The exenteration was successfully performed on September 15, 2010. It was a long four hours waiting to hear how everything went, but luckily, the news was good. Dr. Hammond said the surgery went better than he could have hoped. The best news was that the melanoma was contained in the eye, meaning that it had not begun to spread. This also meant that because the margins were clean, Dr. Hammond was able to put a prosthetic in the eye. The prosthetic is a round silicone ball that is put in place, and then the eye is stitched shut over it. As a result, the eye will look like it is simply closed or “winking” instead of the eye socket being sunk in, which can apparently happen over time.
Strider had to be helped in and out of the car by the vet techs since the anesthesia had made him groggy. We were told that he could start having a little bit of water when we got him home with increased amounts every hour. Pacing the water helps manage the possibility of nausea. He was able to eat that night as well, and surprised us both by snarfing down a half can of wet food. It was also important to get him to move around every hour to help flush the fluid from his body. He had to pee a lot the first night! He also was a little disoriented when he would come out of sleep. This is where I feel the dog really needs to be watched. He has his sleeping spots in the house, and when he woke up, he seemed to want to go to one of them, but he clearly was not aware that he had this huge swelling on the side of his face and it would have been quite easy to bump into something with it. One of us stayed in the living room with him all night as it is the most spacious room in the house, and we would get up and guide him by the collar when he wanted to move.
Incidentally, they did not give us an Elizabethan collar (or as identified in the movie Up, the Cone of Shame) at the clinic. They said that the area is so tender that dogs tend not to bother it. If he were to start irritating it or rubbing it, then we would want to get one. Given the disorientation he was already suffering, I am glad we did not have to also navigate him through the house with the collar the first few days!
When we picked up Strider up at the clinic, they warned us ten ways from Sunday about how bad he would look so that we would not be shocked. I had already looked at pictures on the internet, so I knew what to expect. However, the warnings were apt, as it can be upsetting to see your dog in this condition. The surgical site is shaved, the eye is stitched shut and the entire area is swollen. Here is a picture of Strider the first night (the quality is poor, as I only had my phone with me, and I only came up with the idea of the blog that night! The rest of the pictures are much better):
Day 1, post-surgery
Dr. Hammond also prepared us for what to expect over the next few weeks. The swelling would be present for 7-10 days, and the fluid and the blood that was causing the swelling would eventually come out somewhere. We were warned that there could be oozing of blood and fluid from the surgical site and from the nose, and that this is normal. Greenish or yellowish fluid, however, would not be normal and the vet should be called if this were to occur. The vet tech told us that he could get a bloody nose in the coming days, and she knew of some that had lasted at least five minutes. She encouraged us not to panic, as this would just be the body’s way of draining. If the eye was to ooze liquid, a cold, clean, wet compress could be used on the eye — just pressed, not rubbed — to help keep the site clean.
Also, we were given antibiotics and painkillers for Strider. It is important to use all the antibiotics on a regular schedule to help prevent infection. We also used all the painkillers. Our dog is not much of a whiner, so my theory was to stay ahead of the pain by using the painkillers on a regular schedule. Toward the end, I eased up on them, but in reality, he only skipped one twelve hour period and he was pretty worn out the next day. The painkillers did make him drowsy, incidentally, but I am sure the extra sleep helped him heal as well.
On days two and three, Strider was pretty mellow and seemed a little uncomfortable. One of my family members came by the house the day after surgery and accidentally put her hand directly on the swelling. Strider yelped loudly, as I am sure it hurt, but there was no doubt now that he knew he had this swelling. Nonetheless, when he was up and walking around, he continuously almost bumped the site, so I felt it necessary to help him move through certain tight areas or to ease him away from corners and such. It was particularly problematic when he would turn to the right, and not being able to see, did not seem to be taking in the need for space between his head and the objects in the room. Also, over the next few days, whenever someone new came into the situation, like when our daughter came to the house, he would duck his head and shy away, and sometimes he would yelp even before someone touched him, as a way, I presume, to warn them not to touch the site.
Here are pictures of the surgical site on days 2 and 3:
I should note here that Strider never acted mad at us, and I know this can be a concern for dog-owners. In fact, my husband had been worried about him trusting us again, but that didn’t happen. He didn’t feel great, that was obvious, but he welcomed our presence and attention. I massaged his shoulders and back, knowing that he had been unable to sleep in his normal positions. We were told that dogs are usually back to “normal” after three days, and sure enough, by day four, he was full of energy and wanted to follow my husband around outside, as was the norm on Saturdays. This was the day I skipped the painkiller, and he really did not seem to need it.