The soft tissue surgery service offers a comprehensive referral service for all surgical conditions. We are able to accept referrals in all aspects of soft tissue surgery from routine cases such as TECA to complex thoracic and reconstructive surgery. As well as directly offering referrals the soft tissue surgery service plays a pivotal role in the management of many cases referred to the medicine and oncology services. With our extensive facilities and 24 hour qualified nursing we are able to provide the essential critical care required for complex soft tissue referrals. The service is provided by Terry Emmerson and Benito de la Puerta.

The service accepts referrals in all aspects of surgery including

• ENT surgery including BOAS, laryngeal paralysis, ear surgeries, tracheal collapse
• Thoracic surgery including thoracic tumours, pericardectomy, chylothorax
• Hepatic surgery including portosystemic shunts, hepatic lobectomy
• Urogential surgery including prostatic surgery, incontinence surgery, nephrectomy, ectopic ureter surgery
• Gastrointestinal surgery
• Adrenalectomy
• Reconstructive surgery including axial pattern flaps and free skin grafts
• Oncological surgery including mandiblectomy, maxillectomy, mast cell tumour and sarcoma removal.

The orthopaedic service offers a comphrehensive referral service in all aspects of orthopaedics. Onsite advanced imaging and arthroscopy allows for advanced investigation of orthopaedic conditions whilst extensive surgical instrumentation allows us to perform surgery for all orthopaedic conditions. The orthopaedic surgery service is run by Terry Emmerson and Benito de la Puerta.

The service accepts referrals in all aspects of orthopaedic surgery including

• Fracture fixation including complex and simple fractures
• Cruciate disease including TPLO and extracapsular repair
• Arthroscopy
• Investigation and treatment of elbow dysplasia
• Lameness investigation in adults and juvenilles
• Treatment of growth deformities including distraction osteogenesis
• Management of osteoarthritis
• Treatment of musculo skeletal neoplasia
• Arthrodesis of chronically painful joints

The internal medicine service provides a comprehensive referral service in all aspects of internal medicine. Our state of the art diagnostic facilities including on site CT scanning, ultrasound, digital radiography, full range of rigid and flexible endoscopes, extensive in house laboratory and our intensive 24/7 nursing mean we are able to provide one of the most advanced internal medicine referral services in the UK. Due to the complex nature of many internal medicine cases the service liaisies closely with specialists in all other disciplines available at NDSR. The service is provided by Myra Forster-van Hijfte, Christine Hall and David Walker.

The service accepts referrals in all aspects of internal medicine including

• Respiratory medicine including investigation of nasal discharge, cough, dysponea and exercise intolerance
• Gastroenterology including investigation of chronic vomiting and diarrhoea
• Hepatic disorders including hepatitis and portosystemic shunts
• Endocrinology
• Urinary tract disease
• Infectious diseases
• Haemolymphatic diseases including anaemia and thrombocytopenia
• Immune mediated diseases
• Feline medicine
• Pyrexia of unknown origin

The neurology / neurosurgery service offers a comprehensive referral service for all medical and surgical neurological conditions. Our excellent facilities including on site advanced imaging, electrophysiology, operating microscopy and extensive neurosurgical equipment allow us to provide one of the most advanced neurology referral services in the UK. The service is provided by Rodolfo Cappello. and Ane Uriarte.

The service accepts referrals in all aspects of neurology and neurosurgery including

• Epilepsy including cases refractory to treatment
• Spinal cord diseases including disc disease, wobblers, tumours, malformation and trauma.
• Brain tumours including diagnosis, surgical and medical management
• Infectious and inflammatory CNS diseases
• Neuromuscular diseases
• Peripheral neuropathies
• Movement disorders

The cardiology service provides a comprehensive referral service for all suspected cardiovascular problems. We are one of only a small number of centres in the UK able to offer interventional cardiology procedures such as pacemaker placement and balloon valve dilation. Our extensive facilities including colour flow Doppler ultrasound, holter monitoring, high dependency 24/7 nursing and an interventional cardiology suite allow us to provide one of the most advanced cardiology referral services in the UK. The service is provided by Nuala Summerfield. and Joao Loureiro

The service accepts referrals in all aspects of cardiology including

• Assessment and treatment of congenital heart disease, acquired valvular heart disease and cardiomyopathies
• Assessment of asymptomatic heart murmurs
• Interventional cardiac surgery including PDA occlusion, pacemaker placement and balloon dilation of valvular stenosis.
• Treatment of pericardial disease
• Investigation of exercise intolerant and collapsing patients
• Surgical management of PDA, pericardial disease and certain cardiac tumours
• Assessment and treatment of arrhythmias including 24 hour Holter ECG monitoring
• Treatment of congestive heart failure including emergency management of acute failure
• Management of cardiac failure refractory to routine medications
• Treatment of feline aortic thromboembolism
• Examination for breed club heart testing schemes
• Thoracic radiograph and ECG reporting service

The dermatology service provides a comprehensive referral service for all aspects of dermatology. It diagnoses and manages a wide range of dermatological presentations. The dermatology service benefits from close liason with the oncology and internal medicine services to address potential underlying causes of more complex dermatology cases. Access to specialists in soft tissue surgery allows for the surgical management of appropriate cases. The dermatology service is provided by Inge Geens.

The service accepts referrals in all aspects of dermatology including

• Atopy including intradermal skin testing
• Endocrinopathies
• Recurrent or unresponsive pyoderma
• Recurrent otitis externa
• Parasitic skin disease
• Skin neoplasia
• Immune mediated skin disease
• Undiagnosed puritis and hair loss
• Undiagnosed skin lesions

The oncology service accepts referrals in all aspects of oncology. As well as referrals for diagnosis and management of cancer many owners are referred so owners can better understand their pet's illness and discuss options and prognosis. Oncology is a truly multidiscipline speciality and the service has close interaction with the soft tissue surgery and diagnostic imaging services to provide the best treatment for its patients. In addition to conventional therapies the oncology service is involved in clinical trials to bring the most recent medical advances to our patients. The service is provided by Gerry Polton.

The service accepts referrals of all aspects of oncology and any type of tumour including

• Diagnosis of suspected neoplasia
• Clinical stage determination
• Counselling on therapeutic options and prognosis
• Chemotherapy including novel agents and protocols
• Surgical oncology (provided by soft tissue service)
• Radiation planning and management
• Clinical trial and 'designer drug' therapies

The ophthalmology service accepts referrals in all aspects of medical and surgical ophthalmology. Common indications for referral include loss of vision, ocular pain, ocular discharge and change in appearance of the eye. Highly specialised equipment is available for examination of the eye including slit lamp biomicroscopy, indirect ophthalmoscopy, tonometry and gonioscopy. Our surgical facilities are equipped with a Zeiss operating microscope, a phacoemulsificaion machine, cryotherapy and extensive microsurgical instrumentation. Availability of an onsite CT scanner, mobile MRI, ocular ultrasound and electroretinography allow us to provide a state of the art referral service. The ophthalmology service is run by Elaine Holt and Debra Agapito both of whom are experienced microsurgeons who routinely perform complex intraoccular procedures and corneal grafting procedures.

The service accepts referrals in all aspects of medical and surgical ocular disease including

• Cataract surgery and intraocular lens implantation
• Lens luxation and instability
• Recurrent conjunctival disease
• Nasolacrimal diseases
• Reconstructive eyelid surgery including ectropian, entropian and neoplasia
• Corneal diseases including ulcerative disease, perforation and foreign bodies
• Refractory 'Dry eye'- KCS
• Uveitis
• 'Cherry eye'
• Glaucoma
• Inherited and acquired retinal disease
• Orbital diseases including orbital tumours

The diagnostic imaging service provides imaging support for all the other disciplines at NDSR. Advanced imaging is essential for the management of the majority of referred patients resulting in close interaction between diagnostic imaging and the other services. In addition to this role the diagnostic imaging service provides an out patient ultrasound clinic and a radiograph reporting service for referring veterinary surgeons.

We have extensive imaging facilities allowing us to offer all the major advanced imaging modalities. Facilities available include onsite CT scanning, colour Doppler ultrasound, fluoroscopy and digital radiography and a once/twice weekly MRI service using a mobile MRI unit.

The imaging service is provided by Anna Groth.