Cardiology

What is a board-certified veterinary surgeon?

The term “ACVS Diplomate” refers to a veterinarian who has been board-certified by the American College of Veterinary Surgeons in veterinary surgery. Although any veterinarian may use the term “surgeon”, only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called “specialists” or “board-certified” in veterinary surgery. In addition to completing undergraduate and veterinary degrees, veterinarians wishing to become board-certified in surgery must complete a three-year surgery residency program, meet specific training and caseload requirements, perform research and have their research published. This process is supervised by current ACVS Diplomates, ensuring consistency in training and adherence to high standards. Once the residency has been completed, the resident must sit for and pass a rigorous examination–only then does the veterinarian earn the title of ACVS Diplomate.

Do I need a surgeon who is board certified?

Advances in animal health care have led to a wider variety of treatment options, including highly specialized surgical procedures. Board-certified surgeons spend at least four years after achieving their veterinary medical degree (DVM) being trained by other board-certified specialists in Surgery, Radiology, Pathology, and Internal Medicine with a strict focus on diagnosing and treating surgical diseases in small animals. This concentrated training in surgery allows the ACVS Veterinary Surgeon to keep current with frequent advances in veterinary medicine. Ask your veterinarian if your pet would benefit from a specialist.

Does a consultation always lead to surgery?

Board-certified surgeons have specialized training in diagnosing and treating challenging soft tissue and orthopedic diseases. During your initial consultation, the veterinary surgeon will review your pet’s clinical history, previous test results and treatments, and the clinical course of your pet’s disease. The surgeon will then perform a thorough physical exam of your pet. Following this review, the surgeon will make recommendations. The recommendation may be to proceed directly with surgery but may also include additional diagnostic tests, medical treatment regimens, animal rehabilitation sessions (physical therapy) or a wait-and-watch approach. Occasionally surgery is not the best immediate or long-term option for your pet based on the comparative risks and expected benefits. Your consultation with the veterinary surgical specialist is the most comprehensive way to make this assessment. Your pet will not proceed to surgery until both you and the surgeon are comfortable with the recommended treatment plan.

How is surgical pain managed?

Our practice philosophy is to minimize distress associated with care and treatment of your pet. This includes the use of surgical methods designed to maximize the beneficial effect of surgery with the least possible morbidity and invasion of normal tissues. Examples include the use of arthroscopy, laparoscopy, radiograph-guided procedures, alternative materials (such as titanium), and alternative techniques (such as TTA, TPLO, PAUL and PGR procedures, and ALPS fracture fixation).

Even with these lower morbidity methods, some degree of inflammation and discomfort is expected. We treat anticipated surgical pain preemptively by using multi-modal perioperative analgesia. This often includes the use of epidural analgesia and anesthesia as well as specialized local nerve blocks. The epidural injection is done while your pet is under general anesthesia prior to the start of the surgical procedure and aids in the reduction of the required depth of general anesthesia (and associated depth-related anesthetic risks). In addition, the effect of the epidural injection may reduce post-surgical pain up to 24 hours after the procedure thus limiting pain “wind-up”.

Post-surgical pain and any distress are managed 24 hours per day by doctors in the hospital who are well versed in analgesic and sedative protocols.

At the time of your pet’s discharge from the hospital you will receive post-operative instructions describing signs of pain or discomfort and explaining treatment options, including pain medications and indicated complementary therapies such as icing and massage.

Pain management is complemented by post-operative treatments by our animal rehabilitation service.

What is the typical recovery time for my pet following surgery?

The time expected for your pet to recover from surgery will vary significantly based on the specific disease or injury, the surgery performed, and other potential complicating factors such as pre-existing osteoarthritis or endocrine disorders (e.g. diabetes, Cushing’s disease). These expectations will be specifically discussed at the time of your initial surgical consultation and will be further discussed at the time of patient discharge.

Most perioperative surgical inflammation and its associated swelling, bruising, and discomfort will improve rapidly in the first post-operative week.

Healing from orthopedic procedures may take several weeks, and full return of function may occur over several months depending on the disease or injury, the procedure, and post-surgical rehabilitation.

If at any time your pet does not seem to be recovering at the rate or to the degree expected, please call us or recheck for an evaluation.

What restrictions will be placed on my pet during the recovery period?

Typically surgical incisions will heal in one to two weeks. During this time, you may be instructed to prevent your pet from chewing or licking the incision by using a bandage or a restrictive collar. This is usually the surest way to reduce the risk of post-surgical incision infection or dehiscence (opening of the surgical wound).

Post-surgery confinement of your pet, either in a kennel or in a small room, may be required when your pet is not under your direct supervision. This confinement may be necessary to allow the appropriate healing of the surgical repair.

Who takes care of my pet overnight following surgery?

In most cases an overnight stay is recommended to ensure a safe and comfortable recovery from anesthesia, to ensure there is adequate pain control as needed, to provide attentive nursing care to the surgery site, and to keep your pet clean and comfortable. Most patients that require surgery stay overnight and can go home once they are ready the next day. Some surgeries may require a few days of post-operative hospitalization. The surgeon will advise you prior to surgery how long to expect your pet to be hospitalized. While hospitalized, your pet will receive 24-hour care from BBVSH veterinarians and technicians. There is a veterinarian in the hospital 24/7/365.

How do I make a Surgery appointment?

Boundary Bay Veterinary Specialty Hospital strongly encourages animal owners to obtain a referral from their regular veterinarian whenever possible. This ensures the proper transfer of medical information, is beneficial to the animal and the specialty veterinarian, and will help your companion receive the appropriate care.

Once your veterinarian has sent a referral, we will contact you to set up an appointment. If you have not heard from us within 24 hours of your veterinarian sending a referral, please contact a client care representative at 604-514-8383.

If you need guidance, are unable to obtain a referral, or do not have a veterinarian, please contact a Boundary Bay Veterinary Specialty Hospital client care representative at 604-514-8383.

When are Surgery appointments available?

Surgery appointments are available 7 days per week. Please contact the surgery service at 604-514-8383 if you have questions about an appointment with one of the surgeons.

In case of an emergency: Should your pet become more ill or require immediate intervention before your appointment, please contact our hospital and we can see you on an emergency basis through the emergency service.

Initial (first) surgery consultation:

What is the cost of an appointment?

The initial consult fee is $180.00 plus tax. Once your pet has been examined and you have had a discussion with the Surgeon regarding diagnostic and treatment options, you will be presented with an itemized treatment plan for the options presented to you. You may accept or decline any option.

What should I bring to my initial surgery appointment?

Please bring your pet and any current medications. Your family veterinarian should have provided records prior to your visit. However, it is a good idea to bring an extra copy of your pet’s records just in case.

Please bring any radiographs (x-rays) that have been performed. It is acceptable for your family veterinarian to send digital x-rays/radiographs prior to your visit. If your primary care veterinarian sends the radiographs electronically, please call the day before the appointment to ensure we have received the files.

How long is the appointment?

Your initial appointment may take up to an hour. However, please prepare to spend 1-3 hours at the hospital, as additional tests and possible sedation (and time for recovery) may be required. We respect your time and will do our best to complete the consultation in a timely manner. Please be aware that the surgeons may occasionally be delayed due to emergency cases. If you do have time restrictions, please make us aware so that we can accommodate your schedule. We are often able to perform procedures such as biopsies, x-rays and surgeries the same day as your appointment, in which case you may be leaving your pet with us for a day procedure or overnight for a surgery. If you are travelling from a long distance, please make us aware at the time you make your appointment so that we may do our best to accommodate same-day diagnostics or procedures.

Does my pet need to be fasted for surgery appointments?

Please do not feed your pet after midnight the night before your appointment; it is ok to give your pet water up until the appointment. Please call for instructions if your pet is diabetic, younger than 4 months, or less than 4kg (10 pounds).

Should I bring my pet’s medications?

Please bring to your appointment any medication(s) that your pet is currently taking. When making your pet’s appointment, check whether or not to give any medication that is due the morning of the appointment.

My pet is on a special diet; should I bring the food?

Meals are included in your pet’s hospitalization. However, if your pet requires a special diet, please bring enough for at least two meals. Due to the risk of serious infections, hospital policy requires that you do not bring any raw food.

What should I expect during my initial surgery appointment?

When you arrive for your appointment, please check in with Reception. The receptionist will then advise the surgery service that you have arrived. To start the appointment, an assistant or technician will bring you into an exam room with your pet, complete a history form, and perform a check of all your pet’s vital signs (such as heart rate, temperature, etc.). The surgeon will review the information, discuss your pet’s condition with you, and examine your pet. Once this is complete, the surgeon will go over the diagnosis, any further testing that may be required to reach a diagnosis, and treatment options. Each option will be thoroughly explained so that you can make an informed choice for your pet.

Treatment plan estimate and deposit:

A treatment plan will be prepared for you based on your pet’s specific needs. The treatment estimate will be explained and authorized by you prior to surgery and/or hospitalization. You may accept or decline any diagnostic or treatment options. A deposit of 75% of your estimate is due at the time of surgery; the remainder of the invoice must be paid at the time of discharge.

Overnight or home the same day:

Most patients that require surgery stay overnight and can go home once they are ready the next day. Some surgeries may require a few days of post-operative hospitalization. The surgeon will advise you prior to surgery how long to expect your pet to be hospitalized. While hospitalized your pet will receive 24-hour care from the Boundary Bay Veterinary Specialty Hospital veterinarians. Visits the day of surgery are discouraged (except in the most critical patients) as the stimulation of a visit may result in the need to give additional sedation. The surgeon will call you to give an update following surgery and you are welcome to call in to the hospital overnight for an update if you wish. For patients staying more than one night in the hospital, you are welcome to arrange a time to visit. You will be able to relax, read a book, and visit in our comfortable quiet room. We ask that you call to arrange your visit in advance to avoid busy times.

Primary care veterinarian updates:

So that your family veterinarian will be kept up to date regarding your pet’s condition and care, we will provide your vet with a summary of your pet’s visit including copies of medical records and tests performed.

Suture/Staple removal appointments:

What should I expect for my suture/staple appointment?

Suture removal schedule:

After surgery, most patients require suture/staple removal 10-14 days after surgery. The timing will be discussed during your consult and will be confirmed at the time you take your pet home (discharge). If possible, please make your suture removal recheck appointment with Boundary Bay Veterinary Specialty Hospital as the surgeon would like to evaluate your pet’s progress and ensure healing is progressing as expected. Many procedures will receive additional follow-up instructions at the suture removal recheck. If you are unable to see us within the specified time frame for suture removal, please arrange to have the sutures/staples removed by your family veterinarian. If you choose to do this, please call us with an update and to determine if you should schedule an additional appointment for the surgeon’s evaluation and further instructions.

Length of the suture/staple removal appointment:

Your pet’s suture appointment will take approximately 30 minutes, as the surgeon will need to briefly examine your pet’s progress.

Cost of suture/staple removal:

There is no charge for your pet’s suture/staple removal visit. There will however be an additional charge if there is a need for medications, sedation, additional tests, and bandage changes.

During your recheck examination:

What should I expect at a recheck appointment?

Recheck schedule:

After your pet’s first consultation or surgery, follow-up appointments may be required. When your pet is discharged, we will provide you with a schedule of when to return for recheck appointments.

Fasting for rechecks:

Please do not feed your pet after midnight the night before your appointment; it is ok to give your pet water up until the appointment. Please call for instructions if your pet is diabetic, younger than 4 months, or less than 4kg (10 pounds).

Length of a recheck appointment:

Your recheck appointment will last approximately 45-60 minutes, but please prepare to spend at least 1 hour at the hospital. Patients that require sedation may take longer to accommodate time to recover from sedation before leaving. We respect your time and will do our best to complete the consultation in a timely manner. Please be aware that the surgeons may occasionally be delayed due to emergency cases. If you do have time restrictions, please make us aware so that we can accommodate your schedule.

How the recheck appointment works:

When you arrive for your appointment, please check in with Reception. To start the appointment, an assistant or technician will bring you into an exam room with your pet, complete a history form, and perform a check of all your pet’s vital signs (such as heart rate, temperature, etc.). The surgeon will review the information, examine your pet, and discuss your pet’s progress with you.

Cost of rechecks:

Most routine recheck examinations and recheck radiographs are included in the cost of the surgery. If additional treatments such as bandages, medications, or sedation are required, there will be an additional charge.