Many of us have experienced taking our pet to have surgery at the local veterinary clinic, for either routine or emergency reasons. But have you ever stopped to think about what actually goes on behind the scenes? Behind those consult room doors, lies a whole plethora of veterinary equipment, skilled technicians and medications to treat everything from an eye ulcer to a broken leg. In this article, we will show you just what is needed to treat anything that walks through the door and how that may influence the price you pay. 

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What sort of surgery do vets carry out?

The surgical services that vets offer will vary widely depending on the type of practice they are and the skills of the staff that they employ. Pretty much every veterinary clinic will be able to offer routine surgeries; such as neutering alongside lump removals, dentistry and wound repair. If facilities allow, emergency surgery will be able to be performed on the same site. Or sometimes sent to a larger branch within the same practice. More and more vets are now able to also offer more specialised surgeries such as orthopaedics, ear, nose and throat surgeries, gastrointestinal surgery, urinary surgery or ophthalmic (eye) surgery. Referral practices often have the option to provide highly complex procedures; such as neurosurgery, heart surgery or advanced orthopaedic surgery like total hip replacement. 

For every single procedure that is carried out, a whole host of things are needed. 

Let’s think about even the most basic surgery, such as a neutering

But remember, for more complex surgeries, there may be a much longer list of requirements!

The pet is admitted at 8:15am, but before even this point, things have started behind the scenes…

A consent form is printed, along with an anaesthetic form on which the drugs needed have been calculated. The surgical kit has been sterilised in an autoclave. 

Once admitted, the pet is given a clean kennel with a bed

The kennels are specially designed to be hard-wearing, easily cleaned and safe for the patients. All the beds get laundered after every use. 

The patient is then given a clinical check over, an intravenous catheter placed and the pre-anaesthetic drugs are administered

The clinical check will include equipment such as a stethoscope and thermometer, as well as the vet’s time and knowledge. In order to place a catheter, a nurse will need to use some clippers to remove the hair, surgical spirit and a swab to clean the skin, the cannula itself, tape to secure it in place, a needle bung, saline flush solution in a syringe with a needle to ensure it’s patent and a bandage to keep it protected. The pre-anaesthetic drugs (which may be two or three different medications) will be specialised for veterinary use. And each will be drawn up in a sterile syringe with a needle, then the needle changed for administration. 

Once the pre-anaesthetic medications have taken effect, the patient will be given a general anaesthetic then moved to theatre for the procedure

Once again, the catheter will be flushed to make sure it is in the correct place. The anaesthetic medication will then be drawn up and given, often whilst the animal receives oxygen. Once asleep, they will be intubated with a tube and connected to the anaesthetic machine. This is a complex bit of kit that administers a mixture of anaesthetic gas and oxygen through a circuit made of tubes and valves and mirrors those used in human surgery. 

Throughout all this, the nurse will be monitoring the patient using basic equipment like a stethoscope and more complex equipment known as a multi-parameter monitor which will show the heart rate, breathing rate, blood pressure, oxygen saturation of the blood, temperature and expired carbon dioxide, and taking measurements every 5 minutes. 

The animal is prepared for surgery by shaving the hair off their abdomen and cleaning the skin with a surgical scrub. The vet will also prepare for the surgery by scrubbing their hands and arms with a specialised surgical scrub and brush; then put on sterile gloves and a sterile gown. 

The theatre will also be set up with another anaesthetic machine and circuit; as well as a specially designed operating table, overhead lighting and monitoring equipment. 

When everything is in place, the operation can begin

Whilst the vet is operating, the nurse will be constantly monitoring the animal and adjusting the anaesthetic as required. They may also need to give additional drugs such as pain relief. 

In order to operate, the vet will need a surgical kit with a variety of instruments including clamps, forceps, scissors and needle holders. There will be a number of kits made up for different types of surgery – it most certainly isn’t a one-kit-fits-all – and these kits are all cleaned and sterilised after every use. There will also be kits specifically for dogs, kits specifically for cats and sometimes kits specifically for ‘small furries’ too. 

Consumables such as a scalpel blade, a variety of different suture material and swabs will be used during each operation. The animal may also be on intravenous fluids throughout the procedure which requires a bag of fluid, the ‘giving set’ tubing and the connector to the catheter. In order to deliver an accurate dose of fluids, a machine called a fluid pump is often used. 

After the surgery is finished, the nurse will continue to monitor the animal in recovery. This typically means one-on-one care until they are fully awake. 

They may be placed on a heat pad to keep them warm and be given water and some food. The vet will then spend the time billing the surgery and writing detailed surgical notes. The owner will be called and a discharge appointment made. 

Once recovered, the patient will be discharged 

Usually with further pain relief medication and a surgical suit or cone collar. After an operation, they will usually return to the surgery for at least two further consultations, known as post-operative checks, to ensure that they are recovering well. 

As you can see, an awful lot goes into even relatively straightforward surgery

When we consider that many veterinary practices now offer more and more complex surgeries, these will come with more and more pieces of kit. When dealing especially with orthopaedics or soft tissue surgery, practices need to invest in more advanced diagnostics and more advanced surgical equipment. This will include digital x-ray or even CT or MRI scanners, laparoscopic equipment for carrying out keyhole procedures and plates, screws and drills for orthopaedic work. Dental work requires its own specialised kit along with a separate dental x-ray machine. Ophthalmic surgery requires very fine instruments and often the use of a great deal of magnification. For those that also deal with more exotic species, they will also need their own set of instruments. Alongside all these, comes more advanced requirements for hospitalisation and monitoring too. 

Although a lot of the equipment is able to be reused again and again, it all needs checking daily, and requires regular maintenance to ensure it is working properly and safely. 

So how much does the kit cost?

The price of surgical equipment can vary, but typically speaking, the initial outlay costs can be pretty high. 

  • MRI scanner – £30,000 – £1m (depending on age and quality)
  • CT scanner – £40,000 – >£100,000
  • Digital x-ray system – £25,000 – £50,000
  • Digital dental x-ray machine – around £20,000
  • Ultrasound machine – £2000 – >£10,000 
  • Anaesthetic machine – £1500 – £2000
  • Operating table – around £1500 – £2000
  • Multi-parameter monitor – up to £3000
  • Fluid pump – £500 – £1000
  • Basic surgical instrument kit – around £500-600

And with most practices needing multiples of these (except the imaging systems) even for a single branch, it’s easy to see how costs can spiral. Add in the need for all the consumables which are single use only, even for the most simple surgery, and potentially drawers and drawers of specialist instruments, the total amount of kit required can be extensive. 

Because vets have to work within a wide range of disciplines across more than one species, they have to be prepared for every eventuality. This comes at a financial cost, partly because of the sheer amount of equipment needed. It takes a lot of effort from the whole veterinary team to keep a practice running efficiently and organisation is the key (plus a label maker or two)! 

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