General surgical procedures are those that do not involve bone or joints.
This information is intended as general information for our clients. We can discuss more specific information as it relates to a particular animal after we have examined the pet. Each case is differernt and recommendations for one pet may not be the same for others.
If your pet has had surgery at our hospital and you have specific questions or concerns, please call our office and speak to a surgery technician. You can also email the surgery service at surgery@svsvets.com with specific questions about patients we have already seen. We do not give medical information about patients that we have not examined.
A total ear canal ablation (TECA) is performed when an animal has severe inflammatory disease of the external ear canal or when a growth, which could be cancer, is present within the ear canal or middle ear cavity. This surgery involves the complete removal of the ear canal, however in most cases the pinna or external ear "flap" remains intact.
Complications Related to Surgery
The facial nerve, which controls the lips and eyelids, lies adjacent to the ear canal. This nerve may sometimes become involved in the pet's disease process resulting in the inability to blink as well as a facial "droop" on the affected side. In most cases, the facial nerve can be preserved at surgery; however, even the slightest manipulation can cause dysfunction. This occurs in up to 50% of animals that have this type of surgery. The good news is that this dysfunction is generally temporary, and nerve function usually returns within a few weeks. During this time, you will need to apply a topical lubricant in the affected eye several times daily in order to prevent damage to the cornea from drying. Another concern following this surgery is deafness following removal of the ear canal. Most pets that need this type of surgery have ear canals that are stenotic or closed due to their disease. This means that sound waves already cannot travel to the inner ear where they are transmitted to the brain to create sound. These patients hear only muffled noises (like what you would hear if you covered your ears) and vibration. The structures of the inner ear are not removed with a TECA; therefore, the ability to hear should not be affected by surgery. It is hard to predict the amount of hearing your pet will have following surgery; however, most pets seem to have the same level of hearing as before. Finally, the inner ear is rarely interrupted at surgery. In a small number of cases (<3%), the inner ear may become inflamed from the disease process or surgical manipulation. If this occurs, your pet may experience nausea, head tilting, and circling. This complication is temporary and usually resolves within a few days; however, the head tilt may persist indefinitely.
Medication
Antibiotics given by mouth are indicated in most cases. The ear canal and middle ear cavity are often contaminated with numerous bacteria and yeast organisms. A culture is taken at the time of surgery to make certain that the antibiotic chosen is appropriate for your pet's specific infection. Even if the culture result is negative, your pet should remain on antibiotics for a minimum of 3 weeks.
This surgical procedure is significantly painful; therefore we recommend that your pet have a transdermal Fentanyl patch applied 24 hours prior to surgery. This patch contains a potent morphine-like drug that is slowly delivered through your pet's skin. This will markedly reduce the amount of pain that your pet feels after surgery and make his/her recovery much smoother. In most cases, a non-steroidal anti-inflammatory drug (NSAID) such as carprofen (Rimadyl®), firocoxib (Previcox®) or deracoxib (Deramaxx®) will be recommended. This class of drugs is often helpful in relieving postoperative inflammation, pain, and swelling. This will help your pet to be more comfortable and return to normal function sooner. Side effects occasionally seen with NSAIDs include decreased appetite, vomiting, diarrhea, blood in the vomit or stool and (rarely) liver or kidney dysfunction. If you note any decrease in appetite, vomiting, diarrhea, change in the color of the stool (especially darkening), or yellowing of the skin or eyes, stop the medication and call a veterinarian. Do not give your pet any other medication without consulting us. Many other non-steroidal anti-inflammatory drugs available for people are often toxic in dogs.
Sutures and Bandages
External skin sutures will be placed to close the incision. These sutures should be removed in 2 weeks. You should look at the incision daily and note any discoloration or discharge. Please call our office if you are concerned. A drain may be placed into the middle ear cavity (bulla) at surgery. If this is necessary, your pet will stay in the hospital for a few days until it is removed. While the drain is in place, your pet will have a light bandage applied to the head to prevent him/her from "playing" with their drain.
Portosystemic Shunts are congenital malformations of the hepatic (liver) bloodflow. Shunts are classified as intrahepatic (within the liver) or extrahepatic (outside of the liver). Extrahepatic shunts are more common than intrahepatic shunts, and are generally found in toy breed dogs. The problem arises when the bloodflow from the intestines bypasses the liver, resulting in absorbed toxins reaching the peripheral circulation. These toxins are circulated throughout the body resulting in clinical signs an bloodwork abnormalities.
The clinical signs associated with portosystemic shunts can vary from gastrointestinal (vomiting) to neurologic (head pressing, seizures, abnormal mentation). Clinical signs can worsen after eating, and tend to be worse with a high protein diet. The diagnosis of a portosystemic shunt is made with screening blood tests and confirmed at surgery.
Treatment for a portosystemic shunt is surgery to correct the vascular malformation. Medical management with a low protein diet and medication to change the bacterial content of the intestines is often helpful in controlling clinical signs. Surgical correction can be accomplished using ligatures, constriction devices (Ameroid constrictor), or cellophane banding. Patients are monitored in our 24 hour ICU postoperatively.
Gastric Dilatation Volvulus (GDV) is a syndrome in large breed dogs where the stomach fills with gas and twists within the abdomen. This problem is very common in deep chested breeds and is immediately life threatening. There is no non-surgical treatment for GDV. Emergency surgery is required.
The surgical treatment for GDV involves exploration of the abdomen for any underlying cause, and resection of any devitalized portion of the stomach, bowel or spleen. After the stomach is repositioned and any underlying cause is corrected (if possible), a gastropexy (attachment of the stomach to the abdominal wall) is performed to prevent future volvulus. Postoperative monitoring is very important following GDV surgery. Cardiac arrhythmias and blood pressure abnormalities are common, therefore these patients are monitored closely in our ICU for complications.
If a gastropexy has been performed, future volvulus is highly unlikely, however bloating can still occur. We always recommended feeding large breed dogs multiple times throughout the day instead of single large meals. Exercise after eating should also be discouraged. Prophylactic gastropexies are recommended as well, especially if a patient has a history of bloating after eating.
Intestinal surgery is performed for numerous indications. Obstruction after the ingestion of foreign objects is common in small animals and requires emergency surgery for relief. In older animals, gastrointestinal tumors may occur resulting in the need for surgical resection or biopsy.
Surgery of the bowel requires an abdominal exploration. Exercise restriction is recommended after any abdominal surgery until the incision has healed (generally 2 weeks). We also recommend feeding a highly digestible diet for 2 weeks after any surgery involving the gastrointestinal tract. Depending on the reason for surgery, most animals can return to their normal diet after this time.
Postoperative treatment generally consists of antibiotic therapy, a highly digestible diet, and execise restriction as noted above. Other medical treatments may be recommended depending on the reason for surgery.
Perineal hernias occur in middle aged to older intact (non-neutered) male dogs. These hernias result in swelling on either side of the anus and can occur unilaterally or bilaterally. The most common sign associated with perineal hernias in dogs is straining to defecate. This occurs because the rectum "balloons" into the hernia, and fecal material cannot pass easily outward. Perineal hernias can commonly result in organ entrapment necessitating emergency surgical correction.
If there is no organ entrapment, surgical correction can be performed at a scheduled time. Surgery involves replacement of any abdominal contents and reconstruction of the perineum (rear-end). This reconstruction can use the surrounding musculature, however a synthetic mesh may be necessary in some cases.
