Dave Dickson – RCVS Recognised Specialist in Cardiology

What or who inspired you to become a vet?

It was a combination of my family (we always had pets, and I would spend summer holidays with my grandparents who had several dogs and were mad animal lovers) plus many happy hours spent reading Gerald Durrell and James Herriot novels. Finally I had a school careers advisor who told me I “probably couldn’t get it, it was too hard”, which clearly made me try all the harder!

You are an RCVS Recognised Specialist in Cardiology. What led you to this specialism?

I was a bit of a wastrel in my first few years in general practice, avoiding learning anything too difficult and just getting along day to day. Then I went to work in New Zealand with two fantastic vets – Scott Raleigh and Martin Earles. Between them, they taught me how to really listen and look after clients, and that being a ‘vet geek’ was a good thing. I discovered the love of learning more about a subject and realised that the more I knew, the better I became (or perhaps the less awful I became). This changed my approach to practice. When I returned to the UK, I knew I wanted to take small animal practice seriously and I enjoyed ultrasound, medicine and cardiology, so I enrolled on a certificate. My mentor was Dr. Mark Patteson, who remains a huge inspiration to me, and along the way I have been lucky enough to work with some fantastic cardiologists who try valiantly to keep me in check.

One of the PetSavers’ clinical research grants is jointly supported by the Veterinary Cardiovascular Society and you are its first ever recipient! Can you tell us about the background to the project that this grant is funding?

Whilst I was enrolled for my certificate, I saw that clinical research was an important part of specialising. I read a paper which suggested that basic clinical information could be used to help manage dyspnoeic cats. But there was a problem: the study was performed in referral practice (as most studies are), meaning that the results may not be that applicable to general practice. As a GP vet, I saw a lot of dyspnoeic cats and realised I was in a position to do a similar study of my own. I chatted about it to my colleagues and was brave enough to introduce myself to Dr. Chris Little (another big name in the cardiology world) who really helped me refine the study idea. Between us, we ran the study, which was published in the Journal of Small Animal Practice in 2017. Although I’m proud of the paper, the research isn’t perfect and after finishing it we realised we’d need to repeat it to make sure what we found was real. However to conduct a study of that size, I knew we’d need funding, so I applied for the PetSavers grant and was lucky enough to be awarded it. We are repeating the study, looking at a population of dyspnoeic cats who present to first opinion practice, to see if we can predict what they have using only simple clinical tools.

How do you think vets in general or referral practice will benefit from your research?

My hope is that we confirm the findings in our first study – that simple, easily collectible clinical data can help vets in practice manage dyspnoeic cats. Of course, we might find the first study was wrong, which is always a risk when you repeat studies, but that is part of the fun. As vets, we rarely repeat research to confirm the initial findings were real, so I think it is important for us to always “check our workings” before we believe studies, especially small ones. If we do confirm our initial findings, I think we will have helped to improve management of dyspnoeic cats, whilst along the way challenging some of the dogma often found in veterinary medicine. Ours is a constantly evolving field and only through research can we improve professional standards. Whilst many commonly-held beliefs are true, many are not, and a big part of the enjoyment of research is disproving some of those beliefs. As another of my mentors Mark Rishniw says, “belief belongs in Church”.

Can you share any early findings from your study with us?

Sadly, not yet! We have collected loads of cases (nearly 200 now) but I will need at least a month off work to analyse the data and I haven’t told my colleagues that yet! We are a very busy group of cardiologists so finding time to get research done is somewhat of a challenge, to say the least. But as soon as we have some news, we will be publishing it.

What does PetSavers offer the profession in your opinion?

I think it gives the profession access to research conducted in general practice, something which is rare in veterinary medicine. Because most Specialists work either in academia or private referral hospitals, and most research is conducted by Specialists, the research we get is heavily biased by the referral population. Whilst this doesn’t detract from excellent science our profession does, it means that the results of studies are not always applicable to a general practice setting. PetSavers allows vets in practice to design and run research based in practice, for vets in practice – what a colleague calls “top-down” research (as opposed to “top-up” research, which makes a small number of highly specialised practitioners even more highly specialised, not benefiting many animals). We need to improve the knowledge and management of diseases seen in general practice. Whilst cutting edge research in rare diseases or using techniques only available in a handful of hospitals worldwide is fascinating, it doesn’t help the majority of animals or the vets who look after them. We need to focus research on the largest population of animals, not the ‘privileged few’.

Away from the practice and bench, how do you spend your spare time?

I have three young children, so I spend most of my spare time running, cycling or drinking wine to avoid them. Occasionally, I look after them (usually supervised by a competent adult). I also read a lot – I used to read a lot of research papers but my Diploma cured me of that. I now read for fun.

What advice would you give to vets considering carrying out clinical research for the first time?

Do it. Don’t hesitate, just do it. The key is to pick a good clinical question – one that we don’t know the answer to, one you can answer from practice and one that will change how we manage clinical cases. You don’t have to look far to find questions like these, but you need to think hard about how you will go about answering the question. Think to yourself “do we know this already? If I find an answer will it change what I do? Can I actually perform this study well, in a realistic time-frame, from my current position?” If the answer to these is “yes” then go for it. There are plenty of resources to help you (PetSavers, RCVS Ethics Review Panel, JSAP/BSAVA Clinical Research Assessment and Guidance panel). For my money, performing good quality clinical research is one of the most rewarding parts of my job and I think if more vets did it, our profession would benefit hugely.