Veterinary Ireland highlights battle angainst AMR & Brexit risks

“The battle against Antimicrobial Resistance (AMR) involves a change of mindset as well as a change of practices – and Irish vets are actively playing an important role in this fight” says David MacGuinness, President of Veterinary Ireland. He was delivering the Opening Address at Veterinary Ireland’s annual conference for equine and companion animal vets in Lyrath, Kilkenny (8th and 9th November, 2019).

“The blind use of antibiotics and the unnecessary use of antibiotics are practices which must stop in both human and veterinary medicine. We have to make sure that the most critical antibiotics are preserved for as long as possible by only using them in the most critical cases,” said David MacGuinness.

Veterinary Ireland ratified its Policy Document on AMR in May 2014 and has been educating and working with veterinary members to drive reductions in AMR prescribing. “We need to raise awareness amongst clients using veterinary services that antibiotics should only be prescribed when other treatments have not worked or will not work. This is a change in mindset.”

Using cultural sensitivity swabs is a practical tool which vets can increasingly use to identify if an antibiotic should be used at all. It gives vets more accurate information about what type of antibiotic should be used – so that if an antibiotic must be used, you reduce the risk of contributing unnecessarily to resistance by using the wrong antibiotic. It also provides layers of protection against wasted use and justification for those occasions when critical antibiotics may need to be used.

A BIGGER THREAT THAN CANCER?

‘Protect Me: The Rational Use of Antibiotics’ was the subject of the first presentation in a companion animal vet session at the conference on Friday morning (8th November, 2019). It was delivered by Fergus Allerton BSc BVSc CertSAM DipECVIM-CA MRCVS from Willows Referral Service in Solihull who is a European Veterinary Specialist in Small Animal Internal Medicine.

Fergus Allerton said that antibiotics have saved millions of human lives over the last 90 years but that the threat from resistant pathogens has grown and is now considered a potentially catastrophic threat to mankind. He quoted the 2016 Review on Antimicrobial Resistance (AMR), which predicted that by 2050 up to 10 million people could die per year due to drug-resistant infections. “That is a figure which exceeds the current annual global mortality due to cancer,” according to Fergal Allerton.

He said that a key tenet is to optimise the use of currently available antibiotics so that their potency can be maintained. “Vets often cite client pressure as the reason for antibiotic prescription while conversely, owners attribute the decision directly to the vet,” said Fergal Allerton. “Eliminating unnecessary use of antibiotics in people and animals will help to safeguard this invaluable resource for future generations.”

Veterinary Ireland President David MacGuinness said that the AMR issue means that certain important antibiotics may become restricted or unavailable to equine or other specialist veterinary practitioners in the future, with potentially serious treatment or animal welfare implications in the future.

BREXIT RISKS

Irish vets are also concerned about the potential impact of Brexit on the availability of certain medicines to treat horses, pets or livestock in their care and whether there is the potential risk of shortages. Brexit may not allow dual licencing of some drugs which are currently available in the UK and the Republic of Ireland using dual labelling.

“In addition, the Republic of Ireland veterinary drugs market is an extremely small proportion of total drug sales worldwide in sectors such as the equine sector,” said David MacGuinness. “Some drug companies may find it uneconomical to go through a licencing process which is dedicated to the Republic of Ireland only, creating the risk that some veterinary medicines may become unavailable here.”

David MacGuinness voiced concerns for the Irish equine industry if the present tripartite agreement which exists between Ireland, the UK and France is altered as a result of any kind of Brexit.

“The tripartite arrangement which exists is crucial for equine movement between these regions, including Northern Ireland – but also Irish horses that need to be flown because they have been sold for breeding or taking part in races or competitions, must travel to the UK to board aircraft which have been specially adapted to transport horses,” explained David Mac Guinness.

“Ireland has a strong reputation globally for the quality of its horses. The contribution of the thoroughbred and professional sports horse sectors to the Irish economy and employment is significant. The risk that Brexit could impact negatively on this existing tripartite agreement is a concern to the Irish equine sector as it could affect the transport of Irish horses throughout the world.” 

FLAT FACED DOGS & ANIMAL WELFARE

Brachycephaly features on the Veterinary Ireland conference agenda because of the growing popularity of flat- faced dogs such as pugs, bulldogs or French bulldogs and the associated health problems that the vast majority of these breeds suffer from.

Laura Cuddy (Veterinary Specialists Ireland, Summerhill, Co. Meath) described how many of these dogs have had generations of selective breeding which has emphasised the physical flat faced look of these breeds with large, wide-set eyes and flat noses, which many humans may think looks ‘cute’. In fact, the short skull shape, short muzzle and flat nose means that these dogs can suffer from Brachycephalic Obstructive Airway Syndrome (BOAS).

The normal airway structure in an affected “Brachycephalic” dog is squashed into a shorter nose and skull space. The airways are twisted creating obstacles on the way to the lungs. These dogs may make sounds like a snore, but vets highlight that it is not normal for a dog to snore in that way – what you are hearing is a dog struggling to get essential oxygen into the body. Affected dogs can live in discomfort and even be prone to col- lapsing or ‘passing out’.

Dr Dan O’Neill, originally a graduate of UCD Veterinary College, is Senior Lecturer in Companion

Animal Epidemiology at the Royal Veterinary College in London. He Chairs the UK Brachycephalic Working Group and is a founding member of the Dog Breeding Reform Group.

Dr. O’Neill described Brachycephaly as a ‘Wicked’ issue and outlined some of the health problems involved. Obstruction of the airways makes exercise challenging. These dogs are often vulnerable to heart disease and obesity can be a significant concern. Some may not tolerate heat as they have difficulty cooling down. Some have spinal disease due to vertebral malformations. The wrinkled skin which is associated with pugs is not with- out its problems as the moist folds of skin can be very susceptible to infection or ‘fold dermatitis.’

At an ocular level, brachycephalic dogs’ eyes tend to stick out of their skull a little more than others. They can be prone to eye ulcers. Sometimes it is difficult for eyelids to close over their eyes (even while sleeping) and they can be more exposed to accidents or vision issues. They have less space to fit their teeth, which can lead to periodontal disease.

Research also demonstrates that owners are often unaware of the potential suffering these dogs may go through with many owners believing that their pet is in the ‘best possible health’ or ‘much healthier than aver- age’.

Dr Dan O’Neill also presented on Animal Welfare in Dogs and took part in a separate workshop on ‘Conformation In Pet Species.’

A discussion on equine animal welfare was led by Claire Hawkes, who originally graduated from the University of Queensland, worked in Sydney and is now a recognised European Specialist in Equine Surgery based at Sycamore Lodge Equine Hospital.

Fergus Allerton spoke about Management of Immune Mediated Disease took part in practical Endoscopy demonstration sessions on Thursday 7th November along with Emma Tobin, who focused on Abdominal Ultra- sound.

Rory Breathnach who teaches on small animal internal medicine, toxicology and dermatology at the School of Veterinary Medicine, University College Dublin presented on ‘Chronic Gastrointestinal Disease’ and ‘Cutaneous Manifestation of Systemic Diseases.’

International speakers at the equine conference include Dr. Bryan Waldrige from Georgetown, Kentucky with a special interest in internal medicine and clinical pathology; and Dr. Jim Nutt from Rhinebeck Equine LLP in upstate New York who has a strong interest in sports medicine and diagnostic imaging, including nuclear scin- tigraphy and MRI.

The panel of specialists at the equine conference also included Siobhan McAuliffe, Cormac Burns, Lasmai Nich- olson, Ann Violin, James Gibbons, Peter Hannigan and Aine Rowe.

Further details about the conference speakers and schedule are available at:

http://www.eqcaconference.com/

ENDS