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Friday, August 21, 2015

The Importance Of Post-Op Restrictions

Whenever your pet has surgery your vet likely tells you to restrict activity for a period of time.  For routine spays and neuters that can be difficult since the patients are so active and recovery so quickly.  But these restrictions are actually very important to your pet's recovery, and bad things can happen if you fail to limit their activity.  We saw that this week.
 
About two weeks ago one of my associates performed a routine spay on a happy, active puppy.  The surgery was uneventful and she went home without problems.  About 10 days later she called to check on the puppy and talked to the owner.  The owner reported that there was some swelling, which there shouldn't have been at that time.  She brought the puppy in so the doctor could look at her, and it was discovered that even though her skin had healed well, the abdominal incision had opened and she had developed a hernia.  Thankfully she was still acting like nothing was wrong, and was still just as active and happy.
 
When discussing the situation with the owner we learned that they hadn't been successful in keeping her activity restricted.  We tell all clients to keep activity minimal for at least a week after even a routine procedure like this, as the restrictions lower the risk of complications.  In this case we were trying to decide if the puppy had gotten too active and had broken the internal sutures, or if there was a problem with how the procedure was performed.  I suspected the former, as my associate has nearly three years of experience and is a good surgeon.
 
The owner agreed to let us repair the hernia (not that there was much choice....leaving it was dangerous).  I did the surgery this time as it fell on one of my surgery days, and discovered that the suture had broken in the middle of the incision.  It did look like she became too active and over-stressed the suture.  I was able to repair the problem easily, and used some different methods to make it more secure.  We also sent the puppy home with a tranquilizer to help keep her calm.  Hopefully this time the restrictions will be successful and she won't re-injure herself.
 
I've seen things like this happen before.  Several years ago one of my patients tore her ACL (anterior cruciate ligament....an important stabilizing structure in the knee).  Her owner had surgery performed with a local surgical specialist and it went well.  Three or four weeks after the surgery she was doing so well that the owner let her start being active, even though the surgeon had said to restrict activity for at least six weeks.  Of course, she tore her knee again because the surgery hadn't fully healed.  So she had to have a second surgery to repair the problem.  After that the owner was much more careful to keep her restricted.  Unfortuantely his brother watched her one weekend, about four or five weeks after the second surgery, and didn't keep her inactive.  Yes, you guessed it.  She tore her knee again
And that meant that she needed a third knee surgery!
 
When we veterinarians tell you to keep your pet inactive after surgery, we're giving you this instruction for some very good reasons.  We know that it's hard to keep a young puppy or kitten slowed down, but there are definite risks in not trying.  Complications aren't automatic, but they certainly go up if there are no restrictions. 
 
When your vet tells you about restricted activity post-operatively, listen closely and take it seriously.  If not, you may end up with your pet in an additional, unnecessary surgery.

2 comments:

  1. Another informative post, thank you! It IS hard to keep most pups or kittens activity-restricted! I wish my vet would give some practical suggestions on actually how to accomplish that nearly-impossible feat!

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  2. We had a spay dehisce last week-owner was letting dog run loose. Didn't notice a problem until intestines were purple. Bad deal. But totally preventable.

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