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Caring for Dogs Before and After Surgery

Photo of dog with bandaged middle

Also see these articles:

Disclaimer: I am not a veterinarian, nor do I have any formal training in any medical field. The information presented here is not meant to replace your vet's advice or prescribed medications, but only to suggest additional options to explore, based on your dog's condition.

Pain Relief

PLEASE, if possible, talk to your vet about pain relief prior to bringing your dog home! Adequate pain relief is important, not just for humane reasons, but because it speeds recovery and healing. Please do not wait until your dog is in pain to discover that your vet did not give you anything for pain, or sent you home with Rimadyl and you're afraid to use it.

See Who'll stop the pain: Veterinarians can ease the hurt for more info.

For GENTLE pain relief, use Willow Bark, which is similar to aspirin but may not be as hard on the stomach; it should still be given only with food. Tasha's Herbspirin  (willow bark) also contains flower remedies, which may help your dog relax. Aspirin can be given to dogs (not cats), but it is very hard on the stomach, and should be given only with food, and preferably in a buffered form, with an antacid such as calcium carbonate, aluminum hydroxide, and/or magnesium hydroxide. Do not combine Aspirin with Willow Bark or any NSAID, such as Rimadyl or Deramaxx, or with prednisone (see the section on NSAIDs in my Chronic Pain page for more information). Recommended dosage for aspirin ranges from 5-15 mg/lb every 8 to 12 hours, but the lower end of that range is safer. See Giving Your Dog Aspirin for more information. Some people recommend Arnica 30c (or higher potency, such as 200c) homeopathic pellets; although I'm not a believer in homeopathy, this won't do any harm as long as you also use other means of pain control if needed.

For GREATER pain relief, :

If your dog has been on any NSAID (including aspirin) or on prednisone prior to surgery, do not switch to a different NSAID unless you stop the first drug for at least a few days (or a week, if switching from aspirin to an NSAID). It is important that the old drug be completely cleared from the system before starting the new one. Interactions between the two can be dangerous. I heard from one vet that fatal reactions to Deramaxx were much more likely in dogs that had been given Aspirin in the preceding 7-14 days.

More Information:

For GREATEST pain relief, especially for orthopedic surgery or deep tissue injuries, ask your vet about the use of narcotics: Narcotic pain relievers can be combined with NSAIDs for greater effect, but you should never use more than one NSAID at the same time or more than one narcotic drug at the same time. See Perioperative Use of Opioids in Dogs and Cats for more information. Narcotics can sometimes cause nausea. I have seen Herbs for Kid's Minty Ginger recommended to help with this in dogs. You can also use ginger capsules or ginger tea.

Not recommended (but commonly used):

For more technical information on pain relief, refer (or have your vet refer) to AAHA/AAFP Pain Management
Guidelines for Dogs & Cats and Pain Management at the Veterinary Anesthesia Support Group. Also see their four-part article on Peri-Operative Pain Management: Looking Beyond Butorphanol:

Also, talk to the surgeon and/or anesthesiologist about an epidural. I think such usage is fairly new, but the results can be amazing, especially for orthopedic surgeries. See the article A painless approach to pain management and Epidurals at the Veterinary Anesthesia Support Group for more information on these drugs and procedures.

If you use any of these drugs, discontinue and notify your vet immediately if your dog shows any signs of problems whatsoever. These may include any of the following: vomiting, diarrhea, dark or bloody stools, changes in appetite, changes in the frequency or or amount of urination and drinking, yellowing of the whites of the eyes, or any behavioral change such as aggression or lethargy, disorientation, staring off into space, circling, lack of coordination when walking, or hyperactivity. Never give your dog human medications such as Tylenol (Acetaminophen), Advil (ibuprofen), or Aleve (naproxen), they can be very dangerous for dogs (and even more so for cats). Aspirin is OK, particularly the buffered kind, if given with food (do not give aspirin to cats). Note that aspirin can be dangerous if given within one to two weeks of other NSAIDs such as Rimadyl, Deramaxx, or Metacam. See the section on NSAIDs in my Chronic Pain page for more information.

Holistic alternatives include very high potency Arnica, such as 1M, or other specific homeopathic remedy, and acupuncture. Acupuncture has been shown to be effective in relieving pain; many people believe that homeopathy is helpful, though I am not one of them.

For more information on pain management, see the following articles by Christie Keith:

Also see Pain Control in Your Dog and Cat for a good overview of the different types of medications available.
Your vet may be interested in Options for Analgesia in Dogs, by L.A. Wetmore, a comprehensive article on current pain management techniques before, during and after surgery. Available to veterinarians at www.ivis.org.

See Owner advocacy makes the difference for pets in pain for a detailed description of signs to look for that may indicate your pet is in pain.

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Anesthesia

You may  want to ask your vet what kind of anesthesia will be used, as the older drug Halothane is not considered as safe as Isoflurane and other newer anesthetics.

If you have a dog prone to seizures, talk to your vet about avoiding the use of phenothiazine tranquilizers (such as acepromazine) and ketamine.

Certain breeds are thought to have problems with certain drugs, including Belgian Shepherds, Greyhounds and other Sighthounds, Brachycephalic dogs (such as Bulldogs and Pugs), and Mastiffs, Boxers and Bull Terriers (Acepromazine), so be sure your vet is aware of this before your dog has surgery. The Handbook of Veterinary Drugs says "Giant breeds, as well as greyhounds, appear quite sensitive to the clinical effects of the drug [Acepromazine], yet terrier breeds appear more resistant. Boxer dogs, on the other hand, are predisposed to hypotensive and bradycardic effects of the drug."

Acepromazine (Ace) and butorphanol (Torbutrol, Torbugesic) are among the drugs that certain breeds may be sensitive to. The MDR1 mutation causes multidrug sensitivity in some breeds, including Australian Shepherds (standard and miniature), Border Collies, Collies, English Shepherds, German Shepherds, Longhaired Whippets, McNabs, Old English Sheepdogs, Shetland Sheepdogs, Silken Windhounds, and mixed-breed dogs from any of these breeds (see Dogs with a Drug Problem for information about other drugs these breeds may be sensitive to, which include ivermectin, Imodium, certain chemotherapy drugs, and others).

More information:

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Before Surgery

You should stop most supplements a few days before the surgery, and maybe for a day or two after, as many of them can cause bleeding, including flaxseed oil, evening primrose oil, borage oil, garlic, ginger,ginkgo biloba, ginseng, high-dose vitamin E, and white willow bark. Chondroitin may also increase bleeding, but glucosamine apparently does not. Bromelain and other proteolytic enzymes may also  increase bleeding. MSM apparently can occasionally act as a blood thinner as well. Other herbs that may cause blood thinning include alfalfa, chamomile, hawthorne, meadowsweet, dong guai, saw palmetto, turmeric/curcumin/bioperine/piperine, bilberry, feverfew, red clover and some mushrooms. Although there has been concern in the past that high doses of fish oil may increase the risk of bleeding in people undergoing surgery, a large study found taking high-dose prescription fish oil did not increase bleeding during or after cardiac surgery. See When Herbs and Surgery Don’t Mix for more info.

In addition, high doses of Vitamin C may interfere with anesthesia, so again, best to discontinue for at least a day or two before surgery.

Note that aspirin is a potent blood thinner and should not be given for 7 days prior to surgery, even in small amounts. If your dog has had aspirin in the week before surgery, be sure your veterinarian knows about this.

My dog threw up dried yams (rawhide chew substitute that she had been given the day before) following surgery, so I think it's a good idea to avoid giving any kind of chew that might not be digested quickly for a couple of days before surgery.

An herbal immune booster, such as Tasha's Immune Formula, can be given both before and after surgery to help build up their immune systems and fight off any infections. Milk Thistle given before and after surgery may also help protect the liver from any effects of anesthesia.

See 10 Questions to ask your Veterinarian before Surgery for other factors you may want to think about.

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After Surgery

Milk Thistle or Tasha's Detox Formula can be given for a week after surgery to help detoxify from the anesthesia. Ginger (capsules or fresh) can be given to help with nausea from anesthesia.

On the incision itself, you can use aloe to help it heal and to soothe. Be sure to apply with something sterile, like a Q-tip, or just squirt the ointment directly on the incision without using your fingers, so you don't contaminate the wound with bacteria. Califlora (calendula) gel can also be used on the wound to heal and soothe. Colloidal silver will help prevent infection and heal without scarring, but if the wound is draining, you may want to wait so it doesn't close up too fast. The same is true of Calendula. Colloidal silver can also be given internally, to help prevent infection (see Silver makes antibiotics thousands of times more effective). Arnica gel, Traumeel and Rescue Remedy cream can be used around the wound, but not directly on it. You should be able to find all of these at your local health food store, or even ordinary drug store. Warm compresses may be helpful, especially if the wound is draining. If things aren't looking good around the incision site, and you suspect cellulitis (the tissue around the wound seems hard), hot compresses 3 times daily with the herb plantain can help. If necessary, Bitter Orange/Apple can be applied around the incision but not directly on it to help prevent licking. Vitamin E can be applied to the incision after it has healed to soften the skin and possibly reduce scarring, but research shows that topical vitamin E may actually slow wound healing and increase scarring if applied immediately after surgery, and may cause a skin reaction as well.

Vitamins, especially vitamins C and E, may help with wound healing. This may be a good time to give your dog a multi-vitamin even if you do not do so normally. When using vitamin C, it is best to increase the dosage gradually, as too much can cause loose stools. Note that most multi-vitamin products made for dogs contain too little of anything to be very useful, and human multi-vitamins may contain minerals in inappropriate amounts. See the human oriented article, Vitamin C and Diet Speeds Recovery From Oral Surgery Wounds and the Google book excerpt from Nutrition and Wound Healing for more information.

If antibiotics are used, you should give Probiotics for up to six months following the antibiotic usage, to help restore the beneficial microorganisms in the gut that the antibiotics kill off (along with the bad ones). You can use Acidophilus, but I think it is better to include multiple strains of bacteria. Be warned that Fastrack and some probiotics that include lactose have been known to cause diarrhea in some dogs. Yogurt with added probiotics is another source (regular yogurt's "live cultures" just refer to the bacteria used to make yogurt, not probiotics)..

If your dog had abdominal surgery and you feed raw meaty bones, it may be best to discontinue the bones until the incisions are completely healed (around 10-14 days), and then gradually add them back in. During this time, you can grind them up, or just feed meat with 1/2 teaspoon ground eggshell per pound of meat added back in to balance the calcium/phosphorus ratios.

Note that fish oil, by suppressing inflammation, can also suppress wound healing, so best to wait five days after surgery before resuming this supplement. See Fish Oil: The Dangers of Too Much for more information.

See this video for some activities you can do with your dog while recuperating from surgery: Crate Rest Activities for Dogs after Back, Hip, Leg Injuries, ACL or TPLO, Heartworm treatment, etc.

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Recovery Aids

See the following for alternatives to the large plastic e-collars used to keep dogs from getting at their stitches, and other post-surgical aids. Also see the American Association of Rehabilitation Veterinarians for help finding a veterinarian who does physical therapy and can help with fitting braces, wheelchairs, and such.

E-Collar ("Cone") Alternatives

Body Suits, Coverings and Boots (some can also work in place of an e-collar)

Ice and Heat Packs

Support Harnesses and more

Braces, Splints, Orthotics and Prosthetics

Wheelchairs and Carts

More Products for Handicapped Pets

See Also:

Purdue College of Veterinary Medicine's Center for Paralysis Research is doing research on new treatments for spinal cord injuries, including PEG-mediated neural repair (PEG is short for Polyethylene Glycol) that has been used successfully for some dogs if treated within 72 hours of suffering a spinal injury. I had trouble with the links on that page; you can get to them from this Research Areas page, though they appear to be out of date. Also see their Office of Veterinary Clinical Trials.

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I regret that I no longer have much time to respond to questions. See my Contact page for more information. My name is Mary Straus and you can email me at either or

   


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