Facilities
We aim to provide the best possible veterinary health care service within a general practice set-up. This reduces the requirement for referral to specialist centres as we are able to perform many complex treatments ourselves. Despite this, we are more than happy to refer a client to a suitable specialist when we believe it is in the best interest of your pet.
On this page you will find an overview of our main facilities along with details on some of our main areas of work.
If you wish to go straight to a specific medical / surgical topic, click one of the following options:
Anaesthesia, Cardiology, Dentistry, Dermatology, Imaging, Internal Medicine, Laboratory,
Ophthalmology, Orthopaedics, Soft tissue Surgery
General anaesthetics are required for
most surgical and x-ray procedures. Animals are usually anaesthetised by
initially injecting a drug to render them unconscious before placing a tube down
their airway. Anaesthesia is maintained using a drug mixed with oxygen
gas. At Walnut Tree we also mix the anaesthetic agent with the gas nitrous
oxide as it provides some pain relief and muscle relaxation during the
procedure.
It is impossible to make all general anaesthetics risk free but we aim to keep the risk to a minimum. We use a variety of different injectable agents depending on the patient. At Walnut Tree we now use the inhalational anaesthetic agent Sevoflurane. This drug is mixed with gases and is rapidly absorbed and excreted by the body. Animals will therefore fall asleep quickly (if used alone without injectable agents) and wake-up rapidly once the procedure is over. It is considered to be the safest drug widely available for general anaesthesia in human and animal surgery.
During general anaesthetics it is important to monitor the patient for changes that could result in anaesthetic crises. We use devices that monitor breathing and alert us should the animal fail to take a breath within a set time. This is vital as when animals have problems with anaesthetics the breathing can often be the first sign of a disaster pending.
We also have pulse oximeters. These devices measure the oxygenation of the blood. A fall in oxygenation rapidly alerts us to problems with the anaesthetic.
We
having recently purchased advanced monitoring equipment for our operating
theatres that continuously measure carbon dioxide levels in the anaesthetic gas
mixture as well as ECG monitoring of the heart and pulse oximetry to monitor
oxygenation of the blood. These will greatly add to our ability to safely monitor animals
during anaesthetics.
Cardiology is a specific branch of
medicine and is the study of heart disease. Heart problems can be very
varied in presentation from acute collapse or breathing problems to more mild
signs such as lethargy and exercise intolerance. Coughing is less common
in cats with heart disease than dogs with similar conditions when a moist,
retching cough, often occurring after periods of lying down, is a common sign.
Animals with heart problems often need
a full work-up involving chest x-rays, ultrasound and an electrocardiogram (ECG).
X-ray films show us information about the lung fields and heart shape and size.
Ultrasound gives us an idea of how well the heart contracts, evidence of
enlarged chambers and whether there is abnormal fluid in the pericardial sac
surrounding the heart. The ECG shows us the electrical activity of the
heart and can alert us to specific conduction abnormalities such as the
condition "Heart block" where a pacemaker may be required.
We have invested in a high specification ECG machine to provide accurate, easy to read traces.
We have a
well equipped dental
station that is capable of safely cleaning and polishing your pets teeth.
It also uses high speed dental burrs that are useful for extracting teeth and
for trimming rabbits front teeth in a gentle manner. Dental work must be
performed under general anaesthesia in most cases, (it is not essential for
burring rabbits front teeth).
Dermatology
is the topic of skin diseases. Most dermatology tests involve laboratory
work such as looking down microscopes at skin scrapes for mites. Other
tests may involve taking blood tests for specific conditions. We may need
to send certain laboratory samples to specific external laboratories for some
tests. See our laboratory section for information on our equipment often used in
dermatology.
Imaging is a very important part of
human and veterinary medicine and surgery. The ability to gain information
on what is occurring within the body without major surgical intervention is a
vital step
towards diagnosing illnesses.
The most regularly used imaging tool is the x-ray machine. Our x-ray facilities are able to give us sharp images of most regions of the body on all sizes of pets. We are able to develop our x-ray films rapidly using a fully automatic processor. This ensures consistent results with film processing. X-rays are able to distinguish between different tissues and can show up evidence of cancers, broken bones and many other diseases. Unfortunately they cannot always show us what we need to see (few tests are foolproof).
Our ultrasound machine is used to
assess tissues/organs within the body. It emits sound
waves that are
reflected at different rates depending on the tissues they reach. The
reflected sound waves are turned into a black and white monitor image by the
machine. The ultrasound machine is particularly useful at looking for
abnormalities within organs such as cancers and to see if abnormal amounts of
fluid are present such as if there is internal bleeding. Ultrasound can
also be used to assess the contractility of the heart or for helping to biopsy
tissues without the need for surgery.
Endoscopes are used to look inside the
body and are often used to visualise the inside of the stomach and intestines
or
the airways to the lungs. They contain many fragile fibre optic fibres
some of which carry light from the light source down th
e scope to illuminate the
target and others send the light back up the scope to the eyepiece so that the
internal structure can be visualised. Different sized scopes are
required for different studies, small ones are used for airways and large ones
for the gastrointestinal tract. Some scopes have channels down them that
allow biopsy forceps to pass through or tubes to enable fluids to be aspirated.
Endoscopes are often used to diagnose allergic airway disease (asthma) and
inflammatory bowel disease without procedures being too invasive. Animals
MUST be anaesthetised during scoping!
We now also have a range of rigid scopes. These are useful for looking inside the female bladder and look inside noses of animals to look for foreign bodies, infections or cancers.
In addition to purchasing the rigid scopes, we have recently invested in a camera system to enable us to view magnified images from all of our scopes on monitors.
Many different types of illnesses are grouped under the title "Internal Medicine" including hormone conditions such as diabetes and medical conditions such as anaemia, infection, liver and kidney diseases.
Many different tests may need to be performed on ill animals. These often include laboratory work and imaging studies.
There are several different ways to gain imaging information including taking x-rays, using ultrasound, looking directly using scopes or advanced techniques such as MRI and CT scans. See our range of Imaging equipment above.
Ill animals often need intravenous
fluids (drips) to ensure they do not get dehydrated. We use a variety of
different types of giving set dependent on the specific requirement for each animal.
We have invested in a number of very accurate fluid pumps that automatically
ensure the animals receive the correct amount of fluid over a given time period.
We are able to measure an animals blood pressure by using a Doppler probe. This is a type of ultrasound device that lets us hear a pulse in an animals leg so that we can use a standard blood pressure cuff to measure blood pressure. This is very useful when treating cats with hypertension (high blood pressure) as often seen in animals with overactive thyroid glands, heart and kidney diseases.
We have a very well equipped on-site
laboratory to enable rapid blood and urine tests to be performed. We have
separate biochemistry, haematology and electrolyte machines that provide
accurate results. Our haematology analyser is laser based and considered
to be one of the most accurate analysers outside of large commercial
laboratories.
Our biochemistry analyser not only tests for signs of e.g. kidney disease or liver damage but also can perform assays for hormonal conditions such as thyroid and adrenal gland disorders and can also assess liver function by measuring bile acid levels in blood. We are currently trialling an analyser for measuring blood gases and ionized calcium. This analyser is extremely useful for monitoring and revising treatment of seriously ill animals.
For urine work we can easily test for
blood, glucose and protein using dipsticks. In addition to this we use
refractometers to check the concentration of urine, (dilute urine is usually
associated with illness). It is also important in some cases to check
urine sediment for abnormalities such as crystals that can be associated with
bladder problems. Finally, if a dipstick is suggestive of high protein
levels in the urine, we are able to analyse this in more detail to see if the
amount present is genuinely high by measuring urine protein/creatinine ratios.
Our microscope is used to look for skin parasites, check blood smears, perform cytology and check urine.
We are very well equipped with
facilities to examine and treat many eye conditions. Our specialist
ophthalmology equipment includes a Slit Lamp that permits detailed examination of
the eye itself and a Tonopen which is an electronic device that measures
the pressure inside the eyeball.
For operating we are very proud to own an operating microscope that improves visibility of our operating field immensely. This is a vital piece of equipment for delicate surgery such as placing stitches to repair wounds to the eye. We also own operating "loops" that are magnifying lenses that attach to glasses. We also have a specific range of surgical instruments to facilitate eye surgery.
This practice has a strong interest in
orthopaedic work. We are equipped with a large range of orthopaedic
equipment. We are able to perform bone plating procedures using ASIF equipment.
Alternatively we may choose to use external skeletal fixators (metal frames that
link up outside the body with metal rods to form a scaffold) to repair broken
bones. These fixators are particularly useful when bones have fractured
into many pieces or there is a high risk of bone infection. In addition to
these methods, we often use metal pins/wires down bone shafts or to attach fragments
together.
We regularly perform orthopaedic fracture repairs, cranial cruciate ligament surgeries and many other orthopaedic procedures.
We are now able to offer the Slocum Tibial Plateau Levelling Osteotomy (TPLO) method for treating cranial cruciate ligament injuries in addition to closing wedge TPLO and conventional cruciate treatment surgery .
Soft tissue surgery includes procedures
on anything other than bones. It can be broken down further into
categories such as thoracic (chest) surgery, opthalmic (eye) surgery and
abdominal surgery. Most surgical p
rocedures require a basic set of
surgical instruments. In addition to this, some specialised instruments and
equipment is often required. We have invested in specialised opthalmic,
thoracic and abdominal surgical instruments that widen the range of procedures
we are able to perform.
We use electro-cautery during certain procedures. This is a piece of equipment that uses high frequency radio-waves to heat up tissue between specialised forceps or probes. It is very useful for dissecting around small structures such as thyroid glands. It is mainly used to "seal" blood vessels during operating procedures.