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Caroline Hewson Expertise Series Webinar 1

Caroline Hewson

Caroline Hewson Expertise Series Webinar 1

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Introduction to Veterinary Physiotherapy

Katie Meredith

Katie Meredith will discuss Introduction to Veterinary Physiotherapy. The Role of The Veterinary Physiotherapist in General Practice. The role of Physiotherapy within all realms of human medicine is well established and used for anything from rehabilitation post surgery, injury or neurological insult to cardiac rehabilitation, respiratory care, and optimising performance in the human athlete. As an evidence based allied health profession, Physiotherapy forms an essential part of the multidisciplinary approach to human treatment. This lecture aims to explore the role of the Veterinary Physiotherapist within the General Veterinary Practice team, discussing what the Physiotherapist looks for on assessment, the kind of conditions that Physiotherapy can influence and touching upon the type of treatment modalities used. Physiotherapists use a comprehensive assessment process looking at the animal’s movement patterns (orthopaedic and neurological components), muscle balance and function, and a thorough palpatory examination in order to identify the problems that are then listed to form a treatment plan. This treatment plan ensures that each issue is addressed in order to manage the presenting condition as well as any compensatory changes that may have occurred, with the overall aims being to decrease pain, optimise function and normalise movement. This lecture will also discuss the legal requirement for Veterinary referral, the information required in that referral and the topic of protection of title.

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Common endoparasitic worms of UK cats and dogs: a guide to their management

Ian Wright

Ian Wright will discuss Common endoparasitic worms of UK cats and dogs: a guide to their management. Parasite treatment and control, along with vaccination, forms the cornerstone of routine, but vital, disease prevention in first opinion practice. It also forms a core part of improving human health, as many parasites of pets are also zoonoses. This webinar considers endoparasitic worms of cats and dogs, their epidemiology, clinical significance, zoonotic potential, treatment and control. It will aim to put the knowledge of life cycles and pathogenesis learnt in the early years of Vet school and places them in a practical, relevant context for 1st opinion practice. Rationales behind deworming frequency recommendations and practical control measures will be considered for intestinal roundworms such as Toxocara spp and hookworms, tapeworms such Echinococcus granulosus and Dipylidium caninum as well as for lungworms such as Angiostrongylus vasorum and Crenosoma vulpis. Between them, these parasites represent major health risks for UK pets and public alike.

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Safe Anaesthesia of Brachycephalic Patients

Louise O’Dwyer

Brachycephalics patients are a commonly encountered within veterinary practice, and require special consideration for anaesthesia due to the anatomical abnormalities which feature in these breeds. These abnormalities include: stenotic nares, an elongated soft palate, laryngeal collapse, hypoplastic trachea, and laryngeal saccule eversion. These abnormalities have been grouped together into what is known as brachycephalic syndrome. Clinical signs of brachycephalic syndrome are typical of upper airway obstructive disease and can include stridor, snoring, exercise intolerance, cyanosis and collapse.
When selecting pre-anaesthetic agents for these patients it is preferable to avoid those which may cause deep sedation as this can be associated with excessive relaxation of the upper airway muscles and result in worsening of obstruction. Any sedatives administered should be used at low doses.
Analgesic agenst should be selected for all surgical procedures, e.g. opioids, and should not be avoided due to concerns over respiratory depression, that said, as with all patients, brachycephalics should be closely observed once premedicants have been administered. Brachycephalic breeds tend to have a higher vagal tone than other breeds. Impulses from the vagus nerve result in parasympathetic effects such as bradycardia, bronchoconstriction, and excessive saliva formation. For these reasons it would be worth calculating the dosage of an anticholinergic should these effects become severe. It is highly recommended that brachycephalic patients are “pre-oxygenated” prior to induction of anaesthesia. Administration of 100% oxygen before induction of anesthesia prolongs the time to onset of arterial hypoxemia. This technique increases the body’s oxygen stores, primarily in the functional residual capacity (FRC) of the lungs. Induction should be rapid in order to gain control over the airway. When intubating a brachycephalic patient, expect to use a much smaller endotracheal tube, a wide variety of tube sizes should be selected. A laryngoscope is a necessary tool for intubation, as the amount of redundant tissue in the pharynx may reduce the visibility of the laryngeal opening. While under anesthesia patients can be maintained with inhaled anesthetic such as isoflurane or sevoflurane in 100% oxygen. Sevoflurane is metabolized faster than isoflurane allowing for a faster recovery. This may be an attractive choice when anesthetizing a brachycephalic patient. The recovery period is critical time for all patients undergoing anaesthesiam but particularly for the brachycephalic breeds. The timing of extubation in these patients is an important factor in the recover of these patients and it is important to remember that brachycephalics can sometimes desaturate during recovery, so a portable pulse oximeter is a useful tool during this period. Brachycephalic ideally should be recovered in sternal recumbency with their head slightly elevated. Many clinicians like to wait for brachycephalic patients to be awake and reacting to the presence of an endotracheal tube before it is removed. It is important to have additional induction agent and additional endotracheal tubes ready in recovery in the event that airway obstruction and re-intubation is needed.

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Micro pigs

Gayle Hallowell

Gayle Hallowell will discuss – Micro pigs. The pig, due to its behavioural traits and intelligence, frequently proves a significant challenge as a clinical patient. Added to that, the pet pig is often quite dominant and many owners are a little wary of their pet. There is a current interest in purchasing micro or teacup pigs. However these are not necessarily what their name suggests and clients frequently feel cheated and misled and I believe it is our responsibility to be able to guide people when their new pet grows ten times larger than they expected. The session will aim to cover the various breeds of pig kept as pets and what the current breed description of these micro and teacup pigs is. Although these animals are often beloved pets, they are food producing animals and as such we need to ensure that drugs used and advice given regarding their husbandry is appropriate and this will be covered in the session. As the pig is an omnivore, its anatomy and metabolism is similar, but not identical, to that of the dog, but physical examination findings differ. Frequently the major challenge with the pet pig is safe handling and restraint. This session will aim to cover handling, sedation, catheter placement and anaesthesia. With the focus on the pet pig I will then aim to discuss a problem based approach in these animals to enable a likely diagnosis to be reached. In addition I will endeavour to identify the most likely diseases that will be encountered in this unique group using some case examples. By the end of the talk, hopefully everyone will be looking forward to, rather than dreading the next pet pig that they see in their practice.

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Do lame cows get thin because they are lame or do thin cows get lame because they are thin? The digital cushion thickness story

Dr. Georgios Oikonomou

Several cross sectional studies have in the past shown that there is a strong association between body condition score and lameness, with lame cows found to be thinner than their healthy counterparts. This for long was thought to be a result of lameness; in other words, lame cows were thought to be thinner because they were lame. However, strong evidence now exists suggesting that the relationship is bidirectional. Thin cows may actually be more susceptible to specific lameness causing foot lesions and this could be associated with the thickness of their digital cushion. Interestingly, the role of genetics in this relationship is significant.

Dr. Georgios Oikonomou is a Lecturer of Livestock Health and Welfare at the School of Veterinary Science, University of Liverpool. He graduated from Aristotle University of Thessaloniki in 2002, and during his PhD studies he investigated the genetics of energy balance and reproduction in Holstein cows. He worked for a few years as a veterinarian/herd manager for a 600 cow dairy farm and then decided to cross the Atlantic and work for Cornell University and Dr. Rodrigo Bicalho. There, he got involved in research projects regarding dairy cattle lameness, mastitis, and reproductive diseases; he collaborated with large dairy farms, and was also introduced to the fascinating world of metagenomics. He still collaborates with Cornell University (recently appointed an Adjunct Assistant Professor position at the Department of Population Medicine) and is a co PI in a USDA funded grant that aims to study the dynamics of the mammary microbiota during and after intramammary infection with major mastitis pathogens.

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Don’t let complaints get you down’: Common concerns raised about veterinary professionals and how to avoid them

Eleanor Ferguson and Jerry Davies

In this webinar, Head of Professional Conduct Eleanor Ferguson and Chair of the Preliminary Investigation Committee (PIC) Jerry Davies will discuss some of the common concerns reported to the RCVS about veterinary surgeons and veterinary nurses, and give advice about how these can be avoided. They will also give an overview of how the RCVS concerns process works, highlighting recent changes to College procedures.

Eleanor is Head of the RCVS Professional Conduct Department, and also and oversees the Practice Standards Scheme. She qualified as a solicitor in Scotland in 1982, and in England & Wales in 1987. Originally specialising in litigation, Eleanor spent a number of years advising on inward investment and commercial projects in Asia and Egypt. In July 2004 Eleanor joined the RCVS to help develop the Practice Standards Scheme, which she has headed up ever since. Eleanor subsequently took on the role as Disciplinary Solicitor, and in 2013 became Head of the Professional Conduct department.

Jerry Davies graduated from the Royal Veterinary College in 1974. He is the Chairman of the Preliminary Investigation Committee (PIC). He spent 12 years in the RVC’s Department of Surgery as Houseman, Lecturer in Veterinary Radiology and, latterly, Senior Lecturer in Surgery. He is a Diplomate of the European Colleges of Veterinary Surgeons and Diagnostic Imaging; he is also a Scrutineer for the BVA/KC HD and ED schemes. Working in private referral practice since 1989, Jerry established Davies Veterinary Specialists in February 1998; he now works there part time, as a Radiologist and is Chairman of the Board. Jerry was the 2004 recipient of the BSAVA Simon Award for outstanding contributions to Small Animal Surgery.

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Alabama Rot: Current state of play

David Walker

David Walker will discuss Alabama Rot: Current state of play. Cutaneous and renal glomerular vasculopathy (CRGV or ‘Alabama rot’) is a disease of unknown aetiology that has recently been recognised in the United Kingdom. It is characterised by ulceration of the distal extremities and face in dogs and is variably associated with clinically significant renal azotaemia secondary to acute kidney injury. The disease has received a lot of media attention over the past twelve months and many dog owners are bringing their pets to vets wanting to know more about this disease. The webinar will review the presenting signs, clinical examination and clinpath findings in dogs with CRGV as well as reviewing possible causes of the disease in the UK.

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Getting good things done

Andrew Curwen

What makes for a really great veterinary practice? Based on what has worked in practice, Andrew will demonstrate why it is so important that we take the business of parasite management seriously. Looking at three key points in the interactions that we have with our clients and practice team, he will review those things that we can all do to ensure that we deliver effective healthcare and happy clients. Come along and compare your practice’s current activities, find out which are the most effective and take away some simple ideas to help you get more good things done. Andrew worked in mixed practice before join Grampian Pharmaceuticals as a Veterinary Adviser and then Bayer Animal Health where he became Marketing Manager. In 2006 Andrew joined XLVets, a collaborative group of independently owned veterinary practices. As Chief Executive he has been a part of a team that has developed a range of services and initiatives that enable the XLVet membership to define and deliver “excellence in practice”.

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Caring For Your Clients At Their Animals’ End-Of-Life: The total practice approach

Caroline Hewson

For most practices, a euthanasia appointment is a routine though demanding event—one professional procedure among many in a busy day. For most clients, however, it’s much more than that, being the beginning of a much longer experience of loss and grief. Most veterinary personnel approach their respective roles here with the utmost sympathy. Yet that is an incomplete and lay standard. Due to lack of training, it cannot be a fully professional one. Practices without a trained team risk avoidable difficulties e.g., ~30% of clients are haunted by their euthanasia decision; many vets (~10%) and vet nurses (~20%) say they have compassion fatigue; and ~13% of bereaved clients change practices—often because they “just can’t face” going back. To help practices avoid these inter-related problems, The Webinar Vet will soon launch some exciting new Expertise packages—-one for each sector of team. Created by Dr Caroline Hewson (The Pet Loss Vet), they’re tailored around the challenges of caring for grieving clients in busy, first-opinion and emergency practices. Like how best to handle a phone enquiry about euthanasia. And key elements when breaking bad news to someone you don’t know.

To give you a feel for how these Expertise packages might help in your practice, we’re kicking off with a free introductory webinar for the entire team. Join us on Wednesday May 6 at 1pm when we’ll be sketching out the territory and looking to hear from everyone about your biggest challenges in your piece of client-care at animals’ end-of-life.

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