VOLUME 25 No. 90 JUNE 2019
Become a bird champion Nursing rabbits in practice Calling time on Scottish Folds
monthly dosing because we love them
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CONTENTS
04
VO LUME 2 5 No. 90 JUNE 201 9
Letter from the Editor by Antoinette Ratcliffe
04 Membership Secretary report by Kathy Waugh
EXECUTIVE COMMITTEE OFFICERS
05 President’s report
President Julie Hutt PO Box 35831 Browns Bay Auckland 0753 021 599 059 president@nzvna.org.nz
by Julie Hutt
07 CPD corner: Become a bird champion
by Patricia Gleason and Janelle Ward
09 New Zealand Companion Animal
Vice-President Amy Ross 021 852 664 vicepresident@nzvna.org.nz
Register update
by Nygllhuw Morris
Treasurer & Membership Secretary Kathy Waugh 021 843 277 treasurer@nzvna.org.nz National Secretary Luanne Corles 027 472 1072 secretary@nzvna.org.nz
7
JOURNAL EDITOR Antoinette Ratcliffe journal@nzvna.org.nz Assistant Editor: Catherine Taylor catherine.ellen.taylor@gmail.com
EDITORIAL BOARD Exotics: Kylie Martin Equine: Lyn Hobbs OSH: Libby Leader CPD: Christina Searle and Patricia Gleason
COVER: ‘Three month-old Scottish Fold kitten’ by Psihopat [CC BY 3.0 (https:// creativecommons.org/licenses/by/3.0)] Original image cropped
NZVNA FORMS The registration or list badge order forms, merchandise order forms and new membership forms can now all be found on the website www.nzvna.org.nz or by emailing membership@nzvna.org.nz
The New Zealand Veterinary Nursing Association would like to thank Hill’s™ Pet Nutrition NZ, our gold sponsors, for their continued support of the NZVNA and the veterinary nursing profession.
12
How to be a good team member
16
Nursing rabbits in practice
21 28
by Amy Newfield
by Stacey Vickery
A TRoo story – part 2 by Cindy Paton
Calling time on Scottish Folds CAV update by Sarah Fowler, Rochelle Ferguson and John Munday
30
Book review by Amy Ross
OUR VISION Caring for our community by promoting excellence in animal healthcare. DISCLAIMER The New Zealand Veterinary Nursing Association Journal is published by the New Zealand Veterinary Nursing Association Incorporated (NZVNA). The views expressed in the articles and letters do not necessarily represent those of the NZVNA or the editor, and neither the NZVNA nor the editor endorse any products or services advertised. The NZVNA is not the source of the information reproduced in this publication and has not independently verified the truth of the information. It does not accept any legal responsibility for the truth or accuracy of the information contained herein. Neither the NZVNA nor the editor accepts any liability whatsoever for the contents of this publication or for any consequences which may result from the use of the information contained herein or advice given herein. The provision is intended to exclude the NZVNA, the editor and its staff from all liability whatsoever, including liability for negligence in the publication or reproduction of the materials set out herein.
21
NZVNA
Letter from the Editor With the NZVNA wage survey taking place this year, and the living wage going up to $21.50 this September, there’s no better time to reflect on the value of veterinary nursing to the industry. We work hard studying to become qualified veterinary nurses, we spend so much of our emotional and physical energy caring for our patients and their owners, we work long hours, and yet we still need to convince people of the value of our vocation, both monetary and societal. This is why it’s so important to participate in the NZVNA wage survey, voluntary registration and Vet Nurse Awareness Month in October. We’re not paraprofessionals, we are professionals in our own right, and you can see this from the quality of the articles published in the journal. Something else that I have noticed in my 14 years of veterinary nursing, is that
our career choice usually leads to other specific extracurricular activities, whether it be to pay the bills, support a worthy cause, or as a hobby. Catherine Taylor’s interview with Ellie Clark, the 2018 Hill’s and NZVNA Vet Nurse of the Year winner, is an example of how being a veterinary nurse can be the beginning of a varied and rewarding career that doesn’t stop when you leave the vet clinic. We also get to reflect on the specialty nursing skills needed in rabbit husbandry in Stacey Vickery’s article on nursing rabbits in practice, and take in Cindy Paton’s research and experience of behavioural modification techniques in her second instalment of A TRoo Story. Let’s not also forget that the NZVNA 2019 conference is just days away! If you attended last year’s conference, you’ll remember the enthusiasm of our keynote speaker Amy Newfield. With her many years of experience and her passion for veterinary nursing, she has written an article about how to be a good team member. Are you thinking of submitting an article for the journal? All published articles are up for nomination for the annual Angela Payne award which is presented at the NZVNA conference. Please contact me for details at journal@nzvna.org.nz for more information on how to write an article. Antoinette
Membership Secretary report It is important that you keep your membership details up to date. After each run of the journal I have copies returned undelivered. Please also note that the database is sent to the printer at least a month before the journal is printed. Print months are March, June, September and December. 4 June 2019
You can go online and make changes to your account details at any time, or you can email me on membership@nzvna. org.nz and I will do it for you. To make the changes yourself log in, go to the Membership tab and select Manage My Account. Kathy
NZVNA
President’s report It’s a Thursday evening, and I have yet to get my piece started to meet the journal deadline. Where has the day gone? Instead, I’ve spent time dealing with emails, catching up on reading my journals and a mountain of saved articles, coffee breaks, and working on other tasks that could have waited until next week. Sound familiar? Yes, I have been procrastinating, but procrastination is not being lazy; it usually involves ignoring a task in favour of one that is more enjoyable or easier. While catching up on my reading, a task I enjoy, I am filled with pride to read about our profession and the achievements of those in our association and industry. We need to celebrate our successes and our diversity. Congratulations to all the new graduate veterinary nurses, veterinary nurse assistants, veterinary technologists, rural animal technicians, and those who have taken their careers in different directions. Congratulations to Hayley Squance, currently completing a PhD in emergency management, who is both a mentor and inspiration to many, and to those who completed their CPD to be listed or registered veterinary nurses. New Zealand is small, and we have members from many different backgrounds and countries - this is what makes us who we are. We cannot change what has happened in Christchurch, but we can help make change. Being caring and compassionate, just being there for your friends, encouraging them to follow
their dreams, being happy yourself - it’s contagious. Wellbeing equals “feeling good and functioning well” (Huppert, 2009). Do you remember Dave Dobbyn’s song ‘Welcome Home’? Such great lyrics, and worth listening to every now and again to remind us all of who we are. As Yusuf Islam/Cat Stevens said, “It’s only when good people stay sitting that evil rises”. We’ve seen the opposite in this country. All that is happening in New Zealand, national and international events, and the nature of our work in the veterinary industry, takes its toll on our wellbeing. The Mental Health Foundation has some excellent resources and posters that you can utilise in your workplace. The “Five Ways to Wellbeing at Work“ has been adopted throughout workplaces in New Zealand and is an excellent resource. Take care. Julie Reference Huppert, F. (2009). A New Approach to Reducing Disorder and Improving Well-Being. Perspectives on Psychological Science, 4(1). https://doi. org/10.1111/j.1745-6924.2009.01100.x Resource Mental Health Foundation. (n.d.). Five ways to wellbeing at work toolkit. Retrieved from https:// www.mentalhealth.org.nz/ home/our-work/category/42/ five-ways-to-wellbeing-at-work-toolkit.
NOTICE OF THE ANNUAL GENERAL MEETING OF THE NZVNA Notice is hereby given to all members that the Annual General Meeting of the New Zealand Veterinary Nursing Association (Inc) will be held during the NZVNA conference at the Heritage Hotel, Auckland on Friday 14th June at 11.30am. All members of the NZVNA are invited to attend. Minutes of the previous AGM are available on the NZVNA website.
June 2019 5
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CPD CORNER
Become a ‘bird champion’ By Patricia Gleason Dip VN (Distinction), MSc, MEd (Leadership) and Janelle Ward BVSc, MVSc (Hons) (Wildlife Health), MANZCVS (Avian Health)
According to the New Zealand Companion Animal Council (NZCAC), birds are the fourth most popular pet in the country, with seven percent of homes having one or more birds. Pet birds continue to grow in popularity in households across all demographics, as this figure has continued to increase, rising from six percent in the last NZCAC survey (NZCAC, 2016). Birds also comprise the vast majority of New Zealand native wildlife with many threatened species. The latest NZCAC survey also found that 72 percent of the respondents considered the veterinary team as the best source of information for companion animal related issues (NZCAC, 2016). Yet as far as caring for avian companion animals or wildlife, there can be significant gaps in the knowledge and skills of the veterinary team. Currently, formal training for avian nursing and care is an optional element in the teaching programme leading to the New Zealand Diploma in Veterinary Nursing (NZQA, 2015). This means depending on where you qualify, you may, or may not, develop knowledge and skills for working with this important and continually
increasing population of veterinary patients. Due to this inconsistency in graduate skills and knowledge, many veterinary clinics are unprepared to meet the needs of avian patients. Similar to New Zealand, a recent survey of veterinary clinics in Australia found that while many veterinary clinics are treating wildlife, these patients are a lower priority, often left unattended and untreated for hours. The veterinary clinics surveyed reported that a lack of time, knowledge and skills interfered with their ability to treat these species, and raised questions about the welfare of these animals (Orr, 2019). The veterinary nurse can play a vital role in achieving successful outcomes for avian patients, whether pets or wild birds, by becoming a bird champion. First and foremost, veterinary nurses can advocate for their avian patients, ensuring they receive the same triage and timely care as felines or canines; the basics of warmth, fluids and pain relief can prevent unnecessary suffering and even death (Malik and Valentine, 2018).
After her career in biodiversity conservation, Patricia completed her Diploma of Veterinary Nursing (Distinction) at Massey University, and worked in veterinary clinics in the Bay of Plenty and Waikato before becoming a veterinary nurse educator. She is a founding member of the Allied Veterinary Professional Regulatory Council. She now works in a learning and development role coaching staff and teams in the education sector. Janelle Ward is a wildlife veterinarian working part time for the Department of Conservation, and managing the species work at Sanctuary Mountain Maungatautari. In her spare time she creates and delivers training courses for Learn Bird Care. She has over three years of previous tertiary teaching experience including veterinary nursing and animal care.
| Above: a hungry Eastern rosella chick
June 2019 7
CPD CORNER
Meredith (2008) and Rouffignac (2007) outline some key roles for veterinary nurses in caring for avian patients, including: • Advocate for avian patients • Ensure the welfare of avian patients and same primary care as provided to other companion animals • Ensure appropriate patient comfort (husbandry needs met, fluid therapy, pain relief) • Ensure analgesia for injured animals is prescribed and administered • Learn full history-taking as relevant to avian species • Grow your knowledge of bird species and their needs. If you are saying, “Sounds great, but how can I learn about the needs of birds?”, there are a few ways to upskill in avian nursing in New Zealand, with more opportunities opening up each year. With dedicated wildlife hospitals located in Palmerston North, Dunedin and Christchurch, new practical training opportunities now exist for veterinary nursing students. If you are already qualified, the following options currently exist: • DOC wildlife health training modules (free) – these eight online modules cover specifics of certain avian techniques such as blood sampling and bandaging https://www.doc.govt.nz/ wildlife-health-course • Learn Bird Care (free and paid courses) – online training and practical workshops, created by a New Zealand experienced wildlife rehabilitator and wildlife veterinarian https://www. learnbirdcare.org/ • Practical CPD (paid) – occasionally avian workshops are offered for veterinarians or veterinary nurses https://www. practicalcpd.co.nz/ • Wildlife Rehabilitators Network of NZ (WReNNZ) – usually offer workshops at their annual conference and every second year host a one-day workshop https://www.wrennz.org.nz/ • Wildbase Hospital (paid) – one day Avian First Aid workshops offered around the country (follow them on Facebook for events) http://www. 8 June 2019
massey.ac.nz/massey/learning/ departments/centres-research/ wildbase/wildbase-hospital/wildbasehospital_home.cfm Coming in 2020, in collaboration with Otago Polytechnic, the Wildlife Hospital in Dunedin will be offering postgraduate courses in avian wildlife health for veterinarians and veterinary nurses. Courses will be NZQA approved and include ethics and law, conservation, anatomy and physiology, husbandry, medicine and more! If this is an area of professional development you want to explore, you could also talk to your manager about a membership to WReNNZ (either an individual or clinic membership) for access to articles, presentations, and Facebook private groups for asking questions. Become the bird champion in your clinic and ensure this growing population’s needs are met when they arrive to you by developing your knowledge and skills for avian nursing. References Malik, A. and Valentine, A. (2018). Pain in birds: a review for veterinary nurses. Veterinary Nursing Journal, 33(1), 11-25.
| Above: Ruru healing a broken wing
DOI: 10.1080/17415349.2017.1395304 Meredith, A. (2008). Wildlife triage for the veterinary nurse. Proceedings of the World Small Animal Veterinary Association World Congress 2008. Retrieved from: https://www.vin.com/ apputil/content/defaultadv1.New Zealand Companion Animal Council (2016). Companion Animals in New Zealand 2016. Retrieved from: https:// www.nzcac.org.nz/images/downloads/ Companion%20Animals_in_New_ Zealand_2016_Report_web.pdf ) New Zealand Qualifications Authority (2015). New Zealand Diploma in Veterinary Nursing (Level 6). https:// www.nzqa.govt.nz/nzqf/search/ displayQualificationOverViewWidgetJS. do?&selectedItemKey=2491 Orr, B. (2019). Veterinarians treating injured wildlife for free, despite the challenges. ABC News 14 Jan 2019. Retrieved from: (https:// www.abc.net.au/news/2019-01-14/ what-happens-after-you-take-injuredwildlife-to-the-vet/10712866) Rouffignac, M. (2007). Hospitalised Avian Patients – A Challenge. Proceedings of the World Small Animal Veterinary Association World Congress 2007. Retrieved from: https://www.vin. com/apputil/content/defaultadv1. aspx?id=3866676&pid=11268&print=1
MICROCHIPPING
NZCAR update: pets reported as missing or stolen By Nygllhuw Morris Manager - Animal Register Limited
One of the most difficult issues faced by veterinary clinics and other implanters is what to do when presented with an animal that is already reported as missing or stolen. In consultation with the New Zealand Veterinary Association (NZVA), the New Zealand Companion Animal Register (NZCAR) makes the following recommendations. The NZCAR recommends that every animal that is new to a clinic is scanned and the details checked against the NZCAR. This will highlight if the animal has been reported missing/stolen or allow you to advise an owner their contact details are out of date.
Nygllhuw (Nigel) Morris is the manager of the NZCAR. Before finding a role helping lost pets, Nygllhuw worked in town planning and IT, as well as holding a number of community positions. He currently owns two IT companies. His passions are his family, the five precepts and ‘The Settlers of Catan’.
When a missing or stolen pet is scanned, the first step is to ensure the person presenting the animal is made aware of this fact. It cannot be presumed this person is the guilty party, even if a pet has been stolen. In many cases, the “new owner” has bought or acquired the animal from another source and is unknowingly wanting an initial health check done. At this point, the person presenting the animal can either agree to let the clinic hold the animal while ownership is resolved, or they can leave with the
animal. If they choose to leave the NZCAR recommends that the matter is reported to the police. We also recommend recording any contact details or vehicle registration plates, as this can be used by the police. For dogs, we would also recommend advising the local council. NO DATA STORED on the NZCAR should be given to the person presenting the animal. It can be tempting to ignore any disputed animals to reduce workload. We strongly recommend against this as there is an owner looking for their loved family pet. To save you time, the NZCAR can take over contacting and providing advice to both parties. Sadly, we do get cases where veterinary clinics simply alter the NZCAR database without permission. Sometimes this is changed to the new owner because they are a client or because it is quicker than following up. In one case a veterinary clinic who took a missing animal off the person who brought it in, simply released it back where it was found in the hope it would make its own way home. In each of these cases, not following proper steps has only made the matter worse. It is much easier to begin a
June 2019 9
MICROCHIPPING
notification process with the help of the NZCAR. Regardless of whether the person presenting the animal agrees to surrender it or not, we strongly recommend the NZCAR be notified. This is best done by calling our 0800 LOSTPET (567873) number as soon as possible after the client leaves. Steps the NZCAR can take include: 1. Freezing the NZCAR record so that no further action can be taken. In cases of disputed ownership, we can also make the NZCAR the contact until the matter is resolved. 2. Contacting the owner on the NZCAR to advise their animal has been sighted. It is the owner who must decide the next steps. 3. NZCAR staff can act on behalf of the veterinary clinic to make any calls necessary. We are happy to mediate a solution if possible, or we can advise parties on what the next steps are.
When dealing with missing or stolen animals it must be remembered that clinic staff are not expected to put themselves in a position of risk. Especially if the person with the animal is upset and angry. If two owners simply refuse to discuss ownership, then there is nothing the NZCAR or clinic staff can do. In these very rare cases, the NZCAR can delete the record and block the microchip number from being re-registered. This is a drastic action but is covered in our terms and conditions. Despite having over 700,000 registrations we have only resorted to this step three times. The NZCAR is a microchip database with the sole purpose of getting lost pets home – if the owners of the animal cannot agree on where home is then we cannot do our job. Finally, please remember the three core NZCAR rules:
1. The NZCAR cannot be modified without the consent of the person listed. The only exceptions to this rule are when directed by the courts or Council or the SPCA have legally rehomed the animal. 2. The NZCAR data is confidential and cannot be shared with third parties. Information on previous owners and any contact details are not to be shared with any person without permission. 3. The only purpose of the NZCAR is to get lost pets home. The NZCAR has no legal authority to decide who is the correct owner when it is under dispute. All disputes over ownership are a matter for the courts. For more information on what to do when missing or stolen pets are presented at your clinic, you can call the NZCAR on 0800 LOSTPET (567873) or you can read more at https://animalregister.co.nz/implanters/ pets-reported-as-missing-or-stolen.html
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NOMINATIONS ARE NOW OPEN FOR THE VET NURSE OF THE YEAR AWARD 2019 The New Zealand Veterinary Nursing Association (NZVNA) and Hill’s Pet Nutrition NZ Ltd have joined together for the seventh year running to recognise the dedication and commitment that veterinary nurses show on a regular basis in their chosen profession. We would like to acknowledge the care that you, as veterinary nurses, give to your patients and clients on a daily basis and encourage you to nominate a veterinary nurse that you find inspiring to become New Zealand Veterinary Nurse of the Year 2019. Three finalists will be flown to Auckland for a presentation lunch where one veterinary nurse will be awarded the title of Vet Nurse of the Year. The Vet Nurse of the Year will also be given registration and dinner to NZVNA’s annual conference, courtesy of NZVNA and Hill’s will also award flights, accommodation and registration to the Hill’s VNA Conference 2019 in Australia to the winner. June 2019 11
TEAM WORK
How to be a good team member By Amy Newfield CVT, VTS (ECC) BluePearl Veterinary Partners, Waltham MA
Introduction Being a veterinary nurse is tough. It’s a profession of low salary, bare minimum benefits and tough workplace environments. We get defecated on, vomited on and urinated on. Clients yell at us, veterinarians sometimes lose their patience. We quite literally work on top of each other, we miss meals, holidays and time with family. But despite all of this, we have the best medical patients on the planet. We get to perform cutting edge veterinary medicine to save the lives of our patients. The rewards do outweigh the negatives. It’s important that we act as a good team member because the team you are part of is your family; your wonderful albeit strange, work family. Be nice to the new nurse If you want the brand new nurse to quit in less than six months, ensure you throw them directly on to the floor with little to no training and then be sure to taunt them. It doesn’t matter if they are highly skilled or a brand new graduate, any new hire needs a training period, and being a good team member means it’s your job to help train new members of staff. Many times veterinary nurses assume “it’s not their job” to have to train a new employee, and those same nurses complain when they are short staffed or that those they are working with “are not trained”. Training is a job requirement of everyone, including veterinarians, because you are all on the same team.
Amy is the Emergency Head Technician at Blue Pearl Veterinary Partners in Waltham, Massachusetts. She currently sits on the Academy of Veterinary Emergency & Critical Care Technicians Council of Regents as the President-Elect, and was awarded VMX Technician Speaker of the Year in 2015 and WVC Speaker of the Year in 2016.
12 June 2019
The first two weeks is exceptionally important to any new veterinary technician, veterinary nurse or assistant. The very first day should be orientation only. Expecting a new hire to “hit the ground running” will set them up for failure, and often with their hands above their heads running out of your hospital screaming. Day two you should consider pairing them up with someone in the department to learn the computer system, the front desk or even the layout of the hospital. Day three they may wear scrubs with the understanding they are paired up with someone and are an extra person on the floor. Being an extra person on the
floor should continue minimally for at least two weeks or longer depending on their skill level. The first 90 days are critical to a successful employment. Taking the time to orientate and train new staff members will allow for faster integration in to the hospital. It is your chance to build best practices now. The goals should be broken down into 30 day increments (Dorio & Shelly, 2011). In the first 30 days the goal is to get the new staff member comfortable. They should learn the location/tools needed to perform the job, learn about hospital policies and should be allowed to perform what they know to the best of their ability. No veterinary nurse should be expected to perform at their highest level in the first 30 days; they are not there to “prove” themselves. They should be paired up with a mentor that checks in with them routinely. Heading in to the 60 days period they should begin to feel like they are part of the team (Dorio & Shelly, 2011). They should be familiar with the policies and daily routine, be comfortable with hospital culture and maybe given more responsibility. It’s possible to train a few new skills. During this time they may still have a mentor that checks in with them. It’s important to allow them a decreased patient load to them until they are comfortable, and they should also have periodic conversations with their manager to check in; addressing any concerns up front in a timely manner is imperative. By 90 days the veterinary nurse should be contributing to the hospital (Dorio & Shelly, 2011). It is at this point they should be able to complete all treatments independently. They should be comfortable with the position and it’s possible a few new skills have been taught. At the end of 90 days a meeting should be scheduled with the manager. No surprises based around performance should be discussed at the end of 90 days. Those should’ve been addressed before the meeting, as they arose. Instead the 90 day meeting serves as a check in with the employee. How did the training go? Perhaps there is
TEAM WORK
something that could be improved upon for future hires. How do they like the position? What career goals do they want to set for themselves? Throughout the 90 days all team members need to help with the process of making the new veterinary nurse feel comfortable and get them trained. Rather than watch the new nurse struggle to locate an item ask them “do you need help?”, and rather than have a mindset of “prove yourself” all team members need to have the mindset of “we want you to succeed so we are here to help.” Stop the gossiping! Most veterinary nurses come into the workforce with enthusiasm and excitement. Most actively choose the hospital they want to work at. When they are hired they are excited and often tell their friends and family. Nothing stifles an employee’s enthusiasm and excitement more than the negative effects of a toxic team environment (Scala, 2016). If your current hospital has a toxic team environment, a negative Nancy (or several of them), and/or a gossip problem, then it is a good bet that you are losing team members. In short, the team members are causing the loss of team members. Those same toxic team members complain more because they are short staffed and “woe is them”. They can be seen to share their complaints and cultivate the toxic environment with anyone new who comes in, which results in new hires leaving. Thus the vicious cycle continues of a hospital who has ruined its reputation because the team environment is so toxic no one wants to work there. How many times have you worked in an environment where a brand-new employee, within their first day of employment, has another employee, who’s been there for a while, start talking to them about all the negative things of the new hospital? How is that new employee going to survive in an environment like that? The more senior employee has basically crushed the happiness right out of the new employee. Maybe the new employee can survive one negative Nancy, but if it’s a culture that is riddled with issues they will not survive. To be a great team member you must cultivate a true team approach. Everyone
needs to take some type of ownership in ensuring a healthy team environment. Playing the “blame game” or complaining all the time makes you a bad team member (Scala, 2016). Healthy teams have frequent team builders during meetings, have monthly team meetings and focus on growth for the team. Healthy teams know how to laugh and it is a culture of individuals who work towards not gossiping. Consider having employees sign agreements where they vow not to gossip. While you can’t hold them accountable for it unless it’s bullying, it’s an agreement that all members want to work in a gossip free environment. Managers and supervisors may have to have hard candid conversations with teams about the negative effects of gossiping. If a team is negative the big question is “why?” Perhaps it is leadership that is failing and the team is lacking support. Most reasons “why” are because of a lack of communication. Having a team meeting to address concerns and then ensure leadership follows through can help with a negative environment. Be fair with your own schedule Very few people want to work the Friday, Saturday, Sunday shift or the overnights. No one really wants to work all weekends. These shifts are generally reserved for the newbies. It’s almost like a taunting period. We may find ourselves with a well-qualified nurse, but by default because they are new, we put them on a terrible shift. We tell them things like “as soon as we can, we will get you moved off of this shift”. The new employee is left thinking that will only be a month or two. Meanwhile we know it could be years. This is simply not fair to the new employee. Many of you reading this may be in that situation. It’s not fair to any team member that someone gets to work Tuesday, Wednesday, Thursday every week while an equally hard working nurse is placed on every weekend. Seniority alone is not a good reason for this work schedule. How is the more senior person contributing more to the hospital if they work the less busy posh schedule? Isn’t the person with less experience who works the busier harder schedule contributing more and working harder?
Another thing to keep in mind is that most newer employees are also less skilled. Putting the newer nurse who has less skill on some of the busiest days also sets them up for failure. It is important that we make sure that whoever they’re scheduled with is skilled enough to help them train and grow in their new position. If you want a good team then everyone has to be a team player. The expectation in schedule should be the same for all veterinary nurses because that’s what being part of a team is about. So many veterinary nurses think it’s a right of passage to get a posh schedule simply because they have “survived” in the industry. Hospitals would see less turnover and a happier overall team if the more senior nurse simply was a team player and worked a weekend here or there. All hospitals work with “shift work”, meaning that employees are asked to fill a certain shift. A good team mate shows up on time ready to work at the time they should start. This does not mean strolling in at 7:00am when your shift starts at 7:00am, putting stuff in your locker, getting a coffee and then arriving on the floor at 7:05am. The rest of the team is already working and you’re late. If you’re running late, call and let them know why and apologise. Don’t make a habit of it! If you call out, unfortunately someone else has to get called in. That’s what happens with a shift work position. Certainly it is okay to call out because of an illness or a child’s illness, but it can’t be the “norm”. If you have to call out, be a good teammate and be sure to pick up a shift if you are available to in the future. Don’t be the person who always calls out and then never helps out. Practice the best medicine you can All the benefits, salary, and even positive work environment will not make up for a hospital who has the inability to practice great veterinary medicine. Unfortunately, there are some practices that like to skip corners or offer bad veterinary medicine. As a team member you owe it to your team and patients to practice the best medicine. Skipping corners, like lying about a patient’s physical exam parameters because you were busy and didn’t feel like getting a stethoscope, is not being a good team member. June 2019 13
TEAM WORK
Continuing your education is imperative to being a great team member. If you haven’t gone to a conference or taken an online class in over a year then you are failing your patients. Remember that medicine is always changing, so keeping up with the best new medical advances is imperative to being a good team member.
with any issue is to ensure that a supervisor or manager addresses it within a few days of the offense happening (Dobbs & Dunn, 2013). The supervisor must offer immediate and appropriate feedback to that employee. The second rule of thumb a manager must follow is to document everything.
Listen to your team members If you’ve been in the industry for some time that is great because you have knowledge to share, but also remember to not always assume “my way is the only and best way”. New veterinary nurses are likely to come with newer knowledge, and being a good team member is keeping an open mind to a new technique or piece of knowledge.
Often supervisors are often asked to deal with two employees having issues after multiple issues have occurred. The reality is those two people just had to communicate to each other after the first issue, and be better teammates to each other. Rather than complain behind someone’s back “she never cleans or stocks,” it is the better teammate who says “when I work with you I feel like I’m cleaning and stocking more. Can you pitch in a little more?” Perhaps their response will be “I never have any time to clean or stock because you do it all. Just tell me what you need and I can help.” Conflict resolved! Two teammates worked it out simply by talking, rather than gossiping and complaining and letting it fester.
So many veterinary nurses come in to hospitals with past knowledge. Some of that knowledge is very valuable. Perhaps they learned a more efficient way of doing something. Unfortunately, often the pre-existing staff do not want to listen to them. My advice is to listen to each other. Share ideas and help each other. If you are a manager or supervisor it’s important to listen to your team if they have a new idea on how to do something. Maybe there is a process that is failing and a veterinary nurse has an idea of how to improve it. Great! Being a team member means listening to everyone on the team regardless of whether they are new or have been there 15 years. Everyone has an idea to share. Conflict resolution Conflict resolution is tough when working in a team. Veterinary teams are big on “not talking about it” and “faking it around each other”. Dealing with conflict is difficult especially if it’s one of your good friends. They came in late and upset you. It’s easier to just ignore it. Being a good teammate actually means talking and trying to resolve issues on your own. Politely bringing it to their attention means it will be harder for them to do it again in the future, and hopefully they apologise and learn from their mistake so they can be a better team member in the future. If it is something major where two employees can’t work it out, it should be brought to a manager or supervisor immediately. The golden rule of dealing 14 June 2019
Remember to focus on the issue and not the emotion (Dobbs & Dunn, 2013). If someone is saying hurtful things or talking about feelings, bring them back around to how it is affecting the hospital, their team, or themselves. Treat your teammate how you would want to be treated. Just be kind Assume good intention. That doctor didn’t schedule the extra surgery to ruin your evening. Your fellow veterinary nurse didn’t take an extended lunch because they wanted to make sure you didn’t get one yourself. More likely, that doctor scheduled the extra surgery because they were thinking about the client and patient first. The veterinary nurse who took an extended lunch, which resulted in you not getting one, was thinking about herself. Maybe she had to take a personal call or maybe she’s burned out from her home life and job and is struggling. It’s not about you so stop assuming your coworkers are “out to get you”. Practice kindness with each other. Smile when you come in to work. Say hello to your teammates. Make sure they have eaten and that you also take time to get a break (you’ll be a better teammate if you eat something). Ask if someone needs your
help. Clean up the mess even if it wasn’t yours because you know they have had to deal with a bad patient all day. Help each other out. Assume the best of your teammates and you’ll be happier at work. Stay late when you can. Don’t be the person who always rushes out the door leaving everyone to clean up. Say goodbye to everyone. End the day on a positive note, not just complaining. It makes working in a team so much better. Help your fellow teammates with stress It comes as no surprise that veterinary nurses work in a stressful environment. It is a labour intensive and emotionally charged profession. Veterinary nurses are constantly helping others; they help clients, patients and their co-workers. Unfortunately they often drop the ball when it comes to helping themselves. You cannot survive in this profession if you do not help yourself. Burnout and compassion fatigue are two different things which may be causing you not to survive in this profession. Burnout is a cumulative process in which the individual slowly lacks empathy for a particular situation and is due to an increase in stress or workload. The individual often has feelings of anger and does not care about their work as much as they use to. They watch the clock and know exactly how many minutes are left in each shift. If they see a mess they walk over it rather than stopping to clean it up, because they simply have stopped caring due to burnout. Compassion fatigue is an emotional strain from the consequences of traumatic events such as a stressful case or event. An individual experiencing compassion fatigue may have nightmares or flashbacks about a particular event, be more emotional or they may think about a particular event if something triggers it (Ayl, 2013). Perhaps they poured their heart and soul out over a tragic case of a young dog that was hit by a car. After a week of trying to save the dog it died. That veterinary nurse can still show empathy to other patients, but may be more emotionally invested, cry if they see the same breed of dog or not want to work with a hit by car for some time. It is important to note that the two syndromes can be experienced together.
TEAM WORK
Recognition is the first step. Realising that you need a vacation or a break from work for a few days is important. Talking to your manager, co-workers or a professional will help as well. If you have been in this business long enough, you have a good chance of experiencing one or both of these things. Everyone has different coping mechanisms and it’s important to find yours. Being a good teammate has two parts in this process. Maybe you are the teammate that is burned out. Perhaps you dislike your place of employment and find yourself going in disgruntled every day. You must recognise it within yourself and recognise you are harming the team and yourself. Your teammates don’t want to see you burned out. You’re probably not performing your best and it’s causing issues within the team. It’s also not healthy for you to be burned out. You’re not happy. It’s imperative you help yourself so you can be a better teammate.
The other role is perhaps you see a fellow teammate struggling with burnout or compassion fatigue. It’s not your job to “fix” them, but “pretending like everything is okay” is not okay for the team. Acknowledging that they are going through something and offering to listen is being a good teammate. If they talk about taking their life or harming someone else, you must talk to your manager or report it to someone. If they just want to talk about their problems to you, all you need to do is listen and suggest they seek help. Listening is a powerful tool. It’s not your job to have answers. A good teammate is an ear and a shoulder and not much more. Conclusion Being a good teammate is really about acting how you would want to be treated. Veterinary nursing is not a solo career. Come in on time. Say hello. Help each other out. Help each other to recognise stress, and find your own outlet so you can be the best nurse for
your team and patients. Assume good intention of each other. Train each other and impart your ideas and wisdom to each other. If you are the best teammate you can be, your job will be that much easier. It’s hard enough working with clients and pets. Working in a team should be the easiest part. References Ayl, K. ( 2013). When Helping Hurts: Compassion Fatigue in the Veterinary Profession. Lakewood: AAHA Press. Dobbs, K., & Dunn, L. (2013). Veterinary Human Resources: 101 Questions Answered. Lakewood: AAHA Press. Dorio, M., & Shelly, S. (2011). The Complete Idiot’s Guide to Boosting Employee Performance. Indianapolis: Alpha Publishing. Scala, E. (2016). Stop Nurse Burnout: What to Do When Working Harder Isn’t Working. Collinsville: Heritage Press Publication.
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RABBITS
Nursing rabbits in practice By Stacey Vickery RVN CGVNES, Exotic Registered Veterinary Nurse, Vets Now, Swindon, United Kingdom
Rabbits are a commonly kept household pet, increasing their likelihood of needing veterinary attention and hospitalisation. Because rabbits are a prey species, their care in the veterinary practice will differ from how canine and feline patients are looked after. Some of the factors that should be considered include their prey nature, companionship, diet, environmental considerations, nursing care and pain management. Predator/prey Rabbits are a known prey species in the wild, threatened with carnivorous mammals such as stoats, weasels and ferrets. Pet rabbits still show signs of fear and stress around predator species in captivity (Morgan & Tromborg, 2006), so it is important to ensure that any housing provided for rabbits separates them from other household pets such as dogs and cats. It is rare for good companionship to form between predator and prey animals. In a hospital environment, it is important to reduce stress levels from predators as much as possible, and this can be achieved by having a dedicated prey ward away from the noises and smells of kennels and catteries. If this is not possible in your Figure 1: Hospital set up for rabbit
Stacey qualified in 2012 in the UK and has since gained her City and Guilds Certificate in Exotic Animal Nursing. She has worked as an Exotic Registered Veterinary Nurse for the last five years in her current exotic practice in the UK, and is further developing her studies in exotic animal behaviour.
16 June 2019
practice layout, a pop-up kennel in a quiet clinical room or use of isolation facilities, if not being used for contagious patients or predators, should be considered. If none of that is possible, the veterinarian may want to consider whether anti-anxiety medications or light sedation should be administered to reduce their stress levels. Environmental requirements Rabbits are a very adventurous, inquisitive species and like space to move and roam about. In the wild, they would have a territory averaging 6.3 hectares (Hulbert, Iason, Elston & Racey, 1996). Ideally, they should be housed in a secure enclosure, with a hide space and an attached accessible run area where they can run and play safely (see figure 1). Their enclosures should be high enough so that they can stand up on their hind legs without restrictions. However, while this is a minimum, a larger space will often be preferred. Healthy rabbits, being adventurous, like to dig and burrow and therefore a secure base and sides are required in any enclosure. If housed indoors, their substrate should be considered. All rabbits require some padding for substrate, both in the
RABBITS
household and veterinary practice, to help reduce the risk of pododermatitis. However, if the rabbit is known for their chewing, using carpet as their substrate should be avoided. Carpet can also be problematic as it can be abrasive for rabbits who have signs of pododermatitis or who enjoy digging. For some owners, provision of digging boxes can be a good resolution for most of those, as it will be a safe space in which the individuals can be encouraged to dig and burrow. When housed in a veterinary environment, space and movement should be encouraged, as movement can help stimulate and encourage gut motility. Where possible, runs or access to ward floor space should be used, and hides, food and water should be provided both inside the kennel and in the run area provided. Where you have rabbits with mobility issues, such as arthritis, fracture repairs or ataxia, towels may help provide some grip for the rabbits moving around and make it easier for the patients. This additional padding can maximise comfort and reduce the risk of further injuries. Diet The correct diet is important for all animals, and in rabbits incorrect diet can manifest in problems relating to gut motility, dentition and nutritional balance. Rabbits are hind gut fermenters, meaning the initial fermentation of cellulose and fibre occurs in the caecum. They then need to re-ingest the product of that cycle to obtain the remaining nutrition in the form of caecotrophs. The first digestion allows the absorption of sugars and proteins, the second digestion (the caecotroph digestion) allows the absorption of proteins, fatty acids and vitamins (De Blas & Wiseman, 2010). Caecotrophs should be ingested as soon as they are produced, commonly night time, and if they are being left then this could be a sign of poor health. A rabbit’s diet should contain around 85% hay, 10% grass and fresh greens, and 5% pellets (RWAF, n.d.). Hay and grasses provide high fibre levels and silicate photoliths, which are responsible for the wearing down of the molars and
premolars. This helps reduce dental disease caused by uneven wear on the teeth. The teeth will grow approximately 3 mm a week (Meredith, 2007), and therefore it is important to give enough roughage to wear the teeth down at a similar rate to their growth. It is important that this nutrition is correct as early as possible in the rabbit’s life to help prevent health problems from developing. Diet changes should be made gently and when the individual is healthy. It is often worth getting owners to bring in their own food to present the inpatient with food that they are used to. It can also help identify if they are being fed the correct diets. A fully-functioning gastrointestinal system is pro-kinetic. This is because motilin (a digestive hormone) is produced in the small intestine, which is stimulated and controlled by the fibre levels in the gastrointestinal system (Rees Davies & Rees Davies, 2003). Higher levels of fibre in the diet increases the level of motilin produced which increases gut motility. Therefore, it is important to syringe feed (when clinically possible) a high fibre diet, alongside medical management, as this will help to resolve the stasis. When you are nursing a critical patient, a semi-elemental diet (easy to digest, high energy and lower fibre levels) should be considered. This may be necessary when you have a patient which is very poor in body condition or has undergone major gastrointestinal surgery. When patients do not tolerate syringe feeding very well, it can be initially beneficial to deliver semielemental diets via a nasogastric feeding tube. When focusing on diet, it is important to monitor what is eaten as well as what is offered. Healthy rabbits that are given a range of foods will show high preferences of selective feeding, so whilst owners may comment that a large portion of hay is fed to a rabbit, it is important to establish how much of that hay offered is eaten by the rabbit and how much owners discard. Most rabbits will only want to eat fresh hay, so it is important to ensure that it is regularly refreshed and at an optimum nutritional level.
Companions Rabbits form close bonds to each other and stress can be caused by separation or keeping solitary individuals. Wild rabbits have complex social dynamics and behaviour. They will often share vigilance behaviour (watching for predators and danger), allowing them to all have a chance of feeding in safety. Bonded animals can help to simulate the social grouping they are used to in the wild, although it will be on a smaller scale. When bonding rabbits, it is important to understand individual characters to prevent bonding two dominant rabbits together. Bonding is likely to be time consuming, and owner perseverance is required to see it through until the rabbits can be trusted to be left alone. If a rabbit is sick, housing with a companion may reduce the individual stress of both the sick animal and the companion. Rabbits may show signs of stress or distress due to the absence of their companion, being alone, or potential fear as to what has happened to the companion. It should be remembered that each animal will react differently. When they are both kept in the hospital environment, they should have time together but also there should be an ability to monitor all rabbits for levels of appetite, urination and defecation. If owners do not want to admit them together, then the other rabbit(s) should be monitored at home for signs of gut stasis. Bonding issues can be started by antagonistic behaviours being displayed due to smelling different to each other, or one having gained territory over the other whilst separated. Owners should, therefore, be careful when re-uniting them after any period of separation. Intravenous lines and fluid therapy When sick rabbits are presented, they often show a mild level of dehydration, however this may vary depending on the clinical history and length of time illness has been present for. Fluid therapy is often required when rabbits are sick as, not only do they exhibit signs of dehydration such as poor skin tent and sunken eyes, but fluid can get absorbed away from the gastrointestinal system and be one of June 2019 17
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the causes of gut stasis. Subcutaneous (SQ) fluid therapy is effective, however, uptake is slow. With a fluid maintenance rate of 100mL/kg/24 hours (not including dehydration factors) (Varga, Lumbis & Gott, 2012), it can work out as a large volume and administering large volumes SQ can be painful to the patient. For this reason, it is recommended not to administer more than 5mL/kg/injection site subcutaneously (Turner, Brabb, Pekow & Vasbinder, 2011). Intravenous (IV) access is achievable using a range of sites in a rabbit. Most patients tolerate IV catheters, and these can be easily placed when the smaller size and fragility of their veins is recognised and appreciated. Access is often gained at the marginal or lateral ear vein or either cephalic vein. Saphenous catheters can be difficult to maintain in rabbit patients due to blocking, patient interference and environmental contamination. Cephalic veins are often more easily placed in smaller rabbits with smaller vessels. Arthritic rabbits can show more discomfort and resistance for cephalic and saphenous catheters, and therefore ear veins should be considered over limb veins. In patients with poor co-operation for restraint, sedation and/or addressing any pain levels should be considered prior to attempting placement of a catheter, to minimise patient stress. Marginal ear veins are often the easiest for placement (see figure 2), and in the majority of rabbits weighing 2kg and above, it is possible to place a 26g or 24g catheter. It is best to support the ear pinna when taping and bandaging the catheter in place, to prevent the pinna folding and causing pain, sores or reduced blood flow. A piece of rolled up padding bandage can be used for this but, where possible, it is more comfortable for the patient to use something that can be shaped to the pinna. When you have bandaged the catheter in place, it can help to cover the bung in an additional layer of outer bandage to reduce patient interference and environmental contamination. Pre and post catheter placement care should continue as for any other species. Veins will be fragile so it can help 18 June 2019
sometimes to use smaller syringes and needles to flush catheters and administer boluses. This will reduce the pressure going through the vein, and therefore reduce the risks of vein damage or catheter dislodgement. Many patients will often not tolerate continuous rate fluid therapy lines and will often chew through them. It is therefore common to give four
hourly boluses of fluids both IV and SQ using a butterfly catheter (see figure 3) for slower absorption rate (the SQ volume will be reduced when used in conjunction with IV). Any fluids administered should be warmed prior, so as not to create a shock situation to the patient. With critical patients where constant rate fluid lines can be used, the use of a
Figure 2: Marginal ear vein
Figure 3: Use of butterfly catheter to aid patient compliance with subcutaneous fluid therapy administration
RABBITS
warming device over the fluids should be considered. A fluid pump or syringe driver can prove beneficial with these patients. When warming fluids, it is important to consider the duration of time the fluids take to pass between the warming device and the patient, so they do not cool too much before reaching the patient. Blood pressure can be monitored to help with clinical assessment. Blood pressure monitoring may be difficult in rabbits, and it is important not to clip fur on the underside of the feet as this can cause pododermatitis. If unable to gain a Doppler signal, and therefore blood pressure, it is likely that the blood pressure is low. This should be addressed and further support, whether it be medical or with fluid therapy, should be considered with guidance from the veterinarian (Adami, 2018). Pain Rabbits are very good at hiding signs of pain. They use body language to show pain rather than movement and the obvious behaviours we may see in canines and felines. Often their pain signs are discrete and go unnoticed by owners and veterinary professionals. Pain can be assessed by looking at body posture and positioning, and how well they are ambulating. Changes in any of these positions can signify pain. Abdominal discomfort may be shown by the rabbit hunching, and/or the rabbit pressing it’s stomach against the floor. Palpation can trigger flinching behaviour or aggressive response if painful points are identified. It is important to identify the source of the pain to not only provide adequate analgesia, but also to resolve the problem. It can be beneficial to monitor the patient for a period from a distance, to allow the patient to become comfortable with your presence and then assess normal behaviour. Differences in preferences of feeding or drinking habits can also signify pain, and this could be seen in conjunction with hypersalivation. When assessing pain, it is important to do so in conjunction with a full clinical examination, but timing is important. It is important to first conduct a distance examination of respiration rates, pain
scores and general demeanour, and then approach the patient to assess their heart rate and gut sounds. Temperature and palpation should be last on your assessment as these can alter the Rabbit Grimace Scale (RbtGS), heart rates and respiration rates. Facial grimacing can be identified by looking at the eyes, ears, cheeks, nose and whisker position. They have been studied and the RbtGS has been developed to allow monitoring and assessment of pain levels. This helps provide an objective scale, in conjunction with other previously mentioned factors. It should also be used to assess the effectiveness of the medication administered, and whether there should be further intervention or alterations required for the patient. One of the advantages with the RbtGS is that it can be carried out as a distance assessment which prevents their prey species survival techniques from influencing the result. It should always be remembered to use any scale focusing on one area of the body alongside other measurable scales also allowing full body assessment for pain levels. Many of the analgesics available are not licenced for rabbits and therefore the cascade should be adhered to for correct prescribing by the veterinarian. Despite the potential side effects of opioids (such as buprenorphine) on gastrointestinal motility, pain is often associated with gut stasis and therefore with other supportive medications and nursing care, the effects can be greatly reduced (Clark & Saunders, 2012). It has also been reported that opioids given at higher doses can cause some lethargy and signs of drowsiness. The rabbit patient should be monitored for these signs, and medications should be adjusted as required by the veterinarian.
The use of multimodal analgesia should be considered rather than sole agent. Using multimodal analgesia can create a reduction in the doses required of each individual medication. Common uses include an opioid medication alongside a non-steroidal anti-inflamatory (NSAID) for rabbits, and if there has been some surgical involvement local analagesia can also be included such as a splash block upon suturing the skin. Figure 4 shows the different medications in each category which can be used together (one from each category) to create a multi-modal analgesic approach. Care should be taken with the administration of NSAIDs until hydration and blood pressure are normal and stable for the individual. Due to the survival behaviours of prey animals they will not show exact pain levels, which can result in a rabbit being undertreated for pain. It can therefore be useful to consider if other animals would show pain from the condition, and any reasons why it wouldn’t be the same in rabbit patients. Summary Rabbits suffer from stress related to a variety of reasons, including environmental, physical and psychological. Stress is seen when an individual (human or animal) is in a situation where they have no control or choice. We can do a lot in the home and veterinary environment to reduce this by just adding a few more considerations into the way in which they are housed and nursed. Sometimes just spending more time with a rabbit can reduce stress. However, with other more stressed or difficult patients further changes may be required to settle them and improve recovery rates. With a few species-specific considerations implemented they can recover faster and with better results and, if we can
Figure 4: Different medications of each category for use with multi-modal analgesia Opioid
Non-steroidal Anti-inflammatory
Local Analgesia
• Buprenorphine • Methadone • Morphine • Fentanyl
• Meloxicam • Carprofen
• Bupivacaine • Lidocaine
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improve husbandry, potentially reduce the number of times the animal requires hospitalisation. References Adami, C. (2018). CPD lecture on analgesia and anaesthesia in exotics [lecture notes]. Swindon Vets Now, UK. Clark, M., & Saunders, R. (2012). Managing GI Stasis in Rabbits. Retrieved from https://www.vettimes.co.uk/article/ managing-gi-stasis-in-rabbits/ De Blas, C., & Wiseman, J. (2010). The nutrition of the rabbit. Oxon, UK: CABI Publishing. Hulbert, I., Iason, G., Elston, D., & Racey, P.
(1996). Home-range sizes in a stratified upland landscape of two lagomorphs with different feeding strategies. Journal of Applied Ecology, 33(6), 1479 - 1488. Meredith, A. (2007). Rabbit Dentistry. Retrieved from http://www.medirabbit. com/EN/Dental_diseases/Differential/ Rabbit_dentistry.pdf Morgan, K. & Tromborg, C. (2006). Sources of Stress in Captivity. Applied Animal Behaviour Science, 102(3-4), 262-302. Rees Davies, R. & Rees Davies, J. (2012). Rabbit gastrointestinal physiology. Veterinary Clinics of North America: Exotic Animal Practice, 6, 139-153.
RWAF. (n.d.). Diet – obesity, commercial food and treats. Retrieved from https:// rabbitwelfare.co.uk/rabbit-diet/rabbitdiet-obesity-commercial-food-treats/ Turner, P., Brabb, T., & Pekow, C., & Vasbinder, M. (2011). Administration of subcutaneous to laboratory animals: routes of administration and factors to consider. Journal of American Association for Laboratory Animal Science, 50(5), 600-613. Varga, M., Lumbis, R., & Gott, L. (2012). BSAVA Manual of Exotic Pet and Wildlife Nursing. Gloucestershire, England: BSAVA.
Do you want to be a list or registered veterinary nurse in 2020? To gain entry on to the list or register for 2020, veterinary nurses must: Voluntary list
Voluntary register
Hold a veterinary nursing qualification equivalent to one year full time study
Hold a veterinary nursing qualification equivalent to or greater than two years full time study
Complete at least 40 hours paid or unpaid work as a veterinary nurse in a veterinary facility per year Complete at least 20 hours of CPD* per year - 8 of the 20 points can be claimed as quality non accredited CPD * Newly qualified veterinary nurses are exempt from the 20 hours CPD requirement for the year in which they qualify e.g. if a veterinary nurse qualifies in 2018 they are not required to complete 20 hours of CPD during 2019. However they must upload proof of their qualification to MyCPD Record prior to 31st December. If they have not received their diploma then a letter from their provider is sufficient in the meantime. Only a maximum of eight online quizzes can be used towards your annual CPD. What do I need to do? • NZVNA members will upload their CPD certificates and points using ‘MyCPD’ on the NZVNA website by the 31st December 2019 20 June 2019
• Provide proof of 40 hours veterinary work in the CPD year (i.e. a letter from your employer or a payslip) • Ensure your qualification is already uploaded to the NZVNA website Successful participants will be entered onto the list or register as appropriate to their qualification. The list/register for 2020 will not be published until the 1st March 2020. In order to gain entry on to the list or register for 2020 you must supply evident that you meet the criteria by 31st December 2019. Submit all evidence via ‘MyCPD Record’ on the NZVNA website. All CPD must be achieved during the year of submission.
DOG BEHAVIOUR
A TRoo Story - part two By Cindy Paton VN, Cambridge Vets
In part one of A TRoo Story, Cindy shared insights into Roo’s background and the adjustments she needed to make as an owner of an energetic dog. In part two, Cindy discusses reactive dog behaviour and some of the techniques she used in Roo’s training. It is essential to have an understanding of dog behaviour so we can see the reactive dog in a different light and approach their training differently. Dogs are not naughty, and they don’t do things to spite us. The more a dog is rewarded for performing a behaviour, the more likely it will be repeated. Note that I did not say ‘rewarded for performing a
Cindy Paton left school to pursue her dream of working with horses, but after six years she became disillusioned with the industry, and turned her attention towards becoming a veterinary nurse. After graduating from Waikato Polytechnic in 1997 she began working at Cambridge Vets where she remains to this day, happily mentoring the daily dental caseload, conducting behavioural consults, and running puppy preschool classes.
good behaviour’, because dogs do not see behaviour as good or bad; they perform behaviours that work for them. The rewards can be inherent and selfrewarding, like digging or chewing. The environment does not hesitate to reward the dog, be it a running rabbit or a really good smell. Dog owners and handlers constantly reward our dog’s behaviours, whether we think we do or not. We often give attention to the dog even if we do not like the behaviour we are seeing. Learning self-control is important for all dogs, and especially a dog that reacts before thinking. It is our job to teach a new behaviour that is incompatible with the
| Above: Roo in his halter
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unwanted behaviour. A dog can’t jump up while sitting. I know what you are thinking - easy to say and hard to do - and yes, you are right, and here’s why. A dog’s brain is divided into two halves, the instinctive/reactive brain, and the thinking brain. In a ‘normal’ dog’s brain, when the instinctive brain is triggered it reacts with a ‘what was that?’, fight or flight reaction. A nano-second later the thinking brain fires too but is then able to overtake the reactive brain, fold over top of it and calm it down with rational thought. When a reactive dog’s brain is triggered, the instinctive brain fires and shoots up so far and fast that the thinking brain can’t overtake it and calm things down, and the dog goes into the red zone. Dogs work on a traffic light scale of green, orange and red. Green being a dog that, on noticing a distraction in the distance, can still work well, listen and carry out instructions. Orange is a state of conflict for the dog. As the distraction gets closer, be it a scary person or a wheelie bin on rubbish day, the dog becomes conflicted. In this orange zone the dog is uncomfortable with the gradual proximity of the distraction and can sort of listen and carry out commands, might be slower to comply, and sloppier with performance, as their brain is trying to sort out if they are safe or not safe. This often quickly propels the dog over into the red zone. In the red zone, a dog that cannot think, carry out commands or pay attention to the owner, as they are acting on instinct alone. When a dog is over their threshold, being either over excited or anxious/worried, they get a huge surge of hormones and chemicals into their system, evolution’s way to help them deal with the situation. Their body is running on instinct. We all know this, but what you might not know is that it can take hours to days, or possibly even weeks, for these high levels of circulating hormones to settle back into the normal range. There are many dogs out there living in this constant state of high arousal with high levels of circulating stress hormones. As a result, they react more often and more easily, each overreaction preempting the next. Retraining a dog in this overwhelmed state is impossible, and anyone who tries 22 June 2019
will quickly give up and state that their dog can’t learn. True, a dog in this state can’t learn, but give him a chance to calm down and training will then be a whole lot easier. These dogs need a break from the world so the level of stress hormones can settle and the dog can begin to think straight again. It has been drilled into every dog owner from the beginning of time that every dog needs to be walked every day and this is true, but for some, a bit of down time may do them the world of good. This does not mean the dog is left in the back yard with no entertainment, it just means you need to find other ways to give him the exercise, mental stimulation, and the training he needs to find a way to calmness. Once you have begun to implement new behaviours, being aware of triggers, and can recognise the stress signals your dog is using, then you will be able to begin socialising and exercising your dog with more confidence in his behaviour. Another aspect that can affect a dog’s behaviour is sleep deprivation. Dogs, especially puppies, need to sleep around 16-18 hours a day. Manic behaviour can sometimes be attributed to an over-tired, over-stimulated and overwhelmed dog. Kennelling or containing a dog for periods of time can actually be good for them. When you begin training you must be patient and in a calm state of mind. Be prepared! I cannot stress this enough. Get the equipment you’ll need and prepare a kit that includes a lead, halti/harness, food treats, a whistle (if you have taught ‘come’ to a whistle), a bum bag, a supply of poo bags, a toy etc. Practice your mechanics without the dog. Having hands full of leash, food treats, clicker and/or toy while learning yourself can be tricky. Are you left or right handed? Do you want the dog on your left or right? Your treat bag on the left or right? All of these decisions have to be made before you get the dog out to start working. Work on short, fun sessions and break up the training with play. Don’t repeat yourself. Sit, sit, sit, sit, sit… SIT! Sound familiar? When asking for a known behaviour, give them a moment to process and perform, then praise and
reward when they do. When training a new behaviour don’t be too quick to put a cue to it until you know the dog understands what is required. Be aware of your praise style. Having had previous dogs that responded well to my high pitched, energetic verbal encouragements and fast body movements, Roo found this an invitation to idiocy! Jumping up, barking, biting, spinning in circles and doing zoomies! Taking it right back to basics was something that I chose to do, lowering my voice, calming my movements and teaching less energetic commands. It is hard to assess yourself and change, and even now I occasionally forget and wind him up with praise, but he is very forgiving and I can laugh about it and continue on. Live and learn. These words have resonated with me through my training journey. If I am stuck and the training is not progressing as expected, I look at my method and break the behaviour down into smaller increments. When starting to train a new behaviour, you may get the previously cued behaviours all at once, sit, down, roll over, and a high five, as these worked for the dog last time. This can be disconcerting. Wait for the dog to go still then reward that. Working with a calm dog will help him begin to understand that rewards come after deliberate movement, not random movements. Sometimes we expect way too much behaviour for one measly treat, then wonder why the dog gives up and walks away. When training a new behaviour, break it down into small movements and be generous with the food treats. This keeps the dog engaged and working. Feed for any effort the dog offers as you can then begin to shape towards the desired behaviour. With Roo, the best thing I have taught him is to wear a halti when we are out walking. Four years later I still use the halti, and it is part of our routine when going for a walk. He freely puts his nose into it when I hold it out and it works well for us. He will still pull on the halti when interested in a really good scent but 95% of our walk is calm and controlled. I have also taught a ‘watch’, ‘find it’, and ‘come’ command to a whistle.
Epi-Otic
®
The gentle way to treat problem ears
Better together
Return ears to full health by using Epi-Otic® and EasOtic® in tandem. Medication doesn’t do any good if it’s difficult to administer. When your patient’s ears are sore, you want to reach for a medication that makes life as easy as possible for your client. With its soft nozzle tip, measured dose pump and straw-less siphon, EasOtic® is the easiest ear medication to administer. Its unique combination of ingredients is an extremely safe and effective first line treatment for otitis externa caused by yeast, bacteria or allergic inflammatory processes.
For both augmenting the efficacy of topical ointment, or routine cleaning to help prevent infections, Epi-Otic® is an outstanding skin and ear cleaner. The screw-close tip makes applying the cleaner easier and less messy than other lid types, and the soothing active ingredients makes a disagreeable job less trouble. Pro-tip: Cold cleaner is unpleasant in the ears; slightly warming the bottle by standing it in a jug of warm water for a few minutes can make pet and pet parent much happier.
Talk to your Virbac Area Sales Manager about using EasOtic® and Epi-Otic® together and help your client’s pets ears get better faster.
nz.virbac.com/ears EasOtic® is a Restricted Veterinary Medicine available only under Veterinary Authorisation. Epi-Otic® and EasOtic® are Registered Pursuant to the ACVM Act 1997. ACVM Nos. A6006 and A10305.
DOG BEHAVIOUR
The ‘watch’ command teaches the dog to look at your face or look you in the eye, it gives the dog something else to do instead of staring at the dog that is passing by. ‘Find it’ is another good distraction technique. Teach the dog that ‘find it’ means there is one treat on the ground for them to find. Head down and sniffing is a calming position for the dog. The olfactory centre in the brain is linked to the calming centre. If the dog’s head is down and the nose is on the ground, then the dog is not scanning the environment for something to react towards. You can also teach ‘scatter’, which means there is a handful of treats to find on the ground.
and in a new place. Dogs don’t generalise well so we need to teach them that ‘sit’ at home is the same as ‘sit’ at the park or ‘sit’ in the vet’s waiting room. It takes time and repetition. Don’t expect perfection - if the dog is getting the command right 8/10 times, that is good enough. Move on. Remember to always finish on a positive note. Roo is not perfect, and neither am I, but we are learning together. Some lessons we have learnt the hard way but I have also learnt that new behaviours can be taught, some behaviours can be changed, some behaviours can only be modified, and some issues I need to manage, probably
for the rest of his life. I am always learning and looking for more information because I want him to live his best life. Dog training is made up of hard work, multiple failures and well deserved successes. With training, a little bit of management, patience and flexibility along with great resources, classes and help from trusted advisors we can communicate more effectively with these special animals that make our lives whole. Note from the editor: NZVP Hamilton still provide Canine DNA Breed Identification testing as previously discussed in A TRoo Story - part one.
I have taught Roo to come to a whistle. This works especially well at home when he barks at noises or imaginary visitors, or whatever it is he is seeing that I can’t. I whistle loudly and he runs in to the house from where ever he is and gets a treat. He has learnt this really well and I treat him every time! I am consistent and reliable with this as I consider it an important skill, and if I don’t have treats handy we go to the cupboard and get one together. This skill resets him and he quickly forgets what he was barking at. Sometimes I will use this opportunity to put him in his crate to settle down. Be your dog’s best advocate. I plan in my head how I might deal with situations that may arise when out for a walk. If we see another dog, I am aware that Roo has a very big personal bubble and respect this by turning away and distracting him with a ‘watch’ command or a ‘find it’ command as we go in the opposite direction. If this is not possible and we have to walk past, I move as far away as I can, get him to sit and then offer a scatter so his head is down. An approaching off lead dog is a particular concern so I am prepared for this as well. I distract Roo, keeping his attention and drop a handful of food on the ground in the hopes the other dog will eat that instead of approaching us as we move away. When starting to train, work in a minimal distraction environment. Teach new behaviours until the dog is fluent in your training vocabulary, then work on the same behaviour with a few distractions 24 June 2019
| Above: Cindy with Roo and his award at the Taupō Dog Training Club Obedience Championship Show
VNOTY
Vet Nurse of the Year 2018 An interview with Ellie Clark By Catherine Taylor Assistant Editor, RVN
The New Zealand Vet Nursing Association (NZVNA) combined with Hills™ Pet Nutrition New Zealand Ltd for the sixth consecutive year, to highlight the dedication and commitment displayed by the nominated veterinary nurses. The Hills™ NZVNA Vet Nurse of the Year award recognises the outstanding achievements exhibited within our profession. The selection process becomes increasingly difficult each year with such a high calibre of nominees put forward to choose from. Assistant editor for the New Zealand Veterinary Nursing Journal, Catherine Taylor, interviews the winner of the Hills™ Vet Nurse of the Year (VNOTY) award for 2018, Ellie Clark.
Ellie, can you tell me a little about yourself and why you decided to become a veterinary nurse? I was brought up in Somerset, in the United Kingdom (UK), on a smallholding surrounded by animals from a young age. I have fond memories of feeding the chickens, rounding up escaped cattle, and running away from angry rams! Many hours were spent there walking our family dogs and riding my gorgeous pony, Domino. This upbringing largely credits me wanting a career working with animals, however I wasn’t exactly sure in what capacity. When I left school I worked at a boarding kennels, helping the veterinarian with quarantine checks. I really enjoyed assisting him with examinations and blood sampling, making me think that a career in the veterinary industry might be a good idea! I began to pursue my goal, being lucky enough to gain a student position in a local fast-paced mixed practice in Bridgwater, Somerset. Even on my very first day it just felt ‘right’ and I have never looked back!
Catherine completed her Diploma of Veterinary Nursing at Massey University in 2009 at the Palmerston North campus, before moving back to Auckland’s North Shore to work in both busy general, after hours and referral practices for the past ten years. She has been part of the NZVNA journal editing process since 2016, including writing the odd article. Catherine is currently living in the United Kingdom splitting her time between locum vet nursing within the Greater London area and exploring her temporary home.
Can you tell me a bit about your career path and your current role? I worked in my first practice in Bridgwater for eight years, initially as a student progressing up to the head veterinary nurse role. During this time I undertook extra training enabling me to train student nurses, which is a requirement in the UK. This was an excellent practice to be a part of, which initially treated both large and small animals before splitting into two separate practices. As a mixed practice the nurses would accompany the veterinarians on rural Somerset farms, assisting with tuberculosis (TB) testing, colt castrations and general cow wrangling! Following the practice split, I went with the small animal sector into brand new June 2019 25
VNOTY
purpose built 24 hour premises. I gained a vast amount of knowledge and experience during my time there; working both during the day and covering out of hours emergency shifts. I got to nurse a neat array of species including tortoises, geese, hedgehogs, chickens, iguanas, and a 12 foot albino python called Betty! Anyone who has met me knows I like talking(!) and, combined with my passion for teaching students in the industry, it was only natural that I undertook further training and was placed in charge of training the student nurses that worked with us. Travel has always been a passion of mine, and during my first years of nursing I volunteered at a wildlife rehabilitation centre in South Africa and helped with elephant conservation in Namibia. Both of these experiences have proved invaluable to me in appreciating the accessibility to resources, within most veterinary practices, needed to achieve the greatest standard of care for animals. The travel bug stuck taking me to Adelaide, Australia, for a six month locum position in an extremely busy 24 hour practice, nursing some of Australia’s awesome wildlife and cases I have never seen before, such as snake bites. I was supposed to return to the UK following the end of my locum stint, but a few weeks prior to my departure I had a ‘quick look’ on the Kookaburra website for job vacancies, and out jumped one in New Zealand. Applying on a whim I didn’t think I would get it but… here I am!
I then moved to my current role working alongside Dr Debbie Simpson, a specialist dermatologist at The Skin Vet based in Auckland. I have been here for three years now, enjoying the focus on one clinical aspect of veterinary care as well as being mentored by Debbie. In my role I get to perform procedures such as skin testing, immunotherapy, and ear flushing with a video otoscope. I have been honoured to be asked to present talks and webinars on varying dermatological topics with companies such as Royal Canin, Virbac and Vet Nurse Plus with the knowledge I have gained in my current role. I was especially touched to be invited to talk at the Vet Nurse Plus graduation recently and to present at the Hills Veterinary Nutritional Advocate (VNA) weekend in Australia later this year. What are your main passions or interests within the industry? I have been involved with many different types of nursing over the years including surgery, dentistry, radiography, and now dermatology. That is the wonderful thing about our versatile and diverse industry allowing me to play various roles. I am very passionate about animal care and low stress handling. I think it is so important for us as veterinary nurses to treat every animal with the love and
respect as if they were our own. We need to put ourselves in their place, thinking of how scary an experience coming to the vet clinic can be, and try to make every interaction you have with them as positive as possible. I find nothing more satisfying than when some of our patients who used to be petrified of coming to the vets, are now seen happily hurtling their way through the doors to see us! This work ethic can also apply to our client relations. Building up the rapport and relationship to gain trust as you to look after their fur babies is a large part of our roles as a veterinary nurse. We are able to provide them with the support and advice to promote a positive experience in often the most emotional encounters. I am also very passionate about student training as mentioned, to be able to teach people how to be the best they possibly can be, something that can be carried into any vocation. Veterinary nursing can be a stressful job and I know I have had some amazing role models, mentors and teachers over the years that I aspire to. Teaching students can be time consuming, but we need to remember that we were all new once and with proper guidance we can make them superb! On-going education is also a very important part of our ever changing
Since being in NZ I have had a few roles, including a locum position within a clinic that treated dental referrals and in a small animal general practice. I also had the opportunity to work in a hydrotherapy centre gaining experience in rehabilitation. Having now worked as a veterinary nurse for approximately 14 years, I fancied a new challenge and a change that led me to a position teaching with Vet Nurse Plus. I thoroughly enjoyed training and refreshing my own knowledge base whilst here, gaining my Certificate in Adult Education. 26 June 2019
| Above: Ellie assisting with an aural otoscope examination
VNOTY
and updating industry. I love attending, organising and facilitating continued professional development (CPD) events, and encourage nurses to upskill as much as they can! We are now lucky enough to be able to be registered as vet nurses within New Zealand; the NZVNA have done an amazing job implementing registration for us and holding informative conferences annually that I always try to attend. What was your reaction when you found out you were one of the three finalists? I was really shocked and surprised! I was having a really busy morning with a big procedure scheduled for that day so my brain was on about 20 jobs at once. The lovely Amy from the NZVNA called and I was so confused as to why she was calling me at work! She told me about my nomination and that I was one of the three finalists during that same phone call. I remember being really overwhelmed! I don’t think it really sunk in until I got off the phone. I felt very proud and even at 37 years old I wanted to ring my mum even if it was the middle of the night in the UK! How long did it take for it to sink in that you had won the VNOTY award for 2018? I remember the third place winners’ name being called out and thought how fabulous I am in the top two. The second place name was then read out and I went to stand up and realised it wasn’t me! I then think I sat there for a little while with a stunned look on my face and embarrassingly had a little cry in disbelief! I then think I said ‘Really?’ and ‘Crikey’ about 100 times - you could say it took a while to sink in! This is a tricky one but what do you think made you stand out from the other nominees to be selected? I honestly think the other nominees, Debbie and Becky, were absolutely amazing, meaning the judges had such a hard decision to decide on who would be the winner and I have no idea why they would have chosen me! I am so pleased they did as I am VERY proud to be a veterinary nurse, and am very passionate about the industry which I think was reflected by the person who had nominated me. They had gone to a
huge amount of effort to get references from fellow colleagues, people within the veterinary industry and clients. It was lovely and humbling to hear what people said about me and the difference that I had made to some of them. I was absolutely blown away by my nomination and success. I have worked hard and given 100% throughout my 18 years as a veterinary nurse and always try to be as positive as I can in every situation. We had such an amazing time being treated like royalty by Hills™ and the NZVNA. It is an absolute honour to be awarded such a prestigious award, I am thrilled! What do you like to do in your spare time? I really enjoy health and fitness - recently I have qualified as a personal trainer and Metafit coach. I love attending group fitness classes, taking part in obstacle course races, and half marathons. I also like to do quite a lot of fundraising; my best friend and I raised nearly $13,000 for the NZ Breast Cancer Foundation in 2018 and walked the Great Wall of China for five days. We organised a veterinary nursing CPD event and a fun dog walk to aid our fundraising efforts. This year’s fundraising project was for Oxfam where three vet nurse friends and I completed a 50km trail walk in March to raise money for the charity, our team was called ‘Stay Strong and Vet Nurse On!’ Do you have any pets of your own? I have a cat called Blossom who was found as a tiny kitten on the side of the road and brought into the clinic I was working in at the time. She was full of cat flu, very underweight and covered in ringworm. Something about her really stood out so we isolated and treated her, I then took her home to ‘socialise’ and she never left! I also have a Lurcher called Eddie. He was an SPCA special brought over by his owners from the UK. I had looked after him for around eight years on and off eventually agreeing to have him when his owners went back to the UK. I have now had him full time for three years. When I was teaching, Eddie used to come in and be used for bandaging practice - very handy for identifying bones and muscles
as he is quite lean! Definitely living the life of a vet nurse’s dog! He is such a cool character doing lots of running with me in his prime, however now he is nearly 13 years old so he prefers a long sniff and a short walk! Do you have any words of encouragement for other veterinary nurses in the industry? Perhaps to those who want to become the next Hill’s™ and NZVNA VNOTY? Yes! Starting off each and every day as positive as possible and striving to do the very best you can. Trying to make a difference to every animal you look after and treat them with love, patience and respect. Remember the owners of these animals, as making strong relationships with them will make a lasting bond with your clinic. The veterinary nursing industry can be a tough and very emotional job, talking about any positive or negative experiences can really help. By working as a team providing each other with support is so important. Ask how your colleagues are often, not forgetting to speak up if you yourself are struggling and are in need of help. Further yourself as much as you can by attending CPD events and courses, expanding your knowledge and skill set, to be the best nurse you can. Writing an article for the NZVNA journal is a really good learning stepping stone and you get CPD points too! Making positive improvements within your clinics no matter how big or small, whilst trying to always give 100% will positively impact not only your role but your career. The work you put in will get recognised (even if you sometimes think it isn’t); as long as you make a difference to one person and their pet, you are doing an awesome job. Make people aware of the VNOTY award and nominate someone that you think is worthy of the title. Lots of nurses know about it but by promoting Vet Nurse Awareness month in October, you will help raise awareness of our roles and get more deserving nurses nominated. Be proud of your chosen profession and tell people how wonderful veterinary nurses are! June 2019 27
CAV UPDATE
Calling time on Scottish Folds By Sarah Fowler Editor Companion Quarterly, Rochelle Ferguson and John Munday CAV Executive
Introduction The National Animal Welfare Advisory Committee (NAWAC) released their “Opinion on Animal Welfare Issues Associated with Selective Breeding” earlier this year, agreeing with the concerns raised by Companion Animal Veterinarians (CAV) on the health of Scottish fold cats. NAWAC stated in their report that the “Scottish Fold breed should be banned on welfare grounds.” History of the breed The breed was developed in Scotland in the early 1960s from a white barn cat ‘Susie’, that developed a mutant gene causing folded ears (figure 1a). A breeding programme was started and the breed was registered with the Governing Council of the Cat Fancy (GCCF) in Great Britain in 1966. Along with the characteristic ear folds, the cats also typically have short legs and short thick tails (figure 1b). All Scottish Fold cats can trace their pedigree back to Susie.
breed gained favour and continued in the United States. The breed remains popular there and around the world, particularly in Japan. Pathophysiology The autosomal dominant mutant gene causes osteochondrodysplasia (FOCD). This is a developmental abnormality that produces cartilage that is not strong enough to support the ear in an upright position, causing the ear to fold. The cartilage defect also affects cartilage on articular surfaces, so that a highly progressive degenerative joint disease develops. The altered gene has been identified as TRPV4 (Gandolfi, et al. 2016), which encodes a calcium-permeable ion channel, although how the mutation in TRPV4 affects the development of cartilage is currently unknown. Histologically, death of chondrocytes within articular cartilage and defective maturation of chondrocytes in the growth plate are seen.
In 1971, the breed was banned by the GCCF after it was discovered the same genetic defect that causes the folded ears also resulted in severe arthritis. The Federation Internationale Feline (FiFe) will also not recognise the breed.
Defective endochrondral ossification leads to shortening and distortion of the metatarsal and metacarpal bones. It is also accompanied by progressive periarticular new bone formation and accelerated degenerative joint disease.
Despite the significant welfare cost associated with crippling arthritis, the
In homozygous cats, the condition leads to limb deformity and degenerative joint
Figure 1: Photographs of Scottish Fold cats showing (a) the folded ears and b) the short legs and short thick tail typical of the breed. Photo credit: Pixabay.com and R. Malik.
a
28 June 2019
b
CAV UPDATE
disease, often evident on radiographs from seven weeks of age. The subsequent disability and chronic pain markedly impacts quality of life and frequently leads to euthanasia at an early age. While it was originally thought that arthritis and degenerative joint disease were restricted to homozygous animals, more recent studies have found that all Scottish Folds, including heterozygotes, have some degree of FOCD as determined by radiographically visible bone changes (Malik et al. 1999; Chang et al. 2007; Takanosu et al. 2008). Logically, this is not surprising. If the defective cartilage is unable to support the weight of the pinna, it appears unlikely to be strong enough to have normal function when lining a joint. Heterozygotes do, however, exhibit variable clinical signs. Malik et al. (1999) describe the case histories of ten heterozygote cats, showing that while some were severely affected as to require euthanasia before two years of age, others were apparently clinically asymptomatic at four, five, and eleven years old. Diagnosis A diagnosis of FOCD is suspected based on breed, pedigree and the following, clinical signs: • lameness • reluctance to jump • stiff, stilted gait • short, misshapen distal limbs • swelling of plantar tarsometatarsal regions • short, thick inflexible tail FOCD is confirmed by characteristic radiological findings (figure 2) which include irregular shape and size of tarsal, carpal, metatarsal and metacarpal bones, phalanges and caudal vertebrae, narrowed joint spaces and progressive new bone formation around joints of distal limbs. Treatment FOCD is an incurable progressive disease. Therapy is supportive, consistent with other degenerative joint disease protocols. The mainstay of management is non-steroidal antiinflammatories, supported by weight management, and environmental modification (soft bed, ramps). Other therapies such as pentosan
polysulphate, omega-3 supplements, other neutraceuticals and physiotherapy have been suggested, but are currently unproven. In the past a variety of approaches have been used for severely affected individuals, including ostectomy of tarsal exostoses, pantarsal arthrodesis and radiation therapy, with limited success. Autologous stem cell therapy has been suggested as a treatment but it is currently unknown if this is beneficial. Euthanasia is often required at an early age. Heterozygote controversy In discussing this breed with New Zealand Cat Fancy (NZCF), it is well accepted by breeders that they should avoid breeding homozygous Scottish Folds. Breeders do, however, debate the degree to which heterozygous cats are affected by FOCD, whether all heterozygotes are affected, and if by breeding less affected cats together the problems may reduce over time. Figure 2: Lateral radiographic view of the hindlimbs and tail of a Scottish Fold cat showing severe FOCD. Note the irregular shape and size of tarsal, metatarsal bones and phalanges, narrowed joint spaces, and progressive new bone formation around the joints of the distal limbs and tail, including marked tarsal exostoses. Photo credit: R. Malik.
However, even in the most responsible breeding programs, it is unavoidable that progeny with FOCD will be produced and will suffer from crippling arthritis. CAV do not accept that this “collateral damage” is a reasonable approach to manage cat welfare. NZCF have considered de-registering the breed outright, but have instead opted for a testing and management proposal. They have drafted a policy, that is yet to be implemented, that recommends: • Annual examinations including x-rays and examination for any evidence of lameness, stiffness or pain and with those affected not used for breeding and desexed. • DNA tests to ensure no fold-to-fold matings are inadvertently taking place because of the variable expression of the actual ear folding. Cats with two copies of the mutation to be desexed. • All breeding cats microchipped for tracking of testing. Identity certified by the veterinarian doing testing (including DNA tests). • Pet owners purchasing kittens must agree to allow NZCF or other researchers to contact them periodically with regards the health of their cat. • Review of this policy in association with the data provided from breeders in five years’ time. It is likely that once implemented, these requirements will be a mandatory requirement to register a kitten. It is concerning however that this work has yet to have any date set for implementation. The reluctance by NZCF to de-register the breed is, in part, due to the ability of breeders to continue breeding Scottish Folds outside the confines of NZCF. There is an alternative cat pedigree register in New Zealand, Catz Inc, which will register the Scottish Fold (along with the newly introduced Munchkin cat breed, which NZCF refuses to recognise due to welfare concerns). NZCF believe that until there is a government-backed mechanism to ban a breed, the best welfare protection they can afford Scottish Fold cats is to have them bred in accordance with NZCF rules (once they are implemented). CAV breeding recommendations CAV believes that breeding cats for a certain look when aware of the substantial June 2019 29
CAV UPDATE
risks that many cats will develop a painful, untreatable disease, is unethical and to the detriment of animal welfare.
characteristics as the Scottish Fold but without the crippling genetic mutation and folded ears.
Since FOCD is a highly penetrant genetic disease frequently leading to chronic pain and reduced quality of life, for ethical and welfare reasons, all cats carrying this mutation should not be bred.
“There exists sufficient information to know that breeding these cats is cruel… vets and cat breeders who condone this practice have no scientific basis with which to defend this practice. They are not breeding cats – they are perpetuating a disease state” (Malik 2016).
This welfare issue is quite different to those seen in brachycephalics which have received a lot of attention recently. Because this problem is associated with a single gene that can be simply eliminated within one generation, CAV recommends that Ministry for Primary Industries (MPI) implement an animal welfare regulation to ban the breeding of Scottish Folds in New Zealand. A similar ban already exists in the state of Victoria in Australia. CAV calls for all Scottish Fold breeders to move instead to the Scottish shorthair. This breed has the same breed
References Chang J, Jung J, Oh S, Lee S, Kim G, Kim H, Kweon O, Yoon J, Choi M. Osteochondrodysplasia in three Scottish fold cats. Journal of Veterinary Science 8, 307–9, 2007 Gandolfi B, Alamri S, Darby WG, Adhikari B, Lattimer JC, Malik R, Wade CM, Lyons LA, Cheng J, Bateman JF, McIntyre P. A dominant TRPV4 variant underlies osteochondrodysplasia in Scottish fold cats. Osteoarthritis and Cartilage 24, 1441–50, 2016 Malik R. Cute and condemned to suffering:
it’s time to ban the breeding of mutant cats. https://theconversation.com/ cute-and-condemned-to-sufferingitstime-to-ban-the-breeding-ofmutantcats-65874 (accessed 19 December 2017). The Conversation, Parkville, Victoria, Australia, 2016 Malik R, Allan GS, Howlett CR, Thompson DE, James G, McWhirter E C, Kendall K. Osteochondrodysplasia in Scottish fold cats. Australian Veterinary Journal 77, 85–92, 1999 Takanosu M, Takanosu T, Suzuki H, Suzuki K. Incomplete dominant osteochondrodysplasia in heterozygous Scottish fold cats. Journal of Small Animal Practice, 49, 197–9, 2008 l This article is reprinted with the permission of the Companion Animal Veterinarians Branch of the NZVA
Medical Mathematics and Dosage Calculations for Veterinary Technicians, Third Edition Reviewed by Amy Ross DipVN, RVN, NZVNA Executive Committee Author: Robert Bill Published: 2018 Publisher: Wiley Blackwell 240 pages $72.00 (Book Depository, price sourced April 2019)
30 June 2019
This text jumps straight into a ‘maths test’ designed as a self-assessment tool so you can see where you need to focus your studies on medical mathematics and calculations.
and Celsius to Fahrenheit, which will be of use for anyone that is planning on working overseas where these measurements are used.
From here it goes into a review of key mathematical fundamentals - decimals, fractions, percentages and everyone’s favourite of finding the unknown number - all broken down into chapters with self-assessment calculations at the end.
The text is then completed with an appendix that gives you the answers to all of the self-assessment calculations so that you can check your answers as well as the calculations used to obtain those answers, and see where you went wrong if you have the incorrect answer.
The following chapters then look at measurements used in veterinary medicine, including drug and fluid calculations, understanding drug orders and labels, as well as other calculations used in veterinary medicine. It also includes a section on converting pounds to kilograms,
This textbook is A4 in size and is not an easy to grab pocket-book reference, but it is a well thought out book that I feel that it is best suited for use by students or those that struggle with basic mathematical concepts, not an experienced veterinary nurse.
HENRY HENRY SCHEIN SCHEIN BRAND BRAND TEXTILE TEXTILE DRAPES DRAPES
Perfect for everyday use in surgical procedures Perfect for everyday use in surgical procedures where a reusable surgical drape is preferred. where a reusable surgical drape is preferred.
N NE EW W
Made of durable 100% cotton Made of durable 100% cotton Available in a variety of sizes of fenestrated Available a variety of sizes of fenestrated and plain in drapes and plain drapes Washable Washable
Provet Code Provet Code DRAP HS01 DRAP HS02 HS01 DRAP
Description Description 50 x 50cm, Green 50 xx 70cm, 50cm, Green Green 70
Pack Size Pack Size Single Single Single
DRAP HS03 HS02 DRAP DRAP HS03 DRAP HS04
70 90xx70cm, 90cm,Green Green 90 x Green 100 x90cm, 100cm, Green
Single Single Single Single
DRAP HS05 HS04 DRAP DRAP HS06 HS05 DRAP
100 xx 150cm, 100cm, Green Green 100 100 x 150cm, Green 50 x 50cm, Green 10.5cm Fenestration,
Single Single Single Single
DRAP HS07 HS06 DRAP DRAP HS07 DRAP HS08
10.5cm Fenestration, x 50cm, Green 20cm Fenestration, 7050 x 70cm, Green 20cm Fenestration, 70 x 70cm, Green 35cm Fenestration, 90 x 90cm, Green
Single Single Single Single
DRAP HS09 HS08 DRAP DRAP HS09
35cm Fenestration, Fenestration, 100 90 x x90cm, Green 20cm 100cm, Green 20cm Fenestration, 100 x 100cm, Green
Single Single Single
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For more information or to place an order, contact the Provet Team For more776 information to place an order, contact Provet on 0800 838, visitorwww.provet.co.nz or order the online fromTeam on 0800Connect 776 838, visit www.provet.co.nz or order online from Provet connect.provet.co.nz Provet Connect connect.provet.co.nz
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