SERVICES

MOBILE SERVICES

While our facility is under construction, we are offering mobile surgical services throughout NH and parts of MA and VT. If you are interested in our mobile services, please submit requested information through the Contact Us or contact your primary care veterinarian to initiate contact with us.

How mobile surgery works:

●       Your pet’s initial assessment will occur with your primary care vet.

●       We will work with your primary care vet to determine if surgery is indicated.

●       We will determine if mobile surgery can be performed with a reasonable expectation of safety and standard of care.

  • Referral to a facility with more advanced capabilities may be recommended.

  • It is important to understand that any surgery can result in complications that may require additional treatment, additional surgery, referral to another facility for hospitalization.

●       We will schedule your pet’s surgery to occur at your primary care vet’s office. (exceptions apply).

●       You will drop your pet off at your primary care vet’s office with specific instructions prior to surgery for fasting, medication administration, and other specific parameters.

●       Dr. Casna will speak with you via phone or in person prior to surgery depending on your pet’s surgical needs. At a minimum you will receive a phone call. If an in-person consult is mandatory, we will coordinate this with you the day of surgery. In person consults by request can be arranged on a case-by-case basis (see pricing)

●       Dr. Casna will call you after surgery with an update.

●       Your pet will remain with your primary care vet during recovery and discharged home (typically same day). If additional care/hospitalization is recommended for any reason this will be discussed.

●       Dr. Casna will provide discharge instructions for postoperative care with medications, expected restrictions, monitoring parameters, and recheck recommendations.

Dr. Casna firmly believes that providing mobile surgery does NOT mean he is not responsible for your concerns. Your primary care vet will be a proxy for more minor concerns, but Dr. Casna will always be available to speak with them. Given the nature of mobile surgery responding to emails with emergent concerns in a timely manner can be challenging and is not guaranteed. Although we always encourage you to email us your concerns, so that we stay informed, always make sure to contact your primary care vet as well.

In the event of a major concern/complication postoperatively we DO want to be informed at your earliest convenience. If able, we can make arrangements to be the one to address any major concerns directly. We will always be available to another doctor that needs information or assistance with a postoperative complication in one of our patients.

What We Provide

▬ Minimally invasive imaging:

  • Nanoarthroscopy – used in most joint surgery

  • Mini intraoperative fluoroscopy – will be discussed prior to use when indicated

▬ Bandaging and casting material – This will be provided at the discretion of primary care vet and Dr. Casna

▬ All surgical instruments & devices necessary

▬ Surgical gowns, gloves, patient drapes, table covers

▬ Electrosurgical devices (cautery, vessel sealing, grounding plates)

▬ Surgical suction

▬ All surgical implants, drains and suture material

What Hospital Provides

▬ Nurse(s) dedicated to patient preparation, xrays, and anesthesia
▬ A scrub nurse may be needed and will typically be discussed prior to surgery
▬ Dedicated surgery suite with surgery table, surgery lights, instrument table

  • Table must be a minimum of 30x30 inches unless prior discussion

▬   Means to safely hang a limb for orthopedics
▬ Anesthesia machine with oxygen and inhalant anesthetic gas
▬ Xray machine for preop, postop and recheck xrays
▬ IV catheters and their placement materials
▬ Sterile syringes and needles
▬ Fluid pump is strongly recommended over drip fluids
▬ Syringe pump may be necessary for certain procedures
▬ Anesthesia monitoring equipment:

  • Pulse oximeter

  • Oscillometric blood pressure or reliable doppler blood pressure

  • ECG

  • CO2 monitoring (recommended, required for certain procedures)

▬ Injectable antibiotics

  • Cefazolin – sufficient for most cases

  • Unasyn – can substitute Cefazolin or may be required for certain cases

  • Baytril – may be required for certain cases

  • We can provide antibiotics in some cases if arranged ahead

▬ Premedications

  • Dexmedetomidine

  • Acepromazine

  • Benzodiazepines

  • Midazolam – preferred

  • Valium

  • Opioid

  • Hydromorphone

  • Methadone

  • Fentanyl

  • Morphine – Not preferred

  • Buprenorphine – Can be discussed for certain soft tissue cases

  • GI protectants

  • Cerenia

  • Famotidine

  • Pantoprazole

  • Metoclopramide

▬ Induction

  • Propofol

  • Alfaxalone

  • Ketamine + Valium

  • Telazol – Not recommended for most cases

▬ Injectable NSAID

  • Carprofen – preferred for most cases

  • Meloxicam

  • Onsior – preferred for cats

▬ Local anesthestics

  • Lidocaine

  • Bupivacaine

▬ Basic CPR medications

  • Atropine

  • Epinephrine

▬ Diagnostics: Biopsy, Culture, Cytology, Others

Additional medication & equipment requirements can vary on a case-by-case basis. If there is a deficiency in a required medication or equipment category above at your facility, we can make arrangements to provide the necessary items (additional charges will apply).