Tom Harcourt-Brown MA VetMB CertVDI DipECVN MRCVS is the Clinical Lead of the Neurology and Neurosurgery department at Langford Vets, part of the University of Bristol. He is an RCVS and European Specialist in Veterinary Neurology.
Tom graduated from the University of Cambridge in 2002 and spent a short time in general small animal practice before returning work in his parents’ practice between 2003 and 2007. During this time he studied for his RCVS certificate in diagnostic imaging, which he was awarded in 2007.
In 2007 Tom started a three year post as a senior clinical training scholar in neurology and neurosurgery at the Queens Veterinary School Hospital in the University of Cambridge.
Tom joined Langford Vets in 2010, initially running the neurology referral department on his own but now part of a growing team of senior neurologists, residents in training and one full time neurology nurse catering to one of the busiest referral departments in the UK.
He has a keen interest in clinical research, particularly into diseases commonly seen at Langford Vets, including non-infectious meningitis and encephalitis, as well as spinal cord injury and neuromuscular disorders.
Tom is primarily responsible for seeing and supervising cases referred to the hospital but also spends time teaching the residents and final year students on rotation, as well as being one of the examiners for the European Diploma in Veterinary Neurology.
Tom Kindly agreed to answer the following questions:
What are your feelings on how we currently manage this common debilitating condition in dogs?
I think there is a lot of misunderstanding around arthritis in dogs that complicates management of this disease. The main population of dogs that I see where this is apparent is in dogs those with diseases affecting their peripheral nerves, which causes dogs to be weaker, slow to rise and have reduced exercise tolerance; but is not painful.
Failing to recognise a dog’s clinical signs are due to a nerve disease is problematic because I have seen these dogs on large amounts of pain relief and this is not changing their clinical signs. This causes a lot of distress in owners and increases a dog’s risk of side effects from the medication. In older dogs, nerve diseases are often age-related degeneration and so there is not a specific treatment, but the reassurance that these dogs are not painful is important and it alters the physiotherapy plans that can be made.
As a veterinarian what do you feel is essential for managing canine arthritis effectively?
Ensuring that the signs seen are due to arthritis is very important. This requires a thorough examination of the dog and to hold in mind that there may other explanations for the clinical signs seen – particularly in dogs where their signs of apparent pain are being difficult to manage.
How do you see treatment options for arthritis progressing over the next ten years?
I have seen a huge rise in trained paraprofessionals that can help management of arthritis and I would like to think this will really fill the gap that currently exists between medication and surgery (the two traditional routes for management open to vets).
One concern I have though is the rise of unregulated treatments and nutritional supplements that have not got well established evidence for their use. We do not have large bodies such as NICE in the veterinary profession who can summarise available research for vets, but I am hopeful that other initiatives such as ‘BestBETS for Vets’ can try to give impartial advice about how likely these approaches are to be successful.
If you could have the opportunity to give one tip/ piece of advice to an owner with a dog suffering from arthritis what would it be?
My best advice would be to make sure your vet has examined your animal thoroughly and to share concerns with them. As vets, we have a wide range of expectations from owners and it worries me that some owners can be unhappy with their treatment, or the options offered, and not let their vet know. Most vets want to give the best treatment they can and so would be willing to help owners access more specialist knowledge (such as physiotherapy or assessment by a Specialist vet) if they know that is what is wanted.