StreetVet Conference 2018

What a way to celebrate our fast approaching two year anniversary and say a huge thank you to all our incredible volunteers! The inaugural StreetVet CPD conference #StreetVetSkills was buzzing with anticipation and long-awaited introductions.  Everyone had a story to tell and there was plenty of inspiration, laughter and tears.  Our invincible team of vets and veterinary nurses, who relentlessly pound the streets week after week in eight cities across the UK, were joined by supporters from veterinary practices, partner organisations and by industry representatives.  All shared a single vision of StreetVetting into the future.

Ruth, our gracious compère, had her work cut out keeping us rowdy lot in order and to time – thanks Ruth!  She opened proceedings by introducing Nick Bacon, a Senior Consultant in Oncology and Soft Tissue Surgery at Fitzpatrick Referrals, and his talk on ‘Street Lumps’.  Nick described how he found himself fast-tracked to senior StreetVet in Camden.  He warmed us with tales of his regression back to the grassroots of veterinary care; completely alien to the highly specialist world within which his career has evolved.  Collecting his first ‘street urine sample’ was no mean feat, along with approaching nervous patients and taking blood samples in dark car parks!  Each consultation is a small victory in its own right.  And finally Nick provided a back to basics low-down on common lumps we might see in our patients and what might be causing them.  Did you know that our vets carry basic kits to sample lumps on the streets? In many cases we are just one step away from getting a rapid diagnosis for our patients.

Neurological conditions can be incredibly frightening for owners and challenging for vets to diagnose. Clare Rusbridge, chief Neurologist at Fitzpatrick Referrals, outlined how to perform a neurological examination on the streets and what basic tool kits we should carry.  Who knew that a Maglite could be so useful?! From spinal tumours, to lungworm, to vestibular disease, Clare presented a plethora of practical tips for reaching a diagnosis and potential treatment options.  Understanding which conditions will spontaneously resolve without medical treatment is so important and can be a great reassurance to our owners.

Hitting on one of the most common issues in street dogs, Ian Battersby walked us through the wonderful world of diarrhoea.  An unpredictable supply of dog food donations, well meaning passers-by and the odd Friday night curry all contribute to a high number of gastrointestinal upsets in our patients.   At a more serious level, conditions we might encounter include allergies, bacterial infections, inflammatory bowel disease and parvovirus.  The use of antibiotics is controversial and it is a real skill to be able to identify when they are needed and when best avoided.  Novel treatments are not always as high-tech as you might expect.  Faecal transplants (yes you heard right: instilling faeces from a healthy patient into a patient with gut disease) sound primeval, but are transforming the human gastroenterology world and are creeping into the veterinary surgeon’s repertoire for treatment of chronic intestinal conditions.

As guest speakers go, you don’t get more charismatic than Josh Coombes who is renowned for his street hairdressing and #dosomethingfornothing campaign.  The excitement and emotion in the audience was palpable as he described the power of enabling a homeless person to feel like an individual and reinstating their sense of pride.  His videos showed this metamorphosis in graphic detail. It is with Josh’s encouragement that Jade was able to take the concept of helping the homeless and their dogs, and build StreetVet into what it is today.  Josh spoke vividly of the destitution amongst those on Skid Row in Los Angeles, which holds a population of several thousand street dwellers.  In one man’s words, “There is nothing more valuable you can give someone than your time – no amount of money will ever buy that back”.

Communication is a vital skill when working as a StreetVet.  The Veterinary Defence Society entertained us all with dynamic enactments of situations that we might find ourselves in. Our ‘vet’ who was struggling with empathy and an amusing dose of foot-in-mouth disease, was guided by members of the audience on how he might improve his kerb-side manner.  Braver spectators were keen to step into his shoes and put things right.  Our homeless-actor was totally attuned to those little words and gestures that make all the difference: tone of voice, genuine kindness, explaining actions step by step and allaying fears of separation from her pet.  The overriding theme continually floated was that of trust – this is absolutely essential in our work.  StreetVet would like to express a huge thank you to Geoff Little and his wonderful team of actors, who are always so perceptive and professional.

Thursday ended in a very special way with the first Dean Coleman StreetVet Volunteer Award.  Jade met Dean through her work with StreetVet when he and his dog Huni were in need of help.  They bonded over the realisation that life is not predictable and homelessness can happen to anyone.  He was an exceptional person and StreetVet’s greatest champion, brimming with ideas and excitement for the future of the organisation.  Sadly, Dean passed away earlier this year, and it seems only fitting that we give this award to one of our exceptional volunteers in his memory.  This year’s award was presented to Gabriel Galea our brilliant Camden team lead.  Gabriel has logged hundreds of street consultations, been an integral part of the London core team and is a fountain of knowledge for all things ‘StreetVetty’.  He has a wonderful raport with our clients and is keen to help us all reflect and learn from what we do.  For him, StreetVetting is most certainly a way of life. Well done Gabe from all your StreetVet colleagues!

The first day was followed by a relaxed drinks reception and a real chance for people to connect.  But, despite the chance to kick back and unwind, London StreetVet and conference organiser Anna was back on the streets checking up on patients and giving something back.  In fact, throughout the two day event, disappearing to take a few minutes to check a patient or call an owner was a recurring theme!

The second day commenced with a fascinating insight into the legislation of the Dangerous Dogs Act and the career of Kendal Shepherd.  Kendal is a Registered Veterinary Surgeon and Animal Behaviourist specialising in behavioural assessment and modification particularly relating to this legislation.  The fact that dogs might be seized and destroyed purely based on their appearance, breed or reaction to human conflict seems unjust in an age where we have such expertise available.  Thankfully the law is evolving and beginning to allow behavioural assessment of each dog on an individual basis.  Kendra also mentored us in approaching and handling nervous dogs and interpreting behavioural cues that are so often missed by members of the public.

Shailen Jasani is a highly regarded Emergency and Critical Care Vet who was keen to remind us that we can all perform vital body system assessments with just our stethoscopes and our senses.  He explored the differences between emergency triage and the routine examination.  Emergencies happen when you least expect and quick decision making is crucial: What can be done in the field? What emergencies should be prioritised? When do patients require immediate transfer to a veterinary practice? How will we transport them?  As StreetVets, lateral thinking and teamwork go a long way!

Our second inspirational speaker far surpassed expectation.  Andy was homeless and in a bad way when he met StreetVet co-founder Sam.  He had been let down time and again, so week in, week out, Andy and Bailey turned up at the soup kitchen in fear that the StreetVets would disappear if they weren’t needed.  Andy had acquired Bailey as a tiny pup and was told to put him to sleep as he would never make it.  This was a turning point for Andy. He realised that Bailey needed him in order to survive.  By feeding Bailey goat’s milk, and keeping him safe and warm, he gradually grew into the exuberant, loving and spirited dog that Bailey is today.  Through Bailey Andy learned to trust again. He stopped using drugs and is now housed and looking to the future.  Sam, Andy and Bailey share a remarkable bond that was a privilege to witness and by the time they left the stage there wasn’t a dry eye in the house.

Rosie Allister, manager of VetLife Helpline teamed up with human psychiatrist Alex Thomson to examine the connection between homelessness and mental health.  A shocking 80% of homeless people suffer from mental health issues and improving a person’s housing situation is shown to be the single most effective way to positively impact this.  Sadly, owning a dog is often a huge barrier to accessing accommodation for our owners.  Pets can provide routine, stability, companionship and self identity but also carry with them the burden of stigma, cost and intense distress associated with loss and separation.  Alex discussed how to communicate with someone in mental distress, the sensitive subject of suicide, how and when to get help, and the importance of being able to listen.  This talk was complemented by Vet Ru Clements who impressed on us how important it is to look after yourself whilst doing good.  In a profession where compassion fatigue and burn-out is rife, she reminded us all that you can’t pour from an empty cup; take care of yourself first.

The health and welfare of street dogs is paramount to StreetVet.  David Williams presented a study comparing the lives and health status of homed and homeless dogs.  There was no significant difference found between the two populations, although street dogs suffered less obesity and homed dogs had greater access to veterinary care.   Of course the owner impact is already well documented: street dogs reduce feelings of isolation, drug abuse and suicidal thoughts.  This is certainly an area where future studies could help to validate the work that StreetVet does.

Then, just when we thought we’d seen it all, Nuala Summerfield presented the futuristic world of real time telemedicine.  Gadgets included bluetooth stethoscopes, remote ECG recorders and smartphone ultrasounds.  She envisages us virtually transporting the specialist to the patient on the street and grabbing that elusive diagnostic window before it’s too late.  This would allow us to pool our resources and do what we do best: working with our patients in their own environment.  Nuala brought a real buzz of excitement to the room.  We suddenly all realised what might be possible for our patients and that it’s almost within our reach!

Our final speaker, David Gould from Davies Veterinary Specialists emphasised that the diagnosis of ophthalmic conditions is only possible with the foundation of a robust eye examination.  It is essential to ask of your eye: “Is it painful?” and “Can it see?”  He proceeded to take us on a whistle stop tour of the myriad of eye conditions that StreetVets might encounter.  This is the one situation where working at night is a blessing; who needs a darkened room, right?!  We all frantically wrote lists of equipment to add to our backpacks, from condensing lenses to local anaesthetic drops; it was a brilliant overview and real food for thought.

As StreetVets people rightly assume that we love animals but what they forget is that we really care about people too.  StreetVet embraces the reason why so many of us became vets and vet nurses in the first place.  This congress has transformed what was an incredible virtual community, into an extended family of amazing people who each in our own small way want to make the world a better place. The conference would not have been possible without the unwavering support of our sponsors: Vets4Pets, Goddard Veterinary Group, Simply Locums, Davies Veterinary Specialists, Boehringer, Dechra, CatDogFish and Tails.com.  We thank you so, so much for believing in us and helping us to do what we do.