Q: What is a board-certified veterinary surgeon?
A: Please see the "links" page for a thorough explanation.

Q: Can you diagnose my pet or provide a second opinion by email?
A: No. I cannot provide a diagnosis or a second opinion by email (or by phone). Accurate diagnosis and treatment require a thorough history, a complete physical examination and possibly special tests. Please contact your veterinarian or your surgeon as soon as possible if you have a question or a problem. After hours, over a weekend or during a holiday, contact your local emergency clinic.  When you call your regular vet after hours, there should be information about a local ER on a recording. Whether your pet is my patient or not, please understand that I cannot and will not answer specific questions by email.

Q: Who will take care of my pet when you leave the hospital?
A: When the surgery staff leaves Valley Central Veterinary Referral Center, the staff of the Valley Central Veterinary Emergency Hospital takes over. They treat emergency cases and take care of our patients at night and on weekends, year round. Your pet is therefore taken care of (and sometimes spoiled) 24/7, 365 days per year.

Q: How can I confine my pet after surgery?
A: Most clients worry a lot about the confinement, but if you follow these tips, things go smoothly in most cases.  Cats and small dogs can be kept in a baby play pen, -turned upside down so your pet doesn't escape or try to jump.  Larger pets can be confined in a small room: bathroom, laundry room, spare bedroom, office etc.  If you do use a room, please make sure that there are no harmful products your pet could eat, and avoid furniture your pet could jump onto...


Q: When should my pet have his or her first bowel movement after surgery?
A: Many pets will not have a bowel movement for the first 4-5 days after anesthesia and surgery.  There are several reasons for that: Your pet has been fasted prior to surgery; Your pet may not have eaten well during the hospital stay or the first few days at home; Pain medications may slow down the intestines.
If your pet does not have a bowel movement within 4-5 days after returning home, your vet or surgeon will often suggest a stool softener like Metamucil® or canned pumpkin.

Q: My dog had surgery and now is not eating. What can I do?
A: . Offer boiled, lean meat (chicken or hamburger) mixed with carrots and rice. Gradually wean your dog back onto the regular diet over a week or so.

. Flavor water with low fat, low salt chicken or beef broth to encourage drinking.

. Offer canned dog food or baby food.  Hand feeding may help a lot, too.

. Warming up the food (a little!) will enhance the flavor.

. Please keep in mind that a dog that is confined will need less calories.  Unless your dog needs to lose weight, a rough rule of thumb is to feed 75% of the regular daily amount.

Q: My cat had surgery and now is not eating. What can I do?

A: . Offer smelly foods- like tuna, chicken, or canned food.

. Try baby food, but avoid ONION.

. Petting your cat is relaxing and may stimulate the appetite.  Hand feeding may help a lot, too.

. In some cases, we can prescribe an appetite stimulant.


Q: My pet is vomiting since returning home. Why? What can I do?

A: There can be numerous reasons for vomiting.
. Your pet may be drinking large amounts of water at one time and then vomiting. If so, please offer small, frequent amounts of water.
. Medications (antibiotics, pain medications) may cause nausea and vomiting. In order to see which medication may be causing this problem, separate them by about 2 hours. Normally your pet will appear nauseated within one hour of receiving the medications. After you have narrowed down which medication it may be, please call your vet, who may change or discontinue the medication.
. Try offering the medications in a small amount of food.
. Nausea may be a result of anesthesia and should pass in a few days.
. As a general rule, and with your vet’s approval, withhold any food or water for 12 hours.
. If your pet has had abdominal surgery, becomes increasingly depressed, or the vomiting persists more than 24 hours PLEASE CALL YOUR VET OR SURGEON IMMEDIATELY!

Q: How do I know if my pet is in pain following surgery?

A: Signs of pain can be difficult to assess. Signs may often be very subtle.

Signs of pain include: Biting at the surgical site; Growling or a deep moan/cry; Anxiousness; Restlessness and not wanting to sleep or lie down, or continual pacing; Quiet or reclusive behavior, however your pet may just be upset about leaving and coming back home; The worst discomfort is typically for the first 2-4 days.

Q: Are there any medications I can give at home if my cat seems to be in pain?

A: IT IS VERY IMPORTANT THAT YOU DO NOT GIVE ANY OVER-THE-COUNTER MEDICATIONS TO YOUR CAT FOR PAIN.  MANY OVER-THE-COUNTER DRUGS MAY HAVE SERIOUS SIDE EFFECTS, ESPECIALLY WHEN GIVEN WITH THE DRUGS YOUR CAT HAS BEEN PRESCRIBED. Please call your vet or surgeon if the medications provided for your cat are not helping, -stronger medications may be needed.

Applying a warm or cold compress to the incision area may reduce pain and swelling.

Q: Is it OK if I allow my pet to lick the incision?

A: No. When a pet licks the incision, it delays healing by traumatizing the area. Bacteria from the mouth may cause an infection.

Licking often removes the sutures or staples and opens up the incision, increasing the risk for infection. This may mean another anesthesia to clean up and resuture the wound!

Pets frequently groom themselves and will lick their incisions as well. If the skin is red or irritated, this normally means your pet has been licking.

Q: How do I stop my pet from licking?
A: Collars, such as the Elizabethan collar ("E-collar"), work best by providing a barrier between your pet’s mouth and the incision.  It must be long enough, i. e. extend beyond the nose.  E-collars are clear, so your pet can see through it, and can eat, drink, sleep and even go outside wearing it 24/7.  In fact, the more you leave it on, the quicker they will get used to it!  Taking it off when you are home and putting it back on when you leave frequently leads to problems.

Another type of collar is the "Bite Not" collar, which looks like a neck brace.

If the incision is over the chest or belly, a T-shirt may be worn.

Bitter Apple or similar product may be placed around the incision- not directly on the incision. However this does not deter some pets at all.  Some love the taste!

Possible side-effects of common medications:

This is certainly not an exhaustive list of all side-effects.  Rather, it is a list of the most common side-effects we have noticed in our patients.  They are normally mild, but could be serious.  If you have any doubt about your pet's signs, please call our clinic, your referring vet or the closest emergency clinic ASAP !!!

NSAIDs:

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are a class of drugs commonly used to control pain and inflammation in dogs.

Such drugs include: RIMADYL® (carprofen), ETOGESIC® (etodolac), METACAM® (meloxicam), DERAMAXX® (deracoxib), PREVICOX® (firocoxib),  ZUBRIN®(tepoxalin) etc.

Possible side-effects include: vomiting, diarrhea, with or without blood; lethargy, depression; not eating or eating less; yellow gums and skin; change in drinking.

Pain medications:

Tramadol, Buprenex® (buprenorphine), Torbutrol® (butorphanol), the fentanyl pain patch and similar drugs can cause sedation or constipation.

Antibiotics:

Antibiotics such as cephalexin, amoxicillin, Convenia®, Simplicef®, Clavamox® and Zenequin® can rarely cause vomiting, diarrhea and lack of appetite.

Metronidazole (Flagyl®) also can cause neurological signs such as “goose stepping”, stiff or weak legs and wobbliness.

Steroids:

Steroids include drugs like prednisone, dexamethasone and Depo-Medrol®.  Their side-effects include vomiting, diarrhea, with or without blood; lack of appetite, anxiety, lethargy, depression.  An increase in appetite, drinking and urination are to be expected.

If you notice any of these side-effects, please stop the medications and call us or your referring vet or your local emergency clinic.

Even though we try to avoid fancy medical terms, sometimes we forget... Here are a few definitions to help you better understand your pet’s condition. If you don’t find a word, you could look it up on:
http://medical-dictionary.thefreedictionary.com

Abdomen: The belly.
Adrenal gland: One of 2 glands near the kidneys. They mostly make steroids (cortisone) and epinephrine (adrenaline).
Adrenalectomy: Removal of an adrenal gland, mostly done to treat Cushing's disease or remove a tumor (carcinoma, pheochromocytoma).
ACL (Anterior Cruciate Ligament): A ligament that keeps the knee stable.
Analgesic: A drug that relieves pain.
Anemia: A decreased number of red blood cells.
Anorexia: The loss of appetite.
Arthrocentesis (Joint tap): Puncture with a needle to aspirate joint fluid.
Arthrodesis: The surgical fusion of a joint (most commonly the wrist).
Arthrotomy: Surgical incision into a joint.
Ataxia: Failure of muscle coordination, loss of balance. A wobbly dog is called ataxic.
Atrophy: Decrease in the size of an organ or tissue (e. g. muscle atrophy).
Avulsion: A tear, usually of a ligament.
Benign: A growth that is not malignant and does not spread from one part of the body to another.
Biopsy: The surgical removal of a piece of tissue or organ for examination under a microscope for diagnosis.
Carpus: The wrist.
CAT scan (CT scan): A test using computers and X-rays to create 3-D images of various parts of the body.
Celiotomy: Abdominal surgery.
Chemotherapy: The treatment of cancer with drugs.
Chest tube (Thoracostomy tube): A plastic tube placed into the chest to evacuate air or fluid.
Closed fracture: Fracture that does not cause an open wound in the skin.
Comminuted fracture: Fracture in more than 2 pieces.
Complete Blood Count (CBC): The number of red blood cells, white blood cells, and platelets in a sample of blood.
Congenital: Existing at or before birth.
Crepitus: In a bone, crackling sound due to rubbing of fractured bones.  In a joint, grating caused by the rubbing of joint surfaces.
Cystotomy: Cutting into the bladder.
Dysplasia: Abnormal development (e. g. hip, elbow).
Elbow dysplasia: Abnormal growth of the elbow, that leads to arthritis. Includes OCD, FCP, UAP.
Endoscopy: A procedure to look at the inside of body cavities, such as the trachea (wind pipe), esophagus, stomach, or colon.
Enterectomy: Removal of part of the intestine, e.g. to remove a tumor.
Enterotomy: Cutting into the intestine, e.g. to remove a foreign body.
Esophagus: Hollow tube between the mouth and the stomach.
Eversion: Turning outward, or inside out (e.g. everted saccules in the larynx).
Excision: Surgical removal of a tumor or mass.
Exploratory laparotomy: Abdominal surgery to look at all organs and obtain a clear cut diagnosis.
Extension: Straightening of a joint.
DJD (Degenerative Joint Disease): Similar to (Osteo) Arthritis.
FCP (Fragmented Coronoid Process): Piece of bone that never fuses with a bone in the elbow (part of elbow dysplasia).
Femur: The thigh bone.
FHO (Femoral Head Ostectomy): Removal of the ball part of the hip.  This leads to a false joint made of scar tissue.
Fibula: The small bone in the leg (see Tibia).
Fine needle aspirate (FNA): A procedure in which a needle is placed in a tissue to look at cells under the microscope (cytology).
Flexion: Bending of a joint.
Gastric Dilatation Volvulus (GDV): Life-threatening condition where the stomach gets bloated and may twist on its own axis.
Gastrectomy: Removal of part of the stomach, e.g. to remove a tumor.
Gastropexy: Suturing the stomach to the wall of the abdomen, in order to prevent the stomach from twisting.
Gastrotomy: Cutting into the stomach, e.g. to remove a foreign body.
Hematuria: Blood in the urine.
Hemi-laminectomy: The removal of a portion of the top of a vertebra, most often to remove a slipped disc.
Hip dysplasia: Abnormal growth of the hip, that leads to arthritis & pain.
Histo-pathology: The study of disease by the examination of tissues under the microscope. A veterinarian who specializes in pathology is a pathologist.
Hock: The ankle (same as Tarsus).
Humerus: The bone in the arm.
IVDD: Inter-Vertebral Disc Disease, the classic "slipped disc" of Doxies etc.
Joint tap: Placing a needle in a joint to aspirate joint fluid with a syringe.
JPS (Juvenile Pubic Symphysiodesis): Surgery done to treat hip dysplasia in a young puppy.
Lesion: Any lump or abnormality that may be caused by injury or disease.
Laminectomy: The removal of the top of a vertebra.
Laparotomy: Abdominal surgery.
Laryngeal paralysis: Paralysis of the larynx (voice box) causing difficulty breathing.
Lateral Patellar Luxation: Dislocation of the kneecap (patella) to the outside.  Leads to a dysfunctional knee, arthritis and pain.
Lobectomy: A surgery to remove a lobe (a part) of the lung or the liver.
Lumpectomy: The removal of a "lump" without sacrificing large amounts of tissue around it.
Luxation: Complete dislocation (e. g.: hip).
Lymph node: Small lumps, part of the immune system, located in specific areas. Lymph nodes act as a 1^st line of defense against infection and cancer.
Malignant tumor: A cancerous tumor.  A tumor made up of cancer cells, that can spread to other body parts and/or invade nearby normal tissue.
Malunion: Healing of pieces of a fractured bone in an abnormal position.
Mandible: The lower jaw.
Mandibulectomy: Removal of (part of) the lower jaw.
Mastectomy: The surgical removal of the mammary gland (breast).
Maxilla: The upper jaw.
Maxillectomy: Removal of (part of) the upper jaw.
Medial Patellar Luxation: Dislocation of the kneecap (patella) to the inside.  Leads to a dysfunctional knee, arthritis and pain.
Meniscus: 1 of 2 pads of cartilage in the knee. They can tear or be crushed with an ACL tear.
Meniscal release: Preventive procedure to prevent future tears, done during ACL surgery or TPLO.
Meniscectomy: Removal of (part of) a meniscus after it was torn or crushed.
Metacarpus: The main bone in a front toe.
Metatarsus: The main bone in a back toe.
Metastasis: Spreading of cancer to other parts of the body.
Metastasize: To spread ("to met") from the first cancer site to another organ (often lungs, liver).
MPL: see Medial Patellar Luxation.
MRI (Magnetic Resonance Imaging): A sophisticated test that provides 3-D pictures of organs.
Neoplasia, Neoplasm: A new growth of tissue or cells; a tumor that is often malignant.
Nephrectomy: Removal of a kidney.
Nephrotomy: Cutting into a kidney, e. g. to remove a stone.
Non-union: Fracture where the pieces of a fractured bone do not heal or fuse.
OCD (Osteo-Chondritis Dissecans): Flap of cartilage that does not fuse with the bone.
Oncologist: A veterinarian who specializes in cancer diagnosis and treatment.
Oncology: The study and treatment of cancer.
Open fracture: Fracture with an open wound in the skin.
Ostectomy: Removal of (part of) a bone.
Osteotomy: Cutting a bone. The "O" in TPLO stands for Osteotomy.
Osteoarthritis: Similar to Arthritis.
Palliative treatment: Treatment to relieve pain & symptoms of a disease without the hope for a cure.
Paraparesis: Back leg weakness.
Paraplegia: Back leg paralysis.
Patellar Luxation: Dislocation of the kneecap (patella). Can be medial (slips to the inside) or lateral (slips to the outside).
Pathology (Histo-pathology): The study of disease by looking at tissues under a microscope. A vet who specializes in pathology is a pathologist.
Pheochromocytoma: A tumor of the adrenal gland.
Platelet: Cells in the blood that are responsible for clotting.
Polyp: A growth of tissue protruding into a body cavity, such as an ear or rectal polyp. A true polyp is benign.
Primary tumor: The original cancer site.
Prognosis: The projected outcome of a disease or condition.
Pyometra: Infection of the uterus. Considered an emergency that needs surgery ASAP.  Preventable by spaying.
Radiation therapy: X-ray or electron beam that damages or kills cancer cells.
Radius: The main bone in the forearm (see Ulna).
Recurrence: The reappearance of cancer after a period of remission.
Resection: Surgical removal of a tumor or mass.
Rhinotomy: Cutting into the nose.
Scapula: The shoulder blade.
Seroma: A pocket of liquid (serum) under an incision.
Side effects: Undesirable adverse effects of a drug.
Splenectomy: Removal of the spleen.
Subluxation: Partial dislocation (e. g. in the hip).
Synovial fluid: The joint fluid. Normally clear, thick & in small amounts.
Systemic disease: A disease that affects the whole body instead of one organ.
Tarsus: The ankle (same as Hock).
TECA: Total Ear Canal Ablation.
Tetraparesis: Weakness in all 4 legs.
Tetraplegia: Paralysis of all 4 legs.
THR (Total Hip Replacement): Surgery that replaces all parts of the hip, in order to treat hip dysplasia.
Thoracocentesis (Chest tap): A procedure to remove air or fluids from the chest.
Thoracotomy: Chest surgery.
Thoracostomy tube (Chest tube): A plastic tube placed into the chest to evacuate air or fluid.
Thorax: The chest.
Thyroidectomy: Removal of a thyroid gland.
Tibia: The main bone in the leg (see Fibula).
Total Ear Canal Ablation (TECA): Removal of the inside cartilage of the ear canal to treat severe infections (Cockers...) or tumors.
TPLO (Tibial Plateau Leveling Ostectomy): Surgery to cut and turn the top part of the tibia (shin bone), then apply a metal plate to address an ACL tear.
TPO (Triple Pelvic Ostectomy): Surgery to cut and turn the pelvis part of the hip, to treat hip dysplasia, usually in a puppy.
Tumor: An abnormal overgrowth of cells. Tumors can be benign or malignant.
UAP (Ununited Anconeal Process): Piece of bone that never fuses with a bone in the elbow (part of elbow dysplasia).
Ulna: The small bone in the forearm (see Radius).
Ultrasound: The use of sound waves, usually to diagnose a condition, mostly in the belly or the chest.  Can help taking a biopsy.
Valgus: A joint bent outward (most often the wrist).
Varus: A joint bent inward (most often the ankle).