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Helping you understand what your pet's surgery day might be like

Our Wednesday Surgery Team explains what a typical surgery day looks like.

Dr. Coleman and Gwen in our surgery suite.

Dr. Coleman and Gwen in our surgery suite.

It is often an emotional and scary thing to leave your pet with us for the day. We want to share with you what our typical day looks like and who cares for your pet. Dr. Kraabel and Sarah work in surgery on Wednesdays along with Dr. Coleman and her assistant Jess.  Kelsey, Gwen and Lindsay are our talented Licensed Veterinary Technicians in surgery on Wednesdays.  As has been blogged before, Gwen is also a Certified Veterinary Pain Practitioner.

Surgery days can consist of a wide range of procedures, from spay and neuters to dental cleanings and dental surgeries, growth removals and exploratory surgeries. Admission appointments typically occur in the morning.  Surgery days are notoriously unpredictable.  Procedures can take hours longer than anticipated and time set backs are common.  Dr. Kraabel’s career long attempts to tame these realities have been unsuccessful.  

The receptionist, who has scheduled the appointment, compiled an estimate for the owner and put all the paperwork together, leads owner and patient to an exam room.  Diane, Celine, and Kristen commonly help you on our surgery morning.

Kelsey or Lindsay typically perform the bulk of Wednesday admissions and go over any questions or concerns about the planned procedures. Once all the paperwork is completed and the owner has said their “See you soon”, patients go for a ride in the elevator and head upstairs.  We let them push the elevator buttons.

Sarah and Jess holding Hendrix and Chico after their procedures

Sarah and Jess holding Hendrix and Chico after their procedures

Upstairs, Sarah, Jess, or the technicians record the temperature and weight and set up a kennel for them. As intimidating as this process can be for our patients we take pride in doing our best to console the patient with calming touch, tone, and words of comfort. Cuddling is common. Each kennel is covered with a soft towel or blanket where the patient waits for the procedure, sometimes more patiently than others.  They often receive calming medication at this point, even if their procedure is later in the day.  For our extra worried cats, we place hide away boxes in with them and a towel on the front of the kennel. They need to have a safe and private place to retreat. We also use calming pheromones like Feliway for cats and Adaptil for dogs to help calm their mood.

Each patient receives a pre-surgical exam from the doctor where they look at gum color and listen to the heart. The technician or assistant draws blood, if the patient needs preoperative blood work. Blood work makes sure their kidneys and liver are working normally. The anesthetic machine and monitors are prepared and set up and materials are collated for the planned procedure. A combination of sedative and pain medication are given into the patient’s muscle.  Typically, the assistant gives the patient a big hug or wraps them in a towel for restraint and sedative is injected into the thigh or muscles alongside the spine. Then, we wait for our patient to relax and fall asleep.

Once they are sleepy, their technician places an intravenous catheter. It is always important to have venous access while a patient is under anesthesia. Intravenous anesthesia is given until they are completely asleep to allow the placement of an endotracheal tube. Gas anesthetic and oxygen are turned on and intravenous fluids are started.

Dr. Kraabel shows Lindsay a tooth that needs to be removed.

Dr. Kraabel shows Lindsay a tooth that needs to be removed.

At this point, they are prepared for their surgery and the procedure then takes place. As we said, it may vary greatly how long a patient is under anesthesia but there is not a time limit. The patient’s vital signs are monitored closely throughout surgery by one of the technicians who stays with the patient throughout their procedure. Once the surgery is complete, the support staff will sit with the patient, vigilantly monitoring vital signs until they are able to sit up and swallow. Technicians also focus on pain management and administer post-operative pain medication as needed. At times, internal temperatures may drop during surgery.  The assistants and technicians wrap the patients in warm blankets often cradling and cuddling with them creating a comfortable and smooth recovery period. While the assistant aids in recovery, the doctor records the surgical notes and the technician finishes up filling post-op medications and discharge instructions. 

This is when we will call and let the patient's people know that everything went fine.

Performing surgical procedures is complicated with an intricate collaboration of talented and empathetic caregivers. Each team member is part of the puzzle and has a role in making sure every patient receives the best standard of care and comfort. Be consoled in knowing that when you leave your pet with us, we strive to treat them as our own. 

 

Sarah Kwon, BS, DVM candidate class of 2021

Timothy R Kraabel, DVM, DABVP (Canine/Feline Practice); Vice President, American Board of Veterinary Practitioners

Geriatric Pets

Geriatric Pets Are The Best

 
 

What's better than getting a new puppy or kitten?  Those little eyes, the tiny mews or adorable woofs.  I believe that the Seattle scene is tending in a different--and in my opinion, a better--direction.  Shelters have encouraged, rescues have pleaded, and people are now open to adopting adult animals.    

However, one demographic is all too often forgotten or overlooked:  the geriatrics; the very old;  the ones who are going to come with medications and maybe some accidents around the house.  And  whose time with us is promised to be short.  We in the veterinary field always hope for the best when someone adopts an animal: that this adoption is a promise to care for this loved one for the rest of his or her life; that the family will be there in the end, with promises of the rainbow bridge and that one day they will meet again. But what happens when that promise cannot be kept?  What happens when forces that cannot be controlled by the owner or the pet force a hard decision?

The cat in these pictures is Marmalade, though around these parts she is known lovingly as "Marm.”  She is the quintessential old lady.  Her meow is course and grating and much louder than it needs to be, and there is never any doubt in anyone's mind what she's saying, “Get off my porch.”  I adopted  Marm when she was 17 years old.  She was given to the local Animal Shelter with a heartbreaking story: the elderly owner could no longer live on her own and needed to go to a hospice   that did not allow pets.  Who can imagine being taken away from a beloved pet after so many years?  And the future of a 17 year old cat on thyroid medications in a shelter is not hard to imagine.  When there are so many young healthy animals needing homes, who would want her?

Cue the sap: a technician who has spent her career loving geriatrics.  Why do I always adopt these animals?  What draws me to love the elderly beasties?  Who can say?  I've always thought they were like kittens and puppies in regards to care: sure they need some extra attention here and there when it comes to clean up.  They have stomach issues that cause vomiting and occasional accidents.  But they come with wonderful old souls!  The personality!  They come with a whole arsenal of tricks and quirks.  So, I offered Marm a home.

One of the difficult things we see here at Lien is owners adjusting to changes in their animals as they get older.  This seems especially true for cats.  Many people are concerned that their cat is hiding more, or has been scratching or growling at people when it never did so before.  It is so important to have your veterinarian examine older cats  to see if they have very common geriatric issues such as hyperthyroidism, a disease that will make them feel like they are constantly coming off of a very bad caffeine crash! Or they may have arthritis, which can be managed very well with medications that can even be purchased as tasty treats though compounding pharmacies.  In case you’re wondering, Marm is on medications for both of these conditions and she is much more comfortable today than when I adopted her.  

Changes happen in older pets, but much like people, they can be kept comfortable with the right combination of medications or food and informed understanding from owners.  I hope that the more people understand their geriatric pets and their issues, the fewer of these old ladies and gentlemen we will see in the shelter system.  

The biggest burden of owning a geriatric pet  isn’t the extra time or money or medication.  It comes with the countdown.  You are only given a short time with these beautiful creatures.  But after a year and three months of mutual TV watching, snuggling under covers at night, playing very slowly with catnip toys and letting her tell everyone she sees walk by the house to "get off her property," I can say with certainty that I wouldn't trade a second of the time spent with Marm for a young kitten.  She has been a joy in my life that no countdown can mar. This 18 years "young" cat just keeps getting better with age.

Kelsey Shurvinton, Lead Licensed Veterinary Technician