VN April 2024

VET April 2024 The Monthly Magazine of the SOUTH AFRICAN VETERINARY ASSOCIATION Die Maandblad van die SUID-AFRIKAANSE VETERINÊRE VERENIGING Cholecalciferol toxicosis in dogs CPD THEME Pets www.wvac2024.com nuus•news

Dagboek • Diary www.wvac2024.com Ongoing / Online 2023 April 2024 May 2024 August 2024 SAVETCON: Webinars Info: Corné Engelbrecht, SAVETCON, 071 587 2950, corne@savetcon.co.za / https://app.livestorm.co/svtsos Acupuncture – Certified Mixed Species Course Info: Chi University: https://chiu.edu/courses/cva#aboutsouthafrica@tcvm.com SAVA Johannesburg Branch CPD Events Monthly - please visit the website for more info. Venue: Johannesburg Country Club Info: Vetlink - https://savaevents.co.za/ OP Village Centenary Festival 05-06 April 2024 Venue: OP Village Residence, Onderstepoort, Old Southpan Road, Pretoria Info: Marnus Zaaiman (082 779 8435) / OPVillage.Chairperson@tuks.co.za Online CPD Course: Animal doctor’s guide to managing humans! 05-25 May Venue: ONLINE Info: www.vetskillsts.co.za Western Cape Branch Congress 02-03 August Venue: Protea Hotel, Technopark, Stellenbosch Info: www.vetlink.co.za SAVA Oranje Vaal Branch Mini Congress 09-11 August Venue: Parys – venue to be confirmed. Info: conference@savetcon.co.za NVCG Bush Break 12-13 August Venue: Skukuza, Kruger National Park Info: https://vetlink.co.za/nvcg-2024/

Vetnuus | April 2024 1 Contents I Inhoud President: Dr Paul van der Merwe president@sava.co.za Managing Director: Mr Gert Steyn md@sava.co.za/ +27 (0)12 346 1150 Editor VetNews: Ms Andriette van der Merwe vetnews@sava.co.za Bookkeeper: Ms Susan Heine accounts@sava.co.za/+27 (0)12 346 1150 Bookkeeper's Assistant: Ms Sonja Ludik bookkeeper@sava.co.za/+27 (0)12 346 1150 Secretary: Ms Elize Nicholas elize@sava.co.za/ +27 (0)12 346 1150 Reception: Ms Hanlie Swart reception@sava.co.za/ +27 (0)12 346 1150 Marketing & Communications: Ms Sonja van Rooyen marketing@sava.co.za/ +27 (0)12 346 1150 Membership Enquiries: Ms Debbie Breeze debbie@sava.co.za/ +27 (0)12 346 1150 Vaccination booklets: Ms Debbie Breeze debbie@sava.co.za/ +27 (0)12 346 1150 South African Veterinary Foundation: Ms Debbie Breeze savf@sava.co.za/ +27 (0)12 346 1150 Community Veterinary Clinics: Ms Claudia Cloete cvcmanager@sava.co.za/ +27 (0)63 110 7559 SAVETCON: Ms Corné Engelbrecht corne@savetcon.co.za/ +27 (0)71 587 2950 VetNuus is ‘n vertroulike publikasie van die SAVV en mag nie sonder spesifieke geskrewe toestemming vooraf in die openbaar aangehaal word nie. Die tydskrif word aan lede verskaf met die verstandhouding dat nóg die redaksie, nóg die SAVV of sy ampsdraers enige regsaanspreeklikheid aanvaar ten opsigte van enige stelling, feit, advertensie of aanbeveling in hierdie tydskrif vervat. VetNews is a confidential publication for the members of the SAVA and may not be quoted in public or otherwise without prior specific written permission to do so. This magazine is sent to members with the understanding that neither the editorial board nor the SAVA or its office bearers accept any liability whatsoever with regard to any statement, fact, advertisement or recommendation made in this magazine. VetNews is published by the South African Veterinary Association STREET ADDRESS 47 Gemsbok Avenue, Monument Park, Pretoria, 0181, South Africa POSTAL ADDRESS P O Box 25033, Monument Park Pretoria, 0105, South Africa TELEPHONE +27 (0)12 346-1150 FAX General: +27 (0) 86 683 1839 Accounts: +27 (0) 86 509 2015 WEB www.sava.co.za CHANGE OF ADDRESS Please notify the SAVA by email: debbie@sava.co.za or letter: SAVA, P O Box 25033, Monument Park, Pretoria, 0105, South Africa CLASSIFIED ADVERTISEMENTS (Text to a maximum of 80 words) Sonja van Rooyen assistant@sava.co.za +27 (0)12 346 1150 DISPLAY ADVERTISEMENTS Sonja van Rooyen assistant@sava.co.za +27 (0)12 346 1150 DESIGN AND LAYOUT Sonja van Rooyen PRINTED BY Business Print: +27 (0)12 843 7638 VET nuus•news Diary / Dagboek II Dagboek • Diary Regulars / Gereeld 2 From the President 4 Editor’s notes / Redakteurs notas Articles / Artikels 8 The Rat Thoracic Ultrasound protocol: scanning technique and normal findings 14 Evidence-Based Human Homeopathy and Veterinary Homeopathy 28 Cat Friendly Awards: Midlands Veterinary Hospital First for South Africa Association / Vereniging 16 CVC News 18 SAVA News 20 In Memoriam 36 Legal Mews Events / Gebeure 6 World Veterinary Association Congress 2024 24 OP Students Awards Ceremony 2024 30 Houseparents of Onderstepoort residence: 1985 to 2024 Vet's Health / Gesondheid 39 Life Coaching Technical / Tegnies 34 Royal Canin Column 40 Dental Column Relax / Ontspan 48 Life Plus 25 Marketplace / Markplein 42 Marketplace Jobs / Poste 44 Marketplace/Jobs / Poste 46 Classifieds / Snuffeladvertensies 16 36 20 www.wvac2024.com

Vetnews | April 2024 2 « BACK TO CONTENTS IT IS TIME! In less than two weeks SAVA is hosting the largest Veterinary and Para-Veterinary Congress, the World Veterinary Association Congress, in Cape Town. For more information please visit our website https://wvac2024.com/. Have you registered yet? Now consider a group of baboons. Baboons are the loudest, most dangerous, most obnoxious, most viciously aggressive, and least intelligent of all primates. And what is the proper collective noun for a group of baboons? Believe it or not, a CONGRESS! A congress, however, is a large formal meeting where people come together to discuss issues or questions. It is an opportunity to be educated, or in our case, continuous professional development, to associate with colleagues with similar interests, and to build a network and fellowship. With the wide array of presentations and posters, each and every attendee will have the opportunity to learn something new. You will not only receive CPD points but will leave the congress a more knowledgeable and developed person who can contribute within your sphere of influence, advancing veterinary services. The congress is an opportunity to associate with like-minded, or often, people with different ideas contributing to your education and understanding. Always keep good company. Never waste an hour with anyone who doesn’t uplift and encourage you. You need to associate with people who inspire you, people who challenge you to rise higher, and people who make you a better you. Don’t waste your valuable time with people that are not adding to your growth. The congress will be the ideal opportunity to build not only a national, but international network with specialists and experts in various fields. It will create opportunities for you to meet and discuss issues and concerns in your field of expertise and to obtain contact details of those that can be of value in your sphere of interest. Networking is not about just connecting people. It’s about connecting people with people, people with ideas, and people with opportunities.” - Michele Jennae But most importantly, in this day and age with veterinary professionals experiencing various adversities, fellowship is of utmost importance. Just to meet up with old classmates, and colleagues, to talk over a drink, listen to each other, and let each other know that we are there for them if needed is of extreme importance and undervalued. We can’t afford another colleague to break down or even commit suicide. I trust to meet all of you at the congress for robust discussions to enhance the health and welfare of animals, humans and the environment to make the world a better world in which humanity can flourish. See you there! v Kind regards, Paul van der Merwe From the President Dear members, “Education is for improving the lives of others and for leaving your community and world better than you found it.” - Marian Wright Edelman “A man only learns in two ways, one by reading, and the other by association with smarter people.” – Will Rogers. “Fellowship isn’t just what we do for each other. Fellowship is what we do together for the world” – Eric Bryant

Vetnuus | April 2024 3 “The South African Veterinary Association aims to serve its members and to further the status and image of the veterinarian. We are committed to upholding the highest professional and scientific standards by utilising the professional knowledge, skill and resources of our members, to foster close ties with the community and thus promote the health and welfare of animals and mankind”. MISSION STATEMENT Servicing and enhancing the veterinary community since 1920! Tel: 012 346 1150 E-mail: vethouse@sava.co.za www.sava.co.za EARLY EXPOSURE TO ANIMAL CARE DURING YEAR 1 TRAINING AT ANTIBIOTIC-FREE FARMS AND QUANTITATIVE GENETICS TRAINING (FARM ANIMALS) EU ACCREDITED VETERINARY DEGREE ALLOWING PRACTICE WORLDWIDE FINANCIAL AID SCHOLARSHIPS AVAILABLE GLOBAL FACULTY EXPERTISE IN SMALL AND LARGE ANIMAL MEDICINE ADVANCED FACILITIES INCLUDING ANATOMY AND CLINICAL SKILLS LABORATORIES CURRICULUM ALIGNED AS REQUIRED BY RCVS AVMA, EAEVE, AND WORLD ORGANIZATION FOR ANIMAL HEALTH. unic.ac.cy/vet STUDY VETERINARY MEDICINE IN CYPRUS DOCTOR OF VETERINARY MEDICINE (DVM) 5-Year Undergraduate Degree Programme Targeted for High School Leavers

Vetnews | April 2024 4 « BACK TO CONTENTS The big month has finally arrived. Months and months of planning, networking, decisions and a couple of tears brought forward likely the biggest Veterinary Congress ever, and it is happening right in our backyard. I hope that everyone reading and who is able has already registered. It will be great to meet the faces behind the non-visual communication. The great golfer Gary Player once said: “The more I practice the luckier I get”. I often look at people and say they must have all the luck in the world. Everything just seems to fall into place for them. Always right time, right place. Success gives the impression of being so easy. My own success is always a struggle, it may feel like one mountain after the next. But then I come across this quote. Preparation is never done in the open. Preparation is something done behind closed doors; because preparation comes with failures. With the hype after the success of Dricus Stillnox du Plessis, it is worthwhile to dig up those old Rocky movies. Hard training, long training hours, and unforgiving sparring partners, that all lead up to being ready to face the opportunity. He will tell you of many many fights that he lost. Opportunities that he dreamed of that never happened. But that did not deter him from continuous preparation. Preparation has to be done before the opportunity presents itself. The worst letdown is to be presented with an opportunity and you are not prepared. If I cook or sew something I know that the specific materials or skills are something that I will need to plan. By doing CPD events and even the little one-pointers in Vetnews may be a requirement from the Veterinary Council but it is much more important than that. CPDs are written by people who may have a special interest in a field or who have done some research but sometimes it is just somebody who came across a solution to a problem or challenge you may have. The upcoming Congress is a great way to experience a myriad of different topics all under one roof. Do not let this opportunity slip by missing the preparation. This month we say goodbye to several people. All different circumstances but all will leave a great gap in many many lives as well as the profession. There is a piece on the achievements of top Veterinary and Veterinary Nurse students for 2023. Get to know these faces. They are going places and soon becoming your colleagues. I hope that some will find the Rat Ultrasound protocol helpful, it is a little different. There is a little piece on Homeopathy for those who like to use some alternative medicine. May April be your best month of the year. May it rain in your pastures (just make sure you are prepared to make the best of it). Andriette v From the Editor Editor’s notes / Redakteurs notas

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Vetnews | April 2024 8 « BACK TO CONTENTS The Rat Thoracic Ultrasound protocol: scanning technique and normal findings Respiratory diseases (especially pneumonia) are very common disorders in pet rats. The suspected diagnosis is mostly based on the clinical signs, thoracic auscultation, and thoracic radiography. However, auscultation is insensitive in determining the severity of the disease, and radiographs are often unremarkable. Noncardiac thoracic ultrasonography is increasingly used in veterinary medicine; however, it has not been described in detail in rats. Thoracic ultrasonic examination was conducted on 400 clientowned conscious pet rats. The rats were examined in the period from June 2023 to August 2023 in two veterinary clinics. Due to the small size of the animal, different anatomical considerations, and different evaluation protocols, as well as to meet the optimal outcome of detailed thoracic ultrasound, a standard methodological protocol was developed, and the name RATTUS (Rat Thoracic Ultrasound) was proposed. Typical signs of normal RATTUS were described (bat sign, lung sliding, A-lines, abdominal curtain sign, ski jump sign, lung pulse, seashore sign in M-mode, and bamboo sign). The new evaluation of lung inflation symmetry by substernal access was also described. The methodical approach presented and the normal findings description are proposed to be used for a standard/routine thoracic ultrasound examination in pet rats. Introduction Non-cardiac thoracic ultrasonography is one of the increasingly used imaging methods in veterinary medicine. It complements radiography in the examination of patients with diseases of the chest wall, pleural space, mediastinum, and lung. Ultrasound wave penetration is hampered by gas, such as is found in the aerated lung. Therefore, pleural and lung ultrasound is about evaluating the absence or presence of gas by specific artefacts (1. Different aerations of damaged lungs generate various artefacts that can be used for diagnostic evaluation. Thoracic ultrasound can be a useful diagnostic step in cases where there is fluid in the thoracic cavity, creating soft tissue opacities on the lung radiograph indistinguishable from other conditions (e.g., a thoracic mass). Pleural pathological conditions (pleural effusion and pleural thickening), lung consolidations, and artefact detection can be easily visualised by an ultrasonographic examination for the diagnosis of various thoracic diseases (2, 3). Thoracic ultrasound is preferably performed on conscious animals as anaesthesia may cause artefacts that could be misinterpreted as pathological findings (e.g., gravitational atelectasis) (3–5). An ‘evaluation key’ standardly used in the thoracic ultrasound of dogs and cats includes: bat sign, A-lines, lung sliding, curtain sign, lung pulse, ski jump sign, and B-lines. More information is given in Supplementary material (3–19). Ma et al. (20) described lung ultrasonography in an experimental rat model. However, the animals were examined under pentobarbital sodium anaesthesia in a supine position, and only limited ultrasonographic findings were reported. The aim of the present study is to describe the methodical approach and normal findings of thoracic ultrasound in healthy pet rats. Materials and methods Animals In total, 400 client-owned pet rats were examined in the period from June 2022 to August 2023. The body weight ranged from 260 g to 885 g (mean ± SD 467.1 ± 119.8 g), and the age ranged from 3 months to 30 months (20 ± 4.6 months). Equipment A multifrequency linear probe (8–14 MHz, SonoScape, S22, China, with MI 0.5–0.7, TIS 0.1) was used for the thoracic cavity evaluation. Due to the size of the rats, a micro-convex probe 1 Jekl and Hauptman Veterinary Clinic, Brno, Czechia, 2 Department of Pharmacology and Pharmacy, Faculty of Veterinary Medicine, VETUNI, Brno, Czechia, 3 Vetcardia Veterinary Clinic, Warsaw, Poland Anna Piskovská 1,2*, Katarzyna Kraszewska 3, Karel Hauptman 1 and Vladimír Jekl 1,2 Figure 1 RATTUS performance. The rat was placed on a towel with careful restraint, and the fur was not shaved. We used a lot of gel to obtain ideal contact. The examination commenced with the probe being placed perpendicular to the ribs and the marker pointing cranially (A—examination of the axillary line, first zone, B—examination of the scapular line, second zone—as is visible in the picture, both zones were examined without changing the placement of the probe). Then, the probe was turned 90° with the marker pointing towards the sternum (C). The whole thorax was clearly scanned. For a better demonstration, a Dumbo fuzz (hairless) rat was used. Full article and references: https://www.researchgate.net/publication/378659688_ The_Rat_Thoracic_Ultrasound_protocol_scanning_ technique_and_normal_findings

Vetnuus | April 2024 9 (9–14 MHz, SonoScape, S22, China, with MI 0.7, TIS 0.2) was used only to evaluate the presence of B-lines. For the identification of lung surface artefacts, pleural line, and lung sliding, a special ‘lung preset’ was utilised. This preset had harmonics turned off, used the lowest frequency of the probe (8 MHz) with persistence turned to zero, a focal position set at the level of the pleural line, and used an increased time gain compensation (TGC) at the distal (far) field of the screen. Such settings create a ‘coarser’ picture. The examination was conducted in two-dimensional (2D) mode and in M-mode. In all animals, video loops and images were saved routinely for possible further evaluation. Animal preparation The examination was conducted on conscious (non-sedated) clientowned pet rats. In most animals, it was not necessary to shave the hair if a generous amount of ultrasound gel was used. The examiner carefully restrained the animal with one hand whilst the other hand held the probe. Rat Thoracic Ultrasound methodology Thoracic cavity evaluation was conducted by two operators (KK—an experienced clinician, with over 10 years of experience in performing echocardiographic examinations and 5 years of experience in lung ultrasound with advanced training from human lung ultrasound experts, and AP, with over 1 year of lung ultrasound examination training by KK and human lung ultrasound experts). The examination protocol followed thoracic ultrasound, as described in dogs and cats (3). For better understanding, a detailed description of ultrasonographic findings (‘evaluation key’) is presented in Supplementary material. Due to the small size of the animals, different anatomical considerations, and different evaluation protocols, as well as to meet the optimal outcome of detailed thoracic ultrasound, a standard methodological protocol was developed, and the methodology name RATTUS (Rat Thoracic Ultrasound) was proposed. The RATTUS evaluation commenced with the ultrasonic probe being placed perpendicular to the ribs, with the marker pointing to the head. The probe was then rotated 90° with the marker pointing to the sternum (Figure 1). The last access involved placing the probe substernally to evaluate the lung inflation symmetry (Figure 2). To avoid missing a thoracic pathology, it was essential to examine the entire thoracic cavity. To be sure that the whole thoracic cavity was precisely examined, scanning must be performed bordered by exact anatomical structures. The cranial border of the thoracic cavity was formed by the brachial muscles, and the caudal border was created by visualising the abdominal curtain sign. The curtain sign is created when the lung is filled with air and it expands and retracts over abdominal organs, obscuring the sonographic view into them. When the probe is moved from the dorsal border to the ventral border, the curtain sign needs to be precisely assessed to evaluate the abnormalities. Then, the pericardio-diaphragmatic region was visualised, and sternal and pectoral muscles were evaluated. At the ventral border of the thoracic cavity, a precise examination of the cranial mediastinum was required. The mediastinum was examined to rule out the presence of a neoplastic mass (e.g., lymphoma) (21), and then the subjective assessment of the heart anatomy and function was performed. The dorsal border of the thoracic cavity delineates the hypaxial musculature. The same scheme was used for both sides of the thoracic cavity. To perform a repeatable examination, each hemithorax was divided into two zones: the first extended from the axillary line to the scapular line, and the second from the scapular line to the paravertebral line (Figure 1). Typically, those two zones could be examined from one body–probe contact place due to the adequate subcutis space, which enabled easy movement of the probe from the cranial border to the caudal border and from the ventral border to the dorsal border without changing the location of the probe. Those zones (axillary zone—first zone and scapular zone—second zone) were used to better describe the location of the found pathologies. The substernal access was used to assess the symmetry of the lung inflation. The probe was placed perpendicular to the sternum, with the sternum in the centre of the probe surface. The probe was then moved from the cranial to the caudal border, with special attention to the area of the heart. Attention must be given to the precise placement of the probe on the sternum because oblique placement of the probe might create a false-positive heart shift. Leading Article (The Rat Thoracic Ultrasound protocol....) FIGURE 3 The bat sign is an abstract sign established to help the examiner with lung surface orientation. The image obtained is called a ‘bat sign’, as the rib heads and pleural line resemble the wings and body of a bat. FIGURE 2 Substernal access. The probe was placed perpendicularly to the sternum, with the sternum in the middle of the probe surface. The probe was moved from the cranial border (brachial muscles) to the caudal border (abdominal curtain sign) with special attention to the area of the heart. The marker was placed on the left side to obtain a standardised view.

Vetnews | April 2024 10 « BACK TO CONTENTS Results Rats were considered healthy which were not dyspneic and had normal lung and heart auscultation (no crackles or other pathological sounds were detected). In all of the healthy rats, normal ultrasonographic findings were observed. A complete thoracic ultrasonography was possible in all pet rats. Most rats calmed down after being restless at the beginning of the examination and were easily examined in the sternal recumbency. The duration of the examination was from 10 to 15 min according to the compliance of the animal. RATTUS normal findings The pleural line was a regular, hyperechoic line that moved synchronously with respiration. The bat sign (Figure 3; Supplementary Video 1) consisted of a rib surface and pleural line. Due to the size of a rat, the ribs were seen as round structures even when the probe was aimed transversally, as the probe size prevented a clear view of the intercostal space between two ribs. A-lines were easily visualised as hyperechoic horizontal lines (Figure 4; Supplementary Video 1). The key to identifying lung sliding with RATTUS was to focus on the pleural line and ignore other parts of the sonogram (Supplementary Video 1). The animal and probe must be as still as possible, and colour Doppler imaging might be used to help detect the presence of lung sliding, but this technique is challenging in active rats when the movements of an animal create colour Doppler artefacts. In rats, the heart curtain sign was barely visible, and the abdominal curtain sign was only a slight suggestion of the curtain sign, which is usually seen in larger animals (Figure 5; Supplementary Video 2). It was always necessary to concentrate on the normal curtain sign, and in hyperpnoeic animals, slow motion evaluation might be necessary because, contrary to larger animals, the lungs overlap the abdominal content only in a very small region. The ski jump sign (Figure 6; Supplementary Video 3) was used to rule out small volumes of pleural effusion that may be missed in small rats with the probe-oriented transverse to the ribs. When the ski jump sign was evaluated in rats, the probe was oriented parallel to the ribs, and it was necessary to concentrate on the curving part of the pleura as the small amount of pleural effusion can create a slight suggestion of ‘sailing’ pleura, confirming the presence of the small amount of fluid. The lung pulse in a rat is usually best displayed in the lobes close to the heart (Supplementary Video 4), confirming that the pleura is in contact. The seashore sign (Figure 7) is a visualisation of the lung sliding using M-mode, and it is conducted on rats. To perform an M-mode examination in a rat, the sweep speed on the ultrasound machine needs to be reduced to a minimum. The pleura produces a horizontal hyperechoic line (representing the border between waves and sand). An aerated lung creates a sandy appearance, and the overlying chest wall creates stratifications. Considering that RATTUS is performed without anaesthesia, M-mode evaluation was often very challenging due to the animal’s movement and respiratory rate. In rats, the bamboo sign (Figure 8) artefact is seen even in animals with normal body conditions. This is probably due to the lower amount of fat in the subcutaneous tissue, which creates more reverberation (Figure 9). The substernal access is used for the evaluation of the lung inflation symmetry (Supplementary Video 5). When the sternum was in the middle of the sonogram, both lungs were in the same line, moving synchronously with respiration. The position of the marker pointed to the left side to create a standard and repeatable protocol. Than the left side of the thoracic cavity agreed with the left side of the saved loop for better and standardized orientation. Leading Article (The Rat Thoracic Ultrasound protocol....) Figure 4 A-lines are hyperechoic horizontal lines (yellow arrows) and are reverberation artefacts of the pleural line. Figure 5 The abdominal curtain sign is visualised when the lung contracts over mediastinal or abdominal organs and hides the sonographic view into them as a curtain hides a window; hidden organs are again visible when the lung contracts during expiration.

Vetnuus | April 2024 11 Occasionally, single B-lines were identified. As the examination was conducted with a linear probe in all cases of B-lines, the changing of the depth was used to confirm that B-lines are ‘true’ B-lines (Figure 10). Less than two B-lines were considered a normal/physiological finding (20). Leading Article (The Rat Thoracic Ultrasound protocol....) Figure 6 The ski jump sign is visualised when the probe is placed parallel to the ribs, with the lung curving away from the sonogram, and this creates a sonographic picture like a ski jump. FFigure 8 The bamboo sign is the sign when, between two A-lines, a smaller hypoechoic horizontal artefact is visible and is called sub-A lines or Pi-lines (white arrow, A-lines yellow arrow). Figure 9 Reverberation artefact, where the subpleural line does not show anatomical lung tissue but a reverberation artefact of the chest wall is displayed above the pleura as A-lines. A-lines are reverberation artefacts of the pleura, and the space between the each A-line is a reverberation artefact of the chest wall. Figure 7 The seashore sign is visualised in M-mode when pleura creates a horizontal hyperechoic line (the border between waves and sand). The aerated lung creates a sandy appearance, and the chest wall lying above creates stratifications. T-lines are vertical lines going from the pleural line to the bottom. >>> 12

Vetnews | April 2024 12 « BACK TO CONTENTS Discussion Respiratory diseases (especially pneumonia) are very common disorders in pet rats (22, 23). The suspected diagnosis is mostly based on the clinical signs, thoracic auscultation, and thoracic radiography. However, the auscultation is insensitive to determining the severity of the disease, and radiographs are commonly unremarkable (24). A computed tomography examination seems to be promising in the diagnosis of intrathoracic disease (25) however, this examination is still not available in many veterinary practices. In recent years, pleura and lung ultrasounds have become important tools in human and veterinary medicine (3, 25). It has been shown to be a suitable imaging method for the diagnosis of pulmonary oedema (26–28), pneumonia (29), and pneumothorax (30, 31). Many studies have shown thoracic sonography to be the preferred method for identifying lung and pleural pathological findings when compared to computed tomography, especially due to the lack of radiation exposure and similar examination results. Furthermore, the advantage of thoracic ultrasound is the possibility of performing it ‘bedside’, in contrast to computed tomography (CT) or thoracic X-rays (TXR) (32–36). In RATTUS, the major advantage is the possibility of performing this examination in conscious animals and in normal sternal recumbency. The thoracic ultrasound was mainly described in rodent experimental studies (2, 20, 37, 38). In mice, lung ultrasound has been successfully used to assess pulmonary congestion in a preclinical model of heart failure (39). In companion rats, only a few studies and clinical case reports of thoracic diseases have been published; however, none of them used thoracic ultrasonography as a diagnostic method (21, 40–44). On the contrary, thoracic ultrasound in companion animals is a standard and well-described diagnostic tool for the diagnosis of cardiogenic oedema (45, 46), pneumothorax (3, 47), pleural effusion (3, 48, 49), or pneumonia (50, 51). One of the limitations of this examination is the presence of pathological conditions outside the lung periphery, which may be missed due to the aerated lung causing a ‘physiological’ reverberation artefact (20, 52). Another limitation may be rib shadowing, where smaller pathologies may remain hidden (this issue is partially decreased using the transversal view of intercostal spaces and the fact that most clinically manifested disorders occur in larger areas) (52). Due to these limitations, other imaging techniques such as CT and TXR could be useful to provide a complete thoracic cavity overview. Pleura and lung ultrasound are considered to be a safe, cost-effective, and easily implemented imaging modality that can aid in the assessment of many thoracic pathological findings. It has been shown to improve procedural efficiency whilst decreasing complications, increasing success, and reducing financial strain (53). In the medical treatment of pet rats, the main advantage of RATTUS is the possibility of evaluating the thoracic wall without anaesthesia (in contrast to TXR or CT) (43). Due to the size of the thoracic cavity and the use of a linear probe, the examination is relatively quick and easily conducted. Another advantage of this technique is the repeatability of the examination, which enables the evaluation of the progression of the disease and/ or the efficacy of therapy. However, we have not assessed the repeatability of the RATTUS protocol. The RATTUS protocol and normal ultrasonographic findings reported in the present study may be useful for a routine thoracic examination in pet rats. Further studies in acute and chronic cases of respiratory distress are needed. Publisher’s note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. v Supplementary material The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fvets.2024.1286614/ full#supplementary-material SUPPLEMENTARY VIDEO 1: Physiological sonogram https://1drv.ms/v/s!AglSmr1cGU9agRcvHFeUBQ7BLkVW SUPPLEMENTARY VIDEO 2: The curtain sign https://1drv.ms/v/s!AglSmr1cGU9agRiGIcTXyRE7A7Lt SUPPLEMENTARY VIDEO 3: The ski jump sign https://1drv.ms/v/s!AglSmr1cGU9agRlmPhD2KTf8780n SUPPLEMENTARY VIDEO 4: The lung pulse https://1drv.ms/v/s!AglSmr1cGU9agRomosFYJAwxvrhw SUPPLEMENTARY VIDEO 5: The substernal access https://1drv.ms/v/s!AglSmr1cGU9agRtjcWcRscUZPJkG Leading Article (The Rat Thoracic Ultrasound protocol....) Figure 10 Single B-line (arrow) on linear probe proven by changing depth (A−E—A: depth 2 cm, E: depth 9 cm). The micro-convex probe is usually recommended for vertical artefact assessment; however, by increasing the depth of the image, there is the ability to con firm that B-lines are ‘true’ B-lines and did not terminate before reaching the far field of the ultrasound image.

Vetnuus | April 2024 13 We, the members of the Association, resolve at all times: • To honour our profession and the Veterinary Oath • To maintain and uphold high professional and scientific standards • To use our professional knowledge, skills and resources to protect and promote the health and welfare of animals and humans • To further the status and image of the veterinarian and to foster and enrich veterinary science • To promote the interests of our Association and fellowship amongst its members. Ons, die lede van die Vereniging, onderneem om te alle tye: • Ons professie in ere te hou en die Eed na te kom • ‘n Hoë professionele en wetenskaplike peil te handhaaf en te onderhou • Ons professionele kennis, vaardigheid en hulpbronne aan te wend ter beskerming en bevordering van die gesondheid en welsyn van dier en mens • Die status en beeld van die veearts te bevorder en die veeartsenykunde te verryk • Die belange van ons Vereniging en die genootskap tussen sy lede te bevorder. CREDO

Vetnews | April 2024 14 « BACK TO CONTENTS Evidence-Based Human Homeopathy and Veterinary Homeopathy Simple Summary: According to the simile principle (Similia similibus curentur,or‘Letlikebecuredbylike’),classical(=individualized)homeopathic therapy is based on the individual and not on the indication. Based on the following three facts, the discussion of the evidence in human and veterinary homeopathy lays the foundations for a comprehensive presentation of the evidence on homeopathy: (a) homeopathic medicinal products without indication are 100% identical with regard to production,quality, safety, and principles of application, regardless of whether they are used in animals or humans; (b) if the simile principle is adhered to that classical (=individualized) homeopathic therapy is based on the individual and not on the indication; and (c) if the proof of the effectiveness of individualized homeopathy in one or more indications is available, the logical consequence seems to be that it can be concluded that it is effective in other indications. When criteria for evidence-based medicine for design, conduction, documentation, and rating of studies in homeopathy are considered, effects on all quality levels according to Cochrane criteria are recognizable, especially for individualized homeopathy, even in methodologically high-quality studies. In view of One Health and of the demands of the European Green Deal (Farm2Fork Strategy) and the EU Organic Regulation 2018/848, the application of homeopathy in the sense of integrative veterinary medicine (a combination of patient-oriented conventional and complementary veterinary medicine) and the integration of complementary medicine including homeopathy at the universities seems a necessary consequence and requirement in the interests of the patient. Abstract: (1) Background: Classical (=individualized) homeopathic therapy is based on the individual and not on the indication. (2) Methods: The prerequisite for conducting methodologically highquality studies on indvidualized homeopathy is that the principles of homeopathy are considered since the selection of the simile (the individually appropriate homeopathic medicinal product) is decisive for the effectiveness of the homeopathic treatment because only an application lege-artis can be effective for the respective patient. Apart from this, criteria for evidence-based medicine must be considered for the design, conduction, documentation, and rating of studies in homeopathy. (3) Results: When criteria for evidence-based medicine for design, conduction, documentation, and rating of studies in homeopathy are considered, effects on all quality levels according to Cochrane criteria are recognizable, especially for individualized homeopathy, even in the methodologically high-quality studies. (4) Conclusions: Based on the following three facts, the discussion of the evidence in human and veterinary homeopathy lays the foundations for a comprehensive presentation of the evidence on homeopathy: (a) homeopathic medicinal products without indication are 100% identical with regard to production, quality, safety, and principles of application, regardless of whether they are used in animals or humans; (b) if the simile principle (Similia similibus curentur, or ‘Let like be cured by like’) is adhered to that classical (=individualized) homeopathic therapy is based on the individual and not on the indication; and (c) if the proof of effectiveness of individualized homeopathy in one or more indications is available, the logical consequence seems to be that it can be concluded that it is effective in other indications. In view of One Health and of the demands of the European Green Deal (Farm2Fork Strategy) and the EU Organic Regulation 2018/848, the application of homeopathy in the sense of integrative veterinary medicine and the integration of complementary medicine including homeopathy at universities seems a necessary consequence and requirement in the interests of the patient, which is already expressed in the American consensus guidelines for an integrative veterinary medicine curriculum and is legally anchored in Switzerland by the Medical Professions Act for university teaching and research. Introduction The way homeopathy has been represented over the past years as well as in the article ‘A Systematic Review of Complementary and Alternative Veterinary Medicine: “MiscellaneousTherapies”’, a systematic review on published papers [1], clearly shows the need of indepth knowledge of integrative medicine (a combination of patient-oriented conventional and complementary medicine). In the US, integrative medicine is a self-evident part of the curriculum of the veterinary schools and of the top medical schools, from Harvard to Stanford. In Europe, there is hardly any academic integration and very few public or university funds available for research into integrative medicine, with the exception of Switzerland. Especially, in view of the global threat posed by antibiotic resistance, the integration of complementary medicine including homeopathy at universities is a necessary consequence and requirement in the interests of the patient. Fortunately, it is already expressed in the American consensus guidelines for an integrative veterinary medicine curriculum and is legally anchored in Switzerland by the Medical Professions Act for university teaching and research [2–4]. The German physician Dr. Samuel Hahnemann (1755– 1843) developed the medical system of individualized, so-called classical homeopathy or single-substance homeopathy. The treatment is based on the law of similars—Similia similibus curentur, or ‘Let like be cured by like’. The patient’s individual symptoms lead to the simile, i.e., the homeopathic medicinal product, the symptoms of which, generated in healthy individuals, best reflect the patient’s symptoms [5]. In accordance with the regulations of the European Pharmacopoeia or of the Homeopathic Pharmacopoeia, homeopathic medicinal products are produced in a standardized manner [6,7]. Materials and Methods Since the selection of the simile is decisive for the effectiveness of the homeopathic treatment, for conducting methodologically high-quality studies on individualized homeopathy it is the prerequisite that the principles of homeopathy are considered. Only an application lege artis can be effective for the respective patient. It is unlikely that the desired effectiveness will follow, if the individually appropriate homeopathic medicinal product, the simile, is not selected by appropriately trained and experienced homeopathic doctors/veterinarians according to the basic Comment on Bergh et al. A Systematic Review of Complementary and Alternative Veterinary Medicine: “Miscellaneous Therapies”. Animals 2021, 11, 3356 PetraWeiermayer 1,*, Michael Frass 2, Thomas Peinbauer 3, Liesbeth Ellinger 4 and Edward De Beukelaer 5 1 Veterinary Practice Dr. Weiermayer, 1130 Vienna, Austria 2 Scientific Society for Homeopathy, 06366 Koethen, Germany 3 Medical Faculty, Johannes Kepler University, 4040 Linz, Austria 4 Centaurea, 7312 Apeldoorn, The Netherlands 5 Riverside Veterinary Centre, Marlborough SN8 2AG, UK * Correspondence: petra.weiermayer@outlook.com Full article and references: https://www.researchgate.net/publication/362748157_EvidenceBased_Human_Homeopathy_and_Veterinary_Homeopathy_ Comment_on_Bergh_et_al_A_Systematic_Review_of_Complementary_ and_Alternative_Veterinary_Medicine_Miscellaneous_Therapies_ Animals_2021_11_3356

Vetnuus | April 2024 15 homeopathic principles [4]. A study of 2008 already confirmed that, for the successful application of individualized homeopathy, the basic principles— i.e., individualized selection of a homeopathic medicinal product according to the principle of similarity—must be taken into account [8]. Research in individualized homeopathy that does not respect the essential basic principles of individualized homeopathy prescribing will inevitably lead to negative study outcomes [4,9]. Apart from this, criteria for evidence-based medicine must be considered for design, conduction, documentation, and rating of studies in homeopathy. Results Up to 2014, five of the six meta-analyses on various indications concluded that the effectiveness of homeopathic therapy differs from that of placebo [10–14]. Of a total of 131 original articles, 13 RCTs with minimal risk of bias were identified in the review program from 2014, 2017, 2018, and 2019 [14–17]. Ten of these RCTs testing homeopathy in comparison to placebo resulted in a mean OR of 1.68 (CI = 1.25–2.24; p < 0.001), i.e., a statistical significance for the effectiveness of homeopathy compared with placebo. Such ‘effect size’ seems comparable with, for example, sumatriptan for migraine, fluoxetine for major depressive disorder, and cholinesterase inhibitors for dementia [14]. Five of the 13 RCTs with minimal risk of bias also showed high reliable evidence [18–22]. Especially for individualized homeopathy, effects on all quality levels according to Cochrane criteria are recognizable, even in the methodologically high-quality studies, when criteria for evidence-based medicine for design, conduction, documentation, and rating of studies in homeopathy are applied, e.g., all high-quality trials on homeopathy are considered for rating [4]. As the authors of the article ‘A Systematic Review of Complementary and Alternative Veterinary Medicine: “Miscellaneous Therapies”’ exclude farm animals from the systematic review, they exclude 16 out of 18 RCTs on veterinary homeopathy which were analyzed by the meta-analysis of 2015 [23]. However, further high-quality studies are also necessary in human and veterinary homeopathy, as in the majority of the fields of human and veterinary medicine. For veterinary homeopathy, the review of 2014 and the meta-analysis of 2015 showed evidence of the effectiveness of veterinary homeopathy compared to placebo (p = 0.01 for n = 15, pooled OR = 1.69 (CI = 1.12–2.56), p = 0.02 for n = 2, pooled OR = 2.62 (CI = 1.13–6.05)) [23,24]. In addition to studies to demonstrate the effectiveness of homeopathy in infections, data from health care research, so-called ‘real world data’, show the potential for a significant reduction in the use of antibiotics through homeopathic treatments [4]. Discussion A 2007 Cochrane review of systematic reviews of predominantly conventional therapies revealed that 96% of all systematic reviews call for more methodologically high-quality research [25]. Forty-nine percent of these publications present results that do not allow any conclusions to be drawn about the benefit/harmfulness of the examined intervention. According to this review, 7% of all medical procedures are actually harmful. Only 1.38% of conventional therapies are definitely effective, 43% are classed as effective, but the studies show methodological deficiencies. Based on the results of the meta-analyses of 2014, 2015, 2017, 2018, and 2019, homeopathy should be classified provisionally in the group of therapies (conventional 44%: 1.38% plus 43%), which are effective but need further research [14–17,25]. When criteria for evidence-based medicine for design, conduction, documentation, and rating of studies in homeopathy are considered, e.g., all high-quality trials on homeopathy are considered for rating, especially for individualized homeopathy, effects on all quality levels according to Cochrane criteria are recognizable, even in the methodologically high-quality studies [4]. A review in 2013 already confirmed that more than 90% of all studies had to be excluded in order to be able to conclude that homeopathy is not effective, a common practice applied in some reviews and meta-analyses on homeopathy with negative outcomes [4,26]. By definition, modern evidence-based medicine (EBM) is based on three pillars: the current state of scientific research, the clinical experience of doctors and veterinarians, and the values and wishes of clients and patients [27]. Homeopathy is based on all three pillars of modern evidence-based medicine. There seems to be confusion in the article ‘A Systematic Review of Complementary and Alternative Veterinary Medicine: “Miscellaneous Therapies”’, which describes the different results and outcome variables, that for an intervention to be considered as being effective, it needs to be able to be‘explainable’. In other words,‘scientific’can only be associated with explanations of the mode of action of treatments based on the current anatomopathological approach to medicine and that only medical techniques based on these models deserve attention from the research community. However, knowing how a medicine works has never been intended to be a prerequisite for its use according to the founder of modern evidence-based medicine, David Sackett [27]. Aspirin (acetylsalicylic acid) is one of the most widely used drugs in the world, yet it was used for over 70 years before its mechanism of action was discovered in 1971 [28]. Science is a constantly evolving field and what the scientific establishment declares to be ‘impossible’ in one era, is often proved to be ‘fact’ in another [29]. In view of One Health and of the demands of the European Green Deal (Farm2Fork Strategy) and the EU Organic Regulation 2018/848: (1) to reduce the use of antibiotics by 50% throughout the EU by 2030 (2) to increase the number of organic farms in the EU from 8% to 25% by 2030 (3) to give preference to homeopathy and phytotherapy in organic farms before conventional medicines are used, including antibiotics, the application of these complementary medical disciplines in the sense of integrative veterinary medicine, i.e., to combine best practices of conventional and complementary medical therapy procedures, seems proactive and innovative [30,31]. Hence, the integration of complementary medicine including homeopathy at the universities seems a necessary consequence and requirement in the interests of the patient. Conclusions Evidence for the effectiveness of human and veterinary homeopathy in general, and in particular in the treatment of infections, has been sufficiently proven to justify further research in homeopathy [32]. Hence, obvious non-scientific interests might consequently have led to misinformation about homeopathy in general and within the article ‘A Systematic Review of Complementary and Alternative Veterinary Medicine: “Miscellaneous Therapies”’ [33]. Based on the following three facts, the discussion of the evidence in human and veterinary homeopathy lays the foundations for a comprehensive presentation of the evidence on homeopathy: (a) homeopathic medicinal products without indication are 100% identical with regard to production, quality, safety, and principles of application, regardless of whether they are used in animals or humans; (b) if the simile principle (Similia similibus curentur, or ‘Let like be cured by like’) is adhered to that classical (=individualized) homeopathic therapy is based on the individual and not on the indication; and (c) if the proof of effectiveness of individualized homeopathy in one or more indications is available, the logical consequence seems to be that it can be concluded that it is effective in other indications [34]. Especially for individualized homeopathy, effects on all quality levels according to Cochrane criteria are recognizable, even in the methodologically high-quality studies, when criteria for evidence-based medicine for design, conduction, documentation, and rating of studies in homeopathy are considered, e.g., all high-quality trials on homeopathy are considered for rating [4]. In view of One Health and of the demands of the European Green Deal (Farm2Fork Strategy) and the EU Organic Regulation 2018/848, the application of homeopathy in the sense of integrative veterinary medicine and the integration of complementary medicine including homeopathy at universities seem a necessary consequence and requirement in the interests of the patient, which is already expressed in the American consensus guidelines for an integrative veterinary medicine curriculum and is legally anchored in Switzerland by the Medical Professions Act for university teaching and research [2,3,30,31]. v Article

Vetnews | April 2024 16 « BACK TO CONTENTS The Eastern Cape Province has been grappling with a concerning rise in positive rabies cases since 2021. However, a recent vaccination campaign that SAVA CVC managed in Gqeberha has shown promising results in mitigating the spread of the disease. Sponsored by the Scheinberg COVID19 Relief fund, a private donor, and Boehringer-Ingelheim, this initiative has significantly reduced the number of positive cases in the area over the past two years. Buoyed by the success of the project in Gqeberha, efforts are now underway to extend this initiative across the entire province. Funding from a UK charity (Battersea) has been secured to roll out the campaign, with a focus on vaccinating cats and dogs to curb the transmission of rabies. The project has commenced with the initial deployment of six Animal Health Technicians, organized into three teams. Each team, comprising two members per vehicle, has been assigned the crucial responsibility of administering vaccinations at strategic sites. Notably, one team is dedicated to operations in Nelson Mandela Bay Metro, while the Buffalo City Metro area is covered by two separate teams. Under the guidance of two qualified veterinarians, Dr Gabriella Naidoo in Buffalo City Metro and Dr Renee van Rheede in Nelson Mandela Bay, the teams commenced their operations on March 1, 2024. These experienced professionals oversee the execution of the campaign, ensuring its effectiveness and adherence to best practices. The primary goal of the initiative is to vaccinate 400,000 cats and dogs within a three-year timeframe. To achieve this, teams are employing a comprehensive approach that includes walking the streets in grids, education and outreach efforts targeting schools, police stations, clinics, and communities. Educational materials such as posters and booklets are distributed and talks given at schools to raise awareness about rabies prevention and the importance of vaccination. The project is heavily data-driven, which allows us to be dynamic in our approach – e.g. shifting focus to higher-risk areas, adding resources if required and allowing for post-project sustainability in the region. Collaboration with state teams is integral to the success of the project. While the vaccination teams focus on administering vaccines and education, the state teams are responsible for tasks such as sample collection, testing, and reporting. This coordinated effort ensures a holistic approach to rabies control and prevention. An initiative of the SOUTH AFRICAN VETERINARY ASSOCIATION Non-profit Company: 1998/016654/08 Non-profit Organisation: 000-234 NPO Public Benefit Organisation: 130001321 CVC News I CVC Nuus Tackling Rabies: A Vaccination Initiative in the Eastern Cape Province Back Left to Right: Ayanda Magala (AHT), Zipho Mguzulwa (AHT) Front left to Right: Londa Faizel (AHT), Dr Gabriella Naidoo, Sibonga Ntuli (AHT) NMB Team from left to right: Likhaya Apleni (AHT), Dr Renee van Rheede, Mabetshe Wonga (AHT)

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