We wouldn’t be in this field if we didn’t like to fix cats and dogs. We also typically don’t recommend something we aren’t willing to do for our own pets.

And over the years, we’ve dealt with countless medical issues in our own pets: cancer, broken bones, torn ACLs, etc. Now, just because we would take our pet to surgery does not mean that it is the correct decision for you. Only you can make that decision.

Before you decide on any surgery for your pet, you should be comfortable with the multiple factors that go into this important decision: financial, recovery, expected outcome, our experience with similar situations, success rate, life expectancy, etc.

They can attach their recent, relevant medical notes and recent blood work to that form. Depending on the situation, X-rays can also be attached to the form. They must be in JPEG format.

If you have a very unique or delicate situation, we can talk about it.

We do not accept checks or cash.

A surgery we perform to treat laryngeal paralysis is most common in dogs over 10 years of age, so we’ve done it in 14 and 15 year old dogs – with good results.

As we always say, “age is not a disease.”

Some complications are possible in all surgeries: swelling, bruising, oozing, bleeding, infection etc.

Other complications are related to each surgery, which again should be discussed during the consultation. The best way to prevent them is to follow the discharge instructions.

Since 99% of our patient go under anesthesia, we are obsessed with patient safety.

That is why we do preop blood work and exams, to ensure there are no obvious underlying abnormalities with the major organ systems.

That is why each surgery patient has a dedicated anesthesia nurse, whose only job is patient safety.

Your pet will be monitored before, during and after surgery with sophisticated equipment and by an experienced nurse. In fact, a whole team of compassionate nurses who are known to spoil their patients.

Make sure to discuss all current medical conditions and medications with the surgery team to ensure nothing gets overlooked.

You can read more about this very important topic here:
LRVSS.com/keep-patients-safe-during-after-anesthesia

• ECG (heart electrical activity)
• Heart rate
• Pulse
• Respiration rate
• Blood pressure
• Blood oxygen levels
• Blood CO2 levels
• Body temperature

If any one of these vitals is abnormal, we can address it and make anesthesia safer.

Age is not a disease.

Still, we take multiple precautions when we perform geriatric anesthesia.

A healthy 14 year old pet can have a less complicated and less risky anesthesia than a sick 2 year old, so age is relative.

Each patient gets an individualized anesthesia plan so it is tailored to their specific needs, lowering risk as much as possible.

The #1 responsibility of the anesthesia nurse is to keep the patient as safe as possible.

And we strive to use the lowest amount possible, ideally under 1%, which is very low.

The rest is pure oxygen – often more than 99% – which is delivered through a plastic tube placed in the windpipe (trachea).

Just because a pet looks healthy on the outside doesn’t mean that all organs are healthy on the inside.

Blood work includes 3 parts:

• A Complete Blood Count (CBC), which studies red blood cells, white blood cells and platelets (critical for clotting).
• A full chemistry, which looks at vital organs such as the liver and the kidneys.
• Electrolytes, which can be out of balance in some medical conditions.

If blood work is abnormal, we might need to change our anesthesia protocol and postop medications.

If blood work is normal, then than should make anesthesia safer.

Water: your pet can drink through the night and the morning of surgery. They should stop drinking once you leave home the day of surgery. This prevents dehydration and makes anesthesia safer.

Cats in pain will often groom less than usual.

Don’t assume that nothing can be done because that rarely is the case.

You can read more about this important topic here: HRVSS.com/10-ways-we-keep-patients-comfortable-around-surgery

That said, we’re not miracle workers, surgery causes pain.

This is the reason why we are so generous with pain medications (please read the previous FAQ and the blog post).

We should be able to prevent pain, but we can’t take discomfort away. That will go away with time, pain medications, reduced swelling, improved range of motion etc.

We now know that postop pain relief is beneficial.

It reduces stress, anxiety and discomfort, all of which improves the recovery and your pet’s quality of life.

This is the reason why we are so generous with pain medications at our practice.

All pets go home on 2 or 3 pain medications (please refer to the previous question to learn more about that).

Keep your pet comfortable by providing a soft, clean, dry bed.

It should be placed in the confined area we discussed.

Some pets like a warm environment, others prefer a cooler area.

Even though you are hopefully reassured that your pet made it through anesthesia and surgery, you are still likely nervous, which is completely normal and understandable.

You and your pet are in synch on many levels, so the best thing you can do is to avoid communicating your stress to your pet.

Unless you’re told otherwise, feeding is rarely a big concern on day 1. Keeping your pet hydrated is more important.

If your pet is interested in food, small meal are preferred initially.

Within a few days, everything should eventually go back to normal.

You can try the same for a cat, or you can use tuna juice.

So drowsiness, sleepiness and weakness are all to be expected.

Over the next few days, your pet’s strength and behavior should return to normal.

Also keep in mind that in some cases, you are giving a mild sedative to help with confinement, so in that case being a bit sleepy & resting peacefully are beneficial.

You can read more about it here.

If you have concerns after hours, we would recommend contacting a 24-hour emergency hospital.

The bare skin was scrubbed to place the catheter in a sterile manner.

This is how we dispense IV fluids and some medications.

Occasionally, there is an issue with a catheter. In order to place another one, we may have shaved a second spot on another leg.

There may also be a GREEN (2 inch wide) bandage on the leg. If so, it must be removed when you arrive home to prevent swelling of the leg.

If you see a RED (2 inch wide) bandage on a leg, please call us ASAP.

If your pet has a RED (2 inch wide) bandage on a leg, please call the practice immediately.

The green bandage was placed after your pet’s IV catheter was removed. It’s the same as when you have blood work drawn, and the nurse places a BandAid on your skin.

The difference is, we avoid the sticky tape.

Importantly, it is not meant to replace the cone, only to protect the incision from the environment.

We recommend removing it after 5 days.

If it’s still very adherent to the skin, here are a few suggestions to avoid hurting your pet:

• Work at it little by little. Ripping the whole BandAid like some people do to themselves is not a good idea in a pet.
• Push on the skin to keep it flat while you pull the BandAid away.
• Moisten it with a warm, damp cloth.
• Give it another day or two if it’s truly that difficult or painful.

And it’s usually more than most pet owners expect.

The reason we shave so much hair is to ensure the area around the surgery site is as sterile as possible to avoid any risk of infection. We call shaving a necessary evil.

A lot of shaving is better than the smallest infection.

The good news is, hair grows back as soft and silky as before surgery in 99% of pets.

This can occasionally cause mild irritation and a slight cough. If so, the cough will disappear over the next few days.

However, if it continues beyond a few days, it could be kennel cough or the dog flu (aka canine flu, Canine Influenza Virus or CIV) or even pneumonia, in which case you should contact your family vet.

And please keep it on 24/7 – no exception – as recommended.

Not surprisingly, many pets find these collars strange at first and will attempt to remove them. However, if you are more stubborn than your pet, most will tolerate wearing the cone.

Once they’re used to it, keep the collar on at all times. Don’t be tempted to take it on and off, for example around meals or if you’re sitting with your pet.

Remember – it only takes a few seconds for your pet to damage or open the incision, which can cause an infection.

If you feel your pet’s incision has been damaged in any way, please call the hospital as soon as possible.

Pets can eat, drink and sleep with the cone on. Please don’t take it off to give your pet a break or to be “nice.” This can be very detrimental as it teaches your pet that it can come off.

Then they make it their life mission to take it off.

The damage (self-trauma) can be serious enough that another surgery is required to stitch the incision back up. This means another anesthesia, another surgery, and more money spent!!!

Some pets are very creative and use the sharp edge of the cone to scratch their incision. If that happens, it means the cone is too short so you will need one a bit longer (see handout below). Your family vet can provide one.

Calling it “the cone of shame” is a very unfortunate nickname. We see it as your pet’s best friend to prevent an infection, and your pocketbook’s best friend to avoid the need for additional medical care.

Please refer to this handout to learn more.

In addition, we prefer a hard plastic cone because your pet can see through it, as opposed to the soft cones.

Don’t believe the marketing!

In addition, some are extremely easy to remove!

Don’t believe the marketing!

Scratching can cause some significant damage to the incision and open it up.

Some pets are very resourceful. They can also rub the surgery are on the ground or a piece of furniture.

Depending on the location of the incision, you might be able to cover it with a T-shirt (on the neck only, not the chest), or a bandana, or a “scarf.”

This could be due to a variety of reasons:

• Your pet was fasted, ie did not eat, around 12 hours prior to surgery.
• Anesthesia and some surgeries can slow the transit down.
• Some of the medications given prior to, during or after surgery can slow the GI tract down.
• Your pet may not eat much for a few days after surgery.

Please refer to this handout to learn more.

Contact a vet ASAP if your pet remains constipated more than 3-4 days after surgery.

That’s a complete myth.

Do we need to explain where your pet’s tongue has been?

Their tongue carries countless bacteria, including fecal bacteria (ie nasty bacteria from poop) which could cause a very severe infection.

This is why we insist that your pet who had surgery should be kept away from your other pets.

Please refer to this handout to learn more.

If you see pus (green or white or yellow), call a vet ASAP (us, or your family vet, or the emergency clinic).

Looking at each other through a baby gate or through a crate is fine.

However, if they overstimulate your surgery pet, then you run the risk of injuring the surgery and it may be irreparable. Remember, we only have one shot at healing.

This is the reason why we recommend separating your pets during recovery. If your pet heals properly, then your pets can play and have fun again later.

In most cases, your pet will need to be strictly confined to a small room or a large crate to ensure proper healing of the surgery area. Remember, we have one shot at healing.

Most orthopedic surgeries take 2 months to heal.

Many soft tissue surgeries take 3 to 4 weeks to heal.

The idea is not to turn your pet into a zombie, but to take the edge off, to your pet is a bit more content to be confined.

The only way to do the same with a pet, and ensure that they heal properly, is to confine them. Confinement should be comfortable. We recommend a large crate for small pets, and a small room for medium & large pets.

There should be nothing to jump on (furniture, window sill etc.).

Walking around and pacing are allowed. Jumping and running are not.

Breaking the rules can unfortunately have devastating consequences…

We have one shot at healing.

There is a very high chance that your pet will do what they usually do when you are not around: sleep.

If you have the luxury of coming back over lunch to check on your pet, that is a great option but certainly not mandatory.

There is not much to do after surgery anyway, besides giving the medications at the right times.

There are multiple reasons for that.

For the most part, we can control what happens at the surgery practice.

However, we cannot control what happens at home, or how strict you are with the plastic cone, or how strict you are with the confinement, or how your pet behaves after surgery, or how strict you are with the short walks, or how strict you are with preventing furniture and minimizing steps, or how strict you are with preventing your other pets from interacting, or how strict you are with the physical therapy.

As you can see, there are multiple variables we have no control over.

To some degree, there are also variables you don’t have any control over. Some have to do with the nature of your pet’s condition or your pet’s behavior.

We can’t change the course of arthritis or cancer and other serious conditions.

That said, our expectation, in most cases, is to get 95% of pets back to 95% of normal. Those are pretty good odds…

Make sure we discuss this important question before surgery so you have a realistic understanding of what the goal and outcome of the procedure are.

That said, most pets “toe touch” within 1-2 weeks after surgery.

Some who are braver or more stoic will put quite a bit of weight during that time.

It is not uncommon for them to carry the leg more when indoors, as they are more focused on it.

Conversely, they most often use the leg more when they’re outside, when they are more distracted.

We usually get concerned if a pet doesn’t use the leg by suture removal, usually 2 weeks after surgery. If that is the case, please contact us ASAP.

Bottom line: don’t expect huge changes overnight. We expect improvements on a weekly basis. Each week should be better than the previous one.

Keep in mind that surgery time is only a portion of the time your pet will be under anesthesia.

Your pet will be under anesthesia before surgery (to clip the hair, set up in the OR, scrub the skin etc.) as well as after surgery (to clean your pet up and sometimes to take X-rays).

Delaying removal of a mass will likely mean more time for it to grow bigger. This means a more invasive surgery, more time under anesthesia and possibly fewer chances at getting it all.

Delaying joint surgery (e.g. addressing an ACL tear) will likely mean more time for your pet to be in pain, muscle to melt away and arthritis to get worse.

Delaying “upper airway” surgery (Bulldogs, laryngeal paralysis) will likely mean more time for your pet to suffocate.

Waiting rarely makes things better…

• What type of cancer it is
• How aggressive it is
• Whether we “got it all”
• Whether we provide a cure.

Only then a plan can be recommended for future treatment – if even necessary.

This can include additional surgery to remove more tissue, chemotherapy, radiation, or simply monitoring.

Chemotherapy is a scary word, but all it means it “drug therapy.”

With some cancers, chemo can be as simple as giving a cheap pill.

Now, if the biopsy comes back benign (non-cancerous), then you can sleep better at night knowing the tumor should not affect your pet’s lifespan.

We feel that peace of mind is priceless.

Please refer to this handout to learn more.

In virtually all postop patients, neither is recommended as long as they need to be confined, which is 2 weeks to 2 months depending on the surgery.

If you feel that your pet is smelly, you can give a sponge (local) bath, use pet wipes or dry shampoo (specifically made for pets!).

If you think that your pet’s hair is messy, you can brush them.

Some pets have stitches, which may or may not need to be removed after a few weeks (we will let you know very clearly).

Stitches we don’t remove will dissolve on their own in a few weeks.

Even fewer pets have no external stitches at all. All stitches will be below and within the skin, which means there is no need for suture removal.

This is not a matter of preference, it all depends on the surgery and the location of the incision.

And sometimes, the order changes for a variety of reasons.

Multiple factors go into creating a logical order: age of the patient, medical conditions, urgency, pain level, type of surgery, cleanliness/sterility of the procedure, equipment availability etc.

Before surgery even starts, your pet will receive pre-anesthesia medications or pain medication to reduce anxiety and make anesthesia smoother.

In addition, IV fluids are also provided before anesthesia starts.

• A list of ALL medications and supplements.
• ALL actual medications and supplements, in their original container.
• Your pet’s food.
• Your cat should be in a secure carrier.