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Clinical examination prior to elective surgery:

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•  The patient should be stable before a general anaesthetic.

• Any type of skin infection or systemic infection should be treated

• Skin masses that are close to the surgical wound should be tested with fine need aspiration or skin punch biopsy

• A complete blood test will always be required before surgery 

• A brief neurological exam should be performed, especially for fractures such as pelvic or humeral fractures:

  • Withdrawal reflex – a pinch of a toe or the inner digital skin results in a flex of all the joint of the limb

  • Pain reflex- a pinch with fingers or forceps of the skin overlying the toes with the animal in lateral recumbency will generally result in a behavioural response such as vocalising or trying to bite

  • Sacral reflex – a pinch of the skin around the anus will elicit a brief contraction of the anus

  • Monitor urination / defecation

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*a delay or a negative response to a neurologic test could be secondary to inflammation or pain. Moreover, in some humeral fractures, the patient could carry the limb with a dropped elbow and the foot on its dorsal surface miming a nerve injury. In these cases, the neurologic test should be repeated after 5-7 days from the injury.

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Schedule a surgery

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• Full clinical history, radiographs, and lab results are posted by email;

• A phone call or a what's app message is ideal for emergency referrals.

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Radiograph requirements:

 

• Stifle for TPLO

• Elbow

• Hips

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If there is a suspected intra-articular or Salter-Harris fracture, please consider performing radiographs on a contralateral limb for comparison.

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Postoperative monitoring

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In cases of suspected wound infection:

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• Please collect swab for culture and send it to the lab as soon as the infection or wound discharge is detected;

• Start antibiotic treatment as soon as the infection is detected and adjust it according to the lab results;

• In case of open wounds or implant exposure please always bandage the leg;

• Owners will be asked to fill out a  progress form and send videos/photos by email;

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Please contact us in case of any doubts or complications.

 

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Practice requirements

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• Infusion pump

• Basic surgical kit and swabs

• A roll of recent sterile Vetrap for each procedure

• Opioids drugs (Methadone, Morphine, Codeine, Tramadol, Pardale V)

• Bupivacaine in sterile pack (Marcain 0.5%):

• Gabapentin

• Ketamine

• Large spectrum intravenous antibiotic; clavulanate-potentiated amoxicillin (Augmentin) or cefuroxime (Zinacef)