Brachycephalic obstructive airway syndrome (BOAS) presents a substantial anaesthetic and nursing challenge, with patient outcome heavily influenced by how effectively stress, airway patency and oxygen demand are managed throughout admission, anaesthesia and recovery. Careful, calm handling and proactive stress reduction are crucial, as anxiety and panting can increase oxygen requirements and precipitate airway collapse in dogs with BOAS. Thoughtful drug selection and readiness for emergency intubation or tracheostomy will help veterinary nurses respond quickly to sudden decompensation. Close monitoring of ventilation, cardiovascular status and temperature allows early intervention in the case of hypercapnia, vagal episodes or hypothermia, all of which can significantly worsen recovery in BOAS patients. The recovery period is the stage of highest risk, so maintaining the patient in sternal recumbency with the head elevated, delaying extubation until the patient is fully awake and having equipment for re-intubation immediately to hand are pivotal safety measures. Ongoing nursing vigilance for subtle changes in respiratory noise and effort or oxygen saturation allows intervention measures to be implemented early before complete airway obstruction occurs. In the longer term, clear owner education on harness use, weight control, appropriate diet, environmental modification and recognition of deteriorating breathing will support sustained improvement in patient welfare beyond hospital discharge.
Dermatological disease is a common and often chronic presentation in small animal practice, requiring ongoing management and strong client engagement. A single, in-clinic injection of Cytopoint (Zoetis) provides a full month of relief from pruritus associated with allergic and atopic dermatitis in dogs. This article explores how veterinary nurses (VNs) can transform routine Cytopoint rechecks into high-value dermatology consultations. It highlights the importance of VN-led clinics in developing client trust and engagement, providing continuity of care, supporting long-term treatment plans and enhancing patient welfare through regular monitoring. The use of a recheck schedule and structured appointments is discussed in relation to the monthly administration of Cytopoint as part of multimodal dermatology care. Practical guidance is provided on pre-consultation preparation, including reviewing patient history, checking treatment response data, preparing the medication and familiarisation with related protocols. A step-by-step guide to the recheck consultation is also provided. Communication is identified as a key component of successful consultations, with strategies such as using open questioning, explaining and agreeing management plans with clients to align expectations, and providing meaningful recommendations and supporting information to improve client adherence and satisfaction. VN-led dermatology clinics can enhance clinical outcomes, improve efficiency and increase professional fulfilment within practice.
Pericardial effusion and the subsequent development of cardiac tamponade are life-threatening emergencies that require prompt recognition and intervention to prevent cardiovascular collapse and multi-organ dysfunction. This article provides an overview of the pathophysiology, clinical presentation and nursing management of cardiac tamponade in small animal patients, with a particular focus on the role of the veterinary nurse (VN) before, during and after pericardiocentesis. Common clinical signs associated with impaired cardiac filling and reduced cardiac output are discussed, including tachycardia, hypotension, respiratory compromise, muffled heart sounds and signs of poor peripheral perfusion. The importance of rapid assessment and diagnostic imaging in differentiating cardiac tamponade from other emergency presentations is emphasised. The article outlines the VN's responsibilities in preparing for and assisting with pericardiocentesis, including equipment preparation, patient advocacy, analgesia provision, oxygen supplementation and close physiological monitoring. Potential complications such as arrhythmias, haemorrhage and infection are explored, and the need for vigilant monitoring using electrocardiography, blood pressure measurement and pulse oximetry is highlighted. Post-procedural nursing care is examined in detail, with an emphasis on intensive monitoring, oxygen therapy, fluid balance assessment and ongoing pain management. The article concludes by reinforcing the critical contribution of skilled nursing care, effective communication and multidisciplinary teamwork in optimising patient outcomes following pericardial effusion and cardiac tamponade.
A young female rottweiler was diagnosed with a cervical spinal subarachnoid diverticulum and treated surgically with a dorsal laminectomy and durotomy following rapid deterioration to tetraplegia and escalating pain. This nursing care analysis examines the challenges of the patient's postoperative management, emphasising pain evaluation, optimisation of analgesic protocols, and the difficulty of distinguishing genuine pain from anxiety-related behavioural signs. Intensive nursing interventions included a constant-rate infusion of ketamine, administration of methadone guided by pain scores obtained with the Glasgow Composite Pain Scale, regular repositioning, bladder care, and structured physiotherapy to support neurological recovery and prevent secondary complications. However, the patient's increasing recumbency and anticipatory distress when handled made pain scoring difficult and raised concern that anxiety was mimicking or amplifying pain behaviours. The veterinary nursing team gradually incorporated food-based positive reinforcement and environmental modification to reduce the patient's anxiety, rebuild trust and encourage more independent movement. Over a 7-day hospitalisation period, the patient's mobility and confidence improved sufficiently for her to be discharged, although distinguishing the relative contributions of pain versus anxiety to her prolonged recovery remained uncertain. This case highlights the vital role of veterinary nurses in integrating physical, behavioural and psychological assessment after spinal surgery, and emphasises the need for further research to clarify the interaction between anxiety and perceived pain responses in canine patients.
Patients presenting with spinal neurological disease may require emergency intervention and can be a source of considerable concern for both owners and veterinary teams. Neurological dysfunction can range from ataxia and paresis to tetraplegia and loss of deep pain perception. Appropriate and attentive nursing care is fundamental to supporting optimal outcomes for these patients. Common spinal conditions include intervertebral disc herniation, acute non-compressive nucleus pulposus extrusion, and traumatic, vascular and infectious disorders. Each may produce different clinical signs depending on the region of the spinal cord affected. Following neurological examination, imaging and clinical assessment are used to guide treatment, which may be conservative or surgical; the nursing considerations for each are broadly similar. Veterinary nurses play a central role in admission, monitoring, anaesthetic support and day-to-day management, with care focused on pressure relief, cleanliness, nutrition, hydration, mobility support and bladder management. Vigilant observation for deterioration, including changes in respiratory effort, temperature or demeanour, is essential, particularly in patients at risk of myelomalacia. Whether in first opinion or referral practice, spinal patients rely heavily on consistent, knowledgeable nursing support to achieve the best possible outcomes.
Feline dental disease is very common yet frequently overlooked, with a significant proportion of cats developing oral pathology at an early age while showing minimal signs of pain. This article aims to raise awareness of the most common dental diseases affecting cats and to highlight their impact on welfare, quality of life and systemic health. The pathophysiology, clinical presentation and consequences of periodontal disease are explored, alongside discussion of feline odontoclastic resorptive lesions and feline chronic gingivostomatitis, both of which are significant sources of chronic oral pain. The importance of early detection is emphasised, particularly given the insidious progression of these conditions and the limited ability of cats to express discomfort. The article also considers the potential systemic implications of dental disease, including associations with chronic kidney disease. Methods of dental home care are reviewed, including toothbrushing, dental diets, chews and food/water additives, with reference to Veterinary Oral Health Council-approved products and practical considerations affecting owner compliance. Common barriers to preventative dental care are discussed, such as limited owner awareness, concerns regarding anaesthesia and the challenges of implementing oral hygiene measures in cats. The pivotal role of the veterinary nurse (VN) in client education, preventative care and early intervention is highlighted. Through consistent communication, VN-led clinics and tailored advice, VNs are well placed to improve owner engagement and support long-term feline oral health.
Angiostrongylus vasorum is a potentially life-threatening metastrongyloid nematode parasite of dogs that is now widely distributed across the UK. Its ongoing geographical expansion, complex epidemiology and highly variable clinical presentation present significant diagnostic and management challenges for veterinary professionals. This article provides a comprehensive overview of A. vasorum infection, with a focus on disease recognition, diagnostic approaches, treatment strategies and prevention. The parasite's indirect life cycle, involving gastropod intermediate hosts and fox reservoir populations, underpins its sustained spread and establishment within both rural and suburban environments. Clinical signs are diverse and may involve the cardiorespiratory, coagulation and neurological systems, and range from mild or non-specific signs to severe haemorrhage, respiratory compromise and acute collapse. Laboratory abnormalities, imaging findings and the mechanisms underlying A. vasorumassociated coagulopathies are discussed, highlighting the limitations of traditional coagulation tests and the role of advanced diagnostic tests. The article reviews available diagnostic methods, including in-clinic antigen testing, faecal examination and imaging techniques, and considers the implications of undiagnosed infection in perioperative patients. Current treatment options and supportive care measures are outlined. Prevention is emphasised as a critical component of disease control, with discussion of anthelmintic prophylaxis, client education and the challenges of risk prediction in regions where A. vasorum is endemic.
Humans are arguably the greatest threat to planetary health, evidenced by the changing climate and environmental conditions, which are leading to a potential global crisis. The loss of biodiversity, dispute of scientific facts and threats to population development and/or success are just some of the many related challenges. As human, animal and environmental health increasingly intersect, each can have an impact on the others. With this comes the risk of catastrophic events, such as emerging or re-emerging infectious diseases that can cause epidemics or even pandemics. Dealing with potential challenges on this scale requires a truly international approach. One Health, a global initiative, aims to optimise the health of humans, animals and ecosystems by integrating these fields, rather than keeping them separate. The hope is that risks can be mitigated and challenges recognised and addressed more quickly and effectively through collaboration, communication and coordination between the relevant sectors. In this article, the author considers what veterinary nurses can do to help support the planet, as individuals and as part of veterinary teams. Consideration is given to the role veterinary professionals play in the One Health approach. The aim is to provide readers with a better understanding of the factors surrounding One Health and an overview of actions that could be taken to better support the planet we inhabit.
This article discusses a team-based approach to small animal parasite control, addressing the need to balance effective prevention with concerns about parasiticide resistance, adverse reactions and environmental contamination from parasiticide use. The author outlines how veterinary surgeons (VSs), veterinary nurses (VNs), suitably qualified persons (SQPs) and receptionists can collaborate to deliver risk-based parasite control protocols, using lifestyle assessment and owner education to optimise outcomes. The role of the VN is highlighted, including conducting detailed history-taking, performing faecal egg counts and coproantigen ELISA tests, and supporting the VS's prescribing decisions within legal and professional boundaries. VN-led clinics are described as a key setting for explaining parasiticide product choices, demonstrating ectoparasite checks and parasiticide application techniques, discussing zoonotic risks, and tailoring parasite control plans for dogs, cats and rabbits. The article explains how ‘intelligent worming’ approaches using faecal egg counts and coproantigen testing at appropriate intervals can reduce unnecessary treatments while monitoring parasiticide efficacy and mitigating resistance. By adopting a consistent, evidence-based, whole-team approach, practices can enhance owner compliance, improve animal welfare, support public health and maintain strong client–practice relationships, while enabling each team member to work to the top of their scope of practice.
Raw feeding is becoming an increasingly popular dietary choice for dogs; however, raw diets can have several negative health implications. This article aims to explore the negative effects of a raw diet on canine health and considers the role of the veterinary nurse (VN) in minimising these effects. Through a systematic literature review, eight papers relating to the research topic were identified and critiqued by the authors, allowing conclusions to be drawn on the negative effects of a raw diet. Bacterial and parasitic infections and nutritional imbalances were identified as the most common negative effects of a raw diet. The most commonly identified bacteria were Escherichia coli and Salmonella, with Sarcocystis and Toxoplasma gondii presenting as common parasites, as well as the uncommon coccidian parasite Hammondia heydorni. Musculoskeletal issues were identified as consequences of a nutritionally imbalanced raw diet. Inappropriate raw diets clearly have negative effects on canine health; however, there is a need for further research in several areas in order to more completely understand the issues. Through further research, and VNs' contributions to the promotion of healthy raw diets, animal health and welfare can be improved.
Arterial blood pressure monitoring is a key component of safe general anaesthesia, yet it is not always performed as consistently as other physiological measurements. This article reviews the evidence surrounding hypotension in anaesthetised small animal patients, its causes and consequences, and the relative merits of invasive and non-invasive monitoring techniques. Blood pressure is described as the driving force for tissue perfusion, determined by cardiac output and systemic vascular resistance, and mean arterial pressure (MAP) is used as the primary indicator of perfusion adequacy. In cats and dogs, a MAP of at least 60 mmHg is required to maintain perfusion of vital organs, with values below this threshold classified as hypotensive. The review explores factors contributing to hypotension under anaesthesia, including druginduced cardiovascular depression, changes in preload, afterload and myocardial contractility, and patient-related variables such as bodyweight and subclinical dehydration. Studies assessing perioperative hypotension highlight that it is a common occurrence in dogs and cats, and that reduced perfusion may contribute to organ dysfunction, particularly affecting the kidneys. Intravenous fluid therapy is discussed as a recognised intervention to support circulating volume and improve blood pressure, with evidence demonstrating increases in MAP during isoflurane-induced hypotension. Studies comparing methods for monitoring blood pressure have identified invasive blood pressure measurement as the most accurate technique, and it also produces continuous real-time values and waveforms. However, non-invasive methods are valuable where invasive monitoring is not feasible. The article concludes that veterinary nurses should prioritise routine blood pressure monitoring so timely interventions can be used to support normotension and minimise anaesthetic risk.
This article aims to support clinical supervisors working with student veterinary nurses (SVNs) to achieve competency within the Nursing Progress Log, specifically the ‘Review and discuss evidence-based nursing’ skill, which sits within the Communication section for both equine and small animal pathways. Evidence-based veterinary medicine is a core professional value promoted by RCVS Knowledge and underpins informed clinical decision-making, quality improvement and improved patient outcomes. The article outlines what evidence-based veterinary medicine is, why it is relevant to veterinary nursing, and how it can be applied in practice using a structured five-step approach: asking a focused clinical question, acquiring relevant literature, appraising the evidence, applying findings to practice, and assessing the impact. Challenges associated with sourcing and evaluating veterinary literature are discussed, alongside the importance of understanding reliability, validity and levels of evidence. Key resources, including the RCVS Knowledge evidence-based veterinary medicine toolkits, are highlighted. Practical guidance is provided for clinical supervisors on how to support SVNs to evidence this skill within the Nursing Progress Log. A worked example, based on pain management in rabbits, demonstrates how evidence-based nursing can be reviewed, contextualised and disseminated within the practice team. The article emphasises the role of clinical supervisors in building student confidence, encouraging engagement with research and supporting professional development.
This article outlines the essential veterinary procedures and responsibilities involved in providing emergency first aid and care for bats presented at veterinary practices in the UK. It highlights the legal duty of care under the Veterinary Surgeons Act 1966 and the Animal Welfare Act 2006, and emphasises that bats, like all wildlife, are entitled to prompt assessment, pain relief and, when necessary, humane euthanasia. The article explores bat anatomy, handling techniques and personal protective measures to ensure both handler safety and animal welfare. Common clinical presentations are discussed, including wing membrane tears, fractures, dehydration and contamination with substances such as oil or fly paper. Practical first aid recommendations include rehydration, warming and temporary housing protocols, supported by the creation of a dedicated ‘bat first aid kit’ to be kept in the practice. Furthermore, the article highlights the importance of accurate admission records, awareness of zoonotic risks such as European bat lyssaviruses, and collaboration with the Bat Conservation Trust and registered bat carers. The article aims to increase confidence in bat care among veterinary nurses, improve treatment outcomes and promote conservation efforts for the UK's declining yet ecologically important bat populations
Ear cropping is a surgical procedure that alters the natural appearance of a dog's ears. It is considered desirable by some breed organisations, dog breeders and dog owners, who argue that it has husbandry and health benefits. In contrast, many veterinary and animal welfare professionals consider that ear cropping is done solely for cosmetic purposes and that it negatively impacts on the health, welfare and behaviour of dogs. The procedure is illegal under animal welfare legislation in the UK. However, there has been a marked rise in ear-cropped dogs presenting to veterinary practices in the UK within the past 6 years, alongside increased reports to animal welfare charities concerning both the procedure and the dogs affected. This raises the question of what is driving the demand, despite the procedure being illegal in the UK and in several other countries. This article describes what ear cropping entails and what influences owners or breeders to request that their dog undergo this as a cosmetic procedure. It also highlights the welfare implications of ear cropping and how it can potentially affect dogs throughout their lives. Furthermore, the global challenge of achieving consistency and cohesiveness in legislation and veterinary standpoints, and the progress made in this regard, is discussed.
Fluid therapy plays a vital role in supporting dogs and cats during surgical procedures, medical treatment and emergency care. An understanding of fluid physiology helps veterinary professionals select the most appropriate type of fluid for each patient. Water makes up a significant proportion of bodyweight and is constantly moving between intracellular and extracellular spaces. Illness, injury and fluid loss can disrupt this balance, leading to dehydration, electrolyte changes and reduced circulating volume. This article explores some of the commonly used fluid therapy options, including isotonic, hypotonic and hypertonic crystalloid solutions, as well as synthetic and natural colloids for cases requiring rapid intravascular volume support. Accurate calculation of maintenance requirements, fluid deficits and shock rates is essential to ensure safe and effective therapy, which is also considered in this article, along with methods of administration. Fluids may be administered intravenously, subcutaneously or intraosseously, depending on the patient's condition and how quickly support is needed. Regular assessment of hydration status using physical examination and diagnostic tests guides adjustment of treatment plans. Effective fluid therapy relies on close collaboration between veterinary nurses and veterinary surgeons to provide tailored, responsive care for every patient.
Kinkajous are arboreal mammals native to Central and South America.Their unique behavioural and anatomical characteristics present distinct challenges in a clinical setting. This case study describes the assessment, anaesthesia and diagnostic investigation of a 7-year-old captive, entire female kinkajou (Potus flavus) that presented with a 2-day history of vomiting and inappetence. Safe handling of the patient was a priority due to the defensive behaviours of kinkajous. Anaesthesia was induced using sevoflurane in a modified secure chamber to minimise stress and the risk of injury. Once anaesthetised, the patient was intubated and monitored using multiparameter monitoring equipment. Particular attention was paid to maintaining the patient's body temperature, monitoring salivation and protecting the eyes. The findings of diagnostic imaging and ultrasonography were unremarkable, but blood analysis revealed a markedly elevated amylase level compared with previous baseline results, raising suspicion of pancreatitis. Supportive nursing care included fluid therapy and antiemetic medication, alongside careful monitoring during recovery to reduce stress and ensure safe extubation. The patient recovered smoothly and was discharged with oral medication and assisted-feeding support. This case highlights important considerations when working with exotic species, including safe restraint methods, species-specific anaesthetic risks and the value of individual baseline laboratory data. It also reinforces the key role of the veterinary nurse in maintaining patient welfare before, during and after anaesthesia.
Gastric dilatation and volvulus (GDV) is a surgical emergency that is commonly seen in larger-breed dogs. In GDV, the stomach twists and swells to a significant degree, causing compression of the caudal vena cava, which can very quickly lead to hypovolaemic shock and death if left untreated. Veterinary nurses play a central role in the rapid assessment, stabilisation and ongoing care of patients with GDV. Affected dogs commonly present with retching, hypersalivation, restlessness and marked abdominal distension, but they may also exhibit complex haemodynamic and metabolic disturbances requiring immediate intervention. This article reviews the physiological responses to fluid loss, highlighting how compensatory mechanisms can initially mask hypotension and delay recognition of hypovolaemic shock. It explains the progression from acute neural responses to hormonal mechanisms and the consequences of inadequate perfusion, including the development of metabolic acidosis and rising blood serum lactate. The article outlines the clinical relevance of lactate measurement in assessing perfusion status and monitoring the response to fluid therapy. Intravenous fluid therapy is discussed in detail, including the rationale for using hypertonic saline for rapid intravascular volume expansion, followed by isotonic crystalloids to restore interstitial and intracellular hydration. Guidance is provided on appropriate catheter placement in dogs with GDV, with emphasis on avoiding hindlimb veins due to impaired venous return. The article also summarises key signs of fluid overload to support safe and effective nursing care. Overall, the aim is to equip veterinary nurses with the knowledge and confidence to manage these critically ill patients.
The use of negative-pressure wound therapy (NPWT) is well established and supported within human medicine as an adjunctive treatment in the management of wounds. It is believed to improve wound healing speed, and some early literature suggests an antimicrobial benefit in wounds treated with NPWT. Despite early research having been undertaken in animal models, its use within veterinary medicine is less frequent. The objective of this article is to critically evaluate the available veterinary research on NPWT, to ascertain its efficacy in canine wound management. Literature on NPWT use in the veterinary field has been compiled and reviewed, including discussion of the earliest research in the field and an evaluation of how the research has developed over the past 10–15 years. The author concludes that NPWT appears to be a safe and effective adjunctive treatment in the management of canine wounds, with available literature suggesting that it improves wound healing speed. However, the author adds that larger-scale research is required to conclusively support the use of NPWT in canine patients. High-recruitment, well-controlled studies should be undertaken, as there is a paucity of research on this scale. There is limited evidence to support claims that NPWT has a significant effect on wound bacterial bioburden. NPWT should be used on a case-by-case basis until its efficacy can be conclusively supported. The author recommends that care should be taken to monitor the patient for pain during treatment, due to reported associated discomfort, and staff should be appropriately trained in the application and management of NPWT systems.
Brachycephalic dogs face elevated anaesthetic risks, requiring tailored protocols. However, limited research exists on veterinary nurses’ (VNs’) confidence in monitoring these breeds. This study surveyed VNs in the UK who regularly monitor these dogs under general anaesthesia; 359 valid responses were statistically analysed. Significant differences in confidence were detected between VNs with different qualification routes (p = 0.011), practice settings (p = 0.001) and lengths of time qualified (p < 0.001). Significant correlations were identified between the frequency of monitoring brachycephalic breeds and VNs' confidence. A significant difference in confidence when monitoring brachycephalic breeds compared with non-brachycephalic breeds was evident (p < 0.001), suggesting that breed has an influence on VNs' confidence. Thematic analysis highlighted that financial constraints and staff shortages hinder protocol development. Most respondents expressed satisfaction with existing protocols, though these are typically adapted for brachycephalics, not purpose-built. Further research is warranted to refine anaesthetic care for these patients.
This is the last in a series of three articles that review the assessment and management of pain in ferrets, with examples of chronic pain conditions that affect the species. The article describes some of the non-pharmaceutical techniques used to manage and treat chronic pain in ferrets, including rehabilitation, environmental modification, supplementation and convalescent diets, physiotherapy, acupuncture, photobiomodulation, laser acupuncture and hydrotherapy. A multimodal approachusing both pharmaceutical and non-pharmaceutical interventions is advisable. The article includes a case study of a multimodal approach to the management of pain in a 6-month-old male ferret. The ferret was diagnosed with capital physeal dysplasia (dysplasia of the proximal growth plate of the femur) and underwent a bilateral femoral head and neck excision. He required pain management and rehabilitation over several months. The case study highlights the difficulties in assessing pain in ferrets. It also shows that rehabilitation is an essential part of post-surgery pain management and wellbeing. The article also briefly focuses on the importance of regular veterinary health checks, discusses pain management in relation to end-of-life care and considers the specialist pain management requirements of amputation patients.
