{"id":97,"date":"2015-02-08T06:00:03","date_gmt":"2015-02-08T10:00:03","guid":{"rendered":"http:\/\/www.drphilzeltzman.com\/blog\/?p=97"},"modified":"2022-07-08T14:42:00","modified_gmt":"2022-07-08T18:42:00","slug":"board-certified-surgeon-day","status":"publish","type":"post","link":"https:\/\/www.drphilzeltzman.com\/blog\/board-certified-surgeon-day\/","title":{"rendered":"What does a board-certified surgeon do all day?"},"content":{"rendered":"<h3>A look back at 2014&#8230;<\/h3>\n<p>The beginning of a new year is a great time to reflect on past accomplishments. For me, as a surgeon, it includes thinking of all the patients we helped and which surgeries we performed.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"2117\" height=\"3176\" class=\"size-medium wp-image-110\" src=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2015\/02\/Dr.-Phil-Zeltzman-cleans-up-a-patient-after-surgery.jpg\" alt=\"Dr. Phil Zeltzman cleans up a patient after surgery\" srcset=\"https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2015\/02\/Dr.-Phil-Zeltzman-cleans-up-a-patient-after-surgery.jpg 2117w, https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2015\/02\/Dr.-Phil-Zeltzman-cleans-up-a-patient-after-surgery-200x300.jpg 200w, https:\/\/www.drphilzeltzman.com\/blog\/wp-content\/uploads\/2015\/02\/Dr.-Phil-Zeltzman-cleans-up-a-patient-after-surgery-683x1024.jpg 683w\" sizes=\"auto, (max-width: 2117px) 100vw, 2117px\" \/><\/p>\n<p>Why should you care? Because this little exercise can make you aware of the most common surgical conditions in cats and dogs.<\/p>\n<p>As one of my professors used to say in vet school, \u201cCommon diseases are common.\u201d What this means is that most of the time, statistically speaking, your pet\u2019s diagnosis is going to be straight forward.<\/p>\n<p>This list can empower you to figure out what your pet\u2019s problem may be. I\u2019ve had clients correctly diagnose their pet with an ACL tear or laryngeal paralysis!<\/p>\n<h4>So here are my top 10 surgeries in 2014.<\/h4>\n<ol>\n<li>TPLO &amp; TTA<\/li>\n<li>Belly surgery<\/li>\n<li>Fractures<\/li>\n<li>Tumor removal<\/li>\n<li>Joint dislocations<\/li>\n<li>ACL \u2013 nylon repair<\/li>\n<li>Perineal urethrostomy<\/li>\n<li>Laryngeal paralysis<\/li>\n<li>Hernias<\/li>\n<li>TECA<\/li>\n<\/ol>\n<h4>Let\u2019s go over these surgeries in more detail<\/h4>\n<ol>\n<li><strong>ACL\u00a0SURGERY<\/strong><br \/>\nIt never fails, ACL surgery remains the most common surgery I perform, mostly in dogs, and occasionally in cats.\u00a0 There are reportedly 100 ways to fix an ACL.\u00a0 We\u2019ve talked many times about ACL surgery, so let\u2019s keep it short.<br \/>\nI have tried several techniques over the years, and now use mostly three: the \u201ctraditional\u201d technique with heavy nylon sutures can be used in dogs and cats. In some dogs, the TPLO (Tibial Plateau Leveling Osteotomy) and the TTA (Tibial Tuberosity Advancement) are additional options that typically gives great results.<br \/>\nThese days, TPLO is THE most common surgery I perform.<\/li>\n<li><strong>Belly surgery<\/strong><br \/>\nBelly surgery or \u201cexploratory laparotomy\u201d can be necessary for a number of reasons. The most common reason in 2014 was to remove all kinds of foreign objects: toys, string, hair ties, pieces of a yoga matt, a foam ear plug, a trichobezoar (Harry Potter fans may know this is a hair ball), a sock, pieces of a basketball, an acorn etc.<br \/>\nOther common reasons included removing body parts (gallbladders, benign or cancerous masses), taking biopsies, removing bladder stones, etc.<br \/>\nSome cats had their colon removed because of a condition called megacolon. This is the only reasonable option then cats are so severely constipated, that the colon has become a useless bag of rock-hard poop. At that stage, medications are a waste of time and money. Procrastinating to move on with surgery invariably leads to a much worse anesthesia candidate. These cats may go from otherwise healthy to skinny and unhealthy. Not to mention the fact that they suffer from untreatable constipation.<br \/>\nA few wise clients who knew their dog is at risk for \u201cbloat\u201d (stomach twisting) wanted a preventive procedure performed, called a prophylactic gastropexy.\u00a0 By tacking the stomach to the inside of the belly, we can prevent the twisting of the stomach.\u00a0 It is a life-saving procedure that should be considered in Great Danes (the #1 breed for this disease), German shepherds, Labs and several other large dog breeds.<\/li>\n<li><strong>Fractures<\/strong><br \/>\nMany pets surprised their owners and escaped through an open door or an open gate. Most got hit by a car. Others were hit by their owner\u2019s car \u2013 always a horrible situation. Some were on a leash but ran after something (a dog, a truck etc) and either the (loose) collar slipped off the dog\u2019s neck, or an \u201cextendable\u201d leash offered no control.<br \/>\nA large number of pets are victims of falls.\u00a0 They fell from their owner\u2019s arms, from the couch, from the bed, in the stair etc.\u00a0 We have also seen a number of pets who had a fracture after someone fell on them.<br \/>\nPrevention is possible in most cases: use a (tight) leash, make sure the collar is tight enough, close the door to the outside, lock the gate, and know where your pet is when you drive out of the garage. Oh, and neuter you male pets: many pets with broken bones are not neutered, so they are much more likely to roam and get in trouble.<\/li>\n<li><strong>Tumor removal<\/strong><br \/>\nThis list is sadly endless: in and under the skin, in the chest or on the heart, in the bone (legs, pelvis, jaw\u2026), in the liver, on the stomach, in the intestine, on the bladder\u2026<br \/>\nThankfully, not all tumors are cancerous, and we\u2019ve removed many benign masses.<\/li>\n<li><strong>Joint dislocations<\/strong><br \/>\nWe\u2019ve dealt with virtually every joint dislocation: the shoulder, the elbow, the wrist, the hip, the knee and the ankle!\u00a0 Some are traumatic, some are congenital (i.e. the pet was born that way).<br \/>\nThe most common one is the kneecap dislocation.\u00a0 The kneecap slides out of the groove where it is supposed to live, at the bottom of the thigh bone (or femur). It is common in dogs, and we\u2019ve seen quite a few kitties with that condition last year.<br \/>\nIn some cases of hip dislocation, or because of hip dysplasia, we may need to perform a Femoral Head Ostectomy (FHO). The \u201cball\u201d of the hip (femoral head) is removed during surgery.\u00a0 FHO is also done in pets with a hip fracture or deterioration of the bone (e.g. Legg Perthes disease in tiny dog breeds).<\/li>\n<li><strong>Standard ACL repair<\/strong>:<br \/>\nsee # 1 above.<\/li>\n<li><strong>Perineal urethrostomy<\/strong><br \/>\nPerineal urethrostomy (or in short a P\/U) is performed in cats who have had a urinary blockage several times. The idea is to remove the end of the urethra (aka the penis) and stitch up the lining of the urethra to the skin in order to end up with a much wider opening. It may sound weird, but it typically works very well.<\/li>\n<li><strong>Laryngeal paralysis<\/strong><br \/>\nDogs, mostly Labs, can have a condition that paralyzes their larynx, a.k.a. voice box, and causes them to suffocate. It\u2019s an incredibly stressful condition. Fortunately, surgery (a \u201ctie back\u201d) allows them to have a wider airway, which typically works very well.\u00a0 These patients quickly go from suffocating to being able to breathe comfortably.<br \/>\nTraditionally, we see most \u201clar par\u201d patients in the summertime, when the heat and humidity make their condition worse. What I\u2019ve noticed in the past 2 years, is that we have performed this surgery several times in the winter (November, December).<\/li>\n<li><strong>Hernias <\/strong><br \/>\nA hernia is a condition where an organ ends up where it shouldn\u2019t be. There are several types of hernias.<br \/>\nA perineal hernia is a condition where organs (mostly fat, occasionally intestine or even the bladder) slip through weakened muscles in the pelvis, and slide along the rectum.\u00a0 The end result is a bulge on the side (or sometimes both sides) of the anus.<br \/>\nWhy are the muscles weakened? Most of the time, the condition happens in unneutered dogs (rarely in females and neutered dogs).\u00a0 Therefore, we think that in most patients, testosterone from the testicles causes some muscles in the pelvis to shrink.<br \/>\nThe best prevention is to neuter male dogs early in life.<br \/>\nDiaphragmatic hernia is a condition that most commonly happens after a pet is hit by a car. Organs from the belly slip through a rent in the diaphragm and end up in the chest. Surgery involves putting organs back in the belly and carefully stitching up the diaphragm.<\/li>\n<li><strong> TECA<\/strong><br \/>\nTotal Ear Canal Ablation (TECA) is the best solution for dogs (most often Cockers) who have repeated ear infections. Those can be very painful and some of these dogs become head shy or even aggressive.<br \/>\nSadly, many of these dogs are treated, sometimes for years, with medications, which can\u2019t even go down into the ear canal because it has become so swollen.<br \/>\nTECA is an invasive procedure, with possible complications, which fortunately works very well in the majority of patients.<\/li>\n<\/ol>\n<p>Remembering some of the surgeries we\u2019ve performed in 2014 is also a way to give credit to the wonderful vets, nurses, and pet owners who have been caring for them.<\/p>\n<p>Until next time,<\/p>\n<p>Phil Zeltzman, DVM, DACVS, CVJ<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A look back at 2014&#8230; The beginning of a new year is a great time to reflect on past accomplishments. For me, as a surgeon, it includes thinking of all the patients we helped and which surgeries we performed. Why should you care? Because this little exercise can make you aware of the most common [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-97","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.0 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>What does a board-certified surgeon do all day? | Dr Phil Zeltzman\u2019s Blog<\/title>\n<meta name=\"description\" content=\"The beginning of a new year is a great time to reflect on past accomplishments. 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He performs specialized orthopedic, neurologic, cancer, and soft tissue surgeries on dogs, cats, and small exotics at your family vet\u2019s hospital. After graduating in 1993 from the School of Veterinary Medicine at the University of Liege in Belgium, Dr. Zeltzman simultaneously worked as a general practitioner, emergency vet, and journalist for three years in his native city of Paris, France. He completed a one-year internship at the University of Georgia, followed by a three-year surgery residency at Surgical Referral Service in Buffalo Grove, Illinois. He then worked as a surgeon for four years at a surgical practice in Cincinnati, Ohio, and an additional four years at a surgical practice in Whitehall, Pennsylvania. He is a board-certified surgeon and a Diplomate of the American College of Veterinary Surgeons, a coveted professional achievement Dr. Zeltzman is also a certified surgeon for the tibial plateau leveling osteotomy (TPLO), having performed thousands of these procedures in dogs from less than 30 pounds to more than 250 pounds! The results of his work have been very impressive. Dr. Zeltzman\u2019s interests include all aspects of soft tissue, orthopedic, cancer, reconstructive, and neuro surgery, as well as physical therapy and emergency cases. He also has a strong interest in the prevention and treatment of obesity. His newest endeavor is stem cell therapy for arthritis, kidney disease, liver disease, and inflammatory bowel disease (IBD), as well as tibial tuberosity advancement (TTA). Dr. Zeltzman knew he wanted to be a veterinarian since the age of 5 when his favorite TV shows were Flipper, Daktari, and Lassie. \u201cBecoming a veterinary surgeon has been a dream come true, and I am as passionate about my profession as I was when I first started,\u201d he says. In practice, Dr. Zeltzman\u2019s goal is to offer the best surgical care, the safest anesthesia, and the utmost pain management to all of his patients. Actively involved in teaching, lecturing, and publishing, both locally and internationally, Dr. Zeltzman has published two books: Cocker Spaniels: A Practical Guide for People Owned by a Cocker and Walk a Hound, Lose a Pound, a book on weight loss for both dogs and people, co-written with Rebecca Johnson. He also writes a monthly award-winning newsletter for true dog and cat lovers. It is read in all 50 States, as well as more than 40 foreign countries. This newsletter has evolved into his blog. As a Certified Veterinary Journalist (CVJ), blogger, columnist, and award-winning author, his goal is to write meaningful articles, newsletters, and books that will make a difference in the lives of pets and their owners. He has published numerous articles in national and international veterinary journals, and is currently working on several book projects. He is also a prolific speaker. Dr. Zeltzman is a member of the Cat Writers\u2019 Association, the Dog Writers\u2019 Association and the Authors\u2019 Guild. He is a member of the American Veterinary Medical Association (AVMA), the Lehigh Valley Veterinary Medical Association (LVVMA), and the American College of Veterinary Surgeons (ACVS). 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He performs specialized orthopedic, neurologic, cancer, and soft tissue surgeries on dogs, cats, and small exotics at your family vet\u2019s hospital. After graduating in 1993 from the School of Veterinary Medicine at the University of Liege in Belgium, Dr. Zeltzman simultaneously worked as a general practitioner, emergency vet, and journalist for three years in his native city of Paris, France. He completed a one-year internship at the University of Georgia, followed by a three-year surgery residency at Surgical Referral Service in Buffalo Grove, Illinois. He then worked as a surgeon for four years at a surgical practice in Cincinnati, Ohio, and an additional four years at a surgical practice in Whitehall, Pennsylvania. He is a board-certified surgeon and a Diplomate of the American College of Veterinary Surgeons, a coveted professional achievement Dr. Zeltzman is also a certified surgeon for the tibial plateau leveling osteotomy (TPLO), having performed thousands of these procedures in dogs from less than 30 pounds to more than 250 pounds! The results of his work have been very impressive. Dr. Zeltzman\u2019s interests include all aspects of soft tissue, orthopedic, cancer, reconstructive, and neuro surgery, as well as physical therapy and emergency cases. He also has a strong interest in the prevention and treatment of obesity. His newest endeavor is stem cell therapy for arthritis, kidney disease, liver disease, and inflammatory bowel disease (IBD), as well as tibial tuberosity advancement (TTA). Dr. Zeltzman knew he wanted to be a veterinarian since the age of 5 when his favorite TV shows were Flipper, Daktari, and Lassie. \u201cBecoming a veterinary surgeon has been a dream come true, and I am as passionate about my profession as I was when I first started,\u201d he says. In practice, Dr. Zeltzman\u2019s goal is to offer the best surgical care, the safest anesthesia, and the utmost pain management to all of his patients. Actively involved in teaching, lecturing, and publishing, both locally and internationally, Dr. Zeltzman has published two books: Cocker Spaniels: A Practical Guide for People Owned by a Cocker and Walk a Hound, Lose a Pound, a book on weight loss for both dogs and people, co-written with Rebecca Johnson. He also writes a monthly award-winning newsletter for true dog and cat lovers. It is read in all 50 States, as well as more than 40 foreign countries. This newsletter has evolved into his blog. As a Certified Veterinary Journalist (CVJ), blogger, columnist, and award-winning author, his goal is to write meaningful articles, newsletters, and books that will make a difference in the lives of pets and their owners. He has published numerous articles in national and international veterinary journals, and is currently working on several book projects. He is also a prolific speaker. Dr. Zeltzman is a member of the Cat Writers\u2019 Association, the Dog Writers\u2019 Association and the Authors\u2019 Guild. He is a member of the American Veterinary Medical Association (AVMA), the Lehigh Valley Veterinary Medical Association (LVVMA), and the American College of Veterinary Surgeons (ACVS). 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