During anaesthesia, monitoring (checking vital parameters) is carried out systematically. It allows the cardiac and respiratory function to be monitored, as well as the body temperature. After being anaesthetised, all our patients are intubated and they are kept under anaesthetic using gases. Depending on the circumstances, they may breathe by themselves or may be assisted by a respirator.
Post-operative infection prevention is safeguarded through the separation of premises and their respective ventilation systems being kept separate from other areas. Single-use linens and systematic autoclave sterilisation are used. The use of antibiotics is strictly monitored and adapted to each case. It is not surprising that in most cases, there will be no prescription for antibiotics when you pick up your animal.
Is it essential to operate? Are there other options ?
Before any surgery takes place, you will meet a vet for a consultation. It is vital to discuss the surgical indication with you.
The preoperative report and the imaging examinations are therefore indispensable. This consultation is also the time for us to explain the different options available to you and their potential risks, as well as their cost. This is when we will be able to answer any questions you may have.
For a surgical intervention to take place under the best possible conditions, it must be part of an overall approach in collaboration with other medical disciplines. An evaluation of the specific clinical situation for your animal is essential, prior to the surgical decision being taken. The assessments are carried out in collaboration with the veterinarian treating your animal. They allow the different therapeutic options to be identified in order for them to be explained to you, and for the most appropriate solution to be chosen.
Once the surgical decision has been taken, your animal will be looked after by the surgical team and prepared for the intervention, the operation and post-operative hospitalisation. Surgical activity at Oncovet is organised in such a way as to offer your animal optimised hygiene, security and monitoring.
What about pain ?
Pain relief is always included. For this purpose, following preoperative sedation, patients routinely receive treatment using a molecule from the morphine family. If required, anaesthesia is completed through the administration of anti-inflammatories and a local anaesthetic (nerve blocks). The immediate post-operative period is crucial for the success of the follow-up treatment. Monitoring signs of pain, reanimation if necessary and rapid intake of nutrition are all key factors for good recuperation.
During this period, we will keep you and your vet up to date with information concerning your animal’s illness. Each day, we will contact you to give you information concerning your pet. Visits are, of course, permitted (12:00 to 17:00 daily). They are arranged with our administrative office so that we are able to welcome you as comfortably as possible. These visits are approved by the surgical team and do not involve direct discussion with the surgeon, who will be in the operating room during the visiting hours.
- Unless it is an emergency, your animal must not eat or drink from the evening before the procedure onwards;
- If the animal is receiving medical treatment, it is always best to ask us about the best time to administer the last treatment, and always ensure that you let us know about it;
- Once your animal has been discharged, involved instructions are sometimes given (e.g. taking your animal to your veterinarian...). It is very important to follow these instructions, as they are specifically adapted to your animal, on a case-by-case basis;
- Generally, your usual veterinarian will monitor your animal’s wound. However, sometimes, for complex surgical wounds (skin reconstruction, radiotherapy treatment), you will be asked to have the wounds monitored by an Oncovet surgeon.
Oncological surgery for dogs and cats
What is oncological surgery?
Oncological surgery is a surgical discipline in its own right which solely applies to tumours. It involves the handling of the cancerous tissue, dissection techniques, hemostasis (bleeding management) which are different from other surgeries, with the aim of minimising the spread of cancerous cells and facilitating the complete excision of the tumour (tumour removal). This is one of the steps in treating cancer. In theory, all dogs and cats affected by cancer may require surgical intervention, whether this involves a biopsy to confirm a diagnosis or a definitive surgical treatment. Both before and after the surgical intervention, the surgeon must work in collaboration with other medical disciplines (general and oncological medicine, medical imaging, histopathology...) in order to respond to vital questions: What are we fighting against (type of cancer, recurring cancer) ? How has it progressed (localised or generalised cancer) ? How aggressive is it (determine whether the cancer will recur/metastasise) ?
Different surgical options can present themselves as far as tumour excision is concerned: intra-lesional surgery (within the cancerous tissue), marginal surgery (near to the cancerous tissue), more extensive surgery (far away from the cancerous tissue) and radical surgery (very far from the cancerous tissue, with amputation as an example). We therefore understand that surgery is just one step in the diagnosis and/or the treatment of cancer.
All these important steps are aimed at determining the best treatment and therefore the best prognosis for the dog or the cat. Thus, the treatment must not only take into account the tumour but the patient overall, including the owners !
The options that can be considered must be discussed with the persons who are close to the animal on a day-to-day basis: is the treatment palliative or curative ? What will the consequences for the animal be (side effects and complications) ? Could complications delay the auxiliary treatments (chemotherapy or radiotherapy) ? What is the expected budget ? These questions are covered during the pre-surgical consultation.
Poorly planned surgery could have dramatic consequences for the patient. A poor indication may increase surgical complications, promote incomplete excision and tumour recurrence.
Finally, oncological surgery involves specific postoperative management. At the end of the intervention, care related to the condition of the animal with cancer is applied. This may include pain management, nutritional requirements, rehabilitation, and the discussion of histological results: is the excision complete? Is a repeat intervention required? When will the complementary treatments begin?
In conclusion, oncological surgery remains an important step in the treatment of cancer and must be carried out according to the rules for the well-being of the patient in order to achieve the best possible prognosis. It implies positive indications as well as global patient management using a multidisciplinary approach.
What is neurosurgery?
Neurosurgery is a discipline which treats surgical pathologies of central and peripheral neurological tissues, including surgery of the brain, the cerebellum, the spinal cord, the meninges and the nerves. The neurological damage being treated may have occurred previously or may be of low intensity (pain, abnormal gait or behaviour) but may also be acute or intense (convulsions, abrupt paralysis). Neurological problems may originate from various sources: congenital (e.g. deformations), trauma (e.g.: fractures, hernias..), metabolic (e.g. intoxications, vascular...), degenerative, caused by a tumour...Neurological tissues struggle to tolerate intense or extended onslaughts and some pathologies therefore require urgent surgical treatment.
The diagnostic process for a neurological complaint must therefore follow different steps :
- Confirm that the problem is neurological
- Locate the problem within the neurological system
- Estimate the severity and scope of the neurological lesions
- Determine the cause and/or the pathological process
- Estimate the prognosis based on the medical or surgical management.
Complementary examinations are essential to respond to questions concerning localisation, severity and cause. The most frequently occurring examinations are imaging examinations (radiography / myelography, scanner or IRM), the study of the cerebrospinal fluid, the study of electrical signals (electromyography or electroneurography), biopsies...
The results of these complementary examinations will allow the most appropriate treatment to be evaluated, whether medical or surgical.
The most frequently-occuring surgical indications in our pets are :
- for the skull: traumatic fractures, tumours (meningiomas, chondromas, malformations...)
- for the spine: vertebral instability, cervical myelopathy of the tail (Wobbler syndrome), herniated disks, vertebral or perimedullary tumours, arachnoidian cysts, perimedullary hematomas, malformations...
Neurosurgery involves multi-disciplinary management. Different medical services must collaborate beforehand (doctors, oncologists, radiotherapists, imagers..), during (anaesthetists, imagers) and after surgery (neurologists, doctors, radiotherapists..) to offer the patient the best possible care and the best prognosis.
What is orthopaedics ?
Orthopaedics is a surgical specialism which is intended to prevent or correct pathologies affecting the musculoskeletal system (bones, joints, muscles, tendons and nerves). The area of application includes the thoracic and pelvic limbs as well as the spine.
Orthopaedic surgeries require an accurate diagnosis involving a complete clinical examination (rule out or find a general or concomitant pathology), a specific neurological and orthopedic examination. In fact, certain orthopaedic consultations take place in a traumatic context (falling from a height, the patient having been hit by a vehicle).
The priority for admission is therefore to :
- stabilise the patient, who may be in a state of shock
- establish a full report of the injuries (e.g. do not focus on a leg fracture while missing pulmonary contusions or a ruptured bladder)
- establish a diagnostic and therapeutic plan with the owner
- plan the surgical intervention.
With the exception of an obvious or certain diagnosis, additional examinations will be necessary and will sometimes be discussed and carried out in agreement with the owner/referring vet.
It is important to remember that pain management and temporary stabilisation of a fracture are the priority. The surgical procedure in the operating room will be carried out once the patient is stable and able to tolerate an anaesthetic lasting several hours.
Orthopaedic surgery consists of reducing the fracture and stabilising it using implants such as screws, pins, plates or external fixings and sometimes plaster/resin.
Soft tissue surgery
What is soft tissue surgery?
Soft tissue surgery, as opposed to orthopaedic (solid tissus), includes ENT, thoracic, abdominal (gastrointestinal, urogenital, liver ...) surgeries, skin and reconstructive surgeries.
Soft tissue surgery is a treatment option which is discussed on a multi-disciplinary basis (benefits and complications/secondary effects): your vet alongside an oncological vet or doctor or an Oncovet imager will determine the complementary examinations which are required for a precise diagnosis. It is at this point that the surgical option will be discussed by the vet and the owner.
Pain management and hospitalisation are major parameters in ensuring that soft tissue surgery goes well. Multi-modal analgesia (made up of several molecules, which means that toxic doses of a single molecule are avoided) is used. Frequent evaluation of pain during the post-operative period means that it is possible to wean the patient off painkillers progressively over a period of 24-72 hours. During this time, the period of hospitalisation allows us to monitor the response of the organ and the living creature which has been operated on.
“Minimally-invasive” surgeries include modern operating techniques which are highly technical, meaning it is possible to minimise the “surgical invasiveness” experienced by the patient. These procedures involve small incisions or no incisions at all (e.g. tracheal stent). If the aesthetic advantage is clear, the benefit for the patient is to minimise pain, the risk of infection and the difficulty and duration of post-operative care.
Minimally-invasive surgery is carried out for 2 major indications. The first is a diagnostic indication. This involves exploring the organ using a camera in order to take biopsies for bacteriological and/or histological analysis (for example, a thoracoscopy for the thorax, laparoscopy for the abdomen or an arthroscopy to explore the joints). The second indication is therapeutic. It involves an intervention in order to treat the illness (e.g. to remove a fragment of cartilage which is causing problems for a joint).
Oncovet currently offers this type of procedure in the following areas:
- the joints via arthroscopy of the shoulders, elbows, carpal joint, hip, knee and tarsus
- the chest via a thoracoscopy (biopsy of the pleura, lymphatic nodes, lobectomy...)
- the abdomen via a laparoscopy (oophorectomy, liver biopsies...)
- endovascular or endocavitary for cardiac, tracheal or urogenitary illnesses
Ask the advice of your veterinarian or our surgical team to find out the area of application and to consider it for your pet !