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.
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 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.
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.
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.
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!
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.
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!