The VET Festival for One Medicine – Day 2 Roundup….

Festival busker at vet festival

In his last lecture yesterday Noel said that he had txt God asking for the Sun to be turned on, and this morning it really was. For the first time all week my sunglasses came out of their bag and onto my head. However that is not what I want to write about so back to the VET Festival…

Today is day 2 (and the last day) of VET Festival 2015….

vet festival with Noels ordered sun

One of the first vets I met when I arrived at the Fitzpatrick Referrals center on Tuesday was Clare Rusbridge, one of the senior neurosurgeons at the center. On Tuesday I learnt a ton (I will write about this later!) and Wednesday even more, however today blew me away with an update on Canine Epilepsy. Pushing the limits of technology Clare used interactive txt polling to engage the audience. It was such a big topic that I will write a post just about this later, however the take home messages were that diazepam is not effective (I tested Clare’s reaction here to confirm it!) and that diagnostic tests do not exist for idiopathic epilepsy. Something else I was shocked by is that pharmaceutical companies consider a seizure drug “effective” if it reduces seizures by just 50% – personally this seems a low threshold for me…

Canine epilepsy with Clare Rusbridge

I then headed outside of the main lecture streams (they’re being recorded so I will watch every single one later!!!) however I wanted to learn some more about The Humanimal Trust. This new charity is all about vets and human doctors working together towards One Medicine – sharing expertise for the benefit of all. Even though we are both in the medicine field until today there has been little collaboration between vets and doctors. Actually when you look at the drug development cycle it takes around 13 years to get a new drug to market, and 10% of drugs do not make it on a mouse model… Yet if vets were engaged and dogs were used in the development the time and cost to develop new medicines would decrease greatly! The Humanimal Trust is all about animal and human healthcare moving forward together sharing advances.

The Humanimal Trust for one medicine

It then all became about the spine, such a small amount of time for such a big topic, and my first lecture with Noel. This was different to most with the opening words being about remembering that picking up a scalpel needs to be a carefully considered and thought out decision. It has become tradition for Noel to pick on a member of the audience to help with demonstrating different techniques, and today it was Ian Holsworth…

Noel Fitzpatrick demonstrating on Ians Holsworth

I then had the pleasure of hearing Laurent Findji talk about hepatobiliary surgery – this is surgery of the liver and gallbladder with the associated connecting duct to the intestines. Generally liver surgery is one of the more interesting parts of soft tissue surgery with some highly technical procedures. The liver is split into different lobes all connected to a central area – in terms of surgery the left liver lobe is a lot easier to remove than the right liver lobe. Also it is somewhere you need to be able to get good exposure as the liver sits right against the diaphragm at the end of the ribs.

Laurent Findji talks about hepatobiliary surgery

Something I was really interested in learning about were limb sparing surgery options where instead of amputation a bone (or part of one) may be removed and replaced with an artificial one or a part from elsewhere in the body. This was given by Will Eward from the Duke Cancer Center who is a vet and a human orthopaedic surgeon. During this I learnt loads that will be useful into my future – however the most important points were that when dealing with cancer it really is important that surgery should be planned properly, as correcting future mistakes can be devastating. Once a joint capsule is contaminated then it must be removed preventing artificial joints from being placed. The most dramatic surgery discussed here was a rotationalplasty which is where a knee joint is replaced with the ankle joint – success of this hinges on which way you rotate the foot.

Dr Jane Goodall speaking at VET Festival 2015

The last lecture of the weekend was delivered by someone that is a driver of change in the world for the better, Dr Jane Goodall. The room was packed, and this was the first speaker of the weekend to get a standing ovation from some of the smartest vets, vet nurses and vet students in the world. Dr. Goodall told her fascinating story of how she went from a little girl reading Dr. Doolittle to one of the foremost experts on chimpanzees. It is not my story to tell so I will leave it there; however it is a reminder of how one can achieve whatever they dream if they take the risk.

Dr Jane Goodall standing ovation

The VET Festival is now over; however the journey to One Medicine for One Health has only just begun and I hope that I, as well as you all will be part of it!

The VET Festival for One Medicine – Day 1

Noel Fitzpatrick - Pets Hugs and Rock and Roll

In a field in the grounds of the new Surrey vet school I arrived to a festival today thankful for boots and in typical British fashion with big grey clouds threatening overhead. This was not a festival like any other, in fact it was the first festival I had ever been that had a CT scanner in a tent in a field…

This is day one of the VET Festival – not your normal festival but a place where people pushing the limits of both Veterinary and Human medicine have come to share the latest and future planned advances to benefit both animals AND humans.

Festival CT Scanner - The VET Festival

The day may have started grey, but after the welcome by Noel Fitzpatrick the atmosphere was electric, and heading in my first lecture with Professor Nick Bacon it became apparent why.

Cancer in cats - Professor Nick Bacon

Cancer in cats is sadly very common, and though the cells are often the same as in humans the treatments are not. However there is now the first veterinary oncology hospital which Noel Fitzpatrick opened last Wednesday and today’s first lecture was by one of the senior vets running this hospital Prof. Nick Bacon. This was such a hugely informative lecture that I have decided that it deserves it own entire blog post later in the week to prevent this one becoming a story. The key point was summed up by Nick however when he said “Please please please stick needles into things as it gets easier”. Cytology (looking at cells under a microscope) is an important skill learnt by experience.

Spinal Nerves with Colin Driver

Something that I’ve struggled with until today was the spinal nerves (the other part the cranial nerves are much simpler!). Colin Driver gave a thorough explanation starting with the basics of how the Upper Motor Neurons control the Lower Motor Neurons by inhibition (aka stopping a signal). Therefore UMN problems cause an increase in muscle tone and reflexes, whilst LMN problems cause a decrease in muscle tone and reflexes.    This helps us to determine where the problem is and a appropriate treatment plan. The severity of spinal cord injury has a logical progression of: loss of postural reactions, ataxia, paresis, paralysis, loss of superficial pain and finally loss of deep pain.

External Skeletal Fixation with Jerry

During my first break I managed to find the interesting toys, and spent an hour getting a introduction into external skeletal fixation from European Diplomat Jerry O’Riordan which was very cool as I got to have a play on some fake bones. This is something we don’t currently use in Slovakia so I was very happy to have a opportunity to learn more about this.

Peri-operative pain management orthopaedics with Duncan Lascelles

Then I jumped straight into peri-operative pain management in orthopaedic patients with Duncan Lascelles who was brilliant. What, when and where you use the different types of pain medications can make all the difference to an animals pain level. It is important to remember that pain is a plastic system that can be hyper sensitised and so in some painful orthopaedic conditions it may be worth delaying surgery to control the pain first. This will allow much better (and easier) control of pain post operatively. Also the importance of complementary non-drug therapies need to be remembered and used here as well!

Gait analysis with Julia Tomlinson

It was then onto gait for me, a relatively new field that is expanding very fast – at present a lot of the research and books here are equine focused however canine gait analysis is becoming a much more important part of veterinary medicine. Understanding how the muscles work, and that different parts of the same muscle may have different functions in movement is very important and not something really taught during anatomy at the moment. One of the most important tools here is video to allow the analysis of a animals gait at different speeds especially with smartphone apps for slowing down videos!

Lectures today finished for me back with Duncan to learn about chronic pain – something that can actually shrink your pain as it causes a decrease in the size of the cognitive areas. Even more shocking is that in America in 2012 treatment for chronic pain cost $600bn which is more than cancer, heart disease and diabetes combined! A multimodal approach is important to consider with the example of osteoarthritis being used with NSAIDS to control the pain whilst exercise (which releases natural endorphins) was introduced, along with nutritional changes before reducing the NSAID use.

One Medicine with Noel Fitzpatrick

The keynote at the end of the day had Noel Fitzpatrick introduce One Medicine and the difference that it can make to the world. Animals are often used to develop cures for human patients, yet this does not feed back into veterinary medicine, and vice-versa. In over 100 years the parts of veterinary surgical textbooks about prosthetics have barely changed. Though 92% of dog owners consider their dog a family member, the survival rate for osteosarcoma is only 10%. In HUMANS the 5 year survival rate is 70%. Yet in veterinary medicine we have a new technology called bone wielding which allows us to do amazing repairs of disastrous injuries – yet this technology IS NOT used in HUMANS. Take home message – One Live, One Medicine.

Paws, Hugs, and Rock and Roll was the them of the evenings concert with people coming from all over the UK to be here to support One Medicine and One Live!

Noel Fitzpatrick - Pets Hugs and Rock and Roll