Skink caesarian

WARNING: This video does depict surgery (the successful delivery of baby skinks). (It isn't very gory or bloody, and its 27 seconds long but probably won't play on a smartphone so you might need to rely on ye olde school desktoppe).

One of my favourite articles written in recent history is one I wrote about a caesarian in a pink-tongued skink. I must confess I never knew about this species until I met Jane whilst hanging out with one of my favourite veterinarians, Dr Robert Johnson, at South Penrith Veterinary Clinic.

Below is an extract of an article featured in The Veterinarian Magazine, in the monthly clinical zoo column. 

Jane presented with a mass protruding from a wound on her flank. I assumed it was a kidney. Nope. Twas a gravid uterus. Jane is anaesthetised here and intubated with a catheter functioning as an endotracheal tube. The tape is holding the tube in place.

Jane Doe, a female pink-tongued skink (Cyclodomorphus gerrardii) presented to Dr Robert Johnson following a dog attack in a suburban back yard. For the uninitiated, pink tongued skinks are extremely similar in appearance to Eastern Blue-Tongue lizards, distinguished by a more slender body, a narrower tail, striking cross-band markings and of course a pink – as opposed to blue – tongue, hence the name. They’re just a lot less common.

They typically inhabit forests and woodlands, sheltering below leaf litter, under rocks and other crevices. Populations occur in the Blue Mountains in New South Wales, around the NSW central coast and along the Eastern coastal ranges to Cairns in Far North Queensland.

“We have a unique population in Springwood,” Johnson says. “When we had the old surgery in Springwood we had a couple living under the building, but they often hang around in rooves. Unlike bluetongues, they are very good climbers.”

Their culinary preference for snails and slugs ensures that suburban gardens are the ideal haunt for these critters – just as long as these are free of dogs and cats. Pink tongue skinks will use their climbing skills to escape predation, but not always fast enough to avoid injury.

Such was the case with Jane, who had been enjoying a meal of slugs in a lush suburban garden when she was suddenly disturbed by a curious dog. The dog picked her up in its mouth, biting into her flank. She was prised from the offending jaws immediately by the dog’s owner but the damage had been done – the bite had penetrated her coelomic cavity, and what appeared to be a solid, kidney shaped organ herniated through the defect.

Jane was rushed to the clinic, where Johnson examined her. Close inspection of the hernia revealed a thin sac containing a silver and black striped mass. It wriggled. The mass, it turned out, was a live young pink tongued skink. Jane was pregnant. After a gestation period of just over 100 days, pink tongue skinks are known to produce large litters of 20-30 young (although there are reports of litters containing as many as 67 offspring).

If these were to survive, Jane would require an emergency caesarean. Johnson premedicated her with a combination of morphine (2mg/kg) and midazolam (1mg/kg) via intramuscular injection.

“If it is a small volume you can give it in the front leg, otherwise in the epaxial muscles or subcutaneously.”

Induction can be challenging as venous access in skinks is not always easy.

“Skinks tend to required higher doses of alfaxalone when compared with a lot of other reptiles,” Johnson said. “If we don’t premedicate them they may need up to 20mg/kg IV, but in this case after premedication I gave 10mg/kg via the ventral tail vein, and then left her for ten minutes.”

Intubation is difficult because of the large, slippery and in this case pink tongue obscuring view of the epiglottis which is just caudal to the main body of the tongue. Johnson routinely applies lignocaine and uses an intravenous catheter (with the stylette removed) as an endotrachael tube. In this case, he chose an 18 gauge catheter. Jane was maintained on isoflurane in oxygen using intermittent positive pressure ventilation.

“You can hook them up to a ventilator but we used a trusty veterinary student called Katrina,” Johnson said.

Typically he performs midline caesareans, but in this case the dog had already created a defect.

“We opportunistically used the incision that the perpetrator had inflicted and went for it,” Johnson said.

The wound was cleaned, prepped and extended to facilitate a flank caesarean.

Exploration of the coelomic cavity revealed ruptured oviducts, with several injured and deceased young floating freely. However, the majority (27 out of 30) remained in utero, and were delivered via multiple incisions.

Jane's babies in situ. They are coiled so neatly in that uterus. Note the way their little tails are folded over their bodies.

“We don’t tend to suture the oviducts in skinks and pythons as it does not affect their reproductive ability in my opinion,” he said. “The oviduct is so thin and fragile that you would have to use 7.0 or 8.0 suture material, but you need to get in and out, flush out the coelomic cavity and save the life of the patient.”

The neonates in the "creche" (a lined, heated Tupperware container). The yellow-red bits at the placentas which the babies eat as they wake up. 

And her offspring of course. The neonates were placed together in a Tupperware container placed on a heating pad. Gradually they came to life, slowly animating their limbs and tails. All were attached to large yellow-red placentas, approximately the size of their head. Once mobile, each neonatal skink tucked ravenously into its placenta.

Eating the placenta. Gross but also a vital source of energy. And hey, they don't know any different at this age!

The wound was closed routinely with nylon skin sutures. As her young reanimated in their tiny crèche, Jane recovered slowly from an anaesthetic. Post-operatively she was kept in a warmed vivarium and given enrofloxacin every two days for antimicrobial coverage, after all the flank wound was the result of a contaminated bite. For analgesia she was given meloxicam (0.2mg/kg SC) every second day for around ten days, after which she was released back into the wild.

“We let the babies go virtually the next day,” Johnson said. “At least those which were lively. They have so many babies because there is a high attrition rate – from marauding kookaburras to red bellied black snakes and anything else that wants to eat a juicy neonatal reptile.”

Mum didn’t exactly pine for her offspring.

“There is very little maternal behaviour exhibited by any reptile with the exception of crocodiles which are closer to a bird than a gecko,” Johnson said. “They have a four-chambered heart, they almost have a diaphragm (two membranes, a part pulmonary and post-hepatic membrane that act as a diaphragm) and they guard their nests like birds. But pink tongued skinks are born live so the mother needn’t worry about incubating eggs.”

Can you believe this single creature produced this many offspring?

After being born live and dining out on a placenta, these kids are on their own in the big, bad world. Interestingly, egg laying is more typical in reptiles that live in warmer climates.

“Elapids like tiger snakes tend to have live bearing young because it’s just not warm enough for eggs to incubate in their usual habitat. But pythons and bearded dragons can lay eggs because they live in a warmer climate.”

Johnson was mindful to hospitalise Jane in a temperature controlled environment until she had recovered her appetite and appeared livelier, but tries to avoid keeping reptiles in hospital for too long.

“We released her with sutures still in place as you have to weigh up the potential stress and risk of infection in hospital against the risks of being released. The sutures should not be a major problem as skinks shed their skin in part, not whole. We need to try to avoid keeping free ranging wild animals in captivity for too long.”

By the time of release, 15 out of 30 of Jane’s offspring were thriving.

Johnson will be presenting at the World Veterinary Congress in Prague this year. For further information or to register visit www.worldvet.org

Acknowledgement:

Herpetologist and veterinary anatomist Dr Glenn Shea provided information about the distribution of pink tongued skinks.

Going hairless for the hairy: the fallout

Veterinary student Sy Woon poses with her family the day she sacrificed her locks for charity.

Veterinary student Sy Woon recently shaved her locks to raise funds for charity...so SAT asked her a few questions about the experience.

Tell us a little bit about yourself.

I’m a 4^th vet student at the University of Sydney, passionate about anything and everything relating to animal protection/welfare/rights/ethics! My goal in life is not only saving animals, but educating others (especially children) about animal welfare issues, and to foster in them a love and compassion for all animals. My full-blown bio is detailed here, as I currently work in the role of Sentient, The Veterinary Institute for Animal Ethics’ (http://www.sentient.org.au ) Social Media Coordinator! 

Apart from my love for animals, I am an avid baker of vegan cupcakes, as seen here. 

What inspired you to trim your hair?

I wanted to challenge myself and do something that would really motivate people to fork out for some of my favourite animal charities! Running a marathon didn’t elicit many donations in the past, so clearly I had to think of something more ‘extreme’ (which unfortunately this is regarded as, in our image-obsessed culture). I’ve had long hair my entire life, so this was considered a ‘sacrifice’; though, knowing many animals endure far worse than hair loss, it was easy for me to commit to this.

Can you describe the process?

I created a virtual online event via Facebook, requesting that people donate to a list of my chosen animal charities for my birthday, to support my prospective head shave, with a goal of $3,000! Friends and family donated and sent their ‘receipts’ to me so that I could collate the total. Apart from that, I merely continued reminding everyone these past few months, circulated news to my email networks, and shared the event amongst Facebook groups and pages - I've been truly touched by everyone's generosity, and it was exciting to receive donations from people I’d never met before!

The photos below - taken by Sy's friends - show the process in stages.

Note dogs frolicking in background.

The ponytail comes off.

Then more trimming...

A distinct punk look emerges...

Then a mohawk...

Hair today, gone tomorrow...

Four months later, i.e. this past weekend, the shave itself took place at my cottage in the Camden vet campus, overlooking the beautiful countryside. It was an incredibly fun experience, as Bil my shaver friend experimented with several different short styles (including a mowhawk!) before the final shave, and I loved watching my friends’ and family’s reactions with each cut!

How have people responded?

Friends and family have kindly assured me I “look good” with a bald head and lovingly showered me with praise, but that doesn't worry me since it wouldn't be a sacrifice if I didn't look less aesthetically pleasing! Having been warned by former shavees, I had prepared myself for being ogled at when out in public. And, sure enough, my baldness has been turning heads everywhere I go, mainly curious stares and sympathetic smiles; presumably most assume I am a cancer patient or political feminist. I’ve also been told I resemble a monk! 

So SAT would love to know: have you ever done something to raise funds for charity?

Three things I learned: acute and chronic, upper and lower respiratory tract signs in dogs and cats

This Burmese cat presented with dyspnoea secondary to a marked pleural effusion which is being suctioned via a syringe with a three way stopcock. Mild intravenous sedation was administered.

Keen SAT followers will note my increasingly liberal use of the number "three". But here goes...this week in the CVE's TimeOnline respiratory physiology course I've been reading about respiratory patterns and diagnosing common causes of dyspnoea. And if you keep reading there is a handy table just for you.

These can be tricky to classify in practice, as our tutors pointed out, because animals don't read the textbooks before they present with dyspnoea (ie difficulty breathing, shortness of breath or "air hunger" depending on which definition you prefer). This is especially the case when multiple areas of the respiratory tract are affected simaltaneously, for example laryngeal paralysis (upper respirtatory tract or URT) with secondary aspiration pneumonia (LRT) or trauma with pneumothorax and concurrent pulmonary contusions.

The work of breathing = the amount of energy and oxygen consumed in the process, which might be 2-3% of our total energy and oxygen consumption. But if moderate to severe respiratory tract pathology is present, that can shoot up to 30% which is exhausting and not sustainable long-term, especially if onset is acute and there is little time for the body to compensate/adapt.

So what does it feel like? Well, according to our instructors

• an obstructive respiratory pattern feels like you are breathing through a straw or size 4 ET tube on either inspiration or expiration for five minutes. Both the effort and time it takes to breath increase when the airways are narrowed.
• a restrictive pattern is more like having your chest wrapped in a strong rubber band or being mummified with vetwrap. Instead of taking deep slow breaths you would be forced to take faster, shallower breaths to minimise the effort expended in stretching that big rubber band.

They provided key differentials for chronic and acute causes of dyspnoea, as well as via location in the respiratory tract which I put into table form.

Differential diagnoses for upper respiratory tract disease (characterised by an obstructive inspiratory pattern, and audible stridor which is loudest on inspiration)

Chronic causes	Acute causes
Elongated soft palate Laryngeal paralysis Everted laryngeal saccules Tracheal collapse Brachycephalic airway syndrome Chronic URT infection	Tracheal trauma Submucosal tracheal haemorrhage (eg secondary to anti-coagulant rodenticide) Nasopharyngeal polyps (cats) Smoke inhalation Inhaled foreign bodies Laryngeal spasm Infections Anaphylaxis in cats
Acute or chronic presentation
Granuloma (eg fungal granuloma) Infection Neoplasia (eg nasal lymphoma) Epistaxis Nasal pathology causing nasal cavity obstruction Pharyngeal/laryngeal oedema may present acutely but may be secondary to a chronic disease process

Differential diagnoses for lower respiratory tract disease (characterised by an obstructive or restrictive pattern depending on the site, with wheezes that are loudest on expiration)

Bronchi	Pulmonary parenchyma	Pleural space disease	Paralysis
Feline asthma Chronic bronchitis Bronchiectasia Parasitic airway disease	Left sided CHF Pneumonia (bacterial, fungal, viral, protozoal) Pneumonitis Dirofilariasis Neoplasia Vitamin K antagonist rodenticide toxicity Non-cardiogenic pulmonary oedema ARDS Pulmonary contusions Alveolar haemorrhage (coagulopathy, neoplasia, aspiration) PTE Smoke inhalation	Pneumothorax (trauma, idiopathic bulla rupture, oesophageal or tracheal perforation) Haemothorax (trauma, neoplasia, vitamin K antagonist rodenticide) Pyothorax Chylothorax Pleural exudate (FIP, neoplasia) Pleural transudate (eg LS CHF in cats, pericardial effusion, hypoalbuminaemia) Diaphragmatic hernia Lung lobe torsion	Toxin – snake envenomation, ixodes (tick paralysis), tetrodotoxin, botulism Immune – myasthenia gravis, polyradiculoneuritis (Coonhound paralysis) Cervical spinal disease Hypokalaemia

On burnout, the role of pets in our wellbeing, and organisation: interview with Michelle Nickolaisen

Bombchelle and Rain.

SAT sat down (well kinda...on opposite ends of the earth) e-chatted with Michelle Nikolaisen, the powerhouse behind www.bombchelle.com and a burnout-kicking, systems-wielding, organisational guru. She discussed her relationship with her significant non-human other, Rain, as well as the role of Rain in helping her maintain her own wellbeing. 

Burnout seems to reaching plague proportions everywhere - not just veterinarians, but entrepreneurs, academics, politicians - so I thought the topic was worth a visit. And Michelle also reveals her amazing Rain-inspired tattoo.

Who are you and how did you become an organisational guru?

So, my name is Michelle, I live in Austin, TX, with my dog Rain (which you will soon be hearing all about!). I've been working for myself for almost four and a half years now and I actually started as a freelance writer; I got started doing organizational stuff in a funny way - one of my friends asked how I plan my days/projects/etc. and I wrote her this literally 3,000-word email detailing the process. The idea that not everyone did that or was that organized had honestly never occurred to me (which is laughable in retrospect!). So that's when I started looking into helping other people with their organizational issues. (FWIW...the word guru makes me giggle ;) )

What does an organisational guru do?

I do project/operations/launch management for online business owners, as well as doing consulting on systems and productivity for business owners, and I teach classes/create products on those same materials. 

You mention your dog Rain a lot. Can you tell us a bit about Rain - how did you meet and what do you guys do for fun?

Yes! Rain is a Shiba Inu, who I actually got from my parents. My mom used to show dogs and was gifted two Shibas by one of her friends, and Rain is the offspring of those two Shibas. She was living with my parents in Missouri, but as she got older, she didn't get along with one of the other dogs, so she had to be an outside-only dog; when I was up for the holidays in 2011 I was lamenting to my mom about how I wanted a dog, and she suggested taking Rain home, and tada! 

Rain adores attention.

She's very snuggly, kinda defying the stereotype about Shibas being aloof (although in my experience they tend to bond really strongly with 1-2 people and be more aloof with everyone else). She also LOVES meeting new people, though not so much other dogs, depending on the dog. And she likes to chase the tennis ball...not so much catch it (which you can see here). Sometimes when she gets bored she'll toss it up in the air and bat it around like a cat, it's pretty adorable. 

Have you ever been to the vet with Rain? Can you tell us about the experience?

Actually, she's been in really good health since I got her, so we've only been to the vet once, and it was to get her spayed. I think it was scary for both of us - she's very attached to me and not used to being left alone in strange places, and I almost cried. But of course, she was fine afterwards and so was I. Lots of snuggling involved! 

[Ed: I think its good for veterinarians to hear these things. Owners don't always show us their anxieties at the time, and I think its important to provide reassurance].

Rain keeps watch of her tennis ball whilst scoping snuggling options.

One of the things you talk about on your blog a lot, and help people avoid, is burnout. Why do you think it is so prevalent in today's world?

I think it's kind of a perfect storm of things. We put a lot of focus on productivity and a lot of value in creating work (at your job, etc.) and being successful. Sometimes lip-service is paid to self-care, but the advice is usually pretty fluffy, and it's kind of the equivalent of putting a band aid on the situation - we don't talk about the things that get you burned out in the first place, that got you to where you needed so much self care, and how to prevent that situation from arising again. We kinda just put the bandaid on and then act like that should fix it. 

An example from my own life is that July was a bit of a hellhole - I had a bad reaction to some medication which caused a lot of side effects, one of the most notable ones being insomnia (it'd take me a few hours to fall asleep, and then I'd sleep 8-10 hours, but wake up feeling like I had got maybe 4 hours of sleep). I literally could not stop working, though, because I had a launch that had been in the works since May slated for the first week of August. I got the medication sorted out around the last week of July and then spent most of last week (the first week of August) sleeping 10-12 hours a night. I also had, that week, an acupuncture appointment, a massage appointment, and I got a mani-pedi the week before - all self-care-y things for me - so I was doing pretty good self-care wise, right? 

And I feel like if I was following conventional advice I would have jumped back in on Thursday or Friday when I started to feel ready to work again. But because I'm aware of how burnout works and just how much July drained me, I had the self-awareness to know that my "gas tank" wasn't full, it had just been running on empty for so long that getting it half full felt amazing. So I didn't start getting back into work until today (the 12th), and purposefully made myself get extra sleep and rest this weekend, even though I was starting to have ideas about my next projects and was itching to work on them. 

In the Kick Burnout Kit you mention that Rain is involved in your self-care regime. How does this work?

Having an animal in my space that has very real needs means that I need to take care of her, right? So she's a great way to stay really grounded instead of getting in that space where I accidentally work for 6-8 hours without taking a break. I take her out first thing when we get up and often play some catch with her (because, as shown above, she doesn't play fetch, haha), which starts off my morning exercise/yoga routine, and then I also take her out on my lunch break - which is a good self-care thing because she expects it at a certain time every day, and it gets me out/walking around/actually taking a break. 

It seems win-win: you take a break and Rain gets attention. How can people involve their own pets in this way?

I'd suggest maybe to think about the traps you tend to fall into when it comes to self-care/burnout and then seeing if you can use your pet to help get you out of it. Like, before I started making such a point of taking Rain for a walk on my lunch break, I would take her out for 5 minutes in the middle of the day and that was pretty much my only break the whole damn day. (Until I realized that it would be illegal to make someone else work that way, so why in the world would I do it to myself?!) If you know that you have a tendency to get sucked into projects, set an alarm for once an hour and have it be a five minute play or snuggle break with your pet - things like that. 

You've spoken publicly about struggling with anxiety in the past. What role did Rain play in helping you through?

Rain has been hugely helpful in managing my anxiety - she's one of those dogs that sees when I'm upset and wants to come over and make me feel better. There's been like, a million studies showing that playing with or petting animals boosts helpful emotions and chemicals in the brain, and I know that taking a few minutes to snuggle with her has got me out of many a bad spot. It's also just really heartening to know that there's someone around who loves me unconditionally and shows it in such obvious ways; of course, there are people that love me, and I know that intellectually, but there's a big difference between that and actual doggy snuggles, yanno? 

How has Rain changed you as a person?

I think she's made me a more caring, more patient person, and also more loving. I think that having someone around you who loves you deeply makes it easier for you to be patient in the rest of your life, too. 

Rain has changed Michelle in other ways too...this is a tattoo which was literally done yesterday in Rain's honour. "Fox because she's named after Renard, a medieval trickstery fox figure", says Michelle.

Can you share with us a favourite tip on avoiding burnout?

I don't know if I can pick just one! Definitely, know what the difference is between your tank being actually full and your tank being half full, so to speak. When you start to refill it, make sure that you're not running off half full. Also, know where you're spending your time, and know what activities you find draining and what help prevent burnout for you (they might be different for everyone).

Thanks Michelle and Rain. 

Do you care for orphaned marsupials?

The amount of time and resources spent caring for wildlife is tricky to quantify. Its also challenging to scientifically evaluate "best practice" hand-raising. Honours student Stephanie Glasby is hoping to develop a framework that will ultimately fill some gaps in our current knowledge.

Honours student Stephanie Glasby needs your help. She is looking at how much time and resources veterinarians devote to caring for orphaned marsupials. She's also looking at which marsupial hand-raising practices are believed to be the most important in successfully hand-raising young.

Joey with an injured arm. Image courtesy Dr Derek Spielman.

All you have to do to help is answer a survey from the comfort of your practice/loungeroom/aviary or wherever you happen to be at the time.

Participation will greatly aid the development of a framework for scientific evaluation of marsupial hand-raising protocols.

To complete the survey click here.

Hand-raised joey. Image courtesy Dr Derek Spielman.

Interview with animal ethicist & veterinarian Dr James Yeates

An excellent guide for veterinarians.

SAT was fortunate enough to interview the talented, extremely busy Dr James Yeates. James Yeates graduated from Bristol University in 2004 as a veterinarian, where he also completed a biotethics degree, certificate, dipoma and PhD. He worked in Gloucestershire in private practice, then at an RSPCA branch. He became head of the RSPCA’s companion animals department in 2011 and their Chief Veterinary Officer in 2012. He is based at the RSPCA’s South Support Centre in Sussex.

He is also the author of Animal Welfare in Veterinary Practice, a practical and very accessible guide for veterinarians. (If you click the hyperlink you can download and read some excerpts). One common criticism of ethics teaching is that it tends to remain a little ivory tower. As a lecturer on this topic I am always trying to integrate case scenarios and give students a dose of reality. We expect diagnostic tests to yield black and white answers when this is often not the case. So do with ethical decision making. So its nice to have someone so practical, with their feet grounded in practice, writing about ethics in an accessible way.

When did you realise you wanted to devote your career to animal welfare?

It was after a forum run by the British Veterinary Association Animal Welfare Foundation charity for students to discuss animal welfare issues. I found the discussions could be made useful and practical, drawing on both the practical reflections of intelligent practitioners and the philosophical ideas that I had read as a student. It also made me think that there could be a career forged here, although I thoroughly loved full time GP practice too.

The forewords in your book both suggest that as a profession, vets can do better when it comes to animal welfare. In your opinion, what are the biggest failings and how do we address these?

Most vets are concerned about animal welfare but

• Suffer the same distractions and barriers that everyone does, not least time and money
• Feel somehow that doing “good” work for free is somehow letting the side down
• Don’t think to “look up” at the wider issue (beyond complaining about it over coffee)

Addressing these can be mainly done by us reminding ourselves why we wanted to be vets, and that doing good is a legitimate “bottom line”.

You developed the concept of a welfare account - can you explain what this is and how it works?

This is the idea that you judge yourself on how much welfare improvements or problems you cause – all added up over time. This means that if you do cause some harms (and we cannot avoid it, especially in some ethical dilemmas such as whether to perform a caesarean without spaying) then you can compensate or “offset” those harms by doing more good (eg to educate people to avoid breeds that regularly need caesarians). [I posted on this topic earlier, to read more check out this link].

The gravid uterus of a chihuahua mated with a larger dog resulting in foetal oversize and necessitating a caesarian. There is much can do to prevent such scenarios (desexing for example - in this case the owners didn't intend to breed the dog but didn't consider that the dog might mate with another in spite of their wishes).

Throughout your book you use the metaphor of contagion - referring to both good and bad animal welfare. Why is animal welfare contagious and how do we harness the power for good?

We are all influenced by other people – consciously and subsconsiously. So how we treat animals can affect how others treat animals. This is especially true for vets. As a profession, we look to mirror what our colleagues to (indeed, that’s a basis of avoiding negligence in this country) and we have especial influence as authoritative role models for other people. This means we have enormous potential to influence – for good or bad.

One thing you raise which is interesting is the iatrogenic harm of hospitalisation. As vets we often assume that we are always helping animals. What sort of iatrogenic harms are common to many clinics and how to we ensure that we are aware of these as our practice develops?

Nearly all treatment causes some pain or fear. Most common iatrogenic harms are perfectly legitimate insofar as they are necessary to do good – the mild pinprick of a vaccination is needed to avoid the severe suffering of parvovirus infection etc.

It is easy to think of overtreatment as the big surgery but some overtreatment is from just doing slightly more tests than needed or asking for slightly more repeat consultations for an animal that hates coming to the vets. As vets we need to consider each individual animal – and, for example, decide how often to recheck a diabetic depending partly on its stress on coming to a vets (as well as how well it is doing on its glucose levels).

A puppy undergoes its first veterinary examination. This puppy was born with a (difficult to see in this photo) small hernia (easily repaired in surgery).

What is your impression about how responsive veterinarians are to positive animal welfare changes? 

All vets are keen to improve animal welfare. Often disagreement can be reduced to “philosophical” differences, eg sometimes we have different ideas about what is welfare or to psychology, eg some of us get defensive in public. Sometimes our philosophical points are ways to make our defensiveness sound more convincing! But I haven’t get met a vet who doesn’t care about animal welfare and, with the right discussions, is keen to make improvements. Then the main problem for vets trying to respond is owners who don’t respond…

You mention in the book that there is a possibility that reflection on welfare and education about welfare may be seen as more boring than surgery and medicine CE. Any ideas as to how that could be changed?

No clever ideas, really. Main thought is to make it as practical and non-theoretical as possible, but relating to the wider ideas. For example, we should

• Drop the philosophical labels. Who cares really whether Kant or Hegel said something. Vets do love long words for medical conditions but not for metaethical theories.
• Relate it to all cases, and ask students to actually make a decision.
• Otherwise its just a matter of good teaching and using the range of methods – debates, role playing, case studies etc.

What changes would you like to see in relation to animal welfare in small animal practice in the future?

Greater recognition of it as a specialist subject, but that we all need to know something about as a central part of practice (like any veterinary specialty). Its not all “just a matter of opinion” or all “subjective” – there are ways to make better decisions.

Even hospitalisation can cause stress. Such iatrogenic "harms" can be minimised by providing a quiet, clean environment, soft bedding and a place to hide (esp for cats). Different wards or hospital areas for dogs, cats and exotic pets reduces stress (Phil simply posed in a cat ward here because I needed a photo. Hence he is looking at me with those "are you kidding?" eyes).

How can a single, ordinary veterinarian make a meaningful impact on animal welfare?

• Enjoy doing the extra reflection and caring in day to day work
• Try to improve welfare in the community – give free neutering, educational talks etc.
• Use your veterinary authority to influence key people, not least your member of parliament and local authority.

Thank you James!