Having your dog undergo surgery is scary. Worrying that something will go wrong is a very natural and common fear. My recommendation is to help ensure the best outcome for your dog by (1) Preparing appropriately surgery ahead-of-time (find an excellent and experienced vet to perform the procedure, determine if a specialist should get involved, perform appropriate staging tests, make sure your vet/surgeon knows which medications you're giving and when they were last given)
(2) Learn how to care for your dog appropriately after surgery.
This article will walk you through what to expect after surgery and serve as a guide for how to best care for your dog post-operatively to avoid complications.
After the procedure
Most specialty clinics have a policy of hospitalizing all patients overnight after surgery. This is often ideal and allows the sedatives (given at surgery) to wear off, so your dog is looking "normal" when you pick him up. It also allows for appropriate pain management. Often, intravenous pain medications are given overnight, which allow time for pain patches to kick in.
If an overnight doctor feels that pain is not adequately controlled, they can make a quick change so that your dog's comfort is restored (something you cannot do at home).
This also allows time for careful observation by overnight doctors to ensure that the patient has recovered appropriately and is not having unexpected bleeding or other complications.
Your doctor or nursing staff should then give you a call the next morning with an update. They'll discuss how your dog did overnight, and if everything is going as planned, arrange for a time for you to pick him up later that morning/day.
(1) Get clear on the doctor's recommendations when picking your dog up after surgery. Your clinic should provide written instructions after surgery with do's and don'ts during recovery. You can then refer to this document repeatedly to ensure you're following the doctor's plan.
If your clinic doesn't provide written instructions, consider making a recording of the visit so you're extremely clear on your doctor's recommendations as well as all medication instructions. When you get home, you can take the time to transcribe the notes to paper.
Typically discharge instructions will discuss which medications your dog should be receiving, whether the medications should be given with food, and when the next dose is due. Make sure you're clear on the answers to these questions before leaving the hospital.
The discharge instructions should also state when your dog is due for an incision check or bandage change; sometimes there are sutures or staples to be removed, which needs to be scheduled. Schedule this before you leave the hospital so it gets done on time.
(2) Ask how and when you can reach the surgeon/doctor and their staff if you think there is a problem. When can you call the surgeon? Can you send them photos by email? If they're not available nights/weekends, is there a 24 hour clinic nearby they can recommend? Who is your main contact - the surgeon or the nurse?
It's important to have a plan in place. It's also important that you feel comfortable contacting the surgeon and their staff if a problem or question arises.
The surgeon/vet wants to know if something isn't going right at home. Since they performed the surgery, they're the best individual to determine if you should or shouldn't be concerned about a "problem" or change. Please try to reach out to this person first and in a timely manner to get your dog the help he needs.
(3) Exercise restriction is essential until incision check. For most types of surgeries we recommend exercise restriction until the incision check appointment. Since every situation is different, refer to your discharge paperwork and the advice your surgeon gave when you spoke to them.
Exercise restriction typically means no chairs, stairs, running, or jumping. Keep your dog on the floor and off of furniture. Walk your dog outside (on a leash only - not off leash) for five minutes at a time to use the bathroom a few times daily. This should be the extent of their exercise.
The goal is to minimize motion at the surgery site. If there is too much motion, complications can arise such as incision dehiscensce (the incision rips open and you have to pay for the surgeon to put it back together - nobody likes this and it's not fair to your dog) and seroma formation.
A seroma is a pocket of fluid that develops under the incision due to too much motion (such as running around the yard, playing or going up and down stairs). It typically feels very soft and might feel warm. When are seroma forms, we typically just recommend exercise restriction (again!) and possibly warm packing. Draining the fluid is not recommended (that's a good way to introduce bacteria and cause an infection).
Seroma formation significantly delays healing and can increase the chance of infection. If your dog is due to receive follow up treatment such as chemotherapy, radiation or electrochemotherapy, these treatments will all be delayed, which can shorten the length of a patient's life.
The tough part is that dogs typically feel really well rather quickly after surgery. Once this happens it becomes difficult to restrict their activity.
If your dog is very excitable (think mailman, visitors) ask your surgeon for a medication such as trazodone, which will allow him to stay calm and heal appropriately.
If the surgeon is happy with healing progress at the incision check (typically 10-14 days after surgery) she will likely advise you to slowly increase activity over the next few weeks.
**Note: Once the sutures/staples are removed, we typically recommend refraning from bathing for an additional 3-4 days.
(4) E-collars must be worn at all times until incision check. Dogs don't love e-collars and we don't love seeing our dog in an e-collar. I'm pretty sure most people can agree on this.
The fact is that e-collars do an excellent job of protecting the incision if the collar is the appropriate size and type for your dog.
In most cases, the e-collar only needs to be worn until the incision check (typically 10-14 days after surgery). In the whole scheme of things, this is not a long time.
Yes, e-collars are awkward, but if your dog is able to lick or chew his incision to the point of requiring a second surgery or antibiotics, is that really fair to him? Not really.
In certain cases, a t-shirt, "zen" collar (looks like a small inner tube worn around the neck), or even an e-collar like the one the Frenchie is wearing in the photo above might be appropriate.
These alternative collars are great options but will not work for every dog, so your vet will have to give the final approval based on your dog's conformation (their size/shape) and where the incision is located.
(5) Remember that your dog just had surgery, use common sense. Your dog is unlikely to feel completely normal when you pick him up from the hospital. Even if their pain is adequately controlled they may not have slept well, so they may feel very tired. Expect a dog recovering from surgery to be more tired (it takes a lot of energy to recover from surgery), perhaps eat a bit less, and move a bit more slowly.
Know that their pain medications might cause lethargy or decreased appetite but understand that in the first few days after surgery, it's better for them to be tired than painful. *Make sure you are aware of all of the medication side effects before taking your dog home from the clinic.
Give them some time to feel normal again. What you want to see is progress each day. Your dog should feel better (more energy, better appetite, more normal behavior) each day. If your dog is feeling worse each day (or if you are otherwise concerned) - call the doctor that performed the surgery.
The good news is that dogs typically recover significantly faster from surgery than we expect, which is often a nice surprise for the family. If a surgery is well-planned, if appropriate staging and work-up is completed, if the surgeon is experienced and following surgical oncology principles, and if patients are allowed to recover appropriately, they will have the best chance for a smooth procedure, recovery and good outcome.
Dr. Lori Cesario
Board Certified Veterinary Oncologist
PS: I'm happy to now offer online oncology consultations. Learn more about how this service can help by visiting the Vet Cancer Consultants site.
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