Prior to Surgery:

Before any elective surgery, make absolutely certain that the vet will do a buccal mucosal clot test prior to starting on the procedure after the dog is anaesthetised. (One can be done prior to anaesthetic as well, and should definitely be done in a dog with a history of bleeding.) If the result is out of the ordinary, the procedure will have to be done at another time.

Dissolving sutures should not be used on a dog considered to be at risk for excessive bleeding.Arrange with your vet to be allowed to drop the dog off immediately before the procedure is to take place. Less time in a strange place will keep stress to a minimum.

For the dog that has had previous bleeding problems, it would be wise to transfuse fresh or frozen plasma prior to surgery. Plasma does not need to be cross-matched for blood type. A more concentrated form of frozen plasma is produced in California. It is called cryoprecipitate and may be a wise choice for the dog that is at higher risk because of previous prolonged or severe episodes. Also, DDAVP (desmopressin acetate) can be given during the period prior to surgery. This drug appears to trigger a massive release of vWf in the blood, presumably from storage sites. It seems to help in some cases and not in others. Ask your vet about it.

After surgery keep stress levels as low as possible. Take the dog home as soon as you are allowed. Sedatives may be prescribed to keep the dog quiet and still. Confining the dog to an x-pen is a good idea. Make sure that the dog will not pick at or scratch any stitches. Ask the vet for a repellent spray (such as Variton which also comes in an ointment form) to put on the bandage or incision site. The ones from the pet stores don't deter the dedicated picker!

Page 3: Determining Risk - Page 1: Introduction