Tour of the practice
Atherton Veterinary Centre was established in 1980 as a single vet practice. It quickly grew into a 2 vet practice and in 1991 Mr Hart joined the practice. By 1994 the practice had outgrown the original building. There was a considerable amount of land at the rear of the practice and so a decision was made to extend the premises rather than move location.
After a lot of thought and design the purpose built extension was completed in 1995. At this time it was felt that the practice had grown sufficiently to employ a 3rd veterinary surgeon. This meant not having to employ locums for holiday cover ensuring far better continuity of care.
Very few clients have actually had the opportunity to view the practice beyond the consulting and waiting rooms. Those that have are amazed at the size of the practice and the facilities that are available.
PREP/TREATMENT ROOM
This large room is the hub of the in-patient area. It is in this area that all animals are examined, blood samples taken, treatments administered and anaesthetics given prior to surgical procedures.
LABORATORY – We have invested in laboratory equipment worth in excess of £15000 which enables us to get important biochemistry and haematology results within minutes. This is of particular importance with seriously ill animals and enables us to decide on an appropriate treatment plan more quickly.
Some animals have blood tests performed prior to their anaesthetics.
Some laboratory tests such as hormone assays are more reliably done by external laboratories and therefore we do post some samples away and will normally get these results back by fax within 1-2 days.
Histology samples will usually take 5-7 days to get results back because of the processing required.
All of the external laboratories that we use are chosen for their reputation and expertise and these are constantly reviewed by ourselves.
Quality control is a very important aspect of running the laboratory in order to ensure reliability and accuracy of the results obtained and we run quality control tests on our laboratory equipment on a frequent and regular basis.
We also have a microscope to enable us to examine skin scrapings and urine samples in-house.
ANAESTHETICS – Most of the animals that are anaesthetised are initially given a pre-med on admission which helps to reduce the amount of general anaesthetic needed and makes induction and recovery a lot smoother. Once the pre-med has taken effect the general anaesthetic is administered, usually intravenously into a front leg. The patient is then put on to gas – a mixture of medical oxygen and isoflurane. All of the anaesthetic circuits have the oxygen delivered via pipes from large cylinders. The oxygen passes through a vaporizer where it picks up the correct concentration of anaesthetic. Although we have the facility to deliver nitrous oxide (“Laughing gas”), Isoflurane is one of the safest anaesthetics available and consequently nitrous oxide is rarely used.
All anaesthetic gases are actively scavenged away from the animals and nurses/veterinary surgeons.
Anaesthetics are monitored in a variety of ways - Pulse oximeters are used to provide a continuous readout of pulse and blood oxygen level. Oesophageal stethoscopes are used to monitor heart rate and rhythm and a trained nurse is constantly with the patient until recovery is complete.
DENTAL TREATMENT – Dental disease is very common in dogs, cats and rabbits. All dentistry is carried out in the treatment room so that the operating theatres remain as sterile as possible.
We have the equipment necessary for scaling and polishing teeth, extractions and routine dental surgery. More sophisticated treatments such as orthodontics can be arranged by referral to a specialist. However, such treatments usually require multiple anaesthetics and are rarely necessary in the best interests of the animal. We have a specially designed dental table which ensures that the patient is tilted downwards so that any water from scaling is not inhaled and so that they remain as clean and dry as possible.
PREPARATION FOR SURGERY - Once the patients have been anaesthetised and stabilized they are then prepared for surgery. This involves shaving a wide area around the area that is to be operated upon. The area is then scrubbed with an antiseptic solution and finally surgical spirit is applied. The shaving and cleaning are obviously of extreme importance for sterility and to reduce the risk of contamination.
Once prepared for surgery the patient is wheeled in to one of our two dedicated operating theatres.
OPERATING THEATRES
We have 2 operating theatres dedicated to sterile procedures. Each one is identically equipped with a hydraulic table which can be raised to the height preferred by an individual surgeon and tilted to a set angle if necessary, a wall mounted anaesthetic machine, piped gases and scavenging unit and facilities for administering intravenous fluids. Heat pads are available and plastic cradles are used to position the patient correctly.
The surgical instruments used are identical to those which a surgeon would use to operate on a human and we have a wide range available at all times.
All soft tissue and orthopaedic procedures are carried out in these theatres. If a procedure requires specialist skills and funds are available then the veterinary surgeon may recommend referral to a specialist referral centre. We only use specialists with whom we have built up a strong relationship and to whom we would take our own pets. All have post-graduate qualifications in their field and most are highly qualified RCVS recognized specialists in their own field and are comparable to a Consultant in human medicine/surgery.
RADIOGRAPHY SUITE
Radiography (X-rays) is an important part of investigation of surgical and medical conditions of animals. We have a room set aside specifically for radiography. The animal is placed on a special lead-lined table whilst radiographs are taken so that the x-rays are not reflected away thereby exposing staff.
Because of the positions that animals need to be placed in and because for safety reasons no-one is allowed to hold an animal undergoing radiography, all animals requiring radiography must be anaesthetised or heavily sedated.
Adjacent to the radiography room is a dark room in which is an automatic film processor which enables the veterinary surgeon to obtain dry developed films within 1½ minutes.
We have viewers for reading radiographic films throughout the practice.
Some conditions require more detail for diagnosis than can be achieved with radiography. We can arrange MRI scans for dog and cats as a matter of urgency if needed. These are very expensive but can yield a lot of information, particularly with respect to spinal conditions.
STERILIZING ROOM
The sterilizing room contains 2 high pressure, high heat autoclaves. Surgical instruments are placed in an autoclave once they have been washed after an operation. They are heated to a temperature of 134C which results in complete sterilization. Indicator tubes are used to confirm that the correct temperature for sterilization was achieved on each cycle.
We have 2 autoclaves so that in the unlikely event of one breaking down operations can still continue – obviously of importance if an emergency comes in.
KENNELS
We have 2 kennel rooms. The main kennel has room for 18 in-patients ranging in size from kittens to Great Danes. The kennels are constructed from stainless steel which is easily disinfected and cleaned. Cheaper kennels made from fibreglass or plastic are not used. The animals are bedded down on vetbed – a material that allows liquid to soak through keeping the patient clean, dry and warm. Dogs that are able to do so are taken out for walks as needed at the back of the surgery, especially when staying for any length of time.
The kennel room is set up to deliver oxygen directly to any patient that may need it, for example, animals that are hospitalised for acute heart failure. Each kennel also has the necessary facilities for administering drips to any patient that needs intravenous fluids. All hospitalised animals have an in-patient record chart and an assigned nurse to provide care. The nurse will hand over care for her patients at the end of her shift to another so that no animal is ever without nursing cover. All animals are checked regularly throughout the day and night as necessary by nurses and veterinary surgeons. The overall responsibility for the treatment of any animal admitted lies with the Veterinary Surgeon and we put a great deal of emphasis on continuity of care.
We also have a smaller kennel room assigned as isolation for patients with infectious diseases. Fortunately, with regular vaccinations and boosters this is rarely needed. It is completely separate from all other patient areas and “barrier nursing” techniques are used.
We normally ask owners to telephone between 8.30 and 9.00 each morning for a progress report on any in-patients and again between 6.00 and 7.00 each evening. However, we fully appreciate how concerned owners are for their pets and consequently more frequent phone calls are invited.