Dog Surgery

How to Prepare a Dog for TPLO Surgery

2011-05-02T23:45:00.001-07:00

A canine TPLO surgery helps repair ligaments and is a very complex procedure requiring extensive at-home recovery care.

TPLO (Tibial Plateau Leveling Osteotomy) surgery is a very involved process for a dog and its owner. It is very important to properly prepare your dog and your home to ensure a smooth recovery. Every step that is taken toward recovery leads to faster healing and more effective results. Lack of preparation can lead to your dog experiencing more pain and possibly reversing the effects of the surgery.

Difficulty:: Moderately Easy

Instructions

- 1
  Give all medications prescribed by your veterinarian leading up to and after the surgery. Do not give any medications that are not approved by your veterinarian as they may lead to complications during and after surgery.
- 2
  Find out what postoperative physical therapy will be needed after the surgery and practice with your dog before the surgery. When both of you are familiar with the motions, the process will go much smoother.
- 3
  Prepare your home before your dog returns after surgery. Block all stairs and areas of the house with slippery flooring. Create a confined area for activity restriction for the first few days.
- 4
  Begin training your dog not to jump. Many injuries that lead to TPLO surgery are caused by excessive jumping. Eliminating this bad habit will result in a faster recovery and reduce the probability of a recurring injury.

How to Care for a Dog After Neutering Surgery - The First 24 Hours

2011-05-02T23:43:00.000-07:00

How do I care for a dog who's just been neutered? How do I keep my dog from licking his stitches? Keep reading to learn how to care for a newly neutered dog after surgery.

Spaying or neutering a dog is the only effective method of preventing a dog from reproducing. The surgical procedure used to sterilize a dog is called neutering, while the procedure used to "fix" a female is called spaying. This article will focus on surgery after care for a male dog who has just been neutered. A dog owner will need to take special measures to care for the dog after the surgery is performed to neuter the dog. Recovery from a neutering procedure takes between 10 to 14 days.

Difficulty:: Moderate

Instructions

An E-Collar (a.k.a. "Lampshade," "Cone" or "Elizabethan Collar.")
Betadine
Bland Dog Food Like Plain Skinless Chicken and Plain White Rice
A Male Dog That's Just Been Neutered!

- 1
  PICK UP THE DOG AFTER THE SURGERY: When a dog is neutered, the surgical procedure is typically performed in the morning. Barring any post-surgical complications from general anesthesia, the dog will usually be sent home late in the day. Be sure to go over after care instructions with the veterinarian and ask any questions you may have at this time.
- 2
  HELP THE DOG IN/OUT OF THE CAR AFTER SURGERY: The dog may also have a difficult time getting in and out of the car, so you will need to assist. DO NOT let the dog jump - he may damage the stitches in his fresh incision. Use a ramp or pick up the dog, wrapping your arms around his chest and rear legs (a technique you'd use if picking up a small sheep or goat.) If possible, collect the dog from the veterinarian's office using a sedan-type vehicle rather than an SUV - this will make it easier for the dog to get in and out of the car.
- 3
  HELP YOUR DOG ON STAIRS: After surgery involving general anesthesia, a dog will be groggy and he will usually be a bit off balance. This lack of coordination can make it difficult for the dog to climb stairs, so go slowly and stand behind the dog as he climbs stairs. Be ready to catch him if he starts to fall.
- 4
  BRING YOUR DOG TO HIS BED OR CRATE: When you arrive home, immediately bring your dog to his bed or crate. Chances are, he will go right to sleep. Rarely, a dog will have a normal energy level. This type of dog will need to be kept in a crate to allow for proper recovery in the hours after the dog is neutered.
- 5
  ISOLATE YOUR DOG FROM OTHER PETS AND KIDS AFTER HIS SURGERY: A dog who has just been neutered will experience some pain and discomfort, particularly as the effects of anesthesia are wearing off. Anesthesia can make some dogs a bit disoriented for a period of 18-24 hours after surgery. These factors will make a dog more prone to growling and nipping at other dogs, the family cat or even a child. Prevent dog bites after a dog undergoes surgery by keeping the dog isolated as he recovers during those first 24 hours.
- 6
  OFFER SOME BLAND FOOD TO YOUR DOG: Offer a homemade bland dog food, like plain white rice with plain, skinless chicken or boiled hamburger with the fat strained away. Offer between 1/2 and 2/3 of the dog's normal meal size to prevent stomach upset. This homemade bland food will tempt the dog to eat, but the meal will also be easy on the dog's stomach. Remember, anesthesia will often make the dog nauseated. Also remember that the dog has not eaten in 24 hours. This results in the accumulation of stomach acids which can upset the lining of the stomach, making the dog prone to vomiting and nausea. If your dog does not want to eat the night after surgery, do not force the issue. It is not uncommon for a dog to refuse food after he's just been neutered.
- 7
  TAKE THE DOG ON FREQUENT BATHROOM TRIPS AFTER NEUTERING: When anesthesia is administered, a dog will be provided with additional fluids by IV as a supportive measure. What goes in must come out, so your dog will need to urinate fairly frequently following his neutering surgery. So every 2-3 hours, take the dog outside on leash for a bathroom break. It's important to note that a dog who's just been under general anesthesia will sleep heavily, so some dogs may urinate in their sleep in the hours following surgery. Other dogs who usually signal the need for a bathroom break by standing by the door, etc. may not do this after surgery. So anticipate your dog's bathroom needs and take him out a bit more frequently than usual.
- 8
  DO NOT REMOVE THE DOG'S E-COLLAR: In most cases, a dog who has just been neutered will be sent home with an e-collar, short for Elizabethan collar. It's also known as a "cone" or "lampshade." You must keep this on your dog until healing is complete to prevent the dog from licking the surgical incision. As the dog heals after neutering, the incision will start to itch and the dog could remove the stitches prematurely. So it's important to keep the e-collar on the dog until the stitches are removed.

How to Care for a Dog After Surgery

2011-05-02T23:41:00.001-07:00

Be sure to give your dog lots of TLC during its recovery from surger
When your dog comes home after surgery, it can be heartbreaking. Your beloved pet will definitely need some TLC, but it is also important to listen carefully to the vet's instructions and keep your dog calm. Read on for more information on how to care for a dog after surgery.

Difficulty:

Moderate
Instructions

things you'll need:

e-collar
bedding
his/her clean kennel
antibiotics
boiled chicken/rice for upset stomachs
washcloth
leash
Suggest Edits
1
Listen carefully to the vet's instructions. Some vets will send home a printed list of instructions for taking care of your dog after surgery. Others are less formal, and discuss these steps with you. Don't be afraid to take notes. All vets understand your dog is your baby, and you need to know how to care for him or her after surgery.
2
Keep your dog calm when you get home. This can be especially hard later in the evening or the next day as your dog may feel normal, but his incisions have obviously not healed. It is also extremely difficult if you have another dog, who loves to play. You can solve this problem by taking your healing dog outside on a leash and not allowing him to run around. Some vets recommend this for up to a week. If you see your dog's incision is healing fine, you can allow him or her to go outside without the leash in a few days. Just watch your dog and his incision carefully.
3
Make a comfortable place for your dog to sleep, especially the first night home from surgery. If your dog is used to sleeping in bed with you or on the couch, this may not be possible the first few nights. Use old comforters or blankets to make a comfortable place for your dog to sleep and rest. Put this new bed in the room you will be in during the evening, so your dog can be close to you but still resting. When it is time for bed, you can move the blankets into the bedroom with you if that's where your dog usually sleeps.
4
Purchase an e-collar if your dog will be able to lick or scratch his stitches. The dog in the picture is wearing one of these collars. Most dogs get used to them after a few hours, but they do not love them. However, it is important that your dog does not bother his incision until it heals, or you may be going back to the vet. This could be worse than having your dog wear an e-collar.
5
Use a warm wash cloth to wipe away dried blood and to help with itching throughout the week. Your dog will appreciate the tenderness and help with the itch. Have you ever had stitches? Sometimes the itching is the worst part!
6
Give your dog all of his antibiotics if the vet gave you a prescription. Even if your dog seems completely healed, you still need to finish all the pills to ensure infection will not set in. Caring for a dog after surgery can be time consuming, but it is definitely worth it!
7
Feed your dog very little the night he comes home from surgery. Some vets recommend just a little dry food. If your dog has an upset stomach for a few days, you can give him a mix of very plain people food--boiled chicken and white rice. Then you can start mixing the chicken and rice with his regular food. If the upset stomach continues for several days, then call your vet. Your dog will appreciate all the TLC he is getting when you are caring for him after surgery.

Tips & Warnings

If your dog is used to sleeping in his kennel or likes to lay in there to feel safe, make sure you clean and sanitize it BEFORE your dog comes home from the vet.
If you can watch your dog for an hour or two, then it is okay to leave the e-collar off. Then you can stop your dog from licking or scratching his stitches and give him a break from the cone.
Call your vet immediately if you think your dog is having an adverse reaction to the surgery or any medicine. It is better to be safe than sorry!

Aural Hematoma... A Blood Filled Pocket

2011-05-02T23:14:00.000-07:00

A hematoma is any abnormal blood filled space. An Aural Hematoma is a collection of blood under the skin of the ear flap of a dog or cat. (The ear flap itself is called the Pinna.) Ear hematoma occurs much more commonly in dogs than in cats; a hematoma generally is the result of trauma to the pinna from an injury or from the dog or cat scratching at the ear. The itchy ear can result from ear mites, allergies, infections or foreign matter in the ear canal. Frequent scratching at the ear, or even vigorous shaking of the head, can result in a rupture of small blood vessels beneath the skin of the pinna. Since there is little strength or depth to the tissues of the pinna, clotting may be delayed... especially if the dog or cat continues to upset the clotting by additional self trauma.

The entire ear flap can become swollen, infected and severely uncomfortable to the dog. Hematomas can heal themselves but will leave behind a scarred, crinkled and shrunken pinna. And since the original cause is usually an infected ear canal, the original cause needs to be treated as well as the hematoma itself. Veterinarians generally will recommend surgery to open and drain the hematoma and remove dead and degenerating clots and fibrin. Then sutures are used to tack the skin layers over the thin cartilage center tight to the cartilage to eliminate any space for more blood or serum to accumulate. Of course this is done only under general anesthesia, and antibiotics and anti-inflammatory medication is used post operatively.

During the procedure both ear canals are examined and any treatment and cleaning is done. The sutures are left in place for two weeks, minor cleaning is done at home using peroxide, and the patient is readmitted for a final inspection and suture removal. As with many kinds of ear troubles in the canine (allergies, infections, wax build-up, mites, etc), diligent aftercare is necessary to keep scar tissue and long term pathology from occurring. For a look at what chronic ear infections can do.


The Hematoma is seen on the underside of the dog's pinna. Cats do get Hematomas, too, usually due to ear mites. Hematomas are painful and surgical intervention is common.	The Hematoma is outlined. It could spread along the entire underside of the pinna within days. The ear canals are examined and any pathology is vigorously treated.	The incision is made through the skin down to the thin cartilage to drain and explore the Hematoma. Once healed, hematomas rarely affect the same ear again.	As many sutures as needed are placed through the entire pinna to tack the skin back to the cartilage. Healing is uneventful and generally occurs within two weeks after surgery.

Bladder Stone Surgery In A Dog(Learn About Bladder Stones In A Dog )

2011-05-02T23:10:00.000-07:00

A 1 pound bladderstone removed from a Chow		Bladderstones removed from a dog

Bladder stones in dogs present an interesting medical and surgical challenge for veterinarians. One of the most often-encountered health problems of dogs and cats is urinary tract infections. A fairly large percentage of these infections are caused by or complicated by bladder stones. Any persistent bladder infection should be carefully screened for bladder stones and if present, bladder stone removal should be considered.

Skippy is wondering when it will be his turn to visit the Surgery Room.

	He's had bladder irritation for months but wasn't displaying any unusual signs... until one day he urinated some blood. Fortunately his people caretakers noticed, took him to the animal hospital for an exam and a thorough analysis of the urine and a decisive X-ray. You can see what the veterinarian saw on the X-ray film on the top-right image. The actual stones are seen below the X-ray. For actual sizes of the stones, click on the image to view a larger rendition in a new window.

After the surgery, the stone was sent to a lab for analysis; knowing the composition of the stones helps in determining which special diet might assist in preventing a reoccurrence of bladder stones.


The veterinary technician prepares the surgical area for sterile surgery.	The incision is made with a scalpel and the abdominal cavity is entered.	The bladder is located and gently pulled through the incision.	The bladder is incised and the escaping urine and any tiny stones are caught in sterile gauze.

The larger stones are maneuvered to and through the bladder incision.	The stone is secured and saved for analysis.	More stones are grasped by the forceps and removed from the bladder.	After thorough inspection and flushing, the inner lining (called the mucosa) of the bladder is closed with sutures.

Now another row of sutures closes the muscular bladder wall.	The incision is inspected for leaks and suture security.	The abdominal wall is closed in three layers.	Subcutaneous sutures are placed so that no surface sutures are required.

Discussion of Bladder Stones

There are quite a number of possible factors that interact to allow for the formation of bladder stones. One of the most favorable conditions for mineral formation is urine that is alkaline rather than acidic. In fact, bacteria seem to grow better in alkaline urine, too. (That's why drinking cranberry juice may benefit us humans in preventing infections in the bladder... the cranberry juice promotes a more acidic urine.) As you can see in the photo and X-ray the stones are of various sizes. If just the right (or wrong!) size stone passes from the bladder into the urethra leading outside the body, and becomes lodged... we've got an emergency situation immediately! Any dog or cat with a urethral blockage needs veterinary help right now.

In dogs and cats, grain-based diets contribute to alkaline urine; meat-based diets promote a more acid urine. If a bacterial infection does occur the waste products of those bacteria promote an alkaline urine. Plus the bacteria may provide a nice little solid object upon which dissolved minerals can precipitate (come out of a solution and become a solid). Any patient who has had repeat urinary tract infections should always be evaluated for bladder stones. Kidney stones, fortunately, happen far less often in dogs and cats than bladder stones; but the possibility of kidney stones should always be considered in urinary tract disease. Certain types of urinary tract stones can be prevented by special dietary changes. Genetic programming of kidney function and structure plays a role in the formation of bladderstones and certain breeds (Schnauzers, for example) often seem more predisposed to kidney and bladder trouble than some other breeds. The Dalmatian has a unique physiology and displays a type of stone formation called Urate Stones. Modern veterinary medicine can be of great assistance to dogs and cats that develop bladder stones. Good diets and follow-up care can help our dog and cat friends survive and thrive... even after a surgery such as this.

Pyometra In The Dog

2011-05-02T23:08:00.000-07:00

NEWS: The state of Rhode Island recently enacted a state law that will require cat owners, excluding farmers, to spay or neuter their cats by the time they are six months old... or face a fine if they don't. Governor Dan Carcieri said "By signing this legislation today, we are taking the necessary steps to reduce the number of impounded cats that are euthanized in cities and towns throughout the state".

Pyometra in the dog is a very serious condition! Before we look at what pyometra is, let's review the best way to avoid pyometra... and that is spaying. Pyometra means pus in the uterine cavity; if a pet is spayed the uterus and ovaries are removed so there no chance of pyometra developing.

(There is no such thing as SPADE or SPADED, the correct terms are SPAY or SPAYED). It is major intra-abdominal surgery performed under general anesthesia. If it isn't done precisely and in a sterile environment the outcome can be disastrous. During my career I've never considered any spay "routine"; every one is different and eachpresents a challenge.

Usually the procedure is done prior to the first estrus (heat) cycle and having it done at this time greatly lessens the dog's chances for later development of mammary gland cancer. Some dog owners, for various reasons, want their dog to have one estrus cycle or even one litter of pups before she's spayed. And some pet owners do not want their pet to undergo any surgery. Personal choices do come withresponsibility, too, so it is best to be sure there are homes waiting for any planned pregnancies.
Probably 80% of dog spays are done prior to the first heat cycle. The other 20% will go into their first heat around 9 -12 months of age and then about every 6 to 7 months thereafter until about 9 or 10 years of age. An unspayed dog does incur some special health risks throughout her life. Mammary cancer, unwanted pregnancies, ovarian cysts and cancer, difficult pregnancies... and fights with wandering male dogs who seem to appear from nowhere during the three week estrus cycle are a few troubles that readily come to mind. Cats generally go into their first heat cycle at 6 to 7 months of age. It seems like they go back into heat whenever they feel like it after that! Technically, cats are seasonally polyestrous... which means they go in and out of heat a few times during certain seasons of the year.
Here's a real nasty problem . . . pyometra. The term means pus in the uterus. Any time a veterinarian is presented with a dog or cat suffering from pyometra the condition is considered serious and immediate surgery is nearly always indicated. This pus formation in the uterus results from infection, hormone imbalance or mucous buildup inside the uterus. Most dogs and cats suffering from pyometra are presented because of loss of energy, increased thirst and poor appetite. Plus a good tip-off would be a foul smelling, purulent (means pus) vaginal discharge. Most of the cases of pyometra I've seen in dogs occurred about six weeks after the bitch's last heat cycle. They may not look it on the outside, but on the inside these dogs are really sick! If that swollen, enlarged uterus happens to rupture internally, the dog will rapidly go into endotoxic shock and whatever the veterinarian does may not be enough to save the dog.
Normally, even in a large dog, the uterine horns aren't much thicker than a pencil. See the photo on the right for normal anatomy... click it to enlarge. When pyometra is present the uterus looks and feels more like a stuffed venison sausage. I've removed eight-pound uteruses that should have weighed no more than eight ounces!
For whatever reason, if your female dog or cat hasn't been spayed be alert for pyometra. The condition is more probable in females eight years or older and who experience infrequent or irregular heat cycles or episodes of false pregnancy. Poor appetite, increased thirst, poor stamina and vaginal discharge are cardinal signs. And some patients' white blood cell count can go from a normal of 9,000 all the way up to 75,000. X-rays often reveal two large sausage-like structures in the abdomen. It's time for surgery! These patients should almost always be operated on right now, not after work, not in the morning, not after a few days of antibiotics "to build her up."
The surgery is not a minor procedure. A patient with a uterus swollen with a foul and putrid soup, is simply carrying a bucket of poison that would eventually kill the cat or dog. Many of these patients require I.V. fluid therapy, antibiotics and nutritional support post-operatively. These pyometra patients, once recovered, act like puppies once their near death experience is over!

See what is involved when a pyometra surgery is performed on an 85 pound Malamute...[ Click on the images to see a full sized photo ]


The skin in the midline of the abdomen is incised.	The abdomen is entered and the uterus identified	The uterus is very gently pulled through the incision

If there is any leakage of infected contents, life threatening peritonitis may result	The ovary, ligament and blood vessels are carefully identified	The ovary is inspected to be certain that the entire ovary is excised

After separating the two uterine horns the body of the uterus is visualized	The uterus is removed from the dog after careful ligation of the uterine tissues assures a clean separation	The abdomen is carefully sutured closed layer by layer

Every veterinarian has heard the following conversation when the owner is informed that their dog has pyometra and needs surgery:
"I guess I should have spayed her, Doc, but . . .
a) I wanted her to have at least one litter first.
b) She's got papers a mile long so if I breed her, the pups will be worth big bucks.
c) My brother-in-law says not to spay her because he heard they can die from the anesthetic.
d) I was afraid she'd get fat and lazy.
e) You vets charge too much for just a little poke-and-a-stitch.
f) I thought it would ruin her spirit.

Shall we put one common myth to rest right now? Here goes...
Spaying a dog or cat does not make her become overweight and lazy.

Thirty-one years of practicing small animal medicine and surgery have convinced me that healthy dogs and cats become overweight from either insufficient exercise or consuming too many calories. Unless your pet is sneaking into the fridge at night and making it's own ham and cheese sandwiches, you the owner are responsible for what and how much your dog eats. Lots of unspayed dogs and cats are overweight too, so don't blame the weight gain on the surgery!
You'd be surprised how many dogs (especially Golden Retrievers) are hypothyroid. This condition almost always leads to weight gain. Cushings Disease, a hormonal problem associated with the adrenal cortex, may predispose a pet to gain weight. Weight problems should always prompt a thorough evaluation by your veterinarian. If you choose not to spay your dog or cat, be on the alert for pyometra. It can be dangerous.

by T. J. Dunn, Jr. DVM

Mammary Gland Surgery... Breast Cancer Surgery (Mastectomy) In The Dog

2011-05-02T23:05:00.000-07:00

Mammary gland tumors are common in the dog, and surgery to remove cancerous mammary glands, called a mastectomy, is a routinely done procedure in veterinary medicine. Male dogs almost never get mammary tumors; as well, female dogs that have been spayed before their first heat cycle rarely acquire breast cancer. Statistics demonstrate that if a female dog is spayed after her first heat cycle but before her second cycle, her potential to develop mammary tumors is slightly greater than the dog that was spayed prior to a heat cycle. If two cycles occur, then the spay procedure, an even higher incidence of breast cancer is demonstrated. And spaying after three heat cycles has no effect on diminishing the potential to develop mammary tumors. In short, the sooner a dog is spayed the less the chances for mammary tumors to develop in the future; but after three or four heat cycles, spaying has almost no effect on protection against tumor development. Keep in mind that spaying any dog at any time (as long as the patient is healthy) may be advisable to prevent a very serious uterine infection called PYOMETRA. Also see images of the SPAY (technically called an Ovariohysterectomy) surgery procedure.

Visual inspection and a physical exam probably will not be helpful in determining whether or not a growth is benign or malignant. A biopsy can be done on these growths to determine the cell types, which are highly variable in canine mammary tumors, and to establish the degree of malignancy. Malignancy means that they have the tendency to spread invasively into surrounding tissues and also to be spread by the lymph system to other parts of the body. Most veterinarians will suggest a chest X-ray prior to any mammary gland surgery to see if there is any evidence of metastasis (new tumors as a result of "seeding" from a distant, primary tumor). If there is evidence of tumor spread to other areas, the decision to do a mastectomy may not be advisable because metastasis of mammary gland tumor to the lungs or other body tissues almost always signals a very poor prognosis for recovery in the dog.

Chemotherapy for mammary gland cancer, and/or radiation treatment, can be done but the main effort of treatment is surgical excision of any suspicious mass.

The case shown below is of an eight year old dog that had been spayed and that had small masses in the right third, fourth and fifth mammary glands for a number of months. All of a sudden a rapidly growing tumor near the right fourth nipple attracted the owner's attention and surgery was performed. There was no evidence of metastasis in this patient and removal of the third, fourth and fifth mammary glands was done. Since there was no evidence of tumors in the first and second gland, those were left intact but careful vigilance will be needed to ensure that if any evidence of tumors show up, further surgery may need to be done.

Mammary Gland Surgery In The Dog

This view is of the patient just prior to preoperative preparation of the surgical area for surgery. The large mass between the fourth and fifth nipple is evident.	The surgeon, employing sterile technique, begins the incision near the masses in the glands, being careful not to incise any tumor tissue.	Hemostasis (controlling bleeding) can be challenging in these surgeries due to the mass of tissue to be removed as well as the vigorous blood supply to the area.

One side of the three mammary glands is dissected down to the abdominal wall; then the opposite side is dissected.	Care is employed to remove all the mammary gland tissue but also to leave enough normal tissue that closing the incision will not create excessive tension along the surgical closure.	Blood vessels are tied off and the row of three mammary glands is lifted away from the patient. Some veterinarians will remove all five glands even if no evidence of tumor in other glands is present.

A major artery and vein to and from the area is the Caudal Superficial Epigastric vessels. Lymph channels drain from the last three mammary glands through this small channel through the abdominal wall.	After removal of the mammary glands (along with the tumor tissue) the incision is closed in layers from deep to superficial. The goal is to comfortably close the incision with no tension being placed on the skin.	In this case the skin is closed via two simple continuous sutures to decrease surgical and anesthetic time. The patient is placed on pain control medication for a few days and sutures are removed in 12 days.

It is a good idea to routinely (about once a month) check your dog for breast tumors. If anything unusual seems to be present, than have your veterinarian do a thorough physical exam. At this time a discussion regarding the pros and cons of surgery is important. Remember, it is always easier on the patient to have a small mass removed as contrasted with the removal of a large amount of tissue such as in this case.

The Dog Neuter Procedure

2011-05-02T23:02:00.000-07:00

The dog neuter surgery, and spaying and neutering of dogs or cats in general DOES NOT "make a pet fat and lazy". In a healthy dog or cat, free of hypothyroidism or other medical disorders, overfeeding and insufficient exercise are the sole causes of a pet being overweight. Don't blame the dog or cat spay or neuter surgery if a pet becomes overweight. If you are having trouble with your pet being overweight, read how to keep a pet at optimum body weight.

The dog neuter surgical procedure is performed under general anesthesia and employs sterile instruments and a sterile surgical field. Medical emergencies can arise if a pet becomes infected during these procedures. No surgeon approaches a spay or neuter as if it were "routine" because each surgery is different from every other because each pet is different, and although neutering might be deemed a minor surgery a spay certainly qualifies as a major procedure. (So if you wonder why the charges for these procedures seem high, you just may reconsider after visiting The Surgery Room.)

Castration of a male dog does not "break his spirit"... it is probably the most common routine surgery done in animal hospitals all across the country. IF neutering promoted undesirable physical or emotional impact on the dog, it surely would not e performed as often as it is. Plus every veterinary hospital would be required by law and ethics to have the dog owner sign a notice that they were informed of these possible bad side effects... but there are very few reasons not to neuter a male dog.

Essentially, the structures and procedure are the same for each dog neuter (castration). As you can imagine, though, there are some real differences between working on a 180 pound Saint Bernard or a 4 pound Yorkie! And an overweight patient makes the surgery more difficult and time consuming.

There are no medical, emotional or sociological reasons for a male dog to sire "just one litter". You are misinformed or misguided if you believe that "having just one litter" is somehow good for the dog psychologically or medically. And the emotional or educational benefit to your children to experience the birth and care-taking of a litter of pups should be a very carefully analyzed proposition. Will your children accompany you to the animal shelter when you drop off those last six puppies you "just weren't able to find homes for"? If you do choose to allow your dog or cat to have a litter, please be certain that there are committed pet caretakers waiting and wanting to provide a home for them. Don't contribute to the pathetic destruction of tens of thousands of animals euthanized yearly in pounds and shelters. You do have the power and intelligence to make a difference.

The Dog Neuter Procedure
Click on the image to see a full size photo.


The dog is given a general anesthetic and placed on the surgery table. The area forward of the scrotum is shaved and scrubbed with special surgical soap.	Following the scrub an antiseptic solution is placed on the surgical area. Sterile procedures and instruments are required to minimize infection.	The single incision is made in the skin, not through the scrotum, and slightly forward of the scrotum. Staying in the midline diminishes the slight amount of bleeding that generally occurs.	In this photo the surgeon pushes on a testicle to advance it forward to where the skin incision was made. The tunic, a fibrous covering of the testicle, is located.

Viewing the testicle in the incision opening, the surgeon cuts through the fibrous tunic surrounding the testicle and the connecting vessels and structures are isolated.	Now that the testicle is visible and is exteriorized through the incision, the spermatic cord containing the vas deferens and blood vessels are clamped and the area is inspected where the ligature will be placed.	(It is at times like this that the marvels of modern anesthesia are really appreciated by man and dog! Don't try this at home! Dr. Dunn)	To allow for the removal of the testicle the spermatic cord must be cut. Having a generous blood supply, the cord must be tied securely (ligated) to be sure there is no post operative hemorrhaging.

The second testicle is removed in the same manner. The ligament of the Epididymis and its small vessel are ligated to minimize bleeding.	The final cut is made at the ligament and the testicle is removed. There should be no bleeding at this time. The remaining tissues are replaced within the incision.	The surgeon inspects the surgical area for "bleeders"...little vessels that cause nuisance, but not dangerous, bleeding.	The incision is closed by placing sutures through the deep tissues first and then working upward to the subcutaneous layer.
If you are having trouble with your pet being overweight, read how to keep a pet at optimum body weight. Numerous health benefits are associated with early spay/neutering... ask your veterinarian.			Tens of thousands of abandoned and unwanted dogs and cats are euthanized every year. Please consider spaying and neutering... the best way to curtail the mass euthanasia of dogs and cats.
	Here the surgeon chooses to place subcutaneous sutures instead of visible surface sutures. There is less chance of the dog licking or chewing the area with subcutaneous sutures. The skin is usually healed in 6 to 8 days; the dog is confined for 7 to 10 days postoperatively.

Welcome to the Surgery Room

2011-05-02T22:59:00.000-07:00

NTRODUCTION Dog and cat surgery is an important aspect of every animal hospital's activities. In ThePetCenter's surgery room you are welcome any time! And don't worry, you won’t have to wear a cap, mask and a surgical gown! But you will feel like you are right next to the surgeon during the operations. You will see some close-up photos of dog and cat surgery and read explanations of what the surgeon is doing.
Modern veterinary surgery on dogs and cats is done under conditions designed to minimize the chances of bacterial contamination. Instruments, gowns, towels and other items such as scalpels and clamps are sterilized in an autoclave at 270 degrees under pressure for various lengths of time to kill any microorganisms. As well, the surgeon scrubs the hands and wears sterilized surgical gloves and also wears a gown if the surgery is more than a minor procedure. By adhering to sterile surgical techniques, postoperative infections are seldom encountered.

After any surgical procedure the pet’s owner is given a thorough description of what the surgeon accomplished and what is now expected of the pet owner in terms of post-operative home care. And sometimes that can be a bigger challenge than the surgery! How do you make a happy and carefree dog "take it easy" for ten days? How do you make a cat not jump off the back of the couch? Nevertheless, aftercare is vital to the healing process. In our surgery room today you can view a dog and cat spay and a neuter procedure or take a look at an orthopedic procedure where a torn Anterior Cruciate Ligament (ACL) is repaired. You can also see a minor electrosurgical removal of a nasty looking growth from the gum area of a dog... and there's more if you care to look! Why not tell another dog or cat "person" about this page by using the email referral below? Now... off to see some surgeries.

Orthopedic
Femoral Head and Neck Resection Severe degenerative joint disease made surgery this dog's only option.OCD Shoulder Surgery See this common affliction of young, large breed dogs.Bone plate repair of a fractured tibia in a dog.
ACL Surgery to repair a torn Anterior Cruciate Ligament in the knee of a dog.
A torn ACL is a common occurrence in human athletes. As well, in veterinary hospitals all across the country this type of injury is routinely encountered and corrected. Want to see how?

Dental
Pet Dentistry Dogs and cats need good oral hygiene, too! Take a look at The Bad and The Good.See a Specialist in Veterinary Dentistry in action.


An atonic, underdeveloped bladder in a young dog that displayed urine leaking and chronic bladder infections.	Modern veterinary medical surgical techniques closely parallel human surgical techniques and procedures.

Pyometra In The Dog

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presents a challenge.
Usually the procedure is done prior to the first estrus (heat) cycle and having it done at this time greatly lessens the dog's chances for later development of mammary gland cancer. Some dog owners, for various reasons, want their dog to have one estrus cycle or even one litter of pups before she's spayed. And some pet owners do not want their pet to undergo any surgery. Personal choices do come withresponsibility, too, so it is best to be sure there are homes waiting for any planned pregnancies.
Probably 80% of dog spays are done prior to the first heat cycle. The other 20% will go into their first heat around 9 -12 months of age and then about every 6 to 7 months thereafter until about 9 or 10 years of age. An unspayed dog does incur some special health risks throughout her life. Mammary cancer, unwanted pregnancies, ovarian cysts and cancer, difficult pregnancies... and fights with wandering male dogs who seem to appear from nowhere during the three week estrus cycle are a few troubles that readily come to mind. Cats generally go into their first heat cycle at 6 to 7 months of age. It seems like they go back into heat whenever they feel like it after that! Technically, cats are seasonally polyestrous... which means they go in and out of heat a few times during certain seasons of the year.
Here's a real nasty problem . . . pyometra. The term means pus in the uterus. Any time a veterinarian is presented with a dog or cat suffering from pyometra the condition is considered serious and immediate surgery is nearly always indicated. This pus formation in the uterus results from infection, hormone imbalance or mucous buildup inside the uterus. Most dogs and cats suffering from pyometra are presented because of loss of energy, increased thirst and poor appetite. Plus a good tip-off would be a foul smelling, purulent (means pus) vaginal discharge. Most of the cases of pyometra I've seen in dogs occurred about six weeks after the bitch's last heat cycle. They may not look it on the outside, but on the inside these dogs are really sick! If that swollen, enlarged uterus happens to rupture internally, the dog will rapidly go into endotoxic shock and whatever the veterinarian does may not be enough to save the dog.
Normally, even in a large dog, the uterine horns aren't much thicker than a pencil. See the photo on the right for normal anatomy... click it to enlarge. When pyometra is present the uterus looks and feels more like a stuffed venison sausage. I've removed eight-pound uteruses that should have weighed no more than eight ounces!
For whatever reason, if your female dog or cat hasn't been spayed be alert for pyometra. The condition is more probable in females eight years or older and who experience infrequent or irregular heat cycles or episodes of false pregnancy. Poor appetite, increased thirst, poor stamina and vaginal discharge are cardinal signs. And some patients' white blood cell count can go from a normal of 9,000 all the way up to 75,000. X-rays often reveal two large sausage-like structures in the abdomen. It's time for surgery! These patients should almost always be operated on right now, not after work, not in the morning, not after a few days of antibiotics "to build her up."
The surgery is not a minor procedure. A patient with a uterus swollen with a foul and putrid soup, is simply carrying a bucket of poison that would eventually kill the cat or dog. Many of these patients require I.V. fluid therapy, antibiotics and nutritional support post-operatively. These pyometra patients, once recovered, act like puppies once their near death experience is over!

See what is involved when a pyometra surgery is performed on an 85 pound Malamute...[ Click on the images to see a full sized photo ]


The skin in the midline of the abdomen is incised.	The abdomen is entered and the uterus identified	The uterus is very gently pulled through the incision

If there is any leakage of infected contents, life threatening peritonitis may result	The ovary, ligament and blood vessels are carefully identified	The ovary is inspected to be certain that the entire ovary is excised

After separating the two uterine horns the body of the uterus is visualized	The uterus is removed from the dog after careful ligation of the uterine tissues assures a clean separation	The abdomen is carefully sutured closed layer by layer

Shall we put one common myth to rest right now? Here goes...
Spaying a dog or cat does not make her become overweight and lazy.

Dog Castration

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Castration is the surgical removal of the testicles. Reasons for castration include the following:

	Eliminate the reproduction potential
	Reduce sexual activity
	Reduce tendency to roam and fight
	Reduce general level of agression
	Eliminate testicular cancer
	Resolve disease of the prostate gland

The best age for castration is between six and twelve months of age. At this age the procedure is very low risk and easy to perform. It is also at this age that diseases of the prostate and testicles are virtually non-existant; bad habbits such as marking have not started, and unwanted pregnancies have not added to the overpopulation of the pet world. If your dog is not to be used as a valued breeder, early castration is the responsible thing to do. It could save your dogs life and make him a much more desirable housemate.

After a careful examination, the pet is put under general anesthesia. The best method is inhalent anesthesia since it is much more controlable than injectible anesthesia. The patients also recover without the prolonged "hangover" of injectible drugs. We like Isoflurane gas the best. It is totally metabolized by the lungs and is kind to the liver and kidneys. Even though it is a little more expensive than other anesthetics we think the fast recovery time and increased safety are worth it.

Induction of anesthesia by mask technique.

After induction, an endotracheal tube is positioned within the trachea (windpipe) to deliver the anesthetic gas and oxygen; to keep the pet from aspirating saliva and to provide direct control of respiration if needed.

Shaving the surgical site to remove hair which might contaminate the area and cause infection.

The area is now clipped and ready for sterile preparation. We are looking at the dog positioned upside down with the rear legs towards the camera.

The surgical site is scrubbed with disinfectant soap solutions to remove dirt and debris and kill surface bacteria on the skin.

In keeping with sterile procedure, all instruments are autoclaved to kill off bacteria and spores. The instruments remain wrapped within a surgical "pack" until needed by the surgeon.

This is what we see when the instrument pack is opened.

Sterile drapes have been applied and clamped in position. These further minimize any chance of contamination of the surgical site from surrounding bacteria and dirt. The only area left open is that which is required to do the procedure. Notice the surgeon now has sterile gloves on to prevent contamination of the site from his skin bacteria. Before putting on the sterile gloves the surgeon scrubs his hands with a disinfectant soap to minimize skin bacteria, just in case a glove is pricked.

We are now making the skin incision to expose the testicle. This is about a 1" incission just in front of the scrotum over the shaft of the penis. The scrotum is on the left under the hand.

Notice the testicle beginning to pop out of the skin incision (Just to the left of the scalpel).

Further exposure of the testicle from the skin incision.

The testicle is above the thumb and the cord leading into the body contains the following structures: vas deferens ( tube that carries sperm to the penis), pampiniform plexus (a network of blood vessels that surround the vas deferens and keep the sperm at constant temperature), and internal cremaster muscle which regulates the proximity of the testicle to the body to regulate sperm temperature). In a "closed procedure" a ligation or tie is placed around this entire structure, it is then cut and released freeing the testicle. We do not use this inferior method. We use what is referred to as an "open technique".

In the "open technique" the testicle is elevated from the surface of the skin and is opened to expose the vas deferens, cremaster muscle and pampiniform plexus. Although the "open technique" takes a little more time, this is the best way to perform a castration. Each structure is tied or ligated separately. This is opposed to the "closed technique" where a single ligation (tie) is put around all the above mentioned structures. With a "closed technique" drainage complications can occur post surgery and you can never be as sure that all the internal structures are tied off securely as with the "open technique". We like the "open technique" best.

Making the first ligation or tie. This is done with an absorbable suture material that is securely tied around the vas deferens and pampiniform plexus. In the weeks following surgery the material will be completely absorbed by the body after it has performed its' task of preventing any internal blood leakage.

Once the ligations have been made, the structure is cut and the remaining stump is checked for bleeding before being released into the body.

The stump is held with forceps until we are sure the ligature is tight and no bleeding will occur.

In this view we are ligating the internal cremaster muscle and pampiniform plexus. The cremaster muscle can have a significant artery within it that if left untied can allow severe blood loss. This is the final ligation that will free the testicle for removal.

In this view the testicles have been removed and we are beginning to close the skin incision. We use what is called a buried subcuticular suture pattern. This pattern allows all suture material to be inside the incision. This leaves no outside sutures for the animal to lick, get infected and cause soreness. It takes a little more time than external sutures or merely gluing the incision shut, but we like to do it in the best manner for the pet.

Tying the suture.

The incision is now closed, but some tiny gaps are seen between sutures.

Any gaps are cemented shut using an instant curing medical glue. Many "cheap" facilities use no sutures and only glue. This is inferior in strength to suturing and gluing.

The incision is closed. Notice that there are no external sutures to irritate the pet. In 4 to 6 weeks the suture material will be absorbed by the body and scarring is almost non-existant. At this point we awaken the animal and keep them caged for the remainder of the day for observation. If all is well, we send the pet home at the end of the day.

Things to watch for at home:

The number one complication is licking and chewing at the incision site. Normally this does not occur due to the suture pattern we use in closure, but occasionally we have to apply an Elizabethan Collar to prevent he dog from reaching the site.

We suggest "leash only" exercise for 24 to 36 hours after surgery. This ensures that the pet will not break open the incision while running.

We ask owners to look underneath their dog once a day for the first 4 or 5 days after surgery. If signs of chewing are seen or any seepage or swelling occur, we want to know immediately.

Normally our patients leave in good spirits, wide awake and ready to enjoy the family. They may sleep lots the first night home. By the second day you will never know they had anything done.

What to look for when considering surgery for your pet.

I would want to make sure that my pet was the only one operated on with the sterile instrument pack. I have actually worked for practices that operated on more than one animal with an instrument pack.

Look for quality. Ask the right questions. What type of anesthetic do they use? Gas is best, but more expensive than injectible anesthesia. How is the procedure performed? Are they there for hi quality or hi production? I would want the very best for my pet.

Don't go for the lowest bidder. We have people price shopping every day. All they want to know is the bottom line and rarely ask how the procedure is accomplished. Generally, in surgery, like anything else you get exactly what you pay for. I don't think it's beyond reason to have your questions answered before a surgery is undertaken.