I am going to be spending this week at Montgomery Vets, in Evegate Business park, Smeeth. Today was my first day and I was very excited because they specialise in exotics, something I have not previously had much exposure to. I went in and introduced myself to the head nurse, Leah Parkinson and she showed my around. The vets was tiny with two small waiting rooms, an office, two consulting rooms – one which doubled as a prep room and an operating theatre, as well some space out the back where medication and food is stored and a tiny room acting a kennels. It was so different from both Kingsnorth and Barrowhill vets. There are normally two practicing vets, Clive (who owns the practice with his wife Jane. Jane spends most of her time working as full time vet at Port Lymne Zoo!) and Roland as well as two nurses, Leah and Lucy. After being introduced to everyone, Roland asked me to help him draw up premeds for the cats and rabbit who were undergoing operations this morning. He even let me inject the rabbit, which was brilliant. The premeds included antiinflammatories to reduce the inflamation which inevitably results from invasive procedures, painkillers to lower the heart rate which would otherwise increase because of the adrenaline release stimulated by the pain, making the animal more comfortable whilst under anaesthetic and when it initially wakes up, and sedatives which mean that a lower dose of anaesthetic can be used to knock it out and also reduce the stress the animal feels from being in the vets.
The first procedure was a cat castrate. The cat could be given up to 1ml of anaesthetic, but most cats would fall asleep before all of it was administered. Roland showed me the thick, white medication and explained that only medication of this consistency could be injected into a vein as particles found in almost all other medicines can block venuoles. First, the nurse plucked the fur off the scrotum and cleaned it with disinfectant. Then Roland cut out the first testicle before tying the cord and blood vessel together. As he completed by repeating the procedure with the second testicle, he explained that there were many different ways of doing it. I asked why they didn’t just use an elastic ring as they use during lambing as it would be much cheaper. However, this would raise many welfare issues; it would be likely to get infected with the cat licking it and could easily go wrong, whilst owners would be unlikely to appreciate their cat’s testicles falling off on their carpet.
Next was a cat spay. Unusually, the owner had requested a flank spay rather than a midline. There are advantages and disadvantages to both spaying methods, however at Montgomery Vets they usually perform midline spays. It can be easier to find the uterus on a flank spay but leaves a larger patch of more visible trimmed fur. After the operation, Roland left me with the removed uterus and ovaries and the clamps so I spend some time looking at it close up. Despite having seen many spays previously, I have never been given the chance to handle a uterus and it was really interesting.
The rabbit was now ready to be anaesthetized ready for its dental. It is high risk putting a rabbit under anaesthetic especially as they are unable to put a tube down its throat. Instead, a mask has to be used and therefore a higher concentration of anaesthetic is needed because more of the anaesthetic diffuses into the surroundings rather than the rabbits lungs. Using a specialised stand, the rabbit’s mouth was clamped open. Roland showed me how the top molars were spurring into the cheek and explained that bottom molars would spur into the tongue, although the only the top was a problem for this rabbit. He filed down the spikes and pulled out one of the top molars which was causing the majority of the problems.
An ultrasound scan was performed on a 15 year old border collie. It had previously collapsed, triggering the investigation. Blood tests showed the wrong balance of red cells and plasma but the ultrasound showed no obvious problems. Therefore, the scan used to assist in taking a sample of fluid from the stomach. The ultrasound showed the needle entering the stomach and helped the vet to guide it into an area of fluid – shown as black on the screen. This would be sent to the lab and hopefully reveal more about what could be causing the changes in this dog.
Before lunch, a drug rep from nutravet came in to talk to the vets and nurses about their products. nutravet have developed nutraceuticals – medications made from natural ingredients. These include nutraquin aimed at improving osteoarthritis and other joint degenerative diseases and nutracys to help manage feline cystitis, a huge problem in many cats. The rep was especially advertising the client-aimed leaflets that come with the products so the owner can assess the improvements their animals are making, understanding the purpose of the product and making it easier for a vet to prescribe. Having recently read an article in the Veterinary Times which concluded that there was very little evidence for the effectiveness of nutraceuticals, it was interesting to hear about this company’s success. I wondered how much of it was due to the medication and how much of it was a result of the client-friendly information, helping owners to become more aware of their animals condition and therefore provide better care for them.
After lunch, I spent some time in consults with Roland. A golden retriever was brought in for a preop check before her spay. She had a fishy smell, suggesting that she may be in season, however, her vulva was closed meaning that she was not in season and the spay was ok to go ahead the next day.
A cockatiel was brought in for a beak trim. When the beak is displaced, the top and bottom mandibles do not grind against each other so grow uncontrollably. In situations such as these, the beak had to be trimmed about once a month. It is done carefully using a rotating file. It must be done very slowly otherwise the file becomes too hot causing pain as there are nerve endings and blood vessels further up the beak. This is similar to the quick in nails, meaning that the amount trimmed must be carefully judged. Whilst this was happening, the owner had to be out of the room, this is because birds are highly sensitive and could quickly associate the discomfort of the procedure with their owner’s presence. Instead, the owner ‘saves’ them at the end, ensuring that the bird to have a positive relationship with the client.
A dog with glaucoma was brought in to check on the eye pressure. Previously, there had been an episode where the blood pressure had suddenly escalated. This was surprising as the eye medication the dog was on should have the opposite effect. After putting local anaesthetic in the eye, Roland used a tonometer to measure the pressure. It had now returned to a normal level. Nevertheless, we took a sample of urine to indicate any kidney problems. Placing a small amount of urine in a refractometer, we could check the urine specific gravity which was slightly higher than normal. Using coloured patches confirmed that there was a high protein content in the urine so there could be possible problems with function. However, the client’s financial strains meant they only wanted bloods to be taken for further investigation if it was a necessity. Therefore it was decided to keep an eye on how the dog was doing rather than acting now. Aside from this, the dog also had bad breath so the owners asked for some penicillin to help keep this under control.
A red setter was brought in with red, raw skin where it had been chewing itself. This could be the result of fleas or some other allergic reaction. It was prescribed a steroid spray, to be used on the surface to reduce the inflammation, a cream to sooth the already damaged skin and some flea treatment to prevent the risk of fleas. In addition to this, the owner asked for something to help with his excessive wind so the vet gave them a probiotic which should improve balance in the stomach.
The last consult I saw today was a love bird which had been sitting on the bottom of its cage not eating for 2 days. As prey animals, birds are very good at hiding symptoms and therefore a sudden change like this can indicate a serious problem. The bird had slightly wet faeces and although the wings, beak and body condition were all good, the vet noticed during his examination that one foot gripped better than the other. However, this was unlikely to be related to the symptoms so Roland decided to use trial treatment. They would first try antibiotics, with the importance of eating strongly emphasized. The owners were instructed to offer the bird its favourite foods and add glucose powder to its water if they had no success with solid food.
I really enjoyed my day at Montgomery vets and learnt many new things, especially as I have very rarely seen birds at the vets before.