No Iso, No Problem: TIVA also deserves a place in General Small Animal Practice

Dr. Jesus Nieto Moreno, DVM, PgCertVetEd (UCD), ECVAA Resident, RECOVER Instructor
May 20, 2026

Bluetongue in the UK: what Ireland needs to know before the virus takes hold

August 10, 2026

A UK farm vet’s frontline account of a bluetongue season gone from mild to devastating – and what it means for vaccination strategy in Ireland this autumn.

From the Vet Space Ireland podcast with Michelle Maguire and Richard Ryan (ArchersField Vets, Kilkenny), in conversation with Jonathan Hobbs, farm vet partner at North Park Veterinary Group, Devon, and Junior Vice President of the Sheep Veterinary Society.

A season that changed everything

When bluetongue virus (BTV) first reached the southeast of England in the autumn of 2023, it looked like a containable, one-off incursion. Midge plumes had blown the virus across the Channel from the Netherlands into Norfolk, Suffolk and Kent, and government surveillance picked up a handful of positive animals. Affected herds were culled, exclusion zones were set up, and the virus did not survive the winter. It seemed, for a moment, like a lucky escape.

It was not. Speaking on the Vet Space Ireland podcast, Jonathan Hobbs, a farm vet partner at North Park Veterinary Group in Devon and Junior Vice President of the Sheep Veterinary Society, walked through how that single incursion has grown into what he now describes as the UK farming equivalent of foot and mouth disease for his generation of vets.

In 2024 the virus arrived earlier in the season, giving it enough time to establish in the native midge population before winter. It spread from the southeast towards the Midlands and along the south coast, and crucially, it overwintered. By 2025, helped by a prolonged heatwave and drought that accelerated both midge activity and viral replication in the insects, bluetongue exploded across sheep and cattle farms in the southwest of England.

“Last year was our warning shot. This year is the Dutch experience we were scared of two years ago, where twenty per cent of the national flock was killed.”
– Jonathan Hobbs

What it looks like on farm

The species picture is stark. Sheep are by far the worst affected, followed by cattle, while goats are almost always asymptomatic and camelids remain at some risk. On the practice’s worst-hit farms this season, up to seventy-five per cent of clinically affected sheep have died, which works out at roughly twenty per cent total flock mortality once morbidity and mortality are combined.

Clinical signs in sheep include painful erosions on the dental pad, cuts and crusting around the mouth and nose, swollen heads, and lameness from coronary band involvement, signs that in previous years might have been mistaken for insect stings or adder bites. Cattle tend to show milder signs, including a reddened or crusty nose, swollen teats, reduced milk yield, and some lameness. Hobbs noted that cattle cases are often overshadowed by the sheer volume of sheep cases coming through the door, even though they are almost certainly under reported.

Sheep: dental pad erosions, mouth ulceration, crusty or swollen nose, swollen heads, coronary band lameness
Cattle: nose reddening or crusting, swollen teats, milk drop, lameness, generally milder disease
Goats: almost always asymptomatic
Camelids: at risk of clinical disease

There is no animal to animal spread. Bluetongue moves exclusively via infected midges, which is a key point of reassurance when ruling out other notifiable diseases, though Hobbs stressed that every suspect case still needs to be tested, both to confirm the strain and to rule out foot and mouth disease on farms where clinical signs could overlap.

Vaccination works, and the economics are stark

Hobbs was unambiguous: the vaccine is highly effective, and the practice’s own numbers back it up. North Park achieved roughly fifteen per cent vaccine uptake among eligible stock last year, against a national average of just five per cent, and farms that vaccinated ahead of last spring avoided the barren rates and dummy calf presentations that hit unvaccinated herds hard at scanning and calving.

Out of around sixty confirmed cases at the practice this season, only one has occurred in a previously vaccinated animal, a dairy cow with a complicating BVD persistently infected animal issue on farm that likely affected her vaccine response. Hobbs was also clear that farmers should not hold back on vaccinating bulls and rams despite cautious vaccine data sheet wording. The testes are an immune privileged site, meaning bluetongue virus can persist and shed in semen for months even after an animal has cleared the virus from its bloodstream, with normal semen morphology and motility masking underlying fertility damage. A short, mild vaccine reaction is a far smaller risk than a week or more of fever and illness, or worse, from natural infection.

“A dead bull is going to give you exactly zero calves. A vaccinated bull who might be off for a day is still going to give you plenty.”
– Jonathan Hobbs

The financial case is equally direct. Using an average lamb value of around one hundred and forty pounds a head, a thousand head flock facing twenty per cent mortality could lose in the region of twenty eight thousand pounds. Vaccinating that same flock costs roughly two and a half thousand pounds. As Hobbs put it, that is cheap insurance against a loss that is now playing out on farms across the south west.

Vaccine supply has struggled to keep pace with the sudden surge in demand this season, with wholesalers issuing stock in unpredictable drops rather than the reliable next day delivery practices are used to. Hobbs’s advice to farmers who have not yet vaccinated is to order early rather than wait, given that the peak bluetongue season typically runs from September through November as viral load builds through the autumn.

Reading the case numbers with caution

One of the most important points Hobbs raised concerns how bluetongue statistics are reported in the UK. Government figures record a “case” as an affected holding, not an affected animal, and testing authorities sample only three animals per holding. A single reported case can therefore represent dozens of dead or affected animals on one farm, while a headline figure of a few hundred cases nationally can understate the true scale of an outbreak considerably.

This matters for how the disease is perceived from a distance. Vets and farmers in areas not yet affected, or in countries like Ireland looking at the UK situation from across the Irish Sea, can easily read modest national case counts and conclude the risk is overstated. Hobbs’s message was the opposite: by the time the numbers look alarming, the disease is already established and difficult to control.

What this means for Ireland

Ireland recorded a small number of bluetongue cases in the latter part of last year, and Hobbs believes that was likely sufficient for the virus to have overwintered here. His reading of the UK’s own trajectory, a quiet first year followed by a far more severe second season once the virus reaches a critical mass in the local midge population, is a direct warning for Irish practices and farmers this autumn and into next spring.

Bluetongue was also compared during the conversation to Schmallenberg virus, which is carried by the same Culicoides midge and is already well established in parts of the southeast of Ireland. Hobbs described bluetongue as essentially “Schmallenberg on steroids”, a useful shorthand for vets explaining the risk to clients who may already be familiar with Schmallenberg’s fertility impacts but have not yet seen a bluetongue case.

His central message for Irish vets and farmers is not to be lulled by a mild season. A low case count this year does not mean the risk has passed, it may simply mean the outbreak has not yet reached the threshold it needs to explode the following spring. Supporting general herd and flock health, including worm control, mineral status and nutrition, also appeared to reduce case severity and improve response to treatment on affected UK farms, alongside vaccination as the primary defence.

Sheep Veterinary Society conference, Kilkenny

Hobbs also used the conversation to flag the Sheep Veterinary Society’s autumn conference, taking place in Kilkenny from Monday the 28th to Wednesday the 30th of September. The Society is a specialist division of the British Veterinary Association, open to international members including vets in Ireland, with annual membership priced at around seventy pounds.

The three-day conference costs under five hundred pounds and includes international speakers on bluetongue alongside Irish parasite specialists, with at least half a day dedicated to vets presenting clinical cases from their own practices. Hobbs, who takes over as Society president at the event, described it as a genuinely clinically focused meeting, with much of the value coming from informal conversation between sessions. For more information go to – sheepvetsoc.org.uk

This article is based on a conversation recorded for the Vet Space Ireland podcast. Listen to the full episode at vetspaceireland.ie.

Article written by Vet Space Ireland

To contribute to the Vet Space Journal, appear on the podcast, or get involved with VSI, contact us at inspire@vetspaceireland.ie or visit vetspaceireland.ie

Vet Space Ireland is a non-profit, volunteer-powered veterinary community platform. Founded 2019.

The deal you’ll only ever do once: selling your veterinary practice

August 4, 2026

A Roberts Advisory series for veterinary practice owners

By Roberts Advisory | 4th August 2026

If you own a veterinary practice, you have spent years, or possibly decades, building something with your name on it. You have carried the late calls, the staffing headaches, the quiet worry about cash flow in a slow month, and the pride of a waiting room full of clients who trust you. And then one day, whether by plan or by a phone call you did not expect, the question arrives: would you ever think about selling?

For almost every owner, selling the practice is a thing they will do exactly once. That single fact sits at the heart of everything we want to share in this series, because it changes the odds in a way most owners only realise afterwards.

A game you’re playing for the first time

Think about what happens when an approach comes in. On one side of the table is you: an excellent clinician and a capable business owner, but someone selling a practice for the first and only time in your life. On the other side is a buyer who may complete a deal like yours every few weeks. They have a team of finance and legal people. They have seen every kind of practice, every set of accounts, every negotiating position. They do this for a living.

It is a little like sitting down to a game of chess having played a few friendly matches, opposite someone who plays at a professional level. You might be sharp, and you might do well. But the person across from you knows the openings, the middle game and the endgame in a way you simply cannot after one sitting. That is not a criticism of you. It is just the reality of experience against inexperience, and it is the single biggest imbalance in any business sale.

Your accountant and solicitor are excellent – and this is a different job

When we make this point, owners often say, reasonably, that they already have a trusted accountant and a good solicitor. So they do, and those relationships matter enormously.

But it is worth being clear about what those advisers do brilliantly, and what sits outside their day-to-day. Your accountant prepares your accounts and manages your tax. Your solicitor handles your conveyancing and your legal affairs. They are very good at those things. Negotiating and controlling the sale of a business against a professional buyer, though, is a different discipline again, and for most general practices it is not something their working week is built around. A sale is a specialist, one-off event, and it rewards those people who do it repeatedly.

There is also a quieter point about objectivity. An adviser who has known you for twenty years, who is a friend as much as a professional, can find it genuinely hard to deliver an uncomfortable message at a tense moment. Sometimes the most valuable thing in a deal is someone whose only job is to look after your side of the table, and who has no hesitation about telling you the hard thing when it needs to be said.

What it means to have someone in your corner

So what does a dedicated adviser actually change? Three things stand out, and none of them is about magic.

The first is simple experience. Someone who has been through many of these processes knows what tends to happen next, where the pressure points are, and what “normal” looks like, so that you are not reading every move as a crisis or a windfall.

The second is that a sale is a project, and it lands on top of a working life you still have to lead. While you are negotiating, you are also running a clinic, seeing patients and managing a team. Requests for information and documents can arrive from every direction and at every hour. Having one person hold all of that, and act as the single point of contact, keeps the process calm and keeps you doing the job you actually trained for.

The third is pace. Time is the quiet enemy of any deal. When a process drifts, energy fades, confidence erodes and good deals can fall apart for no reason other than fatigue. Someone whose job is to keep things moving, steadily and to a plan, protects the outcome as much as any clever negotiating point.

You don’t have to be selling to start thinking

Here is the part we most want owners to hear. None of this is a reason to rush towards the door. Most of the owners we talk to are not selling this year, and many are not selling for several years yet. But the owners who do best are almost always the ones who started thinking early, calmly and on their own terms, rather than the ones who were caught on the back foot by an unexpected approach.

Over the coming articles in this series, we will walk through what that looks like in practice: how to think about timing, how to get your numbers in order, how to make the business less dependent on you, and what a genuinely good outcome involves beyond the headline figure. All of it high level, none of it a hard sell.

Because the goal is not to talk you into anything. It is to make sure that if the day ever comes, you sit down to that one game of your life with someone in your corner who has played it many times before.

Roberts Advisory is Vet Space Ireland’s Horizons Partner and works with veterinary practice owners across Ireland on exit planning, business readiness and the sale of their clinic. We are always happy to talk to owners at any stage, whether a sale is years away or already on the table. Reach out to us at hello@robertsadvisory.ie.

Article written by Roberts Advisory for Vet Space Ireland

To contribute to the Vet Space Journal, appear on the podcast, or get involved with VSI, contact us at inspire@vetspaceireland.ie or visit vetspaceireland.ie

Vet Space Ireland is a non-profit, volunteer-powered veterinary community platform. Founded 2019.

VCI approves new accreditation standards as nurse retention crisis continues

July 30, 2026

New accreditation standards for veterinary education take effect in Ireland this week, against a backdrop of continued Oireachtas scrutiny of veterinary nurse recruitment and retention. Across the Irish Sea, a sharp rise in bluetongue cases is a reminder for vets here to keep pushing vaccination advice, while a fresh BVA intervention on RCVS governance reform echoes debates the VCI itself has faced over its own council structure.

By Vet Space Ireland | 30th July 2026

VCI’s new accreditation standards come into force

The Veterinary Council of Ireland’s newly approved accreditation standards for veterinary medicine and veterinary nursing programmes come into operation on 31 July, applying to all existing and future programmes seeking VCI accreditation. Made under the Council’s statutory remit set out in the Veterinary Practice Act 2005, the standards set contemporary benchmarks across curriculum design, clinical training, facilities, staffing and governance, underpinned by defined “Day One Competencies” for graduates.

VCI president Joe Walsh said the standards reflect both the evolving nature of veterinary practice and the Council’s commitment to ensuring graduates meet the highest standards of animal welfare and public protection. The framework was developed following consultation with higher education institutions and stakeholders across the profession, and is aligned with European and international accreditation frameworks to support the continued recognition and mobility of Irish veterinary graduates.

Oireachtas committee continues to probe veterinary nurse retention

The Joint Committee on Agriculture and Food has continued its engagement on veterinary nurse recruitment and retention, hearing evidence that nearly three-quarters of registered veterinary nurses are considering leaving the profession, unsure about remaining, or planning to leave altogether. The Irish Veterinary Nurses Association has pointed to low pay, burnout and limited career progression as the main drivers, noting an average salary of roughly €36,800 and citing unpaid placement hours as a particular concern.

The VCI has since appeared before the committee, telling members that regulation alone cannot resolve every workforce challenge, while Minister for Agriculture, Food and the Marine Martin Heydon has said pay and conditions in privately operated practices are a matter for employers and employees rather than government. The exchanges suggest the issue is likely to remain live well into the autumn.

Bluetongue cases climb sharply in England

Defra figures show 54 confirmed bluetongue (BTV-3) cases in England and Wales since the start of the current season on 1 July, with the National Sheep Association reporting 29 positive cases in the last fortnight alone, 15 of them in sheep. The South West, particularly the Exmoor area, has emerged as a hotspot, with officials linking the rise to lower uptake of vaccination this season. Five further cases, in sheep in Devon, were confirmed as recently as 28 July.

Bluetongue is not a UK-only concern. BTV-3 was first confirmed in Ireland in a Co. Wexford suckler herd in January 2026, and DAFM surveillance has since identified cases in at least eight counties, including Wicklow, Laois, Louth, Monaghan, Kildare, Cork and Tipperary. The department has described bluetongue as a disease Ireland will have to learn to live with, following an EU recategorisation that treats it as endemic and under surveillance rather than something to be eradicated. Against that backdrop, the scale of the current English outbreak is a further reminder of the value of continued vigilance and vaccination advice for farmer clients here.

BVA sets out its stall on RCVS governance reform

The British Veterinary Association has published its response to the RCVS’s consultation on governance reform, which closed on 23 July. BVA is calling for reform to be delivered as a single, holistic package rather than piecemeal changes, and wants RCVS Council members, both veterinary and lay, to be appointed through an open, competitive process rather than elected, mirroring governance models used across human healthcare regulation.

The intervention keeps up pressure on a reform process that has been building since Defra’s white paper on replacing the Veterinary Surgeons Act 1966, published earlier this month. For Irish readers, the debate over how a regulator balances elected representation, lay input and independent oversight has clear echoes for the VCI’s own governance, even though its statutory footing and functions differ from those of the RCVS.

References

Veterinary Council of Ireland (30 March 2026), ‘Veterinary Council of Ireland Approves New Accreditation Standards for Veterinary Medicine and Veterinary Nursing Education’: https://cms.vci.ie/veterinary-council-of-ireland-approves-new-accreditation-standards-for-veterinary-medicine-and-veterinary-nursing-education/

Agriland (18 June 2026), ‘Veterinary nurses: “We are facing a retention crisis” : https://www.agriland.ie/farming-news/veterinary-nurses-we-are-facing-a-retention-crisis/

Agriland, ‘Regulation alone cannot resolve every workforce challenge’ – VCI: https://www.agriland.ie/farming-news/regulation-alone-cannot-resolve-every-workforce-challenge-vci/

Houses of the Oireachtas, Committee on Agriculture and Food video archive (15 July 2026 session): https://www.oireachtas.ie/en/oireachtas-tv/video-archive/committees/11989/

Department of Agriculture, Food and the Marine, ‘Bluetongue Virus’ (case history for Ireland, first confirmed 24 January 2026, Co. Wexford) https://www.gov.ie/en/department-of-agriculture-food-and-the-marine/publications/bluetongue-virus/

Agriland, ‘Bluetongue “a disease we’re going to have to learn to live with” – DAFM’: https://www.agriland.ie/farming-news/bluetongue-a-disease-were-going-to-have-to-learn-to-live-with-dafm/

GOV.UK, ‘Bluetongue: latest situation’ (Defra/APHA case figures for England and Wales): https://www.gov.uk/guidance/bluetongue

National Sheep Association, ‘2026 bluetongue updates’ (24 July 2026 entry https://nationalsheep.org.uk/2026-bluetongue-updates/

British Veterinary Association, ‘BVA calls for holistic approach to RCVS governance reform in its response to the College’s consultation’: https://www.bva.co.uk/news-and-blog/news-article/bva-calls-for-holistic-approach-to-rcvs-governance-reform-in-its-response-to-the-college-s-consultation/

Article written by Vet Space Ireland

To contribute to the Vet Space Journal, appear on the podcast, or get involved with VSI, contact us at inspire@vetspaceireland.ie or visit vetspaceireland.ie

Vet Space Ireland is a non-profit, volunteer-powered veterinary community platform. Founded 2019.

A colleague messaged me mid-morning: “The soda lime canister has cracked — can we still use isoflurane today?”

The short answer was no. A damaged anaesthetic system compromises workplace and patient safety, increasing the risk of gas leakage, personnel exposure, and rebreathing of carbon dioxide. But the more interesting question is: what now?

This is where total intravenous anaesthesia (TIVA) stops being a “specialist technique” and becomes an incredibly useful tool for everyday practice. Despite this, it is still surprisingly underused in general practice, often reserved for referral settings when in reality it can be both simple and highly effective.

In all patients, maintaining cardiovascular stability is one of our main priorities. Inhalant anaesthetics are well known to cause dose-dependent cardiovascular depression, mainly through vasodilation and reduced myocardial contractility, often resulting in hypotension. This effect is not subtle: as vaporiser settings increase, systemic vascular resistance drops and cardiac output falls. In addition, inhalants blunt baroreceptor reflexes, meaning the patient’s ability to compensate for hypotension is reduced. The result is a drug that is very easy to deliver, but not always forgiving, especially in the geriatric, the very young, and the critically ill patients.

Inhalants also impair thermoregulation, contributing to hypothermia, which in turn further depresses cardiovascular function and drug metabolism. All of this creates a vicious cycle that can be difficult to break, especially in longer procedures or fragile patients.

In contrast, TIVA, using propofol or alfaxalone for both induction and maintenance, has been associated with better preservation of blood pressure. This does not mean that TIVA is inherently safer, but in the right patient it can provide a more stable alternative and reduce the degree of cardiovascular depression we often see with inhalants.

Of course, this comes with trade-offs. The most important one is respiratory depression. Hypoventilation (leading to hypercapnia) is common in spontaneously breathing patients on TIVA. These drugs reduce respiratory drive and tidal volume, and without appropriate monitoring this may go unnoticed until it becomes clinically significant. For that reason, capnography should always be used, as a rising ETCO₂ is often the earliest warning sign. If values start creeping above 7.5 kPa (56 mmHg), that is your cue to step in and assist ventilation, either manually or mechanically, while monitoring the pressure gauge and avoiding excessive airway pressures (>20 cmH2O).

Once intervention is required, understanding how to ventilate safely becomes critical. Manual ventilation does not need to be complicated, but it does need to be controlled and as close to normal physiological breathing as possible. A steady inspiration (squeezing the bag) over approximately one second, followed by at least a two- to three-second passive expiration (completely releasing the bag), is usually sufficient. In other words, the inspiratory-to-expiratory (I:E) ratio should generally be around 1:2 to 1:3, meaning expiration should last roughly two to three times longer than inspiration. This mirrors normal breathing, where exhalation is passive and takes longer than inhalation.

Allowing sufficient time for expiration is important for cardiovascular stability. During manual or mechanical positive-pressure inspiration, intrathoracic pressure increases, which reduces venous return to the heart and can decrease cardiac output and blood pressure. Adequate time for passive expiration allows intrathoracic pressure to return to normal, supporting venous return.

During positive-pressure inspiration, the aim is not to “force” the lungs to inflate, but to gently support ventilation. Too rapid or forceful breaths, or insufficient time for expiration, can lead to air trapping and increased airway pressures. As a general rule, peak inspiratory pressure should not exceed around 15–20 cmH₂O in most small animal patients, as higher pressures increase the risk of barotrauma (excessive pressures) and volutrauma (excessive volumes). This can be easily monitored using the manometer present on most anaesthetic machines, yet it is often overlooked in practice.

Another important point is frequency. Over-ventilation is just as undesirable as under-ventilation. The goal is to bring the ETCO₂ closer to the normal range, not to drive it excessively low. In anaesthetised small animal patients, the normal ETCO₂ range is approximately 4.7–6.0 kPa (35–45 mmHg), although values up to about 7.3 kPa (55 mmHg) may be acceptable in otherwise healthy patients without cardiac or intracranial disease. Iatrogenic hyperventilation leads to hypocapnia (ETCO2 below reference range), which causes cerebral vasoconstriction and reduces cerebral blood flow. In severe cases, this can compromise cerebral oxygen delivery and contribute to neurological injury. Therefore, breaths should be delivered at a normal physiological rate (approximately 10–20 breaths per minute), adjusting as needed based on capnography.

Another practical consideration with TIVA is the requirement for a syringe driver. Unlike inhalant anaesthesia, where depth can be adjusted directly via the vaporiser, TIVA relies on a continuous and accurate drug delivery system. This means that access to a reliable syringe driver is essential, and interruption in delivery — whether due to equipment failure, occlusion, or an empty syringe — can lead to changes in anaesthetic depth. While this is not a major limitation in most modern practices, it does require awareness and planning, particularly in longer procedures.

Importantly, even when using TIVA, the patient should be intubated and connected to a breathing system. Endotracheal intubation with a cuffed tube secures the airway, allows delivery of oxygen, enables capnography, and facilitates ventilation if required. Removing these safeguards simply because inhalants are not being used eliminates a significant layer of safety.

Note that patients on TIVA should also always receive supplemental oxygen. Even with a leaky circle system, the machine can still serve as an oxygen source, as ensuring adequate oxygen delivery remains essential in all anaesthetised patients. The breathing system also allows manual or mechanical ventilation if needed. During TIVA, the fresh gas (oxygen) flow should be appropriate for the breathing system used and weight of the animal, but the key principle is simple: all anaesthetised patients should always be receiving sufficient oxygen to prevent hypoxaemia, regardless of the anaesthetic technique.

One of the perceived downsides of TIVA is that assessing anaesthetic depth can feel less intuitive, as some of the reflexes are sensibly preserved even when maintaining a good anaesthetic depth. Instead, you rely on other clinical signs such as jaw tone, eye position and cardiovascular responses — which requires a bit more attention but ultimately makes you a better anaesthetist. It encourages a more proactive form of monitoring, rather than relying on a dial or a number.

Inhalant anaesthesia generally allows faster recovery whereas propofol-based TIVA may recover slightly more slowly but often with smoother quality and fewer excitatory events. However, available evidence is heterogeneous, and recovery characteristics depend largely on protocol design, duration of anaesthesia, and adequacy of analgesia and sedation.

As one of my mentors always says, “You shouldn’t use things you haven’t read about first.” That is really the take-home message. TIVA is not complicated, but it does require an understanding of the pharmacodynamics of the drugs used, its limitations and, most importantly, how to monitor it and manage its side effects appropriately. Knowing when to ventilate, how to ventilate safely, and how to use oxygen effectively are all part of that skill set.

Used well, TIVA is a powerful addition to your anaesthetic toolbox, and one that can make a real difference in stability of anaesthesia and outcome in both routine and emergency procedures.

Other times, all it takes is a cracked canister to remind us why having that option matters.

No Iso, No Problem: TIVA also deserves a place in General Small Animal Practice