Completed in October 1997 and opened by The Queen in April 1998, Beaufort Cottage Equine Hospital is the product of many years of planning. The aim was to provide a state of the art surgical facility to deal with an ever increasing surgical case load, both from the local practice and referred by veterinary surgeons around the country. The Hospital building is designed around the operating suite. This includes two theatres, one dedicated for orthopaedic surgery and the other for the remaining caseload. There are three padded anaesthetic boxes. One is specifically designed for induction and two for recovery from general anaesthesia. These rooms are linked by an electronic overhead rail system which allows complete flexibility between either operating theatre and any of the anaesthetic boxes.

The operating theatres are serviced by cleaning and sterilising areas. Anaesthetic gases are piped in from a medical gas room. Each theatre is monitored by closed circuit television which can be screened in the reception area, ensuring the close co-ordination of activities by all members of staff.

There is also an examination hall with stocks and two examination rooms which are also used for bandage changing, routine treatments, and for the preparation of patients prior to general anaesthesia. A radiography suite caters for the important surgical radiography case load. Within the Hospital building there is accommodation for two resident nurses in individual flats and a bedsit for an extern. The extern is usually a final year veterinary student, or sometimes a visiting veterinary surgeon, who is attached to the Hospital for a period of one month at a time.

The nurses station is the nerve centre for the yard in which treatments are prepared and where patients’ files and records are kept. This has recently been expanded to separate a medication and logistics area from the nurses’ office.

Over the years an increasing number of patients requiring intensive care have been managed in the practice. To deal with these cases most efficiently, part of the stable yard has been incorporated in the Hospital building and connected by a covered breezeway. These stables are used specifically for intensive care. Each box is insulated and equipped with infra red heat panels and facilities for supplying continuous intravenous fluids. Closely associated with the area is a heated store room for intravenous fluids which can be easily administered to the patients by the support staff. The stable yard itself is built in traditional style in block, which matches the Hospital walls and also the Cambridgeshire clunch stone of the Diagnostic Centre.

The surgical case load, which annually includes almost 600 horses treated under general anaesthesia, is divided evenly between orthopaedic and soft tissue surgery. In the orthopaedic case load, arthroscopic surgery and fracture repair are the predominant types of procedure performed. In the soft tissue case load approximately 100 colic surgeries are performed annually, and the remainder comprises respiratory surgery and procedures such as castration, ovariectomy and wound repair.

A laparoscopic service has been developed and used increasingly for examination of patients with chronic colic or weight loss. It can be carried out with the horse sedated in the standing position and is complimentary to other means of investigation such as transabdominal ultrasonography. In the last two years this non-invasive technique has been used increasingly for the removal of intra-abdominal cryptorchid testicles and ovaries.

At the end of 1997 a Nd:YAG laser was purchased and this has proved invaluable for performing respiratory surgery in standing horses. Thus, laryngeal cordoventriculectomy (Hobday), palatal surgery, ethmoidal haematomas and epiglottal entrapment, amongst other lesions traditionally operated under general anaesthesia, can now be done on an out patient basis under sedation and local analgesia.

The Hospital building and its staff work in close co-operation with members of the diagnostic team and there is a free transfer of horses between the two sites, where this is appropriate for investigative or surgical procedures. Commonly horses are referred for investigation to the Diagnostic Centre and then passed on to the Hospital for surgical treatment. Similarly, horses admitted for investigation in the Hospital are often examined in the Diagnostic Centre, for techniques like video endoscopy, gamma scintigraphy and corrective farriery.

The Hospital is staffed by two surgeons and a surgical resident. There are three interns now at the Hospital. One intern carries out routine anaesthesia during the day, and shares the out of hours rota with the second year intern working in the Diagnostic Centre. There is also a third intern who has the responsibility for overseeing the treatment of the in-patients. We have four qualified veterinary nurses and three veterinary nursing auxiliaries. The nursing staff rotate between the theatre and treating the patients in the Hospital yard.

The Hospital reception services the entire site including the Diagnostic Centre and is manned from 8.30am until 5.30pm on weekdays. The out of hours telephone is connected to the practice emergency service ensuring that 24 hour cover is provided for the Hospital. On Saturday and Sunday mornings the reception is manned (between 9.30am and 11.30am) to provide an information service for horse owners and referring veterinary surgeons as well as for admitting routine and emergency cases. Outside these hours, cases can be referred through the normal practice emergency service. There is a nurse on the premises 24 hours daily.

All cases from outside the local Newmarket area must be referred by a veterinary surgeon. Not only does this ensure that the referral service remains completely ethical, but that patients receive appropriate veterinary care when they return home. Reports are issued to the referring surgeon for every case, and these may also be used for insurance purposes. Discharge instructions are provided for every patient leaving the Hospital.

In 2001 the first floor of the Equine Hospital was developed to provide a well equipped lecture and meeting room and a library and computer study facility. This development will enable the Practice to expand upon its already considerable involvement with equine education, to colleagues and veterinary students, to equine nurses, farriers and other equine paraprofessionals and to owners, managers and others who work in the equine industries.