Services

Click on the numbered footnote (or scroll down), to see more information below about these surgeries we perform.

Please find more information below regarding the procedures that we perform.

(For faster navigation, you can use the footnote hyperlinks in the list above.)

For additional information on these surgical issues and diseases, as well as the surgery to fix them, please visit the ACVS website.

UNDER CONSTRUCTION – we’re still adding to this list, check back for more

1. Abdominal Exploratory
   This is a surgery of the abdominal cavity – the entire abdomen is explored to evaluate the GI tract (stomach, small intestines, large intestines, pancreas), the liver, gallbladder, kidneys, urinary bladder, the spleen, and all abdominal structures. Any abnormalities may be biopsied and/or tumors removed. The specifics of what is performed for your pet will be discussed, based on the diagnostics performed before surgery and what we expect to find at surgery. ↩︎
2. Anal Glad Removal
   The anal sacs are paired glands on either side of the anus. Surgery can be done to remove one or both glands due to either cancer or chronic infections/inflammation that lead to issues where the glands don’t empty normally. ↩︎
3. Corkscrew Tail Amputation
   This is a condition that sometimes affects Bulldogs, mostly English Bulldogs. Their tail can be shaped like a corkscrew and sometimes may start to “grow into” the adjacent skin and cause pain and irritation, or more commonly they get skin fold infections around the base of the tail that are very painful. We do an amputation of the tail at the tail base to remove this source of pain, infection, and irritation. ↩︎
4. Cystotomy
   Surgery of the urinary bladder, most commonly to remove bladder stones. ↩︎
5. Digit Amputation
   A digit (toe) may be removed due to a tumor or because of trauma or infection to the toe. A bandage is often placed on the foot for 2 weeks to protect the area while the incision site heals. ↩︎
6. GI Foreign Body Removal
   If your pet has eaten something that has gotten stuck in the gastrointestinal tract (stomach or small intestines), we might need to go into the abdomen to remove it. Common GI foreign bodies are toys (plastic, rubber, or cloth items), corn cobs (which can cause a lot of damage to the intestines!), socks, towels, rocks, etc. ↩︎
7. Hernia Repair
   A hernia is a hole in a body-wall muscle, through which other tissues or organs are protruding. The most common sites for a hernia are the inguinal or groin area, or a tear in the diaphragm, though there are others. Some hernias occur secondary to trauma (animal fights, hit by a car, etc.) though some pets may be born with a hernia. ↩︎
8. Limb Amputation
   The recommendation for amputation may be made due to trauma, cancer, or other reasons. I have come to learn that dogs and cats are largely “3-legged animals with a spare” and most pets do very well with an amputation. Frankly, the process is much harder on us as their caretakers, than it is on them – our pets have an amazing ability to adapt to what life hands them. For a forelimb amputation we remove the entire shoulder blade, for a hind limb amputation we remove the leg at the hip joint. ↩︎
9. Liver/Gallbladder Surgery
   Indications for liver and gallbladder surgery include masses/tumors of the liver and infection, rupture, or other disease of the gallbladder. There is a condition of the gallbladder called a biliary mucocele – this is when the bile in the gallbladder turns from a normal liquid/fluid consistency to become thick and mucoid. This can cause an obstruction along the bile duct and a back-up of bile in the gallbladder with the risk of gallbladder rupture.
   I like to describe the liver as being like a 6-leafed clover because there are 6 lobes of the liver. The gallbladder is nestled between two of those lobes on the right side. All of the lobes connect together at the hilus, which is like the stalk of the clover. Generally speaking, masses on the left side of the liver are easier to get to and to remove, because the lobes are easier to separate and get around when doing surgery. On the right side of the liver, there is more connection between the lobes (almost like the “webbing” between your fingers) which can make it harder to isolate just 1 lobe and sometimes we need to remove an adjacent lobe to get all of the tumor out. Also, remember the gallbladder is between 2 lobes on the right side, so sometimes the gallbladder may need to be removed as well. ↩︎
10. Tumor/Mass Removal
    There can be a wide variety of masses and their location, as well as the extent of surgery indicated to remove them. In general terms, we know that some tumors and benign growths have a capsule and if we just remove the entire capsule we can remove all the abnormal cells. Other tumors and cancers will send out microscopic “fingerlings” of cancer cells that go beyond the lump we can see with the naked eye. For these latter types of cancers, I like the use an analogy of a hard boiled egg cut in half – if the egg yolk is the tumor we can see with the naked eye, we need to also remove some of the egg white (or “normal tissue”) around the tumor as our best chance to remove all of the cancer on our first surgery. Sometimes this means we need to remove 2-3” of extra tissue around the lump we can see or feel. For this reason you can see why it is so important to remove a mass/growth/tumor/cancer when it is smaller. And some areas of the body are easier to work with for wide margin excision (e.g., along the trunk or body) vs other areas that are more challenging (e.g., on the limb or paw, near the eye, etc.).
    Since there is such a wide range of surgical options in this category, more specifics will be discussed with you about what is indicated for your pet. ↩︎
11. Parathyroid Gland/Mass Removal
    There are 4 parathyroid glands, 2 associated with each of the thyroid glands. So we have a “top” and a “bottom” parathyroid on each of the left and right sides.
    The parathyroid glands maintain the calcium level in the bloodstream by producing parathyroid hormone (PTH), which encourages the body to absorb more calcium from the gut (through the diet) and decreasing how much is filtered out by the kidneys to excrete in the urine.
    There is a condition called primary hyperparathyroidism where the calcium level in the bloodstream is too high due to too much PTH. This elevated calcium (hypercalemia) can lead to kidney damage, bladder stones, and sometimes the calcium can start to mineralize along the skin.
    Surgery is performed along the ventral (lower) side of the neck to evaluate and remove any abnormal parathyroid gland tissue. There are 4 parathyroid glands, and often only 1 needs to be removed, but sometimes 2 or 3 glands will be removed. As long as 1 gland remains, it should be able to do the work needed to maintain normal calcium levels, but it may be delayed in “waking up”.
    The biggest risk of this surgery is that the abnormally high level of calcium has caused the normal glands to atrophy or “sleep” because they are not needed. Once the abnormal gland(s) is(are) removed, the PTH will start to drop, and also the calcium in the bloodstream. If the other parathyroid glands “wake up” in time, the blood calcium will return to normal. But if they are delayed, the blood calcium can become dangerously low (hypocalcemia). For this reason, we monitor the blood calcium levels 1-2 times daily for 3-5 days after surgery. We can supplement with additional medications if needed. Common signs to look out for are: scratching/pawing at the face (because it is itchy), a stiff gait in the hind limbs, muscle tremors, or seizures. ↩︎
12. PU – Perineal Urethrostomy
    This procedure may be recommended for a male cat that has had recurrent bouts of urethral obstruction due to a syndrome knows as Feline Idiopathic Cystitis (FIC) or Feline Lower Urinary Tract Disease (FLUTD). This is a complex condition that leads to obstruction of the urethra with grit and/or mucoid plugs. This means the cat cannot urinate and this is a life-threatening issue. There are ways to help manage this disease by increasing water intake, decreasing stress for the cat, and dietary changes. The PU surgery can help because we make a larger opening for the cat to urinate out of, so if the grit and/or mucus start to build up, hopefully they can pass through the urethra and not cause an obstruction. We have to perform an amputation of the penis and suture to urethra directly to the skin where it has a wider diameter. It is extremely important that the cat wear a cone collar for 2 weeks while the incision heals, because if they lick the incision they can cause a stricture – which means the opening gets smaller or even completely closes over and they are at risk of urethral obstruction again. ↩︎
13. Prophylactic Gastropexy
    This is a procedure to attach the stomach to the body wall to prevent it from flipping on itself and creating what is called Gastric Dilatation-Volvulus syndrome or GDV (sometimes called “bloat”). This condition is a life-threatening surgical emergency. Great Danes are at highest risk for this, but any dog with a deep-chested conformation (Doberman Pinschers, German Shepherds, Standard Poodles, Saint Bernards, and even Labrador Retrievers and Golden Retrievers). It is recommended to perform a prophylacic gastropexy on a high-risk breed when any other abdominal surgery is performed, or even when they are spayed or neutered. ↩︎
14. Salivary Mucocele
    This is a condition where saliva leaks out from either a salivary gland or a salivary duct and starts to collect in the connective tissues. This creates and inflammatory response and the body lies down additional inflammatory fluid. All of this creates a swelling. We don’t always know where the leak comes from and suspect it is due to trauma of something hitting along the area of the salivary gland-duct complex. The area of swelling will form near the affect salivary gland-duct complex, so could be under the chin (most common), under the eye, under the tongue, or in the back of the throat. In order to resolve the issue, we need to remove the entire salivary gland-duct complex. Don’t worry, your pet has many salivary glands and will be OK after the surgery. ↩︎
15. Splenectomy
    This is a procedure to remove the spleen. The spleen is an organ in the abdomen that is loosely attached along the left side of the stomach. In the young animal, the spleen has a very important role in the development of the immune system. In adults, the serves to filter out and recycle the red blood cells and iron in the bloodstream, as well as serving as a reservoir of red blood cells. (For example, if a dog is hit by a car or has other significant blood loss, the spleen can contract to “push” more red blood cells into circulation almost like giving the pet its own blood transfusion.)
    Because the spleen has a such a high blood supply and filters the bloodstream, it is at risk of cancer developing there – either as a primary cancer or a secondary cancer that has spread from elsewhere. Sometimes a mass on the spleen will rupture and start internal bleeding – this can require emergency stabilization and surgery. Sometimes we find a mass on a spleen before it ruptures, which gives us some more time to plan for surgery (and the pet is not in a state of shock or critical illness).
    When we remove the spleen, the liver can take over the function of filtering the red blood cells.
    Risks of surgery include hemorrhage (bleeding), arrhythmias (irregular heart beats), sudden death, and potentially a risk of GDV so we often perform a prophylacic gastropexy (see the procedure above) at the same time. ↩︎
16. Subtotal Colectomy
    This is a surgery to remove most of the colon. It is most often performed in cats with a condition called megacolon. This is where the muscles of the colon no longer function appropriately to move feces to the rectum to be excreted, and so the colon becomes distended or stretched out and the cat cannot defecate. There are medications that can help many cats with this condition, but if the medications no longer work, then we have to remove the affected colon.
    We often try to preserve the valve from the small intestines to the large intestine and try to maintain any normal appearing colon. The function of the colon is to resorb fluid from the stool and dry it out. Since we remove so much of the colon, the cats will have diarrhea for a few months. Over time, the remaining colon can adapt resorb more fluid from the stool so the bowel movements can become more normal in appearance, though perhaps more frequent in excretion. These cats basically go from being constipated to having diarrhea. They should remain continent, however, so they know they have to go, they just have go to the litter box much more often.
    Risks of surgery include infection; break-down and leakage of the sutures, requiring another surgery; recurrence of megacolon (so medications are still recommended). ↩︎
17. TECA – Total Ear Canal Ablation
    This is a surgery to remove the entire ear canal – the cartilage “funnel” that extends all the way to the eardrum. This surgery is often performed to remove a tumor or cancer of the ear canal, or for animals that have had chronic ear infections leading to stenosis (narrowing) of the ear canal. This stenosis means air cannot get to the bottom of the ear canal to dry it out, so it remains damp and bacteria and yeast continue to grow and hence the infections can never be fully resolved. These pets also produce a lot of scar tissue around the ear canal and the ears are very painful. In fact, many pet owners have told me that their dogs act like puppies again after the surgery, because the pain is gone.
    We leave the pinna, or ear flap; however, animals with a stand-up ear (like cats, French Bulldogs, German Shephards, etc.) may have the ear flap flop over or to the side after this surgery to remove the ear canal.
    The facial nerve runs along the side of the ear canal and depending on the severity of the cancer or infection/scarring of the canal, it is possible this nerve could be cut or at least irritated during surgery. If this happens, then the pet will not be able to blink their eye on that side of their face, and their lip may droop on that side. If this occurs it is most often temporary from inflammation and irritation at surgery and resolves within 2-4 weeks. Sometimes it may be permanent. If the pet cannot blink we need to apply artificial tear ointment to the eye to keep it lubricated. So sometimes these pets exchange their daily ear drops for daily eye drops.
    The pet’s vestibular system (“balance center”) may also be disrupted from the surgery. This can lead to them tilting their head, or having an uncoordinated walk. Again this is often temporary, but could be permanent.
    We do believe pets can still hear after this surgery, though at diminished levels (like being under water). However, with a large mass in the ear or chronic ear infections and stenosis of the canal, their hearing was already diminished before surgery, so it might not be much different for them. If their other ear is healthy, they will have normal hearing from that ear. Dogs and cats are able to adapt very well to any loss of hearing from this surgery.
    Risks of surgery include suture breakdown (so pets must be in the cone collar so they can’t paw at the incision or rub the side of their face), facial neuropathy and need for eye drops (often temporary but may be permanent), loss of balance and/or head-tilt (again often temporary), continued infection or abscess at the site (so we continue antibiotics typically at least a month after surgery). If the surgery was performed because of a cancer, it might be possible the cancer can spread elsewhere – this will be discussed after the biopsy results return. ↩︎
18. VBO – Ventral Bulla Osteotomy
    This is a procedure to clean out the bulla, or middle ear, through a ventral approach, or under the jaw. This is often performed in cats with an aural-pharyngeal polyp. This is a polyp that forms in the middle ear (the bulla) and may extend down the Eustacian tube to the back of the throat (pharyngeal area) or rupture through the ear drum and extend out the ear canal (“aural” is a term for the ear). These are often inflammatory polyps that form from the cells lining the bulla, and we believe they occur from upper respiratory infections in young cats.
    We can try to grasp the polyp and “pluck” it out, but that only has about a 50% chance of success, because we might leave some of the polyp cells behind. I like the analogy of pulling a weed out of the garden – if you don’t get all the roots, then you can expect it to grow back. Our best chance to get all of the roots out, and in order to do that, we need to do surgery to clean out the bulla.
    We shave the fur under the jaw and there is a small incision by the back corner of the jaw. We dissect down to the bone of the bulla, open the bone, and clean out the bulla.
    Risks of surgery include infection, suture break-down, head tilt or loss of balance (often temporary and resolves in a few days). ↩︎
19. ECS – Extra-Capsular Stabilization
    This is a surgery for a pet who has a torn cranial cruciate ligament (CrCL). This structure is similar to the anterior cruciate ligament (ACL) in people, but a different term is used because cats and dogs have 4 legs instead of 2.
    The knee can be difficult to describe, but I like to use the analogy of a car on a hill. The bottom of the thigh bone (femur) ends in a rounded condyle. This condyle sits on top of the shin bone (tibia), the top of which is flat, but at an angle. Hence, we have a car parked on a hill. The CrCL is like a parking break holding the car on the hill, but now that it is torn, the car wants to slide down the hill. With the ECS surgery, we place a heavy-gauge suture across the joint, connecting to the femur and the tibia, to reconstruct the function of the parking break. The suture is outside the joint capsule or “extracapsular” and does not repair the torn ligament itself, but it does replace the function of the ligament.
    Because the ECS uses only suture material, it can stretch or tear, which is why the TPLO is recommended for larger and more active dogs. ↩︎
20. FHO – Femoral Head Ostectomy
    The femoral head is the “ball” of the “ball and socket joint” of the hip. With this surgery, we are removing the “ball” from the joint and the body will will this space with scar tissue to make a “pseudo-joint” or “false joint”. The leg is still attached to the pelvis by all the muscles, so pets can still use the leg and often have a very good outcome. This surgery may be performed due to severe arthritis from hip dysplasia, or due to trauma (a fracture or hip luxation).
    After surgery, your pet should be on strict rest for 2 weeks until the incision heals. After these 2 weeks, it is very important to encourage using the limb and being active to prevent the joint from “freezing down” or “locking up” due to too much scar tissue formation. Formal Canine Physical Rehabilitation is highly recommended (and can be utilized with cats as well). ↩︎
21. Orthopedic Implant Removal
    We often intend to leave bone plates, screws, pins, and wires in place, in the patient, for the rest of their life. However, we often can remove the implants if we need to, such as due to infection, irritation, or if the implant starts to move, migrate, or back out. Depending on what implant needs to be removed, this may be a minor procedure done under sedation, or could require full anesthesia and a larger incision. ↩︎
22. Patellar Luxation Repair (Medial or Lateral)
    The patella is another name for the kneecap. It is supposed to sit in a groove at the bottom part of the femur (thigh bone). But if the kneecap pops out of place, we call that a luxation (like a rope jumping out of a pulley). The patella may luxate either medially (towards midline) or laterally (towards the outside of the knee. A medial patellar luxation is most common. The surgery to correct a patellar luxation will depend on what is found at surgery, but typically we need to deepen the groove in the femur, adjust the soft tissues that hold the patella center, and also move the point of the shin to help align the quadriceps-patellar tendon mechanism. ↩︎
23. TPLO – Tibial Plateau Leveling Osteotomy
    See more on TPLO here
    This is a surgery for a dog who has a torn cranial cruciate ligament (CrCL). This structure is similar to the anterior cruciate ligament (ACL) in people, but a different term is used because dogs have 4 legs instead of 2.
    The TPLO surgery can be difficult to describe, but I like to use the analogy of a car on a hill. The bottom of the thigh bone (femur) ends in a rounded condyle. This condyle sits on top of the shin bone (tibia), the top of which is flat, but at an angle. Hence, we have a car parked on a hill. The CrCL basically functions like a parking break to keep the car on the hill, but now that the CrCL is torn, the car keeps wanting to slide down the hill. With the TPLO, we make a cut in the shin bone so we can effectively flatten the hill, so we no longer need a parking break. A bone plate and screws are placed in the tibia to hold the bone together while it heals. Nothing is actually done to replace the CrCL since the knee no longer needs it. ↩︎