Plus-Hex CLINICAL
Introduction
This clinical audit looked into the postoperative complications of patients that were returning to a veterinary practice following routine surgical neutering. Data were gathered over a 6-month period in 2023.
The topic of the audit was chosen as a number of members of the clinical team had noticed a trend in patients being admitted to hospital with clinical signs that had developed in the postoperative period.
The article will explore what the initial data revealed, explain the changes the practice put in place, with the evidence to support these changes, and discuss the results of the implementation.
Learning outcomes
• Understand how to carry out an effective clinical audit in practice
• Identify the most effective change( s) to put in place
• Evaluate ways to encourage team members and clients to comply with the new change( s)
Data gathering
To carry out an effective clinical audit, as much data as possible should be gathered to provide a comprehensive overview of the situation. The following specific issues were considered when developing this clinical audit:
• The number of routine neutering procedures the practice carried out per week
• The percentage of surgeries at the practice that were neutering procedures
• The duration of the period over which the data should be collected.
As neutering is performed frequently, it would have been possible to collect a reasonable amount of data over the course of a month. However, to get a more comprehensive look at any issues, the data-collection period was extended to 6 months.
Data were collected from all three of the practice ' s operating sites, and included a total of more than 700 patients.
Several questions were identified, which formed the basis of the information to be gathered from the cases( Table 1).
Table 1. Queries that informed the clinical audit.
Query
What procedure had the patient undergone?
Were any problems present during the 10-day postoperative period?
What interventions were put in place to resolve the issues?
Initial results
It was identified that 26.32 % of patients returned to the practice with some form of complication. This group comprised 11.21 % with gastrointestinal( GI) upset in the form of diarrhoea, with or without vomiting, and 15.11 % that presented with a variety of other problems. As diarrhoea was the main recurring issue, this became the focus of the research into potential causes. Once the data had been analysed, the next step was to identify, if possible, the cause of the diarrhoea and determine what could be done to reduce its incidence.
Extended research
At the time of the study, the practice ' s postoperative advice was to feed patients a bland diet of chicken and / or rice for 24 – 48 hours after the anaesthetic. This was not best practice, so the author conducted some research into the feeding of chicken and postoperative diets. The research identified that chicken was the largest known food allergen in both cats and dogs, causing mainly gastrointestinal signs [ 1 ].
As the practice was part of the Linnaeus group of veterinary practices, the author was also able to contact other practices within the group to ask about their postoperative feeding advice to owners. The advice of the author ' s practice, and others, was that any change to a pet ' s diet should be carried out gradually, over the course of 7 – 14 days, to avoid GI upset [ 2 ]. However, this contradicted the advice given to clients to change their pet ' s diet immediately after surgery.
Response to research
Possible answers Spay or castration
Vomiting and / or diarrhoea
Review postoperative diet
The author presented her research to the practice managers and proposed a change to the practice ' s postoperative feeding guidelines from feeding a bland diet to feeding a reduced portion of the patient ' s normal diet the night after the anaesthetic and a normal portion the following morning. The smaller initial portion was proposed due to the possibility of the patient having GI sensitivity immediately after the operation.
Volume 40( 6) • December 2025
57