Our facilities extend over three properties at 84, 86 and 88 York Street and include three comfortable reception areas and five consulting rooms with one that is specially for behaviour consultations. Away from view are modern glass-fronted ‘day dens’, for cats at 84 York Street and for dogs at 86 York Street. There are fully equipped operating and dental theatres, an x-ray suite, prep room and ultrasound facility. These are augmented by an advanced clinical laboratory and dispensary. Staff have their own kitchen and staff room.  Our diagnostic facilities include electrocardiography, Doppler blood pressure, a range of diagnostic endoscopes and for ophthalmology a biological slit lamp. These are explained in more detail below.

Internal Medicine including Oncology

Internal medicine services cover hormonal, gastrointestinal, urinary, haematologic (blood related), respiratory, infectious, and immune-mediated diseases. The facilities at the London Veterinary Clinic are co-ordinated by Grant Petrie.

Grant investigates medical conditions which are uncommon, complicated or difficult for GP vets to accurately diagnose and treat. These conditions can be broad, may affect one or more organs and may include:

  • Vomiting, diarrhoea or weight loss
  • Metabolic conditions such as diabetes
  • Hormonal conditions such as hypothyroidism or Addison’s Disease.
  • Breathing-related disorders
  • Bloodstream or blood clotting disorders
  • Bone marrow problems
  • Cancers

Once a diagnosis is made, Grant works closely with your GP vet to provide the best possible care and treatment for your companion.

Grant has over 30 years experience medically treating treatable cancers. He gives you clear information at each step of treatment and uses a range of drug therapies.

  • Conventional chemotherapy are drugs used in human medicine but for dogs and cats at reduced doses or simplified protocols or extended treatment intervals, to reduce or eliminate side effects.
  • Metronomic chemotherapy uses small, usually daily drugs that work by inhibiting a tumour’s ability to develop its own blood vessels.
  • Targeted molecular therapies such as tyrosine kinase inhibitors work by binding to specific receptors on cancerous cells preventing the cancer cells from dividing and growing.
  • Immunotherapy uses the body’s immune system to fight a cancer. There are melanoma and lymphoma vaccines used to treat these types of cancer.

Our objective is to make an accurate diagnosis as rapidly as possible while at the same time putting your pet (and you) to a minimum of inconvenience.

Cardiology

Most heart conditions including rhythm disturbances are diagnosed by performing an ultrasound of the heart (echocardiography), electrocardiography (ECG) and/or chest x-rays. For echocardiography and ECG, your companion lies on his or her side on a cushioned table while Dr Grant Petrie (helped by an experienced clinical vet nurse) investigates how the heart is working. Treatment of heart conditions is usually provided by medication.

Grant’s on-site facilities include colour and spectral Doppler echocardiography, digital thoracic radiography, digital ECG recording, blood pressure monitoring and when it is beneficial 24/48 hour ambulatory ECG (Holter) monitoring.

Behaviour

Our behaviour service at London Vet Clinic is provided by veterinary behaviourist, Natalia Aira Bewick. Our bespoke service can help you manage and prevent any behaviour problems in dogs and cats.

A thorough, individual assessment is carried out to provide you with a tailored behaviour therapy plan, this may include a training plan, medical diagnostics, behaviour medications (psychotropics) and/or supplements. Natalia has also created a unique puppy course exclusive to the London Vet Clinic.

Dentistry

Preventing tooth and gum disease is vital and when you visit us we explain how to keep your companion’s mouth, teeth and gums healthy. The reality is, however, that  oral problems are common and because they are we are experienced in and have the sophisticated equipment needed to provide successful care. Dental x-rays are particularly important to help reveal tooth damage below the gum line. Dental extractions when necessary, scaling and polishing, are all time consuming procedures. There are usually two vet nurses assisting the vet with each dental. The London Vet Clinic has a dedicated dental suite for all procedures.

Occasionally unusual dental procedures are needed and when they are these can be done at York Street, without the need for travel to a referral hospital by our dentist Peter Kertesz who has over 40 years of experienced in animal dentistry (and who wrote the first textbook on comparative dentistry).

Dermatology

We will take a full medical history and may take an ear or skin swab or skin scrapings to help with the diagnosis. In rare and unusual skin conditions a skin biopsy may be needed. For allergic skin conditions exclusion diets are often recommended and allergy testing for inhaled allergies (pollens, moulds, dust mites etc) is done on blood samples sent to a specialist laboratory in The Netherlands.

Dr Erin Brennan sees referred dogs and cats with complex skin and ear conditions that don’t or won’t go away, or that go away then come back. These often involve allergy, immune-mediated and autoimmune disease and secondary infectious diseases.

Referred dogs and cats often have itchy or red skin, rashes or hair loss. Others have chronic swellings between their toes or easily damaged nails. Complex ear conditions are initially assessed by otoscopy and cytology, that is examining material from the ears under a microscope. In chronic or complex ear conditions further investigation such as CT and video-otoscopy may be required.

 

Orthopaedics

The most common, sudden joint injury that dogs experience is a torn anterior cruciate ligament. Dr James Creasy is one of the country’s most experienced veterinary surgeons using the ‘Tibial Plateau Levelling Osteotomy (TPLO) procedure to repair torn cruciates in dogs’ knees. He performs around 700 cruciate repairs each year and has been doing so for over 10 years.

James and his colleague Dr Matin Simonovski are equally proficient repairing slipping kneecaps, especially in small individuals and using an arthroscope to examine and repair painful elbow conditions, not uncommon in Labradors and similar size dogs. Of course they also repair broken bones.

 

Ophthalmology

An initial consultation includes a history taking and eye examination. We have the same equipment for measuring the pressure in the eyes (glaucoma) as you may have experienced when visiting an optician or ophthalmologist. As well as ophthaloscopes in all the exam rooms we also have an advanced slit lap for detailed examination of all parts of the eyes.  Our GP vets are experienced with treating all common eye conditions but when they feel that it’s in your pet’s interest to be seen by a specialist, Dr David Williams visits York Street. Dr Williams is Cambridge University’s vet school’s resident  ophthalmologist. He has decades of both teaching and clinical experience. experience treating a wide range of eye conditions including:

  • Entropion/ectropion – (rolled in or rolled out eyelids)
  • Third eyelid surgery including “cherry eye”
  • Abnormal eyelashes irritating the cornea
  • Corneal ulcers
  • Managing complicated “dry eye”
  • Managing glaucoma

When eyes need surgical repairs these can be done at York Street and your companion is back home the same day.

Neurology and Diagnostic Imaging

Among the most useful tools we use to evaluate a pet’s condition is diagnostic imaging. This includes radiographs (x-rays) and ultrasonography (ultrasound) both of which are carried out at York Street.

Dr John Parker sees dogs and cats with neurological disturbances including seizures, loss of balance and/or collapse, neck pain, back pain, inability to walk, paralysis (loss of muscle function), weakness, inner ear disease or disorder or behaviour changes associated with metabolic disorders. John takes an holistic approach to your pet’s health and lifestyle and to your wishes and aims. Each case is different so an individual solution for each situation is considered.

John’s first (and critical) step is the investigation. This allows him to identify the source and probable cause of the underlying disease. He may ask if he can do blood tests. Sometimes examining cerebrospinal fluid helps pinpoint the cause of a problem. Routine x-rays may be useful. In three out of 20 dogs and cats he sees an MRI scan may be useful. In these instances he works with The Ralph, an independent referral hospital where there is a 1.5 Tesla MRI machine.

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X-rays

The most familiar imaging method and most frequently used at the London Veterinary Clinic is radiography or x-rays. Anatomy can be discerned because of differences in contrast between fat, water, bone and metal. Most of the body’s soft tissues are either water-dense or fat-dense. The most commonly taken x-rays are those of the chest cavity, abdominal cavity, limbs, spinal column, and skull.

Because dogs and cats are generally unwilling to hold still, especially in an awkward position, some form of restraint is usually required to take x-rays. While being held by people is a simple form of restraint, hand-restrained pets may still squirm. We often have to take more than a single film and this adds to the potential distress for the dog or cat and potential radiation exposure for people holding the pet. While the amount of radiation received by the pet is minimal, even with multiple x-rays, our concern is cumulative dosing to people. This is why we use alternative methods of restraint.

Where appropriate we keep a fully conscious pet still with well placed soft-covered surrounding sandbags. There are instances where this is inadequate so we selectively use various sedatives or anesthetics. There are many choices of drugs and often only a brief sedation from which a pet is fully recovered within just a few minutes is used. We will discuss with you the need for x-rays and what type of restraint is needed.

Contrast x-rays

In addition to plain x-rays we sometimes use radiographs to do contrast studies. In these instances a dye material is administered that on radiographs has a ‘metallic’ density. The contrast agent most of us are familiar with is barium, and this is sometimes used to evaluate the digestive tract. However, contrast studies are also used with different dye agents to evaluate the urinary system (excretory urograms or intravenous pyelograms – IVP’s), blood vessels (angiograms), and spinal cord (myelograms).

Ultrasound

The next most commonly used imaging method at the London Veterinary Clinic is ultrasonography. High frequency sound waves are used to provide more narrowly focused pictures of internal structures. Details that might be difficult to see on radiographs can often be seen with ultrasound. Ultrasound can also provide “real-time” images of structures to detect such things as movement. Most of us are familiar with ultrasonography to ‘image’ developing fetuses in pregnant women. Real time imaging also permits ultrasound-guided aspiration (placing a small needle into a structure to collect some fluid or cells as is done for amniocentesis in some human pregnancies) or biopsy of internal structures.

More so than radiographs, the success of ultrasonic imaging is directly linked to the skill and training of the ultrasonographer. Individuals highly trained in ultrasound imaging may be able to make diagnoses, obtain samples, and provide treatment advice far better than less skilled or experienced vets even when using identical machines. Grant Petrie and Veronica Aksmanovic undertake our ultrasonography.

Computed tomography uses x-rays in a 360-degree technique with a special scanning machine. Like plain radiographs the amount of radiation exposure for patients with CT is minimal. Technology has progressed dramatically. Current CT scanners allow complete imaging of even large areas in just a few minutes, and the digital images can then be reformatted to provide 3-dimensional reconstructions. Because patient motion greatly degrades the images, pets are always given short-acting sedation/anesthesia for CT scans. We refer pets for CT scans to our associates at The Ralph Vet Referrals and Dick White Referrals.

Magnetic resonance imaging (MRI) is a non-x-ray based technology. It uses a powerful magnet and radiofrequency waves to create highly detailed images of virtually any structure in the body. MRI pictures can provide far more detail than either x-rays or ultrasound. All MR imaging in animals requires anesthesia due to the need for complete immobility during scanning and the relatively longer time needed for MRI than other imaging techniques such as x-rays or CT. There is some overlap between the indications for CT and MRI scanning. The former is generally best for bony details such as elbows, knees and complex fractures. CT is also excellent for pictures of the lungs, and conditions in the ears and nose. MRI is generally superior for brain, spinal cord, and abdominal imaging. If we recommend advanced imaging we will discuss with you the reasons for our preference for either CT or MRI. MRI scans are conducted  by our colleagues at The Ralph Veterinary Referrals and Dick White Referrals.

Fluorsocopy is used on occasion to evaluate such things as swallowing function, angiography (motion studies of blood flow or interventional radiology and interventional cardiology using special catheters), and can be used in orthopedic surgery to evaluate placement of drills, screws, and so forth. It is real-time x-ray imaging. Fluoroscopy is used to place cardiac pacemakers and vessel stents or coils. When needed, fluoroscopy is undertaken at Cambridge University.

Scintigraphy involves the administration of minute quantities of a radioactively-labeled substance into the body, then monitoring and measuring where the radio-labeled substance goes after administration. Bone scans are one form of scintigraphy. Thyroid scans are another. The pictures provided with scintigraphy are crude compared with other imaging modalities, but have the advantage of providing functional images, indicating normal or abnormal function of target organs. We refer patients to Cambridge University for scintigraphic evaluations.

Minimally invasive surgery / Endoscopy

At the London Vet Clinic, we undertake all procedures as ‘out-patient’ activities. We have glass fronted day ‘dens’ for each dog or cat as well as larger walk-in facilities for giant dogs. These are set up so that dogs and cats are in separate rooms and no animal is looked at by another. Animals needing extra oxygen have their own oxygen ‘den’.

Dr Elise Robertson has over 15 years clinical experience in advanced endoscopy. Elise routinely does ‘lap spays’, minimally invasive neutering ops. She also  provides minimally invasive nose and ear investigations and when needed minimally invasive internal biopsies.

When a dog or cat needs continuing care overnight we will arrange for this to be done at a 24 hour facility, usually the Veteris hospital in Shoreditch.

Laboratory

Our Lab facilities at the London Vet Clinic are provided, calibrated and maintained by Idexx, the world’s largest provider of veterinary lab diagnostics. We undertake routine haematology and biochemistry test but also hormone and antibody assays and urine analyses. Our digital screen microscope means that several vets can review samples. We routinely do microscope exams of ear discharges to find the specific cause of these problems.

In additional to our extensive York Street lab facilities we send samples to off-site labs such as the University of Glasgow and the University of Bristol for specialist tests.