Referring Vets

The Isle of Wight is a wonderful place, but the Solent is a significant barrier to cross on two, three, four or more occasions when referral is sought on the mainland.  Island Referrals looks to provide you with an exceptional, local, specialist, referral service. We seek to build a strong, long-term relationship with you, to help you look after your clients even better.

What Clinical Services does Island Referrals Offer?

  • Elective orthopaedics
  • Elective soft tissue surgery
  • Neurosurgery
  • Work-up of cases with an abnormal gait (lameness of one or more limbs, ataxia, weakness, combination)
  • Cranial cruciate ligament (CCL) rupture (grade 1, 2, or 3, sprain, with or without medial meniscal injury, via TPLO and/or lateral fabellotibial suture)
  • Medial patellar luxation (MPL), including femoral osteotomy if required
  • Combination CCL/MPL
  • Angular limb deformity correction
  • Fractures and luxations of all bones/joints, in otherwise stable trauma patients (craniomaxillofacial, mandibular and dental, spinal, fore limb, hind limb, pelvis, paws, tail)
  • Arthrodesis, excision arthroplasty, or amputation
  • Work-up for total or partial joint replacement
  • Arthroscopy and/or arthrotomy
  • Humeral intracondylar fissure (HIF)
  • Osteochondrosis (debridement, and consideration of advanced treatments)
  • Consideration of regenerative medicine (stem cell therapy, or autogenous platelets)
  • Chronic pain management
  • Head and neck/ENT surgery
    • Ear surgery (polyp resection, myringotomy, TECA/LBO, VBO, lateral wall resection, vertical canal ablation, pinnectomy)
    • Arytenoid lateralisation (tie-back)
    • Brachycephalic Obstructive Airway Syndrome (BOAS) – please call to discuss. Aftercare needs to be carefully planned in advance of this procedure, as rarely serious complications arise
    • Oropharyneal stick injury
    • Deep abscesses
    • Salivary mucocoeles
    • Lip fold dermatitis
    • Peri-orbital and retrobulbar surgery, including some eyelid, conjunctival, and adnexal procedures, and enucleation/exenteration – please call to discuss
    • Cleft palate, and oronasal fistula, repair
    • Nasal aspergillosis, including sinusotomy
    • Rhinotomy
    • Maxillectomy and mandibulectomy
    • Cricopharyngeal achalasia
  • Thoracic surgery – due to the intensive aftercare and monitoring required for these cases, only a limited service will be offered in this area initially, on a case by case basis. Please call to discuss.
  • Abdominal surgery – due to the intensive aftercare and monitoring required for some of these cases, only a limited service will be offered in this area initially, on a case by case basis. Please call to discuss
  • Wound assessment and management, including vacuum-assisted wound dressings
  • Perineal rupture repair
  • Anal sacculectomy
  • Vulvoplasty
  • Screw-tail resection
  • Vaginal or anal prolapse
  • Oncosurgery – resection of masses involving any part of the body, and reconstruction, plus provision of chemotherapy and/or referral for radiotherapy follow-up where appropriate
  • Peripheral nerve surgery (decompression, stabilisation, resection of nerve sheath tumours)
  • Spinal surgery – due to the intensive aftercare sometimes needed for spinal patients, initially we are unable to offer this service as a routine. However, if no other appropriate options are possible for the owners, and if we can organise realistic aftercare between us, then we can consider this on a case-by-case basis. Please call to discuss.
  • Brain surgery – it is unlikely for brain surgery to be offered in the near future, for aftercare reasons. However, please call to discuss any cases you might have, just in case we can find a way to help.

 

Frequently Asked Questions:

I’d like some advice, not necessarily a referral
Please email admin@islandreferrals.co.uk with as much information as you wish to give. To enable Ian to give you a full answer, please include a 3-4 line summary of the case, and attach any radiographs and original lab results (such as blood, cytology, and/or histopathology reports), and the full clinical history. Make sure you include a day time phone number, and an evening number if you don’t mind Ian calling you back after hours. Please note – radiographs sent as JPEGs are often fine for orthopaedic enquiries if the quality is reasonable, otherwise please burn a CD and post the DICOMs to Island Referrals or put them through our door. If you prefer, or if the case is more urgent, please call 01983 214744 for a chat with Ian, and he can let you know what he thinks your options are.
I’d like to refer a case

For same-day or next-day cases: please call 01983 214744 to discuss the case directly with Ian and the Referrals Team. You’ll also need to email across a 3-4 line summary of the case, and attach any radiographs and original lab results (such as blood, cytology, and/or histopathology reports), and the full clinical history including up-to-date owner contact details, to admin@islandreferrals.co.uk. For insured pets, please include an up-to-date figure of the total amount spent on this condition at your practice, so this can be factored in to the owner’s decision-making.

Please burn any radiographs to disk, and give this to the owners to bring with them – the quality of DICOM images is much better than JPEG images, making it less likely we will need to repeat these views.

For same-week or next week cases: please email the information across as above. You are welcome to phone too if you wish, but this is not essential, as we will have time to clarify any information with you in these cases.

Which specialist disciplines will see cases at Island Referrals?

Clinical cases don’t come through the door conveniently labelled with their diagnosis, and the way we choose to divide medicine (human and veterinary) into seemingly-convenient organ-based systems of expertise has, unfortunately, led to a fragmentation of care, and a loss of central case overview – often to the detriment of the patient. Ian seeks to change this by championing the role of the skilled generalist, but is not so naïve as to assume he can work without support from other specialist colleagues.

If needed, Ian is backed up via telemedicine support by a diverse collection of specialists in Internal Medicine, Diagnostic Imaging, Neurology, Oncology, Dermatology, Ophthalmology, Anaesthesia and Analgesia, Cardiology, Nutrition, Animal Behaviour, and Veterinary Physiotherapy. These specialist colleagues are able to be consulted by Ian, and their advice relayed to the owners to help with decision-making about their pet.

This arrangement means we can provide the broadest, high-level service we can, with the lowest overheads and therefore the lowest costs. Should it become clear that the needs of the patient are beyond the service on offer at Island Referrals, Ian will call you to discuss your preferences for ongoing referral, and will help make the necessary arrangements, if required.

I’m not sure whether this case is suitable to be treated on island – what do I do??

Please call 01983 214744 to discuss things with Ian, as it should be possible to work out a likely initial plan over the phone, before your client commits to coming. It may be that a consultation is still needed, including a more in-depth discussion of the history, plus a detailed physical exam. If it turns out that Ian’s advice is to seek referral to a different centre, then at least the owners have looked at the local option first and can feel confident that they need to travel further afield – this time!

What is the relationship between Island Referrals and Island VetCare?

Island Referrals is a part of Island VetCare Ltd, which has two equal Directors, Ian Nicholson and Matthew Twitchett. Ian runs the referral side of the practice, and Matthew runs the small animal general practice side, under the same roof. The two sides of the practice share some equipment, facilities, and staff, to the benefit of all. Island Referrals has a visibly separate identity to Island VetCare, including a different phone number, email address, and website.

If I refer a patient to Island Referrals, might I lose my client to Island VetCare?

Island Referrals relies on its reputation, and on the goodwill of the other vets on the island – and Ian will work hard to earn, and keep, your respect and trust. We operate a “no transfer after referral” policy. Island VetCare will not accept a new client if their pet has been referred to Island Referrals within the previous six months, without having first encouraged the client to meet with you to discuss the reasons they wish to change, and ensured this meeting has taken place.

Why should I refer to Island Referrals over my usual referral centre?

Only if you feel like it might be the best thing for that particular patient and owner.

I want to improve my own surgical confidence and skills – can Island Referrals help me?

Definitely. You are always welcome to come and see practice and scrub in, any time. If you refer a case we can arrange to operate together. Ian has taught undergraduates and post-graduates alike, has trained other specialists, and mentored plenty of vets in practice (and interns) seeking further skills and qualifications. He will be providing regular evening talks, and maybe a surgical club, centred around the cases we treat every day – so we can all learn from each other.

Interesting Surgical Links, Published Articles and Training Videos:

This page will grow with time, to become an interesting resource for all things small animal surgical.

To start with, here’s a link to a video showing how Ian places a splinted fore limb dressing.

JSAP Published Article: GI biopsy paper JSAP

JSAP Published Article: Paper published JSAP caudal auricular