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24 hour care Tel: 01908 611637
Tickford Street, Newport Pagnell, Milton Keynes, Buckinghamshire, MK16 9BA

Services we offer

Dr Paul Manning is a very experienced vet, and with his team offers a wide range of consulting and operating services for pets.  The practice has strong interests in many disciplines of medicine and surgery, and in many species.

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Constant efforts are made to improve the service of the practice and to find new or complementary methods of treatment. Some conditions prove to be incurable by the best scientific means so occasionally alternative medicine is used such as Acupuncture.

Our present services and facilities include:

In patient facilities

In patient facilities include separate dog and cat wards to avoid stress for the animals. Ward rounds are carried out three times daily by the duty vets and nurses at 8am, mid-day and 7.30pm. At other times, the health care team monitors progress and provides essential care around the clock in carefully designed working rotas.

Dedicated operating theatres

Our dedicated operating theatres are located to the rear of the building so that serious operations can be carried out free from the hustle and bustle of the surgery. We keep this as clean as possible with a daily cleaning schedule carried out by our nursing team.

Pre-op and diagnostic, on-site Haematology and Blood Biochemical Analysis

Pre-op blood tests are routine for many of our patients because we believe that every patient deserves to have a health check before an anaesthetic as part of our planned programme of care to minimise the risks and maximise the safety of our operating procedures.

Ultrasound machine

Our ultrasound imaging machine is in regular use as a very useful non-invasive diagnostic tool. We use this to look inside pets' abdomens and chests to observe the internal organs. It is particularly useful in pregnancy diagnosis and monitoring. We can provide a picture for expectant owners. It is also useful for looking at problems in the bladder, spleen, liver, kidneys, prostate gland, heart, and in detecting abdominal tumours. It is useful in the diagnosis of eye problems when the cornea at the front of the eye is obscuring the rest of the eye from view due to a white cloudiness for example.

Plain and Contrast Radiography

Our new digital X ray facility includes a very powerful high frequency machine that enables us to take excellent radiographs of animals the size of hamsters to the largest dogs. We can use it to x ray elephants, but have not had many patients of this variety. The machine has the facility to be finely tuned to almost any requirement, and is an extremely useful aid to diagnosis in the surgery. 

Ocober 2011 : Digital Radiography arrived at Astonlee which is exciting because of the new technology, and also the ability to take advantage of better images which can be emailed and stored on our client records rather than in a building where the filing system can be a challenge with thousands of radiographs collected over many years.

 

The new digital x ray machine is useful and now accepted by the BVA Panel who do the hip scoring for various breeds of dog.  In the early years of digital x rays, the quality was not sufficient to satisfy the Panel, but the quality of the technology we now have is excellent and meets the requirements of the panel of scrutineers.

Electrocardiography (ECG)

Our ECG machine is a portable one which we carry around the surgery in a small case and is essential in the diagnosis and monitoring of heart disease. Records are kept for continuous response to treatment.

We have a computerised ECG machine which can record 4 days of continuous monitoring of critically ill patients if required, and the ability to observe and record and retrieve the ECG traces on the computer is useful.  Using the machine does require a degree of patience and technical know how, but it is worth the effort and the investment.

Dentistry facilities

The practice uses modern dental equipment, very similar to that which you would find in your own Dentist's practice. We offer routine advice on dental hygiene, scaling and polishing under general anaesthetic, and extractions where the teeth have become so badly decayed or damaged that no realistic treatment is possible. We also routinely use our x ray facilities to examine teeth in more detail for diagnosis.

We have a designated room for our dental work which enables us to concentrate on the needs of our patients requiring dental treatment, whilst simultaneously ensuring through our air handiling system that cross contamination of other surgical patients is prevented.

24 hour emergency service by our own veterinary surgeons and our own nursing team

Providing a full 24 hour hospital service with our own practice team has been a strong part of the culture and practice at Astonlee for many years.  It requires a considerable effort, and needs considerable resources of time, people, money, training and facilities to provide this.  Astonlee is proud to be continuing to provide this service which we find is of very high importance to many clients. 

Clients are often very reluctant to leave their loved pets in hospital, which is understandable, but the knowledge that at Astonlee there are always people on the premises caring for your pet is a great comfort, and we take this very seriously indeed.

The world of veterinary practice has changed considerably since the days of James Herriot when the vet did everything, attended all species and did all manner of medicine and surgery.

We provide the only full hospital service utilising our own staff 24 hours a day for emergencies and in patients with a member of staff on the premises at all times caring for the patients which are small animals (dogs, cats, rabbits) and exotic species (small mammals such as hamsters, mice, rats, ferrets, guinea pigs, and also some reptiles and birds). 

Clients value this service very highly.  A small survey of clients revealed that only 1/3rd of clients knew that Astonlee was the only practice in the area which provided a full hsopital service with staff from their own practice team, and 29 out of 30 clients actually said they would never go anywhere else if they had known that fact.

It is important for clients to explore and gain an understanding of the different types and levels of service that are provided by different practices so that in an emergency out of hours there is no delay in finding available treatment to a level which you want for your pets and other animals.

At Astonlee, we do focus on our patients, and in out of hours situations with emergencies and critical care this can be fraught with challenges.  Our dedicated team is committed to providing the best of care.  In order to communicate with you the clients in out of hours care situations, we have arrangements to keep in contact with you about your pet's progress in the hospital, including visiting times when you can talk to the vets and nurses providing the care.  Our regular Sunday and Bank Holiday open surgery between 11am and 12 noon (except Christmas Day which is the only exception) also provides a point of contact for easing communication between the clinical team and you the pet owner.

We no longer provide this service for horses and farm animals which we did in the past, but we will be able to supply a contact telephone number of a vet who can provide this service.

Pet insurance advice

Veterinary fees and costs of drugs and treatments can mount up for complex surgery or long periods of treatment. We strongly recommend that all our clients take out insurance to help in covering such fees. The cost of cover is quite low, makes sense and offers value for money. One of our worst headaches at the surgery is being presented with the emergency case, which needs immediate and costly treatment. In these circumstances, it is too late to start worrying about where the money is coming from to pay for it - better to plan ahead and be covered for all eventualities.

Free weight checks

Free weight checks are done by our nursing team. We realise that quite a number of our patients are overweight, mainly because our clients care so much and can't resist the temptation to feed the pet cat or dog whenever he/she comes and asks for more food. By offering our free weight checks, our team can help you to keep your pets in the best of health.

Treatment of exotic pets

Exotic animals produce quite a considerable part of our work. Rabbits are the number 3 pet, after the cat and the dog. We also see lots of guinea pigs, hamsters, gerbils, birds and reptiles. Over the years, our expertise has grown and we have become quite familiar with providing the veterinary care for these species. For example, treatment has advanced and we now use cement beads impregnated with antibiotic in the treatment of some of these cases. Another medicine has been found which helps the digestive processes of the rabbit, which is a great help in many rabbits with chronic 'sticky bum syndrome'.

Pet Healthcare Clinic

Clinics are run by the nursing team at specific times of day:

12 - 12.30; 3 - 3.30; 6.30 - 7.30

Clients are encouraged to make appointments to see the Nurse to discuss topics such as obesity, nutrition, flea and worm control, behaviour, dental care and other aspects of pet care.

Friendly advice is available together with a range of useful treatments: special diet foods, vitamins, eye and ear cleaners, flea treatments, disinfectants and toothpastes.

Complementary Medicines are available at the surgery

The practice is open minded to the use of complementary medicines, eg: Acupuncture, Aloe Vera . There have been many instances where the best scientific medicine has been helped by the use of alternative medicines. Our patients benefit from having this choice available.

Neutering.

Clinical decisions at Astonlee.

Ovariohysterectomy versus  ovariectomy via laparoscopy.

 

Some clients ask about this and the difference between the two.  At Astonlee we prefer ovariohysterectomy by laparotomy because:

 

 

Ovariectomy via laparoscopy

Ovariohysterectomy by open laparotomy

Costs which is a BIG issue.

 

Realistically it would be necessary to charge £500 approx for the laparoscopic technique to pay for the extra equipment, time and clinical training involved compared to approx. £200 or even as low as £130 for a small bitch spey done the traditional way with open laparotomy.

At least £100 more to the client.  Would require at least £30,000 investment by the practice in equipment + further training of the clinical team.

Usually 2 vets are required to perform the operation handling the instruments.

Costs have been carefully maintained for years at Astonlee whilst retaining high standards for the surgery.

Usually only one vet is needed for the whole procedure.

What’s removed?

Just the ovaries, uterus left intact.

Ovaries and uterus removed.

Safety

The suture guns commonly used are not as good as in human surgical practice, and visibility could be obscured if there is a haemorrhage.  It is possible to make the spleen bleed with the insertion of the Verees needle for insufflation of the abdomen.

High degree of security of the ligatures around the arteries with good visualisation of the arteries and ability to see surrounding area for any haemorrhage.

 

Minimal scarring.  2 holes made by laparoscope.

People hardly notice a scar afterwards.  Longer hole made for open laparotomy.

Infection rates.

Reports are low.

Astonlee has very low infection rates.

Complications.

Can have haemorrhage from ovarian artery.

Paul Manning thinks it is less likely to have problems of haemorrhage of a critical nature due to the greater exposure of the arteries and visualisation and access for ligating them.  Astonlee track record for 26 years has been excellent.

Further complications.

Occasional problem with the uterus, especially if a remnant of ovary was inadvertently left inside.

No problem because the uterus is removed.

 

 

Recovery rates.

In human surgery, there is a big difference between recovering from keyhole surgery and open laparotomy where the keyhole surgery may have the patient up and about after a day or two, whereas open laparotomy might be 6 weeks.

In the dog, certainly those operated on at Astonlee, the dogs are up the same day (often within 1 hour of completing the surgery), and are walking although they shouldn’t be running within 1-3 days of the operation.

Scar size.

There is a small hole for each of usually 2 laparoscopes used in the technique, but although the usual scar size is small, sometimes some seromas can form.

Many satisfied dog owning clients have often reported how ‘neat the wound and scar is, how quickly their dog has recovered, and it’s a lot better than the scar humans get having undergone similar surgery themselves.

Humans tend to get scarring even where the stitches have been, which is probably a major driving force behind keyhole surgery in humans.  However, in dogs usually hardly any scar is visible once the wound has healed, not even where the stitches have been placed.  At Astonlee we often place dissolvable sutures underneath the skin wound so there are often no sutures visible from the outside.  Sometimes we place sutures in the skin on the outside as well to give etra security if this is thought to be advisable in any particular individual case.  There is a difference in individual surgeon preference on this point.

 

Pyometra with incomplete ovariectomy.

No pyometras.

 

Uterine cancer can occur but admittedly is rare.  Leiomyoma can occur.

Uterine cancer cannot occur.

 

 

 

Unwanted heats can occur.

Ovarian remnant syndrome probably less likely to occur.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 From August 2015, Astonlee has a new recommendation for bitch speys to be done ideally at 6 months old, but if they are to have the operation at a later date, we have a new policy that we will not normally offe an elective spey for small and medium sized breeds when the bitch is over 8 years old, and for giant breeds this will not normally be done after the bitch has reached 3-5 years of age.  If the bitch has a pyometra or other disease necessitating a spey we will do this, but the important point is we recommend spey your bitches early in their life when the risks are lower and the safety and care for your pet is the highest that can be achieved.

 

References.

Davidson, E.B. (2004)  Comparison of Laparoscopic Ovariohysterectomy and Ovariohysterectomy in dogs.  Veterinary Surgery 33, 62-69.

Proot, J.  (2008)  Laparoscopy Part 5 : Laparoscopic ovariectomy in the dog.  Small Animal Surgery UK Vet 13, 18-22.

Pukacz, M. et al (2009) Simple, minimally invasive technique for ovariohysterectomy in the dog.  Vet Record 165, 688-690.

Sontas, B. H.  Ozyogurtcu, H.  Turna, O  Arun, S.  Ekici, H.   (2010) Uterine leiomyoma in a spayed poodle bitch: a case report.   Reproduction in Domestic Animals; 45: 3, 550-554. 26 ref. 

Romagnoli, S. (2005) Heat after ovariectomy: a clinical problem to manage.   [Italian]

Praxis Veterinaria (Milano); 26: 3, 13-16. 17 ref. 

Zonturlu, A. K.  Kacar, C. (2004)  The ovarian remnant syndrome at the bitch with stump pyometra.   [Turkish] Saglk Bilimleri Dergisi, Firat Universitesi (Veteriner); 18: 1, 69-72. 7 ref. 

Davidson, E. B.  Moll, H. D.  Payton, M. E.  (2004)  Comparison of laparoscopic ovariohysterectomy and ovariohysterectomy in dogs.   Veterinary Surgery; 33: 1, 62-69. 27 ref. 

Okkens, A. C.; Dieleman, S. J.; Gaag, I. van der; (1981),  Gynaecological complications following ovariohysterectomy in dogs, due to partial removal of the ovaries or inflammation of the uterocervical stump.  Tijdschrift voor Diergeneeskunde,  106, 22, 1142-1158, 11 ref.

 

 

 

 

Retained testicles : complications with neutering.

 

Sometimes male dogs or cats in particular either have one or both testicles undescended, with one or both testicles in either the groin or inside the abdomen. This is because the testicle starts life in the embryo near the kidney and descends to the scrotum during development, but sometimes the testicles don't reach their destination. In these cases it can be quite difficult to find the testicle, and that plus the time involved does add considerably to the costs involved. It is, however, important to remove these retained testicles because they can become cancerous later in life.

  

 Rabbits.

Rabbits are important to us.  The first ever pets of the Principal Paul Manning when he was 11 years old or less were rabbits.

One innovation the practice has recently taken on is a set of new devices called 'VGel tubes' for improving the airways of rabbits when they are anaesthetised.  We have looked carefully at this and have dediced that there are significant advantages we can offer you and your rabbits when undertaking general anaesthesia.  Details are available: 

www.docsinnovent.com

 

Vaccinations at Astonlee.

 

Aspects of service

Astonlee Veterinary Hospital

Astonlee makes a difference

Qualified vets

All veterinary surgeons who are doing the vaccinations have their names published on the practice website, and clients are asked if they have any preference for which vet they would like to see (subject to availability and timing).

Some vaccination clinics do not name the veterinary surgeons on their website or in their published literature.

Prices

We have lots of offers for dog, cat, and rabbit vaccinations.

It is very rare for pet owners to come for their pet’s vaccination without having a health need addressed or a concern discussed, or a clinical finding of interest and importance.  We record our findings on our computer records so that we can follow the health of your pet throughout life, and refer back to our notes in future years.

 

Our puppy and kitten vaccination packs are brilliant value.  Our practice and on line shop prices for pet foods are very competitive.

 

Our senior well pet clinics are very valuable and extremely keenly priced in offering services that can help to detect diseases earlier, helping to enable your pets to live longer, happier lives.

Availability, opening hours

Astonlee is open 8am-7.30pm Mon-Friday, and 9-12 Saturdays for routine vaccinations.

Our opening hours enable most people to find a time slot that suits their needs.

The appointment

All our vaccinations are done by appointment so that waiting times are kept to a minimum.

The advantages of having time with the vet of your choice include being able to ask questions and share concerns about your pet’s health on an on going basis throughout your pet’s life.

Premises

 

 

 

 

Storage and supply of vaccines

Astonlee is a purpose built Veterinary Hospital, modern, brick built, and is inspected regularly by the RCVS.

 

 

 

Vaccines have to be kept at properly controlled temperatures both in transit from the manufacturer to the wholesaler, and also from the wholesaler to the practice where we store the vaccines in regularly monitored refrigerators.  The supply and maintenance of these standards is included in the regular inspections carried out by RCVS at Astonlee, which reassures you of our commitment in every detail.

The premises are very welcoming, the car park (free to clients using the practice) is large with disabled access, the waiting room is large and comfortable with areas for cats and an area for dogs, and the consulting rooms are also architect designed, hygienic, secure and private.

Facilities

Modern veterinary hospital, access to excellent clinical and nursing teams with a friendly reception team to greet you and look after you and your pets, access to all the many facilities you might require for your pet.

 

24 hour services

Astonlee is proud of its commitment and presence in the area in providing our own 24 hour services for our clients.  If a problem arises out of hours, we are available to help you and your pet.

 

If there are issues or concerns you have about vaccination, we are available by telephone during the day, and by night (emergencies).

We are unusual nowadays in that we provide all of our own 24 hour services ourselves at our own premises because we know from client surveys that is very important to pet owners, and we know that is important for our patients.

 

 

 

 

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Charter of service

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