6dvancing Clinical Knowlsdgs and Paľisnľ Cars
Antibiotic Stewardship
Generating the evidence to support responsible prescribing
Patient Safety
Our mission to learn from mistakes continues
Parasiticides
Driving improvements towards evidence based parasite control
Patient Outcomes
1 Quality Improvement & Research Report 2025 Back to Contents
Improving decision making through evidence based practices
Content
A Foreword by our Chief Veterinary Officer 3
Introduction 4
Contributors 5
Antimicrobial Stewardship 6
Patient Safety 12
Workplace Safety 14
Improvement Projects 15
Parasiticide Stewardship at CVS 16
Lower Flow Anaesthesia 19
Improving Patient Outcomes 21
Nurse Skill Utilisation 23
Leadership 25
Practice Standards Scheme 27
Harnessing Artificial Intelligence to drive clinical improvement 28
Recognition 30
2025 CVS research publications 31
A foreword by our Chief Veterinary Officer
I have the very lucky privilege of working alongside inspirational colleagues across CVS and supporting our approach to clinical improvement.
This report reflects the commitment to care and professionalism I see every day in teams who continue to strive to provide better, safer care, even in demanding and uncertain settings.
It also reflects the reality that clinical improvement is itself a learning process; we continue to learn not only what needs improvement, but how improvement happens. We learn through trying new things, seeing what happens and then making iterative change.
This means we have to embrace failure. Being open and honest about where we can do better can feel uncomfortable and, at times, risky. Yet a willingness to acknowledge uncertainty and imperfection is what creates the conditions for psychological safety and the most effective learning environment; teams become empowered to speak up and challenge assumptions or the status quo.
We have not arrived! The journey of improvement doesn't have a final destination. The work described here demonstrates a growing culture of openness, inclusion and shared ownership of improvement. When we get this right change is more impactful and more likely to last!
I am extremely proud of our colleagues, what this work represents, and I am grateful to everyone who contributes their courage and commitment to continuous improvement.
Paul Higgs
Chief Veterinary Officer
Generating new veterinary knowledge and improvement in patient care sits at the heart of what we do. It supports our mission of providing the best possible care to the animals we see.
The 2025 Quality Improvement and Research Report brings together our quality improvement (QI) and research achievements into a single view. Bringing these two previously separate reports together reflects both the reality of how we work and the principles of our Clinical Improvement Team at CVS. Research and QI are not separate endeavours as one informs the other, and both move us collectively toward the same purpose.
The topics included in this report reflect where research and QI intersect and amplify one another: from parasiticide prescribing and environmental responsibility, to measuring and improving clinical outcomes, to the continued growth of nursing optimisation, leadership development, and our Practice Standards Scheme. These examples highlight the collective efforts across our Group, demonstrating how colleagues in every part of CVS contribute to shared goals through inquiry, innovation, and continuous improvement.
Over the past year, two major programmes have shaped our direction in clinical improvement: Antimicrobial Stewardship (AMS) and 'Learning from Mistakes'.
Recognising the importance of coordinated, evidence-driven stewardship, we set AMS as our research priority for the year, deepening our collaborations and understanding. Alongside this, QI initiatives across our clinical teams continued to strengthen our approach
to responsible antibiotic prescribing, supporting colleagues with structured tools and data that help drive safer, more sustainable decision-making.
Safety for both our patients and for the people who care for them has also been a defining theme in 2025. Our 'Learning from Mistakes' initiative, launched at the CVS Clinical Conference in late 2024, continued to gain momentum and sits within a wider focus on building safer systems and a supportive learning culture.
This year also saw the conclusion of our widescale collaborative research into workplace injuries, providing valuable evidence to guide further improvements in colleague safety.
This report is a celebration of the scale and impact of research and QI across CVS in 2025: the new evidence generated, change created, and the continued evolution of our care delivery. Together, these efforts strengthen our ability to provide the highest quality
care to the animals under our care and ensures that our learning never stands still.
Introduction
Angela Rayner
Director of Quality Improvement
Imogen Schofield
Director of Research and Data Science
Contributors
We would like to thank the following contributors to our chapters as well as many colleagues who were involved in these projects.
Antimicrobial Stewardship
Angela Rayner, Director of Quality Improvement
Imogen Schofield, Director of Research and Data Science
Charlotte Sinclair, Equine Veterinary Medical Director
Steven Carragher, CVS Farm Vets Quality Improvement Lead
Tara Ryan, Chief Veterinary Nursing Officer
Michelle Farrow RVN, Research Assistant
Elizabeth McLennan-Green, Veterinary Director (Companion Animal)
Tim Mair, Equine Veterinary Director
Patient Safety
Angela Rayner, Director of Quality Improvement
Workplace Safety
Imogen Schofield, Director of Research and Data Science
Rebecca Jackson, Head of Health and Safety
Improvement Projects
Elizabeth McLennan-Green, Veterinary Director (Companion Animal)
Claire Fisher, RVN, Project Lead
Victoria Musk, RVN, Project Lead
Leigh Hinsley, RVN, Project Lead
Parasiticide Stewardship
Elizabeth McLennan-Green, Veterinary Director (Companion Animal)
Charlotte Sinclair, Equine Veterinary Medical Director
Steven Carragher, CVS Farm Vets Quality Improvement Lead
Imogen Schofield, Director of Research and Data Science
Paul Stanley, Advanced Veterinary Practitioner
Michelle Farrow RVN, Research Assistant
Tim Mair, Equine Veterinary Director
Lower Flow Anaesthesia
Charlotte Sinclair, Equine Veterinary Medical Director
Angela Rayner, Director of Quality Improvement
Luis Louro, Specialist in Anaesthesia and Analgesia
Elizabeth McLennan-Green, Veterinary Director (Companion Animal)
Improving Patient Outcomes
Imogen Schofield, Director of Research and Data Science
Elizabeth McLennan-Green, Veterinary Director (Companion Animal)
Charlotte Sinclair, Equine Veterinary Medical Director
Nurse Skill Utilisation
Tara Ryan, Chief Veterinary Nursing Officer
Imogen Schofield, Director of Research and Data Science
Michelle Farrow RVN, Research Assistant
Leadership
Mark Moreton, Director of Learning, Education and Development
RCVS Practice Standards Scheme
Carlos Matos, Clinical Services Manager
Harnessing Artificial Intelligence
Graham Dodds, Director of Innovation, Transformation and Client Experience
Bill Nolan, Provet Operations Support Lead
Richard Fox, Veterinary Cytopathologist
Imogen Schofield, Director of Research and Data Science
Antimicrobial Stewardship
Our work in 2025 built upon the foundations laid since 2021, maintaining our focus on responsible antibiotic use; ensuring that our prescribing supports long term patient health, and the wider global effort to tackle antimicrobial resistance. This year brought both expected progress and unexpected challenges across all our teams.
Collating and generating the evidence to support responsible prescribing and
groiunpfse.ction prevention
Cultivating a culture, where tidiness, cleanliness and hygiene is an important part of everyoneʼs role in infection prevention
Supporting client education and communication of AMS processes or practice policies
Our first focus area for AMS is "collating and generating the evidence to support responsible prescribing and infection prevention". This involves feeding prescribing data back to practices that enables teams to reflect on their own decision-making, discuss prescribing trends, identify variation, and consider changes where needed.
Antimicrobial stewardship in companion animal
Our measure of antibiotic prescribing - the proportion
of prescriptions relative to total consultations - allows us to distinguish true clinical improvement from variations simply caused by workload or case volume. In 2025, supply chain issues created fresh pressure.
Number of HPCIA prescriptions as a percentage of total consults Companion Animal Practices
Jan 2021 - Dec 2026
2.50%
2.00%
1.50%
1.00%
0.50%
0.00%
2021 2021 2021 2021 2021 2021 2022 2022 2022 2022 2022 2022 2023 2023 2023 2023 2023 2023 2024 2024 2024 2024 2024 2024 2025 2025 2025 2025 2025 2025 2026
Jan Mar May Jul Sep Nov Jan Mar May Jul Sep Nov Jan Mar May Jul Sep Nov Jan Mar May Jul Sep Nov Jan Mar May Jul Sep Nov Jan
Some first line antibiotics were temporarily out of stock, forcing practices to prescribe alternatives they would not usually choose, including highest priority critically important antibiotics (HPCIAs). Predictably, HPCIA use rose during these shortages. As supply returned to normal, prescribing patterns stabilised again.
Raising our own ambition
Recognising the impact of several years of successful stewardship work, we also took the opportunity to strengthen our internal benchmark. Our previous
target - 2.3% of consultations resulting in an antibiotic prescription - was several years old. Confident in
our progress, we reduced our benchmark to 2%. This aligns our targets with current performance and challenges us to go further.
Harnessing the strength of a large organisation
One of CVS Group's strengths is our ability to act as a coordinated organisation. AMS is not just a
clinical concern: procurement, product management, laboratory teams, and research all play key roles. When stock shortages occurred, cross team collaboration allowed us to prioritise communication, investigate supply delays, and restore preferred antibiotics as quickly as possible. AMS has become embedded across departments, not just within prescribing teams.
Preparing for the Prescribing with Purpose project
Throughout the second half of 2025, many practices were preparing for one of our new clinical improvement projects launching in January 2026: Prescribing with Purpose. This project supports practices in choosing an area of prescribing behaviour to focus on, using the Model for Improvement to guide structured change.
We provided videos, guidance, examples, and coaching to help practice teams use this method consistently. Importantly, it also created space for peer learning - one of the most powerful drivers of improvement.
We care
Antibiotics remain among the most powerful and lifesaving tools available to clinicians. When used appropriately, they treat infections effectively and ensure that our patients can return to health quickly. But these medicines are fragile resources. Misuse or overuse contributes directly to antimicrobial resistance (AMR), reducing the effectiveness of treatments that animals - and humans - rely on every day.
If resistance continues to grow, antibiotics risk becoming less effective or even unusable in the future. Ensuring antibiotics remain available and effective is therefore both a clinical and moral obligation.
Number of prescriptions as a percentage of total consults BenchmarkOur learnings
2025 reminded us that while AMS remains a priority, real world pressures can sometimes reduce the attention it receives. Even so, the resilience of our stewardship framework meant teams continued to engage with their data, reflect on prescribing decisions, and maintain progress.
We also learned that our AMS work is strongest when it is shared.The improvement networks established for the clinical projects enabled teams to learn from one another, offer solutions, and gain inspiration from colleagues across the country.
Peer-to-peer discussion remains one of the most effective tools we have.
Finally, the events of 2025 reaffirmed the need for adaptable targets and robust data. Our updated benchmark, combined with continued data transparency, provides a strong foundation for improvement in 2026 and beyond.
Collating and generating the evidence around antibiotic prescribing and influencing improvements
Research with the University of Bristol
In 2025, CVS undertook a project to better understand, influence, and improve the prescribing of antibiotics
in companion animal practices. While AMS is a complex and long term challenge, this research project aimed to support clinicians to prescribe responsibly, reduce unnecessary antibiotic use, and safeguard the effectiveness of vital medicines for the future.
Through CVS's collaboration with the University of Bristol and SAVSNET (University of Liverpool), we developed new ways of analysing prescribing data, delivering targeted training, and supporting behaviour change across more than 60 CVS practices.
Certain conditions - otitis externa, cat bite abscesses, and acute diarrhoea - were selected for particular focus because of strong evidence that prescribing patterns could be improved. These are everyday conditions seen in most practices, making them ideal for driving meaningful, real-world change.
Challenge in AMS research
A major challenge in AMS research is identifying why an animal was seen in the first place as clinical notes vary in style and language. Bristol and SAVSNET's researchers addressed this by using natural language processing to analyse the free text clinical records and classify cases into the three specific conditions this project explored.
This capability has opened up new insights for us at CVS, allowing us for the first time to measure antibiotic use by condition rather than relying solely on general antibiotic prescribing data.
Once the cases were identified, researchers compared:
the percentage of consults involving an antibiotic
the type or class of antibiotic chosen
prescribing patterns 12 months before the intervention
prescribing patterns during the 12 month project
Practices not taking part in the project were used as a control group to show that any improvements were directly linked to the intervention.
How we did it - the training intervention
The University of Bristol specialists designed and delivered a comprehensive training package, which included face-to-face workshops, interactive sessions, training on reflective practice and self guided materials for practices unable to join live sessions.
Identification of the three conditions from the clinical notes was undertaken by applying validated topic models to our clinical notes and measuring the subsequent antibiotic prescriptions of these cases. Measures assessed in the project include the percentage of acute diarrhoea, cat bite abscess and otitis externa consultations where antimicrobials have been prescribed, percentage of antibiotics that are HPCIAs and category, and active ingredient of antibiotic prescribed.
The data from the 60+ practices involved is being compared to i) their prescribing data the prior 12 months and ii) compared with the practices not enrolled in the study.
Practices received their own data showing changes in prescribing, helping teams see their progress and
understand where they had improved. A full analysis is due in the next 12 months as this project is written up into a PhD thesis, however preliminary data has so far indicated:
A reduction in antimicrobials prescribed in all three conditions for enrolled practices and a change in antibiotics towards a more 'appropriate' antibiotic based on current evidence.
For diarrhoea, metronidazole use reduced from 40% to 29% of the antibiotics used, and total antibiotic use reduced to ~10% of diarrhoea cases from 18% prior year.
For otitis externa, polymyxin b use reduced from 47% to 30% of antibiotics used, and total antibiotic use reduced to 52% (from 70% prior year).
For cat bite abscesses, cefovecin use reduced from 25% to 16% of antibiotics used and total antibiotics use reduced to 38% (from 75% prior year).
This has been one of the biggest collaborative AMS projects for CVS to date. This demonstrates that CVS can be an effective research partner for universities and a leader in national AMS improvement work. With natural language processing tools helping to make sense of millions of clinical notes, this work represents a major step forward in how we can understand and monitor companion animal health. It's an inspiring example of what's possible when veterinary practices, researchers and industry partners collaborate.
Our learnings
Natural language processing methods unlock new ways of understanding clinical behaviour. Using topic models to classify consults by condition is a step forward. It overcomes long standing challenges in interpreting free text clinical notes and provides new insights that can drive future AMS and clinical improvement projects.
Practice teams value seeing their own data to compare their prescribing before and after the intervention.
The interventions are also supporting behaviour change (through reduced prescribing and more 'appropriate' prescribing) by addressing barriers to change, and enabling discussion.
The final stage of the project will assess whether improved prescribing continues once the active intervention ends. Early signs suggest teams have already made changes, but the long-term goal is to ensure those improvements are maintained. The full results will be available once data analysis is completed.
This AMS project represents an important milestone for CVS's commitment to responsible antibiotic use.
Equine antimicrobial guidelines
We took a step forward in the Equine Division with development of clinical guidelines for antimicrobial use. This project, similarly reflects our ambition to "collating and generating the evidence to support responsible prescribing and infection prevention". The guidelines will be published in Spring 2026.
The idea for the Equine Antimicrobial Guidelines emerged from a dedicated antimicrobial workshop in December 2024. At that event, clinicians highlighted the need for clear, practical, equine-specific guidance that could support decision-making across a wide range of conditions. The project was commenced because our own audits show room for improvement, particularly around dose rates and consistency.
By developing robust antimicrobial guidelines, we are strengthening our ability to use antibiotics responsibly, prioritise patient safety, and support vets with the best available knowledge.
How we did it
Clinicians with subject matter expertise were invited to form working groups to contribute to guideline sections aligned with their specialist interests.
Examples include reproduction, foal medicine and ophthalmology. Contributors met regularly
throughout 2025 to review evidence, draft content and refine recommendations.
The guidelines are based on the best available evidence (recognising that research in equine medicine is sometimes limited), national and international guidance, and the combined clinical expertise and experience from contributors across CVS.
Importantly, the guidelines do more than list recommended antimicrobials. They also address:
Strategies for appropriate use in common equine conditions.
Re-evaluation of optimal doses and dosing intervals.
Situations where antimicrobials are not required.
Best practice approaches to stewardship in real world contexts.
The focus on dosing is particularly important: previous audits within the Equine Division have shown good overall prescribing behaviour but identified variation and room for improvement in dosing rates.
Our learnings
The project has highlighted several important insights:
Evidence gaps remain but we can still make progress - Equine medicine sometimes lacks the depth of research seen in other fields. Developing guidelines meant working carefully with limited data, balancing published research with expert consensus.
Specialist views can vary - Differences in opinion among specialists occasionally
created challenges. Finding common ground required discussion, clinical judgement, and a commitment to consistency.
There is a real need for guidance - Audit data shows that while prescribing behaviours are broadly good, dose rates varies, and some areas have shown increases in the use of critically important antimicrobials. The guidelines directly address these challenges.
Case study: Using simulated germ training to enhance infection prevention in CVS practices From November 2024 to February 2025, CVS' Companion Animal Division conducted a large-scale research project to evaluate whether Simulated Germ Training Products (SGTPs) could strengthen infection prevention behaviours across clinical teams.
Sixty practices participated, with 54 completing the full study. Practices were allocated to 'control', 'low intervention', or 'high intervention' groups, with the high intervention group receiving SGTP materials, direct support and training, and access to an Infection Prevention Pack.
SGTPs - fluorescent powders, gels and lotions visible only under ultraviolet light - were used to assess cleaning effectiveness and stimulate team discussion. Practices completed monthly Bella Moss infection prevention audits alongside pre and post intervention assessments.
Across all groups, mean audit scores improved by
6.12 points, with the proportion of practices meeting the cut off for 'low infection prevention risk' rising from 85% to 91%. The greatest improvement
was observed in the low intervention group, which increased from 85% to 94%, however this
improvement was not significantly greater than the other groups. While SGTP use was not statistically associated with higher scores compared to the control groups, 75% of users recommended its continued use, reporting increased awareness, engagement and constructive team conversation. A useful finding was a link between reported practice culture towards infection prevention
and audit scores. Teams that viewed infection prevention as a shared responsibility consistently achieved higher scores.
Case study: Advancing responsible HPCIA prescribing through collaborative research
In 2025, CVS began funding a three year PhD project at the University of Liverpool to strengthen antimicrobial stewardship by reducing inappropriate use of HPCIAs in equine and companion animal practice.
Despite existing guidelines, national surveillance data indicates that HPCIAs continue to be used in situations where culture and sensitivity testing could better inform clinical decisions.
The research, based at the Leahurst Campus, is being led by Dr. Tamzin Furtado and undertaken by PhD student Hannah Shotnes. It combines large scale epidemiological analysis using SAVSNET and EVSNET prescribing data with social science methods such as interviews and focus groups.
This mixed methods approach aims to uncover the behavioural, logistical and systemic factors that influence prescribing habits in real world veterinary settings.
By analysing these prescribing patterns and exploring practical barriers to diagnostic testing, the project seeks to design and pilot an intervention that encourages greater use of culture and sensitivity tests before prescribing HPCIAs. CVS clinicians will contribute to the development and implementation of this work, ensuring the outcomes are relevant and applicable across practice.
CVS Farm Vets antimicrobial stewardship programmes
groups.
Calf Respiratory Disease
Bovine Mastitis
Sheep Lameness
Our farm programmes focus on preventative health, strengthening herd and flock resilience and delivering tailored, proactive care. By prioritising robust health planning and improved welfare, we help farmers reduce disease risk, optimise productivity, and minimise antibiotic use - supporting sustainable, responsible livestock management for long-term resilience and industry-wide wellbeing and success.
Improving testing and treatment of calf respiratory disease
As the leading cause of morbidity and mortality in calves, Bovine Respiratory Disease (BRD) has both immediate welfare implications and longer-term impacts on growth, efficiency and lifetime performance.
Primary viral infections can rapidly escalate into bacterial pneumonia, meaning treatment alone cannot resolve the underlying problem. Instead, farms require targeted, evidence-based prevention strategies that are informed by diagnostics.
In 2025, a feature of the project has been the move towards bespoke preventive protocols. Using diagnostic evidence, our vets have been able to
identify the pathogens circulating on each farm and develop tailored herd health plans. These often include ventilation and building adjustments, improvements
in hygiene and biosecurity, colostrum and immunity management, risk aligned vaccination strategies, and clearer antimicrobial protocols. No two farms required the same interventions; each plan was shaped by the results, infrastructure and management practices of the individual farm.
In a major step forward, diagnostic testing has increased significantly in 2025 by 97%.
This near doubling in activity indicates that diagnostic testing is becoming an established part of everyday herd health planning and that financial, cultural and practical barriers have been substantially reduced.
Improving mastitis decision making through rapid diagnostics
Bovine mastitis remains one of the most common and costly diseases in the dairy industry. It causes painful inflammation of the udder, disrupts milk production, reduces milk quality, and leads to substantial economic loss across UK herds. Historically, most mild to moderate mastitis cases were treated automatically with antibiotics, despite evidence that fewer than half actually benefit from antibiotic therapy.
How we did it
CVS Farm Vets recognised that faster, farm level diagnostics could transform decision-making.
Mastatest technology is used by all 15 farm practices, which allows milk culture and sensitivity testing to be carried out in-house, with results in just 24 hours, rather than days. Farmers are encouraged to administer NSAIDs while awaiting results with antibiotics used only if later confirmed necessary.
Across the group, we have seen a 15% increase in diagnostic testing in 2025 with a total of over 1,100 clinical samples processed, since the programme began in 2023.
A key barrier to improving stewardship had been the slow turnaround of traditional milk culture, with lab results taking 48 hours or more, which could result in an antibiotic being prescribed unnecessarily due to concern for cow welfare.
Our learnings
A key learning is that the timing of vaccination is critical. Aligning vaccination with predictable stress periods - such as weaning or housing -has improved effectiveness and helped reduce
antibiotic reliance. More broadly, the programme has demonstrated that diagnostics enable deeper, more proactive herd health planning centred on prevention rather than treatment.
Our learnings
The results demonstrate that a significant proportion of cows that may have previously been treated with antibiotics did not require them.
Over 1 in 3 clinical mastitis cases did not require antibiotic therapy.
34% of clinical samples showed either no bacterial growth or E. coli - both of which can resolve with supportive care alone.
16% of cases showed Streptococcus uberis, where targeted antibiotic treatment is appropriate.
Sensitivity patterns allowed vets to shift away from broad-spectrum category C antibiotics towards narrow-spectrum category D penicillins, strengthening responsible medicine use. This targeted prescribing protects the long-term effectiveness of higher-priority antimicrobials.
New for 2025-26: Sheep Lameness Initiative
In 2025, CVS Farm Vets launched an innovative Sheep Lameness initiative to support farmers in tackling one of the most persistent health challenges in UK flocks. Foot rot affects an estimated 10% of sheep nationally and treatment has traditionally relied on remotely prescribed antibiotics. To drive better welfare and reduce antimicrobial use, CVS has introduced a proactive, on-farm approach centred on structured assessment and tailored management.
Using the Five Point Lameness Plan, CVS Farm Vets now conduct comprehensive farm visits that evaluate pasture, flock history, treatment practices and biosecurity, supported by laboratory testing. Each farmer receives a bespoke action plan designed to reduce lameness prevalence to 5%.
Follow up visits track progress and strengthen farm-vet collaboration. CVS colleagues undergo dedicated CPD and Lameness Reduction Advisor training to ensure consistent delivery and meaningful clinical impact across the Farm division.
Protecting psychological safety is therefore essential to protecting our people. When teams trust that events will be treated fairly and used constructively, they are more willing to speak up, seek support and engage in learning. VetSafe supports this openness.
The programme also reinforces CVS' commitment to a just culture where colleagues can report concerns safely; teams take ownership of improvements; learning is shared; every voice is heard; and mistakes are recognised as the result of multiple contributing factors, not just human error.
updates to surgical safety checklists, enhanced equipment maintenance routines, changes to dispensing workflows, improved patient handover processes, and refinements to hospitalisation procedures. Teams who took ownership of their VetSafe data saw gains in teamwork, confidence and patient safety.
Patient Safety
In 2024, CVS launched the Learning from Mistakes mission- our groupwide commitment to patient safety by improving psychological safety, supporting colleagues when things don't go to plan and
strengthening our ability to learn from clinical mistakes. The response from colleagues was powerful.
Teams embraced open conversations, shared their experiences and began embedding learning reviews into everyday practice.
VetSafe is a platform that exists to help us learn from these events by focusing on understanding what happened and how we can prevent similar situations in the future. Each report is an opportunity to learn how to strengthen clinical practice and personal resilience.
2025 was a year of deep support, collaboration and continuous engagement. We built on the momentum created in 2024 and helped teams embed learning from mistakes into everyday practice.
How we did it
Our network of Regional Clinical Leads and
more than 500 Clinical Improvement Advocates (CIAs) remained central to this work. They helped colleagues get started with VetSafe, facilitated learning reviews, raised queries and shared challenges with the wider QI team, supported practice specific improvements and attended virtual meetings to share progress. Their commitment and consistency made them the engine of the project.
The Learning from Mistakes mission continues to strengthen our culture of learning, psychological safety, and continuous improvement. In 2025, we moved from awareness to action: more conversations, reporting,
learning reviews, and local improvements.
Although our aims have been met in the first two years, lasting culture change is our long-term mission - and our goal remains for every CVS practice to use VetSafe and learning reviews routinely.
Number of VetSafe reports
2500
2000
1500
1000
500
We care
Mistakes can occur in any healthcare setting, even when colleagues act with skill, professionalism and genuine care for their patients. When something goes wrong, animals may experience unnecessary discomfort, complications, additional treatment, or -on rare but devastating occasions - loss of life.
Clinical mistakes can also have a significant emotional impact on the colleagues involved.
0
Our learnings
Meaningful improvement happens locally. Practices
see the most benefit when they interpret their own VetSafe reports, reflect on their context, and
make changes that suit their team and own clinical environment. In 2025, local improvements included
2023-2024 2024-2025
VetSafe reporting increased from 761 to 2,275 - a 300% increase - indicating not more mistakes but more trust. Learning reviews helped teams understand that most adverse events result from multiple contributing factors, not just human error alone.
As part of our employee net promoter score survey we regular ask about psychological safety in our workplaces to gauge progress. In the 12 months between September 2024 and 2025, we saw improvements in the percentage of our colleagues
who felt able to speak up about anything that concerns them; the percentage who felt that if they made a mistake at work it will not be held against them; and the percentage who feel there is a culture of continuous improvement in their team.
A focus on medication errors
Every medication error is an opportunity to prevent future harm and, by adopting a rigorous, safety focused approach to product selection, we can reduce the risk of mistakes before they reach a clinical setting.
Product design itself can mitigate risk: labels, colours, vial sizes, cap shapes and storage requirements all influence human performance.
During a large-scale medicine review, Procurement and Clinical teams worked together to screen potential products using Safety Data Sheets to identify items with unnecessary storage complexity, handling risks, formulations likely to introduce error, and products unsuitable for everyday clinical use. Only products that passed this stage moved into a multi-professional tactile review.
Around 20 colleagues took part in this hands-on evaluation, including vets, veterinary nurses, dispensary technicians, practice managers, clinical leaders, and procurement colleagues. Together, they compared products side by side, assessed the clarity of labelling, examined tactile features, evaluated packaging distinctiveness, and discussed how each product would be used in real clinical scenarios. Consensus was required before any product could be recommended for general use in CVS practices, to ensure our choices were grounded in patient safety first, rather than financial considerations.
Workplace Safety
Over the past three years, CVS has partnered with the University of Liverpool on one of the most comprehensive programmes ever undertaken to understand workplace injury, reporting behaviour and
safety culture across UK veterinary practices. This work spanned large animal, equine and companion animal environments and generated important evidence that has revealed the scope of injuries in veterinary practice and, more importantly, the culture that influences how those injuries are understood, reported and acted upon.
We care
This research has outlined how veterinary colleagues see injuries as "part of the job," often leading them to continue to work despite incurring an injury, minimising injury severity, and not reporting the incident.
Understanding this culture of normalisation and presenteeism is important for the profession so we can continue to learn and make improvements.
The research was aimed at informing new safety initiatives and leadership approaches across CVS with the objective of creating safer workplaces for the veterinary profession.
Our learnings
An overwhelming majority (77-90%) of veterinary professionals reported having been injured in their career, with many incidents arising from predictable scenarios such as animal restraint, anaesthetic recovery and equine limb examinations.
Needlestick injuries accounted for around 10% of all incidents. Yet only around 31% of all injuries were reported, reflecting a broader culture of presenteeism and underrating harm.
How we did it
A survey was conducted with around 1,000 CVS colleagues to explore how veterinary professionals defined injuries, their specific causal mechanisms, and why individuals do or do not report injuries
or seek medical treatment. Following this an independent audit of CVS' full accident reporting system 'Safety Hub' occurred to build a detailed picture of both the scale of injury and the culture that influenced its reporting.
As a direct result of our learnings, our teams have implemented a series of evidence-based safety improvements to reduce workplace injuries and drive the cultural change.
We have established a dedicated safety working group to identify risk reduction opportunities and have developed new training modules focused on recognising equine behaviour cues that signal rising
risk, complementing existing companion animal training on safe cat handling and with further canine focused resources in development.
Alongside this, we continue to review policy proactively and have strengthened our significant event learning review process to encourage open reporting,
reflective learning and the cultural shift toward shared responsibility for safety that the research highlights as essential.
CVS Equine response to workplace injury study
CVS Equine has introduced mandatory personal protective equipment (PPE) for all veterinary colleagues.
All our vets, nurses & technicians are now required to wear a hard hat in the vicinity of a horse, pony or donkey - whether in practice, on a yard, or at a client's premises. It is hoped the move will reduce injuries to the head - one of the most common incidents cited by equine vets identified by the research, usually sustained when examining distal limbs.
Our Equine Veterinary Medical Director Charlotte Sinclair said: "All clinicians are at risk. So we've decided to make wearing hard hats mandatory to minimise the potential risk."
Improvement Projects
In 2025, CVS Group launched a refreshed and reenergised model for its yearly Clinical Improvement Projects in our Companion Animal practices.
Our refreshed approach was designed to better support practices, empower teams, and align clinical focus with organisational priorities. This new approach evolved from years of experience and learning about what helps change to happen - and what gets in the way.
In previous years, our Clinical Improvement Projects were more prescriptive. In 2019, for example, the focus on ear cytology was tightly defined, with central instruction on what practices should do.
While tremendous improvements were achieved, engagement varied and the approach did not always inspire a sense of ownership.
We care
At CVS, we care about providing high quality clinical care for animals, by empowering all teams to do
so consistently across our practices. By involving vets, nurses, animal care assistants, front-of-house teams and practice leaders, we aim to ensure that everyone has a role in shaping clinical quality.
By 2025, we had learnt that:
practices want ownership of improvement.
a one size approach does not fit all.
quality improvement works best when teams choose their own priorities.
clinical and operational priorities must be aligned.
everyone - not only clinicians - should be involved.
There are three broad project categories
In 2025, instead of many discrete projects, we simplified the focus to three broad categories; Collaborative Care, Life Stage Assessment and Prescribing with Purpose. These projects are described in detail in other sections of this report. Here, we talk about our new approach.
Under each category sits a bank of resources -learning, tools, guidance, and frameworks. But the projects themselves are not centrally specified.
Each team designs its own project within the chosen category, identifying local opportunities, barriers, measures of success, and who will be involved.
This increased autonomy, encourages teams to choose projects that are meaningful, locally relevant, and motivating.
The 2025 approach is built around:
empowerment rather than instruction.
flexibility rather than prescription.
collaboration rather than individual ownership.
quality improvement skills rather than one off tasks.
This shift has been welcomed by teams and has already delivered higher participation.
Although the projects are still underway, there are some promising outcomes.
Engagement is significantly higher and 95% of practices submitted project plans on time, compared with historically lower engagement. The breadth
of participation is also greater: vets, nurses, front-of-house teams, and practice leadership are all contributing meaningfully.
For example, Parasite Lifestyle Risk Assessments are a strong early indicator of meaningful change with 14,000 assessments completed in just four months. Comparatively, it has been reported a major manufacturer took four years to collect 15,000 responses. This dataset will help challenge
assumptions about parasite risk and influence future prescribing guidance and product availability.
Our learnings
More ownership and simplicity appear to be motivating for our practice teams and, as part of our commitment to inclusive leadership, and actively seeking diverse perspectives, we have
found that designing tools with a multidisciplinary team leads to be better outcomes.
Resources such as the parasite lifestyle risk assessment and the life stage frameworks were built collaboratively - and the quality reflects that. These tools are now used across all three project areas.
However, we continue to find that communication about the projects does not always reach those who need it.
Parasiticide Stewardship at CVS
CVS is committed to collating and generating robust evidence to support responsible parasiticide
prescribing, ensuring we protect animal health while also safeguarding environmental ecosystems and public health. Across 2025, CVS has led and invested in multiple research and QI initiatives, including
a multicentre primary care study on lungworm prevalence, development of risk based prescribing tools, and environmental research, to deepen our understanding of parasiticide use and its wider impacts.
Parasiticides are widely used in veterinary medicine to prevent and treat infestations of worms, fleas and ticks. While these treatments are essential for maintaining animal health and managing zoonotic risks, growing evidence suggests that routine and widespread use
of parasiticides may be contributing to environmental harm - particularly in aquatic ecosystems. Recent studies have highlighted the environmental risks associated with parasiticides used on companion animals, particularly compounds like fipronil and imidacloprid, which can enter waterways through household wastewater or runoff. These substances are highly toxic to invertebrates and have been linked to biodiversity loss and disruption of freshwater ecosystems.
Lungworm Prevalence (Companion Animal)
Worm Risk Calculator
(Equine)
groups.
Sheep Faecal Egg Counting
(Farm)
Lifestyle Parasite Risk Assessment (Companion Animal)
We care
Parasiticides remain essential for preventing parasitic diseases but with increasing concerns about overuse, resistance and environmental contamination, the need for risk based, evidence supported prescribing has never been greater.
This programme of work demonstrates that CVS is taking its responsibilities seriously, actively addressing knowledge gaps and helping the
profession move towards evidence based, risk led, and environmentally conscious parasite control.
Lungworm prevalence research
in Companion Animal
Initiated by clinicians in first opinion practice, the study set out to address an important evidence gap: the true prevalence of Angiostrongylus vasorum (lungworm) in dogs living in the Southwest of England. With national
conversations intensifying around responsible parasite prescribing and environmental impact, the team recognised the need for robust, region specific data to support their risk based clinical decisions.
How we did it
Funded through the CVS Clinical Research Grants programme, the study was conducted across 13 CVS practices located in the Southwest, using only residual blood from dogs already undergoing blood tests for routine clinical reasons. Between late 2023 and spring 2024, 631 dogs were tested, supported by owner lifestyle questionnaires to explore associated risk factors. Ethical approval, study design and statistical analysis were supported by CVS' Ethics Committee. The project required great collaboration and coordination across sites, to raise awareness with owners, collect the data and run the tests.
Key survey findings included:
Prevalence in primary care dogs in the Southwest is low but not zero
Across the 631 dogs tested, three dogs (0.48%) tested positive for A. vasorum antigen. Although the prevalence was low, the presence of confirmed cases particularly in a considered 'at risk region' of the UK, reinforces the need for ongoing surveillance and informed clinical decision-making .
Two of the positive dogs were asymptomatic, highlighting how lungworm can circulate silently in the population and two were not receiving regular lungworm prevention.
But our most at risk population were often receiving preventative lungworm prevention
Multivariable analysis showed that dogs were more
likely to receive monthly prevention if they:
were between 2-8 years old,
walked frequently in parks or playing fields,
slugs/snails are frequently present in the garden,
or dogs were reported by their owners to eat slugs/ snails.
These are well established lungworm risk factors, suggesting that primary care teams are increasingly engaging with risk-based prescribing. Importantly, the low prevalence estimate reported in this study is reflective of the level of preventative parasiticide
coverage in the tested population, which was greater in these higher risk dogs. Therefore, the prevalence needs to be interpreted with this in mind.
Owner understanding of lungworm prevention is highly variable
The study found substantial misunderstanding among owners:
Over half of owners who believed their dog was protected were not using an appropriate licensed product.
22% of owners were unsure which parasiticide they used.
This mismatch between perception and reality indicates a client education gap and presents an opportunity
for improved discussions around parasite risks and product efficacy.
Our learnings
The combined insights from the lungworm prevalence study and risk assessment initiatives show:
Prevalence data support improvements in focused, risk based prescribing.
Owner misunderstanding is a major contributor to inappropriate or ineffective use.
Healthcare plans materially improve compliance and correct product use.
Clinicians are increasingly using lifestyle factors to guide decisions which is an important cultural shift towards responsible prescribing.
New targeted parasiticide products are needed in the veterinary market so clinicians can treat according to patient risk profile.
Continued research is needed to understand environmental contamination risks arising from parasiticide use.
Lifestyle Parasite Risk Assessment in Companion Animal
Taking these results on board, a structured approach to prescribing within companion animal practices was developed with our Clinical Advisory Committee, resulting in CVS launching the Lifestyle Parasite Risk Assessment. This tool helps clinicians evaluate each pet's likely parasite exposure, ensuring prescribing is clinically justified, tailored to individual lifestyles and safer for non target species.
Our new approach aims to make it easier for veterinary teams to create a tailored strategy based on each
pet's lifestyle, exposure risk, and household context. It enables clinicians to evaluate individual risk factors and recommend parasite control programmes that are effective and environmentally responsible.
Training for all team members is being provided via all three of the Clinical Improvement Projects. This training covers: environmental impacts of parasiticides, best practice guidelines from BSAVA and BVA, parasite lifecycle education, zoonotic risk
management, practical application in consultations, and communication strategies for client engagement.
Worm Risk Calculator in Equine Practice
CVS Equine has co-developed and adopted a worm risk assessment tool for veterinary colleagues to use to support strategic endoparasite control in horses. The project aims to reduce anthelmintics use in horses.
The move aims to reduce the risk of anthelmintic drug resistance in horses and to reduce the environmental toxicity of the drug excreted by the horse after treatment. Anthelmintic resistance among horse worms is a growing global problem that has been caused by the over-use of these drugs.
The new 'What's Your Worm Risk' calculator was co-created by CVS Equine and Professor Jacqui Matthews of Austin Davis Biologics. The assessment tool looks at horse level factors - such as age and previous worm egg counts, along with management factors - such as field size, stocking density, dung removal, co-grazing with other animals and diagnostic testing. It calculates the likely level of risk based on widely accepted principles of equine worm infections and, depending on horse-specific input, it will classify the risk of worm infection as low, moderate or high.
If a horse is deemed 'low risk' then worming with anthelmintics (including the use of moxidectin in the autumn/winter) may be omitted, whereas previously it has been recommended that all adult horses
are treated in the winter for small redworms using moxidectin. This then has the effect of reducing the overall use of moxidectin in the equine population.
Faecal egg counting in Farm
Practice
Parasites remain one of the most persistent health and productivity challenges faced by UK farms. In recent years, parasite levels have fluctuated dramatically,
with several seasons showing unusually high worm burdens. These fluctuations place pressure on farmers to make quick, informed decisions about treatment, but without diagnostics, many rely on routine or unnecessary dosing.
Our learnings
The 2025 campaign reinforced the value of regular FEC's as a practical, farmer-friendly diagnostic tool. Farmers appreciated the ability to make informed decisions based on real data rather than relying
on routine worming and many reported improved confidence in managing parasite challenges across their flocks.
A key learning was the notable variation in parasite burdens between farms - and even within the same farm at different points in the season. This highlighted the importance of continued, regular testing rather than one-off checks. The follow-
up FECs post-treatment also proved essential; in several cases, reduced efficacy indicated early warning signs of anthelmintic resistance, allowing vets to adjust treatment protocols proactively.
The programme strengthened the partnership between vets and farmers. Farmers felt supported in making evidence-led decisions that promote welfare and productivity while safeguarding the efficacy of key wormer groups.
The consequences of unmanaged worm burdens are significant. Even subclinical parasite levels can hinder growth rates, reduce body condition, impair wool quality, decrease milk yield and diminish overall productivity. Severe infections cause diarrhoea, anaemia, weight loss and in extreme cases, death.
Equally concerning is the accelerating rise of
anthelmintic resistance on UK farms.
Alongside diagnostic support, CVS vets recommended targeted anthelmintic and anticoccidial treatments based on each farm's parasite profile, grazing system, previous resistance concerns, and seasonal risk factors. Narrow-spectrum wormers were prioritised whenever possible, reserving combination products for situations where they were genuinely appropriate.
In 2025, CVS Farm saw a three-fold increase in testing:
2913 sheep worm egg counts and 371 fluke egg counts
651 cases of cattle gut worm and 237 bovine fluke investigations
How we did it
During the grazing season, practices promoted FEC's at recommended intervals of every three to four weeks. This approach helps farmers diagnose worm burdens earlier, reduce production losses, avoid unnecessary treatments, time wormer dosing effectively, and detect any emerging signs of resistance.
Each practice utilised an OvaCyte machine, enabling worm egg counts to be completed in as little as 20 minutes. This rapid turnaround allowed farmers
to bring samples to the practice, receive same-day results, and leave with the correct, evidence-
based treatment where needed. Samples were also retested 1-2 weeks after dosing to confirm treatment efficacy.
Risk from Companion Animal Ectoparasiticide Use
A CVS funded three year PhD at the University of Bristol is ongoing, exploring the presence, behaviour, and ecological impact of ectoparasiticide residues from products commonly used to control fleas and ticks. This research responds to growing concern about declining invertebrate biodiversity and recent studies detecting fipronil and imidacloprid in UK waterways.
Key components include:
Large-scale pet owner survey.
Veterinary prescribing behaviour survey.
Developing laboratory bioassays to assess residue toxicity to insects and aquatic indicator species.
Field pitfall trapping to investigate impacts on dung associated invertebrates.
Early findings, have highlighted that isoxazolines, widely used veterinary prescribed oral flea/tick products, are water insoluble potentially reducing aquatic contamination risk. Faecal contamination to dung-associated invertebrates also indicates limited risk from isoxazolines based on preliminary data.
However, the long term fate of these compounds in the environment remains uncertain and needs to be considered by the profession.
This PhD is generating foundational data to help shape future prescribing guidance and support responsible use at a national scale.
Lower Flow Anaesthesia
Safely reducing anaesthetic gas use to protect the planet
CVS is taking a major step toward greener veterinary care by including a focus on reducing greenhouse gas emissions in its Prescribing with Purpose project in companion animal practices.
New findings showing substantial reductions in isoflurane consumption and associated greenhouse gas emissions across equine referral hospitals, help us learn from each other about the best way to reduce our carbon footprint and protect patient safety.
We care
Isoflurane, a widely used and volatile anaesthetic agent in veterinary surgery, is also a potent greenhouse gas (GHG). When released into the atmosphere, volatile anaesthetics contribute to climate change, with Isoflurane possessing a global warming potential many hundreds of times greater than carbon dioxide.
The good news is that the effect of anaesthetic gases in the environment is relatively short-lived. If we can reduce their use now, the benefit will be seen in just a few years.
CVS Equine Hospitals achieve reductions in anaesthetic gas use
CVS Equine evaluated current anaesthetic gas use. The aim was to identify practical ways to reduce environmental impact of anaesthesia while maintaining the highest standards of patient safety. In collaboration with the equine division, an EBVS Specialist in Veterinary Anaesthesia and Analgesia supported education and conducted the clinical audit.
The clinical audit revealed a clear shift in anaesthetic practice, resulting in meaningful environmental gains. Across the five hospitals, total Isoflurane usage decreased by 9.6% and oxygen usage by 17.9% between the two audit periods. This resulted in GHG emissions from anaesthetic gases falling from 14.6 to
13.2 tonnes of CO₂e over the study periods.
These findings show that low flow anaesthesia can be implemented responsibly and effectively in equine practice.
Our learnings
The study also explored a hypothetical low-flow anaesthesia model, based on an initial short period of high fresh gas flow followed by maintenance
at 2 L/min. This modelling suggested that, if consistently applied, such an approach could reduce anaesthetic gas-related emissions by up to 34% compared with current practice, highlighting further potential for improvement.
Sustainable anaesthesia in Companion Animal practices
As part of the Clinical Improvement Project -Prescribing with Purpose, we have a focus on undertaking anaesthesia more sustainably in our CVS companion animal practices. Given the large size of this group of practices, we have a real opportunity to make a big difference to our carbon footprint.
Teams will be looking at optimising their equipment and the care they provide in order to reduce anaesthetic gas use, this includes:
Optimising surgical patient care flow so that the time the patient spends under anaesthesia is minimised.
Ensuring patients receive the right analgesia at the right time to reduce anaesthetic gas requirements.
Checking equipment before use to ensure there are
no leaks and everything's working safely.
Fresh gas flow rates are calculated and utilised so that the patient receives what they require rather than using flow rates that are unnecessarily high.
Teams are encouraged to identify the areas for improvement that are right for them and are backed by educational resources as well as the CVS clinical support network provided by regional clinical leads, referral specialists, clinical improvement advocates, and environmental champions - all who are dedicated to sharing their knowledge and supporting each other in improvement. This project began in 2025 and so results will be seen in the coming year.
Improving Patient Outcomes
Improving patient outcomes is at the core of any effective healthcare system because it directly reflects on how well patients recover, function, and maintain their quality of life after receiving care.
We care
Focusing on patient outcomes drives better decision-making. It encourages evidence-based practices, continuous improvement, and accountability among veterinary teams. We can
measure what works, refine treatments, and deliver more personalised care.
Better patient outcomes also build trust. When clients experience positive outcomes, they're more likely to follow our advice, engage in preventive care, and maintain long-term relationships with their veterinary practice.
How we did it
In 2025, we supported this work in a variety of different ways, including:
Validated scoring tools, such as quality-of-life surveys.
Improving the diagnostic pathway to efficiently reach the right diagnosis.
Research - filling in knowledge gaps about the best way to do something.
Collaborative Care in Companion Animal
In 2025, CVS positioned validated instruments like the 'LOAD score' for canine osteoarthritis, quality of life tools for endocrine disease and parasite risk
assessments - at the heart of our Collaborative Care clinical improvement project, one of three QI initiatives within the Companion Animal division.
Veterinary teams routinely make decisions about conditions where owner observations are vital - from chronic pain and mobility to behaviour and quality of life. Yet, without structure, those observations can be hard to capture consistently.
So, our aim was to better measure owner observations, as when clients are invited to contribute structured, repeatable information, they feel more involved and gain a clearer understanding of why treatments matter -strengthening trust and outcomes.
For clinicians, standardised tools that capture this information reduce variation, support earlier detection of deterioration and make it easier to monitor response to treatment over time.
Quality of Life tool for Equine Cushing's
To generate evidence for equine practice, a two-year CVS funded research project with the Royal Veterinary College (RVC) has developed a new validated Quality of Life tool for horses with Pituitary Pars Intermedia Dysfunction (PPID) ('Equine Cushing's') and used this to measure the changes to a horse's quality of life over a longitudinal study, to support clinical judgement at key moments.
PPID is a common condition in older horses. Its impact
on quality of life (QoL) can be subtle, progressive,
and difficult to quantify in the field. Owners often struggle to articulate changes; while our clinicians need consistent ways to capture and track those changes to guide treatment, welfare, and end-of-life discussions. Understanding how horses live with this chronic disease requires further context than tracking blood test results - consideration as to their lived experience with this disease is needed.
This project has developed a newly validated quality of life tool after survey completion by over 600 horse owners and completed a longitudinal study over two
years tracking the QoL of 237 horses. Data indicates that QoL score were worse in PPID-positive horses as the study progressed, compared to non-PPID horses but QoL scores improved slightly over time across groups. Changes in QoL overtime was also influenced by a range of additional factors such as their body condition and presence of other health conditions. The developed QoL tool and findings from this study will support monitoring of treatment response and support clinicians in having more confident and compassionate conversations about what to do next after a horse has been diagnosed.
Reference: Bouquet A, Nicol C, Knowles EJ, Schofield I, Menzies-Gow NJ. Development of a health-related quality-of-life assessment tool for equines with pituitary pars intermedia dysfunction. Equine Vet J. 2026;58(1):190-202. https://doi.org/10.1111/evj.14513
Flash Scanning in Equine
Practice
In 2025, CVS's equine division undertook a project to improve confidence, competence, and use of FLASH scanning (a localised abdominal ultrasound technique) used in the assessment of colic which provides faster triage decisions by providing earlier identification of
serious cases and more appropriate use of referral and surgery.
Colic is one of the most common equine emergencies, ranging from mild to life-threatening. Improving clinicians' confidence in decision-making supports better outcomes and strengthens client trust. This project combined published evidence, clinician expertise, and used a structured, data driven approach to training, evaluation and clinical improvement across the division.
The FLASH scanning project began within the Equine QI Group. All 21 equine practices have a QI lead who asked coordinated survey responses from 93 vets across their practices, roughly half of CVS's equine clinicians.
The survey assessed self-reported confidence in
performing and interpreting FLASH scans:
28% felt competent
48% felt moderately competent
24% felt not competent
Only a quarter of vets felt confident, and 65% wanted further training in interpreting FLASH scans. This highlighted a clear need and strong motivation to improve. So a new structured training programme was provided in partnership with IMV Imaging, which included four practical training days with over 50 vets attending.
Equipment access was also addressed with the introduction of handheld V-scanners to help vets perform these scans more readily, supporting a more flexible and modern approach to diagnostics.
A second survey is planned for 2026, but clinicians are already reporting using FLASH scanning more routinely. Usage increased by 21% during 2025, despite training still being rolled out, showing that greater confidence is translating into meaningful change in practice.
Nurse Skill Utilisation
Insights from the CVS Nurse Survey and the launch of the Nurse Skill Utilisation PhD
In 2025, CVS has undertaken a programme of research to support us in better understanding how nursing skills are currently utilised across our practices and how they might be more effectively enabled and supported.
The CVS Veterinary Nurse Survey, was completed by more than 1,061 nurses working across over 90% of our practices, giving us insights into current patterns of nurse skill utilisation across CVS companion animal practices, reported confidence and satisfaction
of our nurses, and career stage using the nursing career pathway. The findings from this work have directly shaped one of our most ambitious research programmes to date: the Nurse Skill Utilisation PhD, launched in partnership with the Royal Veterinary College.
This report summarises what we learned from our nurses, how this data has informed the development of the PhD, and what this means for the future of veterinary nursing at CVS.
We care
Veterinary nurses are central to the safe, effective and compassionate care delivered across our practices. Their expertise encompasses clinical care provision, case management, patient advocacy,
and leadership in infection prevention and quality improvement. The CVS Veterinary Nurse Survey revealed nurses skills are not always fully utilised in practice, and opportunities to do so varies between practices.
To continue to improve nurse skill utilisation across CVS we need to ensure all nurses have the support, structure, and opportunities to work to the full scope of their skills. The Nurse Skill Utilisation PhD is
one key way that we intend to drive this forward, using an evidence-based approach, developing a framework in collaboration with our nurses, and designing with real-world practice in mind.
Findings From the CVS Veterinary Nurse Survey
Analysis of over 1,000 valid survey responses, representing about 45% of our nursing colleagues, showed a motivated, confident workforce whose capability often exceeds opportunity.
Key survey findings included:
Nursing skills were most frequently applied in routine consultations such as second vaccinations, nail clips and post-operative check. More advanced skills like undertaking fee-generating consultations, dental work and 'Schedule 3 activities' are used less often, even among nurses reporting they have the relevant qualifications.
Many nurses report high confidence in undertaking more advanced procedures and dental work, but do not have regular opportunities to carry these out.
The survey additionally highlighted that nurse skill utilisation satisfaction is not simply about performing more consultations or procedures:
Nurses reported higher satisfaction when they had a balanced mix of nurse-led clinics, clinical procedures, and fee-generating consultations.
These findings reinforce the need to approach optimisation as a systems-level challenge, rather than a prescriptive one-size-fits-all approach to nurse skill
utilisation. Instead, these data alongside other research, suggests focus should be on creating enabling conditions, including clear frameworks, leadership support, protected time, and local flexibility, through which practices can adapt nurse skill utilisation in ways that are both safe and sustainable to their practice.
The Nurse Skills Utilisation PhD
In response to the survey findings, CVS has launched
a pioneering three-year Nurse Skill Utilisation PhD to support the long-term advancement of veterinary nursing within companion animal practice.
Beginning January 2026, the project is led by CVS colleague Michelle Farrow RVN in collaboration with the Royal Veterinary College.
The project will use an action research approach to work directly with nurses, vets and leaders to co-develop a practical, transferable framework for nurse role optimisation that can be applied throughout CVS practices. This project will explore what effective, sustainable nurse skill utilisation looks like across different practice environments.
This landmark project reinforces CVS' commitment to empowering nurses to work to the full extent of their expertise and to shaping a future where the profession is better supported, valued and equipped to thrive.
The launch of this PhD marks a defining moment. As emphasised by senior clinical leaders, including our Chief Veterinary Nursing Officer Tara Ryan, nurses are "at the heart of our profession". The PhD is designed
to address longstanding challenges at a time when the profession is experiencing calls for legislative reform and ongoing advocacy for protection of the RVN title. With these pressures, evidence-based decision-making to support improvement is essential.
Supporting nurses in research and evidence-based practice
Building a research-confident nursing workforce
Alongside our larger research programmes, we are actively supporting nurses to develop confidence and skills in evidence-based practice.
In 2025, we launched the Vet Nurse Journal Club, a bimonthly online forum. Topics so far have included patient warming audits, pre-surgical planning and nutrition. Nurses describe the club as empowering, supportive, and confidence-building, giving them a space to connect and discuss emerging evidence.
We also delivered two in-person Veterinary Nurses in Research Workshops in 2025, attended by more than 40 RVNs. The workshops covered literature appraisal, clinical auditing, study design and case studies presented by our inspiring nurses.
Leadership
Advancing leadership skills and developing people-centric leaders
In 2024-25, CVS set out to address a longstanding challenge in the veterinary profession: how to support talented clinicians, nurses, receptionists, and operational colleagues as they step into their first leadership roles. Across the sector, people are often promoted because they excel in their current job, not because they have received development in how to lead others.
CVS launched its new Level 5 Leadership, Empowerment and Development (LEAD) Programme in early 2025 - the organisation's most significant leadership initiative in this decade. Designed to strengthen career progression, build leadership capability, and enhance people development, the programme is delivered face-to-face and rooted in the practical experience of people that have become successful CVS leaders.
Eighty-one colleagues from practices, farm, equine, HR, finance, and operations have taken part across the first three cohorts. The programme is beginning to change how leadership is understood and practised across CVS.
Each cohort begins with Insights Discovery, a behavioural preference tool that helps leaders understand themselves and others. This shared language frames the rest of the programme, supporting exploration of communication styles, motivations, conflict responses and team dynamics.
We care
Leadership has a measurable impact on clinical quality, colleague experience, patient outcomes and organisational performance. Good leadership enables continuous improvement by creating the conditions in which teams feel safe, motivated, and empowered to innovate, learn from mistakes and contribute to better care.
For CVS, this programme is also a key expression of our employer value proposition - especially
around progression, learning and support. It ensures that anyone stepping into leadership is not left to "figure it out" alone but instead is offered structured development and the confidence to thrive.
The subsequent modules cover the essential building blocks of effective leadership:
Communication, with active listening at its core.
A human approach to leadership, emphasising empathy, psychological safety and constructive responses to mistakes.
Motivation and engagement, based on intrinsic
drivers such as autonomy, mastery and purpose.
How we did it
The design of the CVS LEAD Programme began with listening. Feedback from practice teams, Regional Directors (RDs), support office colleagues and senior leadership practice visits highlighted that many leaders could benefit from the opportunity
to balance daily responsibilities with a stronger emphasis on leading their teams. The programme needed to be about a renewed focus on team needs, nurturing culture, developing individuals and supporting performance.
The insight gathered led to the understanding of what colleagues most needed from development. With this renewed insight, the LED and HR teams co-designed a nine-month programme built around six face-to-face training days. The curriculum was developed to support CVS' I-CARE Leadership behaviour framework.
Delegation and empowerment, reframed as key development tools.
Leading through change, focusing on communicating the "why" and building a shared commitment to improvement.
Professional development and performance, including the introduction of coaching as a central development method.
The success of the programme also reflects the strength of its facilitation. Trainers were selected not only for their expertise, but for their passion and
practical insight - grounding theory in lived experience rather than hours of theory. They shared lived experience to turn abstract ideas into something real.
Participants have rated the six-week course an
average of 4.7 out of 5
Our learnings
Leadership development must be continuous, not a one-off experience. The programme provides a strong foundation, but leaders need ongoing support to embed their learning, particularly coaching.
Consistency of leadership experience matters.
The quality of leadership should feel the same across practices, regions and support office teams. Feedback from the programme has helped shape a parallel Leadership
Development Programme for Regional Directors, ensuring leadership capability is strengthened across every layer of the organisation.
Behaviour, not process, is where most issues begin. The programme's emphasis on real human interactions is because performance challenges are rarely caused by a lack of process or knowledge of policy. Instead, it is behaviour such as empathy, communication, and relationship building that determines success.
Demand for leadership development is high. The speed at which new cohorts filled the course shows that colleagues are hungry for growth.
This programme breaks new ground for CVS -reestablishing leadership development at scale, with evidence led design and continuous refinement. Early results are strong: colleagues value the experience; demand is strong and feedback is positive.
It strengthens our culture of clinical quality, continuous improvement and colleague development. We
are equipping people with the skills, confidence and mindset needed to build psychologically safe, motivated, and effective teams.
RCVS
Practice Standards Scheme
Learning from the RCVS Practice Standards Scheme
CVS embeds the RCVS Practice Standards Scheme (PSS) at the heart of its quality improvement framework, using it as a structured, evidence-based benchmark across all its veterinary sites. Every CVS practice is PSS accredited, and the organisation embraces the scheme as a continuous cycle of improvement rather than a single assessment.
The RCVS Practice Standards Scheme (PSS) is a voluntary accreditation programme run by the Royal College of Veterinary Surgeons to ensure
that veterinary practices across the UK meet and maintain high standards of clinical care, safety and professionalism. It provides a structured framework that encompasses all aspects of veterinary practice, going beyond minimum legal requirements and supporting continuous improvement in veterinary practice.
Practices are assessed every four years, and where gaps are identified, then work to meet 100% of all requirements to achieve accreditation.
We care
We care because the PSS supports the health and welfare of our teams, patients and the wider
community. It helps us to identify what we are doing well and where we need to focus our efforts so that we can improve our ways of working to meet the professional standards we set for ourselves.
Over the past year, CVS concentrated its quality improvement efforts on the areas most frequently highlighted through the RCVS Practice Standards Scheme (PSS) namely:
Medicines regulation compliance and the safe management of controlled drugs remained the primary focus. CVS undertook its annual controlled drug audit across all practices, supporting
teams directly and addressing issues such as incomplete weekly checks, and misunderstandings about acceptable variances as well as gaps in recordkeeping. Medicine temperature monitoring was another challenge, and CVS has explored alternative monitoring devices and developed guidance aimed at improving overall medicines temperature management.
Diagnostic imaging regulation included gaps in not completing actions set out by the Radiation Protection Advisor (RPA). We worked to coordinate
with the Health and Safety team as well as property teams where building or installation issues were involved to ensure work is completed.
Health and safety focused on medical gas storage and fire risk assessment actions. We ensured these issues were escalated quickly to the relevant central teams. Property related concerns, such as damaged flooring, were also prioritised because of their implications for infection prevention and patient safety.
How we did it
In 2025, we focused on:
A comprehensive review of every PSS report
- with action items categorised into a central dataset.
Directed engagement of support teams -property, health & safety and diagnostic imaging actions were escalated immediately to the relevant teams.
Direct support for practices - our clinical services manager provided 1:1 troubleshooting, drop-in sessions and deadline tracking.
Development of new resources - these included medicines (eg. controlled drugs FAQ), training materials and checklists.
Our learnings
The RCVS PSS provides a recognised framework that has helped CVS steadily improve standards of care, not only in our practices, but throughout our business. We view assessment reports as feedback on how well our systems are working, and where we need to improve.
By utilising the collective strength of all teams at CVS, we work together toward ensuring it's easy to do the right thing.
CVS practices meet 96% of PSS requirements at time of assessment.
Harnessing Artificial Intelligence to Drive Clinical Improvement
Artificial intelligence (AI) is rapidly transforming healthcare delivery and supporting improvements in diagnostics, workflow optimisation, and clinical
How we did it
Starting with safety first, CVS began with a referral-centre pilot where specialist clinicians could assess accuracy and safety. This
step helped us to minimise the unintended consequences of implementing these AI tools before considering a wider rollout.
Five referral hospitals tested two AI scribe platforms over three months: no patient or client safety incidents were identified and positive subjective feedback was received.
Next came expansion into 36 first-opinion practices across the UK. Clinicians attended training covering responsible AI use, patient safety, consent processes, and effective use of the tools. CVS collected both subjective feedback and objective metrics.
This pilot represented new territory for CVS - not only in testing AI technology, but also in building the internal capability to evaluate it responsibly.
documentation. For CVS, these technologies offer new and exciting opportunities to enhance clinical care, improve colleague wellbeing, accelerate research, and deliver safer, more consistent decision-making .
AI will never replace the clinical expertise, compassion and judgement of veterinary teams but it could support our teams with evidence. AI tools can reduce administrative burden, strengthen diagnostic accuracy, and enable high quality research at scale.
We care
At the heart of this project was a simple belief: if technology can meaningfully reduce administrative burden, we give clinicians more of the time and energy they need to focus on patients and clients.
Our learnings
Findings from the trial indicate that:
Colleagues were more likely to use the AI consistently when it integrated smoothly into existing technology systems and when others in their team used it too.
Time savings occurred mostly outside the consultation. The greatest benefit from colleague feedback was reduced after-hours admin tasks, fewer late-running sessions, and better lunch breaks.
Overly long or descriptive AI-generated notes discouraged use, while clear, structured templates improved adoption.
Leadership buy-in is crucial. Practices where leaders actively encouraged participation showed higher adoption.
Using AI to Support Veterinary Consultations: A Pilot Project
In 2025, CVS Group undertook one of its most ambitious technology trials to date: exploring whether artificial intelligence could support clinicians during veterinary consultations. When looking at potential options to improve administrative workloads in the consult, AI-assisted scribing looked to offer the possibility to:
Reduce admin time, freeing clinicians to think, diagnose and care.
Improve note quality and accuracy, supporting safer follow-up care and clinical audit.
Allow more meaningful face-to-face interaction with clients.
Support business efficiency, particularly as the ageing pet population drives increasing demand for care.
After completing this project, we concluded that the technologies tested were safe and helpful for clinicians, in certain situations. It also showed that adoption will vary, and that technology must be paired with training, leadership support and thoughtful implementation.
Going forward we have also reflected that governance assessment processes for AI technologies are essential, with training and consent approaches need to be tailored specifically for technology. We will continue to evaluate emerging AI features, monitor safety, accuracy and user experience, and allow AI scribing to grow gradually across teams who want
to use it. The pilot has given us the insight and the confidence to continue exploring AI responsibly, always with patient care, colleague wellbeing and client experience at the centre of the journey.
AI assisted Ki-67 prognostic scoring for canine mast cell tumours: A research project by Finn Pathologists
Canine cutaneous mast cell tumours (cMCT) are frequently diagnosed skin cancers in dogs, but their behaviour after diagnosis can range from benign to highly aggressive. Predicting how an individual tumour will behave is inherently challenging.
Manual 'Ki-67' scoring is one method pathologists can look to predict a tumours future behaviour, however this method is slow, subjective and affected by variations between pathologists. Reducing this variation could improve prognostic reliability, enabling clearer owner discussions, better risk stratification, and more confident use of surgery, chemotherapy and imaging. Recognising these limitations, CVS' Finn Pathologists explored whether artificial intelligence (AI) could enhance diagnostic accuracy.
To do this, pathologists have developed an AI assisted Ki-67 scoring system after working with Aiforia® Technologies. Clinical data on ~200 real cases with
known clinical outcomes - recurrence, survival, and treatment patterns - were collated by oncologists at Bristol Vet Specialists to confirm that AI assisted scoring aligned with established prognostic indicators.
We care
We wanted to increase scoring consistency, improve the prognostic accuracy and increase lab test capacity for this common cancer. CVS is also ensuring the veterinary profession keeps up with human medicine. Digital pathology and AI
assisted diagnostics are advancing rapidly in human medicine. By developing this capability now, we
are demonstrating that AI can be used safely and effectively to enhance our specialist expertise.
The team undertook a rigorous validation process with three pathologists independently scoring cases manually to compare with AI-generated outputs and by repeatedly scanning the same slides over several weeks to assess variability introduced by scanning equipment.
How we did it
Together with Aiforia, we set about building the AI model. The algorithm development included:
Selecting high quality digital Ki-67 images
Manually annotating thousands of regions
Iterative refinement
Weekly analysis of clinical cases
Heatmap development to locate hotspots
A Finn pathologist working within Aiforia's team strengthened the collaboration. During this period, and beyond, one of the Finn pathologists spent part of their week employed within Aiforia's development team - a unique arrangement that strengthened expertise on both sides.
This pathology test has now been offered to practices with this development now supporting routine casework by improving consistency, reducing subjectivity, and facilitating speedy scoring - while pathologists retain final interpretation.
Our learnings
One of the biggest learnings from this project was that AI development in diagnostics is complex, iterative and full of unexpected challenges.
Although AI can perform image analysis at extraordinary speed, its accuracy depends entirely on the quality and consistency of the inputs.
Small differences in slide focus, staining intensity, or scanner performance can significantly affect results.
The team learned that:
AI requires routine monitoring and quality checks
Models need ongoing validation
Hardware changes affect performance
Numerous subtle variables influence output Pathologists must therefore retain final oversight.
The AI assisted Ki-67 scoring project represents a significant advance for CVS and the wider profession. It shows that AI can enhance - rather than replace -specialist expertise, improving diagnostic consistency and supporting better patient outcomes. Most importantly, it highlights the impact of collaboration, innovation and a commitment to high diagnostic standards.
The project developed expertise in AI model development, digital workflows, QC processes and statistical validation - skills now informing new AI initiatives.
Recognition
Research recognition 2025
Tim Mair at Bell Equine: Sage Kester Lifetime Achievement Award from American Association of Equine Practitioners for his equine veterinary
medicine through clinical practice, clinical research, scholarly publications, continuing education, teaching and mentorship.
Nadine Ogden at B&W Equine: The BEVA Richard Hartley Clinical Award. It is awarded to the senior author of the best paper published in Equine Veterinary Journal or Equine Veterinary Education with direct clinical application. Nadine's paper was 'Computed tomography of the equine caudal spine and pelvis. Pathological findings in 56 clinical cases (2018-2023)'.
Deborah Komianos, Regional Clinical Lead: BSAVA Practitioner Award For presentation on 'Reducing use of critically important antibiotics: A clinician-led improvement project across 21 UK small animal veterinary practices'.
Holly Clayton at Market Hall Vets: Best presentation in the vet nursing journal live (VNJ) at BVNA Congress 2025 on her research titled 'The impact of medical castration (Suprelorin) on weight gain in male dogs when compared to surgically castrated and entire dogs'.
Charlotte Sinclair, CVS Equine Veterinary Medical Director. Antibiotic use in first opinion equine practice in the United Kingdom: Serial prevalence point surveys in 17 practices. Equine Veterinary Education. Wiley 'top cited article'.
Quality Improvement recognitions 2025
The RCVS Knowledge Quality Improvement Awards celebrate veterinary team achievements that contribute to advancing the quality of veterinary care. They recognise teams in three award categories:
Antimicrobial Stewardship - Showcasing practical examples where teams are improving responsible antimicrobial prescribing using recognised quality improvement methods.
Quality Improvement to Lead Organisational Change - Celebrating organisations who are working with local teams and using QI theory to embed change.
Quality Improvement in Practice - This award celebrates veterinary teams who have implemented QI techniques to drive improvement.
Champion in Leading Organisational Change - CVS Clinical Improvement Group
CVS Clinical Improvement Team achieved 35,000 fewer HPCIA prescriptions compared to the benchmark by engaging teams and implementing systems to facilitate good stewardship.
Highly Commended in Antimicrobial Stewardship - Central 2 Region
Central 2 Region reduced antibiotic use from 1.43% to 1.06% in a year by setting targets and designing interventions such as team discussions and visual reminders.
Highly Commended in Quality Improvement in Practice - Regional Clinical Leads
This project achieved an improvement in the percentage of patients receiving ocular diagnostic tests, through education, updated guidance and a shift to a contextualised care approach.
Highly Commended in Quality Improvement in Practice - Westmoor Vets
The team conducted a clinical audit to review their prescribing of Omeprazole for cats and dogs.
The initial audit revealed that while the correct dose was prescribed in all cases, 63% of prescriptions did not follow the recommended twice-daily dose
frequency, and 43% were for inappropriate indications
After discussing the guidelines and implementing changes, a re-audit showed significant improvement: 76% of prescriptions followed the twice-daily dose frequency, and 76% were prescribed for appropriate indications. This audit improved prescribing practices, benefiting both patients and the clinical team.
Highly Commended in Quality Improvement in Practice - Yew Tree Vets
The team undertook an audit to improve pain scoring and achieved an increase in the number of patients having scores recorded from 24% to 94.2%, by implementing training, a buddy system, and changes to forms.
2025 CVS research publications
Allerton, F., Sørensen, T.M., Scahill, K., Ruperez, J.E., Swinbourne, F., Verwilghen, D.R., Nolff, M.C., Foroutan, F., Baines, S.J., Vilen, A. and Pelligand, L., 2025. European Network for Optimization of Veterinary Antimicrobial Therapy (ENOVAT) 2025 guidelines for surgical antimicrobial prophylaxis in dogs and cats. Journal of Small Animal Practice.
Andrews ALMM, Izaguirre E, Green J, Scurrell E, Gogova S, Tayler S, Kafarnik C. Treatment With Remdesivir Alone or in Combination With GS-441524 in Cats With Ocular Involvement of Feline Infectious Peritonitis: An Observational Case Series. J Vet Intern Med. 2025 Nov-Dec;39(6):e70253. doi: 10.1111/jvim.70253. PMID: 41035288; PMCID: PMC12489177.
Asorey Blazquez, C., Jolly Frahija, I., Smith, A., Miller, R., Seth, M., Garcia Manzanilla, E. and Valls Sanchez, F., 2025. Retrospective Study of Chronic Coughing in Dogs in a Referral Centre in the UK: 329 Cases (2012-2021). Animals, 15(2), p.254.
Banerjee, A.A., 2025. Does conservative or arthroscopic management of canine medial coronoid disease lead to improved outcomes?. Veterinary Evidence, 10(1).
Beeby L, Martinez M, Bode EF. Idiopathic spontaneous intracardiac microbubbles in an adult dog. J Vet Cardiol. 2025 Jun;59:43-47. doi: 10.1016/j.jvc.2025.03.001. Epub 2025 Mar 12. PMID: 40187142.
Bouquet A, Nicol C, Knowles EJ, Schofield I, Menzies-Gow NJ. Development of a health-related quality-of-life assessment tool for equines with pituitary pars intermedia dysfunction. Equine Vet J. 2025 May 2. doi: 10.1111/evj.14513. Epub ahead of print. PMID: 40314080.
Boyd, K., Dobromylskyj, M., Schofield, I., O'Neill, D., Figueroa, C. and Davies, O., 2025. Clinical Value of Various Histological Factors in Cutaneous and Subcutaneous Mast Cell Tumors in 197 Dogs. Journal of Veterinary Internal Medicine, 39(6), p.e70244.
Cambruzzi M, McFadzean WJ, Covey-Crump G, Deutsch J. Comparing intramuscular ketamine with peri-incisional bupivacaine with or without ketamine in dogs undergoing hemilaminectomy. Vet Anaesth Analg. 2025 Mar-Apr;52(2):244-251. doi: 10.1016/j.vaa.2025.01.002. Epub 2025 Jan 7. PMID: 39915179.
Cameron A, Geldard M, Mair T, England G, Burford J, Freeman S, Pollock K, Wilson E. Experiences of End-of-Life Decision-Making in Equine Veterinary and Charity Teams. Animals (Basel). 2025 Feb 26;15(5):678. doi: 10.3390/ani15050678. PMID: 40075960; PMCID: PMC11898496.
Castellano L, Fews D. Glomus tumour of the abdominal wall in a cat. JFMS Open Rep. 2025 May 7;11(1):20551169251332395. doi: 10.1177/20551169251332395. PMID: 40351810; PMCID: PMC12062611.
Cavasin JP, Chen MC, Ajoyan H, Dobromylskyj MJ, Huang WH, Jager M, Van Brussel K, Rockett R, Nekouei O, Watson P, Bestwick J, Choi YR, Lidbury JA, Cullen JM, Holmes E, Steiner JM, Tu T, Beatty JA. Recurrent integration of domestic cat hepatitis B virus DNA near feline CCNE1 supports an oncogenic role in hepatocellular carcinoma in cats. Tumour Virus Res. 2025 Jul 16;20:200324. doi: 10.1016/j.tvr.2025.200324. Epub ahead of print. PMID: 40681110; PMCID: PMC12332951.
Černá P, Knies M, Assink M, Evans S, Tasker S, Gunn-Moore DA, Hartmann K, Buchta K, Taylor S, Meunier S, Hofmann-Lehmann R, Jacque N, Koonce A, Jacobs C, Gillett A, Lappin MR. Immune-Mediated Hemolytic Anemia in Cats with Feline Infectious Peritonitis. Pathogens. 2025 Jul 4;14(7):660. doi: 10.3390/pathogens14070660. PMID: 40732707; PMCID: PMC12299815.
Chang, C.H., Watson, C., Chatterjee, D., Ward, J., Borgeat, K., Hodgkiss-Geere, H., Dukes-McEwan, J., Hamilton, R. and Hezzell, M.J., 2025. Anti-desmoglein-2 autoantibodies do not discriminate between UK boxer dogs with and without arrhythmogenic right ventricular cardiomyopathy. Veterinary Record.
Cheng WC, Lawson C, Wilkie L, Dobromylsky M, Luis Fuentes V, Holt MR, Ehler E, Connolly DJ. Desmin disorganisation: A key feature in feline hypertrophic cardiomyopathy. PLoS One. 2025 Jul 14;20(7):e0327850. doi: 10.1371/journal.pone.0327850. PMID: 40658643; PMCID: PMC12258562.
Cifre Pallicer, C., Di Bella, A., Kelly, D., Shihab, N. and Karpozilou, A., Poorly differentiated soft tissue sarcoma located in the craniodorsal mediastinum in two dogs and a literature
review. Veterinary Record Case Reports, p.e1110.
Coates V, Alves Nores V, Caulfield S, Purzycka K, Plested M, Salord Torres X. Splenic haemangiosarcoma in a cat treated with splenectomy and metronomic thalidomide. JFMS Open Rep. 2025 Aug 4;11(2):20551169251349729. doi: 10.1177/20551169251349729. PMID: 40766300; PMCID: PMC12322367.
Couto, F., Tabanez, J., Rose, J. and Arrol, L., 2025. Subarachnoid diverticulum associated with an acute non-compressive nucleus pulposus extrusion in a Staffordshire bull terrier. Veterinary Record Case Reports, p.e70084.
Couto, F., Tabanez, J., Rose, J. and Driver, C., 2025. Surgical management of single-level thoracolumbar vertebral body segmentation and formation failure causing progressive thoracolumbar myelopathy in three adult large-breed dogs. Frontiers in Veterinary Science, 11, p.1504477.
Davidson GA, Smith SH, Dobromylskyj MJ. Differentiation of feline cutaneous round cell tumours using immunohistochemistry. J Comp Pathol. 2025 May;219:41-47. doi: 10.1016/j. jcpa.2025.04.006. Epub 2025 May 1. PMID: 40315662.
De Frias JM, Bhatti SFM, Nye G, Gonçalves R, Harcourt-Brown T, Fadda A, Marioni-Henry K, Padley H, De Decker S. Spinal arachnoid diverticula in cats: Clinical presentation, diagnostic imaging findings, treatment, and outcome. J Vet Intern Med. 2025 Jan-Feb;39(1):e17294. doi: 10.1111/jvim.17294. PMID: 39739353; PMCID: PMC11683399.
de la Horra, A.T., Davies, O., Almansa Ruiz, J.C. and Sutton, D., 2025. Computed tomographic findings and histopathological features of suspected facial chondrosarcoma in a domestic
shorthair cat (Felis catus). Veterinary Record Case Reports, p.e70210.
Deards EL, Bright S, Keeley B, Pettitt R, McConnell JF. Computed Tomography, Clinical Findings and Outcomes of Acute Anconeal Process Osteophyte Fractures and Fissures in Nine Dogs. Vet Comp Orthop Traumatol. 2025 Oct 2. doi: 10.1055/a-2702-4680. Epub ahead of print. PMID: 41038245.
Dunkel, B., Hildon, G.L., Coumbe, K.M., Busuttil, E., Von Schweinitz, D. and Devereux, S., 2025. Electroacupuncture as a treatment for suspected trigeminal nerve-mediated head-shaking in 42 horses. Equine Veterinary Education, 37(12), pp.647-653.
Elane GL, Blikslager AT, Mair TS. Trends in the management of horses referred for colic evaluation preceding and during the COVID-19 pandemic (2013-2023). Equine Vet Educ. 2025 Jun;37(6):308-315. doi: 10.1111/eve.14038. Epub 2024 Aug 19. PMID: 40599687; PMCID: PMC12208670.
Elliott J, Reyes-Hughes H, Hibbert A, Blackwell E, Finch NC. Owners' experiences of caring for cats with chronic kidney disease in the UK. J Feline Med Surg. 2025 Apr;27(4):1098612X251314769. doi: 10.1177/1098612X251314769. Epub 2025 Apr 16. PMID: 40235283; PMCID: PMC12035312.
Elvira T, Mallol C, Crawford A, Ives E, Fraser AR, Mari L, Tauro A, Alvarez P, Indzhova V, Corsini G, Lopes B, Brocal J. Facial Myokymia With or Without Concurrent Neurological Deficits in Seven Dogs and Two Cats. J Vet Intern Med. 2025 Mar-Apr;39(2):e70041. doi: 10.1111/jvim.70041. PMID: 40103261; PMCID: PMC11919749.
Fairburn, A.J., Cox, A. and Mair, T.S., 2025. Cystic pancreatitis in a Shetland pony mare diagnosed on ultrasound and computed tomography. Equine Veterinary Education.
Farrell M, Waibel FWA, Carrera I, Spattini G, Clark L, Adams RJ, Von Pfeil DJF, De Sousa RJR, Villagrà DB, Amengual-Vila M, Paviotti A, Quinn R, Harper J, Clarke SP, Jordan CJ, Hamilton M, Moores AP, Greene MI. Musculoskeletal adverse events in dogs receiving bedinvetmab (Librela). Front Vet Sci. 2025 May 9;12:1581490. doi: 10.3389/fvets.2025.1581490. PMID: 40417367; PMCID: PMC12100767.
Frapwell E, Watkins M, Halcrow B, Goodrum H, Burton NJ, Ogden DM, Bright S, Oxley B. Analysis of humeral condylar morphology in dogs with and without humeral intracondylar fissure. Vet Surg. 2025 Jun 2. doi: 10.1111/vsu.14286. Epub ahead of print. PMID: 40457592.
Gatehouse, E. and Pisco, V., 2026. Clinical presentation and management of repetitive circling behaviour in a working cocker spaniel secondary to meningoencephalomyelitis of unknown
aetiology. Veterinary Record Case Reports, 14(1), p.e70301.
Gomes SA, Targett M, Mignan T, Longo S, James M, Stee K, Gunovska H, Costa D, Diogo J, Schofield I, Lowrie M. Post-surgical outcome and recurrence rates in thoracolumbar arachnoid diverticula undergoing durotomy alone or alongside a modified technique of subdural shunt-placement in dogs. Vet Surg. 2025 Jul;54(5):972-982. doi: 10.1111/vsu.14236. Epub 2025 Feb 28. PMID: 40018996.
Gunovska H, Degl'Innocenti S, Targett M, Carrera I, Gomes SA. Case Report: Infiltrative multifocal meningioangiomatosis affecting the spinal cord of a young Labrador Retriever. Front Vet Sci. 2025 Jun 10;12:1580306. doi: 10.3389/fvets.2025.1580306. PMID: 40557270; PMCID: PMC12186452.
Gunovska H, Llanos C, Fitzgerald E, Alcoverro E, Flatz K, Gomes C, Gomes SA. Computed Tomography and Magnetic Resonance Imaging Features of Gracilis Myopathy in Dogs. Vet Comp Orthop Traumatol. 2025 Mar;38(2):87-95. doi: 10.1055/s-0044-1793942. Epub 2024 Nov 15. PMID: 39547682.
Haskey E, Maund V, Allerton F, Browse B, Heard C, O'Donnell C, Davison K, Hertel C, Booth E, Lawrence S, Dever E, Bowe L, Taylor H, Hall K, Trimble K, Junior M, Fennell C, Stevenson N, Sterritt A, Penn E, Nowell L, Collins A, Jones E, Scudder C. Placement, management and complications associated with peripheral intravenous catheter use in UK small animal practice. J Small Anim Pract. 2025 Jan;66(1):3-13. doi: 10.1111/jsap.13782. Epub 2024 Sep 5. PMID: 39238283; PMCID: PMC11736090.
Healy D, Ballarini L, Agthe P, Cantatore M, Moores AL. Significance of incidentally identified bullae and blebs on thoracic computed tomography and prevalence of subsequent pneumothorax in dogs. Vet Surg. 2025 Jan;54(1):52-58. doi: 10.1111/vsu.14144. Epub 2024 Nov 25. PMID: 39584707.
Heaselgrave T, De Risio L, Domínguez E, Scarpante E, Mignan T, Alcoverro E, Spinillo S, Ferreira A, Samarani F, Espinosa P, Cagnotti G, Sánchez L. Presumptive intramedullary intervertebral disc extrusion in 12 cats: clinical presentation, MRI findings, treatment and outcome. J Feline Med Surg. 2025 Jul;27(7):1098612X251349712. doi: 10.1177/1098612X251349712. Epub 2025 Jul
22. PMID: 40692340; PMCID: PMC12290249.
Hood, R.S., Morton, M. and Thomson, D., 2025. Stabilisation of hard palate midline fracture using a trans-maxillary screw in cats: A report of two cases. Veterinary Record Case Reports, 13(3),
p.e70073.
Hordle T, Navarro-Carrillo M, Schofield I, Plested M, Niimura Del Barrio MC. A Comparison of Two Different Methods for Inducing Apnoea During Thoracic Computed Tomography of Dogs. Animals (Basel). 2025 Apr 1;15(7):1014. doi: 10.3390/ani15071014. PMID: 40218407; PMCID: PMC11988056.
Hordle T, Ranninger E, Bettschart-Wolfensberger R. Successful management of two horses with suspected pulmonary haemorrhage in recovery from general anaesthesia. Vet Anaesth Analg.
2025 Sep-Oct;52(5):623-627. doi: 10.1016/j.vaa.2024.11.002. Epub 2025 Feb 21. PMID: 39986920.
Hunt JR, Knazovicky D, Goff M, Harris J, Knowles TG, Enomoto M, Mendl M, Whay B, Lascelles BDX, Murrell JC. Quantitative sensory testing in dogs with spontaneous osteoarthritis. Front Pain Res (Lausanne). 2025 Apr 14;6:1518725. doi: 10.3389/fpain.2025.1518725. PMID: 40297737; PMCID: PMC12034712.
Hunt JR, Knazovicky D, Harris J, Kelly S, Knowles TG, Murrell JC, Lascelles BDX. Ice water immersion does not activate diffuse noxious inhibitory controls of spinal reflexes in sedated or anaesthetised dogs (Canis familiaris): a pilot study. Front Pain Res (Lausanne). 2025 Mar 10;6:1505064. doi: 10.3389/fpain.2025.1505064. PMID: 40129491; PMCID: PMC11931054.
James M, Lowrie M, Rusbridge C. Characteristics and clinical course of myoclonus in Cavalier King Charles Spaniels. J Vet Intern Med. 2025 Jan-Feb;39(1):e17227. doi: 10.1111/jvim.17227. Epub 2024 Nov 9. PMID: 39520132; PMCID: PMC11627513.
Karamanidou, S., Mulet, A.R., Ruiz, J.C.A. and Murrell, J., 2026. Videoendoscopic endotracheal intubation in a cat with unilateral temporomandibular joint ankylosis. Veterinary Record Case Reports, 14(1), p.e70313.
Kelly, R., Lucas, H., Etherington, C., Clarkson, J., Spooner, H., Forrester, J., Moreton, M., Stansbie, N. and Schofield, I., 2025. Evolution of a Veterinary Graduate Development Programme Utilising the 70: 20: 10 Workplace Education Model and Its Potential Impact On Graduate Attrition. Journal of Veterinary Medical Education, (aop), p.e20250039.
Lande, A., Lawn, R. and Martin, S., 2025. Centronuclear myopathy in a Labrador Retriever presenting for evaluation of a 'bunny-hopping'gait. Veterinary Record Case Reports, p.e70108.
Lappalainen, M., Gomez Fernandez, J., Béguin, J., Fournier, Q., Hayes, A., Bing, Y., Rodiño-Tilve, V., Bazelle, J., Borrego, J. and Desmas-Bazelle, I., 2025. Presentation, treatment, and outcome of lipomas of the pelvic canal in dogs. Veterinary Oncology, 2(1), p.28.
Lau S, Platt S, Tauro A, Ricci E, Alcoverro E. Meningoencephalitis of unknown origin with predominant cerebellar involvement in a cat: clinical, MRI and pathological findings. JFMS Open Rep. 2025 Aug 9;11(2):20551169251346436. doi: 10.1177/20551169251346436. PMID: 40786965; PMCID: PMC12335653.
Lipscomb V, Anghileri-Jarman F, Taylor S. Retrospective review of outcome following medical management of a congenital portosystemic shunt in 10 cats. J Feline Med Surg. 2025 May;27(5):1098612X251334086. doi: 10.1177/1098612X251334086. Epub 2025 May 19. PMID: 40384413; PMCID: PMC12089725.
Louie N, Acosta DN, Yeadon R, Bşczkowski PM. Case Report: Laryngeal web in a Yorkshire Terrier. Front Vet Sci. 2025 Jul 21;12:1595548. doi: 10.3389/fvets.2025.1595548. PMID: 40761841; PMCID: PMC12320528.
Louro LF, Sinclair C, Hargreaves L, Coumbe K, Hajeeh Ali M, Percan V, Bacon B, Kukaswadia A, Mair T. Multi-centre clinical audit of oxygen and inhalant anaesthetic usage in equine anaesthesia: The potential benefits of training and low-flow techniques. Equine Vet J. 2025 Oct 4. doi: 10.1111/evj.70108. Epub ahead of print. PMID: 41045252.
Mair, T.S., Hopkins, J.A. and Bellis, I.T., Reasons for veterinary performed equine euthanasia in one veterinary practice in the UK. Equine Veterinary Education.
Mair, T.S., Sinclair, C., Stone, H. and Schofield, I., 2025. Antibiotic use in equine hospitals-Serial point prevalence surveys in six European hospitals. Equine Veterinary Education. Mair, T.S., Stone, H.A. and Schofield, I., 2025. Assessment of serum pancreatic (DGGR-) lipase concentrations in equids with gastrointestinal disease. Equine Veterinary Education.
Martinez A, Alcoverro E, Ives E, Alves L. Evaluation of Cervical Myoclonus in Dogs with Spinal Diseases: 113 Cases (2014-2023). Animals (Basel). 2025 Aug 6;15(15):2298. doi: 10.3390/ ani15152298. PMID: 40805088; PMCID: PMC12345508.
Martinez E, Dobromylskyj MJ, Plested MJ. Bilateral Tonsillar Polyps in a Dog Described on CT. Vet Radiol Ultrasound. 2025 Mar;66(2):e70017. doi: 10.1111/vru.70017. PMID: 40016165.
Martinez Martinez E, Taylor S, Coates V, Plested M. Pulmonary toxoplasmosis in an immunosuppressed cat. J Small Anim Pract. 2025 Jun 24. doi: 10.1111/jsap.13899. Epub ahead of print. PMID: 40552416.
Menendez P, Alcoverro E, Garosi L. Primary intracranial meningeal histiocytic sarcoma causing calvarial hyperostosis in a dog. J Small Anim Pract. 2025 Jul 22. doi: 10.1111/jsap.13905. Epub ahead of print. PMID: 40696260.
Monteiro, B.P., Taylor, S., Dowgray, N., Eyre, K. and Gruen, M., 2025. Feline chronic pain management: the importance of a team approach for optimal outcomes. Journal of feline medicine and surgery, 27(11), p.1098612X251374161.
Motta, C., Condon, A.M., Owen, M.A., Craig, A., Ridge, P.A., Perez, M.C.P. and Oxley, W.H.G., 2025. Feline Shoulder Arthrodesis Using 3D-printed Patient-specific Guides. Veterinary and
Comparative Orthopaedics and Traumatology.
Muthmann S, Schofield I, Kersting M, Blunschi F, Tiefenbrunner JL, Bauer NB, Hazuchova K. Influence of Owner Personality and Other Owner-, Cat- and Treatment-Related Factors on the Perception of Quality of Life in Cats With Hyperthyroidism. J Vet Intern Med. 2025 May-Jun;39(3):e70091. doi: 10.1111/jvim.70091. PMID: 40231815; PMCID: PMC11998023.
Noll, C., Reyner, C., Dechant, J.E., Omura, C., Dixon, P., Nowak, M., Schulte-Bahrenberg, S., Fowlie, J., Lang, H.M., Mair, T.S. and Prange, T., 2025. Equine tongue tumours: A multicentre
retrospective study. Equine Veterinary Education.
Ogden NKE, Winderickx K, Bennell A, Stack JD. Computed tomography of the equine caudal spine and pelvis: Technique, image quality and anatomical variation in 56 clinical cases (2018-2023). Equine Vet J. 2025 Sep;57(5):1265-1278. doi: 10.1111/evj.14422. Epub 2024 Oct 10. PMID: 39390752; PMCID: PMC12326906.
Ogden NKE, Winderickx K, Stack JD. Computed tomography of the equine caudal spine and pelvis. Pathological findings in 56 clinical cases (2018-2023). Equine Vet J. 2025 Sep;57(5):1279-1289. doi: 10.1111/evj.14426. Epub 2024 Oct 20. PMID: 39428125; PMCID: PMC12326895.
Petty MC, Monteiro BP, Robertson SA, Ajadi AR, Mosley C, Murrell JC, Nadkarni N. Myofascial pain syndrome in small animal practice. J Small Anim Pract. 2025 Feb;66(2):75-80. doi: 10.1111/ jsap.13795. Epub 2024 Oct 24. PMID: 39449281.
Phillips RK, Blake AB, Tivers MS, Chan A, Ishii PE, Suchodolski JS, Steiner JM, Lidbury JA. Serum Amino Acid Profiles in Dogs with a Congenital Portosystemic Shunt. Metabolites. 2025 Apr 9;15(4):258. doi: 10.3390/metabo15040258. PMID: 40278387; PMCID: PMC12029160.
Piana F, Wylie S, Belch A, Barthelemy N, Carwardine D, Ogden D, Parsons K. Lateral Epicondylar Fissure Fractures after Transcondylar Screw Placement for the Treatment of Humeral Intracondylar Fissures and Humeral Condylar Fractures. Vet Comp Orthop Traumatol. 2025 Aug 27. doi: 10.1055/a-2685-0035. Epub ahead of print. PMID: 40865560.
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