Episode 19 - Two Week Takedown. Travelling pets, scary bradycardias, career-changing complaints, and a new wormer from KRKA!

1.The GP hook

A brisk GP vet roundup: AHCs and current EU rules, bradycardias you can spot in seconds, complaint handling that protects teams, where BSAVA PetSavers fits if you fancy research – and KRKA’s new spot-on wormer for cats.

A brisk GP vet roundup: AHCs and current travel rules, bradycardias you can spot in seconds, complaint handling that protects teams, where BSAVA PetSavers fits if you fancy research — and a new spot‑on wormer for cats.

The week you’ve had three “my bill is too high” emails, a blue dog at 2am with a heart rate in the 30s, and a client planning to “just get a passport in France.” Grab a brew. Practical updates, short and useful for UK GP teams.

2.Handling complaints without breaking your heart (or your team)

Complaints are horrible but inevitable. How your practice responds is the difference between burnout and learning.

Practice move: convert every medication error into a system improvement (clearer labelling, separate storage for look‑alike vials, distinct sections for cat vs dog formulations).

• Expect them. Nobody is perfect 100% of the time. A no‑blame, improvement‑focused culture changes how a complaint lands and what you do next.
• Separate clinical reflection from self‑worth. Work through records, timelines and communications. Decide what you’ll change — then move on.
• Own honest errors quickly. Medication mix‑ups and dose slips happen under pressure. Escalate early, be open with clients, and focus on system fixes so it’s harder to repeat.
• Back reception and nursing staff. Aggression aimed at non‑clinical team members is unacceptable. Set clear boundaries and support staff in the moment.

3.Travelling pets in 2024: AHCs made simple, and what to tell clients now

Quick facts your reception and nursing teams can use:

What an AHC is

What clients need in practice

Practical tips to make AHCs bearable

Border context

Practice move: put a sign in the vaccine fridge: “Scan microchip and record number. Do not give rabies with other non‑licensed vaccines on the same day.”

Useful official guidance: check the UK government pet travel page for the latest rules and timing.

• A single‑use document confirming animal identity (microchip) and a valid rabies vaccination for travel from GB to the EU (and back).
• A microchip and a valid rabies vaccination.
• Primary rabies vaccination: there’s a wait before the vaccine becomes valid for travel (commonly 21 days for many brands; some brands have a longer wait — check the product datasheet).
• If rabies boosters have been kept continuous, validity runs from the date of administration (no primary‑vaccine waiting period).
• Do not administer rabies on the same day as vaccines that are not licensed to be given together.
• An Official Veterinarian (OV) must issue an AHC within 10 days before travel.
• Tapeworm treatments: required before travel to certain tapeworm‑free destinations (eg, Ireland, Malta, Finland, Norway); returning to the UK from most EU destinations also requires treatment — many owners forget this.
• Delegate the admin: owners can pre‑complete details so the OV time is spent checking and signing.
• Build a checklist and SOP so reception/nursing staff chase details early and avoid same‑day scrambles.
• Use tools that pre‑check dates and common errors — they save huge amounts of time in a busy summer. OV‑Forms is one such web tool that generates completed AHCs and reduces errors; try trial AHCs to see if it fits your workflow.
• Some travellers still use EU pet passports obtained abroad, but that route is unreliable and risky. As vets, avoid advising clients to rely on those workarounds.
• UK pet passports are expected to return as part of wider border alignment discussions; public timelines have been suggested in the coming years. Always check current government guidance before advising clients.

4.Partner note — a new spot‑on wormer option for cats

Sponsored content: KRKA (sponsorship acknowledged). Prescribing decisions remain the responsibility of the prescribing veterinary professional based on the individual patient and current guidance.

Prazemo is a new spot‑on for cats combining emodepside and praziquantel. The formulation targets roundworms, hookworms, lungworms and tapeworms. Why this matters in practice:

As always, choose parasite control on a case‑by‑case basis.

• Spot‑ons are often easier for owners to administer than tablets, improving the chance a treatment is actually given.
• Simple pipette design and quick application reduce stress for reluctant cats.
• Available in multiple pack sizes and indicated for use in a range of situations, including some younger animals and during pregnancy/lactation (check product literature and SPC for full details).

5.Bradycardias and AV blocks you can recognise at the bench

Two recent cases to remind us how fast pattern recognition helps.

Mini‑case — the painful poodle

Mini‑case — the cyanotic Yorkie at midnight

A very short refresher on AV blocks

Quick check — complete AV block on ECG

Clinical pearl

Emergency admission prompt for a bradycardic, dyspnoeic patient

Context matters: incidental low‑grade blocks can be benign (drug‑related or vagally mediated). Focus urgency on clinical signs: syncope, exercise intolerance, hypotension and CHF findings.

• Young poodle with intermittent vocalisation (suggestive of neck pain) and marked tachycardia on exam.
• ECG showed AV conduction disturbance with intermittent runs of tachycardia. Inflammatory markers (eg, CRP) were very high.
• The dog improved with prompt treatment and the arrhythmia settled over several days. Inflammatory disease (for example, steroid‑responsive meningitis–arteritis) can be associated with transient arrhythmias — clinical impression plus response were the working approach.
• Acute dyspnoea, crackles on auscultation and POCUS consistent with congestive heart failure (large left atrium, B‑lines).
• Heart rate was very low and consistent; ECG showed complete (third‑degree) AV block — atrial P waves marching independently of wide, bizarre QRS complexes from a ventricular escape rhythm.
• An atropine response test was tried to check for vagal mediation; most complete blocks are not vagally mediated and the realistic solution when owners elect is permanent pacing. Owner declined pacing.
• First‑degree: PR prolongation; often asymptomatic. Can be vagally mediated or degenerative; usually monitored.
• Second‑degree: some P waves are not followed by QRS complexes. Low‑grade versus high‑grade matters. If symptomatic or bradycardic, an atropine response test can help determine vagal contribution. Medical options sometimes used if atropine‑responsive include propantheline, theophylline or terbutaline. Non‑responders often need pacing.
• Third‑degree (complete): no relationship between P waves and QRS. A ventricular escape rhythm produces wide/bizarre QRS and a slow regular rate. Permanent pacing is the definitive option when owners wish to pursue it.
• P waves at their own (usually faster) atrial rate; QRS complexes at a slower, regular, unrelated ventricular rate.
• QRS complexes are wide/bizarre (ventricular origin).
• Clinically: slow steady rhythm, poor cardiac output, collapse risk.
• A ventricular escape rhythm in dogs commonly sits in the low‑40s bpm range; in cats the escape rhythm tends to be higher. These patterns can be a rapid bedside clue.
• Oxygen and relieve distress (sedation if indicated).
• Furosemide if CHF is suspected; arrange ECG immediately and measure blood pressure.
• Consider an atropine response test to assess vagal contribution (check current dosing guidance before use).
• Rapid cardiology input if pacing may be required.

6.Fancy doing research? Where BSAVA PetSavers fits

BSAVA PetSavers funds clinical research into companion animal health and is open to vets, RVNs and students — not just academics.

What’s available

How to start

Practice move: mention PetSavers at your next team meeting and invite small clinic‑based ideas — lots of useful projects start from a recurring consult question.

• Student Research Projects: short (several weeks) projects with a stipend, supervised by university staff.
• Clinical Research Projects: larger projects up to a couple of years with grant support; practice teams can apply.
• Structured routes: support for Master’s by Research, PhDs and fellowships.
• Joint calls with affiliate groups (eg, cardiovascular or internal medicine societies) for specialised topics.
• Visit the BSAVA site and search for PetSavers to see grant timelines, criteria and case studies. Contact PetSavers to discuss ideas and what a budget can include — they can advise whether time, consumables or both can be covered.

7.Joint supplements: what we actually say in consults

Most owners want to “do something” for a stiff older pet. Keep the message practical.

Owner conversation

• Evidence is mixed. Omega‑3s get a lot of focus now; green‑lipped mussel, glucosamine and chondroitin are still commonly used.
• Curcumin/turmeric is often discussed but has issues with bioavailability and uncertain clinical impact unless formulations and doses are appropriate.
• Boswellia has plausible pharmacological actions but robust clinical evidence in companion animals is limited.
• Safety first: beware owners giving large amounts of oils (pancreatitis risk). Discourage DIY high‑fat dosing.
• “Supplements can help some pets, but results vary. If we try one we’ll also keep doing the basics — weight management, activity adjustments and pain control — and we’ll stop anything that doesn’t clearly help.”

8.Take‑home points

Final word

When the week throws complaints, cyanosis and customs forms at you, fall back on clear systems, simple ECG pattern‑spotting and kind boundaries. The clever bit is making the right thing easy to do on a busy Tuesday.

Useful links

If you’re using an unfamiliar product or performing an atropine response test, always confirm current dosing, route and contraindications from standard references or the SPC before treating.

• AHCs: lead with microchip + valid rabies; allow the vaccine validity period before issuing an AHC; issue within the 10‑day window before travel; remember tapeworm rules in/out for specific countries.
• Plan for increased AHC demand in summer; use checklists, SOPs and tools that reduce OV time and errors.
• Complaints are survivable when handled with honesty, team support and system fixes rather than blame.
• AV blocks: recognise the ECG patterns that matter. An atropine response test can guide whether medical management is feasible; complete blocks commonly need pacing if owners choose intervention.
• BSAVA PetSavers funds practice‑based research at multiple career stages — mention it to curious colleagues.
• Supplements: set realistic expectations, prioritise weight and pain control, and avoid recommending high‑fat DIY oil dosing.
• OV‑Forms: https://ovform.com (practice AHC tool and resources)
• BSAVA (search “PetSavers” on the BSAVA site): https://www.bsava.com
• KRKA (manufacturer): https://www.krka.co.uk
• Official UK pet travel guidance: https://www.gov.uk/bring-pet-to-the-uk