Surgical Services

Many pet owners have questions about various aspects of their pet's surgery, and we hope this information will help.  It also explains the decisions you will need to make before your pet's upcoming surgery.

Is anesthesia safe?

Today's modern anesthetic monitors have made surgery much safer than in the past.  At North Shore Animal Hospital, we do a thorough physical exam on your pet before administering anesthetics. Preanesthetic blood testing is also important in reducing potential side effects of anesthesia.  Ideally, every pet would receive pre-surgical laboratory profiles that are age appropriate to ensure that there is no underlying organ dysfunction, such as liver or kidney disease.  Even apparently healthy animals can have serious organ system problems that cannot be detected without blood testing.  If there is a problem, it is much better to find it before it causes anesthetic or surgical complications. If serious problems are detected, surgery can be postponed until the problem is corrected. Our doctors will present you with blood work recommendations based on your pet's physical examination findings and history. We utilize a combination of anesthetics, including local and injectable anesthetics, to optimize the well-being of your pet. The choice and dose of anesthesia will depend on your pet's age, physical examination findings, and any underlying disease conditions. Some of the anesthetic options we have at our disposal including lidocaine and bupivicaine (local anesthetics), dexmetdetomidine, butorphanol, buprenorphine, ketamine, midazolam, propofol, and alfaxalone. 

Fasting and pre-surgical treatment recommendations have changed over time. We recommend following current guidelines:

• healthy patient: do not withhold water, fast 4-6 hours
• patient < 8 weeks or 2 lbs: do not withhold water, fast no longer than 1-2 hours
• diabetic patient: do not withhold water, fast 2-4 hours
• history of or at risk of regurgitation: withhold water and food 6-12 hours
• emergent patient: surgery to be performed ASAP without fasting

Clients may also have their pets on long-term medications. Guidelines to follow regarding giving long-term medication the day of surgery are as follows: 

• healthy patient: give oral medication
• < 8 weeks or 2 lbs: can give small amount of pate in pre-operative period, give oral medication, monitor blood glucose,  
• diabetic patient: 1/2 meal 2-4 hours before surgery, give oral medication, monitor blood glucose, give 1/2 dose of insulin 2-4 hours before surgery
• history of or at risk of regurgitation: give oral medication, may give anti-vomiting, antacid and promotility medication on doctor's recommendation
• emergent patient: may give anti-vomiting, antacid and promotility medication on doctor's recommendation

Will my pet have stitches?

For many surgeries, we use absorbable sutures underneath the skin.  These will dissolve on their own, and do not need to be removed later.  Some surgeries may require skin sutures or staples.  Regardless of whether sutures are present in the skin, you will need to keep an eye on the incision for swelling, redness, pain or discharge. If there are skin sutures or staples, these will usually be removed 10 to 14 days after surgery.  You will also need to limit your pet's activity level for a time and no baths are allowed for the first 10-14 days after surgery.

Will my pet be in pain after surgery?

Anything that causes pain in people can be expected to cause pain in animals.  Pets may not show the same symptoms of pain as people do; they usually don't whine or cry unless the pain is severe for them.  As with us, pain is a subjective experience and some pets experience pain for the same procedure differently. It is important to us to provide preemptive pain relief, so that any procedure performed has an optimal recovery time. Pain medication will always be provided for any surgical procedure. Most of our anesthetic drugs have pain-modulating properties. Our goal is to minimize signs of pain post-operatively and ensure that the analgesic options chosen are working for your pet. There are a number of validated tools that have been developed to identify signs of pain in our patients, such as the Glasgow composite measure pain scale, the UNESP-Botucatu multidimensional composite pain scale, the feline grimace scale, the musculoskeletal pain screening checklist, the feline musculoskeletal pain index, the Montreal instrument for cat arthritis testing, and client-specific outcome measures for cats and the Glasgow short form scale, the Liverpool osteoarthritis in dogs (LOAD), the canine brief pain inventory, the sleep and nighttime restlessness evaluation, and client-specific outcome measures for dogs. 

Multimodal pain medication is often used, particularly in animals that have experienced chronic pain, to ensure that they are comfortable after surgery. It is important for our team to optimize the welfare of your pets, so it is important for owners to communicate to our team any signs of pain your pet may exhibit after surgery. Behaviors that are not normal for your pet such as isolation, lack of social contact, reduced appetite, or aggressive signs can all indicate pain. Please relay any concerns to team members to alleviate these issues in your pet, if observed.

What other decisions do I need to make?

While your pet is under anesthesia, it is the ideal time to perform other minor procedures, such as nail trimming, ear cleaning (if there is a history or current ear infection), or implanting a microchip.  If you would like an estimate for these extra services, please call ahead of time to notify our team of your requests.  This is especially important if the person dropping the pet off for surgery is not the primary decision maker for the pet's care.

When you bring your pet in for surgery, we will need to 5 to 10 minutes of time to fill out paperwork and make decisions on the blood testing and other options available. Depending on the surgical estimate provided, blood work analysis may be required prior to anesthesia. In addition, an intravenous catheter is often required for long-term procedures such as dental evaluations and treatment under anesthesia, and is recommended for most procedures. When you pick up your pet after surgery, please plan to spend 10-15 minutes to go over your pet's home care needs as discharge instructions will be relayed to you then.

We will call you the day before your scheduled surgery appointment, to confirm the time you will be dropping your pet off and to answer any questions you might have.  In the meantime, please don't hesitate to call us with any questions about your pet's health or surgery.

What surgeries are provided at North Shore Animal Hospital?

Dr. Ferguson will perform the following surgeries: spay, neuter, mass removal, mammary chain removal, cystotomy, exploratory laparotomy, enterotomy, intestinal resection and anastomosis, gastronomy, GDV surgery, perineal urethrostomy, FHOs, limb or digit amputation, and others. Dr. Ferguson will not perform any elective surgeries that reduce the welfare of pets, such as declaws, tail amputation unless this is due to trauma, dewclaw removal, or ear cropping. There are numerous studies that indicate that many pets undergoing these elective procedures have a high likelihood of being in chronic pain. In addition, declawing, in particular, is essential for normal cat behavior. North Shore Animal Hospital has access to a boarded veterinary surgeon that can come on site to provide other surgical services on a case-by-case basis.