Post-op / After Care Instructions

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Recovery Time

After most surgery, pets will need to be confined for a period of time to ensure uncomplicated healing and complete recovery. This period of time can last from 2 weeks to 2 months, and in some cases even longer.

  • 2-3 weeks = OCD, excision arthroplasty, abdominal surgery
  • 3-4 weeks = Patellar luxations, some internal/abdominal surgery
  • 5-6 weeks = Young animal fractures, dislocations, spinal surgery
  • 6-8 weeks = Most fractures, any surgery involving cutting bone, L7-Sl fusion, other fusions
  • 8 weeks = Tibial Plateau Leveling Osteotomy (TPLO), Triple Pelvic Osteotomy, DARthroplasty; Proximal Radial Sliding Osteotomy, Tibial and Femoral Osteotomies, Total Hip Replacements

Confinement

Your discharge instructions will contain additional information about your pet's specific confinement requirements, but we have listed some general guidelines below.

Confinement is 'house-arrest' or restriction to a limited area in an effort to prevent explosive or prolonged physical exertion:

  • Cats: A small crate, covered playpen, shower stall.
  • Toy breed dog: A medium crate, covered playpen.
  • Medium breed dog: A large crate (wire or plastic) or X-pen (exercise pen)
  • Large breed dog: Large to giant crate (wire or plastic) or X-pen.
  • Giant breed dog: A giant crate (wire or plastic) or preferably an X-pen.

Your pet should be confined away from other pets. Small children should be discouraged from playing around this area as it may incite your pet to jump and play. Use a clip on the cage so small children cannot open it and allow the patient to escape.

Should you not be able to crate your pet without causing further injury, call our office and let us help you with suggestions for alternative arrangements.

Traveling

Even a small fender bender accident can cause irreparable injury to a pet which has just been released from surgery! We do not want a recovering or injured animal standing or moving about in the car. Your pet should be transported in a crate or lying down on the seat or floor with someone holding on. If you have other pets, please leave them at home when picking up.

Once home

You will need to take your dog outside to relieve itself. This is NOT for a walk around the block or neighborhood! This is a short walk to a small area for eliminations only then directly back inside. Your pet should be discouraged from using the dog door until you receive clearance to do so (typically 6 week post-operatively). Perform these short leash walks three-four times daily. We suggest that the first person up takes the dog out, followed by the last to leave for work, the first person home, and last to go to bed. If you are also able to get home at lunch, great!

Temperature

We may request that you take your pet’s rectal temperature. An elevated temperature is our first sign of infection. If requested, this will need to be done twice daily first thing in the morning and again in the evening. Normal values for a pet’s temperature are 100.5˚F to 102.5˚F. Evening temperatures can be higher than morning, but should still be within normal values.

Any temperature above this range should be reported to our staff immediately. You should also note how your pet is feeling. Lethargic and listless? Eating and drinking normally? Restless and panting? These and other observations will help our staff determine how we can get your pet feeling better.

Please purchase a digital thermometer and probe covers at your local pharmacy.

Care of Bandages and Splints

Following surgery, your pet will need enforced inactivity for a period of several weeks. Strict exercise restriction means: no running, jumping, hopping on and off furniture, or climbing stairs unassisted. If you have other animals in the house, or children that play with or come in contact with your recovering pet, please keep them separated unless you can fully supervise all interaction. Activity must be limited to very short leash walks for the purpose of your pet going to the bathroom only. The patient should be kept in an enclosed area such as a small yard, dog run, or a small room in the house preferably with solid footing to prevent slipping.

Your pet's splint or bandage requires care and attention. Do not allow your pet to chew or lick the bandage/splint. Use the plastic Elizabethan collar if provided. Keep the splint/bandage clean and dry. If it is damp outside or the surface that your pet must walk upon is wet, place a plastic bag around the bandage to keep out all moisture. Do not leave this plastic bag on the bandage all the time or moisture will develop in the bandage! If the toes are exposed (only the very tips should show) check them daily for evidence of swelling. If more of the toes are exposed outside the bandage, please call. If they become cool, puffy, or painful it is possible that the bandage is impairing the circulation of the limb and will need to be changed. Please call our office immediately if this occurs. If the toes are not exposed, you should try to wiggle your fingers between the layers of bandage, to gently ‘squeeze’ your pet’s foot/toes. Your pet should acknowledge that they have felt your squeeze. If they are unable to feel your squeeze, it may mean that the bandage is impairing feeling and will need to be removed or modified. Again, please notify us immediately. The bandage/splint may loosen at the top of the leg over time. This is not a problem as long as it is still supporting the limb and you can still check your pet's toes (and they are okay). If skin chafing develops at the top of the splint, you may add some padding or baby powder to the affected area. If the bandage/splint is damp or foul smelling, have it changed immediately.

With your help at home, your pet will get maximum protection ad wear from the bandage/splint. If you have any questions regarding your pet's bandage/splint, please do not hesitant to contact our office immediately. We are available to answer questions 24 hours daily either directly or through our voice mail system. Our staff is always happy to help you. Thank you for letting us give your friend the best care possible.

Acepromazine: Tranquilizer

Following surgery, your pet will need enforced inactivity for a period of several weeks. Strict exercise restriction means: no running, jumping, hopping on and off furniture, or climbing stairs unassisted. If you have other animals in the house, or children that play with or come in contact with your recovering pet, please keep them separated unless you can fully supervise all interaction. Activity must be limited to very short leash walks for the purpose of your pet going to the bathroom only. The patient should be kept in an enclosed area such as a small yard, dog run, or a small room in the house preferably with solid footing to prevent slipping.

Many patients refuse to be self-limiting with this mandatory exercise restriction. To help with this we have prescribed acepromazine. This is a potent promazine-based tranquilizer, the intent of which is to "take the edge off", allowing the patient to be content to be less active in the post-operative phase of their rehabilitation. Acepromazine has a variable effect from animal to animal. Because of this, it can be difficult to know the exact dosage appropriate for your pet. We recommend an average dose, based on your pet's size, and that dose is then adjusted by you to achieve the desired effect. Please note that it is extremely difficult to overdose and cause significant harm with this drug. A high dose will result in severe tranquilization, however, which will be manifested as a deep sleep. Some pets can be difficult to arouse from this deep sleep for several hours. Typically a high dose will cause your pet to sleep for approximately 12 hours and then wake up and behave normally. Side effects that your pet may exhibit while on acepromazine include altered breathing patterns, shivering, blood-shot eyes, and protrusion of the third eyelid (a pink fleshy eyelid that people don't have, in the inner corner of the eye socket).

Conversely, animals that have been tranquilized with acepromazine can be roused from their tranquilization. That is, should they experience an appropriate stimulus they can be roused from their rest and temporarily act normally. However, once they have been replaced in a quiet environment, the tranquilizer will again take hold and they will resume tranquility.

Acepromazine is readily metabolized by the liver. As you continue to administer this drug, the liver becomes more adept at ridding the drug in your pet's system. Hence, you may need to increase the drug dose on a regular basis to continue to achieve the desired sedative effect. We recommend increasing the drug by 1/2 tablet at a time as needed. Generally, the drug should be given three times a day, as necessary to achieve an appropriate level of tranquilization. It takes 20-30 minutes for the drug to achieve maximal effect. Obviously, the longer your pet needs to be on Acepromazine, the more judicious your use of the drug should be: within several weeks the liver becomes so adept at processing the drug that an extremely high dose of the tranquilizer no longer has any effect. Interestingly, within a few weeks of discontinuing acepromazine, your pet will once again become susceptible to a very low dose of the drug. This drug is not addictive. In very few cases some pets may have an abnormal reaction to acepromazine and become hyperactive, aggressive, and/or suffer a personality change. This is extremely rare and the effects resolve as the drug wears off. Some pets, (especially spayed females) may also have mild urinary incontinence while on the drug.

Some people do not feel comfortable with the side effects of this medication. Remember, the purpose of placing your pet on this drug is to decrease the tendency to become overactive and undo or damage the repairs made during surgery. If you can achieve tranquility through confinement and environmental control, or if your pet's inherent personality is mellow, then minimal use of this drug would be needed.

NSAID’s (non-steroidal anti-inflammatory drugs)

Following surgery, your pet will need enforced inactivity for a period of several weeks. Strict exercise restriction means: no running, jumping, hopping on and off furniture, or climbing stairs unassisted. If you have other animals in the house, or children that play with or come in contact with your recovering pet, please keep them separated unless you can fully supervise all interaction. Activity must be limited to very short leash walks for the purpose of your pet going to the bathroom only. The patient should be kept in an enclosed area such as a small yard, dog run, or a small room in the house preferably with solid footing to prevent slipping.

Your pet has been sent home with an anti-inflammatory drug. These medications are all aspirin-like drugs from a group that include Deramaxx, Rimadyl, Etogesic, Advil, Zubrin, Prevacoxib, and Metacam. These eliminate pain and discomfort and the cycle of inflammation and irritation associated with surgery, injury or degenerative processes (arthritis). As such, NSAID therapy is an important adjunct during the post-operative period. These drugs also have an important role in the conservative management of many orthopedic conditions.

With the recent FDA withdrawal of Vioxx there has been a great deal of attention given to many NSAID medications; most of this attention points to adverse reactions. It is important to keep in mind that all medications, including NSAIDs, can have side effects, and that for every bad reaction to the drug, there are many thousands of doses administered without any side effects whatsoever!

Since the goal of NSAID treatment is to maximize benefit while reducing side effects we would like to help you identify a list of signs that you could see at home to determine if your pet is having an adverse reaction. Adverse reactions to NSAID therapy include decreased appetite, episodes of vomiting, lethargy, diarrhea, increased water consumption or change in stool color and consistency (dark, tarry). This list is not exhaustive, and other less common symptoms may be seen. If you have any questions regarding adverse reactions, do not hesitate to contact us with your concerns.

Please keep in mind, an overwhelming majority of dogs do well and tolerate these drugs without any of these side effects. However, if your pet is one of those that do manifest any of the above symptoms, please discontinue administration of the medication, and contact us immediately.

Fees for Recheck Examinations

  • There will not be a charge associated with suture removal, unless, of course, there are complications in the healing process. Nor will there be additional exam, consultation, or "office call" fees incurred for return visits associated with your original presenting condition as long as the recheck schedule is followed. Missed appointments or failing to meet the recheck schedule may result in a recheck examination fee.
  • Recheck examinations that include radiographs, bandage changes or sedations will have a fee associated with them. Please ask for an estimate of charges for rechecks anticipated for your pet’s particular condition.
  • In all circumstances we have the best care for your pet in mind. We will try our best to maintain your costs to within those estimated. Please mention any concerns that you may have regarding fees in advance of proceeding with any treatments.