Pre-surgical Considerations
A surgeon must keep certain considerations related to the owner, the patient and the surgeon himself in mind before undertaking surgery.
The Owner
The owner is the custodian and provider of the animal’s needs and therefore has a legal right over his/her animal.
A veterinarian is legally answerable to the owner and must inform him/her the disease, proposed surgical treatment and the possible outcome.
The owner must be convinced that everything is being done in the interest of the patient. Therefore, owner-patient-surgeon relationship becomes very important in veterinary profession to maintain a good rapport.
A surgeon must also consider economic aspects of the case, surgical risk involved, ethics and sentiments of the owner.
After weighing each aspect carefully, the surgeon should make a decision and communicate the same to the owner in a confident and convincing tone.
Being unable to communicate and reason, the animal patient submits itself to the surgeon. Therefore, it is the duty of the surgeon to make sure that his patient gets maximum possible attention.
The veterinarian must remember that both animal and human communities expect him/her to be compassionate and considerate; therefore, he/she should live up to their expectations.
He should inform the surgical risk involved. Surgical risk is a subtle line between the good and bad outcome of surgery.
In case of poor risk, chances of complications or death are more, while in good surgical risk, the chances are less. Surgical risk can be minimized and cannot be entirely eliminated.
Unforeseen incidences can lead to untoward results. Therefore, while communicating with the owner, overzealousness must be avoided. A word of caution should always be passed on to the owner and a surgical risk note should be obtained well before hand.
Nevertheless, a surgeon should not have a pessimistic attitude to unnecessarily put doubts in the mind of the owner.
The Patient
It is imperative to properly record the-
- Identification of the patient with name of the owner
- Surgery to be performed
- Exact part to be operated
- Operating wrong patient or performing surgery on a wrong leg in the open yard system will lead to lot of confusion
History of the patient
Since the animal cannot describe the ailment, the information provided by the owner may prove more beneficial. We should gather full information on the history of the animal. This may help us to screen out whether the animal is fit or not for the operation to be performed e.g. In the last half of pregnancy surgery is contraindicated, in heat period particularly in small animals, surgery is also contraindicated.
Information provided by the owner may prove highly beneficial since an animal cannot describe the ailment.
A surgeon should have experience and analytical power to extract valuable information as an owner may provide misleading history.
A simple language without technical terms should be used while extracting information.
An approach of through questioning with tact and generation without irritating the owner may provide better results.
Clinical signs recorded by owner, probable duration of the disease, status of pregnancy, date of last parturition and status of milk yield should be recorded.
Information should also be gained regarding the treatment previously received by the animal.
The conflicting points of history should be sorted out logically to gather reliable information.
Even though history provided by the owner may be useful it is not a substitute for careful clinical examination.
If history and clinical examination are at variance, it is better to depend upon the examination.
Body condition of the patient
The patient must be carefully examined to ascertain whether it is a fit subject for operation, whether it is debilitated or affected with some condition which renders the operation risk greater than usual.
Vital Parameters
Vital Parameters like Temperature, Pulse rate and respiratory rate are recorded. If the animal is febrile, we should postpone the surgical manipulation.
Laboratory examination
Special attention should be given for zoonotic diseases. Some diseases may remain in sub clinical forms. E.g. Chronic anthrax, Leptospirosis and Brucellosis. In the case of neoplastic diseases, before diagnosing whether the neoplasia is malignant or benign surgical manipulation should not be performed.
Economics of the surgical situation
Economics of the surgical situation should also be considered. If the cost of the surgical manipulation exceeds the cost of the animal, surgery may not be performed.
Pre-operative preparations
Pre-operative preparations like starvation of the animal for 24 hours for major surgeries and 12 hours for minor surgeries. Water should be with held for 12 hours in ruminants.