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Holter monitoring is a means of recording an electrocardiogram (ECG), a trace which shows the electrical activity of the heart. Unlike a conventional ECG, a Holter monitor is a portable device which your pet wears for 1 to 7 days to give us a sustained overview of the heart’s electrical activity. The technique is especially useful for assessing disturbances in heart rate and rhythm investigating whether such disturbances may be responsible for clinical signs including fainting.
Echocardiography is used to assess the structure and physiology of the heart. It utilises non-harmful sound-waves to produce images of the heart and blood flow. It is best performed in conjunction with other assessments of heart disease and cardiologists interpret findings with echocardiography in the context of a physical examination, medical history and, usually, radiographs. Echocardiography is best performed by experienced cardiologists with a high level of expertise in interpretation.
A ‘heart murmur’ is a sound usually caused by turbulent blood flow within the heart and detected by a vet after listening to your cat’s chest with a stethoscope. Most cats with heart murmurs have heart disease, but occasionally murmurs turn out not to be related to significant heart problems. The murmur itself doesn’t tell us how severe a heart problem is or whether it needs treatment. Sometimes disease doesn’t need treatment but may do in the future.
Many excellent treatments exist for cats and dogs with heart disease, but knowing which patients benefit from these is at the core of cardiology.
It is the most robust and gives a more rapid recovery in comparison with other techniques used for this problem. Small, light body mass patients can be treated successfully with medical treatment (pain killers) and a long period of restricted activity, but the recovery period is typically longer than that required following surgery. There are several surgical procedures that can be used to treat cranial cruciate ligament problems, including techniques that replace the damaged ligament and ‘tibial osteotomy’ techniques which modify the shape of the top part of the tibia to make the stifle stable in the absence of a functional CCL. In most cases, tibial osteotomy techniques result in faster recoveries and, of these, TPLO appears to be the most robust technique with a favourably low complication rate.
TPLO stands for tibial plateau levelling operation and is the procedure of first choice for most dogs suffering from rupture or disease of the cranial cruciate ligament in the stifle (the knee joint). When the joint becomes unstable and rather than flexing and extending normally during weight bearing it gives way, and the tibia is pushed forwards. TPLO involves a cut of the tibia (the shinbone) and accurate modification of the slope of the top (the plateau) of the bone. This allows the stifle joint to be re-stabilised during weight-bearing and locomotion. The modified shape of the tibia is maintained using bone screws and a plate. These maintain the corrected shape of the tibia during the healing period of approximately 8 weeks.
A number of different surgical procedures are performed to treat different presentations or severity of hip dysplasia. Very young puppies (4 months or less) with hip laxity can be treated to modify growth and reverse developing hip dysplasia. A minimally invasive technique selectively arrests growth of just the underside of the pelvis, to overcome the early changes of hip dysplasia. Puppies aged 5 to 11 months with mild hip dysplasia can benefit from pelvic osteotomy surgery which overcomes the tendency for the hips to subluxate (partial dislocation). For most severely affected puppies and adult dogs with hip osteoarthritis secondary to hip dysplasia, total hip replacement is the surgical procedure of choice. This is a reliable procedure with a good long-term prognosis, even in puppies.
All canine and feline patients, with the exception of pets suffering from diabetes mellitus that are presented as an emergency, should be starved before the appointment if possible. However, the appointment should not be delayed even if this is not possible. For patients that are presented for the first time it is recommended that they are starved, again with the exception of patients suffering from diabetes mellitus. This will allow certain investigations to be carried out on the same day as the consultation. Owners of patients that present for routine re-examinations will usually be advised as to whether or not their pet needs to be starved for future consultations.
Although information regarding the medication should be provided by the referring veterinary surgeon, clients should bring all medication that has been used in the patient’s eye in the last few days or, if applicable, months. Alternatively a list of the medication may be sufficient.
Most eye medications should be continued throughout the day of examination so that the effect of the eye medication can be assessed. This is particularly important for patients suffering from glaucoma. No medication should be given approximately 30 minutes before the actual appointment.
Physiotherapy is certainly beneficial in all patients following spinal surgery. This can include electrotherapy and land-based exercises as well as hydrotherapy. Every single patient should be assessed by a veterinary surgeon prior to starting physiotherapy and the physiotherapy plan tailored to the individual needs.
Yes, meningitis is often diagnosed in dogs. Most commonly this condition has an underlying autoimmune disorder although infectious causes of meningitis must be ruled out to ensure the safety of other pets in the household and other members of the family.
Seizures are a symptom suggesting that the electrical activity of the brain is altered. However, the causes of seizures are not always found in the brain. This means that, ideally, every patient that experiences seizures should have a thorough assessment including a physical and neurological examination, blood tests, MRI of the brain and spinal tap.
Neurosurgeons performs a wide range of operations, including:
Not at all! In fact most of our patients take a snooze while lying on the Table! The only inconvenience of ultrasound is that fur needs to be clipped. However, rest assured, we never clip more than necessary and we always do it in a tidy fashion.
This depends on a number of factors, including how many radiographs were already taken, whether they include all the views we require, whether they meet our quality standards and whether they have been submitted via the appropriate medium.
Yes, it is crucial that your pet lies absolutely still in the scanner as any movement would result in having to repeat the image acquisition. An average MRI scan lasts for 45 min, which is obviously much too long for any animal to lie motionless.
Although the anaesthetists are rarely involved in initial consultations with pet owners we spend most of our day in direct contact with animals before, during, and after anaesthesia, ensuring the highest standard of care However, should you wish to talk to an anaesthetist, please do not hesitate to ask. We will be happy to meet you and discuss your concerns.
We develop a pain control plan prior to the surgical procedure. When your pet returns to the ward after surgery, he or she will be assessed and the pain control protocol will be started. From that point onwards, each patient is assessed every 2 hours. If pain control is required beyond 24 hours, an anaesthetist will examine the ward records and decide the level of ongoing pain management required. In the majority of cases, patients are discharged only when we are confident that any residual pain can be controlled my mild generic pain killers or anti-inflammatory drugs.
Administration of sedatives and anaesthetics in animals with a full stomach presents an increased risk of complications. The drugs used may affect the function of the digestive system and we would prefer to keep any risk to an absolute minimum.
Dick White Referrals
Station Farm, London Road
Six Mile Bottom
Cambridgeshire, CB8 0UH
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