Nasotracheal intubation can be used as an easy, less traumatic method of rabbit intubation when compared with orotracheal intubation.
Nasotracheal intubation takes advantage of the fact the rabbit is an obligate nasal breather.
Rabbits normally have their epiglottis entrapped on the dorsal surface of the soft palate, thus allowing direct passage of air from the nasopharynx into the larynx and trachea. A tube placed nasally will naturally traverse this pathway from the nasopharynx into the larynx and trachea.
Disadvantages
Potential complications include the possibility of introducing pathogens into the lungs and need for high oxygen flow rates. However, rabbits that received nasotracheal intubation in one study were observed over two months, and no clinical signs of respiratory disease were noted. In addition, high oxygen flow rates were unnecessary.
The first of April brought with it the usual abundance of amusing online articles, tweets and blogs, only claiming credibility until midday – and the veterinary community was no exception.
Sun Life’s “courtesy pet” joke didn’t have vet student Jordan fooled for a minute.
Some April Fools were obvious hoaxes – such as Sun Life’s courtesy pet scheme, offering owners a replacement pet in place of their beloved while away at the vets – while others were a little harder to interpret, such as BEVA’s announcement of a privately funded equine vet degree – or maybe that’s because I was still half asleep and it was the first one I’d seen before realising the date.
Food for thought
Although it was cleared up at midday that BEVA president Mark Bowen was not due to become dean of the first UK equine-only vet school and that the nine traditional degrees would remain the only ones available, it did provoke some thought about whether it would be such a bad idea after all.
While plans for a traditional five-year omnicompetence approach, followed by a further three years of equine-only study, seemed a little far-fetched (fourth year has nearly finished me off – I certainly don’t think I’d hack eight years at vet school), many veterinary schools around the world use a condensed version of this model.
For example, Utrecht University in the Netherlands follows the format of a three-year bachelor’s degree for all species, followed by a three-year master’s degree aimed solely at one species/area (with the exception of 20 weeks). The University of Leige in Belgium compromises in that the fifth year is spent rotating through clinics for all species and half of the final (sixth) year is spent in one area in particular, with a choice of small animal, farm or equine.
Omnicompetence or specialisation?
The question of omnicompetence or specialisation is highly debatable and seems to go around in circles in the UK. Earlier career specialisation would be favoured by some who know, undoubtedly, they never want to see a cat, dog or rabbit again after vet school – likewise for those who shudder at the thought of an emergency caesarean and an angry farmer.
Early specialisation as an equine vet could mean you’ll never find yourself taking a blood sample from a lion. Image courtesy Shamwari Conservation Experience.
But what about those like me, who, after a considerable amount of vet school already under his or her belt and a variety of EMS placements (good and bad), when posed with the question “what sort of practice do you want to go into?” still can’t come up with anything more eloquent than: “Umm… mixed?”
The advantage of omnicompetence is that, in theory, graduates should leave vet school equipped with the knowledge and skills to address most cases in general practice in any field/species, deal with emergencies and know who or where to refer a patient to if the case is beyond his or her abilities.
Early specialisation could change this to the extent an equine or farm graduate asked “can you just look at my dog” may end up looking a bit silly.
Everything changes
Circumstances also change and accidents do happen. A vet may end up sustaining an injury while working with horses or livestock that could prevent him or her from doing so in the future, so a species-specific degree could force him or her to leave clinical practice altogether.
Similarly to the “new vet schools” debate, it is feared introducing species-specific degrees may reduce job availability for graduates who have taken the traditional educational pathway, making the equine sector, in particular, even more “elitist”. Ultimately, this could potentially drive the profession away from the concept of mixed practice altogether.
Master of one?
More like our medical counterparts, we could lose our “Jack of all trades” status and end up being highly specialised instead, which does, of course, have its advantages, but leaves those of us who want a bit of variety and flexibility in the dark.
For me, omnicompetence is definitely the right starting point for a veterinary degree, but I know others have very different opinions. I did, however, enjoy the brief social media debate before a communal sigh of relief.
My personal favourite April Fool this year, however, was the University of Glasgow’s announcement the university tower would be reopening as a public helter-skelter (see video below) – and I’m still disappointed it isn’t true.
Lice eggs at the base of the feather shaft. Credit: Ohio State University Extension.
Several species of lice live on chickens and cement their eggs on the base of feather shafts.
Identification of the species is based on examining an adult microscopically and the area of the chicken’s body they are found on.
The eggs of Menopon gallinae, the chicken shaft louse, appear as clusters of tiny cream-coloured balls. These lice are generally not regarded as pathogenic, and most birds have small populations of several species at the same time.
If the bird is immunosuppressed by another condition, then the number of lice increases and the feathers appear moth-eaten. The lice are large enough to be visible to the naked eye.
Abnormally large numbers of lice on a chicken should initiate a full clinical examination in addition to a husbandry and diet review, as usually there is an underlying problem.
Metabolic bone disease is a common condition seen in almost all house rabbits with dental disease.
House bunnies, restricted from sunlight and eating a diet low in calcium, cannot maintain calcium levels.
The disease is similar to osteoporosis in humans, where there is lack of calcium in the bones. The actual disease is complex and many factors are involved.
The three most important elements involved in metabolic bone disease are calcium, vitamin D and parathyroid hormone. These three factors work closely to maintain calcium homeostasis in the blood.
Calcium retrieval
Bone acts as a storage point for calcium and phosphorous, when blood calcium is low, the body retrieves calcium from bone to maintain calcium stasis.
Dietary calcium needs to be more than 0.44% for blood calcium to remain normal in rabbits. Rabbits eating a diet with lower than 0.44% calcium (most rabbit mixes) will have low levels of calcium in the blood.
Kept in the dark
Exposure to sunlight is crucial for vitamin D synthesis. Vitamin D is essential for absorption of calcium in the gut. Animals with low blood calcium often compensate by producing vitamin D (with exposure to sunlight), and thus absorbing calcium in the gut. This is assisted by parathyroid hormone.
House bunnies, restricted from sunlight and eating a diet low in calcium, cannot maintain calcium levels, and therefore obtain calcium from the bone. Bone then weakens, resulting in dental disease.
Metabolic bone disease is probably the main reason why house bunnies develop dental disease so often. Wild rabbits have adequate exposure to sunlight and free access to grazing. Acquired dental disease is not seen in wild rabbits at all.
Rebecca Hubbard speaks to outgoing BSAVA president Patricia Colville during the association’s 2016 congress.
Dr Colville speaks briefly on a number of topics, including the highlight of her presidency, the launch of the association’s PDP resource and microchipping regulations. She also reveals the thing she’ll miss most about being involved in the day-to-day running of the BSAVA, while offering a word of advice to her successor, Prof Susan Dawson.
Easter brings not only the endorphin rush associated with an abundance of chocolate eggs (perhaps more so for those of us who gave up goodies for Lent), but also the picturesque seasonal backdrop of spring lambs merrily bouncing about.
An abundance of public footpaths allow the wanderer to happily stroll through the British countryside. Image: antbphotos / Fotolia.
If only the reality was so idyllic…
Unfortunately, the lambing season brings with it a growing number of reports of sheep worrying and, even more concerning, reported dog attacks on young lambs.
Right of way
We are lucky to live in a community where many public footpaths allow the wanderer to happily stroll through the British countryside. However, most of these footpaths cross private land, the owners of which have very little choice in their presence and, at best, can apply for them to be moved, but not closed off completely.
The consequence of this is that, short of double fencing or restricting which parts of land are usable, farmers may be forced to keep livestock in fields that aren’t just accessible by the public, but actually form public rights of way.
There are many downsides for the landowner, but most prominently at this time of year is the susceptibility of young lambs to uncontrolled dogs.
It’s a distressing reality there are owners out there who would allow their animals to attack livestock, or lack the good sense to recognise they cannot exercise enough control over their animal to prevent something like that happening.
Keeping it legal
The results of a particularly nasty dog attack on one of my family’s sheep.
The Countryside and Right of Way Act states the public may only exercise their right to access open land if they keep dogs on a fixed lead of two metres or less near livestock.
Under the Dogs (Protection of Livestock) Act 1953, the owner of a dog worrying livestock is guilty of an offence. More recently, livestock are also covered by the Dangerous Dogs Act (1991), under which, if the dog attacks another animal, the owner can be given an unlimited fine, or sent to prison for six months. The owner may also be banned from owning dogs in the future and could be ordered to have the dog destroyed.
While there are laws supposedly protecting livestock, the reality is very difficult to police, unless the farmer catches the guilty dog or has CCTV. A farmer is also within his/her rights to shoot a dog that attacks livestock on their land.
Attacks, while the most instantaneous causes of devastation, are not the only problem. Sheep worrying earlier in gestation can also cause abortion, ultimately at a loss to the farmer.
Encouraging responsibility
Raising awareness within the veterinary and farming community would be preaching to the choir, but is there more we can do, as a profession, to encourage dog owners to take responsibility? Be that keeping their dogs on a lead, obedience training or simply avoiding sheep fields at particular times of year – perhaps it is up to small animal clinicians to lead the way on this one.
Posters in practices reminding owners of the repercussions of their actions could be enough, or even an off-hand remark to an owner about being careful walking through the fields at this time of year.
Wendy began her VN career in 1991 as a trainee at a small animal practice in Surrey. On qualifying, she moved to Yorkshire and started work in mixed practice, and after becoming head nurse, left to relocate to Germany with her forces husband.
Back in the UK in 2000, Wendy moved to Devon and spent two years at a two-branch, small animal practice as a nurse, VN assessor and eventually, practice manager.
Moving to the north-west in 2002, she worked as a nurse in a small animal practice before becoming the Veterinary Nursing Approved Centre coordinator at Myerscough College. After four years there, she returned to practice part-time, where she started working for Anthony Chadwick at his Skin Vet practice. During this time, Anthony launched The Webinar Vet, and, once established, sold up. Wendy stayed behind as operations manager and is often known as “Webinar Wendy”.
In her role, Wendy organises CPD for vets, nurses and SQPs. She also deals with dermatology referral clients and spends at least one day a month working in practice.
Why is she standing?
Wendy says she is “extremely proud” to be a veterinary nurse and wants to take an “active part” in ensuring the profession moves forward.
“I feel I have gained valuable experience throughout my different career roles, which will benefit the role requirements of an elected member and our cause as a whole,” she said. “I have a very good understanding of the varying levels of our profession and I am in a privileged position of having contact with members daily, ranging from students to the most experienced VNs.”
On education, Wendy says she feels “passionately”, and has a “wide exposure”, thanks to her time at Myerscough and The Webinar Vet.
“I believe I will also add value… establishing and reviewing schemes for post-qualification and CPD for VNs. This also includes recommending to the council amendments to the rules relating to the registration, conduct and discipline of veterinary nurses, if required. I am widely accessible to nurses due to my current role, so I can offer effective communication between VNs and the council. On future challenges and issues? You tell me. I aim to be an effective voice for the nurse in practice – an effective voice for you.”
Hustings highlights
Wendy tackled lack of VN engagement in the RCVS in her passionate video, citing poor voting turnout figures and calling the electorate to action. “I want to help increase engagement, hopefully by… carrying on communicating with nurses via social media and within my role at The Webinar Vet,” she said. “Voting in an election is important.
Can you get other VNs to vote? Do you know nurses who don’t vote? If everyone who votes gets one more VN voting, we can increase that [2015 turnout] 11 per cent to 20 per cent.
“It would be great if you voted for me to represent you on VN council, but more importantly though – please, please vote.”
Helen has had a varied career. Qualifying in 1996, she started in general nursing before concentrating on consulting. In 2004, she left practice to work for Petplan, but quickly realised she missed practice life.
Returning in 2007, Helen opened her own practice, employing the vet, finding the premises and having them fitted out. In 2013, she sold it, recognising its growth required more than a sole VN.
Helen now works for Onswitch as one of the trainers on its Bertha Bus, and is a project manager at Mojo undertaking various veterinary projects including working alongside International Cat Care.
Why is she standing?
Helen says she will “fight for VNs to have their voice heard” if she is elected.
“I am proud to call myself an RVN and be part of a dedicated, caring and hardworking profession,” she said. “I am passionate about getting our profession heard.”
This passion is evident when you see how Helen has been promoting the VN title petition. She has written to her MP, generated an article in her local newspaper and even contacted the Chris Evans breakfast show on BBC Radio 2 on the eve of BVNA Congress for the past two years – “VNs would have heard their profession mentioned in the ‘representing the nation’ section,” she said.
Helen believes her daily contact with vet professionals of all kinds is a strength. “Working as a trainer and PR, I meet many VNs, student VNs, vets and receptionists, which keeps me in touch with the issues in our profession,” she said.
Attempting to protect the title is “only the beginning of a great VN future”, says Helen, which should open up more opportunities for VNs and lead to the profession “gaining the recognition we deserve”.
Hustings highlights
Helen thinks Defra’s promise to review Schedule 3, and the possibility of having a tiered system where VNs undertake post-registration qualifications, could be a good thing for career engagement.
“As we qualify, our skills develop from our day one skills and our interests grow, with some VNs preferring more clinical roles in practice and surgery, and others preferring more client contact. Until you’ve experienced that, you don’t know where you want your career to take you,” she said. “By including post-registration qualifications, maybe this would help career development, VNs feeling they had a career and that it was worth staying in the veterinary profession.
“I know this is a main area for why people leave the profession, so I think it is good we work on career development,” she said.
Matthew’s VN career kicked off in 1989 at The Park Veterinary Centre in Watford, a busy mixed and exotics 13-vet practice. It was here he completed his training and here in 1994 where he became senior theatre nurse.
Leaving in 2003, Matthew headed to the Zoological Society of London (ZSL) to pursue his interest in zoo and wildlife nursing, where he remains.
Matthew is a regular lecturer to veterinary nursing and veterinary surgeon undergraduates at the RVC, and lectures on herpetology throughout Europe and America.
Why is he standing?
Matthew says he has “dedicated his life” to being a VN for 25 years, and has observed “many changes” that have taken place during this time.
“Our role and the general understanding of it has improved significantly within my time in the profession and it continues to,” he said. “I am passionate about veterinary nursing and consider myself very lucky to work at ZSL. With my experience and background, I am in a fortunate position to help educate and support the next generation of VNs.”
Matthew said it would be a “great honour” to be elected to council, as will be having the opportunity to represent UK VNs and “contribute to the advancement of our profession”.
“I would relish the opportunity to promote the vital role of the RVN,” he said.
Hustings highlights
In Matthew’s video, he said he feels there needs to be a “greater understanding” of the roles of a modern VN and, while these roles are “misunderstood” by the public, VNs are “too keen to blame this on everybody else”.
“I think a lot of it is our own fault,” he said. “We need to raise our profile and demonstrate professionalism wherever possible, and during my time on council I would really like to push forward on that.”
As a male VN, he would also like to work on diversity within the profession. “I’ve been a VN for more than 25 years now,” he said. “I’ve always really enjoyed it, and haven’t felt at any point that being male has held me back in any way, but again I think this comes down to public perception of what VNs are.”
Summerleaze Veterinary Hospital in Maidenhead was where Samantha gained her NVQ in veterinary nursing in 2009.
Shortly afterwards, she began working at North Downs Specialist Referrals (NDSR), where she achieved her Graduate Diploma in Professional and Clinical Veterinary Nursing from the RVC. After four years at NDSR, Samantha had a brief spell at Moor Cottage Veterinary Hospital in Bracknell before taking the medicine nurse team leader role at Chester Gates Referral Hospital. After a year she moved back to Kent and took up the wards supervisor job at NDSR. She also teaches the Diploma in Veterinary Nursing at Hadlow College.
Why is she standing?
“Exciting” and “dynamic” are the two words Samantha uses to describe the veterinary nursing profession right now, with VNs being seen “more and more as professionals in [their] own right”. “I hope this is only going to get better,” she said.
Samantha also says she would bring “enthusiasm and dedication” to the council, as well as her passion of educating student nurses.
“I always strive to improve my knowledge and nursing skills and have the drive and determination to help mould the profession moving forward,” she said. “I have been privileged to work with a number of amazing nurses and I would like the profession to get the recognition it deserves. I believe it is moving in the right direction with lots of exciting changes on the way, but I cannot imagine a better time to get involved with the profession’s future.”
Another challenge she’s ready for, says Samantha, is the role of RVNs within practice.
“As the qualification and further qualifications increase in skill level, it would be rewarding to see this acknowledged with further delegation to RVNs,” she said.
Hustings highlights
Samantha said she is standing for VN council because, “like a lot of people”, she was not sure “what the council did” and “wanted to play a more active role in the decision-making process of the profession I feel passionately and strongly about”.
As a teacher, it was all about education in Samantha’s video.
“I think our pre-registration education possibly needs reviewing,” she said. “Training placements are scarce and quite hard to find, and this is something we need to work on with employers and course providers to improve for nurses who want to train in the future. On post-registration education… I think RVNs really need to see the value of CPD and I think it should be something that should be undertaken and enjoyed and something we should be able to use in the future.”
