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THE UK’S LEADING MONTHLY VETERINARY PUBLICATION SEPTEMBER 2018 Top picks for
this year’s BEVA
Congress
page 49
SMALL ANIMAL
Managing
cases of feline
leukaemia virus
page 32
LARGE ANIMAL
Cattle hoof care
standards
page 46
OFFICIAL VET
Introducing the
African swine UK’s new CVO
page 42
fever PRACTICE MANAGEMENT
Responding to emerging
Key steps to
disease threats
designing a
practice
page 60
Plus
MENTAL HEALTH Identifying anger and anxiety / NUTRITION Dietary management of M Facebook.com/vetpracticeonline
diabetes mellitus / DERMATOLOGY Dealing with feline allergic skin disease / EQUINE
Performing a neurological examination
N @VetPractice_Mag
WWW.VETERINARY-PRACTICE.COM
CLINICAL NUTRITION
HAS NEVER BEEN THIS ADVANCED
VETERINARY GLOBAL CARE
Management of the Primary Condition
Support of Concurrent Conditions
Restoration of Body Composition
Additional Health Benefits
ADVANCED NUTRITIONAL MANAGEMENT FOR CATS & DOGS
The Veterinary HPM Clinical Diets provide advanced clinical nutrition that is closest
to the nutritional needs of dogs and cats as carnivores.
The Veterinary Global Care Approach, developed by Virbac, goes beyond the
management of a specific health condition, and is based on scientific evidence to
become a valued addition to the management of clinical cases. FOR MORE INFORMATION,
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VIRBAC TERRITORY MANAGER
Shaping the future of animal health
B
EDITOR’S WELCOME
“All there is to smile about in the
equine veterinary profession”
W
elcome to the September issue be implemented should the disease
of Veterinary Practice mag- reach the UK.
azine. We are back from our There will be much more on notifiable
break and have lots to look forward to diseases at the Official Vet Conference,
this month. which takes place in Swindon on 19 and
In an interview with the UK’s new 20 September; visit the conference intro-
Chief Veterinary Officer, Christine Mid- duction in this issue to find out more.
dlemiss, we find out what led her to the The BEVA Congress is also held this
role and how she will be tackling some month – from 12 to 15 September in
of the challenges currently facing the Birmingham; head to the equine section
profession. Christine explains the main for a list of the top 10 things to see and
priorities for the coming year, including do at the event. Jonathan Pycock will be
disease control, EU Exit preparations handing the presidential baton to Renate
and working with the Veterinary Capabil- Weller, and in his final contribution to
are several dermatology articles this
ity and Capacity Project to ensure there the BEVA column, he discusses all there
month, covering topics such as canine
are enough vets to keep on top of the is to smile about in the equine veterinary
impetigo and feline allergic skin disease,
growing veterinary workload. profession. Also in equine, we have a
as well as a guide to dietary management
Also in the Official Vet section, we fascinating interview with Juan Samper,
of diabetes mellitus in cats and dogs.
have an article detailing the processes an equine reproduction specialist based
in place to monitor African swine fever. in the US, and a useful guide to per-
With its presence in continental Europe, forming a neurological examination by
and more recently in China, vets have Caroline Hahn.
been alerted to an increased risk of the For small animal practitioners, our In
disease reaching the UK. Jo Wheeler Focus topic is feline disease – a section
explains how the APHA is keeping track that includes pieces on feline leukaemia
of the disease and what protocols would virus and feline hyperthyroidism. There JENNIFER PARKER EDITOR
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Veterinary Practice | September 2018 1
CONTENTS
IN FOCUS
32 Managing cases of feline leukaemia virus
An introduction to feline leukaemia virus and guide
to successful diagnosis and management of the
disease.
36 Feline hyperthyroidism
Advice on the medical management of feline
hyperthyroidism when faced with concurrent
disease.
39 A look through the latest literature
The latest academic publications providing further
insight into this month’s In Focus topic.
REGULARS SMALL ANIMAL
4 News 20 Nutrition
A snapshot of the topics currently hitting industry Considering a diet-based approach to tackling
headlines. diabetes mellitus and a discussion on how to
approach weight management in cats.
10 Innovation
How technology for monitoring livestock health at 24 Dermatology
the individual and herd levels can improve farm David Grant explores canine impetigo in puppies,
animal management. Chiara Noli begins a short series on feline allergic
skin disease and Jayne Clark takes a deeper look
12 RCVS Knowledge into chronic otitis externa.
A useful tool from RCVS Knowledge helps to keep
vets up to date with the latest research. 31 Dentistry
Considering the pricing of veterinary services and
14 Mental Health how the approach to pricing should be altered
Anger and anxiety are in the spotlight for part two with different clients.
of the series on meditation for beginners.
OFFICIAL VET
16 Insurance
Agria was delighted to sponsor and take part in 40 News and updates
the sixth Animal Welfare Foundation Discussion The latest news and updates for OVs and an
Forum in London. introduction to the 2018 Official Vet Conference.
EDITORIAL ADVERTISING ENQUIRIES HEAD OFFICE
Nic Catterall 5m Publishing, Unit 10, Southill Business
MANAGING EDITOR 07730 762136 Park, Cornbury Park, Charlbury OX7 3EW
Ellen Hardy nic.catterall@5mpublishing.com
© 5m Publishing Ltd (2018): no part of
EDITOR Sally Pye this publication may be reproduced in any
Jennifer Parker 07867 357553 form (except for review purposes) without
Veterinary Practice (ISSN: 0042-4897) is an independent sally.pye@5mpublishing.com the express permission of the editor.
monthly publication, free to members of the veterinary DESIGN
profession in the UK. It is available on subscription: UK
is £40 per year, Europe is £90 per year and the rest of
5m Publishing
PRINTING
EDITORIAL ENQUIRIES
Jennifer Parker
M Facebook.com/vetpracticeonline
the world is £120 per year.
Volume 50, number 6 Buxton Press
07879 998719
jennifer.parker@5mpublishing.com N @VetPractice_Mag
2
42 Introducing the new CVO PRACTICE MANAGEMENT
Find out what the key priorities will be for
Christine Middlemiss in her first year as the UK’s
58 Using net promoter scores
Chief Veterinary Officer.
An introduction to net promoter scores: what
are they, why are they useful and how are they
44 The threat of African swine fever
calculated?
How is the APHA monitoring the risk of African
swine fever and what procedures would be
60 The key steps to designing a practice
implemented should the virus reach Great Britain?
Although there are unique factors to consider,
designing a veterinary practice involves the same
LARGE ANIMAL key steps essential to any building project.
46 Cattle hoof care standards 63 Dealing with tricky situations
Veterinary surgeons in cattle practice are urged Sometimes it will be necessary to dig yourself out
to review their approach to the management and of a hole when dealing with an emotive client.
treatment of the bovine hoof.
OPINION
EQUINE
18 Clifford Warwick
48 The highlight of the year “Pet labelling is required and needs to be entirely
In his last column as BEVA President, Jonathan independently and objectively formulated”
Pycock explains what he is most looking forward
to at the 2018 BEVA Congress. 57 David Williams
“Would you be interested in investigating whether
49 The top picks for BEVA Congress 2018 bank voles near the nuclear reactor in Chernobyl
With internationally renowned speakers and have cataracts?”
notorious social events, there is lots to look
forward to at this year’s event. 64 Gareth Cross
“Now, many students have a career path mapped
52 A global perspective on the equine
out by final year”
profession
Having led a diverse career with experience all
over the world, Juan Samper talks about what the
profession might look like in the future.
Is your subscription
55 Performing a meaningful
information up to
neurological exam date?
Practical advice from a specialist on performing an Email michael@teamworkprofessionals.co.uk to
equine neurological examination – from head to tail. update our records
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Veterinary Practice | September 2018 3
NEWS
Government backs ban on third party sales of
puppies and kittens
The government has announced a con- to new and unfamiliar environments
sultation on a ban on third party puppy and the increased likelihood of multiple
and kitten sales in England. The ban journeys the puppies or kittens have to
will be introduced to help drive up ani- undertake – all of which can contribute
mal welfare standards, the Environment to a chaotic start in life and lead to
Secretary, Michael Gove, has announced. serious health problems and lack of
Confirming the government’s support socialisation.
for the prominent Lucy’s Law campaign, Environment Secretary, Michael Gove,
Defra has published a consultation on said: “A ban on third party sales will
an outright ban that will mean anyone ensure the nation’s much-loved pets
looking to buy or adopt a puppy or get the right start in life. I pay tribute to
kitten must either deal directly with the Lucy’s Law campaign, spearheaded
the breeder or with one of the nation’s by PupAid, Care And Respect Includes
many animal rehoming centres. All Dogs (CARIAD) and Canine Action UK,
The steps follow a commitment by who have fought tirelessly for this step.” dealing in puppies and kittens under the
Prime Minister Theresa May in The proposed ban on third party age of eight weeks and tightening the
December to crack down on puppy sales is part of a series of govern- compulsory licensing of anyone in the
farms, to aim to bring an end to the ment reforms on pet welfare including business of breeding and selling dogs.
grisly conditions found in puppy farm- banning the sale of underage puppies As part of its animal welfare reform
ing and tackle a range of existing ani- and kittens and tackling the breeding programme, the government is also
mal welfare issues. These include the of dogs with severe genetic disorders. bringing in higher maximum sentences
early separation of puppies and kittens New laws come into force on 1 Octo- of up to five years for animal abusers –
from their mothers, their introduction ber 2018 banning licensed sellers from the toughest sentencing in Europe.
RCVS recognised as one of the BSAVA and BEVA
agree Congress
top UK workplaces for women collaboration
The RCVS has been recognised as one veterinary profession (which is cur- Mixed practice vets can optimise
of the best workplaces for women by rently 63 percent female for veterinary CPD, minimise time away from work
the Great Place to Work Institute. The surgeons and 98 percent female for and save money thanks to a new
RCVS came seventh in the medium- veterinary nurses) as far as possible. partnership between the BEVA and
sized company or organisation cate- With two-thirds of the staff at the RCVS BSAVA annual Congresses. Discounted
gory (50 to 449 employees) of the Best being women it demonstrates that attendance for the two leading annual
Workplaces for Women initiative. the College is largely reflective of the events is available to members of both
This year is the first that the Great profession it serves. associations, giving access to high
Place to Work Institute has run this “However, it’s not just about the quality small animal and equine CPD,
initiative; it looked at a number of numbers and with 60 percent of the a full social programme and a host of
factors, including the number and Senior Team at the RCVS being women, other benefits.
proportion of women in leadership including the CEO and Registrar, it BSAVA members will receive a 30
positions, pay parity between men and demonstrates that the College has percent discount on standard tickets
women, workplace policies and how developed a culture in which women for BEVA Congress from 12 to 15 Sep-
they support female employees, as can shatter the glass ceiling and pur- tember 2018, and BEVA members will
well as training and development and sue leadership roles. receive the BSAVA membership dis-
mentoring. “Also, with policies such as flexible count for BSAVA Congress, from 4 to 7
Commenting on the results, Amanda working hours, encouragement of April 2019. Both organisations are run
Boag, RCVS President, said: “One of the home working, shared parental leave by the profession for the profession
key themes of my Presidential year is and enhanced maternity and paternity and share aligned foundations, with
diversity and I think it is very impor- pay, the College goes the extra mile to volunteer vets and nurses designing
tant that, as a regulator, we reflect the support working parents.” the Congress programmes.
4
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VET DENTAL UNITS | VET DENTAL X-RAY | ULTRASONIC SCALERS | HAND INSTRUMENTS | ACCESSORIES & CONSUMABLES
Veterinary Practice | September 2018 5
NEWS
First recipient of WSAVA Gumtree introduces
paywall to curb illegal
Award for Companion pet trading
Animal Welfare
Nalinika Obeyesekere, a veteri-
narian from Sri Lanka, is the first
recipient of the World Small Ani-
mal Veterinary Association’s new
Award for Companion Animal
Welfare. The award, developed
by the WSAVA’s Animal Wellness
and Welfare Committee (AWWC),
recognises individual vets who
Gumtree has announced the intro-
have made a significant contri-
duction of a compulsory paywall in its
bution to animal welfare and
Education. In this role, she has been “pets” category, in a bid to deter unscru-
inspired others to play their part
championing higher standards of veter- pulous operators from misusing the
in advancing welfare globally.
inary practice and the adoption of a one platform and discourage the “casual”
Nalinika graduated with a BSc in
health approach. As founder and trus- trading of animals online. Anyone
wildlife biology and management from
tee of Blue Paw Trust, an organisation wishing to post an ad in the pets cate-
UC Davis, USA, and, in pursuit of her
which aims to enhance human health gory will be required to pay a nominal
primary interest, animal behaviour,
and advance animal welfare, she is foc- fee. The move by the UK’s number one
returned to Sri Lanka in 1985 to work
used on the eradication of rabies from classifieds platform represents a big
in the environmental sector. She later
Sri Lanka and leads projects to improve shift from Gumtree’s “free for all
obtained a BVSc at the University of
the relationship between the public and users” model.
Peradeniya in Sri Lanka and has an
the country’s community dogs. Gumtree has a relationship with the
MVSc from Murdoch University in
Commenting on receiving the award, Pet Advertising Advisory Group (PAAG)
Australia. She is now the owner-
Nalinika said: “The most important – the UK’s leading advisory group made
director of Pet Vet Clinic in Sri Lanka,
thing we can do for animal welfare is to up of 23 animal welfare organisations,
a clinic which paved the way for small
improve and equalise the quality and trade associations and the veterinary
animal practice in Sri Lanka.
standards of veterinary care globally.” profession – that promotes responsible
Her passion for animal welfare is a
Nalinika will be presented with the pet advertising and the safe trading of
consistent theme throughout her work.
award during the 2018 WSAVA World animals via online adverts. Gumtree
She is a founder member of the Society
Congress, which takes place from 25 to works hard to comply with, and in some
of Companion Animal Practitioners
28 September in Singapore. cases exceed, PAAG’s 18 minimum
of Sri Lanka and is now Director of
standards for the rehoming of pets.
Despite the efforts of PAAG and
Animal welfare enhanced by new code for industry operators like Gumtree to meet
laying hens and pullets standards, the illegal pet trade has
continued to circumvent systems across
Strengthened statutory guidance is display more of their natural behav- the industry. The introduction of a
now in place for keepers and owners of iours such as foraging. The user- compulsory paywall in the pets category
laying hens and pullets on how to meet friendly codes also provide detailed creates an obstacle that will naturally
the needs of their birds and enhance guidance to animal keepers on how to discourage users from casually posting
their welfare. This welfare code has assess the welfare of their animals, as pet ads and means Gumtree and law
been updated to reflect the very latest well as on contingency planning to help enforcement agencies can more easily
advice from vets and animal husbandry ensure the welfare of their animals identify illegal operators.
developments, as part of a programme during any emergencies. Canada’s leading online classifieds
of reforms to safeguard and enhance the The codes will be used by enforce- site Kijiji – part of the eBay Classifieds
welfare of animals, the Minister for Ani- ment bodies including APHA inspectors Group, which includes Gumtree –
mal Welfare, Lord Gardiner, announced. and local authorities when investigating introduced a similar paywall policy on
Animal keepers are now expected to allegations of poor welfare to look at a part of their platform in 2014 which
provide a more enriched environment whether animal welfare standards are proved successful in reducing incidents
for all laying hens to enable them to being met. of abuse.
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Veterinary Practice | September 2018 7
ANIMAL BEHAVIOUR
Preparing for fireworks
Up-to-date advice for owners who are pheromone) has been shown to help reduce anxiety and
help dogs cope with challenging situations, including fire-
concerned about the firework season work events, reducing signs of fear such as trembling and
hiding by 93 percent.
GWEN BAILEY Puppies can learn to be completely at ease with loud
noises if work to get them used to them is started early. The
Gwen Bailey, BSc (Hons), worked as Head of Animal
Behaviour for the Blue Cross for 12 years. She founded aim is to habituate them to the point where they can remain
Puppy School, a UK network of puppy class tutors, and relaxed when hearing loud sudden noises. Pups should be
is a past Chairman of the Association of Pet Behaviour
Counsellors. carefully and gradually exposed to recordings that accu-
rately reproduce the pops, bangs and whistles associated
The old advice to ignore your dog when it is frightened by with fireworks.
fireworks flies in the face of what many owners consider Frequency is key. The more the sounds are presented,
appropriate and humane. Dogs are, after all, social and the easier they accept them as part of daily life and the
emotional. Not comforting them when they feel scared, such less notice they will take of them later in life. Pheromone-
as during firework night, is both unnecessary and could based products may provide support and comfort during
make things worse as the dog finds itself deserted by its the early stages of a puppy’s development and encourag-
social support in times of trouble. ing puppy owners to use these products might increase
Much better then to provide comfort, but how this is the chances of the puppy never learning to be afraid of
done is important. A calm, happy manner is needed, rather loud noises.
than an overly sympathetic one which can lead the dog to Some dogs may need a long-term behaviour modification
believe that the owner is scared too. Providing reassurance plan to deal with noise fears and phobias that will involve
that everything is okay by demonstrating that you are not desensitisation and counterconditioning. This should,
worried is essential. ideally, be carried out with the advice and support of a
The use of Adaptil (a synthetic copy of the dog appeasing qualified animal behaviourist.
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W
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veterinary medicine growing ever more relevant the best, most impact-
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quickly – and positively – becoming an in-depth and varied A quick-to-digest
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know where to look? How many papers on exotics would information to chew on and choose whether they want to
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inFOCUS appraise new research for accuracy, bias and other compli-
inFOCUS is a journal watch, which does exactly what it says cating factors, inFOCUS has already done that for you.
on the tin (it “watches” journals), except the tin in this case Not only does that save you a potentially immeasurable
is a bimonthly email highlighting the best recent research. amount of time better spent on animal well-being (as well
as your own), it also gives you the confidence that what you
are being told has been evaluated and endorsed by a team
of independent experts.
That process is gloriously simple too; the RCVS Knowl-
edge Library and Information Service (LIS) keeps track of
infocusvj.org
new material in over 100 publications (including all the
major peer-reviewed journals) all year round, and compiles
a “long list” of the stand-out evidence every two months.
This is then narrowed down to a shortlist of no more than
15, based on an evaluation of overall quality and relevance.
An independent Clinical Review Team thoroughly assesses
these, scoring them on their relevance and interest to the
general practitioner, impact in practice, quality and the clini-
cal soundness of their conclusions and recommendations.
Once the top five or six have been established, the
summaries are drawn up and sent out in the next edition,
ensuring practitioners have the best evidence when they
need it most. VP
To subscribe, visit: infocusvj.org
12life
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Blue Leanie, Walton Street, Aylesbury, Buckinghamshire, HP21 7QW. Veterinary Practice | September 2018 13MENTAL HEALTH
Identifying anger and anxiety
The first step to dealing with emotions present with them? You would have been thinking about
their endearing personality, the kind things they had done
is simply identifying them through for you, listening to music you both like, planning fun nights
meditation out, etc. All those thoughts indirectly contributed to your
bond with that person and helped to build the relationship
into something uplifting and positive.
LAURA WOODWARD
LAURA WOODWARD COUNSELLING
If the emotion you have chosen to observe is affection for
someone, build on it. Take that emotion and think about it
Laura Woodward has been the surgeon at Village Vet
Hampstead for over 10 years. Laura is also a qualified
further. Choose your internal and external reactions to it.
therapeutic counsellor and is affiliated with the ACPNL Embrace the feelings of affection and kindness.
and the ISPC. She runs Laurawoodward.co.uk – a
counselling service for vets and nurses.
When we allow ourselves to spend hours having conver-
sations with someone in our heads, saying all the things we
W
illiam James said “the greatest weapon against wished we’d said to them earlier, we create a monster of a
stress is our ability to choose one thought over character, which makes us feel uncomfortable. We all do it.
another”. And what a waste of time it is reliving the distressing past
Now you are ready to identify an emotion you are feeling. or, even worse, recreating a past conversation which never
It may be something narrow, like anger at someone for happened, isn’t happening now and probably won’t happen
something they have done, or broad, like generalised anxiety. in the future. That time could be spent so much more fruit-
Conversely, it might be as broad as generalised anger or as fully. Be mindful of the present.
narrow as anxiety about an impending future event.
It may be an uplifting emotion of happiness, freedom or Identifying anxiety
excitement. These emotions are often discarded all too Anxiety can be overwhelming. It can be crippling, can
rapidly down the triage list as not needing attention because destroy relationships and make us fail at work. It’s often
they aren’t causing us distress. Embracing these emotions hard to pinpoint a single reason for our anxiety and the
and identifying with them can give us the fuel needed to physical symptoms of a racing heart and tight chest can
address the distressing emotions. cause further anxiety. It becomes our world.
If you’re feeling anxious, is it about something that has
Identifying anger happened in the past or that may happen in the future? Can
Very few people celebrate feeling angry, no matter how justi- you pinpoint the source of the anxiety? Some find that dur-
fied that anger is. Are you enjoying the feelings of anger? Or ing meditation, even identifying that anxiety as a powerful
are they disturbing? Is your anger justifiable because others emotion causes more anxiety and their heart rate increases.
agree with your reasons for being angry? Are you hanging on The physical action of massaging the vagus in your neck to
to the story of why you’re justified in being angry, as if your lower your heart rate can help to regain focus.
story can shield you from the need to let it go and move on? Anxiety about a future event can be overpowering. We
Even though your anger is understandable because may find ourselves worrying about 10 potential outcomes of
someone has behaved cruelly, you can still choose to not be a series of events. In reality, only one of those outcomes is
distressed by seething emotions. This is called insight and going to happen. We will have wasted an enormous amount
it can only be achieved by letting go of judgements. of time and mental energy worrying about the other nine.
So you can see clearly that someone has not an iota of And we will be weaker as a result.
compassion in their body but, by being insightful rather Planning for the future is essential if we are to be sen-
than judgemental, you are able to decide to not feel anger. sible citizens in the workplace, good parents and decent
This means you do not have to revisit the person’s nasty friends. But worrying and stressing about it can occupy the
actions, seek revenge or allocate punishment. Their snide part of our minds better used for increasing our mental
comments fly past you and have no effect on you because strength in order that we can trust ourselves to be able to
you have chosen to not be angry when you hear them. deal with whatever life throws at us, when it’s thrown at us.
Choosing to be wise and non-reactionary frees you from Learning to plan without anxiety, for the short term and the
the need to repeatedly tell your story. It can liberate you long term, is a life skill worth cultivating.
from an endless cycle of “living the story” and telling it so For now, we are merely identifying (and not over identify-
that others can reaffirm in you the perpetual anger. ing with) the emotions. Deciding what to do with them can
Have you noticed how, when you first met your partner/ come later. A plan to deal with anxiety has to be tailored to
spouse/BFF, you thought good and positive thoughts about the individual causes.
them – not only when you were spending time together, We will discuss formulating a plan using imagery during
talking on the phone or texting them, but also when not meditation in next month’s issue. VP
14Re h N ly b
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Veterinary Practice | September 2018 15INSURANCE
SPONSORED CONTENT
Agria at the AWF Discussion
Agria was delighted to sponsor and Simon followed,
bringing to the
take part in the sixth Animal Welfare debate the issue of
Foundation Discussion Forum appropriate levels of
veterinary inter-
T
he Animal Welfare Foundation (AWF) Discussion vention: “We (Agria)
Forum, held in the heart of London’s Westminster, passionately believe
brings together expert speakers, veterinary and in lifetime pet insurance. It enables vets to pull out all the
animal welfare professionals, students and parliamentar- stops, where appropriate.” The issue of appropriateness
ians to confront current remained a key theme throughout Simon’s presentation –
welfare issues and in- discussing when intervention is suitable, and when over-
spire change. It raises the intervention begins to negatively affect an animal’s welfare.
profile of many serious He also discussed the vital importance of the veterinary
animal welfare issues, and insurance sectors working together.
and has helped influence The final speaker, Stuart Carmichael, discussed how an
policy decisions, leading animal’s quality of life must be at the centre of decisions,
to changes in the regula- and how quality of life can be assessed and maintained
tions and laws governing Simon Wheeler discussed when alongside managing
the welfare of animals. veterinary intervention is suitable, clients’ expectations. He
and when over-intervention begins to
The day was intro- negatively affect animal welfare also highlighted how
duced by Chris Laurence, attitudes to pet own-
the Chair of Trustees for AWF, who highlighted the theme: ership have changed,
“What unites us is our passion to improve animal welfare”. leading insured clients to
be more demanding and
VETed Talk unable to let go – and the
Thomas Blaha presented “Taking veterinary ethics from an difficult position this can
oath to the next level” and introduced the audience to The put vets in. Sarah Wolfensohn, Simon Wheeler and
German Veterinary Association for Animal Welfare (TVT). Stuart Carmichael (left to right) took
The panel were joined part in “The Big Debate” on insurance
With over 1,300 members, TVT is recognised as a society of by Agria’s Vet Lead, BVA and quality of life
“veterinary experts for animal welfare”. Thomas also talked past president Robin
about developing an Ethics Codex to unify the profession in Hargreaves, for a thought-provoking Q&A session with the
Germany under a self-prescribed highest standard for ethi- audience.
cally correct decisions in all fields of veterinary medicine. The remainder of the day was packed with insightful
sessions including: “How can we influence client behaviour
The Big Debate for best welfare?”, “The future of animal welfare” – a session
Chaired by Angela Smith MP, The Big Debate asked, “Is of AWF research updates – and “Practice practicals – how
insurance compromising quality of life?” It addressed the practice management strategies can benefit animal welfare”.
issues of quality of life alongside clients’ increasing expec- Agria would like to sincerely thank AWF and fellow spon-
tations for their pets to receive human-like healthcare. sors, Simplyhealth Professionals, for a fascinating, enlighten-
Agria’s Managing Director, Simon Wheeler, was invited as ing day and the opportunity to participate in topics so crucial
a key speaker and participant on the Q&A panel. Alongside to our work and our fundamental beliefs as a business. VP
Simon, Sarah Wolfensohn, Professor of Animal Welfare at
Surrey University, and Stuart Carmichael, Director at Joint
To find out more and to watch all of the Forum’s
Adventures and Professor of Veterinary Sciences at Surrey
talks on YouTube, see: animalwelfarefoundation.org.
University, also presented to the room.
uk/2018-discussion-forum/
Kicking off the debate, Sarah Wolfensohn discussed the
Animal Welfare Assessment Grid (AWAG) – an application
For more information about Agria’s policies, visit: agri-
designed to capture and assess animal welfare data under
apet.co.uk/VPC. As a veterinary professional, you are
the categories: physical, psychological, environmental and
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can work with Agria, visit: agriapet.co.uk/VetVP
life over a lifetime, not just at one moment in time.
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Organised by:OPINION
“Pet labelling is required and
needs to be entirely independently
and objectively formulated” Clifford Warwick
Consultant Biologist and Medical Scientist
T
he term “exotic” can mean several things.
Setting aside “unusual” or “strange”, exotic
might be interpreted as something that isn’t
where it should be. For most, if not all, exotic pets
(ie pet wildlife), that pretty much sums things up.
And if something really ought not to be here in the
first place, how can a casual acquirer of a quotient of
nature hope or plan to make good on a self-promise
or a pet peddler’s assurance that taking care of this
hapless “misfit” will be straightforward?
Relatedly, companion animal establishments (eg
pet shops, breeders, boarding kennels and sanctuar-
ies) that supply or salvage exotic and domesticated
species have long operated without consistent solid
guidance on husbandry and facility assessment. Here,
we take another look at alleviating some old prob- FIGURE 1 The EMODE system provides customers with a guide to how challenging an
animal may be to keep
lems from two new angles – a pet labelling scheme to
promote informed decision making by pet acquirers and
It isn’t about being “bad” people either. It is about bad deci-
evidence-based guidance on husbandry and inspection.
sions and bad information leading to those decisions.
Mis-marketing wild animals as “easy” or “beginner” pets
With over 13,000 species in trade and keeping, any one of
largely sets up animals and people for some nasty falls.
which can present at local vet clinics, many vets recognise
Whether from seller ignorance or deceit, sales pitches are
that traders and public are not the only ones ill-equipped
as crass as adorning one’s bearded dragon in a Batman outfit
to cope, as they themselves become actors in what is a very
as if it were the most natural thing in the world. Well it isn’t!
diffuse story of “battlefield medicine”. Research among vet
professionals and allies indicates that exotics score relatively
low estimates for suitability as pets. Indeed, at the 2017
London Vet Show, the Animal Protection Agency polled
attendees, asking whether greater controls, eg a “positive
list” of approved-only species in trade and keeping, were
warranted, and an emphatic 512 to 1 (a pet seller) said “yes”!
A major recurring obstacle to progress on welfare,
public health and safety, species conservation and invasive
“pest” issues has been the catastrophic failure of efforts
to educate people once animals arrive in their homes. In
recent years, numerous published studies have concluded
that zoonoses warnings fall on deaf ears; neither so-called
“hobbyists” nor regular Joe pet “owners” follow care advice
well. In July 2018, a PDSA report found that one in four
people conducted no research at all before getting a dog,
cat or rabbit.
Miseducation by sellers and “hobbyists” along with “infor-
mation uptake inertia” by keepers frequently render objec-
tive advice unwelcome or inconvenient – so fingers and ears
rapidly become acquainted. Changing mindsets in the home
works poorly, so it makes sense to provide objective pet
18“Pet labelling is required and needs to be entirely independently and objectively formulated”
labelling at point of sale and to provide consistent evidence- has been working on that information challenge, and
based guidance to those who oversee animal establishments. following exhaustive internal and external reviews, the
Product labelling in general has been a big hit – consu- new guidance has now appeared in the journal Frontiers
mers now check out salt, sugar and fat contents before in Veterinary Science.
heading to the till. Yet while food, white goods and even soft The guidelines adopt universal management principles
toys are commonly labelled with cold, hard facts to protect for the organisation of establishments as well as “safety
buyers and extend product lives, no such safeguards are in net” husbandry, including: facility layout; quarantine; behav-
place for sentient creatures. ioural needs; negative welfare signs; zonal climate-based
Accordingly, a detailed review of exotic pet suitability captive parameters; enrichment; and more. In all, over 40
and labelling was recently published in the Journal of sections and 14 tables of scientific information are detailed,
Veterinary Behavior. A key conclusion is that pet labelling plus a dedicated tool for scoring facility conditions –
is required and needs to be entirely independently and offering the most comprehensive and definitive objective
objectively formulated – ie free from convenient claims by resource worldwide. And it’s all free!
sellers. The scheme proposes the EMODE (easy, moderate, More than most, the veterinary profession is familiar with
difficult, extreme) system as the tool to score how challeng- the results of the husbandry failures that accompany bad
ing an animal may be to keep, along with basic information decisions. And more than many, vets occupy roles as
regarding zoonotic risk and supplier details (Figure 1). formal inspectors charged with safeguarding animals,
Objective pet labelling promotes better-informed people and the environment. Time will tell whether these
decisions and is essential for both “consumer” and animal new initiatives glean meaningful results, or whether
protection. Point of sale labelling may, at last, also allow greater efforts should be directed at strict trade bans and
“us” to get ahead of the problem and reduce impulse or conscientious enforcement. VP
misled purchases.
Whereas getting traders and keepers on board with
objective information is more than challenging, profes- About Clifford
sional inspectors recognise their obligations to use Clifford Warwick, PGDip MedSci, CBiol, CSci, EurPro-
evidence-based guidance. A key issue has been developing Biol, FOCAE, FRSB, qualified in biology in 1990 and in
information based on durable, universal, consistently primary healthcare in 2004. He has been a field investi-
applicable evidence, uncompromised by influences from gator of the wildlife trade and has produced around 150
vested interests. Since 2012, a team of biologists and vets publications in animal biology and human medicine.
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Veterinary Practice | September 2018 19SMALL ANIMAL
Dietary management of diabetes
mellitus
A diet-based approach to tackling the in weight per week, and in dogs of 1 to 2 percent reduction
per week, is advised until the ideal body weight is reached.
disease, which is common in both dogs For both species, dietary therapy should minimise the
and cats demand on beta cells to produce insulin, normalise body
weight and muscle mass, reduce postprandial hyper-
glycaemia and minimise fluctuations in blood glucose.
OLIVER GONZALEZ SARMIENTO
Oliver Gonzalez Sarmiento, DVM, MRCVS, finished his Management in dogs
degree in 2011, before completing a rotative Internship
in Spain. Oliver then worked in first opinion practices in Meals should be timed at 12-hour intervals to coincide with
Spain and the UK, focusing on internal medicine. He is insulin administration, ensuring that maximal exogenous
currently completing an internship at Anderson Moores
Veterinary Specialists. insulin activity occurs during the postprandial period. Each
meal should contain half the daily caloric requirement.
NATALIE WATSON
Regular and consistent exercise is recommended.
Natalie Watson, BVSc(Hons), DipECVIM-CA, MANZCVS,
MRCVS, is a European Veterinary Specialist in Small
Animal Internal Medicine. Natalie graduated from the
Fat
University of Melbourne and undertook a small animal Fat should comprise less than 30 percent of metabolisable
internship and a residency in Internal Medicine at
the University of Bristol. She is currently an Internal energy (ME). This is particularly important in dogs with
Medicine Specialist at Anderson Moores. concurrent hyperadrenocorticism or chronic pancreatitis.
If the fasting serum triglyceride concentration is not well
D
iabetes mellitus is a common endocrine disease in controlled, then further dietary fat restriction (less than 20
dogs and cats. It occurs primarily due to secretory percent) may be indicated.
dysfunction of the pancreatic beta cell, and is asso-
ciated with multiple risk factors, including genetic pre- Complex carbohydrates
disposition, physical inactivity, increased age and obesity. Complex carbohydrates (CH) should comprise less than 30
Cats appear to have a disease bearing similarities to type percent of ME. A diet high in insoluble dietary fibre (30 to
2 diabetes in humans, resulting from beta cell dysfunction 40g/1000kcal; diets containing approximately 12 percent
and peripheral insulin resistance. insoluble fibre are likely to be most effective) improves
Current estimates suggest a prevalence of diabetes glycaemic control and lowers mean pre/postprandial blood
mellitus of between 1:100 to 1:500 (Sparkes et al., 2015). glucose, compared to diets containing either very low concen-
However, this has been increasing with the rise in obesity trations of total dietary fibre, or high concentrations of soluble
in both species, with animals in excessive body condition dietary fibre. Insoluble fibre forms a viscous gel in the intes-
almost four times more likely to have the disease (Brito- tine, impairing the absorption of glucose from the gut lumen,
Casillas et al., 2016). thus decreasing postprandial blood glucose fluctuations.
When well managed, the prognosis for affected individ- Complications of excessive fibre include increased
uals can be very good. Studies in cats have shown median frequency of defecation, constipation (psyllium or canned
survival times of between 13 and 29 months (Sparkes et pumpkin can be added to soften the stool), watery stools,
al., 2015). In dogs, a median survival of 24 months has been flatulence (an insoluble fibre diet can be added and the
reported, with 33 percent of dogs surviving more than three quantity of the soluble fibre diet decreased) and refusal to
years (Callegari et al., 2013). eat the diet.
In addition to insulin therapy and regular exercise, diet is
a key factor in the management of the condition. Proteins
Proteins should comprise greater than 30 percent of ME. As
The role of the diet both CH and fat are usually restricted in diets formulated
Weight gain is associated with insulin resistance; therefore, for diabetic dogs, dietary protein will provide a substantial
the first goal of dietary therapy should be to normalise body source of calories.
weight in obese patients, while providing adequate nutrition. Obese dogs fed a diet high in insoluble dietary fibre and
A weight loss goal in obese cats of 0.5 to 2 percent reduction protein with a low-fat content achieve more rapid weight loss
20You can also read
