Bone, Joint and Spine Clinic | Dr. James Harrison | Veterinary Orthopedic and Spinal Surgery

Post Operative Care

Today, surgery has become sophisticated, thus post-operative care is minimal. Additionally, it is rare to have post-operative complications, yet most people have high anxiety when their pets have major surgery. Here are a few considerations that may comfort you and facilitate post-operative care.
You play a role in the success of any surgery that your pet has. One of the most important instructions after surgery is to follow the activity restriction guidelines. This means restriction to a leash if your pet is outside. Some pets require a short period of restriction, while more commonly a three month restriction is required.

Patients with surgical incisions and open wounds are sent home with antibiotics as a preventative measure against infection. Sedatives are also often dispensed. These are given to assist in rest during the first evening or 24 hours. Hopefully, with sedation patients will go home and sleep through any discomfort.

In most cases, a soft cotton compression bandage is placed on the leg. It is there only for compression, not for support. On the other hand, splints and cast are used for support.

Bandages often slip down after a few days, exposing the surgical incision. Do not be alarmed should you see the incision. However, take care that you do not allow the bandage to become wet. One week after surgery, patients are seen to remove the bandage and assess the wound for proper healing and again two weeks after surgery to remove the skin staples.
There is no fee for post-operative care. Patients may be seen as many times as necessary to ensure the success of the surgery and to resolve any concerns of their owners.

What to expect during the first two days post-operative
Patients are released when they are stable. A staff member will review post operative instructions, medications, answer questions and assist in putting your pet in your vehicle.

Following the procedure, your pet may have a dry throat and an occasional cough for 24 to 48 hours. Usually this does not require treatment.

Most surgical incisions are covered with bandages. Those that are exposed will ooze small amounts of blood during the first day. Later a scab will form. Excessive amounts of bleeding should be reported to the staff. If the incision is exposed, do not tamper with it.

For the first day or two, your pet will not feel like doing very much. Expect them not to eat but offer food. Keep a bowl of water close at hand. Expect them not to want to go outside to relieve themselves but offer the opportunity. Do not be surprised if nothing happens. It is not unusual for animals not to have a bowl movement for several days following surgery. If nothing happens for more than three days, you may consider using a glycerin suppository.
During this time, rest is important. Sedatives will be provided to aid in this if needed.

Pain Control
It is best for your pet to go home following surgery and go to sleep. The staff will give you sedatives for that purpose and instructions for their use. Stronger medications are available for pain in exceptional circumstances
The most commonly asked question is,” Will my pet be in pain after surgery?” People tend to equate their own experiences to that which their pet experiences. However, animals are much different than people in the way that they perceive pain. Animals do hurt, but they do not react to it as much as people and therefore need less pain control.

Most pets do well with sedation during the first night or two. If they are sleeping, they are not bothered by pain.

Bowl movements
It is not unusual for animals not to have a bowl movement for several days following surgery. If nothing happens for more than three days, you may consider using a glycerin suppository.

Baths
Most patients can have a gentle bath after the second week following surgery, if there is no splint, cast or bandage. If you use groomers, please tell them not to expect long periods of standing and not to induce vigorous activity.

Diet
Modern commercial dog foods are well balanced. They contain all of the constituents needed for healthy life, including protein and vitamin C which are required for wound healing. If your pet is using a well balanced commercial food, it is not necessary to supplement.

Patients have food withheld for 12 hours before surgery. Also they may have less of an appetite for several days following surgery. Nature has designed the body to well withstand short periods without food. If your pet does not eat following surgery, good old fashioned chicken soup may be a good idea until the regular diet can be resumed. Dogs are especially fond of the taste of chicken. Water intake is far more critical than food intake, thus water should always be available.

Sutures and wound care
Surgical wounds are closed with multiple layers of buried sutures which will dissolve after they have served their purpose. The skin is closed with staples which should be removed 14days following surgery. The staff will remove them or you may find it more convenient to return to your primary care veterinarian. During the time that your pet has staples in the skin, care should be taken to prevent licking or chewing the surgical wound. This may be done by gently scolding or by using a device such as an Elizabethan collar to restrict the reach of your pets head and tongue. Fortunately only a few patients are intractable enough to require such a device. Most of them choose not to bother the wound. If licking or chewing persists, please consult the staff or your primary care veterinarian.

If your pet should remove several staples, all is not lost, for the wound has a second set of sutures beneath the skin which will prevent it from opening entirely. If your pet opens the wound by chewing out all of the staples, it should be treated immediately.

Contact the staff or your primary care veterinarian in the rare event that you should notice a large swelling or drainage from the wound. A purple discoloration of the skin near the wound is very common. This resembles a bruise, but is really due to migration of blood through the skin, which is not a painful process although it may look alarming.

Bandages
Often, bandages are placed on the feet and legs. These bandages are made of soft cotton with an outer layer of elastic wrap. Usually these leg bandages loosen several days following surgery, and slip down, exposing the incision. At that point they may be removed. The staff will remove the bandage during the one week re-evaluation. If the bandage remains snug and in place, it can be removed two weeks after surgery at the time the staples are removed. If your pet has a splint, cast or special bandage, please discuss it with the staff. Often, they require special care.

Activity
Although most skin wounds heal nicely in 10 to 14 days, it takes three months or more for bones, ligaments and tendons to heal. During this three month convalescent period, it is important that your pet have rest. Please have them avoid strenuous activities such as running, jumping, climbing stairs and playing with children and other pets. Most do nicely when in a quiet household or outside in a restricted situation such as on a leash or in a fenced area.

Antibiotics
Antibiotics are given as one of the many procedures to reduce the incidence of infection. Cephalexin is the usual choice because it is safe and effective. It is given every 8 to 10 hours for 7 days. Patients with a history of infection may be given antibiotics for a longer period of time. The medication regimen is usually begun at home the day of surgery. Cats are given Amoxicillin because they are sometimes sensitive to Cephalexin. Both medications may be supplied in a liquid form for those who have difficulty with capsules or tablets.


	Post Operative Care Today, surgery has become sophisticated, thus post-operative care is minimal. Additionally, it is rare to have post-operative complications, yet most people have high anxiety when their pets have major surgery. Here are a few considerations that may comfort you and facilitate post-operative care. You play a role in the success of any surgery that your pet has. One of the most important instructions after surgery is to follow the activity restriction guidelines. This means restriction to a leash if your pet is outside. Some pets require a short period of restriction, while more commonly a three month restriction is required. Patients with surgical incisions and open wounds are sent home with antibiotics as a preventative measure against infection. Sedatives are also often dispensed. These are given to assist in rest during the first evening or 24 hours. Hopefully, with sedation patients will go home and sleep through any discomfort. In most cases, a soft cotton compression bandage is placed on the leg. It is there only for compression, not for support. On the other hand, splints and cast are used for support. Bandages often slip down after a few days, exposing the surgical incision. Do not be alarmed should you see the incision. However, take care that you do not allow the bandage to become wet. One week after surgery, patients are seen to remove the bandage and assess the wound for proper healing and again two weeks after surgery to remove the skin staples. There is no fee for post-operative care. Patients may be seen as many times as necessary to ensure the success of the surgery and to resolve any concerns of their owners. What to expect during the first two days post-operative Patients are released when they are stable. A staff member will review post operative instructions, medications, answer questions and assist in putting your pet in your vehicle. Following the procedure, your pet may have a dry throat and an occasional cough for 24 to 48 hours. Usually this does not require treatment. Most surgical incisions are covered with bandages. Those that are exposed will ooze small amounts of blood during the first day. Later a scab will form. Excessive amounts of bleeding should be reported to the staff. If the incision is exposed, do not tamper with it. For the first day or two, your pet will not feel like doing very much. Expect them not to eat but offer food. Keep a bowl of water close at hand. Expect them not to want to go outside to relieve themselves but offer the opportunity. Do not be surprised if nothing happens. It is not unusual for animals not to have a bowl movement for several days following surgery. If nothing happens for more than three days, you may consider using a glycerin suppository. During this time, rest is important. Sedatives will be provided to aid in this if needed. Pain Control It is best for your pet to go home following surgery and go to sleep. The staff will give you sedatives for that purpose and instructions for their use. Stronger medications are available for pain in exceptional circumstances The most commonly asked question is,” Will my pet be in pain after surgery?” People tend to equate their own experiences to that which their pet experiences. However, animals are much different than people in the way that they perceive pain. Animals do hurt, but they do not react to it as much as people and therefore need less pain control. Most pets do well with sedation during the first night or two. If they are sleeping, they are not bothered by pain. Bowl movements It is not unusual for animals not to have a bowl movement for several days following surgery. If nothing happens for more than three days, you may consider using a glycerin suppository. Baths Most patients can have a gentle bath after the second week following surgery, if there is no splint, cast or bandage. If you use groomers, please tell them not to expect long periods of standing and not to induce vigorous activity. Diet Modern commercial dog foods are well balanced. They contain all of the constituents needed for healthy life, including protein and vitamin C which are required for wound healing. If your pet is using a well balanced commercial food, it is not necessary to supplement. Patients have food withheld for 12 hours before surgery. Also they may have less of an appetite for several days following surgery. Nature has designed the body to well withstand short periods without food. If your pet does not eat following surgery, good old fashioned chicken soup may be a good idea until the regular diet can be resumed. Dogs are especially fond of the taste of chicken. Water intake is far more critical than food intake, thus water should always be available. Sutures and wound care Surgical wounds are closed with multiple layers of buried sutures which will dissolve after they have served their purpose. The skin is closed with staples which should be removed 14days following surgery. The staff will remove them or you may find it more convenient to return to your primary care veterinarian. During the time that your pet has staples in the skin, care should be taken to prevent licking or chewing the surgical wound. This may be done by gently scolding or by using a device such as an Elizabethan collar to restrict the reach of your pets head and tongue. Fortunately only a few patients are intractable enough to require such a device. Most of them choose not to bother the wound. If licking or chewing persists, please consult the staff or your primary care veterinarian. If your pet should remove several staples, all is not lost, for the wound has a second set of sutures beneath the skin which will prevent it from opening entirely. If your pet opens the wound by chewing out all of the staples, it should be treated immediately. Contact the staff or your primary care veterinarian in the rare event that you should notice a large swelling or drainage from the wound. A purple discoloration of the skin near the wound is very common. This resembles a bruise, but is really due to migration of blood through the skin, which is not a painful process although it may look alarming. Bandages Often, bandages are placed on the feet and legs. These bandages are made of soft cotton with an outer layer of elastic wrap. Usually these leg bandages loosen several days following surgery, and slip down, exposing the incision. At that point they may be removed. The staff will remove the bandage during the one week re-evaluation. If the bandage remains snug and in place, it can be removed two weeks after surgery at the time the staples are removed. If your pet has a splint, cast or special bandage, please discuss it with the staff. Often, they require special care. Activity Although most skin wounds heal nicely in 10 to 14 days, it takes three months or more for bones, ligaments and tendons to heal. During this three month convalescent period, it is important that your pet have rest. Please have them avoid strenuous activities such as running, jumping, climbing stairs and playing with children and other pets. Most do nicely when in a quiet household or outside in a restricted situation such as on a leash or in a fenced area. Antibiotics Antibiotics are given as one of the many procedures to reduce the incidence of infection. Cephalexin is the usual choice because it is safe and effective. It is given every 8 to 10 hours for 7 days. Patients with a history of infection may be given antibiotics for a longer period of time. The medication regimen is usually begun at home the day of surgery. Cats are given Amoxicillin because they are sometimes sensitive to Cephalexin. Both medications may be supplied in a liquid form for those who have difficulty with capsules or tablets.