The essential publication for BSAVA members

How To Perform a surgical extraction of a canine toothP10

Clinical ConundrumYoung canine with subcutaneous swellingsP4

The essential publication for BSAVA members

companionMARCH 2009

Medicines GuideHelping practices manage their dispensariesP20

Where are all the veterinary nurses?

companion

2 | companion

1) What part of companion do you enjoy most?

2) Suggest a topic for How To 3) Suggest someone youd like to

see featured in the companion Interview

4) What would improve companion?

3 Round UpNational Pet Month

46 Clinical ConundrumCase of a young dog presenting with subcutaneous swellings

79 Where are all the VNs?John Bonner asks is there really a deficit of Veterinary Nurses

1013 How ToPerform a surgical extraction of a canine tooth

1415 GrapeVINeFrom the Veterinary Information Network

16 New titles at CongressLatest releases from BSAVA Publications

17 Congress Practice BadgeHow to get your whole team to Congress

18 Congress ChairThe end of an era for Andrew Ash

19 Summer CPDJune courses from the BSAVA

2021 New Medicines Guide & Blood SmearsNews and a quick quiz from BSAVA Publication

22 PetsaversLatest fundraising news

2325 WSAVA NewsWorld Small Animal Veterinary Association

26 The companion InterviewPip Boydell

27 CPD DiaryWhats on in your area

companion is produced by BSAVA exclusively for its members.BSAVA, Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL2 2AB.Telephone 01452 726700 or email companion@bsava.com to contribute and comment.

WIN AN iPOD LOADED WITH CONGRESS MP3s

Additional stock photography Dreamstime.com Kamensky | Dreamstime.com Tracy Hebden | Dreamstime.com Suzanne Tucker | Dreamstime.com

As we enter our second year we want to hear what you have to say about companion. At Congress we will be holding focus groups and in the next month we invite all readers to tell us what you like, dislike, think is good and what could be improved.

In April 2008 BSAVA launched companion as an exclusive member benefit to sit alongside its sister publication BSAVAs Journal of Small Animal Practice. Mark Goodfellow, who stepped forward as the volunteer who would steer this initiative as Editor, said that it would address the core aims of the Association, with accessible, instructive CPD features, reports on the activities of our colleagues, articles on the issues facing our profession and, of course, general Association news.

In the last year weve been delighted with the comments we have received. Now we want to make sure we continue to adapt and improve by responding to your ideas so it really is a magazine by members for members.

companion is about to celebrate its first anniversary! Help take us into a second successful year with your comments and ideas

is produced by BSAVA exclusively for its members.

by members for

So, if you have something to say or any ideas for features and subjects, simply answer the questions below and send additional comments by email companion@bsava.com, or visit us on the BSAVA Balcony at Congress. All email submissions received before 31 March will be entered into a draw to win an iPod loaded with all the 2009 Congress talks. We do already have our focus groups organised, but if you are attending Congress and are particularly keen to take part then let us know by email before 16 March.

companion | 3

ROUND UP

NATIONAL PET MONTH

REGISTER NOW FOR CONGRESS

National Pet Month is about to celebrate its 20th anniversary with the theme Healthy Pets Make Happy Pets. Getting involved can benefit your practice and raise funds for charity, as well as help improve animal welfare in your area

With the governments focus on improving the nations health, National Pet Months 20th anniversary campaign, Healthy Pets Make Happy Pets couldnt be more timely. Taking place from 4 April 4 May, National Pet Month (NPM) will once again be campaigning for responsible pet ownership, and raising funds for numerous animal charities, including Petsavers, at the same time.

The month is an important opportunity for veterinary practices to promote their services to pet owners and for animal charities to rally support.

2008 winning eventLast year, the winning event was a joint project between Jubilee Veterinary Centre and Mount Stewart National Trust in Northern Ireland. Mount Stewart is a stunning National Trust House on the shores of Strangford Lough in Northern Ireland, and along with Jubilee Vets, focussed on assistance dogs to put on an event for the local community.

Bryan Muskett from Jubilee Vets we are still celebrating winning the National Pet Month Best Event Award for 2008. In previous years we supported NPM with open days and various social functions. When the opportunity to link up with the National Trust came about we were very positive, as our aim was to involve a lot more people and throw the function open to the community in general.

The facts and figures speak for themselves. On the day we had between 800 and 900 guests through the main entrance, accompanied by approximately 1000 dogs! Every breed and every

conceivable shape and size! On arrival each owner was given a Drontal poo bag dispenser and competition entry forms which were very popular. We hope more practices will join up with compatible organisations and show their local communities the importance of pet health and responsible ownership during National Pet Month.

Get involved todayIts not too late to arrange an event. For more information and to get a free event pack visit www.nationalpetmonth.org.uk the organisers encourage all practices who put on an event to register their details and download their free resources. Find out more about raising funds for Petsavers during NPM on page 22.

There are just a few weeks left to register for Congress before the late booking admin charge comes in. You also have until 12 March to register for the Practice Badge options. See page 17 for further details.

Book for Congress before 27 March to avoid the late registration surchargeThere are just a few weeks left to register for Congress before the late booking admin charge comes in. You also have until 12 March to register for the Practice Badge options. See page 17 for further

registration surchargeThere are just a few weeks left

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CLINICAL CONUNDRUM

CLINICALCONUNDRUM

Case PresentationA 13-month-old female Cocker Spaniel presented with large swellings over the scruff and sublumbar regions. Twelve hours previously the puppy had been seen for lethargy and inappetence by a colleague, who administered antibiotics subcutaneously at the scruff and pethidine intramuscularly in the sublumbar musculature based on a suspicion of cystitis.

On clinical examination the dog was quiet, dull but responsive. On thoracic auscultation a mild increase in interstitial sounds over the entire lung field, with an increase in respiratory effort, was appreciated. Marked haemorrhage within the dorsal sclera of the left eye was seen in addition to the 25x25 cm subcutaneous soft swelling present over the sublumbar region and a similar smaller swelling at the scruff.

The editorial board of companion invites you to consider the case of a young dog presenting with subcutaneous swellings

InvestigationInvestigation centred on elucidating the cause of the dyspnoea and evaluating the possibility of a coagulopathy. Samples were submitted for full haematology and coagulation profile, which documented a mild non-regenerative anaemia, moderate thrombocytopenia (80 x109/l [200500]) and a moderate prolongation of PTT and APTT (sample = 1.5x control). Conscious thoracic radiographs were obtained.

Interpret the significance of the moderate thrombocytopenia and concurrent prolongation in coagulation timesAs the coagulopathy has features of defects of both primary (thrombocytopenia) and secondary haemostasis (including PTT &

Construct a problem list and consider relevant differential diagnosis. Rationalise your further investigative steps

Problem list:DyspnoeaScleral haemorrhage of left eyeSubcutaneous swelling at previous injection sitesInappetence and lethargy (considered to be secondary to the underlying disease).

InterpretationThe presence of increased lung sounds suggested that lower airway disease was the most likely cause of the dyspnoea. The presence of lung sounds made pleural disease unlikely. The sudden development of the subcutaneous masses after injection could be caused by infection but, given the large size and the presence of scleral haemorrhage, haematoma was thought most likely.

Differential diagnoses: (dyspnoea with diffuse interstitial lung sounds)Bronchial disease

AllergicInfectious (bacterial, viral, mycoplasmal)Parasitic ( Oslerus osleri)

Pulmonary parenchymal diseaseOedemaInflammatoryInfectious (bacterial, viral)Parasitic ( Angiostrongylus vasorum)Foreign bodyPulmonary thromboembolusPulmonary haemorrhage

Haematological abnormalitiesAnaemia

Differential diagnoses: (subcutaneous and scleral haemorrhage)Disorder of primary haemostasis

Disorders of platelet function thrombopathiaThrombocytopenia Reduced platelet production Platelet destruction (IMTP) Increased platelet consumption

(DIC, anticoagulant toxicity)von Willebrands disease

Disorder of secondary haemostasisInherited (haemophilia or other factor deficiency)Acquired (vitamin K-dependent coagulopathy)Consumptive DIC

TraumaIatrogenicBlunt

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CLINICAL CONUNDRUM

APTT), disseminated intravascular coagulation (DIC), either localised or generalised, should be suspected. DIC always occurs secondary to a wide variety of primary disease processes including, but not restricted to, neoplasia, immune-mediated and other inflammatory diseases, infectious and parasitic disease, trauma and heat stroke.

What abnormalities are evident on the thoracic radiographs?The thoracic radiographs demonstrate a diffuse broncho-interstitial pattern, coalescing in places to an alveolar pattern, most intense peripherally. The cardiac

silhouette, extrathoracic and skeletal structures are unremarkable.

Based on these results refine your differential diagnosis list and suggest further investigationBased on the thoracic radiography, interstitial pulmonary disease is most likely. Given that a coagulopathy is evident clinically and abnormalities in the components of primary haemostasis and the secondary haemostasis have been documented, haemorrhage into the lung parenchyma is the most likely cause of the observed clinical and radiographic signs. DIC secondary to neoplasia or infection could not be excluded; however, given the dogs age, a parasitic cause such as Angiostrongylus vasorum causing both the radiographic and the clinico-pathological signs was considered most likely. The owner was questioned with respect to worming regime and the dogs walking habits and on discussion it transpired that the dog had a particular proclivity for eating snails.

Faecal evaluation using the Baermann technique was performed to look for Angiostrongylus larvae. Faecal examination can only identify a patent infection, so bronchoscopy and BAL was planned should faecal analysis prove negative.

Diagnosis and treatmentAngiostrongylus vasorum L1 larvae in the faeces confirm a patent infection. Angiostrongylus infection is associated with a consumptive

This case was seen, and treated, prior to the licensing of Advocate for the treatment of canine Angiostrongylus infection. Under the cascade fenbendazole was chosen given its license for the treatment of other parasitic infections in the dog and its documented efficacy against Angiostrongylus vasorum. Readers are advised to follow the prescribing guidelines of the cascade: an authorised product should be the treatment of choice unless there is clear clinical justification to do otherwise.

Turn over for guidelines to submitting your own Clinical Conundrum

Faecal sample following Baermann technique to concentrate larvaeRight lateral thoracic radiograph

DV thoracic radiograph

coagulopathy which, in this case, resulted in scleral haemorrhage and subcutaneous haemorrhage at the site of previous injections. Treatment was initiated with fenbendazole at a dose of 50 mg/kg daily for five days and the dog was restricted to a kennel. Care was taken to minimise trauma and environmental contamination.

Within 48 hours the coagulation profile was normal and within 14 days the subcutaneous haemorrhage was reduced in size and faecal analysis was negative for Angiostrongylus larvae. The owner was given appropriate worming advice and was instructed to prevent further snail eating, by muzzling if necessary.

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CLINICAL CONUNDRUM

The Clinical Conundrum aims to be accessible and thought-provoking, and to allow in-depth discussion of the intricacies of investigating or treating a case. In particular it is hoped that cases will challenge the reader to consider a dilemma, be it a diagnostic challenge or a treatment/surgical decision, and to work through it to a logical conclusion.

Case selectionThe aim of the Clinical Conundrum (CC) is to present clinical scenarios that are encountered in small animal practice and discuss briefly any poignant features of the case. Your CC can focus on the complete case management or one aspect of the case management in more detail.

Example of how a case may be used

A problem-oriented approach to a challenging diagnosis. In this instance the emphasis would be to construct a problem list, consider relevant differential diagnoses and ultimately achieve a diagnosis based on the information gained during investigation.Treatment or surgical dilemma . In this type of case the diagnosis may have

already been made or be relatively simple to reach. The focus of this type of CC would be to challenge the reader to decide how they would gather the information to decide on a treatment plan and to select and justify choice of treatment based on the information obtained.Focus on one aspect of a complicated case. This is most suitable for a more focused evaluation of a single aspect such as anesthetic considerations and pre-anesthesia stabilisation for a clinical presentation, or the subtleties of diagnostic imaging interpretation.

An unusual diagnosis, although interesting, does not necessarily mean that a case will be a suitable to present as a Clinical Conundrum. In fact, the final diagnosis is not the most important part it may be unusual but many cases feature a relatively common problem. The cases that make the best articles discuss a presentation thoroughly, logically progress through the case and achieve a robust diagnosis or treatment choice. It is the dilemma regarding diagnostic or treatment progression which is important, rather than the diagnosis in and of itself. The editorial team are more than happy to advise on the selection of cases for this feature and particularly welcome and encourage submissions from those in general practice.

StyleCase reports should be structured to encourage the reader to consider a different aspect of the case or diagnostic procedure as the clinical picture unfolds. Further written guidance and representative examples of different styles of CCs are available on request.

GUIDELINES FOR SUBMITTING A CLINICAL CONUNDRUMDo you have an interesting case to share with your colleagues? Here are the guidelines for submitting it as a Clinical Conundrum to share with BSAVA members

The editorial team are more than happy to advise on the selection of cases for this feature, the construction of a CC around a suitable case and the refining of submitted work. If you have an idea for a CC but arent sure how to proceed, please do contact us at companion@bsava.com

Preparing a submissionIn total, authors should aim for a piece of 10001200 words in length with up to five illustrative pictures.

Unlike the old Whats Your Diagnosis? articles in JSAP, companion CCs are not indexed on Pubmed and are not citable in the traditional sense. Rather, the style and remit of this feature has been devised to mirror that required by many of the CPD schemes and to become a practical resource for those working in practice. We hope that submitting a Clinical Conundrum will be particularly useful preparation when completing written work required, for example, by the RCVS certificate schemes.

To submitPlease email articles for submission to companion@bsava.com providing illustrations as separate graphic files (at highest resolution available) rather than embedded within the text of a document. Following initial review for suitability and style, the editorial board will then forward submissions for peer review. Review time is dependent on reviewer availability but it is intended that submissions are reviewed within 45 weeks from submission. An honorarium is payable on final acceptance of the article, provision of all figures/pictures in a suitable format and submission of an invoice.

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VETERINARY NURSES

WHERE ARE ALL THE VNs?

More than 1 in 10 of the qualified VNs who responded to the last Royal College nurse manpower survey has taken a second job a clear indication that the salaries offered to these key members of the clinical team are not sufficient, the RCVS asserted.

When it isnt possible to make ends meet on a single full-time salary, then that might be reason enough to leave the job and look for more lucrative opportunities elsewhere. However, inadequate salaries are

Complaints from practitioners that there is a shortage of qualified veterinary nurses in Britain are often raised at professional meetings and on internet discussion groups but are experienced VNs really in such short supply? If so, what is causing this deficit and what can be done to remedy the problem? John Bonner reports

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VETERINARY NURSES

WHERE ARE ALL THE VETERINARY NURSES?

not the only reason why nurses might want to leave the profession; a job with long and often unsociable hours may be difficult to reconcile with the childcare duties often required of young women, who form the vast majority of VNs.

Facts and figuresHowever, are these factors eroding the numbers of qualified VNs available for work? Not according to Royal College statistics, which suggest that the numbers of listed and registered VNs is steadily growing from 6611 in 2006, to 7039 in 2007, with latest figures showing that as of the beginning of January this year there were 2601 listed VNs and 5857 RVNs a total of 8490 on the Register overall. As a result, BVNA president Bonnie Millar thinks that the shortage is perceived rather than real. This situation could be due to a disparity between many employers expectations and those of their employees, she said, adding that if there are any shortages in the supply of VNs, it is certainly not a new phenomenon.

Any erosion in the numbers of nurses remaining on the Register should be more than compensated for by the numbers of newly qualified VNs the numbers of VN candidate registrations has been steady around the 1000 per year mark over the past three years and most of those can be expected to complete their training.

Training in practiceLibby Earle, head of the RCVS veterinary nursing department, points out that the pass rate in the part 1 VN examinations 10 years ago before the introduction of NVQ-based qualification was 49%, compared with 87% last year. So, despite grumbles from many practices about the amount of bureaucracy involved in the assessments involved in the NVQ scheme, it appears to be more efficient than the old green book procedure. While we try to do everything possible to reduce the burden on training practices, at the end of the day VN qualifications are nationally recognised and regulated awards and their delivery and quality assurance inevitably

entails active clinical training and a degree of record-keeping.

Des Thompson, former RCVS appointee to the BVNA Council, acknowledges that practices find the volume of paper work cumbersome but doubts whether those practices that cite it as a reason for withdrawing their training practice status would have stayed the course anyway. Plus, contrary to rumour, there is no shortage of practices keen to train their own staff. The numbers actually rose from 1464 in 2006 to 1536 at the beginning of 2008.

Those practices that dont want to train VNs are usually able to poach them from a neighbouring practice for a couple of thousand pounds increase in salary. But if that might be expected to have an inflationary impact on nurse salaries, there are other factors holding them back. Lincolnshire practitioner and former BSAVA representative on the Nurses Council, Charles Ross, points to the availability of European-trained vets willing to work in VN roles as a factor capping the salaries of experienced nurses. Although legally

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VETERINARY NURSES

entitled to work as veterinary surgeons under EU law, applicants from the accession states will often be prepared to work for a salary much lower than that of a UK or Commonwealth graduate while they improve their practical or English language skills, he says.

Working conditionsBVNA suspects that any difficulties that particular practices may have in recruiting nurses will probably be of their own making. Like any professional group, VNs have their own informal communication networks and news will soon pass along the grapevine if the working conditions at a particular practice are less than satisfactory.

Although salaries will top the list of causes of dissatisfaction for fully trained VNs, lack of recognition will always come a close second. Charles Ross regrets that many of his colleagues still treat their nursing staff in training like the unskilled auxiliaries that helped earlier generations of practitioners. There is little appreciation of the hard work and academic standards needed to complete modern veterinary nursing examinations. But it isnt just the bosses that fail to treat nurses with respect. He feels that many members of the public fail to show the same appreciation for a VNs skills and training that they automatically bestow on their counterparts working in the NHS.

RecognitionThe introduction of degree courses in veterinary nursing was intended to help raise the status of VNs in the eyes of their employers and the public. But there is still some resistance to the notion that training for a job which relies heavily on practical

and people skills can be provided in an academic setting. Mr Ross says that when interviewing for a new nurse he would always favour an NVQ candidate over one with a degree because he believes they will have better hands-on nursing skills.

Even with comparable academic qualifications, VNs must still look on enviously at the career opportunities available to their colleagues in human nursing. Nurse practitioners in the NHS or in specialist hospital roles can maintain the skills that they were originally trained for while earning salaries that would make a VNs eyes water. The only prospects for significant career progression in a veterinary setting lie in a move into practice management or out into the animal health or pet insurance industries.

Economic impactLong-term retention of trained nursing staff because of dissatisfaction with salaries is not purely a UK problem. Bonny Millar is a US citizen and says that there is much discussion across the pond about veterinary technicians leaving practice to look for more money in other areas even when the typical salary for an experienced technician can be upwards of $40,000 a year, plus benefits such as overtime, pensions and health insurance. Although it is uncertain whether this trend will continue if the US economy continues in a downward spiral, she notes.

The UK veterinary nursing profession has developed over a period of almost continuous economic growth and it is anyones guess how it will be affected by a true recession. Des Thompson points out that

for the first time in donkeys years we are hearing stories about veterinary practices laying off staff.

This could make those hard to fill nursing vacancies much more attractive but Mr Ross points out that any economic trends are usually short-lived. A few months of belt tightening would be unlikely to change the basic relationship between VNs and those practices seen as bad employers.

BSAVA president Ed Hall agrees, pointing out that the interests of VNs and their employers lie in exactly the same direction in making their practice as efficient and profitable as possible. If a practice isnt getting any replies to an advert, it is not necessarily because there arent any suitable applicants out there they may need to recognise just what a trained nurse can do for their business.

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HOW TO

PERFORM A SURGICAL EXTRACTION OF A CANINE TOOTH

HOW TO

Lisa Milella of The Veterinary Dental Surgery, Byfleet, Surrey reminds companion readers of the intricacies of this technique

principles can be applied to extraction of any tooth in the mouth. A surgical extraction technique is also used for retrieval of root remnants and if any abnormal tooth morphology exists. It may also be the surgeons preference to use a surgical technique if multiple adjacent teeth need to be extracted as in Figure 2.

Equipment required to perform a surgical extraction(Authors preference Figure 3a)

Scalpel handle and blade ( no.11)Periosteal elevator ( Goldman Fox)Dental luxators and elevators (sharp and of a suitable size) (Couplands No.1 and No.3) Figure 3bExtraction forceps (Pattern 76 and 76N)High-speed water cooled dental drill with a selection of round and tapered burs (No.2 and no.4 round and a 701 tapered fissure bur) Figures 3c & d.

Indications for tooth extraction

Severe periodontal disease (mobility, furcation exposure, periodontal probing depths)

Complicated crown fracture (pulp exposed)

Worn tooth with pulp exposure

Crown root fracture

Odontoclastic resorptive lesion

Non-vital tooth

Persistent deciduous teeth

Teeth involved in a jaw fracture

Unerupted teeth causing pathology

Teeth causing malocclusions

Supernumerary teeth

Chronic gingivostomatitis

What is a surgical extraction?An extraction technique involving raising a flap of tissue to remove bone that forms part of the socket, to allow access to the root and facilitate its extraction (Figure 1).

When should this technique be used?This technique should always be used for extraction of canine teeth, but the same

Figure 1

Figure 2

Figure 3a

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HOW TO

PERFORM A SURGICAL EXTRACTION OF A CANINE TOOTH

Small surgical scissorsRat tooth forcepsNeedle-holdersMonofilament absorbable suture material (poliglecaprone 25 size 5/0)

All equipment should be sterile as tooth extraction is considered a surgical procedure.

Patient preparationGeneral anaesthesia a cuffed ET tube and throat pack are recommended to secure the airway. Local anaesthesia should also be consideredPre-emptive analgesiaPerioperative antibiotics should be given in selected cases only. These include debilitated animals, immuno-compromised animals, animals with

severe local or systemic infection, animals with organ disease or endocrine disorders.Scale and polish all teeth prior to performing any extractions. Tooth extraction, by whatever technique, is a surgical procedure and should be performed in as clean a field as possible. The surgical site should also be irrigated with a chlorhexidine- based mouthwash.Preoperative radiographs should be taken. Radiographs will enable the surgeon to assess any abnormal root morphology and the integrity of the surrounding bone. Postoperative radiographs can be taken to ensure complete tooth root removal.

Figure 3b

Figure 3c

Figure 3d

Figures 4a and 4b: Pre- and post-operative radiographs Surgical removal of a mandibular canine

A This upper canine tooth has a complicated crown fracture (the pulp cavity is exposed). There is a vertical fracture extending on to the root. This tooth cannot be salvaged by root canal treatment and extraction is the only option

B A pre-extraction radiograph of an upper canine tooth shows the length of the root. As a general rule the apex of the canine tooth finishes at the mesial root of the second premolar. This should be taken into consideration when designing the flap. The flap should enable unimpeded access to the whole root if necessary

Technique

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HOW TO

D A sharp periosteal elevator is used to raise a full thickness mucoperiosteal flap. The elevator is positioned at an angle to the bone if too flat, accidental perforation of the flap can occur. The tissue is tightly adhered at the mucogingival junction and care must be taken not to perforate the flap here. The flap raised should give good exposure to the alveolar bone overlying the tooth root. Figures E and F

E

*High-speed burs should be used with extreme caution. Complications include soft tissue trauma, thermal bone necrosis, emphysema and fatal air embolisms.

J The flap is then replaced and sutured in position using a monofilament absorbable suture material and a simple interrupted suture pattern. The flap should be sutured with no tension. Releasing incisions can be made in the periosteum on the underside of the flap to release tension if necessary. Care must be taken not to perforate the flap

G Using a high-speed water-cooled round bur*, a gutter is created on either side of the canine tooth root. Some overlying buccal bone can be removed to enable the mesial and distal edge of the tooth root to be seen. The gutters should be half the width of the tooth root and extend up to 2/3 of the length of the root. The gutters are then connected on the buccal aspect, so that the bone plate overlying the root is removed together with the root

C Vertical releasing incisions are made between the upper canine and lateral incisor rostrally and at the mesial line angle of the second premolar. The blade is also run in the gingival sulcus around the tooth, being careful not to perforate the gingiva. The vertical releasing incisions should extend beyond the mucogingival junction (the junction between attached gingiva and the alveolar mucosa). The incisions can be slightly divergent to allow adequate blood supply to the flap.They should also be made so that there is bone support for the sutured wound and thus incisions should not lie over a void

F

H A dental elevator is positioned in the groove created on either the mesial or distal aspect of the tooth. Elevators should not be used on the palatal aspect of the upper canine tooth to avoid iatrogenic oronasal communication. The elevator should be rotated slowly to tear the periodontal ligament attachment. Tension should be held for about 10 seconds to allow the ligament to tear. The elevator is then moved to the opposite groove and the motion repeated until the tooth starts to loosen. When the tooth is loose, extraction forceps are positioned as far apically as possible and the tooth rotated along its long axis, pulling gently at the same time. The extracted tooth should be checked to ensure that the whole root has been extracted (a postoperative radiograph should be taken if there is any doubt)

I The empty socket should be debrided if there is any granulation tissue or debris. The socket is checked for any loose bone fragments. The edges of the socket should then be smoothed using either a diamond-coated bur or with rongeurs. The extraction site can be lavaged with lactated Ringers solution to remove any remaining debris. The air-water syringe on the dental machine should not be used as air may cause an embolism or emphysema and water is cytotoxic to connective tissue cells

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HOW TO

PERFORM A SURGICAL EXTRACTION OF A CANINE TOOTH

Complication Cause and avoidance

Tooth fracture(crown/root/both)

Incorrect technique careful use of elevators and luxatorsExtraction forceps should not be used before the tooth is adequately loosened

Oronasal communication May be due to infection or iatrogenic damage avoid excessive force during the extraction Figure 7

Jaw fracture Preoperative radiographs should be taken to assess bone loss in advanced periodontal diseaseIncorrect technique (placement of luxators and elevators especially associated with lower canine) must be avoided

Haemorrhage Accidental damage to neurovascular bundle during surgeryHaemorrhage may occur as a result of a root fracturePre-existing disease should be identified before surgery if possible

Displaced root fragments Avoid downward force in cats as the root fragment may be displaced into the mandibular canalAvoid excessive force on the palatal root of the upper carnassial in dogs to avoid pushing the root into the nasal turbinates

Thermal bone damage Adequate cooling of high-speed bur when used

Emphysema Incorrect use of the high-speed handpiece. Avoid blowing air into soft tissue or bone

Soft tissue injuries(gingiva, tongue, frenulum, lip, eye)

Use spatulas to avoid accidental damage when using the high-speed burControlled force when using elevators and avoid slippage by correct holding of instrument and stabilisation of the patients head

Wound breakdown Avoid tension when suturing in the mouth. Periosteal releasing incisions can be made on the surface of mucoperiosteal flaps to release tension. Careful flap planning prior to extraction is required

Table 1: Complications of extractions

Key to success

Knowledge of the correct root morphology

Correct technique

Appropriate tools

Practice and patience

Applying the principles to the lower canine toothThe basic principles described above are used for the mandibular canine with the following exceptions

Figure 5: Care should be taken when placing the vertical releasing incisions and raising the flap to avoid damaging the inferior alveolar blood vessels and nerve exiting the middle mental foramen

Figure 6: A longer releasing incision can be made rostrally creating more of a triangular flap. Dental elevators should not be placed directly mesially and distally but rather on the mesolingual and distolingual aspects of the tooth. This is to avoid fracture of the rostral mandible

Figure 7

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VIN

The Veterinary Information Network brings together veterinary professionals from across the globe to share their experience and expertise. At vin.com users get instant access to vast amounts of up-to-date veterinary information from colleagues, many of whom have specialised knowledge and skills. In this regular feature, VIN shares with companion readers a small animal discussion that has recently taken place in their forums

.comGRAPEVINEheard on the

John Turgai Thanks Mark,

We weaned off the furosemide and ACEI and the resting RR are still 1617 /min. Well treat as respiratory and keep an eye on the RRR.

John Turgai (Day 8) Sophie has had her RRR in the low twenties, and doing well in all respects except that the cough is not being controlled with hycodan alone. She mainly coughs when she is excited and very active.

Mark Rishniw BVSc, MS, DACVIM (Cardiology), VIN Consultant, Ithaca, NYHi John,

There is a left atrial enlargement, and what appears to be a vascular pattern on the films - Im seeing prominent

vessels. The lateral is a bit expiratory, so the dorso-caudal fields are a bit tough to interpret. The cough doesnt sound like a cardiac problem.

I would start with a sleeping respiratory rate at home for a couple of days. If this is normal, then we probably dont have CHF as the cause of the cough.

John Turgai DVM, Park Avenue Animal Hospital, Apoka, FLThis is Sophie, a 13 year-old very happy, active 8.6lb Yorkie who came in today for a second opinion on a cough of about a four weeks in duration. She has been on one quarter of 12.5 mg furosemide once

daily (so shes getting ~ 0.8 mg/kg SID) and 2.5 mg enalapril daily lately having been tapered down from a higher furosemide dose. The owner has not seen a significant improvement in the cough which occurs several (many) times daily including at night. PE - heart murmur 2-3/6, lung sounds are OK to slightly increased. Tracheal palpation does produce a dry honking type cough.

So the heart is enlarged (VHS ~11.3 lateral) with a nice left atrial bulge. I think the caudo-dorsal lung area has prominent vessels and an overall increased density compared to the cranio-ventral areas on the lateral. On the VD, both sides of the caudal lungs have a fluffy pattern that I cant distinguish as perivascular or peribronchial.

Questions: Do you think the rads show that the dog is in failure? I increased the furosemide to 3/4 tabs BID in the meantime.

Thanks.

Michael Harter DVM,Animal Medical Clinics,Rockford, ILI agree with these guys. The left atrium is enlarged but I dont think the dog is in heart failure. I do think there is lung disease, and I believe the primary pathology is bronchial on these films.

William Herndon DVM Diplomate ACVIM Cardiology,California Veterinary Specialists San Diego County CAI also think those lungs are abnormal and that the heart is big ... I am just not sure that CHF is the problem...

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VIN

All content published courtesy of vin.com. For more details about the Veterinary Information Network visit vin.com. As VIN is a global veterinary discussion forum not all diets, drugs or equipment referred to in this feature will be available in the UK, nor do all drug choices necessarily conform to the prescribing rules of the Cascade. Discussions may appear in an edited form.

John TurgaiMany thanks to all.

Mark RishniwHi John,

>>> She has been on both steroids and hycodan without much effect

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CONGRESS

NEW TITLES AT CONGRESS

BSAVA Publications is pleased to announce that there will be four new manuals making their first appearance at Congress this year

BSAVA Manual of Canine and Feline Abdominal Imaging, edited by Robert OBrien and Frances BarrCongress price 49.00BSAVA Manual of Rodents and Ferrets, edited by Emma Keeble and Anna MeredithCongress price 49.00BSAVA Manual of Canine and Feline Wound Management and Reconstruction, 2nd edition, edited by John Williams and Alison MooresCongress price 49.00BSAVA Manual of Canine and Feline Advanced Veterinary Nursing, 2nd edition, edited by Alasdair Hotston Moore and Suzanne RuddCongress price 49.00

Members dont forget your vouchersAt the beginning of this year, all members were sent a booklet containing a number of discount vouchers for use on manuals at Congress. Amongst these were vouchers entitling you to 5 off the member price on each of the new titles. In addition, there is also a voucher to save 10 on the BSAVA Manual of Psittacine Birds, 2nd edition. Simply bring your vouchers with you, plus proof of membership, to the BSAVA publications stand (on the balcony) in the NIA Exhibition to qualify for these discounts.

Special offers for Congress

3 Manual orthopaedics packageThe BSAVA Manuals of Canine and Feline Musculoskeletal Imaging, Musculoskeletal Disorders and Fracture Repair and Management cater for all your orthopaedic needs:

Diagnostics: radiology, arthroscopy, cytologyMedical disorders: developmental, infectious, neoplasticSurgery: fracture fixation, cruciate repair, joint replacement

Practical tips and our trademark step-by-step Operative Techniques make these volumes a valuable addition to the bookshelf of any practice. Now you can benefit from buying the set and save 20; or buy just two volumes and save 10 off the normal combined price.

At this years Congress we are offering delegates the opportunity to add orthopaedic and surgery titles to their library at a very special price.

Visit the BSAVA publications stand on the balcony in the NIA Exhibition to take advantage of these special offers.

3 Manual surgery packageThe BSAVA Manuals of Canine and Feline Abdominal Surgery, Dentistry and Head, Neck and Thoracic Surgery provide a comprehensive guide to small animal surgery:

Principles and equipment: antibiosis, suture materials, wound managementEmergency presentations: gastric dilatation and volvulus, diaphragmatic rupture, eviscerationSurgical procedures: tooth extraction, ovariohysterectomy, tracheostomy

From preoperative anaesthetic considerations to postoperative wound management, these manuals provide a detailed review of veterinary surgery in practice. Save 10 off the total price on two volumes; save 20 if buying all three titles together.

New home for BSAVA PublicationsThis year BSAVA Publications, along with the BSAVA Membership Stand, Petsavers and the Internet Zone, will be located on the balcony in the NIA. Come along to the Publications Stand to purchase your copies of the new BSAVA Manuals and to see what special offers we have for delegates this year. We look forward to seeing you all in Birmingham in April.

CONGRESS

Principles and equipment: antibiosis, suture materials, wound management

dilatation and volvulus, diaphragmatic

Surgical procedures: tooth extraction,

considerations to postoperative wound

detailed review of veterinary surgery in practice. Save 10 off the total price on two volumes; save 20 if buying all three

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CONGRESS

CONGRESS PRACTICE BADGE DEADLINE APPROACHES

The Practice Badge is the best option for the practice that wants to make sure that as many people as possible in its team get the chance to experience the unrivalled science on offer at BSAVA Congress and access the industry expertise in the Exhibition.

With the Practice Badge you can send up to four members of your staff one person per day. Only BSAVA members are eligible to book the Veterinary

Practice Badge however you can send any member of your

team, and break up the allocation of days as it suits your own rota.

With the deadline for the Practice Badge on 12 March, now is the time to make sure that your entire team get access to some of the outstanding science on offer in Birmingham

The Scientific Programme is the cornerstone of Congress and reflects the BSAVAs core mission to promote high scientific and educational standards of small animal medicine and surgery in practice, teaching and research. This years programme has been designed to provide veterinary surgeons and nurses with new skills and ideas that they can implement in practice. This is emphasised as the Association strives to deliver high-level content, including interactive and Top Tip streams as well as a range of State of the Art lectures, Masterclasses and Clinical Research Abstracts. This year we also have a number of sessions where leading experts will debate controversial issues in their field.

In total the Scientific Programme covers 26 different streams and extends to a course of 236 lectures, all of which will be

delivered by renowned speakers from the UK and across the globe. This means that for those choosing the Practice Badge there will be a stream and speaker to appeal to team members with a range of interests and disciplines

in medicine and surgery.For full details of the BSAVA Congress

Scientific Programme for 2009 visit www.bsava.com where you can download the

schedule for the whole four days. Call 01452 726700 or email

congress@bsava.com for more details. The

deadline for booking the Veterinary or

Nursing Practice Badge is 12

March.

Practice Badge however you can send any member of your

team, and break up the allocation of days as it suits your own rota.

offer in Birmingham

companion

26 different streams and extends to a course of 236 lectures, all of which will be

delivered by renowned speakers from the UK and across the globe. This means that for those choosing the Practice Badge there will be a stream and speaker to appeal to team members with a range of interests and disciplines

in medicine and surgery.For full details of the BSAVA Congress

Scientific Programme for 2009 visit bsava.com where you can download the

schedule for the whole four days. Call 01452 726700 or email

congress@bsava.commore details. The

deadline for booking the Veterinary or

Nursing Practice Badge is 12

March.

PRACTICE

The Scientific Programme is the

18 | companion

CONGRESS

How did you get involved in BSAVA?Initially I joined as a student to get JSAP but then kept my membership going for Congress and the weekend CPD courses when I was studying for my certificate. My children loved BSAVA courses as the hotels always seem to have swimming pools and both of them learned to swim courtesy of my CPD attendance. I was delighted to be asked to join Congress Committee, though to this day I have no clue why. I was proposed by the wonderful Sverine Tasker (a huge support during my Cert SAM) and shadowed Sue Brett, with no idea of what I was really taking on. I think Freda Scott-Park was a bit concerned by my (then) standard uniform of Rohan outdoor gear as was I when I became aware of the sartorial standards set by Mike Jessop.

Why did you get involved with BSAVA?Its nice to give a bit back to the profession, plus, it is good fun and you always learn lots of different stuff youd otherwise never know anything about. The opportunity is not to be missed and I would encourage anyone to add another dimension and get involved in steering veterinary development.

What is the most satisfying aspect of the role/s you have undertaken?Exhibition Organiser this was a role with enormous satisfaction watching the NIA transformed from a sports arena into a fabulous exhibition, then you get to knock it all down and try and do it better the next time. I just like doing things well! I love the teamwork and seeing plans turned into reality.

How has the idea of what it meant to be a part of this profession lived up to your original expectations?My father was a vet, so I was brought up to stand in a field with a bottle of calcium acting as a lightening conductor. I wanted to do farm work, then be a surgeon and ended up doing medicine and management in a small animal practice. So not quite as I had planned it but still enormously rewarding.

What aspect of the job makes you want to rant?Bureaucracy its a business as well as a profession so trying to balance expectations of a vocational career with demands of business. Also, the lack of coherent and incisive representation in the

media. I get tired of vets being pilloried as money-grabbing sharks.

What are the most important issues for the BSAVA and the profession?Relevance, value for money, and being truly representative.

How do you feel about the people entering the profession now compared to when you qualified?Theyre brighter!

What are some of your personal ambitions for the future?Spend more time with my family and go fishing rather than read about it!

Which BSAVA manual is the most thumbed in your library?Emergencies.

In what ways has the profession changed since you joined it? In what ways would you like to see it change?It is more businesslike: the positive is that it needed to wake up; the negative is that there will be fewer opportunities to be owners in the future.

If you could go back and give the undergraduate you any piece of advice, what would it be?At the RVC there was a snooker table so Id say apply to a college without a snooker table. Also keep being enthusiastic; to quote Thoreau none are so old as those that have outlived enthusiasm. Have a gap year, remain an assistant, or better still become a locum none of which I did.

How does being a member of BSAVA contribute to your professional life?I used to really enjoy Congress before I had to start worrying about it. Maybe, now Ive done my time on Congress Committee I can start to relax and enjoy the buzz again. I might even get to go to a few lectures!

After three years as Chairman of Congress Committee, Andrew Ash is looking forward to enjoying his last event in the post and passing the baton to John Williams. Here he answers questions about his ongoing involvement with BSAVA and his hopes for the future

CONGRESS CHAIR LEAVES ON A HIGH

CONGRESS

18 | companion

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CONTINUING EDUCATION

SUMMER CPD SELECTIONBSAVA has a series of essential courses taking place in June

Feline DermatologyVenue: BSAVA Headquarters, GloucesterDate: Thursday 11 June 2009

Skin disease of the cat may present with a variety of cutaneous reaction patterns and be due to a variety of underlying causes. While skin disease may not be as common as in dogs, the popularity of cats as pets will inevitably bring their skin conditions to the attention of the clinical practitioner. This course will aim to review skin disease in cats with particular reference to those conditions associated with the paws and face.

For each review, consideration will be given to the methods available to establish a diagnosis and the various therapeutic options available for the control and management of skin diseases.

Topics covered will include eosinophilic dermatoses, miliary dermatitis, immune-mediated diseases and zoonotic conditions

including dermatophytosis and cowpox infection. Case material will be used to illustrate the reviews and delegates will be invited to discuss several cases during the course.

SpeakerAiden Foster is chief editor of the Journal of Veterinary Dermatology, president of the European Society of Veterinary Dermatology and special associate professor in veterinary dermatology at the University of Nottingham Veterinary School. He has had a long term interest in feline dermatology and is co-editor of the BSAVA Manual of Small Animal Dermatology, 2nd edition.

Also in JuneFerrets and Rodents with Emma Keeble and Film Reading with Frances Barr and Fraser McConnell. For more information or to book any CPD course, visit www.bsava.com, call 01452 726700 or email administration@bsava.com

Wound management and reconstructive surgeryVenue: Mottram Hall, CheshireDate: Thursday 18 June 2009

Traumatic wounds are commonly encountered in small animal practice including both traumatic wounds and elective wounds following excision of tumours. Knowledge of anatomy and function of the skin and the physiology of normal wound healing provides a background to the successful management of wounds.

This course provides an opportunity to develop a logical approach to the management of the patient and wound.

The options for reconstruction of cutaneous wounds will be described in a practical manner to allow delegates to develop their clinical skills in this area.

Topics to be coveredAnatomy of the skinNormal wound healingManagement of traumatic woundsPrinciples of reconstructive surgerySubdermal plexus flapsAxial pattern flapsFree skin grafts

SpeakerStephen Baines qualified from Cambridge University in 1990. He was an intern at North Caroline State University and a resident in small animal surgery at the University of Liverpool. He then completed a PhD in tumour immunology at the University of Cambridge followed by a period as Clinical Surgeon in small animal soft tissue surgery. He is currently Lecturer in Small Animal Surgery and Head of Surgery at the Royal Veterinary College. He is a Diplomate of the European College of Veterinary surgeons and an RCVS specialist in small animal surgery. His clinical interests include clinical oncology, particularly cutaneous neoplasia, and wound healing and reconstructive surgery.

Reproduced from BSAVA Manual of Small Animal Dermatology, 2nd edition.

20 | companion

PUBLICATIONS

NEW MEDICINES GUIDEFred Nind and Pam Mosedale are the editors of a new BSAVA initiative aimed at helping small animal practices manage their dispensaries. Here they explain what we can expect from the BSAVA Medicines Guide

The BSAVA Small Animal Dispensing Course, which is held twice a year, has played to packed houses for years. This is not surprising; if you make a prescribing or dispensing mistake you risk being struck off or getting a criminal record. Veterinary surgeons, veterinary nurses, practice managers, receptionists, students and kennel staff all need to get it right first time and every time.

Veterinary Medicines Regulations (VMR) change every year, whilst waste disposal provisions and dangerous drugs regulations seem to be updated even more often. This means that what you learned at a course attended last year or from a booklet published two years ago may no longer be accurate. In addition, medicines inspections will become compulsory for all veterinary practices from April 2009.

With these issues in mind, the BSAVA has developed a comprehensive guide to a wide variety of medicines issues that affect companion animal practice. This Medicines Guide will be available online at www.bsava.com from April. Members who visit the BSAVA stand on the balcony at Congress will also be able to get the first version on a free CD along with a sample of other BSAVA resources.

Written by recognised experts in the field and capable of being frequently updated as the rules and regulations change, the online guide aims to provide a one-stop shop for all medicines issues. The Medicines Guide will be available for all, not just BSAVA members, as a service to the whole profession. It will, we hope, provide balm for all those worrying about the practical and legal constraints on the use of veterinary medicines.

WHAT IS THAT?Can you name these cells and inclusions in blood films from exotic species?

In this ferret blood smear, can you identify (a) the large cell on the left and (b) the clumped cells on the right?

What is this cell, peculiar to guinea pigs?

Can you identify the two cell types in this avian blood film?

1 2 3

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PUBLICATIONS

Premises licensing and inspectionsFrom April 2009 all premises where veterinary medicinal products (VMPs) are stored or supplied will have to be listed on a register maintained by the RCVS on behalf of the VMD. The VMD will be able to inspect these premises.

Those practices which are members of the RCVS Practice Standards Scheme (PSS) will not currently be inspected by the VMD inspectors as their pharmacies will be inspected as part of the PSS. Both inspections by the VMD and under the RCVS PSS will include a check on the RCVS registration of veterinary surgeons and premises, as well as the registration and qualifications of any suitably qualified persons (SQPs).

Medicines classificationAuthorised veterinary medicines fall within the first four categories established by the Veterinary Medicines Regulations (VMR) 2005. These categories have continued through subsequent revisions of the VMR and are as follows:

AVM-GSL: Authorised veterinary medicine general sales list

NFA-VPS: Non-food animal medicine veterinarian, pharmacist, suitably qualified person (SQP)

POM-VPS: Prescription-only medicine veterinarian, pharmacist, SQP

POM-V: Prescription-only medicine veterinarian

In addition, medicines marketed under the Small Animal Exemption Scheme (SAES) do not have a legal distribution category but may be considered for sale and supply purposes to be equivalent to AVM-GSL.

Ten sample questions the Medicines Guide will answer1. Should you report suspected adverse reactions to human medicine

regulators or just to veterinary ones?2. What medicines are you allowed to use in a Greyhound that may be racing

next week?3. How does a veterinary nurse become a suitably qualified person (SQP)?4. What should you do if a pharmacist dispenses a human generic medicine to

your prescription for a veterinary medicine?5. What is the Small Animal Exemption Scheme (SAES)?6. Why is there no hazardous waste in veterinary practices in Scotland?7. Why should medicines be left in their original packaging when adding them

to the out-of-date medicines container?8. How much does it cost to get a Special Import Certificate (SIC) online?9. What do you do with a loaded and charged dart gun dart if you have decided

not to fire it?10. Under what circumstances can prophylactic antimicrobial use be justified?To find the answers to these questions and many more, download the Medicines Guide at www.bsava.com when it goes online in April.

Further informationThe answers and much more information on blood pictures and their significance in exotic species can be found in these BSAVA manuals: Rodents and Ferrets (NEW at Congress, see page 16); Raptors, Pigeons and Passerine Birds; and Reptiles (2nd edition). Figure 1: (a) Normal segmented

neutrophil; (b) clump of normal

platelets. The surrounding cells are

normal erythrocytes.

Figure 2: A Kurloff cell: note the

normal round cytoplasmic inclusion.

Figure 3: The large central cell is a

heterophil. The smaller cells are

normal erythrocytes, which are

nucleated in birds.

Figure 4: Plasmodium sp., the cause

of avian malaria.

Figure 5: Erythrophagia by a

monocyte. Phagocytic destruction

of red blood cells indicates that

intravascular haemolysis occurs in

reptiles.

Figure 6: Azurophils.

Answers

4

5

6What are the two cells marked A in this film from a boa?

What are the intraerythrocytic inclusions arrowed in this lung smear from a Snowy Owl?

What is this interesting phenomenon in blood from an anorectic iguana?

22 | companion

Improving the health of the nations pets

PETSAVERS

PAY PETSAVERS A VISIT AT CONGRESS

PET MONTH WITH PETSAVERSGet involved with National Pet Month 2009 (4 April 4 May) and help raise vital funds for Petsavers.

National Pet Month is again fast approaching and Petsavers is pleased to be involved. During the month there will be inventive events across the country, from sponsored dog walks to garage sales, cake competitions to practice open days helping to raise funds for the associated charities involved.

So, how can you get involved? You could go to one of the events being held and provide your support that way or arrange an event of your own. If you work in practice, National Pet Month can be a brilliant opportunity to engage with your local community. If you cant think of an event, then Petsavers is happy to suggest ideas, or you can order a free event pack through the National Pet Month website.

You can also find out about events close to you through the National Pet Month website and if you are planning an event in support of Petsavers please let us know as we would love to hear about it and help you promote it.

For fundraising ideas, or help with raising sponsorship please email info@petsavers.org.uk

To find out about events close to you check the National Pet Month website www.nationalpetmonth.org.uk

Petsavers will be joining the rest of the BSAVA on the balcony in the NIA Exhibiton this year and we are looking forward to meeting you there. You will be able to meet Petsavers volunteers and find out what Petsavers has planned for the future. Petsavers is always open to fundraising ideas or suggestions, so please feel free to come to the stand and share your ideas. Petsavers will also be running a competition for all delegates, so dont miss out on the chance to win great prizes and get involved with your veterinary charity.

You dont have to be the next Martin Lel or Paula Radcliffe; if you just want a fun day out, then Petsavers would like to hear from you. Once again Petsavers will be taking part in the 10k run. The event will be on Sunday 12 July 2009 in London. Last year 26,000 people, including

your veterinary charity.

ou dont have to be the next Martin Lel or Paula Radcliffe; if you just want a fun day out, then Petsavers would like to hear from you. Once again Petsavers will

be taking part in the 10k run. The event will be on Sunday 12 July 2009 in London. Last year 26,000 people, including

22 |

You dont have to be the next Martin Lel or Paula Radcliffe; if you just want a fun day out, then Petsavers would like to hear from you. Once again Petsavers will be taking part in the 10k run. The event will be on Sunday 12 July 2009 in London. Last year 26,000 people, including

GO ON THE RUN

professional runners such as Stefano Baldini and Catherine

Ndereba, ran the route past many of Londons historical landmarks. The Petsavers team had a great time and raised lots of money for Petsavers in the process. If you would like to take part

then please contact us as soon as possible as spaces are limited,

at info@petsavers.org.uk or call 01452 726723. We can help you

with raising sponsorship, whether that is assistance with sponsorship

forms or setting up a Just Giving page. You can find out more about the event at

www.thebritish10klondon.co.uk

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WSAVA NEWS

WSAVA CE AROUND THE WORLDSri LankaThe WSAVA has been hosting WSAVA CE programmes for practitioners in Sri Lanka for some time, but the usual programme was limited to one or two day

visits and there was obviously a need for assistance on a broader scale in this very poor country.

Dr Roger Clarke, who chairs the WSAVA CE programme in Asia, gave the

first programme of CE that extended beyond the reach of the normal WSAVA programme. He donated approximately two weeks of his time free of charge to teaching final year veterinary students at the University of Peradinaya in Kandy. His airfare was paid by the Commonwealth Veterinary Association and

Above: Dr Roger Clarke (right) and Intervet/Schering-Plough Animal Health sponsor representative Dr Gabriel Varga (second from right) visit with members of the Sri Lanka Veterinary Association during a CE event.

Left: Being exposed to and exploring the beautiful country of Sri Lanka is one of the bonuses of veterinary visitors volunteering their time.

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WSAVA CE AROUND THE WORLD

WSAVA NEWSWSAVA NEWS

he was assisted locally by the Sri Lanka Veterinary Association. While in Sri Lanka, Dr Clarke also lectured practitioners. This was such a success that he looked for ways to continue this teaching programme.

In 2008 Dr Dave Watson, formerly of the University of Sydney Veterinary School, volunteered to go to Sri Lanka on a pro bono basis and he taught the students and practitioners the secrets of problem-oriented veterinary medicine. The ASAVA took over part of the financial assistance for the programme and contributed to the accommodation costs of Dr Watson while he was away. The WSAVA CE programme paid the airfare as part of the WSAVA CE commitment.

In 2009, Dr Graeme Allan will be going, again on a pro bono basis, to help the veterinary school to use its new ultrasound equipment and to teach diagnostic imaging to the students and the staff, as well as the

practitioners who may utilise this service.The involvement of the ASAVA in this

way is very much appreciated by the WSAVA, and we join the ranks of other national veterinary associations in sponsoring our less affluent colleagues throughout the world.

The ASAVA has benefited enormously in its membership of the WSAVA, both in the exchange of knowledge and the opportunity to hold the largest veterinary congress Australia has seen in 2007.

Most of the work in the WSAVA is done by volunteers who give freely of their time and skills for the sheer pleasure that comes from giving. Dr Clarke is actively looking for skilled volunteers who would be prepared to give approximately two weeks of their time teaching in Sri Lanka, with the WSAVA CE programme. An additional benefit is that the volunteers can see this beautiful country with its fascinating history

(at their own expense) while they are there. For further details please contact rogerclarke@pobox.com

PanamaWith a population of 3.3 million people, Panama was the second fastest growing economy in Latin America in 2008. The country has one veterinary college, which is located in facilities that used to house the American Panama Canal Administration offices and is in need of both structural and equipment upgrades.

However, with a reinvigorated leadership and growing membership, AMVEPA has become more active on behalf of its members in 2008, particularly in the delivery of CE. As part of its Global CE Programme, WSAVA hosted its first meeting for small animal veterinarians in Panama City on the topic of Emergency Veterinary Medicine. Lectures were given by Drs Luis Tello (WSAVA Vice President) and Adriana Lopez (LAVECCS Secretary) with approximately 80 delegates attending.

Register for So PauloHave you registered yet? There will be approximately 250 lectures by 75 world-renowned speakers covering over 20 disciplines complemented by an exciting social programme in culturally diverse So Paulo, with all that Brazil and South America has to offer. Please visit www.wsava2009.com for additional details and online registration.Dr Luis Tello introducing the WSAVA CE Programme prior to his presentations on

Emergency Medicine to attendees of WSAVA CE in Panama.

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WSAVA NEWS

PRESIDENTS REVIEWDavid Wadsworth looks back on the last years successes for the World Small Animal Veterinary Association

It is the duty of every President to report on his or her hectic period in office and this Presidents report is no exception. The Dublin WSAVA Congress was the first in a series of congresses which feature Hills Pet Nutrition as our WSAVA Prime Congress sponsor.

WSAVA CongressThanks to the help of Dr Nicola Neumann, Professor Boyd Jones and their teams I can report on a truly great congress in Dublin, which was enjoyed enormously by delegates and exhibitors alike. One congress leads inevitably into the next and we are currently working hard with Dr Marco Gioso, Saliem Saleygh and Wanderson Ferrera and all those involved on the final preparations for the WSAVA 2009 Congress in So Paulo, 2124 July 2009.

This will be only the second time that the WSAVA Congress has been held in South America and we are hoping that it will hit the very high standard set in Dublin. The local organizing committee is talking in terms of 3000 delegates, so make a note in your diaries to be there.

During the autumn of last year the French Association AFVAC celebrated its 50th anniversary and I was fortunate to be invited to Strasbourg to take part in their celebrations. AFVAC has been a leading force in WSAVA for many years and with the help of Drs Carlotti, Roze and Rousselot, is helping to extend the WSAVA Continuing Education (CE)

programme to French-speaking areas of Africa and hopefully also Paraguay.

Worldwide CEThe WSAVA 2008 CE programme has hosted a record number of attending delegates (4159) in 31 meetings spread over four continents. We and the long-term sponsoring partners, Bayer Animal Health, Hills Pet Nutrition, and Intervet/Schering-Plough, can be justifiably proud of the difference that the programme has made to the lives and education of veterinary surgeons in the developing areas of the world.

Member Associations from the UK (BSAVA), France (AFVAC), Austria (VK), Australia (ASAVA), Greece (HVMS), Switzerland (SVK), Denmark (DSAVA), Norway (NSAVA), Finland (FSAVA), and the Netherlands (NACAM) have all contributed financially, either directly or by sponsoring speakers, and we are grateful for this cooperation. It is a particular pleasure to report that the associations from the Czech Republic, Slovakia and Poland, who were initially recipients of sponsorship, have matured and have been contributing to the programme by waiving the small amount of sponsorship that is their due.

Welfare and scienceThe animal welfare committee will be active in 2009 with day-long streams already organized for the TNAVC, FASAVA and WSAVA conferences. Drs Butcher and Clarke continue to do excellent work in the face of a tide of apathy to a subject which should never be taken for granted, even though veterinary surgeons, by definition, are involved in animal welfare on a daily basis.

The Scientific Committee has been extremely active in assisting with the

production of the programme for So Paulo and Dr Michael Day and his committee are considering nominations for prestigious WSAVA Awards which will be announced in So Paulo. The Scientific Standardization projects on Renal Disease and Vaccination continue and interim reports will be made in July 2009.

WSAVA plansThe Board met during the NAVC Congress in Orlando. Top of the agenda was to consider the major strategic planning initiative started in Dublin. Part of this will be to consider the need to stabilize the position of WSAVA by incorporation and registration as a not-for-profit association within a named country. There will be stricter controls, both administrative and financial, but these changes would be necessary to ensure that WSAVA retains its preeminent place in the veterinary world in the future. Dr Kirpensteijn is looking into the formation of the WSAVA Foundation, a fundraising entity, which will be supportive of scientific research projects in the future. Dr Sheehan will also be looking at the WSAVA Congress in all its facets and the Board will be considering an action plan which will be taken to the Assembly in July.

I hope that the result of all this work will be that the Assembly in So Paulo will have major issues to consider and that the active participation of the members in the strategic planning process will see an even more committed and active WSAVA in the future.

26 | companion

companion INTERVIEW

Pip Boydell was born in 1960 (both Pip and his parents joke that he was exchanged at birth), and grew up in Manchester and Bolton. After first studying at Exeter University he went on to the Royal Veterinary College, though claims he never actually wanted to be a vet until the fourth year of the course. After graduating and spending a year in practice, two years in the surgery department at Edinburgh and a year in referral practice in London, Pip realized that, of all the disciplines, ophthalmology/neurology held the greatest attraction and he took up a residency in veterinary ophthalmology at the RVC. Pip established the first UK dedicated small animal referral practice in 1990 and set up the first in-house brain scanner the next year. He has published over 200 peer-reviewed papers and abstracts and is a regular speaker at BSAVA Congress.

THEcompanionINTERVIEW

You have become known within the profession through your published papers and lecturing on ophthalmology how did you first become involved in that area?

Having been informed by the local taxman that only one international conference per year was tax deductible, I learnt that presenting a paper might be counted as advertising and therefore a business expense. Regular attendances at such meetings, both veterinary and medical, led to occasional invitations to lecture and I could see the world and get paid (not alot) for it!

What has been your main interest outside work?

Music has always been a major part of my life, having come of age during the punk era. I have been in some form of band all my life, working on the premise that lack of talent is no obstacle to success, but I have not been offered any major record contract (yet). The Bruise Brothers are currently available for weddings, bar mitzvahs and biker festivals.

I worked my way through college as a disc jockey on pirate radio, live parties and gigs. My most important possession is my juke box (a proper juke box that plays vinyl, Luddite that I am). With age and general

infirmity I retired from playing American Football and moved into traditional and competitive martial arts. I turned pro at the beginning of 2009.

What would you have done if you hadnt been a vet?

Assuming Im not going to make it big in the music industry, I would have done something entrepreneurial. As a student I was very aware of the risk of failing exams and an alternative career progressed running market stalls selling second hand records and Chinese silk clothing (my sister was studying in China at the time). I might have had a chain of stores by now! Currently I run a couple of Chinese kickboxing and Kung Fu clubs.

What is your favourite aspect of veterinary practice?

Dealing with people.

What is your least favourite aspect of veterinary practice?

Dealing with people.

Who has been the most inspiring influence on your professional career?

John Peel, Humphrey Littleton.

Which historical/cultural figure do you most admire?

Genghis Khan.

What is the most significant lesson you have learned so far in life?

People who mind dont matter; people who matter dont mind.

If you were given unlimited political power, what would you do with it?

Encourage investment by the workforce so that all employees own their companies. Remove incentives (tax, social benefits, time off, etc.) for people to have children its discrimination against the childless!

These seem good ideas but are too small scale. How about arranging the destruction (painless) of 99% of the human race so that true anarchy will allow the re-evolution of society? Whew!

If you could change one thing about yourself, what would it be?

I would like to enjoy eating vegetables and healthy food.

What do you consider to be your most important achievement during your career?

That would be winning two gold medals fighting in the British Kickboxing Championships in 2005. n

CPD DIARY

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CPDDIARY

12 MarchThursdayAnaesthesia and analgesia in the 21st centurySpeaker John HirdLeatherhead Golf Club, Ashtead, Surrey. Surrey and Sussex Region.Details from Jo Arthur, 01243 841111, surreyandsussexregion@bsava.com

EVENINGMEETING

19 MarchThursdaySoft tissue surgery: oropharyngeal stick injuriesSpeaker Zo HalfacreeRussell Hotel, Maidstone. Kent Region.Details from Hannah Perrin, hannah@burnhamhousevets.com

EVENINGMEETING

14 MayThursdayBSAVA Cardiology RoadshowSpeakers Rebecca Stepien and Mike MartinRadisson SAS Hotel, Belfast, Northern Irish Region. Organised by BSAVA.Details from the Membership and Customer Service Team, 01452 726700, administration@bsava.com

DAYMEETING

18 MayMondayBSAVA Cardiology RoadshowSpeakers Rebecca Stepien and Virginia Luis Fuentes. Canalside, Bridgwater, South West Region. Organised by BSAVA.Details from the Membership and Customer Service Team, 01452 726700, administration@bsava.com

DAYMEETING

12 MarchThursdayA pain in the ass: surgical disease of the rectum and colon fistulas, megacolon, neoplastic diseaseSpeaker Kathryn PratschkeVSSCo, Lisburn. Northern Irish Region.Details from Shane Murray, shane@braemarvetclinic.co.uk

EVENINGMEETING

19 MarchThursdayVascular disease in small animals: an underdiagnosed problem? Speaker Simon SwiftHoliday Inn, Haydock. North West Region.Details from Simone der Weduwen, beestenhof@ntlworld.com

EVENINGMEETING

18 MarchWednesdayThe Golden HourSpeaker Dan HoldenPark Inn, Llanederyn, Cardiff. South Wales Region.Details from the Chairman or Secretary, southwalesregion@bsava.com

EVENINGMEETING

19 MarchThursdayHow the lab can help you with pancreatic diseaseSpeaker Lindis FouracrePotters Heron Hotel, Romsey. Southern Region.Details from Michelle Stead, 01722 321185, mmstead@btinternet.com

EVENINGMEETING

30 AprilThursdayCardiovascular medicineSpeaker Jo Dukes McEwanThorpe Park Hotel & Spa, Leeds. Organised by BSAVA.Details from the Membership and Customer Service Team, 01452 726700, administration@bsava.com

DAYMEETING

13 MayWednesdayOcular manifestations of systemic diseaseSpeaker David WilliamsPotters Heron Hotel, Romsey. Southern Region.Details from Michelle Stead, 01722 321185, mmstead@btinternet.com

EVENINGMEETING

17 MaySundayIs it respiratory or cardiac disease? Case-based approachSpeaker Clive ElwoodCambridge Belfry, Cambourne. East Anglia Region.Details from Graham Bilbrough, graham-bilbrough@idexx.com

DAYMEETING

8 MarchSundayAcute and painful eye conditions in companion animalsSpeaker John MouldBest Western Glasgow Pond Hotel, Glasgow. Scottish Region.Details from Claire Robertson, 07792 251003, claireadriennelamb@hotmail.co.uk

DAYMEETING

8 MarchSundaySedation/anaesthesia of sick medical casesSpeakers Louise Clarke and Liz LeeceCambridge Belfry, Cambourne. East Anglia Region.Details from Graham Bilbrough, graham-bilbrough@idexx.com

DAYMEETING

25 AprilThursdaySundayBSAVA CongressInternational SpeakersFour day Congress including a challenging scientific programme, scintillating social events and an extensive exhibition. ICC/NIA, Birmingham. UK.Details from the Membership and Customer Service Team, 01452 726700, administration@bsava.com

ThursdaySunday

BSAVA CongressBSAVA Congress

social events and an extensive

Details from the Membership and

ThursdaySunday

810 MayFridaySunday24th annual Scottish CongressRaising the bar in SA practice, for veterinary surgeons & nursesSpeakers Andrew Mackin and Ronan DoyleFairmont Hotel, St Andrews. Scottish RegionDetails from Susan Macaldowie, 07711 633698, smacaldowie@btinternet.com

WEEKEND

21 AprilTuesdayInfectious diseasesSpeaker Susan DawsonBSAVA, Woodrow House, Quedgeley. Organised by BSAVA.Details from the Membership and Customer Service Team, 01452 726700, administration@bsava.com

DAYMEETING

Members price: 191.83 inc. VAT

British Small Animal Veterinary AssociationWoodrow House, 1 Telford Way, Waterwells Business Park,

Quedgeley, Gloucester GL2 2ABTel: 01452 726700 Fax: 01452 726701

Email: administration@bsava.comWeb: www.bsava.com

Recent advances in treating cardiovascular diseases have changed the clinical approaches we use and improved survival times. Discover new ideas about familiar diseases and fi nd a fresh appreciation for the joys of treating geriatric patients.

Thursday 14 MayRadisson SAS BelfastRebecca Stepien and Mike Martin

Monday 18 MayCanalside, BridgwaterRebecca Stepien and Virginia Luis Fuentes

Wednesday 20 MayVenue Daventry Hotel, DaventryRebecca Stepien and Mike Martin

Friday 22 MayBellhouse, Beaconsfi eldRebecca Stepien and Virginia Luis Fuentes

BSAVA Cardiology Road ShowMay 2009

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