Specialist Surgery Services and Rehabilitation

Our Services

  • Soft Tissue Surgery

    • Surgical oncology (maxillofacial, cutaneous, intra-thoracic, intra-abdominal)

    • Intra-thoracic surgery (e.g., patent ductus arteriosus and vascular ring anomaly)

    • Intra-abdominal surgeries (hepatic, gastrointestinal, colorectal, urogenital, various hernia repair) and skin/muscle reconstructive surgeries

    • Laryngeal arytenoid lateralisation for laryngeal paralysis, brachycephalic obstructive airway syndrome corrective surgeries.

    Orthopaedic surgery

    • Joint disease (arthroscopy and cruciate disease, patellar luxation, joint luxation)

    • Fracture repair and angular limb deformity using internal stabilisation (plate osteosynthesis, interlocking nail) and external skeletal fixators (linear, hybrid, circular)

    Spinal surgery

    • Decompressive surgery for intervertebral disk disease (Cervical hemilaminectomiy, ventral slot, thoracolumbar hemilaminectomy, corpectomy, dorsal laminectomy +/- stabilisation

    • Neoplasia, subarachnoid diverticulum, vertebral fracture and stabilisation/fusion

  • Musculoskeletal ultrasound

    • Lameness evaluation and localisation of lesion

    • Intra-articular block for lameness localisation

    • Nonsurgical treatment of musculoskeletal disease

    • Intra-lesional and intra-articular injection of PRP, iPAAG, cortisone

    • Shockwave Therapy

    • Class IV laser (photobiomodulation) therapy

    • Certified canine rehabilitation practitioner/therapist on site

    • In hospital complementary rehabilitation for all surgical patients

    • Geriatric and osteoarthritic problem

    • Residency-trained anaesthetist consultation in conjunction with surgery and sports medicine input

    • Patients with liver/kidney compromise that can’t have NSAIDs

    • Patients with NSAIDs that do not respond well

    • Geriatric patients

    • Osteoarthritis

      NSAIDs is an excellent drug, but there are contraindications or long-term adverse effect. Occasionally it is not enough to control pain and maintain quality of life. We offer multimodal medical approach and aid of shockwave and laser therapies and pain clinic

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Our Facilities

Diagnostic

  • DR X-Ray

    • High resolution digital panel

  • Cone Beam Computed Tomography (CBCT)

    • Superior bone visualisation, compared to conventional CT scan

    • Excellent in complex joints: maxillofacial fracture, elbow, carpal, and tarsal joints

    • More sensitive in bone fracture/fissure, compared to conventional CT scan

    • Dual energy technology to improve soft tissue contrast

  • Fluoroscopy

    • Orthoscan Mini-fluoroscopy in theatre

  • Arthroscopy

    • 1.9mm arthroscopy system

  • Musculoskeletal Ultrasound

    • Assessment of tendon/ligament

    • Precision intra-articular injections

  • Articular block for lameness evaluation

Surgery

  • Two separate State-of-Art theatres, each is dedicated to soft tissue and orthopaedic procedures

  • Supported by intraoperative fluoroscopy and arthroscopy

  • Latest equipment, including bipolar sealing device, GIA and TA staplers, full range of orthopaedic tools (plating, ESF, ILN, E-pen)

Rehabilitation and Sports Medicine

  • Underwater Treadmill

  • Intra-articular injection: Platelet-Rich Plasma (PRP), cortisone, and iPAAG

  • Extracorporeal Shockwave Therapy

  • Class IV photobiomodulation (laser) therapy

  • TES/NMES

  • PEMF

  • Fully equipped gym

Dr Taka is not only a specialist surgeon but also a certified canine rehabilitation therapist (CCRT) through Canine Rehabilitation Institute (CRI) in the United States by examination. At Cedar Mountain Vet Referral, we are fully equipped with rehabilitation modalities. We are also capable of lameness examination, diagnostics and regenerative medicine.

Various modalities of regenerative/sports medicine and rehabilitation are available at Cedar mountain Vet Referral, such as Platelet Rich Plasma (PRP), extracorporeal shockwave therapy (ESWT), Class IV photomodulation therapy (LASER), underwater treadmill, and manual therapy and gym on site.

The unique advantage of Cedar Mountain Vet Referral is that a specialist surgeon, who performs surgeries, also perform rehabilitation. The surgeon who knows what he has done fully understands what to emphasize and what not to manipulate.

Rehabilitation with appropriate modalities can treat patients with osteoarthritis. It has been successful using shockwave therapy, laser, manual therapy and underwater exercises. We are able to reduce or even stop medications. Osteoarthritis can be managed without NSAIDs and pain killers.

Extracorporeal shockwave therapy:

The shockwave machine produces focused, single-pressure pulses of high-energy acoustic sound waves, microseconds in duration, to stimulate healing. Shockwave produces1450 -14,500psi (the pressure under the deep sea) in a small trode. Shockwaves directly stimulate production of growth factors, angiogenesis, anti-inflammatory effect, and increased cell metabolism, disintegration of mineralization, and pain relief. Shockwaves reach deeper tissues than laser and they are effective with less frequent use compared to laser. Combination of shockwave with laser is known to have a synergic effect, and therefore we intend to use both modalities simultaneously.

Shockwave therapy is indicated for musculotendinous disease and nonhealing skin wounds. It has been validated that is shockwave is indicated for tendinopathy (e.g., Achilles tendon problem, shoulder rotator cuff muscle tendinopathy (biceps and supraspinatus tendinopathy).

Shockwave therapy is particularly useful postoperatively for fracture repair and TPLO (encourage healing of osteotomy, preventing patellar tendon thickening, better weight bearing) as well as maintaining joint health and pain relief, various tendinopathy, lumbosacral disease, focal or generalised osteoarthritis. 64% of patients with lameness caused by shoulder pathology did well with shockwave therapy in one study.

Shockwave therapy reduces chronic pain by decreased production of substance P. Shockwave therapy is recommended osteoarthritis, tendon, ligament/muscle healing, degenerative lumbosacral stenosis (Cauda Equina Syndrome), fracture/osteotomy healing, myofascial pain/trigger points, and dermatologic issues (chronic nonhealing wounds).

Underwater Treadmill:

Underwater treadmill is gaining more popularity in canine rehabilitation. There is no doubt that this modality is excellent and accelerate functional recovery of selected patients. However, appropriate use of the modality is crucial for earlier and safe recovery of every patient.

Advantages:

  • The hydrostatic pressure of water reduces swelling and inflammation, which can help alleviate pain. This is particularly beneficial for dogs with osteoarthritis and patients recovering from orthopaedic surgeries

  • Buoyancy of water reduces body weight to bear, helping to maintain active joint range of motion without fully loaded in joints

  • Water resistance to build muscles

  • Weight management is easier as calory spending under water is higher than land exercise

Disadvantages:

  • Some patients may not tolerate with water

  • Treating to target specific muscles is not possible in the underwater treadmill

  • It is hard to correct abnormal gait in the underwater treadmill

  • Contraindicated in patients with open wounds, skin disease, gastrointestinal disorder (vomiting or diarrhea).

  • Patients may not be ready for underwater training if weakness is significant. A proper strengthening of the muscles will be recommended prior to underwater treatment.

miles shaved for injections at the vet