Winter Surgical Considerations for Small Animal Practices

The winter months bring a distinct set of challenges and case patterns to small animal surgical practice. From increased risks of perioperative hypothermia to seasonal toxin exposures and changes in wound healing dynamics, being prepared for these winter-specific factors can significantly improve patient outcomes. Here I share the key considerations I keep in mind during the colder months.

Perioperative Hypothermia Prevention

Hypothermia is a concern year-round in veterinary surgery, but the colder ambient temperatures of winter amplify the risk considerably. Small patients, thin patients, and those undergoing prolonged procedures are particularly vulnerable.

The consequences of perioperative hypothermia are well documented: impaired coagulation, delayed drug metabolism, increased surgical site infection rates, prolonged anaesthetic recovery, and cardiovascular complications. Prevention is far more effective than treatment.

• Pre-warming: Begin warming the patient before induction of anaesthesia. Even 10-15 minutes of pre-warming with a forced air blanket can make a significant difference
• Theatre temperature: Maintain operating theatre temperature at a minimum of 21 degrees Celsius. This may feel warm for the surgical team but is necessary for patient welfare
• Warm fluids: All intravenous fluids and lavage solutions should be warmed to body temperature before administration
• Minimise exposure: Only clip and prepare the area necessary for surgery. Excessive clipping removes insulating fur and increases heat loss
• Active warming during surgery: Forced air warming blankets are the gold standard. Hot water bottles and heat pads carry burn risks and should be used with caution
• Recovery environment: Ensure the recovery area is warm and draught-free, with continued active warming available

Common Winter Presentations

Certain surgical presentations increase in frequency during the winter months. Being aware of these patterns helps with preparation and client education.

Antifreeze Toxicity

Ethylene glycol ingestion peaks during winter as vehicles are winterised and antifreeze products are more commonly in use. Whilst the initial management is predominantly medical, surgical intervention may be required in cases complicated by renal failure requiring peritoneal dialysis catheter placement, or in cases where gastrointestinal decontamination is indicated. Early recognition and aggressive treatment are critical, as the window for effective intervention is narrow, particularly in cats.

Road Traffic Accidents

Darker evenings and adverse road conditions contribute to an increase in road traffic accidents involving pets during winter. These cases often present as polytrauma requiring rapid triage, stabilisation, and potentially emergency surgery for internal haemorrhage, diaphragmatic rupture, or fracture management.

Foreign Body Ingestion

The festive season brings a reliable increase in foreign body cases. Christmas decorations, cooked bones, corn cobs from holiday meals, and children's new toys all present hazards. Gastrointestinal foreign body surgery is time-sensitive, and practices should be prepared for an uptick in these cases from late November through January.

Rock Salt and Grit Injuries

Dogs walking on gritted roads and pavements may develop paw pad irritation, cracking, and chemical burns from rock salt. While most cases are managed medically, severe cases with deep tissue damage may require surgical debridement and wound management.

Wound Healing in Cold Weather

Cold temperatures affect wound healing through several mechanisms that are worth considering when planning surgical cases during winter:

• Peripheral vasoconstriction: Cold-induced vasoconstriction reduces blood flow to the surgical site, potentially impairing oxygen delivery and immune cell migration to the wound
• Reduced mobility: Animals may be less active in cold weather, which can both help (reduced wound tension) and hinder (reduced circulation) the healing process
• Wet and muddy conditions: Outdoor dogs are more likely to contaminate surgical wounds when exercising in wet, muddy winter conditions. This should be factored into discharge advice
• Owner compliance: Cold weather may reduce owner compliance with exercise restriction and wound monitoring, particularly if checks require outdoor visits to kennels

I typically advise more conservative activity restriction during winter months and ensure that discharge instructions specifically address keeping wounds clean and dry despite adverse weather conditions.

Seasonal Case Planning

For elective surgical cases, winter presents some practical considerations. Where possible, I prefer to schedule major elective procedures for periods when post-operative recovery conditions are optimal. However, when surgery cannot wait, additional attention to perioperative temperature management and wound protection is warranted.

Practices may also find it useful to review and restock their emergency supplies at the start of winter, ensuring that warming equipment is functional, antifreeze toxicity treatment protocols are accessible, and emergency surgical kits are complete and sterilised.

Client Education Opportunities

Winter provides excellent opportunities for proactive client communication. Reminding pet owners about antifreeze storage safety, the dangers of cooked bones during the festive period, and the importance of paw care after walks on gritted surfaces can help prevent cases before they arise. A simple seasonal awareness post on your clinic's website or social media can reach many pet owners and position your practice as a trusted source of preventive health information.