Archive for the ‘post-surgical care for dogs’ Category

The Return to Normal

…the swelling just started to disappear!

The vet tech had told me, “Don’t be surprised if you wake up one morning and it’s just flat.” It seemed like over the course of the day, that is exactly what happened. In fact, at one point, he was kind of gagging, and I can’t help but wonder if that fluid drained down his throat. He also did not want the compress at all, and I realized it was because it was sitting right on his bone and not a swelling. I had a hard time at first seeing the site as not swollen, but the shaved hair exacerbates the visual image. With a light touch, we could feel the prosthetic and the bone around the eye socket.

Day 11, in the morning

Day 11, in the evening

Day 11, in the evening, with the purple sutures showing

You might notice in the picture the purple suture threads. Strider was given dissoluble sutures, but with the swelling having receded, the sutures were more visible now. We have been told that they will fall out over time.

We decided to forgo the collar for the night. I was a little concerned about it getting irritated that night, but he had not even made any pretense of rubbing it the two nights previous. In the morning, Day 12, the site was even less swollen and Strider was, for all practical purposes, back to normal.

PHEW!!!!! I don’t know about you, but I realized that when I hear “seven to ten days” for healing, I think it’s going to be seven! We definitely used all ten!

On Day 13, Strider got to return to work with my husband. For a working dog, this made a huge shift for him. We had been gently throwing the ball for him and going on walks, but a German Shepherd has to feel purposeful, and going to “work” fits the bill for him. He seems to have no problem jumping in and out of the car and truck, running up and down the stairs at work, but he is still running into things and people sometimes when he turns to the right. It is time to start some training for him to help him figure out how to track better with the left eye. That will be the next step in his healing.


Setbacks and Frustrations

On the fifth day, Strider was again up and about, hanging out with the guys outside and in the garage. However, he was so full of energy, that he kept running into everyone and hitting the swelling. He would yelp loudly when he did this, and it was becoming stressful to everyone involved. Even though he was acting normal, he was still not adjusting to the blindness in the right eye yet. For many dogs who have an exenteration or enucleation, they have had glaucoma and have already been blind for some time. For a dog like Strider, he went from being able to see just fine out of his right eye, to not being able to see at all. He wasn’t thinking, “Well, I can’t see out of my right eye anymore, so I better turn my head all the way around to make sure I can see before I move.” He was just moving, having only the field of vision available from the left eye.

After bumping the site a few times, he seemed to be done hanging out with the guys. He came inside and we gave him a painkiller, and he lay on his bed most of the day, moping and miserable. I am not sure if we let him do too much or if he just was not being watched closely enough, but maybe relating this situation will prevent someone else from having to go through it.

Day 5

Day 6

By Monday morning, the sixth day, I was concerned that the swelling was still so prominent. I called the clinic and then emailed pictures to Dr. Hammond so he could look at the site (we live three hours from the clinic, so I couldn’t just bring him in! However, having the pictures was a great option anyway, as it didn’t require an appointment.) While I was waiting to hear back, I looked out the window only to see Strider going after the site with his paw. I tore down the stairs and outside so fast, I am surprised I didn’t start a fire! Expecting to see a bloody mess and an empty eye socket, I was relieved to find that Strider had not done any damage to the site. I called my husband and, much to Strider’s consternation, he stopped by our local vet’s office and got an Elizabethan collar. We put him in it immediately, which of course resulted in a pouty, miserable dog. Soon after, a tech from the clinic called to relay Dr. Hammond’s concerns.  His opinion was that Strider had been surreptitiously rubbing the site. Even laying on it, or pressing lightly against a table leg (which we had seen him doing) was considered “rubbing” and it irritates the site well enough to prevent the swelling from going away. Of course, Dr. Hammond recommended the collar, so it was nice to be one step ahead of the game for once!

We kept the collar on Strider for the next five days. He had a little reprieve at night when we could all keep an eye on him, but when I had to work or we needed to sleep, the collar was on. If I had to do this over, I would have had that collar on him as soon as I saw him press the site against anything, so I am hoping that by knowing this ahead of time, you will be able to be more proactive with your dog at an earlier point in the game than we were. I believe his healing was set back a few days because of our lack of realization that he was irritating the site.

Here are some pictures of Strider on Days 7-10:

Day 7

Day 8

Day 9

Day 10

By Day 10, I was feeling stressed and worried that the swelling was not gone yet. Yes, it had been shrinking, but I wanted it gone! The day before, my physical therapist had suggested that I rub Strider’s neck in a downward motion, helping to activate the lymph nodes in the neck. I don’t know if that worked, but Strider liked it, and maybe if I had known that sooner, I could have done it earlier in the week and helped the fluids move out of his system. Other than a few blood trickles from the site the first few days, and a little drip of clear fluid from his nose, we never saw any major release of fluid. I used the cold compress a few times a day, and up until the last day, he sat very patiently while I applied it. The vet tech had told me it would probably offer him relief, and perhaps it did. If I hadn’t worried about the tenderness of the site, I probably would have done it earlier, but once the site started its healing, there was probably some itching going on, which is what prompted the rubbing in the first place. So, yes, use the cold compress (I put a clean, wet cloth in a Ziploc bag in the refrigerator to get it really cold) and see if it seems to offer some relief for your dog!

For some reason, the reality of Strider’s condition made me quite sad toward the end of the week. I felt bad about him losing the eye, I worried about him adjusting, I was scared about what seemed to be a slow rate of healing. These feelings were not overwhelming, but they were there, and I assume they were normal.

By Day 11, I was getting nervous about the swelling when, lo and behold….

Surgery and Days 1-4

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:

Day 2

Day 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.

Day4 picture:

Day 4