The 2014 conference took place at Stirling Management Centre, University of Stirling on the 10th and 11th June.

Below are details of the talks given by the guest speakers. Click on the ‘+’ sign beside each title for a more detailed description.

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Companion Animal Programme, 10th & 11th June

Getting the best out of your X ray machine by Elizabeth Munro
In this session the focus will be on how to obtain consistently high
quality radiographs of the dog and cat, and how best to avoid common
pitfalls.
Some of the challenges of thoracic and abdominal radiography will be
discussed in more detail. Contrast techniques for evaluation of the
urinary and gastro-intestinal systems for first opinion practice will
be reviewed. Although the main focus of the presentation will be on
how best to obtain images of diagnostic quality, getting the best from
your xray machine also involves developing a logistic approach to
interpretation, and this will be described for the abdomen.
Radiographic interpretation of common joint diseases in dogs by Nacho Calvo
This interactive lecture will cover the management and diagnosis of the most common joint disease you will encounter in practice, such as elbow and hip dysplasia, OCD (shoulder, stifle elbow and hock) different stifle conditions (CCL and Patella Luxation) and shoulder pathology. These two lectures will be very practical with the clear objective of providing you with information and skills that can be applied in practice. Radiographs will be shown at the beginning of the lecture so you can test your current knowledge before they are discussed in depth.
How to manage joint disease in practice by Nacho Calvo
This interactive lecture will cover the management and diagnosis of the most common joint disease you will encounter in practice, such as elbow and hip dysplasia, OCD (shoulder, stifle elbow and hock) different stifle conditions (CCL and Patella Luxation) and shoulder pathology. These two lectures will be very practical with the clear objective of providing you with information and skills that can be applied in practice. Radiographs will be shown at the beginning of the lecture so you can test your current knowledge before they are discussed in depth.
Medical management of osteoarthritis pain - looking beyond NSAIDs by Fergus Coutts
Osteoarthritis (OA)-related pain is a common reason for owners seeking veterinary advice and NSAIDs are the cornerstone of OA-related pain management. However, analysis of data from drug trials, insurance companies and practice databases shows there is a significant proportion of dogs obtain poor pain relief from NSAIDs, suggesting the involvement of mechanisms other than inflammation.
Preclinical and clinical research findings into OA will be summarised:
• Pain generating mechanisms associated with OA.
• The mode of action for adjunctive analgesic medicines.
This material will be used to outline a mechanism-based approach for the use of adjunctive analgesic medicines in OA-related pain management.
More than 50 shades of grey – interpreting thoracic radiographs by Yolanda Martinez
Yolanda Martinez Pereira LdaVet CertVC DipECVIM-CA (Cardiology) MRCVS
RCVS and European Specialist in Veterinary Cardiology
This talk will focus in the diagnostic role of thoracic radiographs in feline and canine patients suffering from cardiac and respiratory conditions. Thoracic radiography is a widely available and affordable technique; however, interpretation can often represent a true challenge for the clinician. During this talk, numerous real-case examples will be used to cover the following:
• Assessment of diagnostic quality of your thoracic radiographs and how to fix it
• Combining the information from physical exam/history and thoracic radiographs
• Methodical approach to thoracic radiograph interpretation
• From thoracic radiographs to differential diagnosis and diagnostic plan for your patient
Anaesthetic mortality in animals: can we reduce it? by Derek Flaherty
Anaesthetic mortality is substantially greater in animals than in humans. There are probably a variety of reasons underlying this, but there is little doubt that veterinary anaesthesia has some room for improvement. A number of anaesthetic mortality studies have been carried out in small animals, and have provided useful information on where changes can be made. While certain factors (e.g. advanced patient age) are out-with our control, there are other areas where – with minimal effort – mortality could be reduced. This presentation will quantify anaesthetic mortality figures for different patient sub-groups, thus allowing better risk evaluation for owners, and also highlight potential areas where changes can be introduced to reduce overall mortality.
Medicine – a discussion of challenging cases by Clare Knottenbelt & Gerard McLauchlan
Professor Clare Knottenbelt
After graduating from Bristol in 1994, and working for a year in mixed practice, Clare was the Petsavers Resident in small animal internal medicine at the Royal (Dick) School of Veterinary Studies. She obtained an MSc by Research in Feline Transfusion Medicine and the RCVS Diploma in Small Animal Medicine in 1999. Clare was appointed as a lecturer at the University of Glasgow in 2000 and promoted to senior lecturer in 2006. Clare is currently a Professor of Small Animal Medicine and Oncology and Clinical Director of the Small Animal Hospital University of Glasgow. Her interests include haematology, medical oncology, and cancer prevention.

Gerard McLauchlan BVMS Dip-ECVIM CA MRCVS
After graduating from Glasgow Vet School in July 2006 Gerard undertook a one year rotating internship at Davies Veterinary Specialists. He returned to Glasgow in March 2008 to begin a Residency in Internal Medicine and Oncology which he completed in August 2011. Gerard passed his ECVIM certifying examination and became a Diplomate of the European College of Veterinary Internal Medicine in Sept 2011. His interests include emergency medicine and critical care.

Summary of talk
This lecture will cover the clinical presentation, diagnostic approach and therapeutic options for those cases which just don’t read the textbooks!

Case based scenarios will be used to emphasise the logical approach to these patients and the speakers will discuss between them the various options to working up these often challenging cases.

Audience participation and interaction is encouraged!

Practical approach to rabbit and guinea pig medicine by Livia Benato
Rabbits and guinea pigs are becoming increasingly popular as pets and dedicated owners expect more from their vets regarding knowledge and diagnosis of disease, and veterinary treatments and procedures. A practical approach to these animals as medical and surgical patients is advantageous to reduce the stress and the length of the procedure and for effective management and treatment in a busy practice. Anaesthesia and perioperative care of rabbits and guinea pigs have improved markedly over the years and becoming more familiar with these important areas is necessary for a successful outcome.
Treatment of canine atopic dermatitis by Tim Nuttall
Canine atopic dermatitis is one of the most common conditions seen in practice. It is chronic disease that will require lifelong management. Recent discoveries have revolutionised our understanding of the disease, allowing us to give affected dogs and their owners a good quality of life. This lecture will describe how skin barrier defects, allergic sensitisation and inflammation interact in the pathogenesis of atopic dermatitis. We’ll go through the evidence base for the treatment options that tackle each area. Finally, we’ll see how these can be integrated into a proactive treatment programme to maintain long-term remission.

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Equine Programme, 10th June

Problems in the post-foaling period by Celia Marr
Dystocia is uncommon in mares, but when it does occur there is significant risk of trauma, most often to the mare’s reproductive tract but occasionally involving the gastrointestinal tract or urinary system. Regardless of the exact location, all lead to effusive peritonitis. Prompt recognition and treatment are essential if the mare’s life it to be saved. Retained placenta can also be an emergency in horses, and if that’s not enough, after foaling, mares are also prone to vascular rupture, colon torsion, hyperlipaemia and hypocalcaemia. In this presentation, the emphasis will be on recognition and initial stabilization of these life-threatening conditions.
Diseases of Weanlings by Celia Marr
Infectious disease is most common where foals are kept groups, allowing the level of challenge to overcome the immature immune system. We are seeing increasing threats in this age group: Rhodococcus equi has a significant impact worldwide and is usually associated with dusty paddocks, but we need to remember that in temperate climates, this bug may be building up indoors. Lawsonia intracellularis is widely diagnosed in the UK and anthelmintic-resistant ascarids are giving increasing cause for concern. In this presentation, prevention, diagnosis and management of these weanling infectious diseases will be emphasised.
Donkeys are different - in health by Anna Harrison
Behaviour

Donkeys are stoical and often exhibit a very limited range of pain responses. Subtle behavioural signs must be recognised and acted upon to avoid missing clinically ill donkeys.
Strong bonding behaviour – never separate from a companion
Browsers rather than grazers
Can effectively cow kick!

Anatomy

Pharmacology

Diet

11% more gut length – very efficient – only require 1.5% body weight of dry matter – high demand for fibre
For a healthy donkey with good dentition the recommended diet is ad lib barley straw with a vitamin/mineral supplement such as Top Spec Donkey Forage Balancer
Many will not drink very cold water – take the chill off

Physiology

T – 37.1 (range 36.5 – 37.7)
P – 42 (range 31 – 52)
R – 20 (range 13 – 30)
Highly variable gestation period – 12 – 14 months

Donkeys are different - in sickness by Anna Harrison
Common problems:

Foot disease
Dental disease
Respiratory disease
Hyperlipaemia
Obesity
EMS/PPID

Bear in mind stoic nature of donkeys and non-athletic lifestyle such that many diseases have progressed significantly before recognised by owners. Many are not vaccinated.
Guides to the treatment of common problems are included as electronic handouts and Donkey Sanctuary vets are available 24/7 to discuss cases with colleagues.

Case selection for interspinous ligament surgery by Graham Hunter
This presentation covers the wider diagnosis and treatment of back pain in horses with a more detailed look at the selection of cases suitable for Interspinous Ligament Desmotomy. It will cover the specifics for case-selection and describe and discuss the surgical technique which is carried out understanding sedation.
Case based discussion on approach to back pain by Richard Payne and Graham Hunter
Standing Dorsal Spinous Process Resection.

Despite continued improvement of diagnostic imaging techniques there are still significant limitations in our understanding of back problems in the horse. Pain due to impinging dorsal spinous processes is a well recognized problem for which several treatment options exist. In all cases, and in particular if surgery is to be considered, the most important requirement is a correct diagnosis. If the diagnosis is not secure, surgery will inevitably result in disappointment!

In most cases surgery can be carried out under sedation and local anaesthetic. The approach to case selection and the surgical technique itself will be described. Data on long term follow up and outcome will also be presented.

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Vet Nurse CPD Programme, 10th June

Life through a lens - making sense of cytology by Yvonne McGrotty
Cytology is an essential part of the investigative process in many disease processes. Although in many cases cytology is best left to cytologists at an accredited laboratory, in house examination of some samples can allow clinicians to make a diagnosis quickly and initiate treatment immediately.

A wide range of cytological diagnoses will be covered including red and white cell morphology and platelet estimations, lungworm, urine crystals, lymphoma and mast cell tumours. At the end of this session the nurse should have a greater confidence in using a microscope in house and in assessing a variety of cell types.

The VN's role in the management of acute and osteoarthritis pain by Fergus Coutts
VNs play a central role in pain management, throughout the practice. The phrase “Anticipating, Assessing and Alleviating” was coined for acute pain, but applies to all pain management. Modern analgesic strategies can provide good pain relief. However, individual responses to analgesia may vary and assessment is essential before and after treatment, to ensure adequate comfort and pain relief. In addition to medicines, reducing anxiety and fear is also crucial for good pain management.

Principles of pain management will be discussed using case examples from first opinion practice:
a) Post-operative pain.
b) Procedural pain.
c) Osteoarthritis pain.

Anaesthesia monitoring – getting the most from your equipment by Mike Brampton
Everything we need to know about every monitoring parameter and how to get what we need out of monitors; from ECG to Temperature, from Pulse Oximetry to Capnography, with more than a passing nod at Blood Pressure and other tools, like Dopplers.

Hopefully illuminating, a little different and a bit of a fun look at how to get the best out of the box that goes Bing.

Successful nurse clinics – why, what and how! by Donna Gaylor
Our pets are living longer. It is not uncommon to see a 19 year old cat or a 16 year old Jack Russell coming into the practice. As a result we are also seeing an increase in age related diseases. Running senior clinics is therefore of increased importance and is a key way we can benefit our patients, build relationships with clients and generate revenue for our practice.

Setting up these clinics and obtaining clients for them can be a daunting task. The objective of this lecture is to provide you with the prerequisite skills and the confidence to introduce and run these clinics successfully within your own practice.

The key topics to be covered in this lecture are as follows:
• Introducing senior clinics to your practice;
• Marketing your clinics;
• The initial consultation;
• Age related disease and common worries from owners;
• What is the correct nutrition for senior pets; and
• Follow up clinics and progress monitoring.

Rabbits & guinea pigs – post-operative management & assisted feeding by Livia Benato
Rabbits and guinea pigs are two popular pets that are increasingly seen in private practice. Recovery from surgery and anaesthesia is a critical period and optimal care is necessary for a successful outcome. The patient needs to be placed in a quiet environment and demeanour, body temperature and heart and respiratory rates closely monitored. Analgesia, administration of prokinetic drugs and assist-feeding are also an important aspect of the post-operative management of these animals. Assist-feeding via syringe using critical care formulas is paramount in order to promote the gastrointestinal function and prevent ileus.
CPR – what to do when it all goes wrong! by Derek Flaherty
Recommendations have changed significantly over the past few years with regard to management of animals with cardiopulmonary arrest (CPA). This has arisen as a result of both clinical and experimental studies in several species, which have shown increased survival rates, with good neurological function, following modification of previously described resuscitation techniques. This presentation will highlight what can realistically be achieved in a general practice situation when CPA occurs, and will emphasise some of the errors that are commonly made during attempted resuscitation.

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