Help with questions for surgeon

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Karen & Angus(GA)

Karen & Angus(GA)

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Minou's pre-surgery consult is tomorrow and I am a nervous wreck. This is exploratory with liver and intestinal biopsies. These are the questions I have come up with so far. What else should I ask?

1) How is the procedure done?
What anesthesia?
What monitoring?
2) Possible DX?
Lymphoma
what else?
2) How long will she be hospitalized?
3) What type of care will she need at home?
4) Do I need to bring food?
5) Can she have a T-shirt?
6) Medical information for them
She reacted to her sutures when spayed
She does not tolerate Clavamox or Cephelexin, does okay with Amoxicillan and ??? (need to check her records, I think it was Baytril)
 
Hi Karen

I think I asked, but is there any way to do this laparascopically?

The surgeon won't have info for you on differential diagnoses, probably. You want details about the anesthesia, the monitoring (you want SpO2, ECG, BP, and hopefully ETCO2, though a lot of places can't do that) including who will be doing the monitoring (you want a dedicated tech whose job is to stick with your kitty every step of the way). You want pain meds to start before the cat wakes up and you want to see a modern attitude towards pain -- you don't want to hear that they need to be in pain or they'll be too active, etc.

I would avoid getting a shot of Metacam after surgery. While they're in the hospital, they have access to opioids with much less risk.

I'm sory I can't remember, but if your cat has had any issues eating or with vomiting, you can ask about placing a feeding tube at the same time as surgery. It's simple and doesn't extend anesthesia time appreciably and will allow you not to have to worry about the kitty's appetite as she recovers. If I had a sick cat needing an ex-lap (the nickname for the procedure), she'd get a feeding tube placed until I was sure she was eating on her own. Ask the surgeon about his/her experience here.
 
Thanks Choy-Foong and Jess!

Pain management is definitely an important one!

I looked into laproscopy and there are a couple of places that do them. However, they are all an hour or more away, I am not familiar with any of them, and none of them are staffed 24/7. So, if there were any complications I would have to move her.

I am taking her to a veterinary surgical specialist that is part of the same referral center as her IM vet. I will definitely ask if they do laproscopy. When I talked to her IM vet, she thought an open exploratory was the best option. The IM vet will be at the pre-surgery consultation, so I can ask more about her reasoning and potential Dx then. The center also has an oncologist on staff and an emergency clinic, so they are staffed 24/7. This surgeon amputated my sister's dog's leg. They were really good about pain management, answering questions, etc.

As for vomiting, she has vomited 1 -2 per/week for her entire life. Her appetite has been good. I will ask about the feeding tube anyway.
 
i forget, minou's not diabetic, right?

more thoughts, in no particular order, and some aren't questions for surgeon:

if she's staying over - we made a cage card - fold an A4 sized paper in half width-wise, and printed on it "diabetic - no dry food, feed only owner-provided canned food." laminated it, punched two holes at the top and strung twist-ties through, to tie to door of cage.

will there be an incision? ask if should switch to non-clumping litter (we used yesterday's news) for duration of healing. will climbing into litterbox be ok - how tall are the sides of her litterbox?

if there's compromised renal function, ask about IV fluids pre- and post-surgery.

is biopsy being sent out (sounds silly, i know, but i'd want to make sure).
how long for results, ask for copy to keep.

i dont ask to bring t-shirt, i just do :P they'll understand. be prepared to part with it; if the facility is busy, they do laundry for all patients at once, and even if shirt is marked you may never see it again. small price to pay for kitty's comfort.

experience of surgeon. how many of these have they done. success rate. what complications are possible during/after the procedure.

if you have any alternatives to hard collar, like the t-shirt, or a soft or bite-not collar, bring along for surgeon to evaluate and approve use. if you have your own hard collar, bring along on day of surgery; they charged us an arm and a leg for the hard collar.
 
Jess - I just found out that AVIM offers laparoscopy. Her vet (Dr. K.) recommended open surgery so I will definitely have to ask why.

This is where I am taking her:
AVIM
 
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