Companion February2010

The essential publication for BSAVA members
Pets & Poisons

Work of the VPIS
P4
How To
Place an
oesophagostomy tube
P12
companion
FEBRUARY 2010
BSAVA Congress
Dentistry highlight
811 April
P21
Investigating
haemoptysis
in a young
Border Collie
01 OFC.indd 1 19/1/10 08:51:32
2
|
companion
companion
3 Member Benefits
Behaviour handouts one of the latest member benefits
47 Poison in Pets
John Bonner on the role of the VPIS and its future plans
811 Clinical Conundrum
Investigation of haemoptysis in a young Border Collie
1216 How To
Place an oesophagostomy tube
1720 Satellite Meetings at BSAVA Congress
Dates and times for all the events
2122 Bit Between The Teeth at Congress
Details of dentistry lectures at Congress 2010
23 Education
Courses from the BSAVA
2426 GrapeVINe
From the Veterinary Information Network
27 Petsavers
Latest fundraising news
2829 Publications
Exotic Pets the classic reborn
3032 WSAVA News
The World Small Animal Veterinary Association
3334 The companion Interview
Carmel Mooney
31 CPD Diary
Whats on in your area
Additional stock photography Dreamstime.com
Anna Utekhina; Daniel Rajszczak; Denis Babenko; Eriklam; Gerald Bernard;
Isselee; Judy Worley; Olena Adamenko; Robwilson39
companion is published monthly by the British Small
Animal Veterinary Association, Woodrow House,
1 Telford Way, Waterwells Business Park, Quedgeley,
Gloucester GL2 2AB. This magazine is a member
only benefit and is not available on subscription. We
welcome all comments and ideas for future articles.
Tel: 01452 726700
Email: companion@bsava.com
Web: www.bsava.com
ISSN: 2041-2487
Editorial Board
Editor Mark Goodfellow MA VetMB CertVR DSAM DipECVIM-CA MRCVS
Senior Vice-President Ed Hall MA VetMB PhD DipECVIM-CA MRCVS
CPD Editorial Team
Ian Battersby BVSc DSAM DipECVIM-CA MRCVS
Esther Barrett MA VetMB DVDI DipECVDI MRCVS
Simon Tappin MA VetMB CertSAM DipECVIM-CA MRCVS
Features Editorial Team
Caroline Bower BVM&S MRCVS
Andrew Fullerton BVSc (Hons) MRCVS
Design and Production
BSAVA Headquarters, Woodrow House
No part of this publication may be reproduced in any form without written permission
of the publisher. Views expressed within this publication do not necessarily represent
those of the Editor or the British Small Animal Veterinary Association.
For future issues, unsolicited features, particularly Clinical Conundrums, are
welcomed and guidelines for authors are available on request; while the publishers
will take every care of material received no responsibility can be accepted for any loss
or damage incurred.
BSAVA is committed to reducing the environmental impact of its publications wherever
possible and companion is printed on paper made from sustainable resources and
can be recycled. When you have finished with this edition please recycle it in your
kerbside collection or local recycling point. Members can access the online archive of
companion at www.bsava.com .
A key benefit of membership
More and more new titles and editions are released every year,
and as a member you get these invaluable and popular additions
to your veterinary library at great discounts on the non-member
price, making it a key benefit of membership. Add to this unique
promotional discounts and special offers for members and your
practice library A-Z will soon be brimming with internationally
acclaimed veterinary advice and detailed procedures.
New publications your library could be missing
BSAVA Manual of Canine and Feline
Behavioural Medicine 2nd edition
This manual builds on the success of the first
edition; the editors have again brought together a
host of international experts on behavioural
medicine of dogs and cats. Designed to be even
more practical and user-friendly, this title comes
complete with history-taking forms, questionnaires and a collection
of client handouts on a CD, so that you have the tools to hand to
carry out the recommended actions.
Member price 49.00, subsidised by over a third on the cost
to non-members
BSAVA Manual of Exotic Pets 5th edition
This new edition remains the Foundation Manual for
information across the range of exotic pets, from
small mammals, through birds, reptiles and
amphibians, to invertebrates. More common pets
retain their place but the Manual covers the
ever-increasing range of non-traditional pets
encountered by the veterinary surgeon, such as marsupials, ratites
and crocodilians.
to non-members
Top up your library
Our huge range of veterinary
publications now exceeds 40 titles
and includes the latest in veterinary
medicine in practice. This, when
combined with exclusive member
discounts, knowledgeable staff and
fast delivery, means that the BSAVA
bookstore is your one-stop-shop for
your veterinary library. Buy online,
over the phone, or in person at
BSAVA Congress; there is no better
time to top up your practice library
Visit www.bsava.com today for more information on all
Manuals in our series and news of special offers, buy online to
save on P&P and make sure you continue to develop your
knowledge bank and career.
02 Page 2.indd 2 19/1/10 08:56:27
companion
|
3
MEMBER BENEFITS
BSAVA is adding to the list of member benefits by providing
handouts, now available at www.bsava.com, to inform clients
about behaviour issues in cats and dogs
The BSAVA Manual of Canine and Feline Behavioural Medicine,
2nd edition contains a wealth of further information to help the general
and aspiring specialist practitioner to expand their knowledge with useful
information that can be readily applied to their daily practice. Visit our
online bookshop at www.bsava.com or call 01452 726700 for more
information and to purchase your copy.
A
ll members of the BSAVA can now get free
access to a series of client handouts and
questionnaires on canine and feline
behaviour, available to download from the
Membership page at www.bsava.com simply
log in, go to the Membership page and click on
Access to Manual Handouts.
These handouts are taken from the new edition of
the BSAVA Manual of Canine and Feline Behavioural
Medicine and are designed to enable vets to create a
detailed and functional treatment plan for their
patients. Each document is provided as a PDF file with
a text box in the top right hand corner where you can
add your practice details before printing out. For those
of you buying the Manual, the handouts are also
provided on a CD in the back of the book.
Promoting animal welfare
Behavioural medicine has advanced rapidly and it is
important that practitioners have access to the best
and most up-to-date information. The handouts cover
a wide range of topics and can be divided into four
categories. The handouts on behaviour problems include
issues such as handling aggressive behaviour, house
soiling, and stressful situations such as noise, car
journeys and visits to the vet. A series of forms on new
pets covers training and playing with puppies and
kittens, and introducing new pets to the household
including adopting rescue animals. Other forms give
general training guidance and exercises for owners.
Everyones aim is to achieve the best for companion
animals in terms of their health and welfare, and sharing
this new information should help in shedding some of the
myths about canine and feline behaviour.
Assessing the pets environment
The final broad category of forms covers how to improve
the pets environment, including considerations in animal
shelter settings. In addition, a series of client questionnaires
is included owners can be asked to complete these
before or during the initial consultation. Finally we have
also provided the referral form approved by the
Companion Animal Behaviour Therapy Study Group, for
use when referring cases for behavioural consultations.
You tell us
The BSAVA continually strives to provide its members
with tools to assist their veterinary practice and contribute
to professional development. We aim to develop and
expand the resources available on our website and
welcome your suggestions for information that would be
useful for your practice. Please email your comments and
suggestions to companion@bsava.com
Behaviour
Handouts
now available
03 Page 3.indd 3 19/1/10 08:48:56
2
|
companion
companion
3 Member Benefits
Behaviour handouts one of the latest member benefits
47 Poison in Pets
John Bonner on the role of the VPIS and its future plans
811 Clinical Conundrum
Investigation of haemoptysis in a young Border Collie
1216 How To
Place an oesophagostomy tube
1720 Satellite Meetings at BSAVA Congress
Dates and times for all the events
2122 Bit Between The Teeth at Congress
Details of dentistry lectures at Congress 2010
23 Education
Courses from the BSAVA
2426 GrapeVINe
From the Veterinary Information Network
27 Petsavers
Latest fundraising news
2829 Publications
Exotic Pets the classic reborn
3032 WSAVA News
The World Small Animal Veterinary Association
3334 The companion Interview
Carmel Mooney
31 CPD Diary
Whats on in your area
Additional stock photography Dreamstime.com
Anna Utekhina; Daniel Rajszczak; Denis Babenko; Eriklam; Gerald Bernard;
Isselee; Judy Worley; Olena Adamenko; Robwilson39
companion is published monthly by the British Small
Animal Veterinary Association, Woodrow House,
1 Telford Way, Waterwells Business Park, Quedgeley,
Gloucester GL2 2AB. This magazine is a member
only benefit and is not available on subscription. We
welcome all comments and ideas for future articles.
Tel: 01452 726700
Email: companion@bsava.com
Web: www.bsava.com
ISSN: 2041-2487
Editorial Board
Editor Mark Goodfellow MA VetMB CertVR DSAM DipECVIM-CA MRCVS
Senior Vice-President Ed Hall MA VetMB PhD DipECVIM-CA MRCVS
CPD Editorial Team
Ian Battersby BVSc DSAM DipECVIM-CA MRCVS
Esther Barrett MA VetMB DVDI DipECVDI MRCVS
Simon Tappin MA VetMB CertSAM DipECVIM-CA MRCVS
Features Editorial Team
Caroline Bower BVM&S MRCVS
Andrew Fullerton BVSc (Hons) MRCVS
Design and Production
BSAVA Headquarters, Woodrow House
No part of this publication may be reproduced in any form without written permission
of the publisher. Views expressed within this publication do not necessarily represent
those of the Editor or the British Small Animal Veterinary Association.
For future issues, unsolicited features, particularly Clinical Conundrums, are
welcomed and guidelines for authors are available on request; while the publishers
will take every care of material received no responsibility can be accepted for any loss
or damage incurred.
BSAVA is committed to reducing the environmental impact of its publications wherever
possible and companion is printed on paper made from sustainable resources and
can be recycled. When you have finished with this edition please recycle it in your
kerbside collection or local recycling point. Members can access the online archive of
companion at www.bsava.com .
A key benefit of membership
More and more new titles and editions are released every year,
and as a member you get these invaluable and popular additions
to your veterinary library at great discounts on the non-member
price, making it a key benefit of membership. Add to this unique
promotional discounts and special offers for members and your
practice library A-Z will soon be brimming with internationally
acclaimed veterinary advice and detailed procedures.
New publications your library could be missing
BSAVA Manual of Canine and Feline
Behavioural Medicine 2nd edition
This manual builds on the success of the first
edition; the editors have again brought together a
host of international experts on behavioural
medicine of dogs and cats. Designed to be even
more practical and user-friendly, this title comes
complete with history-taking forms, questionnaires and a collection
of client handouts on a CD, so that you have the tools to hand to
carry out the recommended actions.
to non-members
BSAVA Manual of Exotic Pets 5th edition
This new edition remains the Foundation Manual for
information across the range of exotic pets, from
small mammals, through birds, reptiles and
amphibians, to invertebrates. More common pets
retain their place but the Manual covers the
ever-increasing range of non-traditional pets
encountered by the veterinary surgeon, such as marsupials, ratites
and crocodilians.
to non-members
Top up your library
Our huge range of veterinary
publications now exceeds 40 titles
and includes the latest in veterinary
medicine in practice. This, when
combined with exclusive member
discounts, knowledgeable staff and
fast delivery, means that the BSAVA
bookstore is your one-stop-shop for
your veterinary library. Buy online,
over the phone, or in person at
BSAVA Congress; there is no better
time to top up your practice library
Visit www.bsava.com today for more information on all
Manuals in our series and news of special offers, buy online to
save on P&P and make sure you continue to develop your
knowledge bank and career.
02 Page 2.indd 2 19/1/10 08:56:27
companion
|
3
MEMBER BENEFITS
BSAVA is adding to the list of member benefits by providing
handouts, now available at www.bsava.com, to inform clients
about behaviour issues in cats and dogs
The BSAVA Manual of Canine and Feline Behavioural Medicine,
2nd edition contains a wealth of further information to help the general
and aspiring specialist practitioner to expand their knowledge with useful
information that can be readily applied to their daily practice. Visit our
online bookshop at www.bsava.com or call 01452 726700 for more
information and to purchase your copy.
A
ll members of the BSAVA can now get free
access to a series of client handouts and
questionnaires on canine and feline
behaviour, available to download from the
Membership page at www.bsava.com simply
log in, go to the Membership page and click on
Access to Manual Handouts.
These handouts are taken from the new edition of
the BSAVA Manual of Canine and Feline Behavioural
Medicine and are designed to enable vets to create a
detailed and functional treatment plan for their
patients. Each document is provided as a PDF file with
a text box in the top right hand corner where you can
add your practice details before printing out. For those
of you buying the Manual, the handouts are also
provided on a CD in the back of the book.
Promoting animal welfare
Behavioural medicine has advanced rapidly and it is
important that practitioners have access to the best
and most up-to-date information. The handouts cover
a wide range of topics and can be divided into four
categories. The handouts on behaviour problems include
issues such as handling aggressive behaviour, house
soiling, and stressful situations such as noise, car
journeys and visits to the vet. A series of forms on new
pets covers training and playing with puppies and
kittens, and introducing new pets to the household
including adopting rescue animals. Other forms give
general training guidance and exercises for owners.
Everyones aim is to achieve the best for companion
animals in terms of their health and welfare, and sharing
this new information should help in shedding some of the
myths about canine and feline behaviour.
Assessing the pets environment
The final broad category of forms covers how to improve
the pets environment, including considerations in animal
shelter settings. In addition, a series of client questionnaires
is included owners can be asked to complete these
before or during the initial consultation. Finally we have
also provided the referral form approved by the
Companion Animal Behaviour Therapy Study Group, for
use when referring cases for behavioural consultations.
You tell us
The BSAVA continually strives to provide its members
with tools to assist their veterinary practice and contribute
to professional development. We aim to develop and
expand the resources available on our website and
welcome your suggestions for information that would be
useful for your practice. Please email your comments and
suggestions to companion@bsava.com
Behaviour
Handouts
now available
03 Page 3.indd 3 19/1/10 08:48:56
VPIS
4
|
companion
Poisons in pets
The Veterinary Poisons Information
Service at Guys Hospital in London
provides a vital function in our
profession proven recently when a
newspaper article about antifreeze
poisoning caused a furore and
potentially more cases. Manager
Alex Campbell tells John Bonner
about the role the service plays and
its plans for the future
04-07 Poisons.indd 4 19/1/10 08:54:56
companion
|
5
VPIS
A
poisonous item can prove especially toxic when
a story about it gets into the hands of a national
newspaper. So after Sunday Times columnist
Rod Liddle made an ill-judged contribution to the
animal welfare debate, staff at the VPIS prepared
themselves to deal with a flurry of calls asking for
advice on treating ethylene glycol toxicity in pets.
Liddles big idea was to write a piece applauding
the actions of Katherine Hall who left a tray of tuna
laced with antifreeze to keep her neighbours cats
out of her garden. Both cats died and she was
ordered to pay 1500 in compensation to the
distraught owner. The item brought angry protests
from the BSAVA, BVA and welfare charities, and
raised concerns at the VPIS over the risks of
copycat actions by other people with grievances
against their neighbours pets.
Alex Campbell says there was some evidence of
an increase in enquiries about possible antifreeze
toxicity to the unit in the weeks after the article
appeared. However, before they can say that there
was a significant effect, the staff will have to examine
the data carefully, including the information returning
from practices on the clinical outcomes.
Certainly, there have been incidents in the past in
which people who may not been aware of the toxicity
of a commonly available product were motivated to
use it after reading about its effects a spate of
suicides in the 1980s caused by people ingesting the
herbicide paraquat is the classic example, Alex says.
However, unless there is a rash of enquiries from the
same area, it may be difficult to pick out a sudden
increase against normal background levels,
particularly in early winter when there is an increased
risk of accidental exposure to antifreeze.
Reporting cases
Moreover, not all small animal practices in the
country are subscribers to the VPIS and those that
have already encountered poisoning cases involving
these compounds may no longer need any advice on
how to deal with them. So, the VPIS cannot give
definitive figures on the total numbers of poisoning
cases around the country involving any specific agent,
but it can highlight trends, as well as giving invaluable
guidance for dealing with specific cases.
In 2009, the 14 full time staff at the toxicology unit
handled about 22,000 enquiries from veterinary
practices. That is only part of their workload, as their
primary role is in taking calls from hospital doctors and
GPs on dealing with human poisoning cases. In
addition, they offer other specialist services, such as a
herbal and traditional Chinese medicine advice line
and assistance to the pharmaceutical industry in
conducting clinical trials.
About 1100 veterinary businesses and more than
2000 individual clinics subscribed to the service in
2008, according to the units latest annual report.
This is a 4% increase on registrations in the previous
year. The number of enquiries has also shown a steady
10 to 15% growth over the past few years. Since the
total number of incidents is unlikely to have grown
significantly, this probably reflects a greater awareness
by veterinary surgeons of the value of the service.
When the demand eventually does start to plateau, this
will probably give a more accurate picture of the
overall scale of the problem with poisoning cases in
small animal practice, Alex notes.
In the meantime, his colleagues are seeking to
fine-tune the service offered to subscribers with a
complete overhaul of a database which contains details
of more than 160,000 cases. The new system should be
up and running by April 2010 and will allow researchers
to analyse the data with much greater precision
picking out incidents by individual postcodes and
focussing on incidents in specific breeds.
Types of cases
The overwhelming majority of cases on the VPIS files
involve dogs, which are much more likely to become
the victims of accidental poisoning than cats. The
latter will more frequently ingest a toxin when licking off
a material that has contaminated their coat hence
incidents involving the pollen of lilies and home
decorating products are common reasons for
contacting the unit.
Of course, with dogs it is their undiscriminating
appetites that get them into trouble chocolate,
analgesic drugs and rodenticides are regular products
in the top 10 reports. Labrador Retrievers, Jack Russell
Terriers, West Highland Whites and Staffordshire Bull
Terriers are invariably among the most common
04-07 Poisons.indd 5 19/1/10 08:54:56
VPIS
4
|
companion
Poisons in pets
The Veterinary Poisons Information
Service at Guys Hospital in London
provides a vital function in our
profession proven recently when a
newspaper article about antifreeze
poisoning caused a furore and
potentially more cases. Manager
Alex Campbell tells John Bonner
about the role the service plays and
its plans for the future
04-07 Poisons.indd 4 19/1/10 08:54:56
companion
|
5
VPIS
A
poisonous item can prove especially toxic when
a story about it gets into the hands of a national
newspaper. So after Sunday Times columnist
Rod Liddle made an ill-judged contribution to the
animal welfare debate, staff at the VPIS prepared
themselves to deal with a flurry of calls asking for
advice on treating ethylene glycol toxicity in pets.
Liddles big idea was to write a piece applauding
the actions of Katherine Hall who left a tray of tuna
laced with antifreeze to keep her neighbours cats
out of her garden. Both cats died and she was
ordered to pay 1500 in compensation to the
distraught owner. The item brought angry protests
from the BSAVA, BVA and welfare charities, and
raised concerns at the VPIS over the risks of
copycat actions by other people with grievances
against their neighbours pets.
Alex Campbell says there was some evidence of
an increase in enquiries about possible antifreeze
toxicity to the unit in the weeks after the article
appeared. However, before they can say that there
was a significant effect, the staff will have to examine
the data carefully, including the information returning
from practices on the clinical outcomes.
Certainly, there have been incidents in the past in
which people who may not been aware of the toxicity
of a commonly available product were motivated to
use it after reading about its effects a spate of
suicides in the 1980s caused by people ingesting the
herbicide paraquat is the classic example, Alex says.
However, unless there is a rash of enquiries from the
same area, it may be difficult to pick out a sudden
increase against normal background levels,
particularly in early winter when there is an increased
risk of accidental exposure to antifreeze.
Reporting cases
Moreover, not all small animal practices in the
country are subscribers to the VPIS and those that
have already encountered poisoning cases involving
these compounds may no longer need any advice on
how to deal with them. So, the VPIS cannot give
definitive figures on the total numbers of poisoning
cases around the country involving any specific agent,
but it can highlight trends, as well as giving invaluable
guidance for dealing with specific cases.
In 2009, the 14 full time staff at the toxicology unit
handled about 22,000 enquiries from veterinary
practices. That is only part of their workload, as their
primary role is in taking calls from hospital doctors and
GPs on dealing with human poisoning cases. In
addition, they offer other specialist services, such as a
herbal and traditional Chinese medicine advice line
and assistance to the pharmaceutical industry in
conducting clinical trials.
About 1100 veterinary businesses and more than
2000 individual clinics subscribed to the service in
2008, according to the units latest annual report.
This is a 4% increase on registrations in the previous
year. The number of enquiries has also shown a steady
10 to 15% growth over the past few years. Since the
total number of incidents is unlikely to have grown
significantly, this probably reflects a greater awareness
by veterinary surgeons of the value of the service.
When the demand eventually does start to plateau, this
will probably give a more accurate picture of the
overall scale of the problem with poisoning cases in
small animal practice, Alex notes.
In the meantime, his colleagues are seeking to
fine-tune the service offered to subscribers with a
complete overhaul of a database which contains details
of more than 160,000 cases. The new system should be
up and running by April 2010 and will allow researchers
to analyse the data with much greater precision
picking out incidents by individual postcodes and
focussing on incidents in specific breeds.
Types of cases
The overwhelming majority of cases on the VPIS files
involve dogs, which are much more likely to become
the victims of accidental poisoning than cats. The
latter will more frequently ingest a toxin when licking off
a material that has contaminated their coat hence
incidents involving the pollen of lilies and home
decorating products are common reasons for
contacting the unit.
Of course, with dogs it is their undiscriminating
appetites that get them into trouble chocolate,
analgesic drugs and rodenticides are regular products
in the top 10 reports. Labrador Retrievers, Jack Russell
Terriers, West Highland Whites and Staffordshire Bull
Terriers are invariably among the most common
04-07 Poisons.indd 5 19/1/10 08:54:56
VPIS
Poisons in pets
victims in these incidents, he says. The numbers of
serious incidents involving long-acting anticoagulant
rodenticides is a particular concern at the moment
following the withdrawal of the only oral vitamin K
based antidote available in the UK
. Often it will be
impractical for these animals to receive the number of
doses of the injectible product needed every day to
counteract an agent with such a long half life. This is
something we will be watching very closely, Alex says.
Working with the profession
The success of the VPIS initiative has been entirely
dependent on a two-way exchange of information
between the unit and its subscriber practices.
Following between 50 and 60% of enquiries, the unit
sends a form requesting further details of the case and
its outcomes. About half of those forms are returned
an impressively high response rate for any
questionnaire survey. Yes, it helps that we send these
out with a reply paid envelope and that most veterinary
practices are small organisations in which people
remember the details of a case. But I think the main
reason why the return rate is so good is that vets
appreciate that their efforts matter. The information that
they can give goes straight into the database where it
helps to refine the advice that we are able to give. Our
subscribers feel that they have ownership of this
information and long may that remain so.
Many vets will also know how lucky they are to
have a dedicated national veterinary toxicology
service. Outside the UK, there are only two
comparable initiatives that Alex is aware of. These are
a poisons information service run by a leading US
welfare charity and a French scheme, which is mainly
geared towards farm animal cases. Moreover, the
latter does not attempt to provide the sort of 24 hour,
365 day service that VPIS provides.
VPIS has some subscribers in the Irish Republic
and also gives advice on veterinary issues to the
human toxicology services that operate in many EU
neighbours. However, while it has considered the
possibility of extending the service to veterinary
surgeons abroad, this is not an immediate priority.
Alex points out that there are risks in trying to provide
advice to veterinary surgeons in situations where there
are major linguistic and cultural differences. Even in
countries like Australia and South Africa with a
common language, the major differences in the local
flora and fauna could affect our ability to provide a
comprehensive information service.
Future of the Service
So the long-term future of the service will depend on
Alexs employer, the Guys and St Thomas NHS
Foundation Trust, reaching an equitable arrangement
with its veterinary customers that will allow the service
to at least meet its running costs.
This is bound to result in changes to the current
arrangements under which subscribers pay a single
annual fee based on the numbers of veterinarians
employed in the practice. Alex points out that this may
not be an attractive option for a small practice which
rarely has any need to contact the service. On the
other hand, it is often a very attractive arrangement for
large practices and those providing a dedicated
emergency service providers, which make a growing
proportion of the out-of-hours calls.
Future arrangements are likely to be more like a
mobile telephone contract, with all subscribers
paying a small annual registration fee and then
buying a call package which allows them so many
enquiries over the period of the contract. Under this
sort of pay-per-use arrangement, the cost of each
enquiry will be set at a notional 20 to 25; being
more transparent than the current arrangements, this
can then be charged back to the pet-owning client.
VPIS managers have considered whether the
charges should include a time element to take
account of the complexity of the enquiry or whether it
was made as an evening or weekend call. However,
for simplicity, it is likely that all enquiries will be treated
exactly the same.
Practices should find these arrangements easier to
manage, particularly after the VPIS has finalised the
development of a software package that will allow
client practices to monitor their account online and to
buy credit for further enquiries whenever it is needed.
VPIS hopes these arrangements will be in place by the
end of next year.
One situation in which these arrangements may not
suit the practice is in the case of triage calls where
the pet owners initial telephone enquiry does not
result in a chargeable consultation. In that scenario,
the veterinary practice will either have to overcome the
professions traditional reluctance to charge for
telephone advice or they should simply accept the
financial penalty of having to make a call to the VPIS,
Alex notes.
Communication
To date, the VPIS has kept a fairly low public profile,
dealing almost exclusively with medical professionals
and making little effort to interact with the general
See: www.bsava.com/News/FeaturedArticles/
AvailabilityofVitaminK/tabid/706/Default.aspx
6
|
companion
04-07 Poisons.indd 6 19/1/10 08:54:56
companion
|
7
VPIS
WHEN REPORTING A POISON
For any member of staff at a veterinary practice who takes a call about a presumed toxicological emergency, it is a good idea to
begin the conversation by taking the clients contact details, in case the connection is lost. They should then try to get the essential
details from the client that will shape the later clinical management of the case but be warned, this is no simple task if the client
is distressed.
The first questions should relate to the patient. It is vital to know the following details:
Species
Breed
Age
Sex
Weight (a best estimate may have to do)
Other details past medical history, whether pregnant or lactating and whether on any current medication
The client should then be asked essential details about the presumed poison:
Full name of the product (as it appears on the packaging)
The strength/concentration of the active ingredients
The manufacturers name
Other components (including solvents and excipients)
Presentation or packaging details (tablets, capsules, bottle, etc.)
Presentation during the incident (whether concentrated or diluted, etc.)
For plants and other natural materials which part was consumed (leaves, berries, etc.)
Quantity of material ingested (it can be helpful to ask how much remains in order to assess how much has been consumed)
The practice will also need to know some other details, such as when the exposure occurred. The first obvious step is to prevent any
further contact with the toxin and to check on the safety of any other animals that are not currently showing clinical signs. Clients
should be warned to avoid coming into contact with the presumed toxin themselves. If it is appropriate for the client to attend the
surgery with their animal; they should be asked to bring along a sample of the product or packaging.
There are many sources of useful information, such as standard toxicology textbooks, that can be useful in directing treatment of the
patient. The Internet can be a helpful tool in obtaining details about a particular drug or plant but staff should be aware that much of
the information available online is unreferenced and may only relate to the effects of toxins in human patients. So the VPIS is the best
source of data specific to veterinary patients and can be accessed by any registered veterinary professional.
The service moved in November 2009 to new offices. Its full address is VPIS, Medical Toxicology Information Service,
Mary Sheridan House, Guys Hospital, Great Maze Pond, London SE1 9RT
Tel 020 7188 0200 Fax 020 7188 0700 Email vpis@gstt.nhs.uk
public. However, in another change of policy, its staff
are planning to start communicating more directly with
pet owners by posting information on its website
www.vpisuk.co.uk on toxicology issues. Much of this
will involve brochures and other downloadable
documents produced in association with animal
charities and veterinary organisations. They hope that
improving the quality of information publicly available
will reduce the number of false alarms, causing less
stress for the owner and avoiding needless activity for
their veterinary staff.
VPIS is also planning to improve the quality of the
dialogue that it has with its subscriber practices. This
will include the production of a newsletter drawing
attention to issues such as that mentioned earlier the
recent withdrawal of a key treatment used against a
common cause of poisoning in pet animals. For many
years, VPIS staff have provided regular training for
veterinary students and now plans to extend their CPD
activities with one-day courses for veterinary surgeons
and VNs. There are also plans for VPIS staff to meet
their clients face to face, with stands in the exhibitions
at BSAVA Congress and other major professional
meetings, Alex explains.
VPIS
I think the main reason why the return
rate is so good is that vets appreciate
that their efforts matter. The information
that they can give goes straight into the
database where it helps to refine the
advice that we are able to give
04-07 Poisons.indd 7 19/1/10 08:54:58
VPIS
Poisons in pets
victims in these incidents, he says. The numbers of
serious incidents involving long-acting anticoagulant
rodenticides is a particular concern at the moment
following the withdrawal of the only oral vitamin K
based antidote available in the UK
. Often it will be
impractical for these animals to receive the number of
doses of the injectible product needed every day to
counteract an agent with such a long half life. This is
something we will be watching very closely, Alex says.
Working with the profession
The success of the VPIS initiative has been entirely
dependent on a two-way exchange of information
between the unit and its subscriber practices.
Following between 50 and 60% of enquiries, the unit
sends a form requesting further details of the case and
its outcomes. About half of those forms are returned
an impressively high response rate for any
questionnaire survey. Yes, it helps that we send these
out with a reply paid envelope and that most veterinary
practices are small organisations in which people
remember the details of a case. But I think the main
reason why the return rate is so good is that vets
appreciate that their efforts matter. The information that
they can give goes straight into the database where it
helps to refine the advice that we are able to give. Our
subscribers feel that they have ownership of this
information and long may that remain so.
Many vets will also know how lucky they are to
have a dedicated national veterinary toxicology
service. Outside the UK, there are only two
comparable initiatives that Alex is aware of. These are
a poisons information service run by a leading US
welfare charity and a French scheme, which is mainly
geared towards farm animal cases. Moreover, the
latter does not attempt to provide the sort of 24 hour,
365 day service that VPIS provides.
VPIS has some subscribers in the Irish Republic
and also gives advice on veterinary issues to the
human toxicology services that operate in many EU
neighbours. However, while it has considered the
possibility of extending the service to veterinary
surgeons abroad, this is not an immediate priority.
Alex points out that there are risks in trying to provide
advice to veterinary surgeons in situations where there
are major linguistic and cultural differences. Even in
countries like Australia and South Africa with a
common language, the major differences in the local
flora and fauna could affect our ability to provide a
comprehensive information service.
Future of the Service
So the long-term future of the service will depend on
Alexs employer, the Guys and St Thomas NHS
Foundation Trust, reaching an equitable arrangement
with its veterinary customers that will allow the service
to at least meet its running costs.
This is bound to result in changes to the current
arrangements under which subscribers pay a single
annual fee based on the numbers of veterinarians
employed in the practice. Alex points out that this may
not be an attractive option for a small practice which
rarely has any need to contact the service. On the
other hand, it is often a very attractive arrangement for
large practices and those providing a dedicated
emergency service providers, which make a growing
proportion of the out-of-hours calls.
Future arrangements are likely to be more like a
mobile telephone contract, with all subscribers
paying a small annual registration fee and then
buying a call package which allows them so many
enquiries over the period of the contract. Under this
sort of pay-per-use arrangement, the cost of each
enquiry will be set at a notional 20 to 25; being
more transparent than the current arrangements, this
can then be charged back to the pet-owning client.
VPIS managers have considered whether the
charges should include a time element to take
account of the complexity of the enquiry or whether it
was made as an evening or weekend call. However,
for simplicity, it is likely that all enquiries will be treated
exactly the same.
Practices should find these arrangements easier to
manage, particularly after the VPIS has finalised the
development of a software package that will allow
client practices to monitor their account online and to
buy credit for further enquiries whenever it is needed.
VPIS hopes these arrangements will be in place by the
end of next year.
One situation in which these arrangements may not
suit the practice is in the case of triage calls where
the pet owners initial telephone enquiry does not
result in a chargeable consultation. In that scenario,
the veterinary practice will either have to overcome the
professions traditional reluctance to charge for
telephone advice or they should simply accept the
financial penalty of having to make a call to the VPIS,
Alex notes.
Communication
To date, the VPIS has kept a fairly low public profile,
dealing almost exclusively with medical professionals
and making little effort to interact with the general
See: www.bsava.com/News/FeaturedArticles/
AvailabilityofVitaminK/tabid/706/Default.aspx
6
|
companion
04-07 Poisons.indd 6 19/1/10 08:54:56
companion
|
7
VPIS
WHEN REPORTING A POISON
For any member of staff at a veterinary practice who takes a call about a presumed toxicological emergency, it is a good idea to
begin the conversation by taking the clients contact details, in case the connection is lost. They should then try to get the essential
details from the client that will shape the later clinical management of the case but be warned, this is no simple task if the client
is distressed.
The first questions should relate to the patient. It is vital to know the following details:
Species
Breed
Age
Sex
Weight (a best estimate may have to do)
Other details past medical history, whether pregnant or lactating and whether on any current medication
The client should then be asked essential details about the presumed poison:
Full name of the product (as it appears on the packaging)
The strength/concentration of the active ingredients
The manufacturers name
Other components (including solvents and excipients)
Presentation or packaging details (tablets, capsules, bottle, etc.)
Presentation during the incident (whether concentrated or diluted, etc.)
For plants and other natural materials which part was consumed (leaves, berries, etc.)
Quantity of material ingested (it can be helpful to ask how much remains in order to assess how much has been consumed)
The practice will also need to know some other details, such as when the exposure occurred. The first obvious step is to prevent any
further contact with the toxin and to check on the safety of any other animals that are not currently showing clinical signs. Clients
should be warned to avoid coming into contact with the presumed toxin themselves. If it is appropriate for the client to attend the
surgery with their animal; they should be asked to bring along a sample of the product or packaging.
There are many sources of useful information, such as standard toxicology textbooks, that can be useful in directing treatment of the
patient. The Internet can be a helpful tool in obtaining details about a particular drug or plant but staff should be aware that much of
the information available online is unreferenced and may only relate to the effects of toxins in human patients. So the VPIS is the best
source of data specific to veterinary patients and can be accessed by any registered veterinary professional.
The service moved in November 2009 to new offices. Its full address is VPIS, Medical Toxicology Information Service,
Mary Sheridan House, Guys Hospital, Great Maze Pond, London SE1 9RT
Tel 020 7188 0200 Fax 020 7188 0700 Email vpis@gstt.nhs.uk
public. However, in another change of policy, its staff
are planning to start communicating more directly with
pet owners by posting information on its website
www.vpisuk.co.uk on toxicology issues. Much of this
will involve brochures and other downloadable
documents produced in association with animal
charities and veterinary organisations. They hope that
improving the quality of information publicly available
will reduce the number of false alarms, causing less
stress for the owner and avoiding needless activity for
their veterinary staff.
VPIS is also planning to improve the quality of the
dialogue that it has with its subscriber practices. This
will include the production of a newsletter drawing
attention to issues such as that mentioned earlier the
recent withdrawal of a key treatment used against a
common cause of poisoning in pet animals. For many
years, VPIS staff have provided regular training for
veterinary students and now plans to extend their CPD
activities with one-day courses for veterinary surgeons
and VNs. There are also plans for VPIS staff to meet
their clients face to face, with stands in the exhibitions
at BSAVA Congress and other major professional
meetings, Alex explains.
VPIS
I think the main reason why the return
rate is so good is that vets appreciate
that their efforts matter. The information
that they can give goes straight into the
database where it helps to refine the
advice that we are able to give
04-07 Poisons.indd 7 19/1/10 08:54:58
8
|
companion
CLINICAL CONUNDRUM
Clinical
conundrum
Create a Problem List based on the
history and physical examination
a) Coughing and Haemoptysis
b) Tachypnoea with shallow breathing, and abnormal
lung sounds
c) Pallor
d) Lethargy, inappetence and weakness
What differential diagnoses should be
considered at this stage
The causes of haemoptysis following a period of
coughing can be split into those associated with
pulmonary or cardiac diseases. Defects of coagulation,
either congenital or acquired (rodenticide toxicity), are
unlikely to cause coughing for a prolonged period prior
to the development of haemoptysis but cannot be
completely excluded on this basis.
V n ascular
Cardiogenic pulmonary oedema (left-sided
heart disease) typically pink-tinged rather
than haemorrhagic fluid
Ruptured arteriovenous fistula (rarely causes
haemoptysis)
Bacterial endocarditis (rarely causes
haemoptysis)
Pulmonary hypertension: Congenital or
acquired cardiac defects that result in shunting
of blood (rarely causes haemoptysis)
Pulmonary thromboembolism: Secondary to
neoplastic, endocrine, cardiac, metabolic
disease (rarely causes haemoptysis)
I n nflammatory/Infectious
Chronic bronchitis/bronchiectasis
Bacterial pneumonia
Pulmonary abscess
Parasites: Angiostrongylus vasorum
Eosinophilic bronchopneumopathy
T n rauma: Pulmonary contusion; tracheal rupture;
foreign body (FB)
A n nomalous: Lung lobe torsion (rarely causes
haemoptysis)
N n eoplasia: Primary lung and tracheal tumours;
metastatic disease.
It is most likely that the tachypneoa, abnormal lung
sounds and shallow breathing pattern are caused by
the same pathology as that causing the coughing
and haemoptysis.
Pallor is indicative of poor perfusion and could be
associated with compromise of the cardiorespiratory
system or by anaemia. Investigation of the differentials
of haemoptysis should elucidate if this clinical sign
requires investigation in its own right,
Lethargy, inappetence and weakness are non-
specific signs of systemic disease, and investigation
into the system-specific problems is likely to elucidate
their cause.
What initial investigations would you
consider?
Thoracic radiography will be the first step in this case.
It will give information to further localise the cause of
the haemoptysis to the cardiovascular or respiratory
system and will provide some information as to the
nature of the pathological process occurring. In light of
the pallor, and the (slight) possibility of a coagulopathy,
blood samples should be taken to assess PCV, platelet
number and clotting profile.
Gawain Hammond of the Faculty of Veterinary
Medicine, University of Glasgow and
Chairman of EAVDI (British & Irish Division)
invites companion readers to consider the
investigation of haemoptysis in a young
Border Collie
Case presentation
A 2-year-old male Border Collie presented with a one week history
of progressive lethargy and inappetence, with shallow breathing,
coughing and the development of haemoptysis in the last 48 hours.
Treatment with antibiotics and non-steroidal anti-inflammatories had
produced little improvement.
On physical examination, the mucous membranes were pale, and
bilaterally increased harsh lung sounds were discovered on thoracic
auscultation. The patient was weak, but without obvious
neurological deficits and there was evidence of tachypnoea and
shallow breathing.
08-11 Clinical Conundrum.indd 8 19/1/10 08:42:01
companion
|
9
CLINICAL CONUNDRUM
What is your interpretation of the thoracic

radiographs (Figure 1)?
Right lateral, left lateral and dorsoventral thoracic
radiographs are shown. On both of the lateral
radiographs there is a diffuse patchy alveolar pattern
over the cardiac silhouette, with a further area of
increased pulmonary soft tissue opacity in the
caudodorsal thoracic cavity. This area appears more
rounded and well-defined on the right lateral
radiograph compared to the left lateral radiograph.
On the dorsoventral radiograph, the increased
caudodorsal pulmonary opacity can be seen to be
affecting the left caudal lung lobe area, with a
moderately well-defined consolidated lung lobe with
some air bronchograms (indicating an alveolar pattern)
seen in the left caudal thoracic cavity, adjacent to the
apex of the cardiac silhouette. There is a lobar sign at
the cranial and medial margins of the left caudal lung
lobe (giving sharper delineation of the margins of the
affected lobe) indicating that there is lobar
consolidation. There is no evidence of mediastinal shift
to suggest collapse of this lung lobe.
The radiological diagnosis is that of consolidation
of the left caudal lung lobe and some suspicion of a
diffuse alveolar pattern affecting the more
cranioventral lung fields.
What is your interpretation of the
haematology results?
Parameter Result Reference range
RBC 5.7 5.58.5 x 10
12
/l
Hb 14.2 12.018.0 g/dl
PCV 38 3755 %
MCV 66.7 60.077.0 fl
MCH 25 19.524.5 pg
MCHC 37.4 32.036.0 g/dl
WBC 24.5 6.012.0 x 10
9
/l
Neutrophils 21.07 3.011.8 x 10
9
/l
Lymphocytes 0.98 1.04.8 x 10
9
/l
Monocytes 1.47 0.151.35 x 10
9
/l
Eosinophils 0 0.11.25 x 10
9
/l
Basophils 0 0 x 10
9
/l
Platelets 93 200500 x 10
9
/l
Table 1: Haematological results
Figure 1: Thoracic
radiographs
A Right lateral
B Left lateral
C Dorsoventral
A
B
C
8
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companion
CLINICAL CONUNDRUM
Clinical
conundrum
Create a Problem List based on the
history and physical examination
a) Coughing and Haemoptysis
b) Tachypnoea with shallow breathing, and abnormal
lung sounds
c) Pallor
d) Lethargy, inappetence and weakness
What differential diagnoses should be
considered at this stage
The causes of haemoptysis following a period of
coughing can be split into those associated with
pulmonary or cardiac diseases. Defects of coagulation,
either congenital or acquired (rodenticide toxicity), are
unlikely to cause coughing for a prolonged period prior
to the development of haemoptysis but cannot be
completely excluded on this basis.
V n ascular
Cardiogenic pulmonary oedema (left-sided
heart disease) typically pink-tinged rather
than haemorrhagic fluid
Ruptured arteriovenous fistula (rarely causes
haemoptysis)
Bacterial endocarditis (rarely causes
haemoptysis)
Pulmonary hypertension: Congenital or
acquired cardiac defects that result in shunting
of blood (rarely causes haemoptysis)
Pulmonary thromboembolism: Secondary to
neoplastic, endocrine, cardiac, metabolic
disease (rarely causes haemoptysis)
I n nflammatory/Infectious
Chronic bronchitis/bronchiectasis
Bacterial pneumonia
Pulmonary abscess
Parasites: Angiostrongylus vasorum
Eosinophilic bronchopneumopathy
T n rauma: Pulmonary contusion; tracheal rupture;
foreign body (FB)
A n nomalous: Lung lobe torsion (rarely causes
haemoptysis)
N n eoplasia: Primary lung and tracheal tumours;
metastatic disease.
It is most likely that the tachypneoa, abnormal lung
sounds and shallow breathing pattern are caused by
the same pathology as that causing the coughing
and haemoptysis.
Pallor is indicative of poor perfusion and could be
associated with compromise of the cardiorespiratory
system or by anaemia. Investigation of the differentials
of haemoptysis should elucidate if this clinical sign
requires investigation in its own right,
Lethargy, inappetence and weakness are non-
specific signs of systemic disease, and investigation
into the system-specific problems is likely to elucidate
their cause.
What initial investigations would you
consider?
Thoracic radiography will be the first step in this case.
It will give information to further localise the cause of
the haemoptysis to the cardiovascular or respiratory
system and will provide some information as to the
nature of the pathological process occurring. In light of
the pallor, and the (slight) possibility of a coagulopathy,
blood samples should be taken to assess PCV, platelet
number and clotting profile.
Gawain Hammond of the Faculty of Veterinary
Medicine, University of Glasgow and
Chairman of EAVDI (British & Irish Division)
invites companion readers to consider the
investigation of haemoptysis in a young
Border Collie
Case presentation
A 2-year-old male Border Collie presented with a one week history
of progressive lethargy and inappetence, with shallow breathing,
coughing and the development of haemoptysis in the last 48 hours.
Treatment with antibiotics and non-steroidal anti-inflammatories had
produced little improvement.
On physical examination, the mucous membranes were pale, and
bilaterally increased harsh lung sounds were discovered on thoracic
auscultation. The patient was weak, but without obvious
neurological deficits and there was evidence of tachypnoea and
shallow breathing.
companion
|
9
CLINICAL CONUNDRUM
What is your interpretation of the thoracic

radiographs (Figure 1)?
Right lateral, left lateral and dorsoventral thoracic
radiographs are shown. On both of the lateral
radiographs there is a diffuse patchy alveolar pattern
over the cardiac silhouette, with a further area of
increased pulmonary soft tissue opacity in the
caudodorsal thoracic cavity. This area appears more
rounded and well-defined on the right lateral
radiograph compared to the left lateral radiograph.
On the dorsoventral radiograph, the increased
caudodorsal pulmonary opacity can be seen to be
affecting the left caudal lung lobe area, with a
moderately well-defined consolidated lung lobe with
some air bronchograms (indicating an alveolar pattern)
seen in the left caudal thoracic cavity, adjacent to the
apex of the cardiac silhouette. There is a lobar sign at
the cranial and medial margins of the left caudal lung
lobe (giving sharper delineation of the margins of the
affected lobe) indicating that there is lobar
consolidation. There is no evidence of mediastinal shift
to suggest collapse of this lung lobe.
The radiological diagnosis is that of consolidation
of the left caudal lung lobe and some suspicion of a
diffuse alveolar pattern affecting the more
cranioventral lung fields.
What is your interpretation of the
haematology results?
Parameter Result Reference range
RBC 5.7 5.58.5 x 10
12
/l
Hb 14.2 12.018.0 g/dl
PCV 38 3755 %
MCV 66.7 60.077.0 fl
MCH 25 19.524.5 pg
MCHC 37.4 32.036.0 g/dl
WBC 24.5 6.012.0 x 10
9
/l
Neutrophils 21.07 3.011.8 x 10
9
/l
Lymphocytes 0.98 1.04.8 x 10
9
/l
Monocytes 1.47 0.151.35 x 10
9
/l
Eosinophils 0 0.11.25 x 10
9
/l
Basophils 0 0 x 10
9
/l
Platelets 93 200500 x 10
9
/l
Table 1: Haematological results
Figure 1: Thoracic
radiographs
A Right lateral
B Left lateral
C Dorsoventral
A
B
C
10
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companion
CLINICAL CONUNDRUM
Clinical conundrum
The haematology shows a marked leucocytosis and
neutrophilia, some showing toxic changes, suggestive
of an acute inflammatory or infectious process. There
is also a mild thrombocytopenia. Clotting profiles were
within normal limits.
In light of the radiographic and
haematological findings refine your
differential diagnosis list
Differential diagnoses for a lobar consolidation include
lobar pneumonia (bacterial, foreign body, fungal, etc.),
lobar neoplasia, lobar haemorrhage, atelectic change
and lung lobe torsion. In this case there is no evidence
of mediastinal shift towards the affected lobe to
suggest atelectasis (collapse) and there is no evidence
of pleural effusion or distortion of the bronchial tree
seen to suggest lung lobe torsion. The major
differential diagnoses for the more diffuse alveolar
pattern seen cranioventrally include pneumonia,
pulmonary haemorrhage, pulmonary oedema and
possibly pulmonary neoplasia.
Haematological changes are not consistent with a
coagulopathy as the cause of the observed clinical
signs but instead could be caused by any infectious or
inflammatory focus.
What further diagnostic procedures
could you consider without
anaesthetising the patient?
Where there is pulmonary lobar consolidation,
ultrasound investigation of the lung can be considered.
As long as there is not aerated lung interposed
between the thoracic wall and the consolidated area of
lung, the lung can be viewed via an intercostal
approach. This will require a transducer with a small
footprint or contact area phased array and
microconvex transducers are particularly useful for this.
The parenchyma of the consolidated lung can be
assessed for the presence of bronchial structures and
gas bubbles (which may give a starry appearance of
brightly echogenic foci with distal shadowing) and also
for the homogeneity of the lung parenchyma. A diffusely
hypoechoic lung with uniform echotexture may be seen
with atelectasis, lobar pneumonia, lobar haemorrhage
or lung lobe torsion in these cases the lung often
resembles the ultrasonographic image of liver.
A more heterogenous parenchyma with loss of the
normal shape and occasionally more defined rounded
areas may be seen with lobar neoplasia, granuloma
formation or abscessation. Where the lung is
completely consolidated, bronchi may be seen as
structures with parallel slightly hyperechoic walls and
an anechoic centre due to the presence of fluid within
the bronchial lumen.
What is your interpretation of ultrasound
images from this case?
Both are still images taken of the consolidated left
caudal lung lobe using an intercostal approach.
Figure 2a shows consolidated lung parenchyma
with a heterogenous appearance the cursors
B A
Figure 2
companion
|
11
CLINICAL CONUNDRUM
indicate the margins of a rounded fairly well-defined
nodular area with uneven echogenicity within the lung
parenchyma. Figure 2b shows a tubular structure with
anechoic luminal content traversing the area of
consolidated lung being imaged. Within the lumen of
this tubular structure is a linear hyperechoic structure
(indicated by the cursor). In addition, in this section of
the consolidated lung lobe, multiple hyperechoic
speckles, some with faint distal reverberation, can be
seen, consistent with air bubbles within the
parenchyma of the lung. The tubular structure may be
a fluid-filled bronchus or a blood vessel however no
flow could be detected in this structure using Doppler
imaging, suggesting a bronchus was more likely.
The sonographic findings indicate consolidation
with alteration of the parenchyma of the left caudal
lung lobe, suggesting abscessation, granuloma
formation or neoplasia. The hyperechoic structure
within the bronchus was suspected to be a bronchial
foreign body (possibly a grass seed).
What are your final conclusions from the
results of the imaging studies?
Combining the results of the radiographic and
ultrasonographic studies, the suggestion is of a lobar
pneumonia ( lobar haemorrhage) with abscessation
or granuloma formation due to the presence of a
bronchial foreign body. There is also a suspicion of
more diffuse pneumonia and/or pulmonary
haemorrhage affecting other lung lobes.
What further steps and therapy could be
considered?
In this case, after the patient was stabilised and
anaesthetised, bronchoscopy was performed.
However, the haemorrhage within the bronchial tree
prevented a final diagnosis being reached. At this
stage, options for further investigation would include
thoracic CT or surgical exploration.
The patient was taken to surgery, where a left
7th intercostal thoracotomy was performed. The left
caudal lung lobe was swollen and solid on palpation,
with visible abscessation formation at the
caudodorsal tip. There were multiple areas where the
parenchyma was disrupted, and no functional tissue
EAVDI-BID ABSTRACT PRIZE
The British and Irish Division of the European Association of Veterinary
Diagnostic Imaging (EAVDI-BID) organises two annual meetings (one
pre-BSAVA satellite meeting in Birmingham the day before BSAVA
Congress, and one two-day autumn meeting, usually in October or
November) covering a wide range of imaging topics. Membership is open
to anyone with an interest in veterinary diagnostic imaging. Starting in
2010, the Division is creating a prize to be awarded to the best abstract
presented in the Diagnostic Imaging stream of the Clinical Research
Abstracts presented at the annual BSAVA Congress. The prize will consist
of a book voucher, as well as free registration for the subsequent
EAVDI-BID Autumn meeting, where the winning author will be invited to
present the abstract. If there are any queries, please visit the EAVDI-BID
website (http://cheval.vet.gla.ac.uk/EVDI/ea-bed.htm) or email
g.hammond@vet.gla.ac.uk
could be identified in the lobe. The entire lobe was
removed, and when the bronchial tree was opened, a
chain of multiple grass seeds was found in the
bronchial tree. No evidence of pyothorax or
mediastinal disease was found.
The patient recovered well following surgery, and
was discharged four days after surgery. A swab taken
from the excised lung lobe showed a significant
growth of Escherichia coli.
Use of ultrasound in pulmonary disease
Ultrasonography of the thoracic cavity is not limited to
echocardiography. As long as there is not aerated
lung interposed between the transducer and the
structure of interest, ultrasound examination can add
valuable information to that obtained from thoracic
radiography regarding pulmonary, pleural and
mediastinal disease. The easiest method is to identify
the area of the thoracic wall overlying the lesion from
the thoracic radiographs, and to place the transducer
between the intercostal spaces in this area.
If the lesion is in contact with the thoracic wall,
the parenchymal appearance can be assessed.
In addition, fine needle aspirates of peripheral
pulmonary or large mediastinal masses or pleural
effusions can be obtained under ultrasound guidance
for further analysis. n
10
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companion
CLINICAL CONUNDRUM
Clinical conundrum
The haematology shows a marked leucocytosis and
neutrophilia, some showing toxic changes, suggestive
of an acute inflammatory or infectious process. There
is also a mild thrombocytopenia. Clotting profiles were
within normal limits.
In light of the radiographic and
haematological findings refine your
differential diagnosis list
Differential diagnoses for a lobar consolidation include
lobar pneumonia (bacterial, foreign body, fungal, etc.),
lobar neoplasia, lobar haemorrhage, atelectic change
and lung lobe torsion. In this case there is no evidence
of mediastinal shift towards the affected lobe to
suggest atelectasis (collapse) and there is no evidence
of pleural effusion or distortion of the bronchial tree
seen to suggest lung lobe torsion. The major
differential diagnoses for the more diffuse alveolar
pattern seen cranioventrally include pneumonia,
pulmonary haemorrhage, pulmonary oedema and
possibly pulmonary neoplasia.
Haematological changes are not consistent with a
coagulopathy as the cause of the observed clinical
signs but instead could be caused by any infectious or
inflammatory focus.
What further diagnostic procedures
could you consider without
anaesthetising the patient?
Where there is pulmonary lobar consolidation,
ultrasound investigation of the lung can be considered.
As long as there is not aerated lung interposed
between the thoracic wall and the consolidated area of
lung, the lung can be viewed via an intercostal
approach. This will require a transducer with a small
footprint or contact area phased array and
microconvex transducers are particularly useful for this.
The parenchyma of the consolidated lung can be
assessed for the presence of bronchial structures and
gas bubbles (which may give a starry appearance of
brightly echogenic foci with distal shadowing) and also
for the homogeneity of the lung parenchyma. A diffusely
hypoechoic lung with uniform echotexture may be seen
with atelectasis, lobar pneumonia, lobar haemorrhage
or lung lobe torsion in these cases the lung often
resembles the ultrasonographic image of liver.
A more heterogenous parenchyma with loss of the
normal shape and occasionally more defined rounded
areas may be seen with lobar neoplasia, granuloma
formation or abscessation. Where the lung is
completely consolidated, bronchi may be seen as
structures with parallel slightly hyperechoic walls and
an anechoic centre due to the presence of fluid within
the bronchial lumen.
What is your interpretation of ultrasound
images from this case?
Both are still images taken of the consolidated left
caudal lung lobe using an intercostal approach.
Figure 2a shows consolidated lung parenchyma
with a heterogenous appearance the cursors
B A
Figure 2
companion
|
11
CLINICAL CONUNDRUM
indicate the margins of a rounded fairly well-defined
nodular area with uneven echogenicity within the lung
parenchyma. Figure 2b shows a tubular structure with
anechoic luminal content traversing the area of
consolidated lung being imaged. Within the lumen of
this tubular structure is a linear hyperechoic structure
(indicated by the cursor). In addition, in this section of
the consolidated lung lobe, multiple hyperechoic
speckles, some with faint distal reverberation, can be
seen, consistent with air bubbles within the
parenchyma of the lung. The tubular structure may be
a fluid-filled bronchus or a blood vessel however no
flow could be detected in this structure using Doppler
imaging, suggesting a bronchus was more likely.
The sonographic findings indicate consolidation
with alteration of the parenchyma of the left caudal
lung lobe, suggesting abscessation, granuloma
formation or neoplasia. The hyperechoic structure
within the bronchus was suspected to be a bronchial
foreign body (possibly a grass seed).
What are your final conclusions from the
results of the imaging studies?
Combining the results of the radiographic and
ultrasonographic studies, the suggestion is of a lobar
pneumonia ( lobar haemorrhage) with abscessation
or granuloma formation due to the presence of a
bronchial foreign body. There is also a suspicion of
more diffuse pneumonia and/or pulmonary
haemorrhage affecting other lung lobes.
What further steps and therapy could be
considered?
In this case, after the patient was stabilised and
anaesthetised, bronchoscopy was performed.
However, the haemorrhage within the bronchial tree
prevented a final diagnosis being reached. At this
stage, options for further investigation would include
thoracic CT or surgical exploration.
The patient was taken to surgery, where a left
7th intercostal thoracotomy was performed. The left
caudal lung lobe was swollen and solid on palpation,
with visible abscessation formation at the
caudodorsal tip. There were multiple areas where the
parenchyma was disrupted, and no functional tissue
EAVDI-BID ABSTRACT PRIZE
The British and Irish Division of the European Association of Veterinary
Diagnostic Imaging (EAVDI-BID) organises two annual meetings (one
pre-BSAVA satellite meeting in Birmingham the day before BSAVA
Congress, and one two-day autumn meeting, usually in October or
November) covering a wide range of imaging topics. Membership is open
to anyone with an interest in veterinary diagnostic imaging. Starting in
2010, the Division is creating a prize to be awarded to the best abstract
presented in the Diagnostic Imaging stream of the Clinical Research
Abstracts presented at the annual BSAVA Congress. The prize will consist
of a book voucher, as well as free registration for the subsequent
EAVDI-BID Autumn meeting, where the winning author will be invited to
present the abstract. If there are any queries, please visit the EAVDI-BID
website (http://cheval.vet.gla.ac.uk/EVDI/ea-bed.htm) or email
g.hammond@vet.gla.ac.uk
could be identified in the lobe. The entire lobe was
removed, and when the bronchial tree was opened, a
chain of multiple grass seeds was found in the
bronchial tree. No evidence of pyothorax or
mediastinal disease was found.
The patient recovered well following surgery, and
was discharged four days after surgery. A swab taken
from the excised lung lobe showed a significant
growth of Escherichia coli.
Use of ultrasound in pulmonary disease
Ultrasonography of the thoracic cavity is not limited to
echocardiography. As long as there is not aerated
lung interposed between the transducer and the
structure of interest, ultrasound examination can add
valuable information to that obtained from thoracic
radiography regarding pulmonary, pleural and
mediastinal disease. The easiest method is to identify
the area of the thoracic wall overlying the lesion from
the thoracic radiographs, and to place the transducer
between the intercostal spaces in this area.
If the lesion is in contact with the thoracic wall,
the parenchymal appearance can be assessed.
In addition, fine needle aspirates of peripheral
pulmonary or large mediastinal masses or pleural
effusions can be obtained under ultrasound guidance
for further analysis. n
12
|
companion
HOW TO
How to
Place an
oesophagostomy tube
Clinical nutrition is an often neglected but
crucial part of patient management, and
nutritional support may be required for a
variety of patients. Using material from two
exciting new BSAVA publications, co-editors
Nick Bexfield and Penny Watson explain
when and how to place and use an
oesophagostomy tube
When to consider nutritional support
Special nutritional support (i.e. a change to a high-
calorie, high-protein diet and/or assisted (tube)
feeding) should be considered in cases of:
Recent weight loss: Has the dog or cat lost >10%
of its bodyweight not due to dehydration or obvious
fluid shifts (e.g. diuresis)?
This is relevant even in obese animals: weight
loss in an obese, sick animal will
predominantly be attributed to loss of lean
body mass rather than fat and this is
undesirable. Weight loss and anorexia in an
obese cat are particularly worrying because of
the risk of hepatic lipidosis.
Partial or complete anorexia for >3 days: Has
the dog or cat eaten <85% of its calculated resting
energy requirement (RER) for the last three or
more days?
Animal in very catabolic state or at risk of overt
malnutrition:
Does the animal have: severe burns; draining
sepsis, such as pyothorax or septic peritonitis;
malabsorption or protein-losing enteropathy;
or nephropathy?
If so, is it receiving enough calories and/or
protein?
Is there an obvious loss of weight or lean body
mass to suggest it is not?
Routes of enteral support
There are a few important general rules for feeding
hospitalised animals:
1. IF THE GUT WORKS, USE IT
(applies to the vast majority of our patients).
2. If only PART of the gut works,
use THAT part of the gut.
3. When feeding enterally, use the simplest route
possible which avoids stress to the animal.
4. Appetite stimulants are NOT very effective acutely
and are best reserved for when the patient has
been discharged home and is recuperating.
There are a number of advantages of feeding
animals enterally, which is why every effort should be
made to feed animals in this way. Note: Before
nutritional interventions are initiated, the patient must
be stable cardiovascularly and have had any fluid,
electrolyte and acidbase abnormalities addressed.
There are many enteral feeding methods available
to the practising veterinary surgeon, ranging from oral
or force-feeding to a number of tube-feeding methods.
When using any syringe- or force-feeding method, it is
important to ensure that the animal is receiving a
significant amount of its daily caloric requirements. If it
is not, or if it is becoming stressed by the procedure,
some sort of feeding tube should be placed.
The choice of tubes includes:
Naso-oesophageal
Oesophageal
Gastrostomy (placed at laparotomy or as a
percutaneous endoscopic gastrostomy (PEG))
Jejunostomy.
12-16 How To.indd 12 19/1/10 08:40:57
companion
|
13
HOW TO
The feeding route selected for a particular animal

is based on the following decision-making process.
Jejunostomy tubes are used only if there is a specific
contraindication to placing a tube more proximally in
the GI tract.
The decision-making process
Is the feeding tube going to be required long
term? If so, consider gastrostomy/PEG or
oesophagostomy tube and NOT naso-
oesophageal tube.
Is there a specific contraindication to one or
more tube types? For example, a naso-
oesophageal tube would be contraindicated in
nasal disease; both oesophagostomy and
naso-oesophageal tubes are contraindicated
where there is oesophageal disease (such as
megaoesophagus or oesophagitis).
Is there an anaesthetic risk that makes tube
placement under anaesthetic an unacceptable
hazard? If so, naso-oesophageal tube placement
should be considered as it does not require a
general anaesthetic. This could be used as a
temporary measure until the animal was well
enough for a general anaesthetic and more
long-term tube placement.
What types of diet does the patient require?
Naso-oesophageal tubes require liquid diets,
whereas gastrostomy and oesophagostomy tubes
are of a wider bore and so a greater range of gruel
diets can be used.
It is extremely important to include the owner in the
decision-making process, as they must be willing and
able to provide the necessary nutrition if the animal is
to be able to go home. Many owners can handle the
three or four feedings per day that are typically
required for oesophagostomy or PEG tubes.
Oesophagostomy tubes offer advantages to
practitioners over PEG tubes. Oesophagostomy tubes
can be placed without specialized equipment or
expertise. In addition, whilst they require anaesthesia
for proper placement, the amount of time required is
much shorter than for other procedures. For these
reasons, these tubes are a useful method of providing
enteral nutrition in the practice setting.
Oesophagostomy tubes should not be placed in
animals with the following conditions:
Comatose, recumbent or dysphoric animals at risk
of aspiration
Persistent vomiting the tube may be expelled or
retroflexed into the nasopharynx
Oesophagitis or severe oesophageal dysfunction
(e.g. megaoesophagus).
Cellulitis is the major complication seen after
oesophagostomy tube placement. Oesophageal
stricture formation and fistula formation are possible
but very rare.
Placement technique
The equipment you will need is listed in Box 1. General
anaesthesia is required. The patient is placed in right
lateral recumbency, and lateral and ventral aspects of
the neck prepared aseptically over an area from the
angle of the jaw to the shoulder.
Box 1
EQUIPMENT
Oesophagostomy tube (red rubber tube,
standard polyurethane feeding tube or
silicone feeding tube):
Cats: 1014 Fr; 23 cm long
Dogs: 1424 Fr; 40 cm long
Long curved forceps, e.g. RochesterCarmalt
No. 15 or 20 scalpel blade and holder
25 mm wide adhesive tape
Non-absorbable suture material, needle and
needle-holders
Sterile dressing to cover the tube site
Light bandage for the neck
Cotton wool or soft swabs
4% chlorhexidine gluconate or 10%
povidoneiodine
70% surgical spirit
1 sterile fenestrated skin drape
12-16 How To.indd 13 19/1/10 08:40:58
12
|
companion
HOW TO
How to
Place an
oesophagostomy tube
Clinical nutrition is an often neglected but
crucial part of patient management, and
nutritional support may be required for a
variety of patients. Using material from two
exciting new BSAVA publications, co-editors
Nick Bexfield and Penny Watson explain
when and how to place and use an
oesophagostomy tube
When to consider nutritional support
Special nutritional support (i.e. a change to a high-
calorie, high-protein diet and/or assisted (tube)
feeding) should be considered in cases of:
Recent weight loss: Has the dog or cat lost >10%
of its bodyweight not due to dehydration or obvious
fluid shifts (e.g. diuresis)?
This is relevant even in obese animals: weight
loss in an obese, sick animal will
predominantly be attributed to loss of lean
body mass rather than fat and this is
undesirable. Weight loss and anorexia in an
obese cat are particularly worrying because of
the risk of hepatic lipidosis.
Partial or complete anorexia for >3 days: Has
the dog or cat eaten <85% of its calculated resting
energy requirement (RER) for the last three or
more days?
Animal in very catabolic state or at risk of overt
malnutrition:
Does the animal have: severe burns; draining
sepsis, such as pyothorax or septic peritonitis;
malabsorption or protein-losing enteropathy;
or nephropathy?
If so, is it receiving enough calories and/or
protein?
Is there an obvious loss of weight or lean body
mass to suggest it is not?
Routes of enteral support
There are a few important general rules for feeding
hospitalised animals:
1. IF THE GUT WORKS, USE IT
(applies to the vast majority of our patients).
2. If only PART of the gut works,
use THAT part of the gut.
3. When feeding enterally, use the simplest route
possible which avoids stress to the animal.
4. Appetite stimulants are NOT very effective acutely
and are best reserved for when the patient has
been discharged home and is recuperating.
There are a number of advantages of feeding
animals enterally, which is why every effort should be
made to feed animals in this way. Note: Before
nutritional interventions are initiated, the patient must
be stable cardiovascularly and have had any fluid,
electrolyte and acidbase abnormalities addressed.
There are many enteral feeding methods available
to the practising veterinary surgeon, ranging from oral
or force-feeding to a number of tube-feeding methods.
When using any syringe- or force-feeding method, it is
important to ensure that the animal is receiving a
significant amount of its daily caloric requirements. If it
is not, or if it is becoming stressed by the procedure,
some sort of feeding tube should be placed.
The choice of tubes includes:
Naso-oesophageal
Oesophageal
Gastrostomy (placed at laparotomy or as a
percutaneous endoscopic gastrostomy (PEG))
Jejunostomy.
12-16 How To.indd 12 19/1/10 08:40:57
companion
|
13
HOW TO
The feeding route selected for a particular animal

is based on the following decision-making process.
Jejunostomy tubes are used only if there is a specific
contraindication to placing a tube more proximally in
the GI tract.
The decision-making process
Is the feeding tube going to be required long
term? If so, consider gastrostomy/PEG or
oesophagostomy tube and NOT naso-
oesophageal tube.
Is there a specific contraindication to one or
more tube types? For example, a naso-
oesophageal tube would be contraindicated in
nasal disease; both oesophagostomy and
naso-oesophageal tubes are contraindicated
where there is oesophageal disease (such as
megaoesophagus or oesophagitis).
Is there an anaesthetic risk that makes tube
placement under anaesthetic an unacceptable
hazard? If so, naso-oesophageal tube placement
should be considered as it does not require a
general anaesthetic. This could be used as a
temporary measure until the animal was well
enough for a general anaesthetic and more
long-term tube placement.
What types of diet does the patient require?
Naso-oesophageal tubes require liquid diets,
whereas gastrostomy and oesophagostomy tubes
are of a wider bore and so a greater range of gruel
diets can be used.
It is extremely important to include the owner in the
decision-making process, as they must be willing and
able to provide the necessary nutrition if the animal is
to be able to go home. Many owners can handle the
three or four feedings per day that are typically
required for oesophagostomy or PEG tubes.
Oesophagostomy tubes offer advantages to
practitioners over PEG tubes. Oesophagostomy tubes
can be placed without specialized equipment or
expertise. In addition, whilst they require anaesthesia
for proper placement, the amount of time required is
much shorter than for other procedures. For these
reasons, these tubes are a useful method of providing
enteral nutrition in the practice setting.
Oesophagostomy tubes should not be placed in
animals with the following conditions:
Comatose, recumbent or dysphoric animals at risk
of aspiration
Persistent vomiting the tube may be expelled or
retroflexed into the nasopharynx
Oesophagitis or severe oesophageal dysfunction
(e.g. megaoesophagus).
Cellulitis is the major complication seen after
oesophagostomy tube placement. Oesophageal
stricture formation and fistula formation are possible
but very rare.
Placement technique
The equipment you will need is listed in Box 1. General
anaesthesia is required. The patient is placed in right
lateral recumbency, and lateral and ventral aspects of
the neck prepared aseptically over an area from the
angle of the jaw to the shoulder.
Box 1
EQUIPMENT
Oesophagostomy tube (red rubber tube,
standard polyurethane feeding tube or
silicone feeding tube):
Cats: 1014 Fr; 23 cm long
Dogs: 1424 Fr; 40 cm long
Long curved forceps, e.g. RochesterCarmalt
No. 15 or 20 scalpel blade and holder
25 mm wide adhesive tape
Non-absorbable suture material, needle and
needle-holders
Sterile dressing to cover the tube site
Light bandage for the neck
Cotton wool or soft swabs
4% chlorhexidine gluconate or 10%
povidoneiodine
70% surgical spirit
1 sterile fenestrated skin drape
12-16 How To.indd 13 19/1/10 08:40:58
14
|
companion
HOW TO
Place an
oesophagostomy tube
3. Bluntly dissect through the subcutaneous tissues and make an
incision into the oesophagus over the tips of the forceps.
4. Push the tips of the forceps outwards through the incision to the
external surface.
5. Measure the oesophagostomy tube from this point to the 7
th
intercostal
space (distal oesophagus) and mark the tube with a piece of adhesive
tape.
8. Disengage the tips of the forceps, curl the tip of
the tube back into the mouth and feed it into the
oesophagus.
7. Draw the end of the
feeding tube through
the oesophagostomy
incision and rostrally
into the pharynx to
exit the mouth.
6. Open the tips
of the forceps
and grasp the
distal end of
the feeding
tube.
11. Secure the tube by placement of a Chinese
finger-trap/Roman Sandal suture.
12. Take a thoracic radiograph to confirm correct
tube placement: the tip of the tube should be in
the distal oesophagus, not the stomach. If the
tube does have an integral radiodense marker,
iodinated (not barium) contrast medium can be
instilled into the tube to aid visualisation.
13. Cover the tube site with a sterile dressing and
place a soft padded loose neck bandage.
1. Insert the curved forceps through the mouth and into the oesophagus,
to the mid-cervical region.
2. Turn the tip of the forceps
laterally and use
the scalpel to
make a
510 mm skin
incision over
the point of
the tips.
9. Visually inspect the oropharynx to confirm that
the tube is no longer present in the oropharynx.
10. The tube should slide easily back and forth a few
millimetres, confirming that it has straightened.
Ilustrations drawn by Samantha Elmhurst (www.livingart.com)
and reproduced with her permission
12-16 How To.indd 14 19/1/10 08:40:59
companion
|
15
HOW TO
Meeting energy requirements

Determining the exact energy requirements of individual
patients is unfeasible in clinical practice as it would
require some form of direct or indirect calorimetry. A
more practical and sensible approach is to calculate the
patients resting energy requirement (RER), which
corresponds to the number of calories per day it needs
to meet basic needs. This is a very rough estimation
and may need adjusting in the long term, depending on
patient weight loss or gain. Recent studies show,
perhaps surprisingly, that there is not a great increase in
energy requirement associated with trauma, sepsis or
major surgery in dogs. Therefore, the RER is now used
as the baseline energy recommendation for
hospitalized dogs and cats, regardless of the disease or
surgery. A number of equations are used to estimate
RER; the simplest are shown in Box 2.
RESTING ENERGY
REQUIREMENT
RER (kcal) = 70 x bodyweight (kg)
0.75
or
RER (kcal) = 30 x bodyweight (kg) + 70
To convert kcal (Cal) to kilojoules (kJ) multiply
by 4.185
Box 2
estimated protein requirements for hospitalized dogs
and cats are:
Dogs: 57.5 g protein per 100 kcal fed
Cats: 69 g protein per 100 kcal fed.
Feeding schedule
Note that calculated food intake should not be
given immediately on the first day but introduced
gradually over 23 days to allow the animals
metabolism and gastrointestinal tract the time to
adapt. This is particularly important if using feeding
tubes. The stomachs capacity may reduce by up to
50% after as little as 48 hours of anorexia. In addition,
reduced gastric tone and emptying are features of
anorexia, along with changes in gastrointestinal flora
and metabolic changes, all of which need time to
adapt to the new diet.
Feeding can commence as soon as the patient
has recovered from general anaesthesia.
The daily requirement should be divided into
multiple (5 or 6) feeds per 24-hour day.
Before and after feeding each time , the tube
should be flushed with small amounts (510 ml) of
lukewarm tap water.
An anorexic cat
being fed through
an oesophagostomy
tube
(Courtesy of Rachel
Lumbis)
The RER can then be divided by the caloric density
of the diet to calculate the amount to be fed. It is worth
noting that EU petfood labelling regulations prohibit the
inclusion of the caloric density of diets on the tin or
bag, but the information can be obtained from product
guides or by contacting the manufacturer.
The RER should be viewed as a starting point and
the amount fed adjusted upwards (if continued weight
loss is apparent) or downwards (if the patient cannot
tolerate this amount, e.g. it vomits).
Meeting protein requirements
If using a balanced dog or cat diet, protein
requirements are typically met when the calculated
calories are fed. However, as a general guideline,
12-16 How To.indd 15 19/1/10 08:41:03
14
|
companion
HOW TO
Place an
oesophagostomy tube
3. Bluntly dissect through the subcutaneous tissues and make an
incision into the oesophagus over the tips of the forceps.
4. Push the tips of the forceps outwards through the incision to the
external surface.
5. Measure the oesophagostomy tube from this point to the 7
th
intercostal
space (distal oesophagus) and mark the tube with a piece of adhesive
tape.
8. Disengage the tips of the forceps, curl the tip of
the tube back into the mouth and feed it into the
oesophagus.
7. Draw the end of the
feeding tube through
the oesophagostomy
incision and rostrally
into the pharynx to
exit the mouth.
6. Open the tips
of the forceps
and grasp the
distal end of
the feeding
tube.
11. Secure the tube by placement of a Chinese
finger-trap/Roman Sandal suture.
12. Take a thoracic radiograph to confirm correct
tube placement: the tip of the tube should be in
the distal oesophagus, not the stomach. If the
tube does have an integral radiodense marker,
iodinated (not barium) contrast medium can be
instilled into the tube to aid visualisation.
13. Cover the tube site with a sterile dressing and
place a soft padded loose neck bandage.
1. Insert the curved forceps through the mouth and into the oesophagus,
to the mid-cervical region.
2. Turn the tip of the forceps
laterally and use
the scalpel to
make a
510 mm skin
incision over
the point of
the tips.
9. Visually inspect the oropharynx to confirm that
the tube is no longer present in the oropharynx.
10. The tube should slide easily back and forth a few
millimetres, confirming that it has straightened.
Ilustrations drawn by Samantha Elmhurst (www.livingart.com)
and reproduced with her permission
12-16 How To.indd 14 19/1/10 08:40:59
companion
|
15
HOW TO
Meeting energy requirements

Determining the exact energy requirements of individual
patients is unfeasible in clinical practice as it would
require some form of direct or indirect calorimetry. A
more practical and sensible approach is to calculate the
patients resting energy requirement (RER), which
corresponds to the number of calories per day it needs
to meet basic needs. This is a very rough estimation
and may need adjusting in the long term, depending on
patient weight loss or gain. Recent studies show,
perhaps surprisingly, that there is not a great increase in
energy requirement associated with trauma, sepsis or
major surgery in dogs. Therefore, the RER is now used
as the baseline energy recommendation for
hospitalized dogs and cats, regardless of the disease or
surgery. A number of equations are used to estimate
RER; the simplest are shown in Box 2.
RESTING ENERGY
REQUIREMENT
RER (kcal) = 70 x bodyweight (kg)
0.75
or
RER (kcal) = 30 x bodyweight (kg) + 70
To convert kcal (Cal) to kilojoules (kJ) multiply
by 4.185
Box 2
estimated protein requirements for hospitalized dogs
and cats are:
Dogs: 57.5 g protein per 100 kcal fed
Cats: 69 g protein per 100 kcal fed.
Feeding schedule
Note that calculated food intake should not be
given immediately on the first day but introduced
gradually over 23 days to allow the animals
metabolism and gastrointestinal tract the time to
adapt. This is particularly important if using feeding
tubes. The stomachs capacity may reduce by up to
50% after as little as 48 hours of anorexia. In addition,
reduced gastric tone and emptying are features of
anorexia, along with changes in gastrointestinal flora
and metabolic changes, all of which need time to
adapt to the new diet.
Feeding can commence as soon as the patient
has recovered from general anaesthesia.
The daily requirement should be divided into
multiple (5 or 6) feeds per 24-hour day.
Before and after feeding each time , the tube
should be flushed with small amounts (510 ml) of
lukewarm tap water.
An anorexic cat
being fed through
an oesophagostomy
tube
(Courtesy of Rachel
Lumbis)
The RER can then be divided by the caloric density
of the diet to calculate the amount to be fed. It is worth
noting that EU petfood labelling regulations prohibit the
inclusion of the caloric density of diets on the tin or
bag, but the information can be obtained from product
guides or by contacting the manufacturer.
The RER should be viewed as a starting point and
the amount fed adjusted upwards (if continued weight
loss is apparent) or downwards (if the patient cannot
tolerate this amount, e.g. it vomits).
Meeting protein requirements
If using a balanced dog or cat diet, protein
requirements are typically met when the calculated
calories are fed. However, as a general guideline,
12-16 How To.indd 15 19/1/10 08:41:03
16
|
companion
HOW TO
Place an
oesophagostomy tube
BSAVA GUIDE TO PROCEDURES IN
SMALL ANIMAL PRACTICE
Editors: Nick Bexfield and Karla Lee
This completely NEW publication features common diagnostic, medical, surgical and
emergency procedures in an easy-to-use A to Z listing. Indications, contraindications,
equipment, patient positioning and preparation, and potential complications are noted
for each procedure. The techniques themselves are presented in a step-by-step
format, augmented by photographs and specially commissioned drawings (examples
of which accompany this article). Lay-flat binding allows use in the clinic or lab setting.
Every paying member of BSAVA will receive one complimentary copy as part of their membership.
Members attending Congress will be able to collect them from the BSAVA Balcony, the rest will be
sent out in May.
BSAVA MANUAL OF CANINE AND FELINE
REHABILITATION, SUPPORTIVE AND
PALLIATIVE CARE: Case studies in patient
management
Editors: Penny Watson and Samantha Lindley
This unique publication shows how a team-based approach can be used to improve
patient outcomes. Part 1 presents the latest strategies for pain management, clinical
nutrition, and physical therapy and rehabilitation. The evidence base for therapies is discussed, with
reference to published studies. Part 2 uses a range of case scenarios to illustrate how medical and surgical
treatment, dietary advice, physiotherapy, hydrotherapy, acupuncture, nursing care and homecare
recommendations can form an integrated approach to the management of individual patients.
Available Summer 2010.
The food should be warmed to body temperature
and injected over several minutes.
If the animal shows regurgitation, vomiting or
diarrhoea after feeding, reduce the amount fed in
each meal and check that the food fed is warm
and iso-osmolar.
Tube care and removal
Once a day, the neck wrap and sterile dressing
should be removed and the stoma cleaned using
cotton wool or gauze swabs soaked in 4%
chlorhexidine gluconate or 10% povidoneiodine.
If oozing of purulent liquid suggests infection,
an antibiotic ointment can be applied. A new
sterile dressing is then applied and the neck
wrap replaced.
The oesophagostomy tube can be removed when
it is no longer required; unlike a gastrotomy tube there
is no minimum length of time an oesophagostomy tube
must have been in place prior to removal. To remove
the tube, take off the dressing, remove the suture and
pull the tube gently out. The stoma site will close
rapidly once the tube is removed, but skin sutures can
be placed if preferred.
Procedures in
Small Animal
Practice
Procedures in
Small Animal Practice
BSAVA Guide to
BSAVA Guide to
Nick Bexeld
and Karla Lee
B
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Contents
Abdominocentesis; ACTH response test; Anaphylaxis emergency treatment;
Arthrocentesis; Aseptic preparation; Barium contrast media; Barium studies of
the gastrointestinal tract; Blood pressure measurement; Bblood sampling; Blood
smear preparation; Blood transfusion; Bone biopsy needle; Bone marrow aspiration; Bronchoalveloar lavage; Bronchoscopy; Buccal mucosal bleeding time; Cardiopulmonarycerebral resuscitation; Cardiorespiratory examination;
Cast application; Cerebrospinal uid sampling; Cranial draw test; Cystocentesis;
Dexamethasone suppression tests; Diagnostic peritoneal lavage; Ehmer sling;
Elbow luxation closed reduction; Electrocardiography; Endoscopy of the gastrointestinal tract; Endotracheal wash; Fine needle aspiration; Fluorescein test;
Gastric decompression; Gastrostomy tube placement; Haemagglutination test;
Hip luxation closed reduction; Intraosseous cannula placement; Intravenous
catheter placement; Intravenous urography; Iodinated contrast media; Myringotomy;
Nasal oxygen administration; Naso-oesophageal tube placement; Neurological
examination; Oesophagostomy tube placement; Ophthalmic examination; Orthopaedic examination; Ortolani test; Otoscopy; Pericardiocentesis; Platelet
count; Prostatic wash; Resting energy requirement; Retrograde urethrography/
vaginourethrography; Rhinoscopy; Schirmer tear test; Seizures emergency protocol; Semen collection; Skin biopsy punch biopsy; Skin and hair sampling;
Soft padded bandage; Spica splint; Thoracocentesis needle; Thoracostomy tube
placement; Tibial compression test; Tissue biopsy needle core; Tracheostomy;
Transtracheal wash; Urethral catheterization; Urethral retrograde urohydropulsion;
Urinalysis; Velpeau sling; Water deprivation test; Whole blood clotting time
Edited by Nick Bexeld and Karla Lee
The BSAVA Guide to Procedures in Small Animal Practice provides
practical, step-by-step guidance on how to perform the diagnostic and
therapeutic procedures commonly performed in small animal veterinary
practice. In addition, routine clinical examination of the major body systems,
and protocols for the management of selected emergencies are described. In addition to the actual technique, each procedure has information on
indications and contraindications, equipment required, and potential
complications, together with the editors own hints and tips. Details of
BSAVA Manuals where wider information, such as interpretation of results,
are given throughout.
Special features:
A to Z format to aid information retrieval

Extensive cross-referencing in highlighted text

Specially commissioned drawings

Lay-at binding
This is a truly useful guide, which will provide a valuable and lasting reference
for veterinary surgeons, veterinary nurses and students alike.
ISBN 978 1 905319 17 6
12-16 How To.indd 16 19/1/10 08:41:04
companion
|
17
CONGRESS
Satellite meetings
at BSAVA Congress
BSAVA supports its Affiliated
Groups with funding and
promotion, as well as presenting
them with the opportunity to hold
a Satellite Meeting on the
Wednesday before Congress
(this year 7 April)
ABVA
Association of British
Veterinary Acupuncturists
Venue: Executive Room 1, ICC
Booking contact: Julie Cummings
Email: bmasgeneralmgr@aol.com
Website: www.abva.co.uk
Tel: +44 (0) 1606 786782
AVCPT
Association of Veterinary
Clinical Pharmacology and
Therapeutics
Venue: Hall 7a, ICC
Booking contact: Maria Gregory-
Carlton
Email: secretary@avcpt.org
Website: www.avcpt.org
The neurobiology of pain with
Dr Sue Fleetwood-Walker
Challenges facing new approaches to pain
management in animal species with
Dr Adrian Foster
PK/PD modelling and its relevance to
pharmacological pain intervention with
Ludovic Pelligand
Pain control in osteoarthritis with
Dr Dylan Clements
Acute Pain management in animals with
Dr Jo Murrell
The language of Pain: A human perspective with
Dr Mark Rockett
Panel discussion all speakers
100 for non-members; 70 for members; 70 for
students and residents. Lunch is included
AVSTS
Association for Veterinary
Soft Tissue Surgery
Venue: Hall 6, ICC
Booking contact: Alison Young
Email: avstsadmin@fsmail.net
Website: www.avsts.org.uk
Tel: +44 (0) 1707 666366 ex 2432
A Smrgsbord of topics awaits you at our Spring
meeting for 2010.
With a dazzling array of UK and international speakers
its sure to be a stimulating session.
BrAVO
British Association of
Veterinary Ophthalmologists
Venue: Hall 8a, ICC
Booking contact: Claudia Hartley
Email: claudia.hartley@aht.org.uk
Website: www.bravo.org.uk
Tel: +44 (0) 1638 552700
The British Association of Veterinary Ophthalmologists
(BrAVO) is an internationally recognised society of
veterinary ophthalmologists and vets with an interest in
ophthalmology. We have members not only from the
United Kingdom but also Hong Kong, Australia,
France, Belgium, Sweden, Italy and South Africa. We
are also honoured to have consultant ophthalmologists
from the human medical field as members. We are a
very sociable group, with over 250 members, and
newcomers are welcomed.
BrAVO organises two meetings each year, with
state-of-the-art lectures on all aspects of veterinary and
human ophthalmology. Our Spring meeting is a
one-day pre-BSAVA satellite meeting and includes
both local and international speakers. The winter
BAVEC
Veterinary Emergency Care
Venue: Crompton Room,
Austin Court
Booking contact: Jan MacDonald
Email: jan.macdonald@vets-now.com
Website: www.bavec.co.uk
Tel: +44 (0) 7785 741033
17-20 Satellite Groups.indd 17 19/1/10 08:52:39
16
|
companion
HOW TO
Place an
oesophagostomy tube
BSAVA GUIDE TO PROCEDURES IN
SMALL ANIMAL PRACTICE
Editors: Nick Bexfield and Karla Lee
This completely NEW publication features common diagnostic, medical, surgical and
emergency procedures in an easy-to-use A to Z listing. Indications, contraindications,
equipment, patient positioning and preparation, and potential complications are noted
for each procedure. The techniques themselves are presented in a step-by-step
format, augmented by photographs and specially commissioned drawings (examples
of which accompany this article). Lay-flat binding allows use in the clinic or lab setting.
Every paying member of BSAVA will receive one complimentary copy as part of their membership.
Members attending Congress will be able to collect them from the BSAVA Balcony, the rest will be
sent out in May.
BSAVA MANUAL OF CANINE AND FELINE
REHABILITATION, SUPPORTIVE AND
PALLIATIVE CARE: Case studies in patient
management
Editors: Penny Watson and Samantha Lindley
This unique publication shows how a team-based approach can be used to improve
patient outcomes. Part 1 presents the latest strategies for pain management, clinical
nutrition, and physical therapy and rehabilitation. The evidence base for therapies is discussed, with
reference to published studies. Part 2 uses a range of case scenarios to illustrate how medical and surgical
treatment, dietary advice, physiotherapy, hydrotherapy, acupuncture, nursing care and homecare
recommendations can form an integrated approach to the management of individual patients.
Available Summer 2010.
The food should be warmed to body temperature
and injected over several minutes.
If the animal shows regurgitation, vomiting or
diarrhoea after feeding, reduce the amount fed in
each meal and check that the food fed is warm
and iso-osmolar.
Tube care and removal
Once a day, the neck wrap and sterile dressing
should be removed and the stoma cleaned using
cotton wool or gauze swabs soaked in 4%
chlorhexidine gluconate or 10% povidoneiodine.
If oozing of purulent liquid suggests infection,
an antibiotic ointment can be applied. A new
sterile dressing is then applied and the neck
wrap replaced.
The oesophagostomy tube can be removed when
it is no longer required; unlike a gastrotomy tube there
is no minimum length of time an oesophagostomy tube
must have been in place prior to removal. To remove
the tube, take off the dressing, remove the suture and
pull the tube gently out. The stoma site will close
rapidly once the tube is removed, but skin sutures can
be placed if preferred.
Procedures in
Small Animal
Practice
Procedures in
Small Animal Practice
BSAVA Guide to
BSAVA Guide to
Nick Bexeld
and Karla Lee
B
S
A
V
A
G
u
i d
e
t
o
P
r
o
c
e
d
u
r
e
s
i n
S
m
a
l l A
n
i m
a
l P
r
a
c
t
i c
e
Contents
Abdominocentesis; ACTH response test; Anaphylaxis emergency treatment;
Arthrocentesis; Aseptic preparation; Barium contrast media; Barium studies of
the gastrointestinal tract; Blood pressure measurement; Bblood sampling; Blood
smear preparation; Blood transfusion; Bone biopsy needle; Bone marrow aspiration; Bronchoalveloar lavage; Bronchoscopy; Buccal mucosal bleeding time; Cardiopulmonarycerebral resuscitation; Cardiorespiratory examination;
Cast application; Cerebrospinal uid sampling; Cranial draw test; Cystocentesis;
Dexamethasone suppression tests; Diagnostic peritoneal lavage; Ehmer sling;
Elbow luxation closed reduction; Electrocardiography; Endoscopy of the gastrointestinal tract; Endotracheal wash; Fine needle aspiration; Fluorescein test;
Gastric decompression; Gastrostomy tube placement; Haemagglutination test;
Hip luxation closed reduction; Intraosseous cannula placement; Intravenous
catheter placement; Intravenous urography; Iodinated contrast media; Myringotomy;
Nasal oxygen administration; Naso-oesophageal tube placement; Neurological
examination; Oesophagostomy tube placement; Ophthalmic examination; Orthopaedic examination; Ortolani test; Otoscopy; Pericardiocentesis; Platelet
count; Prostatic wash; Resting energy requirement; Retrograde urethrography/
vaginourethrography; Rhinoscopy; Schirmer tear test; Seizures emergency protocol; Semen collection; Skin biopsy punch biopsy; Skin and hair sampling;
Soft padded bandage; Spica splint; Thoracocentesis needle; Thoracostomy tube
placement; Tibial compression test; Tissue biopsy needle core; Tracheostomy;
Transtracheal wash; Urethral catheterization; Urethral retrograde urohydropulsion;
Urinalysis; Velpeau sling; Water deprivation test; Whole blood clotting time
Edited by Nick Bexeld and Karla Lee
The BSAVA Guide to Procedures in Small Animal Practice provides
practical, step-by-step guidance on how to perform the diagnostic and
therapeutic procedures commonly performed in small animal veterinary
practice. In addition, routine clinical examination of the major body systems,
and protocols for the management of selected emergencies are described. In addition to the actual technique, each procedure has information on
indications and contraindications, equipment required, and potential
complications, together with the editors own hints and tips. Details of
BSAVA Manuals where wider information, such as interpretation of results,
are given throughout.
Special features:
A to Z format to aid information retrieval

Extensive cross-referencing in highlighted text

Specially commissioned drawings

Lay-at binding
This is a truly useful guide, which will provide a valuable and lasting reference
for veterinary surgeons, veterinary nurses and students alike.
ISBN 978 1 905319 17 6
12-16 How To.indd 16 19/1/10 08:41:04
companion
|
17
CONGRESS
Satellite meetings
at BSAVA Congress
BSAVA supports its Affiliated
Groups with funding and
promotion, as well as presenting
them with the opportunity to hold
a Satellite Meeting on the
Wednesday before Congress
(this year 7 April)
ABVA
Association of British
Veterinary Acupuncturists
Venue: Executive Room 1, ICC
Booking contact: Julie Cummings
Email: bmasgeneralmgr@aol.com
Website: www.abva.co.uk
Tel: +44 (0) 1606 786782
AVCPT
Association of Veterinary
Clinical Pharmacology and
Therapeutics
Venue: Hall 7a, ICC
Booking contact: Maria Gregory-
Carlton
Email: secretary@avcpt.org
Website: www.avcpt.org
The neurobiology of pain with
Dr Sue Fleetwood-Walker
Challenges facing new approaches to pain
management in animal species with
Dr Adrian Foster
PK/PD modelling and its relevance to
pharmacological pain intervention with
Ludovic Pelligand
Pain control in osteoarthritis with
Dr Dylan Clements
Acute Pain management in animals with
Dr Jo Murrell
The language of Pain: A human perspective with
Dr Mark Rockett
Panel discussion all speakers
100 for non-members; 70 for members; 70 for
students and residents. Lunch is included
AVSTS
Association for Veterinary
Soft Tissue Surgery
Venue: Hall 6, ICC
Booking contact: Alison Young
Email: avstsadmin@fsmail.net
Website: www.avsts.org.uk
Tel: +44 (0) 1707 666366 ex 2432
A Smrgsbord of topics awaits you at our Spring
meeting for 2010.
With a dazzling array of UK and international speakers
its sure to be a stimulating session.
BrAVO
Veterinary Ophthalmologists
Venue: Hall 8a, ICC
Booking contact: Claudia Hartley
Email: claudia.hartley@aht.org.uk
Website: www.bravo.org.uk
Tel: +44 (0) 1638 552700
The British Association of Veterinary Ophthalmologists
(BrAVO) is an internationally recognised society of
veterinary ophthalmologists and vets with an interest in
ophthalmology. We have members not only from the
United Kingdom but also Hong Kong, Australia,
France, Belgium, Sweden, Italy and South Africa. We
are also honoured to have consultant ophthalmologists
from the human medical field as members. We are a
very sociable group, with over 250 members, and
newcomers are welcomed.
BrAVO organises two meetings each year, with
state-of-the-art lectures on all aspects of veterinary and
human ophthalmology. Our Spring meeting is a
one-day pre-BSAVA satellite meeting and includes
both local and international speakers. The winter
BAVEC
Veterinary Emergency Care
Venue: Crompton Room,
Austin Court
Booking contact: Jan MacDonald
Email: jan.macdonald@vets-now.com
Website: www.bavec.co.uk
Tel: +44 (0) 7785 741033
18
|
companion
CONGRESS
meeting is a two-day weekend meeting that is held in
easy to reach locations around the country, usually in
November. Again we include international speakers,
and usually a medical speaker for a comparative view
in humans.
Members are invited to all meetings and enjoy
discounts on textbooks and journal subscriptions, as
well as eligibility to apply for one of two travel
scholarships (up to the value of 1000 per scholarship
each year) every year.
BVZS
British Veterinary
Zoological Society
Venue: Hall 7b, ICC
Booking contact: Victoria Roberts
Email: victoriaroberts06@tiscali.co.uk
Website: www.bvzs.org
Tel: +44 (0) 7971 482292
EXOTICS FOR GP VETS
Clinical management of ferrets, sugar gliders and
degus Aidan Raftery
Diagnostic approach to the sick bird Kevin Eatwell
Common lizard presentations and their
management Kevin Eatwell
Common chelonian presentations and their
management Stuart McArthur
Safe anaestheisa in rabbits and small mammals
Ian Sayers
The fourth BVZS satellite meeting provides BSAVA
delegates and small animal practitioners in general
practice the opportunity to undertake world class
continuing professional development in non-domestic
species medicine. The programme for the day
complements and expands the exotic pet content in
the main Congress, allowing further development of
your skills and understanding.
Satellite meetings at BSAVA Congress

BVOA
British Veterinary
Orthopaedic Association
Venue: Kingston Room/Faraday Room, Austin Court
Booking contact: Kamila Guilliard
Email: bvoa@btinternet.com
Website: www.bsava.com/bvoa
Tel: +44 (0) 1270 662265
The British Veterinary Orthopaedic Associations
objectives include providing CPD for its members,
funding clinical research, and providing a forum for
discussion and dissemination of orthopaedic
knowledge. Membership of the BVOA is open to
anybody with an interest in veterinary orthopaedic
surgery; general and specialist veterinary surgeons
are welcome.
The association holds two meetings per year the first
is the one day Spring meeting that is held in Austin
Court at the ICC in Birmingham on the Wednesday
immediately before BSAVA Congress. The second runs
over three days, from 1214 November 2010 in Dublin,
Ireland. The Dublin meeting is entitled New horizons in
thoracic limb surgery and will focus on the
management of shoulder injuries. There will be an
exciting mix of international speakers and state of the art
lectures, and a comparative perspective provided by
human orthopaedic surgeons. The social programme
promises to be excellent and includes a tour and dinner
at the Guinness Storehouse on the Saturday night.
Another very important function of the Association is
the provision of funding for orthopaedic research
projects. This is available for members in general
practice as well as those in academia, and is
subject to approval by the Chairman of the
Scientific Committee. For further information,
visit www.bsava.com/bvoa.
BVDA
British Veterinary
Dental Association
Venue: Lodge Rooms 1 & 2, Austin Court
Booking contact: Helen Hyde
Email: helen.hyde@ntlworld.com
Website: www.bvda.co.uk
Tel: +44 (0) 1954 204474
Scientific meeting and AGM with international
speakers, including Bill Gengler (President of the
AVDC), and Julius Liptak
BVDSG
British Veterinary
Dermatology Study Group
Venue: Hall 8b, ICC
Booking contact: Filippo De Bellis
Email: filippovet@hotmail.com
Website: pcwww.liv.ac.uk
Tel: +44 (0) 1707 666366
companion
|
19
CONGRESS
CABTSG
Companion Animal Behaviour
Therapy Study Group
Venue: Hall 11a, ICC
Booking contact: Claire Corridan
Email: clairecorridan@yahoo.co.uk
Website: www.cabtsg.org
Tel: +44 (0) 1606 352091
The two themes for this years Study Day are repetitive
behaviours in companion animals and regulation of
dog trainers and behaviourists.
There will be 3 sessions, the first on repetitive
behaviours in companion animals, the second, a short
paper session on emerging science in the companion
animal behavioural field, and the final session will
address the issues surrounding regulation of dog
trainers and behaviours.
Repetitive behaviours in companion animals are
commonly seen but not particularly well understood.
Identification of the motivation for these behaviours
can be difficult but their management and counselling
of the client can be equally challenging. CABTSG
have two guest speakers presenting on this subject,
Professor Daniel Mills and Dr David Abrahamson,
covering aspects of differential diagnoses,
behavioural and medical management protocols.
Scientific papers are an essential part of CABTSGs
Study Day programme. The new science sessions will
be divided in two, one on the theme of repetitive
behaviours and an open session for papers on any
subject relating to companion animal behaviour.
Our Back to Basics lectures, which have proved so
popular at BVZS meetings, will be presented by
experienced and specialist veterinarians. The
programme will deliver a comprehensive grounding for
the part-time enthusiast whilst the more advanced
exotic and zoological practitioner will be informed of
the latest developments in both understanding and
practical techniques. Each lecture will be 11 hours
in length, followed by time for questions and
discussion.
The Back to Basics presentations will address the
approach to cases seen in small zoo contract work or
whilst developing an exotic pet caseload and so will
be directly relevant to BSAVA and BVZS members.
BVZSs satellite event lunch is sponsored by Genitrix.
In 2008 CAWC (The Companion Animal Welfare
Council) launched a report outlining the need for
regulation of individuals working in the field of animal
training and behaviour. We will be joined by Dr Anne
McBride, Kendal Shepherd and James Yeates, who
will present on the implications of the CAWC initiative
for the veterinary profession, for those working in the
dog training and behaviour field, and for dog owners
and their dogs. This session will be chaired by
Professor Sir Colin Spedding, who is also currently
chairing the CAWC meetings on this subject.
Conference Dinner: Optional conference dinner
6pm in Hall 11A of the ICC (book with registration)
cost 30 per person.
EAVDI (BID)
European Association of
Veterinary Diagnostic Imaging
(British and Irish Division)
Venue: Telford Room, Austin Court
Booking contact: Andrew Denning
Email: andrew@new-priory.com
Website: cheval.vet.gla.ac.uk/EVDI/ea-bed.htm
Tel: +44 (0) 1638 555668
The British and Irish Division of the European
Association of Veterinary Diagnostic Imaging (EAVDI-
BID) is open to any veterinary surgeon, student,
radiographer or nurse with an interest in veterinary
diagnostic imaging. The division organizes two regular
meetings each year a satellite day meeting in
Birmingham on the Wednesday before BSAVA
Congress, and a two-day autumn meeting (usually
October/November) which in recent years has been
held in Cambridge, Dublin and Glasgow. Speakers at
the meetings are drawn from a wide range of
internationally recognised specialists, and cover a
wide range of imaging topics, in both small and large
animal practice. This offers you a fantastic opportunity
for continuous professional development (CPD) in
diagnostic imaging and at an unbeatable price. In
addition, at each meeting there is an informal film-
reading session, with more unusual cases presented
for interpretation (although only imaging residents are
required to present cases to the meeting). Lectures at
the pre-BSAVA meeting in 2010 are hoped to include
MRI of the limbs in small animals and correlating
imaging and arthroscopic findings. For further
information and contact details for the committee, see
the EAVDI website (currently cheval.vet.gla.ac.uk/
EVDI/eavdi.htm although a new website is currently
under construction).
18
|
companion
CONGRESS
meeting is a two-day weekend meeting that is held in
easy to reach locations around the country, usually in
November. Again we include international speakers,
and usually a medical speaker for a comparative view
in humans.
Members are invited to all meetings and enjoy
discounts on textbooks and journal subscriptions, as
well as eligibility to apply for one of two travel
scholarships (up to the value of 1000 per scholarship
each year) every year.
BVZS
British Veterinary
Zoological Society
Venue: Hall 7b, ICC
Booking contact: Victoria Roberts
Email: victoriaroberts06@tiscali.co.uk
Website: www.bvzs.org
Tel: +44 (0) 7971 482292
EXOTICS FOR GP VETS
Clinical management of ferrets, sugar gliders and
degus Aidan Raftery
Diagnostic approach to the sick bird Kevin Eatwell
Common lizard presentations and their
management Kevin Eatwell
Common chelonian presentations and their
management Stuart McArthur
Safe anaestheisa in rabbits and small mammals
Ian Sayers
The fourth BVZS satellite meeting provides BSAVA
delegates and small animal practitioners in general
practice the opportunity to undertake world class
continuing professional development in non-domestic
species medicine. The programme for the day
complements and expands the exotic pet content in
the main Congress, allowing further development of
your skills and understanding.

BVOA
British Veterinary
Orthopaedic Association
Venue: Kingston Room/Faraday Room, Austin Court
Booking contact: Kamila Guilliard
Email: bvoa@btinternet.com
Website: www.bsava.com/bvoa
Tel: +44 (0) 1270 662265
The British Veterinary Orthopaedic Associations
objectives include providing CPD for its members,
funding clinical research, and providing a forum for
discussion and dissemination of orthopaedic
knowledge. Membership of the BVOA is open to
anybody with an interest in veterinary orthopaedic
surgery; general and specialist veterinary surgeons
are welcome.
The association holds two meetings per year the first
is the one day Spring meeting that is held in Austin
Court at the ICC in Birmingham on the Wednesday
immediately before BSAVA Congress. The second runs
over three days, from 1214 November 2010 in Dublin,
Ireland. The Dublin meeting is entitled New horizons in
thoracic limb surgery and will focus on the
management of shoulder injuries. There will be an
exciting mix of international speakers and state of the art
lectures, and a comparative perspective provided by
human orthopaedic surgeons. The social programme
promises to be excellent and includes a tour and dinner
at the Guinness Storehouse on the Saturday night.
Another very important function of the Association is
the provision of funding for orthopaedic research
projects. This is available for members in general
practice as well as those in academia, and is
subject to approval by the Chairman of the
Scientific Committee. For further information,
visit www.bsava.com/bvoa.
BVDA
British Veterinary
Dental Association
Venue: Lodge Rooms 1 & 2, Austin Court
Booking contact: Helen Hyde
Email: helen.hyde@ntlworld.com
Website: www.bvda.co.uk
Tel: +44 (0) 1954 204474
Scientific meeting and AGM with international
speakers, including Bill Gengler (President of the
AVDC), and Julius Liptak
BVDSG
British Veterinary
Dermatology Study Group
Venue: Hall 8b, ICC
Booking contact: Filippo De Bellis
Email: filippovet@hotmail.com
Website: pcwww.liv.ac.uk
Tel: +44 (0) 1707 666366
companion
|
19
CONGRESS
CABTSG
Companion Animal Behaviour
Therapy Study Group
Venue: Hall 11a, ICC
Booking contact: Claire Corridan
Email: clairecorridan@yahoo.co.uk
Website: www.cabtsg.org
Tel: +44 (0) 1606 352091
The two themes for this years Study Day are repetitive
behaviours in companion animals and regulation of
dog trainers and behaviourists.
There will be 3 sessions, the first on repetitive
behaviours in companion animals, the second, a short
paper session on emerging science in the companion
animal behavioural field, and the final session will
address the issues surrounding regulation of dog
trainers and behaviours.
Repetitive behaviours in companion animals are
commonly seen but not particularly well understood.
Identification of the motivation for these behaviours
can be difficult but their management and counselling
of the client can be equally challenging. CABTSG
have two guest speakers presenting on this subject,
Professor Daniel Mills and Dr David Abrahamson,
covering aspects of differential diagnoses,
behavioural and medical management protocols.
Scientific papers are an essential part of CABTSGs
Study Day programme. The new science sessions will
be divided in two, one on the theme of repetitive
behaviours and an open session for papers on any
subject relating to companion animal behaviour.
Our Back to Basics lectures, which have proved so
popular at BVZS meetings, will be presented by
experienced and specialist veterinarians. The
programme will deliver a comprehensive grounding for
the part-time enthusiast whilst the more advanced
exotic and zoological practitioner will be informed of
the latest developments in both understanding and
practical techniques. Each lecture will be 11 hours
in length, followed by time for questions and
discussion.
The Back to Basics presentations will address the
approach to cases seen in small zoo contract work or
whilst developing an exotic pet caseload and so will
be directly relevant to BSAVA and BVZS members.
BVZSs satellite event lunch is sponsored by Genitrix.
In 2008 CAWC (The Companion Animal Welfare
Council) launched a report outlining the need for
regulation of individuals working in the field of animal
training and behaviour. We will be joined by Dr Anne
McBride, Kendal Shepherd and James Yeates, who
will present on the implications of the CAWC initiative
for the veterinary profession, for those working in the
dog training and behaviour field, and for dog owners
and their dogs. This session will be chaired by
Professor Sir Colin Spedding, who is also currently
chairing the CAWC meetings on this subject.
Conference Dinner: Optional conference dinner
6pm in Hall 11A of the ICC (book with registration)
cost 30 per person.
EAVDI (BID)
European Association of
Veterinary Diagnostic Imaging
(British and Irish Division)
Venue: Telford Room, Austin Court
Booking contact: Andrew Denning
Email: andrew@new-priory.com
Website: cheval.vet.gla.ac.uk/EVDI/ea-bed.htm
Tel: +44 (0) 1638 555668
The British and Irish Division of the European
Association of Veterinary Diagnostic Imaging (EAVDI-
BID) is open to any veterinary surgeon, student,
radiographer or nurse with an interest in veterinary
diagnostic imaging. The division organizes two regular
meetings each year a satellite day meeting in
Birmingham on the Wednesday before BSAVA
Congress, and a two-day autumn meeting (usually
October/November) which in recent years has been
held in Cambridge, Dublin and Glasgow. Speakers at
the meetings are drawn from a wide range of
internationally recognised specialists, and cover a
wide range of imaging topics, in both small and large
animal practice. This offers you a fantastic opportunity
for continuous professional development (CPD) in
diagnostic imaging and at an unbeatable price. In
addition, at each meeting there is an informal film-
reading session, with more unusual cases presented
for interpretation (although only imaging residents are
required to present cases to the meeting). Lectures at
the pre-BSAVA meeting in 2010 are hoped to include
MRI of the limbs in small animals and correlating
imaging and arthroscopic findings. For further
information and contact details for the committee, see
the EAVDI website (currently cheval.vet.gla.ac.uk/
EVDI/eavdi.htm although a new website is currently
under construction).
20
|
companion
CONGRESS
ESFM
European Society of
Feline Medicine
Venue: Hall 10, ICC
Booking contact:
Amanda Dennant
Email: conferences@fabcats.org
Website: fabcats.org/conferences
Tel: +44 (0) 1747 871872
Who could argue that cats can be difficult! But then
they can also be fascinating because they dont follow
the rules. However you think of them, they are now a
large part of companion animal practice.
At the European Society of Feline Medicine (ESFM)
pre-Congress day we aim to cover current feline issues
and to provide as much as possible to take back to
practice. This year we are also introducing four practice
tip sessions all cover ins and outs with cats blocked
cats, using catheters, feeding the anorexic cat, and
getting medicines in. Other international speakers will
follow last years very popular approach of 30 minute
update talks on food allergies, atopy, asthma,
ureteroliths and thyroidectomy technique.
Through its monthly international peer-reviewed
Journal of Feline Medicine and Surgery (JFMS) ESFM
provides both basic science and practical clinical
reviews from world leaders for the advancement of
understanding of disease and the treatment of cats in
daily veterinary practice.
Visit www.fabcats.org/conferences/bsava/2010 to
find out more and to book your place dont leave it
too late; we were sold out last year!
consultant in medicine and critical care and a member
of the guideline development group for venous
thromboembolism prevention for the National Institute
of Clinical Excellence (NICE). For those attendees that
are in the processing of writing their CertSAM
casebook there will be a lunchtime session offering
advice. The day will include the following sessions:
Epilepsy: when the (usual) drugs dont work with
Dr Holger Volk
Antimicrobial usage in companion animal practice:
facts and moral dilemmas with Dr Susan Dawson
Case Reports competition presentations
sponsored by Vtoquinol
Venous thromboembolism: learning from a human
perspective with Dr Nandan Gautam
How to write a successful CertSAM casebook
with Jon Wray
Controversies surrounding treatment of aortic
thromboembolism with Dr Matt Beal
Feline acromegaly: separating facts from
assumptions with Stijn Niessen
Fees: Members 65, Non-members 95 (lunch
included if you register before 15 March 2010).
Annual membership: 25.
SAMSocs satellite event is sponsored by
Hills Pet Nutrition and Vtoquinol.
For details or
to book any
Satellite
Meeting
please
contact the
organiser
directly.
VCS
Veterinary Cardiovascular
Society
Venue: Hall 9, ICC
Booking contact:
Yolanda Martinez Pereira
Email: yolanda@zoologicalmedicine.com
Website: www.bsava.org.uk/vcs
Tel: +44 (0) 7743 947802

SAMSoc
Small Animal Medicine Society
Venue: Hall 8a, ICC
Booking contact: Yvonne McGrotty
Email: medicinereferrals@hotmail.com
Tel: +44 (0) 1412 377676
Members of SAMSoc include specialist internists and
general practitioners from the UK and abroad who
share a passion and enthusiasm for small animal
medicine. The society hosts a meeting every year at
BSAVA Congress.
This year SAMSoc are delighted to announce our
speaker from human medicine is Dr Nandan Gautam, a
companion
|
21
CONGRESS
A
mericans are well known in this country for the
high quality of their dental work and so perhaps
it is not surprising that even their pets can
receive cutting edge orthodontic care. A leading
exponent of veterinary dentistry from the US has been
invited to pass on his skills to his British and European
colleagues at BSAVA Congress in Birmingham in April.
Among a series of presentations on different aspects
of oral surgery, Professor Bill Gengler of the University
of Wisconsin will outline the principles of orthodontics
to correct conditions resulting from malocclusions.
From man to beast
Appliances similar to those originally developed in
human dentistry are used with increasing frequency in
dogs on both sides of the Atlantic to create a more
regular bite. But in contrast with human orthodontics
these methods are never used simply for cosmetic
reasons. The orthodontic procedures that we do
perform are only for the health and comfort of the
animal, he explains.
As a member of the American Veterinary
Dental College, he uses these techniques to
prevent or to treat the painful consequences
of malocclusions, not to give the dogs
owners hope of success in shows. As a
group, we are very ethical and try not to
change the appearance so it will have an
advantage in the ring. We also encourage
owners to neuter animals that have
orthodontic treatment resulting from
hereditary defects.
Problems and solutions
Two defects which these methods are often used to
treat are linguoversion of the mandibular
canine teeth (or base narrow canines)
and rostroversion of the maxillary
canine tooth. The former can be a
very painful condition and occurs
mainly in long-nosed dogs such as
Labradors, German Shepherd Dogs
and Standard Poodles. Affected
animals have very narrow mandibles
and lower canine teeth that erupt
vertically, with the result that over time
Bit between
the teeth
at Congress
Dentistry lectures are always
especially popular at
Congress and even more
so when a leading expert
shares their skills
21-22 Congress.indd 21 19/1/10 08:53:09
20
|
companion
CONGRESS
ESFM
European Society of
Feline Medicine
Venue: Hall 10, ICC
Booking contact:
Amanda Dennant
Email: conferences@fabcats.org
Website: fabcats.org/conferences
Tel: +44 (0) 1747 871872
Who could argue that cats can be difficult! But then
they can also be fascinating because they dont follow
the rules. However you think of them, they are now a
large part of companion animal practice.
At the European Society of Feline Medicine (ESFM)
pre-Congress day we aim to cover current feline issues
and to provide as much as possible to take back to
practice. This year we are also introducing four practice
tip sessions all cover ins and outs with cats blocked
cats, using catheters, feeding the anorexic cat, and
getting medicines in. Other international speakers will
follow last years very popular approach of 30 minute
update talks on food allergies, atopy, asthma,
ureteroliths and thyroidectomy technique.
Through its monthly international peer-reviewed
Journal of Feline Medicine and Surgery (JFMS) ESFM
provides both basic science and practical clinical
reviews from world leaders for the advancement of
understanding of disease and the treatment of cats in
daily veterinary practice.
Visit www.fabcats.org/conferences/bsava/2010 to
find out more and to book your place dont leave it
too late; we were sold out last year!
consultant in medicine and critical care and a member
of the guideline development group for venous
thromboembolism prevention for the National Institute
of Clinical Excellence (NICE). For those attendees that
are in the processing of writing their CertSAM
casebook there will be a lunchtime session offering
advice. The day will include the following sessions:
Epilepsy: when the (usual) drugs dont work with
Dr Holger Volk
Antimicrobial usage in companion animal practice:
facts and moral dilemmas with Dr Susan Dawson
Case Reports competition presentations
sponsored by Vtoquinol
Venous thromboembolism: learning from a human
perspective with Dr Nandan Gautam
How to write a successful CertSAM casebook
with Jon Wray
Controversies surrounding treatment of aortic
thromboembolism with Dr Matt Beal
Feline acromegaly: separating facts from
assumptions with Stijn Niessen
Fees: Members 65, Non-members 95 (lunch
included if you register before 15 March 2010).
Annual membership: 25.
SAMSocs satellite event is sponsored by
Hills Pet Nutrition and Vtoquinol.
For details or
to book any
Satellite
Meeting
please
contact the
organiser
directly.
VCS
Veterinary Cardiovascular
Society
Venue: Hall 9, ICC
Booking contact:
Yolanda Martinez Pereira
Email: yolanda@zoologicalmedicine.com
Website: www.bsava.org.uk/vcs
Tel: +44 (0) 7743 947802

SAMSoc
Small Animal Medicine Society
Venue: Hall 8a, ICC
Booking contact: Yvonne McGrotty
Email: medicinereferrals@hotmail.com
Tel: +44 (0) 1412 377676
Members of SAMSoc include specialist internists and
general practitioners from the UK and abroad who
share a passion and enthusiasm for small animal
medicine. The society hosts a meeting every year at
BSAVA Congress.
This year SAMSoc are delighted to announce our
speaker from human medicine is Dr Nandan Gautam, a
companion
|
21
CONGRESS
A
mericans are well known in this country for the
high quality of their dental work and so perhaps
it is not surprising that even their pets can
receive cutting edge orthodontic care. A leading
exponent of veterinary dentistry from the US has been
invited to pass on his skills to his British and European
colleagues at BSAVA Congress in Birmingham in April.
Among a series of presentations on different aspects
of oral surgery, Professor Bill Gengler of the University
of Wisconsin will outline the principles of orthodontics
to correct conditions resulting from malocclusions.
From man to beast
Appliances similar to those originally developed in
human dentistry are used with increasing frequency in
dogs on both sides of the Atlantic to create a more
regular bite. But in contrast with human orthodontics
these methods are never used simply for cosmetic
reasons. The orthodontic procedures that we do
perform are only for the health and comfort of the
animal, he explains.
As a member of the American Veterinary
Dental College, he uses these techniques to
prevent or to treat the painful consequences
of malocclusions, not to give the dogs
owners hope of success in shows. As a
group, we are very ethical and try not to
change the appearance so it will have an
advantage in the ring. We also encourage
owners to neuter animals that have
orthodontic treatment resulting from
hereditary defects.
Problems and solutions
Two defects which these methods are often used to
treat are linguoversion of the mandibular
canine teeth (or base narrow canines)
and rostroversion of the maxillary
canine tooth. The former can be a
very painful condition and occurs
mainly in long-nosed dogs such as
Labradors, German Shepherd Dogs
and Standard Poodles. Affected
animals have very narrow mandibles
and lower canine teeth that erupt
vertically, with the result that over time
Bit between
the teeth
at Congress
Dentistry lectures are always
especially popular at
Congress and even more
so when a leading expert
shares their skills
21-22 Congress.indd 21 19/1/10 08:53:09
22
|
companion
CONGRESS
Bit between the teeth at Congress

the lower canine teeth drill holes through the roof of the
mouth into the nasal compartment, allowing food and
debris to cause a septic rhinitis.
The latter condition occurs frequently in Shetland
Sheepdogs but can also occur in a wide range of
other breeds including Italian Greyhounds, poodles,
and many types of terrier. It is also seen frequently in
cats, and in both species causes lip trauma,
periodontal disease and temporomandibular joint pain.
The underlying principles of orthodontics are to
induce movement in the malpositioned tooth by
applying gentle force on the periodontal ligament.
This will result in migration of monocytes to the
immediate area and their differentiation into bone-
resorbing osteoclasts in the direction of the tooth
movement and into new bone-forming osteoblasts on
the opposite side. To avoid damaging these
structures, the required force should not exceed the
capillary blood pressure of the ligament. While they
can be applied constantly or intermittently, pressure
for at least six hours a day will be necessary to
reposition the affected teeth, he explains.
Basic skills to future trends
While describing the novel technologies and surgical
methods needed to achieve these changes,
Prof. Gengler will emphasise the importance of more
fundamental veterinary skills in achieving a good
visual appearance and functional result. The key
messages that I want to get across are the importance
of knowing your oral and dental anatomy and carrying
out a thorough oral examination.
REGISTER NOW
BSAVA Congress, 811 April 2010
www.bsava.co m Save 5% on online
registrations or download the registration form
congress@bsava.co m to request a
registration pack
01452 726700 for enquiries
Radiography and conventional photographs are
essential in planning appropriate treatment, he says.
As in many situations, the inexperienced newby will
encounter problems through underestimating the
problem at hand or failing to think through the
treatment plan. With orthodontics it is important to be
able to think in three dimensions. It is essential to be
able to understand what effects the appliance you are
using will have on the other oral structures.
As well as bringing colleagues up to date on
current methods, Prof. Gengler will also be able to
highlight future trends. What is over the horizon?
Well dental implants are already here but not widely
used and they will likely be used increasingly with
time. Jaw lengthening or shortening for the correction
of malocclusion through distraction osteogenesis
may become more prominent in the future. And the
use of allografts or xenografts for reconstructive
surgery following surgery for oral cancers is another
new frontier.
21-22 Congress.indd 22 19/1/10 08:53:10
companion
|
23
CPD
S
everal advances have recently been made in the
areas of diagnosis, staging and therapy of
common veterinary cancers. Dr David Vail of
North America and Dr Jane Dobson of the UK both
have active clinical research programmes investigating
novel diagnostic and therapeutic strategies involving
companion animals, and both will be sharing their
expertise at four locations in May.
Applications of novel immunohistochemical,
flow-cytometric and imaging modalities have been
applied to early diagnosis and staging of common
tumour histologies, including lymphoma, mast cell
tumours, osteosarcomas and soft tissue sarcomas
among others. These technologies can lead to early
diagnosis and more thorough therapeutic response
evaluations, and provide additional prognostic
information important to caregivers.
The addition of novel chemotherapeutic strategies,
including the availability of more targeted therapies
such as growth-factor receptor targeting and anti-
tumour vaccines, as well as more accurate radiation
therapy techniques are beginning to have an impact
upon the standard of care in veterinary oncology and
will be discussed at length.
This roadshow will explore all these advances and
techniques and in addition, Dr Vail will illustrate currently
applied clinical trial approaches used to investigate
these new modalities, and Dr Dobson will discuss her
work with photodynamic therapy (PDT) techniques.
Veterinary
oncology
roadshow
Dr David Vail and Dr Jane
Dobson are taking a tour of the
UK to explore what is new in
veterinary oncology
V
eterinary surgeons have been pioneering
minimally invasive techniques since the early
1970s. However uptake was initially slow, partly
due to the prohibitive cost of endoscopy equipment
and partly because of the same scepticism that had
also faced the early pioneers in human practice.
Flexible endoscopy was the first technique to gain
acceptance in the veterinary profession because of
the benefits these instruments give in the exploration
of the tubular structures of the body, in particular the
respiratory and gastrointestinal tracts.
In March Professor Ed Hall of Bristol Vet School will
offer his expertise to vets thinking of purchasing
Introduction to
flexible GI endoscopy
endoscopy equipment, and those who feel they are
not getting full value from their equipment. He will
explore how to perform upper and lower GI
endoscopy, how to get through the pylorus and how to
obtain optimal biopsies, using videos and sharing his
practical experience with endoscopy models.
DATES
19 May 2010 Bellhouse Hotel, Beaconsfield, Metropolitan Region
21 May 2010 Redwood Hotel & Country Club, Bristol, South West Region
23 May 2010 Queensferry Hotel, Fife, Scottish Region
25 May 2010 Mottram Hall, Cheshire, North West Region
Member Fee 203.28 inc. VAT
Non-Member Fee 304.91 inc. VAT
Visit www.bsava.com to register or call 01452 726700.
DATE
18 March 2010 Woodrow House, Gloucester
23 CE.indd 23 19/1/10 08:49:18
22
|
companion
CONGRESS
Bit between the teeth at Congress

the lower canine teeth drill holes through the roof of the
mouth into the nasal compartment, allowing food and
debris to cause a septic rhinitis.
The latter condition occurs frequently in Shetland
Sheepdogs but can also occur in a wide range of
other breeds including Italian Greyhounds, poodles,
and many types of terrier. It is also seen frequently in
cats, and in both species causes lip trauma,
periodontal disease and temporomandibular joint pain.
The underlying principles of orthodontics are to
induce movement in the malpositioned tooth by
applying gentle force on the periodontal ligament.
This will result in migration of monocytes to the
immediate area and their differentiation into bone-
resorbing osteoclasts in the direction of the tooth
movement and into new bone-forming osteoblasts on
the opposite side. To avoid damaging these
structures, the required force should not exceed the
capillary blood pressure of the ligament. While they
can be applied constantly or intermittently, pressure
for at least six hours a day will be necessary to
reposition the affected teeth, he explains.
Basic skills to future trends
While describing the novel technologies and surgical
methods needed to achieve these changes,
Prof. Gengler will emphasise the importance of more
fundamental veterinary skills in achieving a good
visual appearance and functional result. The key
messages that I want to get across are the importance
of knowing your oral and dental anatomy and carrying
out a thorough oral examination.
REGISTER NOW
BSAVA Congress, 811 April 2010
www.bsava.co m Save 5% on online
registrations or download the registration form
congress@bsava.co m to request a
registration pack
01452 726700 for enquiries
Radiography and conventional photographs are
essential in planning appropriate treatment, he says.
As in many situations, the inexperienced newby will
encounter problems through underestimating the
problem at hand or failing to think through the
treatment plan. With orthodontics it is important to be
able to think in three dimensions. It is essential to be
able to understand what effects the appliance you are
using will have on the other oral structures.
As well as bringing colleagues up to date on
current methods, Prof. Gengler will also be able to
highlight future trends. What is over the horizon?
Well dental implants are already here but not widely
used and they will likely be used increasingly with
time. Jaw lengthening or shortening for the correction
of malocclusion through distraction osteogenesis
may become more prominent in the future. And the
use of allografts or xenografts for reconstructive
surgery following surgery for oral cancers is another
new frontier.
21-22 Congress.indd 22 19/1/10 08:53:10
companion
|
23
CPD
S
everal advances have recently been made in the
areas of diagnosis, staging and therapy of
common veterinary cancers. Dr David Vail of
North America and Dr Jane Dobson of the UK both
have active clinical research programmes investigating
novel diagnostic and therapeutic strategies involving
companion animals, and both will be sharing their
expertise at four locations in May.
Applications of novel immunohistochemical,
flow-cytometric and imaging modalities have been
applied to early diagnosis and staging of common
tumour histologies, including lymphoma, mast cell
tumours, osteosarcomas and soft tissue sarcomas
among others. These technologies can lead to early
diagnosis and more thorough therapeutic response
evaluations, and provide additional prognostic
information important to caregivers.
The addition of novel chemotherapeutic strategies,
including the availability of more targeted therapies
such as growth-factor receptor targeting and anti-
tumour vaccines, as well as more accurate radiation
therapy techniques are beginning to have an impact
upon the standard of care in veterinary oncology and
will be discussed at length.
This roadshow will explore all these advances and
techniques and in addition, Dr Vail will illustrate currently
applied clinical trial approaches used to investigate
these new modalities, and Dr Dobson will discuss her
work with photodynamic therapy (PDT) techniques.
Veterinary
oncology
roadshow
Dr David Vail and Dr Jane
Dobson are taking a tour of the
UK to explore what is new in
veterinary oncology
V
eterinary surgeons have been pioneering
minimally invasive techniques since the early
1970s. However uptake was initially slow, partly
due to the prohibitive cost of endoscopy equipment
and partly because of the same scepticism that had
also faced the early pioneers in human practice.
Flexible endoscopy was the first technique to gain
acceptance in the veterinary profession because of
the benefits these instruments give in the exploration
of the tubular structures of the body, in particular the
respiratory and gastrointestinal tracts.
In March Professor Ed Hall of Bristol Vet School will
offer his expertise to vets thinking of purchasing
Introduction to
flexible GI endoscopy
endoscopy equipment, and those who feel they are
not getting full value from their equipment. He will
explore how to perform upper and lower GI
endoscopy, how to get through the pylorus and how to
obtain optimal biopsies, using videos and sharing his
practical experience with endoscopy models.
DATES
19 May 2010 Bellhouse Hotel, Beaconsfield, Metropolitan Region
21 May 2010 Redwood Hotel & Country Club, Bristol, South West Region
23 May 2010 Queensferry Hotel, Fife, Scottish Region
25 May 2010 Mottram Hall, Cheshire, North West Region
Visit www.bsava.com to register or call 01452 726700.
DATE
18 March 2010 Woodrow House, Gloucester
23 CE.indd 23 19/1/10 08:49:18
24
|
companion
VIN
Susan Bertram, DVM Horse Guard, Redmond, OR
Patient is a 9 yr old F/s wheaten terrier, second opinion on rising urine pro:creatinine ratios.
Clinically normal, no wt loss. B wt. 38 lb (17 kg*), BCS= 5/10 (ideal)
Urine specific gravity and protein trends from referring clinic:
Date USG Urinalysis Haematology/Biochemisty* Notes
11/2007 1.030 protein 3+,
neg blood
BUN = 4.6 mmol/l (ref 2.59.6)
Crea = 114 mmol/l (ref 44160)
phos = 1.4 mmol/l
8/2008 1.040 pro: 3+,
trace blood
BUN = 7.5 mmol/l
Creat = 106 mmol/l
phos = 1.4 mmol/l
+ Clavamox
2/2009 1.039 Protein: 4+,
negative blood. UPC = 2.8 (ref 01)
3/2009 1.040 pro: 4+, trace blood UPC = 3.9 BUN = 6 mmol/l
Creat = 88 mmol/l
ALT = 105 IU/l (ref 10100)
TP = 54 g/l (ref 5282)
Alb = 25 g/l (ref 2239)
Chol = 8.2 mmol/l ref (2.88.3)
Amyl = 1736 IU/l (ref 5001500)
Benazapril started
5 mg q 24 hrs, 1/2
baby aspirin and
omega 3 supplement,
NF diet
+ Clavamox
5/6/09 1.018 protein 500 mg/dL, blood neg,
UPC = 7.5 !!!!, by cysto, culture not
indicated per lab.
HCT = 42.8%, all else WNLs
GrapeVINe
The Veterinary Information Network brings together veterinary professionals from
across the globe to share their experience and expertise. At vin.com users get
instant access to vast amounts of up-to-date veterinary information from colleagues,
many of whom have specialised knowledge and skills. In this regular feature,
VIN shares with companion readers a small animal discussion that has recently
taken place in their forums
Discussion: Wheaten Terrier with rising urine protein:creatinine ratios
So, several things stand out:
1) first, pet is not hypoproteinemic or azotemic, but yes, losing protein, which got WORSE after starting the
Benazapril. The other clinic recd increasing Benazapril to BID, and this is when O. sought my opinion.
2) Since the once daily treatment made the values worsen (or, at least didnt stem the progression at all) is
it warranted/safe to increase? The urine specific gravity also decreased and I do not know why they
didnt repeat renal values, only ran a cbc post Tx. I realize this should be done.
Also, I have searched the archives and while I see time and again a low protein diet being recommended,
I have not seen a good explanation. If patient is not azotemic, and is losing protein thru urine, wont protein
catabolism of muscle tissue ensue? How will this help this patient?
I know we should check a blood pressure, too, but the owner was told by her other vet it wont be accurate
because the dog is too spazzy and exciteable.
Appreciate advice on diet question and Rx question.
*Editors note:
Values have been
converted to
SI units for ease of
interpretation.
24-26 GrapeVINe.indd 24 19/1/10 08:50:53
companion
|
25
VIN
Robert Vasilopulos DVM,MS, DACVIM

Veterinary Specialty Center of Tucson, VIN Internal Medicine Consultant
>>> culture not indicated per lab <<< culture is always indicated in these cases needed to do c/s and not c/s IF
>>> which got WORSE after starting the Benazapril. <<< it did get worse but not likely related to ACI worsening of
disease? the benazepril dose is very low dose most use 0.5 mg/kg which would be 9.5 mg and then escalate till
desired effect ie a normal UPC. >>> safe to increase? <<< yes.
>>> urine specific gravity <<< This is only one value and can change minute by minute dont think you can take
much more from 1 value. Recommended to check renal and UA/UPC after each change.
>>> good explanation <<< Decreases protein loss.
>>> wont protein catabolism of muscle tissue ensue? <<< Can lead to problem when alb is low.
>>> blood pressure wont be accurate because the dog is too spazzy and exciteable. <<< If normal then normal
if high then need to decide if real or not.
Susan Bertram
OK, maybe I am being dense, but if ingested protein is going to be lost through the kidneys anyway, are we just trying
to make urine protein lab values look better? Does the protein actually accelerate DAMAGE to the kidneys? Again, I am
talking about non-azotemic patient, such as this dog.
I have heard that low protein diets even in CRF patients, especially cats, may only make the lab values look better, not
actually help, and maybe harm the patient (as in, it wont eat the yukky tasting low protein foods, so it loses weight,
catabalizes its muscle tissue, etc.) and to clarify, do you mean the low protein diet is only a problem when the albumin
is also low?
So, what if now the patient is azotemic after the benazapril? I assume we would NOT increase the dose.
Thanks.
Robert Vasilopulos
>>> Does the protein actually accelerate DAMAGE to the kidneys? <<< Absolutely yes that is one reason we want to
control. Leads to tubular damage and renal failure.
>>> not actually help <<< If you look at the literature some from Hills on k/d compared to other diets the quality and
quantity of life of patient was prolonged/improved.
>>> maybe harm the patient <<< If they refuse to eat then better to have them eat something, use phos binders to
control phos etc.
>>> do you mean the low protein diet is only a problem when the albumin is also low? <<< Some nephrologists think
that giving a very protein restricted diet to a severely hypoproteinemic patient leading to more wt loss etc. is actually
harmful dont think all believe this and no proof in literature
>>> azotemic after the benazapril? I assume we would NOT increase the dose <<< Depends on the degree
if mild then would not worry how do we know the ACEI is causing the azotemia? and not progression of disease
would have to stop the ACEI and recheck values could also try other ACEI
Susan Bertram
I would be interested in literature re: protein damage to renal tubules in carnivores. I knew it was theorized, didnt
know solidly proven. can you refer be to some articles, thanks. Thank you for your input on this case.
Sincerely, Dr. Bertram
Robert Vasilopulos
Not certain of any literature but CVT 13 has a great review article.
Julie Fischer DVM, DACVIM, Veterinary Specialty Hospital-San Diego
San Diego, CA, VIN Consultant Nephrology/Urology
There are lots of references for the nephrotoxicity of proteinuria, most of the primary research comes from human
literature, but the physiology of this particular process is the same. Basically, the proximal tubular epithelial cells try
hard to reclaim protein from the filtrate, and when they get maxed out, transport errors occur, lysosomes spill in the
interstitium, and inflammation with resulting tubulointerstitial fibrosis results. Here is an excerpt on the pathophys
from the notes from one of my glomerular disease lectures:
The major job of the proximal tubular epithelial cells is the reclamation of needed solutes from the ultrafiltrate by
endocytosis, regardless of whether the solutes are there under physiological (normally filtered) or pathological
(leaky glomeruli) conditions. Once reabsorbed from the lumen, the cells secrete the solutes into the renal interstitium
for transport back into nearby vessels. When an increased amount of protein is present in the ultrafiltrate, the
tubular epithelial cells continue to perform this function to maximum transport capacity, packaging proteins into
lysosomes where they are degraded into amino acids. (Despite best tubular efforts, however, transport capacity is
usually exceeded, resulting in protein loss in the urine.) Increased protein endocytosis necessitates increased
lysosomal processing, with increased frequency of lysosomal swelling and rupture, resulting in enzymatic damage to
the cytoplasm.
24-26 GrapeVINe.indd 25 19/1/10 08:50:53
24
|
companion
VIN
Susan Bertram, DVM Horse Guard, Redmond, OR
Patient is a 9 yr old F/s wheaten terrier, second opinion on rising urine pro:creatinine ratios.
Clinically normal, no wt loss. B wt. 38 lb (17 kg*), BCS= 5/10 (ideal)
Urine specific gravity and protein trends from referring clinic:
Date USG Urinalysis Haematology/Biochemisty* Notes
11/2007 1.030 protein 3+,
neg blood
BUN = 4.6 mmol/l (ref 2.59.6)
Crea = 114 mmol/l (ref 44160)
phos = 1.4 mmol/l
8/2008 1.040 pro: 3+,
trace blood
BUN = 7.5 mmol/l
Creat = 106 mmol/l
phos = 1.4 mmol/l
+ Clavamox
2/2009 1.039 Protein: 4+,
negative blood. UPC = 2.8 (ref 01)
3/2009 1.040 pro: 4+, trace blood UPC = 3.9 BUN = 6 mmol/l
Creat = 88 mmol/l
ALT = 105 IU/l (ref 10100)
TP = 54 g/l (ref 5282)
Alb = 25 g/l (ref 2239)
Chol = 8.2 mmol/l ref (2.88.3)
Amyl = 1736 IU/l (ref 5001500)
Benazapril started
5 mg q 24 hrs, 1/2
baby aspirin and
omega 3 supplement,
NF diet
+ Clavamox
5/6/09 1.018 protein 500 mg/dL, blood neg,
UPC = 7.5 !!!!, by cysto, culture not
indicated per lab.
HCT = 42.8%, all else WNLs
GrapeVINe
The Veterinary Information Network brings together veterinary professionals from
across the globe to share their experience and expertise. At vin.com users get
instant access to vast amounts of up-to-date veterinary information from colleagues,
many of whom have specialised knowledge and skills. In this regular feature,
VIN shares with companion readers a small animal discussion that has recently
taken place in their forums
Discussion: Wheaten Terrier with rising urine protein:creatinine ratios
So, several things stand out:
1) first, pet is not hypoproteinemic or azotemic, but yes, losing protein, which got WORSE after starting the
Benazapril. The other clinic recd increasing Benazapril to BID, and this is when O. sought my opinion.
2) Since the once daily treatment made the values worsen (or, at least didnt stem the progression at all) is
it warranted/safe to increase? The urine specific gravity also decreased and I do not know why they
didnt repeat renal values, only ran a cbc post Tx. I realize this should be done.
Also, I have searched the archives and while I see time and again a low protein diet being recommended,
I have not seen a good explanation. If patient is not azotemic, and is losing protein thru urine, wont protein
catabolism of muscle tissue ensue? How will this help this patient?
I know we should check a blood pressure, too, but the owner was told by her other vet it wont be accurate
because the dog is too spazzy and exciteable.
Appreciate advice on diet question and Rx question.
*Editors note:
Values have been
converted to
SI units for ease of
interpretation.
24-26 GrapeVINe.indd 24 19/1/10 08:50:53
companion
|
25
VIN
Robert Vasilopulos DVM,MS, DACVIM

Veterinary Specialty Center of Tucson, VIN Internal Medicine Consultant
>>> culture not indicated per lab <<< culture is always indicated in these cases needed to do c/s and not c/s IF
>>> which got WORSE after starting the Benazapril. <<< it did get worse but not likely related to ACI worsening of
disease? the benazepril dose is very low dose most use 0.5 mg/kg which would be 9.5 mg and then escalate till
desired effect ie a normal UPC. >>> safe to increase? <<< yes.
>>> urine specific gravity <<< This is only one value and can change minute by minute dont think you can take
much more from 1 value. Recommended to check renal and UA/UPC after each change.
>>> good explanation <<< Decreases protein loss.
>>> wont protein catabolism of muscle tissue ensue? <<< Can lead to problem when alb is low.
>>> blood pressure wont be accurate because the dog is too spazzy and exciteable. <<< If normal then normal
if high then need to decide if real or not.
Susan Bertram
OK, maybe I am being dense, but if ingested protein is going to be lost through the kidneys anyway, are we just trying
to make urine protein lab values look better? Does the protein actually accelerate DAMAGE to the kidneys? Again, I am
talking about non-azotemic patient, such as this dog.
I have heard that low protein diets even in CRF patients, especially cats, may only make the lab values look better, not
actually help, and maybe harm the patient (as in, it wont eat the yukky tasting low protein foods, so it loses weight,
catabalizes its muscle tissue, etc.) and to clarify, do you mean the low protein diet is only a problem when the albumin
is also low?
So, what if now the patient is azotemic after the benazapril? I assume we would NOT increase the dose.
Thanks.
Robert Vasilopulos
>>> Does the protein actually accelerate DAMAGE to the kidneys? <<< Absolutely yes that is one reason we want to
control. Leads to tubular damage and renal failure.
>>> not actually help <<< If you look at the literature some from Hills on k/d compared to other diets the quality and
quantity of life of patient was prolonged/improved.
>>> maybe harm the patient <<< If they refuse to eat then better to have them eat something, use phos binders to
control phos etc.
>>> do you mean the low protein diet is only a problem when the albumin is also low? <<< Some nephrologists think
that giving a very protein restricted diet to a severely hypoproteinemic patient leading to more wt loss etc. is actually
harmful dont think all believe this and no proof in literature
>>> azotemic after the benazapril? I assume we would NOT increase the dose <<< Depends on the degree
if mild then would not worry how do we know the ACEI is causing the azotemia? and not progression of disease
would have to stop the ACEI and recheck values could also try other ACEI
Susan Bertram
I would be interested in literature re: protein damage to renal tubules in carnivores. I knew it was theorized, didnt
know solidly proven. can you refer be to some articles, thanks. Thank you for your input on this case.
Sincerely, Dr. Bertram
Robert Vasilopulos
Not certain of any literature but CVT 13 has a great review article.
Julie Fischer DVM, DACVIM, Veterinary Specialty Hospital-San Diego
San Diego, CA, VIN Consultant Nephrology/Urology
There are lots of references for the nephrotoxicity of proteinuria, most of the primary research comes from human
literature, but the physiology of this particular process is the same. Basically, the proximal tubular epithelial cells try
hard to reclaim protein from the filtrate, and when they get maxed out, transport errors occur, lysosomes spill in the
interstitium, and inflammation with resulting tubulointerstitial fibrosis results. Here is an excerpt on the pathophys
from the notes from one of my glomerular disease lectures:
The major job of the proximal tubular epithelial cells is the reclamation of needed solutes from the ultrafiltrate by
endocytosis, regardless of whether the solutes are there under physiological (normally filtered) or pathological
(leaky glomeruli) conditions. Once reabsorbed from the lumen, the cells secrete the solutes into the renal interstitium
for transport back into nearby vessels. When an increased amount of protein is present in the ultrafiltrate, the
tubular epithelial cells continue to perform this function to maximum transport capacity, packaging proteins into
lysosomes where they are degraded into amino acids. (Despite best tubular efforts, however, transport capacity is
usually exceeded, resulting in protein loss in the urine.) Increased protein endocytosis necessitates increased
lysosomal processing, with increased frequency of lysosomal swelling and rupture, resulting in enzymatic damage to
the cytoplasm.
24-26 GrapeVINe.indd 25 19/1/10 08:50:53
26
|
companion
VIN
GrapeVINe
Initial renal injury directly stimulates generation of angiotensin II (ANG II), and both decreased GFR and decreased
plasma oncotic pressure can lead to renin-angiotensin-aldosterone system (RAAS) upregulation. ANG II, and
aldosterone are both pro-inflammatory, and ANG II directly induces upregulation of transforming growth factor-
(TGF-). TGF- causes both tubular cell hypertrophy and increased synthesis of Type IV collagen. Excessive protein
reabsorption activates inflammatory genes, and causes upregulation of tubular-derived endothelin-1 (ET-1, a very
potent vasoconstrictor), monocyte chemoattractant protein-1 (CCL2, formerly known as MCP-1), and an
immunoregulatory cytokine called CCL5 (formerly known as RANTES). The presence of increased ET-1 in the
interstitium leads to ischemic damage, and induces the interstitial fibroblasts to proliferate and secrete increased
amounts of matrix. True to its (former) name, CCL2 attracts monocytes and other inflammatory mononuclear cells,
and CCL5 is chemotactic for T cells, eosinophils and basophils.
Increased interstitial amino acid transport is itself pro-inflammatory, and (combined with the cellular injury described
above, and the results of ANG-II and chemoattractant factor upregulation) eventually results in tubulointerstitial
nephritis with fibrosis and progressive loss of renal function. Magnitude of proteinuria usually determines severity of
inflammatory response, and fulminant, heavy proteinuria can cause inflammation severe enough to result in acute
tubular necrosis and uremia. If proteinuria can be slowed or halted, and the patient can be sustained (e.g., with
standard care or with dialysis), recovery from acute tubular necrosis and recovery from renal failure will often occur.
So no, its not just cosmetic or making the numbers look better proteinuria is pathological in and of itself, and
pathogenicity is proportional to magnitude.
Hope that helps.

Michael Riegger, DVM
Northwest Animal Clinic and Hospital, Albuquerque, NM
Good afternoon all,
Are there any double blinded comparisons of these situations?

Julie Fischer
Hi Michael
Double blinded comparisons of what (though most likely the answer is no)? The following study WAS blinded/
controlled (and had the participation of some folks who truly know their way around the kidney!), and looked at
enalapril use in dogs with GN, evaluating proteiniuria and progression in response to tx, but most of our data come
from (fairly copious) human and lab animal studies.
J Vet Intern Med. 2000 Sep-Oct;14(5):526-33
Effects of enalapril versus placebo as a treatment for canine idiopathic glomerulonephritis.
Grauer GF, Greco DS, Getzy DM, Cowgill LD, Vaden SL, Chew DJ, Polzin DJ, Barsanti JA
Michael Riegger
Thanx! =)
Julie Fischer
You bet. Glad youre looking for the evidence behind the rhetoric!
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.
This thread appears in an edited form. To read the full thread and access the links mentioned
visit http://www.vin.com/Link.plx?ID=4331686
Editors note:
Two familial renal diseases are recognised in the Soft-coated Wheaten Terrier.
1) A juvenile renal disease with pathologic changes suggestive of renal dysplasia.
2) An adult onset protein-losing nephropathy (PLN) either alone or in combination with a protein-losing enteropathy. Increased gut
permeability is suggested to lead to immune complex glomerulonephritis (membranoproliferative glomerulonephritis) that then progresses
to glomerular sclerosis and chronic interstitial nephritis (end-stage renal disease). Clinical findings are those expected in PLN (wt loss,
proteinuria, hypoalbuminaemia, hypercholesterolaemia progressing to PU/PD, azotaemia, hyperphosphataemia and non-regenerative
anaemia ) Hypertension and thromboembolism occasionally develop. The disease is progressive and associated with a poor prognosis.
Treatment is palliative.
24-26 GrapeVINe.indd 26 19/1/10 08:50:53
companion
|
27
PETSAVERS
Improving the health of the nations pets
P
etsavers is currently funding a study on
Establishing potential CSF markers of
degenerative myelopathy in the dog. The study
is headed by Professor T. James Anderson at the
University of Glasgow.
Professor Anderson describes his project:
Degenerative myelopathy (DM) (or chronic
degenerative radicuolomyelopathy, CDRM) is a
condition of the nervous system that affects mostly
older German Shepherd Dogs. A number of other
specific breeds may also be affected, in particular the
Chesapeake Bay Retriever and the Pembroke Corgi.
This slow degenerative condition of the central
nervous system leads to deterioration in hindlimb
action, with affected dogs becoming increasingly
unsteady and eventually unable to walk. Though,
fortunately, this condition appears not to be painful, it
is distressing for both patient and owner; and as
there is no cure, progression leads ultimately to
euthanasia. The frustration of the lack of an in life
diagnostic test is well recognised in veterinary
P
etsavers is looking for runners to take part in the British 10K London
Run. The run is a huge event and 27,000 runners took part last year
for many different charities. The route takes in many of Londons
landmarks including the London Eye and the Houses of Parliament. The
run is taking place on Sunday 11 July 2010, so there is plenty of time to
train and raise sponsorship. If you are interested in taking part please
contact Gene Waterhouse on g.waterhouse@bsava.com. Petsavers has
a limited number of places for the run, so if you are keen to take part please
get in touch soon to avoid disappointment.
Degenerative myelopathy project
Professor T. James Anderson
describes his Petsavers-funded
project on degenerative
myelopathy
practice, particularly as some other conditions may
have a similar clinical appearance.
A major step forward in the understanding of DM
has been made recently in the USA where it has been
revealed that affected dogs share a mutation of a
common gene. The affected gene is Superoxidase 1
(SOD1). SOD1 is involved in protecting cells from free
radicals, which are important in many destructive
pathways underlying disease. The contribution of
SOD1 to DM is now being actively investigated around
the world.
The current understanding is that the presence of
the mutation indicates that a dog has the potential to
develop the disease, but is not specifically
diagnostic. Other diseases, most importantly
degenerative disc disease, can cause similar
clinical signs and/or occur concurrently, but have a
potentially better outcome. Making the correct
diagnosis in an individual dog is important so the
best advice can be given.
This project will examine protein markers that
studies in a disease in man related to the SOD1
mutation amyotrophic lateral sclerosis (ALS)
suggest may be related to the presence of disease.
These disease markers comprise changes in a
group of serum and CSF proteins in ALS. The aim
is developing a test that will allow a diagnosis of DM to
be made with greater confidence.
Calling all runners
27 Petsavers.indd 27 19/1/10 08:35:19
26
|
companion
VIN
GrapeVINe
Initial renal injury directly stimulates generation of angiotensin II (ANG II), and both decreased GFR and decreased
plasma oncotic pressure can lead to renin-angiotensin-aldosterone system (RAAS) upregulation. ANG II, and
aldosterone are both pro-inflammatory, and ANG II directly induces upregulation of transforming growth factor-
(TGF-). TGF- causes both tubular cell hypertrophy and increased synthesis of Type IV collagen. Excessive protein
reabsorption activates inflammatory genes, and causes upregulation of tubular-derived endothelin-1 (ET-1, a very
potent vasoconstrictor), monocyte chemoattractant protein-1 (CCL2, formerly known as MCP-1), and an
immunoregulatory cytokine called CCL5 (formerly known as RANTES). The presence of increased ET-1 in the
interstitium leads to ischemic damage, and induces the interstitial fibroblasts to proliferate and secrete increased
amounts of matrix. True to its (former) name, CCL2 attracts monocytes and other inflammatory mononuclear cells,
and CCL5 is chemotactic for T cells, eosinophils and basophils.
Increased interstitial amino acid transport is itself pro-inflammatory, and (combined with the cellular injury described
above, and the results of ANG-II and chemoattractant factor upregulation) eventually results in tubulointerstitial
nephritis with fibrosis and progressive loss of renal function. Magnitude of proteinuria usually determines severity of
inflammatory response, and fulminant, heavy proteinuria can cause inflammation severe enough to result in acute
tubular necrosis and uremia. If proteinuria can be slowed or halted, and the patient can be sustained (e.g., with
standard care or with dialysis), recovery from acute tubular necrosis and recovery from renal failure will often occur.
So no, its not just cosmetic or making the numbers look better proteinuria is pathological in and of itself, and
pathogenicity is proportional to magnitude.
Hope that helps.

Michael Riegger, DVM
Northwest Animal Clinic and Hospital, Albuquerque, NM
Good afternoon all,
Are there any double blinded comparisons of these situations?

Julie Fischer
Hi Michael
Double blinded comparisons of what (though most likely the answer is no)? The following study WAS blinded/
controlled (and had the participation of some folks who truly know their way around the kidney!), and looked at
enalapril use in dogs with GN, evaluating proteiniuria and progression in response to tx, but most of our data come
from (fairly copious) human and lab animal studies.
J Vet Intern Med. 2000 Sep-Oct;14(5):526-33
Effects of enalapril versus placebo as a treatment for canine idiopathic glomerulonephritis.
Grauer GF, Greco DS, Getzy DM, Cowgill LD, Vaden SL, Chew DJ, Polzin DJ, Barsanti JA
Michael Riegger
Thanx! =)
Julie Fischer
You bet. Glad youre looking for the evidence behind the rhetoric!
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.
This thread appears in an edited form. To read the full thread and access the links mentioned
visit http://www.vin.com/Link.plx?ID=4331686
Editors note:
Two familial renal diseases are recognised in the Soft-coated Wheaten Terrier.
1) A juvenile renal disease with pathologic changes suggestive of renal dysplasia.
2) An adult onset protein-losing nephropathy (PLN) either alone or in combination with a protein-losing enteropathy. Increased gut
permeability is suggested to lead to immune complex glomerulonephritis (membranoproliferative glomerulonephritis) that then progresses
to glomerular sclerosis and chronic interstitial nephritis (end-stage renal disease). Clinical findings are those expected in PLN (wt loss,
proteinuria, hypoalbuminaemia, hypercholesterolaemia progressing to PU/PD, azotaemia, hyperphosphataemia and non-regenerative
anaemia ) Hypertension and thromboembolism occasionally develop. The disease is progressive and associated with a poor prognosis.
Treatment is palliative.
24-26 GrapeVINe.indd 26 19/1/10 08:50:53
companion
|
27
PETSAVERS
Improving the health of the nations pets
P
etsavers is currently funding a study on
Establishing potential CSF markers of
degenerative myelopathy in the dog. The study
is headed by Professor T. James Anderson at the
University of Glasgow.
Professor Anderson describes his project:
Degenerative myelopathy (DM) (or chronic
degenerative radicuolomyelopathy, CDRM) is a
condition of the nervous system that affects mostly
older German Shepherd Dogs. A number of other
specific breeds may also be affected, in particular the
Chesapeake Bay Retriever and the Pembroke Corgi.
This slow degenerative condition of the central
nervous system leads to deterioration in hindlimb
action, with affected dogs becoming increasingly
unsteady and eventually unable to walk. Though,
fortunately, this condition appears not to be painful, it
is distressing for both patient and owner; and as
there is no cure, progression leads ultimately to
euthanasia. The frustration of the lack of an in life
diagnostic test is well recognised in veterinary
P
etsavers is looking for runners to take part in the British 10K London
Run. The run is a huge event and 27,000 runners took part last year
for many different charities. The route takes in many of Londons
landmarks including the London Eye and the Houses of Parliament. The
run is taking place on Sunday 11 July 2010, so there is plenty of time to
train and raise sponsorship. If you are interested in taking part please
contact Gene Waterhouse on g.waterhouse@bsava.com. Petsavers has
a limited number of places for the run, so if you are keen to take part please
get in touch soon to avoid disappointment.
Degenerative myelopathy project
Professor T. James Anderson
describes his Petsavers-funded
project on degenerative
myelopathy
practice, particularly as some other conditions may
have a similar clinical appearance.
A major step forward in the understanding of DM
has been made recently in the USA where it has been
revealed that affected dogs share a mutation of a
common gene. The affected gene is Superoxidase 1
(SOD1). SOD1 is involved in protecting cells from free
radicals, which are important in many destructive
pathways underlying disease. The contribution of
SOD1 to DM is now being actively investigated around
the world.
The current understanding is that the presence of
the mutation indicates that a dog has the potential to
develop the disease, but is not specifically
diagnostic. Other diseases, most importantly
degenerative disc disease, can cause similar
clinical signs and/or occur concurrently, but have a
potentially better outcome. Making the correct
diagnosis in an individual dog is important so the
best advice can be given.
This project will examine protein markers that
studies in a disease in man related to the SOD1
mutation amyotrophic lateral sclerosis (ALS)
suggest may be related to the presence of disease.
These disease markers comprise changes in a
group of serum and CSF proteins in ALS. The aim
is developing a test that will allow a diagnosis of DM to
be made with greater confidence.
Calling all runners
27 Petsavers.indd 27 19/1/10 08:35:19
28
|
companion
PUBLICATIONS
Exotic Pets
the classic reborn
In the US, sugar gliders probably reached their
peak of popularity as a novelty pet about six years
ago. Therefore, most of those clients that are still
keeping them are among the knowledgeable and
enthusiastic minority who have often made
considerable sacrifices to adapt their home and
lifestyle to cope with the demands of these unusual
pets. Usually, these people are also generous in
providing advice and support for other less
experienced owners, Cathy says.
Increasing diversity
Pet marsupials were mentioned briefly in the previous
edition of the Manual, published in 2002, but with the
expansion in veterinary involvement in their care, they
now merit a complete chapter. Another currently
fashionable species, the African pygmy hedgehog (a
hybrid between the white-bellied hedgehog Atelerix
albiventris and the Algerian hedgehog A. algirus) is
also given a chapter to itself.
John Bonner speaks to the
editors of the new edition of the
original veterinary manual on
exotic pet care
Too sweet for their own good?
They sleep all day, they are noisy at night and they
bite. Their dietary needs are difficult to meet, they
scent mark around the home and they need huge
amounts of space to exercise. So they are certainly far
from being an ideal pet but they have the enormous
eyes of a nocturnal mammal, theyre undeniably cute
(as shown on our new cover), and theres the rub
They are sugar gliders (Petaurus breviceps),
small arboreal marsupials native to Australia and New
Guinea. They are also an increasingly popular pet
species in Britain, which is why they are included in a
chapter on pet marsupials in the updated and
expanded new edition of the BSAVA Manual of Exotic
Pets. Sugar gliders feature in the new Marsupials
chapter, written by Cathy Johnson-Delaney, a
specialist in exotic animal medicine based near
Seattle, who is a co-editor of the new fifth edition
which will be published in February 2010. Given the
difficulties that most people face in successfully
keeping sugar gliders, Cathy says she would
discourage any client contemplating buying one who
has not done their homework.
In principle, she is not averse to the notion of
keeping a pet marsupial, provided that it is the right
sort. She herself has a female Virginia opossum
(Didelphis virginiana), a species with a long and
relatively successful record of cohabitation with
humans. But in a 15-year career caring for sugar
gliders she knows that most of the problems that occur
in this and most other exotic species are a direct result
of ignorance and poor husbandry. As such they are
issues that veterinary practitioners are likely to be
asked to resolve and, like many of her colleagues, she
has personally taken responsibility for a large number
of pets discarded when their owners realise that they
cannot cope or they have lost interest.
The advent of the recent BSAVA Manual of Rodents
and Ferrets has led to some reorganisation of the
rodent content, including a new chapter devoted to
chinchillas, degus and duprasi. There are also
completely new chapters on some groups that will be
professionally challenging to all but the most
28-29 Publications.indd 28 19/1/10 08:42:54
companion
|
29
PUBLICATIONS
experienced exotics practitioner, such as crocodilians
and ratites (ostriches, rheas and emus).
One of the more familiar species, the ferret, is
grouped together with two closely related mustelid
groups, otters and skunks. As with some of the
species already mentioned, otters may not be a
regular visitor to the suburban veterinary consult room,
and long may that remain the case. But it is important
to include them, because species like the Asian
short-clawed otter (Aonyx cinerea) are active during
the day and are therefore a favourite for small
zoological collections. So, practitioners may well be
called out to administer preventive healthcare, in the
form of distemper vaccinations, and to treat their
common ailments, such as urolithiasis.
EXOTIC PETS COVERED
Mice, rats, hamsters and gerbils; Guinea pigs,
chinchillas, degus and duprasi; Chipmunks and
prairie dogs; Rabbits; Marsupials; Ferrets, skunks
and otters; African pygmy hedgehogs; Primates
callitrichids, cebids and lemurs; Cage and aviary
birds; Racing pigeons; Birds of prey; Ostriches,
emus and rheas; Crocodilians; Tortoises and
turtles; Lizards; Snakes; Frogs and toads;
Salamanders, axolotls and caecilians; Freshwater
ornamental fish; Marine fish; Invertebrates
User-friendly
As with all BSAVA Manuals, the new Exotic Pets is
intended to be a book that becomes dog-eared with
regular use, rather than something that decorates a
shelf for months on end. The editors have spent a
considerable amount of time checking and amending
the content and format, so that it is possible for the
user to have confidence that they will quickly find what
they are looking for during a consultation.
The idea is that each chapter should be
presented in a consistent and logical way. We have
organised each one so that it begins with a brief
explanation of the natural history of the particular
species or group, and goes on to deal with their
anatomy, physiology, nutrition and husbandry. For the
less experienced practitioner, we also include advice
on how they should be handling that animal before
describing the overall diagnostic
approach and the diseases that
they are most likely to encounter.
We hope that this Manual will
give a vet everything they need
to know in order to approach an
unfamiliar species in a
sensible way and for them to
be able to give an owner good
advice on how to look after it,
Anna explains.
Some species included in the manual may no
longer be strictly classified as exotics rabbits, for
example, long ago entered the mainstream of
veterinary practice. However, co-editor Anna Meredith
from the University of Edinburgh veterinary school,
says it was decided to maintain a comprehensive list
of minor species in the Manual, so that it remains the
go-to publication in the field.
Such have been the advances in knowledge on
rabbits that there is a separate BSAVA Manual devoted
to them. But the condensed information presented in
Exotic Pets will provide a busy practitioner with pretty
well everything they need to know during the course of
a consultation. Any further research can be carried out
later when the practitioner has time to check in the
more specialised volume.
companion
|
29
28
|
companion
PUBLICATIONS
Exotic Pets
the classic reborn
In the US, sugar gliders probably reached their
peak of popularity as a novelty pet about six years
ago. Therefore, most of those clients that are still
keeping them are among the knowledgeable and
enthusiastic minority who have often made
considerable sacrifices to adapt their home and
lifestyle to cope with the demands of these unusual
pets. Usually, these people are also generous in
providing advice and support for other less
experienced owners, Cathy says.
Increasing diversity
Pet marsupials were mentioned briefly in the previous
edition of the Manual, published in 2002, but with the
expansion in veterinary involvement in their care, they
now merit a complete chapter. Another currently
fashionable species, the African pygmy hedgehog (a
hybrid between the white-bellied hedgehog Atelerix
albiventris and the Algerian hedgehog A. algirus) is
also given a chapter to itself.
John Bonner speaks to the
editors of the new edition of the
original veterinary manual on
exotic pet care
Too sweet for their own good?
They sleep all day, they are noisy at night and they
bite. Their dietary needs are difficult to meet, they
scent mark around the home and they need huge
amounts of space to exercise. So they are certainly far
from being an ideal pet but they have the enormous
eyes of a nocturnal mammal, theyre undeniably cute
(as shown on our new cover), and theres the rub
They are sugar gliders (Petaurus breviceps),
small arboreal marsupials native to Australia and New
Guinea. They are also an increasingly popular pet
species in Britain, which is why they are included in a
chapter on pet marsupials in the updated and
expanded new edition of the BSAVA Manual of Exotic
Pets. Sugar gliders feature in the new Marsupials
chapter, written by Cathy Johnson-Delaney, a
specialist in exotic animal medicine based near
Seattle, who is a co-editor of the new fifth edition
which will be published in February 2010. Given the
difficulties that most people face in successfully
keeping sugar gliders, Cathy says she would
discourage any client contemplating buying one who
has not done their homework.
In principle, she is not averse to the notion of
keeping a pet marsupial, provided that it is the right
sort. She herself has a female Virginia opossum
(Didelphis virginiana), a species with a long and
relatively successful record of cohabitation with
humans. But in a 15-year career caring for sugar
gliders she knows that most of the problems that occur
in this and most other exotic species are a direct result
of ignorance and poor husbandry. As such they are
issues that veterinary practitioners are likely to be
asked to resolve and, like many of her colleagues, she
has personally taken responsibility for a large number
of pets discarded when their owners realise that they
cannot cope or they have lost interest.
The advent of the recent BSAVA Manual of Rodents
and Ferrets has led to some reorganisation of the
rodent content, including a new chapter devoted to
chinchillas, degus and duprasi. There are also
completely new chapters on some groups that will be
professionally challenging to all but the most
companion
|
29
PUBLICATIONS
experienced exotics practitioner, such as crocodilians
and ratites (ostriches, rheas and emus).
One of the more familiar species, the ferret, is
grouped together with two closely related mustelid
groups, otters and skunks. As with some of the
species already mentioned, otters may not be a
regular visitor to the suburban veterinary consult room,
and long may that remain the case. But it is important
to include them, because species like the Asian
short-clawed otter (Aonyx cinerea) are active during
the day and are therefore a favourite for small
zoological collections. So, practitioners may well be
called out to administer preventive healthcare, in the
form of distemper vaccinations, and to treat their
common ailments, such as urolithiasis.
EXOTIC PETS COVERED
Mice, rats, hamsters and gerbils; Guinea pigs,
chinchillas, degus and duprasi; Chipmunks and
prairie dogs; Rabbits; Marsupials; Ferrets, skunks
and otters; African pygmy hedgehogs; Primates
callitrichids, cebids and lemurs; Cage and aviary
birds; Racing pigeons; Birds of prey; Ostriches,
emus and rheas; Crocodilians; Tortoises and
turtles; Lizards; Snakes; Frogs and toads;
Salamanders, axolotls and caecilians; Freshwater
ornamental fish; Marine fish; Invertebrates
User-friendly
As with all BSAVA Manuals, the new Exotic Pets is
intended to be a book that becomes dog-eared with
regular use, rather than something that decorates a
shelf for months on end. The editors have spent a
considerable amount of time checking and amending
the content and format, so that it is possible for the
user to have confidence that they will quickly find what
they are looking for during a consultation.
The idea is that each chapter should be
presented in a consistent and logical way. We have
organised each one so that it begins with a brief
explanation of the natural history of the particular
species or group, and goes on to deal with their
anatomy, physiology, nutrition and husbandry. For the
less experienced practitioner, we also include advice
on how they should be handling that animal before
describing the overall diagnostic
approach and the diseases that
they are most likely to encounter.
We hope that this Manual will
give a vet everything they need
to know in order to approach an
unfamiliar species in a
sensible way and for them to
be able to give an owner good
advice on how to look after it,
Anna explains.
Some species included in the manual may no
longer be strictly classified as exotics rabbits, for
example, long ago entered the mainstream of
veterinary practice. However, co-editor Anna Meredith
from the University of Edinburgh veterinary school,
says it was decided to maintain a comprehensive list
of minor species in the Manual, so that it remains the
go-to publication in the field.
Such have been the advances in knowledge on
rabbits that there is a separate BSAVA Manual devoted
to them. But the condensed information presented in
Exotic Pets will provide a busy practitioner with pretty
well everything they need to know during the course of
a consultation. Any further research can be carried out
later when the practitioner has time to check in the
more specialised volume.
companion
|
29
30
|
companion
W
hat an eventful year it has been for WSAVA!
The WSAVA Congress held in So Paulo was
a great success, with over 3500 delegates
making it the biggest WSAVA World Congress ever
staged. It was always going to be a huge party and the
Saturday night event had the delegates dancing and
partying until the early hours of the morning! The
education programme was superb and great credit
must go to Drs Wanderson Ferrara, Saliem Sayeed
and Marco Gioso and their committees for their work
in staging the Congress and setting such a high
standard for the future. Talking of which, the
Assembly voted to take the 2013 Congress to
Christchurch, New Zealand, and we are already
working hard with them to ensure our ongoing
Congress success. We are immensely grateful to
our Prime Congress Sponsor, Hills Pet Nutrition, for
all the help given to WSAVA as we aim to set the
highest standards in veterinary education.
Change and hard work on the Board
There have been changes to the WSAVA Board. We
were saddened that Dr Luis Tello resigned because of
time commitment pressures, but I am really pleased
that he has been able to continue to look after the
WSAVA CE programme in Latin America. His deep
knowledge of the area and his many friends and
contacts mean that the programme runs very smoothly
and I am very grateful for all the help he gives. He was
replaced by Professor Peter Ihrke who I am sure
needs no introduction. He is currently Vice President
and we will be looking to him for his wisdom and
knowledge of international committee work.
Dr Veronica Leong also joined the Board to add
greater depth to a committee which is struggling under
an expanding workload. Her expertise in marketing will
be invaluable in helping us to expand our PR portfolio.
Dr Sheehan has continued to work hard in
developing the treasury, and is now faced with the task
of working with the new Canadian accountants and
instituting another new system that will hopefully be
stable for many years to come as the WSAVA settles
into its new incorporation as a Canadian Registered
not-for-profit company.
Professor Jolle Kirpensteijn and we must
congratulate him on being elected a full Professor
in the University of Utrecht has been working
tirelessly on future WSAVA Congresses and
developing sponsorship opportunities with our
commercial partners. The Assembly voted in So
Paulo to form a Congress Steering Committee to
look into the current structure and future development
of the WSAVA Congress Drs Kirpensteijn and
Sheehan have worked tirelessly to form this
committee and one of its first tasks will be to
examine bids for the 2014 Congress.
Hon. Secretaries are always spoken of as hard
working and Dr Walt Ingwersen is no exception. As
well as his normal duties, he has been the lynchpin in
the negotiations with the Canadian authorities and we
are grateful to him and his wife June for all their hard
work. June will also be developing the prototype
WSAVA secretariat which will function separately to,
but under the jurisdiction of, the Honorary Secretary.
Dr Brian Romberg has not been relaxing after his
tenure as President, he has been working on the
formation of the WSAVA Foundation, again as a
registered company based in Canada, and he will be
submitting his report on this exciting project in Geneva.
What a year!
David Wadsworth, WSAVA President,
reports on an eventful year for the Association
30-32 WSAVA News.indd 30 19/1/10 08:45:45
companion
|
31
WSAVA NEWS
New partnership for animal welfare

The Strategic Planning process identified animal
welfare as one of the four pillars that underwrite the
raison detre of WSAVA. I am extremely pleased to
announce that WSAVA is entering into a partnership
with WALTHAM, a division of Mars Inc., who will work
with the Association in promoting animal welfare
during the WSAVA and other large congresses, in
promoting animal welfare in member association
countries where there is an identified need for an
improvement in standards, and in promoting the
WSAVA Animal Welfare Convention. We are entering a
very exciting phase of development of heightened
awareness of the veterinary profession in this subject.
CE success
The WSAVA CE programme last year hosted 5000
delegates in 32 countries and the work of the committee
will be reported in detail in a later issue. I am grateful to
the help given to me by Drs Julian Wells, Roger Clarke,
Lawson Cairns and Luis Tello in overseeing their
various regional meetings. Our sponsors, Hills Pet
Nutrition, Intervet/Schering-Plough Animal Health and
Bayer Animal Health, provide invaluable help in the
planning stages and work with the Association
representatives in setting up the local meetings. Our
member associations, ASAVA, BSAVA, VOK, AFVAC
and NSAVA have once again been extremely helpful
and generous in providing expertise and funding which
has continued to help our programme to expand.
Other projects
Professor Urs Giger and his team have been making
excellent progress in the mapping of the canine and
feline genomes and identifying the many hereditary
diseases. WALTHAM is to be thanked for their
background assistance and funding for this extremely
worthwhile project which will hopefully improve
standards in breeding for generations to come.
Professor David Polzin organises the Renal
Standardization Project which is getting well into its
stride and the information produced in two years time
should benefit current generations of animals. This is a
huge project and we are grateful to both Hills Pet
Nutrition and Bayer Animal Health for their support.
Professor Michael Day has been chairing the
second phase of the vaccination protocol group and
will be reporting in Geneva on this first truly global
project which will add much needed clarity to a
subject which seems to vary from country to country.
Intervet/Schering-Plough Animal Health have been our
partners in this exciting and challenging subject.
Michael Day and the Scientific Advisory
Committee have worked unceasingly to advise on the
scientific programmes of the WSAVA congresses and
will be overseeing the One Health One Medicine
initiative which will form part of the programme in
Geneva. Renowned international speakers from
both the medical and veterinary professions will
exchange ideas and look to future developments of
mutual interest.
We are looking forward to the next Congress in
Geneva next June. Dr Chris Amberger and his team
have prepared an excellent programme. CPD with Lac
Leman and Mont Blanc as a backdrop what more
can one say! Make a note in your diaries and join us
there.
IN MEMORIAM DR LLUS POMAR
Dr Llus Maria Pomar i Pomar, who was WSAVA President from 198082, passed
away in Palma de Mallorca on 8 November 2009 at the age of 92. Although one
does not pass on such news about a valued friend and colleague without a touch
of sadness, it is also a time to celebrate Lluss many achievements and to be
thankful for the opportunity to have known him. He was one of WSAVAs primary
mentors during the 1980s the WSAVA Presidents achieved a great deal and put
WSAVA on the firm footing that it now enjoys. Llus was also one of the founders
of AVEPA (Spanish Small Animal Veterinary Association), and was a driving force
of small animal veterinary practice in Mallorca and Spain.
30-32 WSAVA News.indd 31 19/1/10 08:45:52
30
|
companion
W
hat an eventful year it has been for WSAVA!
The WSAVA Congress held in So Paulo was
a great success, with over 3500 delegates
making it the biggest WSAVA World Congress ever
staged. It was always going to be a huge party and the
Saturday night event had the delegates dancing and
partying until the early hours of the morning! The
education programme was superb and great credit
must go to Drs Wanderson Ferrara, Saliem Sayeed
and Marco Gioso and their committees for their work
in staging the Congress and setting such a high
standard for the future. Talking of which, the
Assembly voted to take the 2013 Congress to
Christchurch, New Zealand, and we are already
working hard with them to ensure our ongoing
Congress success. We are immensely grateful to
our Prime Congress Sponsor, Hills Pet Nutrition, for
all the help given to WSAVA as we aim to set the
highest standards in veterinary education.
Change and hard work on the Board
There have been changes to the WSAVA Board. We
were saddened that Dr Luis Tello resigned because of
time commitment pressures, but I am really pleased
that he has been able to continue to look after the
WSAVA CE programme in Latin America. His deep
knowledge of the area and his many friends and
contacts mean that the programme runs very smoothly
and I am very grateful for all the help he gives. He was
replaced by Professor Peter Ihrke who I am sure
needs no introduction. He is currently Vice President
and we will be looking to him for his wisdom and
knowledge of international committee work.
Dr Veronica Leong also joined the Board to add
greater depth to a committee which is struggling under
an expanding workload. Her expertise in marketing will
be invaluable in helping us to expand our PR portfolio.
Dr Sheehan has continued to work hard in
developing the treasury, and is now faced with the task
of working with the new Canadian accountants and
instituting another new system that will hopefully be
stable for many years to come as the WSAVA settles
into its new incorporation as a Canadian Registered
not-for-profit company.
Professor Jolle Kirpensteijn and we must
congratulate him on being elected a full Professor
in the University of Utrecht has been working
tirelessly on future WSAVA Congresses and
developing sponsorship opportunities with our
commercial partners. The Assembly voted in So
Paulo to form a Congress Steering Committee to
look into the current structure and future development
of the WSAVA Congress Drs Kirpensteijn and
Sheehan have worked tirelessly to form this
committee and one of its first tasks will be to
examine bids for the 2014 Congress.
Hon. Secretaries are always spoken of as hard
working and Dr Walt Ingwersen is no exception. As
well as his normal duties, he has been the lynchpin in
the negotiations with the Canadian authorities and we
are grateful to him and his wife June for all their hard
work. June will also be developing the prototype
WSAVA secretariat which will function separately to,
but under the jurisdiction of, the Honorary Secretary.
Dr Brian Romberg has not been relaxing after his
tenure as President, he has been working on the
formation of the WSAVA Foundation, again as a
registered company based in Canada, and he will be
submitting his report on this exciting project in Geneva.
What a year!
David Wadsworth, WSAVA President,
reports on an eventful year for the Association
30-32 WSAVA News.indd 30 19/1/10 08:45:45
companion
|
31
WSAVA NEWS
New partnership for animal welfare

The Strategic Planning process identified animal
welfare as one of the four pillars that underwrite the
raison detre of WSAVA. I am extremely pleased to
announce that WSAVA is entering into a partnership
with WALTHAM, a division of Mars Inc., who will work
with the Association in promoting animal welfare
during the WSAVA and other large congresses, in
promoting animal welfare in member association
countries where there is an identified need for an
improvement in standards, and in promoting the
WSAVA Animal Welfare Convention. We are entering a
very exciting phase of development of heightened
awareness of the veterinary profession in this subject.
CE success
The WSAVA CE programme last year hosted 5000
delegates in 32 countries and the work of the committee
will be reported in detail in a later issue. I am grateful to
the help given to me by Drs Julian Wells, Roger Clarke,
Lawson Cairns and Luis Tello in overseeing their
various regional meetings. Our sponsors, Hills Pet
Nutrition, Intervet/Schering-Plough Animal Health and
Bayer Animal Health, provide invaluable help in the
planning stages and work with the Association
representatives in setting up the local meetings. Our
member associations, ASAVA, BSAVA, VOK, AFVAC
and NSAVA have once again been extremely helpful
and generous in providing expertise and funding which
has continued to help our programme to expand.
Other projects
Professor Urs Giger and his team have been making
excellent progress in the mapping of the canine and
feline genomes and identifying the many hereditary
diseases. WALTHAM is to be thanked for their
background assistance and funding for this extremely
worthwhile project which will hopefully improve
standards in breeding for generations to come.
Professor David Polzin organises the Renal
Standardization Project which is getting well into its
stride and the information produced in two years time
should benefit current generations of animals. This is a
huge project and we are grateful to both Hills Pet
Nutrition and Bayer Animal Health for their support.
Professor Michael Day has been chairing the
second phase of the vaccination protocol group and
will be reporting in Geneva on this first truly global
project which will add much needed clarity to a
subject which seems to vary from country to country.
Intervet/Schering-Plough Animal Health have been our
partners in this exciting and challenging subject.
Michael Day and the Scientific Advisory
Committee have worked unceasingly to advise on the
scientific programmes of the WSAVA congresses and
will be overseeing the One Health One Medicine
initiative which will form part of the programme in
Geneva. Renowned international speakers from
both the medical and veterinary professions will
exchange ideas and look to future developments of
mutual interest.
We are looking forward to the next Congress in
Geneva next June. Dr Chris Amberger and his team
have prepared an excellent programme. CPD with Lac
Leman and Mont Blanc as a backdrop what more
can one say! Make a note in your diaries and join us
there.
IN MEMORIAM DR LLUS POMAR
Dr Llus Maria Pomar i Pomar, who was WSAVA President from 198082, passed
away in Palma de Mallorca on 8 November 2009 at the age of 92. Although one
does not pass on such news about a valued friend and colleague without a touch
of sadness, it is also a time to celebrate Lluss many achievements and to be
thankful for the opportunity to have known him. He was one of WSAVAs primary
mentors during the 1980s the WSAVA Presidents achieved a great deal and put
WSAVA on the firm footing that it now enjoys. Llus was also one of the founders
of AVEPA (Spanish Small Animal Veterinary Association), and was a driving force
of small animal veterinary practice in Mallorca and Spain.
30-32 WSAVA News.indd 31 19/1/10 08:45:52
32
|
companion
WSAVA NEWS
T
he official welcome reception will take place
on 2 June at Palexpo and be followed by a
Swiss Apero in the exhibition hall.
The world famous Geneva Fountain will form the
backdrop for the Gala Dinner on 3 June. Participants
will leave from Downtown Geneva on a boat for a
relaxing one-hour cruise on Lake Geneva. A welcome
drink will be served on board as the last light of the
day reflects on the Lake. Following the boat trip the
gala dinner will be served with a musical
accompaniment.
Geneva 2010:
update
To keep up with the latest progress and
learn more about One Medicine, please
join us at the WSAVA World Congress in
Geneva on 25 June 2010
The Swiss Evening Party on 4 June will allow
delegates to discover a historical location of
Geneva: the Btiment des Forces Motrices (BFM).
A former hydro-electrical facility built on the Rhne
River, the BFM will be converted into a giant gala
room to make this a unique event.
The Scientific Programme is now available
look for more information and print your
own copy at www.wsava2010.org

M
i
h
a
i
-
b
o
g
d
a
n

L
a
z
a
r

|

D
r
e
a
m
s
t
i
m
e
.
c
o
m
30-32 WSAVA News.indd 32 19/1/10 08:46:05
companion
|
33
THE companion INTERVIEW
Carmel
Mooney
Q
What was your family life like and was there
any history of veterinary medicine?
A
My one brother and I share a birthday he
was four and really wanted a Dinky car, but got
me instead, so he has never really forgiven me.
My father was a civil servant specialising in pensions
and taxes and my mother (not unexpectedly) was a
full-time housewife. I grew up in DunLaoghaire,
Co Dublin, a small town south of the city and went to
both primary and secondary school locally
St Joseph of Cluny. After school I studied veterinary at
Carmel Mooney was born in Dublin in 1964 the youngest of

eight children (four boys and four girls). She spent many years
as a BSAVA volunteer in various posts, becoming President of
the Association in 2006
Carmel is a 1986 graduate of UCDs former Faculty of Veterinary Medicine. After
spending several years in Scotland where she completed both MPhil (The University of
Edinburgh) and PhD (The University of Glasgow) theses, she returned to UCD initially
as Lecturer and then Head, Department of Small Animal Clinical Studies. More recently
she was appointed as Clinical Director of the University Veterinary Hospital. Carmel
obtained the European Diploma in Veterinary Internal Medicine (Companion Animals) in
1998 and is also a RCVS Specialist in Small Animal Medicine (Endocrinology), awarded
in recognition of her clinical and research work in the field of small animal endocrinology
UCD it was bad enough being a girl but being a city
girl with no family ties to the profession made my choice
somewhat unusual (at least then!).
What was your route into the veterinary
profession; was it something you always knew
you wanted to do?
Veterinary was pretty much what I wanted to do all along
I never really had a second choice. I didnt advertise
the desire to do veterinary very much it would not
been considered an appropriate career by the nuns, so
I used to suggest that I was going to do medicine.
33-34 Interview.indd 33 19/1/10 08:41:34
32
|
companion
WSAVA NEWS
T
he official welcome reception will take place
on 2 June at Palexpo and be followed by a
Swiss Apero in the exhibition hall.
The world famous Geneva Fountain will form the
backdrop for the Gala Dinner on 3 June. Participants
will leave from Downtown Geneva on a boat for a
relaxing one-hour cruise on Lake Geneva. A welcome
drink will be served on board as the last light of the
day reflects on the Lake. Following the boat trip the
gala dinner will be served with a musical
accompaniment.
Geneva 2010:
update
To keep up with the latest progress and
learn more about One Medicine, please
join us at the WSAVA World Congress in
Geneva on 25 June 2010
The Swiss Evening Party on 4 June will allow
delegates to discover a historical location of
Geneva: the Btiment des Forces Motrices (BFM).
A former hydro-electrical facility built on the Rhne
River, the BFM will be converted into a giant gala
room to make this a unique event.
The Scientific Programme is now available
look for more information and print your
own copy at www.wsava2010.org

M
i
h
a
i
-
b
o
g
d
a
n

L
a
z
a
r

|

D
r
e
a
m
s
t
i
m
e
.
c
o
m
30-32 WSAVA News.indd 32 19/1/10 08:46:05
companion
|
33
Carmel
Mooney
Q
What was your family life like and was there
any history of veterinary medicine?
A
My one brother and I share a birthday he
was four and really wanted a Dinky car, but got
me instead, so he has never really forgiven me.
My father was a civil servant specialising in pensions
and taxes and my mother (not unexpectedly) was a
full-time housewife. I grew up in DunLaoghaire,
Co Dublin, a small town south of the city and went to
both primary and secondary school locally
St Joseph of Cluny. After school I studied veterinary at
Carmel Mooney was born in Dublin in 1964 the youngest of

eight children (four boys and four girls). She spent many years
as a BSAVA volunteer in various posts, becoming President of
the Association in 2006
Carmel is a 1986 graduate of UCDs former Faculty of Veterinary Medicine. After
spending several years in Scotland where she completed both MPhil (The University of
Edinburgh) and PhD (The University of Glasgow) theses, she returned to UCD initially
as Lecturer and then Head, Department of Small Animal Clinical Studies. More recently
she was appointed as Clinical Director of the University Veterinary Hospital. Carmel
obtained the European Diploma in Veterinary Internal Medicine (Companion Animals) in
1998 and is also a RCVS Specialist in Small Animal Medicine (Endocrinology), awarded
in recognition of her clinical and research work in the field of small animal endocrinology
UCD it was bad enough being a girl but being a city
girl with no family ties to the profession made my choice
somewhat unusual (at least then!).
What was your route into the veterinary
profession; was it something you always knew
you wanted to do?
Veterinary was pretty much what I wanted to do all along
I never really had a second choice. I didnt advertise
the desire to do veterinary very much it would not
been considered an appropriate career by the nuns, so
I used to suggest that I was going to do medicine.
33-34 Interview.indd 33 19/1/10 08:41:34
34
|
companion
it was good to give something back
to a profession that has served me
well in my working life
Did you know youd have a career in academia

and teaching, or did you originally intend to go
into practice?
Like a lot of new veterinary students, I romanticised
about the perfect life as a mixed practitioner. However,
a couple of late night farm calls in the middle of winter
with the wind and rain whistling around during seeing
practice made me realise it wasnt for me! There was
also the realisation that were other career paths in
veterinary that were every bit as challenging but
perhaps in different ways.
You are known in the field of endocrinology, what
made you choose this specialism?
It is so straightforward you know what a hormone
does and you can easily work out what happens if
there is too much or too little! Actually my first job was
based in small animal medicine at the R(D)SVS
Dr Keith Thoday was my mentor and he had just
completed a PhD on thyroid function in cats and really
engendered my interest in the subject I had never
seen a hyperthyroid cat before then and could not
believe how many cases there were.
Youve been a key BSAVA volunteer for many
years, what did you get out of it?
I started as a volunteer while still at Edinburgh just
helping out the regional committee. Everyone seemed
to be doing it and I had attended a couple of CPD
events run by BSAVA and had enjoyed them. I dont
think there was anything more altruistic than that
although looking back it was good to give something
back to a profession that has served me well in my
working life. It is different working with a group of
volunteers because you all tend to be like-minded and
enthusiastic with similar aims it gives an additional
sense of achievement and I have gained knowledge
and skills that would not normally be gained through
my day job. The icing on the cake however is the
camaraderie and some of my best friends emanate
from my volunteer jobs.
What have been the biggest challenges of your
career so far?
Completing a PhD whilst having my first child was
pretty challenging but the PhD got finished eventually.
What do you consider to be your most important
achievement during your career so far?
To date becoming BSAVA President hopefully there
will be more.
What has been your main interest outside work?
It is quite varied but mostly cooking, walking.
Who has been the most inspiring influence on your
professional career?
Mark Peterson one of the top veterinary
endocrinologists around a prolific writer on the
subject. Undoubtedly most of our knowledge on
hyperthyroidism comes from clinical and research
work he has been involved in, and he has always been
really helpful to me.
What is the most significant lesson you have
learned so far in life?
You can always be proved wrong.
If you could change one thing about your
appearance or personality, what would it be?
Where do I start?
What is your most important possession?
I suppose in so far as a dog or cat can be a
possession, they are always the most important
possession!
What would you have done if you hadnt chosen to
be a vet?
Not really sure. I think I am more comfortable with
small animals but maybe I could have chosen a
different discipline an anaesthetist or surgeon
maybe.
33-34 Interview.indd 34 19/1/10 08:41:37
companion
|
35
CPD
DIARY
9
February
Tuesday
A practical approach to treating
psittacines
Speaker Neil Forbes
Potters Heron Hotel, Romsey SO51 9ZF.
Southern Region
Details from southern@bsava.com
EVENING
MEETING
11
February
Thursday
Thoracic medicine:
the coughing dog
Speaker Simon Swift
David Lloyd Leisure, Moss Lane,
Whittle-le-Woods, Chorley PR6 8AB.
North West Region
Details from Vikki Moran,
vikki.moran@sky.com
EVENING
MEETING
17
February
Wednesday
An update on fish medicine:
goldfish & koi carp
Speaker Peter Scott
Russell Hotel, 136 Boxley Rd, Maidstone,
Kent ME14 2AE. Kent Region
Details from Hannah Perrin,
hannah@burnhamhousevets.com
EVENING
MEETING
23
February
Tuesday
Endocrinology I: PU/PD &
alopecia
Speaker Ian Ramsey
BSAVA, Woodrow House, 1 Telford Way,
Waterwells Business Park, Quedgeley,
Gloucester GL2 2AB
Details from BSAVA, 01452 726700,
administration@bsava.com
DAY
MEETING
5
February
Friday
Rehabilitation & acupuncture in
companion animals (for vets &
nurses)
Speaker Siobhan Menzies
VSSCo, Lisburn. Northern Irish Region
Details from Shane Murray, shane@
braemarvetclinic.co.uk, or VetNI,
028 25898543, info@vetni.co.uk
EVENING
MEETING
7
February
Sunday
How to Step-by-step guides to
practical medical & emergency
techniques
Speakers Nick Bexfield and Karen Humm
Cambridge Belfry, Cambourne,
Cambridgeshire CB23 6BW.
East Anglia Region
Details from Graham Bilbrough,
graham-bilbrough@idexx.com
DAY
MEETING
4
March
Thursday
Head and neck surgery
Speaker Don Sheahan
EVENING
MEETING
7
March
Sunday
Liver disease in the dog and cat:
is diagnosis and treatment a
waste of time, or can I really
make a difference?
Speaker Penny Watson
Pavilions of Harrogate, Great Yorkshire
Showground, Railway Road, Harrogate
HG2 8PW. North East Region
Details from Chris Dale, 01422 833960,
07884 231307, chris.j.dale@btinternet.com
DAY
MEETING
24
February
Wednesday
Poisonings: things best avoided
Speaker Kate Murphy
Park Inn, Llanederyn, Cardiff CF23 9XF.
South Wales Region
Details from southwalesregion@bsava.com
EVENING
MEETING
25
February
Thursday
Lower urinary tract disease in
the dog & cat
Speaker Hattie Syme
Thorpe Park Hotel & Spa, 1150 Century
Way, Thorpe Park, Leeds LS15 8ZB
DAY
MEETING
10
March
Wednesday
How to get the most out of your
in-house lab
Speaker Christopher Belford
Holiday Inn, Barnet By Pass, Elstree,
Hertfordshire WD6 5PU.
Metropolitan Region
Details from Pedro Martn Bartolom, 020
89504995, pmbartolome@gmail.com
DAY
MEETING
14
March
Sunday
Backyard poultry problems and
solutions
Speaker Victoria Roberts
The Glasgow Pond Hotel, Great Western
Road, West End, Glasgow, G12 0XP.
Scottish Region
Details from Ross Allan, 07786 653371,
r_allan_sco@yahoo.co.uk
EVENING
MEETING
10
March
Wednesday
Pets: what souvenirs to
leave behind
Speaker Sue Shaw
South Wales Region
EVENING
MEETING
11
February
Thursday
Perineal disease: lavatory tumour
Discussing the surgical and medical
oncology of the lower urinary and
gastrointestinal tracts and perineum
Speakers Gerry Polton and Nick Bacon
Leatherhead Golf Club, Kingston Road,
Leatherhead, Surrey KT22 0EE. Surrey &
Sussex Region. Registration for this
event must be made in advance.
Details from Gerry Polton, 01883 741440,
gpolton@ndsr.co.uk
HALF DAY
MEETING
18
February
Thursday
Approach to raised liver
enzymes
Speaker Alison Ridyard
Holiday Inn Aberdeen West, Westhill Drive,
Aberdeen AB32 6TT. Scottish Region
Details from Val Pate, 07932 770311,
valpate@ntlworld.com
EVENING
MEETING
A broad network of regional
branches gives you the
potential to meet like-minded
colleagues in your area and
delivers high-quality CPD on
your doorstep. For further
details of events in your area,
visit www.bsava.com
All dates were correct at time of going
to print; we would suggest that you
contact the organisers for confirmation.
10
February
Wednesday
Murmurs in puppies & kittens
also (includes AGM)
Speaker Sue Roberts
IDEXX laboratories, Grange House,
Sandbeck Way, Wetherby LS22 7DN.
Places must be booked in advance as
numbers at this venue are limited.
North East Region
EVENING
MEETING
35 Diary.indd 35 19/1/10 08:53:25
34
|
companion
it was good to give something back
to a profession that has served me
well in my working life
Did you know youd have a career in academia

and teaching, or did you originally intend to go
into practice?
Like a lot of new veterinary students, I romanticised
about the perfect life as a mixed practitioner. However,
a couple of late night farm calls in the middle of winter
with the wind and rain whistling around during seeing
practice made me realise it wasnt for me! There was
also the realisation that were other career paths in
veterinary that were every bit as challenging but
perhaps in different ways.
You are known in the field of endocrinology, what
made you choose this specialism?
It is so straightforward you know what a hormone
does and you can easily work out what happens if
there is too much or too little! Actually my first job was
based in small animal medicine at the R(D)SVS
Dr Keith Thoday was my mentor and he had just
completed a PhD on thyroid function in cats and really
engendered my interest in the subject I had never
seen a hyperthyroid cat before then and could not
believe how many cases there were.
Youve been a key BSAVA volunteer for many
years, what did you get out of it?
I started as a volunteer while still at Edinburgh just
helping out the regional committee. Everyone seemed
to be doing it and I had attended a couple of CPD
events run by BSAVA and had enjoyed them. I dont
think there was anything more altruistic than that
although looking back it was good to give something
back to a profession that has served me well in my
working life. It is different working with a group of
volunteers because you all tend to be like-minded and
enthusiastic with similar aims it gives an additional
sense of achievement and I have gained knowledge
and skills that would not normally be gained through
my day job. The icing on the cake however is the
camaraderie and some of my best friends emanate
from my volunteer jobs.
What have been the biggest challenges of your
career so far?
Completing a PhD whilst having my first child was
pretty challenging but the PhD got finished eventually.
What do you consider to be your most important
achievement during your career so far?
To date becoming BSAVA President hopefully there
will be more.
What has been your main interest outside work?
It is quite varied but mostly cooking, walking.
Who has been the most inspiring influence on your
professional career?
Mark Peterson one of the top veterinary
endocrinologists around a prolific writer on the
subject. Undoubtedly most of our knowledge on
hyperthyroidism comes from clinical and research
work he has been involved in, and he has always been
really helpful to me.
What is the most significant lesson you have
learned so far in life?
You can always be proved wrong.
If you could change one thing about your
appearance or personality, what would it be?
Where do I start?
What is your most important possession?
I suppose in so far as a dog or cat can be a
possession, they are always the most important
possession!
What would you have done if you hadnt chosen to
be a vet?
Not really sure. I think I am more comfortable with
small animals but maybe I could have chosen a
different discipline an anaesthetist or surgeon
maybe.
33-34 Interview.indd 34 19/1/10 08:41:37
companion
|
35
CPD
DIARY
9
February
Tuesday
A practical approach to treating
psittacines
Speaker Neil Forbes
Potters Heron Hotel, Romsey SO51 9ZF.
Southern Region
Details from southern@bsava.com
EVENING
MEETING
11
February
Thursday
Thoracic medicine:
the coughing dog
Speaker Simon Swift
David Lloyd Leisure, Moss Lane,
Whittle-le-Woods, Chorley PR6 8AB.
North West Region
Details from Vikki Moran,
vikki.moran@sky.com
EVENING
MEETING
17
February
Wednesday
An update on fish medicine:
goldfish & koi carp
Speaker Peter Scott
Russell Hotel, 136 Boxley Rd, Maidstone,
Kent ME14 2AE. Kent Region
Details from Hannah Perrin,
hannah@burnhamhousevets.com
EVENING
MEETING
23
February
Tuesday
Endocrinology I: PU/PD &
alopecia
Speaker Ian Ramsey
BSAVA, Woodrow House, 1 Telford Way,
Waterwells Business Park, Quedgeley,
Gloucester GL2 2AB
DAY
MEETING
5
February
Friday
Rehabilitation & acupuncture in
companion animals (for vets &
nurses)
Speaker Siobhan Menzies
EVENING
MEETING
7
February
Sunday
How to Step-by-step guides to
practical medical & emergency
techniques
Speakers Nick Bexfield and Karen Humm
Cambridge Belfry, Cambourne,
Cambridgeshire CB23 6BW.
East Anglia Region
Details from Graham Bilbrough,
graham-bilbrough@idexx.com
DAY
MEETING
4
March
Thursday
Head and neck surgery
Speaker Don Sheahan
EVENING
MEETING
7
March
Sunday
Liver disease in the dog and cat:
is diagnosis and treatment a
waste of time, or can I really
make a difference?
Speaker Penny Watson
Pavilions of Harrogate, Great Yorkshire
Showground, Railway Road, Harrogate
HG2 8PW. North East Region
DAY
MEETING
24
February
Wednesday
Poisonings: things best avoided
Speaker Kate Murphy
South Wales Region
EVENING
MEETING
25
February
Thursday
Lower urinary tract disease in
the dog & cat
Speaker Hattie Syme
Thorpe Park Hotel & Spa, 1150 Century
Way, Thorpe Park, Leeds LS15 8ZB
DAY
MEETING
10
March
Wednesday
How to get the most out of your
in-house lab
Speaker Christopher Belford
Holiday Inn, Barnet By Pass, Elstree,
Hertfordshire WD6 5PU.
Metropolitan Region
Details from Pedro Martn Bartolom, 020
89504995, pmbartolome@gmail.com
DAY
MEETING
14
March
Sunday
Backyard poultry problems and
solutions
Speaker Victoria Roberts
The Glasgow Pond Hotel, Great Western
Road, West End, Glasgow, G12 0XP.
Scottish Region
Details from Ross Allan, 07786 653371,
r_allan_sco@yahoo.co.uk
EVENING
MEETING
10
March
Wednesday
Pets: what souvenirs to
leave behind
Speaker Sue Shaw
South Wales Region
EVENING
MEETING
11
February
Thursday
Perineal disease: lavatory tumour
Discussing the surgical and medical
oncology of the lower urinary and
gastrointestinal tracts and perineum
Speakers Gerry Polton and Nick Bacon
Leatherhead Golf Club, Kingston Road,
Leatherhead, Surrey KT22 0EE. Surrey &
Sussex Region. Registration for this
event must be made in advance.
Details from Gerry Polton, 01883 741440,
gpolton@ndsr.co.uk
HALF DAY
MEETING
18
February
Thursday
Approach to raised liver
enzymes
Speaker Alison Ridyard
Holiday Inn Aberdeen West, Westhill Drive,
Aberdeen AB32 6TT. Scottish Region
Details from Val Pate, 07932 770311,
valpate@ntlworld.com
EVENING
MEETING
A broad network of regional
branches gives you the
potential to meet like-minded
colleagues in your area and
delivers high-quality CPD on
your doorstep. For further
details of events in your area,
visit www.bsava.com
All dates were correct at time of going
to print; we would suggest that you
contact the organisers for confirmation.
10
February
Wednesday
Murmurs in puppies & kittens
also (includes AGM)
Speaker Sue Roberts
IDEXX laboratories, Grange House,
Sandbeck Way, Wetherby LS22 7DN.
Places must be booked in advance as
numbers at this venue are limited.
North East Region
EVENING
MEETING
35 Diary.indd 35 19/1/10 08:53:25
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
Visit www.bsava.com
to register or
call 01452 726700
Zubair009 | Dreamstime.com
DATES
19 May 2010 Beaconseld
21 May 2010 Bristol
23 May 2010 Fife
25 May 2010 Cheshire
BSAVA
Oncology
Roadshow
Explore advances and techniques
in veterinary oncology with
Dr David Vail and
Dr Jane Dobson
36 OBC.indd 36 19/1/10 08:49:40

Companion February2010

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