Dr. Phil Zeltzman’s Blog

A LOOK BACK AT 2021…

The beginning of a new year is a great time to reflect on past accomplishments. For me, as a surgeon, it includes thinking of all the patients we helped and which surgeries we performed the most.

This can give you an idea of which surgeries pets are most likely to need…

So here were our top 10 surgeries in 2021.

1. ACL SURGERY

It never fails.

ACL surgery remains the most common surgery we perform, mostly in dogs (and less so in cats).

We have different procedures in our toolbox depending on the patient.

. TPLO (Tibial Plateau Leveling Osteotomy) is THE most common surgery we perform, by far.

. The “traditional” technique with heavy nylon sutures can be used in well-selected dogs (and occasionally in cats).

. The TWO (Tibial Wedge Osteotomy) has come in handy a few times this year in dogs who had implants that prevented doing a TPLO, or who had extremely steep angle at the top of their shin bone.

. TTA (Tibial Tuberosity Advancement).

One size doesn’t fit all here. We don’t see every problem as a nail, and we don’t only have one hammer.

2. Mass removal

We’ve removed masses in and under the skin, in the chest, in the bone (legs, toes, jaws)…

Thankfully, not all tumors are cancerous, and we’ve removed many benign masses.

3. Belly surgery

Belly surgery or “exploratory laparotomy” allowed us to:

. remove foreign objects from the stomach

. remove body parts (gallbladder, spleen, adrenal gland)

. take biopsies

. remove bladder stones, etc.

You can read about bladder stone surgery here:

Matilda and the amazing bladder stones

Some cats had their colon removed because of a serious condition called megacolon. This is the only definitive solution when cats are so severely constipated, that the colon has become a painful giant bag of dehydrated poop. At that stage, medications are a waste of time and money.

Procrastinating to move on with surgery invariably leads to a much worse anesthesia candidate. These cats may go from otherwise healthy to skinny and unhealthy. Not to mention the fact that they suffer from untreatable constipation.

We also performed a number of prophylactic gastropexies, a preventive procedure designed to present stomach twisting in dogs at risk for “bloat.” This life-saving procedure should be considered in Great Danes (the #1 breed for this disease), German shepherds, Labs and several other large dog breeds.

4. Joint dislocations

We’ve mostly treated joint dislocations in the hip and the knee. Some pets had trauma, others were born that way (congenital dislocation).

The most common one is the kneecap dislocation. The kneecap slides out of the groove where it is supposed to live, at the bottom of the thigh bone (or femur). It is common in dogs, and we’ve treated a few cats with that condition last year.

5. Fractures

We’ve fixed fractures in just about every bone this year, mostly the forearm (radius), the shin bone (tibia) and the thigh bone (femur), as well as some toes, the jaw and the arm (humerus).

To fix these broken bones, we’ve used plates and screws, pins, or a device called an external fixator.

Causes of broken bones mostly included jumping, falling or being hit by a car.

6. TECA

Total Ear Canal Ablation (TECA) is the only definitive treatment for dogs (most often Cockers) and cats who have never-ending ear infections. They lead to pain, head shyness and sometimes aggressiveness.

Unfortunately, most of these pets are treated with medications for years, which can’t even go down into the ear canal because it has become so swollen.

We occasionally perform a TECA in pets who had a tumor in the ear.

TECA is an invasive procedure, with possible complications, yet it fortunately works very well in the majority of patients.

7. FHO

FHO (Femoral Head Ostectomy) is used to treat hip dislocations or hip dysplasia.

The “ball” of the hip (femoral head) is removed during surgery.

FHO is also done in pets with a hip fracture or deterioration of the bone (e.g. Legg Perthes disease in small dogs).

8. Laryngeal paralysis

Dogs, mostly Labs, can have a condition that paralyzes their larynx, a.k.a. voice box, and causes them to suffocate. It’s an incredibly stressful condition. Fortunately, surgery (a “tie back”) allows them to have a wider airway, which typically works very well. These patients quickly go from suffocating to being able to breathe comfortably.

You can read about the amazing story of Mae Mae here:

https://www.drphilzeltzman.com/blog/from-florida-to-pennsylvania-mae-mae-the-lab-gets-a-new-lease-on-life-after-tie-back-surgery-for-laryngeal-paralysis/

9. Brachycephalic syndrome

This condition is seen in dogs (and rarely cats) with a flat face, which caused snoring and difficulty breathing: Bulldogs, pugs, Boston terriers, Persian cats etc.

It typically involves 4 conditions:

. The most visible part are stenotic nares (aka tiny nostrils) which prevents getting enough oxygen. Surgery involved making them wider, aka “a nose job” or a rhinoplasty.

. An elongated soft palate. The tip of the roof of the mouth is so long, that it covers the entrance of the windpipe. When it vibrates, it causes snoring. We can shorten it during surgery.

. Saccules are fleshy structures at the beginning of the windpipe. Over time, the saccules can pop out into the airway – and further block the flow of oxygen. We can remove them during surgery.

. A tiny windpipe, which we can’t do anything about.

You can read more about this surgery done on Kasper here:

https://www.drphilzeltzman.com/blog/guess-who-had-a-nose-job-today/

10. Reconstructive surgery

We did multiple surgeries that required reconstructing a body part:

. Cleft palate (or roof of the mouth), which you can read more about here:

https://www.drphilzeltzman.com/blog/squirrel-gets-a-new-lease-on-life-after-cleft-palate-surgery/

. Male cats who could not pee (P/U or perineal urethrostomy).

. A dog’s penis which had a (benign) tumor.

. Hernias, which are a condition where an organ ends up where it shouldn’t be.

Remembering some of the surgeries we’ve performed in 2021 is also an opportunity to give credit to the wonderful vets, nurses, and pet owners who have been caring for them.

Until next time,

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

www.DrPhilZeltzman.com