Soft Tissue Surgery

Various conditions in the spleen, liver, pancreas, adrenal glands, and other internal organs, as well as body wall hernias, are common areas of focus for abdominal or gastrointestinal surgery. Often pets will first undergo diagnostics such as ultrasound, radiographs, or endoscopy for an initial diagnosis. Your pet’s prognosis and possible complications will be thoroughly discussed prior to proceeding with surgery.

Examples: Septic peritonitis, gastrointestinal foreign body removal, masses of the spleen, liver biopsies, adrenal tumor removal, liver lobectomies for tumors or abscesses, pancreatic tumors, common bile duct obstruction, gall bladder mucoceles, tumors of the gastrointestinal tract, perineal hernias, diaphragmatic hernias, gastric dilatation-volvulus (gastropexy), and many others.

A number of conditions such as cancer, trauma, or pathology can require surgery within the chest (thoracic cavity). These are typically planned, elective surgeries but occasionally problems can arise that require emergency surgery. Signs your pet is having cardiothoracic problems include a fast breathing rate (even when at rest), lethargy, or not eating. A consultation with the surgeon will explain additional diagnostics needed, such as radiographs, ultrasound, and frequently a computed tomography (CT) scan. Your pet’s prognosis and any complications related to the procedure or disease will be discussed. These types of surgeries most often require several nights of hospitalization.

Examples: Lung lobectomy (for bulla or tumors), thoracic duct ligation for chylothorax, laparoscopic pericardectomy, transdiaphragmatic pacemaker placement, patent ductus arteriosus ligation, thymoma removal, persistent right aortic arch (PRAA), and balloon valvuloplasty and others.

Surgical problems within the kidneys, ureters, bladder, or urethra can be seen as a consultation or an emergency that presents rather suddenly. Animals may be sick (not eating or drinking), vomiting, or not urinating. Alternatively, a pet may be urinating too often or have blood in the urine. Diagnostics such as radiographs or ultrasound may be recommended, and additional imaging could be requested if your pet is older or if cancer is suspected. Some animals require stabilization before surgery (like draining urine from a ruptured bladder or giving fluids to a very dehydrated animal). Care can be straightforward (same-day discharge from laparoscopic bladder stone removal) or complicated (multiple-day hospitalization for obstructed kidney stones).

Examples: Ureteral stenting, subcutaneous ureteral bypass placement, bladder stone removal (cystotomy), bladder tumor removal (partial cystectomy), perineal urethrostomy (PU), urethral stenting for transitional cell carcinoma, artificial urethral sphincter placement, and more.

Surgery on the liver and gall bladder is frequently performed. Often these pets have been vomiting, losing weight, or have had increasing liver enzymes noted by the family veterinarian. While ultrasound is typically recommended for these patients, in additional cases a CT scan is beneficial to view the entire liver. We commonly see liver cancer that can be treated with surgery; hepatocellular carcinoma can have a 3+ year survival time without needing chemotherapy. Gallbladder surgery is common in both dogs and cats and like humans, our pets can live happy lives without their gallbladders. Prognosis and complications are always discussed with these types of surgeries as complications are rare but can be serious.

Examples: Liver lobectomy, gall bladder removal (cholecystectomy), common bile duct stenting, gall bladder reroute, and others.

Tumors, bite wounds, or unexplained lacerations (it happens, even in the fenced backyard!) can occur at any time. One of the many advantages our pets have over humans is extensive loose skin with often a thick, furry coat to hide the scar. Our surgeons are skilled at many different wound management techniques: vacuum-assisted wound closure, silver-impregnanted dressings, calcium alginate, and others. Large tumors may first require additional diagnostics, such as chest radiographs, ultrasound, and possibly a computed tomography (CT) scan. Reconstructive closure over these tumors may be feasible, depending upon the goal of surgery. If your pet requires additional bandage changes, these can often be done on an outpatient basis through our skilled nursing team.

Examples: Axial pattern flaps, skin grafts, and other reconstructions, wide resection of tumors, and surgery planning with additional radiation therapy follow-up, chelioplasty, eyelid surgery, nasal fold or screwtail removal.

In assistance with your veterinarian or our dermatologists, surgery of the ear canal (often called total ear canal ablation or TECA) is a common procedure for pets with severe allergies and infections, or cats with polyps in their ear(s). Tumors may also occur in or around the ear canal, necessitating removal. In some cases, additional imaging such as a CT scan is requested to evaluate the middle ear or the extent of the disease.

Examples: Total ear canal ablation with lateral bulla osteotomy (TECA-BO), ventral bulla osteotomy (VBO).

These types of surgeries typically encompass the perineal region (under the tail, around the anus). Both cats and dogs have anal sacs which can become infected (usually in animals with allergies) or have tumors that arise in this location. Other conditions, such as perianal fistulas or megacolon in cats, are treated with medications and other dietary management techniques in lieu of surgery. Our surgeons are familiar with these conditions and can discuss with you additional diagnostics, or if appropriate, consultations with our dermatology or internal medicine services. Often, imaging such as ultrasound or computed tomography (CT) scans are required to evaluate this area.

Examples: Perineal hernias, colonic or rectal tumor/polyp removal, anal sac removal for infection or tumors, and others.

This area of surgery can involve the nose, larynx (voice box), thyroid, esophagus, and other structures found around the head and neck. One of the most frequent surgeries performed is airway surgery for brachycephalic dogs and cats, which are animals with a “smushed” nose – Bulldogs, French Bulldogs, Boston Terriers, Pugs, Persians, and others. Other surgeries can involve the eyes, jaw, or tongue. While our surgeons can perform certain eye and tooth surgeries, a veterinary ophthalmologist or dentist may be better suited for your pet’s procedure.

If in doubt, our surgical coordinators can better direct you or ask a surgeon to review the case, to see if it is appropriate for a surgeon. Often advanced imaging is recommended for these types of surgeries since it is difficult to look inside the nose and throat, and it is important to know if certain nerves and blood vessels are involved in the affected area. Some of these cases are emergencies and must be first stabilized by the critical care service. Any type of surgery around the airway requires close postoperative monitoring to ensure a smooth recovery from anesthesia and avoidance of complications such as aspiration pneumonia.

Examples: Brachycephalic airway surgery (stenotic nares, elongated soft palate, laryngeal saccules), maxillectomy, mandibulectomy, glossectomy, sinus trephination for fungal infection, thyroid tumors, laryngeal paralysis (unilateral arytenoid lateralization), tracheostomy, pinnectomy, and many others.