Well, it is that time of the year for your new puppy dog. Where they are turning close to six months of age, and you need to do some serious thinking about de-sexing (or speying or neutering.... depending on what part of the planet you are on)
But, do you really know what it means? Do you really know what it involves when you ring up the vets in the area, for the "just needa price on desexing my dog" call.
So when you do go to make that phone call (and I am not saying you shouldn't), you really need to ask some other questions also.
Some of the most important questions are...
Who is actually going to do the anaesthetic and the surgical procedure on my dog?
Yup, this is a genuine question you need to ask. Many practices that hire inexperienced vets, will often get them to do the procedure (and this is fine, as we all need to start somewhere). But you might have a preference.... you might not. But even if you don't, knowing that Dr Sam is doing the procedure, rather than "one of the vets" is always nice to know.
Does the price include pain relief?
What anaesthetic monitoring is performed on my pet?
I used to work in a veterinary hospital, where the vet was monitoring the anaesthetic as well as performing the procedure - that means one person doing two jobs! And we all know what that can mean! Happily, this is not a common occurrence these days, but it is still out there... and you need to know! For me, I would never subject my children (or pets) to an anesthetic unless I knew they were being monitored by a human, as well as modern monitoring equipment.
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| I love my Surgivet Multiparameter monitor - |
What after care does my pet need? Who am I going to be able to contact if something does go wrong?
Look, complications are uncommon, but we are talking about major surgery here... and things may not always go according to plan. Who can you call? Who do you call?
Can my pet have dissolvable sutures?
Dissolvable intradermal sutures are less irritating for your pet, and the wound usually heals faster too. And it means your pet doesn't need to come back to have sutures removed (which is uncomfortable). We do intradermal sutures routinely, as your pet's comfort is my prime concern. But external sutures are faster to put in, and cheaper too.
What other fees may I be asked to incur on the day?
We don't like putting pressure on the spot about whether you agree to your pet having pre-anaesthetic blood work and intravenous fluids. For us, we like all of our anesthetics to get "the full deal" and we offer you the two packages which give you reasonable options. But we don't make it a secret that we only reveal to you on the day you come in that your pet we will strongly recommend a full pre-anesthetic blood testing and intravenous fluids, amongst a few other things, and we are upfront about that when you call. Make sure when you do your "ring-a-round" that you ask these questions too.
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| Our modern pathology laboratory - |
It is a full removal of both ovaries and uterus - the female reproductive organs. Now, if you were a human, you would be in hospital for up to a week after your "hysterectomy". In dogs and cats, it is called an ovario-hysterectomy.
I call it "Major Abdominal Surgery", and with any major abdominal surgery... welll it is Major! As I said earlier, it is not a "tying of the tubes".
So lets start at the beginning. It starts the night before, when you give your baby some dinner, and then nothing more to eat after 10. And the next morning, you have two big eyes looking at you expectedly, wondering what they have done wrong to go without brekky. But you know!
A trip to their most favourite place in the world (not) is next.... the vet hospital. We greet them with our excited voices, but whilst they love people, they are not so sure. A small tail wag maybe, but with their favourite blanky and toy, they are settled into their new home away from home.
The owners don't get away with it pain free either, as a Consent for perform surgery needs to be filled out, with lots of questions answered.
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| A full physical examination is given.... but who is checking out who here! |
Whilst the sedative is taking effect, Dirk prepares the operating theatre for the procedure. We have a dedicated "treatment room" and a dedicated "operating theatre".
The treatment room is where the bulk of the examination occurs, and also doubles as our "prep room"... that is, where your pet is initially anesthetised, and the fur shaved off, and "prepped" for surgery.
A cannula (or catheter) is placed into your pet's vein on their leg, and intravenous fluids is started (going on the drip).
The anaesthetic machine is now all set up. An injection of anaesthetic drug is administered intravenously, and your pet is patted whilst it drifts off to lala land. A tube is placed into your pet's airway, and they are connected to a gaseous anaesthetic machine, which allows controlled amounts of anaesthetic and oxygen into your pet for the entire procedure.
After this, the monitoring gear is attached. This never takes away the need for a human body to check, but every little bit helps. We have, what is called, a multiparameter monitor.... I call it the things that goes beep and bling. It does alot of things, and is usually found in specialist centres. We also have another pulse oximeter too, but this is used for short procedures, and measures only oxygenation and pulse strength.
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| Hair and surgery do not mix... has anyone told this dog that? |
Alot has happened up until now, and the "desexing" hasn't even started yet. The skin needs to be cleaned up with specialised antiseptics. But where is the vet? What is Dr Liz up to? I double check that the kit is set up ready to go, that our operating table is in the correct position, and the heating element is on ( this is awesome! - keeps the animals at a controlled temperature). I don my hat, my mask, and then do the "scrub up". You know, the tips of the fingers to the elbows thing like they do in the movies.
The scrub up is the part I hate. A full 5 to 10 minutes is dedicated to this part..... A surgical gown goes on, sterile gloves, and then it is show time.
The patient, by then, is transferred to the operating theatre by the veterinary nurse, and is laid out. As we have a V Top table, with hydraulic height adjustment, no ties are placed around your pet's feet to keep them in position. They lie there, comfortably, with the drip drip of the iv fluids going through (or most times, we use our hospital grade infusion pump).
It is the main show! Scalpel.... forceps.... But first the patient must be draped - this means sterile sheets are placed to keep the only part I need to see in view. In this case, a little section of the tummy, near the belly button.
An incision is made through the skin. One layer down. An incision is made through the fatty tissue (the subcutaneous layer). And then, the muscle layer of the abomen is found - and we are looking for the fibrous middle section to find a spot in which to enter the abdomen.
This is another scary part - it is at this point, it changes from a minor surgery to a Major Abdominal Surgery. I am about to enter the abdomen of another living creature. Everything is humming and buzzing quite nicely, the heart rate is stable, blood pressure is good. Knock Knock....Enter!
And sitting right underneath my entry point, is usually a big fat purply structure - full of blood - the spleen. Now, the fishing expedition starts, which is usually successful, quickly - the first uterine horn is found.
The aim is not to touch or minimally touch other organs within the abdomen.... except the parts that you intend to remove. The horn is tracked back up to an oval structure which is the ovary - and then, we see lots and lots of tortuous blood vessels that come off the aorta - these blood vessels need to be ligated (a fancy way of saying, tying them off).
Scissors finish the job - so only a small section of tissue with a ligature is left behind on that side, and the ovary and horn is gently lifted out of the body. It is then followed along to the other uterine horn and body, which is also tied off the same way.
I am going to stop here for a second to catch my breath!
Vets are doing this procedure for $150 or not much more!
What do you think it is worth? I have yet to meet a vet that prices this surgery properly. It is a procedure which vets are heavily subsidising, as we seem to have this stupid idea that people realise that the procedure is priced below its true value. You don't, until now.
I am in the more expensive price bracket for my area, because I have to cover the costs of the materials that I use.... and I don't use cheap materials or cheap tools. I wonder how other vets could do it for less? I would love to ask them this question, but I can imagine the look I would get!
Back to the surgery table - both ovaries are now no longer attached to the ovarian pedicle, which should be well ligated, and released. We know have the base of the uterus to find. We need to place a suture around the area where the uterus and cervix meet - not a mm on either side, but in this area.... fairly precisely. Big blood vessels complicate things, but we deal with them.
It is Major Abdominal Surgery after all.... we wouldn't be there if we didn't know how to handle them. So that is all tied off, and finally a section of your pet's anatomy is sitting in a sterile tray away from the body. It's not over yet though......
During all of this, the anaesthetic has been monitored, the local anaesthetic has been administered, the fluids are dripping in, and the surgeon is focusing on each individual task, knowing full well all of the things that can go wrong, and hoping that none of them do.
Closing time..... As we went in, we go out.... in three layers, we go out in three too. The abdominal wall is closed to make sure that no fat or other tissue is captured in the process. The subcutaneous layer is closed. And finally the skin. We do dissolvable intradermal sutures, so what we see on the outside is a thin red line. And your pet has nothing that irritates them (other than Dirk's jokes!).
Local anaesthetic gel is applied on the skin (we all know how prickly skin can feel after a close shave), and a tummy bandage applied (like an extra large band-aid.... everything feels better when you are hugged).
Extra pain relief is given, and the bed is warmed up ready. A gentle pat whilst your pet recovers, helps it adjust from the" sleeping, not being aware" phase of the anaesthetic, to the "just woke up, what the hell happened, where am I" phase (at this stage, the tube that was in their airway is now out).
Once settled, they are monitored until they are sitting on their chest, then walking. All pets are monitored, because, really, what has just happened is controlled reversible poison. Blunt, but true.
Big breath time.
