Introduction:
We anesthetize about 15-20 pets a day at our little hospital for dentistry, spaying, castrating, the surgical repair of wounds, the removal of cancers and masses, for C Sections, broken bones and other major trauma, and for abdominal surgery. It's a busy place and we have to be constantly monitoring and constantly ready to correct any little thing going wrong
we love what we do and this page will talk about :
Things to consider and options BEFORE anesthesia and surgery
What to expect when your pet needs surgery
Things to consider AFTER surgery
What surgeries don't we do well and are likely to refer to a surgical specialist
What about costs?
Before Surgery
First of all, if you're nervous about your pet's safety in surgery, please relax.
Under going anesthesia is a lot like scuba diving. Of course it can be dangerous and there's a list of procedures and steps taken to minimize risk ... just like with anesthetia and surgery ... but the vast majority of the time everything goes smoothly.
And anesthestic agents have been greatly improved. They're much safer, smoother, easier to reverse, and much less likely to cause side effects, hang overs, and digestive upset. Not only that, but it's now much easier, more accurate, and inexpensive to pre-test patients for anemia, diabetes, kidney disease, low protein, weak immune systems, and liver disease. That's a big deal; knowing that a patient has one of these problems allows us to change our protocol & medication selection to greatly increase success.
At any rate, we will be discussing all the major steps and options of the anesthesia and surgery process. We will certainly discuss all these options with you in person if you bring your pet in for surgery, but it's nice if you know what to expect before hand. Which options we recommend and which options you choose will vary greatly depending on the age and outward health of your pet and on whether the surgery is simple and quick or not.
And, of course, it keeps coming down to money. It costs more money to use the newest and safest anesthetic agents, to do blood work prior to anesthesia to screen for problems, to run IV fluids and oxygen during recovery, to manage pain well, to use the best antibiotics, and so forth. We try very hard to balance quality, safety, comfort, and success versus expense in our recommendations.
So, if you choose to skip certain options in order to save money, we understand.
Just as long as you understand that increases risk a little bit.
And on this same subject, because there are so many money choices a veterinarian has to make during each step of a surgical proceduce on whether or not to use the least expensive anesthetics, medications, materials, staff, equipment, and facilities available or whether to opt for the very best or somewhere inbetween makes it's difficult to compare the prices each vet charges. Which is the better deal? The vet that charges $75 to spay a cat, $100, or $250 ? Well, that depends, of course, on what compromises were made to keep the cost down
Okay, enough about money. Just know that we follow the Golden Rule as best we can. We don't charge high fees for the sake of our egos or greed, we don't have super expensive surgical lasers to pay off and so forth, but we do charge enough to allow us to do a good job with high safety and comfort for your pet.
What we recommend and do before surgery:
We do most surgery by appointment. So please make an appointment.
Feel free to ask questions. We'll try to make the timing convenient to you.
But in general, we like to have surgery patients arrive in the morning before 11am for pre op work ups and pre op meds. We usually send minor surgery patients home the same day late in the afternoon where as we usually keep the more major surgery patients overnight and discharge them after 11am.
Empty Stomach: Anesthesia knocks out your ability to swallow normally and prevent food or vomit from going down your trachea or "wind pipe". This danger is greatly reduced by having an empty stomach during anesthesia. So don't feed anything except water for at least 9 hours prior to anesthesia.
Check in: Well this is obvious. But don't assume we remember every little thing we may have discussed the previous week. Please double check that we're agreed on what procedure(s) we're doing and if you want us to also remove this wart or that little tumor or do toenails or what not in addition to the main surgery, we'll be glad to accommodate, but please let us know at check in.
This is the time to choose or decline options, make payment arrangements, and also to sign a consent form.
PreSurgical Exam: It should be obvious that surgery is safer when done on a healthy, robust patient rather than on one who is sick, weak, dehydrated, wormy, anemic, in heat, immune compromised, diabetic, feverish, or fighting an infection.
We examine all pre-surgery patients prior to anesthesia and there is no charge for this exam IF we have already examined your pet in the last couple of months. Otherwise it's $20
Pre Surgical History: Also obvious...you would think...but let me know if your pet has had any previous trouble with anesthesia, bleeding problems, or wound healing.
Presurgical antibiotics. I'll recommend them when appropriate.
Preanesthetic and presurgical blood work. Modern anesthetic medications are very safe for the vast majority of patients ... especially if that patient is outwardly young and healthy. But there are major exceptions: Namely those patients with anemias, parasites, diabetes, low protein, or liver and kidney disease. We can detect these problems with simple blood screening tests. The whole package of testing that we recommend for most procedures is just $26.
If we are doing needed surgery on an older pet or sick pet, we may recommend more extensisve testing that in addition to checking for all the problems listed above, also checks for thyroid disease, electrolytes, & infection. $69
Would you want to have surgery done on yourself without prior testing?
Preanesthetic sedation and pain medications. Pre sedating makes pets (and people) calm, less anxious, less stressed, and drowsy which has all kinds of advantages. One of which is it reduces the amount of anesthesia needed making it safer. It improves muscle relaxation and reduces surgical bleeding.
Pre treating for pain improves wound healing, reduces anesthetic volume, and of course, makes your pet happy. There is no extra charge for this, but it's one of the reasons we like to have your pet dropped off at least an hour prior to the surgery.
IV FLuids: During any anesthesia and surgery, especially if we open up the abdomen, there is a lot of fluid loss, electrolyte changes, and a lot of inflammatory agents, hormones, chemicals, and toxins produced by the cells. Ideally, we control and prevent surgical dehydration as well as flush out through the kidneys harmful by products as quickly as possible.
This is done with IV Fluids. Having an IV hook up also means we have ready a direct line to the blood stream should emergency medications be needed.
But IV catheters and fluids cost money ($30). And to save money, we usually skip giving IV Fluids for quick and easy surgeries on young healthy pets. Most young, healthy pets being castrated or having simple wounds repaired recover so quickly it's amazing. But abdominal surgery, including spays, or any procedure on sick or old patients, we will recommend IV Fluids.
Anesthesia:
Listen, robberies of veterinary clinics for anethetic drugs is all too common. (We have been robbed several times)
So, I'm not going to list or discuss in detail all the different anesthetic and pain drugs we have at our clinic on the internet.
But, in general, after pre sedating and after pre treating for pain, we use a combination of injectable anesthestic agents for most of our procedures. This combination of agents is called neuroleptanesthesia and provides very safe, comfortable, and effective anesthesia for short procedures taking less than 45 minutes of actual surgery time. Another great feature of the meds we use is that they are partially reversible...another safety feature.
For longer surgeries, for surgeries that become complicated, and for patients with kidney or liver disease we use Isofluorane gas. If we need to use Isofluorane gas for anesthesia, it usually costs $50 extra
Is there a danger with anesthesia? Always. But much less than when barbituates were commonly used as part of the anesthetic protocol, much less with the new reversing agents available, and much less with the newer injectable and gas agents we routinely use now.
Possible dangers include sensitivity and extreme reactions to the medications, blood pressure changes, bleeding and clotting disorders, and embolisms.
There is a danger that the lungs, kidneys, or liver will have trouble metabolizing the anesthetic agents well. (blood testing alerts us to this potential problem)
And most worrisome of all, is that the heart and/or lungs might stop working.
Luckily, the newer anesthetic agents we use have been greatly improved in this regard ... minimal effect on heart and lung tissue compared to previous barbituate and other agents. And we are always prepared for CPR and cardiac and respiratory arrest recovery.
Another potential danger is human error. If you've seen ER (Emergency Room) on television, you have a pretty good idea of how hectic a trauma center can get...crazy sometimes...with coordination between team members critical. Well, it gets like that sometimes at veterinary clinics too. But we are very careful and either Dr Dunagin or I are always present and supervising any and all anesthetic drugs and either he or I do 100% of the actual surgery procedure. We have 23 staff members including well trained assistants who help monitor breathing, pulse and so forth, do the pre-surgical shaving and scrubbing, assist in the operation, and help close the skin, and watch your pet carefully during recovery.
Hopefully this answers your questions and addresses your concerns in regard to anesthesia, but I will be glad to discuss these issues further in person.
My Momma used to say: "even a kiss can be lethal"
As for me, I would reply: "I'll risk it!"
During Surgery
Once all the details of checking in your pet for surgery and all the careful steps of anesthesia are underway successfully, we perform the actual surgery. Sometimes the actual surgery is super simple and sometimes a long and high risk procedure. And some surgeries are beyond are skills and equipment, in which case we will refer you to a specialist.
Here's what we do well and do often: If underlined with a link, it means there's more information about that particular surgery.
Castrations & OvarioHysterectomies (Spays)
Ceasarian Sections (C-Secections) Ovarian Cancer Infected Uterus
Prolapsed uterus' Ovarians Cyst Removal
Exploratory Surgery Stomach, Intestinal, and Colonic Surgery
Hernia Repairs Mass and Cancer Removal or Reduction
Anal Gland and PeriRectal Surgery Rectal and Vaginal Prolapse Surgery
Trauma Surgery:
We do 2-3 of these a day. Everything from minor lacerations needing suturing to extreme trauma cases from car accidents and gun shot wounds. And lots of bite wound abscess cases on cats.
Eye, Ear, and Mouth Surgery:
Eye Removal
Tear Gland Removal (Tarsal Gland)
Entropion Surgery for ingrown eyelids
3rd eyelid or conjuctival flap surgery
Cataract and more serious eye surgeries are referred to Dr Pentlarge in Athens.
Ear hematoma surgery
Ear canal surgery
Oral surgery of wounds to lips, tongue, throat , cheeks, and jaws.
Cancer & Tumor Surgery
Growths, lumps, and bumps of all types and severity are common in veterinary medicine. We do a lot of tumor removal surgery at our practice. There is also a cancer specialist and treatment center in Greenville now for pets.
Optional Stuff While Your Pet Is Under Anesthesia
Fluoride Treatment: Fluoride hardens and strengthens the enamel which slows the rate of dental and gum disease. $8 or a little more if we have to spend much time cleaning the teeth first.
Dental Sealants: We can coat your pet's teeth (if clean) with polymer dental sealants that keep plague and tarter from forming ! $20
Dentistry: Doing a careful and complete dental cleaning takes a long time under anesthesia so may not be appropriate to do at the same time as another surgery, but if all your pet needs is cleaning off of minor tarter or something quick and simple, we'll be glad to do it. The simple and quick stuff is free.
More involved or complete dentistry is $60 .
Biopsy: Samples of tissue suspected to be cancerous or granulomatous can be sent to the lab for identification by a pathologist. Samples can also be taken for toxicology testing if poisoning is suspected. $65 for the lab fee. $0-50 for the surgical fee.
Toe Nails: We will be glad to trim toe nails for you during surgery. It's free.
We can also drummel your pets toe nails extra short. $20-40
Removal of warts, cysts, dewclaws, etc: We'll be glad to do extra minor surgeries while your pet is under anesthesia for another procedure. The real simple stuff is free. If it requires suturing or surgical staples, it will be inexpensive; $5-25
Ear lavage: We'll be happy to clean out your pet's ears if needed while under anesthesia. There's no extra charge for the cleaning, but it's $4 to treat for ear mites if present.
Anal Gland Expression: This shouldn't be done unless needed; it aggravates the glands potentially making things worse. But if expression is needed, it's easy to do while pets are anesthetized, and we'll be glad to do it at no charge.
Note, however, that there is always a small danger of rupturing anal glands that are swollen and raw.
Tattoos, piercing, toe nail painting, and so forth: Sorry, I'm not your man
Recovery
We have several choices during recovery, and for most of our routine surgeries, nothing extra is usually needed.
Monitoring and nursing: All surgery patients are cleaned up, kept warm, and watched until they are up and breathing normally, swallowing normally, and stable. If they are on IV Fluids, we keep those running until not needed.
Oxygen therapy: This is not needed for most routine surgeries done on young healthy pets, but pure, inhaled, oxygen is a great post op pain reducer and natural stimulant and speed recovery. We will do this automatically for critical patients and recommend it as an option for non-critical patients who have, none the less, been through long or complicated surgeries. I especially like to use oxygen on patients heavily traumatized by car accidents and gun shot wounds.
Great for C Section patients and patients that have had intestinal surgery.
$10-20
Extra pain medication: We are big believers in pain management and both automatically use pain medications before and during surgery at no extra charge. For most patients this is enough and works better than giving pain medications after they start hurting. But there's no getting around it. Some patients act as normal as can be after a surgery and others, after the same type of surgery, moan or howl. For those pets a shot of morphine, metacam, or rimadyl works wonders but costs an extra $10
24 Hour observation and Intensive Care: We are not set up to do this on a regular basis. Be realistic. It costs about $25 an hour to hire a qualified intensive care nurse/technician to do night shift work and even more to have a veterinarian on call all night. So, as an alternative, for the occasional patient that needs night long observation and care, after consulting with you, I either take pets home with me for observation and treatment, have you take your pet to the nearest 24 hour intensive or emergency care hospital available (Anderson or Greenville), or drive back to the clinic several times during the night to do what needs to be done. Going to a 24 hour intensive care hospital costs several hundred dollars for the night, so usually we just do the best we can and luckily the vast majority of post op patients simply rest quietly through the night.
After Surgery
It's amazing how most of our patients recover to normalcy quickly after surgery. But it's still important to take some sensible precautions:
Don't feed for at least 4 hours after surgery and feed small amounts at a time for the first day.
Encourage, or force if needed, rest.
Don't play rough or active games. Walk on a leash. etc.
Ask for tranquillizers if you have a known hyper pet. $2-4
Expect a little inflammation or swelling, but call me or come in for a free recheck if you think something is obviously wrong with the incision site or anything else about the patient for that matter.
Keep the incision clean.
Squirt with a gentle antiseptic 2-3 times daily for the first few days. Hydrogen peroxide is fine for most incisions. I'll dispense chlorhexidine (blue stuff) for sites with high risk of infections such as abscess wounds, draining incisions etc. Keep in a clean area. Keep flies away.
Real Bandages, Liquid Bandages, Wound Drains, and special wound sprays: We don't use or need bandages of any type for most routine surgeries, but if your pet needs any of these, we'll go over with you what you need to do.
Medications: If antibiotics, anti-inflammatories, anti-oxidants, vitamins, supplements, or any other meds are needed or would be beneficial, we'll discuss these with you.
Special High Energy Diets: I will recommend special diets if your pet is recovering from major surgery if weak, debilitated, or if your pet is also fighting a major infection, lost a lot of blood, or otherwise suffered major trauma.
Extra pain relief: We routinely use a pretty potent pain medication combination (acepromazine, xylazine and Telazol) prior to surgery that has fairly good lasting effect. I we often use morphine during and just after surgery. But for surgeries where I must cut through muscle or bone or handle intestines or bladder, We'll recommend Rimydal or Metacam to give for a few days after surgery. The cost is usually $3-5
I don't want you to use Aspirin or Tylenol though, as they cause side effects we want to avoid after surgery such as reduced clotting. (Tylenol (acetominophen) is never recommended to cats)
Antihistamines & E Collars: We will recommend a little post op benadryl or a restrictive collar if your pet has the type of wound that itches a lot or if you have a pet that just won't leave a healing would alone.
Extra love and time and affection spent with your recovering patient
Remove sutures 10-14 days after the surgery unless we used dissolvable sutures.
Follow Up and Rechecks: A lot of things can happen to prevent a wound or surgery site not to heal perfectly. And stress, anesthesia, surgery, and medications can cause secondary side effects, GI upset, diarrhea, gas, and so forth. There's no charge to recheck a post op patient during normal hours so don't hesitate to phone or come back and let us help.
This page is about what to expect when you bring your pet to The FoxNest Veterinary Hospital for surgery.
It discusses precautions to take, about anesthesia, pain management, and about all the little extra things that might be recommended depending on the complexity of the surgery and the health and age of your pet.
I've put prices down for the optional stuff for your information.
On other pages I've written about what to expect for the more common surgeries we do such as spays, castrations, wounds, and so forth. Just click on any of the following links when you are ready, but please read my introductory comments to your right first.
Thanks, Roger Ross DVM
Eye & Ear & Mouth Surgery
It's like a Miracle
Because of surgery and the modern anesthetics that allow us to do surgery, we can cure problems or at least greatly improve both the quantity and quality of life on a routine basis.
The collection of surgery instruments pictured above were in common just a couple of generations ago.
Not anymore. Surgery for very serious diseases and injuries is still a major undertaking, but it's amazing how many surgical procedures are now no big deal.
And these are for problems that just a few generations ago would leave large segments of the population ... pet or human ... dead or badly maimed.
Referrals:
We do a lot of surgery at our hospital. But we are general practioners; not board certified surgeons.
It requires 2-7 years of university training after veterinary school to become a board certified bone, brain, eye, abdominal, or chest surgeon. it's a big deal.
There are such surgeons in Greenville, Atlanta, and at the Veterinary Universities.
If your pet needs surgery that would best be done by a specialist we will certainly tell you. And, of course, there's lots of surgery procedures I simply don't know how to do or have the proper experience or equipment such as heart or brain surgery.
At any rate, we're lucky to have a very impressive veterinary referral center
in Greenville as well as the Veterinary College in Athens, Georgia should your pet need intensive or complicated care.
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