Feline How-To Manual: Before and After Surgery and Dentistry ~ Pawprints and Purrs, Inc.

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Any health care links located here are NOT to replace a veterinarian visit; please take your cat to a vet immediately at any sign of odd behavior or any symptoms of illness or injury. Call your vet and describe your cat's symptoms with any of your concerns about the cat's well-being. Your veterinarian may discover changes in your cat's health that you have overlooked. It is always better to err on the side of caution.

Before and After Surgery and Dentistry

Preparing for Surgical and Dental Procedures

There are three classifications of surgical procedures: elective, such as spaying and neutering operations, nonelective, such as surgical biopsies, and emergency operations, such as those life-saving porcedures that may be necessary if your cat is hit by a vehicle. Depending upon the urgency of the surgery, there are several steps to be taken to prepare your cat and yourself for the procedure.

The night before a scheduled surgery, pick up your cat's bowl and withhold all food and treats after 6:00 PM. This means that if you have several pets, you'll need to confine the one for surgery to a room of his own, or withhold food from all of them to prevent your patient from sneaking a snack. Most veterinarians agree that you can and should continue to leave water available at all times.

By withholding food for at least 12 hours before surgery, your cat's stomach is likely to be empty. One fairly common side effect of most anesthetics is nausea and vomiting. Postoperative vomiting can result in aspiration (inhalation of stomach contents into the lungs). A caustic mixture of food and stomach acids can cause a severe, often fatal pneumonia. If your cat does happen to be fed on the morning of surgery, be sure to inform your veterinarian for the safety of your cat. The surgery will probably proceed as planned, but he may be scheduled for later in the day to allow this meal to be digested.

Withholding food is important for all elective and nonelective procedures. Your vet will take additional precautions to minimize the chance of vomiting and aspiration if emergency surgery is necessary. Because this forced fast is clearly a break in your cat's normal routine, don't let your inside/outside cat outdoors the next morning, as he may find his own breakfast and/or will be disposed when it's time to leave for the hospital.

The admitting staff member will have you sign a permission slip authorizing the anesthesia and surgical procedure at the time of admission to the hospital. Ask for an estimate on the cost of the surgery, preferably in writing. Keep in mind that what you will receive is exactly that, an estimate. Because there is no way to know all the complications and findings at surgery beforehand even in routine elective surgery, the estimate may be different from the actual bill.

Ask your vet or his tech for some details of the surgery: what exactly will be removed, where the incision will be, whether or not there will be any stitches, if they will have to be removed and when. Learn how long your cat will be in the hospital and if there will be any special care or confinement necessary after he comes home. Ask about any medications or special diet. By finding out about these things ahead of time, you can begin to prepare early rather than at the time of discharge - when you may not think of questions until after the veterinary hospital is closed for the day.

After Surgical and Dental Procedures

It takes anywhere from less than one hour to a day or more for the general anesthetics routinely used in veterinary practice to be completely eliminated from the body. Gas anesthetics, such as isofluorane, are rapidly eliminated; they are especially useful in very ill or old patients because of their high degree of safety. They are also useful in fractious patients who require anesthesia simply to allow the doctor to draw a blood sample. Combinations of injectable drugs have certain advantages that make them useful for some procedures. They are usually eliminated more slowly from the body, so your cat will recover more slowly as well.

Your cat's length of stay in the hospital will depend upon the nature of his illness and surgery, and the type of anesthetic that was required.

Most veterinary hospitals have a policy regarding visitation. Visitations are often permitted during specific hours, so you should call ahead. The nursing staff will probably welcome any offer you make to feed your cat and provide simple nursing care. You will need to check with them first, however, before feeding or moving him out of his cage. He may have a special diet, have an IV line, be in more pain if lifted, or simply be too grouchy.

When it's time to go home, your vet should provide you with instructions relating to your cat's home care. This includes diet, excerise, degree of confinement, medication, and any possible complications. Don't be afraid to ask for details in writing. Ask for a demonstration of anything you are not certain you know how to do, such as how to give medication. Find out who to call in case of an emergency after hours. You may be instructed to call an affiliated emergency clinic if there is a problem.

With few exceptions, you should assume that any cat with an incision should be, at the very least, confined indoors for 7 to 10 days. This applies to any incision, whether there are external sutures or not.

When an animal is under anesthesia, the core body temperature drops because of the effects of the anesthetic on the circulatory system and the muscles. This is a normal physiologic response. The muscle trembling generates heat and raises your cat's temperature back to normal. Of course, you can help by safely providing an external source of heat. Also keep in mind that if your cat's fur was clipped or shaven for an incision, he has lost important insulation against cold air temperature and will be more susceptible to loss of body heat.

Because anesthetics can cause nausea and vomiting, and because his stomach has been empty for some time, feed your cat only a small portion of food, if anything at all, on the first night home. Except for a few specific instances, cats should not go more than 48 hours without food.

Here are some general things to watch for once your cat has returned home from surgery:

Anorexia or inappetence: Most cats will eat at least one quarter of their usual amount of food on the first day it is offered. If that stays down and if there is no specific reason to withhold food, you should increase the amount of food offered as quickly as possible, until your cat is back to eating his normal amount. This may occur as quickly as 24 hours post-anesthetic. If your cat does not show an interest in food within the first 24 hours, you should contact your veterinarian.

Cough: Gas anesthetic is delivered to the lungs by a tube placed between the vocal cords and into the trachea (windpipe). Placement of the tube and contact with these delicate tissues can cause a mild irritation, which can cause him to cough. It should only last a day or two. If a cough persists after 48 hours, you should contact your veterinarian.

Dehiscence: The number one source of bacteria in a surgical infection is the patient himself. Your cat has bacteria that normally live on his skin and caus no harm. However, his immune system and his ability to fight infection is suppressed with the trauma and stress associated with surgery, allowing these bacteria to multiply, causing disease. Along with a discharge, infected tissues will appear red, moist, and swollen, and they may have a foul odor. The swelling will cause the stitches to tighten and cut into the skin. The wound margins will no longer hold together and will begin to gap. This infection, dehiscence, can spread under the skin or into deeper tissues. Before it reaches this stage, call your veterinarian.

Depression: Your cat may be quieter than usual and spend most of his time sleeping until the anesthetic has been eliminated from his body. Discomfort and pain contribute to this. You should see a steady increase in normal behavior. If this does not progress, based on the recommendation of your veterinarian, or if your cat regresses, call your veterinarian.

Diarrhea: This is a fairly common occurrence after an anesthesia or surgical procedure and is probably a result of a number of factors, including the return to eating after the necessary fast, a change in diet, the stress associated with the procedure and hospitalization, antibiotics or other drugs, or from some kind of "bug" your cat may have picked up at the hospital. Diarrhea as a result of the first three factors will resolve uneventfully after two or three days. If diarrhea persists after 36 to 48 hours, you should contact your veterinarian.

Discharge and odor: It is perfectly normal for healing wounds to ooze a clear or pinkish-yellow, sticky fluid (serum). In areas where there is a lot of loose skin or movement, like under the foreleg, serum can accumulate in a pocket creating a seroma. You should be concerned about any discharge other than serum. A white, yellow, or green discharge with foul odor means an infection has developed and you should call your veterinarian. If you can, check your cat's temperature before you call.

Fever: Because even the most delicate tissue handling results in inflammation, it is very common for patients to develop a slight fever of one or two degrees above normal for a day or two after surgery. A fever does not necessarily mean that an infection is present. Antibiotics may or may not be necessary. If fever persists after 48 hours, you should contact your veterinarian.

Hemorrhage or bleeding: In small amounts, a drop or two of blood that oozes and collects at a place along the incision and then clots and dries is not a problem. This bleeding usually comes from a very small blood vessel in the skin that was stretched and started to bleed when your cat moved around. Continuous oozing or flow of any significance warrants a call to your veterinarian. It could mean that there is hemorrhage from a larger blood vessel that needs to be ligated (tied off) to prevent significant blood loss. Bleeding from a vessel inside a body cavity is more difficult to detect. Internal bleeding into the abdomen may cause the cat's abdomen to become enlarged. Of course, that would not occur with bleeding into the chest, as the rib cage does not allow the same expansion. Internal bleeding would most likely cause shocklike signs of pale gums and a rapid, but weak pulse.

Swelling, heat, and redness: In moderation, these are normal and natural parts of the process of inflammation. Swelling represents an influx of fluid and components of the immune system that bind, heal, and repair. Aside from the trauma that the tissues sustain even from delicate and precision handling, the suture material used to close the incision also incites the inflammation response, particularly the dissolvable type sutures. The swelling can be intense if a cat is sensitive to the type of suture material used.

Heat is given off as a result of the biochemical reactions involved in inflammation. This extra heat, along with the opening up of the blood supply into the area, causes a pink flush to the skin and the noticeable increase in skin temperature. This would only be noticeable in areas where the fur was shaved or naturally thin, like over the eyes. These signs in the absence of pain, odor, or discharge, will usually resolve on their own or with compressing.

Pain: It's very difficult to assess the amount of pain your cat is feeling. Being so stoic, cats don't often draw on the sympathies of their owners as do canines. Humans extrapolate the potential for pain in many situations from ourselves. We also assess pain by our cat's appetite, activity level, desire for companionship, and even the look in their eyes.

The common painkillers used in dogs - aspirin and phenylbutazone - are extremely toxic to cats. The only safe and effective drugs to control pain in cats are given by injection and must be used in the hospital and under the supervision of a veterinarian. Pain relief at home is best offered by rest, quiet, warmth, treatments like compressing, and antibiotics if appropriate. If you feel your cat is in unnecessary pain, call your veterinarian.

Pallor: The gums and conjunctiva (tissues surrounding the eye), are the best place to assess your cat's color. This is a difficult judgment call and requires some experience to be accurate. All three tissues should be pink. Shades of blue, gray, yellow, or white indicate a circulatory or metabolic problem. Call your veterinarian as soon as possible.

Regression: Your cat should make steady progress back to his old self after an anesthetic, dental, or surgical procedure. Your vet can give you an idea of how long this should take. Complications may have developed if your cat regresses in his recovery. This is particularly important during recovery from orthopedic surgeries.

Vomiting: The vomiting your cat experiences after anesthesia or surgery may be the side effect of the anesthetic itself. Other causes include car sickness, over-feeding or gluttony on his part, antibiotics or other drugs, a "bug," food intolerance or diet change, progression of a disease, or a complication of the surgical procedure. Vomiting as a result of the anesthetic or car sickness should not occur more than once or twice. This vomiting can be minimized by only feeding your cat a very small meal when he first returns home. If vomiting persists after 24 hours, you should contact your veterinarian.

How-to Articles in This Series:

Article   1: How to Choose a Vet
Article   2: Hospital Admission of Your Cat
Article   3: Preventive Care: Vaccinations, Serologic Testing, Spaying & Neutering
Article   4: Preventative Care - Dental Care, Flea Control, and Grooming
Article   5: Cooperation - Restraint Procedures and Trimming Claws
Article   6: Keeping Records
Article   7: Care in the Sick Room
Article   8: Keeping Watch - Your Cat's Vital Signs
Article   9: Nutrition for the Cat
Article 10: Feeding the Cat - Including Newborn Kitten Feeding
Article 11: Medications and Prescriptions
Article 12: Basic Nursing 101
Article 13: Managing Bandages and Splints
Article 14: Before and After Surgery and Dentistry
Article 15: Pregnancy and Delivery
Article 16: Euthanasia

Page URL: http://www.sniksnak.com/cathealth/howto14.html

Resource References:
Caring for Your Sick Cat Carol Himsel Daly, DVM and veterinary consultant
Cat Doctor, Mark Evans, B Vet Med MRVCS
Cornell Book of Cats, Cornell Feline Health Center, Cornell University