It’s 6:00 a.m. on a Monday, and your recently adopted 1-yearold shepherd mix pup Luna is staring at you hungrily from the side of your bed. You roll out of bed and give her the usual morning snuggles and love but are not feeling very good about not giving her breakfast. She is scheduled for her spay surgery this morning, and the veterinary clinic gave you strict instructions: No food after 10:00 p.m. the night before her surgery. As she follows you hopefully to the kitchen, you notice again how nervous you are about her surgery. Will she be okay under anesthesia? Will the surgery itself go smoothly? Will she be well behaved at the veterinary clinic? Will she ever forgive you for the lack of breakfast today?
By 8:00 a.m., you’ve dropped her off at the clinic and gone to work, where you anxiously await the post-op phone call, pretending you’re getting some work done. Finally, just after lunch, you receive the call—Luna has safely recovered from the anesthesia, and the procedure went well. You breathe a huge sigh of relief. The ordeal is over. But what you’re about to discover is that perhaps the hardest part of the surgery is just beginning!
Helping your dog or cat recover from surgery takes time, effort, and absolute adherence to the instructions given by your veterinary team. None of it is much fun, but the consequences of not following instructions can lead to serious, and in some cases, life-threatening consequences.
First, a short treatise on the dreaded Cone of Shame, aka the Elizabethan or E-collar (named after the large, stiffly starched collars popular in the Elizabethan era). People, and especially dogs, tend to heartily dislike the E-collar for many reasons, ranging from aesthetic to prosaic—including difficulty getting in and out of the pet door, some pets won’t eat or drink with it on, and many seem to use the hard plastic ones as a human bludgeoning tool on your shins.
As a veterinarian, I give you this advice: USE THE E-COLLAR. I worked as an emergency veterinarian for years, and nothing is more devastating to owners and the veterinary staff than having a young, healthy dog present at 2:00 a.m., sutures from their spay chewed out, causing their intestines to hang out of the incision. This can lead to one of two things: (1) An expensive second surgery to try to put intestines back (after removing the most damaged parts). Or, (2) if the damage is too great (or the cost too great for the second surgery, which can range from $2,000 to $4,500, depending on degree of damage), then euthanasia may be the most humane option. Of course, this option is heartbreaking for all concerned.
The hard plastic E-collar is frequently the least expensive, and most effective, option. But depending on type of surgery and location (surgery is like real estate: it’s all about location, location, location), other types of E-collars may be options. These include blow-up “donut” type collars, soft-sided cones, and surgical recovery suits/leg covers. Depending on activity level and the severity of the dog’s intolerance of the E-collar, sometimes two are combined, such as the soft-sided cone and blow-up donut. The surgical recovery body suits (that have attachable leg covers for knee and other leg surgeries) can be a great option, but they have some drawbacks, too. Always discuss with your veterinary staff the most appropriate option before going rogue and duct taping your grandchild’s inflatable water wings together around your dog’s neck (yes, this happened!). Also, the veterinary staff will know whether your dog has been wearing its E-collar. If I’m holding the leash of a bouncing baby golden retriever and the E-collar looks brand new, fresh as a spring day—you’re clearly not using that E-collar! If the E-collar comes in looking like it’s been through 8 of the 9 circles of Dante’s hell, then you get a gold star.
If your dog is struggling to accept the unpleasant necessity of the E-collar, or even to stay quiet and rest—I’m looking at you, young post-neuter Labrador—talk to your veterinarian about sedation medications, aka “better living through chemistry.” There are many safe options out there, and your veterinarian would love to discuss these with you to decrease the chance of post-op complications that result from overdoing it or being extremely dramatic about wearing the E-collar.
Which brings us to a brief discussion of what “strict cage rest” means. If your dog, post-ACL knee surgery, is placed on strict cage rest (except for recommended physical therapy/potty breaks), this entails confining your pup to a crate (crate training is a blessing, not a cruelty!), a small exercise pen, and possibly a small bathroom or pantry, etc. This means no jumping on and off furniture, no stairs, no going outside except to potty and only on a leash with either a harness or collar, no zoomies, and absolutely no dog parks or doggie play dates. Even post spay or neuter, too much exercise/motion/movement can lead to “dehiscence,” which is the fancy vet word for “the incision fell apart.” Strict rest is recommended for 10 to 14 days, which is the usual time before skin sutures are removed. Also there is no swimming or bathing until the sutures are out. Summer in the Coachella Valley is a great time for all living creatures to play in the water, but not for 10 to 14 days after surgery.
The consequences of not following instructions can lead to serious, and in some cases, life-threatening consequences.
Now let’s discuss pain medication. There are many different pain medications that can be utilized before, during, and after surgery. Controlling pain is integral to healing well from surgery with minimal complications. Some pain medications may make your pet drowsy, mildly sedated, or even occasionally cause the pet to act somewhat strange. Please call your veterinarian with any questions or concerns about strange behavior on the pain medications, but do check with your vet before deciding not to give them. The vet can prescribe different ones that your dog may do better on, but please do not just stop providing pain management. The exception here is that if any vomiting or diarrhea or lack of appetite occurs, I give you full permission to stop giving the meds, but then you need to call your veterinarian right away or go to the urgent care or ER to have this looked into immediately. Some pain medications can negatively affect the stomach/intestines, liver, or kidneys, and your veterinarian will want to recheck blood work right away if this occurs (yes, even though your pet just had a pre-op blood panel last week).
The post-op recovery period for your pet can be successful and relatively uneventful. As we’ve discussed here, this is mainly dependent on how well you as the owner follow post-op instructions, monitor your pet closely, have them wear the E-collar religiously, strictly adhere to any and all exercise restrictions, and give all medications (but especially pain medications) as directed unless vomiting, diarrhea, or not eating is noted. I always advise owners to just accept that the 10 to 14 days after surgery are going to be a lot of work and worry on their part, but that this is essential to a smooth, uneventful recovery. And I always tell them that their veterinary staff is here to help them and support them in any way possible!
