A board certified veterinary surgeon is a licensed veterinarian who has obtained intensive, additional surgical training. A veterinary surgeon can offer special assistance in the following kinds of cases:
- Traumatic injury and emergencies (such as fractures, skin wounds and lacerations, correction of gastric dilatation-volvulus, and exploratory (abdominal/thoracic) surgery.
- Orthopedic surgeries (such as total hip replacements (THRs), cruciate ligament surgeries (TPLOs), and arthroscopy for joint exploration).
- Soft tissue surgeries (such as tumor/cancer removal and correction of congenital defects).
- Neurological surgeries (such as herniated discs and spinal injuries).
What Additional Training Does A Board Certified Veterinary Surgeon Have?
Veterinarians who want to become board certified in small animal surgery must seek additional, intensive training to become a specialist and earn this prestigious credentialing. Specialty status is granted by the American College of Veterinary Surgeons (ACVS). A veterinarian who has received this specialty status will list the initials, "DACVS," after his or her DVM degree. Or, the veterinarian may indicate that he or she is a "Diplomate" of the ACVS. The word "Diplomate" typically means the specialist has achieved the following:
- Obtained a degree in veterinary medicine from a university certified by the American Veterinary Medical Association following completion of undergraduate requirements.
- Completed a one year general internship, plus an additional three to four years of advanced training in a residency at a veterinary teaching hospital where the veterinarian will have trained with some of the best surgeons in the field and obtained hands on experience. Surgery residents also have to complete a case log in soft tissue, orthopedic, and neurologic surgery.
- Completed the credentialing application process established by the ACVS, including publication of research results.
- Passed a rigorous examination.
Why Does My Pet Need A Veterinary Surgeon?
Just as your own primary care physician may feel the need to refer you to the care of a specialist from time to time, your general practitioner veterinarian may feel your pet needs the additional expertise of a board certified surgeon for certain surgeries. In fact, many general practitioner veterinarians refer all but the most routine of surgeries to specialists"orthopedic and neurology cases, reconstructive surgeries, tumor removals, etc.
Board certified veterinary surgeons also are often affiliated with referral hospitals where they may have access to specialized diagnostic or surgical equipment, the latest and safest anesthesia monitoring equipment, physical therapy or rehabilitation capabilities, and other critical care services that a general practitioner may not have access to. All of these specialized services may be necessary for the optimal care and recovery of your pet.
You can be assured that a veterinarian who knows when to refer you and your pet to a surgeon is one that is caring and committed to ensuring that your pet receives the highest standard of care for his or her problem.
What Kinds of Problems Require the Expertise of a Veterinary Surgeon?
Board certified surgeons can repair complex fractures, perform total hip replacements, and use advanced techniques to repair torn ligaments (ruptured cruciate ligaments) within the knee. They can also remove cancerous growths, manage extensive or nonhealing wounds, and perform reconstructive surgery, such as grafting skin over large injuries. Veterinary surgeons can perform intricate surgeries in the chest or abdomen, such as kidney transplants in cats or repairing heart defects in dogs. Spinal injuries and herniated discs are problems that are also commonly referred to board certified surgeons. Veterinary surgery is also expanding into minimally invasive surgery, such as arthroscopy, thorascopy, and laparoscopy.
Will My Pet Be in Pain?
Surgery is a major medical procedure and is often associated with pain in both animals and humans. You can be assured that your veterinary team"your pet’s general practitioner veterinarian, veterinary surgeon, and any other veterinary specialists involved in your pet’s care"will prescribe pain management options to help keep your pet as comfortable as possible before, during, and after surgery. If you are concerned about pain management for your pet, simply ask your veterinarian.
Will My Regular Veterinarian Still Be Involved?
In many if not most surgical cases, your regular veterinarian will still supervise your pet’s veterinary care, especially if your pet is continuing to cope with a disease or chronic condition. It depends on your pet’s particular disease and health problem, however. Typically, though, your general practitioner veterinarian will oversee many aspects of your pet’s pre-op and post-op care, just as in human medicine. Recovery periods are often prolonged in many surgical cases, particularly in orthopedic surgery, and it is very important to follow your veterinary team’s recommendations concerning at-home recovery guidelines for your pet, follow up care and appointments, as well as any rehabilitation that has been prescribed.
What Do I Bring to My Referral Appointment?
Be sure to bring any relevant medical records or information to your first appointment. Ask your veterinarian for copies of any relevant medical tests, imaging studies, x-rays, or laboratory panels. Remember, you also can do your part to maximize your pet’s recovery by keeping your pet’s traveling medical records organized and by strictly adhering to the recommendations of your veterinary team for the scheduling of suture removal and other follow up appointments, etc. At every appointment, be sure to write down any important recommendations, or ask the veterinarian or a staff member to write them down for you.
Common Referral Surgeries
- Tumor removal
- Limb amputation
- Cruciate ligament repair (TPLO’s and other traditional methods)
- Hip replacement
- Surgical repair of elbow dysplasia
- Spinal problems/herniated discs
- Gastric dilatation/volvulus
- Wound management and skin reconstruction
- Congenital defects
- Urinary obstructions
Cancer does appear to be becoming more common in both dogs and cats, most likely because they are simply living longer. However, early detection and specialized care are leading to increased survival and cure rates in almost all the types of cancers that afflict pets. From surgery to chemotherapy to radiation therapy, veterinary cancer specialists (link to cancer specialty page) can offer your pet the very latest diagnostic and treatment options and the best chance of survival. With optimal treatment, cancer in many cases simply becomes another manageable chronic disease.
Surgery is one of the most common treatment options for pets with cancer, and can lead to enhanced survival times and better quality of life for many affected pets. Your veterinary surgeon will work closely with your general practitioner or veterinary oncologist to ensure your pet is getting the very best care.
Three orthopedic surgeries that are commonly performed in pets are triple pelvic osteotomy (TPO), total hip replacement (THR), and cruciate ligament repair (TPLO).
In the TPO procedure, the bones of the pelvis are cut apart and rotated to more correct positions. In THR procedures, a dog’s diseased hip joints are replaced with prosthetic ones. TPO’s and THR’s are two commonly used surgical techniques for the treatment of canine hip dysplasia (CHD), an inherited and potentially painful disease that affects the hip joints of millions of dogs. Cruciate ligament disease can occur in both dogs and cats, who usually tear or rupture this ligament while exercising, playing, or simply landing incorrectly after a jump. The ligament will not heal without surgery. Surgery helps to stabilize the pet’s knee joint and prevent further wear on the joint and associated structures. An increasingly common surgical technique to correct this situation is called the Tibial Plateau Leveling Osteotomy"or TPLO.
Other causes for Surgery:
Anterior Cruciate Ligament Disease
The most common cause of rear limb lameness in dogs is a tear or rupture of the anterior cruciate ligament (ACL). This painful injury allows degenerative changes to occur in the pet’s stifle joint (which, despite its location, actually corresponds to the human knee joint). Just as in people, this is a delicate joint, prone to traumatic injury, in which the "kneecap" is held in place on top of the tibia by two cruciate ligaments. Rupture can occur when the joint is rotated unexpectedly, hyperextended, or when it is hit catastrophically from the side or the front. Certain conformational defects, such as crooked legs, can also lead to a slow degeneration of the joint over time.
There is a surgical correction, however, that can help alleviate the problem. Tibial Plateau Leveling Osteotomy, or TPLO, is a procedure which puts the animal’s knee joint back in proper alignment. During the surgery, the leg bones are cut and rotated to their proper positions and then stabilized using a metal plate and bone screws. As with any kind of complicated orthopedic surgery, the recovery period is crucial and the animal’s activity must be severely limited. Patients must not be allowed to jump, play, run, climb up and down stairs, or do much more than walk quietly on a leash.
The term elbow dysplasia refers to a degenerative disease of the elbow joint. There are several different potential causes for the problem, that may occur singly or at the same time in the same animal. Elbow dysplasia occurs primarily in medium to large breed dogs. Dogs with elbow dysplasia typically show signs of lameness before reaching one year of age, although in some cases lameness may not become apparent until middle age.
The treatment for this disease can involve surgical and/or medical options. If you think your dog is experiencing problems in his or her elbow joint, be sure to discuss your concerns with your veterinarian.
Canine Hip Dysplasia
This is a hereditary, developmental disease that affects the hip joints of dogs. Certain breeds are more likely to be affected than others. Although its occurrence in large and giant breeds is well documented, there is evidence that it may also be present in smaller breed dogs and cats as well.
Poor conformation of the hip and thigh bone structures result in a "looseness" of this ball and socket joint. This looseness allows the ball part of the joint to move in the socket, instead of remaining stable as it should in a healthy, normal, tight fit. This abnormal movement can create wear and tear in the joint, leading to arthritis. Although signs of the disease do not typically appear until after the dog matures, puppies as young as five to six months can be affected. Hip pain, stiffness, abnormal gait patterns, an audible "clicking" sound while walking, and a reluctance to exercise are all possible signs of hip dysplasia.
The disease is usually diagnosed using radiographs, or x-rays. The treatment for this condition is primarily surgical. In one type of procedure, the Triple Pelvic Osteotomy, or TPO, the bones of the pelvis are cut apart and rotated to more correct positions. In Total Hip Replacement (THR) procedures, a dog’s diseased hip joints are replaced with prosthetic ones. The goal of both surgeries is to provide your pet with some measure of normal activity and function and to reduce the pain associated with the condition. A very high level of success is reported with these surgeries. However, as with all major procedures, it is very important to follow your veterinary surgeon’s recommendations regarding recovery and rehabilitation.
Questions to Ask Your Veterinarian
Many owners are increasingly seeking specialized care for their pets, just as they do with other family members, in order to secure the very best outcome. If your pet is facing surgery, here are some questions you may wish to ask your general practitioner veterinarian:
- How often have you performed this type of surgery?
- Does the surgery require any special equipment? Is it available?
- Does my pet’s surgery require a specialist?
- What should I expect the outcome of the surgery to be?
- What follow up care is necessary?
Did You Know?
Just as in humans, a pet’s recovery from surgery can go more smoothly or even result in a better outcome with the addition of rehabilitation options. Many veterinary referral hospitals offer rehabilitation services, such as water therapy, physical therapy, and massage therapy, as an adjunct to surgical care.
Just as in people, laser surgery is becoming a much more common surgical technique in veterinary medicine, bringing with it the same advantages of reduced blood loss and shorter recovery times.
American College of Veterinary Surgeons
Veterinary Orthopedic Society
American Veterinary Medical Association
The University of Pennsylvania Hip Improvement Program