In first opinion practice we aim to give the highest standard of care to our patients. As for human GPs primary care veterinary practitioners see a wide range of medical and surgical cases. Experiences of individual veterinary surgeons within and between practices will vary, as will the equipment available which will, to some extent, influence the cases which can be worked up and treated in house and for which referral will be recommended.  Our 7 vet team at Holmer are proud to offer a diversity of experience and skills meaning that for the large majority of cases presented we are able to work-up and treat in house. However, some cases require advanced imaging including CT and MRI, some more complex medical and surgical cases are better dealt with by a specialist. Certain therapies, particularly some cancer treatments are only available from specialists. Specialists at referral centres have undergone additional training in their specified field, on average this involves an additional 5 years of training on top of the 5 year veterinary degree. In many ways referral specialist can be compared to human consultants, The diagnostic and treatment options for our pets is phenomenal, the expertise and specialist equipment available at referral does, understandably, come at a relatively high financial cost. For most people having a good insurance cover, with a reputable company, is imperative for them to be able to afford to go to referral. A previous post 'Not all insurance policies are equal' outlined some recommendations for finding the right cover for your pet, please do not hesitate to speak to one of our vets about your individual needs. With regards to the referral process we have referred to a number of relatively local specialists, whilst we may recommend referral to certain centres we will always be happy to take any preferences you have into consideration. Sadly not all conditions have a favourable outcome but as a profession both primary care vets and referral specialists aim to work together to offer the highest level of care for your beloved pet.