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Anesthesia and Surgery
Many people have questions about various aspects of their pet's surgery, and we hope this information will help. It also explains the decisions you will need to make before your pet's upcoming surgery.
Is anesthesia safe?
Today's modern anesthetic medications and monitors have made surgery much safer than in the past. Here at Northwoods, we do a thorough physical examination on your pet before administering anesthetics. Our examination will include checking your pet's temperature, pulse rate and quality, respiratory rate, mucous membranes, and overall attitude. Essentially, our goal is to identify anything that may make us approach the anesthetic plan differently.
Electronic vital monitoring: Our hospital features a fully-equipped modern electronic vital monitoring unit, which constantly monitors your pet's pulse, breathing, electrocardiogram (EKG), pulsoximetry (oxygen saturation of the blood's hemoglobin), blood pressure, and temperature. In addition, there is always a trained technician in the surgery suite who is able to watch your pet closely, including checking pulses and listening to the heart and lungs, to ensure that all is well and alert the doctor if any problems arise.
Continuous flow water blanket: Hypothermia is one of the most common anesthetic complications. Therefore, we have invested in "continuous flow water blankets" which ensure your pet stays warm and cozy during anesthesia. This special blanket is essentially a pad filled with channels of continuously flowing, heated water and is designed to be very safe. The constant flow of water eliminates the risk of burns and circulates warmth to all body surfaces in contact with the pad. Following surgery, your pet is bundled up with blankets and specially designed warmers called "snuggle safes". As the name implies, these warmers are also designed with safety as a number one priority.
Intravenous catheters and fluids: For safety, we may recommend an intravenous catheter to be placed and/or fluids to be administered during surgery. An intravenous catheter is a soft, tubular device which is placed into a vein, allowing immediate access to the circulation in order to administer intravenous fluids, medications such as antibiotics, or emergency medications. Fluids are especially important for long procedures, elderly animals, or animals with pre-existing illness, liver, or kidney disease.
Preanesthetic screening: We offer preanesthetic bloodwork screening, including an in-house complete blood count (CBC) and chemistry profile, which help reduce the risk of anesthesia. The complete blood count looks for problems such as anemia, low platelets (important for blood clotting), and abnormal white blood cell count. This helps us keep closer tabs on your pet's oxygen carrying capacity and immune system status. The chemistry profile gives us information regarding liver and kidney health, protein level, and glucose (blood sugar) level. With the information gained from our physical exam, pre-operative bloodwork, and medical history of the patient, we tailor the amount and type of anesthetic used to the individual status of your pet.
We strongly encourage preanesthetic bloodwork on all pets. If there is a problem, it is much better to find it before it causes anesthetic or surgical complications. Even apparently healthy animals can have serious organ system problems that cannot be detected without blood testing. Animals that have minor dysfunctions will handle the anesthetic better if they receive intravenous fluids during surgery. If serious problems are detected, surgery can be postponed until the problem is corrected.
For geriatric or ill patients, additional blood tests, electrocardiograms, or x-rays may be recommended before surgery as well.
Preanesthetic fasting: It is important that surgery be done on an empty stomach to reduce the risk of vomiting during and after anesthesia. Food should be removed from your pet by 10 PM the evening before surgery. Water can be left down for the pet until the morning of surgery.
Will my pet have stitches?
For many surgeries, we use absorbable sutures underneath the skin. These will dissolve on their own, and do not need to be removed later. Some surgeries, especially tumor removals, do require skin stitches. With either type of suture, you will need to keep an eye on the incision for swelling or discharge. Most dogs and cats do not lick excessively or chew at the incision, but this is an occasional problem you will also need to watch for. If it is likely that your pet will lick or chew at the area, please take home an Elizabethan collar (e-collar) with you to help deter licking. The Elizabethan collar is a cone-shaped device which fits on a tie or your pet's neck collar. A few animals may "pout" when wearing the E-collar because it is something new and different. Remember, your pet does not have to enjoy it for it to provide significant benefit! Much better to put up with some resistance to the E-collar rather than deal with the aftermath of a chewed open incision, which, if into the belly, can be a life-threatening emergency. If there are skin sutures, these will usually be removed 10 to 14 days after surgery. You will also need to limit your pet's activity level and refrain from bathing or swimming for 10-14 days after surgery.
Will my pet be in pain?
Anything that causes pain in people can be expected to cause pain in animals. Pets may not show the same symptoms of pain as people do; they usually don't whine or cry, but you can be sure they feel it. The amount and type of pain medications needed will depend on the type of surgery performed. Major procedures require more pain relief than things like minor laceration repairs.
For most surgeries, including spays and neuters, we give an oral nonsteroidal anti-inflamatory and pain medication the day of surgery to lessen the risk of discomfort and swelling, as well an injectable pain medication from a different drug class. Research shows that using two types of pain medication, called "multimodal pain therapy" is more effective than using one alone. Your pet will go home with pain medication for the next 3-5 days, depending on the surgical procedure performed. We use newer medications, which are less likely to cause stomach upset.
Cats receiving declaw surgery are often sent home with two types of pain medication. We use narcotic transdermal patches for some surgeries as well, especially orthopedic or extensive procedures. The cost will depend on the size of the animal. Injectable pain medications are sometimes used after surgery on both dogs and cats if administration by mouth is not possible. Our patients' comfort is a top priority, and well worth the extra effort.
What can I expect on surgery day?
When you arrive to admit your pet for surgery, we will ask you to weigh your pet and then escort you into an exam room to spend about ten minutes with a veterinary technician going over options and the days' events. If you would like anything other than the main procedure completed while your pet is under anesthesia, please let us know. This may include minor procedures such as dental cleaning, ear cleaning, mass removals, combing out hair mats, dewclaw removal, umbilical hernia repair, or implanting a microchip. If you would like an estimate for these extra services, please don't hesitate to ask ahead of time! This is especially important if the person dropping the pet off for surgery is not the primary decision maker for the pet's care.
Preanesthetic bloodwork, as discussed above, is offered for all anesthetic procedures. Please consider this ahead of time and come with any questions you may have. In ill or geriatric animals receiving surgery, bloodwork is mandatory in order to optimize anesthetic safety. In young, apparently healthy animals, bloodwork is certainly encouraged, though not mandatory at this time.
We will call you the day before your scheduled surgery appointment to confirm the appointment and give you the opportunity to ask any questions. In the meantime, please don't hesitate to call us with any questions about your pet's health or surgery.
At the time of your pet's admission, we will discuss discharge time. Patients typically will either go home between 4-5 in the afternoon the same day (neuters and small mass removals), or between 8-9 the next morning (spays, orthopedic procedures, abdominal surgeries, and sometimes geriatric patients). We will call you when your pet is recovering from anesthesia to give you an update and notify you of changes or details in discharge time and home instructions.
At Northwoods, it is our first priority to maintain patient safety and comfort. We appreciate your trust and confidence in our care!