The materials include a social media toolkit and a board kit, both designed to encourage owner awareness and more frequent conversations on eye health.
There is also a new CPD module, focused on ophthalmology.
The company is running a webinar on 24th September which focuses on management of dry eye and corneal ulcers for brachycephalic dogs
Campaign materials & VPD module: https://www.tvm-uk.com/national-pet-eye-health-awareness-week
Webinar: https://thewebinarvet.com/webinars/take-a-closer-look-big-eyes-big-problems-ocular-issues-of-the-brachycephalic
The Clinical Abstracts provide an opportunity to present new research to the wider veterinary community at Congress and Expo 2025, taking place at Manchester Central on 20th - 22nd March 2025.
Abstracts can be on any veterinary subject, whether it’s the preliminary results of a new study, a discussion of a new technique or a description of an interesting case.
Each application should be based on high-quality clinical research undertaken in industry, practice or academia, and summarised in 250 words.
Applications are welcome from veterinary surgeons, nurses, practice managers and students, with applications from those working in general practice especially encouraged.
Researchers with research of direct relevance to veterinary practice may also submit an abstract for consideration.
Andy Green, Chair of BSAVA’s Congress Committee said: “This is a fantastic opportunity for veterinary professionals to showcase their research to the global veterinary community, and a chance for delegates to learn about the latest concepts and thinkings in veterinary medicine from their peers.”
Entries for the Clinical Abstracts will close on Monday 18th November.
https://www.bsavacongress.com/clinical-abstracts
The project was 'highly commended' at the RCVS Knowledge 2024 awards.
The CVS clinical improvement project found that a major barrier to conducting ultrasound scans was a lack of confidence - both in using equipment and interpreting images.
A recent Canadian industry study has also reviewed barriers, citing a lack of equipment, training and skills as root causes1.
The ultrasound project aimed to review practice equipment, improve clinician case identification, increase clinical skills and confidence, and recommend ultrasound in all appropriate cases.
The company put together resources for vets and nurses designed to help improve ultrasound scan rates, including clinical guidelines, webinars for how to approach cases, and machine guides.
CVS then held training sessions which for vets focussed on case identification and improving diagnostic skills, and for vet nurses looked at how to use ultrasound equipment and conduct scans.
An audit of each participating practices’ ultrasound scan rates was conducted at the start of the project. Results were then shared with each practice every month.
Twelve months after launch, data shows that the number of ultrasound scans has increased by 3,675.
Anecdotal evidence has also shown that colleague confidence and practice team culture has improved as a result of the project.
Dr Victoria Woods, Regional Clinical Lead at CVS responsible for the ultrasound clinical improvement project, said: “It’s fantastic to see the benefits increased ultrasonography is already bringing to our practices on this project – especially as a result of upskilling our nurses.
"I am certain that this will help contribute towards them providing some of the best clinical diagnosis and care in our profession.”
Following the success of the project in its first year, the project is now being developed to focus on echocardiograph and is being undertaken in 52 CVS primary care practices in year two.
Reference
The streams for veterinary nurses will include six lectures on topics ranging from neurology to dentistry, along with guest speaker Hannah Donovan from Donovan Veterinary Behaviour to discuss behaviour in practice.
There will also be a speaker from Davies’ charity of the year: Vetlife.
Davies' hospital director Ben Orton said: “This is a high-level CPD and networking event aimed at our colleagues in the veterinary industry with a raft of advice and insight from some of the leading specialists here at Davies.
“Some of the topics covered include internal medicine, with EBVS European specialist in small animal internal medicine Katherine Clarke giving her expert opinion on chronic enteropathies with a focus on antibiotic prescribing.
“Head of anaesthesia Frances Downing will focus on anaesthesia and feline cardiomyopathies while head of physiotherapy Diane Messum will discuss a holistic approach to the osteoarthritis patient, so there will be plenty of stimulating and challenging content.”
The day-long event begins at 8.30am with arrival drinks and pastries before the morning session, which runs from 9am to 1.20pm.'
After an hour’s break for lunch and networking, the afternoon session will run from 2.20pm to 5pm.
That will be followed by a complimentary hog roast.
www.vetspecialists.co.uk/davies-congress-2024
Charlotte will share practical advice on achieving successful transfusions, in particular looking at how to overcome the challenges in sourcing blood products, especially for feline patients.
The presentation will cover:
There'll be a live Q&A session with Charlotte at the end, when Horiba's experts will also be available to answer veterinary diagnostics-related questions.
https://horiba.link/canine-and-feline-blood-transfusions.
As part of the campaign, vet nurses are invited to share their top tips for maintaining a calm workplace for staff and patients at: https://www.nvsweb.co.uk/products/big-chill.
Veterinary professionals are being asked to share their top tips in two areas.
Firstly, how they prioritise self-care for themselves and teammates, and secondly, how they best deal with nervous, stressed or anxious patients.
All respondents will be entered into a prize draw for a VetYogi practice subscription.
Gemma Vardy, Senior Category Specialist at NVS Group, said: “Mental health and wellbeing have never been more important within the veterinary industry which is why our dedicated Big Chill campaign supports the wellbeing and mental health of veterinary professionals while also shining a light on animal calming products, such as our select healthcare calming chews, which help support calm and enhance patient experiences.”
https://www.nvsweb.co.uk/products/big-chill
As well as raising awareness of suicide and mental health, Maria Mylne, Mary Hall, Callum McRoberts and Kirsty's partner Chris Burn are raising money for two charities: Vetlife and The Canmore Trust.
The Canmore Trust was set up by the parents of another vet who took his own life, and works with individuals, communities, practices, workplaces, schools, colleges and universities that have been affected by suicide, as well as trying to prevent suicide.
The four vets will set off from Land’s End on September 23rd and will arrive in John O’Groats on October 18th.
On the way, they will be stopping off at Bristol, Harper Adams and Keele, Liverpool, University of Central Lancashire, Edinburgh and Glasgow vet schools to speak to students about suicide prevention.
Kirsty was a trusted and respected colleague and vet, and her death had a devastating impact on her partner and colleagues who are fundraising in her memory.
Maria said: “We want to share a message of hope that suicide is not inevitable, and just because somebody has experienced suicidal thoughts, does not mean they will feel this way forever.
"Together we can break the cycle of suicide and keep building suicide safer communities in practice.”
Chris said: “Kirsty was my rock. If you wanted something organised or something fixed, Kirsty was your woman.
"We don't want anybody else to go through the pain we have.
"We want everybody to know that no matter what your mind may tell you, the world is better with you here, in this world.”
www.justgiving.com/team/lejogawareness
https://www.facebook.com/profile.php?id=61559943272380
https://www.instagram.com/lejog_awareness2024
https://thecanmoretrust.co.uk
https://www.instagram.com/the_canmore_trust
lejogawareness@gmail.com
https://www.vetlife.org.uk
They include a webinar from In Communication, a company which specialises in veterinary client communications, which covers things like how to broach costs with clients, communicating treatment options succinctly and time-blind shared decision-making.
The Society has also published eight questions which the public may ask about the investigation, with model responses.
The resources also include a summary of the five concerns raised by the CMA, and advice about how to discuss them with practice staff.
Finally, you can download SPVS' presentation to the CMA which talks about the drivers for fee increases.
https://spvs.org.uk/cma-spvs-response
The toolkit also offers the opportunity for clinical supervisors to take part in bi-annual meetings led by BVNA, the first taking place in-person during BVNA Congress 2024.
Steph Worsley, BVNA Council Member and Clinical Coach Toolkit project lead, said: “BVNA is delighted to have led the work on this toolkit, which we feel is an important resource for any RVN or vet who is carrying out the clinical coach role for an SVN.
"This is a role which is pivotal to any student’s experience of training; responsible for developing the practical skills needed for SVNs to successfully enter the veterinary nursing profession, and requiring a range of coaching, mentoring and leadership skills – on top of continuing clinical support.
"We hope this toolkit helps to make the most of the working relationship between supervisor and student, whilst equipping individuals fulfilling this role with resources to manage the additional demands it can bring.”
https://bvna.org.uk/project/clinical-coach-network-toolkit
The awards are to recognise outstanding veterinary practices that have demonstrated exceptional performance and innovation in areas crucial to the future success of the profession.
There are three categories: Leadership and Management Skills, Team and Self-Development, and Veterinary Start-Ups.
The three category winners will each win day and evening tickets to SPVS Congress 2025 on Thursday 30th January for three team members, plus overnight accommodation at the Hilton Birmingham Metropole.
Shortlisted practices will each win a book of their choice.
The deadline for submissions is Friday 18th October 2024.
https://spvs.org.uk/business-excellence-awards/
The new formula also contains crataegus, L-carnitine and magnesium taurate, and is designed to be used alongside all heart medications.
Alongside the launch of the new product, Vita has also created an infographic highlighting the common signs of heart disease in dogs.
https://vitaanimalhealth.com/common-signs-of-heart-disease
https://vitaanimalhealth.com/product/omnicardio-plus
The course has been made available after its authors, Dr Katherine Wakelin and Sarah Corthorne from the University of Surrey, received a Mind Matters Grant to conduct research which found it improved the mental wellbeing of veterinary professionals.
Katherine and Sarah will also be hosting a webinar from 7pm – 8pm on Tuesday 3rd September to discuss the importance of self-compassion, provide an overview of their research, as well as information on the course itself.
Katherine said: “Our recent randomised control trial has shown the course to significantly improve resilience and self-compassion and reduce rumination and self-criticism amongst veterinarians.
"Therefore, Sarah and I are delighted to now be disseminating the CFT course freely to the veterinary profession, so that as many people as possible are able to benefit from the evidence-based resource.
“Even though our research was conducted on veterinary surgeons, we hope that the course will be useful to all those working in the veterinary team as the content can be applied in a number of contexts.
“Our webinar will explain more about our research, as well as some of the science behind the effectiveness of the course in a veterinary context.
"So, if you are interested in learning more about how CFT may be able to help you and your team, both in a personal and professional capacity, please do come along.”
In order to access the online compassion course, individuals are invited to complete a short questionnaire before and after watching one video (10-15 minutes long) each day for 14 days. The aim of the video intervention is to develop self-compassion skills and reduce self-criticism. This will also allow Katherine and Sarah to evaluate the ongoing impact that the videos are having on those working in the sector.
https://vetmindmatters.org/resources/free-online-compassion-course-for-veterinarian-mental-wellbeing/
The Big Pain Survey is designed to identifying opportunities to help veterinary professionals improve their patient pain management and take a zero tolerance approach to pain in their patients.
Last year's survey revealed that only 18% of veterinary professionals use pain scoring for chronic pain, 78% of practices don't offer pain clinics, only 23% of vets always prescribe analgesia for acute otitis externa, 70% of vets don't do epidural anaesthesia at their practice, and most veterinary professionals agreed that clients' understanding of pain is low.
The organisers say that last year's survey results also suggest that awareness around educational information such as the WSAVA pain management guidelines needs further promotion, particularly when it comes to the use of local anaesthesia.
For example, 39% of practices don’t use local anaesthesia during bitch spays.
Lack of experience was commonly cited as the reason that local anaesthetic was not used for a variety of procedures that would benefit from it, including dental extractions.
For those vets that do use local anaesthesia more regularly, many said they feel they still need further education about it.
Survey: https://forms.gle/ogQmQsCKupW83u7FA
The Nutraotic range includes ear wipes and an ear cleaner, both formulated to provide anti-fungal and anti-bacterial support while moisturising, soothing, and hydrating the skin.
The products are scented with fresh cucumber and melon.
Chris Jones, Managing Director of Nutravet, said: "Our goal at Nutravet has always been to develop the best veterinary strength, healthcare products to aid and support a pet's wellbeing.
"Ear health in dogs and cats is a common concern for many pet owners, and these products give practices high-strength solutions to offer their clients."
www.nutravet.com
Canine Arthritis Management says the service is designed to help address issues with the traditional veterinary care approach, such as short consult times, significant workplace pressure and lack of understanding of the caregiver.
The service offers expert consultations through which veterinary professionals and other caregivers can confer with a dedicated team of experts in canine arthritis for the latest insights and treatment strategies.
The telehealth service can also supplement the veterinary consultation, giving extra time to create personalised care plans for clients, tailored to their dog's specific needs.
Canine Arthritis Management says its care plans are designed with a holistic approach, considering not only the medical requirements of the dog but also its living environment and lifestyle.
Canine Arthritis Telehealth also offers ongoing support and educational resources.
Canine Arthritis Management Founder, Hannah Capon MRCVS said: “One of the biggest misunderstandings surrounding osteoarthritis is that it is simple to manage.
"It is not.
"The long term, waxing and waning nature of the disease, combined with the financial and physical commitments, leads to emotional exhaustion for the caregiver.
"Combining this with a lack of understanding of the disease, confusion regarding the myriad of ways to address it, and anxiety surrounding the future, caregivers of animals with chronic disease need more support, and that is exactly what this service offers.”
caninearthritisteleguidance.co.uk
Founded in 2005 by Jane Howorth MBE, the British Hen Welfare Trust rehomes commercial laying hens that would usually be sent to slaughter, typically at 18 months.
The charity has rehomed hens in schools, community areas, prisons and back gardens around the country, where they have plenty of life left both as egg layers and companions.
The millionth hen, named Henrietta by His Majesty, was rehomed at Highgrove Gardens in Gloucestershire, along with 30 others earlier this month.
Jane said: “We’re thrilled that one million hens have been adopted and extremely pleased that Henrietta and her 30 feathered friends are heading to Highgrove Gardens.
"Helping a lorry load of 4,000 was my original target and we’ve exceeded my expectations by some margin!
"To think that so many hens have had a happy retirement gives me a great deal of pleasure as I’m sure it has for all the kind-hearted British supporters who’ve taken these deserving little creatures into their homes and hearts.
"From the day I started this charity, it’s been a privilege to meet and work with people who want to help hens and to work alongside the egg industry to champion hen welfare and free range eggs.”
www.bhwt.org.uk/one-millionth-hen.
The farriery stream will run all day on Saturday 14 September, with content curated by Dr Simon Curtis who is internationally renowned in the hoof-care world for his remedial farriery textbooks and lectures.
Simon said: “Any historical, perceived divide between science of veterinary medicine and the craft of farriery is no longer in existence.
"The overlap is vast which means it is more essential than ever that vets, nurses and farriers understand each other’s roles in order to maximise their patient outcomes.”
“Farriery isn’t sexy, but it beats everything else for improving soundness.
"It is impossible to maintain or regain soundness without farriery being considered as an integral part of the process.
“The impact good farriery can have on a horse’s ability to tolerate conformational, work-related or other causes of lameness associated pathology is all too often overlooked by all parties, and this should no longer be the case.
"Vets and farriers must work as a team to avoid injury and facilitate recovery wherever possible.”
The sessions will cover things like the importance of trimming, the biomechanical effects of horseshoes, why heels collapse, chronic club foot, digital support and toe-trimming.
The farriery stream is part of 90+ hours of live and on-demand CPD on offer at Congress, with interactive discussions, debates and workshops, and an expanded stream for vet nurses.
https://www.bevacongress.org/programme
BEVA members prices for Congress for all three days are £699 for vets (with concessionary prices available for those in their first three years of graduation or earning less than £25,000), £273 for nurse members for all three days and £300 for farriers and other allied professionals for all three days or £110 for one day.
Practice passes are also available.
'Otitis Externa: Understanding Ear Disease’ will be presented by RCVS Recognised Specialist in Veterinary Dermatology, Former Member BVetMed CertSAD DVD PhD PgCAP FHEA MRCVS (pictured).
Virbac says the webinar will explain how Cortotic can help practices reduce antimicrobial use when treating otitis externa in dogs, whilst offering the same efficacy as a fixed-combination product.
https://bit.ly/CortoticWebinar
There are two main streams – veterinary and nursing – alongside which there will be a number of workshops on dentistry, ophthalmology, electrosurgery and wound management
Speakers will include: Alasdair Hotston Moore, Matthew Oxford, David Williams, Sarah Heath and Molly Varga.
New for this year, there will be a separate two-day SPVS Leadership & Management programme (at extra charge) and interactive mental health sessions run by Vets in Mind.
There will also be sessions run by SCAS/Our Special Friends on 'the bond-centred practice'.
There's a commercial exhibition, a happy hour on day one, a hot buffet lunch, and tea, coffee and biscuits throughout both days.
For overnight accommodation, the organisers have secured a preferential rate (£125) at the on-site hotel – the Courtyard by Marriott – that includes breakfast and parking.
To book, use this link: https://www.marriott.com/event-reservations/reservation-link.mi?id=1709042444468&key=GRP&app=resvlink. There are lots of other options nearby.
Book directly at https://form.jotform.com/240863511432349.
To be invoiced rather than pay now, apply INVOICEME at checkout.
www.vetcpdcongress.co.uk.
Bordetella bronchiseptica is a clinically significant pathogen for canine infectious respiratory disease (CIRD), otherwise known as kennel cough, with 78.7% of dogs with acute respiratory signs testing positive for the bacteria1.
In the same study, 45.6% of clinically healthy dogs also tested positive for Bordetella bronchiseptica, illustrating that clinically healthy dogs can carry respiratory pathogens and could act as sources of infection for susceptible dogs1.
Administered via subcutaneous injection, Canigen Bb is an inactivated subunit vaccine which offers vets a new option when intra-nasal vaccination with a live aerosolised vaccine is not possible or preferred, for example when the dog is in contact with known immunocompromised individuals.
Licensed for use in dogs from 6 weeks of age, Canigen Bb extends protection against Bordetella bronchiseptica in dogs vaccinated with Canigen KC in the last 12 months for a further year with a single dose.
Canigen Bb is presented as a ready-to-use formula in a 10ml multi-dose bottle and can be stored at room temperature (2°C - 25°C) for up to 4 weeks once broached.
It can be administered concurrently (at the same time but separate injections) with Canigen DHP, Canigen DHPPi, Canigen Pi & Canigen Lepto 4.
Andrew Connolly, Marketing Director at Virbac, said: ‘It is our hope that Canigen Bb will increase the overall uptake of Bordetella bronchiseptica vaccination to provide increased protection against this widely prevalent and clinically significant disease’.
The new clinic is led by Marie Kubiak, an RCVS Specialist and diplomate in Zoo and Wildlife Medicine and one of only a small number Specialists that are accredited for reptiles, birds, pet mammals, wildlife, zoo species, fish and invertebrates.
The open day offers a chance to see the new clinic, meet the team, find out how it can support your practice and discuss any challenging cases you have.
Light snacks and drinks will be provided.
RSVP: evolutionexoticsreferrals@gmail.com
https://evolutionexoticsreferrals.co.uk
Evolution Exotics Referrals, Tenbury Road, Cleobury Mortimer, South Shropshire, DY14 0AD
The first change has been made to paragraph 1.6 which now advises general practitioners to check whether the vet they are referring a case to is on the RCVS Specialist or Advanced Practitioner list, explaining the difference to the client and what sets them apart from other vets who might be prepared to accept a referral.
Also, practitioners who accept a referral should provide information to the referrer about the experience and status of those likely to be responsible for the case.
The guidance about conflicts of interest in paragraph 1.7 has also been amended such that referring surgeons should tell clients if they are referring their case to a practice owned by the same group.
There is new guidance about how vets and nurses talk about referral practitioners, with the new advice being to focus on accepted terms such as 'RCVS Specialist' and 'RCVS Advanced Practitioner', and avoid more general terms like 'referral surgeon' or 'consultant' to avoid confusion or implying that individuals hold more qualifications than they do.
Lastly, there is new guidance that vets may only use the name 'Specialist' in the name of their practice where there is genuine and meaningful involvement, and oversight, in case management by at least one RCVS specialist in all disciplines where any clinical services are offered under this business name.
https://www.rcvs.org.uk/setting-standards/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/referrals-and-second-opinions/
Rosemullion Veterinary Practice is a three-site small animal practice owned by CVS.
It has 100 members of staff and dispenses 3,584 medications in an average month.
According to an article in Companion Animal, medication errors account for 30% of all reported errors in veterinary practice1.
Errors can be prescribing errors - where the vet prescribes the incorrect medication or dosage, or dispensing errors where the incorrect medication, strength or volume is dispensed by the pharmacy team.
Some errors can ‘look or sound alike’ – where medications have similar names or packaging – making them easy to mix up.
Rosemullion conducted an initial clinical audit of entries on its VetSafe system between 1st March and 31st May 2023.
Analysis was conducted on the drugs involved, whether they were prescribing or dispensing errors or near misses, and looking for patterns of behaviour or the drugs involved.
During this time there were 29 (0.27%) near misses and 14 (0.13%) errors.
Prescribing near misses most often involved flea and worm products.
Here additional feedback from vets was that it was difficult to remember weight brackets for all products and when weight brackets were included in the drug description this made them easier to prescribe accurately.
As a consequence, the Rosemullion pharmacy team introduced the inclusion of weight brackets on all flea and worm products.
Dispensing errors and near misses were mostly related to ‘look or sound alike’, particularly in worming tablets, flea treatments and Rheumocam cat and dog.
To address this, the Rosemullion pharmacy team added extra labelling to dispensary draws and separated draws for flea and worm treatments into different weight brackets.
Rheumocam – with its similar packaging design and box sizes – was also split into separate cat and dog drawers, and drawers clearly labelled up with the version and volume to make dispensing clearer.
Feedback was also given to the drug manufacturer.
Rosemullion also held a CPD session to highlight the common errors that were occurring, to explain resulting process and systems improvements, and ask the team to take extra care with these dispensaries.
A new ‘handing out medication’ process was also created – involving checking the medication in the bag matched the on the screen notes, confirming it was for the correct animal and validating it was what the owner was expecting.
A subsequent audit was run from 1st October to 31st November 2023.
The results revealed there were no prescribing or dispensing errors (0%) and only 8 (0.13%) near misses during this time.
Alice Bell, Senior Vet and Quality Improvement Lead at Rosemullion Veterinary Practice, said: “We place patient safety at the forefront of all we do.
"We wanted to conduct this extensive audit to assess our prescribing and dispensing processes and systems.
“The methods we had in place made it easy to do the task correctly and the changes we have now put in place have made the process even safer for our clients.
"Our overall error and near miss is now at a really low number compared to our total number of medication dispenses.
“The teams have been very receptive to the improvements and the project has had a positive impact on various aspects of the practice, including on team wellbeing.”
Rosemullion Veterinary Practice’s initiative has recently been recognised with a RCVS Knowledge Highly Commended status at its 2024 awards.
Virbac highlights research which shows that 90% of all dogs over one year are affected by dental issues, including plaque, tartar, gingivitis and halitosis1, but small breed dogs are 5 times more likely to have dental issues than large breeds2.
The new formulation of Veterinary HPM Small & Toy range contains Ascophyllum Nodosum, which Virbac says has been scientifically proven activity on four aspects of oral and dental health: calculus index, volatile sulphur compound concentration, plaque index and gingival bleeding index3.
Virbac points to research which shows that after being absorbed in the small intestine and then secreted into the oral cavity via saliva, Ascophyllum Nodosum inhibits some pathways involved in plaque or calculus development4.
Nutrition-wise, Virbac says the new diet offers 33% less carbohydrate and 34% more protein, on average, compared to other brands sold in veterinary practices5.
90% of the protein included in the diets is also from animal protein.
The updated range also features 2 new kibble sizes (10.5mm & 7.5mm), for smaller mouths.
References
The guides have been developed for vet teams to share with their clients and work through together, so that both sides are on the same page about owner values, pet welfare and behaviour, and diagnosis and treatment options.
A member of the veterinary team and the client can then work together to make decisions and provide quality care.
One of the pet owners who helped develop the guides said: “I always get so worked up with vet consultations that I forget half of what they say, or feel like I didn’t tell them enough about my pet’s history.
"If the vet used these guides at my next consult, they would make me feel very at ease indeed!”
Pam Mosedale, Clinical Lead at RCVS Knowledge, said: “These guides offer a simple, actionable way to help deliver contextualised care in practice.
"To get started, run through the questions in the guide with a client, and see how this can help you devise a treatment plan with the information you’ve discovered.
"This helps you gain a fuller understanding of your patient’s care and wellbeing needs and your client’s circumstances and expectations.
"Ultimately, this will assist you in delivering quality care that aligns with the needs and expectations of your clients.”
There are three contextualised care discussion guides:
RCVS Knowledge is encouraging veterinary teams to adapt the guides to meet their individual needs.
https://rcvsknowledge.org/contextualisedcare
COMMENT
Anything which helps clear communication between the owner and vet is surely to be applauded, and if owners are prepared to spend the time completing the pre-consultation guide, it would surely leave less room for error.
However, arguably the greatest cause of friction between owners and vets is cost, and that is something only mentioned fleetingly, in the context of: 'Are there any other factors that may impact on the care of your pet? e.g planned holidays or financial concerns'.
Isn't it time to stop beating around the bush?
Isn't there an opportunity here for greater clarity over the level of spending a client is happy with?
Is there an acceptable form of words here to ascertain whether - regardless of whether they have financial concerns or not - the client is one of those who wants the cheapest solution to the problem, one for whom money is no object, or someone who sits somewhere in the middle?
Wouldn't that be more instructive than almost anything else?