Preparing Patients for Surgery

Elective surgery patients should be fasted (food withheld) from 8 PM the night beforehand. Water is allowed until that morning. Surgery assistants routinely call owners of surgery patients the night before the procedure to remind them to fast the animals and answer any questions. Estimates are always available for these procedures and often include optional steps. The surgery assistants can help you with any questions at the morning admitting time. At this time, clients sign a consent form and leave at least two reliable phone numbers, in case there is a question and to notify them when the animal is in recovery following the procedure.

Anesthesia

Anesthesia is when a medication is administered to make the patient completely unconscious for a procedure. Usually a sedative is given, then an injection of a single medicine or combination to make the patient lose consciousness and allow an endotracheal tube (airway) to be placed in the trachea (windpipe). This tube keeps the airway open and clear so that oxygen and gas anesthesia can be passed to the lungs. The tube also protects the airway and lungs from any fluid that could otherwise be aspirated. The gas anesthesia we use is isoflorane, because it is very safe and, animals recover very quickly when it is discontinued. With this type of anesthesia, patients usually breathe on their own and do not require a ventilator. If they do not breathe readily, the assistant will give breaths with the anesthetic machine until independent breathing resumes.

Anesthesia is a critically important procedure. We require a recent physical exam, and blood work is always recommended and often required. Patients that have any cardiovascular abnormalities or major organ problems are evaluated individually and may need specific tests, x-rays, or even an echocardiogram done at a referral practice. Drugs are chosen for each patient based on their age, breed, procedure, and pre-existing disease to make the anesthesia as safe as possible. We monitor blood pressure, heart rate, and blood oxygen levels on all anesthetized patients. An intravenous catheter is another component of patient safety. Intravenous fluid administration helps to maintain good blood flow to the vital organs to prevent low oxygen levels and to remove waste efficiently. It also allows access to give medications that affect heart rate and blood pressure as well as pain medication when needed.

Many of our patients that have dental treatment and growth removals are older. Older patients are more likely to have pre-existing problems that should be carefully evaluated before anesthesia. Dental treatments are extremely important to the health of our older patients, so they should not be avoided altogether just because a patient is a senior.

Home Instructions for Surgery Patients

• If your pet has had a general anesthetic today, he or she may be a little groggy.
• Some coughing may occur from irritation of the windpipe from the tube for gas anesthesia. If this is not resolved within 12 hours, please let us know.
• Your pet may be very excited to get home, so be prepared to limit his or her activities and do not offer food or water for the first hour.
• After he/she settles down, you may offer small amounts of water every 10-15 minutes until he or she seems satisfied. Then you may offer small amounts of food.
• Patients with extracted teeth or dental surgery may have small amounts of bleeding that may be visible in the water bowl or on bedding. This should resolve by the following morning. These patients should be offered small "meatball" size servings of soft food that are easy to swallow without chewing for a few days.
• Surgical sites in the skin may be cold compressed for the first 24 hours, then warm compressed after that. Bags of frozen corn/peas or refrigerated, damp washcloths placed in a Ziploc type bag make good cold packs. For warm compresses, you may soak a clean washcloth in warm water and wring it out well, then place it on the site. Most pets will tolerate compressing for 5-10 minutes, 2-4 time daily for the first few days.
• Do not apply medications, ointments, or creams topically to incisions. This may cause the pet to lick or chew at the site. You may use hydrogen peroxide to clean around the site, but not on the wound itself. A small amount of clear or blood tinged fluid may drain from the site the first day, but, if it continues, please call.
• Patients should have very limited exercise (dogs on a leash and supervised) when they get home. Feline patients can be confined for a few days, but dogs with skin incisions should have limited activity for a minimum of 10 days. Please discourage rowdy behavior, and limit the use of stairs as much as possible.
• Sutures may be removed at our office by our technicians at 10-14 days. Dogs with laser surgery sites must keep sutures in for at least 14 days. Some incisions have all of the sutures buried with absorbable material. Your go-home instructions should tell you if suture removal is needed.
• Please check surgery sites at least twice daily to monitor for redness, swelling, missing sutures, discharge, or pain that is not improving. Please call the office if any of these signs occur.