Dr. Phil Zeltzman’s Blog

I asked some surgeon friends what they would tell you if they could sit down with you and have a casual chat around coffee… (tea is allowed).

You can learn a lot from their answers.

There is no sugar-coating here.

I will share their loving, nurturing, bluntly honest tips, then mention their names & locations below. If you ever need surgery for your pet, they are excellent surgeons you can trust.

GENERAL ADVICE

• Dogs are not small people. Cats are not small dogs. Medications used on one cannot always be used safely on the other. Some drugs, given to the wrong patient, can even be deadly.
• If you are not sure about what to do, or if you’re confused about something, or if you forgot what you were told, ASK. There are no stupid questions.
• Your pet may be chubbier than you think. That little bit of chub that you think is hiding under all that fur is more than you realize. It might be cute on a baby, but not on your dog. Thin and fit are essential to a long and healthy life.
• Dr Google is not your friend. A Google search does not replace the years of education and practice needed to become a veterinarian – or a surgeon.
• Don’t be mad at your vet when they give you advice, yet you choose to trust Dr Google or your breeder and things don’t turn out the way you want.
• The receptionists and nurses who support your vet are critical to the function of a pet hospital and the care of your pet. We can’t work without them. Be kind. Treat them with respect. We ALL have your pet’s best interest at heart. That’s the only reason we chose this profession.
• Spay your female pet before the first heat to virtually eliminate the risk of breast tumors. And it will help decrease or eliminate all kinds of bad or expensive diseases.
• Neuter your male dog during puppyhood. It will help decrease or eliminate all kinds of bad or expensive diseases.

AVOIDING COMPLICATIONS

• Surgeons are highly allergic to complications. So we design our postop instructions to minimize the risks to your pet. Our postop instructions are based on science and years of experience.
• Postop care is harder than you want and more important than you realize. We don’t make up recommendations for fun. Or to torture your pet. Or to torture you. They have a purpose and we need you to follow them to reach a happy outcome.
• Why is confinement so critical after a TPLO or a fracture repair? Because if something goes wrong because your pet escapes your care, or because you didn’t follow the rules, the damage could be FAR worse than where we started. And sometimes, the damage is beyond repair… and could require amputation.
• Just because a pet complains about something doesn’t mean that you shouldn’t do it. Just because they don’t like confinement, work, physical therapy or taking pills does it mean they shouldn’t do it. For the same reasons we make kids brush their teeth and take a shower!

Now… also use your judgement.

If your pet hates it when you apply cold or heat, then discontinue it and don’t force it.

If your pet truly hates it when you do physical therapy, then discontinue it, don’t force it, and call your surgeon to try to find out what might be going on.

• Confinement after surgery is not a punishment. It’s a necessity to allow proper healing.
• How does your surgeon choose the duration of confinement? It has to do with how long it takes to heal. In an adult, bone takes 2 months to heal. In a puppy or a kitten, it could take 6 weeks.

It has nothing to do with you or our personal preference. It has to do with Mother Nature.

WHO TO TRUST

• Being a surgeon is different from doing surgery. Many veterinarians do surgery. Very few of us are actually trained as surgeons. Going to a weekend course does not make you a surgeon. Ask tough questions. Do your homework.
• You often get what you pay for. Don’t choose the cheapest option. Then again, don’t believe that the most expensive option is the best one… Choose the best surgeon you can find, based on experience, results and reputation.
• Any surgeon you work with should be willing to answer those 3 simple questions:

– How many times have you performed this surgery?

– What results do YOU get?

– Would you do it on your own pet?

• Being a surgeon does not give us superhuman vision. And NOBODY can give you a diagnosis just by feeling a mass or by looking at it. We need to submit tissue samples to a pathologist to look under a microscope to know what it is. Or we need to take X-rays to see what’s going on inside. Guessing does not help you or your pet.
• The kid at the pet store doesn’t know anything about pet nutrition. Trust your vet.
• Your breeder does not have a veterinary degree. Trust your vet.
• 80% of supplements sold online and at pet stores are complete junk. Trust your vet.

TUMOR REMOVAL

• The first time is the best time. Having someone remove a mass only to find out they didn’t get it all is not a great idea. A second surgery means more expenses for you, more trauma for your pet, and no guarantee that we can get it all the second time around.
• “Just watch it” are the least favorite words of surgeons and oncologists (cancer specialists) alike. Getting cells or tissue samples from a mass to evaluate under a microscope can be the difference between life and death for your pet. Or skip the preop testing, and put the money toward surgery and postop testing.
• Don’t wait until masses are big enough that they bother YOU. Deal with them while they’re small and manageable. Surgery will be cheaper, less invasive and possibly less dangerous if the mass is small.

PETS AND PAIN

• Animals are very good at hiding pain. Remember, in the Wild, animals that show pain get eaten. 

This means 2 things:

– Before surgery, pets will hide their signs and their pain until they just can’t take it anymore.

– After surgery, pain medication should be given as directed by your vet. Don’t stop early, thinking your pet is doing OK because they act normal. Pain meds also decrease inflammation and help rebuild muscles.

• Pets don’t become addicted to pain medications, including morphine-like drugs. Plus, they don’t have thumbs to open the pill bottles…

POSTOP CARE

• Dogs and cats feel better and act like they’re better LONG before they have actually healed. Don’t let those sad eyes trick you into shortening their convalescence period!
• Elizabethan collars (E collars) are used to deter your pet from licking, chewing, scratching or rubbing the incision. Most incision complications are due to self-trauma, ie licking or scratching. Despite the old wives’ tale that dog saliva helps with healing, the truth is that licking, chewing or scratching an incision can lead to skin irritation, infection, pain and prolonged healing if the incision falls apart. Not to mention more fees and more aggravation.
• Leave the E-collar on at ALL times. Your pet will be able to eat and drink and figure out how to get through that doorway eventually! Talk to your surgeon about which style is best for you and your pet’s particular condition.
• Yes, it is OK, and even preferred, for your dog to use the leg after TPLO surgery or a fracture repair. Exactly when they will start to use the leg is tough to predict, but rest assured that if they do use it, it’s because they can.

If you would like to learn how we can help your pet with safe surgery and anesthesia, please contact us through www.DrPhilZeltzman.com 

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Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

SOURCES:

Thank you to my amazing colleagues for their generous contribution:

• Kathy Collins, board-certified surgeon at Veterinary Surgical Services in Rochester and Buffalo, NY.
• Jennifer Wardlaw, board-certified surgeon at Gateway Veterinary Surgery in Saint-Louis, MO.
• Mario Cabrera, surgeon at Cutting Edge Surgical Referrals in Miami, FL.
• Tony Kahn, board-certified surgeon at Anchor Veterinary Surgery in New York, NY.
• Tracy Nicole Frey, board-certified surgeon at SoftSurg in San Diego, CA.
• Jeremiah Moorer, board-certified surgeon at Trek Veterinary Surgery, in Denver, CO.
• I also contributed a few gentle & loving thoughts… Phil Zeltzman, board-certified surgeon in Bethlehem, PA & Harrisburg, PA.