May2014_How to choose . . . a vet for a surgical procedure

Any surgical procedure on an animal is a big deal (even if they ‘only’ have desexing surgery over their lifetime) and deciding who to choose for this service should be carefully considered – the old adage of ‘you get what you pay for’ also sadly applies here.

When procedures are dramatically ‘cheaper’ at one surgery, you need to understand that they cut corners to achieve these low prices – omitting pain relief, using less safe anaesthesia drugs, unskilled staff, and little or no monitoring equipment.  As a pet owner, it is hard to know what is involved with each procedure when you are given an estimate of costs, so to make sure you are comparing like with like, here are some good points to ask about or consider BEFORE booking them in for any procedure:

Anaesthetics… There are a number of anaesthetics that are used in the veterinary industry today but you might be surprised to know that some are safer than others. The use of gaseous agents (inhaled gas) allows us to quickly and easily control the depth of anaesthesia while also administering oxygen via a breathing tube in their windpipe. This is a lot safer than relying on injectable drugs alone, as their levels are harder to control, and they take a lot longer to reverse (if they are reversible at all).  So why would you not use gas anaesthetics for every patient? Because the setup and maintenance of the correct breathing tubes and circuits takes time, hence the benefit of injectable drugs is that the vet doesn’t have to spend as much time on each patient. We also give all pets a ‘pre-medication’ or sedation, which allows them to be fully relaxed in the lead up to the surgery, and sleep off the surgery in the same relaxed way. These pre-medications mean that we need less of the actual anaesthesia induction drugs, so it is better and safer for the animal. Regardless of the drugs chosen, any time your pet undergoes anaesthesia their blood pressure will drop, and putting them on an IV drip is essential to try to maintain their blood pressure at safe levels. 

Check that the anaesthetic will be monitored by an appropriately experienced nurse. It seems silly to even have to say that, but we’ve heard of one clinic that cuts costs by getting the OWNER to monitor the anaesthetic – the most dangerous part of any procedure! Other ways of cutting corners is to have a nurse wandering in and out of theatre to check on your pet whilst doing other tasks, or just leaving the vet in there alone to turn the valves themselves with some spare instruments, so they are not giving full attention to your pet breathing nor the surgical procedure.

Sterile instruments and theatre are important to the recovery and health of your pet. Just as you would expect their cage to be completely cleaned and sterilised after the last pet was in there, sterilisation of instruments and cleaning of the operating theatre area are essential to prevent infections and cross-contamination between pets. You would once again think this was a given, but some surgeries use the same scalpels, needles and forceps in all the different surgeries for that day. Also ask what suture material they will be using, as some old-school practitioners actually still use ‘cat gut’ suture (literally made from the gut of a sheep!), instead of good quality modern suture.

Pain relief should always be offered if the procedure involves something which may cause the pet pain, such as a tooth removal, surgical cutting or a wound. Some procedures, such as desexing, are elective surgeries so it seems only fair that we support our pets with pain relief when the procedure itself is for our own gain too. Studies show that is it easier and better to prevent pain before a procedure is performed, than to try to control it once they already are painful. Human pain relief such as Nurofen should never be given to pets, so it is important to discuss pain relief options prior to taking your pet home. We give every pet an injection of pain relief that lasts around 24 hours, and we offer additional take-home medication at the time of discharge.

Risks and outcomes must be discussed, either on the admission form or verbally when you drop off the pet. It is an unfortunate reality that some pets will pass away even during the most routine or ‘minor’ surgery from unknown underlying illnesses and issues. These risks need to be outlined to you, so you are fully informed when choosing to undertake a procedure for your pet. If it is a high-risk procedure that you are choosing, then you should also be offered the opportunity to sign a ‘Do Not Resuscitate’ form, in the event that your pet becomes gravely unwell and we cannot waste valuable time trying to contact you. Pre-anaesthetic blood tests are always offered at the time of admission and can be helpful in determining if there are any particular risks that your pet will face under anaesthetic. If something worrying is found on these tests, we can use particular drugs or processes to reduce the risk to your pet.

Recovery… Depending on the age, breed, species and temperament of your pet, they may wake up particularly quickly, or they may sleep off their procedure a bit longer. Find a vet that is flexible with their pickup arrangements, to ensure that your pet will only go home once they are awake and it is safe to do so. Recovery should also be in a temperature-controlled, quiet space (i.e. heated cages) and under competent supervision. 

Upon discharge, you will be given a recheck date so we can ensure the wound is healing well, remove sutures and answer any questions you may have. This recheck should be part of the procedure price and not as an additional extra. You will ideally be given written take-home instructions to remind you, as we know you can get distracted waiting for your pet to be brought out. 

Any surgery can be a worrying time for owners, but choosing a veterinarian and clinic that works with you to provide a high level of care, will ease the stress for both you and your pet. Some surgeries can be quite expensive without pet insurance, so it is important to both the animal’s health AND your hip pocket that you make informed decisions.

If this article has raised any questions for you, please call us on 3425 2222 to pick our brains.

Old Mill Animal Hospital