Guidelines for Surgery

GUIDELINES TO HELP PREPARE FOR YOUR PET’S SURGERY

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Chesapeake Veterinary Surgical Specialists (CVSS) is a state of the art surgical practice operating within the Chesapeake Veterinary Referral Center. Like many human surgical and medical practices,  our  business  and  billing  departments work independently of the other businesses within the hospital. CVSS specializes in the surgical diagnosis and treatment, anesthesia,  and post-surgical care of small animals.

If your pet has been admitted to the hospital through the Pet-ER, AAVEC or another CVRC practice with a surgical condition (such as a fracture or abdominal mass), your pet may be transferred to CVSS for surgical care.   At the time of transfer, you must close out your bill with the admitting practice and leave the requested deposit with CVSS.

Some patients may require assessment from  other  services (i.e. ultrasound or cardiac consult) to ascertain whether surgery is safe and practical for the patient.  The practice performing the service may bill you separately and the cost is not included with CVSS ‘s estimate unless otherwise  stated.

YOUR PET’S SURGICAL HEALTH CARE PLAN INCLUDES:

  • Surgery
  • Expected medications & treatments that are required while your pet is in the hospital
  • Hospitalization
  • 24 hr  care by DVM & experienced technicians
  • Suture removal appointment

Additional costs (these may or may not be required for your pet):

  • Bandage changes
  • Recheck x-rays
  • Sedation (sometimes needed for recheck x-rays, bandage changes, suture removal)
  • Labwork
  • Rehabilitation sessions
  • Additional hospitalization after your pet has been discharged

PRE-ANESTHETIC SCREENING

In order for us to best help your pet, it is important for us to be able to evaluate your pet’s overall health, especially before administering anesthesia.

  • Bloodwork:  All requested bloodwork must be performed no more than 2 weeks prior to surgery, by either CVSS or your primary care veterinarian. Most commonly a CBC (complete  blood cell count) and a chemistry profile will be required, however other tests may be required or recommended depending upon your pet’s needs.
  • Radiographs:  If your pet is 10 years of age or older, thoracic radiographs will be required. Other radiographs may also be required, based on your pet’s overall health and the diagnosis.

PRE-OPERATIVE CONSIDERATIONS

 The Evening Prior to Surgery

  • Food & Water.  Your  pet should not eat after  8:00 pm the night before surgery  or as directed  by your  surgeon; if  your  pet is under 6 months old please ask the technician about special feeding instructions. Water  can  be given until 6:00 am the morning  of surgery.

The Morning of Surgery

  • Medications.  Medications can be given the evening prior to surgery. If your pet is taking medication that is critical to their health, such as heart or seizure medications, please give as early as possible the morning of surgery without food. If your pet is diabetic please discuss the insulin dosage with your doctor prior to surgery. Please make sure that you inform us of any medications your pet has been given the day of surgery when you complete our drop-off form that morning.
  • All medications must be in their original vials with directions in order for CVSS to be able to administer the drugs safely. Please list all drugs or special food on the drop-off form.
  • Diet:  Please inform the doctor or technician if your pet is on a special diet or has a sensitive stomach. If your pet is on a special diet or you prefer they eat their regular diet, please bring enough food in a labeled container to last the expected hospital stay.
  • Arrival Time: Your pet will be admitted to the hospital on the morning of surgery between 7:30 am-8:00 am. This allows time for your pet to be examined by the surgeon and for the technicians to prepare your pet for surgery.
  • Please do not leave personal items such as leashes, collars, blankets, or toys with your If you choose to leave such items, they may be lost. CVSS cannot accept responsibility for the return of these items.
  • Please inform the technician when you arrive if your pet accidentally ate after 8pm the night before surgery. We may need to reschedule surgery or perform the surgery later in the day than planned, due to the increased anesthetic risk for your pet.

Consent for Treatment & Surgery:  You will need to complete a consent form for treatment, surgery and anesthesia at the time of admittance to the hospital.  A health care plan estimate will also need to be signed and a deposit left before we can proceed with treatment or surgery.

We need to know if your pet:

  • has had previous problems with anesthesia
  • has had any previous transfusions with products such as blood, plasma or albumin
  • is allergic to any medications

Surgical Time and Doctor Communication:  You may inquire about an estimated time of your pet’s surgery at the time your pet is admitted to the hospital. Unless other arrangements are made by you and your pet’s surgeon, the surgeon will contact you as soon as your pet has recovered from anesthesia. Also, please select only one member of your family to be the primary contact. If others need to know about your pet’s status, please have that person relay the information. Please do not allow multiple people to call the hospital for updates, as this consumes staffing resources, and can affect our ability to provide our hospitalized patients with the care they need.  If diagnostics are performed prior to surgery that may affect the procedure to be performed, the doctor will most likely call prior to surgery.

While your pet is under anesthesia there will be a dedicated nurse  anesthetist  monitoring  your  pet  from  the time of induction until your pet is awake from anesthesia. This allows us to provide exceptional care and minimize the risk of anesthetic complications.


POST-OPERATIVE CONSIDERATIONS

  • The Night of Surgery:  All anesthetized  patients typically remain in the hospital for at least one night to allow us to monitor their recovery from anesthesia and surgery. Visitation on the night of surgery is usually prohibited, as the patients are often medicated and need to The Emergency Clinic staff provides care during the overnight hours, following the surgeon’s treatment plan.
  • Visitation:  If your pet is not discharged the day after surgery, visitation is usually allowed. Please see the enclosed visitation policy for more details.
  • Status updates:  The surgery staff is available to give detailed updates over the phone between the hours of 9am and 6pm. After-hours care is provided by the doctors and nurses of  the emergency  clinic. The  Emergency  Clinic is not  able to give updates on CVSS patients to the owners. If there is a change in your pet’s status, a CVSS doctor will notify you as soon as possible. The status  of all  patients will be reassessed during the hours of 8:00 –  9:00 am. You may call after  9:00 am  to receive  an update  on the status of your pet.
  • Discharge Appointment:  Discharges are performed by appointment only, from 11 am-5 pm Monday through Friday, 9 am-11 am Saturday and 9 am-10:30 am on Sundays . Please call at 9:30 am Monday-Friday and at 9 am on the weekends to schedule your pet’s discharge appointment. At the time of discharge, a doctor will meet with you to discuss your pet’s postoperative care and recommendations for re-evaluation, and physical therapy, if indicated. Please allow 45-60 minutes for the discharge. Please bring extra towels/blankets for the comfort of your pet on the ride home.
  • Incision Care:  Please do not let your pet lick or chew at their incision. Make sure your pet is wearing an Elizabethan collar [E-collarl at all times when unsupervised. Licking will likely lead to an infection and could delay the healing process. Keep the incision clean and dry. Monitor for any discharge, excessive redness or discomfort and contact us should you have any concerns.
  • E-collar:  If you would prefer a soft E-collar, or an inflatable E-collar to the routine plastic E-collar, they may be purchased at most pet stores. Please fit your pet with the E-collar prior to surgery and bring it with you the morning of hospital admittance.
  • Medications:  Please try to give all medications as instructed. Non-steroidal anti-inflammatory drugs [NSAIDS) such as Rimadyl [carprofen), Deramaxx [deracoxib), Etogesic [etodolac), Previcox [firocoxib), etc., should be given with food. Most medication can be given in treats, such as pill pockets, bread, peanut butter, cheese, etc. If your pet has difficulty taking medications please call.  If your pet has any lethargy, vomiting, or diarrhea please discontinue any NSAID and call us.
  • Confinement:  Confinement for your pet is the equivalent to bed rest or house restriction for people . This is the hardest part of your pet’s recovery for you and them, but it is also the most important to ensure a positive outcome.
    • Crate Confinement: A crate is often the most secure form of confinement. This is usually the safest option, especially for the first two weeks of recovery. The crate should be large enough for your pet to stand up and turn around while wearing an e-collar.
    • Room Confinement: Confining your pet to a small room is another option, depending on the type of surgery your pet has had. The room needs to have secure, non-slippery flooring and no access to furniture, stairs, or surfaces the pet may jump on or off.
  • Sling/Harness: Depending on the type of surgery your pet is having they may benefit from the use of a harness or a sling. Please ask if this is something you should bring with you to the discharge appointment.

ACTIVITY RESTRICTION  DURING THE POST-OPERATIVE WEEKS

Your pet will require restricted activity after surgery for a minimum of 2 weeks, longer for orthopedic and neurologic cases. Leash walks should be short(1-3 minutes) and for elimination purposes only. No running, jumping, or off-leash activity. If your pet has orthopedic surgery, restricted activity could be as long as 2-12 weeks, depending on the type of procedure.Please see your individual discharge instructions for these restrictions.

Stairs: Please limit flights of stairs as much as possible. Carry small pets and support larger pets with a sling.

Follow-up  Appointments: Because we book up quickly, we strongly recommend you schedule your follow-up appointments at the time of discharge.

  • Depending on the type of surgery, most orthopedic cases will need to return for follow-up x-rays to evaluate the healing of the which is usually 4 -8 weeks post operatively.
  • If the follow-up appointment is for x-rays, please do not allow your pet to eat or drink after midnight the night before the appointment in case sedation is required.
  • We do not schedule rechecks on the weekend unless it is a medical necessity such as a bandage change, in which case it needs to be scheduled before 11am.

TERMINOLOGY

  • E-Collar/Elizabethan Collar -typically a plastic cone shaped collar worn around the head to prevent licking chewing and scratching areas around the bandage or incision.
  • Extubation – Removal of the endotracheal tube during recovery from anesthesia
  • Intubation – Method of providing an airway by passing an endotracheal tube into the trachea to allow for the passage of oxygen and/or anesthetic
  • Catheter – a flexible tube introduced into the body for administering fluids/medications or withdrawal of fluid, such as urine.  IV catheters and urine catheters are routinely used in our hospital