Stephen BainesYew Tree Lodge Best Western Hotel, 33 Packington Hill, Kegworth, Derby DE74 2DFDetails from eastmidlands@bsava.com

EVENING MEETING – CyMrU/WELsH rEGIoN

Wednesday 13 FebruaryDiabetes explainedSpeaker: Grant PetrieCarmarthen Veterinary Centre SA31 3SADetails from welsh.region@bsava.com

EVENING MEETING – METropoLITaN rEGIoN

Wednesday 13 FebruaryaGMVenue: TBCDetails from metropolitanregion@bsava.com

Day MEETING – soUTHErN rEGIoN

sunday 10 FebruaryHow to solve common problems in small furries, including anaesthesia and post op careSpeaker: John ChittyThe Potters Heron Hotel, Ampfield, Romsey, Hampshire SO51 9ZFDetails from southernregion@bsava.com

Day MEETING

Thursday 7 Februaryshould I give it steroids? problems in small animal gastroenterologySpeaker: Ed HallStonehouse Court Hotel, Gloucestershire GL10 3RADetails from administration@bsava.com

EVENING MEETING – sUrrEy aND sUssEx rEGIoN

Wednesday 6 FebruaryTips, tricks and pitfalls in rigid and flexible endoscopySpeaker: Philip LhermetteThe Holiday Inn, Guildford, SurreyDetails from surreyandsussexregion@bsava.com

Day MEETING – soUTH WEsT rEGIoN

Friday 22 FebruaryImmune-mediated and haematological diseaseSpeaker: Nat WhitleyKingsley Village, A30, Penhale, Fraddon, Cornwall TR9 6NADetails from southwestregion@bsava.com

Day MEETING

Tuesday 5 FebruaryFeeding back to health: clinical nutrition in general practiceSpeaker: Isuru Gajanayake and Rachel LumbisTelford Golf and Spa HotelDetails from administration@bsava.com

aFTErNooN/EVENING MEETING – METropoLITaN rEGIoN

Tuesday 5 Februaryapproach to backyard poultrySpeaker: Steve SmithThe Oxford Belfry, Milton Common, Thame, Oxfordshire OX9 2JWDetails from metropolitanregion@bsava.com

Day MEETING

Tuesday 19 Februarypractical approach to the diagnostic and management issues in cats with kidney diseaseSpeaker: Jonathan ElliottHilton, Stansted AirportDetails from administration@bsava.com

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companion | 35

EVENING WEbINar

Monday 4 March 20:00–21:00practical approach to diagnostic and management issues in cats with kidney diseaseSpeaker: Jonathan ElliottOnlineDetails from administration@bsava.com

LUNCHTIME WEbINar

Wednesday 13 March 13:00–14:00surgical management of aural diseaseSpeaker: Alison MooresOnlineDetails from administration@bsava.com

LUNCHTIME WEbINar

Wednesday 20 March 13:00–14:00ChemotherapySpeaker: Linda RobertsOnlineDetails from administration@bsava.com

EVENING WEbINar

Wednesday 6 March 20:00–21:00basic principles of wildlife rescue and first aidSpeaker: Liz MullineauxOnlineDetails from administration@bsava.com

EVENING WEbINar

Monday 18 March 20:00–21:00Case based clinical approach to stifle lamenessSpeaker: Toby GemmillOnlineDetails from administration@bsava.com

EVENING WEbINar

Monday 25 March 20:00–21:00Therapeutic exercises: a practical approach to what can be achieved in practiceSpeaker: Lowri DaviesOnlineDetails from administration@bsava.com

EVENING WEbINar

Wednesday 10 april 20:00–21:00are blood transfusions possible in small animal practice?Speaker: Susana SilvaOnlineDetails from administration@bsava.com

March 2013

april 2013

EXCLUSIVE FOR MEMBERSExtra 10% discount on all BSAVA

publications for members attending any BSAVA CPD event.

All dates were correct at time of going to print; however, we would suggest that you contact the organisers for confirmation.

EVENING MEETING – WEsT MIDLaNDs rEGIoN

Tuesday 5 Marchacute pain management/peri-operative analgesiaSpeaker: Matthew GurneyWolverhampton Medical Institute, New Cross Hospital, Wolverhampton WV10 0QPDetails from westmidlands@bsava.com

Day MEETING

Tuesday 5 Marcha clinical dissection of brain disease in dogs and catsSpeaker: Pete SmithWildpark Farm, Ashbourne, Derbyshire DE6 3BNDetails from administration@bsava.com

Day MEETING – METropoLITaN rEGIoN

Tuesday 19 MarchWound managementSpeakers: Davina Anderson and Kate WhiteHoliday Inn, Crest Road, Handy Cross, High Wycombe HP11 1TLDetails from metropolitanregion@bsava.com

Day MEETING

Thursday 21 MarchbsaVa Dispensing courseSpeakers: P. Sketchley, F. Nind, J. Hird, P. Mosedale, S Dean, M.JessopHawkwell House, Oxford OX4 4DZDetails from administration@bsava.com

Day MEETING – soUTH WEsT rEGIoN

Thursday 21 MarchMedical and surgical aspects of gastrointestinal diseaseSpeakers: Ed Hall and Ed FriendCanalside, Marsh Lane, North Petherton, Bridgwater, Somerset TA6 6LQDetails from southwestregion@bsava.com

Day MEETING – soUTH WEsT rEGIoN

Friday 22 MarchMedical and surgical aspects of gastrointestinal diseaseSpeakers: Ed Hall and Ed FriendLostwithiel Hotel and Country Club, Lower Polscoe Lostwithiel, Cornwall PL22 OHQDetails from southwestregion@bsava.com

Day MEETING – sCoTTIsH rEGIoN

sunday 24 Marchoncology: top 6 cancers seen in small animal practice, medical and surgical managementSpeakers: Kathryn M. Pratschke and Jenny R. HelmGlasgow University Vet SchoolDetails from scottishregion@bsava.com

Day MEETING – NorTH EasT rEGIoN

sunday 10 Marchsmelly earsSpeaker: Sue PattersonWetherby RacecourseDetails from northeastregion@bsava.com

EVENING MEETING – EasT MIDLaNDs rEGIoN

Wednesday 13 MarchDiagnosis and management of liver disease in cats and dogsSpeaker: Nick BexfieldYew Tree Lodge Best Western Hotel, 33 Packington Hill, Kegworth, Derby DE74 2DFDetails from eastmidlands@bsava.com

OthER UpCOMIng BSAVA CpD COURSESSee www.bsava.com for further details

■■ BSAVA Education Wednesday 17 April Imaging of the muscloskeletal system

■■ BSAVA Education Wednesday 17 April Dealing with specific species: case examples

■■ BSAVA Education Wednesday 24 April Geriatric clinics for cats

■■ BSAVA Education Wednesday 1 May Diagnosis and management options for elbow dysplasia

■■ West Midlands Region Thursday 2 May The coughing dog

Practice Badge Deadline Wednesday 6 MarchThe ICC/NIA, Birmingham, UKEmail: congress@bsava.com

4–7 April

34-35 CPD Diary.indd 35 18/01/2013 11:26

4–7 April 2013

The Congress for the whole teamwith something for everyone from your practice

Join us in April for the very best in veterinary science, business knowledge, and networking.

■ More than 300 lectures catering to all career and experience levels

■ Extended management stream

■ Largest small animal exhibition in Europe, with over 250 companies

The ICC / NIA – Birmingham – UKwww.bsava.com/congress

Register online now

TodayWEDNESDAY

March

with something for everyone from your practice

Join us in April for the very best in veterinary science, business knowledge, and

More than 300 lectures

with over 250 companies

Practice badge

deadline6 March

36 OBC February - Congress Ad.indd 36 18/01/2013 11:27