Post Operative Questions

Gastro-Intestinal Problems:

My pet had surgery and will not eat. What can be done?

Dogs:

• Many pets may not eat their regular dog food after surgery, especially if it is kibble.

• Try canned dog food; such as Hill’s A/D diet (available at the hospital). To enhance the flavor sprinkle a very small amount of garlic powder or chicken or beef broth on the  food.

• Try Gerber strained meats for babies such as the chicken, beef, turkey, or veal

• Try warming the food gently in the microwave to increase the aroma of the food. Test the temperature with your finger to make sure it is not too hot.

• Offer a cooked diet having a 1:1 ratio of a protein source and carbohydrate source. The protein source can be any meat (example: chicken breast, turkey breast, lean hamburger) that is low fat and should be cooked and any residual fat skimmed off.   The carbohydrate can be pasta, potato or white rice.

• Hand feeding; place a small amount of food in the mouth so that they get the flavor

• Warm the food slightly in a microwave as the food will be more aromatic; remember to stir the food before feeding and test the temperature on the bottom side of your wrist; it should only be luke warm.

• Remember that most pets will not eat the first day or two after they get home from surge

Cats:

•  Offer smelly foods that contain fish such as tuna or smelly cat foods

•  Try Gerber strained meats for babies such as the chicken, beef, turkey or veal

•  Hand feeding; place a small amount of food in the mouth so that they get the flavor

•  Warm the food slightly in a microwave as the food will be more aromatic; remember to stir the food before feeding and test the temperature with your finger; it should be only luke-warm.

•  Some cats will only eat dry food, try kibble if your cat normally has been fed that food

•  Petting and stroking your cat frequently will help to stimulate appetite

•  Remember that most pets will not eat the first day or two after they get home from surgery

•  Appetite stimulants such as cyproheptadine may be helpful

•  If your cat refuses to eat anything for 7 days a stomach tube should be placed to provide nutrition so that a serious liver problem (hepatic lipidosis) does not develop

My pet is vomiting now that he/she is at home. What can be done?

• The first thing for you to discern is whether your pet is vomiting or regurgitating. Both will result in fluid or food being brought up. Vomiting always will have heaving or retching of the abdomen prior to expulsion of the vomitus. Regurgitation is not associated with heaving and the pet usually just opens the mouth and fluid or food will be expelled. Usually the regurgitant will be clear or brown colored fluid. 

• Next is to identify the cause of the vomiting or regurgitation.

Causes and treatment of vomiting after surgery

When some pets return home after a stay in the hospital they may drink excessive amounts of water at one time and then vomit; if this appears to be happening the water should be limited to frequent smaller amounts.

• Medications such as antibiotics or pain relief medications (deramax, tramadol) may cause vomiting after surgery. In order to see which medication is causing the problem, the administration of each drug should be separated 2 hours apart. Usually the pet will vomit or appear nauseated (drooling and sick look) within 1 hour of administration of the medication that they are sensitive to. The antibiotic in some cases may be changed to a different one, or may be discontinued. The pain medication may need to be changed as well.

• Stomach upset from anesthesia is a potential cause of vomiting and usually will pass within a couple of days.

• Unusual cause of vomiting after surgery is internal organ failure. Blood testing will confirm this problem. For this reason vomiting should not be ignored if it persists for more than 24 hours.

If your pet had surgery of the bowels or stomach, vomiting is always a concern, as it may indicate that infection of the abdominal cavity, called peritonitis, is present. Do not ignore this sign.

Symptomatic treatment of vomiting involves with holding food for 8 to 12 hours, then introducing small amounts of bland food such as rice and lean cooked hamburger..
It may be necessary to try various drugs to stop the vomiting.  These need to be issued by our veterinary staff.

The most common cause of regurgitation is reflux of acid from the stomach into the esophagus while your pet is under anesthesia. Acidic fluid from the stomach can cause a chemical burn of the esophagus and result in a bad case of heartburn, which is called esophagitis. This results in poor motility of the esophagus so water and food will accumulate in this structure.  If this is suspect, we may prescribe drugs to reduce the acid content of the stomach and to improve the sphincter tone in the stomach.

Regurgitation also can be caused by a neuromuscular degeneration of the esophagus and this problem will persist. It is not associated with surgery, rather other underlying diseases.

When should my pet have the first bowel movement after surgery?

If a pet does not have a bowel movement on the 3rd day of being home, a stool softener such as metamucil can be fed

 Dose of Metamucil 1 tsp per 50 pounds mixed in with each meal (canned dog food)

PAIN:

How do I know that my dog is in pain following surgery?

Signs of pain include

•  crying

•  biting if you get near the surgical site

•  grimacing (lips are pulled back and the the dog looks anxious)

•  tragic look of the face

•  restlessness and not wanting to sleep; pacing

•  if abdominal surgery was done the pet will not lie down on the incision, or will continually sit up in spite of appearing very tired

•  the worst pain will be for the first 2 to 3 days after surgery