Have you ever wondered what exactly happens once your pet has been admitted for surgery? You’ve gone through all the options, signed the consent form, we’ve taken your loved one to set them up in a kennel and now what?
First when your pet is taken to a kennel and set up with a blanket, they get a name band ID as well as a kennel ID. Their surgery details are written on our surgery board – all the items you have consented to are placed up on the board so all involved know what is happening with your pet that day. Your pet will also get weighed, either prior to going to their kennel or after (depending on how much is going on up front because we want your pet to be as still as possible to get a very accurate weight). This current weight determines the doses of sedative/anesthetic and pain medication your pet receives.
Once the veterinarian arrives she does a pre-surgical exam on your pet. She checks temperature, heart rate, as well as general overall health of the eyes, ears, etc. Depending on the type of surgery she also checks teeth, palpates the abdomen, and checks for testicles. If anything is noted that was not already on your surgical consent form (such as; retained baby teeth, umbilical hernia, possible ear infection or ear mites) the doctor will make note to contact the owner before proceeding with surgery and your pet is returned to their kennel. If you have consented to any pre-surgical blood work, the blood is draw before going back to their kennel so it can be run.
Many factors are taken into account when determining the order of surgery, including: type of surgery, contamination factors (ie bacteria from a dental cleaning), whether a patient will be staying overnight, as well as the stress level of the patients (if your pet is experiencing a lot of anxiety, they are often done earlier to allow the pre-med and anesthetic to ease their stress) once this is done the doctor calculates the amount of pre-med your pet will receive. This is determined by weight, age, underlying medical conditions and breed. Breed sensitivity factors are taken into account as well as any medical sensitivity notes on your pet’s file. The pre-med includes both a sedative and pain medication. After their pre-med injection, they are again returned to their kennel. Once the pre-med has caused your pet to be sedated they are brought out and prepped for surgery.
Now we can follow Sasha on her journey:
A registered veterinary technologist will remain with Sasha from this moment on through recovery. First her IV goes in and she is given injectable anesthetic to put her under. Once she is ready she is intubated and hooked up to the anesthetic machine (which releases a mixture of anesthetic gas and oxygen). Sasha is also hooked up to a blood oxygen and heart rate monitor.
Before her surgery site is prepped all other options the owner has consented to are performed. In Sasha’s case she is being tattooed and microchipped for identification.
Next Sasha is prepped for her spay. Her abdominal area is shaved, all the fur is vacuumed away and the site is sterilized.
While the veterinary technologist is prepping Sasha for her spay, the doctor – Dr. Barb Eatock in Sasha’s case – is preparing herself for surgery. Just like in human surgery the veterinarian scrubs with a special soap to disinfect the hands and arms. A sterilized gown and gloves are worn. Sasha is now carefully transported into the surgery ward where she is laid on a special heating mat covered with a towel. She is hooked up to several other monitoring devices; a blood pressure cuff, an oxygen level monitor, a monitor that is checking her respiratory rate and her release of carbon dioxide as well as a special monitor that measures her heart rate and temperature. If needed the technologist can adjust the amount of anesthetic gas she is getting and the rate at which her IV is flowing. She can also create an artificial breath to increase Sasha’s release of carbon dioxide or increase her oxygen level.
Once the technologist has Sasha hooked back up to the anesthetic gas and monitors, Sasha’s body is covered with sterilized surgical drapes with only a small opening in one that allows access to the surgical site. This creates a sterile field that protects against contamination. Using a scalpel the veterinarian makes a small incision through Sasha’s skin and all the tissue, muscles and ligaments in the abdominal wall to get to her uterus. The incision for a spay is always made running from head to tail. This is based on the anatomy of the body to reduce the trauma to the muscles and decrease the amount of time for healing (if cutting across the abdominal wall more muscles are cut which increases the time to heal – think of a woman who has had a c-section). The incision is made as small as possible. The veterinarian then uses a set of special tweezers called forceps to pull Sasha’s uterus out. Note the special shape of Sasha’s uterus. Unlike humans, both dogs and cats have uterus’ shaped like a Y. Each side is called a horn and is where puppies and kittens develop during pregnancy. The base then leads to the vaginal opening. Hemostats are used to clamp off the ends of each horn of the uterus and to the base where they join, to reduce bleeding as they are removed. Once the uterus has been removed the entire surgical site is sutured shut: first dissolving sutures are placed in the interior abdominal wall, then sutures are placed in the layer of skin. During the entire surgery Sasha is continuously monitored by the technologist and stats are recorded every 5 mins.
It is imperative that Sasha is kept as calm as possible especially in the first few days after her surgery. If allowed to run around and jump and play like normal, it is possible for the stitches to tear and her incision would break open. If this happens the intestines and other organs can come through this opening. Until the body has had a chance to start the healing process she needs to be prevented from being a typical kitten.
After Sasha’s surgery is complete, she is given an injectable pain medication, if there are any baby teeth to be extracted, they are removed now. She is then moved back to her kennel where there is a heat disc and lots of warm bedding. It is very important that she stays warm during her surgery and recovery. The technologist remains with Sasha as she starts to come out of anesthetic. In about 5-10 mins she will be attempting to swallow and her endotracheal tube will be removed. The tech remains with her for at least another 10 mins or more until she can sit up and fully swallow on her own.
Sasha remains on IV fluids through the morning and most of the afternoon. She is checked often by the technologists to ensure she is doing well. Since Sasha is a kitten, once she is up and moving around she is offered a snack. Young animals’ metabolisms are very fast and so will need to eat much sooner than an older animal after surgery. Often older animals won’t eat until the next morning as they may feel a little queasy and not be interested in food.
Sasha’s family comes and picks her up in the later afternoon. A receptionist will retrieve her file upon their arrival and ring through the surgery. A technologist will then go over all the details from surgery: things her owners will need to do and watch for as she recovers as well as explain the pain medication and any other medication that may be going home with them. Sasha remains in the kenneling area until all of this information has been given so we can have your undivided attention and answer any questions before being distracted by your pet. While the tech is going through the details with you, another staff member will be checking Sasha’s incision as well as the rest of her over so she is in top shape to go home. If she arrived in a kennel she will be placed in her kennel to be brought up front once instructions are complete.
Although Sasha is leaving the clinic, we don’t consider this to be the end. A technologist will call her family the day after surgery to see how she is doing and answer any questions that may have arisen. In 10-14 days Sasha will be coming back in for an appointment as her incision should be almost completely healed and the external suture can be removed. We ask clients to come in to have this done as it allows us to check the incision over as well as other things preformed in her surgery. In Sasha’s case we will take a quick look at her tattoo and likely rescan her for her microchip to ensure it is still in place.
We encourage clients if they have any questions or concerns to contact us. We want to be sure your pet is recovering completely from their surgery, so if anything is worrying you, we ask you to not hesitate and just call. Occasionally some pets need more pain medications or can get an infection in the incision. There is no cost to you to bring them in for a post-operation recheck, only the cost of medications or additional services if needed.
***Sasha update: She is doing very well post surgery and becoming a busy, active kitten in her new home