A guided tour through canine surgery

Inside an animal OR



Introduction

Monkey's approaching six months old and she should be spayed before she comes into heat for the first time. But a spay surgery is surgery where the doctor cuts into her body and removes some parts, and it's tough to decide if the future benefits* justify cutting her open today. Then there's the recovery period -- will she be in pain?

Gypsy has hip dysplasia and at age four it's beginning to bother him a lot. There's surgery that can give him some relief, but just how dangerous is it? And what are his chances for complete recovery?

Sunny is 12 years old and has several diseased teeth that must be removed. Dogs must be anesthetized to pull teeth, but what are the effects of anesthesia on an old dog?

The prospect of putting Monkey or Gypsy or Sunny through surgery can rattle most pet owners. There are always horror stories about the dogs that didn't make it and empathetic owners who feel every twinge of pain, real or imaginary.

On the other hand, there are also owners who do not take surgery seriously enough, who ignore the doctor's pre-surgery and post-operative instructions out of convenience or an inability to control the pet.

When your pet needs surgery -- elective surgery such as a spay or ear crop, or necessary surgery to repair an injured limb, remove a tumor, or correct an abnormal physical condition -- the first item on the owner's list should be a veterinarian she trusts. Whenever possible, a relationship with a veterinarian should be built up over the life of the pet so there's a history of preventive care and past problems and an assurance that the clinic facilities are conducive to the animal's survival.

Veterinary medicine is as scientific as human medicine. Veterinarians use heart monitors, modern anesthesia, sophisticated x-rays and sonograms, and well-researched surgical and recovery protocols. They have access to a wide range of antibiotics and other medications to solve or avoid post-surgical problems, and are privy to the latest research for improving their jobs and their patients' health.

Once you've chosen a veterinarian, however, don't leave everything in his hands. If there's something you don't understand about the procedure, ask - even if your question seems unscientific or may sound as if you don't trust the doctor. A good veterinarian welcomes questions, and will show you the surgery room and explain the procedures and protocols.


Pre-surgery instructions and preparations

Dogs should not be fed for 12 hours before surgery and should not drink water for eight hours before surgery. That means no food, not even a biscuit before bedtime, and no water, not even access to the toilet bowl. The reason for such a strict regimen is that anesthesia can cause dogs to vomit, and the vomitus can enter the windpipe and lungs and asphyxiate the dog. If your dog gets into the garbage or your son slips him a biscuit or a tidbit from the table, call the doctor before making the trip to the clinic in the morning so he can decide whether to reschedule the surgery.

Veterinarians generally will ask that Fluffy arrive at the clinic before office hours begin so that surgery intakes don't get caught up in the day's regular schedule of appointments.

The following description of surgical protocol is based on observations at Milford Animal Hospital, Milford, OH; the practice of Drs. Gary Clemons and George Wright, and at their sister clinic Withamsville Animal Hospital, where Dr. Kathleen Hutton performs surgery. Details are likely to vary in different clinics as veterinarians work with the drugs, anesthesia, sutures, and procedures they prefer for each surgery.

The dog's day in surgery begins with sedation to "take the edge off," Clemons said. The dosage is based on the age and weight of the animals. The idea is to prevent post-surgical pain, not be forced to treat it, so he uses a combination of drugs that keep pain to a minimum through surgery and afterwards.

While the dog is sedated and relaxed, technicians shave the surgical area, check and clean teeth, and trim toenails before inserting the tube for delivery of the surgical anesthesia. A technician checks the dog's heart rate before injecting a short-acting barbiturate that allows for easy insertion of a brace to hold the dog's mouth open and a tube to deliver the anesthesia. during the surgery.

While the technician prepares the dog, the doctor gets ready for the operation by donning clean “scrubs” and mask and washing hands and lower arms as thoroughly as the surgeons on Chicago Hope and ER..

The surgery room awaits, sterile instrument pack and surgical drape ready. Technicians wheel the sleeping dog into the room and place him on the table, then clip leads to the heart monitor to his body. Every five minutes during the procedure, a technician will check the dog's heart and respiratory rates and will adjust the anesthesia if necessary. They record the heart and respiratory rates on a chart.

The doctors in this practice use Isofluorane as anesthesia. Isofluorane is expelled by breathing; it can be adjusted up or down during the surgery with immediate results, and leaves the dog quickly when the surgery is completed. However, Isofluorane must be closely monitored and some veterinarians do not like or prefer not to use it for all surgeries.

Owners can ask about the type of anesthesia and sedation the clinic prefers for their particular pet in a pre-surgery visit. Some breeds of dogs are sensitive to some barbiturates and anesthesia, so owners of sighthounds should be particularly concerned about the anesthesia protocol chosen by their doctors. Anesthesia is expelled from the body through the lungs, the kidneys, or the liver. If your dog has a history of heart, lung, liver, or kidney disease, be sure to discuss them with your doctor before scheduling the surgery.

Once the surgery itself is completed and the uterus removed, tumor excised, or damage repaired, the veterinarian must close the incision. Sloppy stitching can be chewed out by the dog or allow the incision to become infected. The type of suture can make a difference as well; some dogs may be allergic to the materials in some dissolvable sutures, so the incision does not heal and bleeding and death can result.

A veterinarian's cabinet can contain a dozen or more different types of sutures for different uses. Suture material ranges from natural fibers such as kangaroo or shark tendon, linen, or silk to man-made filaments of nylon, teflon, or steel or titanium wire. Each has its place, and veterinarians have their preferences.

Whatever type of suture is used, the incision should be securely closed. This requires using layers of sutures from the inside out and placing the final stitches so that the dog cannot dislodge them by licking or chewing.

Clemons, Wright, and Hutton use single stitches to close an incision, perhaps taking a bit more time than a running stitch, but more likely to hold if the dog digs at the surgical site.


Post surgical procedure and instructions

Following completion of the surgery, Clemons calls the anxious owner with the results, and the technicians move the dog to the recovery area and get the surgery room ready for the next procedure. They put out a new sterile instrument pack and drape, a new chart for recording the patient's respiratory and heart rates, and a clean pan for the organs to be removed from the next animal.

The dog wakens quickly, and, because the pre-surgical drugs were chosen for their ability to prevent pain, do not seem to hurt as much, Clemons said.

Dogs may be kept overnight following surgery or may go home the same day. Before the staff returns dog to owner, however, a quick meeting with a veterinarian or technician about post-surgical care is required. Generally, the dog should be prevented from running or rough play following any surgery, but instructions will vary with the type of surgery performed. Obviously a neuter surgery requires a shorter recovery period than a hip replacement. However, if the veterinarian says crate rest and short walks only for urination and defecation are necessary to increase chances for a full recovery, don't let Monkey's sad eyes or the lousy winter weather tempt you to circumvent the instructions. This is a time for firmness, not giving in.

Some dogs will chew at the incision no matter what, so owners should be prepared to use an Elizabethan collar to prevent Sunny from reaching the area with teeth and tongue. For most dogs, however, the use of subcutaneous sutures and perhaps a bad-smelling topical preparation around the incision should be enough to prevent undue attention.


Costs

Cost of surgeries vary widely, depending on the clinic, the equipment used, the length of time for the surgery, and the amount of in-hospital post-surgical care. Clinics that use heart and respiratory monitors, sterile instrument packs for each procedure, keep a variety of suture materials and pre-surgical drugs on hand to tailor the procedure to the individual patient, and schedule a “free” post-surgical visit often have higher surgical prices.

Clinics where technicians have many years of experience also have higher overhead expenses that will be reflected in their charges.

Although costs can obviously be a limiting factor in choosing a veterinarian, pet owners should check all the variables before making a decision. It's best to do so before Gypsy needs surgery so you can build up a rapport with the doctor and staff and make sure your pet is in good health before the need for surgery arises.

Norma Bennett Woolf

This page is a part of the Dog Owner's Guide internet website and is copyright 2014 by Canis Major Publications. You may print or download this material for non-commercial personal or school educational use. All other rights reserved. If you, your organization or business would like to reprint our articles in a newsletter or distribute them free of charge as an educational handout please see our reprint policy.



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