Page 7 - Clinical Connections - Summer 2023

Exotics
EXOTICS RADIOSURGERY

Jo Hedley, Head of the Exotics Service, and Vicki Baldrey, Lecturer in Exotic Species and Small Mammal
Medicine and Surgery

he acquisition of a radiosurgical unit with a complex blood supply. The surgical forceps and suture material makes surgery
and surgical magnification loupes loupes allowed us to clearly visualise the faster and more efficient, which has an
Tby the Exotics Service has greatly ovary and surrounding anatomy. And the impact on procedure outcomes.
expanded the depth and breadth of care radiosurgery allowed the abnormal tissue The enhanced capacity allows us to
that can be delivered, including intricate to be removed with minimal blood loss, in a inspire the next generation of veterinarians
procedures for the most delicate patients. way that would not have been possible with in our undergraduate and postgraduate
The equipment has proven invaluable a conventional surgical approach. programmes. The ability to perform more
in cases where patient size has made complex procedures on these and other
visualisation of anatomical structures small exotic animal species is essential
challenging and accurate haemostasis as we continue to develop both our
essential. Both were acquired with the European College of Zoological Medicine
support of the Animal Care Trust, the (ECZM) Herpetology residency and our
registered charity of the RVC. Exotic Animal internship programmes.
Since their arrival last year, both the The surgical loupes have been used
radiosurgical unit and the surgical loupes in novel case presentations, to assist our
have been used regularly. This has enabled visualisation and understanding of unusual
the team to not only enhance patient safety anatomy during a surgical procedure.
in routine procedures, such as neutering, For example, in the case presentation of
but also to perform surgical interventions the guinea pig with a persistent urachal
previously deemed too risky, especially for remnant, as featured in spring’s issue of
smaller patients. Clinical Connections.
Previously surgeons relied on clamping Being able to visualise anatomical
vessels with forceps and then tying off landmarks to a finer level of detail is
with suture material to control bleeding. also helpful when collaborating with our
Radiosurgery makes this process much diagnostic imaging colleagues. It allows us
more efficient for small vessels, using a to report back what was found at surgery
bipolar handpiece. A monopolar handpiece and how that relates to their findings on
allows clinicians to control milder imaging.
haemorrhage from tiny vessels in fat, for
example, which improves surgical field The team
visualisation. The RVC Exotics Service is led by Dr Joanna
Hedley, an RCVS Recognised Specialist in
Case examples Zoo and Wildlife Medicine and European
Examples of use in very small patients Boarded Specialist in Reptile Medicine.
include ovariectomy for treatment of The hissing cockroach case She is supported by RCVS Recognised
follicular stasis in a 61-gram leopard gecko Specialist in Zoo and Wildlife Medicine
and surgical replacement of a prolapse in a The cockroach anatomy was similarly (Avian subspecialty) Vicki Baldrey, RCVS
5-gram hissing cockroach. tiny, and the loupes allowed us to identify the Advanced Practitioner in Zoo and Wildlife
The leopard gecko had an ovarian cyst tissues involved in the prolapse. This would Medicine Nadene Stapleton, Staff clinician
simply not have been possible without them. Jack MacHale, who completed the RVC
We also regularly use radiosurgery in ECZM Herpetology residency in 2021, our
larger patients, such as rabbits, to enable current ECZM Herpetology resident Jess
control of bleeding to maximise visualisation Hornby and two Exotic Animal Veterinary
of the surgical field. Examples include interns: Lucy Robson and Tom Bunn.
nephrectomy in a rabbit with a kidney The team also comprises six Exotic
tumour and amputation of the leg of a parrot Animal veterinary nurses: Abi Edis, Molly
following irreparable damage caused by a Rogerson, Hayley Ayers, Steph Isaacs,
cat attack. Sema Assi-Yamagata and Aneesa Malik.

Efficiency, safety and sharing advances
Both pieces of equipment have widened
our surgical and procedural repertoire,
while enhancing patient safety. The ability to For the RVC Exotics and Small Mammals
The leopard gecko control bleeding without the need for large Service, please call: 020 7554 3528
Email:
londonreferrals@rvc.ac.uk

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