The essential publication for BSAVA members

How To Perform
a surgical extraction
of a canine tooth
P10
Clinical Conundrum
Young canine with
subcutaneous swellings
P4
companion
MARCH 2009
Medicines Guide
Helping practices manage
their dispensaries
P20
Where
are all the
veterinary
nurses?
companion
2 | companion
1) What part of companion do you
enjoy most?
2) Suggest a topic for How To
3) Suggest someone youd like to
see featured in the companion
Interview
4) What would improve
companion?
3 Round Up
National Pet Month
46 Clinical Conundrum
Case of a young dog presenting
with subcutaneous swellings
79 Where are all the VNs?
John Bonner asks is there really
a deficit of Veterinary Nurses
1013 How To
Perform a surgical extraction of
a canine tooth
1415 GrapeVINe
From the Veterinary
Information Network
16 New titles at Congress
Latest releases from BSAVA
Publications
17 Congress Practice Badge
How to get your whole team to
Congress
18 Congress Chair
The end of an era for
Andrew Ash
19 Summer CPD
June courses from the BSAVA
2021 New Medicines Guide &
Blood Smears
News and a quick quiz from
BSAVA Publication
22 Petsavers
Latest fundraising news
2325 WSAVA News
World Small Animal Veterinary
Association
26 The companion Interview
Pip Boydell
27 CPD Diary
Whats on in your area
companion is produced by BSAVA exclusively for its members.
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A
s we enter our second year we
want to hear what you have to say
about companion. At Congress we
will be holding focus groups and in the next
month we invite all readers to tell us what
you like, dislike, think is good and what
could be improved.
In April 2008 BSAVA launched
companion as an exclusive member benefit
to sit alongside its sister publication
BSAVAs Journal of Small Animal Practice.
Mark Goodfellow, who stepped forward as
the volunteer who would steer this initiative
as Editor, said that it would address the
core aims of the Association, with
accessible, instructive CPD features,
reports on the activities of our colleagues,
articles on the issues facing our profession
and, of course, general Association news.
In the last year weve been delighted
with the comments we have received.
Now we want to make sure we continue to
adapt and improve by responding to your
ideas so it really is a magazine
by members for
members.
companion is about to celebrate its first anniversary!
Help take us into a second successful year with your
comments and ideas
So, if you have something to say or any
ideas for features and subjects, simply
answer the questions below and send
additional comments by email
companion@bsava.com, or visit us on the
BSAVA Balcony at Congress. All email
submissions received before 31 March will
be entered into a draw to win an iPod
loaded with all the 2009 Congress talks.
We do already have our focus groups
organised, but if you are attending Congress
and are particularly keen to take part then
let us know by email before 16 March.
companion | 3
ROUND UP
NATIONAL PET MONTH
REGISTER NOW
FOR CONGRESS
National Pet Month is about to celebrate its
20th anniversary with the theme Healthy Pets Make
Happy Pets. Getting involved can benefit your practice
and raise funds for charity, as well as help improve animal
welfare in your area
W
ith the governments focus on
improving the nations health,
National Pet Months 20th
anniversary campaign, Healthy Pets Make
Happy Pets couldnt be more timely.
Taking place from 4 April 4 May,
National Pet Month (NPM) will once again
be campaigning for responsible pet
ownership, and raising funds for numerous
animal charities, including Petsavers, at
the same time.
The month is an important opportunity
for veterinary practices to promote their
services to pet owners and for animal
charities to rally support.
2008 winning event
Last year, the winning event was a joint
project between Jubilee Veterinary Centre
and Mount Stewart National Trust in
Northern Ireland. Mount Stewart is a
stunning National Trust House on the
shores of Strangford Lough in Northern
Ireland, and along with Jubilee Vets,
focussed on assistance dogs to put on an
event for the local community.
Bryan Muskett from Jubilee Vets
we are still celebrating winning the
National Pet Month Best Event Award
for 2008. In previous years we supported
NPM with open days and various social
functions. When the opportunity to link
up with the National Trust came about
we were very positive, as our aim was
to involve a lot more people and throw
the function open to the community
in general.
The facts and figures speak for
themselves. On the day we had between
800 and 900 guests through the main
entrance, accompanied by approximately
1000 dogs! Every breed and every
conceivable shape and size! On arrival
each owner was given a Drontal poo bag
dispenser and competition entry forms
which were very popular. We hope more
practices will join up with compatible
organisations and show their local
communities the importance of pet
health and responsible ownership during
National Pet Month.
Get involved today
Its not too late to arrange an event. For
more information and to get a free event
pack visit www.nationalpetmonth.org.uk
the organisers encourage all practices who
put on an event to register their details and
download their free resources. Find out
more about raising funds for Petsavers
during NPM on page 22.
There are just a few weeks left
to register for Congress
before the late booking
admin charge comes in.
You also have until 12
March to register for the
Practice Badge options.
See page 17 for further
details.
Book for Congress before
27 March to avoid the late
registration surcharge
4 | companion
CLINICAL CONUNDRUM
CLINICAL
CONUNDRUM
Case Presentation
A 13-month-old female Cocker
Spaniel presented with large
swellings over the scruff and
sublumbar regions. Twelve hours
previously the puppy had been
seen for lethargy and inappetence
by a colleague, who administered
antibiotics subcutaneously at the
scruff and pethidine
intramuscularly in the sublumbar
musculature based on a suspicion
of cystitis.
On clinical examination the dog
was quiet, dull but responsive. On
thoracic auscultation a mild
increase in interstitial sounds over
the entire lung field, with an
increase in respiratory effort, was
appreciated. Marked
haemorrhage within the dorsal
sclera of the left eye was seen in
addition to the 25x25 cm
subcutaneous soft swelling
present over the sublumbar
region and a similar smaller
swelling at the scruff.
The editorial board of
companion invites you to
consider the case of a young
dog presenting with
subcutaneous swellings
Investigation
Investigation centred on elucidating the
cause of the dyspnoea and evaluating the
possibility of a coagulopathy. Samples were
submitted for full haematology and
coagulation profile, which documented a
mild non-regenerative anaemia, moderate
thrombocytopenia (80 x10
9
/l [200500])
and a moderate prolongation of PTT and
APTT (sample = 1.5x control). Conscious
thoracic radiographs were obtained.
Interpret the significance of the
moderate thrombocytopenia
and concurrent prolongation in
coagulation times
As the coagulopathy has features of defects
of both primary (thrombocytopenia) and
secondary haemostasis (including PTT &
Construct a problem list and
consider relevant differential
diagnosis. Rationalise your
further investigative steps
Problem list:
Dyspnoea
Scleral haemorrhage of left eye
Subcutaneous swelling at previous
injection sites
Inappetence and lethargy (considered to
be secondary to the underlying disease).
Interpretation
The presence of increased lung sounds
suggested that lower airway disease was the
most likely cause of the dyspnoea. The
presence of lung sounds made pleural disease
unlikely. The sudden development of the
subcutaneous masses after injection could be
caused by infection but, given the large size
and the presence of scleral haemorrhage,
haematoma was thought most likely.
Differential diagnoses: (dyspnoea
with diffuse interstitial lung sounds)
Bronchial disease
Allergic
Infectious (bacterial, viral,
mycoplasmal)
Parasitic ( Oslerus osleri)
Pulmonary parenchymal disease
Oedema
Inflammatory
Infectious (bacterial, viral)
Parasitic ( Angiostrongylus vasorum)
Foreign body
Pulmonary thromboembolus
Pulmonary haemorrhage
Haematological abnormalities
Anaemia
Differential diagnoses:
(subcutaneous and scleral
haemorrhage)
Disorder of primary haemostasis
Disorders of platelet function
thrombopathia
Thrombocytopenia
Reduced platelet production
Platelet destruction (IMTP)
Increased platelet consumption
(DIC, anticoagulant toxicity)
von Willebrands disease
Disorder of secondary haemostasis
Inherited (haemophilia or other
factor deficiency)
Acquired (vitamin K-dependent
coagulopathy)
Consumptive DIC
Trauma
Iatrogenic
Blunt
companion | 5
CLINICAL CONUNDRUM
APTT), disseminated intravascular
coagulation (DIC), either localised or
generalised, should be suspected. DIC
always occurs secondary to a wide variety
of primary disease processes including, but
not restricted to, neoplasia, immune-
mediated and other inflammatory diseases,
infectious and parasitic disease, trauma
and heat stroke.
What abnormalities are evident
on the thoracic radiographs?
The thoracic radiographs demonstrate a
diffuse broncho-interstitial pattern,
coalescing in places to an alveolar pattern,
most intense peripherally. The cardiac
silhouette, extrathoracic and skeletal
structures are unremarkable.
Based on these results refine
your differential diagnosis list
and suggest further
investigation
Based on the thoracic radiography,
interstitial pulmonary disease is most likely.
Given that a coagulopathy is evident
clinically and abnormalities in the
components of primary haemostasis and
the secondary haemostasis have been
documented, haemorrhage into the lung
parenchyma is the most likely cause of the
observed clinical and radiographic signs.
DIC secondary to neoplasia or infection
could not be excluded; however, given the
dogs age, a parasitic cause such as
Angiostrongylus vasorum causing both the
radiographic and the clinico-pathological
signs was considered most likely. The owner
was questioned with respect to worming
regime and the dogs walking habits and on
discussion it transpired that the dog had a
particular proclivity for eating snails.
Faecal evaluation using the Baermann
technique was performed to look for
Angiostrongylus larvae. Faecal examination
can only identify a patent infection, so
bronchoscopy and BAL was planned should
faecal analysis prove negative.
Diagnosis and treatment
Angiostrongylus vasorum L
1 larvae in the faeces
confirm a patent infection. Angiostrongylus
infection is associated with a consumptive

This case was seen, and treated, prior

to the licensing of Advocate for the
treatment of canine Angiostrongylus
infection. Under the cascade
fenbendazole was chosen given its
license for the treatment of other
parasitic infections in the dog and its
documented efficacy against
Angiostrongylus vasorum. Readers are
advised to follow the prescribing
guidelines of the cascade: an authorised
product should be the treatment of
choice unless there is clear clinical
justification to do otherwise.
Turn over for guidelines
to submitting your own
Clinical Conundrum
Faecal sample following Baermann technique to
concentrate larvae Right lateral thoracic radiograph
DV thoracic radiograph
coagulopathy which, in this case, resulted in
scleral haemorrhage and subcutaneous
haemorrhage at the site of previous
injections. Treatment was initiated with
fenbendazole at a dose of 50 mg/kg daily

for five days and the dog was restricted to a
kennel. Care was taken to minimise trauma
and environmental contamination.
Within 48 hours the coagulation profile
was normal and within 14 days the
subcutaneous haemorrhage was reduced in
size and faecal analysis was negative for
Angiostrongylus larvae. The owner was given
appropriate worming advice and was
instructed to prevent further snail eating, by
muzzling if necessary.
6 | companion
CLINICAL CONUNDRUM
T
he Clinical Conundrum aims to be
accessible and thought-provoking,
and to allow in-depth discussion of
the intricacies of investigating or treating a
case. In particular it is hoped that cases will
challenge the reader to consider a dilemma,
be it a diagnostic challenge or a treatment/
surgical decision, and to work through it to
a logical conclusion.
Case selection
The aim of the Clinical Conundrum (CC) is
to present clinical scenarios that are
encountered in small animal practice and
discuss briefly any poignant features of the
case. Your CC can focus on the complete
case management or one aspect of the case
management in more detail.
Example of how a case may
be used
A problem-oriented approach to a
challenging diagnosis. In this instance the
emphasis would be to construct a
problem list, consider relevant
differential diagnoses and ultimately
achieve a diagnosis based on the
information gained during investigation.
Treatment or surgical dilemma . In this
type of case the diagnosis may have
already been made or be relatively
simple to reach. The focus of this
type of CC would be to challenge the
reader to decide how they would
gather the information to decide on a
treatment plan and to select and justify
choice of treatment based on the
information obtained.
Focus on one aspect of a complicated case.
This is most suitable for a more focused
evaluation of a single aspect such as
anesthetic considerations and pre-
anesthesia stabilisation for a clinical
presentation, or the subtleties of
diagnostic imaging interpretation.
An unusual diagnosis, although
interesting, does not necessarily mean that
a case will be a suitable to present as a
Clinical Conundrum. In fact, the final
diagnosis is not the most important part it
may be unusual but many cases feature a
relatively common problem. The cases that
make the best articles discuss a
presentation thoroughly, logically progress
through the case and achieve a robust
diagnosis or treatment choice. It is the
dilemma regarding diagnostic or treatment
progression which is important, rather than
the diagnosis in and of itself. The editorial
team are more than happy to advise on the
selection of cases for this feature and
particularly welcome and encourage
submissions from those in general practice.
Style
Case reports should be structured to
encourage the reader to consider a
different aspect of the case or diagnostic
procedure as the clinical picture unfolds.
Further written guidance and representative
examples of different styles of CCs are
available on request.
GUIDELINES FOR
SUBMITTING A
CLINICAL CONUNDRUM
Do you have an interesting
case to share with your
colleagues? Here are the
guidelines for submitting it
as a Clinical Conundrum to
share with BSAVA members
The editorial team are more than
happy to advise on the selection
of cases for this feature, the
construction of a CC around a
suitable case and the refining of
submitted work. If you have an
idea for a CC but arent sure how
to proceed, please do contact us
at companion@bsava.com
Preparing a submission
In total, authors should aim for a piece of
10001200 words in length with up to five
illustrative pictures.
Unlike the old Whats Your
Diagnosis? articles in JSAP, companion CCs
are not indexed on Pubmed and are not
citable in the traditional sense. Rather, the
style and remit of this feature has been
devised to mirror that required by many of
the CPD schemes and to become a practical
resource for those working in practice. We
hope that submitting a Clinical Conundrum
will be particularly useful preparation when
completing written work required, for
example, by the RCVS certificate schemes.
To submit
Please email articles for submission to
companion@bsava.com providing
illustrations as separate graphic files (at
highest resolution available) rather than
embedded within the text of a document.
Following initial review for suitability and
style, the editorial board will then forward
submissions for peer review. Review time is
dependent on reviewer availability but it is
intended that submissions are reviewed
within 45 weeks from submission. An
honorarium is payable on final acceptance
of the article, provision of all figures/
pictures in a suitable format and submission
of an invoice.
companion | 7
VETERINARY NURSES
WHERE ARE
ALL THE VNs?
M
ore than 1 in 10 of the qualified
VNs who responded to the last
Royal College nurse manpower
survey has taken a second job a clear
indication that the salaries offered to these
key members of the clinical team are not
sufficient, the RCVS asserted.
When it isnt possible to make ends
meet on a single full-time salary, then that
might be reason enough to leave the job
and look for more lucrative opportunities
elsewhere. However, inadequate salaries are
Complaints from practitioners that there is a shortage of
qualified veterinary nurses in Britain are often raised at
professional meetings and on internet discussion groups
but are experienced VNs really in such short supply? If so,
what is causing this deficit and what can be done to
remedy the problem? John Bonner reports
8 | companion
VETERINARY NURSES
WHERE ARE ALL THE
VETERINARY NURSES?
not the only reason why nurses might want
to leave the profession; a job with long and
often unsociable hours may be difficult to
reconcile with the childcare duties often
required of young women, who form the
vast majority of VNs.
Facts and figures
However, are these factors eroding the
numbers of qualified VNs available for
work? Not according to Royal College
statistics, which suggest that the numbers
of listed and registered VNs is steadily
growing from 6611 in 2006, to 7039 in
2007, with latest figures showing that as of
the beginning of January this year there
were 2601 listed VNs and 5857 RVNs a
total of 8490 on the Register overall. As a
result, BVNA president Bonnie Millar
thinks that the shortage is perceived rather
than real. This situation could be due to a
disparity between many employers
expectations and those of their
employees, she said, adding that if there
are any shortages in the supply of VNs, it is
certainly not a new phenomenon.
Any erosion in the numbers of nurses
remaining on the Register should be more
than compensated for by the numbers of
newly qualified VNs the numbers of VN
candidate registrations has been steady
around the 1000 per year mark over the
past three years and most of those can be
expected to complete their training.
Training in practice
Libby Earle, head of the RCVS veterinary
nursing department, points out that the
pass rate in the part 1 VN examinations
10 years ago before the introduction of
NVQ-based qualification was 49%,
compared with 87% last year. So, despite
grumbles from many practices about the
amount of bureaucracy involved in the
assessments involved in the NVQ scheme, it
appears to be more efficient than the old
green book procedure. While we try to
do everything possible to reduce the
burden on training practices, at the end of
the day VN qualifications are nationally
recognised and regulated awards and their
delivery and quality assurance inevitably
entails active clinical training and a degree
of record-keeping.
Des Thompson, former RCVS appointee
to the BVNA Council, acknowledges that
practices find the volume of paper work
cumbersome but doubts whether those
practices that cite it as a reason for
withdrawing their training practice status
would have stayed the course anyway. Plus,
contrary to rumour, there is no shortage of
practices keen to train their own staff. The
numbers actually rose from 1464 in 2006 to
1536 at the beginning of 2008.
Those practices that dont want to train
VNs are usually able to poach them from a
neighbouring practice for a couple of
thousand pounds increase in salary. But if
that might be expected to have an
inflationary impact on nurse salaries, there
are other factors holding them back.
Lincolnshire practitioner and former BSAVA
representative on the Nurses Council,
Charles Ross, points to the availability of
European-trained vets willing to work in VN
roles as a factor capping the salaries of
experienced nurses. Although legally
companion | 9
VETERINARY NURSES
entitled to work as veterinary surgeons
under EU law, applicants from the accession
states will often be prepared to work for a
salary much lower than that of a UK or
Commonwealth graduate while they
improve their practical or English language
skills, he says.
Working conditions
BVNA suspects that any difficulties that
particular practices may have in recruiting
nurses will probably be of their own making.
Like any professional group, VNs have their
own informal communication networks and
news will soon pass along the grapevine if
the working conditions at a particular
practice are less than satisfactory.
Although salaries will top the list of
causes of dissatisfaction for fully trained
VNs, lack of recognition will always come a
close second. Charles Ross regrets that
many of his colleagues still treat their
nursing staff in training like the unskilled
auxiliaries that helped earlier generations of
practitioners. There is little appreciation of
the hard work and academic standards
needed to complete modern veterinary
nursing examinations. But it isnt just the
bosses that fail to treat nurses with respect.
He feels that many members of the public
fail to show the same appreciation for a
VNs skills and training that they
automatically bestow on their counterparts
working in the NHS.
Recognition
The introduction of degree courses in
veterinary nursing was intended to help
raise the status of VNs in the eyes of their
employers and the public. But there is still
some resistance to the notion that training
for a job which relies heavily on practical
and people skills can be provided in an
academic setting. Mr Ross says that when
interviewing for a new nurse he would
always favour an NVQ candidate over one
with a degree because he believes they will
have better hands-on nursing skills.
Even with comparable academic
qualifications, VNs must still look on
enviously at the career opportunities
available to their colleagues in human
nursing. Nurse practitioners in the NHS or
in specialist hospital roles can maintain the
skills that they were originally trained for
while earning salaries that would make a
VNs eyes water. The only prospects for
significant career progression in a veterinary
setting lie in a move into practice
management or out into the animal health
or pet insurance industries.
Economic impact
Long-term retention of trained nursing staff
because of dissatisfaction with salaries is
not purely a UK problem. Bonny Millar is a
US citizen and says that there is much
discussion across the pond about
veterinary technicians leaving practice to
look for more money in other areas even
when the typical salary for an experienced
technician can be upwards of $40,000 a
year, plus benefits such as overtime,
pensions and health insurance.
Although it is uncertain whether
this trend will continue if the US
economy continues in a downward
spiral, she notes.
The UK veterinary nursing
profession has developed over a
period of almost continuous
economic growth and it is anyones
guess how it will be affected by a true
recession. Des Thompson points out that
for the first time in donkeys years we are
hearing stories about veterinary practices
laying off staff.
This could make those hard to fill
nursing vacancies much more attractive but
Mr Ross points out that any economic
trends are usually short-lived. A few months
of belt tightening would be unlikely to
change the basic relationship between VNs
and those practices seen as bad employers.
BSAVA president Ed Hall agrees,
pointing out that the interests of VNs and
their employers lie in exactly the same
direction in making their practice as
efficient and profitable as possible. If a
practice isnt getting any replies to an
advert, it is not necessarily because there
arent any suitable applicants out there
they may need to recognise just what a
trained nurse can do for their business.
10 | companion
HOW TO
PERFORM A SURGICAL
EXTRACTION OF A
CANINE TOOTH
HOW TO
Lisa Milella of The
Veterinary Dental Surgery,
Byfleet, Surrey reminds
companion readers of the
intricacies of this technique
principles can be applied to extraction of
any tooth in the mouth. A surgical
extraction technique is also used for
retrieval of root remnants and if any
abnormal tooth morphology exists. It may
also be the surgeons preference to use a
surgical technique if multiple adjacent teeth
need to be extracted as in Figure 2.
Equipment required to perform a
surgical extraction
(Authors preference Figure 3a)
Scalpel handle and blade ( no.11)
Periosteal elevator ( Goldman Fox)
Dental luxators and elevators (sharp
and of a suitable size) (Couplands No.1
and No.3) Figure 3b
Extraction forceps (Pattern 76 and 76N)
High-speed water cooled dental drill
with a selection of round and tapered
burs (No.2 and no.4 round and a 701
tapered fissure bur) Figures 3c & d.
Indications for
tooth extraction

Severe periodontal disease

(mobility, furcation exposure,
periodontal probing depths)

Complicated crown fracture

(pulp exposed)

Worn tooth with pulp exposure

Crown root fracture

Odontoclastic resorptive lesion

Non-vital tooth

Persistent deciduous teeth

Teeth involved in a jaw fracture

Unerupted teeth causing

pathology

Teeth causing malocclusions

Supernumerary teeth

Chronic gingivostomatitis
What is a surgical extraction?
An extraction technique involving raising a
flap of tissue to remove bone that forms
part of the socket, to allow access to the
root and facilitate its extraction (Figure 1).
When should this technique be
used?
This technique should always be used for
extraction of canine teeth, but the same
Figure 1
Figure 2
Figure 3a
companion | 11
HOW TO
PERFORM A SURGICAL EXTRACTION
OF A CANINE TOOTH
Small surgical scissors
Rat tooth forceps
Needle-holders
Monofilament absorbable suture
material (poliglecaprone 25 size 5/0)
All equipment should be sterile as
tooth extraction is considered a surgical
procedure.
Patient preparation
General anaesthesia a cuffed ET tube
and throat pack are recommended to
secure the airway. Local anaesthesia
should also be considered
Pre-emptive analgesia
Perioperative antibiotics should be
given in selected cases only. These
include debilitated animals, immuno-
compromised animals, animals with
severe local or systemic infection,
animals with organ disease or
endocrine disorders.
Scale and polish all teeth prior to
performing any extractions. Tooth
extraction, by whatever technique,
is a surgical procedure and should
be performed in as clean a field as
possible. The surgical site should also
be irrigated with a chlorhexidine-
based mouthwash.
Preoperative radiographs should be
taken. Radiographs will enable the
surgeon to assess any abnormal root
morphology and the integrity of the
surrounding bone. Postoperative
radiographs can be taken to ensure
complete tooth root removal.
Figure 3b
Figure 3c
Figure 3d
Figures 4a and 4b: Pre- and
post-operative radiographs
Surgical removal of a mandibular
canine
A
This upper canine tooth has a
complicated crown fracture
(the pulp cavity is exposed). There
is a vertical fracture extending on
to the root. This tooth cannot be
salvaged by root canal treatment
and extraction is the only option
B
A pre-extraction radiograph
of an upper canine tooth
shows the length of the root. As a
general rule the apex of the canine
tooth finishes at the mesial root of
the second premolar. This should
be taken into consideration when
designing the flap. The flap should
enable unimpeded access to the
whole root if necessary
Technique
12 | companion
HOW TO
D
A sharp periosteal elevator is
used to raise a full thickness
mucoperiosteal flap. The elevator
is positioned at an angle to the
bone if too flat, accidental
perforation of the flap can occur.
The tissue is tightly adhered at the
mucogingival junction and care
must be taken not to perforate the
flap here. The flap raised should
give good exposure to the alveolar
bone overlying the tooth root.
Figures E and F
E
*High-speed burs should be used
with extreme caution.
Complications include soft tissue
trauma, thermal bone necrosis,
emphysema and fatal air embolisms.
J
The flap is then replaced and
sutured in position using a
monofilament absorbable suture
material and a simple interrupted
suture pattern. The flap should be
sutured with no tension. Releasing
incisions can be made in the
periosteum on the underside of the
flap to release tension if necessary.
Care must be taken not to perforate
the flap
G
Using a high-speed water-
cooled round bur*, a gutter is
created on either side of the canine
tooth root. Some overlying buccal
bone can be removed to enable the
mesial and distal edge of the tooth
root to be seen. The gutters should
be half the width of the tooth root
and extend up to 2/3 of the length
of the root. The gutters are then
connected on the buccal aspect,
so that the bone plate overlying
the root is removed together with
the root
C
Vertical releasing incisions
are made between the upper
canine and lateral incisor rostrally
and at the mesial line angle of the
second premolar. The blade is also
run in the gingival sulcus around
the tooth, being careful not to
perforate the gingiva. The vertical
releasing incisions should extend
beyond the mucogingival junction
(the junction between attached
gingiva and the alveolar mucosa).
The incisions can be slightly
divergent to allow adequate blood
supply to the flap.They should also
be made so that there is bone
support for the sutured wound
and thus incisions should not lie
over a void
F
H
A dental elevator is positioned
in the groove created on either
the mesial or distal aspect of the
tooth. Elevators should not be used
on the palatal aspect of the upper
canine tooth to avoid iatrogenic
oronasal communication. The
elevator should be rotated slowly to
tear the periodontal ligament
attachment. Tension should be held
for about 10 seconds to allow the
ligament to tear. The elevator is then
moved to the opposite groove and
the motion repeated until the tooth
starts to loosen. When the tooth is
loose, extraction forceps are
positioned as far apically as
possible and the tooth rotated along
its long axis, pulling gently at the
same time. The extracted tooth
should be checked to ensure that
the whole root has been extracted
(a postoperative radiograph should
be taken if there is any doubt)
I
The empty socket should be
debrided if there is any
granulation tissue or debris. The
socket is checked for any loose
bone fragments. The edges of the
socket should then be smoothed
using either a diamond-coated bur
or with rongeurs. The extraction
site can be lavaged with lactated
Ringers solution to remove any
remaining debris. The air-water
syringe on the dental machine
should not be used as air may
cause an embolism or emphysema
and water is cytotoxic to
connective tissue cells
companion | 13
HOW TO
PERFORM A SURGICAL EXTRACTION
OF A CANINE TOOTH
Complication Cause and avoidance
Tooth fracture
(crown/root/both)
Incorrect technique careful use of elevators and
luxators
Extraction forceps should not be used before the tooth
is adequately loosened
Oronasal communication May be due to infection or iatrogenic damage avoid
excessive force during the extraction Figure 7
Jaw fracture Preoperative radiographs should be taken to assess
bone loss in advanced periodontal disease
Incorrect technique (placement of luxators and
elevators especially associated with lower canine) must
be avoided
Haemorrhage Accidental damage to neurovascular bundle during
surgery
Haemorrhage may occur as a result of a root fracture
Pre-existing disease should be identified before surgery
if possible
Displaced root fragments Avoid downward force in cats as the root fragment may
be displaced into the mandibular canal
Avoid excessive force on the palatal root of the upper
carnassial in dogs to avoid pushing the root into the
nasal turbinates
Thermal bone damage Adequate cooling of high-speed bur when used
Emphysema Incorrect use of the high-speed handpiece. Avoid
blowing air into soft tissue or bone
Soft tissue injuries
(gingiva, tongue, frenulum,
lip, eye)
Use spatulas to avoid accidental damage when using the
high-speed bur
Controlled force when using elevators and avoid
slippage by correct holding of instrument and
stabilisation of the patients head
Wound breakdown Avoid tension when suturing in the mouth. Periosteal
releasing incisions can be made on the surface of
mucoperiosteal flaps to release tension. Careful flap
planning prior to extraction is required
Table 1: Complications of extractions
Key to success

Knowledge of the correct root morphology

Correct technique

Appropriate tools

Practice and patience

Applying the principles to the
lower canine tooth
The basic principles described above are
used for the mandibular canine with the
following exceptions
Figure 5: Care should be taken
when placing the vertical releasing
incisions and raising the flap to
avoid damaging the inferior
alveolar blood vessels and nerve
exiting the middle mental foramen
Figure 6: A longer releasing
incision can be made rostrally
creating more of a triangular flap.
Dental elevators should not be
placed directly mesially and distally
but rather on the mesolingual and
distolingual aspects of the tooth.
This is to avoid fracture of the
rostral mandible
Figure 7
14 | companion
VIN
The Veterinary Information Network brings together veterinary professionals from across
the globe to share their experience and expertise. At vin.com users get instant access to
vast amounts of up-to-date veterinary information from colleagues, many of whom have
specialised knowledge and skills. In this regular feature, VIN shares with companion
readers a small animal discussion that has recently taken place in their forums
.com
GRAPE
VIN
E
heard on the
John Turgai
Thanks Mark,
We weaned off the furosemide and ACEI
and the resting RR are still 1617 /min.
Well treat as respiratory and keep an
eye on the RRR.
John Turgai
(Day 8) Sophie has had her RRR in the
low twenties, and doing well in all
respects except that the cough is not
being controlled with hycodan alone. She
mainly coughs when she is excited and
very active.
Mark Rishniw BVSc, MS, DACVIM
(Cardiology), VIN Consultant,
Ithaca, NY
Hi John,
There is a left atrial enlargement, and
what appears to be a vascular pattern
on the films - Im seeing prominent
vessels. The lateral is a bit expiratory, so the dorso-caudal
fields are a bit tough to interpret. The cough doesnt sound
like a cardiac problem.
I would start with a sleeping respiratory rate at home for a
couple of days. If this is normal, then we probably dont have
CHF as the cause of the cough.
John Turgai DVM, Park Avenue
Animal Hospital, Apoka, FL
This is Sophie, a 13 year-old very happy,
active 8.6lb Yorkie who came in today for
a second opinion on a cough of about a
four weeks in duration. She has been on
one quarter of 12.5 mg furosemide once
daily (so shes getting ~ 0.8 mg/kg SID) and 2.5 mg enalapril
daily lately having been tapered down from a higher
furosemide dose. The owner has not seen a significant
improvement in the cough which occurs several (many) times
daily including at night. PE - heart murmur 2-3/6, lung sounds
are OK to slightly increased. Tracheal palpation does produce
a dry honking type cough.
So the heart is enlarged
(VHS ~11.3 lateral) with a
nice left atrial bulge. I
think the caudo-dorsal lung
area has prominent vessels
and an overall increased
density compared to the
cranio-ventral areas on the
lateral. On the VD, both
sides of the caudal lungs
have a fluffy pattern that I
cant distinguish as
perivascular or
peribronchial.
Questions: Do you think
the rads show that the dog
is in failure? I increased
the furosemide to 3/4 tabs
BID in the meantime.
Thanks.
Michael Harter DVM,Animal Medical
Clinics,Rockford, IL
I agree with these guys. The left atrium
is enlarged but I dont think the dog is in
heart failure. I do think there is lung
disease, and I believe the primary
pathology is bronchial on these films.
William Herndon DVM Diplomate
ACVIM Cardiology,California
Veterinary Specialists San Diego
County CA
I also think those lungs are abnormal
and that the heart is big ... I am just not
sure that CHF is the problem...
companion | 15
VIN
All content published courtesy of vin.com. 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.
John Turgai
Many thanks to all.
Mark Rishniw
Hi John,
>>> She has been on both steroids and
hycodan without much effect <<<
Hycodan to the point of sedation may be
necessary. Additionally, the owners have
to expect an improvement, rather than a resolution, of clinical
signs. Odds are, well never stop this dog coughing altogether.
And I agree with Mark K - very nice films (textbook!!).
Brendan McKiernan DVM, DACVIM,
Southern Oregon Veterinary
Specialty Center, Medford, Oregon
Given that the cough is not responding
to these doses (steroids and
Hydrocodone) I would increase both...
perhaps to 5mg pred BID for 23 days,
then taper rapidly to hopefully 2.5mg EOD in a week. The
hydrocodone can be increased to sedation if needed.
No sense in trying inhaled steroids if oral does not work IMHO.
8.6lb getting a little weight off this dog would be helpful at
least 0.5lb (1lb if you can).
right caudal lobar pulmonary vein enter the left atrium. It
appears to be collapsing the right mainstem bronchus at that
location, although Im not sure thats actually the case.
Regardless it looks like both caudal lobar mainstem bronchi
collapse distally. So there certainly appears to be enough
evidence of large airway disease to explain this dogs cough.
So if the sleeping resp. rate is still less than 30 bpm in this dog
I would consider a corticosteroid something like Hycodan.
Mark Kittleson DVM, PhD, Diplomate
ACVIM (Cardiology), University of
California, Davis
Very pretty radiographs. On the lateral
this is an expiratory film and the trachea
is collapsed (or at least the dorsal
tracheal membrane collapsed in by the
esophagus). And the left atrium is huge. On the DV the body of
the left atrium is also huge (dense). You can actually see the
William Blevins DVM,MS, DACVR,
School of Veterinary Medicine, Purdue
University, West Lafayette, IN
Hi Folks;
I dont have any magical answers for this
case.
I agree that there are very prominent bronchial markings. This
can be fluid cuffing the airways, for example from congested
lymphatics. The LA is very large and the pulmonary
vasculature is difficult to see. It would be really nice to see a
left lateral view. I certainly do not see an enlarged pulmonary
vein in the left caudal lobe.
On the VD view, I get the impression of a hiatal hernia, but
this is certainly not clear and there is no evidence on the
lateral view. Some of these are sliding and appear and
disappear from one view to the next.
John Turgai
(Day 55) Sophie has lots of energy
and eats well, but still has her cough.
The owner thinks that she is doing a
little better on antibiotics and we
are continuing. She came in for
re-check rads and the trachea looks
somewhat different, although the lungs dont appear to
have changed much.
William Herndon
Severe tracheal collapse, severe
segmental airway compression from the
monster LA ... given the slow RR, I think
the dog needs sedative doses of oral
narcotics (e.g. hydrocodone).
John Turgai
Thanks Mark,
This owner has been very good about
the RRR at home and Sophie is
consistently mid-twenties. She has been
on both steroids and hycodan without
much effect, but Ill just have to
experiment a bit more to see if we can get a better
improvement.
John
16 | companion
CONGRESS
NEW TITLES
AT CONGRESS
BSAVA Publications is
pleased to announce that
there will be four new
manuals making their first
appearance at Congress
this year
BSAVA Manual of Canine and
Feline Abdominal Imaging, edited
by Robert OBrien and Frances Barr
Congress price 49.00
BSAVA Manual of Rodents and
Ferrets, edited by Emma Keeble and
Anna Meredith
Congress price 49.00
BSAVA Manual of Canine and
Feline Wound Management and
Reconstruction, 2nd edition, edited
by John Williams and Alison Moores
Congress price 49.00
BSAVA Manual of Canine and Feline
Advanced Veterinary Nursing, 2nd
edition, edited by Alasdair Hotston
Moore and Suzanne Rudd
Congress price 49.00
Members dont forget your
vouchers
At the beginning of this year, all members
were sent a booklet containing a number of
discount vouchers for use on manuals at
Congress. Amongst these were vouchers
entitling you to 5 off the member price on
each of the new titles. In addition, there is
also a voucher to save 10 on the BSAVA
Manual of Psittacine Birds, 2nd edition. Simply
bring your vouchers with you, plus proof of
membership, to the BSAVA publications
stand (on the balcony) in the NIA Exhibition
to qualify for these discounts.
Special offers for Congress
3 Manual orthopaedics
package
The BSAVA Manuals of Canine and
Feline Musculoskeletal Imaging,
Musculoskeletal Disorders and Fracture
Repair and Management cater for all
your orthopaedic needs:
Diagnostics: radiology,
arthroscopy, cytology
Medical disorders: developmental,
infectious, neoplastic
Surgery: fracture fixation,
cruciate repair, joint replacement
Practical tips and our trademark
step-by-step Operative Techniques
make these volumes a valuable
addition to the bookshelf of any
practice. Now you can benefit from
buying the set and save 20; or buy
just two volumes and save 10 off the
normal combined price.
At this years Congress we are offering delegates the opportunity
to add orthopaedic and surgery titles to their library at a very
special price.
Visit the BSAVA publications stand on the balcony in the
NIA Exhibition to take advantage of these special offers.
3 Manual surgery package
The BSAVA Manuals of Canine and
Feline Abdominal Surgery, Dentistry
and Head, Neck and Thoracic Surgery
provide a comprehensive guide to
small animal surgery:
Principles and equipment: antibiosis,
suture materials, wound management
Emergency presentations: gastric
dilatation and volvulus, diaphragmatic
rupture, evisceration
Surgical procedures: tooth extraction,
ovariohysterectomy, tracheostomy
From preoperative anaesthetic
considerations to postoperative wound
management, these manuals provide a
detailed review of veterinary surgery in
practice. Save 10 off the total price on
two volumes; save 20 if buying all three
titles together.
New home for BSAVA Publications
This year BSAVA Publications, along with the BSAVA Membership Stand,
Petsavers and the Internet Zone, will be located on the balcony in the NIA.
Come along to the Publications Stand to purchase your copies of the new
BSAVA Manuals and to see what special offers we have for delegates this
year. We look forward to seeing you all in Birmingham in April.
CONGRESS
companion | 17
CONGRESS
CONGRESS PRACTICE
BADGE DEADLINE
APPROACHES
T
he Practice Badge is the best option
for the practice that wants to make
sure that as many people as possible
in its team get the chance to experience
the unrivalled science on offer at BSAVA
Congress and access the industry expertise
in the Exhibition.
With the Practice Badge you can send
up to four members of your staff one
person per day. Only BSAVA members
are eligible to book the Veterinary
Practice Badge however you can
send any member of your
team, and break up the
allocation of days as it suits
your own rota.
With the deadline for
the Practice Badge on
12 March, now is the
time to make sure that
your entire team get
access to some of the
outstanding science on
offer in Birmingham
The Scientific Programme is the
cornerstone of Congress and reflects the
BSAVAs core mission to promote high
scientific and educational standards of small
animal medicine and surgery in practice,
teaching and research. This years
programme has been designed to provide
veterinary surgeons and nurses with new
skills and ideas that they can implement in
practice. This is emphasised as the
Association strives to deliver high-level
content, including interactive and Top Tip
streams as well as a range of State of the Art
lectures, Masterclasses and Clinical
Research Abstracts. This year we also have a
number of sessions where leading experts
will debate controversial issues in their field.
In total the Scientific Programme covers
26 different streams and extends to a
course of 236 lectures, all of which will be
delivered by renowned speakers from the
UK and across the globe. This means
that for those choosing the Practice
Badge there will be a stream and
speaker to appeal to team members
with a range of interests and disciplines
in medicine and surgery.
For full details of the BSAVA Congress
Scientific Programme for 2009 visit www.
bsava.com where you can download the
schedule for the whole four days. Call
01452 726700 or email
congress@bsava.com for
more details. The
deadline for booking
the Veterinary or
Nursing Practice
Badge is 12
March.
18 | companion
CONGRESS
How did you get involved in BSAVA?
Initially I joined as a student to get JSAP but
then kept my membership going for
Congress and the weekend CPD courses
when I was studying for my certificate. My
children loved BSAVA courses as the hotels
always seem to have swimming pools and
both of them learned to swim courtesy of
my CPD attendance. I was delighted to be
asked to join Congress Committee, though
to this day I have no clue why. I was
proposed by the wonderful Sverine Tasker
(a huge support during my Cert SAM) and
shadowed Sue Brett, with no idea of what I
was really taking on. I think Freda Scott-
Park was a bit concerned by my (then)
standard uniform of Rohan outdoor gear
as was I when I became aware of the
sartorial standards set by Mike Jessop.
Why did you get involved with
BSAVA?
Its nice to give a bit back to the profession,
plus, it is good fun and you always learn lots
of different stuff youd otherwise never
know anything about. The opportunity is
not to be missed and I would encourage
anyone to add another dimension and get
involved in steering veterinary development.
What is the most satisfying aspect of
the role/s you have undertaken?
Exhibition Organiser this was a role with
enormous satisfaction watching the NIA
transformed from a sports arena into a
fabulous exhibition, then you get to knock
it all down and try and do it better the
next time. I just like doing things well!
I love the teamwork and seeing plans
turned into reality.
How has the idea of what it meant to
be a part of this profession lived up to
your original expectations?
My father was a vet, so I was brought up to
stand in a field with a bottle of calcium
acting as a lightening conductor. I wanted to
do farm work, then be a surgeon and ended
up doing medicine and management in a
small animal practice. So not quite as I had
planned it but still enormously rewarding.
What aspect of the job makes you
want to rant?
Bureaucracy its a business as well as a
profession so trying to balance
expectations of a vocational career with
demands of business. Also, the lack of
coherent and incisive representation in the
media. I get tired of vets being pilloried as
money-grabbing sharks.
What are the most important issues
for the BSAVA and the profession?
Relevance, value for money, and being truly
representative.
How do you feel about the people
entering the profession now compared
to when you qualified?
Theyre brighter!
What are some of your personal
ambitions for the future?
Spend more time with my family and go
fishing rather than read about it!
Which BSAVA manual is the most
thumbed in your library?
Emergencies.
In what ways has the profession
changed since you joined it? In what
ways would you like to see it change?
It is more businesslike: the positive is that it
needed to wake up; the negative is that
there will be fewer opportunities to be
owners in the future.
If you could go back and give the
undergraduate you any piece of
advice, what would it be?
At the RVC there was a snooker table so
Id say apply to a college without a snooker
table. Also keep being enthusiastic; to
quote Thoreau none are so old as those
that have outlived enthusiasm. Have a gap
year, remain an assistant, or better still
become a locum none of which I did.
How does being a member of BSAVA
contribute to your professional life?
I used to really enjoy Congress before I had
to start worrying about it. Maybe, now Ive
done my time on Congress Committee I
can start to relax and enjoy the buzz again. I
might even get to go to a few lectures!
After three years as Chairman of Congress Committee, Andrew Ash is looking forward
to enjoying his last event in the post and passing the baton to John Williams. Here he
answers questions about his ongoing involvement with BSAVA and his hopes for the future
CONGRESS CHAIR
LEAVES ON A HIGH
CONGRESS
18 | companion
companion | 19
CONTINUING EDUCATION
SUMMER CPD
SELECTION
BSAVA has a series of
essential courses taking
place in June
Feline Dermatology
Venue: BSAVA Headquarters,
Gloucester
Date: Thursday 11 June 2009
Skin disease of the cat may present with
a variety of cutaneous reaction patterns
and be due to a variety of underlying
causes. While skin disease may not be as
common as in dogs, the popularity of cats
as pets will inevitably bring their skin
conditions to the attention of the clinical
practitioner. This course will aim to
review skin disease in cats with particular
reference to those conditions associated
with the paws and face.
For each review, consideration will be
given to the methods available to establish a
diagnosis and the various therapeutic
options available for the control and
management of skin diseases.
Topics covered will include eosinophilic
dermatoses, miliary dermatitis, immune-
mediated diseases and zoonotic conditions
including dermatophytosis and cowpox
infection. Case material will be used to
illustrate the reviews and delegates will
be invited to discuss several cases during
the course.
Speaker
Aiden Foster is chief editor of the Journal
of Veterinary Dermatology, president of the
European Society of Veterinary Dermatology
and special associate professor in veterinary
dermatology at the University of
Nottingham Veterinary School. He has had a
long term interest in feline dermatology and
is co-editor of the BSAVA Manual of Small
Animal Dermatology, 2nd edition.
Also in June
Ferrets and Rodents with Emma Keeble and Film Reading with
Frances Barr and Fraser McConnell. For more information or to book
any CPD course, visit www.bsava.com, call 01452 726700 or email
administration@bsava.com
Wound management and
reconstructive surgery
Venue: Mottram Hall, Cheshire
Date: Thursday 18 June 2009
Traumatic wounds are commonly
encountered in small animal practice
including both traumatic wounds and
elective wounds following excision of
tumours. Knowledge of anatomy and
function of the skin and the physiology of
normal wound healing provides a
background to the successful management
of wounds.
This course provides an opportunity
to develop a logical approach to the
management of the patient and wound.
The options for reconstruction of
cutaneous wounds will be described in a
practical manner to allow delegates to
develop their clinical skills in this area.
Topics to be covered
Anatomy of the skin
Normal wound healing
Management of traumatic wounds
Principles of reconstructive surgery
Subdermal plexus flaps
Axial pattern flaps
Free skin grafts
Speaker
Stephen Baines qualified from Cambridge
University in 1990. He was an intern at
North Caroline State University and a
resident in small animal surgery at the
University of Liverpool. He then completed
a PhD in tumour immunology at the
University of Cambridge followed by a
period as Clinical Surgeon in small animal
soft tissue surgery. He is currently Lecturer
in Small Animal Surgery and Head of
Surgery at the Royal Veterinary College.
He is a Diplomate of the European College
of Veterinary surgeons and an RCVS
specialist in small animal surgery. His clinical
interests include clinical oncology,
particularly cutaneous neoplasia, and wound
healing and reconstructive surgery.
Reproduced from BSAVA Manual of Small Animal
Dermatology, 2nd edition.
20 | companion
PUBLICATIONS
NEW MEDICINES
GUIDE
Fred Nind and Pam
Mosedale are the editors of
a new BSAVA initiative
aimed at helping small
animal practices manage
their dispensaries. Here
they explain what we can
expect from the BSAVA
Medicines Guide
T
he BSAVA Small Animal Dispensing
Course, which is held twice a year,
has played to packed houses for
years. This is not surprising; if you make a
prescribing or dispensing mistake you risk
being struck off or getting a criminal record.
Veterinary surgeons, veterinary nurses,
practice managers, receptionists, students
and kennel staff all need to get it right
first time and every time.
Veterinary Medicines Regulations
(VMR) change every year, whilst waste
disposal provisions and dangerous drugs
regulations seem to be updated even
more often. This means that what you
learned at a course attended last year or
from a booklet published two years ago
may no longer be accurate. In addition,
medicines inspections will become
compulsory for all veterinary practices
from April 2009.
With these issues in mind, the BSAVA
has developed a comprehensive guide to
a wide variety of medicines issues that
affect companion animal practice. This
Medicines Guide will be available online at
www.bsava.com from April. Members who
visit the BSAVA stand on the balcony at
Congress will also be able to get the first
version on a free CD along with a sample
of other BSAVA resources.
Written by recognised experts in the
field and capable of being frequently
updated as the rules and regulations change,
the online guide aims to provide a one-stop
shop for all medicines issues. The Medicines
Guide will be available for all, not just
BSAVA members, as a service to the whole
profession. It will, we hope, provide balm
for all those worrying about the practical
and legal constraints on the use of
veterinary medicines.
WHAT IS THAT?
Can you name these cells
and inclusions in blood films
from exotic species?
In this ferret blood smear, can you
identify (a) the large cell on the left
and (b) the clumped cells on the right?
What is this cell, peculiar to
guinea pigs?
Can you identify the two cell types in
this avian blood film?
1
2 3
companion | 21
PUBLICATIONS
Premises licensing and inspections
From April 2009 all premises where veterinary medicinal products (VMPs) are
stored or supplied will have to be listed on a register maintained by the
RCVS on behalf of the VMD. The VMD will be able to inspect these premises.
Those practices which are members of the RCVS Practice Standards
Scheme (PSS) will not currently be inspected by the VMD inspectors as their
pharmacies will be inspected as part of the PSS. Both inspections by the VMD
and under the RCVS PSS will include a check on the RCVS registration of
veterinary surgeons and premises, as well as the registration and qualifications
of any suitably qualified persons (SQPs).
Medicines
classification
Authorised veterinary medicines
fall within the first four
categories established by the
Veterinary Medicines
Regulations (VMR) 2005.
These categories have
continued through subsequent
revisions of the VMR and are
as follows:
AVM-GSL: Authorised
veterinary medicine
general sales list
NFA-VPS: Non-food animal
medicine veterinarian,
pharmacist, suitably
qualified person (SQP)
POM-VPS: Prescription-only
medicine veterinarian,
pharmacist, SQP
POM-V: Prescription-only
medicine veterinarian
In addition, medicines marketed
under the Small Animal
Exemption Scheme (SAES) do
not have a legal distribution
category but may be considered
for sale and supply purposes to
be equivalent to AVM-GSL.
Ten sample questions the Medicines
Guide will answer
1. Should you report suspected adverse reactions to human medicine
regulators or just to veterinary ones?
2. What medicines are you allowed to use in a Greyhound that may be racing
next week?
3. How does a veterinary nurse become a suitably qualified person (SQP)?
4. What should you do if a pharmacist dispenses a human generic medicine to
your prescription for a veterinary medicine?
5. What is the Small Animal Exemption Scheme (SAES)?
6. Why is there no hazardous waste in veterinary practices in Scotland?
7. Why should medicines be left in their original packaging when adding them
to the out-of-date medicines container?
8. How much does it cost to get a Special Import Certificate (SIC) online?
9. What do you do with a loaded and charged dart gun dart if you have decided
not to fire it?
10. Under what circumstances can prophylactic antimicrobial use be justified?
To find the answers to these questions and many more, download the
Medicines Guide at www.bsava.com when it goes online in April.
Further information
The answers and much more
information on blood pictures and
their significance in exotic species
can be found in these BSAVA
manuals: Rodents and Ferrets
(NEW at Congress, see page 16);
Raptors, Pigeons and Passerine
Birds; and Reptiles (2nd edition).
F i g u r e 1 : ( a ) N o r m a l s e g m e n t e d
n e u t r o p h i l ; ( b ) c l u m p o f n o r m a l
p l a t e l e t s . T h e s u r r o u n d i n g c e l l s a r e
n o r m a l e r y t h r o c y t e s .
F i g u r e 2 : A K u r l o f f c e l l : n o t e t h e
n o r m a l r o u n d c y t o p l a s m i c i n c l u s i o n .
F i g u r e 3 : T h e l a r g e c e n t r a l c e l l i s a
h e t e r o p h i l . T h e s m a l l e r c e l l s a r e
n o r m a l e r y t h r o c y t e s , w h i c h a r e
n u c l e a t e d i n b i r d s .
F i g u r e 4 : P l a s m o d i u m s p . , t h e c a u s e
o f a v i a n m a l a r i a .
F i g u r e 5 : E r y t h r o p h a g i a b y a
m o n o c y t e . P h a g o c y t i c d e s t r u c t i o n
o f r e d b l o o d c e l l s i n d i c a t e s t h a t
i n t r a v a s c u l a r h a e m o l y s i s o c c u r s i n
r e p t i l e s .
F i g u r e 6 : A z u r o p h i l s .
Answers
4
5
6
What are the two cells marked A in
this film from a boa?
What are the intraerythrocytic
inclusions arrowed in this lung smear
from a Snowy Owl?
What is this interesting phenomenon
in blood from an anorectic iguana?
22 | companion
Improving the health of the nations pets
PETSAVERS
PAY PETSAVERS A
VISIT AT CONGRESS
PET MONTH
WITH
PETSAVERS
G
et involved with National Pet
Month 2009 (4 April 4 May)
and help raise vital funds for
Petsavers.
National Pet Month is again fast
approaching and Petsavers is pleased to
be involved. During the month there will
be inventive events across the country,
from sponsored dog walks to garage
sales, cake competitions to practice
open days helping to raise funds for the
associated charities involved.
So, how can you get involved? You
could go to one of the events being held
and provide your support that way or
arrange an event of your own. If you work
in practice, National Pet Month can be a
brilliant opportunity to engage with your
local community. If you cant think of an
event, then Petsavers is happy to suggest
ideas, or you can order a free event pack
through the National Pet Month website.
You can also find out about events
close to you through the National Pet
Month website and if you are planning an
event in support of Petsavers please let
us know as we would love to hear about
it and help you promote it.
For fundraising ideas, or help with
raising sponsorship please email info@
petsavers.org.uk
To find out about events close to you
check the National Pet Month website
www.nationalpetmonth.org.uk
P
etsavers will be joining the rest of the BSAVA on the balcony in the NIA Exhibiton
this year and we are looking forward to meeting you there. You will be able to
meet Petsavers volunteers and find out what Petsavers has planned for the future.
Petsavers is always open to fundraising ideas or suggestions, so please feel free to come
to the stand and share your ideas. Petsavers will also be running a competition for all
delegates, so dont miss out on the chance to win great prizes and get involved with
your veterinary charity.
Y
ou dont have to be the next Martin Lel or Paula
Radcliffe; if you just want a fun day out, then Petsavers
would like to hear from you. Once again Petsavers will
be taking part in the 10k run. The event will be on Sunday 12
July 2009 in London. Last year 26,000 people, including
GO ON THE RUN
professional runners such as
Stefano Baldini and Catherine
Ndereba, ran the route past
many of Londons historical
landmarks. The Petsavers
team had a great time and
raised lots of money for
Petsavers in the process. If
you would like to take part
then please contact us as soon
as possible as spaces are limited,
at info@petsavers.org.uk or call
01452 726723. We can help you
with raising sponsorship, whether
that is assistance with sponsorship
forms or setting up a Just Giving page.
You can find out more about the event at
www.thebritish10klondon.co.uk
22 | companion
companion | 23
WSAVA NEWS
WSAVA CE AROUND
THE WORLD
Sri Lanka
The WSAVA has been hosting WSAVA
CE programmes for practitioners in
Sri Lanka for some time, but the usual
programme was limited to one or two day
visits and there was obviously a need for
assistance on a broader scale in this very
poor country.
Dr Roger Clarke, who chairs the
WSAVA CE programme in Asia, gave the
first programme of CE that extended
beyond the reach of the normal
WSAVA programme. He donated
approximately two weeks of his time free of
charge to teaching final year veterinary
students at the University of Peradinaya in
Kandy. His airfare was paid by the
Commonwealth Veterinary Association and
Above: Dr Roger Clarke (right) and
Intervet/Schering-Plough Animal
Health sponsor representative
Dr Gabriel Varga (second from right)
visit with members of the Sri Lanka
Veterinary Association during a
CE event.
Left: Being exposed to and exploring
the beautiful country of Sri Lanka is
one of the bonuses of veterinary
visitors volunteering their time.
24 | companion
WSAVA CE
AROUND THE WORLD
WSAVA NEWS WSAVA NEWS
he was assisted locally by the Sri Lanka
Veterinary Association. While in Sri Lanka,
Dr Clarke also lectured practitioners. This
was such a success that he looked for ways
to continue this teaching programme.
In 2008 Dr Dave Watson, formerly of
the University of Sydney Veterinary School,
volunteered to go to Sri Lanka on a pro
bono basis and he taught the students and
practitioners the secrets of problem-
oriented veterinary medicine. The ASAVA
took over part of the financial assistance
for the programme and contributed to
the accommodation costs of Dr Watson
while he was away. The WSAVA CE
programme paid the airfare as part of the
WSAVA CE commitment.
In 2009, Dr Graeme Allan will be going,
again on a pro bono basis, to help the
veterinary school to use its new ultrasound
equipment and to teach diagnostic imaging
to the students and the staff, as well as the
practitioners who may utilise this service.
The involvement of the ASAVA in this
way is very much appreciated by the
WSAVA, and we join the ranks of other
national veterinary associations in
sponsoring our less affluent colleagues
throughout the world.
The ASAVA has benefited enormously
in its membership of the WSAVA, both in
the exchange of knowledge and the
opportunity to hold the largest veterinary
congress Australia has seen in 2007.
Most of the work in the WSAVA is done
by volunteers who give freely of their time
and skills for the sheer pleasure that comes
from giving. Dr Clarke is actively looking
for skilled volunteers who would be
prepared to give approximately two weeks
of their time teaching in Sri Lanka, with the
WSAVA CE programme. An additional
benefit is that the volunteers can see this
beautiful country with its fascinating history
(at their own expense) while they are there.
For further details please contact
rogerclarke@pobox.com
Panama
With a population of 3.3 million people,
Panama was the second fastest growing
economy in Latin America in 2008. The
country has one veterinary college, which
is located in facilities that used to house the
American Panama Canal Administration
offices and is in need of both structural
and equipment upgrades.
However, with a reinvigorated
leadership and growing membership,
AMVEPA has become more active on
behalf of its members in 2008, particularly
in the delivery of CE. As part of its Global
CE Programme, WSAVA hosted its first
meeting for small animal veterinarians in
Panama City on the topic of Emergency
Veterinary Medicine. Lectures were given
by Drs Luis Tello (WSAVA Vice President)
and Adriana Lopez (LAVECCS Secretary)
with approximately 80 delegates
attending.
Register for
So Paulo
Have you registered yet? There
will be approximately 250
lectures by 75 world-renowned
speakers covering over 20
disciplines complemented by an
exciting social programme in
culturally diverse So Paulo, with
all that Brazil and South America
has to offer. Please visit www.
wsava2009.com for additional
details and online registration.
Dr Luis Tello introducing the WSAVA CE Programme prior to his presentations on
Emergency Medicine to attendees of WSAVA CE in Panama.
companion | 25
WSAVA NEWS
PRESIDENTS
REVIEW
David Wadsworth looks
back on the last years
successes for the World
Small Animal Veterinary
Association
I
t is the duty of every President to report
on his or her hectic period in office
and this Presidents report is no
exception. The Dublin WSAVA Congress
was the first in a series of congresses which
feature Hills Pet Nutrition as our WSAVA
Prime Congress sponsor.
WSAVA Congress
Thanks to the help of Dr Nicola Neumann,
Professor Boyd Jones and their teams I can
report on a truly great congress in Dublin,
which was enjoyed enormously by delegates
and exhibitors alike. One congress leads
inevitably into the next and we are
currently working hard with Dr Marco
Gioso, Saliem Saleygh and Wanderson
Ferrera and all those involved on the final
preparations for the WSAVA 2009
Congress in So Paulo, 2124 July 2009.
This will be only the second time that
the WSAVA Congress has been held in
South America and we are hoping that it
will hit the very high standard set in Dublin.
The local organizing committee is talking in
terms of 3000 delegates, so make a note in
your diaries to be there.
During the autumn of last year the
French Association AFVAC celebrated its
50th anniversary and I was fortunate to be
invited to Strasbourg to take part in their
celebrations. AFVAC has been a leading
force in WSAVA for many years and with
the help of Drs Carlotti, Roze and
Rousselot, is helping to extend the
WSAVA Continuing Education (CE)
programme to French-speaking areas of
Africa and hopefully also Paraguay.
Worldwide CE
The WSAVA 2008 CE programme has
hosted a record number of attending
delegates (4159) in 31 meetings spread
over four continents. We and the
long-term sponsoring partners, Bayer
Animal Health, Hills Pet Nutrition, and
Intervet/Schering-Plough, can be justifiably
proud of the difference that the programme
has made to the lives and education of
veterinary surgeons in the developing
areas of the world.
Member Associations from the UK
(BSAVA), France (AFVAC), Austria (VK),
Australia (ASAVA), Greece (HVMS),
Switzerland (SVK), Denmark (DSAVA),
Norway (NSAVA), Finland (FSAVA), and the
Netherlands (NACAM) have all contributed
financially, either directly or by sponsoring
speakers, and we are grateful for this
cooperation. It is a particular pleasure to
report that the associations from the Czech
Republic, Slovakia and Poland, who were
initially recipients of sponsorship, have
matured and have been contributing to the
programme by waiving the small amount of
sponsorship that is their due.
Welfare and science
The animal welfare committee will be
active in 2009 with day-long streams
already organized for the TNAVC,
FASAVA and WSAVA conferences.
Drs Butcher and Clarke continue to do
excellent work in the face of a tide of
apathy to a subject which should never be
taken for granted, even though veterinary
surgeons, by definition, are involved in
animal welfare on a daily basis.
The Scientific Committee has been
extremely active in assisting with the
production of the programme for So Paulo
and Dr Michael Day and his committee are
considering nominations for prestigious
WSAVA Awards which will be announced in
So Paulo. The Scientific Standardization
projects on Renal Disease and Vaccination
continue and interim reports will be made
in July 2009.
WSAVA plans
The Board met during the NAVC Congress
in Orlando. Top of the agenda was to
consider the major strategic planning
initiative started in Dublin. Part of this will
be to consider the need to stabilize the
position of WSAVA by incorporation and
registration as a not-for-profit association
within a named country. There will be
stricter controls, both administrative and
financial, but these changes would be
necessary to ensure that WSAVA retains
its preeminent place in the veterinary
world in the future. Dr Kirpensteijn is
looking into the formation of the WSAVA
Foundation, a fundraising entity, which will
be supportive of scientific research
projects in the future. Dr Sheehan will also
be looking at the WSAVA Congress in all
its facets and the Board will be considering
an action plan which will be taken to the
Assembly in July.
I hope that the result of all this work
will be that the Assembly in So Paulo will
have major issues to consider and that the
active participation of the members in the
strategic planning process will see an even
more committed and active WSAVA in
the future.
26 | companion
companion INTERVIEW
Pip Boydell was born in 1960 (both Pip and his parents joke that he was exchanged at
birth), and grew up in Manchester and Bolton. After first studying at Exeter University he
went on to the Royal Veterinary College, though claims he never actually wanted to be a
vet until the fourth year of the course. After graduating and spending a year in practice,
two years in the surgery department at Edinburgh and a year in referral practice in
London, Pip realized that, of all the disciplines, ophthalmology/neurology held the greatest
attraction and he took up a residency in veterinary ophthalmology at the RVC. Pip
established the first UK dedicated small animal referral practice in 1990 and set up the
first in-house brain scanner the next year. He has published over 200 peer-reviewed
papers and abstracts and is a regular speaker at BSAVA Congress.
THE
companion
INTERVIEW
You have become known within the
profession through your published
papers and lecturing on
ophthalmology how did you first
become involved in that area?
Having been informed by the local taxman
that only one international conference per
year was tax deductible, I learnt that
presenting a paper might be counted as
advertising and therefore a business
expense. Regular attendances at such
meetings, both veterinary and medical, led
to occasional invitations to lecture and I
could see the world and get paid (not alot)
for it!
What has been your main interest
outside work?
Music has always been a major part of my
life, having come of age during the punk
era. I have been in some form of band all
my life, working on the premise that lack of
talent is no obstacle to success, but I have
not been offered any major record contract
(yet). The Bruise Brothers are currently
available for weddings, bar mitzvahs and
biker festivals.
I worked my way through college as a
disc jockey on pirate radio, live parties and
gigs. My most important possession is my
juke box (a proper juke box that plays vinyl,
Luddite that I am). With age and general
infirmity I retired from playing American
Football and moved into traditional and
competitive martial arts. I turned pro at
the beginning of 2009.
What would you have done if you
hadnt been a vet?
Assuming Im not going to make it big in the
music industry, I would have done
something entrepreneurial. As a student I
was very aware of the risk of failing exams
and an alternative career progressed
running market stalls selling second hand
records and Chinese silk clothing (my sister
was studying in China at the time). I might
have had a chain of stores by now!
Currently I run a couple of Chinese
kickboxing and Kung Fu clubs.
What is your favourite aspect of
veterinary practice?
Dealing with people.
What is your least favourite aspect
of veterinary practice?
Dealing with people.
Who has been the most inspiring
influence on your professional
career?
John Peel, Humphrey Littleton.
Which historical/cultural figure do
you most admire?
Genghis Khan.
What is the most significant lesson
you have learned so far in life?
People who mind dont matter; people who
matter dont mind.
If you were given unlimited political
power, what would you do with it?
Encourage investment by the workforce so
that all employees own their companies.
Remove incentives (tax, social benefits, time
off, etc.) for people to have children its
discrimination against the childless!
These seem good ideas but are too
small scale. How about arranging the
destruction (painless) of 99% of the human
race so that true anarchy will allow the
re-evolution of society? Whew!
If you could change one thing about
yourself, what would it be?
I would like to enjoy eating vegetables and
healthy food.
What do you consider to be your
most important achievement during
your career?
That would be winning two gold medals
fighting in the British Kickboxing
Championships in 2005. n
CPD DIARY
companion | 27
CPD
DIARY
12
March
Thursday
Anaesthesia and analgesia in
the 21st century
Speaker John Hird
Leatherhead Golf Club, Ashtead, Surrey.
Surrey and Sussex Region.
Details from Jo Arthur, 01243 841111,
surreyandsussexregion@bsava.com
EVENING
MEETING
19
March
Thursday
Soft tissue surgery:
oropharyngeal stick injuries
Speaker Zo Halfacree
Russell Hotel, Maidstone. Kent Region.
Details from Hannah Perrin, hannah@
burnhamhousevets.com
EVENING
MEETING
14
May
Thursday
BSAVA Cardiology Roadshow
Speakers Rebecca Stepien and Mike Martin
Radisson SAS Hotel, Belfast, Northern
Irish Region. Organised by BSAVA.
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
DAY
MEETING
18
May
Monday
BSAVA Cardiology Roadshow
Speakers Rebecca Stepien and Virginia
Luis Fuentes. Canalside, Bridgwater,
South West Region. Organised by BSAVA.
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
DAY
MEETING
12
March
Thursday
A pain in the ass: surgical
disease of the rectum and
colon fistulas, megacolon,
neoplastic disease
Speaker Kathryn Pratschke
VSSCo, Lisburn. Northern Irish Region.
Details from Shane Murray, shane@
braemarvetclinic.co.uk
EVENING
MEETING
19
March
Thursday
Vascular disease in small
animals: an underdiagnosed
problem?
Speaker Simon Swift
Holiday Inn, Haydock. North West Region.
Details from Simone der Weduwen,
beestenhof@ntlworld.com
EVENING
MEETING
18
March
Wednesday
The Golden Hour
Speaker Dan Holden
Park Inn, Llanederyn, Cardiff.
South Wales Region.
Details from the Chairman or Secretary,
southwalesregion@bsava.com
EVENING
MEETING
19
March
Thursday
How the lab can help you with
pancreatic disease
Speaker Lindis Fouracre
Potters Heron Hotel, Romsey.
Southern Region.
Details from Michelle Stead, 01722
321185, mmstead@btinternet.com
EVENING
MEETING
30
April
Thursday
Cardiovascular medicine
Speaker Jo Dukes McEwan
Thorpe Park Hotel & Spa, Leeds.
Organised by BSAVA.
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
DAY
MEETING
13
May
Wednesday
Ocular manifestations of
systemic disease
Speaker David Williams
Potters Heron Hotel, Romsey.
Southern Region.
Details from Michelle Stead, 01722
321185, mmstead@btinternet.com
EVENING
MEETING
17
May
Sunday
Is it respiratory or cardiac
disease? Case-based approach
Speaker Clive Elwood
Cambridge Belfry, Cambourne.
East Anglia Region.
Details from Graham Bilbrough,
graham-bilbrough@idexx.com
DAY
MEETING
8
March
Sunday
Acute and painful eye
conditions in companion
animals
Speaker John Mould
Best Western Glasgow Pond Hotel,
Glasgow. Scottish Region.
Details from Claire Robertson,
07792 251003, claireadriennelamb@
hotmail.co.uk
DAY
MEETING
8
March
Sunday
Sedation/anaesthesia of sick
medical cases
Speakers Louise Clarke and Liz Leece
Cambridge Belfry, Cambourne. East
Anglia Region.
Details from Graham Bilbrough,
graham-bilbrough@idexx.com
DAY
MEETING
25
April
ThursdaySunday
BSAVA Congress
International Speakers
Four day Congress including
a challenging scientific
programme, scintillating
social events and an extensive
exhibition. ICC/NIA,
Birmingham. UK.
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
810
May
FridaySunday
24th annual
Scottish Congress
Raising the bar in SA
practice, for veterinary
surgeons & nurses
Speakers Andrew Mackin and Ronan Doyle
Fairmont Hotel, St Andrews.
Scottish Region
Details from Susan Macaldowie, 07711
633698, smacaldowie@btinternet.com
WEEKEND
21
April
Tuesday
Infectious diseases
Speaker Susan Dawson
BSAVA, Woodrow House, Quedgeley.
Organised by BSAVA.
Details from the Membership and
Customer Service Team, 01452 726700,
administration@bsava.com
DAY
MEETING
Members price: 191.83 inc. VAT
British Small Animal Veterinary Association
Woodrow House, 1 Telford Way, Waterwells Business Park,
Quedgeley, Gloucester GL2 2AB
Tel: 01452 726700 Fax: 01452 726701
Email: administration@bsava.com
Web: www.bsava.com
Recent advances in treating cardiovascular
diseases have changed the clinical approaches
we use and improved survival times. Discover
new ideas about familiar diseases and nd
a fresh appreciation for the joys of treating
geriatric patients.
Thursday 14 May
Radisson SAS Belfast
Rebecca Stepien and Mike Martin
Monday 18 May
Canalside, Bridgwater
Rebecca Stepien and Virginia Luis Fuentes
Wednesday 20 May
Venue Daventry Hotel, Daventry
Rebecca Stepien and Mike Martin
Friday 22 May
Bellhouse, Beaconseld
Rebecca Stepien and Virginia Luis Fuentes
BSAVA Cardiology Road Show
May 2009

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