Anesthesia & Surgery; What to expect
and some decisions you need to make for your pet
Check In: We usually ask you to drop your pet off at the scheduled time on an empty stomach. That means no solid food for at least 8 hours prior to surgery. We will spend a little time with you making sure all our ducks are in a row, that we're both clear on everything, make sure all your contact information is up to date, go over some pre-anesthetic and anesthetic choices, and sign off on the consent forms.
Consent Form: Anesthesia and surgery is serious business. A responsible adult will be asked to sign a consent form designed to inform you that of course there are some risks and expenses involved. It would be great if you would print this out and bring it with you if your pet is coming in for surgery soon.
Presurgical exam to make sure your pet is healthy prior to surgery.
Note; This is not a major work up for your pet's skin problems, diarrhea, and so forth ... it's a presurgical exam designed to make sure your pet's hydration, blood pressure, temperature, pupil response, mucus membranes, pulse, heart, & lung sounds indicate a "go" for anesthesia. (Included in the surgery fee)
Choosing Pre-Anesthetic blood work package:
This is the first of 2 big choices you need to make.
Lab Choice # 1: to make sure we don't lose a patient to some of the more common dangers whenever anesthesia and surgery is involved, we should at least screen for
kidney disease, liver disease, diabetes, and anemia. The cost is $32 for these 4 tests.
Lab Choice # 2: If it weren't for money, it would be much better medicine and safer to your pet to also check for infection, protein levels (critical for healing), platelet levels (critical for clotting), and electrolyte levels. For $52 we can do all these tests plus the 4 screening tests in choice #1, plus some additional tests to get an even better evaluation of the liver and kidneys.... both organs being critical for metabolizing anesthetic agents.
We will probably insist on this higher level of testing if your pet is older, sickly, malnourished, or a high risk breed. Or if the surgery is likely to be long or complicated. Or if potent medications are likely to be needed post op.
Choice # 3: You can decline doing any lab work if you must save the money. And if your pet is young and healthy, the vast majority of pets have no complications. But anesthesia and surgery are both serious procedures and occasionally deadly when things go wrong.
You need to sign a liability release if you decline blood work.
Additional Lab Work: depending on the case, we may also recommend heartworm testing, fecal testing, a urinalysis, or a feline leukemia or feline AIDS test prior to a major procedure.
Choosing the type of anesthesia:
Anesthesia Choice # 1: Injectable anesthetic agents. Convenient and inexpensive.
This is what I recommend and use on the majority of young, healthy pets having a quick or minor procedure... especially if the blood work comes up clean. The cost is $60 for most patients.
Anesthesia Choice # 2: Isoflorane GAS Anesthesia. A little more expensive ($90 for most patients), but safer for high risk patients, long procedures, and complicated procedures. It also results in a more rapid recovery. Pre-Anesthetic sedation, induction medications, an open iv line, EKG, electronic monitoring of vital signs, & oxygen therapy are all included with this choice.
Any time internal tissues are exposed to air and any time a patient is under anesthesia for very long there is some degree of dehydration and loss of core body temperature. The kidneys are especially susceptible to damage if deprived of oxygen or hydration. Surgery is very stressful and exhausting to the body and even though most procedures are relatively painless thanks to modern while under anesthesia, the body is still sending out a general alarm to the immune system that it's being invaded. Once the immune system is triggered all kinds of chemical, electrolyte, and other biological changes take place.
Having IV fluids running greatly improves the amount of stress to the body, helps us control core body temperature, flushes out and preserves the kidneys, helps us control electrolyte imbalances, greatly reduces surgical stress to the tissues, and speed recovery.
And in the event of a surgical (excessive bleeding or rupture) or anesthetic (cardiac or respiratory arrest) emergency, we have instant access for emergency medications if there is an open IV line.
Despite all these advantages, we usually skip IV Fluids in quick, routine procedures on young, healthy patients to save money. It costs $45 (including all the catheters, caps, sterile tubing, and bandages) to run IV fluids. BUT, if your pet is older, weak, anemic, full of parasites, or otherwise not in top health ...or if the procedure is long, complicated, or major .... or if you just want to pamper your pet.... we will recommend or insist on fluid therapy.
Pre-anesthetic sedation, induction, morphine pain management, anti-emetic (nausea) meds, atropine, antibiotics, & other medications may be needed depending on the case. These will be given as appropriate by your veterinarian. A lot of the these things are included in the anesthetic and surgery fees, but other things ... like antibiotics... are charged separately in range in cost from just a few dollars to $40.
During Anesthesia & Surgery
Digital Monitoring: we have the latest in computerized, digital monitoring equipment at the FoxNest. Our equipment performs continuous EKG, Core Body Temperature, Resp rate, heart rate, oxygen saturation, and CO2 concentration… all the things we need to know instantly and continuously if your pet should have problems with anesthesia.
Digital monitoring is usually NOT done for very quick and minor surgical procedures using injectable anesthesia to save money. But your surgeon may add $22 to your bill if he thinks your pet needs closer monitoring.
Digital Monitoring in included at no extra charge when a patient is under Gas Anesthesia.
Surgery: I am not going to go into any detail about the many types of surgery we do at our hospital, but know that we are very careful, meticulous, and highly invested in your pet's successful outcome, safety, and comfort. If it's a procedure where we don't have a lot of experience or if it's above our level of competence, equipment, or facilities, we will have told you so. We send at least 2 cases a week to surgical specialty practices for this very reason.
Most minor surgeries and dental procedures at our hospital range in price from $10 to $100. This is often less than the anesthesia and related expenses.
Most major surgeries cost between $100 and $400 in addition to anesthetic and other charges.
Surgery Add Ons: if you want other things done while your pet is under anesthesia such as gross tarter removal, nail trimming, removal of warts, moles, small masses, or dewclaws, just let us know. The fee for doing these types of things are either minimal or done at no charge.
A note about dentistry as an add on: it takes a long time and special equipment to do a meticulous dental cleaning…AND there is some danger of heavy bacteria loads getting into the blood stream during a dental procedure.
So, in general, major dentistry is NOT recommended at the same time as a major surgery. However, we will gladly remove heavy tarter or other MINOR dental procedure while your pet is under anesthesia.
Microchip Insertion: we can put a microchip in your pet at anytime, but it’s easier and more convenient while your pet is under anesthesia. The $32 cost includes lifetime registration and some special special services.
Tattoos, nail painting, piercing's: Sorry, I'm not your man.
Recovery: All surgical patients are watched carefully, kept warm, clean, & comfortable during recovery. There is no extra charge for this. But there is a charge for a few things should they be needed or recommended during this critical time. These include:
Prolonged Oxygen therapy: recommended for long or especially painful surgeries. Very helpful in cases of major trauma.
Laser Therapy: We're excited that we can now offer laser therapy. And it's cheap. ($10). We recommend zapping the surgery site with laser energy after the surgery. It greatly reduces post op inflammation, swelling, and discomfort. It speeds healing. Appropriate and highly recommended for almost all surgeries with the exception of eye surgery and cancer surgery.
Morphine, Rimadyl, Metacam & other pain medications to give if needed during recovery and/or to dispense while recuperating at home.
Medications to control post op nausea: this problem is NOT common but is sometimes needed.
Post op chemo therapy for cancer cases: Sometimes needed. Note; we have limited experience with chemo therapy, but we often consult with the Oncologist in Greenville for your pet. And I have a couple herbal concoctions that have proven successful for certain types of cancer. Cost varies widely.
Post op antiseptic wound washes, antibiotics, E-Collars, & bandages are often needed.
Post op follow up checks, suture removal & so forth are usually done at no charge. Usually suture removal is done 10-14 days after the surgery.
Normal Hospitalization : depending on the situation, some pets will need to be hospitalized before, during, and/or after a surgical procedure; typically for 1-4 days. The cost is $24 a night plus the costs of medications, iv fluids etc.
Intensive Care : Those patients that need constant monitoring and attention are charged a little more ($40/night.) Note; We do NOT have 24 hour care at our hospital so if your pet needs all night observation, I may take your pet home with me for monitoring and continued care.
If your Pet is Having Dentistry
Dentistry: Most every thing written about anesthesia and surgery above applies to dental patients too, except almost all dental patients go home the same day and what your pet will need is a lot more predictable. I wrote a separate page just for Dental Patients outlining a few of the options specific to oral health.