Ludivine, who graduated in 2008, has come over from America to take up the new post, having just completed a three-year residency at the University of Pennsylvania in Philadelphia.
She said: "I’m really enjoying working as part of a great team and working with the various different disciplines here.
"I’m passionate about my ECC speciality and I have a keen interest in respiratory diseases, trauma and acid base disturbances.
"I also like teaching and being updated about the most recent studies in ECC to ensure I can deliver the most up-to-date care possible for our patients."
Ludivine was born in France and originally studied at her home town university in Lyon, progressing to a rotating internship there after graduation.
In 2012, she worked as an emergency veterinary surgeon in several general practices across France and Switzerland, before moving to the United States in 2014 to see how ECC medicine was practiced overseas.
First, she undertook an ECC internship at the University of California, followed by a three-year residency at the University of Pennsylvania.
Away from work, Ludivine enjoys horse riding, running, work-outs and practising her skiing in the French Alps. She also has two dogs Dalhi her Golden Retriever and Baya her German Shepherd.
For more information, visit www.willows.uk.net/en-GB/specialist-services.
The team at the centre will be led by Dr Ryk Botes (pictured right), a Medivet Branch Partner with a special interest in orthopaedics and, in particular, replacement surgery.
The company says it is investing in specialist equipment to help the team refine current surgical techniques, including a gait analysis walkway which will be used to help diagnose the cause of lameness and be a means to measure improvement in surgical cases objectively. The data it provides will also enable the team to publish its results in peer-reviewed papers.
Ryk, who qualified in South Africa and joined Medivet in 2013, said: "The volume of elbow, hip and knee replacements we undertake is growing rapidly and the creation of this new centre of excellence at Medivet Faversham will enable us to provide an even higher standard of service to our clients and to help develop and refine orthopaedic techniques for use by the wider veterinary community.
"Data from the gait analysis walkway will be particularly useful in sharing our findings in scientific papers. We will also use the data to support an ongoing research project in elbow replacement surgery in partnership with one of the leaders in implant technology based in Zurich, Switzerland.
Mark, who graduated from Cambridge University in 1997, has a broad interest in internal medicine but particularly enjoys the challenges posed by gastrointestinal, endocrine, haematology and renal medicine.
He has a PhD in Neuroscience at the University of Cambridge and after completing his PhD he took a residency in Small Animal Medicine at Cambridge, followed by four years in a private specialist practice in the south of England.
Mark was then appointed Clinical Associate Professor in Small Animal Internal Medicine at the Nottingham Veterinary School, where he was responsible for running the final year medicine rotation along with lecturing to all years of the veterinary course.
He was also in charge of the school’s small animal intern and residency programmes in addition to supervising both undergraduate and post-graduate research students.
Mark has also been involved in national and international investigations into canine breed-related diseases such as canine cancer, canine and feline haematology, canine endocrine disease and the development of novel non-invasive biomarkers to help diagnose both simple and complex medical diseases.
Outside work, Mark is a seven-guitar-owning-musician, a race-winning cyclist and a keen runner with a personal best of one hour twenty five minutes for a half marathon. What a relief for the rest of us mere mortals to hear there's something he's rubbish at: he says he swims 'like a brick'.
Mark said: "I’m excited to be joining the outstanding team at Willows who deliver such exceptional care to pets and their owners and such an outstanding service to the referring veterinary surgeons.
"It is a wonderful opportunity for me and I’m really looking forward to making my own contribution to their continued success."
Virtual Vet Derms has been set up to be able to give advice to veterinary surgeons on any aspect of skin or ear disease whether it is allergy, otitis media, cutaneous neoplasia or endocrine-based in any species, including dogs, cats, small furries, exotic pets including raptors, birds and reptiles, horses, camelids, zoo and farm animals.
Sue, herself an RCVS Recognised Specialist in Veterinary Dermatology, is supported by a team of veterinary dermatology colleagues as well as veterinary specialists in exotic medicine, internal medicine (including endocrinology) and consultants with expertise in oncology.
Sue said: "We recognise that not every veterinarian has got access to a local dermatology specialist and that not all clients can or want to travel to a referral centre. The aim of the service is to formalise the advice that dermatology clinicians give to veterinary surgeons to allow them to get detailed help to manage difficult or challenging dermatology cases within their own practice."
The service has been set up under the RCVS Vivet initiative, is approved by all of the major insurance companies and supported with Veterinary Defence Society Insurance cover.
Virtual Vet Derms offers support in a range of ways.
Quick questionsShort questions that veterinary surgeons can submit via the online form on the Virtual Vet Derms website that just require a brief reply. This may be a dose of a drug, a parasite you want identifying, or the interpretation of a blood sample such as an ACTH stimulation test.
Veterinary reportsVeterinary surgeons can use online request forms on the Virtual Vet Derms web site to submit a brief history of the animal and the problem and some good quality photos of the skin condition. There is also the ability to upload histopathology reports, blood samples and any other pertinent information. A detailed written report is sent back to the vet within 48 hours which will describe clinical signs, differential diagnoses, recommended diagnostic tests and treatment option where appropriate. Where possible, Virtual Vet Derms aims to pass the advice request to the nearest dermatologist but vets can ask for advice from any of its specialists.
Telemedicine consultationsFor new cases or for cases where initial advice has been sought, in the client's own primary care veterinary practice via the internet. The Virtual Vets Derms specialist can consult with the owner to provide even more specific advice and support. After each teleconsultation the Virtual Vet Derms specialist will produce a report in the same format as the veterinary report to allow the primary care veterinary surgeon to continue to manage the case more effectively.
Face to face consultationsCan also be arranged via the owner’s vet at the specialist's own practice if there is the need for more specialist investigation that may not be available in the primary care veterinary surgery. In these cases, the specialist will take on the direct care of the case and work with the owner and vet on the best course of action.
General advice Also possible if the vet wishes to direct an owner straight to Virtual Vet Derms.
For more information, visit: https://virtualvetderms.com
The practice's dentistry and oral surgery team, led by Peter Southerden, has now carried out its first two successful reconstructions using the technique, following oral tumour resection.
Use of patient-specific implants (PSI) for jaw reconstruction is a new technique, which provides an alternative to bone regenerative techniques. Both techniques can be used in cases which have had significant jaw resection or need reconstructive surgery after a trauma.
Peter said: "To my knowledge, using this technique to create patient-specific implants for rostral mandibular reconstruction following bilateral rostral mandibulectomy has not been reported in dogs before.
"The reconstructive surgery involves taking pre and post-operative CT scans of the affected area and sending them to a specialist human medical PSI design company, which then uses 3D titanium printing technology to recreate the missing bone.
"In our first two cases, both dogs are doing really well. The feedback we’ve received from owners suggests their dogs have gained significant benefit from the jaw reconstruction process."
Peter is one of three dentistry and oral surgery clinicians at Eastcott alongside Andrew Perry and resident Ingrid Tundo, with a second resident due to join in 2019.
The team caters for dentistry cases including periodontology, endodontics, orthodontics and restorative dentistry, to complex cases including oral tumours, traumatic injuries and congenital issues such as cleft palates.
Peter added: "There aren’t many people with specialist qualifications in this field, possibly only six in the UK and we are the only team working with the backup of a multi-disciplinary referral hospital.
"Having a team of three, soon to be four, is unusual and means we have a big caseload and see a wide range of different cases. We are very keen on developing new techniques such the ones we have already introduced."
For more information about Eastcott Referrals, visit www.eastcottreferrals.co.uk.
The UK has now seen a total of 169 confirmed cases of Alabama Rot across 38 counties, since 2012. Six cases were confirmed in 2012, climbing to 40 in 2017 and 46 so far in 2018.
The new research, which was carried out in conjunction with the Royal Veterinary College, found that almost 95% of confirmed cases of Alabama Rot have occurred between November and May, with the highest number of cases being reported in February.
It also found most of the cases have been confirmed in western and southern parts of England, with the highest number found in West Sussex, Dorset, southern Hampshire, Greater Manchester and Monmouthshire. Far fewer cases have been reported from the eastern half of the country and East Anglia in particular.
David Walker, Head of medicine at Anderson Moores and co-author of the research, said: "This research, which was funded by the New Forest Dog Owners Group and the charity Alabama Rot Research Fund, was designed to look for geographical patterns, as well as environmental and climatic risk factors.
"A distinct seasonal pattern is suggested, with the vast majority of cases occurring between November and March, and limited cases over the summer months – just 6.5% of cases have been confirmed from June to October.
"In the scientific world a lot of research is not earth-shattering, but it all builds together and little by little we make progress.
"This information is good in terms of how we manage the next stage of research, however we need to be careful and not jump to any conclusions at this point".
Researchers say the disease has been reported in a wide range of breeds (35 in total) but, due to the small number of cases, it is not yet possible to say with any certainty whether a specific breed has an inherently increased or decreased risk of the disease. Any patterns may simply be the result of varying breed populations in different parts of the country.
Dr Huw Stacey, vet and director of clinical services at Vets4Pets, has been supporting research on the condition for a number of years. He said: "Since we held the first Alabama Rot conference in May 2017, vets and relevant professionals have been working hard to understand more about the condition.
"We know how the disease presents and how it affects dogs internally, and this research adds some interesting information that may help to increase vets’ index of the suspicion for the disease.
"The information on climate and ground type will help us further explore possible triggers for the disease, but at the moment we can’t say if any breeds are more likely to develop the disease.
"The first sign of the disease that is normally seen is a skin sore or lesion that isn’t caused by a known injury. Most commonly these sores are found on the lower half of the leg and appear as a distinct swelling, a patch of red skin or are open and ulcer-like.
"With 46 cases in 2018 already, it is understandably very worrying for dog owners, but we think the increase in cases is partially due to an increased awareness of the disease.
"However, this disease is still very rare, so we’re advising dog owners to remain calm but vigilant, and seek advice from their local vet if their dog develops unexplained skin lesions.
"While this research may be a stepping stone to finding the cause of Alabama Rot, there is currently no known way to prevent a dog from contracting the disease."
*also clinically known as
The College says the speed and accuracy of scans produced by the new scanner will revolutionise the treatment of animals at the Queen Mother Hospital for Animals (QMHA). It also reduces the need for animals to be anaesthetised before being scanned, with most patients now only requiring partial sedation.
The new scanner has been named the 'Otter Scanner' after a patient of the RVC whose owner was made a significant donation towards the RVC's charity, the Animal Care Trust, which funded the new machine.
Professor Dan Chan, Professor of Emergency and Critical Care Medicine and Medical Director of the QMHA at the RVC, said: "It is very uncommon that such an incredible leap in the care of animals can be achieved with a single innovation.
"Because of the vast improvement in speed and quality of the images produced by the ‘Otter Scanner’ our specialists are now able to obtain much more detailed images of various diseases affecting our patients so that the best possible treatment can be planned.
"At the RVC, one of our most important missions is to always improve the welfare and care of animals and this latest innovation is just another example of that commitment. We are forever grateful to all our supporters who have made this possible."
Michael qualified from the University of Glasgow in 2009 and then worked in first opinion practice in Buckinghamshire and Northern Ireland. He then returned to the University of Glasgow in 2012 to further his training and experience in oncology by completing four years of additional training. He completed an ECVIM residency in oncology in 2016 and became a Diplomate of the European College of Veterinary Internal Medicine and a European Specialist in Oncology in 2017. Michael worked at a private referral practice in Surrey prior to joining Fitzpatrick Referrals. Earlier this year, Michael was awarded a Masters degree in Veterinary Medicine. This additional qualification researched canine mast cell tumours.
Michael said: "I am absolutely delighted to have joined Fitzpatrick Referrals Oncology and Soft Tissue hospital. I have had a long-standing ambition to work as part of the fantastic team here since visiting the hospital during my specialist training in 2015. At this visit, I immediately felt at home in a group of people driven to deliver the very best compassionate care for dogs and cats.
"My ambition is to develop the very best ways to minimise the impact that cancer has on animals. I know that Fitzpatrick Referrals is the best environment for me to be able to achieve this. Throughout the hospital, there is an amazing positive attitude and a collective drive to improve the overall care we can give to pets with cancer. I am also excited by the opportunity to be able to help others to achieve their goals in improving cancer care for pets."
The extension includes a new diagnostic imaging suite with both CT and MRI scanners, a fourth operating theatre, two more consulting rooms, an additional ward for dogs and an expanded office for clinicians.
North Downs hospital director Terry Emmerson said: "This significant investment illustrates our commitment to providing the highest standards of medical and surgical care for our pets in a caring, compassionate environment.
"It has provided us with a number of important new facilities, allowing us to continue to build on our services and our level of care.
As part of the expansion, North Downs has also recruited five more clinicians, two specialising in small animal surgery, one in neurology, one in ophthalmology and one in anaesthesia.
Mr Emmerson said: "All the investment in facilities and technology is very important and exciting but we also recognised the need to invest in recruiting more talented staff to help us make the most of it all.
"That’s why we have added five new clinicians in several key disciplines and in turn increased the size of our clinicians’ office to help incorporate those additional staff.
"It all means we can now offer an even better service, leading facilities and treatment within a far more structured and organised layout which helps makes everything more efficient and user-friendly for staff and patients."
For more information about North Downs Specialist Referrals, visit www.ndsr.co.uk.
This multimillion pound centre will support the provision of advanced first opinion and referral equine services in the Midlands.
Senior Partner Richard Stephenson said: "It was a great honour and pleasure to have His Royal Highness visit our new premises, and our staff eagerly anticipated meeting Prince Charles and showing him the wonderful facilities we now have."
Amongst these are a Fujifilm SonoSite Edge II portable ultrasound system. Richard added: "Pool House is a well-known practice – we’ve been in existence for over 150 years – and we have developed a reputation as a specialist equine imaging centre, with radiography, ultrasound and MRI capabilities. The new facility has been designed to give us increased theatre capacity and stabling, and we needed an additional ultrasound system to match this expansion."
"The demands of equine practice mean that ultrasound is often required in difficult circumstances, and we need systems that can cope with extreme temperatures, dust, straw, mud, water and the occasional knock. Many pieces of equipment used in veterinary medicine were originally intended for a human clinical environment, so can’t stand up to the rigors of our work – they’re simply not fit for purpose. However, SonoSite systems are perfect for us; they’re robust, highly portable and very intuitive to use, which is important for intermittent ultrasound users."
Alabama rot, properly known as Cutaneous and Renal Glomerular Vasculopathy (CRGV) first emerged in Alabama in the 1980s, hence the nickname. The lack of understanding on how it spreads or can be stopped has led to high fatality rates for dogs who develop it.
The reason for its sudden appearance in the UK six years ago also remains a mystery.
The disease causes small clots in blood vessels, which eventually result in skin ulcers, tissue damage, and kidney failure in many cases.
Many theories have been put forward about the cause; anything from E. coli-produced toxins to parasites and bacteria. However, without knowing the exact source it is impossible to develop an effective cure.
The treatment offered by QMHA is known as Therapeutic Plasma Exchange (TPE) or ‘plasmapheresis.’ This method involves filtering all the patient’s blood so that toxic substances, including whatever causes CRGV, are removed. Once filtered, the blood is returned to the patient.
The development of this treatment was made possible by the discovery of the similarities between Alabama Rot in dogs and thrombotic microangiopathy in humans, which is also treated with plasma exchange.
The QMHA academics reported that two out of six dogs who underwent plasmapheresis made a full recovery.
The full findings of the research have been published in Frontiers in Veterinary Science1.
Dr Stefano Cortellini, an author of the study and Lecturer in Emergency and Critical Care at the RVC, said: "Despite the fact that only a third of dogs treated with TPE recovered from their disease, this is the first time that dogs so severely affected by CRGV have been reported to survive and so we remain optimistic that TPE may play an important role in the treatment of this deadly disease."
Reference
Davies says its Cardiac Electrophysiology Laboratory, headed by Pedro Oliveira (pictured right), is one of only four centres in the world to perform the procedure, and it has usually required human medical support. The fact that they've been able to operate independently means the procedure should now start to become more readily available.
The procedure involves introducing special catheters via peripheral veins into the heart, where they are used to record the electrical activity of the heart muscle, thereby allowing the identification of the source and mechanism of cardiac arrhythmias.
Once the abnormal tissue is found, it is destroyed using intense localised energy delivered by another specialised catheter: radiocatheter ablation.
This technique is common in human medicine but very rare in veterinary medicine because of the level of specialisation needed.
In the past, the cardiology team at Davies needed the support of a consultant and a cardiac physiologist from the human field to help carry out the surgery. Having now done it unaided, Pedro is confident that in time Davies will be able to help considerably more patients, promptly after diagnosis.
Pedro said: "In three years we have treated one cat and 19 dogs. Several cases did not survive long enough for surgery despite a waiting time of only a few days to up to two weeks from referral to the procedure. Most of these dogs were puppies. This is incredibly frustrating as if performed early these procedures are curative for most patients."
Davies says that to date it has had a procedural success rate of 100%, with recurrence of the arrhythmia in just one dog. The remaining dogs were cured from their arrhythmias and recovered fully except for two dogs that had sustained too much heart muscle damage and continued to suffer from congestive heart failure.
Pedro added: "Hopefully in the future severe muscle damage can be avoided by early referral when the arrhythmia is detected. If you diagnose a cardiac arrhythmia, especially supraventricular tachycardia, please consider this treatment option because it is very likely to be curative."
The Davies cardiology team can be contacted at cardiology@vetspecialists.co.uk.
Incidentally, Pedro has also co-authored (with Ruth Willis and Antonia Mavropoulou) a new book on electrocardiography. Guide to Canine and Feline Electrocardiography will be published in September 2018 and is available for pre-order on Amazon now, priced at £89.99.
The new practice was created by refurbishing the premises of what was a purpose-built human hospital, turning it into a referral clinic with two operating theatres, separate accommodation and waiting rooms for cats and dogs, offices and a seminar room.
Funding for the refurbishment came from NatWest, with further funds for things like digital radiography and a CT scanner coming from Lombard Asset Finance.
Martin said: "We decided to open East of England Veterinary Specialists to offer a more personal, yet professional service for pet owners in the local community. Thanks to the funding from NatWest and Lombard, we have been able to create a well-equipped surgery where we can offer the highest level of veterinary orthopaedic expertise.
"We have enjoyed welcoming our first customers over the past month and look forward to continuing to establish ourselves as an expert orthopaedic veterinary clinic, where 100% of referred cases will be managed by a Recognised Specialist."
For more information, visit: https://eoevets.com or telephone 01223 795023
Photo: L-R Karl Simper, relationship manager at NatWest, Martin Owen, co- founder of East of England Veterinary Specialists, Mat Parkhouse relationship manager at NatWest and Mark Bush, co- founder of East of England Veterinary Specialists.
Lead surgeon at Roundhouse, Ross Allan (pictured right), an RCVS Advanced Practitioner in Small Animal Surgery, said: "We know many practitioners and clients have been frustrated by the difficulties in availability of TPLO in Scotland and we wanted to change that.
"As with our other Roundhouse Referral offerings, we have done away with long waiting lists, unpredictable pricing, and challenges in clinical continuity. We know that in doing so we will revolutionise access to this service and the experience of its users.
"Our TPLO service offers excellent value and quality – we have invested heavily in the very best DePuy Synthes TPLO plates and implants and, together with our hospital status, standards and track record, we are offering a premier TPLO service in Scotland: a TPLO with a recovery that is as reliable and predictable as our Fixed Price!"
The fixed prices for a TPLO are £3000 for dogs under 40kg and £3100 for dogs over 40kg.
The price includes the consultation, diagnostic X-rays/assessment, pre-surgical blood samples, hospitalisation, anaesthesia, surgery (including implants), follow up consultation and follow up X-rays.
Ross added: "We don’t expect anything to go wrong, but should we need to revise our surgery we would do so at no additional cost to the client – that’s our Fixed-Price Fix!"
To make an enquiry, or refer a patient for a Fixed Price Fix TPLO contact Roundhouse Referrals at 0141 649 1316 www.rhr.vet
The improvements include a new cat ward designed to offer a quieter, more relaxing area away from other animals, and a new walk-in dog ward which will allow staff to treat larger breeds of dogs more easily. The intensive care unit has been expanded and the practice has developed a new chemotherapy area.
John Turkington, the partner at Scarsdale Vets responsible for overseeing the work said: "We are already really proud of the state-of-the-art facilities we have at Pride, but we are not complacent and that is why we have made this significant investment to improve our facilities and ultimately the services we offer our clients and patients. Patient comfort is paramount, which is why we’ve invested in an additional walk in ward for our larger breeds, and a new cat ward with a separate feline examination and treatment area."
As well as the changes to improve clinical care, the practice has also invested in its kennelling services, increasing the number of 'suites' for cats and dogs to stay in its 'hotel' areas whilst their owners go on holiday.
John added: "We want Pride to be recognised as one of the best veterinary hospitals in Europe and to make that a reality we have increased our ward capacity for patient comfort and clinical treatment areas, as well as improving facilities behind the scenes for our staff, to create a better working environment. Alongside that the improvements to our Pet Resort will also meet the growing demands from clients for those services."
Josep Aisa has arrived from Glasgow University, where he spent four years as a lecturer focusing on soft tissue procedures. He has authored numerous scientific papers and given presentations to international veterinary meetings, specifically on orthopaedic conditions.
Josep has a keen interest in oncological surgery and also boasts a broad area of expertise including orthopaedics.
Veronica Mortera has just finished a three-year residency in Neurology and Neurosurgery at Bristol University where she specialised in spinal surgery and inflammatory diseases of the brain. In 2014, she completed an internship in Small Animal Medicine and Surgery at Glasgow University where she authored a paper on MRI abnormalities in dogs with portosystemic shunts.
Veronica also spent three months in Geneva with the World Health Organization helping in the development of Public Health guidelines.
Joining Veronica in the neurology department is Francesca de Strobel, who earned a PhD from the University of Padua, in Italy, after writing a thesis on intervertebral disc degeneration in a large animal model.
Francesca began work as a Small Animal Veterinarian and Clinical Assistant in Neurology at the University’s Veterinary Teaching Hospital before moving to the UK in 2014 to begin an internship in neurology at Dick White Referrals, where she completed a three-year residency programme in small animal veterinary neurology and neurosurgery.
She enjoys all aspects of neurology and neurosurgery, with a particular interest for spinal surgery, metabolic and intracranial disorders.
North Downs is also extending its facilities with new consultation rooms, extra theatre and procedure rooms, more kennels, new staff facilities and extended vet space, along with a new meeting room. It is also creating a central imaging suite, with new MRI and CT scanners.
Hospital director Terry Emmerson said: "These are very exciting times at NDSR as work on the new extension begins and the plans actually start to take shape.
"It’s definitely a powerful illustration of our commitment to offer the very best service possible to all our patients, both in terms of facilities and equipment and in our clinical care."
Photo: From left, Veronica Mortera, Josep Aisa and Francesca de Strobel
João, who graduated from Portugal’s Oporto University in 2009, was recruited from the University of Liverpool, where he was a lecturer in Small Animal Cardiology.
Willows Clinical Director Toby Gemmill said: "This is an exciting time for us. As part of our new extension, our state-of-the-art cardiology suite is now open and fully operational, while we have also appointed a hugely knowledgeable and experienced cardiologist to join the team.
"It is further evidence of our continued commitment to invest in top talent and the best facilities so we can provide the highest standards of care and treatment."
João said: "I’m very pleased to have joined a centre of excellence like Willows and to be working in the fantastic new cardiology suite.
"I enjoy all aspects of medical and interventional cardiology but I have a particular interest in feline cardiomyopathies, cardiorenal syndrome and atrial fibrillation."
Ines, who graduated from the University of Santiago de Compostela in Spain in 2001, has spent the last seven years working at universities in America, Australia and Europe. She undertook her PhD in MR spectroscopy of the brain in dogs at the University of Bern-Zurich in Switzerland. She has a Masters in Radiology from University of Glasgow. She has also worked at the University of Illinois and Sydney University.
Willows clinical director Toby Gemmill said: "Ines is highly qualified and highly regarded, so is a very welcome addition to our talented imaging team. Her experience of working around the world will also be a terrific asset to the practice."
Ines said: "I am very happy and honoured to be joining Willows and to now be part of such a great diagnostic imaging team. "This is a well-known centre of excellence and I’m really looking forward to helping deliver the first class care and treatment that Willows always aims to provide."
For more information, visit www.willows.uk.net.
Shockwave therapy, or Extracorporeal shockwave therapy (ESWT) to give it its full nomenclature, sends mechanical shock waves into the affected area to stimulate the natural healing process by triggering the body’s own repair mechanisms.
The therapy is being spearheaded at Willows by Kinley Smith (pictured right), an RCVS and European specialist in small animal surgery. He said: "Shockwave therapy is a whole new line of treatment and has proved a spectacular success.
"It’s an excellent technique for dealing with certain orthopaedic conditions and there’s no invasive surgery, no wound to heal and no risk of infection so it really is a win-win-win procedure.
"It is particularly effective in the treatment of ligament and tendon injuries.
"There can be immediate pain relief for the dog; after two weeks we start to see lasting benefits and in four weeks we normally see a clear improvement.
"The added bonuses are we can normally reduce any medication; the dog can enjoy more exercise plus it is not as costly as undergoing an operation.
"Surgery is still essential in some of the more acute, problematic cases but shockwave therapy has been a terrific development in helping us provide an alternative treatment in a lot of soft tissue, muscle and bone conditions."
Davies says pulmonic stenosis is one of the most common congenital heart defects in dogs. In most cases it is caused by a malformation of the pulmonic valve with fusion of the leaflets (type A stenosis) or with the presence of rudimentary valves accompanied by hypoplasia of the annulus (type B stenosis).
Dogs with severe stenosis are at risk of sudden death, heart failure and have a decreased survival time in comparison to normal dogs.
Minimally invasive catheter based procedures (balloon valvuloplasty) have become the treatment of choice for valvular pulmonic stenosis, with good results in most but not all cases. French Bulldogs are predisposed to the condition and tend to not respond to valvuloplasty as well as other dogs.1
In this case, the dog was first referred to Pedro Oliveira, RCVS and European Veterinary Specialist in Small Animal Cardiology at Davies, for treatment of severe pulmonic stenosis.
An echocardiogram confirmed the presence of a type B stenosis accompanied by marked right ventricular hypertrophy and also an atrial septal defect.
A standard balloon valvuloplasty procedure was performed without complications and the dog initially showed improvement (click image right to enlarge). Soon after, however, she began to suffer episodes of weakness and collapse and was readmitted.
An echocardiogram showed that the right ventricular obstruction had worsened.
Pedro said: "Re-stenosis has been reported in up to 16% of cases following balloon valvuloplasty and in this case it was suspected to be due to the formation of scar tissue in the valve leaflets. The pressures inside the right side of the heart were now higher than left allowing blood to flow through the atrial septal defect from the right to the left atrium directly without receiving oxygen from the lungs.
"Whenever Gracie got excited or tried to exercise she would go 'blue' from lack of oxygen and collapse. In fact her quality of life was so poor that euthanasia was suggested at that point. For this reason we decided we should attempt this novel procedure. The only other option would have been open-chest surgery (patch graft) but this held a higher risk of complications during the anaesthesia and even death. Also, the cost of surgery would have been higher than this new option."
Pedro performed the procedure with fellow Davies cardiologist, Jose Matos, while Antonia Mavropoulou guided them using transoesophageal echocardiography.
Under a general anaesthetic the heart structure was assessed using transoesophageal echocardiography and angiography to choose the correct size of the stent for Gracie.
An 8mm wide and 4cm long stainless steel catheter tightly mounted on a balloon was chosen.
This was then positioned across the pulmonic valve and the balloon was expanded forcing the stent to open up to its full size (figure 2B). There was an immediate and significant improvement of blood flow through the stent (figure 2C), the patient recovered well and she was discharged four days later.
Re-examination after three months showed improved flow across the stent and a reversal of the right to left shunting across the atrial septal defect. Gracie stopped experiencing episodes of collapse or cyanosis and is now able to exercise and lead a more normal life.
Pedro said: "This technique has been used in very few cases in the whole world and to the best of our knowledge this is the first time it has been used in the UK.
"It is more technically challenging and costly than a standard ballooning although it may provide an effective, safe, and cheaper alternative to patch graft surgery. In this particular case we feel it made an important difference in terms of quality of life and prognosis for Gracie.
NDSR’s European Specialist in neurology and neurosurgery Niklas Bergknut is performing the surgery.
He said: "This type of surgery for dogs is not performed in many clinics across the country.
"The pituitary gland is, of course, a very small gland which is very close to the brain, so it requires considerable expertise to perform the operation, followed by a lot of after-care to help the animal recover properly after surgery.
"The pituitary gland produces hormones which are essential for life, so it is then vital to constantly monitor the dog, its blood, hormones and fluid levels both during surgery and for a longer period after surgery.
"Although surgery may be challenging, the aftercare can be even more challenging and requires very skilled internal medicine specialists to manage the patients after surgery.
"Our medics and nurses carry out various blood tests and manage the fluid balance every hour after surgery and all the way through to the dog going home.
"Every department in the hospital has to work closely together to ensure the best possible treatment and the best possible outcome."
Niklas, who learned the technique from Bjorn Meij, Professor of Surgery at the University of Utrecht, described how the operation is performed. He said: "We go in through the mouth, up through the soft palate and into the underside of the cranium. Then you drill a little hole to access the tumour that way.
"It is obviously essential to make sure you are in exactly the right place or the outcome could be disastrous.
"It is also important to operate as early as possible before the tumour gets too big.
"Trying to remove a big tumour is more difficult and holds greater risks because of the damage that can be done to the surrounding brain in attempting to remove the tumour."
Niklas says that if surgery is successful, the results are impressive, with most dogs making a full recovery and not suffering any recurrence of the tumours, a better outcome than treating the dogs with traditional methods such as radiotherapy.
He added: "Removing the tumour like this is the only way of permanently treating tumours of this type. Radiotherapy is very good too but there is a much larger likelihood of the tumour growing back."
For more information, visit www.ndsr.co.uk.
The 18,000 sq ft centre's facilities include a £1 million imaging suite with state-of-the-art MRI and CT scanners, five operating theatres and extensive kennelling facilities and cat wards. It is also equipped with fluoroscopy equipment with additional mobile C-arm, mobile digital radiography, a Phaco machine and Mindray WATO anaesthetic equipment.
A total of up to 80 staff will be employed at Paragon, including up to 18 referral veterinary surgeons and 32 nurses. Treatment will include ophthalmology, orthopaedics, soft tissue surgery, cardiology, neurology, medicine, oncology and dermatology.
The centre, which is part of Dewsbury-based Calder Vets, which has 12 practices across Yorkshire, is being led by managing director Ian Monteith and clinical director Adam Bell.
Adam said: "The opening of Paragon is the culmination of an 18-month project to bring the very best quality referral veterinary centre here to Wakefield.
"We’re delighted to open our doors and the team here at Paragon Veterinary Referrals are totally committed to, and looking forward to, providing excellent care for patients using the latest veterinary techniques."
For more information about the services Paragon will be offering, and for details of the vacancies on offer at the vet centre, as well as Continuing Professional Development (CPD) opportunities, visit www.paragonreferrals.co.uk.
In one case, Tigga, a 17-year-old cat with an itchy and destructive tumour on her nose, was in complete remission within 44 days. In another case, a tumour vanished in a dog where the aim of the treatment was only to shrink the mass before an operation to remove it.
NDSR, which is based in Bletchingley, is the only referral centre in the UK and one of very few in the world offering electrochemotherapy in pets.
Electrochemotherapy is given in two stages.
First, the patient is given a mild dose of intravenous chemotherapy in the normal way and then, using a probe, a precise electrical charge is given to the area on or around the tumour.
This temporarily opens up tiny holes in the cells, big enough to allow the drug to enter, which then close again in microseconds. This means the drug will only attack cancerous cells, unlike normal chemotherapy, which also kills healthy cells.
Gerry Polton, clinical director of oncology at NDSR, said: "Normal chemotherapy works on the principle of being more damaging to cancer than non-cancerous tissue. Some cancers are more resilient, so there are differences in how they respond to treatment, and this can cause more harm to the patient.
"Electrochemotherapy involves clever anatomical targeting of a specific site and is an effective way of protecting healthy cells.
"The results we are seeing in cases like Tigga’s are unprecedented and we are learning about the procedure all the time. We are always looking for better ways of treating cancer without the effect of harming the patient indiscriminately and this has proved to be a very effective way of doing this."
According to NDSR, the results could help inform the development of the targeted treatment in humans, where electrochemotherapy is used in a small number of cases in the NHS.
At present, many clinical trials are carried out on laboratory animals which are bred with no immune system – but dogs have similarities in genetics to humans and have working immune systems, meaning they can provide a more accurate parallel for how the treatment may work in people.
Gerry said: "A pet dog would be a good model for human cancer studies. It's a mammal with a heartbeat, blood supply and working immune system.
"Progress with electrochemotherapy in animals is being made in parallel with progress in electrochemotherapy in the human field, and what we are learning may even inform what is happening in people.
"Electrochemotherapy is a form of treatment which Cancer Research UK describe as 'fairly new' on its website, with limited information about its effectiveness. So maybe something would be gained from learning together."
The award has been granted to only a handful of practices and requires the achievement of high standards of care and a detailed understanding of the species.
Highcroft has three dedicated exotic species veterinary surgeons, including a European small mammal Specialist and four exotic species nurses, who have either obtained or are studying for their City and Guilds Exotic Species Veterinary Nursing Certificate.
The practice has a dedicated exotic species consulting room, waiting room, ward and an operating theatre, containing state-of-the-art equipment.
In addition to treating rabbits, both vets and nurses in the exotic species team lecture widely to promote the importance of providing a high standard of care to rabbits and to ensure that their welfare is optimised.
Dr Elisabetta Mancinelli DVM CertZooMed Dipl ECZM (Small Mammal) MRCVS heads the exotic species team at Highcroft. A European Veterinary Specialist in Zoological Medicine (Small Mammal Medicine and Surgery) and a RCVS Recognised Specialist in Zoo and Wildlife Medicine, she said: "We are very proud to have been awarded Gold Status by the RWAF. We will continue to enhance the level of care we provide, not just to rabbits but to all exotic species and strive to improve the welfare of all animals under our care, in hospital and at home."
Domingo, pictured on the left with Southfields clinical director Henry L’Eplattenier, will join the Essex referral centre as head of cardiopulmonary service at the start of February.
After qualifying in Zaragoza in his native Spain, Domingo completed an internship and several years in practice in the UK, before joining the University of Bristol small animal hospital as a resident.
He then completed a three-year training programme in small animal internal medicine, followed by a four-year programme in cardiology to become an RCVS diplomate and specialist in veterinary cardiology and small animal internal medicine (ECVIM).
After being appointed as head of cardiology and respiratory medicine at Bristol, Domingo joined Dick White Referrals before his move to Southfields.
Domingo said: "I’m delighted to be joining such a progressive and forward-thinking practice as Southfields. It is clear everyone at the practice is dedicated to continuing its growth and dedication to providing the highest possible level of care."
Southfields’ operations manager Daniel Hogan said: "The arrival of Domingo adds another hugely talented specialist to our growing team of experts. He is, without doubt, at the top of his profession and his passion and dedication are traits which will fit perfectly at Southfields as we continue to grow."
Domingo is also a visiting lecturer in cardiology and respiratory medicine at the Catholic University of Valencia, while he is an active clinical researcher and has published widely in many areas of cardiology and respiratory medicine. His areas of special interest are arrhythmias and interventional cardiology.
For more information about Southfields Veterinary Specialists, go to www.southfields.co.uk.