Preface
As the management of small animal surgical emergencies is constantly evolving, the purpose for writing this second edition is to have an up‐to‐date resource for the veterinary surgeon, critical care specialist, and general practitioner that builds on information presented in the first edition and provides updated information on preoperative stabilization, new and innovative treatment options and aftercare. Similar to the first edition, the majority of chapters are authored by two, and occasionally three, specialists in the fields of both surgery and emergency/critical care to combine the expertise of individuals from these two disciplines. In addition to approximately 70 authors who contributed to the first edition, 18 new authors have agreed to share their knowledge and expertise with the reader. The layout of the second edition is similar to the first edition, with many of the chapters covering step‐by‐step information on emergency stabilization, diagnostic approach, operative techniques, postoperative care, common complications encountered, and how to troubleshoot such complications should they occur. Relevant anatomy, imaging and full color illustrations and drawings have been incorporated into each chapter to support the text. Case presentations have also been included when appropriate.
To strive to enhance the content of the first edition, nine new chapters have been added based on advice received from respected colleagues. Following the introductory chapter, Triage and Initial Stabilization of the Emergency Small Animal Surgical Patient, a new chapter, Operating Room Nursing Tips for Emergency Surgical Procedures, has been added to the beginning of the book to assist veterinary nurses and operating room technicians who may be working with these critical patients. This chapter provides information on patient positioning and preparation in the operating room, essential equipment, and appropriate sterilization techniques. For the section on the gastrointestinal system, four new chapters have been added, including Rectal Prolapse, Colonic Torsion, Surgical Intervention Post‐Celiotomy, and a chapter on Enteral Feeding Tubes. Including the chapter on nutritional support reiterates the importance of appropriate stabilization and aftercare to the ultimate success of the emergency surgical patient. In the cardiovascular system section, a chapter has been added on Open‐Chest Cardiopulmonary Resuscitation, and in the section on wound management, two new chapters have been added, including The Failed Flap and Incisional Infections. Finally, for the section on orthopedic emergencies, in addition to updating chapters from the first edition on the Approach to the Septic Joint and the Surgical Management of Open Fractures, a chapter on Traumatic Joint luxation and Reduction has been added to provide a comprehensive resource when faced with an orthopedic emergency.
Although there are veterinary textbooks that focus on small animal surgery and those that focus on critical care medicine, this is the only book that focuses on the combination of these two disciplines, filling a niche currently vacant in the veterinary literature. Additionally, this book is unique in that the majority of the chapters are co‐authored by experts in both fields. Because surgical emergencies are common in veterinary medicine, this textbook should have a wide audience, including surgical and critical care residents in training, veterinary surgeons and criticalists, and veterinary practitioners who work in emergency medicine or those who have an interest in surgery.
Acknowledgements
I would like to thank the staff at Wiley, with special thanks to Meryl Le Roux and Erica Judisch, for all their help and encouragement throughout this process. Without their support and guidance, completion of this project would not have been possible.
The impact of Covid‐19 on many of the authors who contributed to this textbook cannot be overstated. The disruption in normal work, family routine, health issues, and economic hardship resulted in significant fear and anxiety. I truly want to thank all the authors for their dedication and commitment to this project – I know it wasn't easy.
Finally, since the publication of the first edition, many of us lost a dear friend and colleague, Dr. Lesley King. Lesley was a Professor of Critical Care at the University of Pennsylvania and was instrumental in the development of intensive care as a veterinary specialty. Lesley made significant contributions to the veterinary literature including as a contributor to the first edition of this textbook. Lesley was not only a colleague, but also a good friend, and will be dearly missed.
About the Companion Website
This book is accompanied by a companion website:
www.wiley.com/go/aronson/surgical
The website includes:
Case Studies
Video clips
References
Daisy’s Story
Daisy’s story can be found in Chapter 54 (Case Report 54.2). After an encounter with a porcupine, Daisy underwent two major surgeries and spent weeks in our ICU recovering. During times of COVID‐19, a new normal developed and owners were unable to visit their pets during their hospital stay. Daisy’s owners decided on the next best thing – Facetime! Here she is being read a story during one of her virtual visits with Mom and Dad.
1 Triage and Initial Stabilization of the Emergency Small Animal Surgical Patient
Dana Clarke
University of Pennsylvania, School of Veterinary Medicine, Philadephia, PA, USA
Introduction
One of the most challenging aspects of emergency medicine is being presented with patients who have a variety of clinical signs and disease severities to assess, prioritize, stabilize, and provide with definitive care. The veterinary clinician is reliant on information provided by the client, their physical assessment, and initial diagnostics to determine severity of illness and injury, and therefore, urgency of care. Efficient identification and treatment of respiratory, cardiovascular, urinary, and neurologic derangements is essential for successful patient outcomes. When emergency surgical intervention is required, it is crucial to appropriately stabilize the patient for anesthesia without unduly delaying surgical care.
Triage and Initial Assessment
Triage is an essential tool in the setting of emergency medicine to assess and prioritize critically ill patients [1, 2]. This is particularly true of patients that may require emergency surgical intervention, as the time to provide appropriate stabilizing care and definitive surgical therapy likely impacts patient outcome.
In many veterinary hospitals, nurses obtain pertinent historical information and perform a basic assessment to determine whether the patient needs immediate further evaluation or is stable enough to be seen in turn. In general, over‐triage is preferred to under‐triage in veterinary medicine, as the severity of signs presented by the patient and observed by the