Surgery Discharge Instructions:

Follow-up appointments should be made first in 2 weeks, and again in 6 weeks.

The care your dog receives when he or she goes home after any surgical procedure is critical to a positive recovery. Please protect your dog when leaving the hospital by using either a leash or a carrier.

ANESTHESIA 

Your dog has undergone general anesthesia and may still be groggy and slightly uncoordinated. You should limit and supervise his or her activity for several days. Provide a warm, quiet place for your dog to recover. Most of our surgical patients are anesthetized with gas anesthesia. This can sometimes cause irritation in the trachea and you may notice some coughing, which is normal. If the coughing persists for more than 48 hours or interferes with sleep, please contact us at 406-252-9499.

FOOD AND WATER 

Excessive eating and drinking can sometimes cause stomach upset following surgery. Vomiting may result if your pet is allowed to gorge him/herself with food and/or water as soon as you get home. Pets occasionally do this from excitement, even though they receive proper nutrition while hospitalized.

• Give only a small amount of food and water tonight.
• No changes in food and water are required at this time.

Special instructions:

INCISION/ABSCESS SITE  

Please check your dog‘s incision/abscess site daily for any redness, irritation, swelling, discharge, or drainage. If your dog is bothering the site, please call us. Usually a small amount of licking at the area is not harmful; however, some pets will become obsessive or destructive toward a surgical wound.

• No skin sutures. The incision was closed with absorbable suture that will dissolve
• Skin sutures or staples that need to be removed in 14 days

A drain which needs to be removed in _________.  Blood and fluids will seep from around the drain; therefore, you should keep your pet away from materials (rugs, couches, etc.) that might get stained. Be careful that you and other family members do not come in direct contact with any pus. Wash yourself well if it should happen.

Keep the area clean. Hot pack the wound 2 to 3 times daily for 10 to 15 minutes to help keep it clean and open for drainage.

COOL COMPRESS 

A cool, dry compress may be applied to the surgery site for 10 minutes, 2-3 times a day. This can be accomplished by the use of a cool, damp washcloth placed in a sealable, plastic bag or a bag of frozen peas wrapped in a towel, placed over the incision. Do not allow the incision to get wet. This will aid in the resolution of soft tissue swelling and often offers a soothing sensation to the patient. However, if your pet does not tolerate it, discontinue the cool compress application, as it is not critical for a successful outcome. In most cases, there is no need to continue cold therapy once sutures are removed.

BANDAGE/WOULD CARE

Keep your pets bandage clean and dry. Place plastic bags or Medipaws over foot bandages when your pet goes outside and remove when in the house to prevent sweating in the bandage. If the bandage gets wet, please come in for a bandage change.

Come in for a bandage change in _______________.

Come in for a bandage removal in ______________.

E-collar sent home to prevent your pet from getting at the bandage/wound. To be effective, the E-collar must remain on your pet at all times unless supervised. It may also be helpful to raise the food and water bowls and/or move them away from the wall.

EXERCISE AND ACTIVITY 

Pets recovering from surgery should only have limited exercise. Access to stairs or situations which may cause injury should be avoided.

• Needs restricted activity – minimal running and jumping. Outdoor exercises should be restricted to leash walking for 7 to 10 days.
• Needs activity to be completely restricted for 30 days. Keep confined and quiet – No running, jumping, walks, or stairs. Your pet is only to be taken outside on a leash for periodic potty breaks.
• After completely restricting activity for 4 weeks and sutures have been removed, your pet needs restricted activity for 30 to 45 days. Minimal running and jumping indoor and outdoor exercises should be restricted to leash walking.
• Use a sling for support when walking.

Physical rehab home exercises after spine surgery

Because your dog is uncoordinated, he or she could easily get hurt if allowed to roam free in the house especially around steps or stairs. We recommend you keep confined or under your direct supervision. Soft, dry bedding, at least 1 inch in thickness, must be supplied to prevent pressure sores from developing. 

Superficial heat 2-3 times daily will be helpful. Place a towel over the area and between the warm pack. Remove in 15-20 minutes. When using heat check the skin every 2-3 minutes for redness or over heating. Following warm packing gentle massage should be done.

Passive range of motion exercises for all of your dog’s limbs will help to reduce atrophy and encourage use. Gently grasp your dog’s paw and move each limb in flowing, circular, forward to backward movements. This exercise may be done lying or sitting. Repeat for 10-15 repetitions, several times daily.

Weight shifting exercises will help your dog to regain balance and coordination. Stand your dog squarely on firm footing and gently nudge his or her side at the point of the hip to make the weight shift onto the other leg and support ones self. Alternate from side to side. At first some support may be necessary to avoid falling. If he or she knuckles his or her feet place them appropriately for her. As proprioceptive ability is regained the shifts may be made more challenging. Begin with a 30 second session and gradually increase to 5 minutes per session.

Sling walking should be done multiple times a day and for potty breaks. Try to help your dog place his or her feet when using the sling, offer as much support as need but as little as possible so that your dog is working to support his or herself.

Watch for any increased signs of lameness, decreased limb use or abnormal behaviors and tailor his/her exercises accordingly so not to overtax her system. Please contact us if any of these signs occur. 

If your dog shows worsening of neurological status, such as breathing difficulties, or change in movement in the front limbs, you should contact our hospital or your regular veterinary hospital immediately.  

Sutures will need to be removed 3 weeks from the date of surgery.  

At 1 month from surgery please schedule an appointment with your regular veterinarian to reevaluate your dog, asses his neurological status and evaluate restrictions. Until that time no running, playing, stairs or unsupervised activity.

BLADDER CARE 

If your dog is unable to express his/her bladder on his/her own at this time, it is important that the bladder is manually expressed three to four times daily to prevent urine retention, development of a urinary tract infection, and urine scald from lying in urine. To express the bladder, place your hands on either side of the body, just behind the rib cage. Push your hands inward until your fingers are touching, then slowly move them backwards towards the tail until you feel a round, urine-filled bladder (like a water balloon). Once the bladder is between the fingers/palms of your hands, gently push your fingers/palms together, as well as backwards towards the tail. Continue expressing the bladder until it feels empty/small.  If your pet is urinating on his/her own, palpate the bladder after each urination to make sure that the bladder is emptying completely. Hopefully, as your pet improves, bladder expression will no longer be necessary.

MEDICATIONS

• Medication is not needed
• Medication is dispensed.  Follow all label doses on medications
• Rimadyl – pain and anti-inflammatory medication
• Tramadol – additional pain medication
• Cefazolin – antibiotic injection given at the hospital

ADDITIONAL INSTRUCTIONS

If you can afford the additional cost and travel is not an inconvenience, we recommend setting up an appointment with our rehabilitation facility for a rehab session any time after your two week follow-up appointment.

Laser therapy may also be beneficial 1-2 times weekly if available at your regular clinic or at one near you. Please do not hesitate to call us at any time if you have any questions or concerns.

Please remember, you may observe a decrease in activity or appetite for one day. However, if your pet exhibits any of the following symptoms, please call the hospital right away:

• Vomiting and/or diarrhea occurs
• The incision becomes red or swollen, or oozes blood or fluid
• Your pet chews or damages the incision, suture, or drain
• You cannot give the prescribed medication as directed
• Your pet seems depressed, lethargic, or refuses to eat for more than 24 hours
• There is any change in your pet’s general health or behavior
• You are unable to express your dog’s bladder and he/she is not urinating voluntarily.

Thank you for choosing Animal Clinic of Billings for your pets medical needs.