VP JUNE 2011 - VetSurgeon.org

Transcription

VP JUNE 2011 - VetSurgeon.org
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38
VP JUNE 2011
REHABILITATION
both the level of the
water and the speed
of the treadmill can
be adapted to alter
the load on the legs
and the resistance to
moving in the water.
After injury and
when in pain,
patients often
develop abnormal
patterns of
movement; using the
under-water treadmill
Figure 5. Simple massage techniques can be taught to the can normalise the
owner.
gait, because the
resistance from the
water forces the dog
to use its leg
properly to maintain
balance. It is also a
very effective way of
improving muscle
mass and strength
(Figure 8).
Weight cuffs on
the lower extremities
are often used to
correct the gait and
to break abnormal
movement patterns
Figure 6. Stretching to relieve muscular contractures and
after injuries or with
facilitate recovery from muscle strain after training.
chronic joint
problems. Once
training also effectively improves the
introduced, patients often improve
physical condition of the patient and
their movement immediately. They are
dogs soon begin to enjoy the
also helpful during post-operative and
experience!
recovery periods as patients tend to
The under-water treadmill provides suffer less muscle wastage. It is also
an effective and controlled treatment;
very effective to use the weight cuffs
for the neurologic dysfunction patient
when trying to reduce instability in gait
walking. I tend to use The Kruuse
Rehab weight cuffs as they can be
loaded from just a few grams up to
140 grams (to suit even the largest
dog). These cuffs also come with a
detailed recommendation chart and
instruction manual (Figure 8).
Protectors are used to relieve pain
of the swollen joint or if the joint is
unstable. It is shown on the 4Leg
Check system that most patients
increase their weight-bearing when
using protectors. Protectors have been
used in humans for over 50 years and
even longer in horses with great
results. These results are repeated
when used for dogs!
Figure 7. Water training and (below)
Recovery is
the under-water treadmill.
greatly enhanced if
the protector is
introduced at the
first clinic visit. The
biggest difference is
that the CCL patient
can almost walk
normally before
surgery, which is a
great benefit for the
veterinarian but also
for the patient. The
protectors cannot, of
course, replace surgical procedures but
they are a natural complement for
offering each patient the best care.
I usually recommend the owners
put them on the dog for every walk
initially, gradually reducing use as the
patient begins to improve. Chronic
patients often have a much better
quality of life when they use the
protectors and display an increased
desire to run and play (Figure 9).
Conclusion
Most owners want to have the best
possible treatment for their animals,
but some may not be willing to
provide optimal rehabilitation for
economic or geographic reasons or
just because they are not committed to
achieve the best possible results.
I think that every effort should be
made to inform owners of the positive
effects of rehabilitation and the risk of
chronic problems if rehabilitation is
neglected.
Veterinary surgeons and
rehabilitation staff must work together
to achieve the goal of optimal
treatment. To avoid having to reinvent
the wheel for each patient, a basic plan
should be made for rehabilitation after
each specific type of injury or surgical
procedure; the plan must, however,
always be tailored and adapted to the
need of each individual patient.
Continuous follow-up of the
response and function is an important
part of rehabilitation; at each followup visit the patient must be
reassessed, the plan re-evaluated and
adapted if necessary.
The challenge for the rehab staff
is to decide whether any unexpected
event is a variation of the normal
response to the injury or
rehabilitation procedure or indicates a
complication that requires the animal
to be referred back to the
Figure 8. Rehab weight cuffs placed
on hind limbs.
orthopaedic surgeon. Close contact
between the rehab staff and the
veterinary surgeon is mandatory.
Bibliography
1. Millis, D. L., Levine, D. and Taylor, R. A.
(2004) Canine Rehabilitation & Physical Therapy,
Saunders Publishing.
2. Bockstahler, B., Millis, D. L. and Levine,
D. (2004) Essential Facts of Physiotherapy
in Dog and Cats, Rehabilitation and Pain
Management, BE VetVerlag.
3. Thool, L. (2005) Training physiology,
Forma Publishing Group AB.
4. Stefan Rosén, Anna Holmgren, Marie
Söderström-Lundberg, Fysträning för Hund
(Physiotraining for Dogs): Forma Publishing
Group AB.
5. Melzack, R., Wall, P. D. (Nov. 1965) Pain
mechanisms: a new theory. Science 150 (699):
ss. 971-979.
6. Melzack, R. and Katz, J. (2003) The Gate
Control Theory: Reaching for the Brain. in
Hadjistavropoulos, T., Craig, K. D. Pain:
Psychological Perspectives. New Jersey: Lawrence
Erlbaum Associates. ISBN 0-8058-4299-3.
Figure 9. Left – knee and hock
protectors; above and below: elbow
and carpus protectors.
www.metacam.co.uk
abcd
Metacam contains meloxicam. Prescription only medicine. Further information available from Boehringer Ingelheim Vetmedica,
Bracknell, Berkshire, RG12 8YS, UK. Tel: +44 (0)1344 746959. Email: vetmedica.uk@boehringer-ingelheim.com.
Date of preparation: Apr 2010. AHD 6304. Use Medicines Responsibly (www.noah.co.uk/responsible)
40
VP JUNE 2011
EDUCATION
What is the best way for us to learn?
much of what we now do and think is
CPD: should we be taught like
based.
children or learn like adults?
As such, obedience and
This is a question that has troubled
subservience were required of the
educationalists for many years and
student with the power/responsibility
which has major implications for our
resting with the teacher who decided
profession where the vast majority of
what was to be learnt, how, when and
CPD still focuses on decontextualised
content and is often poorly linked to its indeed whether it had been learnt.
Despite substantial social and
practical application in practice (Cave
informational changes in the last 50
and Dacre, 2008; Davis et al, 1999;
years, it remains the most dominant
Cantillon and Jones, 1999).
form of instruction within veterinary
In this article we will look at three
education and CPD.
approaches: pedagogy, andragogy and
n Andragogy. “Man leading”
heutagogy (Table 1) and their place
and implication in this rapidly changing otherwise known as the art and science
world within which we live. Do not be
of helping adults learn or learnerput off by their names: they are central centred learning. Andragogy was first
to what and how we learn every day in
mentioned in Germany in the 1830s
our practices.
and went on to
As
veterinary
CHRIS WHIPP
discusses three approaches to
professionals
learning and calls for the
in the 21st
adoption of adult learning
century we
principles within the veterinary
are told that
profession
we must be
“selfdirected,
critically reflective, life-long learners”;
develop mainly in Eastern Europe
to do so we need to develop skills and
initially, not gaining prominence in the
move along the learning continuum as
west in its present form until the 1960s
we develop as professionals.
through the work of Malcolm
Unfortunately, currently there are few
Knowles.
Knowles produced a set of
routes and little support to actually
assumptions (Table 1) about adult
help us to achieve this aim, and this is
education which rapidly gained
something that needs to change.
widespread credit and remained central
It’s all Greek to me!
to the adult education debate for some
All three names have Greek origins
40 years. Imbued with the American
which reflect their use and intent,
sense of independence, Knowles,
providing an indication of the
through andragogy, sought to shift
development we need to undertake.
much of the power and responsibility
n Pedagogy. “To lead a child” is
to the learner. Andragogy also respects
otherwise known as teaching,
experience (and error) as valuable
traditional, didactic or teacher-centred
learning opportunities and focuses on
learning. Its modern form developed
problems relevant to the individual.
n Heutagogy. “Self leading” – this
within the mediaeval church schools
and fitted well with the development of might be called the art and science of
Newtonian science upon which so
the self-determined learner. This
approach has only begun to develop
within the last 15 years partially
Chris Whipp, BVetMed, MSc(VetGP),
because of the growing appreciation of
MRCVS, graduated from the RVC in
the importance of context and
1979; after 20 years in practice
relationship in adult learning and
completed a one-year modular course
in clinical coaching, mentoring and
partially because of the particular
supervision at Guy’s hospital in
challenges of the early 21st century as
London. In 2001 he was invited to join
we face an information overload of
the first SPVS Masters set doing a
unprecedented proportions.
masters degree researching learning
Heutagogy suggests that only the
styles and the development of clinical
learner can define what, when and how
expertise whilst contributing to the
a person needs to learn in our
initial groundworks for new RCVS
increasingly complex world.
modular certificate. In 2004 he
Furthermore, to just learn is no longer
completed a postgraduate course in
enough, there is an increasing need to
professional and executive coaching.
develop learning capabilities, to learn
He currently splits his time between
first opinion clinical practice, providing
how to learn faster and more
work-based learning programmes
effectively.
through Middlesex University,
With heutagogy, the power and
professional coaching and the “BEVME
responsibility lies entirely with the
– A Dialogue” initiative. He is a
learner which is consistent with our
founder member of VIEW.
previously stated professional
Table 1.
requirement to become a selfdirected,
critically reflective, life-long learner.
Whilst the above three approaches
have been individually described, they
are really overlapping areas on a
continuum which we each need to
work with/towards as appropriate.
Practical implications
Learning to learn is a key capability and
one that we have never been taught.
When there were no computers and
limited books, then tacit learning and
trial and error were probably OK (ish)
but the world has changed.
In 2006, the total digital content
available was estimated to be equivalent
to three million times the content of all
books ever written (May, 2010). It was
estimated that this had risen to 9.5
million times by 2009 (Wikipaedia,
2011). The challenge of life-long
learning takes on new meaning in this
environment.
When we graduate, we go from a
very largely dependent teacher-centred
to a very largely self-directed learning
environment with little or no support
to help with developing our learning
and self-management skills. Enhancing
inpractice support and the PDP could
really make a huge difference.
Similarly, the university course is
very fact heavy and
this is not the ideal
environment to
develop the critical
and reflective skills
that are required.
The greater pace
and complexity of
veterinary practice
Table 2.
means that even
very experienced veterinary surgeons
need to further develop their existing
expertise in this area.
Good news
In the last five years a very small
number of CPD providers have been
using adult learning principles to
develop capabilities and independence
(Table 2) with the veterinary
profession with good results.
Also, for those interested in
developing their own knowledge of the
issues involved, the “Best Evidence
Veterinary Medical Education
(BEVME) – A Dialogue” is a two-year
UK practitioner-led trans-disciplinary
initiative to bring together stakeholders
from all aspects and stages in
veterinary education to encourage and
foster “best evidence” practice and
provide constructive solutions to
existing challenges. You can join the
group online at
www.surveymonkey.com/s/BEVME.
Lastly, the RCVS has recently
introduced the concept of Clinical
Coaching within the vet nursing
training; if this could be extended to
EMS students and PDP it could offer
very significant opportunities to
coachees, practice coaches and
practices themselves.
n References available from author.
VP JUNE 2011
PRACTICE
41
Watch out – you may be trying
to read your client’s mind!
WHEN clients walk through the
door, we make assumptions based
on how they look, how they speak
and how they behave. That is
perfectly normal and most of the
time the assumptions are correct
and based on concrete evidence.
Sometimes, however, we put more
into their words than what is
actually there – we mind-read.
Backing off from
recommendations
shared some of the options with you
because he assumed that you probably:
1. Wouldn’t want to spend the money.
2. Couldn’t understand and do what he
would ask you for anyway.
3. Didn’t care whether you lived a good
quality life or not.
How much respect would you think
that the specialist had for you? And
how would that make you feel, how
would it look to you and what would
that make you say to yourself ?
One of the
ANNE-MARIE
on-going
SVENDSEN-AYLOTT
challenges of
discusses the dangers of trying to
working with
second-guess what clients want
clients is to be
and the need to treat them with
steadfast and
respect
consistent in
the
recommendations we give. Most of us
Why do we make decisions for
can remember a time where we cringed clients?
at having to tell the client how much a
Because we are in a complex
procedure, some medication or a bag
profession that is a mixture of caring
of food cost – because we were
and science, it is a very tempting step
assuming that the client probably
to start to make decisions for the pet
couldn’t afford it.
owners. There is a variety of reasons
We might even have been thinking,
for this:
n We don’t want to worry the owner.
“If I was her and had her life I would
n We want the owner to think highly
never spend my money on that” – and
of us.
surprisingly often, we will have been
n The owner is having difficulties
wrong. Consequences: a practice that
understanding what we are saying to
makes less money, a pet that may get
him or her and we genuinely don’t
less than the ideal treatment or care
think he or she will be capable of
and an owner who had his or her
understanding anything more complex,
choice taken away from them.
like multiple options.
Whoa there! You might be
n The owner has just said something
thinking: what does she mean by “an
owner who had his or her choice taken we have heard a thousand times before
that most times means that he or she
away from them”? Well, think about it
won’t go for the procedure.
for a moment. If you go to a specialist
n We don’t have enough time to
for a diagnosis or a procedure, how
explain all the options.
would you feel if you found out after
the fact that the specialist just hadn’t
behind it all.
Communicating in a way the client will
understand is about using the SAME
vocabulary (see the articles in
Veterinary Practice in the first four
months of this year for more
information about this), utilising
appropriate visual aids/flow
charts/diagrams or similar to get the
point across and having the time to
make sure that the client has truly
understood what you say.
Providing the full range of options is
simple – what are they, explained
clearly, and should always be followed
by your clear recommendation for what
you think will be the best option. That
Pets mean different things to
is what people come to a veterinary
different people – and only the
practice for.
owners know how important they
They are looking for a
are to them.
recommendation. They are looking
tell you how they are getting on. That
for you – veterinarian, nurse,
gives you the opportunity to help them
receptionist, student – to share their
revisit their choice. And if they are still
expert opinion with them. This is not
happy with it – well, it is their life and
a sales pitch. It is a simple
their pet, so their choice.
recommendation for what you think
will be the best option for
Benefits to the
the pet – not for the
Treating clients
client’s wallet.
bottom line
with utmost
Treating clients with
The last part is key:
respect and
utmost respect and
stepping back and allowing
avoiding that
avoiding that lethal
the client to choose. This is
what differentiates the
lethal mind-read mind-read helps to
build truly strong
above from a sales
helps to build
client loyalty. Client
pitch. The genuine
truly strong client loyalty means that you
respect and
loyalty.
have happy, satisfied
understanding that the
customers who speak
owner must have to do
highly of you everywhere, actively
what is best for them – seen from
drive new clients to your practice –
their point of view. And that they are
and who regularly follow your
the only ones who have the ability to
recommendations.
do so.
Everyone enjoys being treated
If you disagree strongly with the
with respect. And when you enjoy a
choice, make a suggestion that they
place, you keep coming back for more.
come back in a week or a month and
Treat them with respect
Anne-Marie Svendsen Aylott trained
as a veterinarian and ran her own
veterinary practice in Copenhagen,
Denmark, for seven years. She then
spent nine years with Hill’s Pet
Nutrition working with sales, brand
marketing, professional relations and
training. She has trained in both
personal performance coaching and
corporate and executive coaching in
addition to being a certified NLP
Master Practitioner, and works as a
business performance coach with a
range of companies from small sole
traders to global corporations. She
runs Purple Cat Performance Coaching
and can be contacted at
annemarie@purplecatcoaching.com
(website
www.purplecatcoaching.com).
The challenge is, however, that in
order to build true client loyalty and a
strong, cohesive identity as a practice,
you have to treat your clients with
utmost respect at all times.
Respect includes the following:
(a) listening with true attention;
(b) communicating in a way that the
client will understand;
(c) providing the full range of options;
(d) giving a clear recommendation for
what you think will be the best option;
(e) stepping back and allowing the
client to choose.
It goes wrong when any one of the
above is missed out!
Listening with true attention is about
listening for the words used, the way
the client talks and the real concerns
Good communication is about how much the other person understands.
42
VP JUNE 2011
WELFARE
Depression: what can be done?
THERE are some people who are
simply a joy to have around. Often it
is their sociability and sense of
humour that make them popular.
But it is their kindness, generosity,
intelligence and common decency
that keeps them close to the heart of
any group which they choose to
join.
They are people like Mark
Robinson, a vet in large animal practice
in Oswestry. Mark had a loving wife,
two delightful daughters and a
flourishing career which earned him the
goodwill and respect of friends,
colleagues and clients alike.
So why did he decide to walk into
the woods near his home on
Thursday 15th October, 2009 and
end his own life?
The simple answer is that Mark
was suffering from severe
depression. Although this is a
common and debilitating condition,
it is one that receives a
disproportionately small amount of
attention from the medical profession,
clinical researchers, health service
managers and the media. So no one
really knows why depression occurs or
how best it should be treated.
And it is a particular mystery why
this condition has such peculiarly lethal
effects on members of the veterinary
profession. Many factors have been
suggested why this group has such an
unusually high suicide rate. Perhaps the
most convincing explanation stems
from the observation that vets are
unique in viewing euthanasia as a
practical and acceptable solution to
many of the problems encountered in
their routine work.
Few among Mark’s many friends
would have been aware of the turmoil
he experienced in his last seven weeks.
Only his immediate family and the
NHS staff who tried to help him were
witness to the vortex of despair that
drew him away. But while they were
powerless to save him, his family and
Ann Owen.
friends hope to ensure that something
positive will grow to partially fill the
gaping hole that he left behind.
Led by Ann Owen, a practitioner in
Colwyn Bay and a close friend from the
Liverpool veterinary school class of ’81,
they have launched an initiative to raise
funds to carry out the research needed
to help understand and treat
depression.
They hope to mobilise the
compassion and financial resources of
the veterinary profession in support of
a cause which should be very close to
its heart. Their goal is a straightforward
one – to persuade 1,000 practices or
individuals to set up a £10 monthly
JOHN BONNER
reports on an initiative to raise
funds for research into mental
health issues – and the tragic
reason for it
standing order for the charity Mental
Health Research UK, which would
establish up to three Mark Robinson
PhD bursaries.
MHR UK was established in 2007
by Clair Chilvers, who previously
chaired the Nottinghamshire Healthcare
NHS Trust, and two barristers with an
interest in mental health issues, John
Grace and Laura Davidson.
Professor Chilvers had been a
cancer epidemiologist at the University
of Nottingham before being recruited
by the Department of Health in 1999
to take responsibility for all mental
health research carried out nationally
within the NHS.
Little interest
In that role she quickly realised how
little interest was shown in mental
health issues by the charitable sector
compared with the area in which she
was working previously. That remains
so more than a decade later – for every
£1,000 of charitable funds spent on
cancer research, just £26 is spent on
mental illness in all its many forms.
So Professor Chilvers decided that
when she retired from the Civil Service
she would put her energies into setting
up a charity to help support research
into all forms of mental illness, not
only depression but also stress,
obsessive compulsive disorders,
anorexia, bipolar disorder,
schizophrenia, etc.
Together, these conditions impose
an enormous burden not only on the
individuals affected and their immediate
families but also on the wider society
and the national economy. Figures
collated by MHR UK show that one in
four people suffer mental illness at
some time in their lives, and 30% of
visits to GPs relate to mental health
issues.
Furthermore,
every year three
out of 10 people
take time off work
because of mental
health problems,
adding up to 90
million lost days
Mark, with wife Louise and daughters Emma and Alice, on a
per annum. The
skiing holiday at Isola. Below: Mark in New Zealand where
overall cost to the
he went on a Winston Churchill Memorial Trust travel
UK economy is
fellowship a few months before he died.
estimated at more
than £100 billion a year.
Mark’s wife Louise heard about the
work of the fledgling charity when she
and Ann were planning an event to
commemorate his life and decided that
it would be a fitting recipient for any
money raised. They organised a
fundraising walk of about 10 miles over
Long Mynd, a heathland plateau and
area of outstanding natural beauty near
Church Stretton near the Robinson
family home.
This took place over a weekend in
June 2010 during which 140 members
of Mark’s extended family, his friends,
colleagues and clients got together, with
some having travelled considerable
distances to be there.
That weekend raised more than
£16,000 for the charity but it also
generated a feeling among the
participants that it should be more than
a one-off event.
“There was a great atmosphere on
techniques like cognitive behavioural
the walk, it was a lovely sunny day and
therapy in order to improve their
everyone was in great spirits. Nobody
effectiveness in helping patients with
could forget why we were there – we
this particular illness. So there are no
had come to remember Mark but there
fixed ideas about which particular
was a feeling that we should try to do
scientific disciplines the charity will be
something constructive in response to
recruiting its PhD students from, the
what had happened,” Ann explains.
only criterion will be how good they
“There was a suggestion that we
should make it an annual event but after are, she says.
One of the biggest hurdles to be
talking it over we felt that nothing is
overcome in providing better care for
quite so good the second time around.
people with depression is to eliminate
Instead we decided to try and make it
the stigma that prevents people from
the springboard for something bigger.
admitting that they need help, Prof.
“We wanted to get the whole of
Chilvers explains.
profession on board to help carry out
“When I began doing oncology
the scientific research that would find
research in the 70s there was a similar
out why Mark came to feel that way
and to try to stop it happening again to stigma about cancer. That changed
when people were given hope through
somebody else.”
the research that was producing new
treatments and giving people a longer
Capacity building
life and better quality life.
The first stage in that process is
“If we can make the same effort in
capacity building – equipping young
research on severe mental illnesses, that
scientists with the knowledge and skills
will also give hope and that will have a
needed to tackle the challenges that
hugely beneficial effect on the people
clinical depression presents.
with those conditions. They will feel
Prof. Chilvers says the charity’s
trustees, which now include Ann Owen, more able to talk about their condition,
if they no longer fear that they are
have no preconceptions about the sort
going to lose their job or they won’t be
of research it will carry out. For
able to get one in the first place.”
example, this could be looking at the
neurochemistry of depression or
n Ann Owen can be contacted at
alternatively it could seek to refine
annievet@btinternet.com.
Clearing the way to a
flea-free environment.
Only Stronghold treats fleas
and eggs on the pet and existing eggs and
larvae in the environment.
For further information please contact Pfizer Animal Health, Walton Oaks, Tadworth,
Surrey KT20 7NS POM-V Pfizer Animal Health, 9 Riverwalk, National Digital Park,
Citywest Business Campus, Dublin 24 POM Stronghold contains selamectin.
Use medicines responsibly www.noah.co.uk/responsible
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44
VP JUNE 2011
TECHNOLOGY
RVC student’s
website aims
to help
graduates find
their first jobs
maintain and improve it.
He got the idea for the website
during his final year rotations in
January when he began to worry about
securing his first job.
He explains: “I noted that the vast
majority of jobs advertised in
veterinary publications were for vets
with experience. I realised that
WILL Woodley, a final-year student at
securing a first position was going to
the RVC, has created a website,
involve sending out CVs and cover
www.TheVetbook.com (The Vetbook)
letters to a large number of practices,
to help veterinary
along with all the year’s
graduates to get their
other graduates, all this for
first jobs.
jobs where, in all
It is designed for
probability, the practices
final-year students and
weren’t even looking for a
new graduates to create
new graduate.
a profile and up-load a
“I’d heard stories of
mini CV and photo.
2010 graduates who were
Employers are then able
still looking for work and
to go on the website,
with Nottingham
filter candidates
University about to release
depending on what part Will Woodley.
its first vet graduates, the
of the country and what
problem could only get
type of practice they’re looking for,
worse.
and get in touch.
“At the same time, I was developing
More than 100 students from the
an interest in website design and the
RVC are on the site and it is now open potential opportunities that it provided.
to other vet schools and employers.
I therefore set about teaching myself
Mr Woodley says it’s free, quick
the basics of html code and other
and easy for students and vets to sign
languages of the internet and then
up and create a profile/advertise
began designing The Vetbook.
themselves and for practices to post
“It will save practices money on
jobs and look through candidates.
advertising as well as time: no more
“For a few pounds practices can
waiting for CVs to be sent in, read
get in touch with a particular vet they
through, rejected, accepted and a
like the look of, or get access to all the shortlist made.
contact details for a week,” he says.
“Now all they have to do is go
He is currently looking for
online, filter to find the right
sponsors of the website to help
candidates, purchase their contact
details and get in
touch to arrange
an interview.”
Mr Woodley
hopes to open the
site to vet nurses
and locums too,
but, he adds,
“obviously my
personal priority is
graduating in July
and securing the
A portion of a student’s page in Vetbook.
right first job”.
Web 2.0 social
media and the
NOVICE
summer school
AN EU project is being undertaken by
educators from veterinary schools in
Utrecht, Hannover, London (the
RVC), Budapest and Bucharest which
aims to develop an online professional
network to link vets and students
across Europe and beyond, write Sarah
Baillie and Tierney Kinnison of the RVC.
The project is called NOVICE
(the Network of Veterinary ICT in
Education) and focuses on ICT
(information and communication
technology) in veterinary education
and lifelong learning.
Network members are using Web
2.0 social media tools such as
discussion boards, blogs and wikis to
share information and discuss topical
issues. There is a range of special
interest groups and resident bloggers
including experts in the fields of ICT
and veterinary education, as well as
students discussing their training at
university.
Within six months of the
network’s launch it already has a
growing membership – over 700
people have signed up from more
than 30 countries. And best of all, it’s
free to join!
Web 2.0 and social media play an
increasingly prevalent and important
role in veterinary professionals’ lives,
activities and work.
The NOVICE project aims to
enhance members’ Web 2.0 skills,
encourage collaboration and facilitate
informal lifelong learning. Support is
available via a “helpdesk” forum,
frequently asked questions (FAQs),
virtual classrooms and a network of
ICT experts from the five founding
veterinary schools.
As part of the registration process,
new members have to be
authenticated and the site is restricted
to veterinarians, veterinary students
and veterinary and ICT
educationalists, which helps to
alleviate many of the typical
confidentiality concerns of social
media.
As well as building an online
community, NOVICE is holding a
summer school on 25th and 26th
August 2011 at Hungary’s Faculty of
Veterinary Science, Szent István
University in Budapest, to promote
the use of Web 2.0 and ICT in a
veterinary context.
The programme will include
plenary presentations, blended with
more interactive workshops and
demonstrations. The workshop topics
are intended to suit a variety of
participants, whatever their Web 2.0 or
veterinary background – practitioners,
students and educationalists.
Examples include “Mobile devices
in veterinary practice”, “Social media
in veterinary practice: cheap marketing
or expensive waste of time?”, “Casebased learning/virtual patients”, and
“WikiVet”, and an e-learning circus
will allow delegates to have hands-on
experience with all the tools.
Participants will also take part in a
blogging rally through Budapest,
following veterinary-related clues and
tasks, with a prize for the best team.
If you want to know more about
the NOVICE summer school, visit the
website at
www.novicesummerschool.hu. To
learn more about using Web 2.0 and
to join the network, visit
www.noviceproject.eu.
The NOVICE project is funded by
the EU’s Lifelong Learning
Programme.
Veterinary Practice online
ALL issues of Veterinary Practice since March 2008 can be read online on
www.vetsurgeon.org. If you are not already registered on this website, isn’t it
about time you joined the profession’s busiest website with nearly 7,000 users.
VP JUNE 2011
INTERVIEW
45
Tackling issues from lemurs to battery hens
THE entrepreneur and shameless
self-publicist Sir Richard Branson is
used to getting his own way. But
unlike his aircraft, there is no
guarantee that his latest scheme will
get off the ground.
This involves transplanting lemurs
from their native Madagascar to establish
a colony on his private island in the
Caribbean. Conservationists have
warned of the dangers of introducing
new diseases from the Old World to the
New and are lobbying the British Virgin
Islands government to reject the plan.
And if all the critics are as wellinformed, energetic and determined
as Victoria Roberts, there is every
chance that they will succeed.
Victoria is current president of the
British Veterinary Zoological
Society, an organisation whose
membership is acutely aware of the
health and welfare problems that could
result from this ill-advised venture.
“We don’t know what diseases these
lemurs may carry that can affect the local
wildlife or vice versa, nor is it clear what
would happen if they escape to
neighbouring islands. It is a very different
matter if they are in a zoo or a closed
compound, these will be free-ranging.”
Responding to the warnings of
organisations like BVZS, Sir Richard
appears to be reconsidering whether the
lemurs will be allowed to roam freely on
the island. But his critics are unlikely to
be satisfied until he reveals evidence that
he understands the potential risks and
has plans in place to deal with them.
Victoria could offer some pretty
good advice on these matters, having
spent much of the past decade clearing
up the problems caused by wellintentioned but inadequately researched
efforts to provide animals with a better
future.
These are among some of the
estimated 250,000 former battery hens
that have been re-homed, mostly
through the efforts of a small charity
formed in 2005, the British (formerly
Battery) Hen Welfare Trust. Usually
those chickens were handed over to
people who had no previous experience
of keeping poultry. So unless they were
prepared to do their homework or learn
quickly “on the job”, there was a high
risk that their new charges would only
enjoy a brief period of freedom in their
suburban garden home.
Yet those owners who do learn to
look after their hens soon appreciate the
benefits of small-scale poultry-keeping.
It provides the owner with birds that
help keep control of weeds and insect
pests, are entertaining and educational
pets for the children, and are a source of
wholesome protein in the eggs that they
continue to lay long after their retirement
from commercial production.
Indeed, many tyro poultry keepers
become so engaged with their hobby that
they move on to keep hens of the more
robust hybrid varieties or the purebred
strains, with their varied plumage and
equally colourful eggs.
The world of fancy poultry is where
Victoria came from before being
accepted onto the veterinary course at
Liverpool, where she graduated in 2000,
aged 48. She began keeping poultry as a
child in Suffolk and had spent 15 of her
early adult years running the Domestic
Fowl Trust, a rare breed collection in
Honeybourne, Worcestershire.
JOHN BONNER
talks to Victoria Roberts about her
role with the BVZS and her keen
interest in back-yard poultry
“Although as a child I had wanted to
be a vet, I was persuaded out of it. Later,
when I decided that was what I really
wanted to do, it was because I was
frequently being asked to help people to
look after their poultry and I realised that
I could do far more as a vet than as an
ordinary member of the public.”
So when she isn’t helping to run the
BVZS, editing its in-house publications
or earning a living as a locum small
animal clinician, Victoria spends much of
her remaining time writing on poultry
health and welfare for a variety of
audiences – veterinary colleagues, vet
students, poultry breeders and keepers.
Training pet shop staff
In recent months she has also started
getting requests to help train staff at the
pet shops that are becoming increasingly
involved in the supply of birds, feed and
equipment.
At this year’s BSAVA congress there
was the first dedicated CPD stream on
the veterinary care of backyard poultry, a
recognition of the increasing importance
of this sector for companion animal
practitioners. She is also speaking at an
increasing number of veterinary
meetings, has published a book on
poultry health and welfare (Diseases of free
range poultry, Whittet Books: ISBN-10
1873580673) and has written a leaflet to
be published shortly on the BVA website
summarising the main issues for those
considering keeping chickens.
As those attending the BSAVA
sessions will testify, Victoria explains how
poultry medicine is an interesting – but
certainly not an intimidating – challenge
for practitioners who may have only had
a couple of lectures on chickens during
their undergraduate course. Even that
limited amount of training is likely to
have provided an introduction to the
problems of looking after commercial
herds.
The most serious health issues that
practitioners will have to
have potential implications
deal with stem from the
for human health.”In
new owner’s inexperience.
flocks of chickens that are
“Apart from the
fed kitchen scraps, the
increasing numbers of
incidence of salmonella is
birds that are being kept
37% and in an industrial
these days, one other
flock it is only 0.05% – so
thing that has changed
that is an horrendous
over recent years is the
amount of disease.”
introduction of a duty of
The owners would be
care under the Animal
dismayed to find that their
Welfare Act in 2007. If
actions may contribute to
someone gets these birds Victoria Roberts.
animal or human health
without doing their research, they really problems as they will usually have come
are asking for trouble.”
to regard their chickens just like any
“Ex-bats” often arrive with existing other family pet – except that they also
health problems and having been worked produce eggs. But as far as the regulatory
very hard during their 72-week career as authorities are concerned, chickens are
a commercial producer, so they are farm animals and a backyard flock is in
vulnerable to any new disease that comes most respects treated no differently from
along. They can have little tolerance of a commercial unit.
extremes in the weather and an immune
So those veterinary surgeons
system with no experience in coping with helping to care for hobby poultry must
parasites, compared with birds raised for remember their wider professional
a free-ranging existence.
responsibilities. “One thing I
“One of my biggest problems is in emphasise to practitioners is the
rescuing those flocks whose owners have importance of keeping good records
insisted on using herbal wormers. I have on their use of medicines in these
to explain to them that these products birds: that will earn them plenty of
just don’t work,” Victoria points out.
Brownie points in the event of any
Poor husbandry is not just a cause of outbreak of serious infectious
health problems in poultry, it can also disease,” she says.
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46
VP JUNE 2011
MICROCHIPPING
Reunification: much more than just a microchip
Over the last five years, electronic
IT is always warming when we hear
from overjoyed pet owners who have microchip registration has become more
been successfully reunited with their widely adopted by practices. With more
pets thanks to microchips, but do you organisations having high-speed internet
know what goes into this service and access, practices are able to instantly
how has it improved since initial register microchips at the click of a
button.
introduction?
Integral post code software and a
Identification
microchips
and
reunification databases are available printable receipt for the pet owner makes
worldwide and have long been recognised registration faster and simpler than filling
as the primary means to identifying and out paper forms, and with the guarantee
reuniting a lost pet with its owner. Since that forms won’t be lost in the post.
In addition, veterinary software
the introduction of this technology over
25 years ago, what makes the reunification suppliers have enabled direct microchip
system so good and how has it registration through their practice
progressed?
SIMON CLARK
In the UK there are currently
of Avid plc, looks at the value of
four
national
microchip
microchips and developments in
reunification databases: PETtrac,
databases and keeping up to date
which is managed by Avid,
AniBase, PetLog and Pet Protect.
While all four database providers are management software. This takes the pet
separate, reciprocal telephone links are and client information straight from your
provided to the other database systems PMS and registers it directly into the
reunification database using the VetXML
for the purpose of reunification.
schema and transmitted via the Vet Envoy
service.
Use of new technology
The UK PETtrac database was the
New technology made available to
microchip suppliers and reunification first microchip database to begin
databases in the last 10 years has been a accepting instant microchip registrations
key factor in revolutionising customer via VetXML in 2010.
support and enhancing the services that
Reunification
are provided to its customers.
In 2003, SMS reunification through Continued development and use of new
mobile phones was introduced by Avid. technology not only helps the vet practice,
The service know as “TEXTtrac” is an but also has another useful side effect:
SMS-based reunification service which whenever a pet is registered, a certificate is
was primarily aimed at dog wardens and issued to the keeper which confirms the
animal rescue organisations where it was reunification information that is held for
not convenient to make a phone call, reuniting them with their pet. Pet owners
perhaps because of limited network signal are encouraged to check this information
to ensure that there are no mistakes.
or struggling with a dog on a lead.
By
registering
microchips
TEXTtrac enables authorised users to
simply send a text message to a dedicated electronically (via the website or a PMS)
mobile number and in under 20 seconds the owners receive their certificate much
the keeper’s details for the microchip are faster than if the paper forms were
relayed back via SMS. If the pet’s completed – this way it is still fresh in their
microchip is not registered with the mind to check the details and update any
PETtrac database, the automated system inaccuracies.
At the heart of every reunification
provides contact details for the database
in the UK where it should normally be system, speed is a very important factor,
whether it be registering, retrieving or
registered.
updating information.
Nowadays, the process of implanting
a pet microchip becomes less about the
microchip itself and more about the
service provided by the database.
Microchip databases operate 24/7
and require funding to offer a high level of
service. Registration is included in the cost
of the microchip; however, there is a
charge applied to register changes to the
address or owner information. It is
important that, as a practice, you are
aware that charges exist to amend the
owners’ information and that pet owners
are also made aware of these charges.
Competition within the marketplace
for microchip databases has helped to
drive the development of enhanced
services and keep the database charges
low.
It is important that you are aware
which database provider your microchip
supplier uses and what services it provides
to you and your client. Avid provides
freephone numbers for reunification and
database amendment calls so that there is
no financial burden for pet owners or
practices to reunite microchipped pets.
If the call relates to a microchip not
held on the PETtrac database, then it can
be redirected to the appropriate database,
to help the caller more quickly than
redialling.
One problem that has emerged over
the years is how to know which database
to contact regarding a particular
microchip. Whilst most, if not all,
reunification databases offer a reciprocal
phone transfer service to the other UK
databases, a new website, www.check-achip.co.uk, was launched in January this
year to help with this problem.
Simply enter the microchip number
and the website will tell you whether it is
registered with the PETtrac database and
if it is not an Avid microchip, it will try
and direct you to the appropriate
database.
Keeping details accurate
One of the biggest problems faced by all
reunification databases is ensuring that
the contact details for pet owners are kept
up to date.
In 2009 the PETtrac database
launched the Pet Chip Update Campaign,
with a dedicated website, www.
petchipupdate.com, to help pet owners
update their details and give valuable
information to vets and rescue
organisations to aid them with the
campaign.
The website provides web-links,
banners and downloadable resources
which can be used to inform pet owners
about updating their pets’ microchip
details. It also features a “chip checker”
which will help pet owners determine
which database they are registered with.
Free updates
As a direct response to a plea from dog
wardens and rescue centres during
National Microchipping Month (June
2010), the PETtrac database offered free
updates for any pet owner registered with
it. This was a big step and saw an excellent
response from pet owners who had seen
posters and leaflets and wanted to take
advantage of the update amnesty.
The Pet Chip Update campaign was
so successful that this is running again in
2011, so please contact PETtrac if you
would like promotional materials to help
make your clients aware: together we can
get the message across.
Where next?
The 24/7 PETtrac database continually
strives to develop better services and
explore new ideas to facilitate faster
reunification of a found pet. PETtrac
pays particular attention to feedback and
ideas provided by the people who matter
– the veterinary practices, rescue centres
and dog wardens – as these are the
foundation of the reunification system. A
simple and efficient reunification system
is the key to getting a loved pet back
safely.
There will always be updates and
developments to the reunification system
and the key is that you are kept up to date.
To stay up to date with the latest news and
developments,
visit
www.
avidplc.com/update.
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Comfortis tablets contain 270 mg, 425 mg, 665 mg, 1040 mg or 1620 mg of active ingredient Spinosad. Contraindications: Do not use in dogs under 14 weeks of age. Do not use in case of known hypersensitivity to the active
substance or to any of the excipients. Advice on correct administration: Administer with food or immediately after feeding. The duration of efficacy may be reduced if the dose is administered on an empty stomach. Special precautions for use in animals: Use with caution in dogs with pre-existing epilepsy. Use of the product in dogs weighing less than 3.9 kg is not recommended. The recommended dosage regimen should be followed. Special precautions
to be taken by the person administering the product: Accidental ingestion may cause adverse reactions. In case of accidental ingestion, seek medical advice immediately and show the package leaflet or the label to the physician.
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after dosing. Other uncommon or rare adverse reactions included lethargy, anorexia, diarrhoea, ataxia and seizures. Use during pregnancy, lactation or lay: As the safety of spinosad has not been established In pregnant dogs, the
product should only be used according to the benefit/risk assessment by the responsible veterinarian. The safety of the product in male dogs used for breeding has not been determined. Interaction with other medicinal products:
Spinosad has been shown to be a substrate for P-glycoprotein (PgP). Spinosad could therefore interact with other PgP-substrates and possibly enhance adverse reactions from such molecules or compromise efficacy. Dogs receiving Comfortis with ‘off label’ high dose ivermectin have experienced trembling/twitching, salivation/drooling, seizures, ataxia, mydriasis, blindness and disorientation. Overdose: The incidence of emesis has been observed to increase as a function of dose. Mild elevations of ALT (Alanine Amino Transferase) occurred in all dogs treated with Comfortis as well as phospholipidosis; although this was not related to clinical signs in dogs treated up to 6 months.
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VP JUNE 2011
ORTHOPAEDICS
49
‘Super comfortable’
ward opened at
referral practice
FITZPATRICK Referrals of
Eashing in Surrey recently opened a
new ward, which the practice claims
is unlike any other kennel facility in
the UK.
The ward has bacteria-resistant
wipe-down wall coverings and floor
surfaces with underground heating, and
air conditioning optimised for high
efficiency particulate air to minimise the
possibility of infection.
The reinforced glass doors, rather
than gates or bars, permit a wide field of
view for the animals. Each kennel has a
space for medication and notes, and a
“quick reference” daily guide is written
on the glass door each morning; there is
also a radio in each and several are
equipped with televisions to provide
auditory and visual stimulation.
Numerous windows and night-time
dimmers provide a diurnal rhythm to
help comfort anxious animals and help
those with separation anxiety to settle.
Webcams can be connected easily for
remote viewing, and each patient is
checked hourly by the team of ward
assistants, veterinary nurses, surgical
interns, residents and senior clinicians.
The practice owner, Noel
Fitzpatrick, said that owners wanted to
know their pets were receiving roundthe-clock care in the best facility
imaginable.
‘No bars’ policy
“This, in my head, does not involve
bars, so I have a ‘no bars’ policy. I want
the patient to be
super-comfortable
and not to feel
threatened or ‘in
prison’, especially
when some of them
will have severe
physical disability.”
The new ward
was officially opened
last month by the
entertainer Michael
Ball, whose own dog
recently became the
eighth to have a new
The new ward where the kennels all have reinforced glass
kind of hip
doors.
replacement put in
‘Missing dog campaign’
to find pets needing
treatment
for osteoarthritis
FEWER than 25% of dogs with osteoarthritis receive treatment with
NSAIDs, says Merial, which has launched a “missing dog campaign” aimed at
increasing awareness of OA. As part of this the company is helping to run
OA Days in practices to encourage dog owners to visit their practice to
discuss OA.
The product manager for Previcox, Claire Edmunds, says that an OA Day
can be held at any veterinary surgery and is designed to help make clients
more aware of OA and seek advice, as well as raising awareness in the
community.
Heene Road Vets in Worthing has run one such day with help from Merial
and is planning more. The event was publicised with postcards sent out to
clients, waiting room posters and an advert placed in a local newspaper.
Fifteen dogs attended the event, with 11 of those diagnosed as suffering from
OA and requiring treatment.
“Most of those that required treatment were at fairly late stages of
development of the condition and would have benefited from earlier
treatment,” says Jeremy French, the practice director. “The clients were all
happy with the OA Day and on return visits many expressed surprise at how
much more their dogs could do. We are looking to run another similar event
soon and hope for equally good results.”
For details of running OA Days, contact Merial on 0870 6000 123.
by Mr Fitzpatrick and his team after a
traffic accident.
Fitzpatrick Referrals was first
opened in 2008 to create a centre of
expertise in small-animal neuroorthopaedics.
As part of its 92 staff, the practice
now has four hydrotherapists, three
chartered physiotherapists and a wardphysio nurse providing round the clock
physiotherapy to help patients recover
more quickly. The practice also has a
Michael Ball (left) with Noel
Fitzpatrick as the ribbon is cut to
open the new ward.
certified veterinary acupuncturist.
The practice claims to be the only one
in the world to offer certain types of
limb prostheses for cancer, severe
trauma, growth deformities and joint
replacement. Noel Fitzpatrick is the first
vet to successfully apply a prosthetic
limb to a dog where both bone and skin
can grow onto metal.
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50
VP JUNE 2011
ORTHOPAEDICS
Effect of OA reduced
by modest weight
loss
“THE effect of weight loss on lameness
in obese dogs with osteoarthritis” was
the title of a paper published in
Veterinary Research Communications [34 (3)]
last year. Written by W. G. Marshall, H.
A. W. Hazewinkel, D. Mullen, G. De
Meyer, K. Baert, and S. Carmichael, it
described the effect of weight loss on
lameness in obese dogs with
osteoarthritis.
Fourteen obese dogs with clinical
and radiographic signs of OA
participated in an open prospective
clinical trial.
After a screening visit and a visit for
collection of baseline data, the dogs
were fed a restricted-calorie diet over a
study period of 16 weeks that
incorporated six follow-up visits.
At each visit, body weight and pelvic
circumference were measured and
severity of lameness was assessed using
a numeric rating scale (NRS), a visual
analogue scale (VAS) and kinetic gait
analysis.
This was the first study to assess
both subjectively and objectively the
effect of weight loss alone on lameness
in obese dogs with OA.
The results indicate that body
weight reduction causes a significant
decrease in lameness from a weight loss
of 6.10% onwards. Kinetic gait analysis
supported the results from a body
weight reduction of 8.85% onwards.
The results confirmed that weight
loss should be presented as an
important treatment modality to owners
of obese dogs with OA and that
noticeable improvement may be seen
after modest weight loss in the region of
6.10-8.85% body weight.
Animals, or OFA model, and Penn Vet’s
PennHIP model – were applied to a
sample of 439 dogs older than two
years.
The four most common breeds
included in the study were German
shepherds, Labrador retrievers, golden
retrievers and Rottweilers, all breeds
commonly susceptible to hip dysplasia.
According to the Penn researchers,
even if breeders were to selectively
breed only those dogs having OFArated “excellent” hips, between 52% and
100% of the progeny, depending on
breed, would be susceptible to hip
dysplasia based on the Penn Vet scoring
method.
Deficiency of view
“We believe the lower rates of hip laxity
detection using the OFA methods are
not the fault of the expert radiologist
reading the radiograph but rather a
deficiency of the radiographic view,”
says Gail Smith, professor of
orthopaedic surgery, director of the
PennHIP Program.
“We believe many veterinarians are
not using the best test to control a
disease. In many ways this is an animalwelfare issue.”
The findings point to a weakness in
current breeding practices, she says. If
breeders continue to select breeding
candidates based upon traditional
scores, then, according to the Penn
study, they will continue to pair
susceptible dogs and fail to improve hip
quality in future generations.
Supportt for even the
Suppor
hardest
har
dest working joints
OA susceptibility
may be
under-estimated
A study comparing a University of
Pennsylvania method for evaluating a
dog’s susceptibility to hip dysplasia to
the traditional American method has
shown that 80% of dogs judged to be
normal by the traditional method are
actually at risk for developing
osteoarthritis and hip dysplasia,
according to the Penn method.
The results, published in the Journal
of the American Veterinary Medical
Association [Evaluation of the
relationship between Orthopedic
Foundation for Animals’ hip joint scores
and PennHIP distraction index values in
dogs, 237 (5): 537-554] indicate that
traditional scoring of radiographs that
certify dogs for breeding underestimate
their osteoarthritis susceptibility.
The two hip screening methods –
the standard Orthopedic Foundation for
Help sustain dogs’ hard-working joints with a
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51
VP JUNE 2011
Despite well intentioned hipscreening programmes to reduce the
frequency of the disease, canine hip
dysplasia continues to have a high
prevalence worldwide with no studies
showing a significant reduction in
disease frequency using mass selection.
The traditional OFA screening
method relies heavily on conventional
hip-extended radiographs which, the
study contends, do not provide critical
information needed to accurately assess
passive hip joint laxity and therefore
osteoarthritis susceptibility.
“We suspect that all hip-screening
systems worldwide based on the HE
radiograph have similar diagnostic
deficiencies,” Prof. Smith said.
“Hopefully, our results will motivate
veterinarians and breeders to consider
this newer approach.”
The PennHIP method quantifies hip
laxity using the distraction index, or DI,
metric which ranges from a low of .08
to greater than 1.5. Smaller numbers
mean better hips.
The PennHIP DI has been shown
in several studies at multiple institutions
to be closely associated with the risk of
osteoarthritis and canine hip dysplasia.
It can be measured as early as 16 weeks
of age without harm to the puppy.
Specifically, the PennHIP method
considers a DI of less than .3 to be the
threshold below which there is a near
zero risk to develop hip osteoarthritis
later in life.
In contrast, dogs having hip laxity
with DI higher than .3 show increasing
risk to develop hip osteoarthritis, earlier
and more severely, as the DI increases.
Key feature of the PennHIP
radiographic method is its ability to
determine which dogs may be
susceptible to osteoarthritis later in life.
Knowing a dog’s risk for osteoarthritis
early would allow veterinarians to
prescribe proven preventive strategies,
like weight loss, to lower the risk of this
genetic disorder.
Also, dog breeders now have a more
informative measure to determine
breeding quality to lower the risk of hip
osteoarthritis in future generations of
dogs.
Investigating
biomarkers for early
OA diagnosis
MEC1118/NOV10/RFA
ACCORDING to a report in
ScienceDaily, researchers at the
University of Missouri are
investigating potential biomarkers in
dogs for early diagnosis of
osteoarthritis, which could help
identify patients at increased risk of
developing OA.
“By developing methods for
earlier diagnosis of osteoarthritis,
prevention or even curative treatment
strategies to manage the disease
become more realistic,” said James
Cook, professor of veterinary
medicine and surgery and the William
& Kathryn Allen Distinguished
Professor in Orthopaedic Surgery.
“Biomarkers could detect the
disease before pain and swelling
occurs, and owners could take
preventative measures, such as
modifying activities or diet, helping
their pets lose weight and strengthen
their joints, to reduce the likelihood
of their dogs developing
osteoarthritis.”
In the study, the researchers
examined potential biomarkers in
synovial fluid, which is known to have
sensitive and rapid responses to joint
injury.
Taking samples from dogs, they
found that synovial fluid quantity and
quality were altered in injured stifle
joints.
“At the MU Comparative
Orthopaedic Laboratory, we are
particularly interested in identification
and validation of biomarkers that can
detect early stages of osteoarthritis to
provide accurate diagnostic and
prognostic information prior to the
onset of clinical disease for people
and for pets,” said Prof. Cook.
“Our team is making tremendous
progress in developing simple tests on
blood, urine and synovial fluid that
show great promise for helping us
diagnose impending osteoarthritis
before it is too late to help the patient
in the most effective manner.”
52
LIVESTOCK
VP JUNE 2011
A clinician’s dilemma...
YOU are presented with a ram lamb temperature. However, if both become
with general malaise and low grade
blocked, the lamb will quickly become
abdominal pain not painful enough
clinically ill, anorexic, have a hunched
to be termed colic. It has a surgical
gait and painful kidneys. This condition
condition of its urinary tract.
is more common in ewe lambs but a
Diagnosis is fairly straight forward
blocked urethra is more common in
from the history and the clinical signs.
males.
The male urinary tract in sheep is
Urethral obstruction in male lambs
not kind to the surgeon. The urethra is
has the signs described above. These
long and narrow, with a sigmoid flexure will quickly turn to bladder or urethral
and a small urethral appendage.
rupture, renal failure and death. Every
Castrated males appear to be more
effort must be made to prevent the
susceptible to obstruction than entire
formation of calculi. One of the main
males.
problems is the excretion of
Obstruction is virtually unheard of
phosphorus in the urine.
when the animals are at grass but it is
Naturally there are differences
really quite common in animals fed
between individuals but there are also
dried food. The animals will be seen to
differences
strain. The
GRAHAM DUNCANSON
urethra can be
reports on difficulties faced with
felt pulsating
urethral obstruction in sheep, its
just below the
prevention and treatment – but
anus. No
believes he has found the
urine will be
answer...
passed and
the hair near
the tip of the prepuce will be dry.
between breeds and these have been
The classes of sheep most at risk
studied in Holland. Most at risk are
include early born, indoor-reared lambs, Texels followed by Blackface, East
artificially reared lambs, ram lambs bred Friesland, Finnish landrace and lastly
for showing or use in their first year and Suffolks. Texels excrete four times more
store lambs on a finishing ration.
phosphorus in their urine compared to
Urethral obstruction may occur in
Suffolks.
up to 10% of affected male sheep
Dietary considerations
whether castrated or entire. Surgical
treatments have a poor success rate and Clinicians should concentrate on the
diet. Obviously the mineral content of
have welfare implications and so
preventive measures are very important. the diet is important. Cereal diets are
high in phosphorus and low in calcium.
They should be based on reducing
Additional phosphorus must not be fed.
calculus formation.
Lambs which are gaining 200g a day
The most common types of
should not receive more than 0.6% of
calculus seen in animals on a cerealphosphorus in their diet in their early
based ration are phosphates, usually
life; this should be reduced to 0.4% in
calcium or magnesium salts. They form
their later life.
in the kidney medulla and are often
Normally, in ruminant diets a good
found at slaughter or post mortem as
regular supply of magnesium is very
incidental findings.
As soon as they start to obstruct the important; in this instance, however, the
diet should not contain more than 0.2%
flow of urine, however, they start the
of magnesium. Magnesium is absorbed
development of clinical signs. If they
more than twice as efficiently from a
block a single ureter this will cause
concentrate diet when compared to a
nephrosis, which will remain subclinical
roughage diet.
as the second kidney will compensate.
Calcium has a direct link with
There is a danger of pyelonephritis
phosphorus so extra calcium needs to
in this diseased kidney. The lamb will
be fed to make sure the
then become ill with a raised rectal
calcium:phosphorus ratio is greater than
2:1. This will lower phosphorus
Graham Duncanson, BVSc,
excretion in the urine.
MSc(VetGP), DProf, FRCVS, qualified
Another part of the problem is the
at Bristol in 1966. He spent eight years
nature of the diet. High roughage diets
as a Government veterinary officer in
require chewing, which stimulates saliva
Kenya where he was primarily
engaged in disease control. He
flow. Phosphorus is excreted in the
returned to Norfolk in 1975 to work as
saliva, which then is swallowed, allowing
a general practitioner in a mediumphosphorus to be lost in the faeces
sized practice and has been there ever
rather than excreted by the kidney and
since as a large animal/equine
hence to the urine.
practitioner.
If roughage is fed ad lib the amount
of phosphorus in the urine is halved.
Key factors to prevent urolithiasis
Even feeding pellets rather than a coarse are:
mix of concentrates has an adverse
n Ensure an ad lib supply of fresh clean
effect as loose concentrates increase
water from accessible drinkers.
saliva and hence increase faecal loss of
n Make sure that artificially-reared lambs
phosphorus. Apart from the effect on
are used to the supply of fresh water so
phosphorus excretion, a high
that they can be weaned gradually;
concentrate/low roughage diet has an
making older lambs drink milk from a
effect on the excretion of urinary
container rather than sucking allows a
mucoproteins. These act as a nidus for
better transition.
phosphorus calculi formation in the
n Wean lambs which are suckling from
kidney medulla.
ewes when they are still on grass or
Urinary volume has a direct effect
outside on roots, etc., rather than
on calculi formation. The higher the
straight onto a cereal diet.
flow of urine the better. Urinary volume n Leave lambs entire if possible as
is obviously linked directly to water
obstructive urolithiasis will occur in
intake. Lambs must have a constant
rams but it is much rarer.
supply of clean water. This may well be
n Select a suitable breed to fatten on a
compromised in sub-zero temperatures. cereal diet.
The moisture content of the food
n Do not supply free access to minerals
has an effect. What is more important,
containing phosphorus to lambs except
however, is the frequency of feeding.
at grass.
Intermittent feeding triggers a renal
n Add calcium carbonate, calcium
response, so that urine
chloride or calcium
Abrupt weaning, sulphate to the cereal
production is decreased
and hence urine
diet to maintain a
which is to be
concentration is
calcium:phosphorus
encouraged to
increased. Ad lib feeding
that is greater than
lessen the danger ratio
of roughage stimulates
2:1.
of ewe mastitis,
n Feed palatable forage
urine production which
will reduce both ad lib.
in turn stimulates thirst.
n Do not feed pellets.
Abrupt weaning,
fluid intake and
n Feed cabbages, etc. –
which is to be
urine excretion.
these are particularly
encouraged to lessen the
useful for ram lambs
danger of ewe mastitis,
being got ready for sale.
will reduce both fluid intake and urine
n Acidify the urine by adding
excretion.
ammonium chloride to the feed at the
Studies in artificially-reared lambs
rate of 1g per head.
have shown that both are halved at
n Add salt to the diet at the rate of 2g
weaning. Urinary concentrations have
per head to encourage water uptake.
been shown in ewe reared lambs to be
n Give access to urea blocks to
up to three times their strength in the
encourage water uptake provided they
first month after weaning. Ewes with
do not contain phosphorus or high
twins and triplets may not have
sufficient milk and so fluid intake will be magnesium.
reduced in these lambs even though
n If there has been a problem of water
they are suckling their mothers.
supply, do not handle lambs or move
High water intake and hence high
them violently as this may make a
urine output has a high heritability. It is
formed calculus move into an
linked to the potassium composition of
obstructive position.
the red blood cells. So certain
individuals will have a higher urine
Treatment of obstructive
output and therefore be less at risk.
urolithiasis
Certain breeds, e.g. blackface. have been The welfare of the lamb must be at the
found to have a higher urine output.
forefront of the clinician’s mind. Lambs
A normal ruminant urine from
should not be put through painful
animals fed on an ad lib roughage diet is surgical procedures just for monetary
alkaline. On the other hand, a high
gain.
cereal diet lowers the pH, making the
Equally, very careful consideration
urine acid. This effect is beneficial to the must be given before undertaking
lamb as an acid diet lessens the
surgery which may cause painful urine
formation of calculi.
scalding and the risk of fly strike.
The farmer, therefore, has a
Sadly, the use of muscle relaxants is
balancing act to perform as high cereal
very rarely successful. Also,
diets are not necessarily going to have
catheterisation without severe damage
an adverse effect, i.e. they will cause the
to the urethra is impossible. Retrograde
flushing, therefore, is also impossible.
urine to be acid but will increase the
Obstruction can occur at three
level of phosphate in the urine.
VP JUNE 2011
points, which influence the surgical
procedure. This must be performed as
soon as possible on welfare grounds.
Bladder rupture will occur within 48
hours. Urethral rupture with urine
escaping into the tissues may occur
sooner than that.
permitted to sell any part of the
carcase. If the animal has received
medicines or the flesh smells of urine,
the whole carcase should be sent for
incineration.
(b) Marsupialisation
In theory, this surgery could be
performed under sedation and local
Two options
anaesthesia. In reality, however, this
1. If the obstruction occurs at the
would be very difficult and both welfare
sigmoid flexure there are two options
and sterility would be compromised and
for surgery: urethrostomy or
therefore a GA must be advised. The
marsupialisation.
lamb is placed in dorsal recumbency. A
(a) Urethrostomy
linear incision is made through the skin
This can be performed under a GA or
and abdominal muscles just anterior to
sedation and local anaesthesia. The
the preputial orifice towards the
penis is located just below the anus. A
umbilicus.
linear incision is made over the penis
The full bladder is drained by
and it is drawn to through the incision
puncture through a sterile needle
by blunt dissection.
attached to a sterile
The welfare of
The penis is then
piece of tube to the
incised and the urethra
the lamb must be outside of the abdomen.
is located within. The
The rostral end of the
at the forefront
urethra is then sutured
is then drawn to
of the clinician’s bladder
to the skin with
just in front of the
mind. Lambs
multiple small sutures,
prepuce and anchored to
should not be put the peritoneum,
leaving an orifice at
least the size of a
musculature and skin. A
through painful
pencil.
very small hole is
surgical
Urine will flow out
pierced in the bladder
procedures just
and the bladder should
and this is stitched with
for monetary
be flushed with warm
many small sutures to
gain.
sterile water to remove
the peritoneum,
any further stones. The
musculature and skin.
animal should receive antibiotics and
It is very important that there is a
NSAIDs daily and the wound should
seal between the bladder and the
be cleaned.
peritoneum so that urine cannot leak
Historically, clinicians used to
into the peritoneum. The rest of the
perform an urethrotomy rather than an abdomen and skin is then closed in the
urethrostomy as the animal was sent for normal manner. On recovery, the lamb
slaughter as soon as the withhold
should be draining urine through the
period had been reached for any
small hole in the skin which should be
medicines given and the smell of urine
at the lamb’s lowest point on the ventral
could no longer be smelt.
body wall.
The author is concerned for the
Penile amputation
welfare implications for such a
2. If the obstruction occurs at the
procedure. He has a dilemma.
glands penis there is really only one
Therefore, on balance, considering the
surgical option: penile amputation.
welfare of the animal concerned, he
This has been described by other
advises immediate on-farm slaughter in
authors (Hay, 1990). The perineal area
such cases.
from the anus to the scrotum is clipped
The farmer in a UK situation is
and prepared for surgery. The tail is
permitted to dress the carcase and use
held upwards and out of the way by an
it for home consumption – he is not
LIVESTOCK
assistant or by anchoring it in position
to the pelvic fleece. A 4-5cm vertical
incision is made in the midline from the
level of the tuber ischii downwards.
Using blunt dissection, the incision is
deepened until the penis is identified as
a firm, smooth, yellowish organ 1-2cm
in diameter.
By blunt dissection and manual
traction, the penis is isolated and pulled
outwards through the skin incision. The
penis is severed at the lower end of the
incision, but above any area of urethral
obstruction, making sure that the
proximal stump will be long enough to
be fixed outside the wound, particularly
in fatter animals.
Non-absorbable simple interrupted
stitches are used to suture the periurethral tissues to the dorsal end of the
skin wound. Care must be taken not to
puncture the urethra with sutures or to
occlude it by excessive dorsal flexion of
the stump. The animal should receive
antibiotics and NSAIDs daily.
3. If the obstruction occurs at the
vermiform appendage, the course of
action is easy.
If the obstruction is seen in the
vermiform appendage, this can be
snipped off at its base with a pair of
scissors. However, it is vital that all the
preventive measures are taken so that
obstruction does not occur further up.
The animal should receive antibiotics
and NSAIDs daily.
53
are taken immediately with the rest of
the group.
Reference
Hay, L. (1990) Prevention and
treatment of urolithiasis in sheep. In
Practice 12 (3): 87-91.
Postscript
Since writing this article the author has
come across this simple treatment
which may be the answer to his
dilemma.
Surgical tube cystotomy has been
described by workers in India (Fazili et
al, 2010). It is a minimally invasive
technique through the left paralumbar
fossa which can be performed in lambs
or kids. A catheter is placed in the
bladder lumen through a metallic
cannula and fixed to the skin with a stay
suture.
The surgery can be performed
either standing or in right lateral
recumbency. With acidification of the
urine, the urinary crystals are dissolved,
leading to the restoration of full urethral
patency in successfully treated animals
within a few days.
No hospitalisation is required. The
catheter is removed after normal
urination occurs.
No recurrence of the condition was
noted by the workers in a six-month
follow-up.
Reference
Further course of action
A single case of obstructive urolithiasis
in a group should serve as a definite
warning. Treatment of the individual or
euthanasia should be carried out. It is
vital, however, that preventive measures
Malik, H. and Fazili, M. R. et al. (2010)
Minimally invasive surgical tube
cystotomy for treating obstructive
urolithiasis in small ruminants with an
intact urinary bladder. Vet. Rec 166 (17):
528-531.
SVS autumn meeting in Malvern
THE autumn meeting of the Sheep Veterinary Society is to be held in
Malvern, Worcs., from 11th to 14th September.
n The next International Sheep Veterinary Congress is to be held in New
Zealand from 18th to 22nd February, 2013. The event was to have been held
in the convention centre in the centre of Christchurch on the South Island
but following the extensive damage from the recent earthquakes, the decision
has been taken to move the event to Rotorua on the North Island. The theme
will be “Connecting sheep and science”.
54
VP JUNE 2011
LIVESTOCK
New welfare board will aim to restore
trust between vets, DEFRA and others
The ability to engage with animal
THE new Animal Health and
keepers and other stakeholders is
Welfare Board for England is due to
highlighted in order “to gain the
hold its first meeting by the end of
confidence and respect of livestock
autumn this year.
For anyone who wishes to be one of farmers and other animal keepers
through regular meetings”. Essential
the external members of this board, an
criteria for the chairman are leadership,
application pack is available from
decision making, team working,
www.defra.gov.uk/foodfarm/animals/diseases/sharing/. Please communication, and the ability to
assimilate new knowledge; and it is
note that sending in a CV or other
desirable that he or she has experience
information will not be accepted. The
of animal keeping, work of the
deadline for applications is 8th July.
livestock and food industries and
It is quite likely that the paperwork
submissions for a chairman are
already with DEFRA, as the
RICHARD GARD
closing date is 7th June and
reports on progress with setting
interviews are to be held on 20th
up the board to advise DEFRA on
July.
animal welfare – and its changing
The interview panel will be
remit
made up of a senior civil servant
within DEFRA, an independent
experience of the relevant scientific and
assessor, an external expert with a
knowledge of animal welfare and a non- technical issues that affect the livestock
sector and animal keepers.
executive member of the DEFRA
If you can offer a few days each
management board. The panel will
month and are considering applying to
make recommendations to Ministers.
be an external member, then you will
The panel to select the external
be expected to demonstrate leadership
members will also include the newlyand team working, have
appointed chairman and interviews are
communication skills and knowledge.
scheduled for the end of September.
Within the board, knowledge will
Again, Ministers will make the final
include: all kept and farmed animals
selection of the seven external board
(including pigs, poultry, cattle, sheep,
members.
horses and aquaculture) and farming
Principal source
in different parts of England; animal
As the board will be “the principal
health and veterinary science
source of Departmental advice to
(including public health implications);
Ministers, on strategic animal health and animal welfare; wider public interests
welfare [sic] matters relating to
(including safety and security of the
England”, its seems only fair that the
food chain and environmental issues).
DEFRA folk and the Ministers are
Desirable knowledge includes: a
confident in the people offering their
good understanding of how DEFRA
wisdom.
and its agencies operate; an
In the Ministerial foreword to the
understanding of DEFRA’s legislative
information pack, the Minister of State
and delivery arrangements; an
for Agriculture and Food, Jim Paice,
understanding of European and
says: “I want the new board to rebuild
international issues relating to animal
and maintain trust between animal
welfare.
keepers and DEFRA.”
The seven external members, the
Something amiss?
chairman, the CVO, the head of the
It will be interesting to identify the skills
Animal Health Veterinary Laboratories
and understanding of the final
Agency (AHVLA) and three DEFRA
appointees but there seems to be
budget holders have a tough job to do.
something amiss. The original report
The intention is that stakeholders will
clearly indicated that DEFRA needed to
have direct access to the board and that
change and change fundamentally.
recommendations flowing to Ministers
Management alterations and updates
are not expected to be diverted by other needed to be implemented, such as a
advisory committees or agencies.
working budget, and the whole system
The original report indicated that
was simply in need of a good shake-up.
the selected board members would be
The report seemed to say that there
there on merit and the ability to
was a problem with the development of
communicate (VP February 2011: “The policy but an even bigger problem in
Minister, vets and trust”). There were
policy being turned into practice. A lack
not supposed to be any openings for
of confidence and a lack of trust is
specific organisations or self-interest
being experienced at field level. But,
although the criteria for appointing
groups.
board members is just a list, it seems to
be a clone of current presence and it
would be a shame if people with
original ideas were inhibited from
applying.
Some of the members need to be
unlike the typical DEFRA idea of an
adviser or manager. This board cannot
be just a talking shop, and that is exactly
what is feared by folk leaning on the
farm gate.
However, whether you intend to
apply to join the board or not, vets in
large animal practice will need to be
able to identify board members who
will be looking to communicate with
you. If everyone sits back and hopes
that the members will know all and
be able to change things for the
better without direct input from
people in the field, then major
mistakes and errors will continue for
decades.
Unintended consequences
One of the other points from the
original report was to be aware of
unintended consequences. Foresight is a
fantastic gift but often field application
is a frustration that undermines welfare
and the recognition of modern
practicalities appears essential. Direct
use of texting and twittering with the
board, from you and your colleagues,
may come more to the fore for
veterinary matters.
Carl Padgett, president-elect of the
BVA, lists one of his interests as
“veterinary politics” and his close
involvement with animal welfare
committees and meetings will have
provided a sound insight. He comments
that there is a trust issue generally that
needs to be overcome.
There is mistrust that arises from a
direct commercial relationship as
Official Veterinarians providing services
to the delivery partner, the AHVLA.
This relationship is recognised as being
out of date and therefore dysfunctional,
but the trust issue goes beyond OV
matters. It also goes beyond the more
insidious distrust of all things
Government in terms of handling
animal health and includes the apparent
growing mistrust by society of all things
“scientist”.
The foot-and-mouth management
in 2001 resulted in a shift of power in
terms of who controls disease, which
was taken away from vets and towards
politicians and modellers. The current
prevarication over bTB is a major issue.
Carl indicates that vets on the ground
feel somewhat sidelined and so, rightly
or wrongly, are very much allied to the
industry they serve.
Carl Padget, president-elect of the
BVA.
Although there is a big challenge for
the new board to rectify matters and
build trust, with clear devolution and
accountability of responsibility, Carl is
convinced that all is achievable but it
will be difficult. Other than continuing
with the status quo, the board is the only
viable solution on the table and we need
to “commit to the success of the
AHWB”, he says.
Companion animals dropped
In the original report on Responsibility and
Cost Sharing, the aim was stated “to
reduce the risk and cost of animal
disease and improve the welfare of kept
animals”.
The definition of kept animals
included farmed animals, animals kept
by “hobby” farmers, animals kept for
competition, display, performance,
conservation or other reasons, and
companion animals.
However, the knowledge list
required for the chairman and external
members of the new board does not
mention companion animals so
presumably this has been removed from
its responsibility.
A further point of difference from
the original proposal is that the CVO,
Nigel Gibbens, was to be ex officio but is
now a full member of the board, as is
the CEO of the AHVLA, Catherine
Brown, who was to attend meetings
“only as appropriate”.
With so much concern about
animal welfare and the control of
disease, coupled with responsibility
and cost sharing, it seems essential that
the AHVLA is fully involved in any
policies from day one. It is to be
hoped that the applications for board
members are many and that clear and
positive attitudes are evident at the
first meeting in the autumn.
Target E. coli Mastitis.
Baytril is fast:
rapid bactericidal activity 1
Trust…
Baytril is effective:
excellent penetration of the infected tissues 2,3
Baytril is reliable:
high concentrations above MIC90 for E. coli 2,3
Baytril is economical:
rapid improvement in milk production 4
Baytril is evolving:
new i.v. indication against acute E. coli mastitis
Baytril® 10% Solution for Injection/.-,+*),(/'&&%$#%"/!, --*.),/"*(/ /+-/* - )*+/*+*/(+/ + /
information is available on request. Use Medicines Responsibly (www.noah.co.uk/responsible). ® Registered Trade
Mark of Bayer AG. Bayer plc, Animal Health Division, Bayer House, Strawberry Hill, Newbury RG14 1JA. Tel: 01635
563000. Bayer Ltd., Animal Health Division, The Atrium, Blackthorn Road, Dublin 18, Tel: (01) 299 9313. 1. Monfardini
E et al. (1999) Vet Immunology and Immunopathology 67: 373 - 384. 2. Bayer Study No. 27230. 3. Fraatz K et al. (2005)
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56
VP JUNE 2011
PRODUCTS - LIVESTOCK
IBR marker
vaccine
HIPRA UK, based in Nottingham, is
introducing Hiprabovis IBR Marker
Live, described as the first IBR
vaccine that contains two genetic
deletions (gE-/tk-).
The company says the vaccine,
the first live IBR vaccine to be
registered through the European
Medicines Agency, allows the
serological gE- marking, which is
essential for eradication.
“This double deletion gE-/tk- is a
great innovation and confers extra
safety elements to this vaccine which
are: neither establishment of latency
nor re-excretion of the vaccine virus,
and a superior vaccine stability that
reduces the risk of recombination
with wild type IBR virus and
resurgence of virulence,” it states.
n Hipra recently appointed Simon
i
ul y
tr o
as ur Go
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nd ha o w
n
sc ce ww
an to .
ne w ve
r a in to
nd a qu
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gg M l.c
le EA o.
s SI u
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or CA fo
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£6 e
00
0
so W
lu ha
t
t
M ion ’s
as t yo
ti o ur
ti
s?
l
Co
E.
The Vetoquinol solution
to acute mastitis
spelt out...
Barratt as sales representative for
Scotland and Northern Ireland.
Calcium bolus
BOEHRINGER Ingelheim is
launching Bovikalc calcium bolus for
reducing the risk of milk fever in
dairy cows; the product contains
calcium chloride and calcium
sulphate.
The product also provides an
acidifying effect which helps the
cow’s homeostatic mechanisms to
maintain her own calcium levels.
The clinical manifestation of milk
fever is said affect 4-9% of the UK’s
dairy cows, while the sub-clinical
form (hypocalcaemia) can affect up
to 39% of the milking herd per year,
according to Laura Randall of
Boehringer Ingelheim.
The Cowslipper
company in
The
Netherlands
has introduced
the Cowslipper.
This is
described as an
easy and rapid
fitting product
to keep hoof
care products on the place of an
infection. The slipper, a bandage
with spongy filling, needs to be
placed between the claws and
fastened by Velcro. After applying
the Cowslipper, the cow can walk
normally and contamination by
manure will be prevented, the firm
states. The slippers come in packs of
10 with a price per slipper of €4.50.
For details see www.cowslipper.com.
Remote display unit
ART3665
Photo Credits: PhotoAlto / Punch stock, Martin Ruegner / Masterfile, Aubrée Belin / Fotolia.com, Claude P / Fotolia.com, pgm / Fotolia.com
Slipper for cows
A REPUTATION BUILT ON RESULTS
Marbocyl® 10% has proven efficacy to rapidly and safely treat acute
Escherichia coli mastitis. Thanks to its bactericidal action which does
not liberate endotoxins, Marbocyl® 10% administered intravenously,
provides rapid improvement and an early return to milk production.
Marbocyl® 10% contains marbofloxacin. Legal Category: POM-V
Use medicines responsibly. For further information please visit www.noah.co.uk/responsible
Further information is available on request from: Vetoquinol UK Limited, Vetoquinol House, Great Slade,
Buckingham Industrial Park, Buckingham, MK18 1PA. Tel: 01280 814500 Fax: 01280 825460
Email: office@vetoquinol.co.uk Website: www.vetoquinol.co.uk
BCF has introduced the new EasiScan remote display. Designed for
on-farm use, it is described as
durable and compact, weighing less
than 2kg. The 8.4-inch transflective
LCD screen is said to provide
excellent quality images for fertility
and pregnancy scanning can be used
as the sole display for BCF’s EasiScan and Duo-Scan ultrasound
scanners. It is available with a Gorilla
pod, allowing it to be attached to
railings, and a carry strap.
VP JUNE 2011
LIVESTOCK
57
Levels of clinical mastitis
running at far too high a level...
with Staph. aureus and Strep. uberis
OVER the past couple of decades,
significant progress has been made infections. All of the above questions
in reducing cell counts in response help us understand why treatment
success is so poor.
to financial penalties imposed by
It’s always good to review mastitis
milk buyers.
However, levels of clinical mastitis treatment with our clients. Look for
are running at far too high a level with signs of treatment failure – cows with
the national average somewhere in the repeat cases, prolonged treatments
required, changes of antibiotics or
order of 60 to 70 cases per 100 cows
per year, against a target of 30 or less. cows which end up with persistently
high cell counts. There is a great
We still have lots of work to do.
opportunity to make a difference.
Overall bacteriological cure rates
for clinical
mastitis are in
the order of
PETER EDMONDSON
provides his annual update on
60%, which is
trends and developments in the
very
management, prevention and
disappointing.
treatment of bovine mastitis
However,
when you
start to think about it, maybe it’s not
that surprising.
Exciting opportunities
Most of the intramammary tubes
There are a number of exciting
on the market are old and were
changes and opportunities facing us
developed when a clinical cure was all
in the future. Herd sizes continue to
that was expected. Cows would have
expand and this offers opportunity.
been giving far less milk.
We have some large herds with
So why do we give the same
professional managers who are really
amount of intramammary antibiotic to looking at performance in great detail.
a cow yielding 10 litres as the one
High mastitis levels are no longer
giving 60?
tolerated and solutions are required.
If we follow the data sheet
We are also facing some new and
recommendations on intramammary
interesting advances.
The DairyCo mastitis plan is
tubes, we will treat animals just once
helping to highlight problem areas and
or at most on three occasions. Is this
show where improvements need to be
responsible use of antibiotics? Why
made and that is a good step forwards.
do doctors treat us at high doses for
Mastitis data are not analysed
up to 10 days? What bacteria are we
frequently enough on farms and so
treating?
high levels of mastitis are just
On-farm culture
accepted.
In the large dairy herds in the US,
In the future we will be able to
they do on-farm culture and cows
identify HIR cows (high immune
with Gram-negative infections are
response). These cows get less disease,
treated with oxytocin and pain killers.
they will respond better to vaccination
How good is the distribution of
and their colostrum will be superior.
intramammary antibiotic in an udder
These cows get far less mastitis,
with a lot of pus and damage to the
metritis, ketosis and retained placentas
udder tissue?
due to this trait. If individuals started
What impact does three times a
breeding cows with these traits, just
day have on antibiotic levels in the
think of the possibilities.
udder? Then consider the problems
Robots are increasing as people
want more flexibility in their working
day. The problem with robots is that
Peter Edmondson, MVB, DipECBHM,
one system can only cope with a
CertCHP, FRCVS, graduated from
limited number of cows, and if you
Dublin in 1980 and is a practitioner
want to milk, say, 600 cows then you
with the Shepton Veterinary Group,
specialising in mastitis control and milk
will need 10 robots which cost
quality. He provides referral visits
£1,000,000 and the economics of this
throughout the UK and works closely
go out the window.
with many dairy and pharmaceutical
The good news is that robotic
companies throughout the world. He
technologies are being transferred to
also runs, with Roger Blowey, the
other milking systems. You can now
mastitis control seminars for vets,
get effective post-dipping systems to
which are now in their 19th year.
be used on rotary parlours replacing a
labour unit. Delaval has set up a
rotary parlour with robotic teat
preparation and this has endless
possibilities. The whole area of
robotic technology is developing at a
very rapid pace.
Medicine pressures
Pressures on the types of medicines
that can be used in dairy cows
continue to increase. Some of the
supermarkets are not keen on the use
of fourth generation cephalosporins
and this will have impacts if it
becomes mandatory. The likes of
cefquiome, a lactating, dry cow and
injectable antibiotic, would then be
severely restricted.
There is no doubt that the days of
blanket dry cow therapy will come to
an end soon. The use of whole herd
treatment really cannot be justified.
Selective dry cow therapy is
commonly carried out in many other
countries and we have a number of
clients who are already doing this.
They only use dry cow antibiotic in
cows which have had cell counts of
over 120,000 throughout lactation or a
case of clinical mastitis. For heifers,
the figure is 100,000. All cows get an
internal teat sealant.
Some might argue that in some
herds there is no individual cow cell
count data or mastitis records
available for decision making. This is
not an acceptable argument, as the
onus for use of antibiotic dry cow
therapy is with the farmer. He has to
provide justification for its use.
It is likely that these changes will
be introduced in the UK in the near
future with pressure coming from
consumer groups, milk buyers and the
supermarkets.
n Do you want to learn how to tackle
those mastitis problems? If so, then
you need to come to the practical and
interactive Mastitis Control and
Quality Milk Production Seminar run
by the author with Roger Blowey. The
dates are 6th to 8th November in
Gloucester. For more information, see
www.sheptonvet.com.
58
VP JUNE 2011
LIVESTOCK
Plenty of work to do
THERE are active opportunities for
developed over several years with
farmers to take advantage of low
veterinary and farmer training
cost technical help from their vets.
undertaken by Andrew Bradley and
Funding is available to subsidise
colleagues from Quality Milk
veterinary consultancy for BVD,
Management Services Ltd.
Johne’s disease, lameness,
Andrew indicates that uptake of the
respiratory disease and mastitis.
farm data analysis and the “could do,
This is all part of the European
should do and must do” management
Agricultural Fund, which operates until
changes on farm have had a good start.
2013, and forms the South West
The DairyCo training operates for at
Healthy Livestock Initiative with a
least another year with 650 farmers
budget of over £5 million. Counties
currently involved.
included are Cornwall, Devon,
For the vet, an initial step in the
Gloucester, Wiltshire and Somerset.
mastitis consultancy is to complete a 30Although the initiative started in 2007, it page questionnaire with dairy farmer
is now that work on the ground is
clients and their staff. In itself, this
accelerating.
comprehensive collation of information
At the end of it all there will need to about the detail of dairy herd
be an economic justification and so
management is
outcomes are
being
RICHARD GARD
measured.
talks to veterinary surgeon and
There is an
farmer about the practicalities of
administrative
mastitis control and the
oversight
advantages of working together
provided by
the Business
Unit at Duchy College and Kate Brodie likely to raise discussion about specific
at Drove Veterinary Hospital is aware of aspects.
the need to fully understand the farmer
The drying-off technique, for
and vet practice elements of the
example, is identified but when the
financial support.
incidence of new infections in the dry
In order to appreciate better what is period is later assessed, it is easy to
going on with mastitis, I was the guest
assume that the earlier declared
of the Tyndale Farm Veterinary Practice technique may be revisited, discussed
at Berkeley Heath, Gloucester. This is a
and revised.
nine-veterinary surgeon wholly large
Interrogations
animal practice that spreads across the
Treatment of clinical cases, frequency,
bridge into Wales.
duration and product spectrum may
Andrew Henderson explained the
become immediately relevant if cows
aims, ambitions and practicalities with
having repeated cases in the same
paper and computer work, followed by
lactation are later identified.
an interesting visit to a 200-cow dairy
Cell count data can be interrogated
client.
in depth and the treatment of cows
The first impression was that
with a raised cell count is not going to
although two days of veterinary
be appropriate for all herds but is a
consultancy is available to each farmer,
there is a great deal of work to be done specific option that may be applied
depending on the cell count status and
and even though the support may be
ambitions for the herd. It is clear that it
70% of a maximum £1,000 cost, not
is the detail that will become
everyone will be prepared to put in the
increasingly important as the plan
effort required.
develops.
Over 200 vets have now taken part
We visited Martin Wooldridge at
in the DairyCo Mastitis Control Plan
training programme. This plan has been Court Farm and stood amongst the
high and low
yielding groups
with 170 cows in
milk on the day.
Martin is very
proud of the
breeding of his
herd that is now
yielding well, due
to a greater
recognition of
their potential.
He gives credit
The sandy dry cow yard.
to the veterinary
practice for helping
him to identify issues
that were holding back
the production of the
herd. One of these
was mastitis.
Standing in the 16point herringbone
parlour, with
automatic cluster
Martin Wooldridge (left) with Andrew Henderson.
removal, the point was
made that every cow is foremilked. This sand by hand and the time taken is a
difficulty.
was somewhat of a surprise but Martin
As Martin says, “Nobody wants the
has built this into the parlour routine
job”, so it is left for him and he finds
with the advantages of removing any
himself shovelling muck after supper.
debris within the teat, encouraging milk
The Tyndale practice belongs to the
let down and detecting any early signs of
XL Vets group and requests for
clinical mastitis with clots and heat in
information on management of the
the udder.
sand have been placed on the XL
Treatment is now taking place
forum.
earlier, possibly one or even two
With all-year-round calving there is a
milkings earlier, and the clearance rate
for clinical cases is believed to be better. need to continuously keep the sand as
dung-free as possible so Andrew
The mastitis infections in this herd are
mainly environmental contaminants but (andrew@tyndalevets.co.uk) will
welcome any experiences from other
the parlour routine is still seen as an
important part of the control
herds. Are pooper scoopers as used for
programme.
pony paddocks an effective tool?
Teat spraying has been replaced with
Attended calvings
teat dipping and a good covering of
When a cow is close to calving she is
iodine dip is looked for on each teat as
moved to a calving straw yard. The need
the cow exits the parlour.
We had a three-way discussion about for calvings to be attended has been an
issue with oversize calves in the past,
water. With an increase in yield, the
but in recent times a higher number of
volumes required to replenish the milk
heifer calves has been achieved using
production and overcome the stress of
sexed semen. The higher number of
milking need to be related to the
heifers available has allowed the herd to
available drinking trough space so that
expand.
each cow can be satisfied.
The facilities for the down calver are
The subject of stress led to
being reviewed together with the
identification of pain and the
cleanliness of the teats to be suckled, as
recognition of the role of pain relief in
much to reduce the risk of paraTB
the treatment of mastitis. These were
transfer to the calves and prevent
not viewed as minor matters and it was
development of Johne’s disease.
easy to see how one topic, successfully
The high-yielding group of cows
managed, leads to an even greater desire
to develop the control programme even can have short dry periods. One of the
advantages of Cephaguard DC (Virbac)
further.
is seen as a short persistency and so less
Sand-based dry cow yard
risk of antibiotic being present in the
During the very cold weather it became
milk after calving. The spectrum of
difficult to manage the cows to the high activity also includes the environmental
standards being set. The cell count went organisms.
It is important that both the vet and
up and there is some anxiety to see it
his client have confidence in all aspects
stay within the 100,000 to150,000 cells
of the control programme and the
per ml range.
quality of the management changes
Forthcoming data will be closely
following assessment, advice and
scrutinised. Already identified is the
need to reduce contamination on the
consultancy.
teats of the dry cows and a recent
As we were talking in the yard, a
development is a new sand-based dry
shout went up that a glider had landed
cow yard.
in one of the fields. On an earlier
The sand yard has only been in use
occasion when this happened the pilot
for a short time and both vet and
offered to give Martin a trip up, but it
farmer are looking for a little help to
seemed a better bet to have a ride with
make the development as effective as
someone who makes it back to the
possible. The sand has been placed on a airfield.
hardcore base. Three times a day the
Glider landing is not seen as part of
cow pats are forked up and out of the
the farm development.
®
Cephaguard DC
Get your hands on the modern dry cow therapy
With the unique formulation of Cephaguard® DC,
mastitis control is better by F.A.R.
lexibility
The advantageous 35+1 day withdrawal period of Cephaguard® DC optimises milk production
options with high yielders and minimises discarded milk from early calvers.
daptability
The uniform diffusion of Cephaguard® DC throughout the udder effectively protects against
infection, whilst also contributing to reduced new infections post calving1,3.
eliability
Cephaguard® DC – 21st century dry cow therapy, is one of the most advanced cephalosporin
antibiotics in veterinary medicine, proven to reduce infections2,3 with the flexibility to fit a wide
range of dry cow management needs.
Virbac Animal Health
Woolpit Business Park, Woolpit,
Bury St Edmunds, Suffolk IP30 9UP
Tel 01359 243243
Email enquiries@virbac.co.uk
www.virbac.co.uk
POM-V Cephaguard® DC contains cefquinome. Always use medicine responsibly.
1: Ehinger A.M. et al. Pharmacokinetic aspects of a new dry cow therapy. British Cattle Veterinary Association, 2005 Vol 13, part III; 227-230. 2: Thomas V. et al. Monitoring of cefquinome
susceptibility against mastitis isolates collected from diseased cattle in Europe from 1994 to 2005. World Buiatric Congress 2006, Nice, France, PSI-025 (id 572). 3: Thomas E. et al.
Efficacy of a new cefquinome dry cow formulation in a controlled, randomised and partially blinded field study. World Buiatric Congress 2004, Québec City, Canada, 496 (3406).
60
VP JUNE 2011
LIVESTOCK
Much to learn
from findings of
NZ researchers
Healthy Feet programme.
THE 16th Symposium and 8th
The New Zealand dairy cow has
Conference of Lameness in
very different pressures and this is seen
Ruminants took place in Rotorua,
New Zealand, from 28th February to in the lesions recorded by farmers.
White Line disease is the main type of
3rd March.
lameness seen, predominantly as a result
The beautiful country that is New
of thin soles due to the long distances
Zealand was reeling from the recent
that the cows have to walk between
tragedy that had occurred in
milkings.
Christchurch only 10 days before. Talk
Neil described two clinical
of the earthquake was never far from
manifestations from these thin soles.
anyone’s thoughts as nearly every Kiwi
Thin soles and impatient handling of
at the conference had some contact
cows tends to lead to white line
with friends and family living in
Christchurch.
A very
JON READER
poignant twopresents the first of three reports
minute silence
from the international
was held at
conference on lameness in
lunchtime of
ruminants held earlier this year
the first full
in New Zealand
day to
separation, while
remember the victims and those
thin soles in conjunction with poor
affected.
tracks lead to sole separation.
Researchers, practitioners and
As a result, Neil emphasised that the
anyone interested in foot health had
assessment of risk factors in New
assembled at the Energy Events Centre
Zealand tends to look at cow flow into
for four days of talks, workshops and
the “cultural experience”. Delegates had the collecting yard as well as
maintenance and management of tracks.
only to step outside to remind
The overall levels of lameness tend
themselves where they were as the
to be lower in New Zealand with
aroma of sulphur originating from the
prevalence levels around 5%. Sole ulcers
bubbling mud filled the air.
and digital dermatitis are very rarely
Workshop
seen. Dermatitis has been reported in
The day before the scientific content
New Zealand and sole ulceration is
started, a pre-conference workshop was occasionally picked up in heifers that
held to look at the provision of
have prolonged access to a concrete
lameness extension and lameness
feed pad.
programmes in general.
Neil Chesterton gave a brilliant
Much to learn
overview of the Kiwi lameness situation Without doing expensive studies and
as well as the Healthy Hoof
trials in this country, there is much to
programme. This was particularly timely learn from these findings when looking
from a UK situation as DairyCo has
at potential problem areas in the UK
been working closely with Dairy NZ in
situation.
preparation of the launch of its own
Zoe Barker from the UK then
facilitated an interactive workshop for
delegates to critically assess the quality
Jon Reader, BVSc, DCHP, MRCVS,
of data provided by farmers. It was
graduated from Bristol in 1997 and
reassuring to hear that the UK is not the
has been in dairy practice in Somerset
only country to struggle with getting
ever since. He gained the Certificate in
accurate records that can be
Cattle Health and production in 2001.
meaningfully analysed!
He is currently one of the founding
directors of Synergy Farm Health, a
Even lameness anoraks know how
25-vet farm only practice in Somerset,
to enjoy themselves. Each night there
East Devon and Dorset. He is
were various social events, the highlight
particularly interested in large herds
being the cultural experience from the
and the analysis of herd health records
local Maori people. This included a
and the prevention of lameness and
wonderful narrated walk along Lake
mastitis on farm, including introducing
Rotorua, culminating in a traditional
new software to the industry to help
Maori meal in the marae. After the meal
farmers manage lameness.
we were all treated to a life history from
the man who is credited with reporting
the first cases of digital dermatitis,
Signor Mortellaro himself!
The conference was packed with
plenary lectures, three streams of 15minute oral presentations and ever
changing posters.
Dr Jim Gibbs from Lincoln
University near Christchurch, reviewed
the current knowledge of the link
between nutrition and lameness and
investigated some of the long-standing
beliefs. He pointed out that the longestablished pathophysiology of disease
in the bovine foot had been largely
extrapolated from the 1970’s equine
model.
He questioned the role of acidosis
and pH in this pathology. He
highlighted controversial issues over the
actual causes of lameness and examined
the role of endotoxins, exotoxins, as
well as vasoactive amines. He discussed
the limitations of extrapolating the
SARA story.
He believed that there was an overdependence on measuring pH as it was
easy to measure and there was a big
difference between pathology and
physiological outcome. Pin-point
measuring of pH is probably of little
use and more complicated evaluations
using area under the curve of pH might
be more appropriate. He summarised
that we need better knowledge of
rumen microbiology and physiology.
This raised the question among
delegates as to whether there was
another mediator, as yet undiscovered,
that might mediate both lameness and
also a reduction in milk yield. Such an
aetiology might be
linked to the
composition of the
digital fat pad
(Bicalho et al, JDS
2009; Reader et al,
JDS submitted
2011).
The international delegation
descends on the marae.
ongoing research into digital dermatitis.
A large body of work is being done by
the team at Wisconsin led by Nigel
Cook and Dorte Dopfer.
Dopfer’s classification of dermatitis
lesions is now well recognised amongst
researchers.
The team has increasingly
demonstrated the importance of M4:1
lesions. These are the chronic lesions
with a sub acute component (Dopfer,
2000) which act as a reservoir for
infection, and parallels could be made
with a BVD persistently infected animal
(PI). These lesions are the ones that
drive the dynamics of the disease and
are the precursors of the M2 lesions
(acute lesions).
Nielsen et al reported on their work
looking at heterogeneity of cows to
digital dermatitis. They concluded that:
(1) early lactation was associated with a
reduced risk of developing lesions; (2)
lesions occurring in late lactation had a
better chance of recovery; (3) there was
a reduced risk of developing lesions in
parity 3 compared to parity 1; and (4)
that the mean duration of uncensored
DD episodes was 1.7 weeks. They
emphasised the dynamic nature of the
disease.
A poster presentation by Scholey et
al looked at SNPs on cows that were
affected with dermatitis to determine if
some were more genetically susceptible.
Preliminary results suggested that
several regions on the genome
(particularly chromosome 26) may be
associated with disease susceptibility.
Digital
dermatitis
Being an
international
conference, a large
proportion of the
proceedings was
driven by the
One of the many must-see sites at Rotorua.
VP JUNE 2011
Queen’s award winner
NORBROOK Laboratories Ltd has
been awarded the Queen’s Award for
Enterprise. The award is in recognition
of the company’s outstanding
continuous achievement in international
trade.
The chairman and CEO, Lord
Ballyedmond, says the firm has enjoyed
sustained annual growth in recent years,
with export sales increasing by 15% year
on year in the three-year period since
2007.
ROUND-UP
Sciences.
The award which was presented at
the 11th Conference of the European
Committee of the Association of Avian
Veterinarians (EAAV) on 28th April,
was set up as part of the Helga Gerlach
Fund in recognition of the work of
Professor Helga Gerlach, who dedicated
more than 50 years of her life to avian
exotic and poultry medicine.
Mr Forbes is currently the specialist
in exotic avian medicine at Vets Now
Referrals in Swindon
Dogs left home alone
A PET census carried out by Ceva
Animal Health has revealed that more
than 70% of pet owners leave their dog
“home alone” when they are at work.
The online census form, which pet
owners were asked to complete at the
same time as the National Census form
in April, received 565 responses. The full
findings are on secrettohappypets.com.
General manager
GAYNOR Hillier has been appointed
general manager UK and Ireland at
Novartis Animal Health.
She joins the UK arm of the
business having spent the last two-anda-half years working for the company in
America as vice-president of marketing.
Gaynor was recently accepted onto
the NOAH board – she started her
career with NOAH 21 years ago.
Dermatology forum
AVACTA Animal Health is holding its
Dermatology Discussion Forum,
featuring Professor Richard Halliwell
lecturing on allergic skin disease in cats
and dogs followed by an interactive
case-based discussion, on 22nd June in
Southampton and 23rd June in
Hinckley.
A hot buffet is served at 7pm before
the lecture begins at 7.30pm.
To book a place (£20 plus VAT)
contact the company on 0800 8494 550.
‘Rabbit’ webinar
CEVA Animal Health is hosting a free
interactive webinar covering digestive
tract diseases of the rabbit.
Taking place on 14th June, the
seminar will be presented by Simon
Girling, an RCVS Specialist in Zoo and
Wildlife Medicine. It will start at 7.45pm
and last for approximately 1.5 hours,
plus question and answer time. To
secure a place, e-mail
customerservicesuk@ceva.com.
Equestrian award
A NEW award is being introduced as
part of the Animal Health Trust (AHT)
UK Equestrian Awards, to be presented
in London on 3rd November. The
LitoVet Equine Scientific Achievement
Award will recognise a person or group
whose clinical or scientific work has
made a substantial difference to the
equine veterinary world and will be
judged by a panel of leading vets and
scientists.
For details, contact Christine Gird
(christine.gird@aht.org.uk) or see
www.aht.org.uk.
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recipient of the Helga Gerlach Award
for Excellence in Avian Veterinary
61
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62
VP JUNE 2011
TRAVEL
In search of the
Tasmanian tiger
chronicled in this esteemed journal.
DESPITE earnest study, and
Yet, I had unjustly neglected the
extensive scholastic travel, I was
cryptozoological species of the south.
forced to face the uncomfortable
I resolved henceforth to make haste
fact that I was making little
for Australia, where by an entirely
progress towards passing my
unrelated coincidence it happened to
Diploma of Veterinary
be midsummer.
Cryptozoology exams.
Yet without doing so, I had no
chance of realising my goal of
Thylacine ecological history
becoming the first RCVS Recognised
The most southerly cryptozoological
Specialist in the medicine and surgery
species reported within my texts
of those unfortunate animals
appeared to be the Tasmanian Tiger,
considered extinct, or otherwise nonor Thylacinus cynocephalus – the largest
existent, by mainstream biologists.
known carnivorous marsupial of
Something seemed to be impeding
modern times. An apex predator, it
my progress, but what?
As I gazed into the
ANDREW KNIGHT
continues his series on ‘CPD with a
night, icy sleet battering
difference’ with an account of his search
the windows of my
for a species believed extinct – but of
London flat, it occurred
which many unofficial sightings persist
to me that perhaps I had
focused unduly on the
cryptozoological species of the
occupied a similar ecological niche to
Northern Hemisphere.
the tigers and wolves of the Northern
My scholastic expeditions in search Hemisphere.
of the European yeti, Gigantopithecus
Although unrelated, it displayed a
modernis yetii, the Irish leprechaun, or
similar form and adaptations through
leithbrágan, and even Scandinavian
convergent evolution, including
elves, or ælfen, have all been previously powerful jaws, sharp canines and
incisors for seizing and slicing prey,
and a fast, powerful body. Interestingly,
its muscular stomach was extensible,
allowing it to eat large amounts of
food at one time, which gave me a
curious sense of affinity with this
wonderful, misunderstood creature.
Once ranging as far north as New
Guinea, the thylacine was almost
entirely restricted to Tasmania by the
time of European arrival. To our deep
shame, we then proceeded to hunt it
to the edge of extinction. Although
hundreds of unofficial sightings have
been reported since the last official
specimen died a lonely death in
Hobart Zoo in 1936, none has ever
been confirmed.
Prizes of up to $Aust1.75 million
for the capture of a thylacine – which
would, thankfully, be illegal under
protective legislation – were never
claimed. Yet, rumours of their
presence persist, to this very day.
The author near Cradle mountain.
Andrew Knight, BVMS, PhD, CertAW,
MRCVS, London-based veterinary
cryptozoologist, hopes to become the
first RCVS Recognised Specialist in the
medicine and surgery of supposedly
mythical animals (DipCrypt). He is also
increasingly expert in the avoidance of
English winters.
Modern thylacine research
To locate any surviving thylacines, I
would need to search the wildest,
remotest parts of an island already
dominated by wilderness. That clearly
meant the infamous Overland Track.
This 100km (with side-trips) mega-hike
traverses the pristine Cradle MountainLake St Clair National Park, the heart
Thylacines at the Beaumaris Zoo in Hobart, 1910.
of the Tasmanian World Heritage
Wilderness Area. Most of it was
several days walk from the nearest
road, and completely cut off from
civilization.
There would be no electricity, hot
showers, chocolate or soy lattes
available throughout this massive subalpine wilderness, and mobile phone
reception could only be achieved by
climbing the tallest mountains in
Tasmania – and maybe not even then.
How on earth would this
pampered veterinarian survive? My
longest previous expedition had been a
day walk in Snowdonia, and I measure
my inter-soy latte intervals in hours,
rather than days.
Some very serious soul-searching
was clearly called for. How badly did I
want to be a veterinary
cryptozoologist, really? Could I live for
a week without chocolate? What about
a hot water bottle? Looking deep into
my heart, I knew that my choices
would define me as a man.
And so we filled massive packs
with tents, dehydrogenated meals and
survival gear. In the spirit of honesty I
informed my partner that in a survival
situation I’d be forced to eat the
smallest person, which resulted in me
staggering under half her load as well,
in a punishment I thought rather
unfair.
Finally we arrived at the last
outpost of civilization: the Ronny
Creek Visitor Centre café. After a
desperately large final meal of chips,
coffee and other culinary delights
(albeit assisted, in my case, by an
extensible stomach), we shouldered
our packs and set forth into
“questionable”-looking weather.
Midsummer in Tasmania
Unfortunately, any
questions about the
weather were soon
resolved, as we slowly
ascended under
massive loads (at least,
in one case) toward the
high alpine plateau.
Freezing conditions
eliminated our
enthusiasm to detour
to the summit of
world-famous Cradle
Mountain, which by
then was completely
hidden within
ominous-looking
clouds. Instead, we trekked for hours
through beautiful, albeit largely
invisible, terrain, finally battling our
way through snow flurries to the
haven of Waterfall Valley Hut.
Thank God it was midsummer, I
reflected. Although I’d travelled the
rest of Australia, this was why I’d
never yet dared visit Tasmania. The
realisation that I was almost missing
English weather snapped me upright,
with a sudden jolt of fear. I was
obviously becoming hypoglycaemic.
Or hypothermic. Or perhaps delirious.
Urgently, I tore the Kendal Mint Cake
from my emergency supplies, whilst
my partner fired up the butane stove.
The solid infusion of sugar and
peppermint soon restored my
equilibrium, as I knew it would.
The next morning we were greeted
by the terrifyingly beautiful sight of
snow crystals piled half-way up the
windows. I was beyond awe at the
brave souls who had scorned the
safety of the hut, preferring instead to
camp on the picturesque terrain
outside.
Plans to detour to another summit
were rapidly revised, in the face of the
ongoing blizzard now raging above.
Instead, we headed down to the
relative comfort of the valley. It was
time to get acquainted with mud.
Mud, Tasmanian-style
Tasmanian wilderness mud is
legendary. Yet very strict rules exhort
hikers not to detour from tracks,
thereby damaging virgin terrain.
Fortunately, it was midsummer, so the
pools we consequently staggered into
(depth-judgement was impossible, in
the inky water) tended not to swallow
us whole.
Nevertheless, we rapidly learnt the
Acropolis summit spires.
VP JUNE 2011
TRAVEL
Particularly, the bits about the
potentially massive size of this ambush
predator (the largest measured
specimen was 290cm (9.5ft) from nose
to tail), and its unusual ability to open
its jaws 120 degrees wide, thereby
displaying all of its razor-sharp teeth
to those it is about to consume.
A mysterious footprint near the
summit of Mt Ossa.
true value of gaiters and waterproof
boots. We were, however, extremely
privileged to be truly away from
civilisation, heading into the heart of
pristine wilderness, I reminded myself
yet again.
The following days were a coldly
beautiful blur of lakes, mountains,
forests and rugged heathland. A sidetrip to the summit of Mt Ossa,
Tasmania’s highest peak, briefly
resulted in phone reception, and a
quick call to let Mum know we were
still alive.
A photo of a mysterious (if
slightly embellished) paw-print in the
snow near the summit caused great
excitement in a hut that night, amongst
some of our more trusting hiking
companions, bless them.
These visitors to our magnificent
country from the distant corners of
the Earth listened with rapt attention
to my descriptions of the thylacine.
Avoidance of clinical
responsibility
Christmas came the next day, bringing
the ultimate excuse for avoiding
protracted family lunches. Or even, for
that matter, any relatives at all! And
best of all, out-of-hours holiday cover.
Let my practice find me now, I
thought. Heh heh…
Yet, it seemed that I could not
entirely escape my clinical
responsibilities, even in this far-flung
corner of the Earth. Arriving at the
end of a long trek on day 6, we found
Michael in one of the remotest huts.
The day prior he had unbalanced under
the weight of his massive pack (a
common, embarrassing problem), and
fallen from a log, onto his arm.
Extremely swollen flesh protruded
from massive holes in his ragged
dressing. Yet, he was ignoring the pain,
and had just climbed the Acropolis, the
most fearsome peak on the entire
route!
Accordingly, I had him lower his
arm into a nearby
stream (i.e. ice-water)
for 10-15 minutes,
before re-dressing his
massive biceps. He
then grabbed his heavy
pack and fearlessly
marched off into the
wilderness once more,
with instructions to
find a suitable stream
every few hours and
repeat.
Shortly afterwards I was informed
that he was actually a novice operasinger, which just goes to show that
you can never make assumptions about
people and their professions.
Value of deodorant
Stories of marauding pack-eating rats
in the visitors’ book at the final hut
encouraged us to push on to the finish,
resulting in an epic, 25km slog. Finally,
we reached Cynthia Bay at the end of
Australia’s deepest (glacially-gouged)
lake, and descended onto the Visitor
Centre café like ravenous thylacines.
Yet, although our companions and
ourselves had encountered Eastern
quolls, pademelons (wallabies), tiger
snakes, possums, wombats, giant
bumble-bees, friendly leeches and
beautifully-coloured cockatoos, rosellas,
robins and butterflies, unfortunately no
63
Pademelon and joey.
thylacines did we see.
However, as I faced the appalling
sight of a mirror, for the first time in a
week, it occurred to me that these
highly evolved predators could
probably smell us. Or me, at least, from
a mile away. Unfortunately, I had yet to
develop the intestinal fortitude required
to fully immerse myself in the ice-river
rather forcefully requested by my
partner, some three days ago.
Therefore, the results of our
survey could not really be called
conclusive. The elusive thylacine may
still be out there, somewhere. And so I
resolved to return one day, as soon as
they invent more advanced research
equipment. Like a miniaturised soy
latte machine, hot water bottle and hot
shower. Perhaps if my practice tries to
roster me on, next Christmas…
64
VP JUNE 2011
ON THE ROAD
Fantastic levels of
equipment and an
air of quality...
EITHER you embrace technology
TEC technology or a 2.2-litre turbo
and all that it offers you, or you
diesel. Having driven both I can testify
don’t.
that whilst the petrol unit is smooth,
You are either a lover of gadgetry
quiet and surprisingly sprightly, I, like
and believe it is there to make life more
most buyers, would choose the 2.2-litre
enjoyable ... or you are someone with a
i-CTDi diesel which delivers classdeep distrust of anything with batteries
leading performance.
or a power cable, believing it is only a
It’s helped along by a slick six-speed
matter of time before we are overrun
gearbox shared with the Accord saloon,
by cyborgs in scenes familiar to
albeit in slightly amended form to deal
Bladerunner.
with the CR-Vs four-wheel-drive
My uncle and I present a great
capabilities.
example of these polar ends of the
The diesel engine unit picks up
spectrum. Whereas I like to fully
strongly from below 1,500rpm and, for
immerse myself in the latest additions
a car of this size,
to the gadget
ROBBIE TIFFIN
world and get
takes a Honda CR-V for a test and
worryingly
is pretty impressed by its
excited about
performance, its safety measures
any new
and its high level of ‘clever
releases from
thinking’
the Apple
production
line of small, black and shiny things, he
is capable of a reasonably fast 9.3really can’t see the point.
seconds 0-60mph time.
If it was down to him then we
Out on the road, the engine’s
would all be sending carrier pigeons to
punchy nature makes the Honda a
one another rather than e-mails,
perfect companion for long trips, and
listening to music on a gramophone
overtaking presents few problems.
rather than via an iPod dock and playing
Excellent cornering ability
hopscotch on the pavement rather than
It may not be as quiet as some other
Call of Duty on the Playstation 3.
It is for this reason that I adored the cars in this sector, but it’s still refined at
Honda CR-V I have been reviewing this motorway speeds. Its cornering ability is
excellent too, with an agile and
past week, a superb car that has similar
responsive nature that belies its size. A
levels of technology to the Millennium
low centre of gravity boosts stability.
Falcon. Unfortunately, my uncle didn’t
My only gripe on the driving dynamics
get a chance to drive it, probably
because he was too busy mining coal for would be that the sporty suspension
offers limited comfort over bumps –
his fire, sending his son up the chimney
especially for passengers.
pipe or dusting off his Charles Dickens
Refinement and user-friendly
back catalogue.
technology were obviously two of
Either way he has missed a treat, as
this CR-V really is a quite excellent piece Honda’s main priorities when creating
the third-generation CR-V. The design
of equipment. A laptop on wheels,
team’s mission was to create an SUV
some might say.
that was as good to drive as a saloon,
The CR-V comes with a choice of
but still offered the practicality buyers
two engines, either a 2-litre petrol unit
require from a larger SUV-type car.
that uses Honda’s highly acclaimed VPersonally, I think
it’s a real success. I’m
6ft 5in. and had acres of
room within the CR-Vs
well apportioned cabin
and you could easily sit
five fully-grown adults
in here without them
feeling crushed or
cramped in any way.
The high driving
position was also
excellent, offering great
visibility in all directions, as well as that
all-important feeling of a commanding
and secure road presence.
As alluded to earlier, the ace up the
CR-V’s sleeve is quite clearly the
abundance of technology it offers users
as part of the everyday driving
experience.
The CR-V is packed with clever
thinking that you simply wouldn’t expect
to see on a compact SUV of this kind,
many of which are offered as standard,
no cost options.
Features like a rear parking camera,
“active cruise control” (ACC) and
Honda’s clever “crash mitigation
braking system: (CMBS) are all things
you’d expect to see on a pricey luxury
SUV in the next price bracket up, not
on something priced from under
£22,000.
Pedestrian-friendly
Honda, however, has always specialised
on bringing things like this within the
reach of the man in the street. The
design team has also been thinking
deeply about safety with this third
version of the CR-V. Even the outgoing
CR-V (mark II) achieved a three-star
rating for pedestrian safety – which,
according to industry experts Euro
NCAP, put it in the top 10% of
pedestrian-friendly cars on the road.
Plus it got four stars for occupant safety.
This new model has improved on
those results still further with class
leading five-star occupant, four-star
child and three-star pedestrian results.
Impressive stuff.
As well as the fantastic levels of
equipment and superb
safety record, the Honda
also demonstrates a real
air of quality within its
interior design. From the
exceedingly comfortable
seats to the stylish
steering wheel and
cleverly hidden
handbrake, there’s a real
sense of sophistication
once seated within the
cabin.
As already
mentioned, there’s ample
legroom for both front
and rear occupants and
AT A GLANCE
Model tested:
Honda CR-V 5Dr 2.2 i-DTEC EX AT
Price as tested: £29, 650
Fuel economy: 36.4mpg (as tested)
0-60: 9.3 seconds
Top speed: 118 mph
Road tax band: H (£265 per annum)
CO2 emissions: 171g/km
Top speed: 134mph
OVERALL: ++++/5
the higher roof line than other
competitors means there is loads of
headroom for taller occupants.
Over the test period I averaged fuel
economy returns of just over 36mpg
which is somewhat below the 43mpg
stated on the press documentation.
However, this figure is still fairly
impressive for a car of this size and it
should be noted that these lower
economy returns may be due to some
spirited driving that really put the car
through its paces.
Residual values look appealing too
and would make the CR-V a highly
attractive investment for anyone looking
to change or upgrade this car in the
future.
Strangely enough, my uncle is
actually in the market to replace his
ancient VW Golf with something a
little larger and infinitely more
reliable. Given this need, I might tell
him to dust of his monocle and get
down to his local Honda dealer for a
test drive. I honestly think he would
be presently surprised.
THE MANAGEMENT PAGES
n
n
n
n
n
n
Being prepared for the unexpected
A tenant’s guide to rented premises
What’s new with HMRC – and
other issues
Do you have a pension shortfall?
Long/short investing strategies
Buying a practice – part two
Do you have measures in place to
deal with a major disruption?
ACCORDING to a survey for the Business
Understand the business
Continuity Institute, nearly one in five businesses
The first step is to understand your business in terms
suffers some form of major disruption every year. of the potential threats to its normal operation. This is
And as if to prove the point, Aviva, in its bisomething that needs contributions from all of your
annual SME Pulse survey conducted late in 2010,
staff.
found that only 28% of those who took part in the
Look at every aspect of the business and think
survey had any form of business continuity plan.
about the people you employ, the stock you need to
Further, the Aviva survey found that, in general,
work and how you provide your products and services.
business owners grossly underestimated the time it
would take to
Assess the risks
The threats to any business
get the
ADAM BERNSTEIN
are easily categorised and
business back
offers a small business perspective
whilst some of them seem
on its feet
on ‘business continuity’ and how
improbable, it’s
following a
to prepare effectively for the
nevertheless good to
catastrophe.
totally unexpected...
consider them all:
Now
n Natural disasters –
whilst we
don’t suffer (currently) from earthquakes and tsunamis, flooding caused by burst water pipes or heavy rain, or
wind damage following storms.
we are not immune from other threats.
n Theft or vandalism – theft of computer equipment
Cast your mind back to the Buncefield oil depot
could prove devastating; similarly, vandalism of
explosion, the terrorist attacks in London, the floods
machinery or vehicles could be costly and pose health
in Cumbria and the never ending snow falls over the
and safety risks.
last couple of years.
n Fire – few other situations have such potential to
In cold cash terms, you only need to understand
that if your practice is unable to serve the clients, then physically destroy a business.
n Power cut – would you be able to operate without
another will and there’s a fair chance that the client
lighting, IT or telecoms systems, key machinery or
may not return. The unlikely, once-in-a-thousand year
equipment?
event, could be coming your way, so how should you
n Fuel shortages – shortages in fuel could prevent
prepare?
staff getting to work and affect your ability to make
farm or house calls.
Adam Bernstein, BA(Hons), is a freelance writer on
n IT or telecoms system failure – viruses, hackers or
business and industrial subjects.
system failures could affect employees’ ability to work
effectively; what would happen if your telephones or
broadband failed?
n Restricted access to premises – how would your
practice function if you couldn’t access your buildings?
n Loss or illness of key staff – how would your
practice cope if a key member of staff were to leave
or be incapacitated?
n Outbreak of disease or infection – an outbreak of
an infectious disease among your staff could present
serious health and safety risks.
n Crises affecting suppliers – could you source
alternative supplies?
n Crises affecting clients – will insurance or customer
guarantees offset a client’s inability to take or pay for
your goods or services?
n Crises affecting your practice’s reputation – how
would you cope, for example, in the event of your
premises becoming contaminated?
n Terrorist attack – consider the risks to staff and
operations from a terrorist strike.
By thinking of all these as the start of a chain of
events – using a worst case scenario – you will be able
to build a survival plan.
Develop your strategy and plan
Once you’ve analysed the business, you’ll find that
some risks you accept and choose to ignore; others
you accept but you set up a mutual arrangement with
another practice so that in case of disaster they’ll help
you out.
Alternatively, you may attempt to lower risks;
attempt to lower risks and set up a mutual help
agreement; or you could lower all risks and become
Avoid Hazards
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Joint Venture Partnerships
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Owning a Companion Care Vets practice gives you a great opportunity to build your own business,
while avoiding many hazards which could slow you down.
To find out more please call Graeme McConnell on 07917 226790 or visit
The best pet careers
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Companion
Care vets
66
VP JUNE 2011
BUSINESS & FINANCE
self-sufficient.
In reality, your plan will consist of a mix of these
depending on the functions of the business that need
to be up and running so that work can restart.
But however you approach it, ensure that the plan
that comes from the strategy is written in plain English
so that all can understand it. Guidance on writing a
plan can be had through a free piece of software that
has been designed by several insurance companies.
Called ROBUST it’s at https://robust.
riscauthority.co.uk/.
Build in protection
Contemplate where you can build redundancy into
your business without adding too much extra cost.
Whilst there’s no point renting a spare building or
equipment just in case, knowing where you can rent
what you need in an emergency may just save the day.
Similarly, think about where you would go to get
agency staff to fill in for staff absences.
You know that equipment, especially IT, can fail.
The hard drive in your computer, for example, has a
“mean time before failure” rating: in other words, how
long it’s expected to operate before it fails. But that
doesn’t mean that it won’t fail much sooner.
Similarly, an (often automatic) update to the
operating system on your computer may cause more
problems that it cures. The key to both of these
scenarios is to back up your data regularly, at least once
a day, and keep the back-up offsite and accessible.
Telephones and broadband are now so critical to
the running of a business. This is especially acute if
your telephone system is based on VOIP (internet)
rather than the traditional hard-wired BT phone line.
Plan to use alternatives. Is there someone with a
EQUIPMENT
I.T. & IMAGING
REFURBISHMENT
TAX BILL
CAR
t: 01536 52 96 96
e: info@performancefinance.co.uk
w: www.performancefinance.co.uk
Employees have become
wireless connection
more litigious and as
with whom you can
discrimination awards have
agree a reciprocal
no limit, a good case
piggy-back
proven against you could
arrangement?
cost thousands.
If you rely upon
Similarly, ignoring a tax
other equipment, do
demand from HMRC –
you know where you
even though you consider
can get repairs or
it pure fantasy – could lead
replacements from
to bankruptcy. You need
should they too fail?
Practice premises have been flooded out and one
to keep abreast of all legal
Can documents
practice reported some time back that a lightning strike
changes that may affect
be scanned and filed
had severely damaged its computer systems.
the business.
electronically? There
are plenty of fast, double-sided automatic scanners
that will not only turn paper into PDF files that can be Write policies and risk assess
backed up, but which will give you a searchable archive Having good polices and also risk assessing threats
on your computer. Even better, you’ll be able to store
will mean not only will you be able to forestall any
the originals elsewhere at a less expensive location to
obvious threats such as simple fire risks, they may
further spread the risk of loss.
help you lower your insurance premiums on the
basis that you present a lower risk to the insurer.
Insurance
Further, everyone will know what to do. For
Despite rising costs, never skip on your insurances. example, by writing a bad weather policy, both you
Indeed, make a point of recording when they are
and your staff know the effort level that is
due and ensure that you check that they have been
expected when trying to get into work and the
paid for. Don’t forget to note down the policy
pay/leave arrangements for when they fail to make
details and keep them off site.
it.
Apart from the obvious insurances – premises,
You may consider employee issues such as
stock, vehicles, public and employers liability – also discrimination, bullying and sickness absence a
look at:
threat, in which case you should develop policies
n Directors and Officers insurance that covers
for those too. The same applies to health and safety
negligence when running a firm;
issues.
n Business Interruption insurance that pays to
A good policy will not necessarily get you out
keep a business alive following a catastrophe
of trouble if an incident occurs, but it will help
(unlike premises and contents which just pays to
mitigate any penalties heading your way following
replace the physical);
an investigation.
n Keyman Insurance
Do take legal advice before you put your
that provides a sum of
thoughts into policies that are available for all to
money following the
read.
death of a key person –
co-owner or
Emergency contacts
shareholder – to the
Draw up a list of emergency contacts that includes
surviving business
key staff, the utilities (water, gas, electricity,
partner(s) to keep the
telephone and broadband), employment agencies
business afloat or to
and key suppliers. Work out how you can divert
buy out the estate of
your calls if you cannot access the building to do so.
the deceased;
Remember also details of your accountant,
n Critical Illness Cover
solicitor and the tax/VAT office (with your
that pays out following
references). Don’t leave out neighbouring
the diagnosis of defined businesses in case they need to be informed. Also
serious illness that
ensure that you are still able to contact your clients
invariably is terminal or – they need to know that you are still in business,
life-threatening –
especially if you have moved.
especially important for
small businesses or sole Test
traders;
Finally, having spent time, effort and money in
n Permanent Health
creating a disaster recovery plan, you need to both
Insurance that pays an
test it and keep it up to date. Carry out a test
income where the
without telling anyone that it’s a test. See where – if
insured can no longer
– the plan falls over.
work. This too is vital
Ultimately, the threats affecting one business
for the sole trader.
might be quite different for another. But the threats
are real and statistically your business runs a one in
Regulatory
five chance of something serious going wrong.
It would be a mistake
Make sure it doesn’t happen to you or if something
not to mention the
untoward does happen, that you are as fully
regulatory threat of
prepared for it as you can be.
changing legislation, case
Sources of advice
law and tax policy, any
n www.continuitycentral.com
combination of which
n www.businesslink.gov.uk/bdotg/action/
could impact a business.
detail?itemId=1074463289&type=RESOURCES
Employment law is
n www.thebci.org
great example.
FINANCE
FINANCE
FINANCE
FINANCE
FINANCE
VP JUNE 2011
BUSINESS & FINANCE
67
Rented premises: a tenant’s guide
A LEASE is an onerous document
and should not be entered into
without specialist legal advice. Be
aware of the following when
negotiating the provisions of your
lease.
Duration of lease
Be aware that there are various
ways in which rent can be reviewed.
The most common is on an open
market level which is the rent a new
tenant would pay if the property was
let on the open market. Other ways
include fixed increases, linking the rent
to the Retail Price Index or linking the
rent to the tenant’s annual turnover.
Choosing the right term for your lease
is vital. Traditionally, tenants were
granted long lease terms, e.g. 21 years
Repairing obligations
and over. In recent years, however,
Leases should state which costs the
tenants have opted for shorter terms,
landlord and tenant are responsible
e.g. between three and 15 years.
for. If you have a “full repairing” lease,
Note that leases over seven years
you will be responsible for internal and
must be
registered at
PUJA PATEL
the Land
explains what leases are all about
Registry and
and what should be included in
that the term
them, and the need to negotiate
can have
and agree mutually acceptable
arrangements
significant
implications
with regard to the amount of Stamp
external repairs as
Duty Land Tax payable.
well as internal and external
maintenance and decoration. The
Break clause
extent of the tenant’s liability should
If you opt for a longer term, you may
directly correlate with the term of the
require a “get-out” clause to terminate lease.
the lease before it expires. Leases can
Consider accounting for the initial
contain a break clause which allows
condition of the premises by inserting
the tenant to end the lease at a
a Schedule of Condition into the lease
so you are aware of the likely repairing
specified date upon giving a specified
period of notice.
obligations beforehand and can
Landlords are not obliged to
negotiate which party should be
include break clauses and
responsible for these.
understandably some may not want to
You may wish to have photographs
incorporate them at all in order to
professionally prepared and, if so,
protect the return on their investment. retain these with the original lease
This will be a matter for negotiation.
documentation. This may prevent
disputes at a later date.
Rent review
A service charge may also be
Generally, if a lease is granted for
levied in addition to the rent. The
three years or more, it will include
service charge will be used to cover
provisions which allow for the rent to
the cost of certain outgoings made by
be reviewed at intervals during the
the landlord and it should be clearly
term. The intervals can be calculated
detailed in any lease which services
as anniversaries of the term
the landlord will be required to
commencement date or the lease can
provide.
specify exact rent review dates.
Insurance
Puja Patel is a solicitor in the
commercial team at Lockharts
Solicitors; e-mail prp@lockharts.co.uk.
n This article provides general
information and is not intended as
legal advice. Neither the author nor
Lockharts Solicitors will accept liability
for losses arising from reliance on the
information in this article.
Normally, the landlord will arrange the
buildings insurance and the tenant will
be responsible for the payment of the
premiums.
If the landlord arranges the
insurance, you should be provided
with a copy of the terms and be noted
on the insurance policy. The tenant
Business innovation director
NED Flaxman has been appointed director for
business innovation at Pfizer Animal Health.
Mr Flaxman (pictured with Lottie) who completed an
MBA at Cranfield, was previously operations director at
Companion Care.
In his new position he will lead Pfizer’s Vet
Support+ initiative.
should be required to arrange his or
her own contents insurance.
Assignment
Tenants can pass on their lease
obligations by assignment.
Leases will usually prescribe how
this is done and the majority will
permit assignments subject to the
tenant obtaining the landlord’s
consent, which cannot be
unreasonably withheld.
If you are in partnership, the lease
should be able to accommodate any
changes in the partnership without the
landlord’s consent in case a partner
who is a signatory to the lease retires
or dies.
Security of tenure protection
A business tenant is protected under
the Landlord and Tenant Act 1954
(“the Act”), unless the Act is
expressly excluded in the lease.
If the tenant occupies all or part
of the premises when the lease ends,
security of tenure protection entitles
the tenant to an automatic right to
renew the lease (save for in certain
circumstances) and a right to stay in
the premises beyond the termination
date until the lease is renegotiated.
If the Act is excluded in the lease,
however, you will not have a right to
seek a renewal on the expiry of the
lease term and will have to vacate the
premises on the termination date.
Note that on the renewal of a
lease, the landlord can only amend
specific provisions, e.g. the term, rent
and changes which are fair and
reasonable. The landlord of one of
our consultant clients wished to
change a majority of the terms in the
renewal of a lease and we
successfully applied to the Court to
prevent him from doing this.
Conclusion
A lease will impose a number of
rights and obligations on the tenant
and without specialist advice during
negotiations you could end up in an
undesirable position.
Negotiating and agreeing the
terms of the lease is only the start of
the landlord and tenant relationship.
A lease provides the framework in
which the relationship will operate
and taking time to agree the terms
and being aware of your options will
reduce problems in the future.
Should price be the only factor
when purchasing microchips?
Ask about the aftercare service
being passed on to your clients:
Microchips affiliated
with Petlog:
• Are all additional costs to your clients
transparent?
• Is the service delivered robust and backed
by clear results?
• Is it monitored by MAG/BSAVA and
compliant to ISO9001 Quality Standards?
• Does it link with all databases and work at
a European level?
• Is there a true 24/7 service for both Lost
and Found pets?
(Pets don’t always go missing between
9am-5pm!)
At Petlog, we answer “yes”
to all the above,
so you can be assured your clients
are happy and their pets are safe.
That’s The Petlog Promise
0844 4633 999
www.petlog.org.uk/vets
The UK’s largest independent microchip registration and reunification database
68
VP JUNE 2011
BUSINESS & FINANCE
WHAT’S NEW...
Keep details up-todate with HMRC’s
free service
HM Revenue & Customs is quite keen
to tell taxpayers that notification of
changes to their circumstances can be
made any time of the day or night, 365
days a year, with its electronic change of
circumstances service.
If taxpayers have moved, or
changed name, they should let HMRC
know via
www.hmrc.gov.uk/individuals/changeof-circs.htm. Incorrect information can
lead to problems – for example,
taxpayers not getting the right tax codes
and/or other notices that could
adversely affect them.
Taxpayers will receive an automatic
response letting them know that the
form has been completed correctly.
They will also receive an e-mail letting
them know that they have been
updated on any HMRC system that
they are linked to as an individual.
File returns on time
to avoid penalties
A NEW penalty regime for late filing
and late payment of income tax
through self-assessment started in April
and a tax return filed six months late
could attract a penalty of at least
£1,300.
The old £100 penalty was not much
of a deterrent and the new penalties,
which increase over time, aim to get
people to submit returns as soon as
possible.
The new penalties for filing a tax
return late are: day one, an initial
penalty of £100, even where there is no
tax to pay or it has already been paid;
three months late and there will be an
automatic daily penalty of £10 per day,
up to a maximum of £900; six months
late the charge rises to the greater of
5% of tax due or £300; 12 months late
and offenders will be charged the
greatest of 5% of tax due or £300. In
serious cases there is a higher penalty of
up to 100% of the tax due.
Penalties for paying tax late are: 30
days late, an initial penalty of 5% of the
tax unpaid at that date; six months late
and a penalty of 5% of the tax that is
still unpaid; 12 months late and a
further penalty of 5% of the tax that is
still unpaid.
These penalties are on top of the
interest that HMRC will charge on all
outstanding amounts, including unpaid
penalties, until the payment is received.
Penalties will be automatically sent
to all self-assessment taxpayers who do
not file and pay on time. Taxpayers will
be able to appeal against any penalty on
the grounds that they have a reasonable
excuse for not complying on time.
Crackdown on drink
and drug driving
A PACKAGE of measures to tackle
drink and drug driving has been
announced by the Government.
Drivers need to know that improved
testing equipment to detect drink and
drug drivers is to be bought and
changes will be made to “streamline”
enforcement of both offences. In
simple terms, this means that
loopholes will be closed, rehabilitation
schemes will be introduced and
drivers’ rights may be curtailed
following arrest and during the testing
process.
The Government will also examine
the case for a new specific drug
driving offence – alongside the existing
one – which would remove the need
for the police to prove impairment on
a case-by-case basis where a specified
drug has been detected.
However, the prescribed alcohol
limit for driving will not be changed,
with the focus instead on improving
enforcement and education to tackle
drink and drug drivers.
n www.dft.gov.uk/pgr/roadsafety/
drivinglaws/
Consultation on
debt collection
guidance
THE OFT has launched a 12-week
consultation on its updated Debt
Collection Guidance. The new guidance
will apply to all businesses involved in
debt recovery, including creditors as
well as debt collectors and purchasers,
lenders, law firms and tracing agents.
It aims to clarify creditors’
responsibilities for the information they
pass on to debt collection agencies or
debt purchase companies; take account
of other new and developing practices;
take account of other recently issued
OFT guidance; and reflect recent
changes in the law.
The guidance also sets out specific
business practices that the OFT
considers to be unfair, such as creditors
failing to update records or credit
reference agency data, where it has
been established that an individual is
not the debtor, or the debt has already
been paid.
The OFT is inviting those with an
interest in debt collection activities to
respond to the consultation. It will
consider all submissions and, where
appropriate, reflect these in the final
version of the updated guidance.
n http://oft.gov.uk/OFTwork/
consultations/current/debt-collection/
VP JUNE 2011
BUSINESS & FINANCE
69
Do you have a pension shortfall?
adds further to the financial burden of
RECENT studies into retirement
retirement.
savings show that Britain faces a £9
Research shows that the average
trillion savings gap that will plague
lifetime cost of care has risen to
future pensioners for the next 40
£50,000, with one in five facing lifetime
years.
bills of more than £100,000.
The Chartered Insurance Institute
Another worrying statistic, as
(CII) that completed the above study
evidenced by a major study by the life
has said that tomorrow’s average
insurance company Aviva, is that one in
pensioners won’t even have enough to
four pensioners will still be saddled with
cope with day-to-day living expenses
a mortgage debt of £50,000 after they
unless they start saving hard. Their
stop working.
report has found that working Britons
It doesn’t take a genius to work out
face an average £16,700 shortfall per
the potential financial ramifications of
person, per year, if they maintain their
millions of over 55s approaching
current approach to retirement savings.
retirement with no pension, no savings
The main causes for this crisis are a
and large debts. Quite how the current
chronic lack of personal saving from
Government chooses to address this is
individuals and 20 years of plummeting
annuity rates.
Currently, a
DYLAN JENKINS
pension pot
is concerned with Britain’s
of £100,000 is
pensions gap and discusses what
now worth
people should be doing to ensure
around £6,000
they have a financially viable
per annum of
retirement
retirement
still yet to be seen.
income compared with £17,000 in the
early 1990s. The dramatic increase in
Knowledge shortfall
life-expectancy rates is one of the main
As well as a huge pensions shortfall,
drivers for this: a 65-year-old is now
there is also a knowledge gap amongst
expected to live to 83 in the UK.
A savings gap was classed by the CII consumers when it comes to preparing
as a retirement income of less than 70% for their retirement.
MGM Advantage, a retirement
of their previous earned income. It has
income specialist, has said that it has
based this judgment on an OECD
seen evidence of a worrying lack of
report that suggested 70% was a
knowledge from customers approaching
necessary replacement income “to live
their retirement, and has called for
adequately” in retirement.
Some have suggested, however, that better financial education.
“Although there is now greater
the 70% figure sets the bar too high,
consumer understanding of the
especially in a country such as the UK
importance of planning and saving for
where there is a great deal of
discretionary spending. One should also retirement, many people are failing to
take into consideration that most British shop around when their pension
matures to ensure the best possible
homeowners should also be living
income once they have retired,” said
mortgage-free by retirement.
Chris Evans, chief executive of MGM
Potential problem
Advantage.
The proposed 70% of income would
The pressure on people to save
provide £17,500 a year to someone
sufficiently for their retirement is being
made greater by inflation that is
earning the UK’s average wage at
currently twice the Government’s target
around £25,000 today.
of 2%, as well as other economic
To achieve just 50% of prepressures. It has been estimated that to
retirement income – £12,500 for the
average salary earner – the UK’s savings maintain the same living standards as a
year ago, the UK population would
gap is £4.4 trillion nationally, the CII
need to spend an estimated additional
says.
Alarmingly, on average, British
£571.85 per person.
workers retire on just 30% of their preretirement income, meaning this
What can be done?
potential problem is clear for all to see.
So what can be done to ensure you stay
In addition, it is likely that one in
on track to meet your retirement goals?
four future pensioners will also require
A good place to start is to make
exorbitantly costly long-term care which sure you have a retirement date in mind
and to use this as the basis of your
Dylan Jenkins is co-owner of RT
calculations.
Financial Planners Ltd; he can be
Whilst it might not be definitive –
contacted at d.jenkins@rtfp.co.uk or
life can always change – it should serve
on 01242 604066.
as a guide. Then you should start to
calculate the sort of
income you will
need to maintain
your current
standard of living.
When working
with clients I often
advise them to
choose a minimum
level of income as
well as an ideal
target. The next
best step is to take a
detailed look at your
pension and where
it’s invested.
You’ll need to
be positioning your
pension fund for
your choice of
retirement income
option. If you are
young and have plenty of years to go
until retirement, then you can afford to
take a more adventurous approach to
investment risk.
Phase out equity
Conversely, if you are due to retire
within the next few years, then you
should look to phase out all equity
(stocks and shares) investment with a
view to reducing the volatility of your
fund and securing the value with
which you can purchase a retirement
income.
There could be nothing worse at
this time than seeing a stock market
lurch take a chunk out of your pot just
as you’re about to dig in.
Consider maximising your
contributions, too. Particularly if you
are a higher rate taxpayer (remember
that pensions are a highly tax-efficient
means of saving).
You may have grown-up children
you wish to support financially, but try
to strike the balance. As much as you
can should go towards your pot – you
won’t have many other chances to
maximise the
size. If and
when you
purchase an
annuity, this can
make a serious
difference to
your annual
income.
Those in
their 60s will be
faced with
making
important
decisions about
how their
pension fund
produces cash
and income in
retirement.
These are often
lasting decisions
that can have a major impact on your
finances in later life, so is an ideal time
to seek expert independent financial
advice. This is particularly true in the
case of annuities, where the options
are varied.
Essentially, annuities are like
insurance in reverse: you hand over a
large lump sum (your pension pot) to
an annuity provider, and it gives you
regular monthly payments in return for
the rest of your life.
You may qualify for a higher
annuity rate if you are a smoker or
have an illness. This is called an
enhanced or an impaired annuity.
Additionally, you may be fit and
able and want to keep working. This is
now possible because the Government
is set to prohibit employers from
forcing their staff to retire at 65. It
may be beneficial to keep working for
a period and top up your pensions as
much as you can.
It really isn’t all doom and gloom
and for those who have planned
carefully, retirement truly can be your
golden years.
Professional business support
for veterinary practices
From starting or acquiring your first practice,
through developmental growth, to exit
planning and sale we can help you
every step of the way.
70
VP JUNE 2011
BUSINESS & FINANCE
Long/short investing strategies
FOR most investors, the concept of
types of derivatives, fund of funds and
stock market investing is a fairly
money market instruments in addition
simple one: buy a share in a
to permitting the use of index tracking
company for a reasonable price,
techniques.
hold the shares for a period of time
The new rules also gave traditional
and, if they have gone up in value,
fund management companies the
sell at a later date for profit.
flexibility to use many of the same
However, as the financial landscape
tools as their hedge fund counterparts,
has developed and more complex
albeit with additional layers of
structures have evolved, there is a much protection for investors.
broader selection of potential
investment solutions to consider.
What is shorting?
For some, hedge funds have long
A traditional long only strategy relies on
been used as an alternative to traditional buying shares in a company and selling,
“long only” strategies, but until quite
hopefully for a
recently, lack
of
GORDON NICOLL
accessibility
continues his series on explaining
has meant
financial terminology and what is
that they have
involved in this type of
been the
investment strategy
domain of
ultra high net
worth individuals or institutional
profit at some point in the future –
investors.
known as going long on a stock.
In February 2004, changes in
When an investor goes long on an
legislation introduced new levels of
investment, it means that he or she has
transparency and flexibility to collective bought a stock believing its price will
investment schemes, extending the
rise in the future. The converse is also
scope of investments in which funds
true: when an investor goes short, he or
can invest to include deposits, certain
she is anticipating a decrease in the
Practice’s nurses ‘not uniform’
as college proves successful
MEDIVET has introduced a new range of uniforms for its nursing staff.
“The uniforms will help identify and distinguish between the differently
qualified nurses and assistants working in any one of our over 80 practices,”
said Erwin Hohn, senior partner in the group and principal of Medivet’s
training college.
The group has nurses and assistants at three levels: qualified veterinary
nurses (dark green uniform), student veterinary nurses (green and white
uniform) and patient care assistants (blue and white stripe).
“We see this as another way in which we can help our clients understand
the level of expertise they can expect from our staff,” Mr Hohn added.
n Medivet has established its own veterinary nurse training college approved
by the RCVS. This specialises in providing courses for nursing and auxiliary
staff within the profession. Last year it recorded a 100% pass rate for its 49
veterinary nursing students.
'
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share price.
Short selling means you borrow a
stock and sell it immediately. The hope
is that the share will fall in value and
that you can buy at a lower price than
you sold it.
Consider this example. The fund
manager believes that the share price of
Company X is overvalued at 335p. By
entering into a short selling agreement,
the manager would borrow, say, 1,000
shares in Company X from a broker
and then sell them for 335p making
£3,350.
If the share price falls to 200p, the
manager could subsequently buy 1,000
shares in the market for £2,000 to pay
back the broker, having made £1,350
profit (£3,350 - £2,000).
If, however, the fund manager
“shorts” on a share that rises in value,
then the potential losses will be
mirrored. The risks, as are the losses,
are unlimited – a rapid and dramatic
rise in the value of the share will see
the short seller exposed to big losses
until the position is closed out.
investors operate on a “long-only”
basis, some industry commentators
remain unconvinced that a single
manager is able to create a portfolio to
benefit from both winners and losers.
However, the increased profile of
these funds coupled with evidence of
strong, sustained performance from
some managers suggests that they are
likely to continue to grow in popularity.
In a rapidly rising market, in which
most stocks are increasing in value, a
long/short fund will typically underperform a “long only” manager.
The use of synthetic shorting also
introduces default, or counterparty, risk.
Default risk is the risk that the
counterparty providing the derivative
will not be able to pay the contractual
interest or capital on their obligation.
In current markets, default risk is a
consideration for many investors and
the high-profile collapse of several
global banking giants, key players in the
derivatives market, has highlighted this
risk.
Summary
Synthetic shorting
Under the new legislation, fund
managers cannot physically short sell a
stock within a retail fund but they are
able to take “synthetic short” positions
through the use of derivatives. This
enables fund managers to generate
profits from shares in companies where
they believe the future growth and/or
profits of that company are overstated.
The term synthetic shorting relates
to the effect of using a combination of
derivatives that provide the same result
as physically shorting a stock.
What are the risks?
As with any investment strategy, there is
always the risk that the value of the
investment may go down as well as up.
In addition, long/short strategies have
some unique risks.
Being able to identify companies
that display characteristics pointing to
positive growth in the future is, in
isolation, a difficult task. Fund
managers employ a number of different
styles and techniques to achieve
consistent, long-term
growth within their
portfolio.
A successful
long/short strategy
also requires the
managers to correctly
predict the underperformance of
companies.
Whilst the vast
majority of
investment funds
available to retail
Whilst alternative investment strategies
may not suit all investors, the additional
flexibility provided under the new
legislation offers the opportunity to
increase returns in difficult market
conditions by taking short positions.
Investors considering these
strategies should ensure that the
manager they select has a robust
investment approach with strong risk
controls to ensure the expected returns
materialise at an acceptable level of
risk.
n For further information or to
discuss any aspect of financial
planning, contact the author, a
founder member of The Ellis
McComb Partnership, 3 Mortimer
Street, Birkenhead, Wirral CH41
5EU; telephone 0151 650 6520, email ellis.mccomb@sjpp.co.uk;
website www.ellismccomb.co.uk.
The Ellis McComb Partnership is
an appointed representative of St
James’s Place Wealth Management
plc.
VP JUNE 2011
BUSINESS & FINANCE
71
So you want to buy a practice?
Preparing to make a provisional
offer
If you get your offer accepted, have
the practice taken off the market for a
period while you undertake further due
diligence.
A thorough investigation is the key
to effective due diligence and each
practice is different and requires a
complete evaluation. If you have
worked or still work as an assistant in
the practice, you will have an inside
knowledge about the practice’s
strengths and weaknesses.
Prior to making any provisional
offers,you should do the following
three things:
1. Undertake a SWOT analysis of the
practice (strengths, weaknesses,
opportunities and threats relating to it)
to give you comfort about the level and
viability of your provisional offer.
2. Have your business plan template
ready and substitute some actual
practice
figures in to
MALCOLM WRIGHT
show viability
concludes his article on the
after loan
various ways of setting about
costs, etc., on
owning a practice and finding the
the
one that’s right for you
assumption
they will
If you are an
continue to be maintained at the same
external buyer with no inside
level of sales and overheads as the
knowledge, the investigative process is
vendor in year 1.
more difficult. However, with a
3. Have an agreement in principle for
structured approach to the key issues,
funds from a lending source – you will
utilise your business plan for this which you can still obtain a thorough
understanding of the practice’s
should include:
character.
n sales forecast for 2-3
However you decide
years;
Never be
to proceed, make it
n profit and loss (P&L)
prepared to pay crystal clear exactly what
forecasts for 2-3 years;
any value for
you are offering and
n cash flow forecasts for
2-3 years.
any undeclared what it is for! And
Include assumptions
whether it is subject to
income.
to explain your
any criteria, e.g. due
projections (i.e. give a
diligence, etc., and/or
reason why sales will increase by
survey.
100%!).
You will need a response to your
This should ensure the financial
offer within a certain time frame to
purchase of the practice is manageable
allow you to see if the offer is
and you have funding for both the
acceptable.
capital costs and the working capital to
allow you to run the practice.
Offer accepted – the next steps
Remember that this is only the
Verbal agreements have a habit of
preliminary part of the deal and you
being problematic as time passes,
must act quickly if other parties are
possibly one of the parties
interested.
misunderstood something that was said
The next stage is to put in your
or nothing was discussed about a
offer: depending upon the
certain topic which causes disagreement
circumstances you may wish to try and
at a later stage.
make a reduced offer and negotiate
To minimise this, it is sensible to
with the seller.
write up a basic non-legally binding
document that takes into account
Malcolm Wright, BVMS, MRCVS,
everything that has been agreed at the
qualified at Glasgow in 1972. He set
time of the meetings: this is called a
up Westway Veterinary Group in
Heads of Agreement, and it will be
1975 which developed into the largest
tidied up and formalised later by the
veterinary practice on Tyneside,
lawyers.
employing 13 veterinary surgeons with
nine sites. In 1994 he set up Vet-Direct
Services Ltd which was developed as a
short-line wholesaler supplying
veterinary practices throughout the
UK. In 2000 he set up Firstvets Ltd,
with centres in West Midlands,
Glasgow, Durham and Tyneside. In
2011 he set up VetbizCPD a training
company specifically for veterinary
practice. He can be contacted at
Malcolm@vetbizcpd.com.
What is due diligence?
The phrase “Let the buyer
beware” is what due diligence is
about. If you are paying a fair fee
for the practice, you have every
right to undertake a financial and
legal investigation into the practice.
Your initial offer would have
been based upon the financial
accounts presented to you but
sometimes there are things that are
would only pay the book value for the
hidden within the accounts that would
equipment – which is probably much
not come out without deeper
lower than the real time value.
investigation.
However, the result may
Don’t expect the be that you pay a higher
That is where the
process of due
percentage for the
owners or the
diligence (DD) comes
goodwill.
seller’s practice
in. DD may also be a
Remember to
broker to
requirement if you
transfer any hire
advertise the
require funding from a
purchase or lease
practice’s
bank.
purchase agreements
The process of due financial failings.
from the vendor to the
diligence is normally
buyer.
divided into:
n financial due diligence; and
Completion
n legal due diligence.
If everything is OK, your offer has
As a purchaser, it is essential to find been accepted and your funding
out whether there are any “skeletons in requirement granted – now to finalise
the cupboard” and that things are what the deal.
they seem. A seller may know certain
The lawyers should be working to
things that he or she definitely doesn’t
a completion date time frame – make
want you to discover.
sure that you keep things moving.
At this point you should ask the
Purchasing the equipment
seller to make arrangements for you to
Most of the equipment being sold
meet the practice staff: it is essential
should be used routinely in the practice that you have them on your side from
and should be clearly detailed in the
day one and settle any worries they
equipment asset list. With many sales,
may have about the effects of the sale
the equipment is not individually priced of the practice.
and you must look at the complete list
Most sellers are happy to
and estimate the viability of the total
undertake this once they know the
legalities are well under way and they
asking price.
feel comfortable the deal will go
In most cases, certain pieces of
major equipment such as computer
through.
systems, x-ray, scanners and blood
Meet everyone together and let the
chemistry machines will make up the
owner introduce you, but remember
they are still his staff until all the
bulk of the value. These will require
legalities are completed.
some guarantees from the seller.
The thought of the
If the three-yearThere will be
unknown brings
old x-ray which cost
insecurity, so be friendly,
the buyer £3,000
reluctance on
positive and reassuring
breaks down on day 1,
behalf of the
explain your need
the purchaser requires
seller to give too and
some recourse.
for their help.
much
Remember, though,
You are now ready
information. This to take over, and simply
you are buying secondhand goods and
require to undertake the
can be
therefore you must
understandable if stock-take on the day of
expect some items to
and ensure
it seems that the completion
malfunction without
all the utilities are read
information
having any comeback.
and transferred into the
requested has no new owner’s name.
This fact is usually
reflected in the price
So there you are,
material benefit
paid.
you
have your practice;
to the sale.
If the practice has
with a start-up you
Lawyers can make have a blank canvas,
been valued with
a habit of sticking with a purchase you
EBITD system, or the
seller is prepared to
on minor issues. could have a Picasso
offer the equipment at
under the surface. It
the value in the balance sheet, you
will be all up to you from now on.
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