often we hear people comment on why such a routine procedure is so expensive. in todays blog I would like to brief owners on what occurs from start to finish for a routine spay.
1. patient admittance - Technician does an intake with owner and goes over necessary forms. It is at this time owner decide if blood-work is necessary, we always recommend blood work prior to any surgery. Also any questions or concerns that owners have are addressed at this time.
2. Doctor exams the patient to ensure they are fit for surgery and reviews medical records for any previous concerns and current medications
3. technicians take blood from patient and have it analyzed through the in-house analyzers.
4. Doctor reviews the blood work and then chooses the appropriate sedation for that patient.
5. sedations is administered to patient
6. after 15 minutes the patient has an iv catheter andIV fluids placed into the cephalic vein. Choice of catheter, and fluids is based on patient history, blood-work and age.
7. the patient is induced with an iv general anesthetic, an appropriate size endotracheal tube is placed down the patients airways and the patient is placed on an appropriate anesthetic gas
8. the patient is monitored constantly through out the procedure with recordings made every 5 minutes - blood pressure, spo2, ecg, heart rate, respiration rate, jaw tone, eye position, palpebral response to ensure that the patient stays in a safe plan on anesthetic.
9. after clipping and aseptically scrubbing the surgical sight in the treatment room, the patient is transferred to the surgical room, and another surigcal prep is done and then the surgery is performed.
10. the patient is taken to the recovery room, a nurse is with the patient the entire time waiting for the patient to shows signs of swallowing, the patient is continually monitored. Once the patients gag reflex returns the patient is extubated. The Nurse continues to sit with the patient monitoring until the patient is awake and able to sit sternally. Then patient is evaluated every 15 minutes for the first hour to ensure no complications arise.
11. The iv catheter and fluids are removed.
12. technicians enter notes of the procedure and the doctor enters his/her surgical notes.
13. The surgical room is cleaned and disinfected prior to the next surgery.
14. Pain medications and discharge instructions are prepared for the patient.
15. the patient is continually monitored throughout the day and is offered food and water and taken out to the toilet every 2 hours post surgical.
meanwhile all the equipment is check prior to every procedure, anesthetic machines are checked for any leaking, endotracheal tubes are checked to ensure the cuff inflates appropriately. Equipment needs to be cleaned and autoclaved, and laundry needs to be done.
This is a very labor intensive surgery and requires strict standard operating procedures to ensure the safety of your animal. This happens for every patient, regardless of the procedure performed under general anesthetic.
Please note this is how our hospital prepares and cares for patients undergoing a spay procedure. It varies at every hospital and not all hospitals or clinics are the same. there is no written standard operating procedure by the college of veterinarians that consitutes standard of care.
We include IV fluids, this is not optional as it may be else where, and is included in the cost. This is for the safety of the patient and allows immediate access to a vein in-case an emergency does arise and allows us to better control blood pressure as well. In addition every patient is given pain medication prior to surgery and then sent home with appropriate pain medication, again some clinics do not do this or charge extra for this.
Hopefully this give some insight as to why costs can be so variable in veterinary medicine.