Hollybank Encouraging Others; Nurseries to Careers Talks

Hollybank have started the New Year trying to educate others about the veterinary profession.

We confess, some of this has just been playing with our resident guinea pigs, Marmite and Marmalade but the children at Little Weaver nursery loved meeting them and it’s lovely being able to encourage children at an early age to be confident and gentle around animals. 

We have always taken part in school talks and nursery visits but this year we have also attended the Weaverham High School Careers Fair.

Year nine pupils had the opportunity to meet lots of different professionals learning about different careers, what they entailed, the good and the bad, and how to get into that potential career. Two of our vets and two of our nurses attended and we told students about our own personal career paths. 

 

It was a great event for the students and we hope they found it useful. We enjoyed meeting them and thinking that one day some of them may be future veterinarians and veterinary nurses. We wish them all the best of luck!

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Laboratory Updates at Hollybank!

In the last few months Hollybank have been lucky enough to have an upgrade in some of our laboratory equipment. The huge advantage this brings Is the ability to offer the most accurate and quick in-house results for our patients. 

Blood Machines: we have recently invested in a brand new haematology machine. This is what we use to measure the levels of red blood cells, white blood cells and platelets. It provides results as reliable to those from an external lab and  it requires a smaller blood sample which can make things easier for our nervous or more wriggly patients. 

 

 

Urinalysis Machines: commonly a ‘dipstick’ test is carried out which gives an overview of important features in the urine. This includes the presence of red blood cells, white blood cells, protein and glucose. Generally, the result of this test is based on colour change and interpreted visually by a member of staff. The interpretation therefore can be subjective. We now have a specific machine which interprets these results which creates consistency across the board.  An innovative machine has been developed to run alongside this information; it screens a sample of urine and takes pictures of all the components within it, for example urinary crystals. The physical images of these cells are available alongside the dipstick result giving us a complete set of information to evaluate.

Image of cells in urine

Urine Culture Facilities: When we are suspicious of a urine infection it is beneficial to prove its presence and then determine which antibiotic in particular it is sensitive to. This allows appropriate and accurate use of antibiotics which in turn allows the fastest and most effective treatment for your pet. Previously we have had to send these to an external lab. This has a number of limitations; it can take time for a result and some bacteria may grow during the transit time increasing the potential for miscellaneous results.  We now have an incubator and special urine culture plates to provide this facility in-house. It means that the urine is put directly onto the plate increasing the reliability of the bacteria grown and yielding these results within 24 hours. 

 

 

 

 

 

Microscope: Having access to a microscope allows us to evaluate samples from lumps, bumps and bodily fluids. By looking down the microscope we are able to identify cells that are associated with inflammation, infection and cancers. This information helps us to decide with what we may be dealing with and whether it is prudent for an expert to also examine the slides. There is huge variation in the types of cells however so the large display screen allows multiple people to see the same image at one time. This helps interpretation but can also aid learning and development 

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Brave Pet of the Month….Lemmy!

Our brave pet this month is Lemmy, a loyal and loving Cocker  Spaniel who is owned by one of our receptionists, Jane. Lemmy began suffering with lameness in November 2016. Jane had noticed he was starting to slow down on his walks, seemed lame in the evening and occasionally hopped on his right forelimb.

Lemmy was examined and found to be painful in both of his elbows; the right was noted to be worse which correlated with his signs at home. At Lemmy’s age and with the presentation of signs it was likely Lemmy was starting to show signs of osteoarthritis (OA).  This can be secondary to an underlying conformational or developmental issue, for example, elbow dysplasia or can be due to normal wear and tear, often described as degenerative joint disease. He was started on non-steroidal-anti-inflammatories (NSAIDs) which are the preferred drug in the management of OA.

There was a noticeable improvement in his demeanour and level of activity on this medication but over the next few months the lameness in his right forelimb kept recurring and this was usually associated with off lead exercise. Given that OA is a progressive condition it might have just been Lemmy needed more pain relief and management however without imaging the joints we could not rule out there wasn’t a more significant underlying cause or something that could be done surgically. The preferred imaging modality for elbows is CT therefore we referred him to Liverpool Small Animal Teaching Hospital for further investigations

Lemmy’s CT scan showed he had medial coronoid disease in both of his elbows with severe secondary osteoarthritis. Medial Coronoid disease is a a form of abnormal joint development and is encompassed in the term ‘elbow dysplasia’.

There was the option to remove the abnormal cartilage via a minimally invasive key-hole technique. However, due to the level of osteoarthritis already in the joint it was very unlikely that removal of this cartilage would automatically fix Lemmy’s condition. We would still need to manage the secondary OA. Option two therefore was to continue with supportive medical management but at least doing so with the confidence that we are doing the right thing.

The medical management of OA is multi-modal and Jane has worked really hard with Lemmy to encompass them all in his care. 

  1. Pain relief. NSAID’s are the starting drug of choice but as OA progresses it is inevitable that additional pain relief is needed and we have a number of different options for dogs.
  2. Exercise moderation. Strict rest can be initially needed to allow inflammation in the joint to settle. Gradual re-introduction of exercise is the next step and then moderating our pets level and frequency of activity ongoing. Unfortunately, our pets lack any self-preservation and many animals will be able to exercise and do so willingly even though underlying this they are painful. It is therefore up to us to manage what they do. Little and often is better than long walks and limiting high impact exercise like chasing a ball.
  3. Weight management. Keeping your pet lean will reduce the load on your pets joints. Strict feeding and even special diets can be employed.
  4. Joint supplements. A combination of omega 3 and 6 fatty acids, Glucosamine and Chondroitin, green lipped mussel extract and more can help provide important components your pet’s joint needs to repair itself.
  5. Hydrotherapy/Physiotherapy. Hydrotherapy can be helpful to encourage weight loss in a low impact way. Both modalities act to improve the range of motion in a joint and to maintain muscle mass.

 

Despite all of the above, Lemmy was still having good days and bad days. In some dogs an injection of steroid directly into the joint space can help reduce inflammation therefore  inflammation associated pain . We have had very successful experiences with this, however it is not always effective for all patients and it is not always long lasting. 

Stem cell therapy has now become available within veterinary medicine. Stem cells are naive cells which develop according to the environment they are placed in. This can be employed in the management of OA by injecting stem cells into a joint to help repair and replace damaged tissues. Fatty tissue and blood has to be collected from the individual in order to harvest and reproduce the stem cells and this requires a general anaesthetic. Once the injections are ready they are then injected into the joint space whilst under sedation. 

Lemmy had his stem cell therapy injection into his right elbow in October . Four weeks down the line he was doing remarkably well. He was still on some pain relief which is to be expected but he was already coping with far more exercise than he had in a long time. With such a promising response Lemmy is now having a stem cell therapy injection in his left elbow in the new year! 

Lemmy is such a well mannered and beautiful boy, we are so pleased he is feeling comfier and able to enjoy the things he loves to do. All thanks to his wonderful owner Jane who’s dedication and time has paid off.

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