Peripatetic orthopaedic referrals: using the service
Radiographic Reporting
Informal radiographic reporting is offered as a complimentary service: no obligation, no charge, even if there is no possibility of my involvement in the surgical management of a case. I am always happy to review patient files and advise on management options, regardless of circumstance. An x-ray report form should be submitted for each set of radiographs. Ideally, submit radiographs as DICOM files via the Upload Files buttons (on this page, in the footer & VETS dropdown menu).
Scheduling Surgery
It is preferable to initiate contact by phone rather than email for urgent cases. For non-urgent cases, submit a referral form, phone or email as you wish.
Referring veterinary surgeon: please submit the following:
1) Referral Form: ideally, or alternatively a copy of the clinical history.
2) Imaging: ideally, submit radiographs as DICOM files via an UPLOAD FILES button.
3) Procedure Information sheet: owner to read and sign prior to surgery
It is helpful if the Pet Owner can submit a Consultation questionnaire
Pre-Surgery Examination
Examine the day prior to surgery (ideally) or at admission on the morning of surgery. Pay particular attention to the following:
• Examine for evidence of infections such as pyoderma, otitis externa, cystitis or severe gingivitis **.
• Ideally, perform any pre-anaesthetic blood testing the day prior to surgery to avoid delays or postponements on the day of surgery.
• Auscultate the heart and lungs.
** Infection present anywhere in the body at the time of orthopaedic surgery may increase the risk of post-surgical sepsis at the surgical site. If an infection is detected treatment should be instigated. Surgery should be delayed until all infection is eliminated. In some cases, e.g. chronic atopy /pyoderma, elimination of infection may not be achievable and “adequate control” is a more realistic objective; in these cases, it may still be in the patient’s best interests to proceed with surgery albeit with some increased risk of post-surgical sepsis. Please discuss this with me and ensure the client understands the potential implications of proceeding in these circumstances.
Preparing For Surgery
It is helpful if all staff to be involved have familiarised themselves with Perioperative Protocols; a summary to assist in preparing theatre and the patient for surgery, it also lists premedicant drugs and antibiotics including dose rates and intervals, highlights key points relating to perioperative patient safety and includes a checklist for the day of surgery.
Perioperative Analgesia
Options for peri & post-operative pain management may include epidural (preservative-free morphine/buprenorphine + bupivacaine), various constant rate infusions (CRI), serial injections of opioids, fentanyl (Durogesic) patches, fentanyl spot-on (Recuvyra) and buprenorphine patches (cats). Click the following link for more information.
Peri-operative analgesia - clinical guide
Post-Surgery Recheck and X-rays
Physical examinations and follow-up radiographs are performed by the practice in the first instance; case information may then be submitted to me for remote assessment.
Comparison between current and previous radiographs is an integral component of any radiographic reassessment. It is, therefore, important to replicate the positioning of the radiographs taken immediately post-surgery as accurately as possible when taking follow-up radiographs. When submitting follow-up radiographs for review please be sure to include all previous radiographs.
Ideally, please complete a Recheck form at the time of follow-up radiographs/check-ups, or anytime progress is not as anticipated. It is also helpful if the Pet-owner is able to complete a Patient Progress form. The information in the forms helps me to advise appropriately on case management.
We Value Your Opinion
We are always striving to improve our service and are extremely appreciative of all comments and suggestions received. If at any time you wish to provide feedback please do so via the feedback form or contact us directly.
