Surgery and Medicine at Tweed House

We always strive to improve at Tweed House and are constantly updating our methods and procedures in line with evidence based medicine. Some examples of how we have done this are:

• We now use Sevoflurane inhalational anaesthetic. Sevoflurane is commonly used in paediatric medicine, but is not as widely used in veterinary medicine, where Isoflurane is usually the anaesthetic of choice. Sevoflurane allows much finer control off anaesthesia meaning patients are more quickly controlled in their depth of anaesthesia. We felt that if Sevoflurane is good enough for our children it is good enough for our pets and as an animal version is available and has been shown to have these extra advantages we have updated our anaesthesia protocols.

• We have updated our knowledge base by gaining tuition and experience performing TTA surgery for cruciate ligament disease in dogs. This was augmented by purchase of equipment and training to perform Orthozip repair of cruciate ligament disease in smaller dogs. The Orthozip technique allows precise tension control and greater strength for this type of repair. We also have begun to use a new approach to the management of grades 1 and 2 medial patellar luxation in dogs called Ridgestop. This has drastically reduced surgical time and recovery time for patients. We continue to invest in high quality equipment and training to maintain excellent surgical outcomes.

• We were one of the first practices in the country to use Cytopoint, a monoclonal antibody treatment for atopic dermatitis in dogs. Following on from this, Andy was asked to share his experiences of using cytopoint with other veterinary practices.

• We have received training in the use of SOP locking plates for the repair of fractured bones. SOP plates are the only locking plate system specifically designed for veterinary patients.

• We work with Vet Practice Support. They are very experienced veterinary surgeons and have further qualifications in internal medicine, ultrasonography and cardiology. Working with them means that our standard of care can only increase as our diagnostic abilities are improved. It also allows for your pet to be seen for more complex conditions at our surgery, meaning that you do not need to travel long distances to seek referral standard care.

• We have changed our surgical preparation procedures to include ChloraPrep® Patient Preoperative Skin Preparation. Chloraprep is used widely by the NHS for iv catheter placement and surgical preparation procedures and has been shown to provide rapid, prolonged and proven effect against microorganisms such as MRSA. Check that your vet is using ChloraPrep®. We also changed our surgeon scrubbing guidelines to include Sterillium®, an alcohol based hand scrub with proven superior surgical disinfection. It also contains an emollient meaning our surgeons' hands are a lot softer!

• We have invested in 2 Butterfly ultrasound probes. These portable and highly useful devices plug into our phones and iPads and allow us to perform ultrasound examinations of the chest and abdomen whilst you are there. This massively increases the diagnostic yield of a clinical examination and should something be detected we can advise further testing, in full, on our more advanced ultrasound machine. These probes offer an amazing opportunity to exclude diseases within seconds and ensure we always provide appropriate treatment or advice for your pet. It also allows us to run screening campaigns for conditions such as Dilated Cardiomyopathy (DCM) a heart condition seen in certain large breed dogs.

• We carry out audits of our surgeries and procedures to ensure our clinical outcomes are acceptable.

• We hold regular Continuing Professional Development meetings for our staff to improve our clinical knowledge database.

• We are proud of our Royal College of Veterinary Surgeons Accreditation and Nurse Training Practice status.