The Surgery

Our premises are specially designed to help us work to a high standard to give your pet the best chance of recovery. The surgery was purpose built in 2009 to our specifications.

Our waiting area is comfortable and uncluttered with a lovely view out to the adjacent fields. Refreshments are feely available on request. Just off the reception there are two consulting rooms where we talk to clients and examine the animals. We often use the car park and outdoor paths during consultations to assess how animals walk. Our initial consultations last for 45 minutes for new cases and 30 minutes for re-examinations.

Behind the scenes we have a preparation room, two operating theatres, two diagnostic imaging rooms, a kennels, a separate cattery an instrument preparation room, office space and a utility room. We have a small in house laboratory that is principally used to analyse samples of cerebrospinal and joint fluid to rapidly identify cases of inflammatory arthritis and meningitis. We are also able to analyse blood and urine samples and perfom blood gas analysis in house.

Our kennel block provides comfortable accommodation for our in-patients. We have five walk in kennels suitable for the larger dogs which have fitted kennel mattresses and individual heating. All of our kennels can be seen through the glazed wall from the prep room. This allows us to monitor the in patients easily and allows the dogs to constantly see people so that they do not feel alone. We frequently find that animals that have been anxious in other kennels seem to settle down happily when staying with us.  Cats are housed in a separate cattery room to prevent them from becoming upset by the close proximity of dogs.

Operations

We have two sterile operating theatres that are dedicated for orthopaedic use. Both incorporate positive pressure, laminar flow air conditioning with hepa filtration. This constantly removes airborne pathogens and reduces the chance of contamination during surgery. Our operating tables allow accurate patient positioning and incorporate carbon gel heat pads that safely warm the patients during surgery, yet cool down automatically if the temperature at the skin gets too hot. Proper lighting is vital during operations and both theatres are fitted with the latest dual head LED operating lights that provide intense, shadow free illumination with excellent colour rendition. Occasionally additional surgical head lights are worn by the surgeons when performing very delicate surgery. During surgery we routinely use radiofrequency generators to quickly seal blood vessels, reduce blood loss and enhance visualisation.

Not surprisingly, as we exclusively deal with orthopaedic and spinal cases, we carry a wide range of orthopaedic implants and instruments. This includes six sizes of ASIF bone plating kits, locking plate systems, linear and circular external fixators and a comprehensive selection of pneumatic surgical power tools. Many joint problems are investigated using arthroscopy (keyhole surgery). We currently use a high quality digital arthroscopy system made by Stryker, as used in many of the top human hospitals across the world. Arthroscopy involves placing a tiny fibreoptic camera within the joint which gives excellent visualisation of the cartilage and synovial structures. In some cases it is possible to perform arthroscopic surgery to treat the problem without resorting to open surgery. This may involve the use of specialised arthroscopy tools including our power shaver to remove bone or soft tissue or radiofrequency ablation probes to dissolve or tighten the soft tissues around the joint.

Anaesthesia

During periods of anaesthesia the animals are extensively monitored for changes in heart rate, rhythym, blood pressure, blood oxygen saturation, expired carbon dioxide levels and changes in body temperature. We are also able to monitor inspired concentrations of anaesthetic agents that the animals are breathing. These monitors provide a moment by moment update of how deeply the animal is asleep and whether there are anaesthetic problems developing.  We routinely use multimodal anaesthetic technques to allow our patients to be kept under a lighter plane of anaesthesia whilst not experiencing discomfort during surgery. For many routine surgeries this involves a combination of two strong painkilling drugs, local anaesthetics and an epidural given before surgery. This has been shown to minimise the degree of pain experienced by the animal whilst limiting the dose of powerful drugs needed.  During and after surgery all animals are placed on intravenous fluids, the rate of fluid administration being exactly controlled by digital infusion pumps. 

Infection Control

We take infection control very seriously. Prior to surgery, all of our instruments are cleaned, checked, packed and sterilised in one of our two vacuum autoclaves. We take great care in the preparation and storage  of the surgical equipment to minimise the chance of infection. We evaluate the performance of our sterilisation equipment using temperature and pressure indicators in each pack and a twice yearly validated biological test protocol. Before each operation the surgeons dress in clean scrub suits, a head cover and face mask and scrub up before putting on a disposable sterile gown and one or two pairs of sterile gloves. After being anaesthetised, the animals are clipped, scrubbed before and rescrubbed after going into theatre. Drapes are then applied very carefully using at least two layers of sterile disposable waterproof material, so that only the area of interest can be seen. We typically then cover any exposed skin with an iodine impregnated adhesive plastic incise drape so that we can perform surgery without touching the skin. This reduces the chance of bacteria from the animals skin being transferred into the surgical field. After the operation is finished, the incisions are immediately covered with sterile adhesive dressings before the patients are recovered in a clean kennel area. The animals may be given antibiotics before and after the operation and must be prevented from licking at the incision. Whilst some may argue that these precautions may be uncecessary, our infection control audits have shown that we maintain a very low infection rate, comparable with the best ultra clean human operating theatres.