Detailed Information and Guidance for Postoperative Care

What to Do · What to Expect
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Talishan
Posts: 29
Joined: Sat Apr 26, 2008 6:07 pm

Detailed Information and Guidance for Postoperative Care

Post by Talishan » Sat May 30, 2015 10:32 pm

ANY SURGERY CARRIES RISKS. FIND AN EXPERIENCED EXOTICS VET!
If your guinea pig requires surgery, there are a couple of basics to keep in mind. One, any surgery carries risks; in the case of guinea pigs, anesthesia in particular can be tricky. A good, experienced and confident veterinary surgeon, however, assisted by experienced and knowledgeable technicians, makes all the difference and leads to an excellent prognosis for recovery. This is a requirement for any surgery (with the possible exception of emergency surgeries).
www.guinealynx.info/surgery.html

HOW COMPLICATED IS THE SURGERY?
Surgeries vary by how invasive they are. The aftercare you need to be prepared to give depends on how invasive, and how serious, the surgery is.
  • The least invasive surgeries involve, not surprisingly, the skin. Small cysts, etc. can usually be removed without too much difficulty, and with a good chance of a speedy and comfortable recovery.
  • Next in line are surgeries that are somewhat more invasive, but do not deeply invade the body cavity. Surgery for mammary tumors and bladder stones fall into this category.
  • The most serious are the most invasive. Spaying a female guinea pig is very invasive, and very disruptive to their GI tract, as most of it has to be moved aside to reach the ovaries, for example.
ADVICE FOR INVASIVE SURGERIES
Especially if your cavy is having moderately to severely invasive surgery, be thoroughly prepared for some very intensive aftercare. Arrange to take a couple of days off work right after surgery if you can manage it. If anyone can help you (a responsible, mature child, husband or wife, boyfriend or girlfriend, cavy-knowledgeable friend), ask and line their help up beforehand.

Try not to have surgery done on a Friday. If anything goes seriously wrong, you most likely (depending on your vet’s practice) will not be able to reach the vet until Monday morning. Some veterinary emergency clinics can treat guinea pigs competently, but many can’t, and ERs in general are extremely expensive. If you can schedule surgery for a Monday, Tuesday or Wednesday, that’s best.

Your guinea pig will likely come home from the vet chipper, bright, and eating. This is good. It will not stay that way. He or she may very well go straight downhill after that, and scare you half to death. The reason for this is that when your pet is released from the vet hospital, he or she still has postoperative painkillers and fluids in their system. Once those leave the system, the pig, not surprisingly, feels worse. Somewhere between about 24 and 60 hours postop they hit bottom, THEN begin to do better.

Be prepared to:

FORCE FEED. Read the hand feeding links carefully, get some Critical Care now, and make about 3 or 4 1cc syringes with the tips cut off now.
www.guinealynx.info/handfeeding.html

HAVE EVERY MEDICATION ON HAND YOU CAN THINK OF.
  • 1) Reglan (metoclopramide) is a must. It's a mild motility agent and you will probably want to give it to your pig even if s/he is defecating, because what comes out shortly after surgery is what was in the GI tract preoperatively. After that, the pipeline is empty. Guinea pigs are designed to have a constant stream of high-fiber food going through their systems, and if there is a break in the food flow, their systems can begin to simply shut down. The motility agent will help the piggy better process the food given postoperatively.
  • 2) 4 or 5 day's worth of a narcotic: buprenorphine, perhaps Tramadol, perhaps butorphanol; this will depend on what your vet prefers.
  • 3) An NSAID, probably Metacam, possibly Rimadyl (again, this will depend on what your vet prefers).
  • 4) If the incision is on the pig’s underside (as will be the case for bladder surgery, neuters, or mammary tumors), your vet will probably want to use an antibiotic prophylactically (that is, pre-emptively to prevent an infection developing). Try to get Bactrim for this purpose. Some vets will insist on Baytril, but it is harder on the guinea pig’s systems, which are already stressed due to surgery. If the vet insists on Baytril, be sure to get a probiotic to use in conjunction with it.
PAIN MANAGEMENT
You will want to use the NSAID from the very beginning to reduce swelling and inflammation as much as possible as soon as possible. You want to use the narcotic as little as possible, but as much as you need to keep the pig comfortable.

Consider asking the vet for a children's steroid (Pediapred, prednisolone) to have on hand. You cannot use this along with an NSAID, but you can use it instead of one at the very beginning. Steroids are powerful anti-inflammatories and painkillers. For major invasive surgeries, where a lot of organs and/or tissues are disrupted or damaged along the way, your pig may need it at the start.

Then, as the piggy improves, stop the steroid (if you needed it); ramp DOWN the narcotic and ramp UP the NSAID. Then, as s/he further improves, ramp DOWN the NSAID.

This “overlapping ramp-up-ramp-down” technique has worked very well in my experience, and the better cavy vets I have discussed it with have agreed with the protocol.

A word of caution: use as little narcotic as possible. Buprenorphine in particular is a powerful painkiller, but it can also have a very doping, somnolent effect. You want your pet to be as comfortable as possible, but not so zonked out that he or she doesn’t even want to move, much less eat or drink. If your pig is acting like a zombie, or is acting as if he or she is still fully sedated, reduce the amount of narcotic.

ANTIBIOTICS
You will likely be given a pre-emptive antibiotic. Try to get Bactrim. If they insist on Baytril, be sure you have probiotics as well to give. Baytril can affect appetite.
www.guinealynx.info/antibiotic_advice.html

There is one exception to this rule, and that is if your pig develops consistent, persistent harsh breathing after surgery.

Inhalant anaesthetics are acrid, and can sting and dry the nasal passages and bronchii. Most pigs wheeze for a little bit after coming up out of anaesthesia. This is usually transient and passes quickly. If, however, your pig continues to labor to breathe, has wheezy, crackly breathing for longer than the night after surgery, or his or her breathing sounds "harsh" to the vet using a stethoscope, Baytril may be needed.

Guinea pigs' lungs secrete a thick, tacky mucus under anaesthesia. Some vets administer a dose of atropine preop to reduce this secretion. Especially if your pig's surgery takes a while, or if the vet encounters complications that extend the period of time your pig is under anaesthesia, ask your vet about it and watch for this complication. It's not particularly common, but the chances of occurrence go up the longer the surgery takes and the longer the pig is under anaesthesia. Ask before you leave and save your pig and you an unnecessary trip back to the vet.

CLEANLINESS
Many surgeries require an incision on the pig's abdomen. Since they lay on their abdomens, and urinate and defecate near them, it's critically important to keep the area of the incision clean. Vets generally don't use gauze or bandages to cover an incision; they heal better if kept clean but left open to the air.

Make sure the area under your pig is changed out AT LEAST twice a day during the first few days postoperatively, when the pig is moving the least and the chances of infection are highest. Clean white towels or fleece is best to use for the first few days postop.

Make sure your pig is kept warm, but NOT TOO WARM. Guinea pigs have fur and do not sweat. They do not need to be kept as warm postoperatively as a human does. If you use something like a SnuggleSafe disc for additional warmth (especially in cold weather), be sure your pig can move off of it if he needs or wants to.

Make sure your piggy has a hide box, tent or similar to get under. A towel securely clipped over one corner or side of the cage will do. Guinea pigs are prey animals and will feel the need strongly to hide if they instinctively know they cannot evade a predator.

HYDRATION
At first, your piggy probably won't want to drink. Get some unflavored Pedialyte and ask the vet for a 6 or 10cc oral syringe. Be prepared to OFFER this to your pig, but don't force it (like the food, if necessary), however. Fluids are much easier to accidentally aspirate. Most pigs like Pedialyte and will drink it readily from a syringe.

If your piggy is still not drinking and is not getting sufficient hydration from handfeeding, water by syringe or Pedialyte by syringe, then take him or her back to the vet for subcutaneous fluids. Dehydration is disproportionately harder on a cavy than on a dog, cat or human; they feel, and are, in much worse shape when dehydrated. The flip side of this coin is that once they receive fluids, they feel and act vastly better. Sometimes a bolus of subcutaneous fluids, or water or Pedialyte offered via syringe, can help them to turn the corner toward quick and steady improvement.

DON'T GIVE UP!!
Many, many pigs go straight downhill after they get home from the vet, and after 24, 48, 60 or more hours of intensive care, sleep lost to hand feeding, worry and stress, you will be at the end of your rope. That’s exactly when you DON’T want to give up. Guinea pigs can take you to your very last nerve postoperatively, and just when you think there isn’t one ... more ... thing you can do, THEN they turn the corner and get better, sometimes very quickly and often very dramatically. DON’T give up. Keep going and doing what you need to do to help them through the recovery period. It will be well, well worth it, for your cavy and for you.
www.guinealynx.info/postop.html

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