In a previous article, we outlined the recommended approach to assessing patients’ suitability for anesthesia and surgery. Building on this, we spoke with Dr. Annie Varghese, a highly experienced veterinary surgeon in India, to learn how she and her team conduct pre-operative assessments in daily clinical practice. These assessments play an important role in safeguarding an animal’s health and well-being — before, during, and after surgery.
Changing Attitudes Toward Animal Health
Animals and their welfare are becoming increasingly important to people worldwide. Alongside a growing awareness of animal rights and human responsibility, pet ownership continues to rise, with cats and dogs increasingly viewed as family members and companions:
- Over half of the world’s population is estimated to own a pet
- Pet ownership is increasing due to smaller families and later or fewer children
- In developing countries, a growing middle class is driving pet population growth
- Pets are considered “tension absorbers,” with ownership associated with improved human health outcomes
A first-hand witness to these trends is Dr. Annie Varghese MVSc (Surgery) PhD, Chief Surgeon and Veterinary Consultant at Adonai Companion Animal Care in Thiruvananthapuram, Kerala, India. She runs a veterinary hospital specializing in dogs, cats, birds, and exotic pets, with on-site diagnostic and clinical facilities including hematology, biochemistry, hormone assays, microscopy, and urinalysis. Additional services include ophthalmology, imaging, nephrology, cardiology, and blood transfusions. The hospital also conducts training sessions for veterinarians and paraveterinarians in the region.
Why Pre-Operative Screening Matters
The hospital’s promise to pet owners is simple: “We will take care of your beloved pet as if they were our own.” It is therefore no surprise that Dr. Varghese emphasizes the importance of pre-operative assessments to reduce surgical risk, even when owners may initially be hesitant.
As she explains:
“Suppose they bring their dog in for spaying or castration. The pet looks healthy to the owner: it’s eating well, playing, and behaving normally. When we suggest blood work, some owners object. However, blood testing often reveals subclinical conditions. For example, tick-borne diseases are common in this area, and we frequently see low platelet counts. Thrombocytopenia increases surgical risk, including bleeding and anesthetic complications.”
According to Dr. Varghese, approximately 25% of animals experience surgical delays due to abnormal findings, reinforcing the importance of routine screening: “In our hospital, we always do the blood work.”
Physical Examination and Patient History
Dr. Varghese describes the initial assessment:
“We start with a complete physical examination — visual inspection, palpation, percussion, and auscultation. We look for organ enlargement, abnormal heart or respiratory patterns, pain, swellings, or lymph node changes. This helps us understand how physically stable the animal is before interpreting laboratory results.”
Patient history is equally important. “We ask detailed questions about tick exposure, even brief contact. A single tick bite can be sufficient for infection, and this information helps determine whether additional tests are needed beyond the CBC, liver, and renal function tests.”
Before Interpreting the CBC
The animal’s emotional state is also considered:
“Fear and stress during blood collection can influence certain parameters. We note behavior and stress responses before blood sampling, as this context is important when planning surgery.”
Ready for Surgery — or Postpone?
CBC results play a key role in surgical decision-making.
“We review the entire report — RBCs, WBCs, hemoglobin, and cell volume. Even mild abnormalities matter. For example, elevated WBCs and neutrophils may indicate inflammation or infection. In elective surgeries, we may treat first, recheck, and only then proceed.”
Similarly, anemia is addressed prior to surgery to reduce bleeding risk and support recovery.
Biochemistry and Anesthesia Planning
For sick or injured animals, biochemistry profiling is essential.
“We assess liver, kidney, and cardiac function to understand organ impact before surgery. This helps determine surgical timing and anesthetic approach.”
Blood results also guide anesthetic selection. Certain drugs may be avoided in animals with cardiac or liver conditions, and in some cases deep sedation with nerve blocks may be preferred over general anesthesia to reduce risk.
Post-Operative Recovery and Healing
Blood testing also informs expectations after surgery.
“If platelet counts are below 50,000 cmm, we expect slower wound healing. We prepare owners for this and emphasize the importance of follow-up and cooperation.”
A Small Effort With Meaningful Impact
For Dr. Varghese, comprehensive pre-operative assessment supports safer surgery and improved recovery. While it requires additional effort, she believes it is well worth it:
“It’s about applying what we’ve learned and thinking carefully. A little extra preparation can make a big difference — for both animals and their owners.”
Global trends reference: https://www.healthforanimals.org/reports/pet-care-report/global-trends-in-the-pet-population/
