At Rosemary Lodge Veterinary Hospital, we have an on-site Siemens Emotion 16 slice CT scanner. CT (computed tomography) is essentially three dimensional x-ray. It has revolutionised the way in which both human and veterinary medicine is able to assess certain patients. CT and MRI work in very different ways and therefore each has its own strengths and weaknesses. For example, CT can provide excellent detail in bone, creating almost perfect 3D reconstructions of joints, whilst MRI is not a great tool for examination of bones. However, CT does not provide very good detail within the brain or spinal cord tissue, whilst MRI is able to show subtle changes due to inflammation or tumours.
The CT scanner at Bath Veterinary Referrals has allowed us to significantly change and improve how we approach certain cases. This scanner is a "16-slice" scanner allowing us to obtain very detailed pictures for a very short scan time. This means that we can achieve excellent detail in moving organs such as lungs. In fact, once you have seen the detail that we can achieve with CT it is very hard to go back to using x-rays, particularly for lungs and nasal chambers.
CT has many uses, including some of the following common investigations:
- Any respiratory disease e.g. chronic coughing, difficulty breathing
- Nasal diseases
- Orthopaedic diseases including elbow dysplasia and spinal fractures
- Soft tissue surgery planning to assess how deeply a tumour invades into the surrounding tissues
- Large dogs with any abdominal disease (CT has been shown to be more accurate than ultrasound to assess abdominal disease in dogs over 25 kg)
- Trauma cases such as road traffic accidents
We offer CT scans as either part of a referral investigation, which is often the most useful approach, or they can be performed as an outpatient procedure. In the latter case, the animal will be admitted by one of our nurses and the CT performed during the day. We will either provide you with a disc of images or can arrange an external specialist opinion on the scan. For outpatient scans, we need you to indicate which areas are to be scanned, whether you wish us to arrange a specialist opinion on the images and an indication of the clinical questions to be answered.
Outpatient scans do not include consultations or advice from our own clinicians, although if it becomes apparent that other tests would be useful, we will contact you to discuss this. We have set a range of prices for CT scanning that are very competitive (all include sedation or GA, the technique to be at our discretion, but GA offers distinct advantages in most animals).
Magnetic resonance imaging (MRI) is an advanced imaging modality which does not use ionising radiation and produces detailed soft tissue images. The other main advanced imaging modality available to veterinary patients is computed tomography (CT). This utilises x-rays and computer technology to form an image. CT images are useful for assessing bone changes, and for imaging of the thorax. CT scans are also generally cheaper than MRI scans. However, MRI is thought to be safer than CT since it does not use ionising radiation. Compared to CT, MRI also has advantages of the ability to image in any plane, better spatial resolution, better tissue contrast and increased sensitivity to disease processes which alter the water content of tissue. Essentially, MRI is looking at the density of hydrogen ions or protons within the body. These ions are most common in water, so MRI is sensitive at picking up changes in the water content of tissues, as may be seen with inflammation or neoplasia.
MRI is now the gold standard imaging modality for a number of disease conditions, both in human and veterinary medicine. It can also be complementary to other imaging modalities such as CT, ultrasonography and radiography.
The major application of MRI in veterinary medicine is in the field of neurology. This is because of the ability of MRI to “see through” bone, and image the soft tissue within. Conventional radiography and ultrasonography are both extremely limited in visualising the central nervous system. However, MRI and to some extent CT are the imaging modalities of choice for this area. Neurology is not the only field to benefit from MRI technology. For example, Ophthalmologists find it important to assess the retrobulbar space. Delineation of soft tissue masses elsewhere in the body can be important for oncologic surgical planning, and there are a number of internal medicine and orthopaedic uses.
We offer a second opinion referral service for internal medicine cases. Internal medicine is a wide ranging discipline which often involves investigating many of the body's systems. We see a very diverse range of conditions from endocrine problems such as diabetes mellitus, infectious diseases, liver disease and haematological cases to gastrointestinal disorders like inflammatory bowel disease. We have a wide range of diagnostics available to thoroughly investigate these cases including CT, magnetic resonance imaging (MRI), video endoscopy and Doppler colour flow ultrasonography. These will complement modalities such as X-ray and blood testing which are commonly available in most veterinary practices today.
Soft Tissue Surgery
Soft Tissue surgery involves the non-bony tissues of the body; this includes thoracic surgery, gastro-intestinal surgery, surgical oncology, urinary tract surgery and ear, nose and throat (ENT) surgery. Although some soft tissue cases are dealt with in general practice, other cases require more expertise and experience to perform safely and effectively. These include procedures to treat urinary incontinence (e.g. colposuspension), intra-thoracic surgery and removal of tumours which are in difficult areas to operate on or have recurred following an initial surgery. We currently have one advanced practitioner Soft Tissue Surgeon - Samantha Lane. Sam also performs many procedures under key hole surgery to reduce the post-operative discomfort associated with an open surgery.
Neurology involves the diseases of the nervous system, such as spinal disease and epilepsy. Our medical team see a wide range of neurological cases and our head surgeon Jon Shippam is experienced at spinal surgery to treat acute disc disease. We are lucky to be the only private practice in the south west that has permanent MRI and CT facilities on site, which are vital in the investigation of many neurological diseases.
Orthopaedics includes the investigation and treatment of conditions affecting the limbs and spine. Many orthopaedic conditions present as lameness, and investigations typically include gait assessment, physical examination and imaging such as radiography or computed tomography (CT). For spinal conditions we often use magnetic resonance imaging (MRI). For joint conditions arthroscopy (keyhole joint surgery) can provide additional information about the state of the cartilage as well allowing treatment of cartilage lesions or to remove bony fragments. We treat most fractures using the LCP (Locking Compression Plate) system which is a versatile method of internal fixation. External skeletal fixation (ESF) or hybrid fixation is used in selected cases such as for open contaminated fractures. We frequently perform the tibial tuberosity transposition (TTA) for treating cruciate ligament deficiency, but also perform extra-capsular stabilisation in selected cases such as for the smaller patients. We offer limb alignment measurement using CT to allow accurate surgical planning to treat the deformities that cause patellar luxation. The tailored plan may involve a corrective osteotomy of the femur or tibia, or tibial tuberosity transposition. Spinal cord compression commonly caused as a consequence of intervertebral disc degeneration is treated via a hemilaminectomy to relieve compression and remove extruded disc material.
Many new treatments have become available in the UK to treat cancerous conditions and where we find this underlying cause we can advise you on the best treatment options that are available. These commonly include surgery, chemotherapy and radiotherapy. You can employ any or a combination of these treatments depending on the type of tumour found, extent of spread at diagnosis as well as the potential side effects of the treatment and other complicating factors such as co-existing conditions. We can offer some of these treatments in house and regularly see animals back on a 'day case' basis for chemotherapy.
Bath Veterinary Referrals frequently examine and treat eyes with many different problems including lid problems and corneal problems. We also see many problems within the eye such as blindness, retinal problems, uveitis, hyphaema and glaucoma. These problems often have causes beyond the eye, and our team of medics and surgeons, along with our large variety of diagnostic equipment, allows us to treat not just the eye problem, but also to often get to the bottom of, and manage the underlying cause.
Laparoscopic surgery or keyhole surgery is a minimally invasive technique which can be used to perform surgeries through very small incisions in the body wall. We are able to do some procedures entirely using this technique, in other cases we can use the laparoscope to assist with the procedure.
We use this technique in particular for:
- Neutering - laparoscopic ovariectomy (spay) and retained testicle (cryptorchid) removal
- Laparoscopic assisted gastropexy
- Laparoscopic liver biopsies and bile aspiration
- Laparoscopic assisted gut biopsies
- Laparoscopic assisted pancreatic biopsy
- Laparoscopic assisted cystotomy
- Thoracoscopic procedures
Our surgeons Samantha Lane, Jon Shippam and Edward Corfield perform these procedures at Bath Vet Referrals.