Behind the scenes – Super vets

There’s nothing we wouldn’t do for our pets and when they’re poorly we want them to have the very best care possible. But who trains the fantastic vets, surgeons and nurses we rely on? We went to find out…

Nestled in the leafy countryside of the Wirral in the north-west of England lie two centres of excellence in diagnosis, treatment, research and innovation when it comes to the health of our beloved pets. Under the umbrella of Liverpool University, the Leahurst Small Animal Teaching Hospital (SATH) and the Philip Leverhulme Equine Hospital make up one of the largest, most modern and well-equipped teaching hospitals for cats, dogs and horses in Europe. Open 24 hours a day, 365 days of the year, the SATH deals with approximately 11,500 appointments a year – that’s 9,000 dogs of 160 different breeds and 2,500 cats of 24 different breeds! Needless to say, there is a veritable army of dedicated, highly skilled and compassionate staff who ensure that each admission is treated with the kindness and care every pet deserves. Next door, the Equine Hospital deals with more than 1,500 admissions a year with a dedicated team of 35 including clinical lecturers and staff, resident vets, interns, nurses and yard staff. As no two days are the same, we captured just a fraction of what went on in a typical day…

Teamwork

As the SATH is a not-for-profit organisation, Sam Kennedy, the senior hospital administrator, has the difficult job of ensuring every penny earned is put back into teaching the students and providing pet owners with the best service possible. But that’s just a fraction of his role. “Above all we are a team here,” he says, “and we all have a role to play to ensure everything goes as smoothly as possible for staff, students and clients. Everyone is passionate about what they do, whether it’s ensuring the hospital is super clean, fully stocked, breaking new ground, staying on top of the admin or caring for someone’s well-loved pet after a big operation. The dedication here is immense. We couldn’t achieve what we do without this attitude.”

Clean queen

Joan Powell has been here since 6am this morning ensuring the battle against bacteria and cross-infection is always won. On the 6am-2pm shift she is responsible for keeping consulting areas clean and ensuring the three theatres are sterile and ready for the day’s operations. “I’ve been here ten years and I still love what I do. I may be wiping down all surfaces, clearing up little accidents or setting up theatre by doing floor prep or wiping down the walls, but everything helps to ensure the patients are looked after in the very best conditions”

 

Patient rounds

In the myriad corridors behind the waiting rooms lie the wards – dogs on the left and cats on the right. Robyn Richards, a patient care veterinary nurse, is responsible for doing the four-hourly checks on all her patients who may have had surgery, a procedure or a treatment. “We check their temperature, breathing and whether they’re eating and drinking normally, while keeping them as quiet as possible to recover,” she explains.

 

Learning curve

Fifth-year veterinary student Beth Griffiths has spent theweek working closely with inpatients, helped by the nurses and clinicians. Work includes preparing food before surgery and following cases right through to post-op. One of her patients is Jasper, a three-year-old springer spaniel with a foreign-body reaction. A grass seed he swallowed has caused swelling and infection in his throat. “A vet and I will discuss next steps after Jasper has had CT and ultrasound scans to try to identify how easy the seed will be to remove. We’ll speak to the owners when the best course of action is agreed,” explains Beth.

 

Can I help?

As the first point of contact, a welcoming face at reception is just what you need if you’re nervous about what your four-legged friend might be facing. Amy Jones has been manning the desk for three and a half years. “No two days are ever the same,” she explains while booking in Karen Schultheis and her nine-year-old Great Dane, Noya. Amy also arranges follow-ups, takes referral requests from vets all over the country and chases up clinical notes for new clients. “If we get an emergency admission it’s all hands on deck to liaise with the medical or surgical teams in order to free up a slot as soon as possible.”

 

The regulars

Graham Dewhurst travels from Preston every four to six weeks to bring Foxy, his seven-year-old fox red Labrador, for scans and check-ups. Foxy has had three major operations after being diagnosed with cancer over a year ago. Today, she’s the picture of health and taking everything in her stride. “She’s the light of our lives,” says Graham, who can’t thank the staff enough for helping her fight the Big C.

Study room

The SATH plays a key role in the education of fourth- and fifth-year veterinary students, teaching them the very latest concepts and techniques in a caring and supportive environment. Students have the opportunity to experience a wide range of specialisms including cardiology, dermatology, internal medicine, neurology, oncology, orthopaedics and soft-tissue surgery. Every morning, they are allocated time to write up their clinical notes in the student study area.

 

Note taking

Resident veterinary surgeon Giulia Lipreri books in Connie the Connemara pony and checks medical details with her owners, Julie and Brian Holmes. She has melanomas under her tail that need treating with laser surgery and a lump under her belly that needs investigation to make sure it’s not cancerous too. “It is a worrying time,” says Julie. “We’re hoping Connie’s new lump is benign so the PENS laser treatment can go ahead as planned.”

“We will let Connie settle in to her new surroundings before she is seen by the consultant surgeon David Stack later,” explains Giulia.

 

Labour of love

On the general equine ward, Sophie Neil is ensuring the stables are spick and span. As a yard technician, Sophie is responsible for the aftercare of the horses on her shift, which includes mucking out, feeding and administering medicines. In addition, she may be called on to support the six-strong nursing team led by Jane Devaney, doing anything from assisting with an MRI to holding horses for vets’ and students’ rounds. The hospital uses more than 40,700kg of hay in a year – the same weight as seven African elephants!

 

In the stocks

Resident veterinary surgeon Rosie Olley has been at Leahurst for eight years. “Today’s patient is a very poorly boy with a stomach impaction as well as an abscess in his neck. We’ve sedated him to perform an endoscopy and do a biopsy on his duodenum. As horses don’t have gall bladders, the bile ducts have to be checked too.” They use stocks to keep the horse in a safe position for him and the staff treating him. Rosie has her teaching hat on today and is explaining hospital techniques to her student and intern using a camera and monitor.

 

The dispensary

Veterinary nurse Katy Dorricott enjoys her role as pharmacy administrator. Work begins at 7am sharp, when the first delivery arrives from the wholesaler to supply all areas of the Equine Hospital. “We get multiple deliveries through the day as we never know in advance what emergency treatment may be needed.” Every year, the hospital uses roughly 26,000 litres of saline and 42 kilometres of bandaging material – the length of the London Marathon! “As well as making sure all medicines, bandages, surgical items and so on are replaced, recorded and stored correctly, I’m often asked by the vets to research and procure specific drugs and surgical equipment from outside the UK, including Europe and America,” adds Katy.

 

A testing time

The senior lecturer in equine surgery, David Stack, prepares Connie for an ultrasound scan on her new lump. The scan works in the same way as it does on humans but horse hair and the grey pigment in Connie’s skin makes the reading harder, so care must be taken that nothing is missed. After 20 minutes, David and Giulia are happy Connie does not have a tumour and that the swelling may be more of a fatty deposit. Her owners are delighted as she can now have the standing laser surgery on her tail melanomas as planned rather than a more complicated surgery under general anaesthetic in the operating theatre.

 

Handle with care

Experienced veterinary nurses Rachael Jones (right) and Francesca Pleavin (left) have mastered the technique of keeping Onion, a female cat with stage 2 kidney failure, calm and still while she has her blood checked and dressings changed. “I love my job. I enjoy watching the students learn and progress – we often take them under our wing. We’re all animal lovers with pets of our own and get on really well. And of course it’s so rewarding seeing the animals get better and go home,” says Francesca.

 

 High-tech diagnostics

This state-of-the-art Tesla MRI scanner had to be fitted using a rail track as the massive magnet inside weighs six tonnes. The wall of the diagnostic imaging suite had to be removed and then rebuilt, and the eventual cost of the fitted unit was £1 million. This crucial technology ensures that everything can be done in-house very efficiently, from diagnosis to surgery and then being allowed to go home, explains radiographer Hannah Caswell. “This reduces stress for the animals and their owners, who are given news within one hour of their pet being scanned.” Anaesthetist Oscar Bautista stays to monitor Oscar, a large Labradoodle who has a suspected brain tumour, as the scan takes about an hour. A typical scan of a dog costs £1,000 plus sedation.

 

 

Cancer care

Twelve-and-a-half-year-old black Lab Missy is coming to the end of her treatment for lymphoma (white cell cancer), which has involved chemotherapy once a week for nine weeks, then every two weeks over a 25-week period. Erin O’Connell (right), a lecturer in small animal internal medicine, administers the drug, which is extremely toxic, and why protective face masks are used. “The preparation for chemo takes longer than the seconds it takes to administer the drug.” She explains, “We start by giving Missy an anti-sickness drug, then take care that the needle and catheter are in the correct place before we give the chemotherapy, and flush with saline.”

Missy will now go back to the ward with Julia Blakemore, an oncology veterinary nurse, to rest and be checked that she has no adverse reactions so her owners can take her home later.

 

In the operating room

Performed up to eight times a week at the hospital, the TPLO surgery (tibial plateau-levelling osteotomy) on today’s patient – a springer spaniel – takes around an hour and a half and will change the angle of the top of the shin bone by cutting the bone, rotating it, and stabilising it in a new position with a plate and screws. Resident surgeon Tom Cox is performing the operation assisted by Professor Eithne Comerford (in the animal scrub hat). There are around ten staff in the room assisting or observing and this is made possible by the huge medical screens on the walls which provide a live feed for students.

“The equipment we use is the same as is used with humans,” explains Professor Comerford. “This is a very common procedure with a quick recovery, which means this dog will be able to stand and walk tomorrow.”

A price to pay

As anyone with a poorly pet knows, such world-class treatment doesn’t come cheap, and it’s Nicola McKeown’s job to help to make payments as painless as possible. “At any point in the day, I might be raising invoices, dealing with queries or chasing payments with insurance companies, as well as dealing with clients,” she explains. “We do still get people who pay with cash and others who need advice if their insurance companies won’t pay. But we’re all animal lovers and in the 11 years I’ve worked here, I’ve learnt my job is about emotions, not just money. You have to have empathy and I’m not afraid to admit I’ve had a cry with a client at times.”

All photos by: RICHARD STANTON.

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