First Two Weeks: The first couple days when your pet comes home, the  pain will be the worst. Why? Dogs are pretty smart, and they figure out right  away that when they act like they are in pain, they will get more attention  from their owners. It is important to not let your pet loose to run freely,  particularly up and down stairs without assistance. They can go outside ON A  LEASH to go to the bathroom, and then they must return inside and rest.  

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(1) First 72 hours – Keep the bandage on as is possible if your dog  still has one on. This will help significantly with the      swelling. If  no bandage is present we have removed it for you before your  dog left our hospital. We would prefer the bandage stay on  no longer than 72 hours. HOWEVER, IT IS  

NOT AN EMERGENCY SITUATION IF THIS OCCURS OVER A WEEKEND. If  you are having trouble getting the bandage off please  return to our clinic DURING REGULAR OFFICE HOURS and  we will remove it for you!!!  

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2) Pain medication and antibiotics – as written by the doctor. Please  make sure your dog is getting all of the medications that are  dispensed. If the antibiotics are not given the possibility for  infection increases! If the pain medications are not working, do  not overdose, call the office for further recommendations or  additional medications. 

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3) No other exercise is recommended for the first two weeks. 

 

4) Clean the wound daily ONLY IF NEEDED with dilute epsom  salts, and do not allow the dog to lick it. If he attempts to lick  the wound, please get an e-collar. 

 

Second Two Weeks: At this point, walking on leash is tolerated. If your  dog likes to pull, a Gentle Leader will help with this. Pulling creates a  significant amount of torque on the knee! This should be discouraged at all  times during the healing process! 

(1) Pain medication – At this point we will decrease the pain  medications your dog is using, usually by 1/2 for the next 2  weeks. If you find that your dog is uncomfortable please call the  office for further instructions regarding pain relief. 

(2) Apply cool epsom salts to the leg for 20 minutes for swelling if  necessary, then exercise the leg through range of motion 2-3  times per day if possible.  

(3) Walking on a leash is acceptable, but begin with one block and  stop. If the dog returns home and is not in pain, you may 

increase this in 1 block increments every 4-5 days as tolerated,  provided your dog is not in pain when the walk is over. 

(4) While walking, push the dog’s hips towards the operated      leg  slightly to help convince him/her that the leg can be used.

(5) Lift the front end of the dog for 5 second intervals prior to  starting the walk to increase the strength of the leg. Try several  repetitions. 

 

Third Two Weeks: By this time, walks should be in the 20 minute range or  better, and tolerated well. Do not run yet. Increase the duration of walking  as much as you can without causing the dog pain. Do not exceed the 20  minute range. If you have access to a pool, some hydrotherapy is ok, but  NOT unattended nor allowed to swim in water over the dog’s head. Any hydrotherapy over 10 minutes is more likely to exaggerate patellar tendon  inflammation and result in lameness. 

 

Fourth Two Weeks: At the end of this period please return for a follow up  examination, we want to make sure everything has healed prior to  increasing the exercise as tolerated. This MAY require an X-ray to determine  healing of the surgical site. If healing is determined to be sufficient it will not  be necessary. Be forewarned that if you just go home and turn the dog  loose, he will be in pain. This is the point where you can SLOWLY build back  up to full exercise.

REMOVE BANDAGE IN 48-72 HOURS

From hospital discharge – until the first recheck
Gently Massage the quadriceps and hamstring muscles (large muscle groups at the front and back of the thigh respectively). It is best to massage for 2-3 minutes before and after PROM. Massaging will help stimulate blood and lymphatic flow and break down scar tissue within the muscles. Start by applying light pressure and gradually increase it over the course of the massage. Try to keep a steady rhythm. Start close to the toes and move up the muscle towards the hip (be very gentle around the surgery site (under the incision line) as excessive pressure in this area could result in unnecessary discomfort)
Passive Range of Motion (PROM): this activity involves moving all joints of the limb through a comfortable range of motion. This will promote cartilage and joint health, prevent contraction of the muscle and stimulate blood and lymphatic flow. If your pet is reluctant to cooperate, consider muzzling your pet to protect yourself and get the work done efficiently and safely. Have them lie on their side with the affected limb up. Gently and slowly extend and flex each joint (ankle, knee, and hip) 10 times, for 2-3 sessions daily. This should not be an unpleasant exercise and should only take 2 to 5 minutes.
Assist your pet over slippery surfaces or up stairs by carrying or slinging them this will be necessary for the next 8 weeks
Short, slow, controlled short-leash walks are good. Start with 5-10 minute walks 2-3 times daily.
After the above exercises are completed apply a cool compress to the hip (over the knee incision) 3-4 times per day for 5 to 10 minutes for the first 7 days. This will help decrease swelling and discomfort (a bag of frozen peas wrapped in a towel works well).
Typically after the first week the vast majority of swelling has dissipated and cold compresses can be stopped (if excessive swelling is still noted 1 week post surgery please contact the hospital for further instructions) and moist heat therapy initiated. For heat therapy, a commercial heat product is advised. Moist heat has been shown to penetrate better than dry heat. A number of different moist heat products are available at most drug stores and typically contain gel, beads, rice etc. Another way to provide moist heat is to take a washcloth and wet it with warm water. Regardless of the product used it is imperative that it be warm to the touch but not so hot that it is painful when applied to your own wrist. If excessively hot it could result in a thermal burn. This therapy should be performed for 5 to 10 minutes prior to the above exercise sessions.
 

Weeks 2-4
Continue with PROM
Continue with massages
Increase walks to 10-15 minute walks 2-4 times daily. You are still keeping them slow, controlled and on a short-leash.
Sit-Stand-Sit exercises. We call these puppy squats. The goal is to have your dog to sit down and immediately stand back up (small treats help tremendously- watch the calories if your dog is overweight). This promotes extension and flexion of all of the joints of the hind leg and also works all the muscles surrounding the knee. This should be performed 3 to 4 times daily and consist of 5 to 7 repetitions.
Figure Eights To perform this exercise effectively, imagine a large figure 8 on the ground with each circle approximately 10 to 15 feet in diameter (if your dog is having difficulty navigating enlarge the size of the figure 8). Walk your dog around the figure 8 at a very slow speed. This exercise should be performed 3 to 4 times daily and each session consists of ten repetitions. As your dog becomes more adept at performing this exercise the size of the circles can be decreased to 4 to 5 feet in diameter.
Continue with moist heat after the above activities.
 

Weeks 4-6
Continue with massage and PROM exercises if needed or found to be beneficial. Otherwise discontinue.
Increase walks to 15-20 minute leash walks 3 times daily.
Continue Sit-Stand-Sit exercises.
Continue Figure Eights.
 

Weeks 6-8
Increase walks to 20-30 minute leash walks 3 times daily. (if possible in an area where short hills are present- see “Slow Controlled Hill Walks” below.
Continue with Sit-Stand-Sit exercises. Should be increased to ten to twenty repetitions 3 to 4 times daily.
Continue with Figure Eights. Increase to ten to twenty repetitions 3 to 4 times daily.
Controlled stairs, (i.e.- holding your pet’s collar) may be performed at this time if your pet seems up to it. There should be no free access to stairs until permission has been given- typically at the 8 week recheck. Do 5 to 15 stairs (typically one flight) in a row 1 to 3 times daily. If stairs are not present in your home you may take your dog to an outdoor area where stairs are present or just skip this exercise.
Slow Controlled Hill Walks. Use a hill that you can comfortably walk on (not too steep). This exercise involves walking your dog SLOWLY up, down and across the hill with the surgery leg on the down-slope side while on a short (2 to 3 foot) leash. This exercise increases strength and muscle mass of the surgery leg, promotes better balance and improves the range of motion of the knee joint. This exercise should be reserved for after his/her leash walk since your pet will typically be a little calmer and more manageable at this time.
If all is going well at the eight week recheck exercise restrictions are typically lifted with the exception of high impact activities involving ball and frisbee play, rough-housing with other dogs and off leash activities outside of the backyard. Typically all restrictions are lifted by 10 to 12 weeks post surgery.

This document contains information about what to expect after your pet has had FHO surgery. We hope this can better prepare you for your pet’s recovery and answer your questions. This information is a general guideline as to what is normal after surgery. Please understand that your pet may heal faster or slower than what is indicated. Contact us if your pet experiences either a decrease in function or significant increase in pain during the recovery.

 

An FHO removes the portion of the femur that normally forms the “hip joint” promoting the formation of a “false joint” over time as scar tissue develops. Removing the joint will eliminate the source of your pet’s pain, and with careful surgical technique and proper post-op therapy, the average pet will regain most, if not all of his/her normal function. Early physical rehabilitation after FHO surgery is important because inactivity can lead to increased scar tissue and decreased range of motion in the joint.

 

The follow-up care after an FHO procedure is unique among orthopedic procedures as a false joint needs to be formed. Restricted activity is not as important as with a fracture or joint repair. 

 

First 24-48 hours:

• It is normal for your pet to experience discomfort and refuse to urinate or have bowel movements as often as they normally do.

• Walking on 3 legs and/or walking with the surgical leg slightly touching the ground is normal at this point.

• Assistance with a sling may be necessary at this time.

• An increase in bruising and swelling may occur.

• Please check the incision daily for excessive swelling, discharge, or redness. Make sure your pet is not licking or biting at the incision. If an e-collar is sent home with your pet, please make sure that it is worn at all times until the sutures are removed.

• An ice pack can be applied to your pet’s hip every 4-6 hours for 15-20  minutes to help control pain and inflammation. Using a barrier (e.g. thin towel) is necessary between the ice pack and skin if using a commercial gel pack.

 

Activity (Days 1 and 2)

• Activity should consist of short leashed walks for elimination

• When unsupervised, confinement is necessary either in a cage or small area. Your pet is allowed to slowly walk around the house with direct supervision as long as it is not constant.

• No running, jumping, or playing at this time. Stairs and slick floors (e.g. tile and wood) are discouraged, however, if these areas cannot be avoided please assist your pet to prevent falling.

 

After 2 days

• Short 3-5 minute leashed walks can be started every 3-4 hours. Walk very SLOWLY to encourage usage of the leg. Increase the walks by 1-2 minutes each week as tolerated.

• Passive range of motion can be started. Very slowly extend your pet’s hips by swinging his/her leg backwards as far back as tolerated. Hold for 15 seconds and repeat 4 times.

 

*****A recheck exam and suture removal should be scheduled for 14 days after the surgery*****

 

10-30 Days After Surgery

• Continue to increase the intensity of the walks by 1-2 minutes each week. Start walking on inclines.

• Stairs can be done as tolerated.

• Appearance: The surgical leg is used 80-100% of the time when walking at a slow pace. Most pets still shift their weight off the surgical leg when standing. By 2-3 weeks after surgery, all pets should be using the surgical leg when walking. A rehabiliaiton program should be initiated at this time if your pet is not using the leg very well.

 

****** A recheck exam should be scheduled for 6 weeks after the suture removal. ******

 

30-60 Days After Surgery

• Supervised off-leash activity can be done as tolerated.

• Rough play should still be avoided at this time.

• Ball retrieval should be avoided if your pet pounces on the ball or turns quickly. 

• Light jogs can be initiated as long as the leg is being used.

• Continue to increase the intensity of the walks.

• Appearance: A slight limp will still be noticeable and the limb might still be lifted when transitioning to a faster speed. At a standing position, limb should be planted on the ground but still may be in a partially weight-bearing position.

 

After 60 Days 

• Activity such as jumping off and on/off of furniture, cars, etc is usually acceptable ater 2 months.

• Restrictions are based on the dog's comfort level.

• Normal activity can be resumed.

****** If your dog is a performance and/or working dog that requires high intensity exercise, please discuss the level of activity with your surgeon before resuming******

Your pet has undergone a major surgery and is now being discharged for continued care at home. Your job during the recovery period at home is just as important as the surgicalprocedure performed.
What special instructions should I follow after my dog comes home?
Home care after surgery mainly involves the restriction of physical activity. Unfortunately, your dog does not understand the seriousness of surgery or the significance of the recovery period. Most dogs will naturally become very active in a short period of time after surgery and confinement and close supervision indoors is one of utmost importance! This means:
● No jumping or running
● No stair climbing
● No playing with other pets
● No “rough-housing”
When your dog goes outside to go to the bathroom, it must be on a short leash and returned indoors immediately. You may only take your dog for a very short, slow leash walk for 4 weeks, or as instructed by your veterinarian.
If your dog must be left alone, it must be confined to a cage.
If your dog must be left alone, it must be confined to a cage or other small area that is warm and safe.This strict confinement and restriction of activity is necessary during the entire recuperative period. Excessive physical activity often leads to injury or serious complications. This means additional expense to you and added discomfort and risk for your dog.
How should I care for the incision?
Do not bathe your dog or allow the incision to get wet. This also means that you cannot allow your dog to lick the incision at all. Monitor the incision daily for signs of redness, swelling, discharge, or excessive licking. Mild redness and swelling are part of the healing process, and should be expected for the first few days after the surgery. After the first 2-3 days, the swelling and redness should subside and the incision should look better each day. Moderate swelling on or around the incision site is abnormal, and may be an early sign of infection. For routine elective surgeries, any discharge from the incision site is abnormal.

NEVER PUT ANYTHING ON THE INCISION UNLESS YOU ARE SPECIFICALLY TOLD TO
DO SO BY YOUR VETERINARIAN.
Never put hydrogen peroxide or rubbing alcohol on the incision. These chemicals are toxic to healing tissues, and will cause inflammation and delay the surgical healing.
Call us if you observe any abnormalities or if you have any questions or concerns about your dog’s progress.
Your pet is being sent home with an Elizabethan collar (e-collar). This is to prevent your pet from licking the incision or chewing the bandage if one was placed. Without the e-collar, the pet may lick or chew out the sutures resulting in possible infection or additional surgery.
In general, your dog should gradually improve each day. If your dog’s condition changes or suddenly worsens, please call us immediately. 

What is a Dorsal Laminectomy?

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Dorsal Laminectomy is a surgical procedure used in dogs to correct slipped or herniated discs in the lumbo-sacral spine. The lumo-sacral spine is located in the lower region of the spine. Some cases of lumo-sacral intervertebral disc disease may be treated using conservative methods such as medications and exercise restriction. In fact, these are typically the first line of treatment for acute cases. Dorsal laminectomy is usually recommended for severe and recurring cases. Dwarf dog breeds, including the Dachshund, English bulldog, and Welsh Corgi, have a predisposition for developing intervertebral disc disease.

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Dorsal Laminectomy Procedure in Dogs

1. Before surgery, diagnostic imaging will be conducted to visualize the affected disc. This can be achieved through myelogram, MRI, or CT scan.

2. Blood work will be taken to ensure it is safe for the dog to undergo anesthetization.

3. The dog will be anesthetized.

4. A catheter and breathing tube are placed. Analgesics and anesthesia will be administered throughout surgery.

5. The operative area will be shaved, cleaned, and clipped.

6. The surgeon will incise the skin and subcutaneous fat tissues.

7. A periosteal elevator is used to remove the connective tissue surrounding the bones of the spine.

8. The surgeon will use a high-speed burr to remove the lamina, or vertebral bone, and expose the spinal cord.

9. A specialized pick will be used to remove the remaining thin layer of bone covering the spinal cord.

10. The ruptured disc material will be removed.

11. A fat graft will be placed over the exposed portion of the spinal cord prior to incision closure.

12. The dog may be hospitalized for up to seven days.

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Efficacy of Dorsal Laminectomy in Dogs

The efficacy of this procedure will depend on the severity and symptoms of the slipped disc, although the prognosis is generally good. It is a decompression surgery, meaning that it relieves compression on the spinal cord. This usually resolves symptoms. For less severe cases, surgery carries an average success rate of 96%. Doral laminectomy may not be as successful for dogs that do not have any sensation in their toes, or have more than one slipped disc. In these cases, it is more likely that the dog will not respond to conservative treatment. The surgery success rate for severe cases can still be as high as 76% but as guarded as 30%. 

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Dorsal Laminectomy Recovery in Dogs

During hospitalization, your dog will receive twenty-four hour care. Your dog will be discharged within three to seven days. Analgesics will be prescribed to manage postoperative pain. Antibiotics may also be prescribed to prevent infection. Strict cage rest is required for up to one month after surgery, or per surgeon instructions. Owners should ensure that their dog’s crate is padded and comfortable to prevent bedsores. A sling may help support the hind limbs during the recovery process, particularly when the dog is urinating and defecating. If owners observe abnormal urination behavior or symptoms of urinary tract infection, they should consult their vet immediately. It is imperative that your dog remains under strict activity restriction during the first 4 weeks post surgery. Failure to follow activity restrictions may cause complications.

The sutures will be removed within ten to fourteen days after surgery. If owners observe swelling, drainage, or bleeding near the surgery site, they should contact the surgeon immediately. After the sutures are removed, the veterinarian may recommend rehabilitation therapy to speed up the recovery process.

 

Dorsal Laminectomy Considerations

Complications associated with dorsal laminectomy include, but may not be limited to:

• Perioperative trauma to the spinal cord

• Infection

• Hemorrhage

• Seizures

• Recurrence of the condition

• Lameness

Although spinal surgery is complex, these complications are considered rare in dogs. It is important to note that some of these complications may not be associated with the surgery. Sometimes, the dog’s condition is so severe that it does not respond to surgery.

Go Home Instructions: 

• No running

• No jumping

• No rough housing

• No playing with other pets

• No stair climbing

• Activity should only consist of going in and out to use the bathroom ON A LEASH

• Use a sling to assist your pet when moving about and getting up

• Strict crate rest is essential at this time. Crate should have a thick layer of padding to prevent bed sores. 

• Use all medications sent home as directed. 

 Pets that have a history of urinary blockages are generally recommended for a Perineal Urethrostomy. Blockages can be caused by inflammation, urinary crystals, stones, or a tumor. Most frequently, the blockages are caused by crystals or stones. Tiny crystals or stones cause a blockage in the urethra and the pet is unable to urinate. The bladder swells up with urine and is extremely painful for the pet. If not corrected quickly, the bladder may rupture causing sepsis and death.

A PU surgery involves surgically opening the urethra and creating a new, wider opening for urine to pass through. These surgeries have a high success rate and lower the chance of the pet becoming blocked again. This procedure is done under general anesthesia.

Complications are uncommon; however, they can happen. The most frequently seen complications are narrowing of the urethrostomy site, urine leakage, bleeding, urinary tract infections, and incontinence. This is why following the post operative instructions is so important. Pets generally do very well post-surgery as long as they are unable to lick or scratch the surgical site. It is imperative that you keep the e-collar on during the first 2 weeks after surgery. Not only does this allow the incision to heal, but also helps to prevent infection.

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Recovery Instructions:

Activity: You will need to keep your pet indoors for at least the first 14 days while your pet is healing. For cats, please keep it in an area with a litter box so that you can monitor urine output. Litter should be in pellet form to avoid dust or litter particles adhering to the surgical site. Dogs may be walked outside on a leash to eliminate.

Incision: You must not allow your pet to lick or scratch at the incision. This can compromise the incision and cause your pet to require another, potentially less satisfactory, surgery. Keep the incision clean and moist. You can use a warm washcloth to remove any litter that becomes stuck to the incision. Choosing a product like Yesterday’s News or shredded paper instead of traditional clay litter will help keep litter from adhering to the surgical site.  Under no circumstances should you remove the e-collar during the first 2 weeks after surgery. Cats will likely resent the collar for the first days but are still able to eat and drink while wearing it.

Medication: Give all medications as prescribed. Please contact our office or your RDVM if you feel that your pet is having an adverse reaction to any of the medications. Possible side effects of antibiotics include vomiting, diarrhea and/or decreased appetite. If you observe any of these signs please call.

Food: Your pet should always have access to water and eat his/her normal diet. Do not overfeed as this may cause vomiting or diarrhea. Please report any vomiting immediately. Your pet should be fed multiple smaller meals throughout the day rather than one or two large meals. Continue providing your pet’s normal diet until we receive the results from your pet’s bladder stone analysis if one was sent out after your pet’s procedure.

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Recovery:

Please remember that the P.U. surgery does not treat the underlying problem of crystal formation. A P.U. simply enlarges the opening so that subsequent crystal formation no longer results in urethral obstruction. As we discussed, allowing crystals to continue to form will ultimately lead to stone formation. Large stones will not be able to pass through a P.U. site. To prevent further urethral obstruction, we recommend regular recheck urinalyses with your family veterinarian. The first recheck urinalysis should be performed one month after surgery. We do advise a 2 week recheck with us post-surgery to make sure that the incision is healing properly. After that appointment, follow up care can be performed with your regular veterinarian.

 

If you have any questions, please contact our office.