Our Surgical Care Approach
Be warned. Not every veterinary practice will offer the same level of care.
Read below WHY Dandenong Veterinary Hospital offers a unique perspective on Quality Surgical and Anaesthetic Care.
Anaesthesia and Surgery is a complex field, and there can be many options your veterinarian may choose from when it comes to the level of care offered for your furry family member. This covers the medication choices, equipment choices and the rigorous guidelines and Standards Of Care we strive for. It is our priority at DVH to use our skills and knowledge to aim for your pet’s most comfortable and safest surgical experience.
Comparing costs? Be sure to compare apples-with-apples. We too could cut options out completely, or choose a more inferior or cheaper option, but at DVH, we understand how important each choice is. If it was our own pet having a procedure, these are the choices we would make, and we will do exactly the same for your pet.
Let us share below some of the details of our Surgical Care Approach, WHY we have made these choices for you, and WHY we won’t compromise on the level of care your pet deserves.
Total Intra-Venous Anaesthesia (TIVA)
That’s right…not a breathable anaesthetic gas! Alfaxan anaesthetic-agent is given direct into a vein, via catheter.
TIVA is available in our hospital and is frequently utilised for suitable patients and procedures. Alfaxan increases anaesthetic ‘safety margin’, and has minimal cardiovascular side effects and does not impact blood pressure as much as breathable anaesthetic agents. It also allows for a nice steady recovery, which decreases your pet’s confusion, stress and fear. Owners report less after-effects like drowsiness and grogginess, and many pets go home bright and alert like ‘nothing happened’.
Most other clinics will only use a gaseous (breathable gas) anaesthesia. Anaesthetic gas has a lower comparative safety margin, often negatively affects blood pressure, and may prolong the recovery phase, even into the following day.
No E-collar – Internal skin stitches
Internal sutures (rather than visible external sutures) mean increased comfort and less wound licking, allowing us to avoid the annoying E-collars for majority of our surgeries.
Most patients benefit from us taking that little more time (with a special suture and needle) to position the sutures INSIDE the skin layer, not on the skin surface. The size and position of the surgical wound does influence our choice here, but we recognise the value of choosing internal (intra-dermal) suture techniques whenever we can.
Other practices often take the quicker option to simply position skin sutures on the skin surface, many sending every patient home with an E-collar. We have a few select patients that still need the E-collar though, either based on their surgery type (such as internal abdomen surgeries), or nature (some dogs nibble everything and anything on their bodies!), but these are not the majority.
Endotracheal (wind-pipe) pressure-measuring syringe
Anaesthetic patients need a breathing tube called an ET-tube placed in the wind-pipe, which allows us to deliver them breathable oxygen during the procedure. These tubes have a cuff to form a seal, which is inflated by air. We measure the pressure of this cuff with special equipment, to avoid over-inflation.
The windpipe is delicate; at minimum, irritation and excessive pressure from an over-inflated cuff can lead to uncomfortable coughing, however more serious damage can occur with prolonged pressure.
A safe cuff pressure is a “measured” pressure, not a guess! Most other practices fill the cuff by hand, taking a ‘best guess’ at when the correct amount of air has been added.
Multi-modal pain control
Pain relief is delivered in six different ways for our surgical patients. This allows us to reduce the depth of anaesthesia (further reducing risks) AND keeps your pet’s comfort a priority!
- Pre-surgery injection. We start pain relief before anything painful has occurred, which reduces the pain experienced overall.
- Skin-numbing cream at intravenous catheter sites, so they don’t feel the prick from the needle.
- Local-anaesthetic skin or nerve blocks, which means the surgical area is numb while they are under anaesthetic and for the initial recovery period.
- Intravenous, continuous infusion of pain medication (dual-drug combination), running in the IV drip during the entire surgery.
- Injectable pain-relief post-surgery to cover first 24hrs.
- Oral take-home pain relief for the crucial days of the post-operative recovery period, usually easily given in the food.
Other Practices may not provide ALL the above. We wouldn’t want our patients to miss out on any of the above important steps!
Active Patient Warming
Body heat reduces during anaesthesia, and if this is not managed and reversed it can lead to an increase anaesthetic risk and will prologue recovery.
We use a variety of warming methods for our procedures; a warm-air heater which blows air into a special blanket and heats the air surrounding your pet, a warmed table pad, bubble wrapped paws, and lovely snuggly blankets. We can even warm intravenous fluids before they enter into the vein using a special machine, and for wake-up period our patients often have warm water bottles and heat discs.
Improving safety, comfort and recovery are top priorities for us, and active warming ticks all these boxes.
Pumped Intravenous (IV) Fluids
All our General Anaesthetics will be provided with intravenous fluids (via a catheter). This provides many benefits to
- support and manage changes in blood pressure, reducing anaesthetic risk
- improve post-operative recovery (including reducing any nausea in the wake-up period)
- if an emergency occurs we have rapid vein access for required medications
- precise controlled flow of IV fluid via the pump is superior to gravity-only administration
Dedicated Surgical Nurse
We have a nurse specifically assigned to your pet during the entire procedure from induction into recovery to provide focused attention towards monitoring their vital signs, as well as anaesthetic and peri-surgical care. This nurse is not expected to multi-task by managing more than one patient at once, which can occur at other practices. We will also not book large amounts of surgery patients into the daily schedule, allowing focussed care for your pet when they have their procedure.
Advanced Anaesthetic Monitoring equipment
Dandenong Veterinary Hospital has a variety of dedicated monitoring equipment available to more closely monitor early or subtle changes in your pet’s condition:
- Heart rate and ECG (electrocardiograph)
- Respiratory rate and frequency (including an apnoea alarm, should breathing slow)
- Blood Oxygen levels
- Blood Carbon Dioxide levels
- Continuous Body Temperature probe
- Blood Pressure (advanced oscillometric) monitoring
Other Practices do not aways invest in having the same range or quality of advanced monitoring equipment, and and therefore have less information available to them to best manage anaesthetic risks.
Brachycephalic Breed Care
Is your dog considered a brachycephalic (short-nosed) breed?. If YES, then extra care and preparation is necessary. These breeds have elevated risks for regurgitation and vomiting while they are under anaesthetic, and this can cause significant damage to the oesophagus or lead to aspiration pneumonia. They can also have elevated risk entering anaesthetic, and in the recovery phase.
There are additional medications and ICU-care that we utilise to assist these breeds, to reduce the risk of these complications. This includes additional medications to give the evening before, or day-of the surgical procedure, and intensive care and oxygenation if they need it in the recovery period. Not all practices understand these breed risks, and change protocols to reduce them. Brachycephalic breeds need more care than a one-size-fits-all anaesthetic regime.
What breeds (or significant mixes) are considered brachycephalic? Examples: Affenpinscher, Boxer, Bulldog, Brasileiro, Brussels Griffon, Bullmastiff, Boston Terriers, Cavalier King Charles Spaniel, Cane Corso, Chow Chow, Dogue de Bordeaux, English Toy Spaniel, French Bulldog, Japanese Chin, Lhasa Apso, Pekingese, Pug, Shih Tzu
Pre-anaesthetic Blood Testing
Dandenong Vet Hospital advocates for EVERY patient to have a pre-anaesthetic screening blood test, performed in advance of the procedure. This includes young and seemingly healthy patients, and is not just an option reserved for the old or unwell pets, which can occur in other practices.
This gives us the BEST way to identify detectable risks for your pet BEFORE their anaesthetic procedure. If changes are found on testing, we then have the option to investigate and treat the identified problem or disease, and delay anaesthesia until they are well enough. Performing anaesthesia without knowing how well the kidneys and liver are functioning holds additional risk.
We additionally make use of a two-parameter blood test (PCV/TP) on the day of their procedure to assess hydration and red blood cell (oxygen-carrying cell) levels.
The topics detailed above give you a sneak peak into our Surgical Care approach and our high level of Care.
Quality medicine and quality equipment means so much to our patients and their outcomes. Our team will settle for nothing less.
Our difference is in the details!