Lovely, thank you very much indeed. . And Yes, tonight we're, I hope you get some nice pictures tonight.

It's been a long day for everybody, I'm sure. So have some nice pictures and, and, and, and, and, before bedtime. OK.

Firstly, what is CT? So we got a little bit of technical stuff first of all. This is about probably understand least of all of it.

But basically also know as computer tomography or CAT scans that we like to do. And tonight we're talking about X-ray CT, not, not positron. So, not the PET scanning, which is different, different modality altogether, but sometimes confused.

Basically, as you see the slide here, we have this, processing used to generate a three dimensional volume, the inside the object from a larger two-dimensional radiographic images taken around a single a rotation. And if you'd like to read more, actually, this is probably the only time in my entire career I will ever put up a link to a Wikipedia entry, but actually is a really good entry on what CT scans are about and explaining it. And actually technical stuff Wiki can be quite useful, but here we go, here's a wiki link for anybody who wishes to follow such things.

So They then shown in a way, this is what really makes CT so different and how you read it and stuff. And to be honest, all of the imaging of things, if you think about how you show the images is crucial. So the difference say between a plate X-ray and a digital X-ray, it's the same thing.

It's just how it's, how it's demonstrated. So basically, historically these images are all in this sort of transverse planes these sections through the animal. All along the long axis itself there too.

And what the new scanners now do, which ones didn't do, is now we can always sections slices be put together to reformat into different planes to sat your sections, for example, or even then put together 3D structures, the one we all ones we all know and love, these 3D images made up from all these different, different views. And if you really want to get smart, you can put IV contrast in and that can enhance soft tissues, seeing you start producing soft tissue, 3D, images and stuff too, which are really cool. So that's what we do.

What it basically sums up as these are 3D X-rays. So essentially take a lot of X-rays all around the animal and you put them together, you make 3 dimensional X-rays rather than two dimensional, which is, which is great because typically with old X-rays with 2D, what we do is we take different views and in our own minds, we put those together to make a 3D image and May make precision locations, for example, of a foreign body or something. Instead, we have a computer that does that for us with lots of different images, much more detail, much more accurate.

So how does it do that? Well, the typical way for CT is you have arrays of X-ray detectors with multi detectors, and this allows for slices through the animal. And essentially the more slices equals more detail.

So a 64 slice scanner producing more detail than the 16 slice. What are we talking about tonight is what we use, which is slightly different. And that's why I want to explain it because the images you see, some of the images see a little bit different, some as you see from a traditional CT.

And we actually use something called a flat panel volumetric scanner. And there's a reference to the end here from Gupta all in radiographics is a free online, resource, and that to explain how this works, was slightly different. Sorry about technical stuff, but it is, it is useful in the end.

What this does, rather than taking these slices, you actually have the X-ray head rotating around the animal as a 12 centimetre panel. So this flat panel rotates all around the animal, taking a stack rather than individual slices. Now this actually reduces very slightly the soft tissue contrast, which can be an issue in some places, but what it does do in that single pass is it creates enhanced detail of that 12 centimetres section.

So for a whole organ, which was originally intended for, it can be fantastic. Now, I deal with exotics. 12 centimetres, many of my species, an awful lot of the animal.

So we can do a whole body scan in some of these species in 30 seconds, creating this really high definition volumetric composition. And the detail of these is comparable to micro CT images, which is what you see some of the detail on tonight, especially some of the very, very small creatures. So that's what we're using.

That's what I'll be showing you tonight. OK. So what's it good at showing?

Because we'll talk about prices and stuff in a moment. These are not cheap toys. They show anatomy, like X-rays, they show anatomy.

And like X-rays, because they are X-rays, they're really good at showing especially showing bone. Where they're much better, where they're really good is 3D bony structures. So skulls, pelvises, pectoral girdles in the exotics.

Those are really difficult with conventional X-rays because the overlay a bone to really get a great image. CT gets around that because it's just there for 3D bony structures. It's also really good at air contrast, just like X-rays, so lungs and that's absolutely excellent.

For soft tissue for abdomens and stuff, not quite as good as, as other modalities. Maybe it's because X-rays, maybe not. If you put some contrast in that, then we can start getting some good definition of internal organs.

But again, that's probably a secondary usage, especially in the exotic world. What's it not good at? It's not good at neuro neuro tissue.

Now, you can do brain imaging with CT if using contrast, you really get the algorithms right, you can get images which should be able to tell you things like tumours and larger structures. It won't give you much fine detail. MRI is much better for those.

And if that's your primary use, you may be better off looking towards MRI. Again, abdominal structures, I don't think are quite good with the exotics, but they, with contrast use, they can be great.ho is for some of the, of course you got to use intravenous, with some specs we're doing, it's actually quite hard to get a decent intravenous access.

For example, let's say guinea pigs and that sort of thing can be very hard to get invenous access to be able to get that in there. So that can be an issue. Bizarrely, there's a really good, paper from Capella in North America, back in 2016 comparing, Dental imaging, with, with comparing CT with, with, with two dimensional X-ray.

And within that, Capello found that different people reading it got better definition, better detail from a two-dimensional X-rays of the actual shape and structure of the tooth itself. But the CT was much better at defining the roots and showing root disease. So again, different things may be useful in different areas.

I wish you're saying a moment showing maybe depending on type of CT maybe teeth structure can change too with how you look at it. So Is CT better in conventional radiography then? Well, teeth versus roots, maybe you need both.

Overall I would say probably say CT for those. Now one place where conventional radiography is much, much better, and that is really within survey use. And to, to issue that.

One is radiation dose. When you start doing whole body scans, you really are putting into animal for a person, and it scales down quite well, is you're using roughly the equivalent to a year's worth of, of radiation exposure to do a whole body scan. So you're using a very high level, probably a maximum you want to be acceptable within that.

So you do need to try and reduce that radiation exposure for any animal, which you might want to do it again one day. So try not to do whole body scans that reason too. The other reason for everybody who used to be a fan of that House series is remember the house did not like whole body scans.

Why? Because you'll find things on everybody on everything, and you will. And these are known generally as incidental omma.

And you get these lesions and you think, well, that's a disease. What's that about? Is that important?

So sometimes just scanning everything can produce too much information. And, and mislead you in some instance and that can become an issue. So you're much better using your radiography, two dimensional radiography for surveying, for seeing where it's localising where things are, then you can base your CT on those X-ray findings.

So for example, that would be spines and stuff like that can be really useful to using the CT in at a localised area for picking out the detail of important things too. It is much better for three-dimensional bony structure you mentioned earlier, so especially skulls. It's really good at producing detail and it can be in those areas much more sensitive than X-ray.

You pick up much earlier changes, especially if you're looking at tooth roots and stuff. Where it's particularly good, I find is when you've got bonus soft tissue combinations and ears will be a classic example. And I'll show you some ears in a moment, because what radioy won't show you is, is the soft tissue changes within the, the hard tissue canals.

So is it easy to use and read? Well, yeah, in summary, yes. A little bit talk about how the implication that has to be owners in a moment too.

Positioning is critical, just like two-dimensional X-rays, the principles of taking them are really similar. You, I've seen stuff where people say, oh, I just put in a scan and you can, you know, you can edit out, all, all these bits and pieces. You can, but it's like taking a digital picture with your camera.

Is that the more editing you've got to do, the worse the picture is. Same goes for these. If you position better, if you get the, the, the animal will be what you want centralised within the, within the, within the, with the beam, you're going to get a much better image of it straight, everything else there than you.

If it's not, you've got to enhance it. The picture, by the way, is taking whole body scan, sorry, of an axolot, within that because a tends to be still, we're actually using the bag of water to position that. But even saying like that, we're still doing as accurate position we can get away with, we we're with an animal's still conscious there.

So yeah, positioning is critical. When you're reading the CT, well, know your anatomy. You get really nice sharper and anatomical pictures, so sharp you do think, oh my goodness me, do I remember my anatomical textbooks?

Where do I go back to? So you're going to know your anatomy to be able to read it properly. It does help knowing a radiographer who can help you do things and radiologists as well if possible, to help you interpret things and learn some techniques of how to read those.

And also whatever programme you're using, learn how to adapt those images, how to edit them, and what you're doing is you edit them because you can so much change dramatically appear into them by pressing a different button. You need to know what you're doing with that and how it does. And that takes a bit of time, probably my age and more so because then these programmes I find immensely difficult, but it does take time to do so.

And it's really useful in the early stages of sending some images off to a second opinion and comparing results. That's pretty much same as any other clinical technique in the early days. In terms of costs and stuff, they are expensive, but the units are getting cheaper and for most of them, generally to practise break even level, 2 to 3 a week is really always needed to do that.

And that's achievable quite easily because of the number of uses they have. So it's a nice, nice way to go. And for the unit we're using, it's actually quite small, it's almost portable, so actually the space you need and also the amount of radiation is kicking out is a bit less, so we don't need so much shielding and stuff to actually reduce the cost as well too.

This is why CT is becoming much more available now. Because it's becoming more available, yes, you might not have one yourself, but actually somebody nearby could well have it and therefore it makes it easier to use, within each case and makes them more, more of an option when you without hitting so you like glass ceiling of diagnostics. Typically, a CT will be around about 500 pounds plus GA plus contrast, etc.

So again, not cheap, but the benefits that we'll talk about at the moment. Insurance coverage is quite variable too, and that is important. Some insurance companies automatically cover it, and that's great within their overall range, obviously accepting they will have limits somewhere.

Some of them will only cover 50% of cost. So if you are talking to owners, you do need to cover that particularly rather than get a nasty surprise when the claim goes in. So get them to check before, you do the scan and things and see how, how we're going to budget that.

And that can be quite important. Val again, you're going to see what it's worth, what you want to do. And again, another reason, maybe for looking to target these things.

And in enough, the BVA guide to ionising radiation just produced this last couple of months, is very keen on the fact that actually, You don't replace radiography with CT. They are different things and you use it in a much more targeted way. Radio Free is your standard, so, and then the value comes from there.

So an exotics. Well, exotic imaging. Is essential.

Many of our cases we're doing imaging for, as part of a general workout, many because we haven't got so much knowledge about other from clinic examination. Some animals, for example, tortoises are just almost impossible to do a full examination on. So imaging is really a vital part of any exotics case.

They're often because they're very small, we need a lot of detail, and we need all the contrast between different tissues and stuff. If we're using conventional radiography, we also have to take many different views. For example, here, we're using, open mouth rostrachordal view to get looking to be imaging with temporal mandibular joints of a guinea pig.

We're also doing lateral skull views. We dose of ventral skull views for true radiographic workout we're probably doing obliques as well. So you can also take 7 or 8 dental X-rays for a guinea pig or a rabbit, which is getting get enough radiation, getting a lot of images to put together and process and cost wise it's getting towards the cost of the CT anyway.

For something like a bearded dragon here again, we often are using a dental X-ray machine because we need, we, we don't, we will get better detail using that than we would using conventional radiography. And of course, we want to use intraoral plates. We need a very small unit to be able to do that.

So again, maybe we need two units within that, to be doing our exotic imaging, and again, cost isolating from there. OK, so let's say we're gonna CT them. Don't forget that manual restraint is not permitted in a CT because of the levels of radiation used, so unacceptable for anybody else to do that.

Some people who do box restraint methods for some animals to keep them still. I have some reservations on some of those. I can see why they're used in some instances, but I do have worries, because, some of these animals may become distressed in those situations there too.

And actually, overall, I prefer doing sedation or, or anaesthetizing them to keep them still. And that way we're getting over the anxiety effects and things like that. What we also have, if we do sedate or anaesthetize, is that we have, control over respiratory rate.

And for some of these animals to breathe very quickly, we're going to get a lot of artefact if they're breathing fast within, say, a thirty-second, scan. So, this is why with these two pictures of penguins in here, pain on the left as open mask and actually that's breathing like hell. And that was really getting a blurry image.

That's when we had to, we, we, we, we then switched out, we always intubate them, we ventilate them, and we can sort of hold the breathing for a short period of time to get a much stiller, much better picture from them. And that is important. Reptiles much easier for that because they've got much slow respiratory rate.

In we, they should be great if they just sat still, but I found that, our machine makes a very rapid beeping noise that circulates, and they absolutely hate it. I don't know why reptiles hate that. They always move their heads.

So again, sedation, gets around that problem. So what areas are we doing? So let's start with some of the areas we, we, we were using the CT for what we're looking at with it.

So skulls I said, the 3D bone absolutely made for CT, absolutely fantastic. And with the exotics we have a lot of problems with the skull. And again, if we, we, we use radiography, we're often doing multiple views.

It's difficult getting that detailed imaging, getting those views you want because we bone overlay within the skull. So to start off, this is not a small mammal. I showed a rabbit earlier on.

This is, actually a crocodile, a dwarf crocodile, which bits onto a heat lamp and, produces a massive, burn and tissue necrosis through, the dorsal part of its jaw. And this again, I think the conventional radio we really struggle to get a good image with because what we're not looking, just looking at is we're looking at bone necrosis, but also looking at some soft tissue damage. And we can see exactly where it's bitten across through here.

We can see the damage going through here. We can see where the soft tissues being burned and is necrosing. We can see the filling of fluid within the sinus there on this section and transverse section, we can, we can see this a right side is much more heavily affected.

We see some bony damage, we can see that too. So we start predicting where we're going to get tissue that's where we need to control that, where the devitalized tissue is going to come in there for, for planning our surgery and stuff, and that, that helps a lot in dealing with this case. More common use is dental disease.

And here we have a rabbit. We can see lots of issues. We get much clearer view of the roots.

This is a 3D image. We all love 3D images of these creatures. They're not always the most useful, especially in the situation here.

But, here we can see the, the upper motor roots, we can see the, the prominence through there. We're going through the, the breaking through the, the, the, the cortex of the bone. And on the lower jaw, again, we can see the formation of abscess with male positioned, caudal, molar.

We can see the abscess, area, in the bone. We normally use the, conventional transfer sections for these. And here we have a section through the first molar.

We see the maxillary sinus here. We can see, change in the tooth itself there. And we can see on this side here, we can start to see, changes in the, Bone overlaying, the, the, the molar.

So some really good detail of those two in the lower jaw, we can start to see maybe formation and abscess with breaking through the cortex. We can start seeing increased haloing at the bottom of the tooth and sees bulging, of, of the, of the mandibular bone. So we have great detail.

Right, it does fall short as Capello fan is in judging hooks and stuff. And to be honest, we can do that visually anyway, much more accurately and using endoscope, we can magnify that. So again, not the most useful for visualising hooks.

We're using the, sat sections. Again, we can start seeing, especially when we're doing visualisation of abscesses and staging of root disease. Again, we can see these are, We, we can do that with this too.

We can see the change in the upper motors here is doming almost over the motors of chee 2 to 4 here. Again, in the lower section, we can see this playing of the teeth. We can see the breaking of this cadal molar going through the jaw, the cortex of the mandible.

We can also increase our slice thickness and start seeing the molars of the block. And here we do start seeing decent two strikes. We see the curvature of the first pre-molar, which is really important, in grading our dental disease there too.

We, we can see the interations too, so we can start seeing that. So we can play with our slice and play our image enhancement. We start getting more and more, more and more detail of, of, of a staging the dental disease from that too.

So it can be really useful. And that's why I think going back to Capella paper is actually if we use a different type of scanner and different type of section or slices, we can start seeing different levels of detail. OK, where it's really fantastic is abscesses, you start showing the location.

You can start giving much more on prognosis and bizarrely, we've probably done fewer abscess since we started CT in our cases, mainly because we can see the obvious abscess. And when we do the CT we can see all the other abscesses beginning in different, different, arcades and we're thinking, well, hang on, do we want to operate on those because there's gonna be another one fairly soon. So prognosis is really good for that.

But when we do do surgery, it's second to none on surgical planning. It's fantastic. It seems like this for a retrobulbar abscess, and this is a very obvious one.

We can see the eye up here, we see the soft tissue mass behind it, and we can see the 4th molar here with the, destruction of a bone and the, which is where the entry infections coming from. So we can really plan those surgeries, and those are hard to do on conventional radiography. We can different space as well, different areas too.

So this is a guinea pig. We can see the the abscess in the molars here, can very hard conventional radio we to get that that degree of detail. If we go into those two, we can see and this is a rabbit where we've got, different arcades affected.

This is the obvious abscess we all knew about. We could see a massive level of destruction of the mandibular bone. We can warn on this point if we do operate on that, we're very likely get pathological fractures through there, and there may be some consequences in the short term after surgery from that.

But also we know we've got abscess formation within the maxillary sinus, of the upper, left quadrant as well. And we've got abscess formation in the lower left too. We can start seeing a thicker sizes we start really seeing where the, where the, teeth interact.

So here we've got this very beautiful abscess here too. And this is one where I do, I do find the 3D really useful, for surgical planning, same abscess here, we can start seeing exactly where the bones destroyed. We see start seeing where the abscess is coming through there.

And that gives me a sort of 3D image in my head as I'm operating, and, and trying to curate that out to a new extent of where the abs abscess, capsule goes. We can do a small stuff as well. And this is one example where we want really want very fine detail.

So this is a sugar glider. We have, an abscess from the teeth here. It's very difficult to do dental removals and these guys, we start seeing where the abscess is breaking through the, through the jaw here into the sinuses.

We also get a lot of problems with periodontitis and abscessation in bearded dragons. And here is, to transverse section through this dragon here. We can see the bone destruction, and this abscess formation within here 3D view.

Again, I can really see where I've got to go in, which bits of bone I need to be cutting over, curetting out there, and the extent I need to debride that, that, that material. So really good for our surgical planning at that level of detail. We do actually see a lot of temporal mandibular joint problems linked in with dental disease, ear disease and stuff, and small mammals, guinea pigs, especially, but also rabbits occasionally.

And again, we can do this roster record of views, but again, overlay of tissue makes them hard to interpret positioning is really hard and CT is actually much easier for that too. And here's our fairly normal temporal mandibular. If we look here, fairly normal on this side, again, we've got this arthritic change, we've got this fuzz and.

This on, on, on, on this side there. Now, the temporal dibular joint is really mobile in these spaces, when it comes to chewing, and if that's arthritic, if that's infected, then we can start getting, a lot of pain and a reluctance to eat from that too. So again, really useful detail pick up along the way.

We do a lot with sinuses, sinus problems very common, especially in rabbits. We start seeing, abscessation material building up in the maxillary sinuses here. A small amount in this one, much more in this particular case here we start seeing, filling out here to we start seeing bone thinning, alongside here and potentially alongside here as well.

So again, we start to extend this gives direction about where we're going to flash or operate if we want to operate an abscess. These can progress, in this case, here we see much more, it's almost filling the nasal cavity here. We're getting turbinate destruction as well.

So we get much more respiratory tract disease too. And on the, different section to again, we can start seeing the level of bone of osteomyelitis and of sinus filling, again, which areas need to be debrided and surgically removed on this particular view. With that drocystitis can be a sequel to, of, of sinus disease.

And we can do the nice thing about these is if we do a drocystogram, a contrast to bit of a tear ducts in 2D, we often go to do each side separately because of the overlay. CT is very simple. You simply down both sides and the 3D takes care of the rest of it.

Again, we can see this on 2D 3D imaging, we can really start seeing the course of, of the ducts. So we can see it going over the molar roots, we see a thinning here, got some impaction. We can see dilation because the main blockage is just this point here over the incisor roots.

Some more advanced upperspiratory, again, non sinus. Here we can see our sinuses are quite good. We can see we got upper respiratory tract disease, and we're getting filling.

I've got discharge and stuff through this area with it within the nostril within the nasal cavity. And we hear sinus abscess too again planning surgery. So here is a maxillary sinus abscess of the base of the incisor route.

Can we see some advanced dental disease and we can see it's going up through and breaking through the jaw here, kind of a transverse section, we can see that going through. And if we do a 3D imaging for our surgical planning, we can see this our area here. We know we've got to take this bone around this region here, if we're going to do something about it.

And this is an area where we can start seeing tooth, tooth problems there. I mentioned ear disease. I love this for ear disease.

This is absolutely fantastic, changed a lot of way I've worked. This is a true, ear-based abscess. We can see total destruction of the, tympanic bullet on both sides.

We can see a lot of abscess material coming through, bulging, soft tissue mass here under the skin. Now this is probably to a lot of that you probably would see on a conventional X-ray. What you won't see on the conventional X-rays change like this, and this is basically where we have this is a normal ear on this side.

We could, we've got better detail probably see a tum across there, nice gas field, external canal, nice gas field butler. On this side here, you can see you've got nice butter imums there, and we've got this fluid filled external ear that you won't, won't get on conventional X-ray. This is near-base swelling, another common rabbit problem.

Again, we've got flu swelling on this side, but here we've got our, it's a loy rabbit as. We've can see we've got change of the bone, in the middle ear, got middle ear filling with material. And here we've got the ear-based swelling coming out from here.

This is a bulging of the lateral wall of the ear canal. And we can see that quite clearly again for knowing what we can do, whether we can flush or not, whether that's intact to below flushing, that allows a lot of surgical planning. So moving away from heads on lungs and chest and things, we can start looking at basic heart size.

We get a good view of this and it's very large heart here. We start seeing lung detail. It's probably true to say, but virtu every animal has got pneumonia if you look on a CT scan.

We start getting areas we start the areas of consolidation or areas of clarity and stuff. It's even better on birds, which you got amazing difficult lungs to visualise on X-ray. We can really start seeing the detail.

We start seeing the almost the air parts behind that. We often do get abscessation, and, and lesions forming, and we can see the, bronchi bronchioles going through that. Kearney has mentioned, CT is really good at 3D bony boxes, and a colonium is a 3D bony box.

And we can X-ray them. We do a lot of different views from different angles and stuff. It's a very conventional thing to do with it with pneumonia cases.

And as soon if you've got say like a space lesion or abscess, it's brilliant just using conventional radiography. This is great because this gives us fine detail as well, which we often don't get. We, we're with, with conventional radiography.

And here we can see, we can start seeing some of the, actual lung pocketing, so the air sat pockets. On this view here, we can start seeing air sack divisions. These are some of blood vessels going through.

And again, this is a pneumonia case here. We've got enhanced, structures within there. We can start seeing a lot more inflamed air sack walls and things, and a diffused pneumonia form.

And that's quite hard to pick up in an early stage within conventional radiography. Again things you won't see necessarily conventional. This is a very sad case actually.

This is, made for the lungs are actually fine here. We just, just, just plain air through here. We can see got very reduced space this because we got a soft tissue within here.

Miss Hayes shows we've got fluids, so it's acitic tortoise. The reason is that one with spade about a year earlier. And you can see here the bone.

This is normal bone here. You see the bone and this is the section we cut out, plastronectomy incision and see even a year on, we hadn't got complete, healing, and we can see the bone is, is actually unhealthy and necrotic. And this is actually it turned out to be a fungal, peritonitis, due to entry of, of, of, of contaminant through.

This area where the bone had broken down. Very unusual, very rare, but again saying you just could not do a convention radio offer free in shape. It's actually pretty good for bony structures spine.

Again, not so good for neural tissue. We get a lot of arthritic cases, so we can start seeing bridging here. We can start seeing some of the, alter positioning some of the vertebrae.

And again, a lot of aylosing, lesions along some of the vertebrae, in good detail, for some of our, our, our back cases, which in rabbits, small mammals is really, really common and the cause of many different sort of, things like gut stasis persistent, not doing well. We can see that in reptiles as well. We can see these bridging lesions occasionally through here, and this is actually a shark, this is cartilage.

By weighting the CT or soft tissue, we can start seeing some ankylosis and the fusing of the, of the spine that's happening in this. We can, we're not great for neural tissue, but actually avian spines can show quite well. This was a falcon, which, which suffered, hit a post during flight, and it was paralysed on its, on its legs.

What we can see in this one again, different weightings and stuff, we can actually see these lesions here. And this is, basically a spinal bleed. Around about the pelvic level.

And that kind of accounted for the neurosciences. That's the anti-inflammatories time and physio, that birds now actually doing really well and back in a standing, moving well, and, and, and in a breeding programme, which is great. So we can get neural imaging as long as the lesion is big enough and obvious enough to do that.

And with birdsine, which don't have many movable joints in them, this is a really good, good modality for doing that. We can use the fractures to again within surgical planning. so this is an osprey, and we can see this is where it came from wild.

This has got a fused, semi-healed fracture. Again, we can start planning out, we can work our angles. We're going to dissect that down and refracture that.

We can also see here we've got a femoral head fractures in the penguin. And this is one of the problems you are picking up in penguins now with hip disease. And we can see the the separation of femoral head from a femur.

So really use that fine detail for surgical planning really helps a lot. So there's an example we're doing with it and what we can find with it. So what do we offer our clients?

Do you say, I've got to do the scan every time? Well, I said, I don't really like that very much. I'd like to focus it more.

So for virtually every case, we actually offer two dimensional or three dimensional X-rays. We'll outline the pros and cons for it. Unless I prefer, 3D for dentalsis planning, but we can work off 2D because we've done it for years, and we can do that.

So we outline what we prefer and what we're doing. The exceptions are retro bulbar abscess where I really don't think conventional radiography gives that surgical planning, ear disease where it really doesn't show much at all, and avian spines. In those cases, we really do go through and say, look, this is a technique of choice, and we, we, we do, do try and help them towards that.

Otherwise, we tend to give Joyce the team. What's the client feedback? This is important.

Clients love it. Even when they're paying a lot of money themselves for it, they love it. And the reason is because they understand it.

Because you can see it. So we all know when you look at ultrasound images, it's really hard to work out what those fuzzy grey things are. When we look at a two dimension X-ray, we can talk somebody through it.

We've got to explain what, what's what. I put CT images up there and person say, oh, I can see that there, they show me what's on there, and it's really easier to understand images. We always provide our clients with images.

We take a few extras and especially 3D shots. This reconstruction would take home afterwards because they actually love it. And we've got quite a few people who've got school who were teaching schools and stuff.

They take them with their kids and show these pictures and they're absolutely great, get on really well. The clients actually do this. So in summary, for advanced imaging, so MRI is great for neural stuff, but probably CT carries more options, more all around imaging with MRI and it's and it's also a lot cheaper and so probably carries better value for that too.

In exotics, even in a very small spaces, it's capable of giving detail of giving a speedy enough to can to not be too affected by the rapid respiratory rates and stuff too. And it's much more acceptable and affordable than it used to be, whether you use your own or whether you go to local referral centre or a local clinic has got it. And the value to us and to our clients is we now have much improved diagnostics and they really improved prognostics.

And in practise, prognosis is probably more important diagnosis. And that's where I find it really useful and that's where we're really using it from. Thank you.

So thank you very much John for a really, really interesting talk and there's some really interesting pictures there and how cool to get to speak to your little penguin, bless him. They're quite jealous there. We do, we actually do a lot of penguins mainly because I'm really into, I'm into penguin hips at the moment, so I don't, I don't go out much.

But it's, that's something to kind of keep you occupied. It's really interesting. So, yeah.

Well, I, there's no questions coming through at the moment, so I'll just give you guys just a couple of seconds, to, if you've got any questions, just type away in the question and answer box. But I will take this opportunity just to remind everyone, that next Tuesday at 8 o'clock is the 3rd in this exotic series, and John will be back with us again, and he's going to be discussing heart disease in small animals. So yeah, we've got no questions are coming through at the moment, John.

So how, how many, how many CTs do you do daily? Are you doing this all of the time? Is he doing this daily?

No, probably doing about 2 or 3 a week, on average, we get burst of them like a London bus syndrome. So we do do masses and again, still do many more conventional radiographs and stuff, because it's different use and stuff, but we would say we try and target the use there. And yeah, we get great value out of them, .

And, and again surprising, some of the stuff we're gonna find that too. Actually while people think about questions, this is one of the things it also does. It's one of things that makes you smile a bit, .

Because, you know, somebody's, I wouldn't say CT makes lots of money as a practise. What it does do, it really answers the quality of my job. This is sugar glider I did earlier, and one that's kind of fun making 3D images.

But also, I never knew you got air that's this, this fold they they glide with actually fills air when they, they pushed outwards. You can see that through there too. So you actually, it's a brilliant learning tool every time we do a scan, and find a new bit of anatomy and new new bit of learning.

So it makes you smile at the end of the day. Absolutely fantastic. So I've had one question coming through from Hillary, and she's asking, is there a better type of CT machine, and she's maybe asking about section requirement, is that.

I would always talk to an expert on this, and we took a lot of advice we got ours. We've got a flat panel, mainly because, we do do dogs and cats through it. We got it because mostly is going to be exotic.

I want that really fine detail, which is going to give. So that's why we got that too. So you can work out what your major uses are going to be.

Have a chat to the main companies who provide them, so I'll give you good information on that. Have a chat to a friendly local, radiographer radio radiologist, and in particular, if you're going to use an external company, have a chat to them as well about what they like reading, how they like things done, and which, which, what they find from different, Machines, I'll be getting the images through that and so we can say, well, that's really good quality or we know. I got some stuff in this machine wasn't quite as good as some of the others.

And I really like these ones. So take a lot of advice before you get it. But really, the big thing is work out what your case that will be, what you're going to do that like everything else you buy, there isn't going to be a one machine fits everything.

thing. So I guess you have to start collecting them really. But yeah, there's no one size fits all unfortunately.

OK, and Hillary's asking, what companies do you recommend to approach as there seems to be quite a few, companies around. Talk to all of them. I, I'm not, unless they want to pay me commission, I'm not gonna push anybody, for flat, I think it's only marketed by one, but, .

You know, I talked to all of them. They're all pretty good. They're all decent people, and they all, from what I gather, provide a really good level of support.

We're actually very happy what we've had support wise, and that's important as well. I would recommend you get a good, hardware support contract things. The extra heads do have a habit of going, and you want to make sure you're covered and supported, through that.

So, so look at the hardware software support as well. Brilliant, thank you very much, John.