The Webinar Gazette - June 2021 by thewebinarvet

The Webinar Gazette The Webinar vet

To provide: The highest quality vet-led content To be: The world’s largest online veterinary community

JUNE 2021

To have: The planet’s most confident vets

WHAT’S INSIDE CPD’er of the Month Speaker of the Month David’s Review From the Literature

’m writing this intro for the newsletter from a hotel at the NEC in Birmingham! That’s right I’m at a physical conference at the NEC- the first since lockdown. There’s social distancing and I had to do a lateral flow test but I’m here at a marketing conference. It’s difficult to do any networking but I’ve enjoyed it. I’m sure many of us have missed the social element and I’m very confident that the impressive roll out of the vaccine will continue to help us get on the road to normality. I took The Webinar Vet team into lockdown very quickly in early March last year and I’m hoping Mr Johnson won’t be dilatory again bringing us out.

two Manchester clubs. With 10 games to go we seemed to have no chance in getting in the top four and, hence, the Champions League. However, 8 wins and 2 draws plus poor form from Leicester and Chelsea allowed us to sneak in. I’m fascinated by sports psychology and confidence. It’s easy to lose and yet can also come back. Something we can all ponder upon to help us build up resilience. Anfield was a cold place on Sunday afternoon in late May. I was at the top of the Main Stand and the wind was howling through and my hands were numb due to my Raynaud’s syndrome. I do hope the English summer arrives soon!

I was similarly thrilled to be at the football on Sunday watching Liverpool achieve an unlikely third position in the premier league table after the

I’m thrilled to let you know that after the huge success of the World Congress of Vet Dermatology 9 congress, we are also helping ESVD go online

after the Porto physical event was delayed until 2022. AS you may know, derm is my first love and I’m sure it will be a fabulous conference. Ticketing details will be made public soon Finally, I’m still enjoying working on the Simply Vet side of the business as we help many vets and nurses overcome the challenges of IR35. If you’ve got any questions or need any help, please feel free to contact me on my LinkedIn profile or anthony@ thewebinarvet.com

To your CPD success,

Anthony

CPD’er of the month

This month’s CPDer of the month is

TONY XIAO

you can take and learn from with confidence. It has definitely instilled me with a greater sense of confidence in what I do. Thanks very much Webinar Vet!” 1. Which webinar did you enjoy the most this month?

Canine Mast Cell Tumours - Update on New Treatments. Was very helpful and applicable to a current case that I was dealing with. 2. Did you attend any large events this month? If so, which?

Unfortunately I was very busy this month so did not get a chance to attend any. 3. What was the biggest take-home message you learned this month from our webinars?

hanks very much to the Webinar Vet for the recognition in being the Webinar Vet’s CPDer of the month. I have enjoyed the lectures immensely this year and it has definitely made it an easier way for me to study and keep up to date with the latest in medicine, surgery, anaesthesia to name just a few without having to spend endless amounts of time trying to find out what the newest and latest upgrades and techniques and approaches are within our complex field of study. The lecturers are all well renowned and recognised in their fields and hence gives the information a certain level of trust which

The use of Stelfonta as a unique new local therapy for Mast Cell Tumours of all grades. It seems to be specific to MCT vasculature and relatively sparing of the surrounding tissue and hence would be a great treatment for MCT’s in surgically awkward areas. This has implications in being an extremely useful alternative treatment for a previously surgically apprehensive task. 4. Are you looking forward to any future webinars or events from The Webinar Vet?

In general I have a lot of interests and look forward to updating my knowledge with any and all webinars in small animal medicine.

Speaker of Speaker of the Month the Month With over 40 speakers delivering CPD sessions as part of WCVD9, we wanted to highlight a few of them here for you!

Caroline Boothroyd RVN, Cert SAN, VTS(SAIM)

aroline started nursing at a first opinion practice in Liverpool in 2000 and qualified in 2002.

Use discount code

SOTMJUNE https://www.thewebinarvet. com/shop/product-category/ sotmjune2021/?v=79cba1185463

She joined Northwest Veterinary Specialists, a multidiscipline referral centre in 2007. She became a dedicated medicine nurse in 2014 and the dedicated oncology nurse in 2016. She passed the Certificate in Small Animal Nutrition in 2010 and became a Veterinary Technician Specialist (VTS) in Small Animal Internal Medicine in 2014. In December 2020 Caroline passed the application to sit the exam for the VTS in Oncology.

Feedback:

Excellent patient care is a real passion of Caroline’s – she loves to look after patients as she would like someone to look after her own pets.

“Absolutely loved this webinar! Caroline did an amazing job at exposing pancreatitis as it is very complex! Recommend this for vets and nurses. Would love to see more webinars like this! The notes are really good too!”

“Really informative and interesting easy to listen to” ”Very informative, and easy to listen to. Enjoyed this one. Thank you.”

Updates from THE Vet Exhibition It’s been another successful month for THE Vet Exhibition and I have so much to share with you for the month ahead! To keep up to date with the latest information, statistics and exhibitors, be sure to follow THE Vet Exhibition on LinkedIn! Last week we hosted our very first cocktail networking session to answer all of your questions around THE Vet Exhibition and thank you to all who attended! We will host another session on June 24th so if you couldn’t make it last week, we hope to see you at the next one! On June 5th 2021, Conference Virtually will be streaming the Rabbit Welfare and Ethics Day brought to you by The Rabbit Welfare Association & Fund in Auditorium 1. The event will take place online for the first time and more information regarding the event can be found by clicking here! Our wonderful exhibitors MSD Animal Health and NationWide Laboratories have both updated their booths with some fabulous new rabbit content too so be sure to check out their refreshed stands for further information.

THE Vet Exhibition has also launched the Friday Fact Flash where you can also keep up to date with the latest facts and figures from the digital environment. If you are considering exhibiting or would like to discuss any of the available opportunities within the virtual space, please do let me know and we can catch-up in one of the meeting rooms over a coffee (or cocktail)! On a final note, we will be streaming six of the most popular sessions from The Webinar Vet’s Annual Virtual Congress in a monthly cinematic screening! To discuss sponsorship of the sessions which includes a one-hour live Q&A session with the speaker in a branded networking lounge, get in touch via email at Stephanie@thewebinarvet.com I look forward to ‘seeing’ you in the environment soon!

Stephanie, THE Vet Exhibition Show Manager

Not All Cannabinoid Products are Equal! Dr. Dave Tittle BVetMed CertVA GPCert(WVA&CPM) MRCVS is an RCVS Advanced Practitioner in Veterinary Anaesthesia and is in clinical practice in Devon. He sits on the International Advisory Panel for ElleVet Sciences in the US and provides a consultancy service to ElleVance Sciences in the UK.

As the potential for using cannabinoid (CBD) products in certain scenarios increases, thoughts turn to the content of specific brands available on the market. There are numerous studies produced, which have analysed the content of these food supplements; some of their findings can make interesting reading! This area was touched upon in my February 2021 article, but will be expanded further here.

In the UK, a similar analysis was performed by a team of researchers for the BBC Two programme, ‘Trust me, I’m a Doctor’ (BBC, 2019). Their findings indicated that twenty five percent of twelve products analysed contained less CBD than indicated on their labels. Whilst within the constraints of the dose volumes generally administered, an overdose of this magnitude is unlikely to be harmful, products containing either too little or too much CBD than labeled could negate the potential benefits. Furthermore, the variability across products may make it troublesome to obtain a reliable and sustained effect following administration.

As there is little regulation surrounding the supply of hemp based products, it is easy to purchase a product from an online or traditional retail outlet that claims on the packaging to contain CBD. A team from the University of Pennsylvania (Bonn-Miller et.al., 2017) purchased eighty four CBD products from thirty one different companies over a one month period, off the internet. These samples were submitted for independent analysis. It was found that more than forty two percent of products were underlabelled (i.e. contained a higher concentration of CBD than indicated on the packaging); twenty six percent were overlabelled (i.e. the product contained a lower concentration of CBD than stated). Overall, thirty percent of those products analysed contained a concentration of CBD within ten percent of that declared on the product label. Worryingly, this implies that nearly seventy percent of products sold online in the US at the time the study was undertaken, were mislabelled.

Wakshlag et.al. (2020) analysed twenty nine over the counter hemp products available in the US. Perhaps alarmingly, two of these twenty nine samples contained no detectable CBD. All twenty nine samples were found to be under the US Federal limits of less than 0.3% detectable THC (UK regulations are more stringent). However, four of these twenty nine samples contained levels of heavy metals (lead, arsenic and cadmium) above the lower limit of detection. Three of these four were contaminated with lead above the lower detection limit and two of these four products would not pass the requirement for oral consumption based on laboratory analysis and the current USP (United States Pharmacopeia) guidelines.

Figure 1: Analysed Constituents of Hemp Derived Products from the US Pet Market (Adapted from Wakshlag et. al., 2020) CANNABINOIDS (mg/ml or mg/g)

TERPENES (ppm)

4500

Premium Quality CBD+CBDA Product

65 60

4000

3500

3000

TERPENES CBD CBDA THC THCA

2500

2000

CBGA

1500

CBN

1000

THCV

500

CBC

CBDV

20 10 5 0

A respectable company would have readily available to view on request, a Certificate of Analysis detailing the content of each batch of product. This independent testing should measure a number of factors surrounding the product content, including a breakdown of the full cannabinoid content, a breakdown of the full terpene content, pesticide and fungicide levels, mycotoxin and bacterial contamination, heavy metal analysis and residual solvent analysis.

CBG

Figure 2(a): Example of a Certificate of Analysis Evaluating Cannabinoid Content

Comparing apples and pears

Cannabinoid Profile per Serving Serving Size

1mL, 894mg

Cannabinoid mg per serving

Weight %

THC

1.03mg

0.1%

CBD

28.00mg

3.1%

CBN

Not detected

THCa

0.75mg

0.1%

CBDa

29.06mg

3.3%

Δ–8 THC

Not detected

THC CBD THCa

0.1%

CBGa

0.47mg

THCv

Not detected

CBDv

Not detected

CBC

1.31mg

0.1%

Total

60.62mg

6.8%

Max THC

1.69mg

0.2%

Max CBD

53.43mg

6.0%

Figure 2(b): Example of a Certificate of Analysis Evaluating Terpene Content

Terpene Profile Terpene

CBDa CBGa CBC

Test Results

α-Pinene

0.17%

Camphene

Not detected

β-Myrcene

0.25%

β-Pinene

0.13%

δ-3-Carene

Not detected

α-Terpinene

Not detected

Ocimene

Not detected

δ-Limonene

0.17%

ρ-Cymene

Not detected

β-Ocimene

Not detected

Eucalyptol

Not detected

γ-Terpinene

Not detected

Terpinolene

Not detected

Max THC Max CBD

When selecting an appropriate cannabinoid product, there are also some simple comparisons to make, to ensure you are obtaining a high quality product, offering good value for money. These considerations include: the overall content of cannabinoid in the product (i.e. mg/ ml), the cost per millilitre for this product, how long this product would last at an appropriate dose and what is the ratio of CBD to CBDA of the product. A previous article (March 2021) discussed the benefits of utilizing a product containing CBDA alongside CBD in a 1:1 ratio, as it is believed that the presence of CBDA provides an enhanced anti-inflammatory effect. High heat extraction techniques during processing of the hemp plant decarboxylates CBDA to form CBD; some higher end products will utilise an alternative extraction method to preserve CBDA content. A full spectrum product with a robust terpene profile is also a superior option. Caution must be observed in that some products with a high aromatic terpene content (i.e. smell) give the impression of increased potency; this can however mask the fact that generally little CBD is present in the product.

Linalool

0.13%

Isopulegol

Not detected

References:

Geraniol

Not detected

β-Caryophyllene

0.08%

Bonn-Miller, M.O., Loflin, M.J.E., Thomas, B.F., Marcu, J.P., Hyke, T., Vandrey, R. (2017) Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 318 (17) 1708–1709.

α-Humulene

0.04%

Nerolidol 1

Not detected

Nerolidol 2

0.10%

Guaiol

0.06%

Caryophyllene Oxide

0.19%

α-Bisabolol

0.04%

Total

1.36%

Total Analytes

61.96%

British Broadcasting Corporation. 2019. What’s really in cannabis based health products? [Online]. BBC. Available from: https://www.bbc.co.uk/programmes/ articles/sDNZjp3h8lxzv8k8KLYNvW/what-s-really-in-cannabis-based-healthproducts [Accessed 13 May 2021]. Wakshlag, J.J., Cital, S., Eaton, S.J., Prussin, R., Hudalla, C. (2020) Cannabinoid, Terpene, and Heavy Metal Analysis of 29 Over-the-Counter Commercial Veterinary Hemp Supplements. Vet Med (Auckl) Apr 15 (11) 45-55

Further information available on request from: www.ellevancesciences.com or by email: customersupport@ellevancesciences.co.uk

WEBINAR RABBIT NUTRITION –Fuel for life or are we putting the wrong fuel in the engine? CLAIRE SPEIGHT RVN A1 C&G VNES

David’s Review

I Claire has been a veterinary nurse since qualifying in 2007. She has consistently studied, adding knowledge and expertise in rabbit welfare in particular. She is busy combining the role of head nurse in a first opinion practice with lecturing, writing and education around rabbit welfare, her main professional interest. She is the editor of ‘Rabbiting On’, the magazine of the Rabbit Welfare Association & Fund, (RWAF). She is also sales manager for RWAF.

didn’t know what to expect from this veterinary webinar. It has an intriguing title, which immediately made me think what has changed? Have I been giving the wrong advice? This webinar answers those questions The learning objects of the webinar are listed: • The correct and incorrect diet for rabbits • Enrichment for rabbits using nutrition • Life stage feeding •The link between incorrect diet and health conditions in rabbits •How to advise clients on correct rabbit nutrition To introduce diet Claire uses pictures of rabbits eating various food sources. As you might expect Grass and Hay, greens and pellets are

essential and amongst things never to feed are carrots, lettuce, and many fruits (too high in sugar), and no surprise - Muesli. Many owners struggle with the concept of what and how much to feed. To help owners overcome this struggle we are reminded of the feeding pyramid. A neat diagram of a pyramid is ideal for owners. It shows 5% pellets at the top, followed by 10% for greens and at the bottom of the pyramid 85% grass or hay. There is also a picture of a bowl with the appropriate daily amount of pellets, which surprised me-easy to get wrong! The next couple of slides took me back to biochemistry days at college. There is a comprehensive list of rabbit requirements for crude fibre, volatile fatty acids (absorbed from the caecotrophs) and all the necessary essential amino acids etc., which are obtained

by microbial synthesis in the caecum. After describing the passage of digestible and indigestible fibre through the digestive tract we move back to practical advice for rabbit owners. Pellets must be restricted to a maximum, as already stated, of 5% of the diet, and (did you know this?) the correct amount is one level tablespoonful per kg ideal bodyweight, remembering that obesity is a common problem. Pellets are best scattered to encourage foraging, should be eaten within 15 minutes and viewed as a diet supplement. Do not feed pellets from a bowl. Vets will often need to change an incorrect diet to a correct one and a four-week change routine is outlined. Grass is preferable to hay, although hay is most often the main source of fibre, unless a rabbit is fortunate enough to have a large secure outdoor run. It is suggested to feed different types of hay, such as timothy, oat, meadow or brome, avoiding alfalfa. Hay can never be overfed and should therefore be available 24 hours a day year round, constituting 85 % of the diet, as already mentioned. We branch into the benefits of hay in preventing dental disease, and the consequence of calcium deficiency. In just one slide there are many little facts such as the number of chews per minute, the amount of tooth growth per week and how much food is usually consumed in 4-6 minutes. And have you tried chewing hay or grass? The cellulose is very hard and difficult to chew, takes time and reduces boredom and destructive behaviour. If you have ever advised including greens and vegetables in the diet, have you always been clear about the best and worst greens, and how much to feed, bearing in mind that maany owners struggle with correct quantities? I have not been clear but help is at hand. Claire lists half a dozen good greens, and a similar number of bad ones ,with an easy to remember way of calculating the

quantity. Offer a varied selection the size of the rabbit’s head each day, and moderation is key! Water access is of course essential and Claire prefers bowls to bottle, and gives reasons for this. Water should be changed twice daily. Treats are not essential for health but a few are recommended, mainly for training and encouragement to bond. Above all feeding should be fun and there are lots of ideas on how to enrich the experience. The following sections give advice (worth downloading) on how to feed rabbits at various stages of their lives-from baby/young rabbits to elderly/senior rabbits including those judged to be overweight. There is also information on what the droppings tell us, (the number expelled per day will probably surprise you). There is a list of the causes of uneaten caecotrophs, which leads onto the health problems associated with an incorrect diet. Much of this will be familiar ground to vets that regularly treat rabbits, obesity and pododermatitis, dental problems and factors leading to fly strike for example. This is a brilliant webinar full of practical advice on getting the rabbit diet correct. We all know that diet is a major factor in promoting a healthy long life for rabbits, but we still see evidence of incorrect feeding. There is a huge amount that can be done to promote good welfare and this webinar is recommended to all who treat rabbits, rabbit owners and to students. A very useful and recommended resource is the RWAF booklet ‘On the Hop’

WEBINAR THE ENVIRONMENTAL FATE OF PET FLEA PRODUCTS DAVE GOULSON, ROSE PERKINS, MARTIN WHITEHEAD

his is a very timely and necessary veterinary webinar. The WebinarVet has brought together three excellent speakers each with a different focus, which taken together makes a very strong case to re-consider our approach to insecticides, but also asks many questions that suggest the need for further research. In terms of research it would be difficult to find a more knowledgeable scientist than the first speaker, Professor Dave Goulson from the University of Sussex. Apart from publishing hundreds of peer-reviewed articles on entomology he is the author of best selling books such as ‘The Garden Jungle-gardening to save the planet.’ He begins by reviewing some publications demonstrating the steady decline in recent years of insects, due to systemic pesticides in Germany. Similarly there has been a decline in butterflies in the UK, and very strikingly, the Great Yellow Bumblebee. You may not have heard of this bee, because it has been driven to the point of extinction. A map shows the wide UK distribution between 1900 and 1950, followed by the data for 2000-2020. Great Yellow Bumblebees are now found only in the tip of Scotland. So does the loss of insects matter? Dave answers this by a quote from E. O. Wilson, a distinguished American biologist, and a scientist he calls his hero. Wilson’s CV on Wikipedia is worth reading. He has been called the new Darwin, or the Darwin of the 21st century, and at 91 years of age he is still active.

The quote is: ‘If all mankind were to disappear, the world would regenerate back to the rich state of equilibrium that existed ten thousand years ago. If insects were to vanish, the environment would collapse into chaos’ After displaying some beautiful pictures of wildlife under threat he shows a supermarket store laded with fruit from all over the world-an amazing choice. The next photo of the same store shows rows of empty shelves with little choice. This would be our choice without bees. The next illustration looks harmless, even charming, until you are told what it depicts –Japanese workers artificially pollinating fruit trees, because there are no natural pollinators left in this region. There is a list of the causes of insect decline, including climate change, disease, loss of habit and so on. Pesticides are important and are the focus of the webinar. A remarkable slide shows the myriad of chemicals used by an oil seed rape farmer in just one year. The two chemicals picked out for discussion are the neonicotinoids and fipronil. There had been a steady increase in the use of neonicotinoids in the UK until 2018, when under EU law they were banned for farming use. Quite shocking was the fact that neonic seed dressings were absorbed only by 5% in the target crop with 94% leaching into the soil and waterways. Evidence cited from the literature describes the effect of neonicotinoids on the decline of various organisms.

Examples were honeybee colonies in the UK, wild bees, aquatic invertebrates in the Netherlands, insectivorous birds and farmland butterflies. I suspect this is just the tip of the iceberg. Rose Perkins, the second speaker is a vet, and a PhD student under the supervision of Dave Goulson at the University of Sussex. She begins by noting that little is known about the environmental impact of pet parasite products. Her contribution is specifically about fipronil and imidacloprid. These are effective pesticides, water soluble, with high potency and notably persistent, but also with risks to non-target species. Fipronil is broken down to the fiproles, (fipronil sulfone and fipronil sulphide), which are dispersed through pet hair, shed skin and by direct transfer, and they are very toxic to wildlife as shown in a comparative graph. It shocked me. She describes the meticulous research that led to the publication in the journal ‘Science of the Total Environment’ entitled ‘Potential role of veterinary flea products in widespread contamination of English rivers’. She co-authored the publication with the other two speakers in this webinar. The occurrence of fipronil, fipronil metabolites and imidacloprid in English rivers was examined from 2016-2018 using data from the Environmental Agency. I was astonished to see that fipronil was detected in 98.6% of samples and 65.9 % for imidacloprid. Particularly high concentrations immediately down

stream from wastewater treatment works supported the hypothesis that potentially significant quantities of pesticides from veterinary flea products may be entering waterways via household drains. The hypothesis that Fiproles and Imidocloprid pose a risk to aquatic ecosystems is also supported. The final speaker is Martin whitehead BSc, PhD, BVSc, Cert SAM, MRCVS. His qualifications speak for themselves and he is also a co-owner if a prestigious small animal hospital. Martin often contributes to veterinary journals and I think it’s fair to say he enjoys a debate. He makes it very clear where he stands on what is sure to be a very robust and important debate on the use of veterinary parasiticides Responsible use of small animal veterinary parasiticides ……why my veterinary hospital does not have a pet health plan That certainly made me sit up because I have always thought that health plans were the way forward in ensuring good preventive medicinerather than relying on owners to remember. And perhaps tailoring each pet to the plan best suited? Later he describes his reasoning. Martin has researched his article carefully and poses many questions. He reminds us that vets and doctors have greatly over-used antimicrobials for decades, and although there is now guidance usage is still poor. He criticises the fact that many (? most) practices supply year round full coverage for flea, tick and worming products, often within a pet-health plane. He suggests many practices set targets for parasiticidal sales and asks• Is this intensive preventative usage good veterinary medicine? • Is it responsible usage of extremely powerful pesticides? We are given an idea of the size of the problem, numbers of pets involved

nationwide and some startling statistics. As an example, the amount of veterinary use of imidacloprid sold by one company per year is 4 tons! Martin states that there has been no environmental impact assessments done, and furthermore DEFRA and VMD have been lax about this, (but are now considering the environmental effects.) One of Martin’s areas of expertise is Evidence -Based Medicine and it is unsurprising that he asks whether current intensive usage is evidence -based. He provides three compelling reasons why it is isn’t. He continues by detailed suggestions of appropriate use of parasiticides and how to reduce total ectoparasiticide usage. He returns to the title of the webinar and describes why his hospital has never had a pet health plan, in spite of this reducing income. It is hard to argue with his point of view-but there is scope for one of his famous debates! Think about it after watching the webinar. I found the section on the risk – to benefit of ectoparasites and endectocides particularly interesting. As with the rest of this webinar it is meticulously researched, with ten products listed. Which of these are best for the environment? The answer is we don’t know. The reason we don’t know is that the VMD has not required an environmental impact assessment in the authorisation process! Martin talks us through the factors involved, many of which are poorly understood. Examples include how many pets are treated, how often and how parasiticidal products might find their way into the environment. This detailed section ends with a heading –‘Which products are safest for the environment?’ The question is asked ‘are oral products safer for the environment than topicals?’ We don’t know if oral products are safer for the environment overall but common sense suggests not using topicals in dogs that swim, are bathed, or

do hydrotherapy. And reduce the products and use them responsibly. Finally we are asked what else should be done. Martin suggests more research to quantify, assess the level of contamination, involving the Environment Agency and the VMD. If you take on board all that Martin has had to say about this issue, one that he is obviously passionate about, you might agree that all ectoparasiticides should be made POM. I am certainly persuaded that this would be a good first step. The powerful argument for more research must be very pleasing for Dave Goulson. It looks as though Martin has identified at least half a dozen PhD programmes, and perhaps some younger colleagues will be interested? This thoroughly recommended webinar was sponsored by the BVA and Vet Sustain. The final word is given to Justine Sholton BVSc, BSc, MSc, MRCVS. She is Junior Vice President of the BVA and in a short communication outlines the BVA position on the subject of the webinar. It is considered a One Health Challenge and is under development. There will be collaboration with BVA divisions and in the future it is suggested that there is a move away from blanket based parasite plans to evidence based ones. There is a lot to learn from the farm and equine sectors and the aim is to provide practical information to help inform vets and their clients. I thoroughly enjoyed the contributions from the three speakers. There is a huge amount of information and this topic is going to run, and I look forward to more debates. If you spend an hour with this webinar you will be very well informed to join in the debates, and possibly like me, have a reason to think again about your own policies.

WEBINAR: MENTAL RESILIENCE AND WELLBEING TRAINING OLIVIA OGINSKA DVM PgCertSAS MRCVS

livia graduated in 2016 from the Faculty of

perfectionism, people-pleasing and impostor syndrome

Veterinary Medicine at Wroclaw University of

to defeat them

Environmental and life Sciences, Poland. She

• Putting yourself first to serve others well-why self-

has travelled extensively throughout the world and

care is the opposite of selfishness

undertaken surgical internships. During her time in the

• Discovering the process of appreciative inquiry

UK she has embraced many different environments

• Creating a realistic plan to become the best version of

including first opinion practices, referral practices both

yourself without experiencing even more pressure

private and university and charity practice.

• Hope-possibility-community

In spite of her relatively young age, Olivia has been

The six-week course is designed specifically for

mentoring and providing mental health support to

veterinary surgeons, veterinary nurses, practice

her colleagues since graduation. By doing this she

managers, team leaders and a client care team. The

discovered her second passion, which apart from

mental resilience and wellbeing course involves six

surgery, is veterinary wellbeing. It led her to enroll in

steps. As an example the first of these is called ‘Why?’

the Masters degree programme in Applied Positive

Liv shows a montage of newspaper and news outlet

Psychology at Anglian Ruskin University, Cambridge.

headlines showing the extreme negativity we are

Following her second graduation she became a Positive

exposed to on a daily basis. Just tune in tonight to the

Psychology Appreciative Coach and set up Vet Gone

news and you will see for yourself. We are also asked

Real (www.vetgonereal.com).

how many have experienced incivility/bulling at work? The repercussions of incivility are starkly analysed. It

The webinar is free and serves as an introduction

leads onto the first steps in the Why section.

to a six-week course, which you can sign up to. This introductory webinar is very worthwhile watching and

• Stop taking adversity personally

it was extraordinary listening to the poll results on the

• Understand negativity bias

evening transmission. There is no doubt that Liv has

• De-code the toxic environments and anxiety

found that there is a big need for encouragement and

• Start building your resilience.

support for mental health in our profession. She delivers this webinar fluently with passion. I don’t normally use

As stated in the title resilience is crucial and a lack of

that word, but Liv certainly has a passion to help her

it leads to poor outcomes. Being resilient and being in

colleagues deal with the stresses, strains, and anxieties

control is emphasised in this introductory webinar and is

that inflict all of us from time to time.

an important part of the six-week course.

This is a webinar that simply has to be watched in its

The entire webinar is fascinating and thoroughly

entirety, it is very difficult to summarise, but it is sure to

recommended. Liv also runs workshops, and coaches

benefit anyone, however resilient they are, or assume

individually. Via the WebinarVet website the Mental

they are, and perhaps sign up for the full course. I will

Resilience and Wellbeing training course is substantially

outline the learning objectives to give an idea of what

less than usual, but as mentioned the introductory

follows. These are: -

webinar is free. I hope many colleagues take advantage of this and the full course, which is based not only

• Understand the negativity bias

on Liv’s experience in the profession, but also on her

• Re-defining resilience

subsequent training. I was very impressed.

• Befriending anxiety, burnout, compassion fatigue,

From the Literature – June ‘21

ental health and wellbeing for vets and also vet students is currently at the forefront of thinking and the RCVS, BVA and the WebinarVet, amongst others, are all doing a lot to support colleagues. I don’t think there will be any of us who has not suffered stress and anxiety either at exam times (in my case) or those first few years of practice (also in my case.) At college I don’t remember stress being mentioned let alone there being any psychological support and similarly in my early days in

practice. I was fortunate enough to be in a very supportive practice with plenty of backup, but that didn’t stop the stress levels being an all time high in that first year. Resilience was assumed to be inbred, and somehow I survived. In recent years there has been a lot more help available and thank goodness for that. There has also been quite a lot of research published about veterinary students in particular and the latest edition of the excellent Australian Veterinary Journal has an article on this topic.

DEPRESSION, STRESS AND SELF-STIGMA TOWARDS SEEKING PSYCHOLOGICAL HELP IN VETERINARY STUDENTS S. Lokhee and RC Hogg AUSTRALIAN VETERINARY JOURNAL First published 20 April 2021 https://doi.org/10.111/avj.13070

he article is full access and therefore easily accessible. Lokhee and Hogg are both psychologists from the Western Sydney University and the Charles Sturt University of Wagga Wagga respectively. The prevalence of depression among veterinary surgeons and veterinary students is high. Although self-stigma in seeking psychological help is reportedly high in veterinary students, its impact on mental health has been largely unexplored. Stigma or here self-stigma refers to one’s own perceptions that they are undesirable or socially unacceptable if they seek help. An Australian survey found that of those students that had not sought professional help for their mental health problems 25% reported that they were embarrassed ashamed or afraid to do so. Self-stigma may be a critical factor in understanding the mental health status and experience of veterinary students. This article is very well researched and carefully referenced including citing UK and US studies. Its aim was to compare the levels of study related stress, depression symptoms and selfstigma in veterinary students, with those of non-veterinary students, and examine whether stress and self-stigma positively predicted depression symptoms in veterinary students. A total of 287 veterinary students and 317 nonveterinary students from Australia completed the inline questionnaires, the largest Australian study to date.

In the conclusion the authors state that the results indicate significantly elevated levels of stress are present in veterinary students compared with non-veterinary students. No surprise there –we have all been through the intense studying at college. I was surprised that the difference in depression symptoms between the two student cohorts was not statistically significant. Nevertheless it is suggested that reducing stress in veterinary school as well as reducing self-stigma towards seeking psychological help may be important in improving the welfare of veterinary students. Furthermore these findings are important in developing a whole-of –career life course approach to understanding the professional and psychological experiences of veterinarians. It’s really good that well –being and mental health is now a prominent and important subject. This well researched Australian article is the latest in a series that is sure to grow and ensure that nobody should feel there is nowhere to turn in times of stress and anxiety. And from my own experience and I am sure many of my colleagues, euthanasia is a subject that is often very stressful for a variety of reasons, particularly with owners present. Personally I think it is one of the biggest stressors and, again in the Australian Veterinary Journal, there is a study that has looked at how euthanasia is taught in veterinary schools in Australia and New Zealand.

How decision-making about euthanasia for animals is taught to Australasian veterinary students K E Littlewood and others AUSTRALIAN VETERINARY JOURNAL

FIRST PUBLISHED 17 MAY 2021

he article is also full access. By using a questionnaire eight Australasian veterinary school educators were contacted about their teaching of euthanasia decision- making for four categories of animals. These were livestock, equine, companion animals and avian/wildlife. All the colleges reported some teaching of all categories relevant to euthanasia decision making, except for one university, which did not teach this for equines. Observation of euthanasia was rarely reported as a teaching method. The reasons given for not exposing students to euthanasia included a need to protect students from a stressful situation or to protect client privacy. This may be why new graduates are not confident in performing euthanasia in practice, in that they do not have enough experience before graduation. An interesting informal veterinary student survey in the USA (at Tufts veterinary college) lends support to this. The top three topics of interest to the students were talking with clients, techniques, and dealing with things that could go wrong. It seems that teaching varies quite widely and no one has investigated how the process of euthanasia decision-making is specifically taught in veterinary schools in general. Overall the results of the survey show that aspects of euthanasia decision- making are taught in an ad hoc manner to veterinary students in two of eight Australasian colleges. The majority relies on discussion of clinical cases in veterinary schools, and because presentation of such cases is variable it can reasonably be assumed that some students will miss out on teaching possibilities. One of the representative educators summarised the sentiment about euthanasia teaching at one of the Australasian veterinary schools by saying: -

‘We don’t teach that well to students I don’t think-how to handle it, when to pull the plug. It is something you need to learn and be good at. We don’t give them very much guidance’ This is an interesting article and relates mainly to the experience in Australia and New Zealand, and perhaps it’s quite different in the UK, although I am not sure. It does seem a good idea to look at this topic in more detail and perhaps formulate a standard approach. I wonder what recent graduates would say about their euthanasia training and whether they felt well prepared. An analysis of things that went wrong in the first few years and how that could be prevented might help. It would be interesting to know how much issues around euthanasia contributed to stress levels and anxiety. The three areas identified by the Tufts students are important I suspect, and ensuring that these areas are included in any teaching module might reduce stress and anxiety in the early days in practice. Elsewhere in this newsletter I have reviewed the latest webinar, which aims to tackle precisely some of the issues raised in the Australian publications and more. It is by Olivia Oginska, known as Liv, who in addition to qualifying as a vet has undertaken a post –graduate course from Anglia Ruskin University in Cambridge on positive psychology. It is a webinar that seeks to introduce colleagues to positive psychology and if they wish sign up to a six-week course. It’s free and very thought provoking. The old way of getting on with it, sink or swim is no longer fit for purpose and it’s great to see initiatives such as those taught by Liv available to our young colleagues especially, (although anyone could benefit). From the Clinic to the Scope & Back Again. Clinicopathological correlations in small animal & equine medicine.

The BSVP are holding their annual summer CPD meeting online in conjunction with The Webinar Vet on the 16th June. The aim of the event is to improve communication and understanding between pathologists and clinicians, using examples from small animal and equine internal medicine. This one-day meeting is bringing together a host of internationally renowned pathologists, and internal medicine specialists, who will share their knowledge with us, focusing on small animal liver conditions, equine gastric conditions, and cognitive errors and diagnostic uncertainty in pathology. Mystery slides will also be available to facilitate an interactive case-based discussion session, where you can put your questions and comments to our experts. The meeting will be of interest for anatomic and clinical pathologists and trainees as well as small animal and equine internists and primary care veterinarians with an interest in equine GI disease and/or small animal liver disease. This meeting is available live or on demand. BSVP is kindly sponsored by IDEXX and NationWide

NATIONWIDE LABORATORIES – PROUD TO BE PART OF THE TEAM Some cases are complex and difficult to pull together. They require multiple tests and expert knowledge from different disciplines. That’s why NationWide Laboratories are proud to be part of the team and proud to be sponsoring the BSVP Virtual Summer Conference – from the Clinical to the Scope and Back Again. Our veterinary and biomedical science teams have a wealth of knowledge when it comes to helping our clients to interpret their more complex cases. When a 9-year-old male border terrier presented with a history of vomiting and inappetence our diagnostic screen showed evidence of a significant hepatopathy. Ultrasound scan at the practice revealed an enlarged gall bladder and our histopathologist was able to confirm the practitioner’s clinical suspicions of a gall bladder mucocele exhibiting lymphoplasmacytic cholecystitis and cystic mucinous hyperplasia. Whether it’s following through the case of a particularly aggressive subcutaneous mast cell tumour in an unlucky Rottweiler using cytology, histology and immunohistochemistry using prognostic markers Ki67 and C-Kit; or using more complex immunohistochemistry to get to the bottom of an unusual cutaneous plasmacytosis in an elderly Golden retriever, our team works together to provide the best outcome for our clients and their patients. At NationWide Laboratories we are proud to be part of the team.

IDEXX ANATOMIC PATHOLOGY TEAM ACHIEVEMENTS RCPath Achievement Award for Innovation in Pathology Practice The award from the RCPath recognised that IDEXX was the first UK diagnostic laboratory to implement digital pathology for all pathologists, allowing for flexibility of remote working and reduced turn-around-time for clients. Collaboration with technical staff guarantees the quality of slides and images is excellent, in turn ensuring accurate diagnoses and the best patient care. Dr Elena Riccardi is co-author on publication named Best Paper of the Year The 20201 Regulatory and Safety Evaluation Specialty Section (RSESS) Best Paper of the Year Award was won by “The Application, Challenges, and Advancement Toward Regulatory Acceptance of Digital Toxicologic Pathology: results of the 7th ESTP International Expert Workshop (September 20-21, 2019).” The aim of the workshop was to review the current applications and challenges of digital pathology and outline a set of minimal requirements needed to gain future regulatory acceptance for the use of digital toxicologic pathology workflows in research and development. The extensive long-term use of digital pathology is unique to IDEXX and gives our pathologists unprecedented experience in digital pathology. IDEXX provides support for training programs Universities have been severely affected by COVID-19 with closure of campuses and reduction in offering of services. In turn, this reduces learning opportunities for veterinary students and residents. Dr Chris Palgrave, in collaboration with the Field Medical Specialsts and other members of the Anatomic Pathology team, has delivered a series of online webinars, discussion groups and seminars to veterinary students and anatomic pathology residents. These have not only helped universities deliver training to their students and residents, but have also enabled IDEXX to demonstrate the great work it does to a wider audience.

DR THELMA MEIRING ACHIEVES HER MASTERS DEGREE Whilst working full time as a diagnostic pathologist, Dr Meiring has completed her Master of Veterinary Medicine degree at Massey University, New Zealand. Dr Meiring works for the UK team based on a “follow the sun” principle which means cases are read across different time zones, improving turnaround-time for clients.

VACCINATE YOUR RABBIT FROM ITS FIRST HOPS

Be responsible. Prevention matters. Always consult your vet HIPRA UK and IRELAND Hipra UK and Ireland, Ltd., Foxhall Business Centre, Foxhall Lodge, Foxhall Road, Nottingham, NG7 6LH., Reino Unido Tel.: (+44) 0115 845 6486 · ukandireland@hipra.com · www.hipra.com

Inactivated, adjuvanted vaccine (RHDV2)

FLIP-OFF SYSTEM

INACTIVATED VACCINE:

EASY MANAGEMENT:

Active immunization for the reduction of mortality caused by RHDV2

Ready to use product

WHITISH: Emulsion, also available in 10 and 40 multidoses

MONOVALENT VACCINE: Flexibility in protocols and ability to manage each case individually

LOVE AT FIRST SIGHT, PROTECTION FROM ITS FIRST HOPS

Vaccination from 30 DAYS of age

Onset of immunity: 1 WEEK

Duration of immunity: 12 MONTHS

Safety studies conducted in PET RABBITS

Also available for GESTATING FEMALES

Whitish and READY TO USE product

REFERENCES: 1) OIE. 2018. OIE Terrestial Manual 2018. Rabbit haemorrhagic disease. https://www.oie.int/ﬁ leadmin/Home/eng/Health_standards/tahm/3.06.02_RHD.pdf 2) Dalton, K.P.; Nicieza, I.; Balseiro, A.; Muguerza, M.A.; Rosell, J.M.; Casais, R.; Alvarez, A.L.; Parra, F. Variant rabbit hemorrhagic disease virus in young rabbits, Spain. Emerg. Infect. Dis. 18, 2009–2012 (2012). 3) Rachel E. Marschang; Karola Weider; Hanna Erhard; Eva-Maria Klas; Claudia Laik-Schandelmaier. RABBIT HEMORRHAGIC DISEASE VIRUSES DETECTED IN PET RABBITS IN A COMMERCIAL LABORATORY IN EUROPE, The End-to-end Journal (2018). 4) Baratelli M.; Molist-Badiola J.; Puigredon-Fontanet A.; Pascual M.; Boix O.; Mora-Igual F.X.; Woodward M.; Lavazza A.; Capucci L. Characterization of the maternally derived antibody immunity against RHDV-2 after administration in breeding does of an inactivated vaccine. Vaccines 2020, 8, 484. 5) EMA - Eravac EPAR – Product information. https://www.ema.europa.eu/en/documents/assessment-report/eravac-epar-public-assessment-report_en.pdf

: Inactivated vaccine, rabbit haemorrhagic disease type 2 virus (RHDV2), in injectable emulsion. COMPOSITION: Each dose of 0.5 ml contains: Inactivated rabbit haemorrhagic disease type 2 virus (RHDV2), strain V-1037 70% cELISA40*, (*) 70 % of vaccinated rabbits shall give cELISA antibody titres equal to or higher than 40. INDICATIONS: Rabbits: For active immunisation of rabbits from the age of 30 days to reduce mortality caused by the rabbit haemorrhagic disease type 2 virus (RHDV2). ADMINISTRATION ROUTE: Subcutaneous use. DOSAGE: 0.5 ml/animal. ADVERSE REACTIONS: A transient temperature increase slightly above 40 ºC might very commonly occur between two or three days following vaccination. This slight temperature increase resolves spontaneously without treatment by day 5 post-vaccination. Nodules or swelling (< 2 cm) can be very commonly observed in the injection site, which may last 24 hours. These local reactions gradually reduce and disappear without need for treatment. Lethargy and/or inappetence may be observed very rare in the first 48 hours after injection based on postauthorisation pharmacovigilance reporting. WITHDRAWAL TIME: 0 days. SPECIAL PRECAUTIONS: The vaccine provides protection only against RHDV2, cross protection against classical RHDV has not been demonstrated. Vaccination is recommended where RHDV2 is epidemiologically relevant. Vaccinate only healthy rabbits. Do not mix with any other veterinary medicinal products. Special precautions to be taken by the person administering the product: This veterinary medicinal product contains mineral oil. Accidental injection/self-injection may result in severe pain and swelling, particularly if injected into a joint or finger, and in rare cases could result in the loss of the affected finger if prompt medical attention is not given. Store and transport refrigerated (2ºC – 8 ºC). Do not freeze. Keep the bottle in the outer carton in order to protect from light. Use product immediately after opening. Any unused veterinary medicinal product or waste materials derived from such veterinary medicinal product should be disposed of in accordance with local requirements. Keep out of the reach and sight of children. FURTHER INFORMATION: Onset of immunity: 1 week. Duration of immunity: 12 months demonstrated by challenge. Pregnancy: Laboratory studies in doe rabbits in the last third of gestation have not produced any evidence of a teratogenic, foetotoxic and maternotoxic effects. Pregnant does should be handled with special care to avoid stress and risk of abortion. PACKAGING: 10 vials of 1 dose, 1 vial of 10 doses, 1 vial of 40 doses. MARKETING AUTHORISATION NUMBER(S): EU/2/16/199/001-002-003. MARKETING AUTHORISATION HOLDER: Laboratorios Hipra S.A. Avda. La Selva, 135, 17170 Amer (Girona), SPAIN. Under veterinary prescription. Use medicines responsibly. HIPRA UK and IRELAND Hipra UK and Ireland, Ltd., Foxhall Business Centre, Foxhall Lodge, Foxhall Road, Nottingham, NG7 6LH. Reino Unido Tel.: (+44) 0115 845 6486 · ukandireland@hipra.com · www.hipra.com

Inactivated, adjuvanted vaccine (RHDV2)

FROM ITS FIRST HOPS

The only RHDV2 vaccine that can be administered from 30 days of age

WHY EARLY VACCINATION?

IS…

Rabbit haemorrhagic disease virus 2 (RHDV2) is a highly infectious and pathogenic Calicivirus that causes lethal hepatitis and haemorrhages in internal organs, frequently with sudden death, being difficult to diagnose1. Unlike RHDV1, it affects YOUNG RABBITS (<30 days of age). Young rabbits present HIGHER MORTALITY than adults .

LOVE FROM THE FIRST DAY 1) Kits from vaccinated mothers are BORN WITH MATERNALLY DERIVED

can be administered to pet rabbits from 30 days of age All vaccinated animals responded serologically to inducing high antibody responses compared to the negative response in the control group.

Protection from the first day of life. Protection while they are most susceptible.

VACCINATING RABBITS IS THE PRIMARY METHOD FOR THE PREVENTION OF RHDV2

Safety and seroconversion study5:

ANTIBODIES (MDAs) against RHDV2, transmitted through the placenta4:

RHDV2 has largely replaced RHDV1.

EARLY IN LIFE PROTECTION

FAST ACTING AGAINST RHDV2 Onset of immunity: 1 WEEK AFTER VACCINATION. (Two different studies show 100% and 93% of survival after challenge at 7 days post-vaccination)5. Antibody (Ab) creation after vaccination of the doe

Transplacental transmission of Ab to the kits

Kits born with MDAs

2) EFFECTIVE EVEN IN THE PRESENCE OF MDAs in 1-month old animals (100% survival after challenge)5.

Prompt protection to non-vaccinated and young rabbits after losing their MDAs. Fast onset of immunity in the event of an outbreak1. Early immunization of pregnant does, so that they have time to transmit MDAs to their offspring before delivering.

LONG-LASTING IMMUNITY MDAs are no longer detectable from approximately 30 days of age4

Ab creation after vaccination, with no interference with the remaining MDAs

Duration of immunity: 12 MONTHS, demonstrated by challenge.

WHY EARLY VACCINATION?

IS…

LOVE FROM THE FIRST DAY 1) Kits from vaccinated mothers are BORN WITH MATERNALLY DERIVED

can be administered to pet rabbits from 30 days of age All vaccinated animals responded serologically to inducing high antibody responses compared to the negative response in the control group.

Protection from the first day of life. Protection while they are most susceptible.

VACCINATING RABBITS IS THE PRIMARY METHOD FOR THE PREVENTION OF RHDV2

Safety and seroconversion study5:

ANTIBODIES (MDAs) against RHDV2, transmitted through the placenta4:

RHDV2 has largely replaced RHDV1.

EARLY IN LIFE PROTECTION

Transplacental transmission of Ab to the kits

Kits born with MDAs

2) EFFECTIVE EVEN IN THE PRESENCE OF MDAs in 1-month old animals (100% survival after challenge)5.

LONG-LASTING IMMUNITY MDAs are no longer detectable from approximately 30 days of age4

Ab creation after vaccination, with no interference with the remaining MDAs

Duration of immunity: 12 MONTHS, demonstrated by challenge.

WHY EARLY VACCINATION?

IS…

LOVE FROM THE FIRST DAY 1) Kits from vaccinated mothers are BORN WITH MATERNALLY DERIVED

can be administered to pet rabbits from 30 days of age All vaccinated animals responded serologically to inducing high antibody responses compared to the negative response in the control group.

Protection from the first day of life. Protection while they are most susceptible.

VACCINATING RABBITS IS THE PRIMARY METHOD FOR THE PREVENTION OF RHDV2

Safety and seroconversion study5:

ANTIBODIES (MDAs) against RHDV2, transmitted through the placenta4:

RHDV2 has largely replaced RHDV1.

EARLY IN LIFE PROTECTION

Transplacental transmission of Ab to the kits

Kits born with MDAs

2) EFFECTIVE EVEN IN THE PRESENCE OF MDAs in 1-month old animals (100% survival after challenge)5.

LONG-LASTING IMMUNITY MDAs are no longer detectable from approximately 30 days of age4

Ab creation after vaccination, with no interference with the remaining MDAs

Duration of immunity: 12 MONTHS, demonstrated by challenge.

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