Anesthesia and Pain Management

Many people 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 the anesthetic safe?

Today's modern anesthetics have made surgery much safer than in the past.  Here at Essex Middle River Veterinary Center, we do a physical exam on your pet before administering anesthetics.  We adjust the amount and type of anesthetic used depending on the health of your pet.  We carry a variety of injectable and inhalant anesthetics so that we may customize our anesthetic regimen to your pet's needs. 
During your pet's procedure, he/she will be monitored by a technician and comprehensive intra-operative monitoring is available including pulse oximetry, ECG, blood pressure, and repiratory gas monitoring.

Preanesthetic blood testing is important in reducing the risk of anesthesia.  Every pet needs blood testing before surgery to ensure that the liver and kidneys can handle the anesthetic.  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.  Animals that have minor dysfunction will handle the anesthetic better if they receive IV fluids during surgery.  If serious problems are detected, surgery can be postponed until the problem is corrected.

We recommend preanesthetic blood testing and an IV catheter and fluids for all anesthetic patients. We require preanesthetic bloodwork and an IV catheter and fluids in all patients over one year of age.

We offer two levels of in-house blood testing before surgery, which we will go over with you when you bring your pet in.  Our doctors prefer the more comprehensive screen, because it gives them the most information to ensure the safety of your pet.  For geriatric or ill pets, additional blood tests, electrocardiograms, or x-rays may be required before surgery as well.

What preparations are needed prior to surgery?

If your pet is going to be anesthetized, we ask that you do not feed them within 10 hours prior to surgery. Normally, this means giving them an evening meal and then taking all food up for the evening and not giving a breakfast meal. This also means no treats! Our goal is to keep the stomach empty to reduce the risk of vomiting during and after the procedure.
Water should be available at all times!
If your pet is on any regular medication, speak with a staff member regarding pre-surgical protocol.

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, especially tumor removals, do require skin stitches or surgical staples.  With either type of suture, you will need to keep an eye on the incision for swelling or discharge.  Most dogs and cats do not lick excessively or chew at the incision, but this is an occasional problem you will also need to watch for.  If there are skin sutures, 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 days after surgery.

If your pet seems to lick or chew at his or her surgery incision, an e-collar will be recommended. E-collars (short for "Elizabethan Collar") are the lamp-shade like collars that should fit snugly and extend to or past the pet's muzzle so that they cannot lick or chew at thier incision. Collars are fitted properly if you can fit two fingers comfortably between your pet and the collar band, and cannot be easily pulled off. These collars should stay in place any time the pet is not being directly monitored. Many pets seem uncomfortable with the collars at first but will become acclimated very quickly!

Will my pet be in pain?

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, but you can be sure they feel it.  Pain medications needed will depend on the surgery performed.  Major procedures require more pain relief than things like minor lacerations. All surgical patients will receive a pre-operative injection of an appropriate pain medication. After surgery, pain medication is given on a case by case basis.  Any animal that appears painful will receive additional pain medication.

For dogs, we may recommend an oral anti-inflamatory the day after surgery and several days after to lessen the risk of discomfort and swelling.  We use newer medications, which are less likely to cause stomach upset. We also carry stronger narcotic-based pain medications for more intensive surgeries such as orthopedic procedures.

Because cats do not tolerate most NSAID pain medications, we are limited in what we can give them.  Recent advances in pain medications have allowed for better pain control in cats than ever before. 

For feline front declaw procedures, we take pain management very seriously. Declawing is considered as final option for a "destructive" cat.  If an owner decides to declaw thier cat, we recommend that this surgery is performed on younger cats, because they weigh less and are more capable of faster healing. We administer long-acting narcotic pain injections three times daily, and also perform a "ring block" which is a series of injections of local anesthetic to the front limbs. Any cat weighing over 10 lbs. may need a narcotic patch in addition to our regular pain management protocol. If you have more questions regarding feline declaws and our stance on performing the procedure, please speak to a veterinarian during your next appointment.

We use narcotic patches for some surgeries as well.  The cost will depend on the size of the pet, and we recommend that the patch be applied 24 hours prior to surgery.  Injectable pain medications may also be used after surgery on both dogs and cats.  Providing whatever pain relief is appropriate is a humane and caring thing to do for your pet.

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 dentistry, ear cleaning, or implanting an identification microchip.  If you would like an estimate for these extra services, please call ahead of time.  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.  When you pick up your pet after surgery you can also plan to spend about 10 minutes to go over your pet's home care needs.

We will call you the night 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.