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My pet was admitted at 8.30am, will surgery be performed in the morning or afternoon?
For efficiency, we admit most patients between 08.00 and 09.00. Some patients can be admitted the night before in preparation for surgery. To ensure that we support the medical needs of our patients we do prioritise the order of our surgeries based on the clinical needs of each patient.
Breathing issues, spinal compression and trauma cases are generally at the top of our list of priorities.
Fractures are often high up the list because they are often painful, but most can wait a short while. Open fractures with bone exposed are high priority and joint fractures are more pressing than mid-shaft fractures. Fractures high up the legs are more pressing because these can’t be temporarily supported by splints etc. In contrast fractures well below the elbow or knee can often be temporaily stabilised with splints and so can often wait, several days if needs be.
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 then need to 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 are beyond our control and this may mean that it is simply 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. Alternatively why not plan to leave your pet with our nurses overnight and collect the next day? This can avoid a lot of potential waiting around and frustration for you!
Will my pet be supervised overnight?
We have our own nursing cover on site over night on weekdays. All our inpatients can now have round the clock nursing care with us. Our overnight hospitalised patients include animals waiting for procedures the next day, or animals recovering from surgery.
While patients that aren’t on drips and aren’t needing analgesia injections at short intervals might not need overnight care, no animal needing such supervision will be left unattended.
We do make extra charges for overnight hospital care.
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. Following qualification many vets, develop an interest in a particular field of veterinary medicine and choose to undertake post graduate qualifications (Certificates) to become an Advanced Practitioner. This can be followed by the more advanced Diploma which involves a further three to five years of training to become a board-certified Specialist in a particular discipline of veterinary medicine.
At WMR our team of experienced Certificate holders are highly skilled in performing complex procedures ensuring the best possible clinical outcomes.
Are cats and dogs kept in the same kennel room?
We have separate cattery and kennel rooms for 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 also generally don't much like how dogs smell! We have one of our six consulting rooms kept solely for the use by cats, so it never gets the lingering scent of dogs.
Cats that are hospitalised for any period of time have cages that are large enough for them to pace around stretch their legs. The cat cages don't face each other so they can't wind each other up!
Big dogs have "walk in" kennels and we have secure cages where our longer term canine in-mates can safely get a breath of breath of fresh air!
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!
How do Tibial Plateau Levelling Osteotmy (TPLO) and Tibial Tuberosity Advancement (TTA) work?
TPLO was developed inthe 80's by Barney Slocum. Whether it is done by means of making a curved radial cut in the tibia or by removing a wedge of tibia, the goal is to reduce the natural slope of the top of the tibial (the tibial plateau that forms the lower side of the knee joint) to something close to perpendicular to the long axis of the tibia. In normal dogs the slope of the plateau is around 250. So the femur, the thigh bone that sits above the knee joint, "wants" to "ski" backwards down the sloping tibial plateau. The cruciate ligament, when intact, stops the femur from doing this. But if the ligament is broken .... So by making the palteau "flat" we engineer a situation where the femur doesn't want to try and ski off the tibia any more!
TTA was devised in Switzerland aroudn 2004. The idea is that the tendon that links the knee cap (patella) to the shin bone (tibia) is made perpendicular to the top of the tibia (the tibial plateau) when the patient is weight bearing. This helps stop the tibia from shearing forwards with respect to the thigh bone (femur) when muscles tense during weight bearing. The change in the angle to a perpendicular one is achieved with a bone cut in the tibia, the insertion of a spacer (titanium cage) into the gap, and stabilisation during bone healing using a variety of metalwork.
Healing or TPLO and TTA typically takes around 8 weeks to have any significant strength.
How likely is infection in the wound?
Not likely at all. We are scrupulous in our standards of disinfection and hygiene, and in preparing wounds for surgery. We strive for zero-infection rate, but the sad reality of surgery is that this elusive goal is never quite reached. Infection risk in otherwise routine surgery is often quoted at around 1‰.
Why does the clip need to be so big?
We need to prepare wounds thoroughly for surgery to minimise the risk of infection. This requires that the hair is clipped back to the skin. We need to ensure that there is a wide margin of prepared skin around the planned wound. It will grow back!!
Do blood tests make anaesthetics safer?
Probably not, in the immediate sense of “anaesthetic safety”. Pre-operative blood tests can identify pre-existing liver and kidney disease and so these tests do reduce the likelihood that a patient with pre-existing liver or kidney problems will undergo an anaesthetic without the owner having been counselled as to the risks. If the liver is diseased, then your pet may have more trouble clearing anaesthetic drugs from its body. If the function of the kidneys is already reduced, then the kidney problems might be further exacerbated by anaesthetic drugs that reduce blood pressure and reduce blood flow to the kidneys. We do pre-anaesthetic blood tests as routine and the information gained is often used to tailor the pre-med and anaesthetic regime and fluids to the particular patient.
What Internal Medicine referral services are available at West Midlands Referrals?
Orthopaedics, Soft Tissue, and Spinal Surgery form the core referral services provided at WMR. In additional, our expert team of Advanced Practitioners also provide referral services for patients requiring an Internal Medicine referral. Our Internal Medicine service is provided by Mayra, a highly experience ultrasonographer. Our Internal Medical offering provides a referral service for chronic patients where an intensive therapy unit is not required.