Hill Country Veterinary Surgical Specialty FAQs

Yes, absolutely, we would.

We wouldn’t be in this field if we didn’t like to fix cats and dogs. We also typically don’t recommend something we aren’t willing to do for our own pets.

And over the years, we’ve dealt with countless medical issues in our own pets: cancer, broken bones, torn ACLs, etc. Now, just because we would take our pet to surgery does not mean that it is the correct decision for you. Only you can make that decision.

Before you decide on any surgery for your pet, you should be comfortable with the multiple factors that go into this important decision: financial, recovery, expected outcome, doctor’s experience with similar situations, success rate, life expectancy, etc.

We accept all major credit cards and Scratch Pay. We do not accept checks or cash. We are sorry for the inconvenience.

Old age is virtually never a deciding factor in our minds. A surgery we perform to treat laryngeal paralysis is most common in dogs over 10 years of age, so we’ve done it in 14 and 15-year-old dogs – with good results.

As we always say, “age is not a disease.”

Appropriate pre-operative testing, intra-operative support, and post-operative management are imperative for any surgical case, but especially for senior patients or those with pre-existing conditions to ensure the patient has the best possible surgical outcome.

This is something you should ask your referring veterinarian, or if you elect to schedule a consultation with HCVSS, we will discuss it openly.

Some complications are possible in all surgeries: swelling, bruising, oozing, bleeding, infection, etc.

Other complications are related to each surgery, which again should be discussed during a consultation. The best way to prevent them is to follow the discharge instructions.

Other complications are related to each surgery, which again should be discussed during the consultation. The best way to prevent them is to follow the discharge instructions.

There is always a risk with sedation and anesthesia, no matter how healthy the patient is or how short the procedure is.
Since 99% of our patients go under anesthesia, we are obsessed with patient safety.

That is why we do preop blood work and exams to ensure there are no obvious underlying abnormalities with the major organ systems.

That is why each surgery patient has a dedicated anesthesia nurse whose only job is patient safety.

Your pet will be monitored before, during, and after surgery with sophisticated equipment and by an experienced nurse. In fact, a whole team of compassionate nurses who are known to spoil their patients.

Make sure to discuss all current medical conditions and medications with the surgery team to ensure nothing gets overlooked.

The anesthesia nurse monitors vitals closely throughout anesthesia:

• ECG (heart electrical activity)
• Heart rate
• Pulse
• Respiration rate
• Blood pressure
• Blood oxygen levels
• Blood CO2 levels
• Body temperature

If any one of these vitals is abnormal, we can address it and make anesthesia safer.

The answer is: minimally.
Age is not a disease.

Still, we take multiple precautions when we perform geriatric anesthesia.

A healthy 14-year-old pet can have less complicated and less risky anesthesia than a sick 2-year-old, so age is relative.

Each patient gets an individualized anesthesia plan, so it is tailored to their specific needs, lowering risk as much as possible.

The #1 responsibility of the anesthesia nurse is to keep the patient as safe as possible.

After giving a sedative and pain medications, we use an anesthesia gas called isoflurane, which is extremely safe.
And we strive to use the lowest amount possible, ideally under 1%, which is very low.

The rest is pure oxygen – often more than 99% – which is delivered through a plastic tube placed in the windpipe (trachea).

We require it for the same reason it’s required in humans.
Just because a pet looks healthy on the outside doesn’t mean that all organs are healthy on the inside.

Blood work includes 3 parts:

• A Complete Blood Count (CBC) studies red blood cells, white blood cells, and platelets (critical for clotting).
• Full chemistry, which looks at vital organs such as the liver and the kidneys.
• Electrolytes can be out of balance in some medical conditions.

If blood work is abnormal, we might need to change our anesthesia protocol and postop medications.

If blood work is normal, then that should make anesthesia safer.

Food: please don’t feed your pet after 8 pm the evening before surgery. This decreases the risk of vomiting and makes anesthesia safer. There are exceptions to this, for example, for very young, very small, or diabetic patients, so we should discuss this before surgery.

Water: your pet can drink through the night and the morning of surgery. They should stop drinking once they leave home on the day of surgery. This prevents dehydration and makes anesthesia safer.

A decreased appetite, panting, guarding of a body part (e.g., being “head shy”), reluctance to move, and any type of limping can be signs of pain.

Cats in pain will often groom less than usual.

Don’t assume that nothing can be done because that rarely is the case.

Postop pain was once thought to be good for decreasing movement and improving healing.

We now know that postop pain relief is beneficial.

It reduces stress, anxiety, and discomfort, all of which improve the recovery and your pet’s quality of life.

This is the reason why we are so generous with pain medications at our practice.

The best you can do is provide a calm and relaxing environment.

Keep your pet comfortable by providing a soft, clean, dry bed.

It should be placed in the confined area we discussed.

Some pets like a warm environment, while others prefer a cooler area.

Even though you are hopefully reassured that your pet made it through anesthesia and surgery, you are still likely nervous, which is completely normal and understandable.

You and your pet are in synch on many levels, so the best thing you can do is to avoid communicating your stress to your pet.

Just like a human, your pet may have no interest in food after anesthesia and surgery.

Unless you’re told otherwise, feeding is rarely a big concern on day 1. Keeping your pet hydrated is more important.

If your pet is interested in food, small meals are preferred initially.

Within a few days, everything should eventually go back to normal.

You could try to flavor a dog’s water with low-salt, low-fat broth.

You can try the same for a cat, or you can use tuna juice.

Your pet has received sedation or general anesthesia. Just like in people, it can take a while to process the effects of the drugs.
So drowsiness, sleepiness, and weakness are all to be expected.

Over the next few days, your pet’s strength and behavior should return to normal.

Also, keep in mind that in some cases, you are giving a mild sedative to help with confinement, so in that case, being a bit sleepy & resting peacefully are beneficial.

Given how generous we are with pain medications, it is less likely to be because of pain, and more likely a reaction called dysphoria.

If you have concerns after hours, we would recommend contacting a 24-hour emergency hospital.

In addition to shaving the surgery site, we shave a small area to place an IV catheter.

The bare skin was scrubbed to place the catheter in a sterile manner.

This is how we dispense IV fluids and some medications.

Occasionally, there is an issue with a catheter. In order to place another one, we may have shaved a second spot on another leg.

It is OK if it stays on until the sutures are removed at 10-14 days, as long as it stays clean and dry.

If the BandAid/Hypafix becomes wet or soiled, please remove it at home.

This greatly depends on the surgery. And it’s usually more than most pet owners expect.

The reason we shave so much hair is to ensure the area around the surgery site is as sterile as possible to avoid any risk of infection. We call shaving a necessary evil.

A lot of shaving is better than the smallest infection.

The good news is hair grows back as soft and silky as before surgery in 99% of pets.

Your pet had a plastic tube placed in the windpipe (trachea) during general anesthesia to deliver oxygen and anesthetic gas.

This can occasionally cause mild irritation and a slight cough. If so, the cough will disappear over the next few days.

However, if it continues beyond a few days, it could be kennel cough or the dog flu (aka canine flu, Canine Influenza Virus, or CIV), or even pneumonia, in which case you should contact your family vet.

You should have been given an Elizabethan collar (“E”-collar or plastic cone) which will prevent your pet from licking or chewing the incision, so please use it.

And please keep it on 24/7 – no exceptions – as recommended.

Not surprisingly, many pets find these collars strange at first and will attempt to remove them. However, if you are more stubborn than your pet, most will tolerate wearing the cone.

Once they’re used to it, keep the collar on at all times. Don’t be tempted to take it on and off, for example, around meals or if you’re sitting with your pet.

Remember – it only takes a few seconds for your pet to damage or opens the incision, which can cause an infection.

If you feel your pet’s incision has been damaged in any way, please call the hospital as soon as possible.

Pets can eat, drink and sleep with the cone on. Please don’t take it off to give your pet a break or to be “nice.” This can be very detrimental as it teaches your pet that it can come off.

Then they make it their life mission to take it off.

The damage (self-trauma) can be serious enough that another surgery is required to stitch the incision back up. This means another anesthesia, another surgery, and more money spent!!!

Some pets are very creative and use the sharp edge of the cone to scratch their incision. If that happens, it means the cone is too short, so you will need one a bit longer (see the handout below). Your family vet can provide one.

Calling it “the cone of shame” is a very unfortunate nickname. We see it as your pet’s best friend to prevent infection and your pocketbook’s best friend to avoid the need for additional medical care.

We don’t trust the soft cones after seeing many pets lick and chew around them.
In addition, we prefer a hard plastic cone because your pet can see through it, as opposed to soft cones.

Don’t believe the marketing!

We don’t trust donuts or ring “cones” after seeing many pets lick and chew around them.

In addition, some are extremely easy to remove!

Don’t believe the marketing!

Occasionally, we can’t use a plastic cone. This mostly includes surgery in the neck area because the sharp “back” end of the cone would rub on the incision.
Scratching can cause some significant damage to the incision and open it up.

Some pets are very resourceful. They can also rub the surgery area on the ground or a piece of furniture.

Depending on the location of the incision, you might be able to cover it with a T-shirt (on the neck only, not the chest), a bandana, or a “scarf.”

Depending on the time and day, you should call us, your family vet, or the closest emergency clinic if you feel you are dealing with an emergency.

Your pet may not have a bowel movement for 24-36 hours after surgery.

This could be due to a variety of reasons:

• Your pet was fasted, i.e. did not eat, around 12 hours prior to surgery.
• Anesthesia and some surgeries can slow the transit down.
• Some of the medications given prior to, during, or after surgery can slow the GI tract down.
• Your pet may not eat much for a few days after surgery.

Contact a vet ASAP if your pet remains constipated more than 3-4 days after surgery.

Please don’t believe the urban legend that says that pet saliva speeds up healing.

That’s a complete myth.

Do we need to explain where your pet’s tongue has been?

Their tongue carries countless bacteria, including fecal bacteria (i.e. nasty bacteria from poop), which could cause a very severe infection.

This is why we insist that your pet who had surgery should be kept away from your other pets.

We do not recommend applying anything to the incision. Ointments and salves tend to attract debris and fur and may predispose the area to infection.

If you see a discharge or some bleeding or oozing, we recommend very gently cleaning it with a soft cloth or a paper towel and TAP water. No chemicals of any sort should ever be used.

If you see pus (green, white, or yellow), call a vet ASAP (us, your family vet, or the emergency clinic).

This depends on the interaction.

Looking at each other through a baby gate or through a crate is fine.

However, if they overstimulate your surgery pet, then you run the risk of injuring the surgery, and it may be irreparable. Remember, we only have one shot at healing.

This is the reason why we recommend separating your pets during recovery. If your pet heals properly, then your pets can play and have fun again later.

This will be discussed before surgery. It all depends on the procedure.

In most cases, your pet will need to be strictly confined to a small room or a large crate to ensure proper healing of the surgery area. Remember, we have one shot at healing.

This will be discussed before surgery. It all depends on the procedure.

Most orthopedic surgeries take 2 months to heal.

Many soft tissue surgeries take 3 to 4 weeks to heal.

We can somewhat control a hyperactive pet with a mild tranquilizer or sedative. You can request it, or we will ask you if you think your pet will need one.

The idea is not to turn your pet into a zombie but to take the edge off so your pet is a bit more content to be confined.

When a human has surgery, they are typically forbidden from running around, jumping around, and playing tennis.

The only way to do the same with a pet, and ensure that they heal properly, is to confine them. Confinement should be comfortable. We recommend a large crate for small pets and a small room for medium & large pets.

There should be nothing to jump on (furniture, window sill, etc.).

Walking around and pacing are allowed. Jumping and running are not.

Breaking the rules can, unfortunately, have devastating consequences…

We have one shot at healing.

Many of our clients work for a living, so they are away from home for 8 to 12 hours per day.

There is a very high chance that your pet will do what they usually do when you are not around: sleep.

If you have the luxury of coming back over lunch to check on your pet, that is a great option but certainly not mandatory.

There is not much to do after surgery anyway besides giving the medications at the right times.

For the most part, we can control what happens at the surgery practice.

However, we cannot control what happens at home, how strict you are with the plastic cone, how strict you are with the confinement, how your pet behaves after surgery, how strict you are with the short walks, how strict you are with preventing furniture and minimizing steps, how strict you are with preventing your other pets from interacting, or how strict you are with the physical therapy.

As you can see, there are multiple variables we have no control over.

To some degree, there are also variables you don’t have any control over. Some have to do with the nature of your pet’s condition or your pet’s behavior.

We can’t change the course of arthritis or cancer and other serious conditions.

That said, our expectation, in most cases, is to get 95% of pets back to 95% of normal. Those are pretty good odds…

Make sure we discuss this important question before surgery, so you have a realistic understanding of what the goal and outcome of the procedure are.

Every pet is different, so it’s hard to predict.
That said, most pets “toe touch” within 1-2 weeks after surgery.

Some who are braver or more stoic will put quite a bit of weight during that time.

It is not uncommon for them to carry the leg more when indoors, as they are more focused on it.

Conversely, they most often use their leg more when they’re outside, as they are more distracted.

We usually get concerned if a pet doesn’t use the leg by suture removal, usually 2 weeks after surgery. If that is the case, please contact us ASAP.

Bottom line: don’t expect huge changes overnight. We expect improvements on a weekly basis. Each week should be better than the previous one.

Each surgery is different, although most are under 1 hour.

Keep in mind that surgery time is only a portion of the time your pet will be under anesthesia.

Your pet will be under anesthesia before surgery (to clip the hair, set up in the OR, scrub the skin, etc.) as well as after surgery (to clean your pet up and sometimes to take X-rays).

If surgery is recommended, then there is hardly ever a situation where delaying it is beneficial to your pet.

Delaying the removal of a mass will likely mean more time for it to grow bigger. This means a more invasive surgery, more time under anesthesia, and possibly fewer chances of getting it all.

Delaying joint surgery (e.g., addressing an ACL tear) will likely mean more time for your pet to be in pain, muscles to melt away, and arthritis to get worse.

Delaying “upper airway” surgery (Bulldogs, laryngeal paralysis) will likely mean more time for your pet to suffocate.

Waiting rarely makes things better…

If a mass comes back cancerous, we learn several things from the pathologist:

• What type of cancer it is
• How aggressive it is
• Whether we “got it all”
• Whether we provide a cure.

Only then can a plan be recommended for future treatment – if even necessary.

This can include additional surgery to remove more tissue, chemotherapy, radiation, or simply monitoring.

Chemotherapy is a scary word, but all it means is “drug therapy.”

With some cancers, chemo can be as simple as giving a cheap pill.

Now, if the biopsy comes back benign (non-cancerous), then you can sleep better at night, knowing the tumor should not affect your pet’s lifespan.

We feel that peace of mind is priceless.

Surgery patients should not be bathed or groomed until after suture removal.

In virtually all postop patients, neither is recommended as long as they need to be confined, which is 2 weeks to 2 months, depending on the surgery.

If you feel that your pet is smelly, you can give a sponge (local) bath, use pet wipes, or dry shampoo (specifically made for pets!).

If you think that your pet’s hair is messy, you can brush them.

Most pets have staples to close the incision. This is the fastest option, which means shorter anesthesia.

Some pets have stitches, which may or may not need to be removed after a few weeks (we will let you know very clearly).

Stitches we don’t remove will dissolve on their own in a few weeks.

Even fewer pets have no external stitches at all. All stitches will be below and within the skin, which means there is no need for suture removal.

This is not a matter of preference. It all depends on the surgery and the location of the incision.

We decide on the order of surgeries once all patients have been admitted. And sometimes, the order changes for a variety of reasons.

Multiple factors go into creating a logical order: age of the patient, medical conditions, urgency, pain level, type of surgery, cleanliness/sterility of the procedure, equipment availability, etc.

Before surgery even starts, your pet will receive pre-anesthesia medications or pain medication to reduce anxiety and make anesthesia smoother.

In addition, IV fluids are also provided before anesthesia starts.