What do you do for lab work prior to the procedure?
We do a complete blood count or a CBC. That's going to check for any signs of anemia before the surgery to ensure that there's no infection, ensure enough white blood cells to protect against the infection if it does occur, and that there are enough platelets to help the blood clot after the incision is made. We also test the liver and the kidneys to be sure the anesthetic and post-op pain medications will be safe. If we have pets over the age of seven, we also do a thyroid test. For anybody that we do an open abdomen surgery on, like a spay, we also do a pro-time and a PTT to check the blood clotting to make sure it's also safe for the surgery.
Dr. Marty Greer
Veterinary Village
Does my pet have a pre-op EKG?
Yes. Although we do a complete physical exam prior to the anesthesia, including listening to the heart, there can be heart problems such as arrhythmia, an irregular heartbeat, which can lead to intraoperative complications, including anesthetic death. We can't always tell that from simply listening, so we do an EKG that is sent to a cardiologist for assessment prior to the anesthetic procedure.
Why does my pet have a shaved place on its leg, and do you use an IV catheter?
All the patients that we put under anesthesia for any time period, more than about five minutes, receive an IV catheter. That allows us to give IV fluids for support during the anesthetic period to keep their blood pressure up and give IV access if an emergency drug needs to be administered during the anesthetic procedure.
What do you do with the IV fluids? Are they cold, or are they warm?
That's a great question because room temperature IV fluids are pretty cold going to the vein. We warm them, which helps keep the patient warm while under anesthesia. We have a little device that the IV tubing runs through to keep that fluid line warm. We know anesthesia causes a drop in the internal body temperature, so this is one of the several ways we can help compensate for that by using warm IV fluids.
What is a certified veterinary technician, and why is that important?
We use certified veterinary technicians or CVTs that are required in the state of Wisconsin to be present during anesthesia. Our CVTs are highly experienced in specialized care, which is so imperative for safe anesthetic and recovery.
What do you use for anesthesia?
There are lots of choices for anesthesia. We tend to use an injectable anesthetic agent, either Propofol or Alfaxan, which are very short-acting. They are much safer for the heart and blood pressure than some of the other anesthetic agents commonly used in other veterinary practices. We feel much more comfortable with those two drugs than we do with some of the others.
What is the tube in the trachea for?
That's another great question. The tube in the trachea keeps the airway open so that we can get oxygen in and out so that if your pet has any opportunity to regurgitate, it protects their trachea from aspiration. Most practices reuse the endotracheal tube over and over, and I think that's kind of yucky because reused tubes can spread disease. The disinfectant that's used to disinfect them can irritate the trachea and cause a cough. Those tubes can get stiff and cause trauma when they're reused, and you may not be able to keep the saliva and the water out of the pet's airway if the balloon or the cuff on that tube is damaged. All of those things can lead to aspiration pneumonia. We are very particular that the tube gets used one time and one time only, and then it gets donated to a local shelter for anesthetic procedures.
Why do you use oxygen?
Oxygen is really essential to your pet's brain and heart, and we want to keep them well-oxygenated during anesthesia. They tend not to breathe as deeply during anesthesia, so it's very important that they get a hundred percent oxygen. Some devices are used in other practices that deliver a lower quantity of oxygen, but we like to have 100% oxygen from a tank delivered to your pet during the procedure.
What do you use to monitor my pet when they are sleeping?
Another great question. Besides our CVTs, our certified vet technicians, we use two surgical monitors. One is electronic, which picks up the EKG, the blood pressure, the SPO2, which is oxygenation, the end-tidal CO2, which tells us how well they're ventilating, the respiratory rate, and the heart rate. Then we use a second one that allows us to hear the heart and the respirations. We just kind of double up on that. You can never be too safe during an aesthetic procedure.
What do you do for post-op pain?
There are several things we do. One is we use intraoperative local anesthetic agents like Lidocaine or Novocaine as an injection or an infusion at the site of the incision. We use post-op and pre-op pain medication so that when your pet wakes up, they've already got that medication board so that they don't wake up painful. Third, we use a post-op laser to improve wound healing and minimize pain. We also make many of our surgical incisions with a laser, which helps to seal the blood vessels and the nerves. All those things can really minimize pain. We want your pet as comfortable as it can be after surgery for recovery.
Can my pet have post-op sedation?
Yes. There are definitely pets that need it. Some pets are too active after surgery, or they're more likely to play with another dog in the household. If you feel like you have one of those dogs, by all means, ask us for post-op sedation so that when you leave the hospital, you have it in your hand. If you get home and discover that your pet is more active than you expected, we can always get that medication to you later. But it's nice to have it the first night home so that you've already got it in your hand if you need it.
How do you keep my pet warm?
We use warm towels and the warm Ivy fluids, and then they wake up on a heated bed during the recovery. During the procedure, they're on a warm surgical table that's padded to protect the patient and keep them comfortable. So we do several things. We use warm fluids, a warm towel, a warm table, and then a warm post-op bed.
Are there any stitches that need to come out after surgery?
That depends on the procedure. Some procedures have the sutures buried under the skin, so you don't need to come back for anything. Sometimes we put the sutures directly on the skin. Those are stitches that need to be taken out by a pair of scissors. Frequently we use staples in the incision. There are times when staples are more appropriate to improve wound healing, especially if we have a young dog that's fairly active. They tend to leave the staples in, and they hold better than sutures alone.
What kind of sutures do you use if you have to use them?
Another great question. There are several different kinds of suture materials on the market. We use only the best suture material. We want your pet to have the best wound healing they can have.
What if there is a postoperative complication?
Seven days a week, we're open at Veterinary Village, and between the two clinics at Checkout and Nature's Preserve, we're also there seven days a week. Each of those practices is open five days a week, but they overlap, so we are available seven days a week at both practices. Monday through Friday, we're at Nature's Preserve, and the other five days, we're at Checkout. We've got full coverage after surgery. We're not 24 hours a day, but we have seven days a week of coverage, so if you have a question, if you want to send us a photo, or if you need something checked up afterward with an appointment, we're happy to do that for you. We're here to help.
If I have more questions regarding surgical procedures, what should I do?
You can give us a call at any one of the two practices. You can send us an email, and we'll check those. After hours, we have an answering service with real people who answer. They are veterinary technicians and can also help you with any questions you might have. We're pretty much there to help you anytime. Please don't hesitate to call or send us photos if you have any questions that you need to follow up on.
If you still have other questions and you'd like to reach out to us, you can call us directly at (920) 269-4072, you can email us, or you can reach out on social media. But please do reach out, and we'll get back to you as fast as we can.