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Surgery on our Pets: What Really Goes on Back There? By Dr. Ed Mapes There is understandable concern on the part of folks dropping their pets off for surgery at the Veterinary hospital in McKinney TX. What really goes on back there beyond those exam room doors? Pets are placed in the care of the Veterinary staff, which performs a number of tasks to keep them safe during surgical procedures. Here’s how we handle a typical surgical case: The pets are given a physical examination to estimate overall health by observing parameters such as hydration levels and color of mucous membranes along with heart and lung function. We also look for conditions such as: parasite infestations on the skin allergic conditions that could force postponement of the procedure ear infections skin masses or tumors umbilical or other types of hernia tooth and gum for disorders males being neutered have two testicles descended females being spayed aren’t in heat or pregnant Blood is then drawn for testing to assure that the pet is a suitable candidate to undergo anesthesia and the operative procedure. The blood chemistries assess functions of organs such as the liver, kidneys, and pancreas to be sure that: 1. the anesthetic is properly metabolized and removed from the body. 2. being under anesthesia will not impair organ function. A CBC (complete blood count) gives information about the presence of infection, stress, whether the pet is anemic or dehydrated, and that the blood clots normally. It is not uncommon for this screening to point out problems previously undetected, at which time surgery is often postponed and further measures taken to assess and treat the disorder. After drawing the blood sample, we install an intravenous catheter – usually into a vessel in the front leg (the cephalic vein). This catheter serves several important functions: 1. Permits the administration of intravenous fluids. Anesthesia tends to slow the heart rate and decrease blood pressure – the fluids help us maintain blood pressure, which supports all of the organs. In fact, many older patients are somewhat dehydrated; a process that happens naturally with age. These patients actually benefit from the fluid therapy, which boosts their overall body hydration. 2. Provides us with a ready access port directly into the circulatory system. This is useful for giving substances such as antibiotics during surgery, but can prove vitally important should a patient begin to have problems under anesthesia. In that scenario, we’re able to give drugs to speed the heart rate, increase blood pressure, control abnormal heart rhythms, and regain a lost heart beat. The seconds saved by having a catheter in place could even prove to be life-saving, allowing immediate administration of emergency drugs. After blood analysis confirms their health, patients are given injections that offer tranquilization/sedation, pain control, and antibiotics (pre-anesthetic medications). Sedation is important at this time because it calms and relaxes anxious pets, and the patient requires less of the drugs that actually initiate anesthesia (induction agents). Approximately 30 minutes after receiving their pre-op medications, patients are reexamined and then proceed to the surgery suite for their procedure. There, we utilize the intravenous catheter to give an injection of a short-acting inducing agent, which provides enough anesthesia for us to install the breathing tube (intra-tracheal tube) into the pet’s trachea. Once done, the tube is connected to the gas anesthesia machine, which delivers oxygen and anesthetic gas at measured amounts that we control on a constant basis. The anesthetic gas is breathed into the lungs, enters the blood stream, and produces anesthesia in the brain necessary for the operation. At this point, we connect the intravenous fluid line to the catheter and start the fluid flow. An EKG machine, pulse oximeter, blood pressure gauge and thermometer are connected so that we can monitor the heart, percentage of oxygen in the blood, breathing rate, blood pressure and temperature during the entire procedure. No, this isn’t a modern human operating room! Patients breathe gas from the anesthetic machine, receive intravenous fluids, and are connected to devices that monitor them closely. Also pictured are the patient warmer and laser unit. A machine that circulates warmed water through a pad keeps the body temperature warm during the procedure. The monitoring devices enable a technician to keep very close watch on the patient while the surgeon concentrates on the operation itself. Adjustments to oxygen flow and level of anesthetic gas are made throughout the procedure in response to readings and observations to keep pets at optimum safe levels. Gas is discontinued minutes before the surgery is completed so that the pet wakes up shortly after the final suture is placed. This is one of the reasons that modern anesthesia is so safe – patients wake up very quickly when the gas is exhaled from the lungs. The intra-tracheal tube is removed once the pet demonstrates an ability to swallow. Monitoring equipment is removed, fluids are discontinued in most cases, and a final temperature is taken when the pet is awake. Close monitoring continues in the recovery area, and then we observe them until release from the hospital. Pain is controlled from the moment of pre-anesthetic injection, continues throughout the operation, and then for several days afterward. The initial injection is sometimes followed by local nerve blocks when indicated – feline declawing, dentistry procedures, and orthopedic surgeries are examples. Additional injection(s) are given after surgery when indicated, and pain medication is sent home with the patient to provide control during the healing phase. The laser surgical unit makes incisions that do not bleed, and produce far less pain, inflammation, and swelling afterward. This is a great advancement in veterinary surgery, and all of our surgeries are now done with the laser to help our patients. We know that a trip to the hospital can be a scary event for our pets, (and their humans!) and that none of them would choose to have surgery performed. Modern medicine gives us the means to make their visits safer, more pleasant, and less painful than ever before – and that’s what practicing good medicine is all about. Animal Hospital McKinney TX Stonebridge Animal Hospital 5913 Virginia Parkway, Ste 100 McKinney, TX 75071 (469) 507-2433