Dr. Alexander J Smithson
Dr Alex J Smithson BVM&S BDS(Hons) CertEndod DipEndodontology MRCVS
Dual-qualified Veterinary Surgeon & human Dental Surgeon
What to Expect
We understand that this can be a stressful time for pet-owners and hope that once you have been referred to us the information below will help explain the process and make it as simple as possible for you.
Preceding Weeks
We send out information by email or post to confirm your appointment and advise you of our details and travel information. If you have not received this for any reason, please call.
If you need to change or cancel your appointment for any reason please do so at your earliest opportunity (and at least 24hrs) to allow other pets a chance to be seen.
Health Checks
If your pet requires blood testing, medical assessments (eg rechecks with a cardiologist for heart patients) prior to anaesthetic it is often good to obtain this prior to referral at your own vets, with results sent to us. This is especially true of animals with other illness or compromise and in the elderly, where results may influence anaesthetic protocol or delay treatment. We can of course also provide blood testing (on the same day for many tests) and offer the expertise of a multi-disciplinary team by prior appointment if required.
Insurance
We see many cases, both insured and uninsured, and treat both equally. However we do understand that finances can be a factor to consider and are happy to guide you in all aspects of treatments and costs. If you have insurance for your pet it helps to go through a few checks to avoid any issues with that. Many insurers now require that you inform them in advance of referral. We recommend that you contact your insurers in all cases to:
- advise them of referral
- check your policy (including whether it is lifelong or 12month, when the policy years runs from and to)
- check coverage for dental and oral conditions
- check for any exclusions
- check your excess
- obtain claim forms (ideally 3)
- obtain pre-authorisation where possible
If your pet is insured you will need to bring all insurance documents, including certificate of insurance, to your appointment. We recommend pre-authorisation of potential insurance claims wherever possible. Not all insurers enable this, but where available it gives you advance notice, in writing, of the cover you have for that condition.
Direct claims may be processed in certain cases and with pre-authorisation. There may be a small administration fee for direct claims which would typically not be claimable. If you have any queries re insurance please contact the surgery.
Day Before
Starving
Please do not feed cats and dogs after 10pm the night before your appointment. If your appointment is for a consultation only, or you are unsure, we would always advise starving anyway – it reduces vomiting during travel, assists blood testing and your pet is ready just in case. It is important for anaesthetic safety that animals are starved a minimum of 6hours, so if an accident occurs please ensure we know what time. Water can be left down overnight.
Medications
In most cases we advise that you give your pet its usual medications as normal the day before. Where morning medications are prescribed this may typically be given provided it is possible without food. We will need to know what your pet has had (including dose – feel free to bring the medicine containers) and when. If in any doubt please contact the surgery.
Other
Please check that you have the following items ready:
- Travel information
- Charged mobile phone – pre-place our telephone number in your phone in case of issue, we have 24hr telephone answering.
- Any relevant paperwork and medical information such as checklist, xrays, blood results.
- Insurance documents (including policy booklet, certificate and claim forms).
- Vaccination record.
- Food and drink for yourself if you have to travel any distance.
Day of Attendance
Travel
Please allow plenty of time to reach the referral centre, ‘commuter period’ traffic can add to journey times and it is ideal to allow dogs chance to go to the toilet after travelling.
If you would like a drink or require the bathroom on arrival please just ask at reception.
Referral Consultation Appointment
Consultations are typically in the morning, between 8am and 9.30am. Operations are then performed throughout the morning and afternoon. Each consultation is of 30mins duration for new cases (15mins for rechecks) and enables you and your pet to meet Dr Smithson and for you to discuss your concerns and ask any questions. Feel free to bring a list if that helps you; we also use a check-list to go through safety and medical background checks.
Your pet will undergo a general conscious examination during the consultation to check for any underlying issues which may be important for health and anaesthetic safety. Head, neck and oral/ dental examination is performed as far as possible – this does depend on the compliance of your pet too of course! It is important to realise that conscious oral and dental examination is limited in all cases; typically definitive assessment relies upon examination under general anaesthetic and xray imaging. The latter is essential to be able to assess the roots of teeth and areas of bone, where disease processes are often diagnosed. If necessary other tests such as blood or viral testing or imaging techniques, CT and MRI, will be discussed.
Discussion of your pet’s case, what the options are and the advantages, disadvantages and costs of each allows you to make an informed choice. You are not obliged to have treatment with us and if there is no need to have treatment or if an alternative with another colleague is advantageous, then Dr Smithson will advise you of that.
We will require your contact information for the day and guide you as far as possible on expected timing of procedures. The vast majority of patients are day cases, ie operated upon and discharged to go home the same day. We operate all day and patients recover at different rates or may require medications after operations, thus pets may be discharged in the evening. We try our best to schedule operations to suit each client and patient optimally but as with any operation day, it can be a long day and it is good to be prepared for this. In some situations we recommend overnight hospitalisation or can offer this if it suits you best.
Operations
If an operation is required, you wish to proceed and give your consent, your pet will be admitted for the day. They have comfortable beds within the kennel area, often with under-mattress heating. Normally areas of hair are clipped to safely access blood testing, placement of drip-lines for intravenous fluids and obtain blood-pressure measurements.
Animals receive pre-medicants to relax them, intravenous fluids to support blood pressure and aid recovery and the anaesthetic drugs and equipment we use are as used in human hospitals. Dr Smithson is very particular about ensuring good analgesia and we use a variety of pain prevention techniques and pain-killing medications. A specialist anaesthetist may be used in some cases (primarily patients of higher risk) and would be discussed and arranged well in advance if so.
Typically both investigation and relevant treatment is performed under the same anaesthetic; this would also be discussed and agreed upon during your consultation. It is not unusual to find additional issues during investigation and in some cases operations are staged (split over different dates), either to provide optimal treatment or to allow further discussion and consideration before proceeding.
Patients recover in a comfortable environment and we will call you to advise estimated time of discharge. At the discharge appointment your pet’s treatment will be explained, medications, food and post-operative directions provided and you have chance to ask any questions. If your pet is to be hospitalised we will typically go through this information by telephone. We provide a report for your referring vet to ensure they are up to date with everything too. Should you have any queries after you have left the surgery please feel free to call.
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Registered office: Bank House, 6 - 8 Church Street, Adlington, Chorley, Lancashire, PR7 4EX