Dr. Phil Zeltzman’s Blog

Most pet owners are not really concerned about surgery.

They’re mostly afraid of anesthesia.

Here are their top 5 concerns, based on multiple conversations with pet lovers.

Note: we will not discuss one classic question here, which was answered in a previous blog:

https://www.drphilzeltzman.com/blog/is-my-pet-too-old-for-anesthesia/

1. Is Anesthesia Safe for My Pet?

Having a pet die under anesthesia is probably the #1 fear of most pet owners.

And we’d be the first ones to tell you that no anesthesia is 100% safe.

Few things in life are.

Driving a car, flying on a plane or eating peanuts in not 100% safe.

The fear of anesthesia is very emotional and somewhat irrational.

It has to do with fear of the unknown.

It probably has to do with the magic of anesthesia.

Think about it.

We put a patient under anesthesia.

We do surgery, – and sometimes very invasive surgery (cutting tissues, removing body parts, putting broken bones together) – while the pet is sound asleep and completely pain free.

And then they magically wake up – all thanks to our amazing nurses.

Maybe not super happy, but overall comfortable.

And after a few hours or a few days, they look like they never had anesthesia.

What we can to help pet these days is truly remarkable!

Yet most clients are terrified of anesthesia.

Science confirms how incredibly safe anesthesia is.

The risk of a pet dying under anesthesia is, on average, under 0.25%.

While every death is an absolute tragedy, this number is incredibly low.

The risk is even lower in healthy patients, and a bit higher in very sick patients.

Still, this number is very low, which means that anesthesia is overall very safe.

2. What Are the Real Health Risks of Pet Anesthesia?

Many pet owners are concerned about how their pet’s preexisting health conditions could affect their ability to handle anesthesia.

Now, that’s a fair concern.

As you can imagine, a pet with severe heart disease, kidney disease, or liver disease, can be affected by anesthesia.

It’s very clear that pre-existing health issues increase the risk of anesthesia, making this a significant concern.

So what do we do to minimize the risks?

. We do a physical exam before any anesthesia and surgery.

. If we detect a mild heart murmur, we can change one of the drugs we use to put a patient under.

We can be more conservative with the amount of IV fluids we give to the patient, so we don’t overload the heart.

Some pets with severe heart disease should have an ultrasound of the heart and may need heart medication.

That would make anesthesia safer.

We require full blood work before any anesthesia and surgery.

If we find out that the patient has kidney or liver disease, we put them on IV fluid first thing in the morning to give their body time to get rid of the toxins before anesthesia and surgery.

Then we rely on the family vet to decide what medications, food, or supplements could support the liver or the kidneys.

3. What to Expect After Anesthesia?

Some pet owners worry about how their pet will recover from anesthesia.

They want to know how long it will take for their pet to wake up, how they will feel afterward, and what to expect during the recovery process.

A. How long will it take for my pet to wake up?

It takes a few minutes to a few hours.

It’s hard to predict, every patient is different.

As you can imagine, a young, healthy pet will usually wake up faster than a senior pet with a serious health condition.

B. How will my pet feel after anesthesia?

We wish we knew!

We don’t know how pets feel after anesthesia.

They refuse to tell us!

It’s probably safe to assume that they feel the same as a human waking up from anesthesia: groggy, spacey, and discombobulated.

The main difference is that pets, unlike humans, have no clue what just happened.

That’s when it’s important to have amazing, loving, caring nurses who can reassure their patients and make the waking part less stressful.

4. Will My Pet Be in Pain After Anesthesia?

Some pet owners are concerned that their pet is in pain during and after anesthesia.

We are extremely aware of this, which is the reason why we are so incredibly generous with pain medications.

Before, during and after our most common surgery, the TPLO (to address a torn ACL), we use about a dozen different types of pain medications!

That’s a lot!

In other surgeries, we use every possible way to fight pain.

For example, we routinely inject a pain-blocking medication near a nerve (similar to what you get at the dentist), under the guidance of an ultrasound.

As we always say, “pain is not acceptable.”

We have made a tremendous amount of progress in the last few years to understand, prevent and treat pain.

We now have access to safe and powerful drugs, and we use them every time we can.

5. What to Expect After Surgery?

Pet owners who haven’t worked with us before probably worry about not fully understanding the surgery, the risks and the postop instructions.

We provide a ton of information so that our pet owners are fully educated before anesthesia and surgery ever happens.

We explain food and water restrictions, which medications to give or not give, and all specific preop and postop instructions.

We communicate via phone, email, video and face-to-face.

We provide written instructions, which we go over line by line, right before a pet goes home.

We always ask “do you have any questions?” several times, until all questions are answered.

So our clients should feel very well prepared before their pet’s surgery.

And if that were not enough, we’re just a phone call away if there’s any additional questions.

We may have done a procedure 1,000 times.

Yet for most pet owners, it’s their first time.

So we educate them step by step, so they are fully prepared.

Hopefully the answers to the top 5 concerns you may have before your pet’s anesthesia and surgery reassured you.

We will do everything we can to ensure a safe and happy outcome.

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

Is my pet too old for surgery?

We often hear this question from pet lovers, and even occasionally from family vets.

What they really mean is: is this pet too old for anesthesia?

Our usual answer is “Age is not a disease,” which is true.

Age is just a number.

We’ve seen extremely sick 5 year old patients, and very healthy 15 year old patients.

Which one do you think is at higher risk for anesthesia?

In addition, all dogs are not treated equal. A 10 year old poodle cannot be treated like a 10 year old Mastiff (we are alluding to the fact that it is said that small dogs live longer than large breeds).

Rather than a blanket, somewhat tongue-in-cheek answer (“Age is not a disease”), the solution to the dilemma is a bit more nuanced.

It’s not so much the age, or the number of years, that matter.

Instead, it’s the consequences of aging that we should focus on, because it makes the patient more “frail”.

What is a frail patient?

In humans, “frailty” is defined as having less “fuel in the tank” and being “easier to be stressed out” (in the medical sense).

Frailty better predicts getting in trouble (or dying) under anesthesia, compared to age alone.

A frail patient will have a tougher time maintaining their heart rate and blood pressure, or staying warm, or breathing well, while under anesthesia.

Their liver and kidneys may be less capable of eliminating toxins (e.g. anesthesia drugs).

Who is considered a senior patient?

• Senior age is tough to tell in a dog, so it is considered to be the last 20% to 25% of the pet’s lifespan.
• Cats are more uniform in size compared to dogs, so they’re considered senior once they turn 10.

So how do we keep senior patients safe?

We take multiple precautions, depending on the particular patient, including:

• smaller drug amount.
• more padding, from the kennel to the OR and back.
• more heat support.
• more oxygen at the beginning and the end of anesthesia.
• conservative amounts of IV fluids to avoid overloading the heart.
• appropriate amounts of pain medications: not too little, not too much.
• overall more TLC, which might include hugs, kisses and handfeeding.

How about anesthesia drugs in older patients?

The general idea is to give as little as needed.

More specifically, we can lower the amount of drugs to put them, and keep them, under anesthesia.

In addition, we sometimes will avoid using a certain type of drugs altogether, depending on the organs affected, such as heart, liver, and kidneys, based on preop exam & blood work results.

And of course, like any of our patients, a senior pet will be closely supervised by one of our amazing nurses, from the very beginning to the very end of anesthesia.

How many senior patients die under anesthesia?

Thankfully, dying under anesthesia is exceedingly rare when all of the above precautions are taken.

In 2008, a gigantic British study (on almost 100,000 dogs and almost 80,000 cats) showed that 0.17% of dogs and 0.24% of cats die under anesthesia.

And you would think those numbers could be even lower today with safer drugs, better protocols and fancier anesthesia monitoring.

A death is always a tragedy, but these numbers are incredibly low when you remember that they combine the absolute healthiest and the absolute sickest of patients.

So remember, it’s not the age of the patient that matters, as much as how sick they are.

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

Pete Baia, DVM, MS, DACVS

I was very fortunate to attend the 12^th Symposium for the International Association of Veterinary Rehabilitation and Physical Therapy (IAVRPT) in Cape Town, in South Africa.

Below are some notes that can be of interest to pet lovers.

I will also intersperse a few nice pictures, with a caption. 

It was an amazing conference, with over 200 people, from all over the world, who dedicate their lives to physical therapy and rehab in pets.

What is a force plate?

I attended a day of “lab” work centered around the use of a force plate.

A force plate is a sensitive platform embedded in a walkway, that objectively measures the weight a patient places on each leg, in order to diagnose subtle lameness and track their progress during rehab.

Vets (mostly surgeons) have said for years that the weight distribution is not 50-50 between the front and back legs. We’ve said it’s 60% in the front, because the front legs “carry” the head, the neck and the chest. And the back legs mostly “carry” the belly, so that’s only 40% of the weight.

Force plate analysis shows that this is a generalization. We just can’t compare the body shape of a mini Doxie, a Bassett hound and a mastiff.

This is important when we talk about the impact of weight loss and leg amputation.

Weight loss benefits the entire body, and now you understand why it helps the front legs even more, since they “carry” more weight.

The speaker, a physical therapist, also explained that seemingly minor things can change the results of force plate analysis: the position of the pet’s head, a wagging tail, turning the head to get a treat, pulling on the leash, wearing a neck collar rather than a harness, etc.

Bottom line: a force plate is very helpful to diagnose a difficult lameness, and we have a lot more to learn!

How to best treat arthritis pain?

I loved a lecture presented by a surgeon, who reminded us that the source of pain in a patient with arthritis is the LINING of the joint.

Therefore, treatments should target the lining of the joint.

We’ve started to inject various products and medications in our patients’ joints, with excellent results.

We started years ago with:

• stem cells 
• PRP (Platelet Rich Plasma), both of which you may have heard of in people.

Now, we also inject:

• collagen (Spryng®)
• steroids (cortisone)
• hyaluronic acid etc.

The results have been very impressive, including in “desperate” cases where nothing else had helped the patient.

When should we use modern arthritis drugs?

Another physical therapist reminded the audience of something surgeons know all-too-well. The newer anti-arthritis medications like Librela® and Solencia® should not be used when a joint is instable. To avoid potentially devastating side-effects, surgery should be recommended first in these patients, specifically to stabilize the joint.

In addition, these drugs should NOT be combined with Non-Steroidal Anti-Inflammatory drugs (NSAIDs), again for fear of potentially disastrous side-effects.

So remember, our current understanding is that there are at least 2 situations when Librela® and Solencia® should not be used:

• with an unstable joint
• with an NSAID

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

I was very fortunate to recently visit South Africa and Zimbabwe after a veterinary conference. Since 100% of the pet owners we meet are animal lovers, I thought I would share some information and pictures about his incredible trip.

When traveling through southern Africa, it’s impossible to miss the lively antics of monkeys.

We mostly observed 2 species: vervet monkeys and baboons.

These primates are not only fascinating from a scientific perspective, but their bold behavior provides unforgettable moments for visitors – sometimes a bit scary!

Here’s a look at these cheeky creatures and my personal encounters with them.

Vervet Monkeys in South Africa

Vervet monkeys may not be the most well-known monkeys, but they are found across sub-Saharan Africa.

They are small monkeys, weighing only 6 to 11 lbs (3 to 5 kg).

For comparison, that’s the weight of a Yorkie or a mini Doxie.

They have distinctive, cute, black faces framed by white fur and long tails that help with their agile movements.

These monkeys are highly social, living in troops that can range from a few individuals to over 50.

Their diet is omnivorous, meaning they eat a bit of everything, including fruits, flowers, insects, and sometimes small animals.

Adorable Vervet Babies

Vervet monkey babies are adorable, with their tiny black faces and inquisitive eyes.

These shy little ones are often seen clinging tightly to their mothers’ bellies as the moms move gracefully through trees.

As they grow, they begin to explore their surroundings cautiously, staying close to their protective mothers.

The sight of a vervet mother tenderly grooming her baby is a heartwarming reminder of the strong bonds within these social groups.

A Bold Encounter

During lunch in South Africa, I witnessed just how bold vervet monkeys can be.

A guest was enjoying his meal when, in the blink of an eye, a vervet jumped onto the table and grabbed a piece of chicken.

The guest’s surprised scream was met with the monkey’s triumphant retreat to a nearby tree, where she enjoyed her stolen snack.

I apologize for the blurry pictures, but it’s a miracle I was able to get shots from the encounter, which lasted a split second!

And during this entire scene – her baby clung to her belly!

Baboons in Zimbabwe

Baboons are much bigger monkeys. They are among the largest primates in Africa.

Male typically weigh 44 to 88 lbs (20 to 40 kg), so between a Border Collie and a Lab.

Females average 22 to 33 lbs (10 to 15 kg), same as a Cocker or a Beagle.

These primates live in complex social structures and display remarkable intelligence, including tool use and problem-solving skills.

Their diet is even more varied than that of vervet monkeys, ranging from plants to small mammals.

Close Call with a Baboon

One afternoon in Zimbabwe, while visiting the impressive Victoria Falls, I found myself a little too close to a baboon for comfort.

It certainly wasn’t intentional. We simply stumbled across a group crossing the path…

We stopped and observed, respectfully, with complete admiration since it was by far the closest encounter, and the biggest group.

They kept moving around us, looking for food on the ground.

At one point, a large male sat just a few feet away.

I froze (OK, OK, aside from taking 348 pictures of him!).

For a heart-stopping moment, I thought he might leap toward me.

Instead, he jumped into a tree with effortless grace.

While baboons can be intimidating due to their size and sharp canines, they generally avoid conflict with humans unless provoked or seeking food.

The canines of a male are easily the size of those of a German shepherd or a Rottie!

Why Are Monkeys So Bold?

Since we invaded their territory, these monkeys have adapted to human presence, often frequenting tourist spots where they’ve learned that food is very easy to come by.

Both vervet monkeys and baboons have adapted to living alongside humans.

In many areas, their natural habitats overlap with villages, towns, and tourist hotspots.

They’ve learned that humans often mean easy access to food, whether it’s from unattended picnics, restaurant tables, or open car windows.

Their boldness is a testament to their intelligence and adaptability, but it’s also a reminder of the challenges of human-wildlife coexistence.

A Word of Caution

While vervet monkeys and baboons might seem amusing or endearing, it’s important to treat them with respect.

Feeding them or leaving food accessible can encourage aggressive behavior and disrupt their natural foraging habits.

Observing these animals from a safe distance ensures both your safety and their well-being.

Final Thoughts

From the cheeky vervet monkey who stole a restaurant guest’s chicken dinner to the imposing baboon that startled me in the Wild, these primates leave a lasting impression.

Their boldness adds a unique charm to encounters with Africa’s wildlife, blending humor and awe.

Just remember to protect your snacks – and keep your distance!

We can’t help your baboon, but if you would like to learn how we can help your cat or your dog with safe surgery and anesthesia, please contact us through www.DrPhilZeltzman.com 

Never miss a blog by subscribing here: www.DrPhilZeltzman.com/blog 

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

I was very fortunate to recently visit South Africa and Zimbabwe after a veterinary conference. Since 100% of the pet owners we meet are animal lovers, I thought I would share some information and pictures about his incredible trip.

When Malema swiftly moved from his tracker’s seat, on top of the hood of the jeep, to the safety of the passenger seat, we knew that danger was near.

The group went quiet in anticipation, staring at the road ahead.

Suddenly, two majestic male lions appeared, lounging in the middle of the road!

We held our breath, in complete disbelief. After all, this was our very first outing!

The lions just sat there, pretending to ignore us.

At one point, one rolled on his back, like a household cat.

700 pictures later, the lions decided they were bored of being the center of attention.

They got up, and peacefully walked around the jeep, one on each side, staring at us with curiosity.

They moved with effortless grace, with a silent, powerful stride. The lion on the right locked eyes with me. It lasted a second, but I will never forget it. He was within 3 feet of me.

After a few moments, the lions disappeared back into the bush.

We sat in stunned silence, hearts pounding, trying to process what just happened.

It was an unforgettable encounter.

It was a reminder of the wild’s power and the incredible privilege of witnessing such beauty.

We can’t help your lion, but if you would like to learn how we can help your cat or your dog with safe surgery and anesthesia, please contact us through www.DrPhilZeltzman.com 

Never miss a blog by subscribing here: www.DrPhilZeltzman.com/blog 

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