Specialty care surgery services.
We offer a wide range of procedures performed at a level of expertise expected from doctors who have undergone a structured postdoctoral training program in small animal surgery.
Our practice is fully equipped and staffed to perform a wide range of surgical procedures in dogs and cats, from the common to the complex.
Knee problems are the most common reason for referral in dogs, and in most instances are caused by damage to the Cranial Cruciate ligament (CCL) or from kneecap problems (Medial Patellar Luxation or MPL).
Cranial cruciate ligament.
Cranial cruciate ligament (CCL) is the most common condition we treat. CCL is the same as ACL in people, but in dogs, it’s called the CCL because they walk on all four limbs.
The severity of a CCL injury varies based on the type of dog, their activity level, and body weight.
We perform a variety of procedures for CCL injury in dogs. These include:
- Tibial plateau leveling osteotomy (TPLO)
- Tibial tuberosity advancement (TTA)
- Extracapsular repair
We will discuss with you our approach to knee surgery based on what we know has worked well for many patients over a course of years, with the best chances of positive results.
The medial meniscus is a shock-absorbing cartilage structure that sits between the two bones of the knee. It can become damaged after the CCL becomes damaged. We have seen medial meniscal tears develop on the first day of ligament damage and as long as 1-2 years after.
If you hear clicking in your dog’s knee, it’s possible that the meniscus is damaged. Surgical debridement or removal of the torn tissue has a significant impact on improving limb use, regardless of the type of treatment done to stabilize the knee.
Medial patellar luxation.
Medial patellar luxation (MPL) is common in small dogs under 20 pounds of body weight; however, it can occur in dogs of any size.
If a pet has MPL, it means the patella (kneecap) has come out of place. MPL is second to CCL in terms of frequency and requires a high level of expertise to correct. The groove where the kneecap sits will need to be deepened to provide balance via a combination of release of tissue on the inside and tightening on the outside. In addition, it is frequently necessary to move the bone where the kneecap tendon attaches.
We perform a wide variety of fracture repairs in dogs and cats.
Damage to tendons and ligaments often requires a specialist to evaluate and recommend the best treatment available. Your pet may need to have a luxated superficial digital flexor tendon repaired, a paw hyperextension injury treated, or a collateral ligament replaced.
No matter what, we are here to help you make the best decision for you and your pet if they require tendon/ligament surgery.
Hip dysplasia in dogs frequently leads to arthritis, which sometimes necessitates surgical treatment. The good news about hips is that they are amenable in many instances to medical treatment. There are, however, a number of distinct cases where surgery may be beneficial.
Triple pelvic osteotomy.
Triple pelvic osteotomy (TPO) is performed in young dogs before the onset of arthritis. TPO is considered a specialist surgical procedure and it is important to use a surgeon who has experience in evaluating dogs for TPO because some dogs will have better outcomes with surgery than others.
TPO is generally done in dogs between 6-10 months of age.
Femoral head ostectomy.
Femoral head ostectomy (FHO) can be performed in dogs with dislocated hips, broken hips, or hips that are very arthritic.
This procedure is appropriate for smaller dogs and cats when done for chronic hip dislocation or where the head of the hip is fractured or broken.
Proper treatment selection is essential for the patient with FHO, and we caution anyone not to choose this procedure for hip dysplasia unless pain is intractable and not responsive to medical management.
Spine, Head and Neck Surgery
Herniated disks in the spine and neck are common, especially in dogs like Dachshunds. Cats can get them, although they are extremely rare. If you have a small breed dog that cannot walk, it may be a surgical emergency and it is vital that you contact your veterinarian, emergency clinic, or a specialist in spine surgery immediately.
In our practice, we use myelography (a specialty radiographic procedure) done under general anesthesia. We have found that myelography is very accurate at localizing a herniated disk. We are equipped to perform surgery on the spine, commonly referred to as a hemilaminectomy, in the thoracic/lumbar area or as a ventral slot in the neck area. Since these procedures are often needed to be performed on an emergency basis, our availability to help can sometimes be limited.
Head and neck surgery.
Dogs and cats can develop a variety of disorders in their heads and necks that require surgical intervention.
In Florida, chronic ear infections are common, especially in cocker spaniels. The combination of their skin type, along with the humidity of Florida, leads to chronic infections that end up with the ears closed off and the pet in pain. The pain from end-stage ear disease often goes unnoticed by pet owners. In older cocker spaniels, it is mistaken for the dog being lazy and wanting to sleep a lot.
The procedure that is used to treat chronic ear infections in dogs is total ear canal ablation-lateral bulla osteotomy (TECA-LBO). TECA-LBO is highly effective at resolving chronic ear infections in dogs if performed by an experienced surgeon so that complications are minimized.
Salivary mucoceles are a problem where damage occurs to a duct that drains saliva into the mouth. This leads to an accumulation of saliva under the skin of the head and neck.
Draining the saliva with a needle is often done to diagnose the problem, but the only cure is to remove the affected salivary gland(s). Dogs have over eight salivary glands, so dry mouth is typically not a complication if two (and even four) glands are removed.
Laryngeal paralysis surgery.
Laryngeal paralysis occurs primarily in older Labrador and golden retrievers. Most patients requiring surgery are older than ten. Initial signs of laryngeal paralysis include heavy/raspy breathing, which often goes unnoticed by pet owners and can develop several years before overt respiratory difficulty. As symptoms progress, there is increased difficulty breathing, a tendency to overheat, coughing after drinking water, coughing at night, weakness in the limb and sometimes difficulty eating.
Laryngeal paralysis surgery, performed by an experienced surgeon, can significantly alleviate respiratory difficulty in dogs and has a high chance of being a lifesaver. The pet must show enough of the correct signs to be treated with surgery.
Soft Tissue and Cancer Surgery
A rewarding part of having received specialty training involves being able to help cancer patients in their time of need. A cancer diagnosis in a pet is scary for most pet owners, and we understand that. Our surgeons have years of experience in the surgical treatment of all types of cancer. There are some types of cancers that can be cured with surgery alone and others may require additional treatment with chemotherapy or radiation therapy provided by an oncologist.
Abdominal surgeries include:
- Spleen removal for tumors
- Extrahepatic portosystemic shunt surgery
- Liver surgery
- Bladder surgery
- Stomach and intestine surgery
Common hernias in dogs include perineal hernias, which are located around the tail and rectal region. They almost always occur in non-neutered male dogs. Perineal hernias present as swelling around the tail, sometimes worse on the right side before the left becomes affected. Eventually, perineal hernias will cause difficulty with defecation and occasionally problems with urination. They are treated with a muscle flap procedure to close the hernia.
Inguinal and abdominal hernias occur in dogs and occasionally in cats. Inguinal or scrotal hernias in male dogs are the most likely to cause problems via intestinal blockage.
The most common urogenital issue in dogs and cats is caused by small stones forming in the bladder, which then travel into the urethra. This can cause difficulty or inability to urinate.
Bladder stones are common in dogs and are frequently diagnosed incidentally when an x-ray is performed. Some stones are treated by diet, while others require surgery to be removed. Each pet may differ slightly on what is needed to best treat bladder stones.
Male cats are particularly predisposed to urethral blockage, which necessitates perineal urethrostomy (PU). We commonly perform urogenital surgery in dogs and cats for urethral obstruction. The most common presentation is a male dog that is having difficulty urinating. In female dogs, bladder stones can cause recurrent urinary tract infections.
Thyroid cancer in dogs is associated with a good prognosis if the tumor is within certain size limits and freely moveable.
The neck has four parathyroid glands, which are essential in calcium regulation. Older dogs can develop an overactive solitary parathyroid gland that causes a marked elevation in calcium levels, called hyperparathyroidism. This can occur in cats but is very rare.
Successful treatment of abnormal thyroid and parathyroid glands requires an experienced surgeon to recognize and remove the abnormal glands.