NewsThe newsletter of the Langford Small Animal Referral Hospital

CPD EVENINGS NOW FREE! p2

FELINEFOCUS p4

HOSPITALNEWS p2

BABESIA UPDATE p3

Spring 2016

Small Animal

Upcoming CPD

28th - Evening Bites - Traumatic woundsAre you worried about wounds and traumatised by trauma? This evening course will cover the essentials of wound management including first aid and initial management and selection of dressings.

3rd - Evening Bites - IVFT (intravenous fluid therapy) updateRefresh your IVFT knowledge with our Emergency and Critical Care Specialist, Sophie Adamantos.

10th - Nurse Evening - Clinical governanceIn order to comply with Practice Standards Scheme, veterinary practices are now required to have some form of clinical governance (CG) in place. This session will provide an overview of what CG is and its relevance within practice.

16th - Vet Day - Decision making for common hip and pelvis problemsThis one day lecture course will discuss the investigation and management options for a range of commonly diagnosed problems affecting the hip and pelvis of dogs and cats.

26th - Evening Bites - Film reading eveningImprove your radiology skills with a selection of radiographs to interpret and discuss with the help of our radiologists.

7th - Evening Bites - Cardiology updateFind out what’s new in the management of small animal cardiac patients.

If you have any special requests or would like to discuss any of our CPD courses in more detail, please contact Kathryn Burton on

cpd@langfordvets.co.uk or 07475 754 463.

Keep up to date on our CPD via www.langfordvets.co.uk/cpd

@LangfordVets or www.facebook.com/langfordvetssah

TEAM NEWS:

New Neurology ClinicianWe are pleased to welcome Francois Liebel to the Small Animal Hospital team.

Having graduated from the National Veterinary School of Toulouse in France, and completed a one year rotating internship at Virginia-Maryland Regional College of Veterinary Medicine, Francois came to the UK to work as a neurology clinician in 2010 before joining us in 2016.

His interests include all aspects of veterinary neurology. In particular, the diagnosis and surgical management of brain and spinal tumours.Welcome Francois!

New Medicine ResidentsWe’re pleased to welcome two new residents to the Small Animal Hospital medicine team.

Firstly, welcome to Jennifer Stallwood. Jennifer undertook a rotating internship at the University of Glasgow in 2014, and has successfully passed the RCVS CertAVP in emergency and critical care before joining us in February 2016.

Fiona Whitworth has also joined the medicine team. Fiona returns to Langford having completed her internship here and we’re excited to have her back as part of the team.

Congratulations!We’re delighted to announce that all of our medicine residents passed their exams this year - an unprecedented 100% success!

Firstly, a big well done to Vicki Black, Emi Barker, Jenny Reeve and Natalie Finch who have all successfully passed their specialist certifier exams and are now diplomates of the European College of Veterinary Internal Medicine. And congratulations to Natalie Watson and Andrea Holmes who passed the first part of their specialist exams.

More congratulations are in order for Carys Havard and Lizzie Covey (pictured) for passing their Vets Now emergency and critical care exams. This means all of our ICU nurses are all specialised in Emergency and Critical Care.

April

May

June

HOSPITAL NEWS:

Dog Arthritis StudyOver the next three years we will be carrying out a study to assess osteoarthritis pain mechanisms in dogs. This is the first step towards enabling us to provide personalised pain relief to dogs suffering from chronic pain.

We are seeking to recruit pet dogs with osteoarthritis to participate in the study.

For more information on the study, and to find out how you and your pet could help, visit: www.bristol.ac.uk/vetscience/research/projects/bristoldogarthritisstudy/

Exciting news! CPD Evening Bites are now FREE! We’re pleased to announce that, as of 1st May 2016, our Evening Bites CPD programme for vets and nurses will be free of charge!

If you have any delegates already booked onto courses after this date we will arrange reimbursement of either funds or Loyalty Scheme points, according to how payment was made at the time of booking.

We look forward to seeing you at a CPD event soon!

Ticks have recently been in the news as Babesia canis has been identified in the UK in non-travelled dogs in Essex. The Molecular Diagnostic Unit of Langford Veterinary Services have long been at the forefront of research into tick borne diseases, primarily via the Acarus Laboratories, and we are currently assisting Professor Richard Wall’s research team at the University of Bristol with their Big Tick Project.

The Acarus Laboratories provide a comprehensive set of diagnostic tests for tick borne infections including Babesia spp.

Babesiosis is caused by intraerythrocytic protozoan parasites; these are divided into LARGE Babesias e.g. B. canis (most important in Europe), Babesia rossi and Babesia vogeli and SMALL Babesias e.g. Babesia gibsoni, Babesia microti-like/Theileria annae. They are all transmitted by ticks of several species, by blood transfusions and possibly biting (especially the small babesias). They have a global worldwide distribution esp. domestic dogs in Africa, Europe and Asia. Babesia canis (identified in the Essex cases), B. vogeli and Babesia microti-like have been reported in untravelled dogs in the UK.

Signs usually occur soon after travelling (few days to two weeks) and can include fever, lethargy, weakness, anorexia, jaundice, pallor, splenomegaly and haemoglobinuria.

Haematology may show haemolytic anaemia (typically regenerative) ± jaundice; and a thrombocytopenia is common. Blood smears made from capillary blood (e.g. ear) may improve organism recovery and visibility for large Babesia species, but they can be difficult to find on blood smears and cytology cannot differentiate the different Babesia species. PCR is the diagnostic method of choice and can be used to monitor efficacy of treatment (PCR should be negative after treatment of large Babesia species). In the Acarus laboratories, we perform a generic Babesia PCR followed by sequencing of positive samples, to allow identification of any specific Babesia species

found to be infecting your patient. This is important as treatment differs depending on which Babesia species is found.

Pictured: A Dermacentor reticulatus tick removed from an untravelled puppy in the UK that was subsequently confirmed to have B. canis infection.

For large Babesia species, treatment with imidocarb dipropionate (5 - 6.6 mg/kg IM or SC, given once, then repeat two weeks later; can be obtained from large animal vets, as this is used to treat cattle with babesiosis, but it is not licensed for use in dogs) is indicated. Treatment of small Babesia species is more difficult. Supportive treatment for shock and anaemia (e.g. blood transfusions) may be required if severe disease occurs.

Prevention of babesia infection requires aggressive tick control with ascaricides; if a dog is travelling to an endemic area, tick treatment should be started before travelling and continued as indicated for the ascaricide agent; although tick prevention should be advised in non-travelled dogs too, especially with the recent reports of Babesia in untravelled dogs. Some ascaricides have tick repellent activity too, which is useful to prevent any tick biting in the first place. It is important to advise that owners still do a daily tick watch – they must inspect their pets daily for ticks (they can be small!) and remove them as total reliance on preventative ascaricides is not advisable. They should use appropriate devices, and preferably gloves due to possible zoonotic transmission of some tick borne agents such as Borrelia burgdorferi.

For further details on this and other imported diseases, join us for one of our FREE Imported Disease CPD Roadshows on the 17th and 19th May (details under CPD news).

Imported Disease Roadshow

Imported diseases are becoming increasingly common in the UK as a result of pet travel and an increasing trend to rehome dogs from abroad.

Refresh your knowledge of the threats facing travelling pets, and the recommended preventive treatments, with our FREE interactive CPD roadshow in a friendly, informal atmosphere.

Roadshow dates:

• 17th May - Park Inn by Radisson, Cardiff North

• 19th May - Exeter Court Hotel, Exeter

The evening starts at 7.30pm with a bacon bap - please let us know if you have any dietary requirements when booking.

For more information or to book your place on either event, please email cpd@langfordvets.co.uk or phone 0117 928 9572.

HOSPITAL NEWS:

Do you have a case requiring a lateral thoracotomy?We are carrying out a study in dogs to investigate a ‘muscle sparing’ technique of opening the chest, which may be less painful and result in a faster recovery than the standard technique.

We are looking for dogs over 10kg, which may require thoracic surgery through a lateral approach (e.g. lung lobectomy, pericardectomy, thoracic oesophageal surgery, thoracic foreign body). The charge for dogs enrolled in this study is £2,500, which includes all treatment and hospitalisation (normal cost: £3,500 - £5,000).

You will be welcome to come and observe the surgery. You will also receive a FREE webinar when you refer a case to us and owners will be given a £30 M&S voucher at their free six week check-up consult.

For more information about this study please contact:

Guillaume Chanoit: g.chanoit@bristol.ac.uk

or Anna Nutt: Anna.Nutt@bristol.ac.uk

Tel: 0117 928 9420/9447

HOSPITAL NEWS:

New Study: The clinical use of EMLA cream before intravenous catheter placement in dogsWe are currently running a study to investigate whether we can improve the experience of dogs during catheter placement.

This study, led by Hugo van Oostrom PhD DVM MRCVS, Senior lecturer in Veterinary Anaesthesia, involves temporarily numbing the skin locally with a cream, similar to the cream used in children prior to intravenous catheter placement. We hypothesize that numbing the skin will make the dogs feel more comfortable during catheter placement and if proven this will likely become standard practice within the hospital.

If your client’s dog is admitted to Langford Veterinary Services Small Animal Referral Hospital, they will be asked if they would like their dog to participate in the study. Their dog will only be enrolled on the study if he/she requires an intravenous catheter while being hospitalised and they are under no obligation to allow their dog to be enrolled in the study.

Labs Update: Babesia

CPD NEWS:

Pushkin presented to the Feline Centre at Langford Veterinary Services when he was just one year old. He had been quiet for a few days, lost weight and had gone off his food. On examination Pushkin’s mucous membranes were very pale and he had a heart murmur. His blood tests showed he was severely anaemic and leucopenic. Pushkin’s bone marrow was not producing reticulocytes. The heart murmur was attributed to the severe anaemia and the blood being less viscous.

Emergency treatmentPushkin required a blood transfusion as immediate emergency treatment to increase his red blood cell level and make him more stable for further investigations to determine the cause of his illness. His blood type was checked and he received a fresh whole blood transfusion. The next day, Pushkin was anaesthetised for investigations including bone marrow sampling, chest x-rays and ultrasound scanning of his abdomen and heart. He recovered well from these investigations and was monitored closely in our feline intensive care unit. Pushkin was diagnosed with a condition call myelofibrosis which affects bone marrow function.

MyelofibrosisMyelofibrosis can arise due to the immune system attacking cells in the bone marrow. It can be primary or secondary to an underlying disease such as immune-mediated haemolytic anaemia (IMHA), leukaemia or cancer. No underlying disease was found in Pushkin. Relapse of myelofibrosis can occur in the future.

How did we treat Pushkin?Pushkin started treatment to suppress his immune system (prednisolone and chlorambucil) and his red and white cell levels

began to increase. Once Pushkin was stable enough he was discharged on continuing treatment (tablets).

Follow upWe saw Pushkin for a recheck at the Feline Centre two weeks later and he had made great progress, which was fabulous to see. Over the next eight months Pushkin’s treatment was gradually reduced and he continued to make excellent progress. Pushkin is now off all treatment and is back to causing mischief with his brother Pasha.

The Feline CentreThe Feline Centre has particular expertise in the fields of haematology and transfusion medicine, enabling it to be a centre of excellence for dealing with feline anaemia. We can perform on-site blood typing and have access to blood transfusion products for urgent use in severely anaemic cases.

Blood administration to recipients can be closely monitored in the cat pod of our ICU and we are now using motorised bone marrow needle devices to facilitate rapid and less traumatic collection of bone marrow samples. The multidisciplinary approach to cases that the Feline Centre provides includes excellent clinical pathologists who aid in the interpretation of often complicated feline haematology profiles to best direct investigation and diagnosis of cases.

Small Animal Hospital Reception Opening Hours Mon-Fri 8am - 7pm (phone lines open at 8.30am)

Sat 9am - 1pm

Call us on 0117 928 9420For out of hours 01209 823456Emergencies accepted 24 hours a day

Email us: sah@langfordvets.co.ukLangford Veterinary Services Ltd is a wholly owned subsidiary of the University of Bristol

www.langfordvets.co.uk

Case Study: PushkinFELINE FOCUS:

Feline CoronavirusFeline coronavirus is a very common pathogen of cats. It is generally harmless, but a devastating disease called feline infectious peritonitis develops in a small proportion of infected cats.

Sam Saunders (pictured) is currently doing a PhD on Type 1 feline coronaviruses. This is being supervised by Dr Séverine Tasker of the Feline Centre. By discovering the cell entry receptor for the virus and building a system in which it can be propagated in cell culture, Sam hopes to better understand the effect of viral mutations and create a platform for vaccine development. Having graduated from the Royal Veterinary College in 2013, Sam worked in practice and as an anatomy demonstrator before embarking on her PhD. Her interests include feline medicine, infectious disease and pathology.

Haemoplasma ResearchHaemoplasmas are small, wall-less bacteria that have the potential to induce fatal anaemia in cats by adhering to red blood cells and inducing haemolysis. Little is known about their exact pathomechanisms as haemoplasmas cannot be cultured in vitro for further study. At the moment, no rapid, reliable diagnostic means are available and testing requires PCR which cannot be performed patient-side.

Serina Filler, who graduated from from the University of Veterinary Medicine in Vienna in 2012, has recently joined the team of Dr Séverine Tasker and Dr Chris Helps to explore new diagnostic approaches and vaccine candidates. Serina has been focused on feline medicine and research ever since starting vet school and will be exploring the surface proteins of haemoplasmas to help understand, diagnose and possibly prevent clinical disease.