Neither Bose nor Bang & Olufsen can compete with the boom of live music, especially when the ivories were being tickled by our own organist extraordinaire, Chris Pearce, at the famous BEVA Dinner Dance. Zoom and Teams have their place; but you cannot beat a BEVA Congress in the flesh. Huw Griffiths, his committee, and the BEVA team welcomed speakers and delegates from around the world to Liverpool for the 60th Congress, with the first full attendance since the Covid pandemic.
Straight from the flag drop I was reminded of the best of BEVA. Extracted from the status quo and without distraction from normal routine, I moseyed into the Wednesday Welcome Drinks; tired, a wee bit wired and cocktail-deficient. Swiftly medicated and in search of a familiar face I was bumped out of my bubble by conversing with likeminded vets from Sweden and Japan. These ‘chance’ encounters led to learning of a lameness locator for iPhone and a discussion about a nutritional basis for developmental orthopaedic disease in Japanese foals. An inspirational Israeli vet described establishing his own practice, and how he'd budgeted to get to BEVA “because it is the best".
With a brisk morning run with other BEVA attendees and an obligatory Strava post made, my body and mind was reset and ready to soak up some science from a diverse programme. Hard skills and soft skills, novel research and historical reflection, contentious debate and current affairs; it had it all in abundance! Here are just a few picks.
Hard skills
Congress proved it can cater to all; recent graduates and mixed practitioners included; with a ‘How to … ‘session from Mike Hewetson on placing a subpalpebral lavage system – something I've never actually done but have always wanted to try. This practical lesson was full of photos and helpful hints, such as waiting five minutes between medications to avoid dilution and washout. An article from Carslake (2019) was referenced as an evidence base to the question of upper or lower eyelid, the conclusion usually being that either is fine; allthough Mike suggested the ventronasal fornix of the lower eyelid, as it is easier and the third eyelid can protect the cornea from a displaced footplate. Great take home advice for a coalface practitioner attempting a technique for the first time - who's going to have to practice plaiting!
Soft skills
Mike's talk was book ended by a double bill of Carolyne Crowe, firstly on supporting a colleague during a client's complaint, and secondly on spotting a colleague struggling with mental health; a great dovetail. Carolyne dissected why mistakes occur, deconstructing the problem down to a fishbone diagram of contributing factors including competence, communication, owner compliance and safety culture; before suggesting not to argue about the past but to argue for the solution. This also allowed her to introduce the Veterinary Defence Society's VetSafe App; a tool for confidentially reporting significant events that cause patient harm, other losses or near misses. This can then be used for quality improvement and risk management. Carolyne's encore graphed pressure against performance, with a green zone demarking when a sustainable amount of pressure can see us achieve our potential. If we are under too much pressure for too long, we enter overwhelm. Once that pressure drops, we don't necessarily go back to being productive, unless we take the required time to recover. Increase pressure again too soon and we'll be straight back to overwhelm.
Research
Highlights from the clinical research stream included ‘Diagnostic accuracy of plain radiography to identify synovial penetration in horses with traumatic limb wounds’, something which Michotte et al (2022) identified as being absent from the current literature. Their findings suggested that caution is required when concluding that synovial structures are not involved based on plain radiographs alone; a low negative predictive value. In contrast, a high specificity and positive predictive value when radiographic findings suggest synovial penetration means this can be a reliable finding.
‘A cohort study of horses diagnosed with pituitary pars intermedia dysfunction (PPID) in the United Kingdom’ was presented by well published authors on the subject, Tatum et al (2022). The objective of describing changes in clinical signs and treatment with chronological progression will allow vets to advise owners on long-term management and prognosis. Of the 72 cases of PPID in the study, pergolide doses following instigation of treatment remained unchanged in 78.2%, increased in 10.9%, decreased in 7.3%, and was discontinued in 3.6%.
History
Celia Marr presented the inaugural Peter Rossdale Memorial Lecture, an educational celebration of the works of the forefather of modern equine perinatology, especially neonatal maladjustment syndrome which is the most common reason for admission to British neonatal intensive care units in the current era. “The duty of clinicians to publish is one which, in many aspects, is as strong as that of the duty of care of the individual patient” (Rossdale, 2000). Celia's commentary noted how the evidence-based medicine movement that came to the fore in the 2000s was heralded as novel by some proponents, but had been practised by Peter for nearly half a century. More than just an engaging explanation of historical development, this lecture served as a relevant memoire of key points for equine practitioners, including a differential diagnosis list for the collapsed neonate: sepsis, neonatal maladjustment syndrome (and synonyms), and haemolytic disease.
Debate
Before Congress the Equine Veterinary Group's online discussion forum had a busy thread on the use of radiography and other ancillary diagnostic aids in the context of a pre-purchase examination (PPE). This topic was tackled head-on by experienced and pragmatic speakers who rose to their task of guiding vets in practice through these often litigious waters; PPE is still number one at the top of the Veterinary Defence Society claims charts. An important point I took from this session was that it is necessary to provide an objective report on radiographic abnormalities detected as part of a PPE, as well as a subsequent opinion on them. Knowing that this could be a daunting prospect for some clinicians, it was good to find that help could be found in the form of VetCT; an imaging company present in the exhibition hall who could provide this service remotely.
Current affairs
Ask what the biggest issue in equine veterinary today is and there will be a few prominent topics; although probably none as far reaching, and potentially enduring as the current difficulties in staff recruitment and retention. The most poignant and significant contribution to this discussion was not to be found in any of the PowerPoints or abstracts; it came from the floor, from a current student who commented that we must seek to positively engage with vet students while they are seeing practice, and not only avoid putting them off but instead highlight the virtues of the profession by ‘Championing the equine vet’.
This stacked scientific agenda was perfectly balanced by a buzzing social scene. They say you can't plan fun, but if you're Nick Bova; you can book exclusive use of Flares and give free passes to all your new friends. BEVA Congress – see you in Birmingham, 2023.