The essential publication for BSAVA members

Feline Osteoarthritis
Diagnosing and treating
arthritic cats
P4
Clinical Conundrum
Consider the case of
the vomiting dog
P7
companion
JULY 2009
Electronic Devices
Training aid or
cruel tool?
P11
How to
investigate
and treat
a rabbit
with urine
scalding
companion
2 | companion
3 Association News
Claire Lamb reports on
this years BSAVA Scottish
Scientific Congress
46 Feline Osteoarthritis
Current research into the
diagnosis and treatment in
arthritic cats
710 Clinical Conundrum
Consider the case of the
vomiting dog
1113 The Electric Device Debate
Effective training aid or a
cruel tool?
1416 How To
Treat a rabbit with
urine scalding
1719 GrapeVINe
From the Veterinary
Information Network
2021 You Say Trykia
I Say Trakea
Geraldine Hunt on her move
from Australia to America
22 Petsavers
Latest fundraising news
2325 WSAVA News
The World Small Animal
Veterinary Association
26 The companion Interview
Kate Tunley
27 CPD Diary
Whats on in your area
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A
s a busy veterinary professional you
will know that completing 35 hours
of CPD a year in order to maintain
your clinical and diagnostic skills can be a
challenge so you will want to get the
most out of the time and money you spend
on developing your skills. We want that for
you too.
Our standards are kept high, and our
costs are kept low. As a not-for-profit
organisation that exists to represent and
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support the profession, we can subsidise our
courses and offer our members great
discounts. At the same time our courses are
still delivered by leading international
specialists, offering the widest range of topics
to give you choice, value and excellence.
Now is the time to look at what is
available in the Autumn.
Visit www.bsava.com or for more
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or call 01452 726700. n
Oncology
22 September, Gloucester
Speaker Rob Foale will cover the
approach to treatment of cancer
patients and will discuss the
treatment regimens for common
tumours in cats and dogs.
Delegates will consider the
approach to treatment of cancer
patients, recognition and treatment
of common tumours in the dog and
cat, as well as advanced and
future treatments.
GIT
24 September, Leeds
You will consider the diagnosis,
causes and treatment of liver and
pancreatic diseases in the dog and
cat, with a focus on canine chronic
pancreatitis and chronic hepatitis
and the spectrum of liver disease
in cats. Penny Watson will present
and review recent developments in
diagnosis and treatment in these
areas. WSAVA standards and their
relevance to clinical practice will
also be discussed. There will be a
strong focus on illustrating these
points with clinical case studies.
companion | 3
ROUND UP
SCOTTISH
CONGRESS
SUCCESS
More than 180 delegates enjoyed a weekend of lectures,
workshops, exhibitions and more than a little socialising
at this years BSAVA Scottish Scientific Congress at
St Andrews in May. Claire Lamb reports
ASSOCIATION NEWS
L
eading experts in small animal medicine
and surgery provided 16 brilliant hours
of CPD at Scottish Congress in May,
which had an ambitious theme: Raising the
Bar in Small Animal Practice for Veterinary
Surgeons and Nurses.
Superb science
Dr Andrew Mackin from the Mississippi
State University College of Veterinary
Medicine was on hand to share his
international expertise, with veterinary
lectures on pyrexia of unknown origin,
anaemia and hypoalbuminaemia, while the
nursing lectures considered care of dogs
and cats with anaemia and/or bleeding
disorders, and care of the cancer patient.
Top of the bill on the surgical CPD was Mr
Ronan Doyle thanks to kind permission
from a very heavily pregnant Mrs Doyle. His
topics covered septic peritonitis and
urethral obstruction for the vets and
postoperative care of the critical patient
and wound drains for the nurses.
Both speakers were excellent and their
lectures both practical and informative.
Meanwhile, Friday and Saturday afternoons
were taken up with a series of workshops,
covering a broad range of subjects such as
diabetes, cardiology, renal disease and
anaesthesia. A Receptionists/Practice
Management stream was run all day on
Saturday, covering client care and sales
skills. The congress title lectures are now
available exclusively to members online
from www.bsava.com.
Stunning social
There were some weird and wonderful
sights to behold on Friday night at the
Sporting Heroes fancy dress party. Among
those on display in their athletic finery were
several footballers, gymnasts, sumo-
wrestlers, and an entire polo team. The
evening also offered a competitive edge for
those inspired by their sporting attire, with
a pub quiz and various games set up around
the room, including a surf-simulator.
Delegates could also explore the
beautiful East Neuk of Fife on a coastal
walk on Saturday morning, which even
included some glimpses of wild seals.
National VN Week 1925 July
As ever, vet nurses are being encouraged to celebrate their profession, raise money for charity and highlight the
role of the veterinary nurse. Bonny Millar, President of BVNA, says during VN week, practices have a chance to
demonstrate the skills of their nurses, and fun events provide an ideal way to reduce barriers between clients and
the practice team. Vets and practice managers know what a great contribution a good vet nurse can make to the
practice and community, so we would love to see everyone pulling together, as this can only help boost morale
amongst clients and staff during these difficult financial times. Find out more at www.bvna.org.uk
Despite some typically Scottish weather in
the afternoon, the Falconry display was
impressive and a few hardy souls braved
the elements on Fairmonts world famous
course for the annual golf competition. The
Gala Dinner hosted 300 glamorous guests
on the Saturday night with a superb ceilidh
band, excellent speeches, good food and a
few drams in the hotel bar into the wee
small hours.
The latest products and offers were also
on display with around 50 of the countrys
leading companies attending a large trade
exhibition. So, all-in-all, another superb
weekend at St Andrews thanks to the
continued support of delegates, speakers
and sponsors. Scottish Region committee
would welcome any comments and
suggestions in the planning of our 25th
Congress in 2010 (email scottishregion@
bsava.com) and hope you can join them.
4 | companion
FELINE OSTEOARTHRITIS
FELINE
OSTEOARTH RITIS
Jenny Moffett explores
the current research
into the diagnosis and
treatment of this
previously under-
documented condition
signs of the disease may be hard to
recognise by owner and vet alike. In a
recent study which looked at a population
of cats aged one year and above, 22%
showed radiographic signs of OA. Of these,
only a third exhibited clinical signs of OA
such as lameness, a stiff gait, or difficulty in
jumping. It may be argued that OA cannot
be diagnosed definitively by radiography.
This is what makes the 2006 study by
Clarke and Bennett particularly interesting.
In this study a cohort of 28 cats with
historical or clinical, as well as radiographic,
evidence of osteoarthritis were
investigated. Here, the cats were clinically
examined by a vet whilst the owners
completed a questionnaire which looked at
the animals demeanour, food intake, and
presence or absence of lameness. Amongst
the interesting findings of this study was
that lameness was not a common sign of
feline OA. In addition, other clinical signs
that are relatively common in dogs with
OA, such as crepitus, synovial effusion and a
decreased range of joint motion, were not
H
ow many of your feline patients
over the age of ten are on
medication for osteoarthritis? For
those that arent, how many do you believe
would benefit from such therapy? The
number could be much higher than you
think. Feline osteoarthritis (OA) is a
condition that, in the past, has been poorly
documented. However, new research
demonstrates that we may be under-
diagnosing this painful condition.
Diagnosis
Current research suggests that although
osteoarthritis is prevalent in cats, clinical

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companion | 5
FELINE OSTEOARTHRITIS
FELINE
OSTEOARTH RITIS
in the cat. From here we can see that
detecting OA in a cat on clinical
examination is potentially challenging.
This low level of lameness also has
implications in owner history and, speaking
at last years WSAVA Congress, the
University of Glasgows Professor David
Bennett commented on how this can lead
to chronic pain going untreated in the cat:
One of the main explanations is the fact
that lameness is not the most common
clinical feature of osteoarthritis. The most
common features are a reduced level of
activity and a reduced ability to jump. Since
OA is more common in the older cat, these
changes in lifestyle are often explained as
the effects of old age rather than as an
indication of chronic pain.
Treatment
Current research into feline osteoarthritis
has gone some way toward increasing
awareness of the condition, but what about
treatment regimes? There is a wide variety
of supplements, nutraceutical and so-called
functional foods available which purport to
aid joint health in the cat, but how many are
scientifically valid?
There is a relative scarcity of
information in the literature on feline
therapies but a recent article by Sanderson
et al., published in the Veterinary Record,
carried out a systematic review of the
management of osteoarthritis in the
dog. According to this study, current
research shows the strongest supportive
evidence for NSAID therapy in OA, over
and above other treatments such as
chondroprotectives. Admittedly,
extrapolation to the cat may be difficult
but in the absence of defining evidence
it provides a useful guide.
Chondroprotectives are one of the
largest groups of joint supplements, but
whether they actually work is not as cut
and dried as one would think. The
University of Liverpools Professor John
Innes, a co-author on the Veterinary Record
paper, says, There is a potential role for
chondroprotective agents if we could
actually demonstrate that there is such a
thing as a chondroprotective agent. In
fact, the term chondroprotection has
lost favour, and the preferred term in
osteoarthritis circles is now structure
modifying agents. This takes into account
the idea that these compounds may affect
more types of tissue or none, depending
on your point of view than cartilage.
Therapies
According to Prof. Innes, there have been
some promising studies with regard to
glucosamine in humans. The one that made
the most headlines was a study back in 2001
by Reginster. It was a multicentre study
where they looked at glucosamine and its
ability to modify the progression of knee
osteoarthritis in people. This study, says
Prof. Innes, did indeed show that
glucosamine seemed to halt the progression
of OA, at least in terms of cartilage erosion.
However there is now a shadow of doubt
attached to the work. He explains: In its
day it was a robustly designed study. The
6 | companion
FELINE OSTEOARTHRITIS
trouble is that, since then, the way that
people would like efficacy demonstrated
has changed. Back then, they were using
x-rays and looking at joint space, inferring
from joint space how thick the cartilage was
and checking it over time. Now, people say
that you actually need MRI to look at
cartilage. The technology has moved on. To
my knowledge there are no studies using
MRI to show that anything slows down the
progression of osteoarthritis as far as
cartilage loss is concerned in clinical,
human patients. This requirement to MRI
scan joints also presents a barrier to
effective veterinary research as the
cartilage in feline and canine joints is too
thin to be measured this way.
Prof. Innes also points out that it is
not useful to see all chondroprotectives
as the same. I try and avoid lumping all
nutraceuticals together because its a bit
like lumping all drugs together and saying
theyre either good or bad. Theyre
different molecules. As for other
therapies such as chondroitin sulphate
and EPA (eicosapentaenoic acid), there is
even less research than there is for
glucosamine. EPA has been the subject of
some work by Prof. Innes. Our work was
on EPA, which is an omega-3 fatty acid,
and we showed some effect in vitro on
canine and feline cartilage. Although this
work hasnt been published in a peer-
reviewed journal, he suspects that in vivo
clinical studies would be a useful next
step with EPA.
Alternatives
In the US there has also been interest in
alternative forms of pain relief for feline
osteoarthritis. There have been anecdotal
reports on the use of tricyclic
antidepressants such as amitriptyline
and clomipramine, which are used to
treat neuropathic pain in humans, for
chronic pain in cats. Another drug used in
human neuropathic pain and which is
thought may have potential in cats is the
anticonvulsant gabapentin.
When it comes to novel therapies such
as these, Prof. Innes is guarded: I know
some people are using [gabapentin] for
chronic pain in dogs, and maybe cats, but
there are no data on the efficacy of that.
It wouldnt be my first line choice. As
with dogs, he explains, NSAIDs should
be the core therapy in cats with OA, as
long as there are no contra-indications.
Meloxicam is the one NSAID licensed
for long-term use in this species, with
another in the pharmaceutical pipeline,
according to Prof. Innes.
And what about that tabloid
favourite, stem cell therapy? There
have been reports that stem cells
have been used successfully in the
treatment of OA in the dog.
Under this procedure the
animal is anesthetised and a
sample of fat cells are taken.
Stem cells are harvested from
the fatty tissue in a laboratory
and then administered to the
joint via intra-articular injection.
Again Prof. Innes says that this
mode of treatment should be
approached with caution. He says:
More evidence is required to
understand the mechanism. Other
considerations such as the need to
anaesthetise and the difficulty associated
with intra-articular injection in a small
animal make this procedure of uncertain
use in the feline
OA patient.
Diet and exercise
It seems that there is little or no research
to demonstrate efficacy of pain relief or
disease/structure modifying effects in
alternative remedies for feline OA. If you
really want to prevent or slow OA then
weight management may be the most
effective course. Prof. Innes says: Nice
work has been done in dogs on weight and
showing that keeping a dog slim throughout
its life will slow down the progression of
OA compared to overweight dogs. Keeping
a dog at an optimal body condition score
seems to be disease-modifying or structure-
modifying. Nothing has been done in cats,
to my knowledge, but one would hope
that that would translate to cats. So it
seems that, for the moment, we
should target our attention on
diagnosing the disease
Prof. Bennett
recommends the use of
yearly mobility/lifestyle
questionnaires in mature cats
and using NSAIDs, where
appropriate. And whilst the jury
is still out on joint supplements
and nutraceuticals, it seems that
old-fashioned exercise and
weight management have a
role in preventing and
slowing feline OA.
FELINE OSTEOARTHRITIS
companion | 7
CLINICAL CONUNDRUM
CLINICAL
CONUNDRUM
Andy Elliott BVM&S MRCVS of Brook House Veterinary
Hospital invites companion readers to consider a vomiting
dog which presented difficult management decisions during
investigation and treatment
Given the dogs propensity for the
ingestion of foreign bodies, this was
considered most likely, although the history
and clinical signs also raised the suspicion of
conditions such as pancreatitis or gastric
ulceration. Parvovirus and haemorrhagic
gastroenteritis were considered unlikely in
the absence of diarrhoea. Intussusceptions
are more common in younger animals,
whereas neoplasia is more likely at this age.
The owner was confident that the dog had
not had access to any toxic substances.
Splenic haemorrhage was less likely, given
the normal heart rate and mucous
membrane colour.
How would you investigate and
manage this case?
Blood biochemistry and haematology
profiles were indicated to screen for
non-gastric causes of vomiting and to
assess for metabolic derangements that
may have occurred as a consequence of
vomiting. Imaging of the abdomen was
indicated, given the abdominal pain and
vomiting, to assess the gastrointestinal
tract and associated organs, and look for
the presence of free fluid in the abdomen.
Given the previous history of foreign body
ingestion, radiographs were taken first
rather than using ultrasonography.
Can you establish a provisional
diagnosis from the blood and
imaging results?
Haematology and biochemistry
(Table 1): There is a mild anaemia and mild
elevation in ALT. There is a significant
elevation in the cholestatic enzyme ALKP.
Given the vomiting and abdominal pain,
pancreatitis was a possibility. A low-normal
potassium was attributed to GI loss.
Case Presentation
A 10-year-old MN 23 kg
English Springer
Spaniel presented with
a 2-day history of
lethargy and vomiting.
The owners
description was that of
true vomiting rather
than regurgitation. The
dog had a history of
three previous
enterotomies to
remove intestinal
foreign bodies but none
in recent months. The
remaining history was
unremarkable. On
examination his general demeanour was quiet (BCS 3/5). Rectal
temperature was 38.5C, heart rate 80 beats/min, respiratory rate 20
breaths/min and the pulse quality was good. Mucous membranes were pink.
Lymph nodes were normal. On palpation the abdomen was uncomfortable
and tense, so appreciation of any pathology was difficult.
Figure 1:
The patient
Create a problem list and
rationalise the most likely
differential diagnosis
Problem list vomiting and
abdominal pain
The main differentials initially considered
for this presentation were:
Acute gastritis/gastric ulceration n
Gastrointestinal foreign body n
Intestinal stricture, intussusception, n
neoplasia
Pancreatitis n
Peritonitis n
Haemorrhagic gastroenteritis/ n
parvovirus
Splenic torsion/haemorraghic splenic n
mass
Poisoning/toxin ingestion n
Hypoadrenocorticism n
8 | companion
CLINICAL CONUNDRUM
CLINICAL CONUNDRUM
Radiographs: The radiographs show a
spherical soft tissue-density mass of
approximately 10 cm diameter, caudal to
the liver. This is the most obvious
radiographic finding but if the entire film is
examined carefully, caudo-dorsal to the
mass on the lateral view there is a focal area
of small intestine with an abnormally large
diameter and a pattern of frequent serosal
undulations or plications. The intestine
cranial to this and dorsal to the mass is also
moderately dilated without a discernible
lumen. These radiographic signs are
compatible with an intestinal linear foreign
body. The large mass in the cranio-ventral
abdomen is likely to be associated with the
liver, spleen or omentum. Whilst an
abdominal mass could be the cause of the
dogs clinical signs, the history of dietary
indiscretion and the radiographic findings
consistent with an intestinal foreign body
were considered to be of greater
significance. Inflated left and right lateral
thoracic radiographs were unremarkable.
The radiographic changes were discussed
with the owner. Additional diagnostic
techniques such as ultrasonography to
further localise and stage the mass were
discussed but were declined and the owner
opted for exploratory surgery.
Results Reference
range
Change
ALKP 1139 IU/l 23212 High
ALT 276 IU/l 10100 High
Urea 6.6 mmol/l 2.59.6
Creatinine 79 mol/l 44159
Glucose 7.11 mmol/l 3.897.94
Protein 66 g/l 5282
Na 149 mmol/l 144160
K 3.5 mmol/l 3.55.8
Cl 110 mmol/l 109122
Hct 36.0 37.055.0 Low
Haemoglobin 11.9 g/dl 12.018.0 Low
MCHC 33.1 g/dl 30.036.9
WBC 7.5 x 10
9
/l 6.016.9
Neutrophils 6.9 x 10
9
/l 3.312.0
Lymphocytes 1.5 x 10
9
/l 1.16.3
Platelets 379 x 10
9
/l 175500
Smear analysis RBC normocytic normochromic
Table 1: In house blood results
Figure 2: Lateral abdominal radiograph Figure 3: Ventro-dorsal abdominal radiograph
companion | 9
CLINICAL CONUNDRUM
In this case dehydration was not evident
but, if present, fluid deficit and electrolyte
abnormalities should be corrected prior to
anaesthesia and surgery. Intraoperatively
intravenous Hartmanns was initiated at a
surgical flow-rate of 9 ml/kg/h. An
exploratory laparotomy was performed. An
intestinal linear foreign body causing
pleating of the duodenum and proximal
jejunum was found (Figure 4). There were
no significant adhesions from previous
enterotomies. There was also a large
solitary mass attached to the left lateral
lobe of the liver which appeared friable but
was not bleeding. The rest of the abdominal
organs were examined and no further
abnormalities were found.
Intravenous prophylactic broad
spectrum antibiotics should be given
immediately prior to surgery which involves
entering the intestinal lumen. Antibiotics
should be repeated intraoperatively 2 hours
after the initial dose.
What assessment should be
made before attempting removal
of the foreign body?
The position and extent of the foreign body
should be assessed. In this case the foreign
body was fixed at the pylorus and extended
through the duodenum and into the mid
jejunum. Surgery involving the duodenum
needs special care to avoid trauma to the
pancreas and damage to the pancreatic and
biliary ducts.
The integrity and viability of the
intestinal wall must be assessed. As
peristaltic waves attempt to advance the
object, the intestines crawl up the linear
foreign body resulting in pleating or
gathering of the intestine. This results in
partial intestinal obstruction, and erosions
through the mesenteric border of the
intestinal wall and eventually peritonitis.
Such perforation causing peritonitis is
associated with high mortality. Therefore,
careful assessment of the mesenteric
border is especially important, as necrotic
areas can be missed due to the deposition
of fat. If there is marked localised
peritonitis and fibrosis from perforation,
resection and anastomosis are indicated.
The standard subjective criteria for
viable intestine are: colour, arterial
pulsations and peristalsis. Fortunately, in
this case the intestinal wall appeared viable
and there were no areas of necrosis or
perforation visible.
Removal of the foreign body
The affected sections of intestine were
packed off (exclusion draping) using large
abdominal swabs. It is important to avoid
drying off of exposed intestine so it is useful
to have an assistant apply warmed sterile
saline as necessary to exposed viscera.
An enterotomy incision was made
longitudinally on the antimesenteric border
of the proximal jejunum. The foreign body
(a large dishcloth) was identified and the
distal end was exteriorised. It is essential
not to pull a linear foreign body forcefully as
this may cause intestinal perforation. With
very gentle traction applied to the proximal
part, a portion was exteriorised and the
cloth was sectioned. The enterotomy
incision was closed using an absorbable
monofilament suture (2 metric
poliglecaprone 25) in a simple interrupted
appositional pattern. An omental patch was
sutured over the intestinal incision.
A further enterotomy was made in the
transverse section of the duodenum and
from here it was possible to remove the
remainder of the cloth easily. This incision
was closed in the same way.
A fine needle aspirate of the liver mass
was obtained for cytology. A surgical biopsy
and histopathology may have been more
valuable in identifying the mass but the
author elected for an FNA due to the
friable appearance of the mass.
The abdomen was lavaged with copious
quantities of warm saline. Clean sterile
drapes, gloves and surgical kit were used for
abdominal closure.
What are the postoperative
concerns?
The dog was monitored closely for clinical
signs of intestinal wound dehiscence,
leakage and peritonitis, which are relatively
common complications of enterotomy (up
to 16% of cases in one study).
Figure 4: Exploratory laparotomy showing the plicated intestines and the large
liver tumour
10 | companion
CLINICAL CONUNDRUM
The Authors Experience
I was motivated to submit a case to Clinical Conundrum after having seen the
recent guidance article in companion, encouraging those of us in general
practice to do so. This particular case was chosen because not only was it
interesting and challenging from a clinical perspective but the dog was also a
particular favourite patient of mine. I have got to know him very well as a result
of various misdemeanours over the years, mostly involving the ingestion of
foreign bodies! It was also a personal challenge for me to aim to get an article
published and this seemed like a good opportunity.
The emphasis of the initial draft of the submission was on the considerations
and pitfalls of hepatic surgery, as for me this was the more interesting
component to the case. Also I wanted to emphasise the importance of reading
the entire radiograph rather than just finding the obvious abnormality on the
film. The constructive criticism from the editorial board led to a couple of
redrafts and rewording of some parts of the article and also a change of focus from the hepatic surgery to the
linear foreign body. It was thought that this emphasis might be more useful to practitioners as intestinal foreign
bodies are more commonly seen and dealt with in practice and prompt intervention can be critical.
As it was my first peer-reviewed article I was very grateful for the feedback from the medicine and surgery
specialists who were prompt, approachable and helpful. The biggest challenge, given the permitted word count,
was knowing what should be included in full and which parts only summarised.
I would recommend that other practitioners consider submitting a Clinical Conundrum because it is an easily
accessible and practical resource for colleagues. It has also led me to consider best practice principles and to
think about the reasons behind the decisions I make daily when dealing with cases. I would also recommend that
colleagues who dont already take photos of their more interesting cases consider doing so, as these can be very
useful for both client education and future reference.
Submission of a Clinical Conundrum may also be useful preparation for completing written work in a
postgraduate qualification. The positive feedback and helpful advice I received has encouraged me to consider
writing up other cases in future.
Contribute a Clinical Conundrum
If you have an unusual or interesting case that you would like to share with your colleagues, please submit
photographs and brief history, with relevant questions and a short but comprehensive explanation, in no more
than 1500 words, to companion@bsava.com . All submissions will be peer-reviewed.
Postoperatively the dog was maintained
on IV fluids at 2 ml/kg/h, antibiotics and
opioid analgesia. He made an uneventful
recovery from the surgery. Small amounts
of water were offered 8 hours post-
operatively and small frequent bland meals
were given the next day.
Why was it prudent not to
proceed with excision of the
hepatic mass at this surgery?
A linear foreign body is an urgent and
life-threatening condition; the liver mass
was not and appeared to be a solitary
lesion amenable to excision by liver lobe
resection. An intraoperative decision was
made to leave the mass and deal with it as
an elective procedure following further
staging and assessment of the dogs
coagulation status, which would also enable
availability of cross-matched blood.
The cytology results were suggestive of
a primary hepatic neoplasia of epithelial
origin. The dog made an uneventful
recovery so, 3 weeks later, a partial
lobectomy of the left lateral liver lobe
was performed to remove the liver
tumour. This was successful and the dog
made a full recovery.
The mass was confirmed by
histopathology to be a well differentiated
hepatocellular carcinoma. This is the
most common primary hepatic neoplasia
and has a mean age of occurrence of
between 10 and 11 years of age. It can be
highly metastatic but usually only in
advanced cases. It was fortunate for this
dog that the discovery of the tumour
was made as an incidental finding during
the management of an intestinal foreign
body. There are sparse data concerning
the outcome in dogs following surgery,
but the literature suggests a fair prognosis
with complete excision of localised
tumours. n
companion | 11
DEBATE
I
n the electric collar debate, they have
come down on the prohibitionist side
over to the west of Offas Dyke. Welsh
rural affairs minister Elin Jones announced a
proposal to outlaw the use of electric
collars for dogs in June 2008, subject to a
consultation process on possible
exemptions to the ban. Similar legislation
has been discussed in the Scottish National
Assembly, but at Defra it was felt that a
decision has to be based on sound scientific
evidence and the information available
simply wasnt good enough.
The Department is providing funding of
469,000 for three organisations, the
universities of Lincoln and Bristol and its
own Central Science Laboratory in York,
to investigate the physical properties of
these devices and their biological and
behavioural effects on the animal. The
researchers, led by veterinarians Daniel
Mills at Lincoln and Rachel Casey in Bristol,
are due to report their findings early next
year. Meanwhile, Professor Mills is also
heading a Companion Animal Welfare
Council (CAWC) study looking at the
ethics as well as the science of electric
collars. Its remit also covers the devices
used to contain animals within an invisible
fence, products specifically omitted from
the Defra study. The CAWC study will
gather evidence from the personal
experiences of dog owners, behaviourists
and veterinarians who have used these
technologies (see www.ecollar-survey.org).
Use or abuse
Electric collars, or electric pulse training
aids, apply a static charge to the wearers
skin as an aversive stimulus to discourage a
particular unwanted behaviour. They are
used in three main situations. One category
consists of devices activated by the owner
if, say, the animal does not respond to
being called, usually when distracted by
humans, other dogs or potential prey
(including livestock). The other types
contain sensors that respond automatically
either to the noise of persistent barking or
when the animal strays too close to an
antenna wire marking the perimeter of the
owners property.
Devices made by member companies of
the Electronic Collar Manufacturers
Association (ECMA) have a maximum
energy output of 2.5 joules, giving a
stimulus that is orders of magnitude weaker
than the electric fences used in agriculture,
or even the abdominal exercise devices
used as slimming aids.
Nevertheless, both the BVA and
BSAVA are opposed in principle to the use
of electrical training systems. Shocks
received during training may not only be
acutely stressful, painful and frightening for
the animal but also may produce long term
adverse effects on behavioural and
emotional responses, according to the
BSAVA policy statement of March 2006.
The Association recognises that all
Are they an effective
training aid or a cruel
and unnecessary prop for
lazy, irresponsible pet
owners? Views on the
role of electronic collars
for controlling dogs tend
to polarise. However,
those veterinarians still
sat astride the fence on
this issue will soon be
able to make a rational
assessment based on
carefully conducted
scientific research.
John Bonner reports
THE
ELECTRIC
DEVICE
DEBATE
12 | companion
DEBATE
electronic devices that employ shock as
a means of punishing or controlling
behaviour are open to potential abuse
and that incorrect use of such training
aids has the potential to cause welfare
problems. Apart from the potentially
detrimental effect on the animal receiving
the shocks there is also evidence that there
is a risk to public safety from the use of
shock-collar based containment systems, as
they may evoke aggression in dogs under
certain circumstances.
So the BSAVA is concerned about the
possibility of an owner using these devices
in temper to punish a misbehaving animal
with repeated shocks. Many veterinary
behaviourists also worry that the devices
will be used without an understanding of
the principles of good training and The
Kennel Club takes a similar view. An
electric shock collar trains a dog to respond
out of fear of further punishment having
received a shock when it does not perform
what is asked of it rather than from a
natural willingness to obey. This is not the
type of training method that the Kennel
Club would endorse, says Caroline Kisko,
the Communications Director for the
Kennel Club. Furthermore, an angry or
inferior trainer or even novice owner could
misuse a collar to abuse and punish. It is
unacceptable that these products are
readily available by mail order, via retail
outlets and on the internet, and are
therefore available to anyone, with no
training or supervision whatsoever.
The Kennel Club has obtained peer-
reviewed scientific evidence which proves
that the use of electronic training products
is not only unpleasant but also painful and
frightening and may influence the dogs well
being in the long term in a negative way.
So, many feel the pulses could be used
at the wrong time or in the wrong situation
for the dog to associate the aversive
stimulus with the particular misbehaviour.
An animal could then respond aggressively if
it mistakenly associates the discomfort
caused by the pulse with some innocent
party or factor in the worst case, a nearby
child. Also with the perimeter systems, a
dog could become aggressive through
frustration caused by the conflict between
its desire both to cross the barrier and to
avoid the electrical pulse that it would
receive if it does so.
Evidence and opinion
Lord Duncan McNair, spokesman for the
ECMA, insists that there is no evidence
that a single brief electric pulse will cause
the animal distress. His organisation has
conducted research among dog owners
who have used the collars and the
overwhelming majority are satisfied with
the product. Nearly all respondents said
that their animals show no signs of fear or
resentment when the collars are put on.
There are an estimated 350,000 of these
collars in use in this country, and if the
results were as they (the Kennel Club and
other critics of the technology) say they
are, then vets surgeries would be full of
traumatised or aggressive dogs where
are they?
Moreover, there is a sizeable body of
veterinary opinion which believes that the
collars do not cause significant distress
and that the devices provide welfare
benefits that outweigh any negative aspects
of their use. Yorkshire-based practitioner
Pip Boydell has used a collar on his
Rottweiller bitch to stop it stalking and
killing ducks. Two or three shocks
administered when the dog began
approaching the birds have been effective in
eliminating that problem behaviour. He
questions the logic of banning collars on the
grounds that they could be misused by an
angry and vindictive owner to hurt their
animal Arent they more likely to use a
stick? he asks.
THE ELECTRIC DEVICE
DEBATE
12 | companion
companion | 13
DEBATE
Boundary fences
Kent practitioner John Sauvage has some
reservations about training dogs using
aversive stimuli, although he argues that it is
unrealistic to suggest that any training
methods can be completely reward-based.
However, he unequivocally supports using
the collars as containment devices. He says
he has used them on his own dogs, which
have learned quickly how to avoid receiving
shocks by straying off his property and will
always respond to the warning noise that
precedes the pulse.
Allowing dogs to roam around a
garden where they cannot be contained
by conventional fences, provides a better
quality of life for that dog and there is
much less risk of its escaping and being
killed or injured on the road, he points out.
Both vets question the logic of banning
these containment devices used for
companion animals without also prohibiting
the use of much more powerful electric
fences in agriculture.
The Kennel Club has never actively
lobbied against invisible fences. Although
we do not advocate the use of the fences
there are several distinctions between
them and the remote control shock collars
which are worth noting, says Caroline
Kisko. The collars are manually controlled
by humans and can be administered
without warning or chance to escape.
The fences issue a warning beep before
the shock so the dog has a chance to step
away from the fence and therefore in this
respect has a choice as to whether it will
be shocked or not.
Research and evaluation
Professor Mills recognises that the debate
over electric collars raises complex issues
which can not be settled by concentrating
solely on the animal welfare aspects. A
decision on the future use of this
technology will have to take account of
other interest groups beside the pet animal
and its owner their neighbours, road
users, etc. But at least the Defra project
can ensure that the outcome is based on
solid science.
Previous discussions about electric
collars have often been based on
extrapolating from experiments carried out
on other species and using technology very
different from that used in modern
commercial devices. He points out that the
collars are not intended to be used for
punishing bad behaviour. The idea is to
interrupt that activity and to follow up by
rewarding the desired behaviour, for
example, by stopping a dog from running
away and encourage it to respond to being
called back.
The project aims to assess the
immediate and long-term effects on the
animal of the electric charge. In that
respect, it may not be logical to ban the use
of electric collars while allowing other
technologies based on different aversive
stimuli such as those which spray
citrus-based compounds into the dogs face,
he points out.
If the project is successful, it may help
to bridge the philosophical divide between
the two factions in the debate. One thing I
am certain about is that on both sides of
the argument, they care passionately about
the welfare of dogs and think that what they
are doing is in the best interests of the
animal. It is just that they have come to very
different conclusions about what
constitutes good welfare.
Welsh
consultation
27 May was the last date for
interested parties to submit
opinions to the Welsh
Environment Department on the
proposed ban. The minister was
seeking comments on two
possible exemptions to the
regulation for collars used as
part of perimeter control system
and for last chance cases
where the devices are used on
animals that may otherwise be
euthanased because of a
behaviour problem. companion
will return to this subject in a
future issue. If in the meantime
you have any comments youd
like to make about this subject
visit the companion forum at
www.bsava.com
companion | 13
14 | companion
HOW TO
TREAT A RABBIT WITH
URINE SCALDING
HOW TO
Brigitte Reusch lecturer in
Rabbit Medicine and
Surgery at the Royal (Dick)
School of Veterinary
Services, discusses one of
the common conditions
affecting pet rabbits
subluxations; behavioural or neurological
micturition disorders (due to trauma or
Encephalitozoon cuniculi); or excessive
production of urinary sediment (due to
hypercalcaemia) and cystoliths.
As rabbits have a unique calcium
metabolism they are predisposed to
excessive urinary sediment if they are fed a
diet high in calcium. Rabbits passively
absorb all ingested calcium from their
digestive system, and then excrete 60% of
the excess calcium via the urinary tract;
this compares with 2% in most other
mammals. If there is chronic excess in
dietary calcium or a problem in the urinary
tract slowing voiding of urine, precipitation
of the calcium ions into crystals and stones
will occur.
What clinical signs may be seen?
Alopecia, erythema and secondary
pyoderma are all features of urine scalding
(Figure 1).
How can urinary incontinence
be distinguished from polyuria?
As both incontinence and PU/PD result in
urine scalding, differentiation between these
two syndromes is the first step during
investigation. Incontinence can be difficult
to distinguish from polyuria on history,
although careful observation of the rabbit
urinating usually aids differentiation,
particularly if clinical signs compatible with
urinary tract disease are present. Clinical
signs that may be found are palpation of a
large or small firm bladder, palpation of a
cystolith, and discomfort on abdominal
palpation. Signs of lower urinary tract
disease include stranguria, urine scalding,
pollakiuria, anuria, discomfort or pain
evident by bruxism or vocalisation during
Table 1 Differential list for polyuria/
polydipsia in the rabbit
Renal insufficiency and failure n
(including Encephalitozoon cuniculi)
Oral pain/dental disease n
Liver disease n
Psychogenic water drinker n
(boredom)
Hypercalcaemia n
Pyometra n
Postobstructive diuresis n
Diabetes mellitus n
U
rine scalding in rabbits is a clinical
sign that is seen frequently in
practice. The causes of urine scalding
commonly include conditions causing
polyuria or urinary incontinence. Unless the
cause or causes are investigated, supportive
treatment alone is likely to be effective.
The causes of polydipsia and polyuria
are similar to those in the cat and dog
(Table 1). However, endocrine diseases are
less common and, instead, dental disease
or oral pain is a common cause of polydipsia
in the rabbit. Cystitis is common, may be
one of the predisposing factors for
urolithiasis in rabbits and can be associated
with incomplete voiding. In addition,
incomplete voiding may be caused by:
lumbosacral vertebral fractures or
Figure 1:
Photograph of
erythema and
alopecia of the
perineum and
ventral abdomen
in a female rabbit
with chronic urine
scalding
Reproduced from the
BSAVA Manual of
Rabbit Medicine and
Surgery, 2nd edition
companion | 15
HOW TO
urination, urination outside the rabbits
latrine, haematuria, anorexia, depression
and reluctance to move.
What are the causes of urinary
incontinence?
Causes of incontinence can be grouped
according to the effect on bladder size.
Large distended bladder
Causes include: (a) neurogenic disorders
including upper and lower motor neuron
lesions and reflex dyssynergia (e.g. E.cuniculi,
Toxoplasma, lumbosacral vertebral fractures
or subluxation); and (b) outflow tract
obstruction (paradoxical incontinence).
Clinical signs of outflow tract
obstruction are dysuria/stranguria, urine
dribbling, haematuria and, on palpation, a
distended bladder that is difficult to express
and catheterise. Paradoxical incontinence
occurs because the intravesicular pressure
exceeds pressure within the urethra,
resulting in urine leaking past an outflow
obstruction. The most common causes of
partial outflow obstruction in rabbits are
calculi. Other potential causes include
bladder or urethral neoplasia, bladder
polyps, urethral strictures, severe urethritis,
and (in the male) prostatic disease. The
author has seen a case of partial outflow
obstruction in a female rabbit due to
advanced uterine adenocarcinoma. Rabbits
with partial urethral obstuction can be
stable in this compensated condition for
long periods, but if urethral resistance
increases progressively, further hypertrophy
of the bladder occurs. Decompensation may
finally occur due to the resultant decreased
luminal volume and loss of ability of the
bladder to contract and empty.
Small or normal bladder size
Causes include: urethral sphincter
mechanism incontinence (USMI); detrusor
hyperreflexia/instability; or congenital
disorders (e.g. ectopic ureters). Analogous
to the case in dogs and cats, oestrogen and
testosterone are believed to contribute to
urethral muscle tone, and ovario-
hysterectomised rabbits can develop USMI.
Clinical signs that may be observed include
dribbling of urine when relaxed or asleep,
but otherwise normal voiding of urine. In
contrast, detrusor hyperreflexia or
instability is the inability to control voiding
due to a strong urge to urinate as a sign of
cystitis or urethritis.
How can I investigate the cause
of urine scalding in a rabbit?
A presumptive diagnosis is often made
based on historical and clinical signs and
following clinical examination. However,
thorough investigation is required to rule in
or out common causes, including oral pain
from tooth root disease, which would only
be found on skull radiography.
Hospitalisation is usually required to allow
evaluation of urination, including
observation of posture and, where possible,
urine stream flow and character.
Most rabbits with dysuria tend also to
have polyuria, making observation of
urination more feasible than in normal
rabbits, which are naturally secretive in
hospital surroundings. Immediately after the
rabbit has attempted to void, the bladder
should be palpated to estimate the residual
volume. In the healthy rabbit almost all
urine, including urine sediment, should be
passed with each voiding. If the bladder is
still large following voluntary voiding, the
rabbit should be sedated for catheterisation.
A blood sample should be taken from the
lateral saphenous or femoral vein for
routine haematology and biochemistry to
help rule in or out some of the common
causes of polydipsia and polyuria.
Routine urinalysis and bacterial culture
should be carried out. Cystocentesis can
usually be performed in the conscious
rabbit, although sedation is recommended in
fractious patients. Free catch urine samples
can be obtained relatively easily from
litter-trained rabbits, using sterilised
aquarium gravel as a replacement for litter
in their tray. Urethral catheterisation under
sedation or general anaesthesia can be both
diagnostic and therapeutic, as removal of
sludgy urine sediment and flushing with
sterile saline often alleviates the clinical signs.
Haematuria can be differentiated from
red urine caused by plant porphyrin
pigments by a positive reaction for blood on
dipstick testing or >5 red blood cells per
high powered field on urine sediment
examination, as opposed to fluorescence of
plant pigments under the ultraviolet light of
a Woods lamp.
Neurological examination is indicated in
all cases with large bladders. Plain and
contrast radiography and ultrasonography
will reveal bladder wall, neck or urethral
abnormalities and identify cystoliths or
urethroliths (see Figure 2). In addition
ultrasonography has been shown to
estimate bladder hypertrophy accurately in
rabbits. Cystoscopy has been used in female
rabbits and allows further complementary
assessment of the lower urinary tract and
indirect assessment of the upper urinary
tract, by evaluation of urine production by
each ureter.
Serology for E.cuniculi infection should
be carried out in all cases; a positive titre in
addition to neurological signs support the
diagnosis. A urine or faecal PCR will also
give a definitive diagnosis of E.cuniculi
Figure 2: Lateral abdominal radiograph demonstrating a very large bladder
filled with radiodense material. The sediment was removed by repeated flushing
of the bladder via urethral catheterisation
16 | companion
HOW TO
TREAT A RABBIT WITH
URINE SCALDING
infection in those rabbits that are actively
shedding the parasite, which usually occurs
in the first 3 months of infection. Renal
biopsy and parasite identification may also
help in diagnosis.
A 24-hour water measurement test is
recommended to confirm polydipsia
(>120 ml/kg/day). An average consumption
taken over 3 days in the rabbits home
environment is usually representative.
Further investigation of the aetiology of the
polyuria should then be carried out.
How do I treat urine scalding in
a rabbit?
Therapy with broad-spectrum antibiotics
such as enrofloxacin (1030 mg/kg orally or
s.c. q24h) or trimethoprim/
sulfamethoxazole (co-trimoxazole
suspension) (30 mg/kg orally q12h) should
be implemented while awaiting urine culture
and sensitivity test results. Analgesia,
non-steroidal anti-inflammatories and/or
partial opioids are recommended,
depending on renal function.
Supportive treatment in the initial stage
of urine scalding involves careful clipping of
fur around the perineum, cleaning the
perineum and topical treatment of the
pyoderma. Once the pyoderma has
resolved, application of a water-resistant
barrier spray or cream can be helpful to
avoid recurrence of skin scalding and
pyoderma. Weight loss is recommended in
overweight rabbits, as obesity will
exacerbate urine scalding and clinical signs
of urolithiasis.
Sedation or general anaesthesia and
urethral catheterisation to remove
sediment and small cystoliths is indicated if
excess sediment is found on radiography.
What specific treatment can be
used in rabbits with excessive
urinary sediment or uroliths?
Urinary acidification via diet is not
practical, as rabbits have naturally very
alkaline urine. Urohydropropulsion is a
non-surgical technique used in cats and
dogs to remove small round urocystoliths,
and has been used successfully in rabbits.
Pre-anaesthetic diazepam is recommended
to relax the urethral smooth muscle, and
pre-emptive analgesia is recommended.
Once anaesthetised, 46 ml/kg sterile
saline should be administered through a
urethral catheter to moderately distend
the bladder, after which the catheter
should be removed. The rabbit is held in
an upright position and the bladder is
manually expressed using steady firm,
digital pressure. The procedure is
repeated as necessary and then followed
up with radiography to ensure removal
of all uroliths has been achieved.
Haematuria and dysuria are expected for
up to 2 days following this procedure.
Particular care must be taken in bucks
to ensure that uroliths are small enough
to pass through the urethra to avoid
urethral obstruction.
Cystotomy is recommended for the
removal of all medium to large or irregular
cystoliths. Reverse urohydropropulsion is
recommended to return large urethral
uroliths to the bladder for removal by
cystotomy.
How do I treat urinary
incontinence?
Response to therapy frequently aids the
diagnosis of urinary incontinence. A positive
response to diethylstilbestrol* (0.5 mg per
rabbit orally once or twice a week) is
suggestive of USMI. Treatment of
urolithiasis and management of urine
scalding is required.
What long-term treatment and
prevention can be carried out for
rabbits with excessive urinary
sediment?
Client education regarding dietary
modification to reduce dietary calcium is
recommended for long-term management
and prevention of excess sediment
precipitation or retention and the formation
of uroliths (see Figure 3). Timothy grass-
based pellets should be fed, and then only in
a small quantity (e.g. one tablespoon/day/
rabbit). The majority of the diet should be
mixed meadow hay or Timothy hay (a pile
of hay equal to the size of the rabbit), some
root vegetables and moderate amounts of
green leafy vegetables (a small handful daily).
In general, items to be avoided include all
vitamin and mineral supplements, alfalfa
(pellet or hay), excess kale, carrot tops,
dandelion and clover.
What prognosis should I give?
Prognosis is dependent on the cause and
severity of the lesion. Chronic renal failure
carries a poor prognosis. Chronic over-
distension or severe hypertrophy of the
bladder carries a poor prognosis for
recovery. E.cuniculi unresponsive to
fenbendazole treatment (20 mg/kg orally
q24h for 30 days) also carries a poor
prognosis. However, a large proportion of
rabbits have excessive urinary sediment as a
result of being fed excess dietary calcium
and resulting urinary tract disease. In these
cases, once the sediment has been removed
and the diet is corrected, the prognosis can
be good. n
Figure 3: Diagrammatic demonstration of the correct way to feed adult pet rabbits
70% of diet = good quality
grass (growing>hay)
28% vegetables, herbs,
small amounts of fruit
2% pellet i.e.
12 tablespoons/day
pellet use as treats
*Editor comment: Diethylstibestrol may not
be readily available; phenylpropanolamine has
also been recommended for USMI in rabbits.
companion | 17
VIN
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
Vicki Sokolowski, DVM, Ladyvet Animal Hospital, Ladysmith, WI
I have a 10 year old DSH that has lost 3 pounds in the last year with a BUN of 42 (15 mmol/L urea), creatinine of 3.8 (336 mmol/L), an
albumin of 3.3 (33 g/L), and a calcium of 12.2 (3.05 mmol/L) (11.3 (2.83 mmol/L) is the high end of normal on our machine). Owners
brought her in for routine yearly physical. On exam, when I went to draw blood, out popped a large mass from her thoracic inlet I had
not felt it at all during initial exam. It is almost the size of a ping-pong ball. I had tested T4 also, and on our Idexx machine it said it was
over 7 (90 nmol/L). I sent it to our reference lab to see how much over 7 it was, and it came back normal at 4.1 (54 nmol/L). I re-sent a
second sample, thinking something got goofed up, but still normal at 2.7 (34.8 nmol/L). Aspirate of the mass sent in at the time of the
intial exam came back Epithelial cell morphology compatible with thyroid gland epithelium and cells appear benign. I am now thinking
this mass may be a parathyroid gland? Am planning on removing it next week. I am thinking the mass has to be removed no matter
what, so better use of funds to remove and histopath than to send in for inonized Ca and parathyroid hormone. I am wondering about
giving calcium supplementation do we start it the day the mass is removed or wait to see if we have a problem. Track calcium how often
after removing mass? If it is a parathyroid mass, I understand that it is possible that the other glands are so suppressed they will not
function right away. It is still possible the mass is not parathyroid also, and then there should be no effect on calcium at the time of
removal. I had started her on methimazole when we got a T4 here of over 7, but now am thinking I should stop?
VIN Consultant
I would vote for the ionized calcium and PTH level now (sent to MSU), as I think its a better idea to know ahead of time if this is a
parathyroid mass rather than a thyroid mass. If its not parathyroid, then you dont have to monitor the calcium daily post-op (we do that
for at least 5 days post-op). With renal failure, the total calcium level can be elevated slightly, but the ionized calcium is normalso this
hypercalcemia may not be real. If it is a parathyroid mass, then we not only need calcium supplementation post-op, but also calcitriol. If
its a thyroid mass, then we would like for it to come out surgically. First I would take thoracic films, as this could be a thyroid carcinoma,
then would do surgerywe need the surgery to be very rapid and efficient when the renal failure is this significant, with lots of fluid
therapy (hopefully theres not a heart murmur?) and monitoring of blood pressureId tend to send something like this to a surgeon.
Finally, for the azotaemia, if the kidneys palpate small, then wed vote for:
-culturing the urine (now and every 46 months) via cysto, automatically, even if the sediment is quiet
-measuring blood pressure (now and then every 46 months)
-a low protein diet
-starting calcitriol (not at the anti-hypoPTH dose used post-op in parathyroid removal, but at the lower chronic renal failure dose)are you
familiar with using this?
Victoria Sokolowski
Frisky is already on the Hills k/d diet, she does not have a heart murmur, and her BUN and creatinine have stayed stable for the last year.
Urinalysis done with a sample obtained by cystocentesis had a few RBC and no growth on culture done at reference lab when she was
here for her physical a week ago. We do not have her on calcitrol. Will the tests tell us for sure that whether this is thyroid or parathyroid?
If it is a parathyroid mass, than do we start the calcium the day before removal, the day of removal, or wait and monitor and just start if
levels drop?? Should she stay hospitalized for the 5 days after surgery that she is monitored, or can owners bring her in every day?
Owners are bringing her in tomorrow morning for the blood-draw.
VIN Consultant
Usually the tests will help us diagnose primary hyperPTH. If it is a parathyroid mass, then I order some calcitriol so its in the hospital if
necessary but dont start it unless the calcium is dropping precipitously (giving it along with IV calcium gluconate initiallly dont be
tempted to give calcium gluconate SQ). I dont keep them hospitalized for 5 days to check calciumhopefully the owner can bring them in
daily for the blood draw (usually I try to do this toward the end of the day so I know that the calcium looks stable-enough in the PM for
them to be probably ok overnight). Are you familiar with using calcitriol for CRF?
Discussion: Mass in neck-Parathyroid
18 | companion
VIN
Victoria Sokolowski
The results of the labwork; Intact parathyroid hormone 57.3, Ref Range 04 pmol/L, Ionized calcium 1.55, Ref Range 01.4 mmol/L,
25 hydroxyvitamin D: 114, Ref Range 65170 pmol/L. There is an elevation in ionized calcium concentration without the expected
suppression of parathyroid hormone production. These results support a diagnosis of primary hyperparathyroidism which is typically due
to a parathyroid adenoma. The vitamin D is normal. So, I would say from the results that we should go ahead with surgery and be ready
with the calcium, as it definitely is a parathyroid tumor. Normally benign? It feels very encapsulated do I need to worry about wide
margins, or can I stay just outside the capsule?
Tina M. Wolfe, DVM, MS, DACVS, VIN Consultant
A few things I want to stress with regard to sx...
1. Since the calcium is only mildly elevated, I would be very surprised if any supplementation will be needed post op definitely monitor
for it on lab work and clinically, but problems are more likely when there is a very significant preop elevation. As for calcitriol certainly
consider it for the renal disease, but I agree that it isnt a necessity in a case like this with regard to surgery/mass removal.
2. Be careful and prepared for problems when operating in the thoracic inlet region. Sometimes the pleura can get penetrated during
the surgery resulting in a sudden pneumothorax. Is the mass well definined and movable?? Most parathyroid masses are quite small
often pea sized so this is a bit of an odd presentation. Also be careful of the recurrent laryngeal, vagosympathetic trunk, etc. that reside
in the vicinity.
3. With renal disease, it may also be worthwhile to start your IVF prior to surgery at least a few hours. With this calcium level youd
probably still be ok with LRS, but a non-calcium containing fluid could be considered as an alternative.
Typically if you do not disrupt the capsule it should be fine. Have you gotten chest films? Ectopic tissue can reside anywhere from the
thyroid glands to the heart base.
Victoria Sokolowski
Surgery went well. I have attached a couple pictures of the mass. Calcium was up to 12.9 (3.23 mmol/L) before surgery, and 2.5 hours
after surgery the calcium was 11.2 (2.8 mmol/L). She was stable through surgery, but does have a little bleeding now. We are continuing
to monitor her calcium. We have submitted the mass for histopathology. It looked to me like the parathyroid had kind of wrapped itself
around the thyroid gland like a vine?
Victoria Sokolowski
Frisky continues to do great. Incision looks good. Her calcium is continuing to drop (we are at 9.9 (2.48 mmol/L) now) but the decrease
seems to be slowing. I plan on checking calcium later, removing the IV, and sending her home tonight. I have not supplemented any
calcium so far. I was going to have owners feed her 4 times a day, and advise if she starts declining food, as that may be an indication of
hypocalcaemia. Any other early indicators I can tell them to watch for?
VIN Consultant
Usually I check the calcium in the afternoon/early evening each day for 56 days post-op. One of the early signs of hypocalcaemia is
rubbing of the face.
Victoria Sokolowski
Histopath results came back. Diagnosis: Right thyroid lobe: Sections of four pieces of this specimen are examined. All sections reveal
prominent multinodular follicular cell hyperplasia with the thyroid nodules having solid, microfollicular, normofollicular, and macrofollicular
patterns. Parathyroid tissue is not seen in any of these sections. The thyroid follicles that are not in nodules but are within normal shaped
thyroid lobules have clear to pale staining colloid instead of normal darkly eosinophilic staining colloid. Comment: Because parathyroid
tissue is not seen in these sections, deeper sections and additional formalin-fixed tissue will be examined. Results below. So, today we got
the amended results, which are not so good for the kitty
companion | 19
VIN
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.
Addendum: Deeper step sections of two of the previous blocks and sections of nine additional pieces of formalin-fixed tissue: It became
obvious that my previous interpretation of multinodular follicular cell hyperplasia was not correct and that the nodules/lobules identified
are part of a multilobulated/nodular parathyroid carcinoma. In addition to the solid pattern, microfollicles, normofollicles, and
macrofollicles (previously described in the original report), this tumor has other tumor patterns including ribbon and trabecular. The
diagnosis of a parathyroid carcinoma rather than adenoma is based on two important findings including a small focus of capsular invasion
with infiltration of the adjacent adipose tissue and a nearby venous tumor embolus with attachment to the wall of the vein. The few
lobules of thyroid tissue in these sections have mild C-cell hyperplasia, compatible with the history of hypercalcemia. The parathyroid
carcinoma, including the tiny focus of capsular invasion and the venous tumor embolus, appear excised. However, the prognosis should be
guarded for possible metastases, which based on human carcinomas, might take many months to many years to become apparent. One
should be concerned about metastases if hypercalcaemia recurs. The cat should now have normal serum calcium following surgery. For
our interest and for confirmation of the findings in this addendum, special stains for chromogranin-A and for calcitonin have been
requested and the results will follow in an addendum. Her calcium today at 5:15 pm is 9.9 (2.48 mmol/L), so I think we will be OK on the
calcium, but we are checking again tomorrow to be sure. Let me know what you think. I was going to recommend monitoring calcium
levels every 6 months should we be doing it more often?
VIN Consultant
I think youre almost there in terms of monitoring calcium levels, but Id still run one today and tomorrow. Then Id run a chem screen
every 3 months. There are a couple of posts in the database that suggest that even if malignant, these tumors can have a slow metastatic
behavior.
Victoria Sokolowski
Frisky stopped in again this afternoon, and blood calcium was 9.4 (2.35 mmol/L) which is basically steady. Latest histopath results are
interesting Addendum: Chromogranin A and calcitonin staining are negative. Parathyroid tumors should be chromogranin A positive.
Thyroglobulin staining will be performed to determine if the cellular proliferations are of thyroid follicular origin and the result will be
noted in another addendum.
Dennis Bailey, DVM, DACVIM (Oncology), Oradell Animal Hospital, Paramus
Interesting case. Parathyroid tumors in cats typically are large enough to be palpated at the time of presentation, as was the case with
this cat. Based on few cats, they have a slightly higher relative percentage of parathyoid carcinomas compared to adenomas. Having said
that, metastasis is still very uncommon. I know this cat had a tumor embolus seen on histopath, but this does not mean that the tumour
necessarily has metastasized. The rate-limiting step for metastasis is not the ability of the tumor cells to get to a distant place in the
body, but rather the ability of the tumour cells to survive and divide once they have gotten there.
Parathyroid carcinomas usually do stain positive for chromogranin A, and while there is considerable homology in this protein across
species, I wonder if this stain has been validated in cats. The negative calcitonin would argue against a thyroid medullary tumor. I agree
that it is reasonable to perform other stains for thyroid follicular. If it is negative for the thyroid folliculary markers, I would still asume
that this was a parathyroid tumor based on clinical presentation and resolution of hypercalcaemia post-operatively.
Since the metastatic rate is low, and there isnt any standard chemotherapy for parathyroid carcinomas, I would opt for monitoring. I
would check an ionized calcium (more sensitive then total calcium) every 23 months for the next year, and then gradually decrease the
frequency of measuring. Palpate the neck area and regional lymph nodes very carefully at each visit. If you wanted to be very thorough,
thoracic rads in 6 and 12 months would be reasonable as well.
Victoria Sokolowski
Final histopath results: conclusion was parathyroid carcinoma. Frisky continues to do well. Addendum: The neoplastic cells are negative
with thyroglobulin staining although a small amount of positivity is noted in a remnant of normal thyroid tissue. The case has been
reviewed by Dr. Moore who also favours a parathyroid carcinoma. It is possible that our chromogranin A stain does not work well with
feline tissue.
Addendum: The immunohistochemical stained sections are examined. The chromogranin-A stain did not work on the neoplasm or on the
control C-cells within the thyroid tissue of the submitted specimen. The histopathological diagnosis remains parathyroid carcinoma. For
our interest on our first case of feline parathyroid carcinoma, an immunohistochemical stain for synaptophysin has also been ordered and
the results will follow in another addendum.
Addendum: Results of immunohistochemical stained section for synaptophysin: The epithelial cells of the parathyroid carcinoma and the
normal thyroid follicular cells stained negative for synaptophysin. The C-cells associated with the thyroid follicles stained strongly positive
for synaptophysin. As expected, those C-cells had previously stained intensely positive for calcitonin but unexpectedly only very faintly with
chromogranin-A, suggesting that the antibody titer for chromogranin-A stain procedure was not properly diluted/titered for the feline species.
This discussion has been edited for print. Find the full discussion online at www.vin.com/Link.plx?ID=65331
20 | companion
PUBLICATIONS
YOU SAY TRYKIA
I SAY TRAKEA
Soft tissue surgeon
Geraldine Hunt on her
experience of moving
from Australia to
America to work at
The UC Davis School
of Veterinary Medicine
I
was struggling with a soft tissue sarcoma.
Could I have a pair of Wheatlanders? I
asked. Silence. I glanced up. The theatre
tech looked perplexed. Please? She
turned to the anaesthetist. What did she
say? What landers? Wheatlanders, I
repeated, which didnt help. It wasnt that
they didnt know the instrument; they just
werent used to the accent.
It was my first week at the Veterinary
Medical Teaching Hospital (VMTH) at UC
Davis and the sweat on my brow had little
to do with the difficulty of the surgery. San
Francisco offers a relaxed lifestyle about as
close as you can get to Australia, but I was
being constantly reminded that I was half a
world away from home: 11,935 kilometers
across the Pacific Ocean (7416 miles if
youre going the other way), 7 hours time
difference and a language barrier to boot!
The journey begins
After 19 years at the University of Sydney
I had decided it was time for a change and,
like the pioneers of the 18th century,
headed for the Wild Wild West. I landed a
little over 13 hours later and prepared, with
some trepidation, to start a new life.
Before being allowed into the country,
however, I had to master a new calendar.
Month first, said the man at Immigration,
as if speaking to a 5-year-old. Having run
that gauntlet, I picked up my 5 suitcases
and walked into the open air. I left Sydney
on a Sunday morning and it was a balmy
30 degrees. This morning in Northern
California it was still Sunday and it was
still 30 degrees, but there was ice on
the sidewalk.
I had two weeks to get organized before
going into clinic and was hosted by the
Executive Dean of the Veterinary School.
He even lent me his car; a brave move
considered that I was driving on the wrong
side of the road.
In Sydney I lived 5 minutes walk from
the beach and a similar distance from the
local caf strip. In the countryside around
Davis, with its long, straight roads spearing
between walnut orchards, you can sit on
cruise control and listen to three or four
Garth Brooks songs before getting even a
sniff of cappuccino.
Youre paralysed here without a car, so
one of my first ports of call was the local
dealer. With the rising cost of fuel (gas), no
social security number and no credit rating,
I thought a small, economical Japanese
hatchback would be sensible. I walked away
the proud owner of a Jeep Liberty.
Next, the State of California insisted I
prove my competence on the roads by sitting
a behind-the-wheel driving test. Immediately
I was 17 again, waiting nervously for the
driving examiner to appear. My ex-students
from Sydney would have been delighted to
see me shaking for a change.
Making the transition
I entered the VMTH for my first day on
clinic with some trepidation. I had been a
big fish in a small pond at Sydney. Here I
was joining a staff of over 300. My
international reputation had earned me
a job in this pre-eminent veterinary
school, but that meant nothing to the first
year residents or the Ward Techs. I was
going to have to earn their respect, and
pretty quickly.
Dan Brockman, from the RVC, had
warned me about the difficulties of
transitioning from one continent to another.
You might have done something a hundred
times, he said, but it will still go wrong in
those first few weeks. He was proven right
within a few days, when I demonstrated the
correct way to perform a meshed skin
20 | companion

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companion | 21
PUBLICATIONS
graft. If you use good surgical principles,
prepare the recipient bed properly, and
have good aftercare, you can expect a 95%
success rate, I told the resident. In fact,
Ive never had one fail. Seven days later, the
resident was kind enough to remain silent
as we peeled the dead graft, like rotting fish
skin, from its tissue bed.
That same fortnight blessed me with my
first-ever near exsanguinations from a soft
palate resection, a periorbital cyst and a
sarcoma removal, in three consecutive
patients. Falling upon the age-old defence of
the surgeon, I asked, Are the anaesthetists
giving some sort of anticoagulant to these
patients? The who? asked the hospital
director. Oh, you mean the
anesthesiologists. I soon realised that
nobody was interested in hearing me say,
Ive never seen this complication before.
I had my first horrible disaster with a
cats ureter. Sadly, it was my first ever
experience with a cats ureter. On the same
day I failed my driving test because I gave
way to everyone on the right. In Australia,
you would be failed for not giving way to
everyone on the right, but of course I
wasnt in Australia any more.
I had travelled so many times to the
United States that it didnt seem strange at
first, but I had a moment of panic towards
the end of the third week when I realised I
was not on holiday this time.
Making a life and friends
Being so far away from family and friends
brought home the importance of working
relationships. We spend up to 12 hours a
day with our colleagues; share drama,
heartache and victory with them. Together
we face irate owners, killer patients and the
frustrations of trying to do our very best
for clients dealing with their own financial,
emotional and time pressures. Our techs
and other colleagues are the ones who pat
us on the back when we pull something off
that makes us feel like the best vet in the
world and its their shoulders we cry on
when nothing goes right.
Supportive as my new UC Davis
family is though, the announcement that
I had failed my driving test met with
unanimous laughter.
Meeting the challenge
UC Davis has a great caseload; varied and
challenging and plenty of them. Dogs and
cats are just part of it. The Companion
Avian and Pocket Exotic Unit provided me
with a significant challenge. Mary Anne
keeps prolapsing, said Dr Hawkins. We
think she needs an exploratory.
Mary Anne was a 50 gram leopard gecko
and her prolapse turned out to be a large
bowel intussusception. While they
anaesthetised and placed her on a ventilator,
I read the anatomy book! After reducing her
intussusception, I spayed her. I could almost
have believed I was operating on a kitten
until I encountered two large eggs.
The following week I found myself
suturing the wing of a bald eagle. It was a
sobering responsibility; the well-being of
the United States national emblem.
The Oncology Unit attracts many
cancer patients that keep us busy in the
operating room. We have MRI, CT, medical
oncologists and a linear accelerator at our
fingertips, but the old-fashioned 4 cm
margin is as popular here as anywhere in
the world.
I have often answered my pager to hear,
Dr X wants to know if you could come
into surgery for a minute. I used to walk in
to find a sheepish resident standing over a
patient that looked like it had been attacked
by a shark. What do you suggest we do
now, Dr Hunt?
After a few more months and many
shared challenges, the residents now
proudly announce, Look, Dr Hunt, Ive
made a BIG hole. Excellent, I reply. They
wait for the words they know are coming.
Now open up the BSAVA Manual of Canine
and Feline Wound Management and
Reconstruction and work out how youre
going to close it. n
PUBLICATIONS
Ramesh Kumar | Dreamstime.com
22 | companion
Improving the health of the nations pets
PETSAVERS
PETSAVERS
GRANTS 2010
SUPPORT THE
PETSAVERS
10K TEAM
P
etsavers is inviting applications for Clinical Research
Projects for consideration in August 2009, with the final
vote taken in March 2010.
Qualified veterinary surgeons are invited to apply for funds
to support a clinical study in small animal pets, the objective of
which is to advance the understanding of the cause and/or
management of a clinical disorder.
The projects should not involve experimental animals and
should further the knowledge of the small animal practitioner.
Joint applications between veterinarians in practice and
academia are welcome.
Funding is available for grants between 1000 and 8000.
The closing date for applications is 14 August 2009.
The terms and conditions, as well as application forms, can
be found on the Petsavers website.
Petsavers invites
applications for Clinical
Research Projects.
Apply now for a grant
between 1000 and 8000
I
ts not to late to show your
support for the Petsavers 10K
team; just go to the Just Giving
website www.justgiving.com
and search for Petsavers under the
find a charity section, and make a
donation to encourage our various
runners. Thanks to all those
who are putting on
their running shoes
for us on 12 July
if you are in London
come and cheer
our team on you
wont miss them as
theyll all be wearing
their bright yellow
Petsavers running vests
and T-shirts.
PETSAVERS PHOTO COMPETITION
F
ollowing on from the success of the last, the next competition
is opening earlier to give you and your clients more time to
take that winning picture. Check the Petsavers website this
summer for full details of the prizes and terms and conditions. The
theme is Pets we love and there will be two categories, Adult
(over 16) and Junior (under 16). So grab your camera and get
snapping today.
companion | 23
WSAVA NEWS
WSAVA ACTIVITIES AND
COMMITTEE REPORTS
Dr David Wadsworth,
WSAVA President, looks
at some of the highlights
of a busy year and the
challenges ahead
T
he next WSAVA year promises to
be even more exciting than this one
has been. The 50th birthday
celebrations will begin in So Paulo and
conclude in Geneva in 2010 on the shores
of Lac Leman, with the Mont Blanc massif
providing the backdrop for a wonderful
Congress Banquet.
This year has seen a great deal of hard
work carried out by the various members
of the Board and Committee Chairmen.
The main theme has been that the time has
come to add further professionalism to the
WSAVA, in all its facets. The Board, under
the guidance of Walt Ingwersen, has been in
discussions with solicitors and will present a
paper to the Assembly asking for approval
to incorporate the WSAVA as a company in
Canada and to register it as a not-for-profit
entity. This charitable status should make
discussions with sponsors easier. There will
also be discussion on the formation of the
WSAVA Foundation. Jolle Kirpensteijn has
been the lead on this topic and he will give
an update to the Assembly in So Paulo. It is
envisaged that if all progresses smoothly,
the WSAVA Foundation will be launched
during the Geneva Congress.
As part of this process of increased
professionalism, the Board would like to see
greater accessibility to the Associations
members and an ability to take in-between
meetings decisions with the approval of the
Assembly. Brian Romberg, far from resting
after his presidential term, has been
working hard to suggest amendments to the
Constitution which will enable us to
function properly in the 21st century. The
Board is also looking to employ a part-time
executive officer or a company/organization
that can reduce the workload on the
Honorary Secretary and other officers.
Strategic planning
The Honorary Treasurer, Di Sheehan, has
been updating the financial system with a
view to making reporting easier with
incorporation comes the necessity to file
accounts by a specified date every year. She
The 2009 WSAVA Executive Board. Left to right: Dr Brian Romberg (Immediate
Past-President; South Africa), Dr Luis Tello (Vice President; Chile), Dr David
Wadsworth (President; UK), Dr Jolle Kirpensteijn (President Elect; Netherlands),
Dr Di Sheehan (Honorary Treasurer; Australia), and Dr Walt Ingwersen (Honorary
Secretary; Canada)
24 | companion
WSAVA ACTIVITIES AND
COMMITTEE REPORTS
WSAVA NEWS WSAVA NEWS
also has been looking very hard at WSAVA
congresses and following up on the strategic
planning meetings held last year in Dublin,
which suggested that changes to the current
format should be considered. While no
changes can take place until 2014 at the
earliest, it is imperative that decisions are
taken otherwise the WSAVA Congress
will not move forward in a world which is
rapidly changing. Di will also be leading the
next round of strategic planning meetings in
So Paulo it is vitally important that the
views of all the association members are
sought on an annual basis to allow the
Board to take the WSAVA in the direction
wished by the membership.
Getting the message out
Luis Tello has been working hard to
produce the news bulletins and leaflets
which give knowledge of the WSAVA to the
outside world. He has done a remarkable
job in updating the image of WSAVA and is
responsible for the production of the 50th
birthday booklets and pins. In his spare time
he has been organizing the continuing
education events in South and Central
America and is to be thanked for setting up
a new event in Panama, in addition to the
existing events in Uruguay, Peru, Ecuador,
Colombia and Venezuela.
Future congresses
Jolle is also responsible for overseeing the
WSAVA Congress bids and this year we
have exciting proposals from Washington
DC and Christchurch, New Zealand, to
consider. It is important that all Association
members consider the bids carefully. Both
have many merits and I hope that the
decision will be taken on the basis of what
the member associations consider to be the
best for WSAVA.
Sponsorship
Jolle is also the negotiator for all the
WSAVA sponsorship contracts and his
efforts have resulted in close working
partnerships with Hills Pet Nutrition, which
is the WSAVA Prime Sponsor for WSAVA
Congresses, the Gastrointestinal, Hepatic
and Renal Standardization Projects, the
website and news bulletin production, and of
course the long-running and most valuable
WSAVA continuing education programme.
Bayer Animal Health has provided invaluable
assistance in the Renal Standardization
Project, the website and news bulletin
production and the CE courses, and
Intervet/Schering-Plough has supported the
Vaccine Standardization Project and CE. We
are extremely grateful to these companies
whose aim is to work towards our shared
goal of Continuing Veterinary Excellence.
Continuing education
The WSAVA CE programme continues to
go from strength to strength, with over
5,000 delegates at 34 meetings in 30
countries being enthralled by the
improvement to their postgraduate
education. I have said it before, and I will
repeat, that CE is the cornerstone of
WSAVA work it entirely fits in with our
vision to continue the development of
global companion animal care and with our
mission to foster the exchange of scientific
information between individual veterinary
surgeons and veterinary organizations. The
programme could not take place without
the dedicated work of local organizers and
the regional organisers, Luis Tello in South
America, Roger Clarke in Asia, Lawson
Cairns in Africa and Julian Wells in Eastern
Europe. As well as our long-term sponsors,
Hills Pet Nutrition, Bayer Animal Health
and Intervet/Schering-Plough, we are
grateful to the associations for France
(AFVAC), Australia (ASAVA), the United
Kingdom (BSAVA), The Netherlands
(NACAM), Norway (NSAVA), Greece
(HVMS), Switzerland (SVK), Austria (VK),
Denmark (DSAVA), Finland (FSAVA) , the
Czech Republic (CSAVA) and Slovakia
(SkSAVA), who have all donated funds to
support this venture. It is truly good to
know that there are people with the vision
to support the future of the profession.
Animal welfare
The Animal Welfare Committee another
cornerstone of WSAVA work continues
to work hard to increase the standard of
animal welfare internationally. As veterinary
surgeons, we take it for granted that we are
involved in animal welfare on a daily basis
but there is so much more that can be
achieved. Roger Clarke and Ray Butcher
have organized programmes for the
FASAVA Congress in Bangkok in November,
for the WSAVA Congress in So Paulo and
for the NAVC Congress in Orlando this
year. They are in contact with other
international welfare organizations and we
hope that their efforts will continue to be
effective in this field.
Scientific advice
The Scientific Advisory Committee, under
the chairmanship of Michael Day, has strong
ties with the academic world and our
Standardization Projects are reported
annually to ACVIM and ECVIM. The
committee is formed entirely of
internationally renowned academic
veterinary surgeons and gives advice on
congress programmes, state-of-the-art
lectures and the prestigious WSAVA Awards,
companion | 25
WSAVA NEWS
COMMITTEE
FOCUS: SAC
T
he Scientific Advisory Committee
(SAC) of the WSAVA advises and
assists the Executive Board in
developing links with the academic world
involved in research and development in
small animal veterinary science. Its aim is
to stimulate academic participation under
the auspices of the WSAVA, and at the
same time to promote worldwide access
to knowledge resulting from research.
Following the Dublin Congress in
2008, the SAC had a major change of
membership as the chair and several
members came to the end of their terms
of office. The committee acknowledges
the past leadership of Dr Anjop Venker
van Haagen and the contributions of Drs
Robert Washabau, Hylton Bark and
Maurice Rose.
The current membership of the SAC is:
Michael J. Day, University of Bristol,
United Kingdom [Chairman]
Marc Vandevelde, University of
Berne, Switzerland
Yoshito Wakao, Azabu University,
Japan
Dale Bjorling, University of
Wisconsin, USA
Cecile Clercx, University of Lige,
Belgium
Gad Baneth, Hebrew University,
Israel
Lorrie Gaschen, Louisiana State
University, USA
Richard Squires, James Cook
University, Australia
A major role of the SAC is in the
scientific scrutiny of new proposals for
Standardization Projects and in monitoring
the progress of existing projects.
WSAVA Gastrointestinal
Standardization Group
The SAC has assessed a proposal for a
second phase of funding and made a
recommendation to the Executive
Board. The SAC has monitored the
progress of the GI Groups Phase I
activities (which concluded in 2009) and
has noted the recent completion of an
ACVIM Consensus Statement to add to
previous outcomes. The group continues
to work towards production of a book
and an agreement has now been signed
with a publisher.
WSAVA Vaccination
Guidelines Group
The SAC has assessed a proposal for a
second phase of funding. An endorsement
was made to the Executive Board and
funding was secured for this project.
The VGG has now held two meetings
(January and May 2009) and will be
producing updated guidelines for
veterinarians in late 2009 and guidelines
for pet owners and breeders in 2010, in
addition to addressing education in
veterinary immunology and vaccinology.
The VGG is also conducting a review
of vaccination practice in WSAVA
member countries.
Other activities
The SAC has reviewed an interim report
from the WSAVA Renal Standardization
Group, and has had preliminary contact
from the WSAVA Liver Standardization
Group which will submit a proposal for a
second phase of activity in 2009.
The SAC is also closely involved in
developing the scientific programme for
the annual World Congress, with the
Geneva programme already complete. We
also assist in selecting the WSAVA Award
winners, and in evaluating and advising the
WSAVA Executive Board on the merits of
a variety of scientific proposals that come
before the Association.
Professor Michael Day
gives an insight into the
work of the Scientific
Advisory Committee
and also oversees the scientific integrity of
Standardization Project applications. We
are grateful to all involved in the work of
this committee, and Michael explains more
about this opposite.
Out and about
I was fortunate to be able to attend the
50th birthday celebrations of AFVAC in
Strasbourg last year and have attended the
BSAVA Congress in Birmingham and the
German Congress in Baden Baden. The
Board met during the NAVC in Orlando for
the spring meeting and Jolle has attended
congresses in The Netherlands, Japan, and
Korea. Di has been to the Australian
Congress and Walt to AAHA. There have
been interviews with the Veterinary Times
and vetpulse.tv, plus an interview with
AnimalPharm, the newspaper of the
pharmaceutical manufacturing companies.
All in all, it has been a hectic 12 months
and it is appropriate that I should also
mention June Ingwersen, WSAVA
Administrative Assistant, who has been
working tirelessly alongside Walt to keep
the show on the road both during his
absences and when he is at home!
Dr David Wadsworth, WSAVA President
26 | companion
companion INTERVIEW
Kate Tunley was born and bred in the Midlands and graduated from Cambridge veterinary
school in 2000. She has worked both in private practice and at the RVC but throughout
her training and professional career has travelled the globe, often volunteering her
veterinary skills to the communities she has visited
THE
INTERVIEW
What was your most recent
adventure?
Id always wanted to do some voluntary
work overseas so, after convincing my boss
that a sabbatical was a good idea, and a lot
of research, I had my plan: three months in
Grenada, West Indies, and three months in
Southern Uganda!
Did you run into any problems?
On arriving in Grenada I had to convince
customs that the drugs I had with me were
kindly donated for the sole use at the
islands animal shelter, and not for my own
personal use or gain!
You volunteered for GSPCA, what
did this involve?
The GSPCA is a shelter and clinic with only
three full-time staff, the rest is done by
volunteers. The primary aims are to provide
low cost veterinary care, including the
treatment of the islands many street dogs.
So, much of this work involves population
control; I lost count of the number of dogs
and cats we spayed and castrated. Rabies is
also a problem. Weekends were spent
loading up the van with supplies and heading
out to the more remote areas to set up free
rabies clinics to encourage people to
vaccinate their animals. We also set up a
neutering clinic in a local school, and with
the assistance of some enthusiastic
veterinary students managed to neuter
about 30 animals in a day.
Was it all work, work, work?
I do hold my hands up the island of
Grenada and its smaller sister island of
Carriacou are stunning and a fair amount of
time did involve beaches, diving, trekking
and the odd Pia Colada!
How did Uganda compare?
Kisoro is a small, very poor town set in the
foot of three impressive volcanoes. Although
very pretty, it quickly became apparent that
in a place where food, water and electricity
were in short supply, a small animal vet was a
little surplus to requirements! Fortunately
though, Kisoro is full of welcoming, positive
and enthusiastic locals, who, when I offered
my help, were only too pleased to accept.
So if you werent dealing with
animals, what did you do?
Two days after arriving I found myself in
front of a class of children, expectantly
looking at their new science and maths
teacher! I had to speak a little more slowly
so they could understand (and laugh at) my
English accent, but for two days a week they
learned all about the cardiovascular system,
the respiratory system, husbandry of cattle,
poultry and reproduction.
Did you miss veterinary work?
Not at all. The other three days a week I
worked in the local government hospital. I
soon found myself scrubbing up to assist
with caesarian sections, inguinal hernias,
lump removals and stitch ups (of which, due
to the slightly erratic motorbike driving
habits of the locals, there were many!). Take
a very busy local hospital with, in all honesty,
not enough doctors, and the help of a vet
suddenly became very useful. Having eight
years of general surgical experience, I was
amazed just how similar the jobs were the
surgical handling, techniques and equipment
were identical, the main difference being
that I was less likely to get bitten!! Obviously
a big problem is the HIV/AIDS epidemic, but
the government has really tried to increase
awareness, and this included us going into
schools with doctors and talking to children
who are sadly all too aware of the disease
and its consequences.
So what did you learn and would you
do another trip?
I was totally moved by the warmth and
humility of the Ugandans, their ability to
accept help graciously and the generosity
shown towards me given how much I have in
comparison to how little they have. I learned
being a vet wasnt all about just being a vet.
The skills we get taught are useful in so may
more ways than simply in a consulting room,
the ability to adapt to the situation as it
arises, to be able to explain and teach
information, and so importantly the ability
to communicate. Sounds gushy, but I
definitely came back to work realising how
lucky I am. Now if I can just persuade work
to let me have some more time off
CPD DIARY
companion | 27
CPD
DIARY
3
September
Thursday
Angiostongylus
Speaker Sheila Brennan
The VSSCo, Lisburn. Northern Irish Region
Details from Shane Murray, shane@
braemarvetclinic.co.uk, or VetNI,
028 25898543, info@vetni.co.uk
EVENING
MEETING
9
September
Wednesday
Orthopaedics: the diagnosis
and management of carpal
and tarsal problems
Speaker Hamish Denny
The University of Bristol, Langford
House, Langford, North Somerset
BS40 5DU. South West Region
Details from Kate Rew,
kate@linhayvet.co.uk
EVENING
MEETING
10
September
Thursday
Preparing for bonfire night
special. Drugs used to treat
behaviour/phobias
Speaker Danny Mills
The Acorn House Veterinary Surgery,
Linnet Way, Brickhill, Bedford
MK41 7HN. East Anglia Region.
Details from Graham Bilbrough,
graham-bilbrough@idexx.com
EVENING
MEETING
23
September
Wednesday
Management of
dermatophytes
Speaker Anita Patel
The Russell Hotel, 136 Boxley Road,
Maidstone, Kent ME14 2AE. Kent Region
Details from Hannah Perrin,
hannah@burnhamhousevets.com
EVENING
MEETING
1
September
Tuesday
Sending your dog to rehab
Speaker Fiona Doubleday
The Potters Heron Hotel, Ampfield,
Romsey, Hampshire S051 9ZF.
Southern Region
Details from Michelle Stead, 01722
321185, mmstead@btinternet.com
EVENING
MEETING
10
September
Thursday
Practical haematology:
detective work for nurses
Speaker Kostas Papaliouliotis
BSAVA, Woodrow House, 1 Telford
Way, Waterwells Business Park,
Quedgeley GL2 2AB.
Organised by BSAVA.
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
DAY
MEETING
13
September
Sunday
Considering behaviour in
veterinary medicine
Speaker Sarah Heath
The Pavilions of Harrogate, Great
Yorkshire Showground, Harrogate
HG2 8QZ. North East Region
Details from Karen Goff, 01924 275249,
northeastregion@bsava.com
DAY
MEETING
15
September
Tuesday
Endoscopy
Speaker P.J. Noble
The Swallow Hotel, Preston New Road,
Preston PR5 0UL. North West Region
Details from Simone der Weduwen,
01254 885248, beestenhof@
ntlworld.com
EVENING
MEETING
22
September
Tuesday
Oncology I
Speaker Rob Foale
BSAVA, Woodrow House, 1 Telford
Way, Waterwells Business Park,
Quedgeley GL2 2AB.
Organised by BSAVA.
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
DAY
MEETING
10
September
Thursday
ECGs for dummies like me
Speaker Geoff Culshaw
The L.A Lecture Theatre R(D)SVS,
Edinburgh. Scottish Region
Details from Claire Robertson,
07792 251003, claireadriennelamb@
hotmail.com
EVENING
MEETING
9
September
Wednesday
Haematology Road Show
Speakers Guillermo Couto and Michael Day
Day meeting at the Daventry Hotel,
Sedgemoor Way, Daventry,
Northamptonshire NN11 0SG.
Organised by BSAVA
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
11
September
Friday
Haematology Road Show
Speakers Guillermo Couto and Michael Day
Day meeting at Mottram Hall, Wilmslow
Road, Mottram St Andrew, Cheshire
SK10 4QT. Organised by BSAVA
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
14
September
Monday
Haematology Road Show
Speakers Guillermo Couto and Michael Day
Day meeting at the Marriot Hotel,
Kingfisher Way, Hinchingbrooke
Business Park, Huntingdon PE29 6FL.
Organised by BSAVA
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
16
September
Wednesday
Haematology Road Show
Speakers Guillermo Couto and Michael Day
Day meeting at the De Vere Hotel, Hook
Heath Road, Gorse Hill, Woking GU22
0QH. Organised by BSAVA
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
For further details of CPD courses in your area,
please visit www.bsava.com
Members price: 191.83 inc. VAT
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

Wednesday 9 September: Daventry Hotel, Northamptonshire

Friday 11 September: Mottram Hall, Cheshire

Monday 14 September: Marriott Hotel, Huntingdon

Wednesday 16 September: Gorse Hill, Woking

J
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Why is this dog bleeding? How do
I administer a blood transfusion?
Is it a spherocyte? When do I need to
request a Coombs test?
The answers to these and many other
questions will be addressed in
this full-day programme on
haematology in practice,
led by Professor
Guillermo Couto from
the Ohio State University
and supported by
Professor Michael Day
from the University of Bristol
For more information
or to book visit www.bsava.com,
email administration@bsava.com
or call 01452 726700
Haematology
Road Show