Pre-operative Instructions

Common:

· Scrotal bruising and swelling in males that resolves without treatment

· Self-inflicted trauma to the surgical site. This includes suture removal by the animal, skin infections caused by licking and other damage. Prevent these problems by purchasing an e-collar.

· Hematoma or seroma (non-painful swellings near the incision or in the scrotum) that resolve without treatment

· Minor swelling and redness around the incision that resolves without treatment

· * Figures recorded by Dr. Cobb based on 8000 surgeries.

· Other: There is also the possibility of unforeseen complications

Appointments

What to Do Before Clinic Day

· Put your appointment date in your calendar. Be sure to arrive during the given time-frame as we stagger appointments to minimize lines. We will call when your pet is ready to be picked up, generally between noon and 2 pm. We greatly appreciate clients who come right away. If you do not hear from us, please plan to arrive at 3:15 pm. Pick ups later than 3:30 will result in a $20 cash charge per 15 minutes.

· FRANKLIN TWP APPTS ONLY...Mail a deposit check or money order payable to Ace of Spays for $20 per pet to hold your spot(s). Mail to Ace of Spays, 1485 Route 38, Hainesport, NJ 08036. Include your appointment date on the check. The check will only be cashed if you do not show up for your appointment. Otherwise, it will be returned to you when you pick up your pet and you will be asked to pay cash in full at that time. WE WILL NOTIFY YOU BY E-MAIL IF YOUR APPOINTMENT IS CANCELLED AND FILLED BY ANOTHER PET DUE TO LACK OF DEPOSIT.

· Pre-operative blood tests are recommended especially on pets over 4 yrs of age. Pets can be born with or develop outwardly unapparent kidney or liver problems which increase the risk of anesthetic death. Bleeding disorders are not uncommon in pets. Pre-operative heartworm testing is recommended for all dogs over 7 months old that have never been tested or that have missed preventative treatments. Charges: $20 for Heartworm test, $20 to check for bleeding disorder (more testing needed if this test is positive), $30 to check kidney and liver function. Add $45 if you want an exam, a medical records chart and one-on-one time with the vet. ALLOW 48 HRS BEFORE YOUR SURGERY DATE FOR RESULTS.

· Click on the links at the top of the page and read about extra services, post-operative care and the consent paragraph you will sign at the clinic. E-collars are strongly recommended. Post-operative complications from licking the incision can be very expensive and a $10 preventative with an e-collar is worth the expense. Pain relief medications to go home are also strongly recommended as pets on pain relief medications eat sooner and feel better than those without. The cost is $20 for a 3 day supply. Please read post-operative care to avoid unnecessary questions at the clinic. We are happy to help you and will politely answer any questions. However, it saves time if we do not have to answer questions such as “when can I bathe my dog” or “how long should he wear the e-collar”, or “when can I feed her” These answers are easily found by clicking the post-operative care link above.

· CASH ONLY-Be sure you have enough cash on hand as we do not accept checks or credit cards during clinics. Surgery prices are $95/female dog, $85/male dog, $75/female cat, $55/male cat. $20 extra for dogs over 49 lb. Be sure to have enough to cover any extras you are interested in as well.

· Reschedule if your pet becomes ill or if your dog goes into heat. Spaying a dog (but not a cat) in heat is much harder on the dog and also slightly more dangerous. Dogs have heat cycles every 6 months. They usually bleed for 1 week during the heat cycle but have added uterine blood supply for longer. The first sign that a dog is going into heat is a swollen or enlarged vulva (vagina). PLEASE reschedule for 4 weeks after the bleeding stops.

What to Do the Morning of Surgery

1. Withhold food, not water. Kittens & puppies under 4 months of age can have a teaspoon of canned cat food the morning of surgery. For all other pets, withhold food starting at midnight the night before surgery. Doing otherwise can result in death. Do not remove water.

2. Make sure you have your cell phone turned on and with you all day or provide a # where we can reach you.

3. If your pet is friendly, look at the pink part of his/her gums prior to surgery. Make a mental note of the color for comparison purposes in case of post-operative concerns.

Bring the following to the clinic:

A towel or blanket that can be discarded if soiled. Pets get cold after surgery.

You do NOT need to bring proof of vaccination unless you want a rabies shot for your pet AND your pet has previously been vaccinated for rabies. Then you need to bring proof of rabies vaccination or we will give you a 1-year license instead of a 3-year license.

Your pet(s)

Dogs must be on leashes or in carriers. We prefer carriers for small dogs.

Cats must be in cat carriers or traps. Bring each cat in a separate carrier or trap. They can injure each other while recovering if in the same carrier. Cardboard carriers are acceptable but we prefer plastic carriers.

What to Do When You Arrive

1. It is helpful to leave dogs in the car initially if weather permits so you can fill out the consent form(s) without holding a leash at the same time.

2. Complete and sign a consent form for each pet.

3. Walk dogs on our property before entering. Please bring a bag to pick up waste.

Extra Services That Will Be Offered on The Consent Form

$20 Pain relief medication-2 day supply

$10 E-Collar to prevent damage to the incision

$16 Flea and tick control for 1 month (Frontline Plus)

$30 Microchip with Lifetime Registration (Home Again)

$20 Dog Heartworm Test*

$25 Cat Leukemia AIDS Test*

$10 Ear Cleaning

$10 Nail Trim

*Surgery is underway before we have test results. Schedule an appointment at out shot clinic if you want results prior to surgery.

$15 Dog Distemper: distemper, parvovirus, adenovirus type 2, +/- parainfluenza.

$15 Cat Distemper: rhinotracheitis, calici, panleukopenia

$10 Rabies Vaccine

$15 Tapeworm treatment

$25 ea. Dog dew claw removal (extra hind toes)

N/C Ear Tip The tip of the left ear is removed (feral cats only)

$10 Deworm-hooks/roundworms

$20 Ear Drops to go home for ear mites: Tresaderm

Pain Relief Medications: Anesthesia only controls pain while pets are asleep. At Ace of Spays, all pets receive another shot that controls pain for 6-8 hours. 2 days of extra pain relief is a great idea for all pets. Abdominal surgery, such as a hysterectomy (comparable to a spay), is painful. Removing testicles is also painful. Pets on pain relief medication eat sooner and recover faster after surgery. The medications we use are very safe and effective. Do not purchase pain relief medication for aggressive cats as it will be impossible to administer.

E-Collars: prevent pets from damaging the incision. Licking causes infections. Chewing causes suture removal. E-Collars are recommended to prevent further medical expenses. Male dogs are notorious offenders.

Microchips: A rice sized pellet is inserted under the skin. All pets entering animal shelters are scanned for chips. The scanner picks up the chip number. The shelter calls the national registry and finds the owner.

Feline Leukemia/AIDS Test: Neither disease is transmissible to humans. Once cats are infected, they remain infected for life. Infected cats can live for years. In-house tests are screening tests. There is another, more expensive test that can be run in animals with positive results to verify infection, though these also are not fully reliable. Kittens born to infected queens can test positive for AIDS up until 6 months of age even if they are not infected themselves. If your pet tests positive for either condition, call to discuss how best to proceed. Until a final determination is made, keep these cats separate from non-infected cats. More details are available at njace.org.

Distemper Vaccines: Vaccination is not required for appointments but it is recommended that puppies and kittens have at least 2 of their initial series of shots prior to arrival. We make every attempt to minimize exposure but the chances of exposure still exist. Multiple distemper shots are given to puppies and kittens until they are over 12-16 weeks old. These are usually given at 3-4 week intervals starting at 6-8 weeks of age. Our practice protocol is 1 shot a month starting at 7-8 weeks of age and ending at or after 16 weeks of age. We then give a final booster at 1 year of age. At least 2 shots are required before a pet is protected from disease and at least one of the shots must be given at or after 12-16 weeks of age. There are conflicting opinions about distemper vaccination intervals for adult pets ranging from the need for annual shots, to one shot every 3 years, to no more distemper vaccines at all. We opt for the latter choice as research indicates immunity is long and vaccination reactions (see attached) do occur.

Rabies Vaccines: Rabies is required by the State. Pets must be at least 3 months of age for a rabies shot. After the first shot, another is given in 1 year and then every three years thereafter. We must see a former rabies certificate for your pet (recent or expired) in order to provide a 3 year shot. State law requires it.

Tapeworm Treatment: Tapeworm segments look like rice. They are caused by fleas. If you see tapeworms, we recommend a good flea control program and treatment for tapeworm. Frontline plus is very effective against fleas.

Dew Claw Removal: Dew claws (extra toes on a dog’s hind legs) that are not firmly attached can get caught on things causing painful tears. We remove loose dew claws but not ones with firm bony attachments.

Declawing: We do not declaw cats unless the only other option is euthanasia and then the surgery is NOT done during spay/neuter clinics. Declawing involves the removal of bone. It is very painful. Most kittens outgrow poor clawing behavior. “Soft Claws” available at PetsMart are glue on plastic tips that prevent damage from clawing.

Deworming: Pets should be on a regular deworming schedule. Many heartworm preventatives contain deworming medication as well.

Consent Paragraph

I am the owner, or the authorized agent for the owner, of the animals described on this form, and I have the authority to execute this consent. I hereby give Dr. Lori Cobb, Ace of Spays, LLC and any authorized agents, staff, or representatives consent and authority to perform spay/neuter surgery. This surgery, which requires general anesthesia, involves the removal of the uterus and ovaries in females and removal of the testicles in males. I understand what will be done. I also understand that my pet will not be checked for pregnancy prior to surgery and that, if pregnant, fetuses will be aborted. I have been informed that there are certain risks and complications associated with any operation or procedure of this type. I have read “Potential Complications from Spay/Neuter Surgery” and “Post-Operative Care Instructions.” My questions, if any, have been answered. I further understand that during the course of the operations or procedures, unforeseen conditions may arise that may necessitate the performance of additional procedures. I authorize the use of appropriate anesthesia and pain relief medication as needed before or after the procedure. I have been informed that there are risks associated with the use of any medication. I understand that the veterinarian performs all surgeries and utilizes clinic support personnel as deemed necessary. I understand that I am financially responsible for all post-operative veterinary care whether it is provided by Ace of Spays, LLC or another veterinary facility. I agree to pick up my pet before the closing time listed on my paperwork or I will pay $20 per 15 minute interval until I arrive in order to compensate tired staff. If I have indicated I want vaccinations, I hereby consent to having my pet vaccinated for the diseases indicated. I have read and understood to my satisfaction “Vaccination Reactions”

Potential Complications of Spay/Neuter Surgery

Please call Ace of Spays. LLC at (609) 267-6770 if you have any questions

Rare:

· Anesthetic complications resulting in death (1/2500 animals*)

· Other anesthetic complications resolving with treatment (1/5000)

· Hernias in females-breakdown of the internal sutures (1/8000)

· Delayed wound healing (0)

· Urinary incontinence-dribbling urine/inability to control urination (0)

· Infections in the abdomen or the remaining small piece of the uterus (1/8000)

· Weight gain in females (0)

· Bleeding during or after surgery either internally, from the incision or from the vulva that can result in death.

· (1/1000 repaired surgically)

· Infection in the skin near the incision or sutures (1/8000)

· Adhesions or other complications which may impair gastrointestinal or urinary tract (0)

Vaccination Reactions

Recommended vaccines help protect your pet from deadly or potentially deadly and fairly common diseases. Muscle soreness, sluggishness, loss of appetite +/- mild fever are occasionally seen for a day or two after vaccination. On rare occasions, pets have an allergic reaction. Hives and/or facial swelling are the most common signs. Pets with these reactions should be treated promptly as the condition can, on very rare occasions progress. On extremely rare occasions, pets have allergic shock reactions to shots. This may be seen as difficulty breathing, weakness, collapse or even death. These reactions generally occur within 5 minutes of vaccination but can take longer. These reactions can occur in pets that have been vaccinated in the past without problems. Pets can develop sarcomas (tumors) at the injection site (reportedly 1/10,000 shots). These tumors are most frequently reported with rabies vaccines and feline leukemia vaccines (reportedly 1/1000 shots). They are very difficult and expensive to treat and can result in the need for euthanasia. There are also reports of dogs developing immune mediated anemia from vaccinations. This appears to be rare but can be deadly.

Post-Operative Care Instructions

What to Do After Surgery

No Exercise: Avoid exercise (jumping/running etc) for your pet for 7-10 days post operatively. This may require confinement in a crate or small room. If a cat or small dog is confined to a bathroom, be certain the toilet seat is down the first night to avoid drowning. Dogs should be walked on a leash rather than allowed freedom in the yard.

Keep Inside: Dirt and flies create post-operative problems. House feral cats in a climate controlled area in traps for a minimum of 2 days (1 week preferred). Keep dogs and tame cats indoors for 1 week.

Keep Warm: Provide towels for cats to lie down on. Keep dogs warm with blankets. Avoid heating pads.

When to Give Food and Water: Water can be provided immediately. Use a shallow pan for water for cats for 24 hours after surgery. Provided your pet has not been vomiting, you can feed a small amount of canned pet food or finely chopped/ blended bland human food (like cooked chicken and rice) when you get home from the clinic. If that stays down, several additional small meals can be fed at hourly intervals. Total food intake for the evening should be no more than what you would feed for an evening meal on a normal night. Resume normal feeding the morning after surgery. If you did not purchase extra pain relief medications, do not be alarmed if your pet does not eat the first day or two. Pet’s on pain relief medications generally eat well immediately. Please contact us if that is not the case.

Pain Relief Medications: Your pet’s pain relief injection will last about 6 hours. If you purchased pain relief medications at the clinic, please give as directed on the label. Do not give over-the-counter products without consulting a veterinarian. Some are toxic to pets and all decrease clotting abilities.

Litter Pans: Use shredded paper, a product called “Yesterday’s News,” or absorbent crystal cat litter in order to avoid dust in the incision for 3-7 days. This is most important for male cats as there are no sutures in males.

No Baths: Do not bathe your pet for 10 days after surgery.

E-Collar: If you are using an e-collar, keep it on for 7-10 days.

What to Expect After Surgery

Cats are mildly sleepy and wobbly for the first evening but generally resume normal activity by the following morning. Cats that are acting overly excitable (running into things, circling and banging around) should be housed in carriers until they are normal. This may take 36 hours.

Dogs are wobbly for up to 24 hours. Sluggishness improves gradually to a normal activity level over 1-3 days.

Your pet should be willing to move around and should be easily roused from sleep.

Shivering is common, especially in dogs, for 6-12 hours.

Eyes appear watery or film covered from a protective lubricant.

Pets often drool for up to 12 hours due to the anesthetic agents.

Occasional vomiting occurs for 12-24 hours in some pets. Seek medical attention if vomiting is severe.

A few drops of blood from the surgical area occur in some pets during the first night. If combined with excessive lethargy (sleepiness) or if blood loss is more than a few drops, seek veterinary advice.

Males can develop fluid accumulation in the scrotum making it appear as though they still have testicles. This swelling can get as large as 2 times the size their testicles had been. This resolves over 1-6 weeks.

Mild swelling or redness can occur at the site of the incision and last up to 7 days.

A non-painful lump can occur near the incision up to 2 weeks after surgery. Provided your pet continues to behave normally and the lump does not disappear when pressed gently, this is a seroma (an accumulation of fluid) and will resolve without treatment within 3-6 weeks.

Sutures are absorbable but the process takes up to 3 months. Do not be concerned with lingering stitches unless there is pain when touched or discharge (pus) around them. There are not stitches in male cats. There are no stitches in young male puppies.

Licking of the surgical site can occur (especially in male dogs) and should be avoided with an e-collar. These are available at our clinic or at PetsMart. Pets can remove sutures and cause infections by licking.

What to Expect After Surgery (cont’d)

There is sometimes a small (less than 1/8 inch high) protrusion of pinkish colored tissue extending the length of the incision. This is the inside layer of the skin and is not a problem.

What Requires Veterinary Care After Surgery

If you see the following signs or if you have other concerns that are not explained in “What to Expect After Surgery,” contact Ace of Spays, LLC (see below) or your local veterinarian. Where it says immediate consultation or care is required, keep making phone calls until you make human contact. This may require contacting an emergency clinic (some are listed below).

A “lump” near the incision that disappears when pushed on, or that is accompanied by poor appetite or other signs of illness. Immediate consultation with a veterinarian required.

Anything protruding from the incision other than a small (less than 1/8 inch high) line of pinkish tissue. Immediate consultation required.

Bleeding or discharge from the vaginal area at any point after surgery (can start as long as 2 weeks after surgery). Immediate veterinary consult required for blood. Consultation within 24 hours for other discharge.

Though mild bleeding from the incision (a few drops of blood here and there the night of surgery) occasionally occurs, more significant bleeding can be a sign of problems. Compare your pet’s gum color to how it looked before surgery. Immediate consultation with a veterinarian required.

Moderate to severe lethargy (sleepiness) especially if accompanied by very pale pink or white gums can indicate internal bleeding even if there is no outward sign of bleeding. Immediate consultation required.

Severe swelling (over 3 times the size the testicles had been) of the scrotum of male dogs that occurs within 24 hours of surgery. Check gum color. Immediate consultation recommended.

Decreased appetite or activity level that lasts more than 2 days requires a phone consult within a day.

Missing sutures (other than in male cats and young male puppies, who never had any). This can wait a day in any male dog and in female cats or dogs that still have internal stitches. Use an e-collar in the meantime…purchase at pet store.

Skin discoloration or pus around the incision requires treatment within a day or two.

A greenish hue or a moist reddish coating indicates your pet has been licking when you are not watching. Get an e-collar and seek veterinary care within a day or two.

A painful swelling near the incision can be the sign of an infection/abscess requiring attention within a day.

Reaching Ace of Spays, LLC for Post-Operative Questions

Please read “What to Expect After Surgery” before calling. For non-emergency questions, leave a message at (609) 654-2921 or send an e-mail to aceofspays@comcast.net. Messages are checked sometime between 6-9 AM and between 3-6 PM. For greater concerns only, call Dr. Cobb on her cell phone at (609) 519-0789 between 9AM and 8 PM. She may offer to meet you at a South Jersey location of her convenience or she may refer you to an emergency clinic. Regardless, you are responsible for all post-operative care. If it is between 8 PM and 9AM, or if Dr. Cobb does not answer, and you believe your pet needs attention within a day, please contact your local veterinarian or an emergency clinic such as one of those listed below. Please also leave a message at (609) 654-2921.

Who to Call for an Emergency

All post-operative care is at the pet owner’s expense. Some emergency clinics are listed below. Please also let us know about any problems.

SJES University of Pennsylvania Animal Emergency Mt Laurel Emergency

Linwood, NJ Philadelphia, PA Langhorn, PA Mt Laurel, NJ

(609) 926-5300 (215) 898-4685 (215) 750-2774 (856) 234-7626

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