Protexin Veterinary has launched Pro-Kolin Advanced, a new gastrointestinal support product for dogs and cats.

Protexin says Pro-Kolin Advanced contains beneficial micro-organisms, several prebiotic sources, an optimal level of a dual-source binding agent and soothing fibres to support gastrointestinal function. 

The company also says that in a study involving 148 dogs, Pro-Kolin Advanced significantly improved clinical outcome compared to a placebo¹.

Protexin Veterinary Director, James Kyffin, said: "Pro-Kolin Advanced represents an exciting development for Protexin Veterinary and fits in perfectly with our ethos to produce innovative, research-based products of the highest quality for pets.

"It is the first product of its kind to be supported by a randomised, controlled clinical trial that was undertaken in first opinion veterinary practices across the UK and Ireland.

"Not only are we pleased to be able to offer veterinary surgeons with an evidence-based option for the management of acute gastrointestinal disturbances, but also a very palatable formulation that was readily accepted by 92% of the dogs in the study." 

Pro-Kolin Advanced is available in 15ml, 30ml and 60ml syringes for dogs and 15ml syringes for cats. The flavourings used in the product contain no proteins or common allergens so Pro-Kolin Advanced can be used in animals with known hypersensitivities. 

Reference

1. Nixon S. (2018); in submission; data on file.

The Royal Veterinary College reports that one of its Internal Medicine Clinical Training Residents, Myles McKenna, has been involved in diagnosing the first case of leishmaniosis in the UK where it is believed the infection was spread from one dog to another.

Leishmaniosis is caused by the parasite Leishmania infantum, which is endemic in some areas of Europe, but not in the UK. The patient in this case had not travelled outside the UK.

In endemic areas, the infection is carried by female sand-flies and spread through sand-fly bites. Transmission has also been reported via dog bites from an infected dog and infected blood transfusions, although the RVC says these routes have not been reported in the UK before.

Dogs with Leishmaniosis display a range of signs that can take months to years to develop after initial infection. Typical signs include:

• Weight loss

• Lack of energy or enthusiasm 

• Increased thirst and increased urination 

• Changes to the skin (particularly around the eyes, ears and feet)

• Vomiting or diarrhoea 

• Lameness due to joint pain 

• Sudden nose bleeds 

• Soreness around the eyes 

Treatment is available for dogs with leishmaniosis, but infection is difficult to clear and long-term medication is therefore frequently needed. Leishmaniosis can be zoonotic - meaning it can be passed to people in rare situations.

Apparently there is another leishmaniosis case reported in the Veterinary Record this week, this time where the dog was suspected of contracting the disease via sand-flies unintentionally brought back in its owners' luggage following a trip to Spain.

Myles McKenna said: "It is important to take note of this first reported case of likely dog-to-dog transmission of Leishmania infantum in the UK. Historically we had considered this to be a condition affecting dogs with a travel history to areas where Leishmania infantum is endemic. Dog-to-dog transmission in non-endemic areas has previously been reported, for example in the USA, but this case serves as a reminder to UK veterinary surgeons that we must be vigilant for conditions such as Leishmania in non-travelled dogs and that alternative transmission mechanisms do exist."

Photo: Bone marrow cytology showing macrophages with numerous intracellular organisms consistent with Leishmania species amastigotes. Credit Charalampos Attipa

The RCVS Disciplinary Committee has postponed judgement on Hertfordshire-based veterinary surgeon Amir Kashiv, who was charged with the inadequate care of a dog, for a period of two years.

At the outset of the hearing, Mr Kashiv, from Vets & Pets, Broxbourne, denied all aspects of the charges against him. During the course of the inquiry, some heads of charge were not pursued and some he admitted, leaving the remaining heads of charge to be determined. 

The charges concerned the treatment of a Scottish Terrier, called Tanzy, whose owner, Mrs Greenhill, brought her in to see Mr Kashiv on 5 March 2015. Mrs Greenhill was concerned about blood in Tanzy’s urine and swellings in her mammary glands. After carrying out a cytopathology test, Mr Kashiv advised Mrs Greenhill that Tanzy would require surgery to remove the mammary glands. There were no further tests conducted, and no alternatives to surgery suggested.

On 13 March another veterinary surgeon at Vets & Pets therefore undertook a right-side mammary strip on Tanzy, discharging her the following day. On 17 March Mrs Greenhill brought Tanzy back in for a post-operative check and was seen by a locum veterinary surgeon, who found her to be in good condition.

On 20 March Mrs Greenhill then became concerned about Tanzy’s deteriorating condition and returned her to see Mr Kashiv. He admitted Tanzy for observation over the weekend but did not conduct any further tests at that stage, apart from radiography on 22 March. The hospitalisation records were of poor quality and substantially incomplete.

On 23 March Mr Kashiv then informed Mrs Greenhill that Tanzy could be discharged, although he recommended an MRI scan to assist in the diagnosis; this was declined on cost grounds. He did not however explain clearly to Mrs Greenhill that Tanzy’s prognosis was bleak, and did not give adequate home care instructions.

Tanzy continued to deteriorate, and on 24 March Mrs Greenhill took Tanzy to the RSPCA Harmsworth Hospital where a veterinary surgeon conducted tests which showed that Tanzy was in renal failure. The veterinary surgeon then called Mrs Greenhill and recommended that Tanzy was put to sleep, which was then performed in Mrs Greenhill’s presence.

The Committee found that Mr Kashiv had failed to conduct the necessary investigations when Tanzy was admitted from 20 to 23 March 2015, being satisfied that, by the time Tanzy had been hospitalised for a period of three days, it was mandatory for a blood test to have been performed, given her marked deterioration.

The Committee also found while Mr Kashiv did express his opinion that Tanzy’s prognosis was poor, he did not give the full explanation required in the circumstances of this case to enable Mrs Greenhill to understand fully the prognosis. The Committee also considered that Tanzy was not in a fit state to be discharged on 23 March 2015, and that he had failed to keep sufficiently clear and/or detailed and/or accurate records.

After full consideration, the Committee found that Mr Kashiv’s actions amounted to serious professional misconduct, and was satisfied that his actions fell far short of the conduct to be expected of a reasonably competent veterinary surgeon in respect of heads of charge 1, 2 and 3 but not 4.

Although it was concerned "about the culture of care in the practice, in particular not having in place proper protocols and procedures and without necessary support from properly trained staff", in deciding on appropriate sanction, the Committee was satisfied that there were "a number of serious misjudgements by Mr Kashiv in this case".

The Committee decided to postpone judgement for a period of two years, whilst recommending that Mr Kashiv agree to undertake a structured programme to benefit his clinical practice including a Personal Development Plan, mentoring, practice visits, additional CPD and regular reports to the Disciplinary Committee.

Non-compliance with these undertakings may result in the hearing being resumed at a date earlier than the two-year period.

Stuart Drummond, Chairing the Disciplinary Committee and speaking on its behalf, said: "The Committee considers that Mr Kashiv is a dedicated veterinary surgeon, as evidenced by the large number of testimonials, and that he provides a valuable service to the community, particularly with rescue animals.

"Nevertheless, the Committee considers that there were a number of fundamental failings in Mr Kashiv’s clinical competence which are required to be addressed during the period of postponement. For the reasons set out above the Committee considers that Mr Kashiv’s clinical practice will benefit from a structured programme over the period of postponement, whilst protecting the welfare of animals, maintaining public confidence in the profession and declaring and upholding proper standards of conduct."

For the full charges, findings and decisions, see: http://www.rcvs.org.uk/concerns/disciplinary-hearings/ 

Dunbartonshire-based Georgina Bretman has been struck off the Register of Veterinary Nurses by the RCVS VN Disciplinary Committee following her conviction in 2017 for causing unnecessary pain and suffering to an animal.

In August 2017, Georgina Bretman was found guilty of causing unnecessary pain and suffering to her two-year-old dog Florence by injecting the animal with insulin, causing the dog to suffer from hypoglycaemia, collapse, convulsions and seizures, for which it needed immediate veterinary treatment to avoid coma and death.

Following her conviction, Miss Bretman was sentenced to a Community Payback Order, with a requirement to carry out 140 hours of unpaid work. An order was also made to take Florence away from her and to ban her from owning a dog for two years. 

At the VN Disciplinary Committee hearing, Miss Bretman admitted the facts as contained within the charge against her and the Committee found the charge proved.

The Committee went on to consider whether the charge rendered Miss Bretman unfit to practise.

The Committee heard from Miss Bretman’s counsel, Mr O’Rourke QC who indicated that Miss Bretman accepted that her conviction rendered her unfit to practise as a Registered Veterinary Nurse. The Committee found Miss Bretman’s actions in deliberately administering a poisonous substance to  Florence thereby risking Florence’s death to be “very serious and deplorable conduct on the part of a veterinary nurse, a member of a profession specifically entrusted to look after and care for animals.” It also took into account the fact that Florence needed urgent veterinary treatment to avoid death and that Miss Bretman was in a position of trust over Florence as her owner.

Stuart Drummond, chairing the Committee and speaking on its behalf, said: "Miss Bretman’s conduct was also liable to have a seriously detrimental effect on the reputation of the profession and to undermine public confidence in the profession. The fact that she was a veterinary nurse was made clear at the trial and reported in the press. The Committee considered that members of the public would be rightly appalled that a Registered Veterinary Nurse had committed an offence of this kind.

The Committee was satisfied that this conduct fell far below the standard expected of a Registered Veterinary Nurse and that Miss Bretman’s conviction was of a nature and seriousness that rendered her unfit to practise."

The Committee then heard oral evidence from Miss Bretman in which she explained that she had always been passionate about working with animals and working in the veterinary profession and how she enjoyed her work as a veterinary nurse with a particular interest in hydrotherapy and rehabilitation.

She spoke about the devastating effect of the incident and the shame that was ‘brought down on her head’. She told the Committee that she had been suspended from her job and, since her conviction, had not worked as a veterinary nurse.

However, Miss Bretman said that, while she accepted and respected the verdict of the court, her stance remained that she had not done what was alleged and now hoped to rebuild her career as a veterinary nurse. She accepted that the offence of which she had been convicted was very serious, particularly for a veterinary nurse.

In considering Miss Bretman’s sanction the Committee took into account the aggravating and mitigating factors. Aggravating factors included the fact there was actual injury to an animal, that it was a pre-meditated and deliberate act against an animal for whom she was responsible, the fact that a medicinal product was misused, a lack of insight and a lack of remorse.

In mitigation the Committee took into account the fact she had no previous disciplinary history, had received positive references and testimonials and that, following the conviction, she demonstrated a willingness to be removed from the Register and to not work with animals to avoid causing embarrassment to the RCVS.

Stuart Drummond said: "The Committee was of the view that the nature and seriousness of Miss Bretman’s behaviour, which led to the conviction, was fundamentally incompatible with being registered as a veterinary nurse. The conduct represented a serious departure from professional standards; serious harm was deliberately caused to an animal; the continued denial of the offence demonstrated a complete lack of insight, especially in regard to the impact of her behaviour on public confidence and trust in the profession. In light of these conclusions, the Committee decided that the only appropriate and proportionate sanction was removal from the Register.

"In reaching this decision the Committee recognised the impact this was likely to have on Miss Bretman, which was unfortunate given her young age and her obvious passion for a career as a veterinary nurse. The Committee had considered with care all the positive statements made about her in the references and testimonials provided. However, the need to protect animal welfare, the reputation of the profession and thus the wider public interest, outweighed Miss Bretman’s interests and the Committee concluded that removal was the only appropriate and proportionate sanction. The Committee determined that it was important that a clear message be sent that this sort of behaviour is wholly inappropriate and not to be tolerated. It brought discredit upon Miss Bretman and discredit upon the profession". 

The Committee then directed the RCVS Registrar to remove Miss Bretman’s name from the Register. Miss Bretman has 28 days from being notified of the Committee’s decision to submit an appeal.

The Veterinary Medicines Directorate (VMD) has issued a statement following media reports and concerns raised on social media about serious adverse events given in dogs given a vaccine containing four strains of Leptospira bacteria:

"We would like to reassure vets, and through them dog owners, that we are constantly reviewing adverse event report data to ensure that the benefits of each UK licenced veterinary medicine product outweighs the risk posed by their potential side-effects.

There are a number of vaccines authorised in the UK containing either two (L2) or four (L4) strains of Leptospira. Based on the most recent periodic safety update report data received for each product, the incidence of adverse animal reactions for all L2 vaccine products combined is 0.015%; for L4 vaccine products this figure is 0.069%.

In other words, the VMD has received fewer than 2 adverse reactions for L2, and fewer than 7 for L4, for every 10,000 doses sold. This includes every suspected adverse event reported, even cases that were considered unclassifiable or were later found to be unrelated to the vaccine.

The overall incidence of suspected adverse reactions for both L2 and L4 vaccine products is therefore considered to be rare."

The British Veterinary Zoological Society (BVZS) has issued new guidelines for veterinary nurses working in the field of British native wildlife rescue and rehabilitation.

The guidelines are designed to support veterinary surgeons, veterinary nurses and wildlife rehabilitators, in order to promote and achieve the best possible care and welfare for indigenous British wild animals in accordance with UK law.

The Society says that guidelines are needed because:

• All veterinary surgeons in practice are at some point likely to be presented with injured or orphaned British wildlife.
• Full care to the point of successful release of suitable cases back to the wild requires good collaborative working relationships between veterinary professionals and wildlife rehabilitators.
• Wildlife casualties are covered by the Veterinary Surgeons Act and Veterinary Medicines Regulations. Therefore veterinary surgeons and nurses have legal as well as ethical responsibilities for the care of these animals.
• Wildlife carers and rehabilitators also have responsibilities, and may benefit from clarification of these at the interface between veterinary medicine and general animal care.
• Failure to fulfil these responsibilities may lead to action by the RCVS, as well as prosecution under the Animal Welfare Act, 2006 or other wildlife legislation.

Mark Stidworthy, BVZS President (pictured above right), said: "The rescue and rehabilitation of wildlife by veterinary surgeons and wildlife professionals is highly valued by the British public, making a positive contribution to local communities, the health and welfare of individual animals and to conservation. We hope these guidelines will inform best practice in this area and ensure its continued success."

Theresa Amory, Chair of the British Wildlife Rehabilitation Council (BWRC) said: "BWRC aims to support and promote the professional integrity of wildlife rehabilitators. While we recognise that meeting all of these guidelines may be difficult (particularly for smaller scale rehabilitators) we hope that they will enable rehabilitators to work alongside veterinary partners with increased awareness and confidence in their own working policies and procedures."

Michael Stanford, BVZS Senior Vice President, Veterinary Defence Society Claims Consultant said: "The BVZS Wildlife Guidelines should ensure all stakeholders involved with wildlife rehabilitation are acting in the best interests of animal welfare, with the added reassurance that they are acting in accordance with UK law."

Liz Mullineaux, veterinary surgeon and one of the authors of the guidelines said: "Working with British wildlife has always been challenging, for both vets and rehabilitators, in terms of what is ethical, legal and of an adequate clinical standard. These guidelines clarify many of those things, describing best practice and achievable standards for this area of work."

The guidelines can be downloaded from: http://www.bvzs.org/images/uploads/BVZS_Good_Practice_Guidelines_for_Wildlife_Centres_011016_.pdf 

CVS has announced the acquisition of its first two practices in The Netherlands. 

The company says it is a further step forward in its plans to expand into Europe and follows the launch of its online pharmacy business, Animed Direct, into France during 2016.  It adds that further acquisitions are expected in Europe during 2017, in addition to continued growth in the UK.

The two Dutch practices joining CVS are the Kliniek voor Gezelschaps Dieren, a three site small animal practice based in the central Netherlands, and a single site small animal practice, Dierenziekenhuis Drachten, based in the north of the country. Both practices cited the business support and staff development opportunities offered by CVS, combined with the clinical freedom and practice autonomy it allows, as the reasons for choosing to join the company.

Simon Innes, CEO at CVS, said: "We see many parallels between small animal practice in the Netherlands and the UK and have been talking to practices in the country about the benefits of joining us for some time. The level of interest has been encouraging and we are delighted to announce the acquisition of these two practices and welcome their teams to the CVS family.

"During 2017, we will continue to explore opportunities to extend our activities into Europe, particularly in the Netherlands and in Ireland."

Boehringer Ingelheim has re-launched its website www.metacam.co.uk with a redesign which aims to help cat and dog-owning clients identify and manage pain in their pets. 

Brand Manager Dr Amy Scott said: "Because pain is often very difficult for owners to spot, the website highlights some of the common signs that indicate their cat or dog is suffering.

"We have also included a range of additional measures that owners can take to improve the quality of life and maintain the joint health of their pet once Metacam has been prescribed. These include weight management, regular and gentle exercise and alternative therapies such as hydrotherapy or the use of joint supplements such as Seraquin."

The website highlights common painful conditions such as arthritis, as well as more acute scenarios such as post injury or surgery. It also describes the changes in behaviour owners should be aware of that could indicate their pet is in pain, for example reluctance to exercise, change in appetite, displays of aggression or depression.

Amy added: "The correct use of NSAIDs is also an important consideration for effective pain management. To help with this, the website contains a section on Metacam administration for owners, featuring a short video on accurate dosing and treatment."

The BSAVA has launched a series of client information sheets for drugs commonly used off-label.

The information sheets were the brainchild of Professor Ian Ramsey, Editor-in-Chief of the BSAVA Small Animal Formulary. He said: "As a referral vet I write a lot of letters to owners and vets that include instructions about the drugs that I am prescribing or dispensing for a patient. Often these drugs are unusual or cytotoxic, and are very commonly only authorized for human patients. As Editor of the Formulary I am acutely aware of the responsibility that I have for making sure owners understand what these drugs are for and what the side effects might be."

The BSAVA says it hopes the leaflets will overcome the challenge veterinary surgeons have in remembering all the drug information that needs to be related to clients, and the problem of clients forgetting what they have been told verbally by the clinician during a consultation.

In addition to a basic introduction to the Prescribing Cascade, each of the client leaflets provides the following information:

• What is the drug?
• Why has my pet been prescribed the drug?
• How should I store the drug?
• How do I give the drug to my pet?
• How long will my pet need to take the drug?
• What should I do if I run out of tablets?
• What should I do if I miss a dose?
• What should I do if my pet is accidentally given too many doses?
• Can my pet take this drug if I am already giving them other drugs?
• What are the possible side effects of the drug for my pet?
• What should I do if my pet is unwell while taking the drug?
• What should I do if a person accidentally takes this drug?
• Whom do I contact if I want to know more?

The first batch of client information leaflets, which relate to the following medications prescribed for dogs and cats, is now available for members to download from the BSAVA website (http://www.bsava.com/):

• Allopurinol
• Amitriptyline
• Amlodipine
• Aspirin
• Atenolol
• Colchicine
• Diazepam
• Digoxin
• Erythromycin
• Famotidine
• Fludrocortisone
• Gabapentin
• Ketoconazole
• Lactulose
• Levetiracetam
• Misoprostol
• Mitotane
• Omeprazole
• Pentoxifylline
• Phenoxybenzamine
• Piroxicam
• Pyridostigmine
• Ranitidine
• Sotalol
• Ursodeoxycholic acid
• Vitamin K1

Each of the leaflets has a space for veterinary practices to add their details before distributing them to their clients, and the BSAVA says more may be added during 2011.

A comprehensive review published open access online in the Veterinary Record today has concluded that there is insufficient evidence to support the use of homeopathy in food producing animals as a way to prevent or treat infectious diseases.

Homeopathy is widely used in livestock, especially to replace or reduce the use of antibiotics in the treatment of infectious diseases, although its use is often seen as controversial. For organic agriculture, homeopathy is even promoted.

In the review, Dr Caroline Doehring and Professor Albert Sundrum from the University of Kassel, Germany, assessed peer-reviewed studies on the efficacy of homeopathy in cattle, pigs and poultry published between 1981 and 2014.

They analysed a total of 52 clinical trials, 34 with cattle, 12 with pigs and six with poultry. They were published in 48 publications.

Of these, 28 concluded that the homeopathic remedy administered was effective, 22 showed no efficacy and 2 were inconclusive.

Only 10 trials provided information on cure rates for the treatments. These varied to a high degree, while the remedy used did not seem to make a big difference.

Trials on pigs were frequently efficacious, while studies with cattle or poultry had a similar distribution of efficacious and non-efficacious treatment.

Double-blind randomised controlled trials reported efficacy of the homeopathic treatment almost as often as they reported lack of it.

Meanwhile, single-blind and non-blind randomised controlled trials, and observational trials were more likely to present evidence of efficacy, suggesting that positive outcomes may be due to bias.

Other study limitations, such as potential conflict of interests, low sample size, risk for selective reporting and bias, were found in the majority of trials.

While some clinical trials showed effectiveness, the authors of the review question the reliability of the evidence, because all studies had a range of limitations. For example, all clinical trials were conducted under very specific conditions and none were repeated under comparable conditions.

Therefore, the authors say the findings cannot be be used to recommend homeopathy: "The current evidence of studies providing evidence in favour of homeopathy lacks reproducibility and therefore cannot claim to have sufficient prognostic validity."

"Due to a lack of prognostic validity, replacing or reducing antibiotics with homeopathy currently cannot be recommended unless evidence of efficacy is reproduced by RCTs and proven in various farm practice conditions."

MSD Animal Health has launched 'No Hiding', a campaign designed to educate pet owners about parasite control and add value to the consultation process by encouraging veterinary nurses and front-of-house staff to get more involved and share their expertise and experience.

MSD says the campaign will help veterinary nurses and front-of-house staff start the conversation about parasite control by asking clients about their pets' favourite hiding places, where parasites are often found. The supporting campaign tools and materials are designed to help practice staff then uncover pet owner needs to ensure they get the best recommendation.

Amanda Melvin, Marketing Manager at MSD Animal Health said: "Vet nurses and front-of-house staff are usually the first contact pet owners have with the practice. Yet the potential they have to add value to the whole consultation process is often underestimated.

"Our ‘No Hiding’ campaign has been designed to make use of this expertise by helping them find a way of sharing their knowledge. When it comes to pet owners this is usually best achieved by sharing those conversations about the unusual quirks and habits of their pets. That way they can uncover their hiding places and give them the best advice on parasite control."

The ‘No Hiding’ campaign offers a range of resources for practices including in-practice training, social media support, and interactive waiting room resources - demonstrating the practice’s expertise and allowing pet owners to share in the unique hiding habits of their pets. 

For further information, contact your MSD Animal Health account manager.

Wood Green, The Animals Charity and TotallyMoney.com have launched the Cost of Christmas Pets calculator to help prospective pet owners understand the total lifetime financial commitment involved with owning an animal.

According to the calculator, the most expensive animal is - by virtue of its longevity - the tortoise (£27,787 over 75 years), followed by a small dog (£19,224 over 15 years), a large dog (£17,234 over 11.5 years) and a medium-sized dog (£16,828 over 11.5 years). A cat comes in at £12,322 over 16 years. A chicken will set you back £4,701 (it's not clear whether they've offset the money you'll save in eggs). The cheapest is a fish, at £914.