What happens when my pet is left at the clinic for surgery?

by Dr. Francesca Matthews

The following information is a generalisation of what will happen for a routine elective procedure such as a spey or neutering operation or a dental at the Veterinary Centre clinics. There may be some variations depending on the specific case and when different procedures are required.

 

 

On arrival, the morning of surgery

 

On arrival at the Veterinary Centre you will usually be seen by one of the clinic veterinary nurses. They will be responsible for admitting your pet. They will double check all your details, your pet's details and what procedure you are bringing your pet in for. They will also ensure that you leave a contact number for the day that you will be available on at all times.

 

Reason why we need a reliable contact number:

If we find that we need to do anything else while your pet is under anaesthetic - for example, we find a lump or the procedure ends up being more complicated than expected, we can contact you immediately to advise and get permission to do additional procedures.

 

Once the procedure is completed and your pet is recovering, we like to be able to contact you and advise that your pet is doing well and arrange a pick up time.

The third reason, and hopefully an event that doesn't happen, but can in rare cases, if something goes wrong during anaesthetic then our veterinary clinic staff also need to be able to contact you immediately.

 

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What else will the pre-admission check entail?

The veterinary nurse will also ask if there is anything else you want doing at the same time such as your pets nails trimming. If it is possible veterinarians and their staff will try and accommodate these requests. However, in certain cases, some additional procedures may not be advised to be carried out at the same time. Our veterinary clinic staff will be able to advise whether the additional procedures you request are possible.

 

The admitting veterinary nurse will then check that your pet has had food and water withheld for the required length of time. For cats and dogs this is usually 8-12 hours for food, and since the early morning for water. Rabbits and other small pets have much higher metabolisms and they also do not have the same propensity to vomit, so withholding food is generally not recommended in these species. The veterinary nurse will also check that your pet is healthy, for any medications they are on, any previous problems with anaesthetics and so on.

 

Once they are satisfied that everything is in order you will be asked to sign a consent form to say that you have had explained to you the risks of anaesthesia and that you understand these. This is the same sort of thing you would be asked to sign at a hospital. It is not a waiver of responsibility on the Veterinary Centre's behalf, but provided due diligence is undertaken and an adverse event occurs, then you are accepting the risks. Your pet will then be admitted to the hospital.

 

 

Hospital admission

 

On admission your pet will be given a clinical examination (a once over like your pet receives at its annual vaccinations). The Veterinary Centre staff obtain baseline measurements of heart rate, breathing rate and temperature for your pet so these things can be monitored under anaesthetic. If there are any concerns with the clinical examination you will be contacted.

 

 

Anaesthetising your pet

 

The example given here is for a standard routine surgery such as a desexing operation or dental in a cat or dog using a full general anaesthetic, firstly by injection in the cephalic vein (intravenous) in the leg, and then maintained via gas anaesthetic (one they breath in and out). There are many variations used depending on the procedure and the demeanour of your pet.

Following the clinical examination your pet will receive a pre-medication which contains a pain relief medication and a sedative. This helps to relax your pet and gives them good pain cover. Pain medications are best given prior to the painful event and in an elective surgery situation this is possible. Your pet will still be conscious after being given the pre-medication.

Approximately 40 minutes later your pet will get an injection into the vein in the front leg (the cephalic vein). A general anaesthetic agent is injected and this induces your pet into unconsciousness. This allows one of our veterinarians to place an endotracheal (ET) tube which is a plastic or rubber tube that is inserted into the trachea or windpipe. This keeps the airway open while your pet is unconscious. The Veterinary Centre staff then attach the anaesthetic machine to the end of the tube coming out of your pet's mouth, which ensures your pet is breathing a mixture of oxygen and gas anaesthetic. Gas anaesthetic is excellent for keeping your pet at the right depth of anaesthesia and can be very quickly and easily adjusted.

Once your pet is attached to the machine and in a good depth of anaesthesia, the procedure can start.

 

Review another article in this section for more on anaesthesia an also pre anaesthetic blood tests.

 

 

The procedure

 

What happens here depends considerably on the procedure. We will use an example of a routine desexing operation.

Firstly your pet is positioned on the table. Next the area where the surgery is to occur is clipped using electric clippers. The area needs to be significantly bigger than the surgical cut because it is important no hair can accidentally get into the wound and contaminate it. Also if something goes not to plan and a larger hole is required, then the clip area already allows for this. It is not good practice to clip an animal again while there is a surgical hole because of the very high risk of contamination.

Next the veterinary nurse will clean the site with surgical cleaning agents such as iodine (this is brown in colour and you may have seen this on your pet's skin post surgery before). Once the area has been cleaned and freed of as many bacteria as possible the surgery can begin.

While the veterinary nurse has been attending to the surgery site, the veterinarian will be undertaking a surgical hand scrub and placing on a sterile gown and gloves to ensure they cannot contaminate the surgery site.

 

Next the veterinarian will place a sterile cloth (or drape) with a hole in it (called a fenestration) over the area that he or she wishes to make the surgical incision into.

 

The procedure is carried out and the surgical site sutured back together. Usually there are sutures on the outside which need to be removed 10 - 14 days later, but in some cases the skin will be held together with sutures that are buried under the skin and these will dissolve by themselves.

During the surgery, your pet is monitored under anaesthetic by one of our qualified veterinary nurses who takes continuous readings of heart beat, respiration rate, colour of the gums and other signs to ensure your pet is at the correct depth of anaesthesia. That is, that is not too light and feeling things and not too deep and at risk of an adverse event.

 

 

Waking up

 

Once the surgical site is closed, the drape is removed and the anaesthetic machine is turned off. Your pet is left to breathe pure oxygen for a few minutes, before this is also removed. Once your pet has regained its swallow reflex, the ET tube is also removed and your pet is transported back to a recovery area for further monitoring until he or she can hold his or her head up again.

 

It is at this stage that a phone call is normally made to you to advise that everything went well and to arrange a suitable pick up time.

Once your pet has regained control of its body again, they will usually choose to go back to sleep again for a while, so generally veterinary clinics will keep pets in for another 3 - 4 hours after the procedure. Following this, you can come and pick up your pet.

 

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