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Beyond steroids and bronchodilators - investigating additional therapies for horses with severe equine asthma

1 August 2019

Chronic inflammatory airway disease in horses has been known by many names over the past few decades, including heaves, chronic obstructive pulmonary disease (COPD), inflammatory airway disease (IAD) and recurrent airway obstruction (RAO) – with the variant of summer-pasture associated RAO (SPRAO).

In 2016, the American College of Veterinary Internal Medicine (ACVIM) revised consensus statement on IAD in horses proposed a further change in terminology, combining IAD and RAO under the umbrella of ‘equine asthma syndrome’, with a differentiation into mild-moderate equine asthma (formerly IAD) and severe equine asthma (formerly RAO).1 This change in terminology was based on the realisation that chronic airway inflammation in horses is likely to be a collection of clinical and clinicopathological manifestations – or phenotypes – that may have different underlying pathophysiological mechanisms, similar to human asthma syndrome.1,2

This evolving thought process has highlighted the need to further...

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Randomised study of the immunomodulatory effects of azithromycin in severely asthmatic horses

1 August 2019

Neutrophilic inflammation is believed to contribute to the airway obstruction and remodelling in equine asthma. Azithromycin, an antibiotic with immunomodulatory properties, reduces pulmonary neutrophilia and hyper-responsiveness in human asthmatics and decreases airway remodelling in rodent models of asthma. It was therefore hypothesised that azithromycin would improve lung function, mucus accumulation and central airway remodelling by decreasing luminal neutrophilia in severe equine asthma. The effects of a 10-day treatment with either azithromycin or ceftiofur, an antimicrobial without immune-modulating activity, were assessed using a blind, randomised, crossover design with six severe asthmatic horses in clinical exacerbation. Lung function, tracheal mucus accumulation, tracheal wash bacteriology, bronchial remodelling, airway neutrophilia and mRNA expression of proinflammatory cytokines (interleukin (IL)-8, IL-17A, IL-1β, tumour necrosis factor-α) in bronchoalveolar lavage fluid were evaluated. Azithromycin decreased the expression of IL-8 (P=0.03, one-tailed) and IL-1β (P=0.047, one-tailed) but failed to improve the other variables evaluated. Ceftiofur had no effect on any parameter. The reduction of neutrophilic chemoattractants (IL-8, IL-1β) justifies further efforts to investigate the effects of a prolonged treatment with macrolides on airway neutrophilia and remodelling. The lack of efficacy of ceftiofur suggests that severe equine asthma should not be treated with antibiotics at first-line therapy.

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Exploring early life events including diet in cats presenting for gastrointestinal signs in later life

1 August 2019

Our study aimed to determine if certain early life events were more prevalent in cats presenting to veterinary practices specifically for gastrointestinal signs on at least two occasions between six months and 30 months of age. Data from an owner-completed questionnaire for 1212 cats before 16 weeks of age and subsequent questionnaires for the same cats between six months and 30 months of age were reviewed. Of the 1212 cats included, 30 visited a veterinary practice for gastrointestinal signs on two or more occasions. Of the early life events recorded, cats reported with vomiting, diarrhoea or both, and/or those not exclusively fed commercial diet(s) that meets the World Small Animal Veterinary Association (WSAVA) Global Nutrition Committee (GNC) guidelines before 16 weeks of age were more likely to visit veterinary practices specifically for gastrointestinal signs on at least two occasions between six months and 30 months of age (P<0.001, odds ratio (OR)=2.64, 95 per cent confidence interval (CI)=1.66–4.22 and P=0.030, OR=1.51, 95 per cent CI=1.04–2.22, respectively). Ensuring cats exclusively consume commercial diet(s) that meets the WSAVA GNC guidelines and further studies identifying specific aetiologies for vomiting and diarrhoea before 16 weeks of age to enable prevention may reduce the number of cats subsequently presenting to primary care veterinary practices for repeated gastrointestinal signs.

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Evaluation of alfaxalone and dexmedetomidine for intramuscular restraint in European hedgehogs (Erinaceus europaeus)

1 August 2019

The European hedgehogs may require the use of chemical restraint for clinical examination because of their tendency to roll up as a defensive behaviour. This study evaluated the effects of alfaxalone combined with dexmedetomidine for restraint of hedgehogs undergoing pre-release health checks and atipamezole for recovery.

Twenty hedgehogs received alfaxalone 2 mg/kg and dexmedetomidine 0.05 mg/kg intramuscularly in the quadriceps. If the righting reflex was still present, both drugs were administered at half of the initial doses. A semiquantitative scale scored sedation; clinical variables evaluated included pulse rate, respiratory rate, arterial haemoglobin oxygen saturation, end-tidal CO2 and body temperature.

The righting reflex disappeared between 141 and 880 seconds. Overweight animals required one additional injection to achieve adequate relaxation. Pulse rate decreased during the procedure and increased after atipamezole administration. Respiratory rate and end-tidal CO2 did not change statistically throughout the procedure but one hedgehog showed haemoglobin oxygen saturation lower than 90%. Recovery after atipamezole was smooth and complete. Body temperature decreased over time.

The sedation protocol may represent an effective combination to restrain European hedgehogs and atipamezole provides a rapid antagonism. Additional sedatives administration may be required in overweight animals and an external source of oxygen should be available.

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Selected highlights from other journals

1 August 2019
What disorders are the most common in UK bulldogs?

D. G. O’Neill, A. M. Skipper, J. Kadhim and others

PLoS ONE (2019) 14

doi: 10.1371/journal.pone.0217928

• What did the research find?

Bulldogs comprised 0.6 per cent of all dogs born in 2013 attending the participating veterinary practices, rising from 0.35 per cent in 2009. The median longevity of the breed was 7.2 years, with females generally living longer than males. The most prevalent disorders recorded were otitis externa (12.7 per cent), pyoderma (8.8 per cent) and obesity (8.7 per cent). The skin was the most commonly affected body region (28.6 per cent), followed by the eyes (18 per cent), ears (13 per cent), gastrointestinal tract (11.6 per cent) and upper respiratory tract (10.5 per cent).

• How was it conducted?

The clinical records of all bulldogs under primary veterinary care at clinics participating in the VetCompass programme during 2013...

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Higher risk of xylitol gum poisoning with some products

1 August 2019

One of the Veterinary Poisons Information Service’s (VPIS) remits is toxicovigilance.

Xylitol, commonly used in sugar-free products, is a well-recognised toxic hazard to dogs, causing hypoglycaemia and liver failure. In February 2018, Mars Wrigley Confectionery UK launched a new range of Starburst Gums called Starburst Fruity Mixies, Starburst Strawberry Cubes and Starburst Red Berry Sticks. These products are described as a mix between a gum and a sweet, and the Fruity Mixies and Strawberry Cubes both contain a high concentration of xylitol (over 50 per cent).

The VPIS has been monitoring cases involving these products and have nine cases with complete follow-up. Eight cases involved Starburst Fruit Mixies (available in packs of 100 pieces) and one involved Starburst Strawberry Cubes (packs of 30 pieces).

In six cases involving the Fruit Mixies the dose ingested was estimated to range from 15 to 200 pieces of gum. The dogs ranged in...

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Bookmakers responsibility to greyhounds

1 August 2019

Josh Loeb’s excellent news article (VR, 20 July 2019, vol 185, p 73) reinforces the absolute requirement to put good welfare at the heart of any sport that uses animals for entertainment, such as racing greyhounds.

Much could be improved if bookmakers took their responsibilities towards greyhound welfare seriously. The introduction of a statutory levy on all bookmakers, alongside additional measures, such as improved kennelling and mandatory training in animal husbandry for those working within the sport, would go a long way towards improving welfare for racing greyhounds.

It is a shame that despite all the requests from charities and the government, the bookmakers continue to ignore their moral and ethical obligation to look after the welfare of their greatest attribute: the greyhound. Therefore, I’m pleased that journalists and researchers such as Mia Cobb, who is referenced in the article, are bringing such an important issue to the fore.

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Discrimination in the veterinary profession

1 August 2019

I welcome the BVA’s report on discrimination and thank the BVA for raising these important issues through their survey (VR, 13 July 2019, vol 185, pp 34-35), which will pave the way for a more equal profession.

Discrimination in the workplace is completely unacceptable. I encourage all veterinary professionals to contribute to the conversation and to speak up about discrimination, and I urge everyone, especially employers, to take action to tackle this kind of behaviour in the workplace.

Our vets play a critical role in controlling disease outbreaks, safeguarding animal health and welfare, supporting trade and tackling global One Health challenges, such as antimicrobial resistance. I will be joining the profession-wide discussion about the findings of the report to ensure that, as colleagues and as employers, we all support our veterinary surgeons.

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Genetics of equine metabolic syndrome

1 August 2019

Equine metabolic syndrome (EMS) is defined as a complex disorder characterised by a phenotype of insulin dysregulation, obesity and a predisposition toward laminitis, resulting from the combination of one or more inherited genetic alleles and environmental influences.1

Recently, a genome-wide association study (GWAS)2 identified two genetic markers for EMS located in the FAM174A gene region in Arabian horses: BIEC2-263524-C and FAM174A 3’ UTR -11(G) (Equus caballus chromosome 14:69,276,814 and 14:69,119,991 in EquCab2.0, respectively), with a correlation of 98 per cent between the two. However, uniform fasting guidelines were not followed and the studied populations were older than the general age of onset of EMS.3 This led to inconsistent diagnoses of EMS, since variability in non-structural carbohydrates, content of forage and age of horses influence metabolism and phenotypic measures.1-4

In addition, some EMS cases used for the GWAS were affected...

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RCVS need to acknowledge general practitioners

1 August 2019

The RCVS recently published the papers from the May meeting of the advancement of the professions committee (APC) (www.rcvs.org.uk/who-we-are/committees/advancement-of-the-professions-committee/7-may-2019).

I note the papers are redacted in two respects, in relation to the costs of the activities discussed and in respect of regulatory matters where advice has been sought by third parties relating to RCVS activities.

Concerns have been voiced recently about council voting on RCVS matters in a hidden manner, with no opportunity to identify how councillors, including elected councillors, are behaving. Together with, what looks to me to be, increasing redactions in committee papers I see RCVS entering a new phase of ‘bunker’ behaviour, quite at odds with their undertakings of ‘honesty and transparency’ outlined in the current strategic plan for 2017-19 (p 4).

With these changes of behaviour I also struggle with the RCVS’ self-appointed leadership role in supporting leadership in the profession. I would contend...

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BVA Council reps 'shocked but not surprised by discrimination findings

1 August 2019

Following an ‘unprecedented’ response to BVA’s recent surveys on discrimination in the workplace, BVA Council members were asked how the Association could help address the issues raised.

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Microchip scanning position updated

1 August 2019

Council members were asked to approve an updated BVA policy position on microchip scanning and databases.

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Council news in brief

1 August 2019
Telemedicine and the RCVS

Several Council reps reported that members in their regions were concerned that the RCVS was ‘doing things behind closed doors’ regarding telemedicine and its review of ‘under care’ and 24/7 cover. They were looking for reassurance that the profession would be thoroughly consulted on these issues. BVA President Simon Doherty said the RCVS had assured BVA there was ‘no conspiracy’ and that it was committed to pan-professional consultation and engagement. BVA will be engaging with members as the issues progress.

Prioritising welfare issues to focus resources

Cathy Dwyer, director of the Jeanne Marchig International Centre for Animal Welfare Education, attended the Council meeting by invitation to describe the recent Delphi study she and her team had carried out for the Animal Welfare Foundation (AWF). The study aimed to identify and rank animal welfare issues to help the AWF prioritise the funds it has available...

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Feather pecking, rabbit housing and fireworks policy positions approved

1 August 2019

Subject to minor amendments, Council members approved new BVA policy positions on feather pecking in poultry and on the housing of rabbits. Both issues had been identified as priority welfare problems as part of the BVA Animal Welfare Strategy.

Following some discussion, the Council also agreed a revised position on fireworks, which expresses BVA’s support for further restrictions on the sale and use of fireworks to safeguard animal health and welfare.

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'Stop the divisive and toxic communications

25 July 2019

Recently, I have met many vets, particularly younger members of the profession, working in corporate practice who are angered by the way their professional integrity is being publicly questioned by colleagues working in so-called independent practice. This is becoming a growing issue and something I wish to draw the profession’s attention to.

In some recent newsletters and public communications, there has seemingly been an orchestrated campaign to question the motivations of vets, depending on the ownership structure of the organisation they work in.

Typical comments I have read include: 1 ‘I believe that clients and their animals under veterinary care will be better served where owners work within the practice...Independent ownership offers vets the freedom to provide the treatments that are the best and most economic for individual clients.’ 2 ‘By not having external investors or non-veterinary management to answer to, we can make decisions with animal care our...

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Quick reference guide for cattle vets

25 July 2019

Reviewed by Eleanor White a final-year vet student who is currently on rotations.

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Health and welfare in a multi-animal environment

25 July 2019

I often say to my teenage kids that by the time they go into the workplace there will be jobs open to them that don’t currently exist. Shelter medicine is one of those; it was only in 2014 that the American Veterinary Medical Association recognised it as a specialty in the USA. So far, all textbooks on this subject have come from the USA, so the arrival of this new manual, which focuses on common issues and diseases here in the UK is welcome.

Most of our larger animal rescue charities have vets working on site. Many vets also have an input into charity work: the book quotes a survey in 2008, which found that 94.8 per cent of UK vet practices worked with charities in some way.

This book is a great introduction to those new to or dabbling in shelter medicine, while also providing a good reference...

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NASA put out a call for potential astronauts and appointed a vet

25 July 2019

Vet Richard Linnehan is an adjunct professor at North Carolina State College of Veterinary Medicine – he is also an astronaut, reports Tim Peeler.

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Ruminant research bursaries awarded

25 July 2019

MSD Animal Health has awarded ruminant research bursaries to two vets. The first award has been made to Sophie Mahendran (pictured, far right) from the University of Surrey, for her randomised trial comparing the effects of antimicrobial and NSAID treatments for calf bovine respiratory disease on lung pathology assessed using thoracic ultrasonography. The second award was made to George Giles of Giles and Parsons Farm Vets, for his research on the development of veterinary fertility services that meet market demand – a qualitative study of seasonally calving herds in the UK.

The MSD Animal Health Research Bursary for veterinary surgeons offers annual awards of up to £4000 each. Projects must be completed within one to two years and the veterinary practitioner proposals are judged by university academics to ensure independent assessment.

Research bursary applications will open again in August. Further details can be found at www.msdahresearchbursary.co.uk

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People

25 July 2019

The chair of the Food Standards Agency (FSA) Heather Hancock has announced the appointment of 35 independent members to the FSA’s Scientific Advisory Committees, of which the following three are vets: Jane Gibbens has been appointed to the Advisory Committee on Microbiological Safety of Food, and Nicholas Jonsson, of the University of Glasgow, and Cheryl Scudamore of Abbey Veterinary Services/NationWide Laboratories have been appointed to the Committee on Toxicity.

The Veterinary Management Group (VMG), which represents veterinary professionals working in leadership and management roles, has appointed five new board directors to help it develop the support it provides to its members. They were appointed following interviews at the VMG’s board meeting in June and join the board with immediate effect. The new directors are:

Alison Daubney, practice manager, Summerleaze Vets

Mark Gill, operations director, Goddard Veterinary Group

Gavin Mitchell, managing director, IMV Imaging

Tracey Morley-Jewkes, hospital director, Willows Veterinary...

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