Choosing A Veterinarian For Your Pet

Common Myths about Surgery and Dogs

1. Myth: “My dog is too old for anesthesia”

Please do not let your neighbor, your friend or the internet tell you that your dog is too old or sick for anesthesia. And don’t be afraid to seek out an expert on the topic. Keep in mind, if your dog is that old, surgery is probably not being recommended for merely cosmetic reasons. Your veterinarian is probably talking about it because of a life or death situation, or a serious quality of life issue.

A thorough physical exam and blood work should always be performed before anesthesia. In older dogs, it may be wise to also take chest and belly radiographs, as well as an ECG to be safe. Some dogs may need to be stabilized prior to anesthesia, which may mean fixing blood work abnormalities, giving IV fluids, or giving a blood transfusion prior to anesthesia and surgery.

2. Myth: “Surgery is painful”

This is actually a true statement. However, surgical pain should not be ignored in 2015. We have many safe pain medications to choose from to treat pain before, during and after surgery. We should also remember that depending on what dogs’ conditions are, they are most likely already in pain, which will continue to stay the same or worsen without surgery. The goal of surgery is often to decrease pain.

3. Myth: “There is no point if there is no cure”

This mostly relates to dogs with a tumor. It is a matter of opinion and expectations. And it’s a very personal decision. Without the benefit of a biopsy, we don’t know whether a mass is cancerous or benign until it is removed and analyzed. Even when a mass is cancerous, it doesn’t necessarily mean that it’s the end of the road. Ultimately, your decision should not be based only on quantity of life (survival), but mostly on quality of life.

Ironically, sometimes, the situation doesn’t depend on whether a mass is benign or cancerous, but on where it is located. A perfectly benign mass blocking the windpipe, the esophagus (the tube between the mouth and the stomach) or the urethra (the tube between the bladder and the outside world) will have life-threatening consequences.

4. Myth: “My dog will not survive confinement”

Confinement is often required after surgery. The time required depends on the procedure. Confinement may be in a crate, an upside down baby/puppy play pen, a small room, or part of a room. The larger the dog, the larger the area can be – within reason of course. It may seem cruel to some, but preventing jumping and running is critical to allow proper healing. Outdoors, dogs in recovery need to be under supervision and on a leash for just enough time to eliminate. Dogs don’t know what is best for them. You should.

Minimizing the Risks of Anesthesia in Dogs

Anesthesia is like any medical procedure—there are benefits and risks, and death can occur under anesthesia. Approximately one in 1,000 healthy cats and one in 2,000 healthy dogs die under anesthesia each year. While any anesthetic-related deaths are unacceptable, these incidence rates are actually quite low. But of course, there’s still plenty of room for improvement. One of the reasons we still see deaths related to anesthetic procedures is because not all practices are actively taking all of the steps necessary to reduce anesthetic risk.

The Anesthetic Process

Anesthesia occurs in several steps, with opportunities at each step to minimize risks for your pet.  Below I present a simple outline of the steps involved in anesthesia. 

  • Assessment.  Anesthesia starts with an assessment of your pet’s health.  The veterinary medical team will assemble any needed medical history and lab results, and perform a physical exam.  Here is where they could be assigning an anesthetic risk factor and determining if any specific interventions might be helpful to reduce anesthetic risk for your pet.  Complications such as low blood pressure, shallow breathing, low body temperature, slow heart rate, and delayed recovery from anesthesia can all be anticipated and planned for during the assessment stage.  An anesthesia plan can provide guidance for prevention, recognition and treatment of anesthetic complications.
  • Pre-anesthetic medications.  “Pre-meds”, as they’re referred to in the hospital, have many benefits. Amongst other functions, they provide preventive pain management, reduce stress, and minimize the necessary dose of other anesthetic drugs.  Pre-meds are specifically chosen for your pet, based on his or her unique anesthesia profile.
  • IV catheter.  This allows for the administration of IV drugs and fluids, as well as the IV induction of anesthesia, which is safer and less stressful than mask induction.  Presence of an IV catheter is especially important if an emergency drug is needed to treat a complication.
  • Pre-oxygenation and IV induction.  Pre-oxygenation charges the lungs with oxygen and it, along with the IV induction step, promotes a smooth, controlled transition to unconsciousness.
  • Endotracheal intubation.  Placing an endotracheal, or “breathing”, tube protects the airway and lungs from accidental inhalation of foreign material such as stomach contents, saliva, blood, water, cleaning paste, or tartar. Such a tube is also necessary to maintain anesthesia with inhalant gases.
  • Maintenance of anesthesia with patient monitoring and support.  At this point the patient is unconscious and the procedure is underway.  Isoflurane or sevoflurane anesthetic gases are the most appropriate agents for maintenance of anesthesia.  Clinical research indicates they both are equally safe and effective.  Monitoring of your pet is crucial to assess vital signs and enable recognition and prevention of complications, or timely treatment of them should they arise.  Patient support might include administration of IV fluids and drugs to prevent or treat complications and warming of the patient to prevent loss of body temperature.

Considering surgery for your dog? Take these 4 steps

If your veterinarian is recommending a procedure for your senior dog, it’s because she or he believes that it will help your dog feel better. (And maybe live longer too!)

Here are specific steps to take to help you determine what’s best for your dog:

  • Have a frank discussion with your vet about the procedure and share any concerns you have.
  • Ask your vet to lay out the pros and cons of the surgery.
  • If you or your veterinarian feels uncomfortable about proceeding, you can ask for a referral to a specialty facility (usually a large, 24-hour hospital with specialty doctors and advanced equipment).
  • Please don’t write off the procedure because of the myth that your dog is “too old for surgery or anesthesia.”

Before Anesthesia

Prior to receiving anesthesia, your veterinarian will perform a thorough physical exam on your pet, review your pet’s medical history and discuss any risk factors. Your veterinarian may also perform blood tests on your pet to check for any indications of a developing medical problem or anesthetic risk. If you have any questions about your pet’s health or his or her anesthetic risk, ask your veterinarian for an explanation that will help you make an educated decision.

Prior to anesthesia, your pet will likely be given a pre-anesthetic sedative to reduce his or her stress and ease the process. An intravenous catheter is usually placed to allow administration of fluids and medications. The anesthetic may be delivered by gas inhalation (using a gas anesthesia machine), intravenous infusion, or a combination of the two.

During Anesthesia

While under anesthesia, your pet will receive monitoring and care comparable to what you’d receive if you underwent anesthesia. This may include intravenous fluids and/or medications to support your pet’s circulation and blood pressure; an endotracheal tube inserted into your pet’s trachea (windpipe) to deliver the anesthetic gas and provide oxygen to your pet’s lungs; pulse oximetry to measure the oxygenation of your pet’s blood; blood pressure monitoring; temperature monitoring and warming blankets to prevent hypothermia (low body temperature); and electrocardiography (ECG, also called EKG) to monitor your pet’s heart.

After Anesthesia

Once the procedure is done and it’s time for your pet to wake up from the anesthesia, your pet will likely be placed in a quiet, semi-dark cage or kennel to recover. Pets are closely monitored during this time to make sure that they are recovering normally and that care is provided quickly if there are any problems. Pads and blankets are used to keep your pet warm during the recovery, but it’s not uncommon to see a pet shivering while they recover from anesthesia; however, this doesn’t necessarily mean your pet is cold. Some pets may also vocalize (whine, bark or meow) during recovery. The endotracheal tube is removed when your pet is awake enough to swallow normally. Fluids and/or medications may be continued through recovery, depending on your pet’s condition.

Preparing for surgery

Before the procedure, ask your veterinarian if you can give medications in the morning — some may be needed, but some can be skipped. Also ask if you should drop off your pet’s medications or food the day of surgery. It’s always betterDog preparing for surgeryfor your pet to eat his normal food, whether it’s generic food or a special diet. You may have been told how much confinement your pet will need after surgery, and what that entails; please make sure you have a room, a play pen or a crate prepared for the day your pet comes home.

The morning of surgery

You will need to drop your pet off early in the morning, even though surgery may not occur until late morning or the afternoon. Why is that?  There are multiple reasons, depending on your pet’s specific situation. Your veterinarian may wish to:

  • Run a physical exam
  • Run blood work
  • Place an IV catheter
  • Administer IV fluids
  • Start specific medications
  • Take X-rays
  • Perform an EKG
  • Calculate anesthesia drug doses

Plastic Surgery Preparation

The Smart Guide To Choosing A Plastic Surgeon

For anyone considering cosmetic surgery, it can be an exciting but also intimidating time. How do you choose a surgeon that will meet all your expectations?

There are several key factors to consider when choosing a surgeon. This article will detail what to look for specifically. Having a good plastic surgeon can make all the difference

The show centers on surgery-gone-wrong. Some of the botched jobs can be nightmarish. There are uniboobs from out-of-proportion implants, and many individuals who have had too many bad procedures (even individuals who have tried to make themselves into living-dolls).

Through the show, it’s up to the surgeon to fix these botched jobs and give these individuals quality work that will save their appearance. The end results are always rewarding to watch, but honestly, no one wants to be featured on Botched. Everyone wants their first-time surgery to go smoothly and result in a beautiful improvement.

Make sure the surgeon is board-certified

For plastic surgery, you want a doctor who’s certified by the American Board of Plastic Surgery. It’s simple: The American Board of Medical Specialties’ website will tell you if a doctor is board-certified in plastic surgery.

Plastic Surgery

When you hear of plastic surgery, what do you think of? A Hollywood star trying to delay the effects of aging? People who want to change the size of their stomachs, breasts, or other body parts because they see it done so easily on TV?

Those are common images of plastic surgery, but what about the 4-year-old boy who has his chin rebuilt after a dog bit him? Or the young woman who has the birthmark on her forehead lightened with a laser?

What Is Plastic Surgery?

Just because the name includes the word “plastic” doesn’t mean patients who have this surgery end up with a face full of fake stuff. The name isn’t taken from the synthetic substance but from the Greek word plastikos, which means to form or mold (and which gives the material plastic its name as well).

Plastic surgery is a special type of surgery that can change a person’s appearance and ability to function.

Reconstructive procedures correct defects on the face or body. These include physical birth defects like cleft lips and palates and ear deformities, traumatic injuries like those from dog bites or burns, or the aftermath of disease treatments like rebuilding a woman’s breast after surgery for breast cancer.

Cosmetic (also called aesthetic) procedures alter a part of the body that the person is not satisfied with. Common cosmetic procedures include making the breasts larger (augmentation mammoplasty) or smaller (reduction mammoplasty), reshaping the nose (rhinoplasty), and removing pockets of fat from specific spots on the body (liposuction). Some cosmetic procedures aren’t even surgical in the way that most people think of surgery — that is, cutting and stitching. For example, the use of special lasers to remove unwanted hair and sanding skin to improve severe scarring are two such treatments.

Why Do Teens Get Plastic Surgery?

Most teens don’t, of course. But some do. Interestingly, the American Society of Plastic Surgeons (ASPS) reports a difference in the reasons teens give for having plastic surgery and the reasons adults do: Teens view plastic surgery as a way to fit in and look acceptable to friends and peers. Adults, on the other hand, frequently see plastic surgery as a way to stand out from the crowd.

CHOOSING THE RIGHT PROCEDURE

Cosmetic Surgery Procedures

Here you will find a list of common and popular cosmetic procedures, both invasive and non-invasive. Learn the basics about each procedure, who ideal candidates are, intended results, recovery details, and alternative options.

Body Procedures

Upper Body Lift – Lower Body Lift – Back Lift – Belt Lipectomy

When a person loses a significant amount of weight, through gastric bypass, lap band surgery, post-pregnancy, or diet and exercise, they can be left with an abundance of excess skin that cannot possibly conform to the new contours of their body. The lose skin makes it difficult to feel confident, fit into clothing, and or it may get in the way of maintaining personal hygiene and cause rashes and skin infections.

Arm Lift – Upper Arm Lift – Brachioplasty

An Arm Lift, or brachioplasty, reshapes drooping, sagging skin and fat deposits underneath the arm from the underarm to the elbow. While diet and exercise can help to improve body contours, they cannot reshape sagging skin. An upper arm lift may be combined with liposuction to create a sculpted upper arm that complements the rest of your figure.

Autologous fat transfer – Gluteal augmentation surgery – Buttock augmentation with fat grafting

It has become increasingly popular to have fuller, rounded buttocks. This look is achieved by the Brazilian Butt Lift, which uses excess fat, harvested from other parts of the body, to reshape the contour of the buttocks

How to Choose a Surgeon

In the process of selecting a plastic surgeon, you may choose to have multiple consultations or receive referrals from friends and family. If you have located a surgeon using Smart Beauty Guide’s Select a Surgeon search tool, then you have already started the process of finding a qualified plastic surgeon. If you get a referral from a friend or doctor, be sure to find out if they have the right qualifications before the consultation.

Board Certification

A doctor’s board-certification is the best indicator of his or her training in a particular medical or surgical specialty. In the USA, look for certification by the American Board of Plastic Surgery (ABPS), the only Board recognized by the American Board of Medical Specialties (ABMS) to certify doctors in the specialty of plastic surgery. In Canada, look for certification by the Royal College of Physicians and Surgeons of Canada (RCSC). International plastic surgeons should be board certified in their country of origin and a member of ISAPS and IPRAS.

ASAPS Membership

ASAPS membership ensures that in addition to certification by the ABPS or RCSC, a doctor also has significant experience in cosmetic surgery. ASAPS membership is by invitation only. Plastic surgeons who are not citizens of the United States or Canada who meet the high professional and ethical standards required for ASAPS membership may become ASAPS international active members. To ensure that your doctor is a member of ASAPS, search for them with our Select a Surgeon tool.

Experience

Experienced aesthetic plastic surgeons generally perform a wide range of cosmetic surgeries on a regular basis. Patients should ask about the surgeon’s experience with the particular procedure being considered. If considering a “new” technique or technology, patients should inquire whether results that substantiate safety and effectiveness have been published in a peer-reviewed journal.

Facility Accreditation

Cosmetic surgery can safely be performed in a hospital, a surgicenter or an office-based surgical facility: Current published data show that accredited office-based facilities have a safety record comparable to that of hospital ambulatory surgery settings. However, the majority of office-based surgical facilities are not accredited. Another advantage of selecting an ASAPS member is that all ASAPS surgeons operate in accredited, state-licensed or Medicare-certified facilities.

Smart woman’s guide to choosing the right surgeon

It seems like there has been a tsunami of media recently highlighting the dangers of making a bad choice when it comes to cosmetic surgery or other aesthetic procedures.

Ask your GP, local nurse or other medical professional

Many of our patients come with a referral from a doctor or medical professional. Those professionals have generally seen many results and want to avoid some of the issues associated with unqualified surgeons. In many cases, nurses also come to us as patients or refer their friends because they also see a range of results. But even GPs get it wrong, so refer to the next point to make certain some is a genuine Plastic Surgeon.

Choose a REAL Plastic Surgeon – unfortunately anyone with a basic medical degree can call themselves a ‘cosmetic surgeon’. The government has promised to regulate this, but hasn’t yet which leads many women to believe those doctors have special training in in surgery, when the vast majority have not.

Then really research that Plastic Surgeon. Here are some things to think about:

Being able to see many proper before and after photos (not just selfies in underwear) says a lot about the skill of the surgeon and the satisfaction levels of their patients. So make sure you see lots of results on patients with similar body types to your own with results that match your goals.

Ask how many of that procedure they have performed. Obviously we specialise only in breast and body surgery, so we have performed thousands of those operations. Other surgeons may do a little bit of everything but we think being a specialist in just a few operations is better for mastery.

See if you like the vibe of their clinic, their team and the connection with the Surgeon themselves. If the fit doesn’t feel natural, then it is best to look elsewhere because surgery is a journey and you want to feel comfortable with the crew you are on that journey with.

Remember that cost is definitely a factor, but so to is your safety and the quality of the outcome. As we say, “we don’t do $6,000 breast augmentations, we fix $6,000 breast augmentations.”

Eye Care Centers

How to choose an eye doctor

It may be human nature to surround ourselves with people who see things the way we do. But we should also include a few who see things a little differently. This applies especially to your eye doctor.

The person you choose to provide your annual eye exam should be as much an ally as an expert. Above all, he or she should be able to tell you what you need to know about your vision health — even when you don’t see it coming.

Eye care experts generally recommend a comprehensive eye exam every year or 2, depending on age or vision needs.1 And with roughly 60,000 optometrists and ophthalmologists operating in the U.S.,2 there are plenty of choices. Here are 6 considerations we recommend when deciding on the best eye doctor for you.

Get a read on your network

More than 87% of Americans with vision benefits intend to get eye exams within 12 months.3 Many carriers, including EyeMed, offer online portals that enable you to search by proximity, and get a feel for the mix of in-network independent and retail providers. Remember: Staying in-network translates to lower out-of-pocket costs — that means more money in your pocket.

Eye care professionals fall into three categories. Be sure to see the right one.

Optometrists are primary healthcare professionals for the eye. Doctors of Optometry examine, diagnose, treat and manage diseases, injuries and disorders of the visual system, the eye and associated structures as well as identify related systemic conditions affecting the eye.

Ophthalmologists are medical doctors, licensed to diagnose and treat all eye diseases, as well as perform surgery. Think about optometrists and ophthalmologists like your family doctor and a surgeon — except within the vision world, ophthalmology is a specialty within a specialty.

Opticians are technicians who fit frames and lenses that have been prescribed by an optometrist or ophthalmologist to correct the patient’s vision

How to Choose the Best Optometrist: Your Complete Guide

Struggling with your eyesight?

Need professional help to resolve the problem? Thankfully, you won’t have to look far. The United States is expected to have 46,000 optometrists working around the country by next year. That’s a lot of eye doctors to choose from.

Know the Different Professions

It’s worth noting the different eye-disciplines. You need to know you’re seeking the right support from the outset. The term ‘eye doctor’ gets thrown around a lot these days. But there are two distinctive professional fields to know about: optometrists and ophthalmologist. They definitely aren’t the same!

Seek Recommendations

Let’s assume you know you need to see an optometrist. The easiest step for finding one is often to seek direct referrals. Set about asking your friends, family members and colleagues for recommendations. Who do you know who relies upon glasses and regularly visits the eye doctor for support?

Look for Reviews

Think about your process of deciding somewhere new to eat. Finding a good restaurant can be hit and miss. That’s why sites like TripAdvisor were set up and quickly skyrocketed in popularity. They provide independent ratings and reviews by patrons that reveal a service’s quality.

Check That the Price is Right

Your ideal optometrist will fall within your price range. There’s no point going somewhere you can’t afford. Always finding out about charges prior to receiving treatment. You don’t want to have the examination, only to be surprised by a crippling invoice at the end.

Optometrist or Ophthalmologist: How to Choose the Right Eye Doctor

When it comes to eye problems, everyone knows that they need to consult with a specialist. Often the most confusing part is, which one do we go to? Whether it’s a routine check up, or experiencing vision problems, a simple online search can leave one scratching the head and staring at dozens of options ranging from optometrists to ophthalmologists.

Education

At the end of the day, a major chunk of the difference comes down to education. An optometrist is not a medical doctor. They receive a doctor of optometry (OD) degree upon completion of four years of optometry school, preceded by three years or more years of college.

Surgery

An optometrist cannot perform eye surgery. Being healthcare professionals, they can nevertheless provide basic eye care including sight testing, diagnosis, sight correction, treatment, and general ocular management. In fact, in some areas, optometrists can deliver better results such as prescribing contact and eyeglass lenses due to the extent of exposure they get vis-à-vis such cases.

Performing Research

This is another area of difference between optometrists and ophthalmologists. The former’s ability to perform research is restricted by their qualification.

How to choose the right eye doctor?

Your decision whether to consult an ophthalmologist or an optometrist may be influenced by many factors such as the severity of the visual distortion, budget constraints, incorrect diagnosis etc. What we need is a proper classification of preferences to ease out your decision of consulting either of the two professionals.

Choosing an Eye Doctor

Where do you go when you are having difficulty with your eyesight? Depending on the extent of the problem, your answer may vary. There are several different types of eye doctors and eye specialists you could see, including an ophthalmologist, optometrist, and optician.

What Is an Ophthalmologist?

Ophthalmologists are eye doctors that specialize in the medical and surgical care of the eyes and visual system, and also the prevention of eye disease and injury. They can be either doctors of medicine (MD) or doctors of osteopathy (DO).

While medical doctors focus on disease-specific diagnosis and treatment, osteopaths concentrate on the loss of structure and function in different parts of the body due to disease, including the eye. An eye doctor who is an osteopath would give treatment based on the assumption that treating the parts of the visual system with the use of medicines, surgery, diet, and other therapies, will therefore treat the underlying eye problem.

What Is an Optometrist?

Optometrists are eye doctors of optometry (OD). They are trained to examine, diagnose, treat, and manage some diseases and disorders of the eye and visual system. The optometrist has completed pre-professional undergraduate education and four years of professional education at an accredited college of optometry. In addition, some optometrists may have completed a one-year optional residency in a specialized area. Optometrists have not attended medical school.

What Is an Optician?

Opticians are eye healthcare professionals who work with ophthalmologists and optometrists to provide vision services related to the diagnosis and treatment of vision problems and eye disease. They assist optometrists and ophthalmologists in providing complete patient care before, during, and after exams, procedures, and surgeries. With a two-year technical degree, opticians analyze and interpret eye prescriptions; determine the lenses that best meet a persons needs; oversee ordering and verification of eye-related products from start to finish; dispense, replace, adjust, repair, and reproduce previously ordered contact lenses, eyeglasses, and frames.

Tips For Choosing The Best Eye Care Center For Your Family

Find a Local Eye Care Center

To get the obvious out of the way: it’s ruinous to drag your family to a faraway place for eye care. Few kids like car rides and every parent knows that if the kids aren’t happy, you’re not going to have a good time either. Plus, your entire family keeps a busy schedule. You don’t want to be tripping over yourselves trying to get from soccer practice and dance recitals to Buck’s Discount Care For Eyez on the outskirts of town or Big-Time Corporate Chain in the next town over. You want to be able to get the vision care you need quickly and easily, where you live. More importantly, you want to find an optometrist that cares about your community. You’ll get more personal and trusted treatment from a familiar face. That will help ease any fears in the family about going to the eye doctor and is a great way to support the community you’re a part of.

Ask if They Treat All Ages

Taking a child or a grandparent into an eye care center for their first exam is enough of an event. If the optometrist you’re seeing doesn’t have experience treating particular age groups, that can add undue pressure and result in some clumsy interactions and sub par treatment. Find out ahead of time whether the eye care center you’re considering has experience treating all ages. You want to find an optometrist that has seen it all and is equally comfortable treating a 4-year-old as they are treating an 80-year-old and every age in between. If you’re looking for a family vision care center, make sure that the entire family can find the treatment they need there. That will make eye doctor appointments easier on your family and will spare inexperienced optometrists the awkwardness.

Make Sure They’re Qualified

This tip can apply across the medical care spectrum. But, it’s important. Your family is what matters most. Ensure that you’re taking them to an eye care center with licensed, credentialed, and experienced optometrists. How long the vision center has been in business, how trusted it is within a community, and its experience treating patients should all be considered when choosing where to take your family for vision care. You want to find an optometrist that will be a resource for vision care throughout each family member’s life. That’s a tall task and not everyone will be up to it. Find eye doctors who want that life long relationship and have the skills to back it up.

Go Somewhere with Selection

After you receive top-flight medical care from an optometrist and they determine you need glasses or contacts, it’s a humongous benefit to be able to find what you need right in the same vision center. Opt for an eye care center that has an incredible selection of glasses (lenses and frames) for every need. Not only should you be able to order contacts from your vision care center, but you should also be able to find the perfect pair of glasses. Find an eye doctor that has brand names at competitive prices. A good selection will make it easy for each person in your family (who needs glasses) to find the pair that works for them! Think about the trouble saved when you’re able to knock out eye exams and find new glasses for everyone in the same place.

Examine The Mission

What is the Mission of the vision care center you’re looking into? Do they seem primarily concerned with cultivating lifelong eye care relationships with patients of all ages? Or, do they seem like they’re motivated by making money and taking on as many new patients as possible to grow profits? If it’s the latter, you have to ask yourself ‘Is this the right place for me and my family?’ Especially for younger children, it’s important to find an optometrist who will put them at ease and be a steady resource for all kinds of vision maintenance and improvement. An optometrist that can provide vision for life is invaluable to your family. Find an eye care center with values that match your own. It’s the groundwork for a successful and lasting eye care relationship.