Hamilton has an F1 Fracture

Meet Hamilton, a seven year old black and white feline. He suffered (what was almost certainly) a car accident and fractured his tibia in two places. Spookily, Hamilton has the name of Lewis Hamilton and a mechanic at the Bahrain F1 Grand Prix this weekend also suffered a double tibial fracture.

X Ray and Surgery

Like many cats with severe fractures, Hamilton was limping but otherwise bright and happy. X ray, however, showed a double tibial fracture. This is a serious injury for any animal, but our Surgical Certificate holder, Suanne, repaired the break by using two plates and screws, one over each break, some wires around the fragments (called cerclage wires) and a pin down the centre of the bone to aid stability.
This all makes for an impressive looking X ray.

The fracture

The repair, view from the front

The repair, view from the side

Recovery

Hamilton is recovering nicely, he has to be kept confined in a cage (we keep a few cages to loan out to cases like this) for a few weeks which he finds very frustrating. This is equivalent to a person being ‘signed off’ and advised to rest but once a cat feels OK they want to be out and about again and can’t understand why we won’t let them!
Once we are happy he is healing nicely, he will be allowed ‘room rest’ and then hopefully get back to a full and active life as soon as possible.

Road Accidents and Cats

If we let cats have free roaming outside then there is always a risk of being hit by a car. It is difficult to prevent this, you can keep your cat indoors all the time but some owners (and some cats!) find this unacceptable. Keeping your cat in at night helps too, at least in the day time drivers can see cats and try and avoid them. There may also be ways of altering your garden to make it difficult for a cat to access the road.

At the end of the day, it is a sad fact that if you want your cat to enjoy the freedom of outdoors and be around you when you are in the garden, then you have to weigh up the risks of road accidents (and other types of misadventure too – cats are naturally curious).

Can you see through our X rays?

Like most veterinary clinics, we offer X rays for our patients. They allow us to see ‘inside’ our patients to help us diagnose and treat them. As you might expect, there are numerous laws and regulations regarding their use.

RPA and RPS

Firstly, we have to have a Radiation Protection Advisor (RPA). This is an independent, qualified and regulated person who oversees our whole setup and who we can go to for advice.  Inside the practice we have  Radiation Protection Supervisor (RPS) – in our case it is Michael – who is responsible for the day to day use of our machine.

Radiation

Radiation is a bit like sunbathing, the more you absorb the greater the risk of harm.. Everyone absorbs radiation every day. This ‘background radiation’ is in rocks (granite has a relatively high amount), buildings, food (1.5% of the potassium in a banana is radioactive!), medical sources (scans and X rays) and cosmic radiation. These levels are very small. For our X ray machine we have to follow the As Low As Reasonably Practicable (ALARP) guideline. The biggest risk to staff isn’t directly from the X ray beam, but as it passes through the patient, some of it is ‘scattered’ around the room and this is where most of any dose we might pick up comes from.

Exposure

In an X ray unit there are three ways of decreasing exposure to staff (and pets);

Time – shortest exposures and as few as possible. Digital X rays and careful set up helps this too. Digital X rays allow us to modify the image after we have taken it (within limits) thus avoiding possibly having to take another exposure. Digital X rays also allow us to e mail them to get expert analysis if required.

Distance – the further away the lower the dose. We have to have a ‘Controlled Area’ around our machine which we restrict access to when radiographs are being taken.

Shielding – lead screens and aprons etc Our apron has to be tested every year and properly stored and maintained.

Digital X rays allow us to analyse and share.

Training

We have to train and supervise our staff, provide safe practices, provide risk assessments and Health and Safety training and keep updating and re-inforcing all of it. We have to have contingency plans in case of any accidents or equipment problems. Unlike in people who will stand in the appropriate position, our patients do not so we use sedation or anaesthesia. It is forbidden for anyone to hold a pet whilst it is being X rayed, even with lead gloves on. We have a selection of sandbags, troughs and ropes to position our patients.

We have a variety of positioning aids, here modelled by Snoopy

Monitoring

We have to monitor the exposure our staff get by using the little dose meters you may see on our uniforms. Staff have to wear these at work but not take them home! We also have to monitor the general radiation around our X ray room. and keep records. There is also a requirement for us to record and log every exposure we take.

Like so much in life, there is a lot of regulation involved but it benefits patients and staff alike.