How do I get a referral to the Dover Veterinary Hospital?
Please contact your veterinarian if you are interested in potential referral to the DVH for consultation with our veterinary staff. Your veterinarian has the most medical information on your pet and will often diagnose the condition prior to referral. When you and your veterinarian decide to pursue referral to the DVH they will compete a referral form and direct you to call us for an appointment with the appropriate coordinator.
If there is an emergency than your veterinarian should contact the appropriate personnel at the DVH and arrange an immediate referral. Once an initial evaluation has been performed we will be able to update your veterinarian on your pet's condition.
How do I make an appointment at the DVH for a surgical consultation?
Once the decision to pursue referral is made with your veterinarian and they have provided referral information to the DVH staff than feel free to call the DVH at (603) 742-6438 and ask for the surgical coordinator (Cindy Norwood or Charles Evans) to make the appointment. We understand that your pet is a special family member and try to accommodate all patients as soon as possible. If your pet needs to be seen on an emergency basis and the surgical staff member is unavailable, another member of the DVH veterinary staff may admit your pet, perform the initial examination and then transfer the case to the appropriate surgical staff member at the earliest opportunity.
Please bring all pertinent medical history, laboratory results, medications and special diets if necessary. If there are any radiographs that will assist the DVH surgical staff please bring them with you. If you wish, toys, blankets, etc… may be left with you pet during their stay to make them more comfortable.
What does the estimate I receive mean and include?
During the initial evaluation the surgery staff will provide you with an estimate for your pet's care. This estimate is usually for the entire pre-operative, operative and post-operative care that they will receive while at the DVH. The estimate normally has a low and a high end, and in most cases if there are not complications requiring additional treatments or extended hospitalization most final bills tend to be towards the low end. This estimate provided at the initial consultation is good for a period of 30 days.
Why are the services at the DVH more expensive than my regular veterinarian's office?
Because of the specialized care, procedures and in many cases additional equipment requirements our fees may be higher than your regular veterinarians.
Payment is due at the time of discharge. A deposit at the low-end of the estimate is required for patients admitted for hospitalization and procedures. Additional deposits may need to be collected during the hospital stay as estimates are updated or the patient's condition changes. We try to make every effort to keep clients informed if there are changes to the original estimate. You are encouraged to ask questions regarding all financial matters until you are comfortable.
We accept cash, check and most major credit cards for payment. In addition, there are additional financing options available through the Care Credit option. If you are interested in additional information regarding this financial aid option and are having difficulty with the on-line information please contact the DVH staff.
What are general recommendations for patients with chronic arthritic changes and lameness?
Weight control: Your pet should be maintained at a lean body weight, as this will greatly improve their ability to get around and decrease pain in affected joints.
Exercise program: A regular, controlled exercise program to maintain muscle mass will be of benefit. Swimming is an ideal, non-weight bearing exercise that can aid in maintaining muscle mass without causing further joint damage. Heavy exercise should be avoided especially on hard surfaces such as concrete.
Medications:
Analgesia: There are many medications that can be used to provide pain relief as necessary. The use of non-steroidal anti-inflammatories is the most common way that chronic low grade pain is treated. These medications can be used intermittently prior to and during periods of increased activity and then letting them set their own activity level. The primary side effects to watch for include anorexia, vomiting, diarrhea or dark colored stools. If any of these clinical signs are noted please discontinue the medication and call either the DVH or your veterinarian for further advice.
Chondroprotective Agents: Chondroprotective agents are drugs that help protect cartilage as it attempts to repair itself. They have become increasingly popular in treating DJD. Two such drugs are Cosequin® and Glyco-flex®. They consist of glucosamine and purified chondroitin sulfate, major building blocks of cartilage. Although many anecdotal reports exist of substantial clinical improvement in dogs treated with these drugs, scientific data is lacking. Clinical trials are in progress to assess their effectiveness and early results do seem to indicate a positive effect in many patients. Cosequin and Glyco-flex are neutraceuticals, i.e. dietary supplements or food additives that do not require FDA approval. They are given orally. Adequan®, on the other hand, has been approved by the FDA for the management of DJD in dogs. It works by inhibiting some mediators of inflammation, as well as enzymes that contribute to the destruction of cartilage. This chondroprotective agent is given to dogs by intramuscular injection. Because the drugs work in different ways, NSAIDs and chondroprotective agents can be given simultaneously to dogs that are severely affected.
Additional therapies to consider for the hip dysplasia (in addition to medical or surgical options) include:
Veterinary acupuncture - Some practitioners have found this modality to be very helpful to decrease pain in their patients. Although there is only limited clinical data in the veterinary field to support this modality, there are practitioners specifically certified if you are interested.
Physical therapy - Mr. Charlie Evans is a trained physical therapist with additional certification in veterinary patients and is also available for consultation on physical therapy modalities as part of a pre-operative or post-operative treatment protocol.
An external fixator is a device used to immobilize a bone or joint using either smooth or threaded pins placed through the bone to be stabilized. These pins then exit the skin and are either attached to a metal or carbon fiber connecting rod using clamps or sometimes an acrylic compound I used to create the connecting bars. The potential benefits of external fixation include: minimal disruption of the affected bone and the healing that is already starting to occur immediately after fracture of the bone occurs; in most cases all implants are removed once fracture healing has occurred so there is no chance for long term implant complications; if there is a severely contaminated wound overlying the fracture the wound can be addressed while the fracture is stabilized externally. (Add picture)
A ring fixator is a type of external fixator device that uses small wires placed at angles through the bone and held in place on circular rings. The rings are then stabilized using small threaded bars that span the region of the fracture and externally support the area. These fixators are a sub-type of external fixator and are useful in stabilizing fractures with only small segments of bone to work with, the treatment of angular limb deformities and are also used for treatment of some types of bone cancer in limb sparing surgery to prevent amputation. Like other external fixators these implants are removed once healing ahs occurred.
Hospitalization times vary tremendously based on the surgery performed, the medical status of the pet, their recovery from general anesthesia, etc… In general, most orthopedic patients are discharged 1-2 days post-operative. During their stay you may visit at any time, but we generally discourage visit immediately post-operative as most patients are still recovering from the anesthetic event.
Can I visit my pet while they are being treated at the DVH?
You may visit your pets at any time while they are a patient at the DVH. There are no set "visitation hours". To ensure that there is available personnel to accommodate your visit please contact either the clinician responsible for care of your pet or the appropriate coordinator (Charlie Evans or Cindy Norwoord) to set up the visitation time.
Are after-hours and weekend visits and discharges a possibility?
Evening visitation can be accommodated but we prefer if clients visit prior to the office closure at 8:00 PM. After this time period visits can be arranged with the attending clinician and/or service coordinator(s). Weekend discharges are not a problem at all and many pets are discharged either on Saturday or Sunday. In most cases the attending clinician will have prepared the discharge instructions and your pet will be discharged by the on-call clinician. If there are any questions please let the clinician know and in most cases may be able to contact the attending clinician prior to discharge.
What communication will I receive while my pet is a patient at the DVH?
While your pet is a patient at the DVH the minimum communication would be at least one daily call. For surgical cases the attending clinician will call the client after surgery to update them on the procedure, and how your pet is doing at that time. If you wish, follow up calls can be made or you may call at any time the DVH is open to get an update on your pet. After the main office closes at 8:00 PM the phone lines switch to a message service. If you wish a later call back please let your clinician know and they will have one of the nursing staff communicate with you at that time. Your veterinarian receives several notices on your pets stay including usually an initial phone call/fax message regarding the surgical plan and a follow-up referral letter that describes the services provided during your pets visit and covers post-operative recommendations
Should I get my dog to lose weight prior to orthopedic surgery?
In most cases the pet has gained weight due to inactivity caused by either a chronic painful lameness and exercise restriction imposed by the clinician or owner. Although it would be ideal for all pets to be at an ideal body condition prior to surgery this is not realistic as they cannot exercise to assist with the loss of weight. Therefore, earlier surgical intervention and proper physical rehabilitation will make it much easier for these patients to be active in the future and attain a leaner body condition which will make it much easier on affected joints.
What is a Diplomate of the American College of Veterinary Surgeon?
The term "ACVS Diplomate" refers to a veterinarian who has been board certified (received a diploma) in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.
Veterinarians wishing to become board certified must complete a three-year residency program, meet specific training and caseload requirements, and perform research and have their research published. This process is supervised by current ACVS Diplomates, ensuring consistency in training and adherence to high standards. Once the residency has been completed, the resident must sit for and pass a rigorous examination. Only then does the veterinarian earn the title of ACVS Diplomate.
How is my veterinarian involved in the patient care process?
Your veterinarian is an important aspect of the both the pre-operative and post-operative care for your pet. The Animal Care Team is made up of the owner (client), the general practice veterinarian and the DVH surgery staff. Difficult cases in many cases may be best managed by a specialist. When a referral is indicated, the primary care practitioner should discuss this process with the client. In most cases the referring veterinarian can contact the DVH surgery staff for consultation regarding the most appropriate care of you pet. If referral is warranted than the necessary information is a gathered and a consultation visit is established. Due to you veterinarians training and knowledge of your pet it is usually much better for them to discuss the case directly with the surgery staff member. In this way, the surgical specialist can be properly informed as to the patient's history and the scope of the current problem. Once the referral is made, the DVH surgery staff will provide state-of-the-art surgical patient care. As part of the healthcare team, the surgeon will keep the referring veterinarian and client informed of the patient's progress throughout the specialized care. After patient discharge, the referring veterinarian may also provide additional postoperative follow-up care. This continuity between surgical specialist and primary care veterinarian ensures the best possible outcome for the patient.
The Dover Veterinary Hospital is staffed with a trained veterinary nursing staff 24 hours a day, 7 days a week, 365 days a year if there are patients in the hospital. The DVH in most cases has a staff veterinarian in the building until ~ 9 PM and doctors are on call if there are any questions regarding patient health, or if a patient requires veterinary attention.