Special Pointers for Pediatric Surgical Patients

The following pointers highlight the main considerations when performing a pediatric procedure:

Pre-Surgical

The handling of pediatric patients before surgery should be minimized to prevent excitement before sedation for surgery. The staff should be urged to resist the temptation to play with them. Excited animals will resist being restrained and they become more difficult to sedate.

It may be easier to use intramuscular injections for initial sedation, as less restraint is needed.

Animals should not be fasted for more than 3-4 hours before the procedure to avoid hypoglycemia.

Hypothermia can be a problem for these patients. A small area of hair at the surgical site should be clipped and a warm surgical scrub used. The use of alcohol should be avoided or minimized because of its cooling effects on the skin.

There are many different protocols in the literature for pediatric anesthesia. The most successful protocols are usually already in use by the veterinarian with adjustments for the weight difference. The use of inhalation anesthesia mitigates many of the concerns about the biotransformation of anesthetic drugs in the liver and kidneys of pediatric patients.

Good monitoring of the patient for safety is no different from the protocols used for any other patient, ie, observing the heart and respiratory rate, depth of anesthesia, the color of the patient’s mucus membranes, etc.

Surgical

A supplemental source of heat should be used to prevent hypothermia. Warm water heating pads covered by a blanket or towel on the surgical table work fine.

Some surgeons recommend that the surgical incision for female puppies should be 2-3 cm caudal to the umbilicus for easier exposure to the uterus. Its location remains the same in kittens as it is for adult cats.

Tissues must be handled gently and close attention paid to hemostasis, but this is true in any surgical procedure. The truth is, in most cases, bleeding in these animals is minimal.

Pediatric animals tend to have a lot of clear abdominal fluid, but this is normal.

The animals should be tattooed in the inguinal region or tattoo ink applied to the incision to identify them as having already been neutered. This is more critical for female animals than males, but it might spare male animals from exploratory surgery if it was assumed the animal had bilaterally retained testicles.

Post-Surgical Considerations

Heating lamps are fine to use to prevent hypothermia. These patients should be monitored closely during recovery, and if there are problems, their temperature and blood glucose should be checked.

A small meal should be offered within an hour after anesthetic recovery to minimize the chance of developing hypoglycemia. If there are signs of hypoglycemia, treat quickly and accordingly.

Just The Facts, Please

Myth: A female cat or dog should have a litter before she is spayed.
Fact: The sooner you spay your female, the better her health will be in the future. As long as a kitten or puppy weighs more than 2 pounds and is 2 months old, he or she can be neutered or spayed. Many veterinarians practice perfectly safe early sterilization. The longer a female goes unspayed, the greater the likelihood of developing mammary tumors or uterine infections. In fact, a female spayed before her first heat (6 to 9 months of age) has one-seventh the risk of developing mammary cancer as an intact female.

Myth: Spaying or neutering (sterilization) will alter my pets personality.
Fact: Any slight changes will be positive. Regardless of the age when spayed or neutered, your pet will remain a caring, loving and protective companion. Neutering will reduce the need to breed, and that has a calming effect on many animals. Both neutered male canines and felines tend to stop roaming and fighting, and they also lose the desire to mark their territory with urine.

Myth: Companion animals will become fat and lazy if they are neutered.
Fact: Absolutely not! Lack of exercise and overfeeding make pets fat and lazynot neutering. Your pet will not gain weight if you provide exercise and monitor food intake. Neutering is good for your pet, since sterilized pets tend to live an average of two to three years longer than unsterilized pets.

Myth: Sterilization is a dangerous and painful surgery for my pet.
Fact: Spaying and neutering are the most common surgeries performed on animals. With a minimal amount of home care, your pet will resume normal behavior in a couple of days.

Myth: Children should witness the miracle of birth.
Fact: Countless books and videos are available to teach your children about birth in a responsible manner. Letting your pet produce offspring that you have no intention of keeping is teaching your children irresponsibility. Anyone who has seen an animal euthanized in a shelter for lack of a home knows the truth behind this dangerous myth.

Many states and counties have established low-cost spay/neuter programs that make the surgery affordable. Many cities also offer reduced licensing fees for owners of spayed and neutered pets. To find a low-cost program near you, call your local humane society or shelter, or call toll-free (800) 248-SPAY.

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