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STEP by STEP Surgery

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Meet Kylie

Kylie is going to have Ovariohysterectomy Surgery today.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

This is Kylie checking in for surgery with her owner Savanna signing paperwork for her Ovariohysterectomy and pre-surgical bloodwork.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

We have an Open Hospital Policy; this gives all owners the ability to remain with their pet throughout any procedure.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Kylie, weighing in for surgery

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Next step includes prepping and placing the IV catheter, so we can administer IV medications and fluids. Just like people.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Spraying Bitter Apple to prevent her from chewing at her catheter before surgery.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Before surgery we do pre-surgical blood work to test for any abnormalities that can interfere or complicate anesthesia.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Just like people this is essential before surgery for safe anesthesia.

Depending on age we have 3 different levels of pre-surgical bloodwork that we run. Mini, Routine, and Complete.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Pre-Surgery

Dr. Koulianos performing a physical exam. Each patient gets this exam done before surgery.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Start Anesthesia

Now starting with anesthesia. Kylie is being an amazing patient for us through this whole surgery.
In the following pictures you see our intubation process. All animals are intubated for surgery so that their airway is protected and so that we can give positive pressure ventilation for the safest anesthesia.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

After intubated we then hook up Kylie to our ADS machine for positive pressure ventilation (which will breathe for her while sedated and control the amount of isoflurane gas anesthesia she gets), SPO2, and EKG to monitor her vitals. Also while sedated Kylie is unable to blink to produce tears so we apply artifial tears to both eyes while sedated to keep lubricated.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Cleaning the Area

Before moving Kylie into the surgery room we shave around the surgery site to clear the way for a sterile field.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Here we have our companion Therapy Cold Laser System which increases your pets ability to heal faster after surgery or any traumatic injury.

This system helps to ease pain, improve mobility, and speed healing. This system is also used in human hospitals for the same purposes.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Here is the ADS positive pressure ventilation in our dental suite. This allows us to regulate the amount of gas anesthesia (Isoflurane) given to each patient while sedated.

This machine is set to each patient’s weight in order to be sure they each receive the proper amount of oxygen.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

This is our Surgical Suite monitoring equipment. This includes our State of the Art Wireless Patient Monitoring System.

This allows us to record and monitor Pulse Ox, SPO2, Blood Pressure, EKG, and Temperature.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

All surgical packs are autoclaved and 100% sterile. We use only one pack per patient.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Dr. Koulianos scrubbing before gowning up and going into surgery.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

The surgery site is then cleaned again and sterilized with surgical scrub and alcohol.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

The doctor is now gowned and gloved in a sterile manner for surgery.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor
  1. Now surgery has started by placing a sterile field over the area where the doctor will make the incision.
  2. Then the abdomen is opened.
  3. The uterus and ovaries are identified and removed.
  4. The suture used in the abdomen is absorbable.
  5. The doctor is then careful to check for any areas of bleeding or abnormalities.
  6. Then the abdomen is clothes with three layers (the abdominal wall, the subcutaneous area, and skin).
  7. During this time the anesthesia/Surgical tech is carefully monitoring the patient’s vitals.
Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Recovery

After surgery the patient is moved to recovery.

By using high-tech anesthetics we can quickly bring patients out of anesthesia. The pre-surgical anesthetics and pain medications make for a very smooth and calm recovery.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

As our veterinary hospital is open, pet owner Savanna is able to sit with her little girl while she is waking up from surgery.

Pets really appreciate a calm soothing voice and touch therapy during recovery.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Waking Up

Now fully awake, but a little drowsy from the post op pain medications, the patient is just about ready to go home.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

The catheter is now being removed and pressure bandage placed to cover the catheter site.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Dismissal with the Technician and Doctor.

Step-by-Step Pet Surgery at the Animal and Bird Medical Center of Palm Harbor

Going over all details and answering any questions the owner may have.

Discussing discharge instructions and post operative pain medications to go home with.

Spay (Ovariohysterectomy) and Neuter Information

Information on Ovariohysterectomy (Spay) For Dogs and Cats

First, some basic reproductive terminology:

Spayed = a female cat or dog who has had both ovaries and uterus surgically removed, and is not capable of producing offspring.

Neutered = a male cat or dog who has had both testicles surgically removed, and is not capable of producing offspring. Also known as castration. Some refer to “neutered” as a male or female dog that has been surgically altered to render them sterile (testicles removed or ovaries removed, making them not capable of producing offspring).

Related terms: desexed, fixed, altered

Intact = not spayed or neutered, the animal has reproductive organs capable of producing offspring.

Queen = intact female cat

Tom = intact male cat

Bitch = intact female dog

Dog = intact male dog

Is spaying a major surgery?

Yes, because it involves surgically entering the abdomen, it is considered “major surgery”. This should not frighten pet owners however, since this surgery is routinely performed, and very safe. There are inherent risks with any anesthesia or surgical procedure, and talking over your fears and concerns with your veterinarian should help you understand any special risks that your pet may have. (For more on the actual surgery, see below.)

Myth #1 – I’ve heard that my pet should have a heat cycle first — she will be a better pet.

Myth #2 – I’ve heard that my pet should have a litter first — she will be a better pet.

These are two common misconceptions about spaying. You will do so much more for the health of your pet by spaying before the first heat. It has been reported that by doing so, you will reduce the chance of mammary (breast) cancer in your pet by as much as 97% over their lifetime. The chance of other reproductive cancers (uterine, ovarian, mammary) and uterine infection is eliminated in spayed animals. Even after the first heat, spaying will reduce the risks of certain cancers and eliminate reproductive organ disease.

Providing a loving environment for your pet, proper health care, and proper training will be the most influential benefit to maintaining a happy pet that fits into your family.

Non-spayed females have an increased risk cancer (uterine, ovarian, mammary) and an increased risk of a life-threatening uterine infection as they get older.

 

Why does my vet want to do pre-surgery blood work on my pet?

Many veterinarians offer pre-anesthesia screening to their patients, and may have you sign a waiver if you decline these blood tests. Why is this so important? It provides a way to assess kidney and liver function prior to undergoing anesthesia among other things. The liver and kidneys are the primary routes that the anesthetics are broken down and removed from the body. If they aren’t working well, then anesthesia may be more of a risk. There are many anesthetic agents available, and your veterinarian may also use the blood screening information to determine the best anesthetic protocol for your pet.

 

What happens during the surgery?

Your pet will be sedated and anesthetized so she won’t feel any pain or be aware of what is happening. Her breathing and heart rate will be closely monitored by the veterinary staff. The surgeon makes a small incision on her abdomen (belly area) and removes the two ovaries and uterus, usually just above the cervix. All vessels and tissues are ligated (tied off) to prevent bleeding and lessen chances of post-operative bleeding or infection. Once the ovaries and uterus are removed, the surgeon begins the closure of the body wall and skin — muscle, subcutaneous, and skin are sutured (stitched) back together. Your pet may have absorbable sutures, skin staples, or sutures visible in the skin that will need to be removed by your vet 10-14 days after surgery.

 

How soon will she be “back to normal”?

Most people are surprised at how quickly their pets recover from surgery (certainly much sooner than their human counterparts!) Most pets are up and alert shortly after surgery and after resting quietly for a day or two, most are back to their “normal” self. It is very important to restrict activity in those pets that are very active — too much activity can actually delay healing or cause post surgical complications, such as dehiscence (opening of sutures) or bleeding.

The 4 Veterinary Secrets That You Need To Know Before Your Pet Has Surgery

Studies done at multiple veterinary schools show that when veterinarians use the same techniques and protocols as used in humans – the risks for surgery are reduced to same level or even below human hospitals. As a pet owner you need to know about the most significant surgical risks to your pet. When comparing one hospital with another you need the facts to make an informed decision.

1. Type and Method of Anesthesia used
by the Veterinarian makes all the difference
in your pet’s safety during surgery.

Havanese getting prepped for minor surgery.
Havanese getting prepped for minor surgery.

There are many very different drugs and methods of anesthesia used by veterinarians. The safety and the cost of these drugs vary greatly. You may wonder why a veterinarian would choose anything other than the safest technique.

Anesthesia for an ovariohysterectomy (spay) can cost a veterinarian from $5.00 for cheap injectable anesthetics with no monitoring to over $220.00 for inhalant anesthesia monitored with EKG, blood pressure, pulse oximeter, computers that breath for your pet during the anesthesia, and highly trained anesthesia technicians. That is why low cost spay and neuter facilities are so profitable.

In today’s current economy, a veterinarian who does low quality, high risk anesthesia can actually charge ½ the fee that a veterinarian doing high quality, safe, low risk anesthesia surgery can charge. On top of that, the veterinarian offering the less expensive high risk anesthesia can earn twice as much money from a surgery such as an ovariohysterectomy (spay) or neuter. Low cost surgery is much more profitable for veterinarians.

Mistakenly, most discount spay neuter facilities do not explain the shortcuts that they take – using inexpensive but high risk injectable anesthetics, little to no monitoring, poorly trained low wage staff, using the same instrument pack for multiple patients, not autoclaving instrument packs, using discount suture.

Discount low cost spay and neuter facilities provide a great service in providing a low cost alternative for families that have financial difficulties. At the same time low cost surgical centers reward veterinarians with a much higher profit. But, rarely do these facilities explain to clients the shortcuts that they are taking, the lower standards of care and the higher risk for anesthetic death and infection for the dogs and cats. Like many things in life you get what you pay for.

A Safer Way

The only way to reduce a pet’s anesthesia risk to the same or lower than people is to use the same techniques and equipment used by human anesthesiologists. That is why veterinarians whose primary concern is about their patient’s safety purchase such expensive anesthetic equipment and use more expensive anesthetic drugs.

  • The first step is preanesthetic blood screening and exam to determine if your pet is healthy enough for anesthesia and if they have any conditions or problems that could affect anesthesia.
  • Then an intravenous catheter is placed in the vein with sterile technique. Then the pet receives pre-anesthetic drugs that reduce anxiety along with pain medications. Pain medications before surgery are much more effective than pain medications after surgery.
  • Then a short acting anesthetic is given so that a tracheal tube can be placed. This tube prevents aspiration pneumonia and provides a safe and effective path for oxygen and gas anesthesia.
  • High tech veterinary anesthesia utilizes very safe gas anesthetics balanced with intravenous medications such as morphine, lidocaine and ketamine. Veterinarians providing state of the art safe anesthesia always give intravenous fluids during surgery.
  • The pet is monitored with a pulse oximeter, EKG, blood pressure monitor, body temperature, breathing rate, and attached to a computer that gives a specific amount of oxygen and anesthetic by body weight algorithms. In this way the pet’s lungs are safely fully inflated during surgery reducing anesthetic hypoxia.

Not only is the type of anesthesia critical for the safety of your pet, but also the skill and level of training of the veterinarian and anesthesia technician determines the safety of your pet’s procedure.

The type of anesthetic drugs, the surgical equipment, and level of training of the technicians and veterinarian determines the safety of your pet’s surgery more than any other factor.

2. Cellular Hypoxia during Anesthesia
is what usually what causes death during anesthesia.

The number one cause of complications leading to death for a pet is cellular hypoxia. This happens when cells are starved of oxygen. When the cells of the heart are starved cardiac complications occur.

Oxygen is transferred to the blood stream through the lungs. Then the heart is responsible for pumping the oxygenated blood to the cells. During anesthesia, pets do not expand their lungs and breathe in as much air as when awake. This combined with lower cardiac output can lead to dangerous cellular hypoxia.

Cellular hypoxia varies greatly with different anesthetic drugs and anesthetic protocols. Less expensive drugs and techniques greatly increase the risk of fatal cellular hypoxia. To prevent cellular hypoxia anesthetized patients need positive ventilation that expands the lungs to get more oxygen into the body. Close monitoring of both the heart and body oxygen levels. This requires special anesthesia equipment and highly trained anesthesia technicians.

The Animal & Bird Medical Center uses expensive ADS 1000 computers that breathe for your pet while under anesthesia, Nelllcor pulse oximeters to monitor oxygen, blood pressure and ekg’s to closely monitor cardiac function. Our technicians are required to go through extremely comprehensive training.

3. The importance of Sterility
and Quality of Surgical Equipment and Sutures.

Another complication in surgery can come from improperly sterilized surgical instruments. There is only one acceptable method of sterilizing – extreme heat and pressure created by an autoclave that kills all bacteria, fungi, and viruses. Quality veterinary hospitals use a single pack of autoclaved instruments for each surgery, just like in human hospitals. A common practice in discount veterinary hospitals is to use one surgical pack for many patients to reduce costs resulting in cross patient contamination of bacteria and viruses.

A lower and less sanitary option of cleaning is immersion in a cleaning solution and using the same surgical pack on multiple patients. Since the late 1800’s, we have known poor sterilization results in sepsis and the spread of disease.
Also surgical instruments vary greatly in quality. Poor quality surgical instruments have poor tissue handling resulting in more trauma and higher complications. Quality veterinary practices purchase expensive German instruments. Other hospitals purchase low quality cheap instruments made in Pakistan.

The most common cause of fatal hemorrhage is poor surgical technique, often from using inexpensive and inferior instruments and cheap suture that has poor tissue handling capabilities. Discount spay and neuter clinics often purchase second rate products in rolls, just like fishing line. Rolls do not remain sterile as they become used and frequent handling can weaken substandard sutures. Quality suture is sold in individual, sterile packs with an individual needle.

At the Animal & Bird Medical Center all routine surgeries are done with an individual autoclaved surgical pack. The surgeon wears a sterile surgical gown, cap and gloves exactly like in human hospitals. We use the most expensive German instruments because our patients deserve the best. We use the same sutures used by plastic surgeons because this high quality suture causes less reaction and discomfort for our patients.

4. Your pet’s safety depends on the
Surgical Training of Veterinarians and Staff
and this varies greatly from one hospital to another.

In human medicine doctors are required to do advance training after medical surgery before doing surgery in hospitals. In veterinary medicine, no such training is required. That is why there is such a wide range of surgical abilities and training in veterinarians as compared with human surgeons.

It is up to each veterinarian to get advanced surgical training and develop their surgical skill after veterinary school. The skills of veterinarians vary widely from extremely unskilled to high levels of mastery. Surgical fees reflect the additional costs of advanced training and continuing education of veterinarian’s that are highly skilled. Veterinarians are very aware of their personal level of proficiency and charge according to their surgical expertise.

The skills of the veterinary technician and anesthetist in assisting the doctor before, during, and after the surgery are critical in your pet’s surgery and recovery. Dr. Murphy personally trains all veterinary technicians in his hospital to meet his level of expertise. Because they are highly motivated people, Dr. Murphy hand picks each technician for training. He pays for his staff to attend continuing education classes. The veterinary technicians at ABMC are very capable in phlebotomy (taking blood samples) , running laboratory panels, intubation and monitoring all devices like the pulse oximeter, EKG, blood pressure, etc. during surgery, among other procedures.

Before one is allowed to assist in surgery, a vet tech needs to show the ability to follow doctor instruction and also the aptitude to think ahead and anticipate circumstances, as well as adapt to fast changing conditions. They become the connection between the doctor, pet, and machines as the surgery progresses. After surgery, nurses lovingly care for your pet and vigilantly watch for changes in your pet’s condition, alerting the doctor if anything seems unusual.

Now that you know the risks how do you know your pet is receiving the care you expect? Ask to watch the procedure. Hospitals that take pride in providing care are happy to have you watch your pet’s surgical procedures.