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Referrals

A fast, personal referral service for you & your clients

At Mill House Referrals, we offer a fast, personal referral service for you and your clients. The practice is a single site and has a policy of continual investment in new equipment and techniques. We are very happy to discuss cases with you over the telephone.

Clients of other veterinary practices are reminded that the referral service at Mill House Referrals is only available through referral from your own veterinary surgeon.

To find out more about the referral services we offer, please select an item from the menu below.

  • General Information
  • Acupuncture
  • Dermatology
  • Emergency & Critical Care
  • Imaging
  • Internal Medicine
  • Laparoscopy
  • Ophthalmology
  • Radiology & Ultrasound
  • Surgery

General Information

You are welcome to visit the practice to discuss our referral service and view our facilities. Referring veterinary surgeons may also be present during investigations of their referred patients if they wish. Please see here for our current referral price list.

Procedures can often be completed whilst clients wait, and where possible, clients may stay with their pets during some examinations, e.g. ultrasound. Clients are very welcome to visit hospitalised pets at reasonable times and according to staff availability. There is ample free parking within the surgery grounds.

We no longer carry out heart test certification.

Acupuncture

Veterinary acupuncture has been practised in China for thousands of years, and has gained popularity in the West during the last decade.

The Ancient Chinese said that illness was a state of imbalance or blockage in the normal energy flows of the body and that acupuncture, acting on the channels of energy flow, restored them to normal. Modern research has shown that the pain relief effect of acupuncture occurs through several mechanisms. These include reducing pain perception through nerve inhibition, changes of neurotransmitter levels including increased levels of endorphins – (the body’s natural painkillers), and changes of neurochemical receptors.

Acupuncture is useful for a variety of conditions, especially pain relief for muscle and joint disorders. Additionally, it can help chronic pain which is not being controlled adequately by conventional treatment or when drug side effects are a problem. Acupuncture can be used along with medications, sedatives and anaesthetics and can be used as an additional treatment.

Acupuncture is a useful form of therapy especially for conditions that do not respond well to orthodox means. It is not a cure-all but should be considered with other established methods of treatment. It can fill a gap but will never replace conventional therapy and can at times be beneficial when other treatments have failed.

Treatment sessions usually last about 20 minutes and involve the insertion of very fine needles into specific points of the body to produce physiological responses which result in a healing effect. Most animals do not show any signs of discomfort, or object to the treatment. They will often relax and some even fall asleep during treatment. Sometimes the animals may feel slightly stiffer immediately following treatment and may be a little sleepy for a few hours, but this is generally a sign of a good response and is followed by improvement the next day.

The average number of treatments is about four and if improvement follows it will usually be apparent by then. Some problems may need as many as six treatments before showing signs of improvement but generally if there is no improvement at all after three treatments it is unlikely that acupuncture will have an effect. Treatments are usually once a week to begin with, then at longer intervals according to progress. Chronic conditions may subsequently require booster treatments at varying intervals.

If you would like to know more about our acupuncture service at Mill House, please give Sarah Colegrave a ring on 01553 771457. Cases can be seen as first opinion or by referral via your normal veterinary surgeon. For referrals, a full report will follow each visit.

Dermatology

  • Detailed initial consultation and full work up
  • Hair and skin scrape microscopy
  • Cytological evaluation of skin and ear canals
  • Intradermal skin testing for atopic patients
  • Allergen-specific Immunotherapy for management of atopic dermatitis
  • Skin biopsy
  • Routine ‘allergy clinic’ follow-up appointments
  • Internal medicine back-up

Our referral veterinary surgeon for dermatology is Alison Shearer and she visits the practice approximately every three weeks to see cases.

Alison is willing to investigate cases with any dermatological presentation, from atopic dermatitis to immune-mediated diseases. Ear diseases are evaluated from a dermatological perspective to enable the optimal treatment options to be utilised. The aim with all cases is to make a prompt diagnosis and assessment of all factors impacting on the skin condition and to formulate a long-term approach to management.

Intradermal skin testing is offered as the preferred method of evaluating the allergens involved in cases of atopic dermatitis. This remains a useful diagnostic tool and gives a therapeutic option where allergen-specific immunotherapy is appropriate. A number of other therapeutic options exist for the control of atopic dermatitis and the full range of options is discussed with clients, enabling fully informed choices to be made.

If it is possible to withdraw therapies prior to referral, this allows for all investigations to be performed at the first consultation. However, it is acknowledged that it may not be possible to withdraw all therapies, so Alison is willing to discuss this with referring veterinary surgeons if difficulties are anticipated. The following are guidelines for withdrawal:

  • Steroids – stop for 1 month
  • Antihistamines – stop for 2 weeks
  • Ear drops – stop for 7-10 days
  • Oclacitinib (Apoquel) – is best withdrawn for 2 to 4 weeks, especially if it has been used for longer than 2 weeks.
  • Antibiotics – withdraw for 5 to 7 days, if possible.
  • Avoid shampooing for 2 days before the appointment

Where clients are unable to pursue referral, Alison can be contacted by first-opinion veterinary surgeons for advice.

Emergency & Critical Care

With personnel on site in the hospital at all times and a sophisticated range of intensive care equipment, comfortable wards and experienced professionals, we have everything to hand for your pet’s needs in an emergency – whatever the time – day or night.  As an accredited and inspected RCVS Hospital, our standard of care meets the requirements of our regulatory body at the highest level. All pets are given soft Vetbeds to lie on and receive personal nursing care. Cats and rabbits have their own separate wards, as we understand that they can be worried by noise and the presence of dogs. We have large kennels for giant breeds and incubators and warm air beds for small and intensive care patients. Pheromone diffusers are used constantly to provide a calm atmosphere.

Imaging

Our modern digital radiography suite is available for use 24 hours a day. Our powerful x-ray machine can image any pet from a small reptile or bird to the largest St Bernard.

Because we see so many chest cases, our machine has to be capable of taking very fast exposures. The x-ray table has specific attachments for accurate positioning which is so important for examinations such as films taken for the BVA/Kennel Club Hip Dysplasia Scheme.

To comply with Health and Safety Regulations, patients are not held for x-rays, and so films are usually taken under anaesthetic or sedation, unless this would be life-threatening. Accurate positioning is vital for high quality diagnostic films.  Do talk to us about sedation for routine x-rays such as for the BVA/ Kennel Club Hip Dysplasia Scheme. Unlike a human hospital, there are no waiting lists for operations or x-rays, so if your pet requires an x-ray, we can usually offer an appointment within a week or two of our recommendation.

Internal Medicine

We offer a comprehensive referral service in Internal Medicine. We have a fully equipped laboratory on site allowing us to obtain fast results for patients, including full haematology and biochemistry, blood gases, electrolytes and clotting profiles.  We have a state-of-the-art x-ray suite with digital processing for clear and accurate results, as well as a colour-flow Doppler ultrasound machine with a selection of probes to suit a wide range of patient sizes and study types. Judy Mosedale accepts referrals for full abdominal ultrasound, basic cardiac ultrasound, assessment of more superficial structures and ophthalmic ultrasound (alongside Michael Morter). We also have modern, digital endoscopy equipment with a range of endoscope sizes to suit different patients and diagnostic procedures.

Ultrasound/Laparoscopic Biopsy

Abdominal ultrasound examinations may show abnormalities that need biopsy for further diagnosis.
Before biopsy, we need to know that the patient’s blood clotting function is not compromised, particularly if liver disease is suspected. We can perform tests here or the referring vet can perform the tests and forward the results to us.

We are very happy to offer advice over the telephone. Please call to discuss any medical cases with Judy Mosedale or Rhiannon Jones.

Laparoscopy

Keyhole (laparoscopy) surgery is a minimally invasive technique common in human surgery, and we are delighted to be able to offer this gold standard option for a speedier recovery for your pet. Laparoscopy is suited to many surgical procedures such as bitch spays, biopsies, retained testicle removal and gastropexy

What’s so special about laparoscopy?

  • Small wounds mean less pain for your pet
  • Faster recovery compared to open surgery
  • More accurate, visually aided surgery for fewer complications

What makes it different to normal surgery?
All surgeries involve making an incision (cut), but with laparoscopy we only make three tiny little wounds which allows a faster recovery time for your pet. We inflate your pet’s abdomen with sterile carbon dioxide and use an optical telescope to visualise the abdominal organs.  The magnified image is displayed on a medical monitor which allows us to look inside the body; and specialised instruments are used for minimally invasive surgery.

What are the costs?
We do charge a little extra for this specialised surgery, but we feel the benefits of a faster recovery with less discomfort really are worth it – that’s why we have invested in the same equipment as used in human surgery.  Ask a member of the team about laparoscopy. It takes a higher level of veterinary expertise to perform these procedures successfully.

Here’s what our Clinical Director Sarah Colegrave has to say about it:

“I have pioneered the use of laparoscopy here at Mill House because I am keen to perform surgery with the least discomfort to our pets.  I have been delighted with the speed of recovery the dogs and cats show, and the feedback from their owners.  Many procedures can be performed as day cases – reducing the stress for our pets and owners”

Sarah Colegrave, MA VetMB BSAVA PGCertSAECC MRCVS

Ophthalmology

We have a range of modern diagnostic equipment for a thorough ophthalmic assessment, including direct and indirect ophthalmoscopy, a slit lamp and a Tonovet – for measuring intra-ocular pressures.  We also have specialist ophthalmic surgical instruments and binocular operating loops for ophthalmic surgical procedures.

If you would like to refer an eye case, please call to speak to Michael Morter.  He is also very happy to offer telephone advice.

Radiology & Ultrasound

Our radiology facilities are available for use at all times. Our powerful high frequency 300 mA x-ray machine and digital imaging systems allow us to take and analyse high quality radiographs at any time, and generally examinations can be undertaken on the same day as referral. For health and safety reasons, patients should not be held for x-rays, and to improve patient comfort and image quality, we generally use a sedative or general anaesthetic.

  • High frequency Sedecal 300mA 120kV Xray generator with floating top table and Bucky grid, and automatic exposure control
  • Konica Regis HD digital CR system with PACS
  • Dedicated dental X-ray unit with Durr digital processing and PACS
  • Philips C arm image intensifier
  • Facilities for contrast studies
  • Advanced Colour and Power Doppler Digital imaging using two ATL 5000 Ultrasound machines with 2 sector scanners (2-3 MHz and 4-7 MHz), a linear array 5-12Mhz and curvilinear 5-8MHz.
  • 2D and M-mode ultrasound
  • Colour flow, pulse and continuous doppler
  • Ultrasound guided liver biopsy
  • Laparoscopic biopsies, laparoscopic spays, cryptorchid neuters, gastropexies
  • Thoracoscopy

Surgery

Our Surgery referrals are managed by Clinical Director, Sarah Colegrave.

Sarah qualified from Cambridge in 1989 and joined us in 1990.  Sarah holds her Post Graduate Certificate in Emergency and Critical Care.  She also has specific interests in surgery and pain management.  She welcomes referrals for critical care cases, surgery, including laparoscopic surgery and acupuncture.

Sarah is happy to accept referrals in soft tissue surgery, such as total ear canal ablation, perineal hernia repair, perineal urethrostomy, thoracotomy, gall bladder removal, abdominal mass excisions, GDV surgery and gastropexy, enterectomies and many more.

Sarah performs the Modified Maquet Procedure (MMP) for cranial cruciate repair. The key benefits of this procedure over the other methods are:

  • Less invasive surgical technique
  • Excellent outcomes
  • Shorter convalescence
  • Appropriate for dogs of every size
  • No need for bone grafting or similar

Please call to discuss any surgical cases with Sarah Colegrave, who will be only too happy to help and advise you.