Surgery is only the first step in repairing an injury or defect. Ensuring that pets rest during recovery is essential to the process. So is rehab. Here’s what to know about successful recuperation, through the experience of a lucky pup.
Milo looked like a normal puppy when he was brought to Oklahoma State University Veterinary Teaching Hospital in Stillwater, but the happy little hound pup had an unusual problem: he was born with his paws upside down, a condition called bilateral congenital elbow luxation. Unable to use his front legs, he pushed, scooted, and crawled his way around. His owners gave him up to Oliver and Friends Farm Rescue and Sanctuary, which sought help for him from OSU veterinary surgeon Erik Clary.
Performing surgery earlier this month, Dr. Clary was able to bring the elbows back into alignment and hold them in place temporarily with pins during the three-week healing process. The pins keep the bones in alignment as internal scar tissue forms to hold the elbows in place and the surrounding bones take shape as Milo grows.
The rapidly growing puppy requires frequent bandage changes.
“If he was an adult dog, we might be able to get the whole three weeks out of one bandage and splint,” Dr. Clary says, “but he’s growing so fast that we have to change his bandage every week.”
Stay Still and Chill
While the pins do their job, Milo wears a large front-body splint to keep him still and protect the pins as the bones, muscles, and other tissues grow and repair. Normal puppy activity can stress or break the pins, allowing the elbow joint to move back out of place as well as complicating pin removal.
In some respects, Dr. Clary says, surgery is easier than recovery. Puppies are resilient and usually bounce back quickly from surgical procedures, but that doesn’t mean they’re ready for all-out activity. Far from it. Keeping them still so the body can heal is frequently a challenge.
For Milo, the splint serves not only to hold the joint in place but also to contain his puppy energy. His foster caretaker has her hands full preventing him from moving around or flipping himself over and potentially damaging the repair.
R&R Is Key
When the pins are removed this week, the real work begins. Beyond normal healing, Milo must learn how to walk, something that most puppies begin to do at two to three weeks of age. Milo has never walked normally, so he not only needs to have his muscles built up and his range of motion extended but also discover the mechanics of locomotion.
That will take place under the supervision of Cara Blake, DVM, a board-certified veterinary surgeon and certified canine rehabilitation therapist. The most important element is to establish range of motion in the elbows, which are stiff not only from the preexisting disease but also from weeks of immobility. Range-of-motion and proprioception exercises are among the techniques that will help.
We can’t sit pets down and say “Look, jumping up on the furniture and running to the door when you hear the doorbell isn’t a good idea after your surgery,” so it’s important to prevent activities that could injure a healing bone or other injury. Restricting or moderating activity usually starts with keeping the pet in a crate or exercise pen, letting them out only on leash to eliminate and then putting them right back up.
Keeping them from licking and chewing their wounds is important too. That’s why veterinarians stress the importance of wearing the hated “cone of shame.”
“Dogs like to lick and chew wounds—that’s just a natural behavior—but that can spell badness for a surgical incision,” Dr. Clary says. “We have to rein that in.”
Keep Calm and Carry On
Fortunately, there are ways to help pets stay calm and entertained in confinement. Soothing scents such as lavender and chamomile have a reputation for being relaxing, but a study published last May in the journal Applied Animal Behaviour Science found that other scents have benefits, too. They included vanilla-, ginger-, coconut-, and valerian-scented essential oils, each applied to a different cloth. Dogs exposed to the scents were less likely to bark, whine, or howl and spent more time resting and sleeping. Those are conducive to recovery.
Canine pheromones aren’t scents, but the chemical messengers communicate a sense of wellbeing. The synthetic products mimic the secretions by a mother dog when puppies are nursing and can be sprayed in the environment, wiped inside a carrier, or diffused in a room. Pheromone collars are also available.
Interactive toys that can be used in a small space and don’t require the dog to move around engage the brain and can be just as healthfully tiring as physical exercise. Strew a Snuffle Mat with treats or stuff a hollow toy with squeeze cheese, cream cheese or peanut butter (make sure it isn’t sweetened with Xylitol), stud it with kibble, chopped carrots, and other favorite treats, freeze it, and then give it to your dog. He’ll work on it for hours getting out all the goodies. Worried about your dog getting fat? Fill the object with your dog’s regular amount of food and let him work for his meals.
Your dog hates that plastic lampshade around his neck? Ask your veterinarian about using a soft collar or one with space for a scented insert with calming effects. You can also teach your dog to place his head in the collar on his own to get a special treat. Bonus if you do this training before he ever needs to wear one.
Dr. Clary says Milo has a 50/50 chance of being able to walk normally one day, but he’s getting everything he needs for the surgery to be successful.
“What happens after surgery is just as important as what happens during surgery,” Dr. Clary says. “After surgery, you’ve got to have the right kind of care. If you don’t, that could put all the work on the front end in jeopardy.”
This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.
Published January 28, 2019