Common Soft Tissue Procedures

What is an ear ablation?

A total ear canal ablation (TECA) means removal of the ear canal(s). It is performed when an animal has severe inflammatory disease of the external ear canal or when a growth, which could be cancer, is present within the ear canal or middle ear cavity. This surgery involves the complete removal of the ear canal, however in most cases the pinna or external ear "flap" remains intact.

General information

The most common question asked about ear canal ablation is "Will my pet be deaf?". The ear canal is only a conduit for sound waves to travel to the inner ear where sound is actually perceived. The inner ear is not affected by this procedure, therefore the ability to perceive sound should not be changed. Although it is difficult to predict, most people report that their pet's hearing is about the same after surgery.

A drain may be placed into the middle ear cavity (bulla) at surgery. If this is necessary, your pet will stay in the hospital for a few days until it is removed. While the drain is in place, your pet will have a light bandage applied to the head to prevent him/her from "playing" with their drain.

Postoperative care

Antibiotics given by mouth are indicated in most cases. The ear canal and middle ear cavity are often contaminated with numerous bacteria and yeast organisms. A culture is taken at the time of surgery to make certain that the antibiotic chosen is appropriate for your pet's specific infection. Even if the culture result is negative, your pet should remain on antibiotics for a minimum of 3 weeks.

In most cases, a non-steroidal anti-inflammatory drug (NSAID) such as carprofen (Rimadyl®), firocoxib (Previcox®) or deracoxib (Deramaxx®) will be recommended. This class of drugs is often helpful in relieving postoperative inflammation, pain, and swelling. This will help your pet to be more comfortable and return to normal function sooner. Side effects occasionally seen with NSAIDs include decreased appetite, vomiting, diarrhea, blood in the vomit or stool and (rarely) liver or kidney dysfunction. If you note any decrease in appetite, vomiting, diarrhea, change in the color of the stool (especially darkening), or yellowing of the skin or eyes, stop the medication and call a veterinarian. Do not give your pet any other medication without consulting us. Many other non-steroidal anti-inflammatory drugs available for people are often toxic in dogs.

External skin sutures will be placed to close the incision. These sutures should be removed in 2 weeks. You should look at the incision daily and note any discoloration or discharge. Please call our office if you are concerned.

What is a portosystemic shunt

Portosystemic Shunts are congenital malformations of the hepatic (liver) bloodflow. Shunts are classified as intrahepatic (within the liver) or extrahepatic (outside of the liver). Extrahepatic shunts are more common than intrahepatic shunts, and are generally found in toy breed dogs. The problem arises when the bloodflow from the intestines bypasses the liver, resulting in absorbed toxins reaching the peripheral circulation. These toxins are circulated throughout the body resulting in clinical signs and bloodwork abnormalities.

General information

The clinical signs associated with portosystemic shunts can vary from gastrointestinal (vomiting) to neurologic (head pressing, seizures, abnormal mentation). Clinical signs can worsen after eating, and tend to be worse with a high protein diet. The diagnosis of a portosystemic shunt is made with screening blood tests and confirmed at surgery.

Treatment for a portosystemic shunt is surgery to correct the vascular malformation. Medical management with a low protein diet and medication to change the bacterial content of the intestines is often helpful in controlling clinical signs. Surgical correction can be accomplished using ligatures, constriction devices (Ameroid constrictor), or cellophane banding. Patients are monitored in our 24 hour ICU postoperatively.

Postoperative care

Surgery to correct a shunt requires an abdominal exploration. Exercise restriction is recommended after any abdominal surgery until the incision has healed (generally 2 weeks).

Postoperative care depends on the nature of the shunt and the severity of clinical signs. In most cases, broad spectrum antibiotics and low protein diet will be recommended. Other medical treatments may be recommended depending on the patient's condition.

What is gastric dilatation volvulus (GDV)?

Gastric Dilatation Volvulus (GDV) is a syndrome in large breed dogs where the stomach fills with gas and twists within the abdomen. This problem is very common in deep chested breeds and is immediately life threatening. Clinical signs include abdominal distension and unproductive retching. There is no non-surgical treatment for GDV. Emergency surgery is required.

General information

The surgical treatment for GDV involves exploration of the abdomen, correction of the volvulus, and resection of any nonviable portion of the stomach, bowel or spleen. After the stomach is repositioned and any underlying cause is corrected (if possible), a gastropexy (attachment of the stomach to the abdominal wall) is performed to prevent future volvulus. Postoperative monitoring is very important following GDV surgery. Cardiac arrhythmias and blood pressure abnormalities are common, therefore these patients are monitored closely in our ICU for complications.

If a gastropexy has been performed, future volvulus is highly unlikely, however bloating can still occur. We always recommended feeding large breed dogs multiple times throughout the day instead of single large meals. Exercise after eating should also be discouraged.

Postoperative care

Surgery to correct a GDV requires an emergency abdominal exploration. Due to the pathophysiology of the gastric dilatation, many problems can occur in the postoperative period. This requires intensive monitoring in our ICU for cardiac arrhythmias, bloodwork abnormalities, and blood pressure changes.

After discharge, exercise restriction is recommended until the incision has healed (generally 2 weeks).

Large breed dogs should be fed small meals frequently instead of single large daily feedings. Elevated food bowls have been encouraged by some, however there is no proof that this affects the incidence of gastric dilatation.

What is intestinal surgery?

Intestinal surgery is performed for numerous indications. Obstruction of the bowel after the ingestion of foreign objects is common in small animals and requires emergency surgery for relief. In older animals, gastrointestinal tumors may occur resulting in the need for surgical resection (removal) or biopsy.

General information

Surgery of the intestine is not always an emergency. However, when the small intestine becomes obstructed, its blood supply can become compromised. Radiographs may not show the actual object that is causing the obstruction, and the diagnosis is often made based on the gas pattern in the bowel loops. In some cases ultrasound may help to confirm the diagnosis prior to surgery.

Postoperative care

Surgery of the bowel requires an abdominal exploration. Exercise restriction is recommended after any abdominal surgery until the incision has healed (generally 2 weeks). We also recommend feeding a highly digestible diet for 2 weeks after any surgery involving the gastrointestinal tract. Depending on the reason for surgery, most animals can return to their normal diet after this time.

Postoperative medication generally consists of antibiotic therapy, pain control, a highly digestible diet, and execise restriction as noted above. Other medical treatments may be recommended depending on the reason for surgery.

What is a perineal hernia?

Perineal hernias occur in middle aged to older intact (non-neutered) male dogs. These hernias result in swelling on either side of the anus and can occur on one or both sides. The most common sign associated with perineal hernias in dogs is straining to defecate. This occurs because the rectum balloons into the hernia, and fecal material cannot pass easily outward. Perineal hernias can result in organ entrapment necessitating emergency surgical correction.

General information

Perineal hernias almost always occur in older male dogs that have not been neutered. The cause of the hernia is unknown, however is thought to be related to testosterone. For this reason, we recommend neutering at the time of the hernia repair.

If there is no organ entrapment, surgical correction can be performed at a scheduled time. Surgery involves replacement of any abdominal contents and reconstruction of the perineum (rear-end). This reconstruction generally uses the surrounding musculature, however a synthetic mesh may be necessary in some cases.

Postoperative care

It is not uncommon to have incisional complications such as infection when surgery is performed near the anal area. For this reason, broad spectrum antibiotics are usually prescribed in addition to pain medication.

We recommend feeding a low residue, hightly digestible diet during the recovery period to decrease the amount of feces produced. Some mild straining to defecate is expected due to the pain and inflammation associated with surgery, however this should not be excessive.