Specialities

Small Animal Clinic of Estonian University of Life Sciences functions as reference clinic and frequently receives critical patients who need intensive care and monitoring. Therefore, a separate emergency medicine and intensive care department was formed two years ago. 

Who are we?
Currently three veterinarians specialising in emergency medicine and intensive care (Dr Kadri Janson, Dr Valentina Oborina and Dr Raidy Mägi) are working in our clinic. Additionally, several junior veterinarians and veterinarians specialising in orthopaedics and internal diseases rotate in the department. During the night, outside regular working hours, veterinarians specialising in different fields provide high quality emergency care services.  

What services do we provide?
The state of severely injured animals or those in critical condition is commonly fragile and has to be stabilised before it is possible to perform any further diagnostic procedures or tests. That means that intravenous cannula is first placed enabling administration of the necessary medications and fluids. Additionally, the vitals are taken. If necessary, oxygen is administered to facilitate respiration.
The most common diagnostic procedures during an emergency visit are blood sampling and analysis, diagnostic x-ray examination/ radiology, and express ultrasonography. Express ultrasonography is a procedure during which the veterinarian controls the presence of fluid in the thoracic and abdominal cavities. More comprehensive ultrasonography, where the internal organs are measured and their structure is analysed, is performed by an internal disease specialist, when the animal condition is sufficiently stable for the procedure. The staff members of the emergency medicine and intensive care department often have to deal with critical patients referred from other departments, and therefore, cooperation among specialists is essential.  

Who are our main patients?
In most general terms, our patients are all the animals whose condition requires constant monitoring and care. Critical patients are placed in an ICU stationary in the centre of the department, where their condition is continuously monitored and treatment plan is adjusted if necessary. 
We mainly deal with patients who need blood transfusion, suffer from chronic respiratory and/ or cardiac diseases, or experience urination problems. Furthermore, our veterinarians and their assistants constantly monitor patients with major traumas and those, who may suffer from seizures. 
Our staff members may insert a gastric tube to feed the patient or place urinary catheter if necessary.
The staff members of emergency medicine and intensive care department treat and suture smaller skin wounds.

Visiting an ICU patient
ICU patients are regularly under the effect of rather strong medications. Additionally, there may be other patients in the department. Due to these as well as biosecurity factors, daily visits by the animal owner or keeper are not recommended. 
Communication takes place twice a day via phone or if there are any changes in the patient’s condition. We hope for your understanding if the veterinarian cannot always answer the phone immediately – the doctor will always call you as soon as possible and provide you with all the necessary information!

Raising awareness among animal owners
Emergency medicine and intensive care department issues various brochures for the animal owners to warn them about different risks and provide information about how they can help their animal themselves in an emergency situation. 

It is expensive
Emergency care of critical patients in the clinic is expensive. Why so? Critical patients often require individual approach and monitoring, which means that somebody has to constantly be close to them, take their vitals, adjust the treatment plan, and administer necessary medications. The animal may need numerous blood sampling, repeated ultrasonography, or other diagnostic procedures, which may significantly increase the cost of their stationary treatment. 

One has to be prepared for emergencies
Unlike people, there is no Health Insurance Fund for animals. Thus, we suggest that every owner should insure their animal. You may find more information about pet insurance by clicking on the links below: 

https://www.if.ee/en/eraklient/kindlustused/lemmiklooma-kindlustus​link opens in new page

In our clinic it is possible to apply for instalment credit from Medicredit and Placet Group. For more information visit the company's webpages: https://www.medicredit.ee/en/link opens in new page & https://partner.laen.ee/emulink opens in new page

Surgery and anaesthesiology department
In addition to planned surgical procedures, animal patients who need complicated surgeries are often referred to Small Animal Clinic of Estonian University of Life Sciences. At the moment, there are four fully equipped operating rooms in our clinic. Two of them are used for orthorpaedic surgical procedures and the other two – for soft tissue surgeries. 

Who are we?

Five surgeons work on our team: Rainer Hõim, Ants Kuks, Diana Leppsoo, Marju Suviste, Tuuli Vaino, Nikolajs Oborins and Martin Karindi.

Anaesthesia is performed by Aleksandr Semjonov and Raidy Mägi. Finally, we must not forget about our wonderful assistants.

What does a surgeon do?

Surgery is one of the most important types of animal clinic services. Experienced surgeons of our clinic are always prepared to perform a planned or emergency surgeries. Routine neutering surgeries of male and female animals, various hernia surgeries, and numerous orthorpaedic surgical procedures, e.g. treatment of bone and joint problems are considered planned procedures.  Head surgical procedures, i.e. ear canal removal, opening of the nostrils (e.g. to remove a tumour), shortening of the soft palate in short nosed or brachycephalic breeds, salivary gland removal are considered to be more complicated planned surgeries.

The most complicated and serious conditions requiring emergency surgical intervention are removal of foreign bodies from the intestine and stomach, severe complicated bone fractures, bladder stone removal, caesarean sections, pyometra or surgical removal of infected uterus, surgical management of gastric torsion, etc. One of the most important parts of neurosurgery are spinal surgical procedures on cats and dogs, e.g.  surgical treatment of herniated vertebral disc causing spinal cord compression may give the animal a change for fast recovery.

Our clinic performs various thoracic surgeries:  we repair diaphragmatic hernias, remove lung tumours and manage cardiovascular conditions. An experienced team of anaesthesiologists and availability of lung ventilation equipment ensure success of most surgeries and fast recovery of our patients. We have successfully treated liver shunts, removed tumours from gall bladder, kidney, and liver. 

What does the anaesthesiologist do?

Development of anaesthesiology has provided opportunities for enhancement of surgical services.

Our clinic is one of the few in Estonia offering anaesthesia as a separate type of service. An anaesthesiologist usually remains at the background, but their work is a key to success of complicated surgical procedures. An anaesthesiologist evaluates the condition of the patient, the complexity of the surgical procedure, and based on that, decides on the safest type of anaesthesia. The task of the surgeon is to solve the main problem, while the anaesthesiologist keeps the patient alive and ensures the animal does not experience any pain.

Surgical procedures during which the patient cannot breathe on their own are considered most complex. All thoracic surgeries and most lengthy surgical procedures belong to this category. Moreover, all animals suffering from lung or heart conditions may experience respiratory failure. At the moment, our clinic has the best mechanical lung ventilation equipment in Estonia. The availability of both advanced pulmonary ventilation equipment and experienced team of anaesthesiologists helps patients with respiratory failure both during anaesthesia and in an ICU. The team of anaesthesiologists offers their services to dentistry, intensive care and neurology departments of our clinic.

What happens to your animal in surgery?
From the moment you hand your pet over to the surgeon of the animal clinic, it is never left alone, not for a single minute. First, the team of anaesthesiologists starts their work – they carefully examine the patient, take the necessary blood samples, in certain cases, consult the cardiologist.  Then, the patient is administered an injection of anaesthetic and prepared for the procedure. When the patient is fast asleep, the leading figures, surgeons, “step onto the stage”. They decide whether the patient needs any additional diagnostic procedures, such as x-ray examination/ radiology and computer tomography, or it can be moved directly to the operating room.  During the surgery, the animal is connected to several monitors that provide the doctors with the opportunity to constantly observe and re-evaluate the patient’s condition and notice even minor complications caused by the surgery itself or anaesthesia. Careful monitoring of anaesthesia significantly lowers the risks.

After the surgery, the patient is handed over to the team of the stationary unit, who, together with the doctors, would monitor the animal to calmly and safely recover from anaesthesia. Patients in critical condition are transferred to the ICU, where they are constantly monitored. Finally, you receive a long expected call from a surgeon, anaesthesiologist, or ICU veterinarian, who would inform you about the condition of your pet.  
In general, you may take your pet home, when it has entirely recovered from anaesthesia and its life is no longer in danger. 

Cardiac diseases develop in all animal species, but in our clinic we focus on diagnostics and treatment of cardiac conditions primarily in dogs and cats. Most patients of the cardiologic department of the clinic are either referred from other departments of our clinic or from other clinics around Estonia. 
The services provided by the cardiologic department of the clinic are supervised by an internationally recognised specialist and a lecturer in cardiorespiratory medicine of our university, Doctor Paul Fridtjof Mõtsküla. 

The common symptoms in patients requiring a cardiologist’s consultation are abnormal cardiac sounds (murmurs) or irregular rhythm (arrhythmia) discovered during a routine clinical examination, as well as breathing problems, decreased exercise tolerance, or fainting. Cardiac conditions significantly increase anaesthesia related risks. Therefore, the department of anaesthesiology often sends us patients expecting surgeries or other procedures performed under general anaesthesia for additional diagnostic tests.
During the visit, the veterinarian carefully studies the patient’s medical history and asks the owner about the previous course of the disease, as well as analyses the test results and other information related to the condition. After clinical examination of the animal, the veterinarian suggests the possible diagnoses and makes decisions about further diagnostic procedures.  
Most tests and procedures performed on cardiac patients are done without sedation. However, in some cases, sedation may be required, and therefore, it is recommended not to feed your pet 6–8 hours before the visit (drinking water may be available all the time).  

The most important diagnostic method is cardiac ultrasonography or echocardiography, that allows the veterinarian to assess anatomic structures and mechanical functioning of the heart.  For the procedure, the animal is placed on its side on a special soft platform. The procedure is normally performed without any sedation and does not cause any discomfort to the animal. During the procedure, heart wall thickness, the size of the parts, valve structure and functioning, and heart chamber contractions and relaxations are assessed. Doppler sonography is used to evaluate blood flow velocity inside the heart and in large blood vessels. This method helps determine even minor leaks in the valves, heart wall defects, and blood flow obstructions. 

Electrocardiography is performed to evaluate the heart rhythm. Rhythm disorders/ Arrhythmia may not constantly reveal themselves/ itself. Therefore, Holter monitoring, i.e. a 24- or 48-hour outpatient electrocardiography or monitoring of the cardiac rhythm, may be required. Thus, special self-adhesive electrodes are attached to the chest and a vest or suspenders holding a small ECG device of the size of a mobile phone is put on the animal. This procedure allows the cardiologist to monitor and evaluate the cardiac rhythm during the whole day, both during active and resting periods. Holter monitoring is essential if the animal suffers from fainting episodes. 

X-ray examination/ Radiology is used to study cardiovascular system and assess the condition of other thoracic cavity organs. This procedure is also usually performed without any medicinal sedation. Additionally, in order to diagnose cardiovascular diseases, it may be necessary to measure blood pressure, perform blood sample analysis to assess the condition of different internal organs or evaluate oxygen supply to various tissues (pulse oximetry and blood gases).

After the procedures, the diagnosis is confirmed and treatment plan developed. The veterinarian usually discusses the treatment plan with the pet owner, gives recommendations on how to monitor the animal at home, and suggests possible additional or repeated diagnostic procedures. As far as our clinic is affiliated with Estonian University of Life Sciences, veterinary medicine students may attend consultations and be present during the procedures. However, you should not worry, as the safety of all the manipulations is guaranteed by your treating veterinarian and the students are not allowed to perform any procedure without careful supervision of the specialist

Dermatological services

• Skin and ear parasites – diagnostics and treatment;
• Itching/ Pruritus – diagnostics and treatment;
• Skin infections – diagnostics and treatment;
• Ear infections – diagnostics and treatment – outer, middle, and inner ear inflammations;
• Ear procedures – foreign body removal, sample taking, outer and middle ear irrigation;
• Allergy diagnostics and treatment, including treatment of atopy, allergy shots specifically developed on the basis of allergy tests (allergen-specific immunotherapy);
• Hair loss without itching – diagnostics and treatment;
• Autoimmune skin diseases – diagnostics and treatment;
• Dermatological manifestations of internal systemic diseases (e.g. endocrine system disorder, such as hypothyroidism, overactive adrenal glands, etc.) – diagnostics and treatment;
• Changes in hair and nail condition.

Short description of dermatology services

Dermatological problems are relatively common in cats and dogs. According to some statistical data, approximately 17–25% of all visits to the animal clinic are related to skin or ear problems. Every day, a dermatologist has to deal with problems like toe licking, abdominal skin infections, armpit redness and itchiness, hair loss from the back and abdomen in cats, ear scratching, head shaking, and unpleasantly smelling discharge or non-itchy hairless areas.

During a visit to a dermatologist, a detailed medical history is composed describing the peculiarities of the diet, lifestyle, and previous treatment. This detailed interview may be rather time-consuming. The animal should be accompanied by the family member who is best informed about the pet’s health issues and treatment. We additionally recommend to prepare for the visit at home and take notes about the food and treats the animal consumes, and their composition, external parasite control methods used, medications administered and their efficiency (e.g. ear drops, shampoos, medications: name, quantity, length of treatment).

During the visit, a sample of the skin and from the ear are taken, to confirm or eliminate the presence of the parasites and/ or infection. 
A lamp with a special light spectrum is used and samples are taken to be studied under the microscope and inoculated in the laboratory from cats with dermatophytosis.
In case of chronic and/ or reoccurring bacterial skin/ ear infections, it may be necessary to take microbiological samples (for bacteriological analysis) to determine the pathogen (bacterium) and its sensitivity to antibiotics.
For final diagnosis of various skin formations and abscesses, needle samples (fine needle aspirations) are taken to study the cells under the microscope. In case of several skin diseases, it is necessary to take a tissue sample (biopsy) and study it in the laboratory (histological examination). 

General blood haematology is performed to evaluate overall health condition before starting continuous oral treatment or during its course to monitor the patient’s health.  Hormone tests may be necessary to diagnose endocrine system disorders (e.g. hypothyroidism in dogs) or to monitor the course of treatment (e.g. increase/ decrease medication dosage). In order to prepare an individual allergy medication (immune serum or the so-called allergy shot), it is required to perform haematology to determine allergen specific antibodies. All the above mentioned procedures and commonly painless and are conducted during a regular visit to the clinic. However, if your pet is really restless and nervous, light sedation may be performed. Deeper sedation is needed to take skin samples for biopsy, ear diagnostic imaging (see below), deep ear irrigation, or broken nail removal. These procedures are usually planned and scheduled after primary examination. 

If the animal is suffering from itching

Itching is an unpleasant feeling and the most frequent (25–45%) cause of the visit to a dermatologist. Pruritus may be induced by parasites (e.g. mange), allergies (e.g. food, dust mites, pollen), or secondary skin infections (e.g. certain skin tumours). 
Pruritus diagnostics has to be gradual and systemic. Therefore, it may be time-consuming and you have to be patient: it is a lengthy process, but it is possible to find the exact cause of the disease! Depending on the medical history, the veterinarian will explain to you in detail what diagnostic procedures are necessary (e.g. external parasite control, exclusion diet).
Pruritus may be accompanied or cause reddening of skin, hair loss, scabs and/ or purulent small abscesses, etc. If the disease is chronic, fair skin may become darker and thicker (the so called ’elephant skin’ condition). Thus, skin diseases that have developed due to pruritus of different causes may eventually have a similar clinical picture!
When the diagnosis is clear, the veterinarian will suggest treatment plans suitable for your pet.

Ear infections are also considered to be dermatological disorders

It is often believed that ear problems are a separate type of disorders, but actually, ears are also covered with skin, and the problems are considered dermatological. The causes of external ear infections are often (though not always) the same as in case of pruritus or skin infections.
The inflammation may start in the outer ear (i.e. until the eardrum) but develop/ spread further into the middle and inner ear. The most common cause of middle ear infection in dogs is chronic outer ear infection, which, in its turn, is often caused by (undiagnosed/ untreated) allergies.
Auditory canal and eardrum are examined using an otoscope (a cone lamp equipped with magnifying lenses and light).
This procedure is not commonly painful, but sometimes the ears may be so infected (swollen, painful, reddened, and excessive discharge) that their examination and medication administration may not be possible.

In this case, the veterinarian may first prescribe a course of oral medications, for example pills, and only when the condition has improved and the pet is more comfortable with its ears being touched, cleaning and irrigation procedures, as well as administration of the ear drops may be continued. In case of chronic ear disorders, diagnostic imaging may be necessary (e.g. radiology, MRI, and CT examinations) to determine the spread of the disease, presence of middle/ inner ears inflammation, and irrigation possibility/ necessity. All these procedures are performed under anaesthesia. 

The treatment of ear infections is successful if the primary cause of inflammation is determined (e.g. pollen allergy), secondary infection (e.g. bacterial otitis) is treated, chronic changes in the ears are under control (e.g. earwax producing glands are significantly enlarged, auditory canals are constricted), and possible predisposing factors are avoided (e.g. frequent cleaning of the ear, the use of unsuitable cleaning methods).

Hair loss without itching

There exist numerous diseases that are not accompanied by pruritus, but are characterised by hair loss. There may be hairless spots or larger symmetric areas on the body. The process may start at a young, middle, or old age and be either accompanied or not by other symptoms signalling deterioration of the overall health condition (e.g. excessive water consumption/ urination, inexplicable weight loss, lethargy). One has to be particularly careful when diagnosing hair loss in cats, as the process is not frequently spontaneous, but self-inflicted, which means cats excessively lick themselves and induce hair loss! As the causes of hair loss without itching are numerous and treatment possibilities are different (e.g. Demodex mites, endocrine system disorders), a visit to a dermatologist and careful examination may help find the solution. 

What do you have to keep in mind about a visit to a dermatologist?

1. When coming to the clinic, make sure you have enough time to carefully examine your pet, find the cause of the skin/ ear disease, and be able to treat it! The first visit to a dermatologist usually lasts 90 and a re-check visit – 60 minutes. NB! If you are more than 15 minutes late for the visit, in order to offer you the services of the highest quality, we would ask you to schedule another appointment.  
2. If possible, we recommend that the animal is brought to the clinic by the family member who is best informed about the pet’s lifestyle, diet, and medications.
3. It is also advisable to do your homework – e.g. gather information on the food and treats (name and composition) the pet has consumed or continues consuming, on the medications and care products administered and used (shampoos, oral medications, ear drops, etc.); on the type flea/ tick repellents applied.
4. 4If your pet suffers from re-occurring skin problems and you have previously consulted a dermatologist outside Small Animal Clinic of Estonian University of Life Sciences, we recommend to take with you or send via e-mail (to [email protected] marking „Dermatology“ as the topic, your pet’s and your names) your pet’s medical record.  It may help better plan the visit, save your time and probably money (e.g. it may not be necessary to repeat recently performed blood tests).
5. Do not wash your pet, clean its ears, or use ear drops before your appointment with dermatologist! For the test results to be reliable, it is not recommended to perform any of those procedure during up to 48 hours before the appointment. Do not stop administering any prescribed oral medication, however.
6. Sedation is normally unnecessary to perform routine dermatological procedures. However, some particularly restless animals may be sedated to perform routine and/ or more complicated procedures, such as deep ear irrigation, diagnostic imaging, biopsy sampling, removal of detached nails (or some other diagnostic procedures and tests). Therefore, if your pet is scheduled for any of the above mentioned procedures that are performed under sedation/ anaesthesia, or if you think that your animal may be restless and nervous, please do not feed it at least 8 – 12 hours before the appointment. The animal may still consume water  in normal quantities
7. We would also like to draw your attention to the fact that one of the main peculiarities of our clinic is participation of veterinary medicine students (including international students) in our daily work: they may job-shadow your veterinarian being present during the visit, but do not independently
8. In our clinic, we have a veterinarian specialising in dermatological problems of (small) rodents, birds, reptiles, and other exotic animals. 

You can book an appointment with dermatologist via

Phone +372 503 3878.

Regular working hours: E–R 9.00–20.00.
Address: Kreutzwaldi 62, 51014, Tartu.
E-mail: [email protected] (to be used for general inquiries and feedback, it is not possible to book, reschedule or cancel the appointment via email).

Eye disease diagnostics and treatment

In our clinic, we diagnose, manage, and treat all types of ophthalmological problems. Our veterinarian Kristi Sisask specialises and has completed in-depth training in ophthalmology. 

A visit to an ophthalmologist usually starts with a conversation with the patient’s owner or handler to gather the necessary information on the medical history, and is followed by several diagnostic tests. First, the specialist will ask you several questions about the onset of the problem and its course. During ophthalmological examination, the condition of the patient’s eyes is evaluated. Several diagnostic procedures may be performed, e.g. damage to the cornea is controlled using fluorescein eye stain test, lacrimation and intra-ocular pressure are measured, internal structures of the eye are evaluated. Depending on the results, further diagnostic procedures may be prescribed and a treatment plan developed. 

Measuring intra-ocular pressure (tonometry) to eliminate glaucoma

Glaucoma is a serious eye disease, where intra-ocular pressure increase may result in irreversible loss of vision and eye pain. Therefore, early diagnosis and treatment are essential, as these can help delay loss of vision for as long as possible.  Tonometry or measurement of intra-ocular pressure is done using a special apparatus. In our clinic, we use Tonovet and Tonopen tonometers. The procedure is fast and well tolerated by the animal, the results are immediately available. 

Gonioscopy

Gonioscopy is a method used to diagnose primary glaucoma.  During the procedure, irridocorneal angle or the anatomical angle between the eye’s cornea and iris is examined. Thus, the canals along which the aqueous fluid is moving inside the eye are examined using special equipment. As a rule, light sedation is needed to perform the procedure. Your veterinarian evaluates the necessity of the procedure. 

Biomicroscopy

During this procedure, the eye is examined using a special eye microscope (biomicroscope). This examination helps determine small defects, eyelash abnormalities (ectopic cilia, dischitia), foreign body, evaluate the condition of eye anterior chamber, iris, and lens.

Direct and indirect ophthalmoscopy

Eye fundus is examined using an ophthalmoscope to eliminate fundus diseases. It may be necessary to dilate the pupils to perform ophthalmoscopy, and therefore, pupil dilating eye drops are administered 20 minutes before the procedure. 

Ultrasonography

Eye ultrasonography is used if, for a certain reason, it is impossible to perform ophthalmoscopy to evaluate internal structures, or if tumours are suspected in the eye or orbital cavity. During eye ultrasonography, internal structures of the eye are evaluated. Animal does not usually require any sedation for the procedure. However, anaesthetic is administered to the eye before the procedure to make it more comfortable. 

Eyelid correction surgery

Healthy and appropriately structured eyelids are necessary for normal functioning of the eye. The condition of the eyelids has to be checked if the animal suffers from eye squinting, lacrimation, and inflammations. The eyelid may be turned inward (entropium), be drooping and rolled outward (ectropium), or several problems may exist at the same time. Eyelid disorders cause reoccurring eye infections, corneal damage, pain, and even vision loss. Such patients need eyelid correction surgery. In more complicated cases, several surgeries may be necessary. The procedures are performed under general anaesthesia. The surgery is followed by a 2–3-week long treatment. The extent of the surgery is determined during individual pre-surgery examination.

Correction surgery of the third eyelid lacrimal gland prolapse (cherry eye) and third eyelid turn

The third eyelid protects the eye from trauma, drying, excessive light and impurities. The third eyelid prolapse makes it more visible, more susceptible to infections, and more painful. The condition may develop due to nervous system or internal disease.  The exact reason is determined during clinical examination in the animal clinic. The third eyelid lacrimal gland prolapse develops in dogs and, less frequently, in cats. It mainly occurs at a young age. Some dog breeds are predisposed to lacrimal gland prolapse (English Bulldog, Cocker Spaniel, and Pomeranean) in one or both eyes. It is related to the weakness of the connective tissue holding lacrimal glands together. One of the signs of the third eyelid prolapse is a pink or reddish formation, similar to a berry (therefore, it is named “cherry eye”), in the inner corner of the eye (as seen in the picture). The prolapsed lacrimal gland is placed back and is fixed. 
Dogs of large breeds and less frequently cats may suffer from the third eyelid turn. In this case, the deformed part of the eyelid is removed to normalise the eyelid position.  
These procedures are performed under general anaesthesia.

They are followed by a 2–3-week long post-operative treatment.  

Surgeries of corneal diseases (including conjunctival flap and artificial cornea placement, as well as removal of necrotic corneal tissue)

Cornea is the layer covering the front of the eye. Normal cornea has to be transparent and without any patches. Trauma, irritation, and bacterial infections may cause corneal ulceration. The treatment depends on the extent of the damage. It is frequently sufficient to administer medication directly into the eye, however, sometimes oral medication is also required. In case of more severe damage, when there is a risk of rupture or cornea penetrating ulcer, it may be necessary to suture it. Thus, the animal’s own conjunctival, corneal, or artificial corneal tissues are used. The procedures are performed under general anaesthesia. These are followed by a 3–9-week course of medication. 
In certain cat breeds, especially Persian cats and British Shorthairs, corneal dystrophy (necrosis, sequestrum) are common. The symptoms include eye squinting, lacrimation, and light or dark brown patches on the cornea. Grey-reddish infected area may develop around those patches. The exact cause of necrosis remains unknown. Herpes virus infection is suspected to be the initial cause of the disease. Additionally, certain breeds are predisposed to rolling of the eyelid, which may result the drying of the cornea and lead to the conditions described above. At the initial stage, necrosis and corneal infection are managed using eye drops.  However, this method may not always be successful, and then, necrotic tissue has to be surgically removed. The procedure is performed under general anaesthesia. It is followed by a 3–8-week course of medication.

Prosthetic eye/ ocular prosthesis placement (intrascleral prosthesis)

In cases of reoccurring eye pain or irreversible loss of vision, e.g. as a result of glaucoma, it may be recommended to remove the eye and replace it with a prosthesis to alleviate pain and improve pet’s quality of life. 
Prosthetic eye is cosmetically more appealing and allows the animal to move and blink the eye. 
Intrascleral prosthesis is a black silicone ball of the size of the normal eye. The prosthesis is placed into the eye through the opening made in the sclera. Thus, eyelid, conjunctiva and cornea are preserved. The surgery is performed under general anaesthesia. It is followed by a 3–6-week course of anti-inflammatory medication. After the surgery, the eye has to adapt to the prosthesis, and therefore, it is normal if infection develops: cornea turns greyish-red, conjunctiva becomes swollen and reddens, the animal may squint the eye. All the symptoms gradually disappear. Finally, cornea will remain grey and afterwards turn brown, but reddening and pain will disappear.
This surgery is performed on cats, dogs, and horses.
Possible complications include rejection of the prosthesis, as well as chronic treatment resistant infection and pain. These complications are relatively rare. In case of complications, eye removal may be considered. 

•    Contact your veterinarian to get recommendations and advice.
•    Rinse the eye with saline solution, special eye rinse, or clean tap water by putting 4–6 drops into the eye, gently swabbing with a cotton pad and removing crust around the eye.
•    Avoid any pressure to the eye.
•    Prevent the animal from rubbing and scratching the eye. Put on a collar if necessary. 
•    Do not administer any medication if not prescribed by the veterinarian.
•    Contact the veterinarian as soon as possible.

Ophthalmologic emergency care

Conditions requiring first aid:
•    Eye squinting for more than 2 hours
•    Wound in the eye area
•    Eye trauma caused by a cat 
•    Sudden eye increase
•    Falling out of the eyeball
•    Bleeding in the eye
•    Eyelid wound

Emergency care provision
First of all, it is necessary to contact your veterinarian or call our clinic to get consultation and advice. 
As a rule, any general veterinarian may provide ophthalmologic emergency care and, if necessary, further refer the patient to an ophthalmologist to perform more specific procedures.

Ophthalmologic emergency care at home
•    Contact your veterinarian to get recommendations and advice.
•    Rinse the eye with saline solution, special eye rinse, or clean tap water by putting 4–6 drops into the eye, gently swabbing with a cotton pad and removing crust around the eye.
•    Avoid any pressure to the eye.
•    Prevent the animal from rubbing and scratching the eye. Put on a collar if necessary. 
•    Do not administer any medication if not prescribed by the veterinarian.
•    Contact the veterinarian as soon as possible.

We are dealing with small animal dental and oral pathologies in two fully furnished dental offices in Estonian University of Life Sciences Small Animal Clinic by the combined efforts of our two enthusiast in veterinary dentistry level veterinarians - Kadri Kääramees and Aiki Saaremäe -, and our team of excellent assistants.

We are supported by our anaesthesiologist – Aleksandr Semjonov, and colleagues from diagnostic imaging and surgery as needed.

In addition to patient work we are also actively involved in disseminating small animal veterinary dentistry related knowledge among our colleagues and future colleagues aka veterinary students. 

A large part of our work consists of diagnostics and treatment of the most common oral and dental conditions dogs and cats suffer from, namely periodontal disease and dental hard issue injuries.

We also deal with malocclusions, different inflammatory oral cavity syndromes, oral masses and traumatic injuries to the soft tissues, bones and joints of the head and oral cavity.

Diagnosing and treating oral and dental problems in dogs and cats always neccessitates general anaesthesia. This is because our pets are not patients to whom we could communicate like we would for a fully aware, rational human the nature of and need for these procedures nor the self-restraint needed for those – sharp and rotary equipment used during these procedures would thus present a very real and obvious danger to both the patient and the operator if we would try to do the procedure in an awake or a lightly sedated animal. Intubation – placement of a breathing tube into a patient’s trachea – is also obligatory for most dental procedures for the purpose of the protection of the airways.

For patients with concurrent health problems or advanced age, our anaesthesiologist will be monitoring the anaesthesia safety if deemed neccessary. 

In diagnosing oral and dental problems, diagnostic imaging is of great importance in addition to a thorough examination under anaesthesia; most commonly, intraoral dental radiography is employed for the purpose, but also, if needed, computed tomography or other modalities.

We always have our patients and their owners come in for an awake examination and consultation first before setting a time for the anaesthetic procedure. This helps us to get a preliminary read about the problem in hand and its extent, enables us to do pre-anaesthetic checks and allows us to work with the owner to decide which would be the most suitable solution for a particular  pet-owner-problem combination.

With many an oral trouble, owner-administered routine homecare will be of utmost importance.  We do have to remember though that an awake examination does not give us all the information about oral cavity and dental conditions we need and a more thorough diagnostic examination will take place during an anaesthetised procedure that will then be planned for; also, generally, treatment of discovered pathologies is very often begun within the same anaesthetic episode.

A dentistry procedure under a general anaesthesia – called a comprehensive oral health assessment and treatment (COHAT) – consists of a thorough examination and charting of the oral cavity and dentition, intraoral radiography, supra-and subgingival dental cleaning and polishing and formulating a further treatment plan as needed.

We would like to encourage our good colleagues who wish to refer a patient to us or just discuss a case with us to contact our dental team veterinarians via link herelink opens in new page.

In addition to the common X-ray and ultrasonography, it is possible to perform computer tomography (CT) and magnetic resonance imaging (MRI) examinations at the Small Animal Clinic of the Estonian University of Life Sciences. Diagnostic imaging helps to diagnose or rule out various conditions. The results of the examinations are generally interpreted by specialists in-house, but in complex cases, the results are sent to international specialists for interpretation.

Computer tomography (CT)

The computer tomography works with X-rays, and as a result of the examination, it is possible to depict the study the area needed in great detail layer by layer, as well as in 3D projection. It is possible to visualize various changes that may go unnoticed on X-ray examination.

Why does the patient undergo the CT scan? 

This method provides accurate information about bones, joints and internal organs. CT is one of the most important diagnostic methods in modern orthopedic surgery and traumatology. As a result, surgeons receive much more information about the pathological processes in the joint or bone and can plan the operation much more precisely, which in turn reduces the likelihood of complications from surgery and anesthesia. CT is also the best method for diagnosing tumors. This allows you to see the exact location of the tumor, its extent and its connection to other organs.

CT scans are performed on animals in sedation, i.e., medications are used to immobilize the animal. The combinations and doses of anesthetic drugs differ from those of the animals undergoing surgery, and the risk of anesthesia in the study is generally low. In the case of risk-increasing diseases, an anesthesiologist will be involved in the procedure.

The duration of the examination is less than 20 minutes, but more time is goes to preparing the procedure and the animals recovery from sedation.

Magnetic resonance imaging (MRI)

The magnetic resonance imaging device works with a strong magnetic field, which allows the imaging area to be imaged section by section. The procedure is mainly performed on patients in the neurology department in connection to the indicated central nervous system examinations.

An MRI scan can accurately assess the condition of both the brain and spinal cord and the conditions that affect them. For example, this method makes it possible to determine the cause of an animal's seizures. In a paralyzed animal, MRI is the most important method to determine the location of the spinal cord compression. Only when the problem area is clear can surgeons solve the problem and restore the animal's mobility.

The MRI examination is performed in animals under general anesthesia, as the animal must be immobile throughout the examination. The whole procedure can take 2-4 hours. In the presence of diseases that increase the risk of anesthesia, an anesthesiologist will be involved in the procedure.

Reminder:

• As the procedure is performed under sedation or general anesthesia, the animal must be admitted on an empty stomach. This means that there must be at least 6 hours between the last meal and the start of the appointment. If the appointment is in the first half of the day, food must be removed late in the evening. It is allowed to drink water, you do not have to take it away.
• Make time for the day of the procedure. We approach each animal individually and it is difficult to predict the exact time. The animal is allowed for home treatment as soon as possible after recovery. 

At the moment, the service is not offered in the Small Animal Clinic of the Estonian University of Life Sciences. 

Physiotherapy is currently only offered in one clinic in Estonia by the Erivet clinic in Tallinn. 

Physiotherapy plays an important in recovery, pain relief, and rehabilitation after injury, disease, or surgery. Additionally, it is crucial in solving chronic, lasting problems and has proven its efficiency in alleviating age related problems.  Physiotherapy helps preserve and enhance strength and flexibility, restores normal movement patterns, and fosters normal functioning of cardiovascular system. 

How to book an appointment with a physiotherapist?

In case of a healthy dogs, no reference letter is required, and it is possible to book an appointment by calling our clinic reception.
If your dog is suffering from a certain condition, a reference letter from the regular treating specialist is required. The veterinarian diagnoses the animal, evaluates its condition and the necessity of physiotherapy. Finally, the physiotherapist will design the treatment pan if it is necessary.

When coming to the appointment

If your pet has previously visited another clinic, please send their medical history well in advance of the visit to: [email protected].

The animal should be fasted for a few hours before the visit. If your pet has a favorite sweet (or toy) to motivate them with, take them with you. And the same way: if there is food intolerance, your sweets are a safer choice. There are sweets in the physiotherapy office, but they may not always be suitable for everyone.

The process of physiotherapy

At the first visit, a physiotherapeutic assessment is performed, where the physiotherapist examines for past and present concerns, looks at the animal's movements, palpates its muscles and assesses joint mobility. If the animal is very anxious or apprehensive on the first visit, a more thorough examination may be postponed to the next visit.

Based on the findings of the evaluation, goals are set with the owner and a further physiotherapy plan is agreed. Physiotherapy is always a collaboration between the owner, the veterinarian and the physiotherapist. The owner has a very important part in the whole process and this must be taken into account, because in the case of chronic or some skeletal muscle problems, for example, the recovery process can take several months.

Methods of physiotherapy

• The most important method of physiotherapy is therapeutic exercise, in other words, active movement. We try to find an exercise plan for each patient that suits his or her abilities and leads to goals. Be it re-learning and maintaining natural postures or more complex combinations of exercises: it is physical activity that is most important in recovery. We can use balance boards and pillows, barriers, treadmills, etc. to gradually increase the load.

The physiotherapist also instructs the owner on how and how often to perform the exercises at home and what to keep in mind with their pet.

• Manual therapy
  These are the so-called “hands-on” techniques aimed at alleviating muscle tension and spasms, as well as pain caused by them. Manual therapy includes passive stretching and passive joint locomotion exercises, joint mobilisation. Moreover, a physiotherapist is able to exploit the animal’s natural reflexes to stimulate active joint mobility.
• The methods include laser, therapeutical ultrasonography, TENS and EMS electrical treatment methods, heat and cold treatment.

Does my pet need physiotherapy?

If you are not sure if a physiotherapist can help or should see a veterinarian first, feel free to write to [email protected]

Who are exotic pets?

Exotic pets are becoming more and more popular besides dogs and cats. Owner’s knowledge about keeping exotic pets is increasing and due this, more help is sought from the veterinary clinics. Other parts of the world exotic pets are also known as non-traditional companion animals, but in Estonian language we are using the term “Exotic pets” for animals who are not dogs or cats but kept still at home as companion animals. Exotic pets are rabbits, ferrets, parrots, African hedgehogs, sugar gliders, reptiles and different rodents: guinea pigs, chinchillas, hamsters, degus and rats. 

Most commonly owners come to Estonian University Small Animal clinic with rabbits, guineapigs, rats, ferrets   or parrots.

There is a lot of information out in the Internet about health problems and treatments, still diagnosis should be  made and treatment prescribed by a veterinarian who has deeper knowledge about exotic pets. Many drugs  and supplements, that are sold in human pharmacies are not suitable for animals, and especially for exotic  animals, because their specific anatomy and physiology. Also, many drugs suitable for dogs and cats  are suitable for exotics. Using wrong medication or supplements can cause more harm than good, so in cases  of health issues proper veterinarian should be visited. Exotic pets hide their signs of illness until the last moment, so regular health check is needed to detect any problems early on. Young animals should be checked once a year, older animals 2-3 times per year.

Who are we?

In our clinic exotic animal medicine service is provided by veterinarian Kristin Tõnise.

What do we do?

The Small Animal Clinic of Estonian University can be visited with a pet just for a husbandry consultation or in cases of health problems. We do first opinion visits as well as referrals from other veterinarians.

Services, that are offered: 

• Husbandry consultations
• Behavioral problem consultations for rabbits, rodents or ferrets
• Regular health-checks
• Diagnostics and treatment of dermatological and ophthalmologic problems
• Parasite problems: external and internal parasites, fecal sample check-ups
• Diagnostics and treatment of dental problems, dental trimmings, and removal of teeth
• Imaging diagnostics: ultrasound, radiographs, computed tomography, and MRI
• Blood sampling
• Surgery: planned and emergency surgery, pathological (neoplasia, abscesses, wounds) or non-pathological surgery (spay and neuter)
• Diagnostics and treatment of neurological problems
• Orthopedic problems and if necessary, we collaborate with orthopedic surgeons
• Cardiologic problems collaborating with cardiologist
• Hospitalization

Most common causes for clinic visits?

Most commonly exotic pets arrive to the small animal clinic due to anorexia, depression, but also with nodules or masses and dental problems. 

Many owners come with their pets for regular health checks, vaccinations, or surgical procedures.

Every visit we do, we ask information about husbandry, take proper anamnesis, do a clinical evaluation of the pet and then we can decide if and what kind of diagnostic procedures and the treatment the pet needs. Due to the large number of different species and different diseases, there is not always one specific working protocol, but we take into account the specific patient who is seen by the veterinarian. 

What to keep in mind when visiting the clinic?

1. Exotic pet who is kept with a companion, should be brought to the clinic with the companion to reduce stress that is caused by the visit.
2. The animal should have his/her own banket (that has the pet’s smell), suitable substrate and food (if not indicated otherwise) in the transport cage. Rabbits and rodents are prey animals, meaning they become stressed more easily and to reduce the stress, the visit and transport to the clinic should be made as comfortable as possible.

3. When coming for a visit, time should be taken and on the first visit a husbandry form should be filled. This is so we could give advice about husbandry and proper feeding, if necessary, do corrections, so the pet could have the best life possible. Many diseases in exotic pets are caused or amplified by incorrect husbandry.  

4.Husbandry form should be filled as exactly as possible, so at home photos of the dry food could be take, so we can check if they are suitable for your pet.

5. When rabbits are brought to the visit room, they should be let run freely in the room if possible. Rabbits are curious animals, and this helps to reduce the stress.

6. Guinea pigs, chinchillas and other small rodents should be kept in their cages, but ferrets should be let to run around but trashcan can should be removed from the floor.

7. Reptiles should be kept warm when visiting the clinic, for this a box with hot water bottle or warm water bag should be used.

8. If you have previously visited some other clinic due to some health issues, please bring information from your clinic with you.

We are used to the fact that animal clinics mostly deal with the treatment of pets, productive animals or horses. However, animals living in zoos and animal parks can also be in need of help. Estonian University of Life Sciences and the Tallinn Zoo have a cooperation agreement and within the framework the veterinarians of our veterinary clinic help the zoo in the treatment of its inhabitants. We also operate internationally, with major partners such as Wildlife Pharmaceuticals (Ltd) in South Africa, Warsaw Zoo (Poland), Attica Park (Greece) and several other agencies. Aleksandr Semjonov, who is a senior lecturer and holds a PhD in veterinary medicine in the anesthesiology of wild and zoo animals and is a member of the European Association of Zoos and Wildlife Veterinarians, is the head of the field of zoo medicine in the Estonian University of life Sciences. 

What makes zoo medicine special?
Firstly, the zoo is home to many species of animals and their anatomy, physiology and diseases are very different from each other. Secondly, many zoo animals are dangerous to humans and require anesthesia for examination or treatment. And thirdly, due to the size and dangerousity of the animal, transport to the animal clinic is usually not possible, so we are forced to make visits to the zoo.

Who are our patients?

In Estonia, we provide veterinary assistance primarily to the Tallinn Zoo. Over the years, we have anesthetized many different species of animals: lions, polar bears, muskoxen, camels, bison, gaur, Przewalski's horses, chimpanzees and also the largest residents in the zoo, the African elephant.

For example,each year the veterinarians of the Estonian University of Life Sciences Large Animal Clinic visit the zoo to trim the hooves of the world's largest bovine- the gaur. The surgeons of the small animal clinic visited the zoo to treat the elephant's wound. In cooperation with human doctors, we have also performed health examination on the person's closest relatives - chimpanzees.

We always involve the university's veterinary students in our work.

Internationally, we have treated a variety of predators, elephants, giraffes, rhinos, sea lions and walruses, and dolphins.

What are the main focuses of our activity?

• High quality anesthesia and treatment for zoo animals
• Development of zoo biosecurity programs
• International training courses for veterinarians and students
• Zoo animal research.

Teaching and courses

Zoo animal medicine is taught to veterinary students in the subject of zoo and wildlife medicine. Many Estonian University of Life Sciences students have also conducted research in this field and successfully defended their dissertations. In cooperation with the South Africa's pharmaceutical company Wildlife Pharmaceuticals (Ltd) South Africa, we conduct annual Zoo, Exotic and Wild Animal Anesthesia courses in various European zoos, South Africa and India. The aim of the course is to provide in-depth knowledge and skills necessary for the work of a zoo veterinarian.

Additional information and questions:

Senior Lecturer Aleksandr Semjonov
[email protected]