Surgeries and cases suitable for management at WMR

We have the experience and the equipment to manage a very wide range of surgical, ophthalmological, medical and dermatological problems. We have been doing referral work for many years and we have the experience and the expertise to advise you on what is best for you and your pet. The following is by no means exhaustive, but gives you a flavour of what we can offer:

Orthopaedics

  • Anglular limb deformity: Twisted limbs, typically the “forearms”, are not unusual problems in growing dogs. If these aren’t properly and promptly addressed, the consequences can be catastrophic for future joint function.
  • Arthrodesis: Fusing diseased joints is sometimes the only option to restore pain free mobility. We are experienced in fusing wrists, ankles, shoulders, and on occasion knees and elbows.
  • Arthroscopy: Using an arthroscope to show a magnified view of joints, typically the elbow and shoulder, on a television screen.
  • Complex fracture repair: We have a vast experience of fixing fractures and an excellent record of success.
  • Cruciate ligament rupture: This knee ligament rupture is very common, and we’ve done hundreds and hundreds and hundreds of them, using a variety of techniques, some of them ultra-modern.
  • Joint replacement: Hip replacements for medium or large dogs, and (from July 2013) elbow replacements. These surgeries require extreme attention to prevent infection and we can only offer these at Lichfield.
  • OCD Surgery: Problems with the joint cartilage in shoulders, elbows, knees and ankles are relatively common and can require surgery to save or to salvage the joint.
  • Patella luxation: Dislocating kneecaps are common in many breeds of dog, and are usually straightforward to sort out.

Spines

  • Compression of the spinal cord and spinal nerve roots can be an acute emergency requiring the burring of windows in adjacent bone to relieve compression. Hemilaminectomy, dorsal laminectomy and ventral slots are some of the techniques we use to address these problems.
  • Fracture fixation: where the spinal cord is not completely transected by trauma, the results of surgical stabilisation can be extremely good and extremely rewarding. But these cases need the proper care before, during and after surgery if the desired outcome is to be achieved.

Soft tissue and general surgery

  • Complex wound reconstruction: Whether wounds are caused by trauma or by the removal of large tumours, there is an array of skin flaps and techniques that we can use to persuade skin to cover the gap.
  • Diaphragmatic rupture: This is a common finding in cats that have been hit by cars. It is relatively easy to fix surgically, but the real challenge is for the anaesthetist to breath for the patient while the repair is carried out.
  • Ear canal surgery: Ear disease is the bane of the lives of many cats and dogs and must cause untold discomfort and pain. Removing part or all of the external ear canal and sometimes part of the middle ear canal can make a huge difference to quality of life.
  • Extra hepatic PSS occlusion: This is most often seen in young, small breed dogs. “Dirty” blood from the intestines bypasses the liver through an abnormal blood vessel (the “shunt”) and mixes with the “clean” blood in the general circulation. This can result in brain problems and seizures. After appropriate medical stabilisation, surgically occluding the shunt is usually very rewarding and offers the patient the chance of a normal life.
  • Laryngeal tie back & airway surgery: The inability to breath normally must be a frightening experience. Airway surgery commonly involves shortening the soft palate, “tying back” tissue in the larynx to maintain a wider airway, and creating temporary or permanent holes in the trachea (the “windpipe”).
  • Maxillectomy / mandibulectomy: Tumours of the mouth are relatively common. Removing a section of jaw can often deliver excellent resolution of problems and a surprisingly good cosmetic result as well!
  • Neoplastic surgery: The key to tumour removal is to know the nature of the tumour before operating, to adequately remove the tumour with a single surgery and then to give appropriate medical care post-operatively.
  • Perineal herniarraphy: Older dogs, typically uncastrated ones, can develop faecal and urinary straining with swelling around the anus. Perineal herniation involves failure of the muscles of the pelvis to hold back the abdominal contents during straining. Hernia repair (accompanied by castration) is reasonably straightforward and usually resolves the straining and the swelling.
  • Thyroidectomy: Over production of thyroid hormone is a very common problem in aging cats. Once stabilised by medication, these cats usually do very well indeed with removal of the overactive glands.
  • Thoracotomy: There are a range of conditions involving the lungs, the oesophagus and even the heart that can require us to need to surgically enter the chest. Again, the skills of the anaesthetist are every bit as important as those of the surgeon.
  • Urethrostomy: Cats and dogs, usually males, frequently suffer from an obstructed urethra, the tube that drains urine from the bladder. Surgery is often the only way to deal with these problems in the short and in the long term.

Ophthalmology

  • Medical examinations: Through indirect and direct ophthalmoscopy, and slit lamp examination, we can often diagnose the cause of an ocular problem and then provide treatment accordingly.
  • Tonometry: Measuring the fluid pressure inside the eye is a particularly useful procedure in order to diagnose conditions like glaucoma, a painful build up of pressure in the eye. If this is left untreated it often leads to blindness.
  • Gonioscopy: A special procedure that measures the drainage angle of the eye where the iris meets the cornea.
  • Ultrasound examination: Using a scanner similar to those used to scan pregnant ladies, we can scan the internal structures of the eye and those directly behind the eye.
  • Electroretinography: A special piece of equipment is used to measure the electrical responses of cells in the retina at the back of the eye.
  • Retinal photography: Collecting images of the back of the eye is particularly useful in diagnosing a wide range of ophthalmic conditions.
  • BVA/KC/ISDS Eye examinations and litter screening: Numerous breeds suffer from hereditary eye defects and we can screen your pets for these conditions.
  • Ophthalmic Surgery: We provide a full surgical service covering “adnexal procedures” on structures around the eye, and “intraocular surgery” for problems involving the contents of the eye itself. We use an operating microscope for many procedures, especially the intraoccular ones. We have phacoemulsification facilities for treating cataracts. We use electrolysis for the treatment of distichiasis (abnormal eyelash growth).

Medical, dermatological and ultrasound referrals

We offer a medical, dermatological and ultrasound investigation service, though there are some restrictions on the dates that this is available. This service is provided by Roger Wilkinson at our Lichfield surgery. Because Roger lives some way away from Lichfield we group cases together for him so that he can do full days with us at Lichfield, typically one day every week or two. Obviously this means that acute/critical cases are less likely to be suited to this service. To get challenging medical and dermatological cases reviewed by Roger, your vet needs to send case notes, x-rays and laboratory reports by email to westmidlandsreferrals@gmail.com. We will discuss these with Roger and a decision can be made about whether the case might be suitable to be seen through West Midlands Referrals for clinical examination and for the formulation of an investigative and therapeutic plan.