This is written from my own personal experience as a general practitioner and a veterinary surgeon (DVM). For clarification, I am a DVM, which includes any veterinarian that wants to perform surgery. However, I am not a board certified veterinary surgeon (DVM, DACVS); a higher level of surgical certification.
First, some things you should know:
1. $$$ Pet surgery may be expensive, but it's a fraction of the costs associated with human surgeries. HOWEVER, if your pet has insurance, similar to human insurance, the cost savings will be comparable. The savings depends on the level of insurance, the procedure and veterinary hospital. Pet insurance can and should be obtained when they are a puppy/kitten because no pet insurance will cover pre-existing conditions. Plan to pay a fraction of the cost of human medical insurance. I recommend Healthy Paws Pet Insurance & Foundation. Use the link to educate yourself!
2. No answers = new vet! If you feel like you can't ask questions or get answers from the veterinarian, the person who will perform the anesthetic procedure, or the surgery on your pet - find another vet. This will cost you money, but that's all it will cost - it won't cost your pet their well being.
3. Yes, vets are busy - please take that into consideration. If it seems like your vet is too busy to answer your questions in the moment consider saying something along the lines of "You appear to be really busy/distracted right now, but I do have a few more questions. Would it be better if you gave me a call at a later time to discuss?" If they agree, leave your written questions so they have time to prepare the answers to the best of their ability. Do not let a busy vet deter you from gathering the knowledge that you seek.
4. RESEARCH ONLINE!! I know that we as vets challenge the information that you found on Dr. Google - great - keep it coming. Why? It prepares you! When you formulate your own questions and deepen your understanding of your unique situation, it can help solidify the bond and build shared trust between you and your vet. I love it when a pet owner comes to me with credible sources. It shows me that we make a team with the same goal in mind - caring for their pet. It's a great day when I learn something new from a client; it gives me the ability to pass on that knowledge to another family - everyone wins. For credible information for pet parents, check out the American Veterinary Medical Association at AVMA.org for great resources.
5. Understand the importance of asking questions - asking questions not only rewards you with answers, BUT it also shows your level of care, commitment, and understanding of the impending medical procedure. Do some vets get annoyed with an abundance of questions? If we are busy in that moment, it may seem so; but fundamentally - NO. Your pet is voiceless; you have the one thing they don't. Use your voice for them and everyone will rewarded. Additionally, be prepared to learn and take notes. As a vet, I love it when people take notes because it helps organize and consolidate your pet's health care. We think you're A+ pet parents!
Let me know if you think I left something important out of this blog! Please - for the improvement of all of our inquiring minds.
Surgical Checklist/Questions to ask
NOTE: These questions are informational. Cutting corners in standards of care doesn't always warrant a worse outcome; it makes a worse outcome a higher possibility. There is variability in outcome depending on the procedure and health status of the patient.
For example, a fifteen year old cat with kidney disease will have a higher chance of a complication without intravenous fluids during anesthesia than a one year old cat that's completely healthy.
Tip: Cost effectiveness:
If you can't afford all of the standards that you would like for your pet, that does not mean you should forgo the procedure. If the lack of procedure means your pet will suffer, you should adjust your expectations to the situation that will give your pet the highest chance of comfort and returning to health.
Tip: Vet connection to you and your pet:
I don't perform surgeries anymore, but when I did, I had a strong connection with my patients and it encouraged me to succeed. I did work at an AHAA hospital, so we did have plenty of the bells and whistles of any modern practice. However, my outcomes were not always 100%. There have been complications and if any veterinary surgeon tells you that they never had a complication, they are not being truthful.
Question: Type of procedure and your vets surgical experience:
What procedure will you be performing AND what experience do you have with it? A new grad, performing his second cystotomy, may be less comfortable answering this question than a more seasoned vet. However, it doesn't mean your veterinarian should be discounted for lack of experience. This question does open the door for more discussion as to wether this is the right vet to perform this service for you.
Question: Surgical team:
Will my pet be monitored by a certified veterinary technician during the surgical procedure? AAHA hospitals are required to document a pet's vitals under anesthesia. Unfortunately, this may shift the technician's focus from physically observing the patient to recording vitals from a machine. In an ideal world, two eyes (the vet's and the tech's) are better than one.
Question: Pre-operative lab work:
Will the veterinary practice perform pre-anesthetic bloodwork? How comprehensive will that lab work be? What is the additional cost?
All bloodwork is NOT created equally. A few options are:
Clotting profiles - ensure the blood will clot appropriately
Complete blood counts (CBC) - red and white blood cell data and platelet concentration
Full chemistry - includes kidney and liver enzymes, as well as electrolyte/mineral levels
Low-cost clinics may only offer a hematocrit (pictured at the right) test to visualize blood cell concentrations to make sure the pet is not anemic (low number of red blood cells). A comprehensive blood panel could increase the cost of a procedure by a few hundred dollars and many practices make pre-anesthetic profiles mandatory - BUT it's the depth of the profile that is variable.
Here's what I would want checked before I put MY pet under anesthesia:
1. CBC - platelets are usually sufficient, unless it's a major surgery, in which case I would want the vet to pay attention to clotting times
2. Complete Chemistry (Chem20, or 25) to check liver enzymes and kidney enzymes
3. Heart worm test if my pet wasn't on heart worm prevention
4. Fecal test to ensure they were negative as any parasite infection
5. Urine test. This is low on the priority list unless you have a pet with a history of urinary issues or if collecting samples from your pet is difficult.
Question: Supportive care in surgery:
Will my pet be given intravenous fluids during the procedure to support oxygen delivery and blood flow? Not every hospital prioritizes supportive care during every anesthetic procedure - especially when the patient is young.
If your pet was neutered or spayed at a rescue, odds are that they did not receive fluids during that procedure. Administering fluids requires supplies, monitoring, and money. It's better for the pet and I recommend it for all of my pet's procedures. However, it can easily add a few hundred dollars onto the bill. If your pet is older than five years old or has any clinical signs of illness, I highly recommend that you request this service.
Question: Recovery time:
What is the average recovery time? This is for your own knowledge - if you need to take time off of work to help your pet recover, then you need to plan accordingly. Just like humans, recovery can be less stressful if your pet has help!
Question: Post-operative pain management:
Will my pet be in pain after the procedure? If so, what pain meds will they be prescribed? If there is any incision involved in the procedure and the vet says that they won't be in pain - RUN! Additionally, if your pet is having a major procedure performed and the only pain med prescribed is a non-steroidal anti-inflammatory (NSAID) - question it.
For example: if you had hysterectomy or if you were castrated (surgically removed reproductive organs), would ibuprofen would cover the pain? If you had ten teeth extracted, would you be happy with Aleve? If the answer is "NO", then be kind to your pet and request something a little stronger than an NSAID- the bare minimum would be the debatably effective pain control medication - Tramadol.
Question: Overnight care:
If my pet will be staying overnight, does that mean he will be monitored overnight? Does the clinic have qualified personnel (NOT the custodial crew or untrained kennel assistant) monitoring my pet? If there is an issue, will a veterinarian will be on call?
Overnight hospital stays have become far less common because most hospitals are not staffed overnight - some practices still keep pets overnight even when nobody is monitoring them. In my opinion, this is more risky then sending the pet home with their owner and asking/training the owner to monitor them. If someone is nearby to recognize a problem, then someone can bring the pet to a 24-hour care center or ER if needed.
Question: Post-operative recovery:
Will my pet recover in the presence of a technician? Odds are that sh@t is going to hit the fan during recovery - not during the procedure where your pet is heavily monitored. Therefore, you want to ensure that a technician sits with the pet until they are awake and sitting up.
In a high-volume, low-cost clinic, resources are limited and surgical team responsibilities can be spread thin. During my surgical career,I did no start another procedure until my patient from the last procedure was sitting up and alert.
Question: At-home post-op emergency:
What do I do if my pet experiences post-surgical complications after surgery? What emergency hospital do you recommend? What should I know to assess whether or not my pet is experiencing an emergency or a complication that can wait until the practice opens in the morning?
What to watch:
1. Respiratory complications such as an increased breathing rate, struggling to breathe, abdominal breathing are 100% - Go to the ER NOW!
2. Neurological (seizures, instability, unable to walk) - Go to the ER NOW. If there's any question, an ER visit will at most cost you $200 for a consult, and the peace of mind may be worth it.
3. Bleeding depends on the amount and source of bleeding.
4. Pain can likely wait until the morning as long as your pet can can maintain an acceptable level of comfort
How to prepare:
Step 1: Have a list of every ER vet in your area handy
Step 2: Call them in the case of an emergency! If your pet is experiencing excessive bleeding, you will want to give the ER a call to ensure a veterinarian is not in surgery with another patient. This is a very common occurrence in 2023 and I have had to send people an hour away to the nearest ER that had an available vet.