Knowledge Award audio overview: Antibiotic use in cat and dog dental procedures by Cockburn Vets

Hello, my name is Caitlin Burchill and I’m speaking on behalf of Cockburn Vets who are a small independent practice in the Midlands. Something that’s really important to us is sort of
collaborative working and that ethos of professional development in the team. And We had 11 vets who played a role in this initiative and four of which were recent graduates, one including myself. So, in January 2024, as part of the commitment to sort of improve our stewardship in general with regards to antibiotics, we committed to reviewing our use of antibiotics in cat and dog dentals. Now, we did have several clinical areas that we considered, but the dental procedures was an area that we felt we really could make a positive change and where the whole team was sort of on board with that and so it was also the time that we, the first time that we’d sort of completed an audit of this size. And We knew that the data would be relatively easy to collect for our dental procedures through our PMS.

So, we completed a literature review, and we found that for most routine sort of dental work in dogs and cats, antibiotic use isn’t indicated. So we looked at the AHA dental care guidelines
for dogs and cats and sort of looking at intraoperative antibiotics and as well as postoperative antibiotics for dentals, in which case sort of only relevant if we have that sort of presumed osteomyelitis radiographically.

We carried out an audit of our 2023 dental cases and we found that 35 % of our patients were potentially treated unnecessarily with antibiotics. We worked as a team to produce a protocol
all together of when we thought it would be appropriate to dispense antibiotics for our dental cases. We were really careful to anonymise all of the data to ensure that the team felt
comfortable to have open discussions, reflections about progress and setbacks so that no one person felt that they were being discriminated or picked on or anything like that because that sort of open reflection was really important to us.

We revisited the initiative sort of quarterly, and we also had a real focus on dental CPD throughout the year and another important aspect was sort of our recent graduates, again
including myself, having those open conversations with our VetGDP advisors to increase our confidence with our dental procedures, using practical training on cadavers and also support with our patients where we needed it. Some of the more experienced vets who had routinely been using antibiotics for quite some time were sort of understandably initially reluctant to adopt that change, but thankfully the positive clinical outcomes that we saw meant that
they were quick to sort of embrace the initiative overall.

When we re-audited our antibiotic use for the second half of 2024, we found that actually very few of our dental procedures were given antibiotics. So, none of our cats in that time and only two of our dog patients, both of which had previously undiagnosed grade four periodontitis.

We’re confident that these behavioural changes will withstand the test of time because it was quite a long project for us overall and hopefully there’s going to be no relapse with the team
for unnecessary prescription of our antibiotics. Since finishing that audit cycle, we’ve already reviewed our use of antibiotics in diarrhoea cases and we’re currently processing the use of
antibiotics in our canine otitis externa cases as well.

Obviously overall we’re making a tiny difference, but we do believe that every sort of professional in the veterinary industry has a responsibility to protect these important
medications and we feel like we’re at least doing our very small bit and are happy to share that knowledge.

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