Advanced Vet Surgery

27/01/2024

Treatment of a patient with a CCL (cranial cruciate ligament) tear and a long standing MPL (medial patella luxation). This required moving the articulating surface of the tibia medial relative to the tibial tuberosity (the point where the patella tendon attaches on the front of the shin bone) to treat the MPL, at the same time as performing a TPLO to treat the CCL tear. When the tibia is cut and moved a plate is used to hd the plate in position whilst it heals. In this case the plate requires extra bending to fit the bone surfaces.

30/11/2023

I listened to 10 hours 11 minutes of music on 25th May, which translates to over 5 hours driving and 5 hours operating. Long day 😴

23/07/2023

Vulvoplasty performed to remove excessive skin folding over the v***a causing severe ulcerative dermatitis and hyperplasia.
An ellipse of skin was excised surrounding the v***a and the skin sutured in place, which allows air to access the v***a rather than having the warm, urine soaked skin which is perfect for bacterial infection.

13/06/2023

A cranial cruciate ligament tear and chronic medial patella luxation corrected using a modified TPLO (tibial plateau levelling osteotomy). The proximal portion of the tibia is translated medially, which lateralises the tibial tuberosity and patella tendon insertion. Here the tibia was medialised 5mm to improve patella tracking. This requires the plate to be heavily contoured to fit the new plateau with angling the screws proximally up into the joint.

28/05/2023

Nephrectomy (kidney removal) performed following investigation of weight loss and inappetance and abdominal ultrasound, which revealed a soft tissue mass of the left kidney. No other abnormalities or secondary masses were detected. I'm guessing sarcoma, but carcinoma is also possible. Histopathology will tell us in a few days, I'm hoping it is good 🤞

23/03/2023

Reconstruction of a cleft palate (both hard and soft palates) in an 8 month old patient who was having severe recurrent rhinitis (inflammation of the nasal passage) due to food impaction and infection.
Reconstruction involved a bipedicle flap to fill the hard palate defect, and primary 2 layer repair of the soft palate.

21/03/2023

Great to be back attending international conferences with presentations by some of the leading veterinary orthopaedic gurus of the profession.

01/09/2022

A client baked me a cookie for operating on her dogs knee 🍪. Absolutely made my day 😁

25/03/2022

Ununited Anconeal Process (UAP) excision.
UAP is a developmental condition where a portion of bone at the back of the elbow joint fails to fuse in position as the young dog grows, and is most commonlyseen in larger breed dogs. The failure to fuse means the bone can become dislodged and be painful in the elbow causing lameness.
Surgery either involves reattachment using a screw or removal, depending on the age of the patient. In this case removal was opted for.

11/03/2022

😔

“Pets, it turns out, also have last wishes before they die, but only known by veterinarians who put old and sick animals to sleep. Twitter user Jesse Dietrich asked a vet what was the most difficult part of his job.

The specialist answered without hesitation that it was the hardest for him to see how old or sick animals look for their owners with the eyes of their owners before going to sleep. The fact is that 90 % of owners don't want to be in a room with a dying animal. People leave so that they don't see their pet leave. But they don't realize that it's in these last moments of life that their pet needs them most.

Veterinarians ask the owners to be close to the animals until the very end. ′′It's inevitable that they die before you. Don't forget that you were the center of their life. Maybe they were just a part of you. But they are also your family. No matter how hard it is, don't leave them.

Dont let them die in a room with a stranger in a place they dont like. It is very painful for veterinarians to see how pets cannot find their owner during the last minutes of their life. They dont understand why the owner left them. After all, they needed their owner’s consolation.

Veterinarians do everything possible to ensure that animals are not so scared, but they are completely strangers to them. Don't be a coward because it's too painful for you. Think about the pet. Endure this pain for the sake of their sake. Be with them until the end.”

- Tricia Mo’orea

Photo credit: Travis Patenaude.

19/02/2022

Medial patella luxation, where the knee cap dislocates to the inside of the knee, secondary to a non-existent trochlear groove (groove where the knee cap sits). Correction in this case required creation of a new groove (block recession trochleoplasty) to allow the knee cap (patella) to sit in the middle of the knee.

29/01/2022

So the results are finalised...
The most popular names of patients I operated on this year are 🥁🥁🥁

Bella 11 🏆🏅🎉
Molly 10
Bonnie 9
Lilly 8
Charlie 7
Lucy 7
Nala 7
Rosie 7

Interestingly, the most commonly used names were all girls names.

Happy new year and best wishes 😊

04/11/2021

Life is complicated and sometimes so is surgery and recovery.
A TWO performed 2 weeks prior, patient escaped and ran chasing another dog, caused an avulsion fracture of the tibial tuberosity which required reduction and fixation using a 1.25mm diameter pin and 0.8mm thick wire. Luckily the plate and screws were all stable.

31/10/2021

Another tumour resection, this time a soft tissue sarcoma over the triceps muscle. The mass was excised with 2cm lateral margins and a deep margin of the fascia of the underlying triceps mm..
The wound defect was able to be closed by undermining the subcutaneous tissues around the margins and bringing the edges together in 2 layers, the subcutaneous tissues and skin sutures.
** I always use interrupted suture patterns for wound reconstruction, in case a part of the wound healing fails, to prevent the entire wound opening.

24/10/2021

Palliative (relieving pain without dealing with the cause of the condition) surgery to excise a necrotic soft tissue sarcoma on the chest of patient. The picture doesn't do the smell justice 🤢🤮 Unfortunately there were multiple masses surrounding this mass. Thoracic radiographs (chest xrays) did not show any metastatic (secondary) tumours.
Options include;
1 Wide, curative intent surgery would have involved resection of the caudal sternum thoracic wall and was declined. This may have afforded a local cure, but there were many other masses suggesting a more widespread disease.
2 Marginal resection (excision of the mass with minimal margins) was elected with the expectation that microscopic tumour would be left behind and have the potential to regrow.
3 Marginal excision followed by radiation therapy to kill microscopic tumour left behind.

19/10/2021

My spirit animal.... I'd kill for hair like that 😄

05/10/2021

Update on the axillary skin fold flap following excision of an intramuscular mast cell tumour. A picture from the owner a couple of days before suture removal. The tumour was excised with good margins.

21/09/2021

An interesting tumour removal for this week. An intramuscular mast cell tumour, within the triceps muscle. MCT are normally found just beneath the skin, but this one was located within the lateral head of the triceps brachii muscle. Excision required removal of the portion of muscle containing the tumour, and reconstruction using an axillary skin fold (armpit skin fold) flap to fill the wound defect.
Investigation of spread of the tumour to the lungs, liver or spleen, and local lymph nodes were negative. Pathology and grading of aggressiveness of the tumour will be performed on the excised tissue.

01/04/2021

Some interesting facts about our profession and why we do it because we love it and not much else.

Dr Kate works at our Coomera practice and is a new graduate. 👩‍🎓 Did you know that a Bachelor of Veterinary Science takes 5-6 years of full time study to achieve? It also has an entry score of OP1 or ATAR 98.85 and the degree can take 20 years to pay off. 😳

The award wage for a new graduate veterinarian is $26.32 per hour or $53,000. The award for an experienced senior veterinarian with more than 10 years experience earns $37.93 per hour or $75,000.

Sadly, our vets are told ‘You’re just in it for the money’ almost every single day, so I feel it necessary to educate the public on how much they actually earn in the hope this statement will not be said again. 😕

These high achievers are paid very poorly for the level of skill & education required and the stress they are under daily. They are truly in the job as they have a calling to help animals and deserve to be treated with respect & kindness. 🐶💕🙏🏼

One of the reasons the industry is suffering from a severe veterinary shortage is the high drop out rate. Vets are leaving the industry in droves and studies have shown the main reason for them leaving is not the poor pay & working conditions but the abuse and emotional blackmail from clients. This has to stop before there are no vets left. The Veterinary industry is in danger of collapse! 🛑✋

There are currently over 130 positions vacant for veterinarians between the Sunshine Coast & Gold Coast. The average time it takes to find a new vet in Australia is 6months and many of these jobs won’t get filled at all. Practice Owners are also selling up because they can’t get help & are burnt out. 😪Corporate ownership of veterinary practices on the Gold Coast is now nearing 60%. The family vet is becoming extinct so please choose a family owned vet wherever possible. 🙏🏼

Despite the terrible position the industry is in, I again want to say ‘Thank you’ to our clients who bring joy to the faces of our vets and nurses daily and treat them with kindness. You really make a difference to our day and we love it when you visit!! 🤗🙏🏼🥰

To those who want to say ‘You’re just in it for the money’ or ‘If you cared you’d do this free’, I hope after reading this post you never want to say that again. These statements are literally killing vets and are so far from the truth it’s not funny.

We’re working really hard to ensure our vets love their job because there are not many left and a world without vets is a very scary place. 😔

Please be kind to vets, they’re a dying breed. 👩‍⚕️ 🐾

https://www.google.com/amp/s/amp.abc.net.au/article/13131676

https://www.sbs.com.au/news/insight/overwhelming-response-to-insight-s-episode-on-veterinarian-crisis-i-had-no-idea-this-happened

12/02/2021

I suspect this will be a very interesting and eye opening read for many.

We are very excited to announce that the “brachy book” is ready for pre-order!

This book will equip veterinary professionals, animal welfare scientists, breeders and owners with up-to-date information about brachycephalic health and welfare. Cutting-edge knowledge is shared across a range of disciplines including respiratory disease, ophthalmology, dermatology, dentistry, neurology, obesity, reproduction and anaesthesia.

Three leading researchers from the Cambridge BOAS Research Group, Dr Jane Ladlow, Dr Nai-Chieh Liu, and Dr David Sargan, contributed to two of the chapters entitled “Brachycephalic Obstructive Airway Syndrome (BOAS) – clinical assessment and decision making” and “The genetics of brachycephaly, population genetics and current health testing for brachycephalic breeds”. These chapters summarize the work carried out during the past 10 years at Cambridge and the relevant studies.

Check out the book via the following link:

https://www.routledge.com/Health-and-Welfare-of-Brachycephalic-Flat-faced-Companion-Animals-A-Complete/Packer-ONeill/p/book/9780367207243?fbclid=IwAR2Z2AhWFHjtM-_is1nxFoZQhKkBCbRTHgxv7_Rv3b5OUeXHIv_ZMUmCwIE

Apply the code FLY21 to get 20% off when placing an order!

09/01/2021

02/01/2021

Perineal Hernia (hernia of the abdominal organs past the a**s and pelvic floor) repair using an Internal Obturator Transposition Flap.
Images show the flap being elevated into position to reconstruct the pelvic floor and close the hernia.

09/12/2020

I met this little baby ringtail possum, lost his mum and waiting to go to a wildlife carer for release.

06/12/2020

A rostral hemimandibulectomy (lower jaw excision) to remove a locally invasive benign tumour (Acanthomatous ameloblastoma). Surgery involved removing 3 incisor teeth, the large canine tooth and the supporting mandibular bone.

12/11/2020

Repair of an oronasal fistulas (hole connecting the mouth with the nasal passages) which was allowing food and water to pass directly from the mouth into the nose causing recurring nasal infections. The oronasal fistula were a result of multiple teeth extractions due to severe rotten teeth and infection, which did not heal over after removal.

16/10/2020

Useful information for owners of short-nosed breeds who have had airway surgery.

Why is my dog not ‘cured’ by BOAS surgery?

Surgery cannot cure BOAS but instead aims to alleviate the symptoms and reduce the likelihood of further deterioration.

BOAS is a complicated syndrome resulting from multiple abnormalities within the upper and lower airways. Some of these abnormalities can be improved with surgery (e.g. narrow nostrils, overly long soft palate) but others are either impossible or very difficult to treat (e.g. hypoplastic trachea, oversized tongue and thick soft palate). Some dogs also have other abnormalities of skull structure, making their symptoms worse and less likely to improve with conventional surgical techniques.

For all patients with BOAS, long term lifestyle modifications are essential to minimize the impact of airway compromise even after surgery is performed. The most common symptoms that persist in spite of surgery are snoring and heat intolerance. To reduce the impact of this we advise the following:

- Always make sure your dog is kept cool and has access to water whenever possible.

- Keep your dog slim with both diet and exercise modifications;
Do not over exercise your dog – stop him/her when you notice her/his breathing has become heavier.

- Monitor for any worsening of breathing signs (e.g. increased breathing noise; sleep apnoea; frequent regurgitation; decreased exercise tolerance) and contact your vet if you are concerned.

Prevention is always better than treatment – however it is not easy to reverse the effects of many generations of selective breeding. We strongly recommend that breeders take responsibility for health testing dogs involved in breeding programmes and that dog owners research the potential diseases within each breed. For dogs with BOAS a combination of surgery and lifestyle modifications are likely to be required to effectively manage their symptoms long-term.

22/09/2020

A quick update on the skin flap surgery performed a few weeks. There was a small breakdown of the end of the skin flap where we expected, but this has healed without intervention. The body is an amazing thing.

02/09/2020

A small hemimaxillectomy to excise a previously biopsied benign oral tumour (ossifying fibromatous epulis) which arises from the periodontal ligament. Usually they can be excised superficially with an excellent outcome, but given the firm adherence to the portion of upper jaw (maxilla) and the premolar teeth 2 and 3, a hemimaxillectomy including PM 2 and 3 was performed with narrow margins to achieve curative excision.
If this was a malignant or more invasive mass a much larger portion of jaw excision would be required.

27/08/2020

😊

18/08/2020

Surgical excision and reconstruction of a malignant round cell tumour on the pelvic limb (hind leg) of a Labrador.
Surgery involved wide excision of the mass, with 2cm lateral margins and a deep margin including the underlying fascia (muscle sheath).
The wound was closed using a subdermal plexus inguinal skin fold flap.