Welcome to a new episode of the Skinflint Podcast, celebrating our impressive milestone of 10,000 downloads. This episode is a deep dive into the crucial role of sustainability in veterinary dermatology, presented to you by Nextmune UK and Elearning.Vetand featuring Monika Linek.

Chapter 1: Setting the Sustainability Stage

(03:10) Sue introduces Monika to the podcast, who shares her experience as a German dermatologist and diplomat of the ECVD. Monika discusses her work in a referral practice in Germany and her involvement in "Parents for Future," advocating for climate justice and sustainability.

(05:20) Monika defines sustainability as meeting present needs without compromising future generations' ability to meet their own. It involves maintaining a balance to prevent depletion of natural resources and harm to ecosystems.

Sue emphasizes the importance of sustainability in preserving the Earth for future generations. Sustainable practices ensure a lasting and enduring system for future generations.

(06:40) Sue raises the issue of sustainability in veterinary dermatology practices and asks Monika about potential improvements. Monika highlights several areas for improvement, including reducing carbon footprint from energy use, transportation, and waste management.

(07:39) Monika acknowledges the challenges of telemedicine in veterinary dermatology due to the necessity of physical examinations. However, she sees potential in remote consultations for follow-ups or initial assessments, particularly for referring practices. Finding a balance between technology and quality care is crucial. Monika also notes telemedicine's ability to reduce clients' carbon footprint by minimizing travel, a point Sue agrees with, emphasizing its role in complementing traditional consultations and promoting sustainability.

Chapter 2: Navigating Sustainable Solutions

(10:19)  John asks about areas in veterinary dermatology that could reduce carbon footprint. Monika underscores the importance of considering the environmental impact of drugs, particularly antibiotics and anti-parasitics. She notes the shift towards antibiotic stewardship and the need to rethink the use of topical anti-parasitics like chlorhexidine. Monika emphasizes the necessity of rethinking and changing practices regarding drug usage to minimize environmental impact.

(12:32) John appreciates Monika's insights and finds them encouraging, as these considerations align with responsible veterinary practices. He delves into the choice between systemic and topical treatments in dermatology, seeking Monika's opinion on their sustainability. Monika discusses the need for susceptibility testing before antibiotic use and emphasizes the benefits of combining topical treatments with antibiotics to reduce treatment duration. She advocates for avoiding systemic antibiotics when possible, relying on topical treatments alone for superficial pyoderma.

Regarding alternatives to chlorhexidine, Monika suggests hypochlorous acid as a more environmentally friendly option. Sue agrees, highlighting the importance of effective yet eco-friendly alternatives that do not compromise animal health.

(16:28) The conversation shifts to the development of technologies like photonic therapy as potential replacements for topical treatments. However, Sue acknowledges the challenge of balancing efficacy, cost, and environmental impact in private veterinary practice. Monika points out the need to address the pricing of eco-friendly products, highlighting the broader systemic issues surrounding their accessibility and affordability.

Chapter 3: Practical Sustainability

(18:36) John raises a practical question about the disposal of unused medications and antiseptics. Monika mentions new guidelines in the UK for returning unused or expired antibiotics and medicines to clinics for proper disposal. She highlights the importance of implementing better waste disposal systems for medicines in the future.

Sue adds that the UK has an "antibiotic amnesty" campaign encouraging people to return unwanted antibiotics to designated drop-off points instead of disposing of them improperly. These drop-off points include pharmacies and veterinary clinics, which have appropriate methods for disposing of clinical waste.

(21:36) John raises the idea of reusing items in veterinary practice, such as scalpels and biopsy devices, instead of relying solely on single-use plastics. Monika suggests that while it may be challenging to revert to using glass syringes, there are still opportunities to explore reusable alternatives for certain items, such as surgical gowns and towels. Sue emphasizes the importance of putting pressure on manufacturers to produce more recyclable and sustainable products, even if it means paying a bit more.

When discussing sterilization methods, Sue acknowledges that there are various factors to consider, such as the environmental impact of disposing of sterilizing solutions. Monika suggests that methods like autoclaving could be more sustainable if powered by renewable energy sources like solar or wind power, reducing their carbon footprint.

(26:53) John reflects on the complexity of sustainability discussions within veterinary practice, noting that while there may not always be clear answers, the important thing is that people are actively engaging in conversations and considering sustainable practices. Monika raises concerns about greenwashing and emphasizes the need for genuine action rather than just slogans. Sue adds that changing habits can be challenging but underscores the importance of prioritizing sustainability in everyday actions, even those seemingly small, like shutting down computers.

(29:00) Shifting the conversation to dietary choices for animals, Sue asks about sustainable options for food trials, particularly considering allergies. Monika discusses the challenges of finding novel protein sources and suggests that home-cooked diets may be more sustainable, though caution is needed, especially with cats. She also highlights the need for transparency from pet food manufacturers regarding the carbon footprint of their products, echoing the call for informed decision-making and accountability in veterinary practice.

(34:35) Monika highlights three key tips for sustainable veterinary dermatology practice: rethinking antibiotic and antiparasitic use, addressing waste management through the waste hierarchy, and reducing paper consumption by embracing digital solutions. Sue acknowledges the importance of these tips, emphasizing their relevance for all veterinarians. John expresses gratitude to Monika for her insights and contribution to the discussion on sustainability in veterinary dermatology.