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I dropped my pet at 8.30am – why wasn’t it operated on until the afternoon?!
For efficiency, we admit cases between 08.00 and 09.00 or thereabouts. We obviously can’t do all the operations between 10am and 11am! So we prioritise the order in which we do surgery cases according to clinical need. We completely understand that your pet is of paramount importance to you – of course it is – but please try to remember that every other owner feels the same way about their pet too!
Breathing issues, spinal compression and eye trauma cases are generally top of the list of priorities.
Fractures are often high up the list because they are often painful, but most can wait a short while. Joint fractures are more pressing than mid-shaft fractures, and fractures high up the legs are more pressing because these can’t be temporarily supported by splints etc.
Cruciate ligament injuries and luxating patella (knee cap) surgeries are “elective”, meaning that these surgeries are for problems that the pets have usually had for weeks or longer, and they won’t be in much discomfort while they wait. So these cases are a lower clinical priority.
Some procedures are classed as “dirty” ops, like ear surgeries and anal furunculosis cases for example. We typically do these last because the theatres can then be blitz-cleaned after them.
If we know that clients have come from afar and have very long journeys home, we will do our very best to get these cases done in timely fashion.
Our aim is to achieve client satisfaction and we will our very best to accomodate the needs of you and your pet.
Will my pet definitely be going home the same day?
If you’ve been told that discharge of your pet is likely later the same day, then it is very probable that we’ll be able to discharge your pet late afternoon or early evening the same day. But we can’t say definitely.
There is always the possibility that we will need to change the plan. If another very pressing case has to be done first, then that can lead to delays which mean that it may prove to be impossible to stick to the original plan.
If your pet requires extra aftercare – extra fluid therapy or analgesia, or if it has a slower than usual recovery from the anaesthetic / procedure, then that too might lead to a change of plan.
We will do our very best to avoid un-necessary hanging around for you.
Many clients go home, go to work or find something to do to occupy themselves for the day before ringing us in the afternoon to confirm that they can come back to collect. This can avoid a lot of potential frustration for you!
Will my pet be supervised overnight?
Animals waiting for procedures the next day, or animals that that aren’t on drips and aren’t needing analgesia injections at short intervals may be left unsupervised overnight.
No animal needing supervision will be left unattended. Overnight care may be by a nurse or by a vet as appropriate. We can provide “eyes on” veterinary supervision throughout the night for cases that need close monitoring. For this, we use the services of a large local animal hospital. We provide the transport of animals between that hospital and our own facility. For the great majority of cases, the cost of this “eyes on” hospitalisation is included in our fee and we cover their charges, at least for the 3 days that would usually be covered by our fixed prices (see separate section on fixed prices). Exceptions to this might include cases that had initially been referred to us by that very practice (in which case we’d have already reduced our charges in respect of this).
Why is metalwork required? Why not just a cast or a splint?
Dressings / casts / splints often seem like a really good, economic, minimally invasive and simple way to immobilise fractures and orthopaedic injuries but there are some issues relating to dressings / casts / splints that make them less than ideal:
No dressing / splint / cast is ever going to fix an injury as rigidly as a rigid metallic fixation construct, whether that be a plate, fixator etc. The small movements that are still allowed within a dressing / splint / cast will have consequences:
There will be more discomfort because of movement at the injury site.
Inadequate immobilisation may lead to less satisfactory healing or healing failure. Movement at a fracture site may well stop bone union from occurring and may result in much larger bone callus forming.
For a dressing to work to immobilise a fracture, the joint above and below the injury must be immobilised. This means that injuries near or above the elbow or the stifle simply can’t be effectively immobilised with a dressing.
Even for injuries below the elbow and stifle, the immobilisation of adjacent joints by a dressing / splint / cast can lead to adverse consequences – joints don’t “like” to be immobilised and loss of range of motion and muscle loss often accompanies dressings / splints/casts that are maintained for significant lengths of time.
Fractures are usually painful, and to get effective dressing / splint / cast changes done, repeated sedation or even anaesthetics may be required. This can significantly increase costs and also the impact on the patient.
In growing dogs, the limb can outgrow the dressing in a matter of days, and frequent dressing changes are required.
Sores can develop under dressings, especially over pressure points like the ankle. Sometimes the way the dressing is put on can make these sores more likely, but all vets and nurses who put on dressings on regularly will get the odd dressing related sore in their patients. These sores usually clear up really well once the dressing is removed, but if the dressing has failed to solve the problem and a “Plan B” of internal fixation is subsequently required, it is far from ideal to be creating surgical wounds through inflamed skin. The risk of infection developing after the revision surgery would then be significantly increased.
If dressings get wet or slip they will actually make things worse, not better:
Wet dressings lead to skin sores (imagine what a baby’s bottom would look like if it was left in the same wet nappy for a day …)
Slipped dressings are now no longer protecting the injury, and in fact are effectively lengthening the limb, increasing the forces acting on the injury.
So although we do occasionally use splints and casts, for the most part we prefer metalwork for rigid fixation and immobilisation of injuries.
What is the difference between a General Practitioner, an Advanced Veterinary Practitioner and a Specialist?
All vets practicing in the UK must be registered with the Royal College of Veterinary Surgeons (RCVS). The designation Member of the RCVS (MRCVS) legally allows them to do any act of veterinary surgery. Nowadays most vets, after qualifying, developing an interest and expertise in particular sub-fields of veterinary medicine and/or surgery. Some choose to go on to get post graduate qualifications. These are Certificates or the more advanced Diplomas.
A “specialist” is an expert in a given field, recognised by the Royal College of Veterinary Surgeons. They have usually passed the relevant Diplomas. The criteria required to be called a “specialist” is difficult and somewhat onerous to achieve and many experienced surgeons have not sort to be recognised with this qualification. We are not “specialists”. Our veterinary surgeons have passed one or more post-graduate surgery examinations called Certificates. The pass rate for these was something like 1 in 5.
Some referral procedures do need the attention of a specialist – intrahepatic liver shunts would be a good example. Surgery within the central nervous system itself would be another. If we think that you and your pet will be better served by redirection to a specific specialist, we will tell you so and we have good and close relations with specialists in neurology, oncology and cardiology to name but a few.
However many advanced procedures can be carried out by experienced Certificate level surgeons such as ourselves, and often at a fraction of the cost, with very comparable outcomes. Take fracture repair for example; there will be many specialists who have not repaired anything like the number of fractures that we have. Surgeries for cruciate ligament ruptures are another good example. We have done thousands of cases and we have complication rates and outcomes that we are rightly proud of. We have friends who’ve become Diploma holders having done no more than 50 cruciate ligament surgeries.
In 2015 the RCVS introduced the Advanced Practitioner status as a middle tier between general practice and specialists. Jon and Andy are recognised by the RVCS as Advanced Veterinary Practitioners in Small Animal Surgery; Lorna is recognised by the RVCS as Advanced Veterinary Practitioners in Veterinary Ophthalmology and Roger is recognised by the RVCS as Advanced Veterinary Practitioners in Small Animal Medicine.
Are cats and dogs kept in the same kennel room?
We have separate kennel room for cats and dogs. Many dogs, however well meaning they are, make a lot of noise! Unfortunately most cats don’t appreciate this! So we keep these species apart in separate rooms. We have a range of kennels and cages in various sizes to accommodate all sizes of pets. Cats that are hospitalised for any period of time have cages that are large enough for them to pace around stretch their legs and.
How risky is the anaesthetic?
Everybody worries about anaesthetics, but the truth is that unexpected anaesthetic deaths are rare. Age is not the huge factor that many think it is: an otherwise “well” elderly pet is often a less risky anaesthetic than a “poorly” younger one. We use modern anaesthetic methods, we only employ experienced Registered Veterinary Nurses, and we stay with your animal from the moment of induction of anaesthesia to the time at which they are recovered and sitting up. We have comprehensive multi-parameter monitoring equipment in the prep-room and both theatres. With monitoring of expired CO2 levels, blood O2 levels, blood pressure, body temperature, ECG (heart electrical activity), heart/pulse rate etc etc, you can rest assured that we will watch your pet like hawks!