The essential publication for BSAVA members

Aggressive Pets
Potential dangers faced
by those working in
practice
P7
DACTARI
The dangers of
importing animals with
serious pathogens
P4
companion
SEPTEMBER 2008
Rabbit
Medicine
Advances
in knowledge
and science
Clinical Conundrum
Investigation of
coughing in a young
Labrador Retriever
P 10
companion
2 | companion
3 Congress Art
Ed Hall visits the creator of the
2009 design
46 DACTARI
John Bonner examines
The Dog And Cat Travel And
Risk Information scheme
79 Aggressive Pets
Pete Wedderburn on the
dangers faced in practice
1013 Clinical Conundrum
Investigation of coughing in a
young Labrador
1417 How To
Collect a diagnostic bone
marrow sample
1819 Letters from America
Selected discussion from
the Veterinary Information
Network
2021 The Age of the Rabbit
Advances in rabbit medicine by
Michelle Ward
22 Petsavers
Latest fundraising news
2325 WSAVA News
World Small Animal Veterinary
Association
26 The companion Interview
Claire Bessant of FAB
27 CPD Diary
Whats on in your area
companion is produced by BSAVA exclusively for its members.
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CALL FOR
CONGRESS 2009
ABSTRACTS
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T
he Clinical Research Abstracts
provide a fantastic forum for
clinicians in every sort of
employment to present a short talk to
fellow veterinarian surgeons.
Abstracts cover a huge range of surgical
and medical disciplines, and all Congress
delegates are encouraged to attend. The
presenters range from undergraduate
students, nurses, residents, practitioners
and scientists, to learned professors and
company directors.
The audience for the CRAs is also
varied, but all who come along are definitely
interested in the talks they attend. There
is no snoozing in these intimate gatherings,
says Laura Blackwood of the Congress
Scientific Programme committee. The
atmosphere is friendly and helpful, rather
than daunting and confrontational, and
debate is often lively. Many of the abstracts
presented result in publication months or
years later, but the CRAs allow everyone to
find out whats new and can be the start of
new projects and collaborations.
The BSAVA is particularly keen for
general practitioners to submit abstracts,
and if in doubt about the suitability or
otherwise of the topic for presentation
they can contact Sorrel Langley-Hobbs
sjl41@cam.ac.uk of the Congress
Scientific Programme committee for advice.
To submit an abstract visit
www.bsava.com during the month-long
submission window 1 October to
1 November 2008. This deadline will
be strictly adhered to. n
Clinical Research Abstracts are an essential and important
element of the scientific programme at the BSAVA
Congress. Online submission of Clinical Research Abstracts
takes place 1 October to 1 November
companion | 3
CONGRESS
CREATING CONGRESS
E
ach year the current President finds or
designs an image to be used to
promote their Congress. Finding
something to follow Carmel Mooneys
Warhol-esque dog, Mike Jessops golden
Govinder print and Frances Barrs startling
thermal dog & cat images was a real
challenge especially when my own artistic
talent is so limited. As I like and collect art
deco pottery, and knew that the angular
representation of the Scottie dog was an
iconic symbol of the era, I searched Google
Images for an art deco Scottie, which led
me to Russell Akerman, Echo of Deco and a
trip to his pottery.
Pottery passion
Russell was completely untrained in
ceramics when he first found work in a
ceramics caf in the Lake District,
teaching tourists to make pottery. His
natural talent was obvious and developed
rapidly. Today he is a well known studio
potter, with works exhibited in galleries
and private collections worldwide. He
produces exquisite vases in terracotta and
porcelain, with elegant pinched necks and
sumptuous glazes.
As well as being very talented, Russell is
exceptionally modest. He actually took the
time to tidy his studio before our visit,
although the thin veneer of clay dust
suggested that he spends most of his time
working. The potter is also very patient,
perhaps because 1015% of his output has
to be discarded because of breakages or
flaws. He even took time to tutor my wife
Marie, resulting in her successful throwing
of her first ever pot. His passion for his
work shines through all he does, and his
interest in the Art Deco style was obvious.
Echo of Deco
In addition to his art pottery, Russell owns
Echo of Deco, a specialist contemporary
studio creating individual pieces of ceramic
art for pottery collectors and Art Deco
enthusiasts. The company was founded in
2004 with his father, Malcolm. Ark Deco is
their collection of ceramic animal figures
inspired by the well known Noahs Ark
story. The design of the Ark Deco
ornaments aims to capture the unique
personality and character of each animal
interpreted in its simplest form, using
distinctive geometric and angular lines
characteristic of the Art Deco style.
Congress creations
Russells Scottie dog will be the main
symbol of Congress 2009, but other animals
(dove, cat and rabbit) will also feature.
Finally, Russell has agreed to produce a
unique piece to be raffled at the Congress
Banquet in aid of Petsavers.
Russell hopes to have a studio with
an adjacent salesroom to market his art
soon but for more information about him
and his work now, visit his website
www.echo-of-deco.co.uk
Russell Akerman has produced the Art Deco themed
ceramics that will feature on all Congress material and at
the event itself in 2009. Ed Hall and his wife visited the
artist in July to see the creative process and talk to Russell
about using the images for Congress
BSAVA Congress
25 April 2009
Some of the finished Art Deco pieces
await dispatch
Artist Russell Akerman with
BSAVA President Ed Hall
Russell begins with the raw materials
4 | companion
WELFARE
DACTARI A C LEAR VIEW
The Dog And Cat Travel And Risk Information scheme
provides a view of the dangers of importing animals with
serious pathogens. John Bonner reports on how the
profession views the scheme
WELFARE
companion | 5
WELFARE
DACTARI A C LEAR VIEW
U
nlike Clarence, the lion who
struggled with strabismus in the
1960s television show Daktari,
veterinary bodies could see clearly what
was going to happen when the DACTARI
scheme was launched in 2003. The BVA
and BSAVA both urged DEFRA against
establishing the scheme as an entirely
voluntary reporting system, believing that
there should be compulsory notification
of significant new diseases in the pet
animal population.
Impact, effort and practicalities
Current BSAVA President Professor Ed
Hall notes that other voluntary reporting
schemes, such as that covering adverse
drug reactions, are widely believed to
underestimate the numbers of cases
involved. Practitioners have little
incentive during a busy working day to
spend time on non-routine and apparently
non-essential tasks.
His Bristol University colleague, Dr Sue
Shaw, estimates that it would take up to
15 minutes for a practitioner to log on to
the Defra site, navigate their way to the
appropriate page and fill in the relevant
DACTARI form. She says the Department
offers very little added value in terms of
advice and publicity material to encourage
reporting and it downplays the risks of the
diseases covered by the scheme notably
babesiosis, ehrlichiosis, dirofilariasis and
leishmaniosis. Moreover, the Department
insists that disease reports can only be
submitted by private practices, not by the
commercial laboratories normally
responsible for confirming the diagnosis.
However, laboratories would provide a
more logical channel for reports given their
greater experience of both the scientific
and administrative procedures involved.
Budget barriers
Dr Shaw is not alone within the veterinary
profession in suspecting that Defras
reluctance to become more heavily involved
in the control of companion animal diseases
is a pragmatic decision resulting from tight
budgetary restrictions. Certainly, three of
the main DACTARI diseases are mainly
confined to dogs and so have none of the
economic and strategic importance of those
diseases in livestock, such as foot-and-
mouth and bluetongue, requiring
compulsory notification. Yet leishmaniosis is
also a significant zoonotic disease, affecting
the human population in countries like Italy
and Spain, which have the sandfly vector,
and are favourite destinations for Britons
taking their pets abroad under the Pet
Travel Scheme.
Public health
Concerns over the potential risk to public
health, prompted Liberal Democrat MP
Andrew Stunell (Stockport, Hazel Grove) to
ask a Parliamentary Question about the
results of DACTARI monitoring of
leishmaniosis in July. Junior minister at Defra
Mr Jonathan Shaw told him that between 1
January 2003 and 30 September 2006 there
were 19 confirmed and 5 suspected cases of
canine leishmaniosis reported to the scheme.
These cases are a small fraction of the
number of cases recorded by Dr Shaws
Acarus laboratory at Bristol. She has
confirmed more than 700 cases and has no
statistics of cases seen at other veterinary
laboratories around the country. The
CICADA scheme run by Intervet is an
attempt to get a handle on the frequency of
different diseases seen at small animal
practices. Its market survey-based methods
are very different from those of the
DACTARI scheme and so are not directly
comparable. However, the 150 or so
practices that have participated in the three
surveys to date have already recorded eight
cases of leishmaniosis. If those practices are
representative of the country as a whole,
then these reports would tend to indicate
that these diseases are more prevalent than
might be evident from the passive reporting
which occurs, said John Helps, veterinary
manager with Intervet UK.
Appropriate approaches
With practitioners becoming increasingly
experienced in recognizing and treating
canine leishmaniosis cases, it will become
ever more difficult for private diagnostic
laboratories to keep tabs on the numbers of
cases in the UK. It is now being managed as
an endemic disease of dogs in the UK and
there is no reason to report it as being
unusual anymore, Dr Shaw suggests.
Of course, leishmaniosis is not yet a true
endemic disease, as the insect responsible
for transmitting the protozoan parasite
Chronic ehrlichiosis in a Labrador
Retriever. The dog was from Sardinia
but had lived in the UK for 2 years
before presentation
Reproduced from BSAVA Manual of Canine and Feline
Infectious Diseases
6 | companion
WELFARE
concerned the sand fly (Phlebotomus spp.)
is not present in the UK. However, as with
bluetongue there is evidence of a northward
shift in the distribution of the disease and its
vector. Defras confidence that even if sand
flies are accidentally introduced they would
not survive under UK conditions is hardly
justified, as the insect has already been
recorded in the Channel Islands, Dr Shaw
points out.
So, would a viable population of
Mediterranean sand flies even be a
prerequisite for the disease to establish in
the British Isles? A practitioner in west
Wales has now identified a case, confirmed
at the Bristol lab, of leishmaniosis in a dog
that has never travelled abroad to a
disease-endemic area. This raises the
possibility of the disease having found an
alternative transmission route, but whether
this is dog-to-dog or via a different
arthropod vector is not yet clear. The only
way to find out would be to conduct the
sort of monitoring of wildlife as well as
domestic species that Andrew Stunell
suggested in his Parliamentary question.
Defra collaboration
Stunell was told there is no targeted
surveillance for leishmaniosis in wildlife and
no cases have been identified via the
existing wildlife scanning surveillance system
to date. Nevertheless, a Defra spokesman
denied that the department is ignoring the
risks posed by new zoonotic diseases. He
pointed to collaboration between the
department and the Health Protection
Agency whose joint Human Animal
Infections and Risk Surveillance (HAIRS)
group regularly reviews the situation with
leishmaniosis and other zoonoses.
Through its Veterinary Laboratories
Agency, the department is also participating
in the worlds first interdisciplinary centre
dedicated to the study of zoonotic diseases.
The centre will be based at the Liverpool
veterinary schools Leahurst campus and is
supported by a 1.7 million grant from the
Northwest Development Agency.
One way of finding out the size of the
problem to be addressed at the new centre
would be to gather reliable data on the
numbers of dogs with leishmaniosis living in
the UK, as the available treatments do not
eradicate the parasite and these dogs may
remain a source of future infections. But
Defras spokesman said making a disease
such as leishmaniosis notifiable could place
an unnecessary burden on pet owners as
effective control measures could be difficult
to implement and enforce.
Financial implications
BVA president Mr Nick Blayney suggests
that making a disease notifiable does not
automatically create a financial burden, as
the costs depend on what further measures
are then needed to eradicate the disease.
There would be financial implications in
Defra staff time when investigating an
outbreak but that doesnt necessarily
carry huge costs and if Defra cant manage
even that, then is there any point in having
the department? he asks.
Chris Laurence, veterinary director of
the Dogs Trust, believes that the concept of
DACTARI was flawed from the beginning
because it only set out to record numbers
of positive cases. To be of any value as a risk
assessment system, it would also be
necessary to record negatives, the total
numbers of dogs travelling with pet
passports, in order to assess the prevalence
of disease accurately.
So as far as he is concerned, there is no
point in arguing for changes in the DACTARI
recording methods It is a lost cause, he
said. But there is a very good reason for
getting hold of good epidemiological data,
not only for dealing with leishmaniosis. It
would also help control other diseases
relevant to the EU derogation granted to
the UK and four other member states on its
rules for the import of non-commercial
animals (see companion June issue, The
Quarantine Question).
Gathering data
Through their membership of the umbrella
body Pets in Europe, the Dogs Trust and
other UK welfare organisations are trying
to gather reliable data on the incidence of
leishmaniosis and other companion animal
diseases across the whole European
Community. By emphasising the resulting
human health implications, the group
wants to persuade the European
Commission to give pet animals a much
higher political priority.
Only legislation introduced by Brussels
is likely to have any significant impact on
controlling companion diseases when there
is so much movement of animals throughout
the 27 member states. If the Commission
began to take companion animal diseases as
seriously as the major economic diseases of
livestock, Britain would be able to take
action against exotic diseases like
leishmaniosis without running the risk of
being accused of protectionism. But the
benefits of measures to stop the
northwards spread of this disease would
also be felt in those countries where it is
endemic. If you talk to vets in Greece and
Italy, they would love to be able to do
something about these conditions but at the
moment their governments are just not
interested, Mr Laurence said.
Clinical manifestations of leishmaniosis: lingual granuloma formation
Reproduced from BSAVA Manual of Canine and Feline Infectious Diseases
companion | 7
THROUGH
GRITTED
TEETH
Aggressive dogs present a
serious challenge to vets in
practice. Pete Wedderburn
considers the potential
dangers faced by those
working in practice
D
espite the ban on dangerous
breeds, there seems to be a
continuing trend for keeping large,
strong dogs that can present a serious
threat to humans. Apart from the physical
danger to vets, staff and other clients, there
are potential legal issues if a client is bitten
by their own pet while the vet is in charge.
To review the issues involved, imagine a
fictitious series of events that could happen
in any clinic.
This first point of contact is a good time to
make initial enquiries. Is the dog easy to
handle? Does he get on well with other
animals? If there are any issues like these, it
makes sense for the receptionist to suggest
that the dog could be left outside in the car
until the vet is ready to call the client in for
the consultation. If there is a history of
difficulties handling the animal, a plan of
action can be made in advance. Does the
owner have a muzzle? Is it possible to put a
muzzle on the dog? The practice should
have a protocol advising receptionists on
the right questions to ask, and suggesting
the appropriate course of action to take
when an apparently aggressive dog is
expected to arrive at the clinic. This may
include booking an extra-long appointment,
and informing the vet on duty in advance.
As before, queries about muzzling need to
be made. Fear aggression is common, and it
may be easier for an owner to place a
muzzle than for the vet to approach a
fearful animal. Some owners, who know
that the dog does not like vets or is likely
to be aggressive in the consulting room can
be asked to muzzle the dog in the waiting
room prior to the consultation or contact
with surgery staff. At this point, the
question about who would be responsible if
an owner were bitten needs to be
addressed. A legal position could be taken
that the veterinary surgeon is the
professional person in charge of a situation
when there is risk involved, and therefore
may have a liability if somebody is injured. If
a veterinary surgeon judges at any time that
it is not safe to proceed, then they should
not do so. Each owners ability to handle his
or her animal should be carefully assessed.
If an owner offers to apply a muzzle
provided by the practice, the vet should
ensure that the owner is competent to
carry out the task without the risk of injury.
Vets have a legal obligation to ensure that
the workplace is safe. As the RCVS Practice
Standards checklist states, Employers must
have a Health and Safety policy setting out
how they ensure risks to Health and Safety
of employees, contractors and customers
are kept as low as reasonably practicable.
The hazards involved in restraining animals
need to be assessed, and a set of Local
Rules needs to be formulated to advise staff
on the appropriate way to deal with
aggressive animals. These need to be seen
to be regularly reviewed and updated as
needed. Appropriate equipment and
protective clothing (such as gauntlets,
muzzles, and a dog-catching pole) needs to
be provided, and training must be given to
all staff members in their correct use. Any
incident where a staff member is injured
needs to be carefully recorded in the
Accident Book. The practice must have
employers liability insurance, as well as
public liability insurance, to give the practice
financial protection if a claim for damages is
made either by a staff member or a member
of the public.
Veterinary surgeons who are assistants
should talk to their own financial advisors
about permanent health insurance, to cover
the eventuality of being unable to work for
a sustained period in circumstances where
the practice insurance may not cover them
because they may be deemed to be the
responsible professional person.
AGGRESSIVE ANIMALS
A new client telephones to
make an appointment for their
large male Rottweiler
A client arrives in the waiting
room with a large and
boisterous German Shepherd
Dog, telling the receptionist
that he does not like vets
During the consultation
process, a veterinary nurse
who is helping to restrain a
growling terrier is badly bitten
on her arm
8 | companion
Again, vets need to remember that they
may be held legally responsible for activities
that take place inside the consulting room.
If a vet is not comfortable with the safety of
a situation involving the restraint of an
aggressive animal, they should state their
opinion, and refuse to continue.
Behaviourist Jon Bowen stresses the
importance of reading the body language
of dogs, so that a tendency for aggression
can be identified before any damage has
been done.
If you ask many experienced vets,
you will discover that they suffer more
dog bites in the first few years of practice.
With time and a few painful incidents,
vets learn to recognise the signs that a
dog may bite, and they take fewer risks.
Jon recommends that all vet clinic staff
should be reminded about the key
aspects of canine body language that
offer early warning signs of aggression.
If a dogs tendency to aggression is
identified early during an interaction, a
muzzle can often be applied. Once the dog
has been aroused to the point of an
aggressive incident, it can be too late to
intervene with a muzzle. A higher level of
intervention, such as sedation, may become
necessary, with all of the extra
complications that are involved.
Can a vet refuse to treat a patient in such
circumstances? Veterinary surgeons have a
responsibility to ensure the welfare of the
animals under his or her care, but human
welfare still comes before animal welfare.
A vet can make a decision on the basis of
protecting the people involved in a situation
like this. The RCVS agrees that the welfare
of people must come first. The RCVS adds
that the aggressive nature of the animal
should be made clear on the clinical notes, so
that another vet taking over treatment of the
animal is made aware of the risk involved.
Sedation is sometimes the only answer.
Oral medication (such as acepromazine) has
traditionally been given prior to visits to vet
clinics, with limited effectiveness. The ideal
answer would be a low-volume, safe, highly
effective knock-down sedative, which is
reversible, but as anaesthetist Lynne Hughes
from University College Dublin Veterinary
School explains, the perfect sedation
method does not exist. A combination of
drugs is more effective than any one drug
on its own, Lynne says. Every case needs
to be looked at individually one
combination of drugs may suit one dog,
whereas a different cocktail will be more
effective for another. Examples of sedation
protocols are listed in the table opposite.
Lynne stresses that a sedated animal is not
necessarily a safe animal. Some sedatives
can have the effect of depressing a dogs
AGGRESSIVE ANIMALS
THROUGH GRITTED TEETH
Signs of fear,
progressing into
aggression
1. Fearful avoidant behaviour:
Cowering
Flattened ears, tail down
Shaking, trembling
Attempts to escape
2. Passive fearful defensive
behaviour:
The above, plus...
Hackles raised
Baring of teeth
Avoiding direct staring eye
contact
Growling
3. Confrontational fearful
defensive behaviour:
Hackles raised
More erect body posture
Barking/loud growling
Direct eye contact
Lunging/snapping/biting
1 & 2 are attempts to avoid
conflict; the dog is trying to warn
the person away.
Dogs will move between these
stages, but may go straight to
confrontational behaviour if
previous attempts to avoid
conflict have failed.
The owner tells the vet that the
dog does not need a muzzle,
and that he can hold the dog
securely, but then either he or
the vet/nurse gets bitten
A 12 stone Bull Mastiff is
clearly unmanageable due
to aggression. After a number
of incidents, the vet has
recommended euthanasia of
the dog on safety grounds.
The owner refuses to agree
to this and wants to
continue to bring the dog
back to the clinic
A stocky, muscular,
Labrador cross is brought
into the consult room. The
dog growls when the vet tries
to take his temperature
A 40 kg Border Collie snarls
and snaps whenever a muzzle
is brought close to his head
companion | 9
A crossbred terrier is brought
in for treatment following a
dog fight. On checking the
records, the vet discovers
that this is the third incident
in a space of a year
natural inhibition to bite. More than one
vet has suffered a severe bite after an
apparently sedated dog has suddenly made
an unexpected aggressive lunge.
When a dog is being euthanased due to
aggression, at which point is a gun needed
rather than a vet with a needle and syringe?
These occasions are rare, and decisions
may involve liaison between police officers,
the RSPCA, and local veterinary surgeons.
Sometimes, deft use of a dog-catching
pole, a muzzle and chemical sedation
(including potent oral medication in a
bait) can be adequate. Safety of humans
must always be paramount.
AGGRESSIVE ANIMALS
Sedation protocols for aggressive dogs. Lynne Hughes, UCD
Drug combinations Notes
Acepromazine (ACP)
0.0200.05 mg/kg
(to max of 2 mg) +
morphine 0.5 mg/kg i.m.
High doses of ACP should be reserved for healthy dogs and avoided in Boxers or giant breeds. Morphine will
cause vomition unless the dog is in pain (remove the muzzle until vomition occurs and warn the owner in
advance). Dogs are sensitive to noise when sedated. Deep sedation lasts 2030 minutes. Glycopyrrolate
0.01 mg/kg (or atropine 0.04 mg/kg) may be administered i.m. if bradycardia occurs
Medetomidine 1020 g/kg
+ butorphanol 0.30.5
mg/kg (or morphine
0.30.5 mg/kg) i.m.
High doses of medetomidine should be reserved for healthy dogs. Sudden arousal may occur.
Reliability of sedation is improved by addition of an opioid but can also potentiate
respiratory depression. Additional ketamine (5 mg/kg i.m.) may be required in very
aggressive dogs. Wait at least 40 minutes after ketamine before reversing with
atipamezole (or convulsions may occur). Owner should be present for reversal
A call comes in from the local
police station. A Golden
Retriever has attacked three
people, causing serious
injuries. Euthanasia is clearly
indicated, but the police
officer is not sure if anyone
will be able to get close
enough to the animal to give
an injection
Vets need to be aware of the fact
that illegal dog fighting seems
to be increasing in
popularity. There is
an ethical dilemma
about the correct
course of action to
be taken if a
dog is suspected to be
involved in this activity. The
RSPCA are happy for all such suspicions to
be reported directly to them. The 24 hour
Cruelty and Advice Line is 0300 1234999,
and a message can be left for the Special
Operations Unit. Such reports can be made
anonymously, but personal involvement may
be needed to find out further information
or if legal action ensues. The RCVS advice
on breaching client confidentiality can be
found in the Guide to Professional Conduct
and is also amplified in an Advice Note
Client confidentiality reporting
alleged criminal activity (www.rcvs.
org.uk/advicenotes). Essentially, a
veterinary surgeon may breach client
confidentiality if choosing to report
suspected criminal offences.
companion | 9
Details of drug dosages and
methods of application of
drugs mentioned in this
article must be verified by
individual users.
Also see BSAVA Small
Animal Formulary.
10 | companion
CLINICAL CONUNDRUM
CLINICAL
CONUNDRUM
Case Presentation
A 2-year-old female neutered
Labrador was reported to have
been retching and coughing for
several months. Initially signs
occurred chiefly after eating but
they had now increased in
frequency and could occur when
excited or when resting. The
cough had mostly been non-
productive but on occasions
yellow or green mucus had been
expectorated. The dog panted
more after exertion than she used
to but her overall exercise
tolerance was good. There had
been no ocular or nasal discharge.
Sneezing had been absent. Her
weight had not altered.
Mike Stafford Johnson of
Martin Referrals describes
the investigation of coughing
in a young Labrador
Retriever
companion | 11
CLINICAL CONUNDRUM
Examination
On physical examination, heart rate was
100 beats per minute and no murmur was
audible. Pulse amplitude was normal and
mucosae were pink. Respiratory sounds
were normal. Increased tracheal sensitivity
was present, with tracheal pinching
inducing coughing.
Radiography
Under anaesthesia, lateral and dorsoventral
thoracic radiographs were obtained. A
close up of the lateral and a dorsoventral
view are shown here.
What changes are evident?
What is the lung pattern
demonstrated?
Skeletal and extrathoracic structures appear
normal. Cardiac shape and size appear
normal, as does the pulmonary vasculature.
A generalised marked bronchial pattern
is present. The thickened bronchi resemble
tramlines when seen longitudinally and
doughnuts when seen end-on.
What are the differentials for
such a lung pattern?
A bronchial pattern is caused by bronchial
wall thickening or mineralisation. The
differentials include:
Inflammatory/Infectious
Peribronchial cuffing and mucosal
inflammation in chronic bronchitis, with
or without accompanying evidence of
bronchopneumonia. Causes of chronic
bronchitis include bacterial, viral, fungal,
protozoal and parasitic infections, and
pulmonary infiltration with eosinophils
( parasitic infection). Clinical signs
associated with chronic bronchitis
include cough (variably productive),
exercise intolerance and, in some cases,
an exaggerated sinus arrhythmia due to
increased vagal tone
Anomalous Mineralisation is seen in
older dogs and in chondrodystrophic
breeds of all ages
Metabolic Mineralisation is observed
in hyperadrenocorticism
Neoplastic e.g. bronchial carcinoma
or diffuse bronchial lymphoma.
Most likely cause in this case?
In a young mesocephalic dog, eosinophilic
bronchitis is the most likely differential
diagnosis resulting in such a pronounced
bronchial pattern. Infectious causes such as
bordetellosis do not typically seem to be
associated with such a marked pattern,
whilst bronchial neoplasia would be unusual
at this young age and is unlikely in a dog
which appears otherwise to be well.
What are the typical
bronchoscopic findings?
Most commonly there will be abundant
mucus present in multiple bronchi. Recently,
cases have been described where mucus is
not apparent but there is moderate to
marked erythema of the airways. Chronic
untreated cases may show localised or
multiple areas of bronchiectasis.
Additional diagnostic tests
Tracheobronchoscopy was performed.
The trachea appeared normal. There
was widespread mucus present in all of
the major mainstem bronchi.
12 | companion
CLINICAL CONUNDRUM
CLINICAL CONUNDRUM
Bronchoalveolar lavage (BAL) was
performed and samples sent for cytology
and bacterial /fungal culture.
Cytology revealed vast numbers of
eosinophils and low numbers of
macrophages; respiratory epithelial cells
and neutrophils were also evident. Bacteria
were not apparent cytologically.
Bacterial and fungal culture was negative.
These findings are typical of
eosinophilic bronchitis.
What are the causes of this
syndrome?
Eosinophilic bronchitis can be associated
with Angiostrongylus vasorum infection, and
exotic diseases such as heartworm
(Dirofilaria), or even fungal infection, are
also rare causes. However, the majority of
cases in the UK are classed as eosinophilic
bronchopneumopathy (EBP) (previous
referred to as pulmonary infiltrate with
eosinophils (PIE)), having excluded these
other differential diagnoses. EBP is a disease
in which the definitive cause is not known
but is suspected to be a hypersensitivity
reaction to inhaled allergens. Certain
breeds, especially Huskies or Husky
crosses, appear to be predisposed. In
addition, we document more cases in
Labradors and Jack Russell Terriers than in
other breeds. Affected dogs are usually
under 4 years of age.
Additional tests that can be
considered?
Whilst EBP may be suspected based on
clinical signs and signalment, diagnosis
requires exclusion of other differentials in
addition to demonstration of consistent
radiographic, bronchoscopic and BAL
cytology findings.
To exclude other differential
diagnoses, faecal examination for
Angiostrongylus vasorum lungworm larvae,
using the Baermann technique, and/or
examination of BAL samples for larvae
should be undertaken. If there has been a
history of travel abroad it is appropriate to
test for Dirofilaria.
Is treatment advised?
Yes. Bronchiectasis may occur in a
proportion of chronically affected dogs if
untreated. Such a lesion will not resolve
and will likely predispose to secondary
bacterial infection. Some affected dogs
will show lethargy and inappetence.
Untreated dogs can develop marked
dyspnoea. Nasal discharge due to spread
of the inflammatory reaction to the nose
may occur early or late in the course in
some dogs.
Therapy
Even if no evidence of lungworm is
apparent, fenbendazole is advised at
50 mg/kg daily for 1014 days.
In the majority of cases the condition is
suspected to be due to pulmonary
hypersensitivity to an inhaled allergen.
These dogs will require corticosteroids.
Avoidance of any known irritants such
as smoke or household sprays is advised
in all cases.
Oral prednisolone at
immunosuppressive doses initially is
advised. The usual starting dose is
1 mg/kg twice daily for 14 days, then
re-evaluate. The dose is halved/
tapered every 2 weeks according to
progress. Aim for a maintenance
dose of 0.5 mg/kg every second day.
A total course of 35 months is
necessary for most dogs.
Many dogs will not relapse after a
single course. Others will relapse
after months and may require a
further 35-month course(s). Other
dogs may relapse immediately once
steroids are ceased, and these dogs
likely require long-term treatment.
Inhaled steroids may be useful in
some dogs where chronic treatment
is necessary or steroid side effects
are unacceptable. Either
beclomethasone or fluticasone may
be provided via metered dose
inhalers into spacers. The usual dose
is 125250 g per metered
inhalation, 12 puffs twice daily.
These may be sufficient to control
signs alone or in combination with
oral steroids.
It is likely that severely affected dogs
will require oral steroids to control signs
initially, followed by inhalant therapy with
or without oral steroid therapy once
stabilised. In some dogs following tapering
to a withdrawal of the steroid dose, clinical
signs do not recur, in other therapy is
required long term.
Contribute a Clinical Conundrum
If you have an unusual or interesting case that you would like to share with your colleagues, please submit
photographs and brief history, with relevant questions and a short but comprehensive explanation in no more than
1500 words to companion@bsava.com
All submissions will be peer-reviewed.
companion | 13
CLINICAL CONUNDRUM
Eosinophilic bronchopneumopathy
Infiltration of the airways or pulmonary
parenchyma by eosinophils has
previously been described in the dog as
pulmonary infiltration with eosinophils
(PIE), pulmonary eosinophilia or
eosinophilic pneumonia. The present
convention is to use the term
eosinophilic bronchopneumopathy in
recognition that eosinophilic infiltration
involves both airways and parenchyma
in the majority of cases.
The cause of EBP remains unclear, and
most cases are classed as idiopathic
but, as mentioned above, a
hypersensitivity to aeroallergens is
suspected. However, the supporting
evidence is scant and on occasion
contradictory, as whilst some dogs have positive intradermal skin tests to a variety of aeroallergens, the majority
do not. Furthermore, there is little doubt that the pathophysiology of lung allergy is different to that manifested in
the skin and that assessing these dogs by intradermal skin testing is less than ideal.
Cytological examination and bacterial culture of mucus collected by tracheal lavage or at bronchoscopy is
necessary to confirm the diagnosis of EBP. Bronchoscopy also allows visual inspection of the airways and the
presence of a moderate to large amount of
greenish/yellow mucus is typical, as well as
evidence of bronchial inflammation and even wall
irregularities. It is the cytological examination of this
greenish material, and its relative eosinophil count,
which confirms the diagnosis of this disease.
Healthy dogs usually have <5% eosinophils found
in fluid collected by BAL whereas in those affected
with EBP, eosinophils may constitute >50% of the
cells harvested. Examination of the BAL also
enables diagnosis of Angiostrongylus vasorum
infection and neoplasia, which are important
differential diagnoses. Similarly, bacterial
pneumonia can be excluded on the basis of
bacterial culture, although it should be remembered
that the large bronchi of dogs are not completely
sterile and a positive culture result must be
interpreted in the context of the case in question
and the sampling technique employed.
Bronchoalveolar lavage cytology from a dog with EBP
(Wright-Giemsa stain, original magnification x800).
Courtesy of K. Papasouliotis
Endoscopic views of the bronchi of a dog with EBP. Note the tenacious
greenish material, mucosal thickening (and, although not typical,
compression of the bronchial lumen by associated bronchial
lymphadenopathy). Courtesy of K. Murphy
14 | companion
HOW TO
COLLECT A DIAGNOSTIC
BONE MARROW SAMPLE
HOW TO
I
t has been said that with practice,
collecting bone marrow becomes as easy
as placing an intravenous catheter. That
may be a slight exaggeration but once a
clinician gets over the fear factor,
collecting bone marrow is not difficult.
Making good smears from the bone marrow
sample can be more challenging! If the
practitioner does not perfect the art of
making good smears then the interpretation
of the bone marrow sample may be
rendered meaningless.
Benefit
The first step in collecting a diagnostic bone
marrow sample is selecting a patient that
will benefit from the technique.
There are many indications for
performing bone marrow aspiration
(Table 1). Some are immediately obvious
(e.g. non-regenerative anaemia after
excluding extra-marrow suppression);
others are less clear (e.g. in patients with
fever of unknown origin but without
obvious haemopoietic disease).
In most patients it is preferable to
collect both an aspirate and a core biopsy
sample. Suitable sites include the iliac wing,
proximal humerus and proximal femur.
Anaesthesia
The authors preference is to use general
anaesthesia and to sample from the
proximal humerus (Figure 1), although
aspirates from a number of sites including
the iliac crest (Figures 2 and 3) can be taken
under sedation with local anaesthetic. The
author prefers performing bone marrow
aspiration under general anaesthesia for a
number of reasons:
The procedure can be performed
quickly and without pain during the
technique
If a dry tap is obtained, aspiration can
be attempted from the other humerus
or another of the sites listed above.
Premedication and anaesthetic agents/
protocol may be influenced by the patients
Kate Murphy from the
Small Animal Hospital,
University of Bristol,
offers a useful guide to
collecting bone marrow
Table 1: Indications for performing
bone marrow sampling
Pancytopenia
Non-regenerative or poorly regenerative
anaemia
Neutropenia or thrombocytopenia where
the cause is not obvious (not usually
performed in suspected immune-mediated
thrombocytopenia)
Suspected haemopoietic neoplasia,
myelodysplasia, or marrow dysfunction
as indicated by ineffective cytopoiesis
or erythropoiesis
To evaluate iron stores when other
information is inadequate
Fever of unknown origin
Evaluation of lytic bone lesions
Staging of neoplasia, e.g. lymphoma, mast
cell tumours, histiocytic disease
Investigation of hyperglobulinaemia
Investigation of hypercalcaemia
Evaluation of unexplained leucocytosis or
thrombocytosis
Figure 1:
Site for
bone
marrow
sampling
from the
proximal
humerus
primary disease and the reader is referred
to more specialised texts such as the BSAVA
Manual of Anesthesia and Analgesia for advice
on this aspect.
Equipment required
Jamshidi bone marrow needle, e.g. Bone
marrow aspiration/ biopsy needle (11G
x 4) (Kendall Monoject, Tyco
Healthcare UK Ltd)
companion | 15
HOW TO
Figure 2:
Site for
bone
marrow
sampling
from the
iliac wing
Figure 3: Site for
bone marrow
sampling from the
proximal femur
20 ml syringe
Local anaesthetic (without adrenaline)
No. 11 scalpel blade
Anticoagulant (sterile) CPDA/ACD
(collect from transfusion bag) or EDTA
(prepared from a standard EDTA blood
tube; see below)
Microscope slides (> 10)
EDTA pot & formalin pot
Surgical drape & sterile gloves
Strong assistant
Preparation
Bone marrow interpretation is a challenge
but this can be reduced if a blood sample is
taken into an EDTA tube on the day of the
bone marrow collection. This allows the
bone marrow to be interpreted in the light
of current peripheral haematological status.
Before starting the bone marrow
collection it is important to treat the
aspiration needle with anticoagulant to
avoid clotting during sample collection.
1
Remove the stylet and attach the
20 ml syringe to the needle.
2
Aspirate the ACD/CPDA/EDTA
anticoagulant in a sterile fashion and
roll anticoagulant around the syringe before
squirting the excess out this should leave
the syringe and needle coated (Figure 4).
3
Remove the syringe and carefully
replace the stylet, ensuring it is
properly sited and fully locked.
If you do not have blood transfusion
bags in the practice it is possible to
pre-treat the syringe by adding sterile
saline or water which is injected into an
EDTA blood tube and then aspirated.
COLLECT A DIAGNOSTIC
BONE MARROW SAMPLE
16 | companion
HOW TO
COLLECT A DIAGNOSTIC
BONE MARROW SAMPLE
Since bone marrow aspiration is rarely an
emergency procedure, the practitioner is
advised to order in some commercial
anticoagulated blood bags to improve
the success of their bone marrow
aspiration as, in the authors experience,
using EDTA for this purpose is not as
effective at preventing clotting of the
marrow sample.
Procedure using a Jamshidi
biopsy needle
This needle is designed to take both
aspirates and core samples. General
anaesthesia is induced and once the patient
is stable:
1
Position the patient in lateral
recumbency.
2
Widely clip the area around the
scapulohumeral joint.
3
Surgically prepare the biopsy site.
4
Position the leg with the humerus
flexed (parallel to the patients
thorax) (Figure 5). Ensure a strong
colleague is holding the leg for you and
the humeral shaft) using a drilling/firm
forward rotating action and steady
pressure (Figure 7).
Counterpressure from an assistant
holding the limb can be helpful (they push
with all their might against you pushing from
the other end!). Initially it can be hard to
get the bone marrow needle to get a
purchase into the bone, and occasionally it
slips off. If this is happens, start again and
recheck your anatomical landmarks. Once
you are happy the needle is in the correct
position, retry going very slowly and with
controlled forward pressure.
Figure 5: Position of the limb for
obtaining a bone marrow aspirate
from the proximal humerus
Figure 6: Make a small stab incision
with the scalpel blade
Figure 7: Use a firm forward drilling
pressure to advance through the
cortex and into the marrow cavity
prepare them for the pressure you will
be applying to the leg they will need to
apply counterpressure.
5
Instil local anaesthetic to the level of
the periosteum over the greater
tubercle of the humerus.
6
Re-scrub the area.
7
Make a small stab skin incision with
the No. 11 scalpel blade (Figure 6).
Figure 4: Coating the needle and
syringe with anticoagulant
8
Insert the Jamshidi needle with the
stylet firmly in place (check the stylet
has been firmly replaced after the aspiration
of anticoagulant described earlier).
9
Humeral samples are taken by
palpating the most proximal facet of
the humeral head (greater tubercle).
Gradually advance into the marrow cavity
(heading towards the elbow and parallel to
Reduced resistance is usually felt as the
needle enters the medullary cavity. If
correctly placed, the needle should feel
solidly fixed in place, and moving the
needle should result in moving the bone
itself. If the needle is placed too medially
over the humeral head, it is easy to
penetrate the joint capsule. This does not
pose a significant danger to the patient but
can render the bone marrow sample
non-diagnostic if contaminated by joint fluid
and may cause mild joint inflammation.
10
Once the needle is believed to be
correctly sited, remove the stylet.
Attach the 20 ml syringe (previously coated
with anticoagulant) and aspirate firmly
(Figure 8). As soon as bone marrow (which
looks like thick blood) is noted in the hub of
the syringe, stop aspirating you do not
need more than 0.2 ml of bone marrow
(Figure 9). Excessive suction will result in
haemodilution of the sample. There are no
prizes in the technique for the biggest
sample collected just for a diagnostic one!
companion | 17
HOW TO
COLLECT A DIAGNOSTIC
BONE MARROW SAMPLE
Figure 10: Transfer the marrow
sample on to glass slides
Figure 11: Technique for spreading
bone marrow on the slide
Figure 12: Core sample pushed out
of the needle
Figure 13: Preparing an impression
smear from the bone marrow core
sample
Figure 8: Apply pressure to obtain a
small quantity of marrow
Figure 9: A small marrow sample
has been collected
of each. There are a number of alternative
techniques. It may be helpful for
practitioners to discuss the technique of
preparing the slides with the clinical
pathologist who will evaluate the bone
marrow sample.
a. Excess blood is allowed to run down
the slide on to absorbent paper, leaving
flecks of marrow attached to the glass.
b. A clean slide is then backed on to the
remaining marrow and the marrow is
allowed to spread along the edge of the
spreader slide, which is then swiftly
pushed forward to provide a thin smear
with a feathered edge (Figure 11).
11
Detach the syringe but leave the
needle in place and replace the stylet
whilst smears are prepared.
12
Smears are prepared by angling
multiple slides at 45 degrees (Figure
10) and placing a drop of marrow at the top
It is essential that smears are prepared
and air-dried immediately. It is important to
assess whether a diagnostic marrow sample
has been obtained grossly by looking at the
slides as they dry. If the slides look like
blood smears they probably are. Marrow
smears should look like blood but with fatty
bits and refractile spicules.
13
Obtain a core biopsy sample by
removing the stylet and advancing
the needle approximately 23 cm further
into the bone. Move the needle swiftly
sideways a few times to break off the
distal part of the sample and then retract
the needle. Use the blunt probe supplied
with the needle to push the core sample
out (from tip through the handle) (Figure
12). The core sample can be gently rolled
along a slide to produce an impression
smear (Figure 13) which can be helpful
to provide more rapid results if the
bone marrow aspirate is non-
diagnostic. The core is then placed in
a pot of formalin.
14
Submit samples for cytology and
histopathology. A concurrent blood
sample should be submitted to aid
interpretation, as discussed above.
Additional investigations may be
performed on bone marrow samples,
e.g. infectious disease tests, iron profile,
Coombs test.
Problems
Common problems in obtaining diagnostic
bone marrow aspirates and core biopsy
samples are:
Haemodilution of the sample
Poor smear preparation too thick or
inadequately spread material.
18 | companion
VIN FORUMS
The Veterinary Information Network brings together veterinary professionals
from across the globe to share their experience and expertise. At vin.com
users get instant access to vast amounts of up-to-date veterinary information
from colleagues, many of whom who have specialized knowledge and skills.
In this regular feature, VIN shares with companion readers a small animal
discussion that has recently taken place in their forums.
LETTERS FROM
AMERICA
Discussion Creator
This is a dog referred to me because the owner
wanted to see if the eye could be saved. What do
you think?
18 | companion
companion | 19
VIN FORUMS
All content published courtesy of vin.com. The names of participants have been removed from this feature. For more details about the
Veterinary Information Network visit vin.com. As VIN is a global veterinary discussion forum not all diets, drugs or equipment referred to in
this feature will be available in the UK, nor do all drug choices necessarily conform to the prescribing rules of the Cascade.
Discussion Creator
One of the other long-term problems is dry eye due to decreased corneal sensitivity:
lagophthalmos
re-proptosis
corneal ulcer/rupture
In fact most of the strabismus is due to the tear of the medial and ventral rectus muscles.
Reply 1
Ewww!
I put one back in that looked a lot like that... acute trauma that happened in a boarding incident on a Sunday
morning. As they say, Not too good.
It went well initially, but has had complications since.
However, with this one Im curious about a couple of things the appearance of the lens, for instance. Also, is there a
foreign body? What is the white-ish object or tissue at the lateral aspect of the globe?
Reply 2
What complications do we see with proptosis?
Reply 3
Potential infection, lateral strabismus due to occulomotor nerve damage or an avulsed medial rectus (often leads
to corneal ulceration). Also rarely lens lux, nerve avulsion, rupture of eye muscles, blindness and chronic pain.
Discussion Creator
That is the optic nerve. Since the optic
nerve is torn then ciliary arteries that
supply blood to the eye are also torn.
There is no blood supply to eye. This eye is literally
dead. If this eye were placed back in the orbit, it
would start to rot in the dogs head.
This eye should be enucleated and its already 95%
enucleated.
The lens looks cloudy because there isnt a blood
supply to the eye and an aqueous circulation in the
globe. Since there is no oxygen supply to the lens,
the lens develops a cataract. (Just as all dead
animals develop cataracts after death.)
20 | companion
PUBLICATIONS
THE AGE OF
THE RABBIT
T
he domestic rabbit has undergone a
dramatic social transformation in the
past decade or so. The humble
backyard childrens pet of yesteryear has
evolved in more recent times into a popular
part, along with dogs and cats, of the
companion animal aristocracy.
Part of the family
For some time it has been recognised on
the grounds of popularity that this small
herbivore is well deserving of its third place
on the podium of UK mammalian pet
ownership. However, not only have the
sheer numbers of rabbits increased, so too
has the general public acceptance of this
animal as a valued family member.
Rabbit owners
Client expectation is at an all-time high in
many veterinary disciplines. The rabbit-
owning fraternity are no exception to this.
With improvements in the availability of
health information and the formation and
promotion of rabbit welfare organisations,
rabbit owners are becoming increasingly
knowledgeable. Their enthusiasm for quality
clinical care is abundant and the general
consensus is that the level of veterinary
services available at the local practice for
Mrs Smiths French Lop, should be no
different from that available for Mr Browns
Labrador cross. And why should it be?
Professional response
As a result of this rapid social promotion,
the veterinary profession has been forced
to respond by developing a branch of
science devoted to the medical care of this
unique creature. Far from being little dogs
and cats, and also differing in many ways
from large domestic herbivores like horses,
rabbits have unique behavioural, anatomical
and physiological characteristics that are
essential considerations in the prevention,
diagnosis and treatment of disease.
In the past rabbits had a reputation for
being: next to impossible to anaesthetise
safely; highly prone to all manner of
postoperative complications: difficult to
treat medically with available therapeutics:
and too prone to stress to hospitalise.
Advances in knowledge
Thankfully, with advances in knowledge and
skill these concerns have been allayed. Yes,
it is certainly true that rabbits are
susceptible to a number of problems that
may not be such an issue in dog and cat
medicine, but with an improved
understanding of their particular needs it is
now entirely possible to resuscitate
critically ill rabbits effectively, to perform
lengthy surgical procedures safely and to
provide long-term medical care for chronic
disease conditions.
Michelle Ward discusses the
changes and advances in
rabbit medicine
A hospitalised rabbit with a severe
head tilt due to suspected infection
with Encephalitozoon cuniculi.
A catheter has been placed in the right
marginal ear vein and secured with a
bandage for administration of
intravenous medication and fluids
20 | companion
companion | 21
PUBLICATIONS
Rabbit Manual
The BSAVA Manual of Rabbit Medicine and Surgery,
2nd edition, edited by Anna Meredith and Paul
Flecknell, reflects the increase in interest and
understanding of rabbit health and disease. Filled
with colour illustrations, it includes chapters on:
general nursing care; cardiovascular disorders;
dentistry; diagnostic imaging; euthanasia;
respiratory disorders; digestive system disorders;
urogenital system and disorders; nervous and
musculoskeletal disorders; ophthalmology; dermatoses;
behaviour problems; therapeutics; anaesthesia and perioperative care;
and common surgical procedures. For more information or to order visit
www.bsava.com or call 01452 726700. Member price: 49.
Rabbit undergoing a routine dental
examination. Due to the anatomy of the
oral cavity, accurate assessment of
cheek tooth crown height and shape
requires sedation and the use of
appropriate equipment (gags and
cheek dilators)
About the author
Michelle Ward
BSc BVSc(Hons I) DZooMed(Mammalian) MRCVS
RCVS Recognised Specialist in Zoo
and Wildlife Medicine
Michelle Ward studied at the University of Sydney,
Australia, gaining degrees in both zoology and
veterinary science and developing interests in animal
nutrition and exotic/wildlife medicine. Following
graduation and a short-term post as a research
assistant, she moved to the UK to begin work as a veterinary surgeon in
private mixed practice. For over three years Michelle worked at practices in
Worcestershire, Lincolnshire and Yorkshire and during this time developed a
keen interest in rabbit and rodent medicine and surgery. In August 2004 she
was appointed the Petsavers Senior Clinical Training Scholar in Rabbit and
Exotic Medicine at the University of Edinburghs Royal (Dick) School of
Veterinary Studies. Michelle is now Lecturer and Manager of the Exotic
Animal and Wildlife Clinic at the Royal (Dick) School of Veterinary Studies.
Michelle also contributed to the BSAVA Manual of Rabbit Medicine and
Surgery, 2nd edition. For more information about Petsavers and the work it
supports visit www.petsaversorg.uk .
Rabbit medicine and rabbit surgery are
emerging as disciplines in their own right.
Recent advances include: improved
understanding of the relevance of the
protozoan parasite Encephalitozoon cuniculi
to rabbit health; surgical methods for the
treatment of abscesses; long-term
management of acquired dental disorders;
diagnosis and treatment of renal failure
and various forms of neoplasia; recognition
and treatment of behavioural disorders; and
the application of advanced imaging
techniques such as CT and MRI to the
diagnosis of disease.
Preventive medicine
Whilst our ability to diagnose and treat
complex conditions is improving, it is
important not to lose focus on the one area
of practice that is likely to have the greatest
impact on rabbit welfare preventive
medicine. Through effective client education
and the promotion of lifelong health
management plans, including vaccination,
biannual health checks, regular dental
assessment and parasite control, it is hoped
that the disease entities related to
suboptimal husbandry (which are still all too
common) will become less prevalent.
This is an exciting time to be involved in
the veterinary care of rabbits as new
disease entities are being diagnosed and
novel solutions to old problems are being
discovered all the time. Who knows, the
next discovery could well be in your
consultation room.
22 | companion
Improving the health of the nations pets
Leaving a legacy to
Petsavers can mean making
a lasting difference to the
way your profession
diagnoses and treats small
animals in the future
PETSAVERS
WHERE THERES A WILL
CHRISTMAS CARDS
P
etsavers has received valuable income
from donations left by vets and animal
lovers in their wills. Legacies provide
more than 80% of its income and there are
few other financial sources to help fund the
many investigations needed to make a
difference to the way we treat the animals
in our care. So the veterinary charity has
produced a Remembering Petsavers in Your
Will leaflet to help advise on ways to make
a difference to animal welfare.
How it works
Once you have identified the value of your
personal assets, investments and property,
decide on the amount you wish to donate
to Petsavers. This is called a pecuniary legacy.
A second option is to leave a residual
legacy. That is, donating to Petsavers what is
left after all specific gifts have been made to
family, friends and relations. A third way is
to leave certain assets for Petsavers such as
stocks and shares or other items that we
can turn into cash: valuable stamp
collections, items of jewellery, or property
all can provide essential funds to help us
help pets.
What next?
Petsavers always recommends involving
a solicitor in drawing up your will.
Whatever you leave to Petsavers will
make an enormous difference. For more
information or to request the leaflets for
your practice email info@petsavers.org.uk
or call 01452 726700.
P
etsavers aim is to fund work into
helping diagnose and treat the
illnesses that affect small animals so
that the profession can further
improve the health and longevity
of our nations pets. We do this
by funding clinical studies and
clinical training programmes.
In the last 30 years Petsavers
has given nearly 2 million
towards these goals. We rely
on the support of veterinarians, nurses
and pet owners.
By buying our Christmas cards this
year you will help to fund even more
studies to improve the treatment and care
of pets. You can buy them as cards from
your practice to your clients, or even buy
them to sell on to those visiting your
practice. A range of designs and styles
will be available. For more information
about the cards this year visit
www.petsavers.org.uk or call 01452
726700 to request an order form.
companion | 23
WSAVA NEWS
WSAVA WORLD CONGRESS
DUBLIN 2008
T
he WSAVA board has been very
active over the last year. Besides a
voluminous amount of e-mail
correspondence, we also participated in a
number of teleconferences and held a full
board meeting in Tampa, USA, in May at the
time of the AAHA conference. I would like
to express my appreciation to the AAHA
Board of Directors for the hospitality
afforded to us. A significant amount of time
was spent debating strategic planning under
the guidance of David Wadsworth. We
concluded by redefining both the goals and
mission statement of the WSAVA. We also
met with the directors of AAHA to discuss
the possibility of their hosting a WSAVA
congress in the near future.
I had the pleasure of representing your
Association at the inaugural South European
Veterinary Conference in Barcelona in
October 2007 as well as at the South
African Veterinary Association Congress
which was held at Sun City last month.
I received a number of other invitations to
attend member association meetings but
due to time constraints I was not able to
accept. I apologize for this.
World representation
Jolle Kirpensteijn, Anne Sorenson and Luis
Tello (the latter two in their personal
capacity) attended the North American
Veterinary Conference (NAVC) in January
2008. At this conference one stream of
lectures was dedicated to the WSAVA and
was chaired by Jolle. I would like to thank
the NAVC directors and Colin Burrows in
particular for this means of promoting the
WSAVA. This will be ongoing at future
NAVC conferences.
David Wadsworth and Jolle Kirpensteijn
attended the British Small Animal Veterinary
Association (BSAVA) congress in April.
At these venues the opportunities were
used to meet with our sponsors,
representatives from industry, and
members of the various boards of directors.
I thank all these member associations for
the hospitality afforded to our executive
board members.
David Wadsworth carried out two
site visits to Brazil, in preparation for
the 2009 So Paulo WSAVA World
Congress, where he held meetings with
the congress organizing committee, the
PCO, and sponsors.
Treasurers
Jolle Kirpensteijn and Di Sheehan worked
very hard to get our financial books in
order. Jolle kindly offered to continue as
caretaker treasurer until the end of 2007
and finally handed the reigns over to Di in
May of this year. As you can understand, the
changing of bank accounts and the transfer
of information between Canada, the
Netherlands and Australia did not make it
that easy to get all the paperwork in place
in time for this meeting.
Communication
Walt Ingwersen has worked tirelessly on the
website, updating information, and
improving the layout of the homepage. Luis
Tello has been as busy as ever producing the
news bulletin and WSAVA flyers. He has
also been responsible for the new-look
logos. We thank them for the amazing PR
job they did. I would also like to thank Bayer
Healthcare and Hills Pet Nutrition for their
sponsorship of the website and news
bulletin. As always I appeal to all assembly
representatives to supply Walt with updated
information on the activities of your
association for posting to the website and
for this section of WSAVA News.
Sponsorship
I am pleased to report that the Hills Pet
Nutrition sponsorship contract has finally
Dr Brian
Rombergs
Presidents
Report to the
WSAVA
Assembly
delegates in
August
24 | companion
WSAVA WORLD CONGRESS
DUBLIN 2008
WSAVA NEWS WSAVA NEWS
been signed. This contract encompasses the
sponsorship of our congress as the sole
Prime Partner and the co-sponsorship of
our CE program, website and news bulletin
and the renal standardization project.
We also concluded contracts for
co-sponsorship of our website and news
bulletin, renal standardization project, and
CE project with Bayer Healthcare and for
co-sponsorship of our CE program with
Intervet/Schering Plough Animal Health.
Appreciation
I would like to thank the committee chairs
and members for their contribution during
the year. In particular I would like to thank
Anjop Venker van Haagen for her years of
commitment as chairperson of the Scientific
Advisory Committee. Anjops term of office
has now been completed and her position
will be filled by Prof Michael Day.
Microchipping
At the strategic planning meeting in Tampa
it was agreed that, thanks to the past
leadership and work on standardizing
microchip technology by members of the
WSAVA microchip committee, issues
related to microchipping no longer required
a stand-alone committee. Microchips will
now fall under the umbrella of the animal
welfare committee. I would like to thank
Fred Nind for chairing the microchip
committee and for representing the
WSAVA at ISO WG3 meetings. Fred has
informed us that he would still be available
to represent the WSAVA at these meeting
should we require him to do so.
CPD
The Continuing Education project under the
leadership of David Wadsworth continues
to be one of our main goals. David was ably
assisted by Roger Clarke, Luis Tello and
Lawson Cairns. Without the support of our
sponsors Bayer Healthcare, Hills Pet
Nutrition, and Intervet/Schering Plough
Animal Health we would not have been able
to take CE to as many locations as we did.
However, further expansion of this project
is being curtailed by a lack of finance and we
are actively involved in seeking a fourth
sponsor. I thank all our member associations
who contribute in some way or another to
this venture without your assistance our
task would be that more difficult.
Welfare
The Animal Welfare Committee co-chaired
by Ray Butcher and Roger Clarke was mainly
involved in organizing the welfare seminars
for this congress and the forthcoming
congress in Brazil as well as the drawing up
of the programme for the WSAVA welfare
stream for the FASAVA congress.
Special projects
The Standardization Projects are still
attracting an enormous amount of
attention. At this meeting the
Gastrointestinal Group will be highlighting
their significant achievements; the Atlas of
Canine and Feline Gastrointestinal Endoscopy
and Related Pathology is expected for
release towards the end of 2009. This
project was jointly sponsored by Hills Pet
Nutrition and the WSAVA. Our sincere
thanks to Robert Washabau and his team
members for a task well done.
After the successful publication of the
International Guidelines for the Vaccination
of Dogs and Cats in September 2007 by the
Vaccine Guideline Group, Intervet/Schering
Plough Animal Health have once again
agreed to sponsor this group so that they
can continue their work for another year.
The group has set itself three distinct goals:
the active consultation on the existing
guidelines with national leaders from
member countries of the WSAVA; the
further consideration of the scientific
evidence base for minority vaccines not
considered in the initial report; and the
production of information on vaccination
for pet owners and breeders.
With the purchase of the Scan Scope
system and its installation at the Texas A&M
University at the beginning of this year, the
Renal Standardization Group has proceeded
with its study. Our appreciation to Bayer
Healthcare and Hills Pet Nutrition for their
sponsorship of this study.
To all the project leaders and group
members our sincere gratitude for your
involvement in these studies which are of
immense importance to academics,
specialists, and practitioners. Claudio
Brovida remains our special projects
co-ordinator and we really appreciate his
enthusiasm for these projects and the time
and effort he devotes to them.
The Hereditary Diseases Committee
under the leadership of Urs Giger met
recently in France to finalize the
development of their website, the
production of an informational booklet,
and to approve the database. ke
Hedhammar, Peter Markwell and Urs
presented lectures on hereditary diseases
during this years Congress.
Partnerships
We have maintained a cordial relationship
with FECAVA, FASAVA, FIAVAC and
FAFVAC and today we welcome The
Federation of Small Animal Practitioners
Association of India (FSAPAI) into our fold.
We must thank Umesh Karkare for his
tireless efforts in bringing this to fruition.
I would like to congratulate Larry Dee
and Roger Clarke for being acknowledged
companion | 25
WSAVA NEWS
by AAHA for their contributions to the
profession. They were presented with their
awards at the AAHA congress. I apologize if
I have left out any other committee or
assembly members who may have received
similar recognition.
Handovers
I have now completed my two-year term
of office and I would like to extend my
sincere gratitude to all my fellow board
members who have given me unbelievable
support over the last two years and to
you the assembly members for allowing
me the privilege of leading this great
association. I must also thank my wife
Isabel for her support and for allowing me
time off to accomplish my WSAVA
commitments. I will be handing over the
presidency to David Wadsworth who I
know is more than capable of looking after
the affairs of the WSAVA.
Larry Dee has completed his term as
Past President and will be leaving the Board.
Larry in his diplomatic way could always be
relied upon for valued advice. Larry is not
lost to veterinary politics and will once
again focus his attention on the American
arena. I wish him well and I know that he
will always be available to the WSAVA
should we require his input.
Anne Sorenson has unfortunately
decided to vacate the post of honorary
secretary, which she has held for four years.
This post is an enormously taxing position
not only did she have to contend with the
daily needs of the board and assembly
members but she also had to answer letters
from the public seeking advice on veterinary
matters. Mom, as Anne is affectionately
known, will be really missed at Board
meetings, especially for how well she looked
after us. I am sure Poul however will be
happy to have his wife back.
Pernille Blok Rissom has acted as our
secretarial assistant, a position she occupied
with much enthusiasm. Pernille will be
vacating this position as of this meeting and
I thank her for her diligence.
Luis Tello has been nominated
unopposed to the position of vice president,
as has Walt Ingwersen to the position of
honorary secretary. We are very fortunate
that these two highly efficient and hard
working gentlemen have made themselves
available to serve your executive.
New award
Your executive committee has decided to
institute a Presidents Award as from this
year. This award will be presented on a
time-to-time basis by the President of the
WSAVA in recognition of the recipients
outstanding contribution to the association.
The recipient will be selected by the
executive board and the award consists of a
plaque, to be presented at the assembly
meeting, together with complimentary
congress registration and two tickets to the
formal congress social event. The first
presentation took place during the meeting
in Dublin and the first recipient is Dr Hans
Klaus Dreier from Austria.
To Nicola Neumann and the members
of her committee, our grateful thanks for all
your hard work in organizing the Dublin
congress. It takes endless hours of planning
and meetings to arrange and manage a
congress such as this and we express our
sincere appreciation to everybody
concerned. I must also thank VICAS for
taking on this venture a small association
in numbers but not in effort.
WSAVA Vision: WSAVA is
dedicated to the continuing
development of global
companion animal care
WSAVA Mission: To foster the
exchange of scientific information
between individual veterinarians
and veterinary organisations
News from the Morocco
Veterinary Medical Association
The main aims of AMVAC (Association
Marocaine des Vtrinaires pour Animaux
de Compagnie) are:
To organize continuous education on
small animal medicine, surgery, nursing
and nutrition for the Moroccan
Veterinarians
To keep our members informed on
the recent scientific and technique
news concerning small animals
National and international
representation of the profession
within government and other
veterinary organizations
Participation in veterinary congresses
and meetings.
While AMVAC is less than 2 years old,
our 30 members (including private
MEMBER ASSOCIATION UPDATES
practitioners and faculty from the
veterinary school in Rabat), have been very
active in hosting small animal continuing
education meetings, which have included:
Small Animal Cardiology: organized in
collaboration with the WSAVA and
AFVAC and held in January 2008
featuring two French guest speakers
Small Animal Dermatology: held in
March 2008 in collaboration with the
WSAVA and AFVAC, also featuring
two guest French lecturers.
Proposed AMVAC future CE activities
include a seminar on the most common
skin diseases in small animals, scheduled
for October 25 of this year, and a CE
meeting on Emergency and critical care to
be held some time in 2009.
26 | companion
companion INTERVIEW
Claire Bessant grew up in Northern Ireland with her teacher mother, chemist father
and younger brother and sister. After studying Animal Physiology at Leeds she worked
in advertising, before a career with the British Veterinary Association in its editorial
department. She is now Chief Executive of the Feline Advisory Bureau
THE
companion
INTERVIEW
You have become known within the
profession through your work at the
Feline Advisory Bureau but you
previously worked in publishing.
What prompted that change?
I started editing FABs Journal back in 1990
when I was working on a freelance basis.
When the chief executive job came up it
was part time and I thought it would be
interesting. Much of what FAB does is
presentation of information, whether it is
written or at conferences, and I have had
to learn (and keep learning) about all the
other aspects of running a charity in the
constant struggle to raise profile and funds
for our work.
Who has been the most inspiring
influence on your professional career?
I have been very lucky to work with some
fantastic people whose enthusiasm and
generosity of time and intellect have made
work a joy. Andy Sparkes, Ross Tiffin, my
feline expert panels, my trustee directors
and colleagues across the world with an
enthusiasm for cat medicine have made the
work feel like it is making a difference.
What do you consider to be your
most important achievement during
your career?
To come up with ideas and then to make
them happen, maintaining high quality,
bringing new ideas and making the subject
relevant to a particular market gives a
great feeling of achievement. Examples
would be Easy to Give awards, Cat Friendly
Practice, WellCat for Life and our
achievements with the European Society of
Feline Medicine there are some very
exciting developments in the Journal of
Feline Medicine and Surgery to come
next year too.
What has been your main interest
outside work?
As I am a single mum with a full time job,
four children, a house with a large garden,
a dog, three cats and lots of family and
friends to keep in contact with, I have to
say that there is not much time for hobbies!
I sometimes have a book on cats to write
as well. Last year I enjoyed some travel,
often with work, but also to Tonga to swim
with Humpback whales, which was an
amazing experience.
If you could change one thing about
your appearance or personality, what
would it be?
Perhaps on occasion I would be a bit less
trusting, and sometimes a bit more
courageous doing things I dont enjoy, like
driving, sport, going on rough seas or
dealing with conflict.
What is the most significant lesson
you have learned so far in life?
Work with people you like and trust;
integrity and honesty are priceless, friends
cannot be valued enough. Have fun and
surround yourself with enthusiastic people
who think their glass is half full, not half
empty. Try to look at things in a different
way and not just follow what has been
done before.
What is your most important
possession?
It has to be my relationship with my family
and friends. Though if you are talking
material things, then the photographs I have
taken over the years.
What would you have done if you
hadnt chosen to work in animal
welfare?
One of my daughters is studying English and
I must say if I had my time again I would
love to do that and photography the
sciences were pretty dry to study and often
pretty difficult to get enthusiastic and
passionate about. However, my job now
enables me to mix science with
creativity, so I cant complain.
FAB is 50 this year. For more
information visit www.fabcats.org
CPD DIARY
companion | 27
5
October
Sunday
Practical dentistry for general
practitioners
Speaker Norman Johnstone
Day meeting at the Dunkeld House
Hotel, Dunkeld. Scottish Region.
Details from Lisa ODonnell,
telephone 07970 546334,
email lisao_donnell@hotmail.com
8
October
Wednesday
An update on feline chronic
gingivostomatitis
Speaker Alex Smithson
Evening meeting at IDEXX Laboratories,
Wetherby. North East Region.
Details from Karen Goff,
telephone 01924 275249,
email northeastregion@bsava.com
8
October
Wednesday
Geriatrics
Speaker Stijn Niesson
Evening meeting at The Holiday Inn,
Haydock. North West Region.
Details from Simone der Weduwen,
email beestenhof@ntlworld.com
CPD
DIARY
22
October
Wednesday
Heart murmurs in cats
Speaker Adrian Boswood
Evening meeting at The Potters Heron
Hotel, Romsey. Southern Region.
Details from Michelle Stead,
telephone 01722 321185,
email mmstead@btinternet.com
14
October
Tuesday
Immune-mediated disease of
dogs and cats
Speaker Sheena Warman
Evening meeting at The Park Inn,
Llanederyn, Cardiff. South Wales Region.
Details from the Chairman or Secretary
email southwalesregion@bsava.com
15
October
Wednesday
Wildlife and exotic
emergencies
Speakers Anna Meredith and
Sharon Redrobe
Day meeting at The Hilton, Bromsgrove.
Organised by BSAVA.
Details from BSAVA Customer Service,
telephone 01452 726700,
email customerservices@bsava.com
22
October
Wednesday
Feline infectious diseases
Speakers Rachel Dean and Sheila Wills
Day meeting at Janssen Laboratories,
High Wycombe. Metropolitan Region.
Details from Allison van Gelderen,
email allivetuk@yahoo.co.uk
23
October
Thursday
Whats sensible and whats
new in canine lymphoma
Speaker Gerry Polton
Evening meeting at Leatherhead Golf
Club. Surrey and Sussex Region.
Details from Jo Arthur,
telephone 01243 841111,
email surreyandsussexregion@bsava.com
28
October
Tuesday
Lower urinary tract disease in
the dog and cat
Speaker Hattie Syme
Day meeting at BSAVA HQ, Gloucester.
Organised by BSAVA.
Details from BSAVA Customer Service,
telephone 01452 726700,
email customerservices@bsava.com
23
October
Thursday
Small animal dispensing
course
Speakers Phil Sketchley, Steve Dean,
John Hird, Fred Nind, Peter Gripper
Day meeting at The Basingstoke Country
Hotel. Organised by BSAVA.
Details from BSAVA Customer Service,
telephone 01452 726700,
email customerservices@bsava.com
6
November
Thursday
Practical haematology:
detective work for nurses
Speaker Kostas Papasouliotis
Day meeting at BSAVA HQ, Gloucester.
Organised by BSAVA.
Details from BSAVA Customer Service,
telephone 01452 726700,
email customerservices@bsava.com
6
November
Thursday
Exploring the true potential
of cytology
Speaker Andrew Torrance
Afternoon meeting at The Potters
Herron Hotel, Romsey. Southern Region.
Details from Michelle Stead,
telephone 01722 321185,
email mmstead@btinternet.com
6
November
Thursday
Raptor medicine
Speaker Nigel Harcourt-Brown
Evening meeting at The Swallow Hotel,
Preston. North West Region.
Details from Simone der Weduwen,
email beestenhof@ntlworld.com
23
October
Thursday
Traumatic brain and spinal
cord injury: What can I do?
Speaker Giunio Bruto Cherubini
Evening meeting at The Russell Hotel,
Maidstone. Kent Region.
Details from Hannah Perrin,
email hannah@burnhamhousevets.com
12
November
Wednesday
Rabbits: its not the teeth or
gut, what next?
Speaker John Chitty
Evening meeting at The Park Inn,
Llanederyn, Cardiff. South Wales Region.
Details from the Chairman or Secretary
email southwalesregion@bsava.com
12
November
Wednesday
CPD road show: surgical
emergencies
Speakers Karen Tobias (USA) and
John Williams
Day meeting at The Stirling Management
Centre, University of Stirling Campus.
Scottish Region.
Details from BSAVA Customer Service,
telephone 01452 726700,
email customerservices@bsava.com
13
November
Thursday
LA calls for SA vets
Speaker: Graham Duncanson
Evening meeting at Russell Hotel,
Maidstone. Kent Region.
Details from Hannah Perrin, email
hannah@burnhamhousevets.com
For more information contact Customer Services
on 01452 726700 or email customerservices@bsava.com
or visit www.bsava.com
Small Animal Dispensing Course
Date: Thursday 23 October
Speakers: Fred Nind
John Hird
Peter Gripper
Steve Dean
Philip Sketchley
Venue: Basingstoke Country Hotel
Course Fees: BSAVA Members: 176.00 + VAT (206.80 inc. VAT)
Non Members: 236.00 + VAT (277.30 inc. VAT)
Wildlife and Exotic Emergencies
for Vets and Veterinary Nurses
Date: Wednesday 15 October
Speakers: Anna Meredith
& Sharon Redrobe
Venue: Hilton, Bromsgrove
Course Fees: 140.00 + VAT (164.50 inc. VAT)
Endocrinology II
Date: Tuesday 25 November
Speaker: Ian Ramsey
Venue: Woodrow House
Course Fees: BSAVA Members: 161.70 + VAT (190.00 inc. VAT)
Non Members: 315.00 + VAT (370.13 inc. VAT)
Practical Haematology:
Detective Work for Nurses
Date: Thursday 6 November
Speaker: Kostas Papasouliotis
Venue: Woodrow House
Course Fees: 190.00 + VAT (223.25 inc. VAT)
BSAVA CPD