
Tip of the Month - June
7 June 2019
Neurology
Vestibular disease
Clinical signs for Vestibular Syndrome can include a head tilt, wide base stance, vestibular ataxia, rolling or leaning to one side, pathological nystagmus (either spontaneous or positional), reduced oculocephalic reflex and strabismus...
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Tip of the Month - May
3 May 2019
Oncology
Idiopathic chronic rhinitis in cats
Idiopathic chronic rhinitis can be frustrating to manage, due to its largely unknown aetiology and frequent recurrence of clinical signs. Here are some top tips and thoughts on how to approach these cases...
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Tip of the Month - April
5 April 2019
Oncology
The Coughing Dog
How often do you see an old dog with a cough which just doesn’t seem to respond to antibiotics? It’s not that often, but when you do, there’s a certain sinking feeling when you realise you finally have to take thoracic radiographs and there is a very real chance that a lung mass will be present...
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Tip of the Month - March
1 March 2019
Anaesthesia
Minimising Risk of Anaesthesia in Brachycepalic Dogs
Anaesthesia and airway management in brachycepalic patients can be very challenging and a source of concern to vets and owners...
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Tip of the Month - February
1 February 2019
Neurology
When to refer a dachshund with a suspected thoracolumbar slipped disc?
For dachshunds with sudden onset spinal pain or neurological deficits in the pelvic limbs, the most likely differential is a thoracolumbar intervertebral disc extrusion (slipped disc)...
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Tip of the Month - December
7 December 2018
Internal Medicine
The thyroid and the kidneys: a love-hate relationship!
Hyperthyroidism and chronic kidney disease (CKD) are common conditions in older cats, so it is not terribly surprising that they can occur in the same patient. Hyperthyroidism “artificially” increases renal blood flow and glomerular filtration rate, potentially therefore masking renal insufficiency. Following therapy, when euthyroidism is restored, the true state of the cat’s renal function will be appreciated. Unfortunately predicting the development of azotaemia in this situation is difficult.
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Tip of the Month - November
2 November 2018
Internal Medicine
Interpreting Pancreatic Lipase (PL) Results in Dogs with a Balanced Overview
Acute pancreatitis is a common cause of vomiting, inappetence, lethargy and abdominal pain in dogs, but confidently diagnosing pancreatitis can be a challenge.
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Tip of the Month - October
5 October 2018
Soft Tissue Surgery
Haemoabdomen in Dogs
The most common cause in dogs is acute nontraumatichaemoabdomen secondary to malignantneoplasia causing splenic rupture. Other causesinclude trauma, iatrogenic following surgery(e.g. ovariectomy) or diagnostics (e.g. FNA),coagulopathies or torsion of the liver or spleen.
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Tip of the Month - August
17 August 2018
Internal Medicine
Vaccination on patients on immunosuppressive medications and chemotherapy
Deciding whether to vaccinate an animal on immunosuppressive medication or chemotherapy is challenging. Vaccination in such patients is not sanctioned by vaccine companies, as they have not thoroughly investigated their products in this setting. There is some experimental data to offer guidance in these situations, but this is limited. As both pet owners and vets, we are keen to avoid preventable diseases, but do not want to cause harm by vaccinating animals if it is unsafe to do so. Ultimately the decision to vaccinate any animal on immunsuppressive medication or chemotherapy must be made on an individual basis, by considering their vaccinal history, their current health status and medications, and their current risk factors for exposure to these infectious diseases.

Tip of the Month - June
4 July 2018
Soft Tissue Surgery
Vacuum Assisted Closure
Vacuum assisted closure (VAC) or negative pressure wound therapy (NPWT) is a simple but effective method to promote rapid wound healing. It has been shown to be effective for management of large, complex, acute wounds as well as chronic wounds that have failed to heal by conventional methods. It is also commonly used to stabilise free skin grafts following placement.
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Tip of the Month - May
18 May 2018
Internal Medicine
Liver disease can be associated with specific clinical signs such as jaundice, non-specific clinical signs such as hyporexia, or can be asymptomatic and discovered incidentally when performing biochemistry tests for other reasons. It is important to be aware that liver disease may be primary (inflammatory hepatopathies, copper accumulation etc), or secondary to other pathologies within the portal system (eg reactive hepatopathies commonly seen secondary to gastrointestinal pathology).
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Tip of the Month - April
20 April 2018
Soft Tissue Surgery
Enterotomy and enterectomy are commonly performed procedures in practice due to the frequent occurrence of gastrointestinal foreign bodies. Although these are common procedures, good surgical technique is essential as the consequences of dehiscence are devastating with the development of septic peritonitis.
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Tip of the Month - March
2 March 2018
Internal Medicine
Diagnosing hyperadrenocorticism with confidence
Canine hyperadrenocorticism:
How to not stress about the diagnosis
- Identify other diseases before endocrine testing
- ACTH (Synacthen®) is not necessary to diagnose the condition in many dogs
- UCCR is rarely used to confirm the disease
- Beware the 'unwell' dogs with hyperadrenocorticism

Tip of the Month - February
2 February 2018
Anaesthesia
'Local anaesthesia techniques for ovariohysterectomy'
Female ovariohysterectomy is one of the most common surgical procedures in veterinary practice. It can be extremely painful and although systemic pain medication is routinely included as part of the peri-anaesthetic protocol, some cases still respond to surgical stimulation and may display signs of pain during recovery period...
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RSA Insurance Group – Important Update
9 November 2017
In order to stay committed to excellence and fully support our clients, North Downs Specialist Referrals will now be subsidising the £200 fee that may be charged to our clients by the Royal Sun Alliance (RSA) as part of their preferred provider’s scheme.
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