Surgery

Most pets will have an occasion during their lifetime where they undergo a general anaesthetic to have a surgical procedure performed. It can be very worrying for owners parting with their pets on the appointed day, particularly because this is an area of expertise that most people do not witness themselves. Although we cannot walk you through the specifics of surgery here, we can give you an idea of what we are talking about with certain terminology, how we decide when to perform surgery, and what some of the common risks are.

Broadly speaking, we refer to surgical procedures as either elective, or non-elective.

Elective means that we have chosen to do a procedure: it is not an emergency, and there is a choice about whether we perform the surgery or not. These procedures are extensively varied and form the main bulk of procedures that we perform. They include neutering operations, non-essential lump removals, ear flush procedures, planned amputations etc.

Non-elective surgeries are those that we have little choice in performing, if we wish a patient to improve, and frequently come with more time constraints than elective procedures do. These could include procedures such as pyometra surgery, caesarean sections, traumatic amputations, unplanned splenectomy, removal of foreign bodies in the stomach or intestine etc.

We are able to perform a wide range of surgeries in the clinic, on most parts of the body. The vast majority of elective procedures involve a patient going home on the day of the surgery, unless the procedure is performed late in the day or complications arise.

Many of the non-elective surgeries are emergency procedures or carry an increased element of risk for the patient. In these cases, we may require you to transport your pet to our out-of-hours partners for continued care through the night.  In some cases, your pet may require several days of hospitalisation.  In other cases, we may simply wish to ensure your pet’s recovery is as smooth as possible, and request that they stay with us overnight for monitoring. We are not here throughout the night, so we would only recommend this option for patients that we feel comfortable with and confident in their recovery.

For both elective and non-elective surgeries, there are certain stipulations that we ask you to meet prior to your pet undergoing a general anaesthetic. These can be found here. It is not always possible to achieve these in an urgent situation. If the patient is stable, we may delay surgery for as long as it is safe to do so, to give them a lower anaesthetic risk and stabilize them as much as possible.  This could include providing intravenous fluid therapy, antibiosis, or support feeding. For genuine emergencies, we simply have to work with what we have!

It can be very difficult as a pet owner and loving ‘parent’ to know whether your pet requires immediate assistance. Everything is an emergency to a worried mum or dad! It is part of our job to triage patients and work out when the best time to operate would be. This depends on many factors, such as implementation of required aftercare at home, stability of the patient before surgery and during any waiting period, clinic opening times and staff availability to give optimum skills, and anticipated recovery times. Rest assured that we are experienced in making these decisions, and do so with the aim of achieving the best outcome for your pet on every occasion. We will always listen to your concerns and weigh them against the clinical situation, and will try to assist and guide you every step of the way.

The vet will always try to talk you through the risks to any surgical procedure. Inherently, there are 4 risks that cannot be avoided with any surgery involving a general anaesthetic:-

• The anaesthetic itself will always be a risk. Most of the time, this risk is very low (0.5% in dogs and cats, <3% in rabbits, <5% in birds and reptiles), but it is increased for paediatric and geriatric patients, those that have chronic disease, and emergency presentations. We may suggest a blood test  before your pet has an anaesthetic, to allow us to tailor our choice of sedative to your pet’s body.
• Bleeding: any procedure that involves making an incision comes with a risk of cutting a blood vessel. Again, most of the time, bleeding is swiftly and easily controlled. However, there are some major arteries that can be tricky to deal with – even during elective surgeries.
• Infection is always a risk when we are opening a body cavity, so we perform clean surgeries in an operating theatre that is as clean as any room can be. Intestinal surgeries carry a far higher risk, because of what they hold inside. Your pet may receive antibiotics before, during and after some surgical procedures, or may require a dressing to be placed and frequently changed.
• Wound dehiscence (breakdown) after surgery can be caused by excessive movement by the patient, tension on a wound, reactions to suture material, infections at the operation site, cancerous areas, and by patients scratching or licking at the wound.

During the procedure

We are fully equipped for monitoring sedated and anaesthetized patients effectively both on our ambulance and in our clinic.  We monitor heart rate, breathing rate, depth of breathing, as well as the concentrations of oxygen in the blood. We also monitor the percentages of oxygen and carbon dioxide in each breath to allow us to find problems early on and rectify them.  We monitor blood pressure and may also have a continuous ECG in place to monitor cardiac function.  For anaesthetized patients, we are likely to place a tube into the airway to allow us to breathe for the individual if needed. Patients will have an intravenous access point inserted wherever possible, so that we can administer medications.

We may recommend concurrent fluid therapy to support blood pressure – this can be administered in a number of ways depending on the species, and facilities are available for all of these.

Discharge

Patients are usually discharged with a nurse, who will run through the care required at home, any medications your pet may need, and any required changes to their feeding or exercise regimes. Common post-operative information can be found here.  The nurse will also check on your pet usually around a week after surgery is performed, to ensure that the wound is healing well and that your pet is comfortable. We can address any queries or concerns you may have at this time, although we would always ask you to contact us with pressing queries before your appointment.