Archive for October, 2011:

dressing2
General

Dressings – The dos and don’ts

By admin On October 28, 2011 - 0 Comments

If your dog or cat is lame, and you get referred to Northwest Surgeons, you are likely to see one of the orthopaedic team. Some lame patients have fractures or ligament damage and have a dressing placed by the referring vet for support. Some cases may have damage to the skin and tendons in the leg, and a dressing is applied to cover and protect these. In the management of wounds at Northwest Surgeons your pet can benefit from the expertise of our soft tissue surgery specialist Catherine Sturgeon. Equally some of the cases seen at Northwest Surgeons require management by the placement of a dressing and may be sent home from the hospital with a dressing in place to protect the skin, soft tissues or healing bones.

Having seen some complications recently, we felt that some general advice on dressings may be of use. Many of the complications seen are avoidable.

• It is always worthwhile considering that a complication with a dressing, however trivial it may seem, is worth reporting as some complications can develop into limb-threatening problems.

• If a dressing is properly applied then the patient should be comfortable. We feel that a dressing should be well tolerated if it is comfortable. If your dog or cat is chewing or licking the dressing, this should raise doubts about the comfort. If the dressing is uncomfortable it may be putting pressure in areas it shouldn’t and complications can arise.

DOS

• Contact a vet you have any concerns.

• Keep the dressing dry. This can be achieved by applying a plastic bag or specially designed boot (which can be ordered from a vets or on-line) over the dressing to stop it get wet when walking on damp ground.

• Monitor the dressing for signs of the dressing slipping. The dressing will slip down the leg so watch the toes (if they are visible) and if you can no longer see them then the dressing is likely to have slipped. Also look at the top of the dressing, is it possible to see part of the leg which you couldn’t originally?

• Monitor for swelling. This is often seen in the toes, if they are visible, but can also be seen at the top of the leg.

• Monitor the dressing for abnormal smells. This could indicate a problem and the dressing probably will require changing.

DON’TS

• Ignore your pet if they start to chew at the dressing. If the dog or cat seems to be paying more attention to the dressing than normal then it probably is uncomfortable and needs to be changed.

• Allow the dressing to get wet and not seek veterinary attention. The foot can become damp and start to fester if left unattended.

• Leave the plastic cover in place after the animal has been outside as the foot can become sweaty and damp.

• Ignore any abnormal smells.

• Ignore a dressing if it has slipped.

Once a dressing has been applied and an animal is sent home with the dressing in place, we, as vets, can no longer control what happens to the dressing. It is therefore requires excellent ownership to carefully monitor and protect a dressing. But between the team at Northwest Surgeons and your own vet, we are here to help. Northwest Surgeons is staffed 24-7 by a Veterinary Surgeon so there is always advice at hand.

As vets we would much rather be contacted about a problem and find out it is a minor concern and nothing to worry about, rather than seeing a dog or cat where a dressing problem had arisen, nothing was done initially, and the problem becomes major and we find nothing more can be done to save the limb. Luckily, these cases are rare but they do happen and we all need to be aware of the potential risks.

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vetspecialisation-oct11
General

The future of veterinary specialisation – have your say now!

By admin On October 13, 2011 - 0 Comments

We have previously written detailed blogs on the complicated and unclear nature of specialisation and referral procedures in veterinary practice

11th August 2011:  Is my veterinary specialist a proper specialist?   

26th August 2011:  Referral to a Specialist: Your freedom to choose (Provided you ask the right questions). 

We strongly believe that the system of veterinary specialisation is currently unfair to the animal owning public and that it does not ensure that animal owners are always given the best options for care of their much loved pet.  Pet owners need a system that is transparent and robust to ensure that they are always given the best possible advice when referral to a specialist is indicated.  The public must also have absolute confidence in the qualification and re-accreditation of any veterinary surgeon they are seeing, especially those claiming “Specialist” status.  At present this is not the case:  The problem is a complex can of worms and if you have the time you might want to read the previous blogs to understand why.
There is, however, a glimmer of light on the horizon.  The Royal College of Veterinary Surgeons (RCVS) is the body that governs the veterinary profession in the UK and which is charged with acting in the interests of the animals and the public, not the interests of the profession.  A Working Party of the RCVS has reported on the issue of specialisation in the profession and has produced a public consultation paper (which you can read HERE).  This report is independent of any vested commercial interest in veterinary practice and it very much endorses our view of the current problems.  The report goes on to propose very significant changes to the organisation of specialisation in the profession which, if adopted by the RCVS, should go some considerable way to improving matters for animal owners and animals in the UK.  

Northwest Surgeons completely supports the findings of this Working Party and we are keen to see the findings of the report enshrined in our Professional Code of Conduct.  There is no guarantee that the findings of the report will be adopted in full or in part by the RCVS.  The report must go before the Council of the RCVS and it is the Council that will decide which (if any) parts of the report are adopted. By its very remit, the council must take both veterinary and public opinion into consideration when making its decisions, but should put the public needs first.  However, The Council is a large body with over 40 representatives on it with very diverse opinions, not all of which will be in favour of clarifying matters for the public in the way that the Working Party has proposed.  It is therefore very important that you have your say if you care about the quality of the specialist that may be looking after your animal in the future.  It is unlikely that another Working Party would be convened on this subject for many years.
You might also want to visit www.rcvs.org.uk to read the RCVS view.
On page 25 of the consultation document there is a list of 10 questions for consultation.  Please take the time to read the document and to report back to the working party by answering the questions on page 25, explaining in your reply that you are a member of the animal owning public. 

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dontthrow
Feature

Think before you throw that stick!

By admin On October 7, 2011 - 0 Comments

For many dog owners, the longer summer evenings mean a chance to enjoy some of the beautiful countryside of the North West with their pet. Inevitably for many people, the temptation to throw that stick your dog lovingly drops at your feet during the walk is just too much to resist. What could the harm be? Unfortunately, that innocent game of fetch could turn in to a painful injury for your pet and an expensive trip to see the vet.

Every summer we see a number of dogs who have a penetrating injury of the delicate tissues at the back of the mouth after jumping to catch a stick. Sticks can travel long distances in the tissues of the neck and pieces of stick will sometimes end up as far down as the chest cavity. It is impossible to know when the stick is removed by the owner whether any pieces have been left behind. In addition these dogs can also have painful injuries to the back of the throat, oesophagus or windpipe. We also see dogs that have developed an abscess in the tissues of their neck due to the pieces of stick which can be left behind after a penetrating injury. This can happen up to several months after the initial injury.

Treatment of stick injuries often requires camera examination of the oesophagus and windpipe and advanced imaging such as a 3D x-ray scan (computed tomography) or an MRI scan to try and identify where the soft tissue damage is and also the location of any pieces of stick which have broken off as the stick is pulled out. Attempting to find pieces of stick without the help of such scans can be very difficult and involves large scale dissection of the soft tissues of the neck. It is a little bit like attempting a road trip in the middle of the countryside with no map and no satellite navigation. This therefore increases the risk that pieces of stick will get left behind leading to the development of further abscesses.

Surgery also means navigating some very important and delicate structures such as nerves, blood vessels and the windpipe. In some cases, opening and exploration of the chest cavity can be required to ensure all the pieces of stick are removed. Luckily here at NorthWest Surgeons we have access to the specialist scanners and cameras we need to help these dogs and our soft tissue surgeon Catherine Sturgeon is experienced in dealing with these tricky cases. However, it is important to remember that even with the expertise of a specialist surgeon and specialist scans, it is difficult to give an owner a cast iron guarantee that all foreign material has been removed. It is therefore much better to avoid the risk in the first place so why not treat your dog to a new toy!

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