Page 7 - Clinical Connections - Summer 2023
P. 7

Exotics
        EXOTICS RADIOSURGERY

        Jo Hedley, Head of the Exotics Service, and Vicki Baldrey, Lecturer in Exotic Species and Small Mammal
        Medicine and Surgery


             he acquisition of a radiosurgical unit   with a complex blood supply. The surgical   forceps and suture material makes surgery
             and  surgical  magnification  loupes   loupes allowed us to clearly visualise the   faster  and  more  efficient,  which  has  an
        Tby  the  Exotics  Service  has  greatly   ovary and surrounding anatomy.  And the   impact on procedure outcomes.
        expanded the depth and breadth of care   radiosurgery allowed the abnormal tissue   The  enhanced  capacity  allows  us to
        that can be delivered, including intricate   to be removed with minimal blood loss, in a   inspire the next generation of veterinarians
        procedures for the most delicate patients.  way that would not have been possible with   in  our  undergraduate  and  postgraduate
          The equipment has proven invaluable   a conventional surgical approach.   programmes.  The ability to perform more
        in cases where patient size has made                                    complex procedures on these and other
        visualisation  of  anatomical  structures                               small exotic animal species is essential
        challenging and accurate haemostasis                                    as we continue to develop both our
        essential. Both were acquired with the                                  European College of Zoological Medicine
        support  of  the  Animal  Care  Trust,  the                             (ECZM)  Herpetology  residency  and  our
        registered charity of the RVC.                                          Exotic Animal internship programmes.
          Since  their  arrival  last  year,  both  the                          The surgical loupes have been used
        radiosurgical unit and the surgical loupes                              in  novel  case  presentations,  to  assist  our
        have been used regularly. This has enabled                              visualisation and understanding of unusual
        the team to not only enhance patient safety                             anatomy during a surgical procedure.
        in routine procedures, such as neutering,                               For example, in the case presentation of
        but  also  to  perform  surgical  interventions                         the guinea pig with a persistent urachal
        previously deemed too risky, especially for                             remnant, as  featured in spring’s issue of
        smaller patients.                                                       Clinical Connections.
          Previously  surgeons  relied  on  clamping                             Being able to visualise anatomical
        vessels  with  forceps  and  then  tying  off                           landmarks  to  a  finer  level  of  detail  is
        with suture  material to control bleeding.                              also helpful when collaborating with our
        Radiosurgery makes this process much                                    diagnostic imaging colleagues. It allows us
        more  efficient  for  small  vessels,  using  a                         to report back what was found at surgery
        bipolar handpiece. A monopolar handpiece                                and  how  that  relates  to  their  findings  on
        allows  clinicians  to  control  milder                                 imaging.
        haemorrhage from tiny vessels in fat, for
        example,  which  improves  surgical  field                              The team
        visualisation.                                                          The RVC Exotics Service is led by Dr Joanna
                                                                                Hedley, an RCVS Recognised Specialist in
        Case examples                                                           Zoo  and  Wildlife  Medicine  and  European
        Examples  of  use  in  very  small  patients                            Boarded Specialist in Reptile Medicine.
        include ovariectomy for treatment of   The hissing cockroach case        She is supported by RCVS Recognised
        follicular stasis in a 61-gram leopard gecko                            Specialist  in  Zoo  and  Wildlife  Medicine
        and surgical replacement of a prolapse in a   The  cockroach  anatomy  was  similarly   (Avian subspecialty) Vicki Baldrey, RCVS
        5-gram hissing cockroach.           tiny, and the loupes allowed us to identify the   Advanced  Practitioner  in  Zoo  and  Wildlife
          The leopard gecko had an ovarian cyst   tissues involved in the prolapse. This would   Medicine Nadene Stapleton, Staff clinician
                                            simply not have been possible without them.   Jack MacHale, who completed the RVC
                                              We  also  regularly  use  radiosurgery  in   ECZM Herpetology residency in 2021, our
                                            larger patients, such as rabbits, to enable   current  ECZM  Herpetology  resident  Jess
                                            control of bleeding to maximise visualisation   Hornby  and  two  Exotic  Animal  Veterinary
                                            of  the  surgical  field.  Examples  include   interns: Lucy Robson and Tom Bunn.
                                            nephrectomy  in  a  rabbit  with  a  kidney   The  team  also  comprises  six  Exotic
                                            tumour and amputation of the leg of a parrot   Animal  veterinary  nurses:  Abi  Edis,  Molly
                                            following irreparable damage caused by a   Rogerson, Hayley  Ayers, Steph Isaacs,
                                            cat attack.                         Sema Assi-Yamagata and Aneesa Malik.

                                            Efficiency, safety and sharing advances
                                            Both  pieces  of  equipment  have  widened
                                            our  surgical  and  procedural  repertoire,
                                            while enhancing patient safety. The ability to     For the RVC Exotics and Small Mammals
         The leopard gecko                  control bleeding without the need for large   Service, please call: 020 7554 3528
                                                                                       Email:
                                                                                     londonreferrals@rvc.ac.uk

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