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Most veterinarians who dedicate their practices to companion animals perform surgery at least a few times a week. Increasingly, however, our clients are clamoring for the highest quality care … which is where board-certified surgeons come in. But how do pet owners know which surgeries are best left to the credentialed specialists?

Truth is, there's no hard and fast rule here. After all, the vagaries of price vs. affordability mean that plenty of pets can't access the best possible care available. Nonetheless, knowing whether the kind of surgery your pet requires is typically undertaken by a specialist or a generalist (like me) can be an invaluable decision-making tool.

Which is why I was excited to read vet surgeon Dr. Phil Zeltzman's newest e-mail newsletter. Not only does he include the single cutest dog trick video I've probably ever seen (enough reason to subscribe right there), he also details the ten most common surgeries board-certified veterinary surgeons like himself are called upon to perform.

Drum roll, please

1. ACL repair

This is the dreaded cruciate ligament surgery in dog knees. All by itself, this surgery is a multi-billion dollar a year veterinary industry. Seeing as it's the most common surgery they perform, it's now become the vet surgeon's bread and butter, which is probably why a vet surgeon will always be the best choice should your dog need one. Experience is crucial in getting good outcomes.

2. Fractures and dislocations

Other vets can do these, but the specialized equipment and expertise required to address each individual traumatic event means these scenarios are almost always best left to the specialists.

3. Belly surgery

What Dr. Z means by this is the kind of non-routine exploratory surgery that requires open access to the abdomen.

4. Cancer surgery

Though many cancer surgeries will also require abdominal entry, he lists these separately for good reason. They're in a category unto themselves.

5. Spinal surgery

Neurologists also do these, but surgeons and neurologists tussle over who's best at "backs."

6. FHO

This is the dreaded "femoral head ostectomy," a salvage procedure in many hip dysplasia cases and more than a few trauma-related situations.

7. Knee cap dislocation

The "medial patellar luxation," or "MPL," is another common procedure. Indeed, it's one that should be much less common than it is, except that plenty of pet owners don't recognize that their small breed dogs’ little limp can mean big trouble to their future comfort.

8. Ear surgery

By this, I think Dr. Zeltzman means the TECA, mostly. That's "total ear canal ablation." This is another of our salvage procedures, one undertaken when the ears have become so chronically infected that nothing but complete removal of the ear canal can achieve a comfortable condition.

9. Perineal urethrostomy in cats

A "PU" we call it. Though I know plenty of old-timer vets who will take this one on, and I've considered learning it given the preponderance of urinary obstruction in cats (the condition that gives rise to it's need), I've always demurred. Removing a penis is not something I undertake lightly.

10. Laryngeal paralysis

When big dogs start to breathe loud and raspy as they get older, lots of times they've got laryngeal paralysis. Surgeons are lifesavers here. They know just how to fix it so the airways stay open.

10.5. Amputation

This one was tied for the 10 spot. Of all of these in the list (except maybe belly or cancer surgery), this is the one surgery I'll be called on to perform most often. Reason being: cost. If a pet's owner can't afford to save a traumatized limb they'll be unlikely to be able to afford the surgeon's higher amputation fee. In fact, I've been known to do this one for free. After all, it's a lifesaver.


I'm sure there are plenty more surgeries best left to the über-pros, but this list of Dr. Z's most popular ways to spend his professional life is a pretty darn good start. Quibble though you may over whether it's OK for your general vet to perform your pet's X, Y or Z surgery, I have only this to say: If you do eschew a surgeon's superior skills, do so knowing you had a damn good reason to do so.

Dr. Patty Khuly

Pic of the day: Dr. Wosar operating on Slumdog's leg, by Me

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