Here are answers to many questions you may have, after your pet is discharged from the hospital. Please feel free to call us at any time, day or night, for further information regarding any of these concerns.

APPETITE BANDAGE, CAST OR SPLINT IS SOILED, WET, OR OFF BATH CONFINEMENT & LIMITED ACTIVITY CONSTIPATION & BOWEL MOVEMENTS CRYING & WHINING DIARRHEA DIET ELIZABETHAN COLLAR IMPLANT OR HARDWARE IS EXPOSED OR VISIBLE INCISION CARE

INJURY TO SURGICAL SITE MEDICATIONS MEDICATION REFILLS PAIN PANTING SEROMA (FLUID POCKET) SHAKING & TREMBLING SPINAL SURGERY NURSING CARE SWELLING URINATION VOMITING

Decreased appetite is very common during illness, or after surgery. There are several things you can try:
- offer favorite foods or treats
- warm the food slightly (just over room temperature) to increase the odor/taste - offer chicken baby food (alone or on top of the regular pet food)
- some dogs may be willing to eat cat food because of its oilier and fishier taste
- some pets like chicken/beef broth alone or with regular pet food

Please call us in twenty-four hours with a progress update. Of course, for your peace of mind, we are happy to recheck your pet at any time. If your pet had been eating well, and then loses their appetite, please call us immediately.

Call us immediately if you have concerns about your pet's bandage. Confine your pet to a single room or similar small area until you can call us and we can advise you to whether the bandage needs to be replaced.

If the bandage becomes soiled, damp, chewed, or chewed off, please do not rebandage at home. Duct tape and other items can trap moisture within the cast/bandage causing inflammation of the skin and tissues. In some cases, bandages inappropriately applied at home can even cut off the circulation to the foot. We are here 24 hours a day to help: always call us if there is any problem with the bandage. There is usually no charge to redress or recheck a bandage.

After a cast or splint is first removed, it may take 1-2 weeks for your pet to become accustomed to using the leg without the splint. Do not be alarmed if your pet seems to be much more lame at first, after the splint is taken off.

Only bathe your pet after the sutures have been removed, and all bandages, splints, or casts have been removed. Until then, a rub-down with a damp towel is a safe alternative.

Your post-operative report will advise one of the following:

A. Cage rest: confinement to a cage or large traveling carrier, at all times. Dogs maybe taken outdoors on a leash to relieve themselves, but no other activities are permitted.
B. Strict confinement: confinement to one or two rooms with nothing to jump onto or off of.
C. Limited activity: leash walks of less than five minutes, several times a day, and confinement to one level of the home with minimal or no use of the stairs.
D. No heavy exercise: normal leash walks are permitted but no running, roughhousing, chasing, or visits to the dog park.
E. Normal activity: no restrictions at all.

CONSTIPATION/BOWEL MOVEMENTS    top

Difficulty having bowel movements can be expected after illness, anesthesia, or surgery. It often takes a few days for the gastrointestinal system to return to normal function. Fortunately for dogs and cats it is not vital to their health to pass a stool on a regular daily basis.
You may give a small amount of vegetable oil mixed in each meal (one-half teaspoon for a cat and up to 3 teaspoons for a big dog). If this does not result in a stool within thirty-six hours, please call. We can give an enema if necessary, but rarely does this prove necessary. As an alternative, Laxatone paste can be obtained from either your general veterinarian, or from our hospital.

CRYING/WHINING    top

Although vocalizing can indicate discomfort, it is usually not a sign of pain (instinctively most dogs will not vocalize because in the wild, this would attract predators!). Often, it is due to excitement and agitation that your pet feels on leaving the hospital and returning to the familiar home environment. It is also common due to frustration/anxiety in spinal surgery patients who cannot walk. In patients that cannot walk, it may indicate a full bladder, so try carrying your pet outdoors or to a litter box so they can relieve themselves. If this does not work, please call for further advice.

If the signs are mild and intermittent, you may simply monitor the situation. If they are persistent, please call us for advice. In some cases, a sedative or pain medication maybe be prescribed.

DIARRHEA     top

Diarrhea may be seen after your pet has been in the hospital. This can be caused by change in diet but usually stress from being away from home is the cause. In some patients, medications may cause diarrhea.

If no blood is noted in the diarrhea, you can try feeding a bland diet for 2-3 days to help the digestive tract get back to normal. If the diarrhea is bloody or lasts longer than 12-24 hrs, please contact us immediately. If your pet becomes lethargic or vomits, please contact us immediately.

A bland diet can be purchased from your veterinarian (usually in cans) or you may feed cooked/steamed rice mixed with an equal volume of either chicken broth, boiled chicken, chicken baby food or cooked turkey. Very lean and boiled hamburger meat can be substituted as well. Feed small meals every 4-6 hours.

We do NOT recommend using any over-the-counter medication to treat the diarrhea. Please call us if there are any questions or problems.

DIET     top

Unless your post-operative letter advises otherwise, please feed the normal diet after surgery. If the appetite is poor, see "APPETITE" above.

ELIZABETHAN COLLAR     top

We rely on you to keep the Elizabethan collar (E-collar) on your pet. While they may not enjoy it initially, they will enjoy even less having to come back to our office for a recheck visit to repair an incision that has been chewed open. They will need to wear the collar on for an even longer period if this happens! Most pets become accustomed to the collar within one or two days and they can eat, sleep, and drink with it on. We are counting on you: please keep the Elizabethan collar on your pet.

IMPLANT OR HARDWARE IS VISIBLE / EXPOSED     top

Please immediately confine your pet to a single room or a cage, call us, and come in so the doctor can recheck the area.

INCISION CARE     top

Do not clean the incision or apply hydrogen peroxide or any ointments unless your post-operative letter advises otherwise.

A mild amount of swelling is normal around the incision. However, if there is discharge, progressive swelling, increasing redness, signs of discomfort or if your pet has chewed out any sutures, please call us.

If your pet is chewing at the incision, an Elizabethan collar (E-collar) should be immediately obtained, and kept on 24 hours a day until the sutures are removed (See "ELIZABETHAN COLLAR" below).

We will be happy to recheck your pet, for your peace of mind, if you are concerned about the incision. There is no charge for this recheck.

INJURY TO SURGICAL SITE     top

If for any reason you suspect that your pet has reinjured the surgical site, please call us immediately for advice.

MEDICATIONS     top

What time did my pet receive medications in the hospital?

Twice a day medications are given at 8 A.M. and 8 P.M.
3 times a day medications are given at 8 A.M., 4 P.M., and midnight.
4 times a day medications are given at 8 A.M., 2 P.M., 8 P.M., and 2 A.M.

At home, you may give the first dose as soon as you get up, and the last dose just before bedtime.

How do I give the medications?
Try to place the medication in a piece of cream cheese, turkey hotdog, peanut butter, chicken, or any other treat your pet likes (use just enough to give your pet the medication). There is a description of how to give medications attached to this hand-out, and also on the back of your return appointment slip. Please feel free to call with further questions, or to check if the medication can be changed to a liquid form (or discontinued).

MEDICATION REFILLS     top

If your have used up the pain medication and you feel your pet still has discomfort, please call and we will be happy to discuss dispensing a refill of the pain medication.

Ethically, we cannot refill medications prescribed by your general practice veterinarian. Please call them for this service.

For surgical patients, we will dispense medication for the immediate post-operative period. However, long-term medications (such as arthritis medication) should be obtained from your general practice veterinarian.

State Law prohibits refilling medication prescribed by another veterinarian unless an ASEC doctor has examined the patient first.

PAIN     top

Despite the medications we have prescribed, some pets will still show signs of pain at home: restlessness/inability to sleep, poor appetite, lameness or tenderness at the site of surgery . Please confine your pet to limit their activity. Then call us immediately so we can dispense or prescribe additional medication if necessary to keep your pet comfortable.

PANTING     top

This is commonly seen after surgery. It may indicate soreness but is often due to anxiety. Pets who have had spinal surgery and cannot move may be frustrated or anxious and will often pant. Please call and we can help determine whether additional pain medication is advised.

We will be happy to check your pet at any time, day or night, for your peace of mind.

SEROMA (FLUID POCKET)     top

In any healing surgical area, fluid produced during the healing process may accumulate and form a seroma (fluid pocket). Fortunately, this is not painful and does not impair the healing process.

Eventually, the body will reabsorb the fluid so if the seroma is small, we typically will leave it alone. If it is large, we may remove the fluid with a needle and syringe or even place a drain. If you notice a seroma developing, please call. We may wish to recheck the area to ensure there is no infection.

This is a very common response to physiologic stress after surgery, injury, or any other health abnormality. The amount of shaking or trembling may be dramatic, but it does not imply severe pain, cold, or distress. It may involve the entire body, or just the area of surgery. It is most noticeable in the first 5 to 7 days post-operatively, and typically subsides in 1-2 weeks.

If there are signs of pain such as restlessness, lack of appetite, or crying out, please call us. In all cases, we will be very happy to recheck your pet.

Please refer to the "Post-Op Laminectomy Nursing Care" handout which you received.

A small amount of swelling is normal postoperatively due to the body's reaction to the surgery and the buried suture materials. This will gradually resolve over a span of weeks and months as the tissues heal. If the swelling is increasing or the area is red, inflamed, painful, or producing discharge, please call immediately and we can recheck your pet.

It is common to have slight swelling in the foot where the intravenous catheter was placed. You may remove the small piece of gauze and tape, where the catheter was removed, on the afternoon that your pet goes home.

Generalized swelling of the hind leg, ankle, and foot is common after pelvic or knee surgery since the circulation in the leg is temporarily slightly decreased. Fortunately, this is not a source of pain and will resolve in 5-7 days. You may gently massage the area, working from the foot upwards, but the leg may be sore and often it is better to simply leave the area alone.

A persistent tissue irregularity or small lump may persist weeks or months after surgery. This is due to the fibrous healing reaction which the body produces while reabsorbing the suture materials beneath the skin. These abnormal areas of texture and contour will gradually resolve and flatten out over several months. Do not be alarmed, since this is not a source of pain.

Some pets may urinate less after surgery or seem to be unable to control urination. This is usually very temporary. Call us immediately if any blood is noted in the urine, straining to urinate is noted or if no urine is noted for more that 12-24 hours. Many pets initially drink less after returning home, so expect less urination. In a few cases, they may drink more, for the first few days.

It is not unusual after surgery and anesthesia, to see occasional episodes of vomiting. If the vomiting continues, blood is noted in the vomitus or if the pet is not holding down any food or water, call us to check with the doctor and see whether the pet should be brought in. We will be happy to recheck your pet if you would like.