After your pet has surgery, post-operative care is critical in terms of comfort, safety, and recuperation. Proper post-op care aids healing, minimises the risk of requiring additional corrective surgeries, speeds recovery and is vital to a successful outcome. Your pet will be as comfortable as possible, and furthermore you will spend less money at the vets if you can eliminate the need to go back for preventable problems.
As a general rule, think of how you or another member of your human family would feel after anesthesia and surgery, and what concerns you would have. Although our dogs and cats don’t complain the same way that we do, they are as biologically complex and feel the same discomfort as we do.
Learn what to expect.
Bruising, Seepage and Odors
Bruising may be normal, but excessive bruising might warrant checking with your vet. Continual seepage of blood or other fluids from the incisions is not normal. If there is still intermittent seepage beyond 24 hours post op, contact your veterinarian. Also contact your veterinarian if the incision has an unpleasant odor, because that usually indicates an infection.
This point simply cannot be stressed enough: Follow the medication schedule exactly and give prescribed medications for the length of time indicated. A plastic pill box imprinted with the days of the week can help you avoid missing or doubling a dose.
Some people find it helpful to create a log and record when medication is given, particularly if there is a possibility of more than one person giving medication. If you create such a record, you can also log signs of discomfort or pain. You can record urination and bowel movements as well as physical therapy and outdoor exercise; this information is a great source for the veterinary team when tracking improvements or problems with recovery.
- Pain medications are necessary in some circumstances. Pain is significantly easier to prevent than to eliminate. Follow your vet’s instructions about pain medications. In the immediate post-operative period, watch for signs that your pet may be uncomfortable. Some people expect that an animal will vocalise when in pain but that’s not always the case. Dogs in pain will be unable to settle down and rest, while cats are more likely to hide and stop eating. Pain-free healing through pharmacology is a good thing.
- If you miss a dose, do not double up the next dose. Simply resume the dosage schedule with the next treatment and keep giving the medication until it’s gone. Do not use more of any medication than has been prescribed without first checking with your veterinarian.
- Do not give any medication or supplements without first discussing it with your veterinarian. Such drugs as aspirin, acetaminophen (Tylenol) and ibuprofen (Advil) can be toxic to most animals, and can be fatal if given to cats.
- If your pet is on antibiotics, use all of the medication prescribed even if your pet appears to feel better. If the antibiotics are discontinued early, the infection may return stronger than before and with more immunity to the medication.
- Many liquid medications need to be kept refrigerated. Gently shake them or roll them in your hand to remix them before giving them. If a refrigerated medication is left out, contact your vet to discuss the length of time it was not refrigerated, and ask if you need to replace the bottle.
- If your pet spits out the medicine or doesn’t ingest all of it, don’t give additional medications until the next scheduled dose to avoid over-medicating.
- Before you take your pet home, make sure you understand how to give the medications and what the tools are for dispensing them. Use the specific measuring equipment provided, not your own measuring spoons or syringes. Your veterinary team should give you any necessary tools, such as a syringe marked with units or pre-filled syringes. Sometimes syringes are marked with units called cc’s (cubic centimeters) but the instructions are written for ml, or milliliters. One cc and one ml are the same amount (1 cc = 1 ml) and the terms can be used interchangeably.
- Do not cut or crush tablets unless instructed to do so. Crushed tablets can taste bitter, and sometimes make it difficult to determine how much was taken. Also, some pills do not have the active medication evenly dispersed within, so giving a partial pill results in administrating an unknown dose. Some medications can be toxic to humans. Use gloves when handling these medications to protect your health (your veterinarian will advise you when this applies).
- Children should not be allowed to medicate pets.
- Many people will give a pill with a treat, but be aware that some types of treats are inappropriate for certain conditions. For example, giving pills in fatty hot dogs to a pet recuperating from pancreatitis will only inflame the situation. Now is not the time for more regular treats than usual.
- Some pets will eat pills along with their food, but many will not. Some options include hiding the pill in chicken pieces or malleable treats designed to hide a pill. However, ask your vet for tips on how best to give the medication
Activity is often restricted for a period of time after surgery, ranging from several days to many weeks, depending on the type of surgery. It may be a difficult reality to live with, but an important one.
Restricting a dog’s activity can be challenging, particularly when he begins to feel better, but it is absolutely necessary, even for playful puppies. You may need to restrict your dog on a leash at all times, both inside the house and out, including going out for elimination. Be certain you understand what level of activity (including such things as playing, roughhousing, jumping up and down off furniture or counters, getting in and out of vehicles, or running to the doorbell) is or is not acceptable before you bring your pet home,.
INADEQUATE RESTRICTION OF ACTIVITY IS A COMMON CAUSE OF POST-OPERATIVE COMPLICATIONS AND SUBSEQUENT INCREASED VETERINARY VISITS AND COSTS.
Crates are particularly useful during these periods. If you don’t have a crate, consider keeping your pet in a small room such as a half bath or laundry room.
Many pets prefer to be with their owners when they aren’t feeling well. Some will try to follow you around the house, up and down stairs, and so on. If you use a crate to restrict activity, move the crate to the room you’re going to be in so your pet doesn’t feel the need to follow you around. The more normal his routine is, the happier he will be.
Some orthopedic surgeries require two months or longer for adequate recovery. Back or neck surgeries may require several weeks before an animal is able to walk unaided.
When your veterinarian says it is time for your dog to start limited exercise, such as short walks up and down the driveway or down the block, don’t use a retractable leash. Cat-obsessed dogs will bolt no matter how they’re otherwise feeling, and running like that can cause serious complications.
The most difficult part of the healing process is when your pet begins to feel better and wants to be active. Remain firm. Stimulate his mind; feed using food puzzles, give him an interactive toy that doesn’t require him to get up and move. Kong-type toys stuffed with a treat can keep dogs active and distracted for several hours. Sit on the floor to be with your pet. Keep using a crate and restraints throughout the timeframe given to you by your veterinarian.
The key thing to bear in mind is that our pets have no ability to understand and comply with restrictions such as you would receive from your physician after surgery.They cannot abstractly anticipate that certain activity might disrupt their recovery or cause major complications, and they do NOT have any innate sense of how much activity is acceptable. With modern surgical techniques and contemporary strategies for pain control, most dogs and cats will be willing and able to do much more than is in their best interest well before they should. Therefore, since you are in charge (not to mention the one paying the bills for their surgery!) you have the obligation to out think your pet, anticipate all the ways your dog or cat might enter into inappropriate activity, and establish safeguards to prevent such occurrences.
Surgical incisions need to remain dry to prevent infection. If the incision becomes dirty, gently clean it with saline solution (such as contact lens solution). Otherwise, leave it alone. Keep checking the incision frequently until it is completely healed. Things you’re checking for include swelling, oozing, pus, redness, heat, bad odor, loose or missing staples or stitches, or cuts. Excessive licking can irritate an incision and cause infection or drainage. A normal amount of drainage is none to just a few drops. The incision may be slightly puckered when your pet comes home, but it should continue to improve to normal smooth skin as it heals. If it does not, a recheck with the veterinarian is a good idea.
Incisions generally heal within 7 to 14 days. External sutures, staples, etc. should be removed by the veterinary team. Some incisions are closed with buried, absorbable sutures that do not require removal. Your veterinarian will advise you whether there are or are not stitches or staples that require removal, and when.
Do not let your pet lick the incision, as licking can introduce infection or pull the stitches out. The old myth of saliva as being helpful or having antibacterial properties is simply not true.
Appetite, Elimination, and Bathing
A decreased appetite usually isn’t a concern for the first day after surgery. If your pet is not eating or drinking 24 hours after going home though, notify your veterinarian.
Fresh water should always be available.
Except for emergencies, pets are not fed for at least part of the day of or before surgery. As a result, many will not have a bowel movement for 1 to 2 days after coming home. This time frame is normally not a concern. If your pet does not produce any stool for 2 days after returning home, call your veterinarian.
Don’t be surprised if your pet has some incontinence after surgery. It’s not unusual and shouldn’t last long.
Cats who like to lie down in their litter box should have shredded newspaper instead of their regular litter to avoid getting litter in the incision.
Hold off on giving any baths until after the sutures are out and your doctor has given permission for bathing.
Cones and E-Collars
Lampshade-like cones, also called Elizabethan collars or e-collars, go around your pet’s neck. These devices help prevent your pet from irritating the incision, creating an infection, and pulling out stitches or staples. Your veterinarian or a veterinary technician should show you to how to put the e-collar on and take it off.
The plastic e-collars can make it hard for your pet to eat or drink, and they can bruise your legs when they move past you. Some e-collars are made of fabric or may be inflatable. These may or may not work depending on where your pet’s incision is located, and there is no point in using one if he can still reach the incision. Ask your vet for recommendations.
Eating can be complicated and messy while wearing an e-collar. If so, remove the e-collar so your pet can eat, but do not let him out of your sight while it is off. It only takes a moment for a dog or cat to get at stitches and open an incision, which will be painful, delay healing, and require more veterinary care and cost.
Bandaging, Splinting, and Casting
After certain surgeries, your pet may need to be bandaged, splinted, or casted. All of these materials need to remain clean and dry. This means staying off dewy ground, and out of the rain, puddles, mud, the water bowl, kiddie pools, and baths. If it’s raining or the ground is wet when your pet has to go outside to eliminate, cover the bandage with a plastic bag; check that there aren’t any holes in the bag and tape it to keep the bag up. Remove the bag and tape as soon as the pet comes back inside. If bandages get wet, have them checked and replaced as needed as soon as possible.
Problems associated with wet bandages, splints or casts can range from an irritated incision to more serious complications, including in some cases gangrene that results in loss of the limb.
Bandages need to be checked regularly, at least three times a day, preferably more.
Watch for swelling above or below the material and report any swelling immediately to your veterinarian. If the bandage, splint or cast is too tight, the swelling will cut off necessary circulation.
Smell the material every day. A new, bad odor indicates that it should be rechecked by the veterinarian as soon as possible and certainly within a few hours of noticing such a change.
- To reduce swelling, use a cold pack after surgery every 10 to 15 minutes throughout the 4 to 6 hours after the surgery. Bags of frozen vegetables are best. If you use ice, make sure to place it in a plastic bag and wrap it in a towel to avoid excessive cooling.
- If the leg is splinted the digits may be left exposed at the bottom. Check the toes each time you check the splint to make sure he can still feel his toes (lightly pinch to see if he pulls the limb away or otherwise reacts), and also check for excessive swelling or coldness of the digits. Any concerns with the appearance of the digits or bandage should prompt an immediate call to your veterinarian or local veterinary emergency clinic.
- Splints and casts should only be adjusted by your veterinarian. Some splints need to be used for many weeks.
- Splints and casts are not always comfortable. Expect a bit of licking or chewing, and possibly mutilation of the cast or splint. If you suspect there is a problem, it’s better to prevent additional trouble, so talk to your veterinarian sooner rather than later.
Sometimes a drain is placed under an incision, usually because the area was contaminated before surgery. The drain allows any infectious fluids to flow out of the body.
Your veterinarian will provide specific instructions on drain care, but generally you will need to clean the drain more than once a day and you will need to clean any discharge that seeps out at the base of it. Your veterinarian will instruct you on when to bring the pet back in to remove the drain.
Some animals, especially dogs, have a difficult time after surgery in getting up or in the car, and need a little help. A long towel can be used as a sling under the hind end to give support. With a leash or harness on your dog, place the towel sling under the belly in a U-shape with the ends up over the back. Grasp the ends and you can lift your pet fairly easily. Toes should touch the ground.
Leave the mouth alone. You should see a little bit of improvement each day. If there is not improvement each day or your pet seems to be doing worse, inform your veterinarian.
Typically, analgesics are given before and during surgery to reduce post-operative pain. Analgesics will be prescribed by your veterinarian; give them as directed even if he acts like he doesn’t need it. Your pet won’t tell you through vocalising that he is hurting; and if it does hurt then you are far behind getting it under control, as preventing pain is significantly easier than relieving it once it is established.
Some facial swelling and blood or blood-tinged saliva is normal for 3 to 5 days. Prevent your pet from pawing or rubbing his face. Pets with sutures, particularly cats, may make funny motions with their tongues, but it’s nothing to worry about. Cats may hide for a few days.
A rotting smell in the mouth 3 to 5 days after surgery requires an urgent visit to the vet, as it is most likely caused by the surgery site opening at a suture line. This would typically requires another surgery.
Pets should always have access to fresh water. Pets should be back to eating within 24 to 72 hours. Offer soft food for 14 days. Use the pet’s regular food: dry food soaked in warm water for 15 minutes, or canned, unless the veterinarian prescribes something else.
Attitude, daily improvement, and urination are more important than eating.
For lanced and stitched abscesses, warm compresses are helpful for the first few days. To hot pack the area, use a warm – not hot – washcloth applied to the wound for 5 to 10 minutes several times a day. The washcloth should be as warm as you can stand it against your own skin, and it should be wrung out so that you are applying moist heat, and not soaking the wound.
Physical therapy is advantageous after certain surgeries. Ask your veterinarian if it’s appropriate, and what facilities are nearby that can guide you on your pet’s physical rehabilitation.