What do we do?

Our range of services

  • Cardiology
  • Oncology/Electrochemotherapy
  • Ophthalmology
  • Orthopaedics
  • Soft Tissue
  • Spinal Surgery
  • Dentistry
  • Laparoscopy
  • CT Scanning
  • Magnetic Resonance Imaging
  • Ultrasonography
  • Radioactive Iodine Therapy
  • Neuro Diagnostics

Cardiology

Our cardiology service is run by Kate Hildick-Smith and is based at our Yate practice, she is also able to see cats at the Rowe Cat Clinic also in Yate at Brimsham which may be.  

Cardiology services include:

•    Echocardiography 
•    Murmur investigation
•    ECG and radiograph interpretation
•    Holter ECG monitoring
•    Management of chronic cases

As well as taking cardiology referrals at our Yate practices, Kate is also happy to provide peripatetic services to local partner practices, helping to bridge the gap between primary care practice and referral centres. Whilst this would predominantly be for cardiology cases, if there are internal medicine cases that require abdominal ultrasound (with interpretation relevant to the case) and/or assistance with diagnostics and case management/treatment, then Kate is happy to help. 

For any further information or advice, please do not hesitate to contact our Yate practice on 01454 318016 by email at referrals@rowevetgroup.com

 

Oncology/Electrochemotherapy

Our Oncology service is run by Dr Elisa Best who is qualified in both surgery and oncology.

She is able to perform oncological surgery with an understanding of tumour biology as well as adjuvant (follow up) treatments including chemotherapy and electrochemotherapy. She works closely with our visiting imager Mags Costello for staging cancer patients.

We offer the following:

  • Oncology consultations for advice
  • Cancer patient staging including CT and Ultrasound /Ultrasound guided sampling
  • Oncological Surgery
  • Chemotherapy
  • Electrochemotherapy

Electrochemotherapy is a local treatment for tumours that uses a combination of IV or intralesional chemotherapy combined with application of short electric pulses to the tissues. The current causes the cell membranes to temporarily open allowing drugs to enter into the cancer cell (electroporation). This process results in greater drug uptake by the cell compared to injection or tablets. After the electrical pulses stop, the membrane seals allowing the cells to continue to live (reversible electroporation) which is important for normal tissues around the tumour. However, the tumour cells will die due to the effect of the drug that has entered the cell.

Electrochemotherapy can be used either on its own or in combination with surgery.

Ophthalmology

Here at Rowe Referrals, the team offer a comprehensive ophthalmology service including cataract and lens luxation surgery by phacoemulsification with intraocular lens placement (including sutured intraocular lens placement where traditional intraocular lens techniques are not possible), electroretinography, advanced ophthalmic imaging, uveitis management, gonioscopy, glaucoma endolaser and shunt surgery, laser indirect ophthalmoscopy, a full range of corneal surgeries including corneo-conjunctival transposition and transplantation, parotid duct transposition, complex eyelid surgery, re-constructive ophthalmic oncologic surgery and ocular prosthesis surgery.

All procedures are undertaken with high end anaesthesia (including the availability of sevoflurane, capnography, pulse oximetry, ECG, continuous temperature monitoring, Bair Hugger patient warming system, ventilator and where appropriate neuromuscular blockade.)

Early referral is encouraged especially in cases of lens luxation, glaucoma, cataract and corneal ulceration.

Outpatient Eye Clinics

In order to make the expertise of the eye team more readily available we have partnered with a number of practices in South Wales and the South West to offer regular outpatient clinics for both new cases and follow up examinations. In some cases, at some sites, it may be appropriate to offer minor surgical treatments on an outpatient basis however in the majority of cases surgical treatment is offered at the main clinic in Bristol where as well as having a fully equipped eye hospital we have a dedicated team on site 24 hours a day.

Orthopaedics

Our brand new Orthopaedic service based at our purpose built hospital in Bradley Stoke is now up and running. Rowe Referrals offers a wealth of surgical experience, as well as state of the art technology including an onsite CT scanner. 

Joe is happy to give advice on case management to vets by phone or email, even where referral isn’t an option. If you have any questions, or would like to refer a case, please contact the Referrals department on referrals@rowevetgroup.com or call 01454 521000.

For any further information or advice, please do not hesitate to contact our Bradley Stoke Hospital on 01454 521000 or referrals@rowevetgroup.com. Find us here.

Soft Tissue

Our soft tissue referral service is based at the purpose built Bradley Stoke Hospital site with a full range of support features, including a state of the art CT Scanner. The CT scanner allows us to perform advanced imaging onsite with results being available within 2 hours if required.

Our 24 hour hospital provides veterinary care for our critical patients pre and post surgery. We offer most soft tissue procedures but have special interest in surgical oncology (cancer) cases, wound management, surgical management of ear disease and airway surgery for BOAS cases. Our highly qualified surgical nursing team are experienced in all aspects of surgical care including advanced anaesthesia and wound management.

Our state-of-the-art theatre has equipment available, enabling more complex soft tissue procedures to be performed such as vessel sealing devices, harmonic scalpel and Negative Pressure Wound Therapy.

The soft tissue surgery services includes the following;

  • Upper and Lower Airway Surgery
  • Abdominal Surgery
  • Perineal Surgery including anorectal surgery
  • Oncological Surgery
  • Laparoscopy (key hole surgery)
  • Wound Management including Negative Pressure Wound Therapy
  • Head and Neck and Surgery (including ear disease)
  • Surgery for foreign body retrieval/stick injury

For any further information or advice, please do not hesitate to contact our Bradley Stoke Hospital on 01454 521000 by email at referrals@rowevetgroup.com or refer a case using our online referral form here.

Find us here.

Spinal Surgery

At Rowe referrals we are able to offer urgent same day referrals for cases requiring spinal surgery. Cases are seen by our Neurology service with an accurate assessment being achieved by hands on physical and neurological examinations, and with the use of our on-site state of the art 3.0T MRI and 16-slice CT scanners.

Our spinal surgeons Ian Jennings and Elisa Best offer, same day, decompressive surgery including hemilaminectomy and ventral slot procedures for acute disk extrusions, with continued treatment at our 24 hour hospital with dedicated out of hours staff.

Decompressive surgery for acute Intervertebral disk extrusions

Cervical Disks - A Ventral slot is usually performed although lateral dorsal laminectomy or facetectomy may be required for some compressive lesions

Thoracolumbar disks - A hemilaminectomy is the most commonly practised procedure however pediculectomy (mini-hemilaminectomy) can be more appropriate for some ventrally located extrusions

Lumbosacral disks - Dorsal laminectomy gives the best access to an extrusion in this region

Chronic disk protrusions (or longer standing extrusions) of the thoracolumbar spine can also treated surgically with pediculectomy and partial lateral corpectomy (removal of part of the vertebral body) to allow decompression with a reduced risk of further spinal cord injury.

We have close links with tertiary referral specialist neurosurgeons and surgery for other conditions i.e. Degenerative lumbosacral disease, subarachnoid diverticulae & tumours are managed on a case by case basis in collaboration.

If you would like some free advice on a potential neurosurgical case or to refer please contact us.

Dentistry

Our dental referral service is run by Magdalena Wilczek DVM, MRCVS with the support of Jerzy Gawor DVM PhD, DAVDC, DEVDC, FAVD, MRCVS.

Referrals can be made for the following:

• Second opinion on oral examination and dental x-ray
• Treatment of periodontal disease
• Complicated extractions
• Malocclusions
• Gingivitis stomatitis and other inflammatory diseases in cats and dogs
• Tooth resorption
• Root Canal
• Enamel disorders
• Selected maxillofacial fractures and / or neoplasia

As part of a wider Referral department, Magdalena is happy to take elderly patients and those who have complicated underlying conditions, such as diabetes, CKD and heart disease, as the team can work together to provide a holistic approach to their care and treatment. We can provide advanced diagnostic imaging (including dental x-rays, CT, MRI, radiology and ultrasonography), 24-hour hospitalisation as well as oncology support.

Laparoscopy

We offer laparoscopic (keyhole) surgery at Rowe Referrals, performed by our soft tissue surgeon Elisa Best. We perform routine neutering (ovariectomy and ovariohysterectomy) as well as cryptorchid castration.

Other procedures that can be performed laparoscopically include prophylactic gastropexy, liver biopsy and cystotomy.

For any further information or advice, please do not hesitate to contact our Bradley Stoke Hospital on 01454 521000 or referrals@rowevetgroup.com. Find us here.

CT Scanning

What is CT?

CT (Computed tomography) scanning is a diagnostic tool which is used to look at various parts of the body, especially those made of bone, air and soft tissue structures. It uses X-rays to produce images.

CT is a continuous beam of X-rays which spins around a doughnut shaped gantry. The tube head which produces the X-ray beam spins very quickly and the patient is moved through on the table, and of each spin of the tube head, a series of slices of X-ray images are taken. Once this information is taken, computers use their software to produce images which we can recognise and interpret to help aid our diagnoses. Interpretation of the slices are sometimes sent for a second opinion to an advanced imager.

CT scanning has some advantages over plain x-rays and other types of imaging modalities.

  • CT produces slices which are cross sections of the patient and the software that the images are run through will remove any superimposition of any overlying structures, which makes our interpretation of images much easier.
  • Slices can be added together electronically to produce images and slices of different thicknesses to look for small abnormalities.
  • Unlike MRI scanning, Ct slices can be electronically stacked in many different directions so that the images can be manipulated and can reconstruct tissues which can help give more insight into an abnormality.

CT scanner at Rowe Referrals

The Siemens Somatom 16 slice CT scanner at Rowe Referrals can produce advanced images. Each time the tube head rotates 16 slices of imaging information can be obtained and the thickness of these slices can be adjusted, even down to half a millimetre in width. Scan length time is very short, for example, a large dog chest can be imaged in around 15 seconds, an incredibly short amount of time. For this reason most of our patients can be scanned with a sedative rather than full general anaesthesia, although sometimes anaesthesia cannot be avoided.

We sometimes need to look at some structures more carefully, and we use an injected dye (contrast agent) which is a liquid injected into the patient via their intravenous catheter. As the dye passes through the veins, arteries and organs, we take further sets of images to be able to see how this dye moves through the different body parts and can help us diagnose abnormalities with your pet.

Please contact us at any time if you are at all concerned.

For any further information or advice, please do not hesitate to contact our Bradley Stoke Hospital on 01454 521000 or referrals@rowevetgroup.com. Find us here.
 

Magnetic Resonance Imaging

Rowe Referrals now has a 3.0 Tesla MRI scanner available onsite - one of only a few used clinically across the whole of Europe. The high field strength allows us a much more detailed view of our cases in comparison with lower field scanners, increasing our diagnostic yield, and the ability to perform more complex investigations including functional MRI (fMRI) and non-contrast angiographic studies with greater clarity. 

MRI is used at Rowe Referrals across all disciplines, and although it is routinely used in the investigation and diagnosis of neurology/neurosurgical cases it is invaluable as a diagnostic tool with ophthalmic and retrobulbar disease, orthopaedic conditions (particularly helpful with the investigation of joint disease) as well as soft tissue/muscular disorders.

Further Info for Pet Owners

For more info or advice, please do not hesitate to contact our veterinary MRI centre on 01454 521000 (option2) or email mri@rowevetgroup.com.

Ultrasonography

We are delighted that Mags continues to be able to offer imaging consultations at our Bradley Stoke Hospital. Maggs currently uses a state of the art digital system equipped with colour and power Doppler, five broadband probes (10 MHz linear, 7.5 MHz microconvex linear & 3 electronic phased array probes, 3.5-10 MHz) which allows her great versatility. Images are crisp and sharp due to full digital technology. It is equipped with some of the latest technology including tissue enhancement and contrast harmonic ultrasound. Abdominal ultrasound and cardiac ultrasounds are offered routinely and the choice of probes means every size of animal is well catered for. 

The 10 MHz linear probe makes examination of superficial tissues and small parts much easier e.g. thyroid and parathyroid glands. It is useful in the investigation of hypercalcemia and masses in the neck, which may be thyroid, salivary etc. The larynx and trachea are also amenable to examination. 

High quality musculoskeletal examinations are also possible with this probe. Ultrasound is under utilised in the evaluation of shoulder lameness. Most of the shoulder can be easily examined with ultrasound, which is useful as this is a tricky area to evaluate fully with radiography. MRI is expensive and may be difficult to interpret. Even arthroscopy may miss lesions that can be seen clearly on ultrasound. 

Vascular ultrasound has great clarity, whilst Power Doppler technology adds further information as illustrated in the adrenal mass (see picture below).

Ocular examinations are very worthwhile with the new system due to enhanced near field resolution and improved image clarity. Conditions affecting the iris, lens, retina as well as retro-bulbar conditions will be now be more amenable to examination.

For any further information or advice, please do not hesitate to contact our Bradley Stoke Hospital on 01454 521000 or referrals@rowevetgroup.com. Find us here.

Radioactive Iodine Therapy

Our Wotton Under Edge Hospital is now one of only a handful of Veterinary Hospitals in the UK that is able to offer radioactive iodine for the treatment of hyperthyroidism in cats.

Hyperthyroidism (overactive thyroid glands) is a very common disorder of older cats. It is caused by an increase in production of thyroid hormones from the thyroid glands, which are situated in the neck. Common signs of hyperthyroidism include an increase in appetite with a decrease in bodyweight, some cats can become seriously ill with this condition.

A single radioactive iodine injection is successful in treating hyperthyroidism in approximately 95% of cats.

A one off injection and a 10 day stay in hospital could be all that your cat requires to treat the condition. The benefits of radiotherapy treatment include:

  • No more struggling with daily medications!
  • No more routine bloods to check thyroid levels
  • No need for surgery

Although your cat has to be hospitalised in our approved treatment unit whilst undergoing radiotherapy, we do our best to ensure they have a comfortable stay by providing:

  • Air conditioned / temperature controlled facilities
  • Television for visual stimulation
  • Audio tracks specially geared towards your cats unique hearing range
  • Radio
  • 24 hr surveillance camera to enable safe monitoring of your cat

The current cost of treatment is £3,200.00 inc VAT. This cost is essentially a ‘package deal’ covering pre-treatment investigations, the treatment itself  and hospitalisation for 28 days, after which time your cat can be discharged. This does not include the cost of treatment for any concurrent medical problems, any unexpected diagnostic tests or post-treatment blood tests.

If you would like to find out more about how our radiotherapy unit may be able to help your cat, please ring our dedicated referrals hotline on 01454 521000.

Are you a pet owner and have further questions? View our FAQ's

For more info or advice, please do not hesitate to contact us on 01453 843295 or 01454 521000 or email iodine@rowevetgroup.com.

Neuro Diagnostics

The Neurology service at Rowe Referrals is run by Ian Jennings. He will see all neurological cases including:

  • Investigation of seizures
  • Paroxysmal Dyskinesias
  • Abnormal mentation
  • Cranial Nerve disorders
  • Vestibular signs
  • Tremor syndromes
  • Ataxia
  • Neck Pain
  • Spinal Disease
  • Suspected Syringomyelia
  • Peripheral nerve disease
  • Neuromuscular Disease

As well as a comprehensive physical and neurological examination, diagnostic imaging with our state of the art 3.0T MRI, or 16-slice CT, scanners may be undertaken. We also perform cisternal and/or lumbar cerebrospinal fluid (CSF) sampling and any blood tests required, these are analysed in our dedicated on-site laboratory to reach a definitive diagnosis as quickly as possible.

Our Neurology department works closely with our Medicine, Surgery and Oncology services to enable us to treat a wide selection of conditions, as well as having close links to specialist tertiary referral centres.

If you would like some free advice on a neurology case please contact us on 01454 521000 or to refer please click here.

Refer a Case

Information Sheets

General Anaesthesia

Why does my pet need to be anaesthetised?

Many of the procedures we carry out in the hospital cannot be performed conscious or under sedation as your pet will not be relaxed enough to ensure we can carry out investigations thoroughly. As we cannot ask your pet to sit still in specific positions for sometimes long periods of time general anaesthesia is often necessary even in diagnostic stages of referral to us

What is an anaesthetic?

There are various different types of anaesthetics, but they all lead to the loss of sensation. General anaesthetic enables the state of a reversible unconscious state which is normally begun by firstly injecting an induction agent into the vein, to start your pet ‘sleeping’ and then followed by gases being breathed in by your pet into their lungs to keep them asleep for a longer period of time. The drugs we use stop the brain being able to recognise messages being passed from the nerves in the body, as the anaesthetic drugs pass from the lungs into the blood-steam and finally to the brain

My pet is having an anaesthetic, what do I need to do?

  • You will be instructed by our team to fast your pet overnight. The length of time of the starve will be determined by the procedure you pet is being referred for and you will be advised when booking your referral appointment
  • Please allow you pet access to water throughout the fasting period
  • Please keep cats indoors before the procedure to prevent them from getting food from elsewhere. It will also ensure they are easier to find in the morning
  • Please give your dog plenty of opportunity to empty their bladder and bowels by allowing a short walk in the morning of your appointment (unless you pet is on strict cage rest)
  • If you have kept a diary of your pet’s behaviour (for example seizure records or videos) please bring this with you to your appointment, along with any medication you pet is currently receiving (preventative flea and worm products are not necessary)
  • If you notice any signs of illness or injury prior to your appointment please inform us either before you arrive or when you see one of our team

What happens to my pet once they are admitted?

The choice of anaesthetic will be decided and chosen by one of our veterinary surgeons once they have given your pet a full clinical examination and decided what procedures are required to be undertaken

A pre-anaesthetic medication (‘pre-med’) will normally then be injected, which allows your pet to relax in the veterinary environment.

Once you pet is relaxed, we will place an intravenous catheter into either a front or back leg vein. This gives us easy access to a vein to provide medications to your pet easily and effectively.

This catheter will also allow us to begin the anaesthetic by injecting anaesthetic drugs into your pet’s vein, and then for us to place a tube down your pet’s trachea (windpipe), so then remainder of the anaesthetic can be delivered by gas.  

How is my pet kept safe under general anaesthesia?

Once anaesthetised your pet is connected to an anaesthetic machine. This machine delivers a mixture of anaesthetic gases and oxygen, and is adjusted to allow your pet to be kept asleep during procedures. Each machine can have different types of circuits attached depending on your pet’s individual requirements

Whilst under general anaesthesia you pet will be closely monitored by a member of our qualified staff and in addition specialised monitoring equipment is used to closely observe your pet’s progress. The type of equipment used will depend on the procedure being carried out and the clinical history of the individual patient.

We can measure using our monitoring equipment:

  • Heart rate and rhythm (electrocardiogram)
  • Pulse rate and quality
  • Respiratory rate and rhythm
  • Body temperature
  • Blood Pressure
  • Oxygenation levels of the blood (pulse oximetry)
  • Carbon dioxide levels in the breath (capnography)

We also record many other readings to we can measure and altar the depth of the anaesthetic including, eye position and reflexes, gum colour (mucous membranes), jaw reflexes, which are recorded every 5 minutes on a record chart.

The information we record allows us to anticipate and problems before they actually occur. Adjustments can be given to help stabilise parameter for example, extra intravenous fluid therapy and additional drugs. If there is any concern regarding your pet’s breathing, we can connect them to a machine which can breathe for them (ventilator).

Whilst your pet in under general anaesthesia, the body loses the ability to maintain body temperature. We constantly monitor this temperature and take steps to help reduce the amount of heat your pet is losing.

We use a range of equipment to help keep patients warm. Our theatres are equipped with heated beds and warmers, we can wrap patients in foil and bubble wrap, use heated bean bags to name just a few, to enable your pet’s temperature to remain stable and provide a quicker recovery from general anaesthesia.

Once the procedure is finished we switch the anaesthetic gas off, and allow your pet to recover. If your pet has been under anaesthetic for a long period of time or is older, recovery can be slower, but all patients are constantly monitored until they are fully awake.

Our hospital is operational 24 hours a day with qualified veterinary surgeons, qualified nurses and highly skilled care assistants to ensure your pet is cared for to the highest standards. We welcome calls into the hospital to give you clinical updates on your pet, and if you pet needs to stay with us, appointments for visits can be organised.

Will my pet feel pain?

Patients that are receiving a general anaesthetic will have a painkiller incorporated into their premedication, and subsequent pain relief may be given whilst your pet is under anaesthesia. Continuing pain relief will be decided by our veterinary surgeons dependent on each patient’s individual requirement.

What can I expect when my pet comes home?

If your pet is discharged on the same day of the procedure, they may be a little sleepy. The drugs we administer may still have some effect in the system. Your pet will be discharged by one of our veterinary nurses who will advise you to keep your cat indoors) and for dogs to be only walked in the garden on a lead, this is normally for 24-48 hours (or in some cases longer as some procedures carry some very specific discharge instructions).

Please follow the discharge form provided to ensure medication are given as directed and any specific care that is required.

Offer you pet some light bland food for the first 24 hours (boiled chicken or fish and rice) and water. Some conditions will have specific feeding instructions which will detailed to you on discharge, and similarly if your pet has special dietary requirements you will be advised also.

Keep your pet in a warm comfortable place when they return home, and try and reduce over exertion e.g. playing with other animals or games. Please observe for any abnormalities including pain, sickness, diarrhoea, lethargy and contact your own vets or ourselves if worried at all.

Please contact us at any time if you are at all concerned.
 

Common Ophthalmic Conditions

Giving your pet medication

We understand that giving medications to your pet can be sometimes a difficult time. The medication prescribed to your pet need to be administered as advised by the veterinary surgeon or veterinary nurse.

We will be happy to demonstrate giving medications to you, please do not hesitate to ask. 

It can be helpful to have two people involved with administering medications, one to hold and one to give. Please be careful to not get bitten or scratched. Some people find wrapping cats within a towel advantageous.

Once administered, please praise your pet ready for next time.

Drug labels

Every medication dispensed will have a label on it which we ask you to read carefully and follow.
Drug labels contain you surname and address, your pet’s name, the medication name, how much medication should be given to your pet and how often. There may also be extra information to specific for the drug.
Unless you are advised, please continue the drug to complete the course. Only stop if you are instructed to do so. This is especially important for drugs such as antibiotics as stopping early can lead to the disease reoccurring and antibiotic resistance.

If you are concerned at any time, please call us.

Storage of medications

  • Please store all medication out of the reach of children and animals.
  • Store medications away from direct sunlight.

Please ensure that the medications are stored at room temperature, but some may be required to be refrigerated. If a drug has a specific storage requirement, this will be on the label or you will be advised.

Handling medications

After handling medications, please ensure you wash your hands thoroughly.

Some medications should not be handled by pregnant women. If you are concerned please check with the veterinary surgeon or veterinary nurse. Please wear gloves or do not handle at all.

Please make us aware if you are allergic to any medications yourself e.g. penicillin. Some of the drugs we can use are fairly similar. 

Timing of medications for your pet

We advise you try and give medications the same time every day.

  • Twice daily: give roughly 12 hours apart
  • Three times daily: give roughly 8 hours apart
  • Four times daily: give roughly 6 hours apart

Repeat prescriptions

If your pet is on a long term medication, they will require regular check-ups and re-examinations to allow repeat prescriptions to be issues. This is normally every 6 months, but with some medications, re-examinations are more regularly. This may mean that repeat bloods may need to be taken and examined, or to adjust dosages according to weight changes, as well as giving your pet a thorough examination to ensure the drug prescribed is working effectively. 

Please be aware that we do not stock all drugs routinely, and we ask for 24 hours’ notice for all repeat prescriptions, and some medications are not available on repeat prescriptions and will require a re-examination.
If you are planning a trip away, please make sure you have adequate medication for your pet in advance.

Side effects

If you are at all concerned that your pet maybe suffering from any side effects from the medication you have been prescribed, please contact us immediately. Side effects can be numerous, so please ring to check if you are at all concerned.

Administering oral medications (by mouth)

Tablets

The easiest way to give your pet tablets is to disguise them cunningly in food for them to eat. But this can depend on the type of medication. We will advise you if you are able to give the medication with food.
Some tablets can be broken up or crushed into the food, but occasionally this makes the medication taste worse, or decrease their effectiveness. It also may not be safe for you to handle the tablets in their crushed form.

You can hide the medication in food (which is normally effective with dogs) or in a tasty treat. Care must be required if your pet has a sensitive stomach which is sensitive to other types of food. If your dog’s stomach is not sensitive, using treats like small amounts of cream cheese, sausage, pate, chicken or ham may help. Cats may like tuna or prawns.

Give a small treat without the tablet first, then give a treat with the tablet, followed by a treat again without a tablet.

If your pet will not take tablets in food, they may need to be administered directly. 

Gently tip your pet’s head backwards, so they are looking up at the ceiling. This then allows you to pull the lower jaw down easier and place the tablet at the back of the mouth. Close the mouth, and stroke the throat to try and encourage a swallow.

Pill poppers are available to help with placing the tablet to the back of the mouth without getting bitten, and may be of help with cats. Ask one of our reception or nursing staff to show you how they may help.

Some medications can be crushed and dissolved in water, which then can be syringed into your pet’s mouth. Please check first. 

There may also be some alternatives to tablets. If you are concerned about being able to administer tablets, please let us know. 

Liquid medications

You can disguise liquids in foods, just like tablets. However, sometimes these medications can be squirted straight into the mouth. To do this, gently hold your pet’s mouth closed and insert the syringe into the corner of their mouth between the lips and teeth. Squirt the medication gently across the tongue. Do not squirt the liquid to the back of the throat, as it may go down the airway. Continue to keep the mouth closed and stroke the throat area to encourage swallowing.

Administering ear treatments

Cleaning ears

Hold the ear flap up to allow exposure of the external ear canal. Place the nozzle of the bottle carefully into the external ear canal and squeeze the bottle. Gently rub at the base of the ear, which encourages the solution to pass down the ear canal. Pets will often shake their heads once the solution is applied. Wipe out any wax with moist cotton wall, but never use cotton buds down the ear. To distract pets from shaking their heads, you can feed them directly after or take them for a walk. 

Some of the ear treatments do contain steroids, so pregnant women should not come in contact with them. When administering them, all should wear gloves.

If your pet’s ears seem very painful after applying cleaner or medications, then please contact us.

Administering eye treatments

Please refer to separate information sheet.

Creams and ointments

Please apply these in the areas which the label directs you or where the veterinary surgeon has demonstrated only. 

Some of the medications contain steroids, so should not be handled by pregnant women, and all should wear gloves when creams or ointments are being applied. After applying the medication, try feeding, playing or walking your pet to distract them from licking the area. Sometimes a buster collar is required.

Common Ophthalmic Conditions

Is my pet in pain?

Pain is very difficult to recognise in our pets as they cannot tell us easily how they are feeling.

Dogs

Dogs tend to show behavioural changes when they are in pain and discomfort. If your pet has an obvious surgical wound it is easier to ascertain if they are in pain, but otherwise we have to train ourselves to observe pets for pain.

The following are behavioural changes which you dog may exhibit, but the list is not exhaustive. All dogs will experience pain very differently and all individuals will respond to pain in differently. Certain breed of dogs can be more sensitive to pain stimulation too.

  • Unusually inactive, unresponsive or quieter than normal
  • Restlessness
  • Panting excessively
  • Not sleeping or changes in sleep patterns
  • Not responding to familiar people
  • Attention seeking
  • Howling, whinging, yelping
  • Licking or chewing an area
  • Unusually aggressive or being submissive
  • Not able to eat
  • Lameness
  • Looking uncomfortable in the abdomen e.g. hunching the back
  • Will not climb steps or stairs, or reluctance to jump
  • Reluctance to get up or to lie down
  • Reacts badly when you try to lift or carry

Cats

Cats are very different to dogs, as they tend to hide their pain, which makes observing them for signs of pain more difficult. Changes in behaviour are normally an indicator of pain.

  • Quieter than normal, reduced activity
  • Biting and scratching (when you cat is normally friendly)
  • Avoiding being handled and aggressiveness
  • Attacking and biting a part of the body
  • Over grooming their coat, or under-grooming cause poor coat condition
  • Howling or meowing more than usual
  • Inappropriate elimination (going to the toilet in the house not in the litter tray)
  • Changes in the sleeping pattern
  • Lameness
  • Not happy to jump or climb when previously happy to do it
  • Hiding away

I think my pet is in pain, what should I do?

I you think your pet may be in pain, please contact your veterinary surgeon for advice. The veterinary surgeon may ask you some questions about your pet’s behaviour, but we are always on the end of the phone if you need some help and advice.

Please contact us at any time if you are at all concerned.

 

Common Ophthalmic Conditions

MRI

What happens when patients have an MRI scan?

The pet will be admitted to the scanning centre prior to the scan so that a physical examination can be carried out along with blood tests where necessary. In order to keep still for the duration of the scan the pet will require a general anaesthetic. Once anaesthetised the patient will be placed gently in the scanner and positioned in the optimum way to achieve the best images possible. Our imaging team will then carry out a number of scans, in various planes, to give us all the information we need for a speedy diagnosis.

Usually, after a few hours the pet will have recovered sufficiently to go home provided no further treatment or investigations are required. There are no known side effects and the procedure is completely harmless.

Common Ophthalmic Conditions

Radioactive Iodine Therapy

What is Involved? 

A single dose of radioactive iodine (I131) is given by subcutaneous injection. The iodine is concentrated in the thyroid gland where it emits beta-radiation, killing the surrounding hyperfunctioning cells. Parathyroid gland function is unaffected. The iodine that is not concentrated in the thyroid gland is very rapidly eliminated in the urine, saliva and sweat in the first couple of days following the injection. The remainder is very slowly eliminated due to thyroid hormone turnover (with the I131 incorporated into the hormone) and due to decay of the isotope (the half-life of I131 is eight days). Cats must stay with us in an isolation facility for at least 10 days after the injection until most of the radioactivity has been eliminated. A nurse feeds the cats and cleans their cages every morning. Lighting and daytime stimulation such as radio or cat television is altered throughout the day.

What does it cost? 

The current cost of treatment is £2545.00 inc. VAT for a 10 day stay and £3045.00 for a 28 day stay. These costs are essentially a ‘package deal’ covering pre-treatment investigations, the treatment itself and hospitalisation. This does not include the cost of treatment for any concurrent medical problems or any unexpected diagnostic tests.

How successful is it?

A single radioactive iodine injection is successful in about 95% of cats treated.

How quickly will you know if it has worked?

The thyroid hormone concentration is generally within normal limits one month after the radioactive iodine injection. In some cases it can take up to six months for the thyroid hormone concentration to return to normal following treatment.

What needs to be done before the appointment? 

1. Cats need to be confirmed as hyperthyroid on the basis of a total thyroxine (tT4) concentration above the laboratory reference range. We will treat cats with high - normal total Thyroxine (tT4) measurements where hyperthyroidism has been confirmed by free T4 assuming compatible clinical signs are present. If a case is accepted for referral on the basis of a free T4 measurement, we will require repeat free T4 (by equilibrium dialysis) and total T4 measurements approximately two weeks prior to the referral appointment – we will advise you of this accordingly.

2. Assessment of renal function. Renal function is profoundly influenced by thyroid status – excessive thyroid hormone concentration leads to increased cardiac output resulting in an increase in glomerular filtration rate and consequently a decrease in circulating creatinine concentration. Normalisation of total T4 concentration induces a decline in GFR and can therefore unmask underlying renal abnormalities. Studies show that a decrease in GFR will occur within 4 weeks of radioactive iodine treatment with little decline after this point, but for a proportion of cats this can result in the development of azotaemia (creatinine greater than 140μmol/L) which can take up to six months to manifest.

For newly diagnosed cats that are non-azotaemic (creatinine less than 140μmol/L) and have a urine specific gravity of greater than 1.040 the magnitude of this decrease in GFR has been shown to be no more than one IRIS stage, which at worst could result in the unmasking of IRIS stage II renal disease. As the development of mild renal disease is not associated with a decreased survival time unless associated with hypothyroidism, we no longer require a period of stabilisation as a therapeutic trial to assess the effect of treatment on renal function. If there is a waiting list for treatment we will advise you to start either medication or Hills y/d diet: in this case blood tests will be required 4-6 weeks prior to the appointment with us.

Cats that are azotaemic at diagnosis or cats whose owners feel that any development of azotaemia should be avoided where possible do still benefit from a therapeutic trial of anti-thyroid medication to assess the renal response to reversible treatment before radioactive iodine treatment is considered.

Euthyroid cats on medication or y/d diet that are non-azotaemic or have stable IRIS stage II renal disease (creatinine less than 250μmol/L) are suitable candidates for radioactive iodine treatment.

If the reason for referral for radioactive iodine treatment is that the cat cannot tolerate anti thyroid medication or the owner is not able to medicate the cat, radioactive iodine treatment is still possible assuming the cat is non-azotaemic prior to referral.

In order to assess renal function we require testing of urine specific gravity and serum urea, creatinine and phosphate. If there is a long delay between the blood tests to assess renal function and the appointment with us, further blood tests should be performed 4-6 weeks prior to the appointment to ensure nothing significant has changed.

3. Cats need to be vaccinated for flu and enteritis within the last year.

How long must the cat remain in isolation? 

All cats treated with radioactive iodine will stay for a minimum of 10 days following the injection. They can then be discharged assuming a number of conditions at home can be met for a further 18 days, after which no further precautions are required. These conditions are that:

  • The cat will be confined indoors, without access to occupied bedrooms and will use a litter-box.
  • The owners can restrict the time spent cuddling the cat or holding the cat on their lap.
  • The owners are able to ensure that any children in the household will remain at a safe distance from the cat and its litter-box.
  • There is no-one in the house that is pregnant, or trying to become pregnant.
  • There is a secure outside storage area (garage, shed) where soiled litter can be stored for one month before being put out for collection. If this is not possible, special litter can be purchased that can be flushed down the toilet, but the household plumbing must be in good working order to do this.

If cats are discharged after 10 days, their owners will have to sign a document stating that these conditions will be met. If these conditions cannot be met at home, cats may board with us for the additional 18 days at a cost of £30.58 per day. The level of radioactivity emanating from the cats 10 days after treatment is relatively low, but this is considerably higher than background and will continue to be so for several weeks. The risks associated with this radiation level are small provided that sensible precautions are taken.

Which cats aren't suitable for treatment? 

1. Thyroid carcinoma. Although thyroid carcinoma can be treated with radioactive iodine, the doses of radioactivity required are greater than those that we have authorisation to hold, so we are unable currently to offer treatment to these cats. There is increasing evidence that hyperthyroidism is a spectrum of disease and that transformation to carcinoma may occur over time: therefore cats that have been treated medically for a long time and in whom increasing doses of anti-thyroid medication are required to maintain euthyroidism may be at risk of carcinoma development.

2. Naughty cats! We appreciate that hyperthyroid cats can be feisty and it is not a particular problem if, for example, a cat is difficult to collect blood samples from. The cats that we cannot accept for treatment are ones that will not allow their cages to be cleaned without attacking the Nurses, which increases the risk of contaminating them with radioactive urine.

3. Cats with significant concurrent medical problems. If cats become ill after they are injected, we cannot attend to them without being exposed to high levels of radioactivity. Therefore we cannot take cats that are known to have other serious concurrent problems. Medications can be put in the cat’s food, but the cats cannot be given tablets directly.

4. Unsuitable owners! Some cats would be fine to treat with radioactive iodine, but their owners will not be parted from them for required time. We are unable to compromise on the amount of time that we keep the cats here in the Hospital. It is not possible for owners to visit while their cats are with us.

Follow-up Appoinments

Cats will require blood tests to assess their kidney function and thyroid levels four weeks, ten weeks and six months after treatment. Blood should be collected for a total T4 and biochemistry and urine for specific gravity and sediment examination to check for urinary tract infections. The cost of these tests is not included in the treatment.

For more info or advice, please do not hesitate to contact us on 01453 843295 or 01454 521000 (option 2) or email iodine@rowevetgroup.com.

Common Ophthalmic Conditions

Sedation

Why does my pet need a sedation?

You pet may require a sedation to allow them to relax so they cannot feel a moderate level of discomfort. We use sedation for some diagnostic procedures that are not very painful but would be uncomfortable if you pet was conscious.

What is a sedation?

The sedation will allow your pet to undergo investigation providing them with a ‘sleepy state’ which enables relaxation. They will be unlikely to remember what has happened under the sedation. There is always an opportunity to convert a sedation to a general anaesthetic if this is indicated.

My pet is having a sedation, what do I need to do?

  • You will be instructed by our team to fast your pet overnight. The length of time of the starve will be determined by the procedure you pet is being referred for and you will be advised when booking your referral appointment
  • Please allow you pet access to water throughout the fasting period
  • Please keep cats indoors before the procedure to prevent them from getting food from elsewhere. It will also ensure they are easier to find in the morning
  • Please give your dog plenty of opportunity to empty their bladder and bowels by allowing a short walk in the morning of your appointment (unless you pet is on strict cage rest)
  • If you have kept a diary of your pet’s behaviour (for example seizure records or videos) please bring this with you to your appointment, along with any medication you pet is currently receiving (preventative flea and worm products are not necessary)
  • If you notice any signs of illness or injury prior to your appointment please inform us either before you arrive or when you see one of our team

What happens to my pet once they are admitted?

The choice of sedation will be decided and chosen by one of our veterinary surgeons once they have given your pet a full clinical examination and decided what procedures are required to be undertaken

Once you pet is relaxed, we will place an intravenous catheter into either a front or back leg vein. This gives us easy access to a vein to provide medications to your pet easily and effectively.

How is my pet kept safe under sedation?

Once under a sedation your pet is connected to an anaesthetic machine to provide oxygen. Each machine can have different types of circuits attached depending on your pet’s individual requirements

Whilst under sedation you pet will be closely monitored by a member of our qualified staff and in addition specialised monitoring equipment is used to closely observe your pet’s progress. The type of equipment used will depend on the procedure being carried out and the clinical history of the individual patient.

We record information every 5 minutes to monitor depth of the sedation and this allows us to anticipate and problems before they actually occur. Adjustments can be given to help stabilise parameter for example, extra intravenous fluid therapy and additional drugs. If there is any concern regarding your pet’s breathing, we can convert them to a general anaesthetic.

Whilst your pet in under sedation, the body loses the ability to maintain body temperature. We constantly monitor this temperature and take steps to help reduce the amount of heat your pet is losing.

We use a range of equipment to help keep patients warm. Our theatres are equipped with heated beds and warmers, we can wrap patients in foil and bubble wrap, use heated bean bags to name just a few, to enable your pet’s temperature to remain stable and provide a quicker recovery from general anaesthesia.

Once the procedure is finished we will reverse the sedation, and allow your pet to recover. If your pet has been under sedation for a long period of time or is older, recovery can be slower, but all patients are constantly monitored until they are fully awake.

Our hospital is operational 24 hours a day with qualified veterinary surgeons, qualified nurses and highly skilled care assistants to ensure your pet is cared for to the highest standards. We welcome calls into the hospital to give you clinical updates on your pet, and if you pet needs to stay with us, appointments for visits can be organised.

Will my pet feel pain?

Patients that are receiving a sedation will have a painkiller incorporated into their drug plan, and subsequent pain relief may be given whilst your pet is under sedartion. Continuing pain relief will be decided by our veterinary surgeons dependent on each patient’s individual requirement.

What can I expect when my pet comes home?

If your pet is discharged on the same day of the procedure, they may be a little sleepy. The drugs we administer may still have some effect in the system. You pet will be discharged by one of our veterinary nurses who will advise you to keep your cat indoors) and for dogs to be only walked in the garden on a lead, this is normally for 24-48 hours (or in some cases longer as some procedures carry some very specific discharge instructions).

Please follow the discharge form provided to ensure medication are given as directed and any specific care that is required.

Offer you pet some light bland food for the first 24 hours (boiled chicken or fish and rice) and water. Some conditions will have specific feeding instructions which will detailed to you on discharge, and similarly if your pet has special dietary requirements you will be advised also.

Keep your pet in a warm comfortable place when they return home, and try and reduce over exertion e.g. playing with other animals or games. Please observe for any abnormalities including pain, sickness, diarrhoea, lethargy and contact your own vets or ourselves if worried at all.

Please contact us at any time if you are at all concerned.

 

Common Ophthalmic Conditions

Ultrasound Scanning

What is ultrasound scanning?

Ultrasound scanning is a diagnostic tool which is used to look at parts of the body. Unlike radiographs, ultrasound scanning uses sound waves rather than radiation to produce a picture of the area we are interested in.

The patient is laid on a table and gently restrained. The area of concern is clipped of hair, and ultrasound gel applied. A probe is then placed against the skin which transmits a wave, and then receives a wave back. The computer then builds a picture using the waves of the area we are looking at.

Does my pet have to be clipped?

Ultrasound waves do not pass through air so the hair does need to be clipped so the probe can be in direct contact with your pet’s skin allowing a diagnostic picture to be seen. The gel used is applied to your pet and the probe to ensure there is good contact and to further increase picture quality.

Why does my pet need an ultrasound scan?

Ultrasound scans provides outstanding detail of soft tissues, and allows examination of areas which cannot be easily seen on radiographs. We can even ultrasound the eye! Radiographs cannot distinguish between the inside and outside of organs which are filled with fluid, such as the bladder.

The scan shows us a moving (or real-time) image of what we are investigating, which is particularly useful if we are looking at the heart. We can also use the images to allow us to take biopsies via a needle with the ultrasound guidance. Sometimes your pet may require a sedation to allow sampling.

Please contact us at any time if you are at all concerned.

 

Common Ophthalmic Conditions