companion

DECEMBER 2009

The essential publication for BSAVA members

How to investigate and

treat feather plucking

MRSA Clinical Conundrum BSAVA Congress

Protecting yourself and A case of coughing in a The entire Scientific
your patients young Labrador Programme for 2010
P4 P8 P17
companion

3 Association News
New RCVS Trust Library benefit
4–7 MRSA

TO DO –
Mike Jessop on protecting yourself and your patients
8–11 Clinical Conundrum
Consider a case of coughing in a young adult Labrador

END OF YEAR
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Investigate and treat a feather plucking parrot
17–20 Congress Science

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companion | 3
MRSA

MRSA

4  |  companion
 MRSA

Emerging strains of antibiotic-resistant bacteria are a growing threat to

the health of humans and animals. Veterinary staff are playing a key
role in these developments – both as part of the cause and the
solution to the problem. BSAVA Past President, Mike Jessop, attended
a conference in London which examined the actions that practitioners
should be taking to protect their patients and themselves

N
“ ow wash your hands” is the familiar
warning in toilet facilities of public
buildings across the country.
Perhaps it is time for the owners of
veterinary premises to put up a
few more of those signs, not
just in the smallest room but
throughout the building.
Improving hygiene standards
is a fundamental step in
reversing the spread of
methicillin-resistant
Staphylococcus
aureus (MRSA),
the main threat
to the
effective­
ness of
essential
antibiotic
agents. However,
it is only one of many
actions that veterinary
surgeons and VNs will
need to take to tackle
this serious animal and
public health risk.
A report by the influential
American Academy of Microbiology
(AAM), published in October,
highlighted the complex reasons for the
development of antibiotic resistance which,
to a large extent, is an inevitable
consequence of microbial evolution. This
can only be addressed through joint action
by all those involved in developing, licensing,
prescribing and using these drugs, creating
scapegoats of any particular link in that chain
will not solve the problem, the report said.
The challenge is formidable. “At the
present time, resistance essentially is
uncontrollable. The reasons behind the
establishment and spread of resistance are
complex, mostly multi-factorial and mostly
unknown. The consensus was that efforts
must target both bacterial transmission and
antimicrobial use,” said Jacques Acar, chair
of the AAM working group.
The antibiotic issue
Veterinary surgeons are responsible for
prescribing significant quantities of
antibiotics and their veterinary premises are
a focal point for the transmission of resistant
strains between humans and animals. So vets
must take some responsibility for any loss of
antibiotic sensitivity and play a big part in
dealing with the consequences. Specific
actions were discussed at a meeting
organised by the Bella Moss Foundation,
with sponsorship from Defra.
The charity (www.
thebellamossfoundation.com) was
established by Jill Moss after her dog died in
2004 as a result of developing an MRSA
infection in a postoperative wound. She has
earned respect from many members of the
profession as a result of her tireless efforts
to raise awareness of the issue and educate
both the profession and the public.
One of the main priorities for the
profession must be to get a better handle
on the scale of the problem in veterinary
practices, says Jill Moss. “The problem here
is that there is nobody collecting and
collating reliable information on the number
of pets that get infected with these bacteria.
We have reports sent to us by members of
the public and we can’t say whether these
are necessarily confirmed cases. But what is
clear is that the number of incidents appear
to be growing – a year ago we were getting
told of 10 to 15 cases a week, now it is
more like 20 to 30, not just in the UK but
from all over the world.”
Growing problem
MRSA is a much more recent problem for
veterinary surgeonss than for human
medics, who identified the first incidents in
1961. David Lloyd, professor of veterinary
dermatology at the RVC, told the meeting
that the first cases in animals were not
reported until 1999. MRSA in animals is
now recognised as a worldwide problem
and our understanding of the epidemiology
of these strains is growing rapidly. The

companion  |  5
 MRSA
MRSA
© Andreas Teske | Dreamstime.com
commonly identified risk factors include
contact with a human carrier of the MRSA
organism, three or more recent courses of
antibiotics, surgical implants and a stay of
two or more days as an in-patient at a
veterinary clinic, he said.
Vets also appear to be important as
carriers of the MRSA organism, with
positive swabs taken from 3.9 per cent of
vets in contrast to 0.7 per cent of the
general population. Moreover, studies have
shown a direct link between increased
veterinary surgeon colonisation and
increased patient infection rates. Perhaps
unsurprising as MRSA is a ubiquitous
organism which transfers easily between
humans, animals and fomites.
However, it would be unwise to become
fixated on a single bacterial strain. The
profession has to be vigilant in keeping track
of emerging bacterial threats. Most animal
MRSA cases occur in a hospital setting, but
a community-acquired form of MRSA has
become a significant challenge in human
medicine and this problem may spill over to
the veterinary field. Moreover, there is
growing evidence of methicillin resistance in
other staphylococcal species and even then
in some non-related pathogens. So it is
essential for the veterinary profession to
carry out regular reappraisals of its
infection management procedures.
The numbers of MRSA infections
6  |  companion
reported in animals is still relatively low
compared to the frequency of human cases,
noted Tom Maddox, from the National
Centre for Zoonosis Research at the
University of Liverpool. However, university
centres like the Liverpool Small Animal
Hospital are reporting a year-on-year
increase in cases and it is likely that most
general practitioners will encounter a case
at some point.
Mr Maddox advised submitting samples
for microbiological analysis from any cases
of persistent infection which have failed to
respond to empirical antibiotic treatment,
especially if fluoroquinolone or beta-lactam
antibiotics have been used. Practitioners
should be particularly suspicious of infection
in cases of animals that have received
long-term antibiotics, are
immunosuppressed as a result of disease or
treatment, have postoperative or traumatic
wounds, or have been in contact with a
known human or animal carrier of MRSA.
Diagnosis and treatment
Laboratory diagnosis of MRSA resistance is
straightforward and it may be worthwhile
for the practitioner to call the lab to discuss
the results and their implications for future
treatment. When MRSA is confirmed, the
bacterium should be considered resistant to
all penicillins, beta-lactams, cephalosporins
and related antibiotics, irrespective of any
reported sensitivity. Other familiar agents
such as tetracyclines, potentiated
sulphonamides and often gentamicin are
usually effective in treating small animal
isolates. For superficial or localised
infections, practitioners should consider
topical therapies such as fusidic acid. They
may also consider antibiotic-impregnated
implants, and standard wound management
procedures such as irrigation and
debridement may be of value.
The prognosis in most cases is likely to
be good although some may need prolonged
treatment. Mr Maddox emphasised the
importance of good communication with
owners, to ensure that effective hygiene
procedures are carried out and to identify
any potential zoonotic risks, such as an
immunocompromised family member or
one about to undergo surgery themselves.
Using fluoroquinolone and some
cephalosporin antibiotics in veterinary
practice is particularly controversial
following the UK Chief Medical Officer
Liam Donaldson’s warning that these
products should be restricted for treatment
of humans. However a blanket ban on
veterinary use should not be necessary,
argues Mark Dosher, from the Bella Moss
Foundation. The foundation would certainly
like veterinary surgeons to reduce their use
of antibiotics generally, but these particular
products should still have a role in small
animal practice provided they are used
responsibly. “They should not be used in
any animal unless there is a clear indication
that they will be effective,” he suggests.
Antimicrobial products
However the veterinary profession is on the
back foot in its attempts to defend access to
these groups of antibiotics. There is simply
insufficient data to prove that current usage
is safe and responsible, warned Dr Susan
Dawson, also from the University of
Liverpool. The only figures available are those
from the Veterinary Medicines Directorate,
whose last annual report in 2008 showed
that while the overall therapeutic use of
antibiotics in animals is declining, sales of

fluoroquinolones and cephalosporins are still
going up. Most of these products are being
used in livestock animal species but in 2007 a
significant amount (33,621 kg) was used in
non-food species.
There is a limited range of antimicrobial
products available for use by veterinary
surgeons; most of those are broad spectrum
products and all the licensed preparations
are also used in human medicine. So vets
must be mindful of the impact of veterinary
antibiotic use on the normal gut flora in
patients, Dr Dawson warned. Antimicrobial
resistance in non-pathogenic bacteria could
act as reservoirs of genetic materials for
later transfer to pathogenic species.
Prudent use of antibiotics is essential to
avoid further restrictions on their
availability for veterinary surgeons, an issue
that has been taken on board in the
livestock sector through the work of RUMA
(the Responsible Use of Medicines in
Agriculture Alliance). Its director, Dr Tony
Andrews, described the changing attitudes
towards antimicrobials in farm species over
the past 10 years and the growing pressure
from organisations like the World Health
Organization for ever stricter controls.
The issues surrounding antibiotics use
were essentially the same for every branch
of the veterinary profession and the advice
offered by RUMA was the same,
irrespective of where the practitioner was
working. Take full responsibility for
prescribing antimicrobials, he warned.
“Always be able to justify your choice –
antibiotic use is no longer a right for a
veterinary surgeon, it must be responsibly
used. So please remember the RUMA
mantra on antimicrobials – use as little as
possible but as much as needed.”
SA vet viewpoint
From my perspective as a purely small
animal practitioner, I made a few
observations of my own at the meeting. My
feeling is that we are not entirely blameless
on some issues which may have relevance
to the rise of multi-resistant bacteria. Are
there occasions, for example, when we are
lured into trying out exciting new antibiotic
MRSA
regimes and ignore those stalwarts of
yesteryear which remain an effective part of
our armamentarium? It is easy to be
Top tips
Good hand hygiene is the
seduced by pharmaceutical advertising with
its emphasis on products like the
1 simplest and most
fluoroquinolones and cephalosporins. important step to reducing
Just as important, we must guard bacterial transmission
Thorough cleaning of the
against financial considerations clouding 2 practice premises is also
our clinical judgement. We must ensure
essential. Identify key
that we are never tempted to choose a
transmission areas, e.g.
new exciting high value drug ahead of a
keyboards, door handles,
familiar old product that may be equally
otoscopes
effective. Another potential sin which we
Effective protective
must strive to avoid is laziness; the 3 clothing, e.g. theatre
temptation to use a broad spectrum,
scrubs, masks, gloves
catch-all therapy rather than opting for a In cases of chronic
specific treatment for the particular 4 infection, ensure that
bacterium identified or strongly suspected. samples are taken for bacterial
Removing that particular hair shirt, typing and sensitivity testing
there are others involved in the supply and Rely on good surgical
use of veterinary medicines who should also 5 asepsis and only give
consider whether the policies that they prophylactic antibiotics in the
have adopted are always the most sensible rare, high-risk cases
ones under the circumstances. My feeling is Use long established,
that the regulators (chiefly Practice 6 low-tech antibiotics such as
Standards Committee) also have a lot to potentiated sulphonamides
answer for. There are issues we cannot wherever possible
ignore – practice inspections are Use the minimum possible
aggressively enforcing the 28 day rule on
7 dose to achieve the stated
using a vial of antibiotic once it has been therapeutic goals (i.e. RUMA’s
broached. Add to this the increasing “Use as little as possible but as
difficulty in obtaining injectable antibiotics much as needed”)
Ensure as far as possible
in single-patient doses and that adds up to
produce an insidious pressure to overuse
8 that the client complies with
rather than waste a valuable product. the dosing instructions
Check that there are no
I would argue that these problems
provide further evidence, if that were
9 potentially vulnerable family
needed, of the dangers of our profession members if a dog or cat develops
becoming overreliant on the sales of MRSA
Use topical antibiotics and
products rather than our hard won 10 non-antibiotic approaches
knowledge. We are bombarded with advice
(e.g. debridement and  wound
and literature trying to force us to adopt a
irrigation) wherever possible
retail mentality when we should be
Be aware of, and test for,
focussing our efforts on earning 11 the risk of resistance
professional fees from the advice that we
developing in other bacterial
are able to offer.
species
For full access to the BSAVA’s MRSA
Be open, honest and
Guidelines and Frequently Asked 12 realistic should MRSA be
Questions, visit the Advice section at identified
www.bsava.com  n
companion  |  7
 CLINICAL CONUNDRUM

CLINICAL
CONUNDRUM
Felipe de Vicente and Kathryn Pratschke of the Faculty of Based on the information so far,
create a problem list and
Veterinary Medicine at Glasgow University invite consider differential diagnoses.
companion readers to consider a case of coughing in a Which single diagnostic step is
young adult Labrador likely in this case to be most
useful in narrowing the list of
possibilities?
The only problem noted was a chronic
non-productive cough.
The differential diagnoses to be
Case Presentation
considered for a non-productive cough
A 20-month-old male entire Labrador Retriever presented with a 2-month
include:
history of intermittent coughing, usually dry and non-productive. He had
failed to improve during treatment with antibiotics and antitussives by the
n Vascular – early cardiac disease without
referring veterinary surgeon. Otherwise he
pulmonary oedema
was clinically well. The patient
n Infectious (viral, parasitic or
presented in good general
bacterial)
condition, being of normal body
n Traumatic – tracheal foreign bodies.
size for his age and breed.
n Anatomical – bronchial compression
The only previous
(including left atrial enlargement),
problem was an umbilical
tracheal collapse
hernia, which had been
n Inflammatory – pulmonary infiltrates
surgically corrected when
(such as eosinophilic
he was 10 weeks old.
bronchopneumopathy),
Physical examination was
tracheobronchitis,
unremarkable; the dog was
bright, alert and responsive. n Neoplasia – primary or metastatic
The respiratory rate was disease.
28 breaths per minute, with
pink mucous membranes A radiographic study of the thorax is
and capillary refill time less likely to allow rapid narrowing of this list of
than 2 seconds. The heart differential diagnoses and allow decision
rate was 96 beats per making regarding further investigation.
minute with femoral
pulses strong, What is your interpretation of
symmetrical and the radiographs provided?
rhythmic. Thoracic On both the dorsoventral and lateral views
© Rcpphoto | Dreamstime.com

auscultation was the cardiac silhouette is enlarged and

difficult to evaluate globoid (Figure 1a and Figure 1b). The
as he was quite ventral area of the diaphragm cannot be
restless during the delineated and the gastric axis is displaced
examination. cranially. On the lateral view, ventrally and
caudally there is an area which contains

8 | companion
 CLINICAL CONUNDRUM

several radiodense structures and overlies

the cardiac silhouette. The appearance is
suggestive of pyloric gravel sign and perhaps
other foreign material. On the dorsoventral
view, the area consistent with the gravel
sign is located in the midline, and the
diaphragmatic outline at this level again
cannot be completely visualised. No
abnormalities are evident in the observed
lung fields.

What is your provisional

diagnosis and what would be
your next diagnostic steps?
Given the thoracic radiographic findings,
which show the presence of abdominal
viscera in the thoracic cavity, a
pericardioperitoneal diaphragmatic
hernia (PPDH) was considered likely.
Although a traumatic diaphragmatic Figure 1a
rupture could have been a possible
diagnosis, the globoid nature of the
cardiac silhouette made a congenital
PPDH more likely. Therefore, abdominal
imaging was indicated to evaluate the
extent and nature of the diaphragmatic
deficit and to determine which abdominal
organs had herniated.
Abdominal radiographs demonstrated
cranial displacement of the abdominal
structures (Figure 2). An ultrasound
examination revealed a large amount of
mineralized material in the pyloric outflow
tract, which extended cranioventrally to
the liver and into the pericardial sac. It
was possible to trace the duodenum from
adjacent to the heart, running caudally
through the diaphragmatic defect into
the right abdomen. Also present within
the pericardial sac were liver lobes and the
Figure 1b
gall bladder.

companion | 9
CLINICAL CONUNDRUM
CLINICAL CONUNDRUM
What does the mineralized
material seen on both
radiography and ultrasound
suggest?
The mineralized material in the pyloric
outflow tract and the radiographic gravel
sign indicate a chronic partial pyloric
obstruction.
What is the likely final
diagnosis?
These findings were suggestive of a
pericardioperitoneal diaphragmatic hernia
(PPDH) with chronic partial obstruction to
gastric outflow.
How would you manage this
case and what are the potential
perioperative concerns?
Surgery is indicated with two aims, first to
repair the PPDH and secondly to manage
the pyloric obstruction.
Ventilation under anaesthesia is usually
required for PPDH surgery, as lung
expansion can be compromised. Atelectic
lungs should be slowly re-inflated avoiding
airway pressures above 15 cm H2O during
10  |  companion
Figure 2
ventilation. This is to reduce the risk of
re-expansion pulmonary oedema
developing, although this may not be
evident until several hours after the surgery.
There is also a risk of reperfusion
injury to incarcerated viscera (especially
the liver) and possible abdominal
compartment syndrome (in which the
abdominal cavity is insufficiently capacious
for the returned organs). Although the
surgical plan does not include entering the
pleural cavity, provisions for chest drain
placement should be made preoperatively
in case this becomes necessary.
Intrathoracic adhesions are uncommon but
can hinder retraction of the organs back
through the defect. In some cases,
particularly in cases with sternal defects,
the diaphragmatic defect can be difficult to
close and appropriate implant materials to
aid closure may be required.
Surgical findings in this case
During the procedure analgesia was
provided with epidural morphine and a
constant rate infusion of fentanyl. The
patient was artificially ventilated
throughout anaesthesia. Methadone was
given as part of the premedication, and a
dose of meloxicam was also administered
intravenously. Amoxicillin/clavulanate
(600 mg) was given intravenously every
90 minutes during the surgery.
A ventral midline exploratory
coeliotomy was performed, extending from
the xiphoid process to the cranial preputial
level. A large congenital diaphragmatic
hernia (pericardioperitoneal diaphragmatic
hernia) was confirmed and a concurrent
gastric foreign body identified. The pylorus,
duodenum, pancreas and quadrate and left
medial liver lobes were retracted from the
pericardial sac. There were no adhesions
present in this case. Examination of the
herniated liver lobes showed some
anatomical variation in the shape of the
lobes when compared with the expected
normal appearance, and turbulence was
visible in the portal vein adjacent to the
porta hepatica.
These changes were presumably due to
hepatic development in an extra-abdominal
location as a result of the congenital hernia.
There was evidence of widespread intestinal
and mesenteric oedema plus lymphatic
congestion, again most likely related to the
hernia and periodic organ displacement.
A standard gastrotomy was performed,
and a foreign body was retrieved (a
medium-sized ball, collapsed) (Figure 3). The
gastrotomy site was closed routinely in two
layers. Surgical gloves and contaminated
instruments were changed prior to
continuing with the rest of the surgery.
The dorsal portion of the diaphragmatic
defect was sutured in a continuous pattern
using polydioxanone; however the ventral
defect was too large for straightforward
suture closure. A sheet of Vet-Biosist was
soaked in sterile saline then sutured in place

Figure 3
with interrupted sutures of polydioxanone
to fill the defect. This was then overlaid
with a layer of omentum, sutured in place
with interrupted sutures.
Copious peritoneal lavage was
performed with warmed sterile saline
prior to a final swab count and routine
abdominal closure. In this case no chest
drain was required as the pleural cavity
was not entered.
What are the key postoperative
concerns?
In some cases re-expansion pulmonary
oedema can develop following repair;
therefore close postoperative monitoring of
respiration is required. Fluids were
continued at maintenance levels (2 ml/kg/h)
until the next day. No oxygen
supplementation was needed. Methadone
was given every 4 hours to provide
analgesia. No antibiotics were used during
the postoperative period.
The dog made an uneventful recovery
and was discharged the day after surgery.
Carprofen was prescribed and it was
recommended to feed the dog three or four
small meals a day for a week, as well as
exercise restriction.
What is a pericardioperitoneal
diaphragmatic hernia?
A PPDH is an abnormal communication
between the pericardium and the
abdomen. PPD rupture may occur as a
result of trauma in humans (in whom the
diaphragm forms one wall of the pericardial
sac); however, true PPDHs are always
congenital in dogs and cats, in which no
direct communication should exist between
the pericardial and peritoneal cavities after
birth. The most widely accepted theory
regarding the embryogenesis of this
defect is that the hernia occurs due to
incomplete development of the septum
transversum of the diaphragm. This could
be a result of a teratogen, a genetic
anomaly, or prenatal injury.
This condition can be asymptomatic,
with the PPDH being an incidental finding
during investigation of another unrelated
problem, or found at post-mortem
examination. The severity of any symptoms
present depends on which structures are
involved in the hernia, the size of the
hernia itself, and the degree of movement
that is allowed forwards and back through
the hernia.
Clinical signs are usually related to the
herniated organs compressing the
intrathoracic structures leading to
respiratory signs including coughing.
Gastrointestinal signs may occur when
structures of the digestive system are
herniated (especially the intestines). Most
CLINICAL CONUNDRUM
affected animals are diagnosed before 4 years
of age and males appear to be predisposed.
What other conditions have
been associated with
pericardioperitoneal
diaphragmatic hernia?
PPDH has been associated with other
anomalies of closure of the embryonic
midline, such as cranial abdominal hernias,
umbilical hernia and sternal deformities, as
well as congenital cardiac abnormalities. It is
worth noting that in the case presented
here the history included repair of an
umbilical hernia at 10 weeks of age.
PPDH has been implicated as the cause
of intrapericardial cyst formation in both
dogs and cats, and has been associated with
pulmonary vascular disease.
Portal hypertension, incarceration and
strangulation of abdominal viscera may
develop as a result of organ herniation.
Reperfusion injury can rapidly develop once
herniated organs are replaced, leading to
profound systemic signs. The occurrence of
chronic gastric outflow obstruction in this
case is not a typical finding with PPDH and
seems more likely to have resulted from the
concurrent gastric foreign body.
What is the prognosis with
PPDH?
Surgical correction carries a good prognosis
provided the animal survives the immediate
perioperative period. Concomitant
intracardiac defects or pulmonary vascular
disease could be detected preoperatively
with more advanced diagnostic imaging
techniques, such as an echocardiogram, and
are associated with a poorer prognosis.
However, sternal and abdominal wall defects
have no adverse effect on survival.  n
companion  |  11
HOW TO…

HOW TO…

INVESTIGATE AND
TREAT A FEATHER
PLUCKING PARROT
Kevin Eatwell, lecturer in ■■ After wing clipping What clinical signs may be
Air sacculitis seen?
Exotic Animal and Wildlife ■■
■■ Allergic disease (inhaled or food) The external appearance of a pet parrot is
Medicine at the Royal (Dick) ■■ Behavioural problems usually of importance to the owner, but
Chlamydophilosis
School of Veterinary
■■ despite this some owners fail to present a
■■ Cloacal disease
bird until the clinical signs are severe. The
Science, discusses the most ■■ Excessive allopreeening from another
bird pattern of feather change or damage may
common condition affecting ■■ Folliculitis (bacterial or fungal) lead the clinician to suspect particular
Heavy metal toxicity conditions and it is important to identify
pet parrots ■■
■■ Hepatic disease the exact nature of the feather damage.
■■ Hypocalcaemia Feather plucking can be seen when the bird
■■ Neoplasia is physically removing feathers, preventing
■■ Nutritional disorders re-growth of an area and leading to alopecia
■■ Painful focus
(Figure 1). In contrast, feather pickers or
■■ Parasitic disease
■■ Poor socialisation chewers traumatise feathers; these can be
■■ Proventricular dilatation disease clearly evident on examination but are not
■■ Reproductive activity plucked. A third group can self-traumatise

F
Table 1: Differential list for causes of areas leading to intense pain, blood loss,
eather plucking, feather picking or
feather plucking (most common in alopecia and scarring. In these cases urgent
self-trauma are commonly presented in
bold) intervention is required.
clinical practice. Many owners will
present a bird looking for a quick resolution
to a problem that has existed for many
years. Yet unless these cases are
investigated thoroughly to identify any
underlying factors leading to the plucking,
presumptive treatment is likely to fail.
The causes for feather plucking broadly
fall into two categories: either a
psychological problem that has resulted
from captivity; or a specific illness leading
to the damage. What the clinician must do
first is identify any problems by reviewing
the clinical history, physical examination
and diagnostic testing. These findings should
be evaluated in context of the feather
plucking to associate them directly with the
problem. At this stage therapy can begin,
depending on the diagnosis. In urgent cases
remedial therapy may be required whilst
achieving a diagnosis. Common causes Figure 1: This Patagonian conure has been selectively plucking feathers on the
associated with feather plucking are listed legs. This can indicate underlying reproductive disease and inappropriate pair
bonding of a parrot to its owner
in Table 1.

12  |  companion
 HOW TO…

What are the important
questions to ask during a
consultation?
It is critically important to evaluate the
bird’s history as a whole. Many factors,
ranging from skin irritation or desiccation
through to inadequate nutrition, can
predispose to feather damage. Thus a
thorough husbandry review is indicated and
all predisposing factors should be
eliminated. General husbandry advice
should be given (and followed) in all cases of
birds with feather damage (Table 2).
It is important to discuss the bird’s
socialisation with the owners in detail.
Parrots generally perceive their owners as
parental figures when young, siblings when
adolescent, and as mates and competitors
when adult. Inappropriate pair bonding may
be seen, with the bird becoming fixated on
one individual and aggressive to other
people. Signs seen may include mating
postures or regurgitation, for example.
The anatomical site where the bird has
damaged the feathers is important. The
distribution of feather damage may suggest
a painful focus in the area and may be
centred over a wing clip (Figure 2), the
proventriculus, the ovary, the air sacs, the
liver or vent, for example. It is important to
identify where the feather damage started,
as it can spread over a wider area over time
as clinical signs progress.
Having worked out the site of the
damage, you then need to find out if the
owner is witnessing any inappropriate
behaviour such as excessive grooming,
plucking or even pain responses from the
bird. If so, this may associate the damage
with the presence of the owner and it may
be that the bird is seeking attention from its
owners, which they probably will be giving
and hence rewarding the behaviour.
Conversely, other birds may damage
themselves when the owners are absent.
You also need to identify if any previous
treatment has been administered by the
owner or other veterinary surgeons prior
to visiting you. Some of these treatments
may have been inappropriate. There may
have been some diagnostic tests
performed previously as well, whose
results may be useful.

■■ Improve the diet and avoid fatty foods.

A complete pelleted diet should be
offered, along with some fresh fruits
and vegetables.
■■ Provide the bird with access to either
natural or artificial UV-b light. Birds
can see into the UV spectrum and
this facilitates natural behaviour
and helps prevent hypocalcaemia
(which is a particular problem in
grey parrots).
■■ Ensure the bird is not exposed to an
excessive photoperiod; 12 hours of light
a day is sufficient for most equatorial
species.
■■ Avoid any inhaled toxins such as
tobacco smoke, PTFE (from non-stick
frying pans) or deodorants.
■■ Spray or mist the bird daily with warm
water.
■■ Improve the bird’s socialisation with
multiple owners and consider training
the bird to stimulate it.
■■ Never get the wing clipped. Figure 2: This grey parrot has started traumatising the feathers at a site of a
previous wing clip. This can progress to self-trauma of the skin of the wing tip,
Table 2: General husbandry advice for requiring amputation
owners

companion  |  13
HOW TO…

INVESTIGATE AND TREAT

A FEATHER PLUCKING PARROT

How can I investigate the causes ■■ Radiography is important and two views essentially rules out or diagnoses many
of feather plucking? should be taken, a lateral and a of the potential underlying factors
Every clinician you speak to will have a ventrodorsal. These can be useful to leading to feather plucking. At this
different list of diagnostic procedures they look for signs of proventricular point, if a number of common medical
perform and each plan is, of course, tailored enlargement or for radiodense foreign conditions have been eliminated,
to each individual case. The important bodies such as heavy metals. Chronic remedial hormonal therapy may be
factor is to prioritise diagnostics and aim to joint disease causing a painful focus may indicated, if an active gonad (and hence
get as much information as possible to rule also be seen in older birds. likely excessive pair bonding) was
■■ The next step to consider is identified on laparoscopy.
out as many of the underlying factors
laparoscopy (Figure 3). This, although ■■ Should these tests fail to lead to a
quickly and economically.
invasive, provides far more information diagnosis then investigation of primary
Whilst screening for infectious disease
about the bird’s health status. The skin disease should follow. Detailed
is important (there are PCR tests for
clinician can evaluate the air sacs, liver, examination of the skin and feathers is
psittacine beak and feather disease (PBFD),
heart, proventriculus, lungs, kidneys, important and should be undertaken
polyoma virus and Chlamydophila), the
gonads (and hence reproductive status), while the bird is anaesthetised. If any
importance of such results has to be taken
spleen, intestines and cloaca. This areas are of concern, then diagnostic
in context. What is the real likelihood of an
adult grey parrot, housed in isolation for a
number of years, with perfect head
feathers, having been exposed to PBFD?
Although a Chlamydophila PCR may be
positive, is there significant pathology (liver
or air sac disease) leading to plucking over
the keel? Instead of rushing in with specific
testing, looking at the bird’s health status as
a whole may yield more useful results.

Author’s suggested
investigatory procedure
■■ The bird should be anaesthetised and a
full blood profile taken. This is useful to
rule out hypocalcaemia, liver disease,
renal disease, low proteins and also to
check for signs of systemic infection
such as a monocytosis or toxic activity
within the white cell lines. For
example, if the bird had PBFD then a
low white cell count may be seen. In
contrast, significant Chlamydophila
infection will elevate the white cell
count and there may be signs of liver Figure 3: This blue and gold macaw is undergoing laparoscopic biopsy as it has
hepatomegaly which may be related to its poor feather quality
damage on the profile.

14  |  companion

samples can be taken. Fret marks can
be seen where feather growth has been
disrupted due to a poor diet or
PBFD. Changes in pigmentation of
feathers, which can become black or
pink plumage depending on species, can
occur with liver disease.
Skin scrapes can be examined for
ectoparasites in areas of hyperkeratosis.
Abnormally thickened blood feathers
can be removed and the pulp examined
cytologically for ‘pulpitis’. Diff Quik
staining can reveal bacteria or
heterophillic inflammation. Alternatively
a skin biopsy sample can be taken
(including a quill feather) and sent for
histopathology. This is of particular
importance where ulceration, nodules
Figure 4: This Princess of Wales parakeet has a uropygial gland tumour that
requires surgical removal. A collar will need to be placed to prevent damage to
the granulating surgical wound created
or signs of chronic disease are seen.
Neoplastic conditions are also on the
differential list in these cases (Figure 4).
Culture of skin lesions can also be
performed. The techniques used mirror
that used for mammalian skin disease.
Caution is to be advised when
interpreting skin tests, as many cases of
‘pulpitis’ or inflammation can be due to
secondary opportunistic infections as a
consequence of the feather plucking.
Treatment of theses conditions with
antibiotics and analgesics may help to
control feather plucking, but the
underlying cause should always be
thoroughly evaluated.
■■ Specific diagnostics may be indicated for
an individual case: e.g. PBFD or
HOW TO…
Chlamydophila PCR; crop biopsy if
proventricular dilatation disease is
suspected; or blood lead or zinc levels if
heavy metal toxicity is suspected. A full
faecal analysis may also be required if
endoparasitic disease is suspected.
■■ If all medical conditions have been
excluded it suggests that there is a
behavioural element to the problem
and remedial behavioural therapy can
be undertaken.
How should a severe case be
managed?
If the bird is at risk of causing significant
self-trauma then remedial action may need
to be undertaken urgently for humane
reasons. This may necessitate: a collar to
be placed to prevent self-trauma; analgesia
for pain control; debriding, cleaning and
dressing wounds; and antibiotics if the
wounds are infected. However these are
not stand-alone solutions, and a thorough
review of husbandry and clinical history are
indicated alongside a diagnostic plan. There
is little point in collaring a bird and
providing psychotropic drug therapy
without confirming this is 100% necessary.
Other birds may start performing
self-trauma as a result of a painful focus.
This can be seen in birds that have been
wing clipped and that have subsequently
damaged the end of their wing, impairing
feather regrowth. In severe cases
amputation of the wing tip is required.
Another common site of self-trauma is the
keel. Birds incapable of flight can jump off
high perches or the top of the cage when
scared. The landing is rough, leading to a
‘split keel’ as the bird hits the ground.
Osteomyelitis is possible in these lesions
and surgical treatment is generally indicated.
companion  |  15
HOW TO…
INVESTIGATE AND TREAT
A FEATHER PLUCKING PARROT
How should treatment be
tailored?
Improving husbandry and treating any
specific condition identified is important.
Damaged feathers may require removal
under anaesthesia (Figure 5) or imping
(grafting of donor feathers onto damaged
feather shafts). Analgesia is important
during the regrowth phase as the bird may
become overly pruritic as a large number
of follicles all grow at once. Topical
treatments may be used but should be
limited to products specifically marketed
for birds. Topical steroids are generally
contraindicated.
Figure 5: This grey parrot is having severely traumatised feathers removed
under anaesthesia to facilitate new growth
16 | companion
What prognosis should I give?
In many chronic cases resolution is difficult
and at best the condition is managed. The
owner requires total commitment to the
case. It can take many months to improve a
bird’s condition and these cases require a
primary clinician to be in charge of case
progression. Consideration should be given
to refer to an RCVS specialist for a
complete evaluation of the case, diagnostic
evaluation and subsequent management.
The BSAVA Manual of Psittacine Birds
provides more details on the diagnosis and
treatment of psychological problems and
skin disease in parrots. ■
BSAVA Manual of
Psittacine Birds
To treat a sick bird
properly it is
essential to
understand
aspects of normal
biology and this is
what you will find in
the BSAVA Manual
of Psittacine Birds,
along with the many advances in
psittacine medicine.
Clinical examination is presented
in a logical, highly practical way,
with integrated photographs of key
features. Colour images of
haematology and cytology, and a
step-by-step post-mortem
examination procedure illustrate
the role of clinical pathology.
Imaging views of normal and
abnormal presentations are
included. The systemic illness
chapters are designed to be read
in their entirety or to be referred to
as needed. For general
practitioners the most commonly
seen psittacine patients are small
parrots, cockatiels and
budgerigars, and a chapter is
devoted to their common
problems. This practical approach
to the sick bird is extended in
an appendix of diagnostic
algorithms for common
presentations such as ‘fluffing up’,
fitting and feather damage.
A pictorial guide to droppings
illustrates normal and abnormal
appearances and their
significance.
For more information or to buy the
manual visit www.bsava.com or
call 01452 726700.
 CONGRESS SCIENTIFIC PROGRAMME 2010

Thursday 8 April
Austin Court
Time Hall 1 Hall 3 Hall 5 Hall 8 Hall 10
Kingston Room

EXOTICS
SOFT TISSUE VETERINARY
DERMATOLOGY ENDOCRINE IMAGING I SPINAL SURGERY A practitioner’s
SURGERY MASTERCLASS
guide to…

0830 Cutaneous drug Recent advances in the A surgical approach to Abdominal radiology: Lumbosacral stenosis: Dealing with venomous
reactions in dogs and understanding of canine the oncological patient the pitfalls presentation and species and dangerous
cats diabetes mellitus diagnosis wild animals

Ed Rosser (USA) Lucy Davison (UK) Julius Liptak (USA) Wilfried Mai (USA) Thomas Gödde (Ger) Mark Amey (UK)
0900–1230 m
Executive 2
0915
Blood gas evaluation:
0925 Feline symmetrical Intensified insulin Reconstruction after oral Diagnostic imaging in Lumbosacral stenosis: Post mortem how to use the numbers
alopecia: diagnosis and therapy in cats with oncological surgery the diagnosis of surgical management examination of exotics to help the patients
management diabetes mellitus abdominal sepsis
Matt Beal (USA) &
Amanda Boag (UK)

Ed Rosser (USA) Claudia Reusch (Sui) Julius Liptak (USA) Wilfried Mai (USA) Thomas Gödde (Ger) Mark Stidworthy (UK)
1010
1000 EXHIBITION OPENS & COFFEE BREAK – NATIONAL INDOOR ARENA
1105 Diagnostic tools to Approach to the Thoracic wall tumours: Thoracic radiography: Management of Respiratory diseases in
identify skin infections uncontrolled diabetic surgery and interpretive principles congenital spinal rabbits, rats and degus
dog reconstruction disorders

Claudia Nett (Sui)
1150
1200 Dermatophytes:
diagnosis and therapy
Ian Battersby (UK) Julius Liptak (USA) Tobias Schwarz (UK) Jacques Penderis (UK) Anna Meredith (UK)
Update on IGF-1 as a Perineal masses: Thoracic radiology: the Spinal trauma Anorexia and weight
diagnostic tool for surgery and pitfalls loss in parrots
acromegaly reconstruction

Claudia Nett (Sui) Claudia Reusch (Sui) Jane Ladlow (UK) Wilfried Mai (USA) Malcolm McKee (UK) John Chitty (UK)
1245
EXHIBITION & LUNCH – NATIONAL INDOOR ARENA

Austin Court
Time Hall 1 Hall 3 Hall 5 Hall 8 Hall 10
Kingston Room

EXOTICS
SOFT TISSUE IMAGING
DERMATOLOGY ENDOCRINE SPINAL SURGERY A practitioner’s
SURGERY How to…
guide to…

1405 Updates on the diagnosis
and treatment of sebaceous
adenitis and seasonal flank
alopecia in dogs
Ed Rosser (USA)
1450
1500 Secondary infections in
allergic patients: Malassezia, disorder?
bacterial folliculitis
Claudia Nett (Sui)
1545
Endocrinopathies and
hypertension
Claudia Reusch (Sui)
Obesity: an endocrine
Alex German (UK)
Perineal hernia (rupture) …take good hip and elbow Appropriate use of Emergencies in birds of prey
radiographs advanced imaging in spinal
Tobias Schwarz (UK) disease
…take optimal thoracic
radiographs
Peter Holt (UK) Fraser McConnell (UK) Erik Wisner (USA) Nigel Harcourt-Brown (UK)
Surgical treatment of rectal …decide which imaging modality Wobbler syndrome Oh no, I have a sick fish
neoplasia to use for the urogenital tract coming in!
Tobias Schwarz (UK)
…take diagnostic samples
with ultrasound guidance
Peter Holt (UK) Michael Herrtage (UK) Laurent Garosi (UK) Ray Butcher (UK)
CLOSE FOR BSAVA LECTURE – HALL 1

1630

BSAVA LECTURE – HALL 1

JOE SIMPSON – TOUCHING THE VOID

1700
WELCOME RECEPTION – NATIONAL INDOOR ARENA
Come and enjoy a free drink with the exhibitors

1900
EXHIBITION CLOSES IN NATIONAL INDOOR ARENA

companion  |  17
CONGRESS SCIENTIFIC PROGRAMME 2010

Friday 9 April
Time Hall 1 Hall 3 Hall 5 Hall 8 Hall 9 Hall 10

FELINE TRANSFUSION VETERINARY

INTERACTIVE ONCOLOGY SEIZURES BEHAVIOUR
ORTHOPAEDICS MEDICINE MASTERCLASSES

0830 Managing
persistent vomiting
i Feline lymphoma
Epileptic seizures:
classification and
Equipping the practice
for feline orthopaedic
Does my patient need a
transfusion?
Mental stimulation for
dogs to prevent
diagnostic approach surgery behaviour problems:
what makes a good toy
or game?

Dave Ruslander (USA) Holger Volk (UK) John Lapish (UK) Amanda Boag (UK) Helen Zulch (UK)
0900–1230 m
Executive 1
0915
Challenging
0925 Canine mammary Metabolic and toxic Fracture planning in Canine blood donation: Taking care of dog cardiopulmonary
tumours causes of epileptic cats the practicalities behaviour in everyday diseases
seizures veterinary practice:
make your life easier!
Lynelle Johnson (USA)
& Virginia Luis Fuentes
Kenny Simpson (USA) Jo Morris (UK) Laurent Garosi (UK) Rico Vannini (Sui) Gill Gibson (UK) Kendal Shepherd (UK) (UK)

1010
EXHIBITION & COFFEE BREAK – NATIONAL INDOOR ARENA Executive 2
1105 Feline medicine
i
Multimodality care:
when to cut, irradiate or
STATE OF
THE ART
s Forelimb fracture repair
in cats
Blood banking: an
alternative to DIY?
Life skills for puppies;
practical tips for new
Diagnostic challenges,
clinical presentations,
use chemotherapy for Genetic testing in owners and long-term
cancer canine and feline management of food
epilepsy allergy in dogs and cats
Ed Rosser (USA)
Dave Ruslander (USA) Cathryn Mellersh (UK) Katja Voss (Australia) Amanda Boag (UK) Helen Zulch (UK)
1150
1200 Is it cancer? How to MRI – imaging changes Practical and Safe transfusion “Help, my dog has
read your pathology in epilepsy: cause and economical methods for medicine practices bitten someone; what
report effect mandibular fracture should I do?”
repair in cats

Mike Lappin (USA) Sue Murphy (UK) Fraser McConnell (UK) Harry Scott (UK) Matt Beal (USA) Kendal Shepherd (UK)
1245
EXHIBITION & LUNCH – NATIONAL INDOOR ARENA

Time Hall 1 Hall 3 Hall 5 Hall 8 Hall 9 Hall 10

FELINE TRANSFUSION VETERINARY

INTERACTIVE ONCOLOGY SEIZURES FARM PETS
ORTHOPAEDICS MEDICINE MASTERCLASSES

1415 Not just a string of

numbers: how to i Skin tumours in the cat Optimising maintenance Foot fracture repair in
management of cats
Rational use of blood
products
Treating the sick pet
chicken
1415–1745 m
read a clinical chemistry epileptic seizures Executive 1
report
Diagnosis and
management of chronic
intestinal disease
Dave Ruslander (USA) Jacques Penderis (UK) Katja Voss (Australia) Victoria Roberts (UK)
1500
Kenny Simpson (USA) &
1510 Skin tumours in the dog Refractory epilepsy Common joint problems Treating the sick pet pig Ed Hall (UK)
in cats and how to
manage them
Executive 2
Corneal surgery
Graham Duncanson
Harold Tvedten (Swe) Dave Ruslander (USA) Holger Volk (UK) Rico Vannini (Sui) Matt Beal (USA) (UK) Ingrid Allgoewer (Ger)
1555
EXHIBITION & TEA BREAK – NATIONAL INDOOR ARENA
1650 Conundrums in
hypertension i Feline seizures Pelvic fractures in cats:
when and how to repair
Feline transfusion
medicine: uniquely
Treating the sick pet
goat
challenging aspects

Jacques Penderis (UK) Katja Voss (Australia) Sophie Adamantos (UK) Kat Bazeley (UK)
1735 PREPARATION
FOR BANQUET
1745 Emergency Feline femoral fracture Blood typing and cross Group health for the
management of seizures repair and how to avoid matching: what to do hobby farmer
complications and when

Clarke Atkins (USA) Karen Humm (UK) Rico Vannini (Sui) Gill Gibson (UK) Kat Bazeley (UK)
1830
EXHIBITION CLOSES IN NATIONAL INDOOR ARENA

18  |  companion
 CONGRESS SCIENTIFIC PROGRAMME 2010

Saturday 10 April
Time Hall 1 Hall 3 Hall 5 Hall 8 Hall 9 Hall 10

TNAVC VETERINARY
INTERACTIVE FELINE MEDICINE OPHTHALMOLOGY GASTROENTEROLOGY CARDIOLOGY
Reptiles MASTERCLASSES

0830 What are these

radiographic bone i Feline vaccinology:
what’s the best
Eye testing for
hereditary eye diseases
What’s new in feline
pancreatitis
Common reptilian
emergencies
Systemic arterial
embolism in cats
changes?
m
approach to preventing
infections in cats? 0845–1230
Hall 6
Mike Lappin (USA) Sheila Crispin (UK) Kenny Simpson (USA) Doug Mader (USA) Clarke Atkins (USA) In-house blood smears
0915
0925 Wellness programmes Genetic testing for Imaging the pancreas ER/ICU care of reptile Asymptomatic cats with
Harold Tvedten (Swe)
for a healthy practice hereditary eye diseases patients murmurs

0900–1230
Executive 2
Erik Wisner (USA) Margie Scherk (Can) Cathryn Mellersh (UK) Michael Herrtage (UK) Doug Mader (USA) Kerry Simpson (UK)
Soft tissue sarcoma in
1010 the cat and dog
EXHIBITION & COFFEE BREAK – NATIONAL INDOOR ARENA
Julius Liptak (USA) &
1105 The polytraumatised
cat: how to face the i Feline vaccinology:
what’s the current
Breed-related eyelid
disorders
Diagnosis and
management of acute
Fracture repair in
reptiles
Differentiating cardiac
from respiratory disease
Dave Ruslander (USA)
challenge thinking on vaccine- pancreatitis
associated side-effects?

Mike Lappin (USA) Ingrid Allgoewer (Ger) Dan Chan (UK) Doug Mader (USA) Clarke Atkins (USA)
1150
1200 Unique challenges to Primary glaucoma: Chronic pancreatitis in Reptilian gout Why do dogs with
manage the neonate diagnosis, differential the dog: a new disease murmurs cough?
and kitten diagnosis and treatment entity?
options

Rico Vannini (Sui) Margie Scherk (Can) Claudia Hartley (UK) Penny Watson (UK) Doug Mader (USA) Luca Ferasin (UK)
1245
EXHIBITION & LUNCH – NATIONAL INDOOR ARENA

Time Hall 1 Hall 3 Hall 5 Hall 8 Hall 9 Hall 10

TNAVC VETERINARY
INTERACTIVE FELINE MEDICINE OPHTHALMOLOGY GASTROENTEROLOGY CARDIOLOGY
Dentistry MASTERCLASSES

1415 Why is this rabbit

not eating? i Fever of unknown origin
in the cat
Inherited conditions of
the lens: diagnosis and
Chronic vomiting: what’s Maximising dentistry in
the cause? your practice
ACE inhibitors,
azotaemia and NSAIDs
1415–1745 m
treatment options Executive 1
Imaging in the diagnosis
of vascular liver
diseases in dogs and
Ingrid Allgoewer (UK) Jimmy Simpson (UK) Bill Gengler (USA) Clarke Atkins (USA) cats
1500
1510 Inherited conditions of Chronic gastritis in dogs Regional anaesthesia Hypertensive heart Wilfried Mai (USA) &
the ocular fundus and cats and oral pain disease: importance, Victoria Johnson (UK)
management monitoring and
treatment Executive 2
Frances Harcourt-Brown Locking implants in
(UK) Mike Lappin (USA) Sheila Crispin (UK) Kenny Simpson (USA) Bill Gengler (USA) Clarke Atkins (USA) orthopaedics
1555 Katja Voss (Australia) &
EXHIBITION & TEA BREAK – NATIONAL INDOOR ARENA Malcolm Ness (UK)
1650 Ophthalmology
i FELINE MEDICINE
STATE OF
THE ART sOral trauma Goals and side-effects
of heart failure
The emerging importance treatment: what should
Homecare and end of
of bacteria in we monitor?
life issues inflammatory
bowel disease
Margie Scherk (Can) Kenny Simpson (USA) Bill Gengler (USA) Anne French (UK)
PREPARATION
1735 FOR PARTY
1745 NIGHT Therapeutic implications Endoscopic evaluation Orthodontics Managing
of renal insufficiency: of the GI tract tachyarrhythmias:
new thoughts current approaches

Ingrid Allgoewer (Ger) Margie Scherk (Can) Jimmy Simpson (UK) Bill Gengler (USA) Simon Dennis (UK)
1830
EXHIBITION CLOSES IN NATIONAL INDOOR ARENA

companion  |  19
CONGRESS SCIENTIFIC PROGRAMME 2010

Sunday 11 April
Time Hall 1 Hall 3 Hall 5 Hall 8 Hall 9 Hall 10

CLINICAL VETERINARY
IMAGING II …MADE EASY RESPIRATORY UROLOGY GERIATRICS
PATHOLOGY MASTERCLASSES

0900 Small animal thoracic

imaging I
Microchipping… Managing snotty-nosed
cats
Current trends in canine Diet in the ageing
urolithiasis (including animal
Interpretation of graphic 0900–1230
reports from m
Chris Laurence (UK) management) haematology Executive 1
instruments
Microscopy… Feline bug transfusions:
important blood-borne
infections
Erik Wisner (US) Elizabeth Villiers (UK) Lynelle Johnson (USA) Jodi Westropp (USA) Dan Chan (UK) Harold Tvedten (Swe)
0945 Mike Lappin (USA) &
Séverine Tasker (UK)
0955 Small animal thoracic Skin scraping… Managing snotty-nosed Current trends in feline The ageing heart and Cytology I: how to get
imaging II dogs urolithiasis (including lungs back something better
management) Executive 2
Claudia Nett (Sui) than ‘non-diagnostic’ on
FNAs Lameness of unknown
Getting blood from an
origin? Evaluation and
aggressive cat… prevalence of foraminal
Erik Wisner (US) Margie Scherk (Can) Jon Wray (UK) Jodi Westropp (USA) Geoff Culshaw (UK) Balázs Szladovits (UK) lesions along the spinal
vertebral column
1040
EXHIBITION & COFFEE BREAK – NATIONAL INDOOR ARENA Thomas Gödde (Ger)
1145 Abdominal imaging Bone marrow Tracheal collapse: the Occult urinary tract The ageing Anaemia in the cat
aspiration… tip of the iceberg infections musculoskeletal system
Elizabeth Villiers (UK)
Placing an
oesophagostomy tube… Sorrel Langley-Hobbs
Fraser McConnell (UK) Karen Humm (UK) Lynelle Johnson (USA) Clive Elwood (UK) (UK) Harold Tvedten (Swe)
1230
EXHIBITION & LUNCH – NATIONAL INDOOR ARENA

1400
EXHIBITION CLOSES IN NATIONAL INDOOR ARENA

Time Hall 1 Hall 3 Hall 5 Hall 8 Hall 9 Hall 10

IMAGING II …MADE EASY RESPIRATORY UROLOGY GERIATRICS CLINICAL PATHOLOGY

1400 Review of small animal

orthopaedic disease
Placing a PEG tube… Use of bronchoscopy and
bronchoalveolar lavage in
STATE OF
THE ART s The ageing brain Anaemia in the dog

Lucy McMahon (UK) small animal medicine Laser lithotripsy: its use for
canine and feline urolithiasis
Indirect ophthalmoscopy…

Erik Wisner (USA)
1445
1455 Interventional radiology:
overview and veterinary
applications
Lorraine Fleming (UK)
Joint taps…
Harry Scott (UK)
Medicating birds…
Lynelle Johnson (USA) Jodi Westropp (USA) Holger Volk (UK) Harold Tvedten (Swe)
Chronic cough: making the Advanced diagnostics for The ageing kidney Cytology II: interpretation of
diagnosis lower urinary tract evaluation cytological preparations
in small animals

Matt Beal (USA) John Chitty (UK) Lynelle Johnson (USA) Jodi Westropp (USA) Hattie Syme (UK) Balázs Szladovits (UK)
1540
1550 Role of the tracheal stent for Acid–base interpretation… Chronic cough: Managing multidrug- The ageing eye Testing for FIP, FeLV and FIV
the management of tracheal management resistant urinary tract
collapse Amanda Boag (UK) infections
Emergency echo…

Matt Beal (USA) Virginia Luis Fuentes (UK) Brendan Corcoran (UK) Jane Eastwood (UK) David Williams (UK) Séverine Tasker (UK)
1635
TEA & COFFEE – ICC – HALL 3 FOYER
CONGRESS CLOSES

For full details of the Veterinary and

Nursing Programme for Congress 2010
visit www.bsava.com
Details correct at time of going to press

20  |  companion

Once you’ve enjoyed some of the best veterinary science in
the lecture halls and discovered the latest industry innovations
in the Exhibition, you’ll be ready to let your hair down…
Y
ou’re having a laugh aren’t you? Well
you will be if you make sure you’ve
got your Party Night ticket for the
Saturday of Congress. You’ll be treated to a
double whammy of fun this year, with your
cult comedy host Stephen Grant turning on
the laughing gas with a short set, before
introducing you to one of the most
popular names on the comedy circuit…
Jason Manford
In 1999, at the Buzz Comedy Club in
Manchester, fate stepped in to turn Jason
Manford from a 17-year-old glass collector
into a professional comic. When a
performer didn’t arrive for their set one
evening, Jason stepped in – an event which
marked the beginning of his comedy career.
Just six gigs later he was winning comedy
awards and today he’s a TV panel show
stalwart, providing the laughs as one of the
captains on 8 out of 10 Cats. Even if you
CONGRESS
don’t recognise his face, you’ll know what
he sounds like, as he can currently be heard
as one of the voices in the BBC comedy
sketch show, Walk on the Wild Side and for
the Churchill Insurance adverts.
Jason Manford joke:
ing out
About tipping when din
a pound, you
You can’t give an adult
u go mate,
may as well say ‘there yo
ts’.
get yourself some swee
Have a drink on us
In between the comedy and the music you’ll
be able to indulge in some nice nibbles
from the Party Night buffet and get
yourself some drinks. Don’t forget
to use your drink tickets earlier
in the evening during Happy
Hour, when your drink ticket
is worth double!
companion | 21
CONGRESS
CONGRESS
TOP
TUNES
The Proclaimers
Twin brothers Craig and Charlie Reid will
lead the Party Night musical frivolities. As
The Proclaimers, they have enjoyed huge
success across the globe with emotional,
honest, witty, sing-along raucousness that
entertains fans across the generations.
Sound beginnings
After building a strong following in Scotland,
in January 1987 they made a now seminal
appearance on Channel 4’s The Tube,
performing Letter From America. Singing in
regional accents about Scotland – they were
Essential a far cry from the mid-Eighties playlist
reminder to staples of Rick Astley and Sinitta. Voted
NME Readers’ Best New Band that year,
members they toured the UK extensively and
Letter From America, produced by
Remember, if you register for
Gerry Rafferty, went Top 3.
‘whole Congress’ before
31 January we will give you
£25 to spend on CPD or
manuals on the BSAVA Balcony
at Congress. Conditions apply.
The regular Early Bird deadline
is 10 February.
22 | companion
companion | 22
Resurgence
In 2007 they topped the UK singles chart
again with a rousing new rendition of their
classic anthem I’m Going to Be (500 Miles), a
collaboration with comedians Peter Kay and
Matt Lucas for Comic Relief, raising over a
million pounds in the process. EMI
re-launched their 2002 “Best Of” collection,
re-entering the Album Charts at number 5.
Matt Lucas is a huge fan and in the sleeve
notes of their “Best Of” compilation he
writes: ‘I find it hard to put into words quite
how the music of The Proclaimers makes
me feel. It makes me laugh. It makes me cry.
It just makes me generally euphoric’. ■
Book your Party Night tickets
with your Congress registration
to avoid disappointment. For full
details about all the social acts
and events and to register, visit
www.bsava.com.
 VIN

GrapeVINe
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 have
specialised knowledge and skills. In this regular feature, VIN shares with companion
readers a small animal discussion that has recently taken place in their forums

Discussion: Pancreatitis versus old pancreas

Marc Silverman, DVM
Agoura Animal Clinic, Agoura Hills, CA

I have a sick patient that could use your input. Alex is a 17 year old M/N DSH with an 8 day history of illness. He first
presented to our practice on 7/7/09 with weight loss over 1 month and anorexiav and vomiting for 3 days. He was
febrile on presentation (T=103.8F), 7–8% dehydrated, listless, and had a 2/6 left sternal systolic heart murmur.

Chest and abdominal radiographs were normal except the kidneys seemed somewhat rounded instead of kidney-
shaped. Urinalysis showed SG1.015, pH=6, no protein and unremarkable sediment. Subsequent urine culture was
negative. Systolic blood pressure was 125mm Hg.

In-house blood work showed the following abnormalities: low normal HCT=25% with normal RBC morph. Increased
BUN (112, normal 16–36), increased Creat (5.3, normal 0.8–2.4), PO4 (8.6, normal 3.1–7.5) and low K (2.8, normal
3.5–5.8).

Treatment was initiated with IV L/R and K+ supplement, injectable Pepcid, sodium ampicillin, and Zofran. After 2
days, the cat’s dehydration had resolved, he was normothermic, his heart murmur had not changed, he had not
vomited since being hospitalized, he was much more alert, but still had a poor appetite.

Blood work was repeated and his azotemia and hypokalemia had improved to the point that we felt that they may no
longer be contributing to his anorexia. His anemia was more severe but a bit more than we expected from
rehydration alone:

BUN now 60 from 112

Creat now 3.6 from 5.3
HCT now 19% from 25%

Mirtazepine was started (1/4 tab of 15mg tab q 72 hours) and he was switched from injectable Zofran to Cerenia. We
also started him on sucralfate.

The following day (day 3 of hospitalization) he appeared more animated but still would not eat so the owner elected
to take him home for a day to see if his appetite would be better at home. He was discharged with L/R and 20meq
KCl/L and the owner was instructed to give him 100cc SQ daily, plus oral Cerenia, Pepcid, Sucralfate (given
separately) and amoxicillin. Two days later (yesterday evening), Alex was returned to us due to persistence of the
poor appetite.

Blood work showed his anemia was worse (HCT=15% still normocytic, normochromic) and his kidney function tests
were stable (BUN=50 Creat=3.5). We ultrasounded his abdomen today (I wish we had done this on day 1).

We found his abdomen unremarkable except for his pancreas (which is hypoechoic with possibly a mild hyperechoic
rim) and his kidneys (which don’t seem to have as crisp a contrast between the cortices and medullae). So our
presumptive diagnoses are now that he has had pancreatitis the entire time and the kidney disease has been more
chronic and only of secondary consequence to his illness. We are also considering that he could have IBD or
lymphoma, but we did not find any areas of small intestine that were thickened.

Please evaluate the following images of his kidneys, liver and pancreas. Videos will follow. We are not sure how much
change can be present in a normal geriatric feline pancreas, so please tell us if you feel a diagnosis of pancreatitis can
be made from this study.

The images we made with our 12L probe seem washed out (darker and less contrast) even though the detail seems
better (smaller pixels?) than with the 8C probe. Any suggestions on tweaking the settings for better images?

Thanks, Marc

companion | 23
VIN

GrapeVINe

1 2

3 4
Figure 1: Liver and portal vein
Figure 2: Right kidney
Figure 3: Left kidney
Figure 4:Left limb of pancreas
Figure 5: Right limb of pancreas with duodenum

Robert Hylands DVM, VIN Associate Editor

Diagnostic Imaging, Westbridge Veterinary Hospital, Mississauga, ON, Canada

The images demonstrate as you suspected an inflamed pancreas. What is different though is the lack of thickening of
the adjoining duodenum. Sometimes I only see the inflammation near the head of the pancreas in the acute stages of
the disease. The surrounding fat does seem hyperechoic but no fluid is noted. Perhaps this would be more evident on
the videos. In older cats what we often see is nodular hypoechoic zones within the parenchyma of the pancreas. I do
not really appreciate this in your cat. To me this looks more like a chronic active pancreatitis but only further testing
would confirm.

The anemia is of obvious concern in this patient. Is there any evidence of a response? What is the platelet count? The
kidneys do not seem diseased enough to be the root of this problem. Look for other causes, loss or lack of production…

As for the L12 perhaps you are using the wrong preset, maybe try something like a carotid or thyroid preset or
decrease the gain.

24 | companion
 VIN

I do not know if your cat was on fluids during the US scan but
there are signs of pyelectasia (dilation of the renal pelvis) (see the 6
arrows on your image). I would have expected better CM
differentiation since this patient was on a diuresis fluid rate
previously. I would suspect that these changes seen in both the
cortex and medulla are real and more an indication of age
secondarily affected by the pancreatic condition.

Marc Silverman 

Bob, Thanks so much for the comments.

>>> The anemia is of obvious concern in this patient. Is there any

evidence of a response? What is the platelet count? The kidneys do
not seem diseased enough to be the root of this problem. Look for
other causes, loss or lack of production... <<<

Still normal RBC morphology and platelet count is normal. I think

there has to be some anemia of chronic disease, but I think there
may be some blood loss too, so I’m giving Epogen and will start an Figure 6: Right
iron supplement. kidney with
pyelectasia
The chronic active pancreatitis makes a lot of sense with the 1 month history of weight loss. (dilation of the
>>> I do not know if your cat was on fluids during the US scan but there are signs of pyelectasia (see the arrows) on renal pelvis)
your image. <<< arrowed

The cat was on sq fluids after IV fluids in the hospital, so that makes sense.

So, the client was getting to the end of her rope yesterday, so I decided to start the cat on prednisolone for possible
chronic pancreatitis ± IBD and Alex is feeling much better today and had a great appetite. I’ll keep you all informed
on his progress. Looking forward to hearing any other gems from the videos.

The video can be viewed by following this URL: http://www.vin.com/Link.plx?ID=4257678

Thank you for the comments on checking the pre-sets for the 12L probe.

Robert Hylands

Gabapentin seems to work well for the pain in these patients also.

I still suspect the same conditions noted above after visualizing the videos. It is possible to biopsy a pancreas with US
although I would only do it at the extremity of one of the lobes.

Marc Silverman 

Thanks Bob,

I usually give these guys hydromorphone in the hospital and buprenorphine at home. Have not been very happy with
Tramadol in cats. Seems like they fight the taste and/or vomit it a lot. I’ll give the gabapentin a try.

Cathy Wilkie DVM, VIN Associate Editor, Animal Medical Hospital, West Vancouver, BC, Canada

Marc, I hate Tramadol in cats, too. They are usually wigged out on it. Buprenorphine rocks.

Editor’s notes
For more details and prescribing information see the appropriate pages in the BSAVA Small Animal Formulary 6th edn.
■■ Pepcid – famotidine (H2-receptor antagonist) p128
■■ Zofran – ondansetron (highly selective 5HT3 antagonist) – antiemetic p246
■■ Mirtazepine – (benzazepine and tetracyclic antidepressant) – appetite stimulant
■■ Epogen – (human recombinant erythropoieitin) p123

This thread appears in an edited form.

To read the full thread and access the links mentioned visit http://www.vin.com/Link.plx?ID=4254390

All content published courtesy of VIN with permission granted by each quoted VIN Member.
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. Discussions may appear in an edited form.

companion  |  25
PUBLICATIONS

CHRISTMAS
QUIZ
Test your knowledge with our BSAVA Publications Quiz,
based on the BSAVA Manuals released in the last
12 months (Abdominal Imaging, Behavioural Medicine,
Rodents and Ferrets, and Wound Management).
Do it just for fun, or for your chance to win these
four new veterinary manuals. Simply email your answers
to companion@bsava.com before 31 December 2009,
the winner will be drawn from all the correct responses
Wound care
Imaging

3 5
What ‘A’ could have caused this What ‘J’ is a type of silicone drain
1 gaseous dilatation of the stomach? available in different lengths, with a
large flat end that contains multiple
A3:
fenestrations?
What ‘N’ is the initial phase of an
excretory urogram? A5:
A1:
4

2 What ‘D’ is the type of lateral view 6

What ‘P’ is another name for these which requires the patient to be What ‘S’ is a type of muscle flap
normal duodenal out-pouchings placed in lateral recumbency and indicated to close defects of the
seen with contrast radiography? use of a horizontal X-ray beam? perianal area and perineal hernias?
A2: A4: A6:

26 | companion
 PUBLICATIONS

Rodents and ferrets

9
What ‘E’
has been
caused by
scruffing
in this
hamster?

A9:

What type of cells, beginning 11

with the letter ‘K’, are a unique
population of leucocytes found in
guinea pigs and recognizable by
their oval or round inclusions?
A11:

What ‘F’ is a type of papilla

10 found on the long, mobile

What ‘A’ is a disease of ferrets
and mink caused by a parvovirus?
12
tongue of ferrets, which is
missing from this list:
filiform, vallate, foliate?

A10: A12:

Behaviour

What ‘J’ are a type of forceps

used for microsurgery?
7
A7:

13 What ‘A’ is a type of affiliative

15
What ‘E’ contributes to
independent play/activity in a dog? behaviour characterized by two cats
rubbing their heads, bodies or tails
A13:
on one another?
What ‘S’ is a possible A15:
behavioural problem in
© S.J. Elmhurst (www.livingart.org.uk)

dogs with clinical signs of What ‘P’ is a type of

destruction, vocalization, learning also known as
14 house soiling or self-
trauma/licking?
16 classical or respondent
conditioning?
A14: A16:

What ‘H’ describes this

8 For more information
about the latest
tension-relieving mattress suture?
BSAVA manuals
A8: visit www.bsava.com

companion | 27
PETSAVERS
Improving the health of the nation’s pets
THREE NEW
EXCITING AWARDS
To celebrate the their
35th anniversary, Petsavers
has funded three new
valuable projects
A
s 2009 draws to a close, so does
Petsavers’ 35th year. Petsavers was
formed in 1974 as the Clinical
Studies Trust Fund and has been devoted to
improving our understanding and treatment
of the diseases affecting our pets ever since.
To celebrate Petsavers’ 35th year,
Petsavers decided to make a special one-off
award of up to £25,000. Qualified veterinary
surgeons were invited to apply for funds to
support a clinical study in pet small animal,
28 | companion
the objective of which must be to advance
the understanding of the cause and/or
management of a clinical disorder. The
projects, like all Petsavers-funded studies,
could not involve experimental animals and
the project must also further the knowledge
of the small animal practitioner.
The Petsavers Grants Awarding
Committee met this August to discuss the
applications received and decide which
application would receive the special
Petsavers 35th anniversary award.
The standard of applications was high
and eventually the grants awarding
committee decided to fund not just one
project, but three.
35th anniversary projects
Using molecular genetics to
1 predict more accurately the
prognosis for dogs with mast cell
tumours, awarded to Mrs Suzanne
Murphy of the Animal Health Trust. The
aim of this study is to confirm the
consistent differential expression of eight
genes that putatively display different
levels of expression between mast cell
tumours that metastasise and mast cell
tumours that do not.
We hope that all three projects will be a great success and are delighted to be able to
fund them all. If you are interested in Petsavers’ grants and projects please visit our
website to find out more: www.petsavers.org.uk ■
Computed tomography
2 assessment of efficacy of
arthroscopy in the treatment of medial
coronoid disease by a prospective clinical
study, awarded to Mr Elvin Kulendra of
the Royal Veterinary College. The aim of
this study is to test the hypothesis that
dogs with elbow lameness associated
with fragmentation of the medial
coronoid process have greater functional
improvement after arthroscopy in which
articular fragments are completely
removed than when fragments are either
partially or incompletely removed.
Diagnostic value of transverse
3 sectioning in the evaluation of skin
biopsy specimens from alopecic dogs,
awarded to Dr Ross Bond of the Royal
Veterinary College. The aim of the study
is to challenge current veterinary
pathology practice by providing evidence
that transverse sectioning, in conjunction
with routine vertical sectioning, is of
additional diagnostic value in the
histopathological evaluation of biopsies
from alopecic dog skin, as noted in
human dermatopathology. Samples from
cases of canine alopecia generated
through the clinical caseload are to be
evaluated histopathologically after both
vertical and transverse sectioning. In
addition to this varied case material, the
techniques are to be applied
comparatively to characterise the
pathological features of an alopecic skin
disease of Curly Coated Retrievers.
 CPD

SHARPEN YOUR
SURGERY SKILLS
The BSAVA surgical mini-modular programme starts with detail, with the aim of highlighting the special
considerations necessary for surgery at
the basics and builds to develop higher levels of surgical different levels within the urinary tract.
decision making, offering practical tips on how to achieve Surgical management of urinary incontinence,
urinary tract neoplasia and urinary tract
declared surgical goals trauma will be described, along with essential
steps in patient assessment and stabilisation.

A
ll modules for the surgery course
will be presented at Woodrow
House in Gloucester by Dan
Brockman and a second speaker (to be
confirmed). Book before 1st January to
make an even greater saving on your usual
member discount.
Back to basics
Tuesday 16 March
The first module will serve as a reminder of
basic physiology of the abdominal cavity
and organs, and will cover a range of
generic and specific recommendations
regarding surgery inside the peritoneal
cavity, from the provision of perioperative
antibiotics and instrument selection to
consideration of the redundancy in
different organ systems.
Surgery of the alimentary tract Abdominal pot pourri: pancreatic,
Wednesday 28 April adrenal, biliary tract and liver
The second module will discuss specific Tuesday 15 June
gastrointestinal diseases to reinforce the Finally, the fourth module will address
principles highlighted in the first surgical diseases of specific organs in more
module. More common diseases, such as detail, with the aim of highlighting the
intestinal obstruction, gastric dilatation and special considerations necessary for
volvulus and large bowel diseases, will be different organs. Diagnosing and treating
diseases of the extrahepatic biliary tract,
used to illustrate best surgical practice
pancreas and adrenal glands all have their
relevant to any surgical practitioner. Patient
evaluation, stabilisation, surgical treatment own specific challenges and pitfalls; these
and postoperative care will all be covered will be highlighted and discussed. ■
in more detail.
FEES Member Non Member
From large kidney to Booked
small bladder before £734.45 £1101.67
1 Jan 2010
Tuesday 11 May
On the third module you will explore After
£773.10 £1159.65
1 Jan 2010
surgical diseases of the urinary tract in more

DISPENSING FOR THE

WHOLE PRACTICE
T
he essential dispensing course from BSAVA helps veterinary practices manage their dispensaries with
up-to-date information on the new Medicines Regulations. The content of the course provides you
with everything you need to know about dispensing and now includes equine and clinical waste
elements too. The next course takes place in Cambridge on 16 March. Places fill quickly, so book early to
save money and avoid disappointment. For more details and to book, see the flyer enclosed with this
edition or visit the website. ■

For more information or to book a place on a BSAVA CPD course,

visit www.bsava.com, email administration@bsava.com or call 01452 726700.

companion | 29
CPD IN SHANGHAI
Geoffrey Chen reports on
the WSAVA’s continuing
education programme
T
he annual WSAVA Continuing
Education programme was held in a
packed Shanghai Science Hall on
17 September. The WSAVA invited Dr Terry
King from Australia Veterinary Specialist
Services Pty Ltd to deliver a lecture about
emergency veterinary medicine and critical
care. The lecture was introduced by the
President of the Shanghai Small Animal
Veterinary Association, Dr Geoffrey Chen,
and was translated by Dr Shu Dai from Hill’s
Pet Nutrition China Division.
Dr King gave lectures on the diagnosis
and treatment of sepsis in dogs and cats, and
Dr Terry King, Dr James Holder and Dr Geoffrey Chen with the Hill’s team in
Shanghai
30 | companion
We wish all of our WSAVA
family and colleagues within
the veterinary/animal health
profession a wonderful
transfusion in critical cases. Dr King
holiday season and all the
graduated from the University of
very best wishes throughout
Queensland School of Veterinary Science in
the New Year
1975 and spent the next 19 years in private
practice in Brisbane. After a year’s sojourn
in the USA and Brisbane’s Animal
Emergency Centre, Terry joined the
University of Queensland Veterinary
Teaching Hospital in late 1995 as a medical
resident, becoming Director of the Clinic
and Hospital in 1997 and 2002 respectively.
Dr King enjoys the emergency aspects of
veterinary practice and has a special interest
in treating the critically ill. He is highly
WSAVA M
committed to family veterinary medicine,
prolonging the human–animal bond.
The WSAVA CE programme in Shanghai
was sponsored by Bayer Healthcare, Hill’s
Pet Nutrition China Division, and Intervet/
Schering-Plough Animal Health. ■

A NEW VICE PRESIDENT
WSAVA is pleased to
welcome Dr Peter Ihrke to
the executive Board
W
e are pleased to announce that
Dr Peter Ihrke has been
elected to join the WSAVA
executive Board in the WSAVA Vice
President position. Dr Ihrke has had a long
history of involvement and contribution to
the WSAVA, both as the Assembly
representative of the American College of
EMBERS IN THE NEWS
Dr Ray Butcher, co-chair of
the WSAVA Animal
Welfare Committee, was
presented with the British
Veterinary Association
CHIRON AWARD 2009
T
he award, which marks outstanding
contributions to veterinary science
or outstanding services to the
profession, judged in either case as being of
a calibre commanding international or
interprofessional recognition, was
presented to Dr Butcher during the Awards
Ceremony at the BVA’s Annual Congress in
Cardiff on Saturday 26 September 2009.
Veterinary Dermatology (ACVD) and as an
avid participant in the delivery of WSAVA
CE. The latter commitment has resulted in
his spending his current sabbatical year
travelling extensively throughout South
America providing continuing education
lectures, assisting in the dermatology
service duties of various South American
veterinary colleges, and being an
ambassador for the WSAVA.
For those who may not be familiar with
Dr Ihrke’s background and
accomplishments, he graduated from and
completed a residency in Dermatology at
the University of Pennsylvania. He was a
Diplomate of the ACVIM (dermatology) and
then became a Diplomate of the American
College of Veterinary Dermatology
(ACVD). Currently, Dr Ihrke is a Professor
of Dermatology and Chief of Dermatology
at the University of California, School of
Veterinary Medicine. He also is an Adjunct
Clinical Associate Professor of
Dermatology at Stanford University School
of Medicine.
Dr Ihrke is the author or co-author of
Dr Butcher has dedicated his career to
advancing animal welfare. As well as
working in his clinic he is currently a
Veterinary Advisor and Board Member of
the World Society for the Protection of
Animals (WSPA), involved mainly in
promoting humane methods of stray dog
control throughout the world. He
represents WSPA on the World Health
Organization (WHO) working group
dedicated to reduce the burden of rabies in
Asia and is a Founding Director and Board
Member of the Alliance for Rabies Control,
an organisation whose vision is a world
where all countries have eliminated rabies.
Most recently Ray has been involved
with the Blue Dog Trust – a multidisciplinary
project to educate children how to behave
with dogs in order to reduce the incidence
WSAVA NEWS
over 200 papers, book chapters, and
proceedings and has co-authored, authored
or co-edited 4 books. He has lectured at
nearly 450 veterinary meetings, including 17
world congresses, in 37 countries. His
interests include all skin diseases in all
species, with emphasis on infectious skin
diseases and immunological skin diseases.
He has served as President and held other
positions on the executive boards of the
ACVD, the American Academy of
Veterinary Dermatology (AAVD), the
Academy of Veterinary Allergy (AVA), the
4th World Congress of Veterinary
Dermatology, and the American Board of
Veterinary Specialties (ABVS).
His most meaningful honours include the
Faculty School-wide Distinguished Teaching
Award at UC Davis, Honorary Life Member
of the European Society of Veterinary
Dermatology (ESVD), the ACVD Award for
Excellence, being named an Honorary
Foundation Diplomate in the Asian College
of Veterinary Dermatology, and receiving
the WSAVA Hill’s Excellence in Veterinary
Healthcare Award in 2009. ■
of dog bite injuries in young children.
He has been presented with numerous
awards from distinguished bodies,
including the 2000 WSAVA International
Award for Service to the Profession and
the special service awards from the
national companion animal veterinary
associations of Britain, France, Spain,
Portugal and Hungary. He has been
awarded Honorary Membership status of
the BSAVA. In 2007 he was awarded the
Alf Wight Memorial Award for Animal
Welfare by the BSAVA/Blue Cross. BSAVA
has also awarded him the Melton Award
and the Frank Beattie Travel Scholarship.
He is also a Past President of both the
BSAVA and the Federation of European
Companion Animal Veterinary
Associations (FECAVA). ■
companion | 31
WSAVA NEWS

WSAVA NEWS

GENEVA 2010 IS
GETTING CLOSER!
Dr Christophe Amberger, symposia. Parallel to the main meeting in
English, we will also have German and
Congress Organising French streams.
Committee Chair, extends Geneva is a living postcard with a long
history of giving a warm and generous
an invitation to the welcome to its guests. All sessions will be
WSAVA World Congress held at the Palexpo, near the airport, with a
direct train connection to the main railway
station of Geneva, downtown near the lake
and all facilities of the city centre. We look
■ Feline leukaemia virus infection:
overview and new developments
■ Canine IBD: did we learn anything
since we switched millennium?
Hospital infections
■
■ Infectious disease and the kidney
■ Total hip replacement
■ Advances in cardiology.
More information on the scientific

O
n behalf of the Swiss Society of
Small Animal Medicine, I am
really pleased to invite you to the
WSAVA 2010 world meeting in Geneva on
2–5 June. We plan to offer you a
stimulating scientific meeting as well as a
large and attractive social programme.
FECAVA and FAFVAC will be associated
with our congress and hold their annual
forward to seeing you there!
SOTALs
State-of-the-art-Lectures, or SOTALs, are
designed to present current scientific
information on emerging or contemporary
issues in small animal veterinary medicine.
Always very popular, this coming year’s
lectures include:
programme, social events, and other
highlights of the WSAVA 2010 Geneva
World Congress website can be accessed
through the WSAVA website homepage or
directly at www.wsava2010.org. Register
online now: “early bird” registration is
available until 15 February. Abstract
submissions are still being accepted online
through until 31 January. ■
© Loren File | Dreamstime.com

32 | companion

JOHN
HIRD
John Hird was Born in Halifax in 1947, the middle of three
brothers. His father was company secretary at a wire
drawing company and his mother a doctor who was one of
the early pioneers of family planning. He went to prep
school at the age of 7, then to Repton School in Derbyshire,
where despite all his efforts he never made the grade as
goalkeeper for the 1st XI. Though, once at Liverpool Vet
School he managed to assist the Vet Faculty soccer team
with promotion to the first division in the University
League, before gaining Honours in Finals. Following a year
as house surgeon at Leahurst, John spent a year working in
large animal practice in Glastonbury, before returning to
Liverpool to his first anaesthetic post under Prof Ron Jones.
He then spent three years working for the famous
veterinary anaesthetist Dr Leslie Hall at the Cambridge
Vet School, where he obtained the RCVS Diploma in
Veterinary Anaesthesia, before returning to Halifax to take
over a mixed practice. In the late 90s he went to work for
the Veterinary Defence Society as a Claims Consultant.
John has been President of the BSAVA, President of the
Association of Veterinary Anaesthetists, and received
numerous awards, including the BSAVA Melton Award,
and the Francis Hogg Medal from the RCVS
THE companion INTERVIEW
Q
Tell us about your varied
career and combining that
with family life.
A
I married Jean when I returned to
practice in Halifax, and together we
built up the practice to the stage
where we could afford an assistant. Julia was
the vet in question, the finest large animal
vet you could wish for, and who swept away
in an instant any doubts that gloomy West
Yorkshire famers might have harboured
about ‘lasses’ not being up to the job.
Our sons John and Tom were born
within a year of each other. Tragically John
died of leukaemia just before his eighth
birthday, but Tom has blossomed into a
graduate in Marine Biology, with strong
thespian tendencies. As the practice
continued to grow I took on two partners,
who I was very fortunate to be able to call
good friends and between us the practice
grew even faster. Eventually I felt it was
time for a change and in 1997 I left the
partnership on being appointed as a
Claims Consultant for the Veterinary
Defence Society, where I have honed my
advisory and counselling skills over the last
14 years. I have still retained my interest
in all things anaesthesia and have been
lucky enough to visit different parts of the
world as a consultant.
companion  |  33
THE companion INTERVIEW

…I sat in the co-driver’s seat of a Mk2 Escort over a period

of 15 years… The relationship between driver and navigator
is very similar to that which exists between surgeon and
anesthetist; one takes the limelight while the other quietly
ensures that the finish line is crossed without catastrophe…

My main fault is that I’m not forceful

enough, having suffered from a lifelong
tendency to regard everyone else’s opinion
as more valuable than my own.

What is the most significant lesson you

have learned so far in life?
Doing ‘the right thing’ isn’t always the right
decision.

If you were given unlimited political

What do you consider to be your most
important achievement during your
career?
I would like to think that I have been
moderately successful in translating hard
scientific knowledge and presenting it in an
interesting and stimulating way relevant for
the general practitioner. Veterinary
anaesthesia is a potentially pretty dry
subject, and, as it is always a means to an
end in practice, it needs some spicing up in
order that vets might consider it interesting
enough to be important in its own right.
What has been your main interest
outside work?
Over the years I have to say motorsport,
particularly road and stage rallying. I sat in
the co-driver’s seat of a Mk2 Escort over a
period of 15 years, wondering which tree
we were going to hit. The relationship
between driver and navigator is very similar
to that which exists between surgeon and
anesthetist; one takes the limelight while
the other quietly ensures that the finish line
is crossed without catastrophe. Those who
know me well may consider that my undying
support for Halifax Town FC is an affliction,
rather than an interest.
When and where were you happiest?
I don’t like the use of the word ‘were’, as it
implies that I’m not as happy now. I really
enjoyed my early days as a single-handed
large animal practitioner reviving a very run
down practice in Halifax. Those days were
very similar to the life described by James
Herriot. I can remember Jean carrying
home our first week’s takings from the
surgery, which amounted to the princely
sum of £80.
Who has been the most inspiring
influence on your professional career?
As a Liverpool undergraduate I was very
fortunate to be taught by Paul Neal and
Barry Edwards, who gave me a wonderful
grounding in large animal medicine and
surgery. However, it was Prof Ron Jones
who ignited my career-long interest in
anaesthesia, and who has been my mentor
throughout my career.
If you could change one thing about
your appearance or personality, what
would it be?
I’m quite content with my appearance,
probably because I don’t have to look at it,
but my personality could do with a tweak.
power, what would you do with it?
That’s an easy one. I would abolish the
lunacy which masquerades as the EU
Common Fisheries Policy. I would ban
whaling and institute sustainable marine
fishing policies worldwide.
Which historical or literary figure do
you most identify with – and why?
I would choose the great author PG
Wodehouse. Although I could never come
close to his peerless mastery of the English
language, I would identify with his gentle
sense of humour, coupled with an innocent
approach to life, which enabled him always
to see the best in people.
What is your most important
possession?
My collection of LPs, most of which are jazz
albums which have never made it on to CD.
One day I will find the time to transfer
them all on to my iPod.
What would you have done if you
hadn’t chosen to work in the veterinary
sphere?
I have to answer in retrospect, because at
the time I never had any other ambition but
to become a veterinary surgeon. With
hindsight I would have trained to become a
medical anaesthetist.  ■

34  |  companion
 CPD DIARY

CPD 24 January 5 February

DAY EVENING
Sunday Meeting Friday Meeting

Fixators and cruciates with Rehabilitation & acupuncture

DIARY
parallel VN session on
‘surgical nursing and
physiotherapy’ – includes
AGM 12:30pm
Speaker Noel Fitzpatrick and Donna Carver
The L.A Lecture Theatre R(D)SVS,
Edinburgh. Scottish Region
Details from Adam Gow, 07886 686473,
adam.gow@dsl.pipex.com, or
Andrew Francis, 07961 071761,
andrew.francis@ed.ac.uk
in companion animals (for
vets and nurses)
Speaker Shiobhan Menzies
The VSSCo, Lisburn. Northern Irish Region
Details from Shane Murray,
shane@braemarvetclinic.co.uk, or VetNI,
028 25898543, info@vetni.co.uk
9 February
Tuesday
EVENING
Meeting

A practical approach to
14 January EVENING
Meeting treating psittacines in general
24 January
Thursday DAY Speaker Neil Forbes
Sunday Meeting The Potters Heron Hotel, Romsey SO51
Update on lymphoma and 9ZF. Southern Region
other common neoplasms Companion animal Details from Michelle Stead, 01722 321185,
Speaker David Argyle anaesthesia: how to take the mmstead@btinternet.com, or southern@
The VSSCo, Lisburn. Northern Irish Region bsava.com
Details from Shane Murray, shane@ stress and worry out of the
braemarvetclinic.co.uk, problem cases
or VetNI, 028 25898543, info@vetni.co.uk Speaker Andy Bell
The Ramada Hotel, Leeds Road,
10 February
Wednesday
EVENING
Meeting
Wetherby, West Yorkshire LS22 5HE.
Murmurs in puppies and
19 January
Tuesday
DAY
Meeting
North East Region
Details from Chris Dale, 01422 833960,
07884 231307, chris.j.dale@btinternet.com
kittens (also includes AGM)
The IDEXX Laboratories, Grange House,
Dentistry for the generalist Sandbeck Way, Wetherby, West Yorkshire
Speaker Alex Smithson LS22 7DN. North East Region
Details can be accessed from Chris Dale,
Cottons Club Hotel, Manchester Road,
Knutsford WA16 0SU. North West Region
Details from Simone der Weduwen,
26 January
Tuesday
DAY
Meeting 01422 833960, 07884 231307, chris.j.dale@
btinternet.com
01254 885248, beestenhof@ntlworld.com Critical care medicine:
maximising survival
Speaker Amanda Boag
11 February
Thursday
HALF DAY
Meeting

20 January
Wednesday
EVENING
Meeting BSAVA, Woodrow House, 1 Telford Way,
Waterwells Business Park, Quedgeley, Perineal disease
Gloucester GL2 2AB Speaker Gerry Polton
Physiotherapy: getting Tom, Details from BSAVA, 01452 726700, The Holiday Inn, Gatwick, Horley RH6 0BA.
Jerry and Spike fit again administration@bsava.com Surrey and Sussex Region
Speaker Lowri Davies Details from Jo Arthur, 01243 841111,
South Wales Region joarthur85@btinternet.com, or Jackie
Casey, 01483 797707, Jackie.casey@
28 January
Details from the Chairman or Secretary, DAY greendale.co.uk
southwalesregion@bsava.com Thursday Meeting

20 January
Wednesday
EVENING
Meeting
Urinary tract I: kidney disease
in the dog and cat: an
17 February
Wednesday
EVENING
Meeting

evidence-based approach to An update on fish medicine

Maxillofacial surgery diagnosis and management
Speaker Dick White Speaker Hattie Syme
The Potters Heron Hotel, Romsey SO51 The Thorpe Park Hotel and Spa, 1150
9ZF. Southern Region Century Way, Thorpe Park, Leeds LS15 8ZB
Details from southern@bsava.com Details from BSAVA, 01452 726700,
administration@bsava.com
Speaker Peter Scott, Zoo and Aquatic
Veterinary Group
The Russell Hotel, 136 Boxley Rd,
Maidstone, Kent ME14 2AE. Kent Region
Details from Hannah Perrin,
hannah@burnhamhousevets.com

21 January EVENING
Meeting 18 February EVENING
Meeting
28
Thursday January DAY Thursday
Thursday Meeting
Managing pancreatitis in dogs Approach to raised liver
and cats Reptile medicine and surgery enzymes
Speaker Penny Watson Speaker Simon Girling Speaker Alison Ridyard
The Russell Hotel, 136 Boxley Rd, The Holiday Inn, Gatwick, Horley RH6 0BA. The Holiday Inn Aberdeen West, Westhill
Maidstone, Kent ME14 2AE. Kent Region Surrey and Sussex Region Drive, Aberdeen AB32 6TT. Scottish Region
Details from Hannah Perrin, Details from Jackie Casey, 01483 797707, Details from Val Pate, 07932 770311,
hannah@burnhamhousevets.com Jackie.casey@greendale.co.uk valpate@ntlworld.com

For further details of CPD courses in your area, please visit www.bsava.com

companion  |  35
2010 BSAVA
Modular Programme
broaden your expertise and
expand your skills in general practice
Modular
series A 2010
Venue: BSAVA Headquarters,
Woodrow House, Gloucester
Timetable: Registration 09:30,
Lectures: 10:00, Finish: 18:00
■ Critical Care – 26 January
with Amanda Boag
■ Endocrinology I – 23 February
with Ian Ramsey
■ Endocrinology II – 27 April
with Mike Herrtage
■ Clinical Pathology – 25 May
with Elizabeth Villiers
■ GIT I – 22 June
with Penny Watson
■ GIT II – 28 September
with Alex German
■ Haematology – 19 October
with Clare Knottenbelt
■ Clinical Nutrition – 23 November
with Penny Watson
Modular
series B 2010
Venue: Thorpe Park Hotel & Spa,
Leeds
Timetable: Registration 09:30,
Lectures: 10:00, Finish: 18:00
■ Urinary Tract I – 28 January
with Hattie Syme
■ Urinary Tract II – 25 February
with Hattie Syme
■ Respiratory Medicine – 29 April
with Brendan Corcoran
■ Treating the Cardiac Patient –
27 May with Jo Dukes McEwan
■ Emerging and Infectious
Parasitic Diseases – 24 June
with Sue Shaw
■ Oncology I – 30 September
with Rob Foale
■ Oncology II – 21 October
with Rob Foale
■ Neurology – 25 November
with Jacques Penderis

FEES BSAVA Member

(inc VAT)
Non Member
(inc VAT)
Early Bird Price: 5% discount offered on all bookings received by 31st December 2009
Full modular course £1294.85 £1942.28
Individual module £193.11 £289.67
© Unopix | Dreamstime.com

4 Modules booked at the same time £734.45 £1101.67

Clinical Pathology (25 May) Individual module £215.32 £322.98
Prices from 1 January 2010
Full modular course £1363.00 £2044.50
Individual module £203.28 £304.91
4 Modules booked at the same time £773.10 £1159.65
Clinical Pathology (25 May) Individual module £226.65 £339.98

For more information

visit www.bsava.com
or call 01452 726700
British Small Animal Veterinary Association
Woodrow House, 1 Telford Way, Waterwells Business Park, Quedgeley, Gloucester GL2 2AB
Tel: 01452 726700 Fax: 01452 726701
Email: administration@bsava.com Web: www.bsava.com