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
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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.
BANDAGE,
CAST, OR SPLINT IS SOILED, WET, OR OFF:
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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.
BATH
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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.
CONFINEMENT/LIMITED
ACTIVITY
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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
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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
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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
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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
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Unless your
post-operative letter advises otherwise, please feed the normal
diet after surgery. If the appetite is poor, see "APPETITE"
above.
ELIZABETHAN
COLLAR
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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
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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
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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
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If for any
reason you suspect that your pet has reinjured the surgical site,
please call us immediately for advice.
MEDICATIONS
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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
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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
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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
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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)
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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.
SHAKING/TREMBLING
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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.
SPINAL
SURGERY:
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Please refer
to the "Post-Op Laminectomy Nursing Care" handout which
you received.
SWELLING
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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.
URINATION
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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.
VOMITING
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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.
