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In accordance with Schedule 3, VNs cannot discuss a pet ' s obesity without it having been diagnosed by a VS, as obesity is recognised as a disease by organisations including the British Small Animal Veterinary Association( BSAVA):‘ The BSAVA recognises obesity as a disease that can cause health and welfare problems for all companion animals and, therefore, strongly recommends that bodyweight and body condition score are monitored regularly and diets modified to maintain a healthy weight and body condition score.’ [ 7 ]
However, if there is a practice policy in place, a VN can be delegated the task of observing if an animal is above an ideal BCS and begin discussing weight-loss diets and exercise, if the patient is otherwise healthy. Similarly, if a VS diagnoses a pet as obese, they can refer the pet to see a VN for weight-management advice. Patients can benefit hugely from collaborative care and good communication between VNs and VSs.
‘ Under care’ guidance
Under the 2023 update to the RCVS ' s‘ under care’ guidance [ 8 ], VSs themselves no longer need to physically examine a patient for the animal to be considered under the VS ' s care, apart from if the patient needs controlled drugs, antimicrobials, antifungals, antibiotics, antivirals or antiparasitics, or has a notifiable disease [ 8 ]. If a VN gathers the patient ' s history, performs a health check and relays their findings to the VS, this may be sufficient for the VS to make a clinical diagnosis and prescribe certain medications, dependent on the case. Of course, as with any task delegation, the VS must be confident in the VN ' s ability to perform these tasks, but the approach does create further scope for VN-led consultations.
The 2023 update of the‘ under care’ guidance has further highlighted how VNs can and should be utilised, such as in medical management consultations for long-term medical conditions. Consultations could include triaging, history-taking and clinical examination, including weight, BCS, muscle condition score( MCS), nutritional status, pain and physical parameters( Figure 3).
Although VNs cannot decide which diagnostic investigations to perform, practices could have in place a standard operating procedure( SOP) that details which diagnostic tools a VN can use with each condition and at which point in a patient ' s care. These diagnostic investigations could include taking and analysing blood samples, urinalysis and blood pressure measurement.
The SOP would need to be precisely worded, with no room for misinterpretation, detailing set, strict parameters for when a VS should be consulted. Flow charts can be a great way to present SOPs, as they leave no room for any clinical decision-making by the VN but still give the VN autonomy within their remit under Schedule 3 [ 3 ].
Figure 3. Consultations could make more use of VNs ' skills in triaging, history-taking and clinical examination.
These types of VN-led appointments offer many benefits to the practice. VSs should have more time to see patients and perform surgical procedures. The bond between the practice and its clients will be strengthened by clients having regular contact with a VN, preferably the same VN, which improves trust and increases the opportunities for any early signs of changes in a patient ' s health to be identified quickly. In addition, this continuity of care can reduce the likelihood of errors, as a VN will become familiar with the histories of the patients they see. VNs themselves will also benefit from the professional bond formed with regular clients and patients, and will gain job satisfaction from using their skills in accordance with the Schedule 3 exemption.
The‘ under care’ guidance includes specific guidelines on antiparasitic treatments that are classified POM-V( prescription-only medicine – veterinarian), which restrict what a VS can delegate. However, in consultations, VNs can still discuss the different parasites, their life cycles and their methods of transmission, including vectors. They can also‘ triage’ the patient by taking a relevant history to ascertain which parasites the pet is likely to need preventative treatment for, whether the client is, or will be, breeding from the animal, and what method of administration will work best for both the patient and client. Of course, this is not a‘ one size fits all’ situation and each patient ' s needs are individual. Relevant questions the VN may ask a dog owner could include:
• Does the client have mobility issues that would make it difficult for them to give tablets?
• Would less frequent dosing be beneficial?
• Is the dog( such as a labrador) likely to eat anything and everything they come into contact with?
• How often does the dog go swimming?
Volume 40( 6) • December 2025
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