The essential publication for BSAVA members

companion
MAY 2014
Who is who
Meet your regional
committee
P24
Congress stories
Highlights from a
record breaker
P4
How To...
Utilize radiotherapy for
oral tumours
P16
Causes
of dysuria
01 OFC May.indd 1 16/04/2014 13:56
2
|
companion
Log on to www.bsava.com to access
the JSAP archive online.
EJCAP ONLINE
To access the latest
issue of EJCAP visit
www.fecava.org/EJCAP.
Find FECAVA on Facebook!
3 BSAVA News
Latest from your Association
45 A quality Congress
Main stories from the event
69 Congress in pictures
Four days in the frame
1013 Clinical Conundrum
Dysuria in a poodle
1415 Rehab for the whole practice
Valuable new manual
1621 How to
Utilize radiotherapy for dogs with
oral tumours
2224 Who is Who
Get to know your region
2627 PetSavers
Dermatology funding
2829 WSAVA News
World Small Animal Veterinary
Association
3031 The companion interview
James Anderson
3233 Regional CPD
Local knowledge close to home
3435 CPD Diary
Whats on in your area
companion is published monthly by the British
Small Animal Veterinary Association, Woodrow
House, 1 Telford Way, Waterwells Business Park,
Quedgeley, Gloucester GL2 2AB. This magazine
is a member-only benet. Veterinary schools
interested in receiving
companion should
email companion@
bsava.com. We welcome
all comments and ideas
for future articles.
Tel: 01452 726700
Email: companion@
bsava.com
Web: www.bsava.com
ISSN (print): 2041-2487
ISSN (online): 2041-2495
Editorial Board
Editor Mark Goodfellow MA VetMB DPhil CertVR DSAM
DipECVIM-CA MRCVS
CPD Editor Simon Tappin MA VetMB CertSAM
DipECVIM-CA MRCVS
Past President Mark Johnston BVetMed MRCVS
CPD Editorial Team
Patricia Ibarrola DVM DSAM DipECVIM-CA MRCVS
Tony Ryan MVB CertSAS DipECVS MRCVS
Lucy McMahon BVetMed (Hons) DipACVIM MRCVS
Dan Batchelor BVSc PhD DSAM DipECVIM-CA MRCVS
Eleanor Raffan BVM&S CertSAM DipECVIM-CA MRCVS
Features Editorial Team
Andrew Fullerton BVSc (Hons) MRCVS
Design and Production
BSAVA Headquarters, Woodrow House
No part of this publication may be reproduced
in any form without written permission of the
publisher. Views expressed within this
publication do not necessarily represent those
of the Editor or the British Small Animal
Veterinary Association.
For future issues, unsolicited features,
particularly Clinical Conundrums, are
welcomed and guidelines for authors are
available on request; while the publishers will
take every care of material received no
responsibility can be accepted for any loss or
damage incurred.
BSAVA is committed to reducing the
environmental impact of its publications
wherever possible and companion is printed
on paper made from sustainable resources
and can be recycled. When you have finished
with this edition please recycle it in your
kerbside collection or local recycling point.
Members can access the online archive of
companion at www.bsava.com .
Additional stock photography:
www.dreamstime.com
Annemario; Dkcphotography; Herman Lumanog;
Imagery Majestic; Isselee; Oleksandr Marynchenko;
Scott Griessel; Silkenphotography; Teemu Tretjakov
Whats in JSAP this month?
Prevalence and demographics of
the MYBPC3-mutations in
Ragdolls and Maine coons
T
he objective of this study from
Casamian-Sorrosal et al from the
University of Bristol was to
determine the prevalence and
demographics of two myosin-binding
protein C (MYBPC3) mutations that affect
Ragdolls (R820W) and Maine Coons
(A31P) in the British Isles.
Using a database of genetic testing
laboratory samples from 2018 Ragdolls
and 742 Maine Coons, data were analyzed
with respect to mutation status, age, sex
and county of origin. The actual
prevalence was compared to the
expected HardyWeinberg prevalence.
The prevalence of the R820W mutation
in Ragdolls was found to be 27% (25.6%
heterozygous, 1.4% homozygous), and
that of the A31P mutation in Maine Coons
was 39.4% (36.4% homozygous, 3%
heterozygous). There were more female
cats and the median age was 6.4 months
(Ragdolls) and 5.9 months (Maine Coons).
This is the first report of prevalence
and demographics of the R820W and
A31P mutations in Ragdolls and Maine
Coons, respectively, in the British Isles.
The prevalence is high, which is of
relevance for breeding and screening
programmes. The significant difference in
genetic distribution may suggest early
death of homozygous Maine Coons.
Adapted from Casamian-Sorrosal D., et al. JSAP 2014; 55:
269273
ALSO IN THIS MONTHS ISSUE
Whole blood manganese concentratons
in dogs with primary hepatts
Fish oil supplementaton increases
concentraton of adiponectn in
healthy dogs
Doxorubicin-based chemotherapy
for dogs with right atrial masses and
pericardial eusion
Manual vs laboratory PCV and total
protein using EDTA and LiH canine
samples
Cloacal prolapses in reptles
02 Page 02 May.indd 2 16/04/2014 16:52
companion
|
3
Your views count
B
SAVA regularly participates in a variety of
consultations. Occasionally the short timescales
(sometimes just a few days) can make it difficult
to fully involve all members. So we now
undertake our own internal consultations on subjects
that are considered to be important to veterinary
professionals in small animal practice just the kind of
issues that we may be asked to consult on in the future.
Last year we undertook successful member
consultations on the role of veterinary nurses in monitoring
and maintaining anaesthesia, and on the advantages and
disadvantages of a new veterinary school. More recently
we have been consulting on the development of
appropriate clinical standards for small animal practice,
24 hour cover, and the use of ketamine in practice.
These consultations take place online at
www.bsava.com/consultations and we would
encourage you to visit these pages regularly to
participate and comment on the subjects that matter
most to you. We will remind you of them in our monthly
emails, and where time allows here in companion. We
want to represent our members where it counts please
help us to do that. n
Editorial hand-over for companion
Mycobacterium bovis in cats
PetSavers Mucky Pups
A
team of four from North Yorkshire are
aiming to take on the worlds biggest
obstacle course for PetSavers. The team
of PetSavers Mucky Pups are hoping to
raise as much as possible for PetSavers by taking
part in the new stamina-sapping Rat Race Dirty
Weekend, held at the Burghley Estate in
Lincolnshire on Saturday 10 May.
Tiff OKelly, the Captain of the Mucky Pups
said: When we originally decided to take up a
challenge to raise fund for PetSavers it was
decided that we needed to do something big. After
a little research, it became clear that it doesnt get
much bigger than the Rat Race Dirty weekend
20 miles and 200 obstacles including mud pits and
lake swims, this challenge seemed appropriate for
what we want to achieve. PetSavers is a fantastic
charity that does great work but needs more
people to know about them! After a little cajoling I
had my squad, and the PetSavers Mucky Pups
team was born.
To donate to the PetSavers Mucky Pups
challenge visit www.justgiving.com/PetSavers-
MuckyPups n
I
n April companion
celebrated its sixth birthday.
It was launched in 2008 with
Mark Goodfellow as Editor.
His vision and leadership have
seen companion become one
of BSAVAs most valued
member benefits and an
essential part of members
regular continued professional
development as well as a
vehicle for the association to
engage with members. The
success of companion is a
result of his commitment and
enthusiasm.
Dr Goodfellow will now hand
over the editorial reins to
Simon Tappin. Simon, who
works in practice at Dick White
Referrals, has been involved
with companion for several
years, commissioning and
editing the Clinical Conundrum
and How To articles.
In taking over the Editor
role, Simon said: It has been a
privilege to work with Mark on
companion and I look forward
to building on the excellent
foundations he has created. His
commitment to excellence and
providing genuinely useful,
accessible content for his
fellow BSAVA members has
been inspiring, and in taking on
this role I am aware that we
have a lot to live up to. I know
that the entire Association
appreciates his invaluable
contribution to companion. n
A
recent article in the Veterinary Record, with
information from Public Health England
(PHE), raised concerns about the
prevalence and zoonotic potential of
Mycobacterium bovis in cats.
The Chief Veterinary Officer, Nigel Gibbens,
followed this up with a letter in Veterinary Record
which summarizes current information on M. bovis
infection in cats.
BSAVA has published its own summary online,
based on current information, and at the time of
writing BSAVA Scientific Committee is preparing a
more complete, evidence-based information and
advice document for veterinary surgeons and this will
be made available on the website in May. n
Tiff OKelly
Lucy Horsman
Ian Henderson
03 Page 03 May.indd 3 16/04/2014 14:14
4
|
companion
Congress 36 APRIL 2014
A quality
Congress
O
nce again the numbers stacked up to make
BSAVA Congress a record breaker. The
official total was 6311. Yet President
Professor Michael Day was keen to talk
about the event in terms of quality not just quantity.
Quality is what continues to set BSAVA Congress
apart, he said. The quality of the faultless
organization, the quality of the scientific content, and
the quality of our exhibition and incomparable social
programme.
All the CPD you need
Vets and vet nurses jointly acquired more than
100,000 CPD hours in a packed and varied scientific
programme across the four days. Thanks to exclusive
access to lectures within the online podcast library, not
only can BSAVA members make Congress last all year
long, but they can also achieve their entire 35 hour
quota of CPD from this one event.
It wasnt just the science that topped up delegates
skills either. The increasingly popular Management
Stream provided lectures on business topics that
included public relations, accountancy and human
resources. This addition to the programme draws a
diverse audience of vets, VNs and practice managers
making Congress an event for the entire team.
Alice in Congress land
Respected commentator, author and broadcaster
Professor Alice Roberts gave an engaging keynote
speech to a packed ICC hall on the role of evolutionary
science in demonstrating how the human and animal
worlds are intertwined. Her talk had the audience
riveted and she proved a popular choice to follow in
the footsteps of distinguished scientists at BSAVA
Congress in recent years, such as Richard Dawkins,
Lord Robert Winston, and Baroness Susan Greenfield.
A time to celebrate
The BSAVAs charitable arm PetSavers celebrated its
40th anniversary in style at Congress, with a bubbles
and cupcake birthday party on its Balcony stand.
PetSavers used the occasion to announce 40,000 of
funding to be split between the seven veterinary
colleges, with the remaining 5,000 available to
veterinary nurses who apply for funding.
PetSavers also launched its 200 Project an
appeal to every veterinary practice to raise 200 each
this year, a figure which would secure future funding
and reduce PetSavers reliance on unpredictable
income sources such as legacies.
Enticing Exhibition
Well over 1800 veterinary books were snapped up on
the BSAVA Balcony, including Congress debutants
the BSAVA Manual of Canine and Feline Radiography
and Radiology; the BSAVA Manual of Rabbit
Medicine, and the BSAVA Manual of Rabbit Surgery,
Dentistry and Imaging. Eligible BSAVA members also
collected their complimentary copies of the new
BSAVA Small Animal Formulary, and the BSAVA
Guide to Procedures in Small Animal Practice from the
Membership Stand on the Balcony.
Nearly 300 exhibitors, including new and familiar
names, filled the National Indoor Arena, with many
choosing to launch new products and offer exclusive
deals. Delegates took advantage of the numerous
offers available and of course walked away with bags
of free gifts and samples. The competition prizes were
also particularly impressive this year including the
chance to win a Range Rover, and a conservation
safari holiday.
The Stand Awards were hotly contested this year
4
|
companion
04-05 Congress Intro.indd 4 16/04/2014 14:29
companion
|
5
Congress 36 APRIL 2014
because so many of the exhibitors had been
remarkably creative. Pharmaceutical manufacturer
Bayer won the best space-only stand award for its art
gallery-themed display. The large shell scheme award
went to Forum Animal Health and the small shell
scheme award was won by Chunk Training.
Big Issues
Friday was Big Issues day and the stream
culminated in a session where Chief Veterinary
Officers from each of the four UK administrations were
invited to the first ever question and answer session
with BSAVA delegates.
They may have been expecting to discuss the
issues that have dominated debates between
government veterinary staff and their colleagues in
private practice in recent months, such as
antimicrobial resistance, compulsory microchip
identification and illegally imported puppies. But the
discussion was dominated by an issue that had flared
up in the national press only a few days before.
The government vets were admonished for failing
to keep their colleagues in companion animal practice
properly informed of the possibility of zoonotic human
infection from cats suffering from bovine tuberculosis.
A Basingstoke practitioner in the audience
complained that government colleagues had not
alerted staff in local practices to a cluster of cases of
Mycobacterium bovis infection in nine cats around the
Newbury area, which had also resulted in two human
cases. I understand that the last of the cases
occurred in March 2013 but the first I knew was when
I read about it last week in the Daily Mail, she said.
It isnt all work
The social programme included comedy by popular
stand-up Marcus Brigstocke, compred by Rhodri
Rhys who returned following his success at last years
party night. Boy band Lawson provided musical
entertainment on Saturday night and ensured that
revellers were already in the dancing mood by the time
the late night disco got started.
By the profession for the profession
Outgoing BSAVA President Michael Day was keen to
remind us that this event was truly created by the
profession for the profession when he said two years
of planning comes together for this extraordinary event
during these four days, and I have seen at first hand
the level of detail and preparation that occurs.
Most of that preparation is done by vets and VNs
who volunteer their time and expertize to the two
Congress Committees responsible for putting the
entire event together. They are supported by staff from
Woodrow House HQ who head to Birmingham from
Gloucester each year. This year the Head of Business
Operations pedometer revealed that he had covered
309.70 miles during his week at Congress. That might
be another record breaking figure for 2014.
A new era begins
When Katie McConnell was inducted as the new
BSAVA President on the Sunday of Congress she said
it was an honour to have been asked to lead such a
fantastic organization; Like so many previous
Presidents, I look back on my early volunteering days
with deep affection but it would have been a great
surprise to my earlier self to be told that one day I
would be the BSAVA President.
During my presidential year I would like to meet as
many BSAVA members as I can, hopefully in their own
regions. I plan to travel to regional BSAVA continuing
education meetings, not to stand up and lecture but to
listen to individual members and find out what the
BSAVA means to them. The BSAVA is run by members
for members and the only way to shape its work is to
become engaged with it. n
04-05 Congress Intro.indd 5 16/04/2014 14:29
6
|
companion
Congress 36 APRIL 2014
DUNKIN AWARD
Robyn Jarrett
Congress in pictures
Congress is the perfect time for us to celebrate and honour
colleagues who do outstanding work in the veterinary
profession. The prestigious BSAVA Awards were presented
during the event and recognized the achievements of the
professions unsung heroes
THE SIMON AWARD
Michael Guilliard
THE WOODROW AWARD
Timothy Nuttall
THE AMOROSO AWARD
Susan Haywood
THE MELTON AWARD
Pam Mosedale
THE J.A. WIGHT
MEMORIAL AWARD
Sarah Cleaveland
PETSAVERS AWARD
Zachary Goodrich
THE BOURGELAT AWARD
Claudia E. Reusch
THE BLAINE AWARD
Jacques Penderis
CLINICAL RESEARCH ABSTRACT
(Top to bottom): Practitioner
Award (sponsored by companion):
Anna Tauro; Intern/Graduate
Award: Joana Gonalves Aguiar;
Surgical Award: Mickey Tivers;
Medical Award: Nele Van den
Steen; Nurse Award: Wendy
Barnett; Poster Award: Xavier
Navarro
06-09 Congress in Pictures.indd 6 16/04/2014 16:20
companion
|
7
Congress 36 APRIL 2014
With another record breaking year for delegate numbers, the
exhibitors at BSAVA Congress had to make sure they came
with plenty to impress and they did just that. This was a
colourful, lively exhibition, packed with innovation, special
offers, exclusive launches and engaging stories
Who says there is no time
to relax in the Exhibition?
The Merial sweet shop gave delegates an energy rush and their feline friend helped them to talk about their new
parasite control for cats
Congress is a chance for delegates
(and presidents) to get close to
industry experts and test out their
latest offerings
There were lots of new releases at
Congress. Safe Solutions chose
Congress to launch three new
products and discuss new EU
regulations
As well as hosting their awards
during Congress week, Petplan
had lots of fun on their stand
Exhibitors got creative and
competition prizes were even
more generous than ever
Bayer won the best stand award
and gave away hundreds of funky
frames
Weight management was the focus
for Royal Canin as it sought to
capitalise on the PDSAs recently-
announced pet obesity findings
The NIA played host to almost
300 exhibitors this year
06-09 Congress in Pictures.indd 7 16/04/2014 16:20
8
|
companion
Congress 36 APRIL 2014
Congress in pictures
From the glittering gala that is the
BSAVA Banquet on Friday Night, through
the daily treats and events in the
Exhibition and culminating with the
ever-popular Party Night on Saturday,
BSAVA Congress has a reputation for
putting on memorable social events
Everyone enjoyed the talk given
by Professor Alice Roberts
including Alice!
International delegates
enjoying the underwater
delights of the SeaLife Centre
at a special reception
Chart makers Lawson provided the
rock element, making sure
delegates were in the mood to
keep dancing into the early hours
Marcus Brigstocke was the latest
top name comic to entertain at the
Comedy Club
Party Night has earned an unrivalled reputation for bringing the
profession together for an informal night of laughter and dancing
BSAVA Banquet provided delegates with an opportunity to dress up and
enjoy a glamorous evening with superb food and great company
PetSavers Patron Gyles Brandreth with Wolfgang Dohne and
Pedro Martn Bartolom at the Petplan awards
06-09 Congress in Pictures.indd 8 16/04/2014 16:20
companion
|
9
Congress 36 APRIL 2014
From students to founding members of BSAVA, all ages and
levels of experience need to be taken care of and provided for
at BSAVA Congress. This is possible because it is an
organization run by the profession for the profession
The first Veterinary Nurse Merit Awards were collected
at Congress
Barbara Weaver and Sheila Crispin were given Honorary
Life Membership at the AGM
The 201415 Officer team is led by President Katie McConnell and is joined by
Susan Dawson (far right)
Clinical Research Abstract award winners. CRAs are an
important part of Congress that nurture new science and
talent within the profession
The two new rabbit Manuals
launched at Congress were
best sellers. Marion Jowett,
BSAVA Publishing Manager,
celebrated the launch with
John Chitty and Richard
Saunders at her last Congress
after working with BSAVA for
17 years
Quality science sits at the heart of Congress and each year the vets and VNs on Congress
committee aim to creative an innovative programme that maintains standards
More lectures at Congress now have a practical or
interactive element, allowing delegates to meet the
experts and get involved
06-09 Congress in Pictures.indd 9 16/04/2014 16:21
Louise Bird, Resident in Small
Ani mal Medicine at Anderson
Moores Veterinary Specialists,
invites companion readers
to consider the causes of
dysuria in a 3-year-old male
neutered Standard Poodle
10
|
companion
Clinical conundrum
Case presentation
A 3-year-old male neutered Standard Poodle
presented with a 2-year history of intermittent
stranguria and pollakiuria. The episodes
occurred at irregular intervals during periods
of stress. His bladder was usually easy to
express during an episode; however, at times
bladder expression was difficult and urethral
catheterization was necessary to relieve the
obstruction. On each occasion the catheter
was reported to have passed easily. Urine
culture had infrequently been found to be
positive for bacterial growth on free-catch or
catheterised urine samples and on these
occasions antimicrobial therapy had been
commenced. Most episodes of stranguria had
resolved without antibiotic therapy over a
23 day period.
The owners reported the dog to have
developed stranguria following a period of
hospitalization for symptomatic treatment of
acute-onset gastrointestinal tract disease.
Physical examination revealed him to be
bright and in good body condition. The general
physical examination was within normal limits.
On gentle bladder palpation, a small stream of
urine was produced without signs of dysuria
and the stream continued when bladder
palpation was stopped. The bladder remained
palpably moderately full following this.
Neurological examination was unremarkable.
10-13 CLINICAL CONUNDRUM.indd 10 16/04/2014 14:54
companion
|
11
Create a problem list based on the dogs
history and physical examination findings
Stranguria
Pollakiuria
Urinary retention
What differential diagnoses should be
considered at this stage?
Several disorders may result in stranguria and
pollakiuria with a full bladder in the dog:
Urolithiasis
Neoplasia of the bladder/urethra
Urethritis
Urethral stricture/trauma
Bladder displacement/entrapment
Prostatic disease
Neurogenic dysuria
Clinical signs of stranguria and pollakiuria in this
case were chronic (2-year history) and intermittent,
which made conditions such as urolithiasis, lower
urinary tract neoplasia, bladder displacement/
entrapment and prostatic disease unlikely. However,
some of the potential conditions may cause intermittent
signs and could not be fully excluded based on history
and physical examination alone. Uncomplicated
urinary tract infection was felt unlikely as the patient
had repeatedly presented with a full bladder.
This dog appeared to have urinary retention; the
differential diagnoses can be divided into neurogenic
and non-neurogenic causes:
Neurogenic causes of urinary retention
Upper motor neuron bladder dysfunction (occurs
with a lesion of the suprasacral spinal cord
segments; pons of the brainstem to L7)
Lower motor neuron bladder dysfunction (occurs
with a lesion in the sacral spinal cord segments)
Detrusorurethral dyssynergia (reflex dyssynergia)
Primary detrusor atony
Non-neurogenic causes of urinary retention
Anatomic urethral obstruction (secondary to such
processes as infection, inflammation, calculi,
neoplasia, blood clots)
Functional urinary obstruction (urethral spasm,
urethral stricture, idiopathic)
Medications (opioids, anticholinergics, tricyclic
antidepressants, calcium channel blockers)
Considering the neurogenic causes of urinary
retention: lesions of the suprasacral spinal cord
typically result in dysfunction of ascending
proprioceptive and descending motor tracts,
manifesting clinically as tetra- or paraparesis and
ataxia, which were not present in this case. Lesions of
the brainstem and spinal cord cranial to S1 were
considered very unlikely based on a combination of
history (intermittent and chronic clinical signs) and
physical examination findings (normal neurological
examination).
Occasionally very dorsal spinal cord lesions such
as subarachnoid diverticuli can result in urinary or
faecal incontinence in the absence of other
neurological signs), so upper motor neuron bladder
dysfunction could not be entirely excluded at this
stage. Patients with lower motor neuron bladder
The patient posturing to urinate unproductively
10-13 CLINICAL CONUNDRUM.indd 11 16/04/2014 14:54
12
|
companion
Clinical conundrum
dysfunction usually have concurrent neurological
abnormalities, such as flaccid paraparesis and
depressed genitoanal reflexes, which were also
not present.
A normal stream of urine was produced on
abdominal palpation and was continued when
abdominal palpation was stopped; this would make
primary detrusor atony less likely, as this condition
commonly results in a weak or absent urine stream.
There was no history of prior medications resulting in
non-neurogenic urinary retention.
Therefore, at this stage, detrusorurethral
dyssynergia, partial anatomical or functional urinary
obstruction, or a dorsal spinal cord lesion such as a
subarachnoid diverticulum remained the most likely
differential diagnoses.
What initial investigations would you
consider?
The diagnostic work-up in this case was directed
towards differentiating between neurogenic and
non-neurogenic causes of urinary retention.
Abdominal ultrasonography was performed to
exclude mechanical obstructions of the urinary outflow
tract (such as prostatic disease and bladder
entrapment) as best as possible. This revealed the
bladder wall to be mildly, but diffusely, thickened. This
change was felt likely to have been the result of
previous cystitis or fibrosis. As there were no discrete
lesions, neoplasia was considered to be unlikely. The
remainder of the urinary tract, which could be
assessed with ultrasound, was considered normal.
Urinalysis and urine culture were performed on a
sample obtained by cystocentesis, as urinary tract
infections had infrequently been diagnosed during
episodes of stranguria. Urine culture revealed a
heavy growth of Enterococcus sp. This was thought
to be secondary to urine retention rather than the
underlying cause of clinical signs, as urinary tract
infections had only occasionally been diagnosed
during previous periods of stranguria and most
episodes of stranguria and historically had resolved
without antimicrobial treatment. A 10-day course of
potentiated amoxicillin was prescribed; culture of a
mid-stream urine sample collected at the end of the
antibiotic course was negative.
How do the results of these initial
investigations help refine the differential
diagnoses?
Idiopathic detrusorurethral dyssynergia remained a
differential, as diagnosis of this condition is based on
the exclusion of detectable pathological conditions
that could also cause urine outflow obstruction.
The distal and prostatic components of the urethra
could not be examined with ultrasound due to
overlying bone, so a partial intraluminal or extraluminal
urethral obstruction could not be fully excluded at
this stage.
A neurogenic cause secondary to a spinal cord
lesion also remained possible. However, the majority of
patients with spinal cord disease severe enough to
cause urinary tract signs are neurologically abnormal
on examination.
What further investigations may be
helpful at this stage?
Urethroscopy was performed to assess the distal and
prostatic urethra. The only abnormality detected was
an area of mild mucosal inflammation approximately
10 cm from the prepuce. This lesion was not causing
intraluminal obstruction of the urethra and was
thought unlikely to be the cause of the clinical signs.
It was presumed to be secondary to urethral
catheterization prior to urethroscopy. The mucosal
surface of the bladder appeared normal.
Contrast urethrography (in combination with
double-contrast cystography) would have been an
alternative method of imaging these areas if
endoscopy had not been available or were limited due
to patient anatomy (urethroscopy is generally limited to
female and larger male dogs).
Although a subarachnoid diverticulum was
thought to be an unlikely differential in this case,
magnetic resonance imaging of the spine was
performed to exclude this and other structural
neurological disease definitely; the MRI revealed no
obvious abnormalities.
Final diagnosis
These findings exclude a partial intraluminal or
extraluminal urethral obstruction or a spinal cord lesion
10-13 CLINICAL CONUNDRUM.indd 12 16/04/2014 14:54
companion
|
13
as an underlying cause of the stranguria, pollakiuria
and urinary retention.
The history and exclusion of other causes indicated
idiopathic detrusorurethral dyssynergia, with likely
secondary urinary tract infection.
Idiopathic detrusorurethral dyssynergia
Idiopathic detrusorurethral dyssynergia is a
functional disorder of the voiding phase of micturition.
This phase requires a coordinated contraction of the
detrusor muscle of the bladder, with simultaneous
relaxation of the internal and external urethral
sphincters. In patients with idiopathic detrusor
urethral dyssynergia there is contraction of the
bladder without relaxation of the urethral sphincters.
Affected patients have a normal initiation of voiding
but urination is then interrupted by contraction of the
urethral sphincter, resulting in a urine stream which
may be narrowed, occur in spurts or dribbles; or
patients can sometimes have complete obstruction of
urine flow.
Stranguria and dysuria, the same signs as seen
with mechanical obstruction of the urine outflow tract
(e.g. by urethral mass or calculi) can be present.
Affected patients usually retain urine, evident as
increased residual volume of urine in the bladder. The
bladder is often hard, turgid, and can sometimes be
difficult to express manually because of the increased
tone to the urethral muscles, but a urethral catheter
can be easily passed into the bladder.
An underlying anatomical or neurological lesion
has not been described in dogs with idiopathic
detrusorurethral dyssynergia. Most cases have a
normal neurological examination. Affected patients
usually have an acute onset of clinical signs, and
for this reason, trauma or a small vascular accident
in the lower lumbar spine have been suggested
aetiologies.
In a study of 22 dogs with idiopathic detrusor
urethral dyssynergia (Daz Espieira et al; 1998),
affected patients were middle-aged male dogs (13 of
22 were entire), of large and giants breeds. Nine of
the 22 dogs had periodic clinical signs of dysuria/
stranguria, with or without complete obstruction, for
longer than one year. Therefore, this presentation was
fairly typical of those reported in the literature.
How would you manage and treat this
case?
Treatment is directed towards coordination of
detrusorurethral activity during urination, by relaxing
the urethral sphincter. Both a sympathetic (affecting
the striated muscle of the external urethral sphincter)
and a somatic (affecting the smooth muscle of the
internal urethral sphincter) form of idiopathic
detrusorurethral dyssynergia are recognized. For
this reason, both phenoxybenzamine and diazepam
were prescribed.
Phenoxybenzamine is an alpha adrenergic
antagonist and reduces urethral smooth muscle tone
in small animals. Side effects of alpha antagonists
include gastrointestinal upset, hypotension and
incontinence.
Diazepam is a skeletal muscle relaxant and can be
used to reduce striated muscle tone within the external
urethral sphincter. The major side effect of diazepam is
sedation, although paradoxic excitement and
hepatotoxicity are also possible.
An alternative alpha antagonist is prazosin, which
is a selective alpha
1
receptor blocker. Adverse effects
are similar to those of other alpha antagonists,
particularly hypotension. Sedation, behavioural
changes and seizures have been recognized with the
intravenous administration of prazosin, but have not
been observed with oral preparations.
Outcome
Two weeks after phenoxybenzamine and diazepam
were commenced the clinical signs were significantly
improved, although some sedation secondary to
diazepam was reported after several days. The plan
for ongoing management was to introduce both
medications for short course as soon as signs of
stranguria and dysuria were noted. Due to the
reported side effects of diazepam, and as chronic
dosing of this medication can lead to upregulation of
the hepatic microsomal enzyme system and,
therefore, tolerance to the drug in dogs, diazepam
was not prescribed to be given continuously. In
addition, clinical signs were intermittent and urination
was normal between episodes, so continual dosing of
both diazepam and phenoxybenzamine was deemed
unnecessary in this case.
References
available online
MORE
ONLINE
10-13 CLINICAL CONUNDRUM.indd 13 16/04/2014 14:54
14
|
companion
Rehabilitation
for the whole
practice
C
ompanion animals are undergoing previously
uncontemplated treatments and surviving what
would once have been rapidly fatal conditions.
The BSAVA Manual of Canine and Feline
Rehabilitation, Supportive and Palliative Care is aimed at
the whole veterinary team, drawing on all their skills to help
patients achieve as full a function and quality of life as
possible after surgery, trauma or disease, and to manage
chronic conditions effectively for the benefit of the animal,
owner and the practice team.
From principles
The principles of rehabilitation, supportive and palliative
care are detailed in the introductory chapters of the Manual.
The science behind pain and its management, clinical
nutrition and physical therapies is explored, and the clinical
applications are reviewed with reference to published
evidence of efficacy and/or effectiveness.
In any clinical case, the aims of rehabilitation should be:
To limit pain
To return the animal to normal function where possible
To reduce recovery times.
Rehabilitation requires patience and time. Realistic
timelines need to be set, so that the veterinary practice and
the owner can assess progress and identify when this is too
slow or inadequate. Realistic outcome measures need to be
set with, ideally, input as appropriate from physical
therapists, nurses and nutritionists, as well as veterinary
surgeons and owners.
to practical applications
A unique feature of this remarkable Manual are the
case-based scenarios that demonstrate how the
principles of rehabilitation can be put into practice.
The cases cover diverse topics: from elbow arthritis in
an elderly cat, to inflammatory bowel disease in a
dog; and from glaucoma in dogs, to leg amputation in
cats. Each case is presented in a similar manner and
details the following areas, as appropriate to the
individual patient:
Patient history, clinical signs on presentation and
diagnostics
Agreed medical/surgical management
Acute/chronic pain management
Fear, stress, conflict concerns
Nutritional requirements
Physiotherapy
Hydrotherapy
Acupuncture
Other nursing and supportive care
Owner advice and homecare recommendations.
To purchase your copy of the
BSAVA Manual of Canine and Feline
Rehabilitaton, Supportve and
Palliatve Care: Case Studies in Patent
Management, visit the website at
www.bsava.com or call our
Membership and Customer Services
Team on 01452 726700.
The BSAVA Manual of
Canine and Feline
Rehabilitation, Supportive
and Palliative Care provides
valuable information for
every member of the team
Main image
reproduced from
BSAVA Manual of
Canine and Feline
Rehabilitation,
Supportive and
Palliative.
Courtesy of
David Prydie
14-15 Publications Rehabilitation.indd 14 16/04/2014 15:06
companion
|
15
Exclusive to VN Members
Launched at BSAVA Congress
in April, the BSAVA Casebook
for Veterinary Nurses,
edited by Rachel Lumbis
and Stuart Ford-Fennah,
is the latest loyalty benefit
for VNs renewing their
BSAVA membership
Veterinary nursing has developed considerably over the
past decade, with the role of the Veterinary Nurse
continually expanding and advancing. Registered
Veterinary Nurses (RVNs) now demonstrate an
acceptance for autonomy, accountability and
responsibility for their actions, and adherence to the
RCVS Code of Professional Conduct.
In defining a professional role for veterinary
nurses, one of the first steps has been to introduce the
nursing process and models of nursing into the
veterinary nursing syllabus. This has led to the
creation of care plans through which the nursing care
of veterinary patients can be systematically assessed,
planned and delivered by VNs. The introduction in this
casebook, adapted from the relevant chapter in the
BSAVA Textbook of Veterinary Nursing, 5th edition,
provides information on the principles of nursing
models, whilst two of the case studies are linked with
care plans that demonstrate how these principles can
be applied in practice.
The BSAVA Casebook for Veterinary Nurses
showcases a selected number of cases originally
published in the BSAVA Manual of Canine and Feline
Rehabilitation, Supportive and Palliative Care.
These range from acute severe pancreatitis in a dog
to chronic gingivostomatitis in a cat and from triaditis in
a cat to osteosarcoma in a dog. To make these studies
even more valuable to VNs, additional information on
nursing considerations has been added to each case.
Eligible BSAVA VN Members who did not collect
their complimentary copy at BSAVA Congress will be
sent their Casebook by the end of May.
BSAVA VN Merit Award
Rehabilitation
and physiotherapy
Lowri Davies and Tamsin OBrien
Attendance courses:
Friday 12 September, Saturday 13 September
and Saturday 25 October
at SMART Clinic, Cardiff
Evening webinars:
Tuesday 14 October and Tuesday 18 November
This Award will place nurses
in the framework of the
rehabilitation team and
cover the processes
involved with the different
types of therapies available
and how they can be
applied, assessed and
monitored.
Therapies covered will
include hot and cold
therapy, acupuncture and
electrotherapy. Practical
sessions will support the
theory learnt. To further your
learning, the Award will finish
with an online assessment
and case study.
Book your place now at www.bsava.com or by calling our
Membership and Customer Services Team on 01452 726700.
14-15 Publications Rehabilitation.indd 15 16/04/2014 15:06
16
|
companion
How to
utilize radiotherapy
for dogs with oral tumours
Introduction to radiation therapy
Radiotherapy is an important and increasingly
available treatment modality for the treatment of
neoplastic conditions in veterinary patients, and oral
tumours make up a significant part of the caseload of
the veterinary radiation oncologist. Radiation is most
commonly and most ideally used in the adjunctive
setting that is postoperatively in the presence of
microscopic disease but this treatment modality can
also be used in the gross disease setting in
appropriate cases.
There are currently six centres in the UK with the
ability to treat patients with radiotherapy: the
Universities of Liverpool, Edinburgh, Glasgow and
Cambridge, VRCC Veterinary Referrals in Essex and
the Animal Health Trust in Suffolk.
Radiation works by killing tumour cells. Photon
beams are generated by a linear accelerator (Figure 1)
and directed through tissue. This results in the release
of electrons and free radicals, which cause damage to
DNA, RNA and cellular proteins via both direct and
indirect effects. Tumour cells (Table 1) and surrounding
normal tissues vary in their sensitivity and hence
response to radiation.
Definitive radiation protocols consist of numerous
treatments of a small dose of radiation; most
commonly 2.74.2 Gy administered daily or on
alternate days and the objective of therapy is to
maximize tumour control.
Hypofractionated radiation protocols are
administered less frequently, often once weekly, and
Sarah Mason was the recipient of the 2013 BSAVA Frank Beattie
travel scholarship, which allowed her to travel to the University of
California Davis to spend two weeks learning more about
radiotherapy for the treatment of neoplasia in companion animals.
Here Sarah presents an introduction to the use of radiotherapy in
the management of canine oral tumours, illustrated with cases
showing the practical knowledge gained on her trip
Figure 1: The linear accelerator at the University of Liverpool
16-21 How To.indd 16 16/04/2014 15:19
companion
|
17
How to
utilize radiotherapy
for dogs with oral tumours
Late side effects develop many months following
treatment. These can include permanent alopecia,
fibrosis and leucotrichia (growth of white hair) in the
treatment field and ocular side effects can include
KCS, uveitis, bone necrosis and lens fibrosis.
Intensity-modulated radiotherapy (IMRT) is an
advanced form of radiation therapy which allows
superior conformation of the radiation dose to the
three-dimensional shape of the tumour. This modality
is available in the USA and I was able to learn how to
plan and treat IMRT patients during my trip to UC
Davis. IMRT allows more sparing of the normal tissues
and consequentially fewer side effects should occur.
This capability is not yet available in UK veterinary
centres but hopefully should become so over the next
few years.
Canine oral tumours
The most common malignant oral tumours in dogs are
melanoma, squamous cell carcinoma (SCC) and
fibrosarcoma (FSA). Melanomas are highly metastatic
tumours and the tumour has often already
metastasized by the time of diagnosis. Metastases are
less common in SCC and FSA.
Surgery (maxillectomy or mandibulectomy) is
usually the best treatment option for small, rostrally
located tumours, and sometimes for more caudally
located tumours. Dogs tolerate these surgical
procedures well and in some cases of low-grade
tumours this will be curative. Preoperative CT assists in
determining the extent of tumour margins and
consequently surgical planning and in some cases
may help to determine whether a patient is a surgical
candidate. In cases where surgery is not possible but
the tumour is sensitive to radiation, this can be used as
a sole treatment modality (malignant melanoma and
round cell tumours within the oral cavity; non-surgical
candidates). If complete surgical margins are not likely
to be achievable then radiotherapy can be used
pre- or postoperatively.
In order to assess whether radiation therapy is
appropriate for the patient, a biopsy is required to
determine the tumour type. Cytology of an oral mass
may not be diagnostic, as many oral tumours are
significantly inflamed at presentation. Staging can be
performed following discussion with the client
Tumour type (canine) Sensitvity
Round cell (plasmacytoma/histocytc
sarcoma/lymphoma)
Very sensitve
Squamous cell carcinoma Sensitve
Malignant melanoma Sensitve
Acanthomatous ameloblastoma
(previously epulis/basal cell
carcinoma)
Sensitve
Sarcoma (high grade) Medium sensitve
Fibrosarcoma (low grade/biologically
high grade)
Least sensitve
Table 1: Radiation sensitivity of canine oral tumours
higher doses of radiation are used per treatment
fraction. Hypofractionated regimes are more
appropriate in the palliative setting or for patients
with comorbidities where slowing tumour progression
or improvement of clinical signs is the objective
of treatment.
The dose of radiation that can be delivered to a
tumour is limited by the damage caused to
surrounding normal tissue and the consequential risk
of acute or chronic treatment associated side effects.
Radiation side effects
As radiation also causes damage to normal tissues,
side effects will result from treatment. Appropriate
radiation planning avoids as much normal tissue as
possible. However, the anatomical location of oral
tumours and closely associated normal structures
means that a balance has to be struck between
maximizing the dose to the tumour and minimizing the
normal tissue dose.
Acute radiation side effects occur between weeks
2 and 4 after starting therapy, can worsen in the week
or two after treatment, and have normally resolved
within a few weeks of treatment completion. Skin
within the treatment field is likely to become alopecic,
erythematous and moist desquamation can develop.
Inflammation of mucous membranes similarly occurs
and mucositis and conjunctivitis are common.
Corneal ulceration or keratitis are also possible acute
sequelae to radiation therapy if the eye receives a
significant dose.
16-21 How To.indd 17 16/04/2014 15:19
18
|
companion
How to utilize radiotherapy
for dogs with oral tumours
regarding tumour type and likelihood of local and
systemic metastasis. This usually includes fine needle
aspiration of the local lymph nodes and abdominal
and thoracic imaging, although this will depend on the
tumour type.
Case selection
Appropriate selection of cases for radiotherapy and
management of client expectations is important in
order to prepare clients for their pets treatment. It is
unlikely that radiation therapy will be curative for
canine oral tumours, and clients need to work with the
oncologist to understand and commit to the treatment
objectives for their pet. This can range from attempting
to achieve control of local disease in the medium to
long term (definitive protocols) to palliation of large/
painful tumours in order to reduce pain and improve
quality of life (palliative protocols).
Tumour size is an important factor in local tumour
control: tumour recurrence following surgery
radiotherapy is more likely in larger tumours. Prompt
diagnosis and treatment of canine oral tumours is
paramount in order to achieve the best possible
outcome for the patient. Unfortunately, many oral
tumours, particularly those located caudally, are not
evident to the owner until they have reached a
significant size, and treatment in these cases can
be challenging.
Patients should be in good enough clinical
condition to proceed with treatment. Neither age nor
the presence of comorbidities should preclude
treatment as long as the oncologist feels that the
benefit of treatment outweighs any risk to the patient.
However, comorbidities are likely to impact on the
oncologists recommendation regarding palliative
versus definitive radiation protocols and whether or not
surgery should be attempted. The benefit of radiation
in cases where distant metastatic disease is present
should be assessed on a case-by-case basis.
While radiation does not cause systemic side
effects, general anaesthesia is required and severely
debilitated patients or pets with expected lifespans of
less than 23 months are not likely to benefit from
treatment. Radiation oncologists are always willing to
provide advice on case selection and management
prior to referral.
Role of the referring veterinarian
Prior to referral for radiation therapy, clients should be
advised of the approximate cost of treatment and that
therapy will require multiple visits (between five and
twenty depending on the protocol) to the referral
centre. Boarding of pets is an option at some centres
but this will add to costs. Radiotherapy treatment has
to be administered under general anaesthesia and the
client should be prepared for this.
The patient will most likely require a CT scan to be
performed for radiation planning at the centre
administering the treatment. This is because radiation
planning software is calibrated to the specific CT
scanner and treatment machine. It is usually not
possible to plan treatment from MRI or CT scans
performed at other veterinary practices and the owner
should be advised of this prior to referral. However, if
these have been done it is important to provide the
radiation oncologist with a copy. This is particularly
relevant if the patient has had surgery since the
original imaging was done, as the entire tumour
volume should be included in the radiation field.
An appropriate work-up prior to referral includes
measurement and biopsy of the oral mass and
palpation and fine needle aspiration of both
submandibular lymph nodes. If thoracic radiographs
are performed, these should be three inflated views
(right and left lateral and dorsoventral views).
Treatment planning ( any further appropriate staging)
can then be performed as appropriate for the tumour
type at the referral centre, following discussion with the
client regarding likelihood of metastatic disease and
prognosis with various treatment modalities. Good-
quality digital photographs of the lesion prior to biopsy
can be very useful to the radiation oncologist.
At referral the referring veterinary surgeon should
provide:
A summary of the patients medical history/referral
letter, including measurements and location of the
mass
A copy of the histopathology report from the
tumour biopsy (if not immediately available this
should be forwarded as soon as possible)
A digital copy of any previous radiographs/CT/MRI
scans in DICOM format (or radiographic film) and
photographs of the lesion
16-21 How To.indd 18 16/04/2014 15:19
companion
|
19
Copies of cytology and other clinical pathology
reports when performed
Details of any current medication
This should minimize treatment delays and also
avoid repeat testing for the patient.
Once options have been discussed and the
client and oncologist have agreed on the
treatment, planning can begin. A specific radiation
plan has to be made for each patient and
specialized computer radiation planning software
is required (e.g. Pinnacle/Eclipse). The objective of
treatment is to administer 100% of the planned
dose to the entire planned treatment volume (PTV).
This is easier said than done in some cases and
compromise has to be made in avoiding dose to
the normal tissues: an individual plan can take
several hours to generate.
Some case examples of patients with oral tumours
treated with radiotherapy are presented below.
In summary, dogs with oral tumours are candidates
for radiation therapy if:
Surgery has not achieved tumour-free margins or
tumour-free margins are considered minimal
Surgery (maxillectomy/mandibulectomy) can be
used to downstage the disease and radiotherapy
planned postoperatively
The tumour is too extensive for surgery
The tumour is causing pain/discomfort/mass effect
The dog has oral melanoma
The client is committed to treatment and
associated costs (currently palliative protocols cost
around 16002500 and definitive around
36004500; not including the cost of CT/other
staging which would be estimated at 8001500).
Acknowledgements
The author is very grateful to BSAVA for the award of
the Frank Beattie scholarship 2013 which supported
travel to UC Davis.
Figure 2: (A) Side effects at the end of radiation treatment: mild mucositis. (B) Resolution of the mucositis 4 weeks after
completion of therapy
A B
A 7-year-old male neutered Golden Retriever
presented following incomplete excision of an
amelanotic melanoma from the right buccal and
mandibular gingiva. Staging was negative for local
and distant metastasis and the dog received
4 weekly fractions of 8 Gy to treat residual
microscopic disease. Side effects were minimal
(desquamation of the skin of the lip and mucositis;
Figure 2) and the dog remained disease-free for
9 months following treatment.
Case 1
16-21 How To.indd 19 16/04/2014 15:19
20
|
companion
Case 2
Figure 5: 3D
reconstruction
showing
extensive bony
lysis associated
with the tumour
in this case
Figure 6: The dog at the end of treatment. There is
generalized alopecia of the treated area. The left-sided
facial swelling has improved
How to utilize radiotherapy
for dogs with oral tumours
A 9-year-old female neutered cross-breed dog
presented with an extensive oral tumour involving
the left maxilla and nasal cavity and extending into
the brain (Figures 3, 4 and 5). The dog had
moderate left-sided nasal discharge and evidence
of nasal obstruction, and the left submandibular
lymph node was mildly enlarged and firm. Staging
included a biopsy of the primary tumour, which was
diagnosed as squamous cell carcinoma, and fine
needle aspirates of both submandibular lymph
nodes which confirmed carcinoma metastasis to the
left submandibular lymph node.
The dog received a hypofractionated radiation
protocol in order to palliate the clinical signs;
unfortunately the eye was in the treatment field and
received a similar dose of radiation to the tumour.
Minimal side effects (mild mucositis, alopecia (Figure
6)), periocular dermatitis and conjunctivitis occurred.
Two months following the end of her treatment, she
had significantly improved clinical signs and
continued to enjoy an excellent quality of life.
Figure 3: Positioned for treatment. The tumour is evident
as an extensive left-sided facial mass
Figure 4: CT images:
(A) Transverse section
and (B) sagittal section.
The tumour involves
much of the left
maxillary region and
nasal cavity, and
extensive left-sided
bony lysis and facial
distortion can be
appreciated
A
B
16-21 How To.indd 20 16/04/2014 15:19
companion
|
21
A 10-year-old female neutered Greyhound
presented for treatment of a maxillary squamous cell
carcinoma (Figure 7). Maxillectomy was performed
to downstage the disease, however, tumour cells
remained at the surgical margins. Radiotherapy was
planned to treat the residual microscopic disease.
The patient underwent postoperative CT and
radiation planning. A thermoplastic mask was
moulded and a custom pillow (Mouldcare

)
made to fit the exact shape of the patients head
(Figure 8).
Figure 8: Positioned for treatment. The head is positioned
on a customized pillow and supported by a moulded
plastic mask
Figure 9: Two weeks after treatment. Alopecia,
desquamation and crusting of the skin and nasal planum
can be appreciated
Figure 7: At presentation. The SCC presented as an
exophytic maxillary gingival mass
Figure 10: Four weeks after treatment, with resolving side
effects. Alopecia is more extensive but the previous
desquamation has resolved
She then received 12 fractions of 4 Gy radiation
delivered on a Monday/Wednesday/Friday basis.
Side effects during treatment were mild and
consisted of some moderate mucositis.
Side effects worsened in the 2 weeks following
treatment and desquamation of the skin in the
treatment field developed (Figure 9). One month
following radiation treatment the patient remained
disease-free and her side effects were resolving
(Figure 10). Three-monthly monitoring for
recurrence was planned for the next 12 months.
Case 3
AVAILABLE FROM BSAVA
BSAVA Manual of Canine and Feline
Oncology, 3rd editon
Edited by: Jane Dobson and Duncan Lascelles
Member price: 55.00
Price to non-members: 89.00
WHAT THEY SAY
...an excellent publicatonsufciently rewriten
and updated to make it a worthwhile purchase
The content is state of the art as much as
possible remains very easy to reada very
atractve purchase for practtoners and students
JOURNAL OF SMALL ANIMAL PRACTICE
16-21 How To.indd 21 16/04/2014 15:19
22
|
companion
Getting to know
your region
The hard work of our regional volunteers
underpins the BSAVA. These vets and VNs
organize courses and social events throughout
the year to make sure their fellow members get access
to quality, affordable CPD and local peer support.
Heres a whos who of our invaluable regional family
3
6
4
9
5
2
1
7
10
11
12
8
1: Cymru/Wales
Chair: Esther Barrett
Treasurer: Branwen Davis
Secretary: Roberta Eley
Regional Rep: Marina
Crockford
Hamish Cormie
Craig Connolly
Sian Howley
Emily Ward-Smith
Rhian Williams
Emma Gerrard
Sian Evans
Emma Owen
Alongside the expansion of the region at the
beginning of 2013, we also introduced free
registration at our regional evening CPD meetings
for all BSAVA members. Our aim is to provide free,
high quality CPD at a venue near you so please
watch out for meeting updates in companion and
on the BSAVA website. Have you ever thought of
becoming a BSAVA Regional Volunteer? If youd
like to find out more about joining the BSAVA
Cymru/Wales committee wed love to hear from you
simply email cymru.wales.region@bsava.com.
Esther Barrett
2: East Anglia
Chair: Pascale Collins
Treasurer: Melanie Fleming
Secretary: Hannah
Brinsmead
Farah Malik
Fiona Smith
James Warland
Kerry Hall
Simone Knudsen
Lizzie Murch
If you have never come along to one of our
regional events please do try. Our courses are an
affordable way to learn with great speakers in a
friendly atmosphere. If youd like to find out more
about joining the BSAVA East Anglia Committee
and have the opportunity to get involved with
regional events, wed love to hear from you. You
can get in touch with us by sending an email to
eastanglia.region@bsava.com.
Pascale Collins
3: Southern
Chair: Krista Arnold
Treasurer: Lucy Chadwick
Secretary: Carl Gorman
PetSavers Rep: Jayne Fisher
Sam Le Vallee
Scot Crae
We aim to run informative and topical meetings for
the benefit of the Southern regions vets and
nurses close to home throughout 2014, with talks
from specialists in their fields from around the UK.
If youd like to find out more about joining the
BSAVA Southern committee and the opportunity to
get involved with regional events, wed love to hear
from you. You can get in touch with us by sending
an email to southern.region@bsava.com.
22-24 Who is who in Regions.indd 22 16/04/2014 16:47
companion
|
23
4: Metropolitan
Chair: Tim Williams
Treasurer: Anna Marshall-Brown
Secretary: Rebecca Geddes
PetSavers Rep: Karen Humm
Regional Rep: Allison van Gelderen
Jelena Catchpole
Heather Covey
Esther Bijsmans
Matthew Swaffield
We are here to organize the kind of CPD events that
you are interested in, so if you have any requests
for future topics you would like to see, please let us
know. Suggestions from veterinary nurses are
extremely welcome we are hoping to organize a
meeting for nurses in 2014. Similarly, if you have
any feedback youd like to share with us, please get
in touch. You can get in touch with us by sending
an email to metropolitan.region@bsava.com.
7: North East
Chair: Tim Shearman
Treasurer: Maurice Kelly
Secretary: Helen OKelly
PetSavers Rep: Julia Thomson
Lucy Nicholson
Sally Whitehead
Victoria Lee
Paul Spellman
Chris Robinson
Victoria Roberts
Hannah Langley
North East Committee meetings are friendly and
fun, and we always have sticky toffee pudding!
One of the main benefits of being on the
committee is that you get to go to regional CPD
events for free. Wed welcome any suggestions
you may have for new venues to hold our meetings
in perhaps you feel we should bring a CPD event
to your town please get in touch. Wed also be
interested to know what topics youd like us to
cover and which speakers youd like to hear from.
You can get in touch with us by sending an email
to northeast.region@bsava.com.
5: Scottish Region
Chair: Graeme Eckford
Treasurer: Gerard McLauchlan
Secretary: Yvonne McGrotty
PetSavers Rep: Sharon Sharp
Madonna Livingstone
Lyndsay Kennedy
Sam Woods
Julien Guevar
Barbara-Ann Innes
We are working hard to put the finishing touches to
the Scottish Congress for the end of August and we
are looking forward to another successful year.
Were also excited to announce that weve just
finalized our CPD plans for 2015! If youd like to find
out more about joining the BSAVA Scottish
committee and the opportunity to get involved with
regional events, wed love to hear from you.
You can get in touch with us by sending an email
to: scottish.region@bsava.com.
6: South West
Chair: Nic Hayward
Treasurer: Jim Hughes
Secretary: Ellen Harmer
PetSavers Rep: Caz Haywood
Jo Aplin
Rachel Mason
Jennie Babington
Gabi Habacher
Sam McGuinness
Emily Parr
Guy Poland
Kate Esler
Ruth Pearson
Louise Longstaff
Jennifer Beard
Jenny Ross
Fiona Peffers
Whilst we have a healthy 17 members on our committee,
we are still seeking at least one volunteer from Cornwall
to enable us to provide more courses in the far South
West. If youd like to know more about what volunteering
entails, please get in touch! Also, please do let us know
what courses youd like to see and well do our best to
organize them. You can get in touch with us by sending
an email to southwest.region@bsava.com.
Nic Hayward
22-24 Who is who in Regions.indd 23 16/04/2014 16:47
24
|
companion
Getting to know your region
8: Northern Ireland
Chair: Lynsey Hamilton
Treasurer: Barbara McConnell
Lesley Moore
Paul Crawford
Katrina Cusack
The BSAVA Northern Ireland Congress will take
place on 2324 May at the Armagh City Hotel. With
Internationally renowned speakers in both the
Veterinary and Nursing streams, the theme for NI
Congress this year is the abdominal patient, with
the main emphasis on the management of surgical
cases. If youd like to find out more about joining
the BSAVA Northern Ireland committee please
email nireland.region@bsava.com.
11: East Midlands
Chair: Joanne Douglas
Treasurer: Mark Dunning
Secretary: Helen Ozleton
Savannah Williams
Mike Davies
Anneli Beese
Tirzah Woodthorpe
Douglas Dick
Jennifer Irving
We recently introduced our Pub Clinical Club meetings
and they have already proved to be a huge success.
These meetings offer you the chance to discuss hot
topics, get top tips and clinical updates with colleagues
from practice/referral centres/universities in an
interactive, friendly environment with a FREE meal.
Attendees also have the opportunity to win prizes in our
Clinical Pub Quiz. If youd like to find out more about
joining the committee wed love to hear from you
please email eastmidlands.region@bsava.com.
Mike Davies
10: North West
Chair: Andrew Iveson
Treasurer: Neale Roach
Secretary: Peter Graham
Rebecca Littler
Turlough ONeil
Simone Der Weduwen
Weve recently finalized our
courses not only for the rest of
2014 but for 2015, so we hope
that youll be able to come along and join us
we would really like to meet you. We are currently
quite a small committee and extra members are
always welcome if youd like to find out more
about joining the BSAVA North West committee
and the opportunity to get involved with regional
events, wed love to hear from you.You can get
in touch with us by sending an email to
northwest.region@bsava.com.
Andrew Iveson
12: West Midlands
Chair: David Godfrey
Treasurer: Hannah Gritti
Secretary: Jo Godsall
Secretary: Simon Godsall
Regional Rep: Will Walker
Dave Fisher
Isuru Gajanayake
Vicky Pheysey
Stephanie Jayson
Laura Jordan
Tom OReilly
Apart from our practical day on caged birds, reptiles
and small mammals, all of our CPD in 2014 and 2015 is
free to BSAVA members (vets and nurses). This is our
Committees initiative to increase delegate numbers
and to provide another benefit to you being a BSAVA
member every year. We will always welcome new
committee members, so please contact us and well
explain what you can gain by getting involved email
to westmidlands.region@bsava.com.
9: South East
Chair: Louise Smith
Treasurer: Cathy Thomson
Secretary: Roger Holden
PetSavers Rep: Alison Livesey
Regional Rep: Muna Roberts
Julian Hoad
Whilmari Worrow
Jane Pomeroy
Wolfgang Dohne
This year weve decided to focus on providing CPD
courses with a practical element. If youd like to find
out more about joining the BSAVA South East
committee and the opportunity to get involved with
regional events, were particularly keen to hear from
vet nurses as well as anyone living in Kent or East
Sussex. You can get in touch with us by sending an
email to southeast.region@bsava.com.
Louise Smith
GET INVOLVED
To fnd out more about getng involved with your region you
can contact Jennie Bartholomew on j.bartholomew@bsava.com
or get in touch with your region directly.
22-24 Who is who in Regions.indd 24 16/04/2014 16:47
For more information or to order
www.bsava.com/publications
BSAVA reserves the right to alter prices where necessary without prior notice.
BSAVA Publications
COMMUNICATING VETERINARY KNOWLEDGE
e-BOOKS AVAILABLE FROM BSAVA
BSAVA Members have been asking to have the Associations
highly-respected series of Manuals as e-Books; to read on PCs,
tablet computers and e-readers. The BSAVA is pleased to
announce the launch of five more e-Books, bringing the total
number of Manuals available in this format to ten.
How to order
Members can order e-Books from www.bsava.com. Once your
order is processed, you should be able to access your files from the
My orders/downloads area of MyBSAVA (login required). You will
be able to select the file types that suit your particular e-readers,
and load the e-Book on to multiple devices.
See www.bsava.com/ebooks or email publications@bsava.com
for further information.
Exclusive to BSAVA Members
Prices from 25
ePUB and Kindle formats
available
25 Publications Advert May.indd 25 16/04/2014 15:21
26
|
companion
Celebratng 40 YEARS of improving the health of pets
Dermatology
and dermato-
endocrinology funding
Professor Keith Thoday tells
companion readers about the
research funded in support of
veterinary dermatology and dermato-
endocrinology over the past 40 years
T
he BSAVA charity PetSavers
(initially called the Clinical Studies
Trust Fund) has been in existence
for all but the first three years of my
professional career. In that time, I and
many others who have worked in the areas
of dermatology and dermato-
endocrinology have received significant
financial support in our research
endeavours and in the training of the next
generation of specialists.
Over the years, I have had eight
awards from PetSavers. I received my first
in 1980. I was just about to register with the
University of Edinburgh to carry out my
part-time PhD research into an alopecic
condition in cats, then called feline
endocrine alopecia as it was suspected to
have a hormonal basis, possibly
hypothyroidism. As a full-time lecturer,
I needed money for research
consumables: I applied for and was
awarded 2000. Looking back now, it is
hard to imagine that we didnt even know
what the main feline thyroid hormones were
and certainly had no reference intervals for
them. This grant allowed me to confirm not
only that they were thyroxine (T4) and
triiodothyronine (T3), but also the effects
on their plasma concentrations of age,
gender, breed, heredity and environment.
Uncovering feline
hyperthyroidism
Shortly after I had begun my PhD, the first
cases of what appeared to be truly a new
disease (rather than a newly-recognized
disease) were seen in the USA and, very
quickly, subsequently in the UK and the
Netherlands. This condition, feline
hyperthyroidism, was to demand a large
amount of my clinical and research time
over the next 20 or so years.
With further sequential financial support
from PetSavers in five tranches between
1983 and 1993, together with my MSc
student Carmel Mooney and subsequently
my PhD student Darren Foster, we were
able to define further the historical, physical
and diagnostic features of the disease,
various aspects of its medical management
and some features of its aetiopathogenesis,
a total of 15 peer-reviewed publications and
five invited book chapters, all directly or
indirectly supported by PetSavers awards.
As befits such an important disease,
research into other aspects of feline
hyperthyroidism has received subsequent
support, with Jonathan Elliot (2000), Tim
Williams (2010) and Natalie Finch (2012)
all looking at different aspects of a major
problem, the development of
compromised kidney function after
treatment for the disease.
Canine endocrine
dermatopathies
The diagnosis of two important canine
endocrine dermatopathies has also been
supported by PetSavers. In 1996, Carmel
Mooney investigated various aspects of
canine hypothyroidism and in 1997, Ian
Ramsey looked at the thyrotropin response
to thyrotropin releasing hormone in dogs.
Switching to hyperadrenocorticism, in
1999, Carmel then studied the value of
17-hydroxyprogesterone measurements in
the diagnosis of the condition and in 2001,
Ian carried out further studies in dogs
being treated for Cushings-like syndrome
in determining changes in their parathyroid
hormone concentrations.
Nowadays, skin biopsy in dermatology
is a tool used on a daily basis in practice. It
is easy to forget that the science (and art)
of dermatopathology had to be learned so
that we can rely on its diagnostic value as
we now do. In 1985, Pauline McNeil at the
Glasgow Veterinary School was awarded a
grant that laid some of the foundations of
this specialty.
Commitment to dermatology
Skin disease associated with micro-
organisms is one of the most important
26-27 PetSavers.indd 26 16/04/2014 15:28
companion
|
27
aetiological areas in canine dermatology
and, as such, has been well financed by
PetSavers. When I began working in
dermatology, Malassezia pachydermatis
was not recognized as a canine pathogen.
Now, few dermatologists (and many
general practitioners) would go a working
day without identifying its involvement in
some dog with skin disease. Leading the
way in investigations into this yeast has
been Ross Bond who was initially
supported by the CSTF/Ella Dora Renison
Studentship (1992) at the Royal Veterinary
College (RVC), with subsequent PetSavers
funding (1996) in this area.
It is probably correct to say that any
canine skin disease may become
secondarily infected with bacteria, usually
the animals own bacterial flora.
Recognizing the importance of bacterial
skin disease, PetSavers has strongly
supported research in this area.
Richard Harvey (1991) investigated the
population dynamics of Staphylococcus
pseudintermedius on canine skin during
his residency at the RVC and Pauline
McNeil looked at in vivo culture of canine
hair follicles (1998). As the first stage of
cutaneous bacterial infection is adherence,
we became very interested in this process
at Edinburgh and PetSavers (1999)
financed Peter Forsythes investigations
into the effects of breed and anatomical
site on adherence of pathogenic
staphylococci to corneocytes from healthy
dogs during his residency with us.
Canine bacterial otitis externa is very
common in veterinary practice so it is no
surprise that this multifactorial condition
has received support from PetSavers. In
2011, Neil McEwan at the Liverpool School
was awarded funds to study the efficacy of
topical antibacterial agents with and
without the addition of the sensitizing and
bactericidal agent ethylene-diamine
tetra-acetic acid-tris (EDTA-tris) on
Pseudomona aeruginosa isolated from
canine ear infections.
In 2012, Carly Bell was supported in her
investigations into the in vivo antimicrobial
action of two ear cleaning solutions on
canine otitis externa. In another bacterial
study, Susan Dawson (1998) at the
Liverpool School was awarded funds for an
investigation into the effect of antibacterial
treatment for bacterial skin disease on the
antibacterial resistance of faecal
Escherichia coli isolates from dogs, a study
which, as we continue to contemplate
emerging bacterial resistance, is of great
current relevance.
The microclimate of the canine skin
and coat has potential effects on many
conditions, not least on bacterial
pyoderma. In 1991, from referral practice,
Chris Chesney was given an award to
investigate the moisture content within the
dogs haircoat.
Funding all areas
Viruses and parasites were not neglected
by PetSavers. Elizabeth Pegg of the RVC
received one of the very earliest grants
(1980) to study the biology of the common
ear mite of the dog and cat, Otodectes
cynotis, while in 1983, Derrick Baxby and
Rosalind Gaskell of Liverpool University
received funds to investigate the incidence,
source and clinical features of feline
cowpox. Feline cowpox was rarely
recognized until this work and the disease
is, of course, a potential zoonosis.
My colleague at Edinburgh, Adri van
den Broek, was interested in the effects of
gut fat absorption on a number of canine
skin conditions. In 1990, he received two
awards, one to investigate gut fat
absorption and clearance in atopic dogs
before and after subcutaneous allergen
immunotherapy and the second to study
zinc and fat absorption in dogs with
zinc-responsive dermatosis. One of the
reasons why this latter condition is far less
common nowadays stems from the results
of the studies carried out by Adri and the
Edinburgh group at this time.
Eosinophilic granuloma is a feline
reaction pattern with which all small animal
clinicians will be familiar. In 2010, Anja
Kipar received an award to elucidate the
pathogenesis of this troublesome
diagnostic and therapeutic problem.
Supporting specialization
PetSavers has not confined itself solely to
funding research projects. As well as Ross
Bonds studentship noted above, Sue
Paterson received financial support during
her studies for the RCVSs Diploma in
Veterinary Dermatology. She told me
recently that it would have been very
difficult for her to have undertaken and
completed her studies from general
practice without this award. I also was
delighted that PetSavers funded a
Residency in Dermatology at Edinburgh in
2000. Our appointee, Silvia Colombo,
carried out some excellent research on
canine atopic dermatitis, studied for the
Diploma of the European College of
Veterinary Dermatology and passed the
examination at her first attempt. Both Sue
and Silvia are now European Veterinary
Specialists in Dermatology.
In looking back over the awards that
PetSavers has made in my specialist areas
in its 40 years of existence, I find myself
constantly impressed at the foresight and
excellent judgement that the Awards
Panels have consistently shown. They have
invariably given grants in areas important
to clinical practice and made them to
people who subsequently did what was
hoped of them. PetSavers has a long and
successful history and a fantastic future:
heres to the next 40 years. n
26-27 PetSavers.indd 27 16/04/2014 15:28
28
|
companion
T
he stage is almost set for the 39th WSAVA
World Congress which takes place in Cape
Town from 1619 September 2014. It
promises to be amazing, so if you havent yet
thought about attending, plan now to take advantage
of the Early Bird Rates for registration which are on
offer until 1st June.
When making your preparations, make sure you
check out the Pre-Congress Programme on Monday
15 September. The theme is Vets in the Wild a Peek
Behind the Scenes with speakers including South
Africas leading wildlife veterinarians who will discuss
topics ranging from rhino and lion conservation to
experiences of wildlife ophthalmology and dentistry.
South African veterinarians are at the forefront of
wildlife medicine their experiences make this a
unique session that is not to be missed!
Destination South Africa
Every country in the world displays some diversity, but
South Africa, stretching from the hippos in the
Get ready for
Cape Town
Early bird rates for the 39th WSAVA World
Congress end on 1st June 2014
Limpopo River to the penguins waddling on the Cape,
takes some beating. It befits its position at the
southern end of the worlds most epic continent, with
more types of terrain than photographers can shake
their zoom lens at.
Theres the deserted Kalahari, Namakwas
springtime symphony of wildflowers, iconic Table
Mountain and Cape Point, Kruger National Parks
wildlife-stalked savannah and, running through the
east of the country and into Lesotho, the
Drakensberg. KwaZulu-Natals iSimangaliso
Wetland Park alone has five distinct ecosystems,
attracting both zebras and dolphins.
If youre interested in another kind of wildlife, hit the
nightclubs on Cape Towns jumping Long St or sample
African homebrew in a township shebeen. When its
time to reflect on it all, do it over seafood on the
Garden Route, curry in Durbans Indian Area, a
sizzling Cape Malay dish, or a braai (barbecue) in the
wilderness accompanied by a bottle of pinotage
produced by the oldest wine industry outside Europe.
South Africans are some of the most upbeat,
welcoming and humorous folk youll encounter
anywhere, from farmers in the rural north who tell you
to drive safely on those dirt roads, to Khayelitsha kids
who wish you molo (good morning in Xhosa).
28-29 WSAVA NEWS.indd 28 16/04/2014 15:35
companion
|
29
F
ollowing the devastation in the Philippines
caused by Typhoon Haiyan last November, the
Philippine Animal Hospital Association (PAHA)
appealed to the veterinary community in Asia
and around the world for help. A tremendous response
was received we received inquiries and offers of help
from veterinarians as far afield as Israel, Japan,
A global community
pulling together for
the Philippines
Dr Amie Babasa, PAHA Past
President, reflects on the support
given by the international
veterinary community following
Typhoon Haiyan
Singapore, South Korea and Canada. We also
received financial assistance from Dr Alane
Cahalanes fundraising work in Hong Kong with
donations from the Hong Kong Veterinary Association,
veterinary clinics, individual vets and pet owners. It
was a wonderful surprise to know that there were
colleagues out there in the world who truly cared and
went out of their way to communicate their intent to
help us.
Haiyan made us realize how unprepared we were
for disasters. We had no support system or protocol in
place so it was a learning experience and we had
great support from International Fund for Animal
Welfare (IFAW), World Society for the Protection of
Animals (WSPA) and Humane Society International
(HSI). A positive development is that we have now
formed a coalition with international, national and local
organizations to address animal relief and rescue.
With the experience and insights we gained from
Haiyan, we are now working to put in place an
information campaign to educate our clients about
disaster preparedness. We aim to help build localities
resilient to disasters while we look into training we can
undertake to help us prepare for any future disasters.
We would like to thank everyone who helped and
continues to help us. It is what being a global
community is all about!
Suspect a hereditary disorder?
Use the WSAVAs search tool
for DNA testing
Thanks to Dr Urs Giger and his team on the WSAVA Hereditary Disease
Committee, the WSAVAs work in the area of DNA testing for hereditary
diseases in dogs and cats worldwide has grown rapidly over the past year.
There are now 53 labs and a list of 175 different mutations and diseases.
The WSAVA lab search tool has also been developed and is currently
being updated by the Committee, which was in part supported by
Waltham and Wisdom Panel

. You can access the tool from the PennGen

Laboratories website. If you have a puppy or kitten of a particular breed
and you suspect a hereditary disorder, do check this valuable web tool for
available DNA tests and laboratories based on breed or disease.
Dr Urs Giger
28-29 WSAVA NEWS.indd 29 16/04/2014 15:35
30
|
companion
Q
What can you tell us about your
chosen veterinary career?
A
Im a bit of a child of James Herriot.
Louth is a market town in a rural
area and I envisaged a life as a
member of a rural community with an
active outdoors life, related to agriculture. I
consider myself to be an academic vet. I
think it is important that the profession
embraces and recognizes the full range of
opportunities available to vets that draw on
their training, experience and motivation. I
think the profession needs members who
are academics and who focus on
developing the evidence that underpins
the professions activities.
My current role is about engaging
with colleagues to manage and develop
the BVMS programme, which is
undergoing a period of change as we
introduce a fundamentally redesigned
programme. I am meetings man. I have
meetings with everybody
to keep them informed and work through
any problems. Engagement is at a
range of levels: school, college,
university and RCVS. Other meetings
involve contributing to the research
projects I am involved with.
Professor
James
Anderson
BVM&S MVM PhD
DSAO DipECVN
ILTM MRCVS
the companion interview
James Anderson was born in Redruth, Cornwall in
1960 and grew up in Louth, Lincolnshire. He
graduated as a vet from the Royal (Dick) Veterinary
School at the University of Edinburgh in 1984. He
spent four years in mixed practice in Lancashire and
Leicestershire before moving to the University of
Glasgow Veterinary School to train in surgery. In 1992
he was awarded the Diploma in Small Animal
Orthopaedics. He undertook research training in basic
neuroscience which led to the award of a PhD. In 2002
James was awarded the European Diploma in
Veterinary Neurology. His clinical interests include
Great Dane myopathy; the impact on owners of caring
for a dog with epilepsy; the use of acute phase
proteins in the diagnosis of inflammatory central
nervous system disease; biomarker discovery in
neurological disease; and developing the evidence
base for decision making in veterinary education. He is
responsible for directing Glasgows veterinary
professional programme.
30-31 Interview.indd 30 16/04/2014 15:36
companion
|
31
there is a tendency to focus on
the disease in small animal work,
but we must remember to look at
the impact on owners as well
What made you decide to move to a
university from general practice?
In my first practice I concentrated on large
animal work because it was what I wanted
to do, but it was at a time when uncertainty
was developing about the future for those
practices because of milk quotas and
changes in the management of animal
diseases. It was obvious at the time that
small animal specialties were going to
develop further and so I started to look for
a post at a vet school for further training. It
was about opportunities they were
emerging in small animal and possibly
disappearing in large animal. I moved to
Glasgow because of the reputations of Neil
Gorman and Stuart Carmichael, head of
orthopaedics. My intention was to develop
specialist skills and be part of the
development of specialist practice.
How did studying surgery at Glasgow
change your personal and professional
perspective?
I experienced working with a focused
multidisciplinary group and realized the
power that group had in developing itself
and meeting client needs. This made me
think that breadth would be important in
specialist practice. I also experienced the
mechanisms of research and realized that
specialist clinicians benefit from
understanding how to conduct research, to
serve the needs of clients and develop the
techniques of the future. I realized I wanted
to be a specialist clinician who could
contribute to taking things forward. My
research training was with Ian Griffiths.
Working with Ian changed my perspective
on what research was about and
importantly how to ask the right question
which is where all research starts.
What made you decide to specialize in
neurology?
After I came to the university to get
specialist training I realized the
environment was totally different to
practice. You have a far better
understanding of what it takes to do
research to understand the problem and
the difference between making an
educated guess and having evidence to
substantiate your opinion.
I got the opportunity to do a PhD in
neurobiology, related to orthopaedics.
Glasgow was one of the few places with a
specialist neurology practice. We were
looking at characterization of genetic
mutants related to myelin development and
maintenance. All sorts of things happen to
myelin. You either dont develop it properly,
as seen in congenital and acquired
conditions, or you can lose myelin. It is more
prevalent in humans with conditions like MS
but it does happen in animals. Off the back
of that we received a lot of MS funding.
What can you tell us about your clinical
interests?
They are all developments on a common
theme. I think epilepsy is a disease that
people find difficult. It is not going to go
away, it is a condition you have to manage.
What struck me was the impact on the
owners rather than the patients, so we
started looking at them and how they felt
about having a dog with epilepsy.
If you are managing a disease it is a
slightly triangular process between you,
the patient and the owner or carer. There is
a tendency to focus on the disease in small
animal work, but we must remember to
look at the impact on owners as well.
Great Dane myopathy was an
interesting phenomenon. What we really
did not know was the underlying basis of
the disease. Myopathy is an early onset
muscle disease. They never develop as
their unaffected siblings would they are
weaker and not as well muscled. You can
have a mixture of affected and unaffected
puppies. It leads them to be euthanized at
a young age, though it seems that it is not
so common now.
My biggest interest has been in making
a specific diagnosis at an early stage.
Neurology is full of conditions that are
diagnosed by exclusion. Epilepsy is one
example of that. Another is SRMA (steroid
responsive meningitis arteritis). No one
knows what causes it. It is fairly easy to
recognize, so we started to look at that and
see if we could find markers of disease,
progression and recurrence. We then
picked up the biomarker theme with
degenerative myelopathy in German
shepherds. The recent understanding of
genetic background has made it more
straightforward to focus on and we have
made discoveries with biomarkers that will
allow us to move from disease exclusion to
specific diagnosis.
The reason for doing this is that a lot of
the stress from the owners perspective is
the vet saying well we think it is this, but
we cant prove it. Sometimes you get it
right, sometimes you get it wrong. You can
spend a lot of money making sure your
diagnosis is correct. There are good
reasons to develop tools to make diagnosis
as specific as possible. We have been
looking at markers in cerebrospinal fluid
and our goal is to look for markers in blood
and urine.
What have been the most exciting
developments in neurology or
neuroscience over the past 10 years?
From a clinical perspective it is the
increasing affordability and availability of
MRI. This imaging technique can remove a
huge amount of the technical issues
involved in understanding a patients
issues. I always think it shines a light into
the darkness.
Other developments are in some ways
taken for granted as the work happens
elsewhere rather than in the clinical
environment. These are the diagnostic tests
for specific diseases. I think there is much
more that can be done in this area to
improve the lot of our patients, our clients
and as a profession, to improve confidence.
What is the most important lesson life
has taught you?
Can I have two? As a group we only go
forward if we can work effectively together.
Life is about taking opportunities.
30-31 Interview.indd 31 16/04/2014 15:36
32
|
companion
Local
News from BSAVA Regions
knowledge
West Midlands practical
dentistry weekend
The West Midlands practical dentistry weekend in
February, run jointly with BVDA at Solihull
College, was a great success. Full classes
attended lectures on first-opinion dentistry
including examining and charting, radiography
(manual and digital) and extraction techniques.
Delegates were then able to get hands-on and
practice all these skills.
Metropolitan asks:
skin work up or
no skin work up?
For many, dermatological cases are the bread and butter of
everyday practice, but do you know the best way to manage
and treat these frequently challenging conditions? In this
day meeting on 18 June, Ross Bond and Anke Hendricks
from the Royal Veterinary College will address key
questions relating to the management of canine and feline
skin and ear disease in general practice.
Topics will include:
Skin work up or no skin work up?
Pyoderma again, what now?
Food for thought managing cutaneous food
hypersensitivities
Quality of life matters optimizing the treatment of
atopic dermatitis
Lotions and potions medical management of ear
disease
The meeting will be held at the Holiday Inn, Elstree, just
off the M25 and A1 in north London and will cost
150 + VAT for BSAVA members.
North East region:
cardiology for nurses
As our first nursing speaker, Charlotte Pace provided an
interesting and practical perspective on the nurses role in the
management of cardiac patients.
This began with a pragmatic description of congestive
heart failure starting as soon as fluid starts to accumulate and
then we discussed management of heart disease and the
nurses role in this. We got an excellent overview on echo
images (and ways to combat nurse boredom when assisting
in echo) as well as great tips about understanding the needs
of the patient.
A joint session on ECGs between the vets and nurses
was followed by a session where topics were chosen by the
nurses present.
North East region: rabbit dental
BSAVA North East were delighted to welcome back Bob
Partridge, founder member of the BVDA, for the third in its series
of dental lectures especially as he very sportingly agreed to
donate 1 to Petsavers every time he said root instead of
reserve crown!
Bob illustrated his talk with lots of excellent photos and
X-rays showing just how a rabbits teeth should be, and offered
plenty of practical advice on how to manage dental disease.
There were also lots of very interesting and well answered
questions at the end. It was great to have a few VNs in the
audience and we look forward to seeing more at our future
meetings. The evening was kindly sponsored again by
KRUUSE and we are very grateful to Idexx in
Wetherby for letting us use their
lecture room and common
room twice a year.
This talk coincided
with our Regional Annual
Meeting, and so delegates
got to hear how we are able to offer
such excellent quality CPD in the
Region at affordable prices because
all the organization is done by
volunteers. Sadly there were no
volunteers to join the Committee, but
if anyone is having second thoughts
then please contact us at northeast.
region@bsava.com.
32-33 Regions.indd 32 16/04/2014 15:57
companion
|
33
North East region: wound
management for VNs
Take a guided tour around wound management with Louise ODwyer
and explore the commonly seen types of wounds and their
underlying pathology, as well as their appropriate treatment. We will
review the usual, and less usual, wound dressings and why they may
be suitable for a particular wound type. The aim is to give delegates
an improved understanding and increased confidence in dealing
with difficult cases.
Louise ODwyer is Clinical Director for PetMedics in Manchester.
Her interests include all aspects of emergency care but particularly
trauma patients, as well as anaesthesia, infection control and wound
management. Louise is the co-author of Practical Emergency and
Critical Care Veterinary Nursing as well
as Wound Management in Small
Animals: A Practical Guide for
Veterinary Nurses and Technicians, and
the BSAVA Pocketbook for Nurses.
This is an evening meeting (with
delicious sandwiches by TeaHee) and
takes place on the 3 June in Wakefield.
The meeting is free to BSAVA nurse
members, although of course vets are
also welcome. The meeting is kindly
sponsored by Zoetis.
Demystifying medicine
in the South West
BSAVA South West is proud to present Demystifying Medicine,
a north and south double act to be presented on consecutive
days in Bristol and Cornwall on 25/26 June.
Our speakers Mark Dunning and Nick Bexfield, both
Clinical Associate Professors at the University of Nottingham,
will present an entertaining and interactive day aimed at
untangling the complex world of small animal medicine. Using
real life clinical cases, this day course will review a wide variety
of small animal medical disorders, including GI, endocrine and
haematological diseases.
Delegates will learn how to identify salient problems,
formulate differential diagnoses lists and diagnostic plans,
interpret the results of diagnostic tests including blood and
imaging studies, and understand the latest treatment options.
And get to use those wonderful congress zapper remotes!
This course promises to be a pragmatic and hugely valuable
day for new graduate and old hand alike. Book early to avoid
disappointment.
Find out more about regional CPD near you from
at www.bsava.com
The emergency patient
and nursing plans in
Southern region
After the great success of our first nurse meeting last
autumn, Southern Region has invited Kath Howie RVN to
return for a repeat of her emergency evening talk for
nurses on 17 June.
Join us in Basingstoke to discuss triage of patients
presenting as emergencies and the nurses role in
recognizing those patients that need immediate
treatment. We will cover commonly seen emergencies
and the VNs role in assisting the veterinary surgeon and
management of these cases. We will spend some time
looking at the monitoring tools we have available to us for
the emergency patient and the limitations and positive
aspects of each. We will also discuss analgesics, fluid
therapy, monitoring of the emergency patient and some
handy hints and tips to help you with the less
co-operative patient.
Nursing plans are greatly under-utilized and in the
emergency patient nursing plans need to be constantly
changing and flexible, but also completed clearly so that
anyone can come along and see the requirements of that
patient at a glance. There will be examples of emergency
cases, including video, to illustrate some of the more
commonly seen emergencies and some time for
questions and answers at the end of session. We look
forward to seeing you there.
32-33 Regions.indd 33 16/04/2014 15:57
34
|
companion
CPD diary
LUNCHTIME WEBINAR
Wednesday 21 May
13:0014:00
Endocrine diagnostics
Speaker: Carmel Mooney
Online
Details from administration@bsava.com
LUNCHTIME WEBINAR
Wednesday 14 May
13:0014:00
SAVSNET
Speaker: Alan Radford
Online
Details from administration@bsava.com
DAY MEETING
WEST MIDLANDS REGION
Wednesday 7 May
Holiday bugs
Speaker: Maggie Fisher
Wolverhampton Medical Centre, Wolverhampton
Details from westmidlands.region@bsava.com
AFTERNOON MEETING
SOUTHERN REGION
Thursday 15 May
Orthopaedic problems of the
shoulder, elbow and stifle
Speaker: Andy Moores
Holiday Inn Express, Southampton
Details from southern.region@bsava.com
EVENING MEETING
NORTH EAST REGION
Wednesday 7 May
The inappetent cat
Speaker: Roger Wilkinson
Idexx Laboratories, Wetherby
Details from northeast.region@bsava.com
May
June
DAY MEETING
Thursday 1 May
Whats new in allergies in cats
and dogs
Speaker: Stephen Shaw
Hilton, Stansted Airport
Details from administration@bsava.com
EVENING MEETING
SOUTH EAST REGION
Tuesday 6 May
Improving the health of pedigree
dogs
Speakers: Steve Dean and Tom Lewis
The Stepping Stones Pub, Dorking
Details from southeast.region@bsava.com
DAY MEETING
Wednesday 7 May
Is it me or are these lenses on this
microscope covered in oil? A very
practical guide to getting the most
out of in-house cytology
Speaker: Emma Dewhurst
Woodrow House, Gloucester
Details from administration@bsava.com
DAY MEETING
METROPOLITAN REGION
Sunday 18 May
Whats new for old cats?
Speakers: Hattie Syme and Roseanne Jepson
Holiday Inn Express, 275 Old Street, London
Details from metropolitan.region@bsava.com
EVENING MEETING
SOUTH WEST REGION
Tuesday 20 May
Cranial cruciate ligament disease:
where are we now?
Speaker: Neil Burton
Cullompton Rugby Club, Devon
Details from southwest.region@bsava.com
EVENING MEETING
SOUTH EAST REGION
Wednesday 4 June
Suture materials
Speaker: Davina Anderson
Leatherhead Golf Club
Details from southeast.region@bsava.com
DAY MEETING
SOUTH WEST REGION
Tuesday 20 May
Introduction to abdominal
ultrasonography
Speakers: Nic Hayward and Esther Barrett
The Canalside, Bridgwater
Details from southwest.region@bsava.com
EVENING MEETING
CYMRU/WALES REGION
Tuesday 20 May
Managing liver and pancreas
disease in dogs and cats: an
interactive case based evening
Speaker: Penny Watson
Carmarthen Veterinary Centre
Details from cymru.wales.region@bsava.com
EVENING MEETING
CYMRU/WALES REGION
Wednesday 4 June
Fluid therapy in small animal
practice: are all fluids created
equal?
Speaker: Dan Holden
The Unicorn Inn, Cardiff
Details from cymru.wales.region@bsava.com
EVENING MEETING
EAST MIDLANDS REGION
Tuesday 20 May
The PUB Clinical Club: topic TBC
Speaker: TBC
The Royal Oak, Ockbrook
Details from eastmidlands.region@bsava.com
DAY MEETING
Wednesday 21 May
Companion animal diabetes
mellitus management in practice:
an up-to-date, holistic,
21st-century view
Speakers: Stijn Niessen and Yaiza Forcada
Hatfield Oak Hotel, Hatfield
Details from administration@bsava.com
DAY MEETING
Thursday 5 June
Practical haematology: detective
work for nurses
Speaker: Kostas Papasouliotis
Woodrow House, Gloucester
Details from administration@bsava.com
EVENING MEETING
NORTH EAST REGION
Tuesday 3 June
Wound management for nurses
Speaker: Louise ODwyer
Chantry Vets, Wakefield
Details from northeast.region@bsava.com
AFTERNOON MEETING
SCOTTISH REGION
Thursday 29 May
Exotic emergencies
Speaker: Livia Benato
Dundee Discovery Centre
Details from scottish.region@bsava.com
34-35 CPD Diary.indd 34 16/04/2014 16:00
companion
|
35
EXCLUSIVE FOR MEMBERS
Extra 5 discount on all
BSAVA publicatons for members
atending any BSAVA CPD event.
All dates were correct at tme of going to print; however, we
suggest that you contact the organizers for confrmaton.
LUNCHTIME WEBINAR
Wednesday 18 June 2014
13:0014:00
Breed schemes
Speaker: Aimee Llewellyn
Online
Details from administration@bsava.com
LUNCHTIME WEBINAR
Wednesday 25 June
13:0014:00
CT/MRI: what is it?
Speaker: Andrew Parry
Online
Details from administration@bsava.com
LUNCHTIME WEBINAR
Wednesday 16 July
13:0014:00
Pericardial disease
Speaker: Rachel James
Online
Details from administration@bsava.com
LUNCHTIME WEBINAR
Wednesday 23 July
13:0014:00
Triage of the poisoned patient
Speaker: Daniel Lewis
Online
Details from administration@bsava.com
July
LUNCHTIME WEBINAR
Wednesday 20 August
13:0014:00
Analgesia and pain assessment
Speaker: Jackie Brearley
Online
Details from administration@bsava.com
LUNCHTIME WEBINAR
Wednesday TBC August
13:0014:00
Basic ophthalmic exam
Speaker: TBC
Online
Details from administration@bsava.com
August
September
OTHER UPCOMING BSAVA CPD COURSES
See www.bsava.com for further details
Metropolitan region
Friday 5 September
Emergency surgery
East Midlands region
Tuesday 16 September
The PUB Clinical Club: topic TBC
West Midlands region
Tuesday 16 September
Communicaton
BSAVA Educaton
Wednesday 17 September
Diferent diagnosis of haematuria
BSAVA Educaton
Thursday 18 September
Getng the most from cardiac diagnostcs
EVENING MEETING
SOUTH WEST REGION
Wednesday 18 June
Veterinary evidence: how do I find
it and is it any good?
Speaker: Rachel Dean
RSPCA, Bristol
Details from southwest.region@bsava.com
DAY MEETING
SOUTH WEST REGION
Wednesday 25 June
Demystifying medicine
Speakers: Nick Bexfield and Mark Dunning
Hilton Bristol, Bradley Stoke
Details from southwest.region@bsava.com
EVENING MEETING
EAST MIDLANDS REGION
Tuesday 20 May
The PUB Clinical Club: Topic TBC
Speaker: TBC
The Royal Oak, Ockbrook
Details from eastmidlands.region@bsava.com
DAY MEETING
SOUTH WEST REGION
Wednesday 9 July
Are you flummoxed by fluids?
Rethinking fluid therapy in
emergency patients
Speakers: Sophie Adamantos and
Christina Maunder
Darts Farm Shopping Village, Exeter
Details from southwest.region@bsava.com
DAY MEETING
SOUTH WEST REGION
Thursday 26 June
Demystifying medicine
Speakers: Nick Bexfield and Mark Dunning
Kingsley Village, Cornwall
Details from southwest.region@bsava.com
DAY MEETING
Tuesday 24 June
Top tips and tricks for closing and
reconstructing wounds in small
animal practice
Speaker: Jackie Demetriou
The Bridge, Wetherby
Details from administration@bsava.com
DAY MEETING
Tuesday 2 September
Scared of orthopaedics? Building
your confidence and skills in
practice
Speaker: Peter Attenburrow
Oulton Hall, Leeds
Details from administration@bsava.com
DAY MEETING
Thursday 4 September
Good grief my patient is all fur and
teeth: handy tips on nursing small
exotic mammals
Speaker: Wendy Bament
Venue: TBC
Details from administration@bsava.com
DAY MEETING
NORTH WEST REGION
Wednesday 11 June
The acute abdomen
Speaker: John Williams
Holiday Inn, Haydock
Details from northwest.region@bsava.com
EVENING MEETING
SOUTHERN REGION
Tuesday 17 June
Recognition of the emergency
patient; including triage and
implementation of nursing plans
Speaker: Kath Howie
Old Basing Village Hall, Basingstoke
Details from southern.region@bsava.com
EVENING MEETING
EAST MIDLANDS REGION
Tuesday 17 June
The PUB Clinical Club: Collapse in
the dog: a night at the movies
Speaker: Mike Martin
The Royal Oak, Ockbrook
Details from eastmidlands.region@bsava.com
DAY MEETING
METROPOLITAN REGION
Wednesday 18 June
Skin and ear disease in dogs
and cats
Speakers: Ross Bond and Anke Hendricks
Holiday Inn, Elstree
Details from metropolitan.region@bsava.com
34-35 CPD Diary.indd 35 16/04/2014 16:00
Full your potential
BSAVA Dispensing
Course
Avoid dispensing disasters
Understand the legislation
Cope with the prescribing cascade
Dispose of medicine waste safely
Be aware of adverse reactions and be pharmacovigilant
Use antibiotics responsibly
Impress the Inspectors
For Veterinary Surgeons and Veterinary Nurses
Next event:
9 October 2014
Frimley Hall Lime, Camberley, Surrey
This course meets the RCVS Practice Standards Veterinary hospital pharmacy course requirements,
is AMTRA accredited and carries 41 AMTRA CPD points
From webinars at home and evening meetings in your region,
to postgraduate certicates in medicine, surgery, emergency care and
ophthalmology BSAVA CPD can offer you accessible education that
gives you new skills, and more condence. We are run by the profession
for the profession we understand your needs.
Visit us online at www.bsava.com/cpd to nd out more about courses
that will help you full your potential.
36 OBC.indd 1 16/04/2014 16:00