Do the doctors provide updates during surgery and during the 7 days post-operative?
Yes, you will receive regular updates from the doctors each day after the daily evaluation tests are complete in the early afternoon.
While in the recovery period what is the dog’s awareness like? I'm assuming they are very tired?
Most dogs tend to be exhausted from traveling and the surgery, but each dog is different and towards the end of the 7-day hospital stay many dogs regain a lot of energy very quickly. It is very important to keep your dog calm while visiting them durring these crucial days to allow the heart and any inflammation time to heal.
Typically how long are they hospitalized for?
Except in cases where complications occur that require additional treatment, the dogs are hospitalized for 7 days following the surgery.
Will I be able to visit my dog to reassure it while it is hospitalized?
You will be able to visit your dog as much as you want post-surgery. However, you may find that your dog will need a lot of rest for recovery, especially the first few days after surgery. If it calms your dog for you to be there, you may opt to visit more frequently, but some dogs get excited to see their owners and the added agitation is unwanted during this sensitive recovery period. Each dog is different and the doctors can help you assess what is right for your dog. If you choose to stay away, leaving a shirt with your scent or a favorite toy can be calming.
What do the doctors do if a dog gets a blood clot post-surgery?
Plavix is started immediately after surgery and is increased in frequency and length until the clot dissolves. Also, most dogs are kept on Plavix (low doses) for 3 months post-op. In cases where the blood clot moves into the blood stream, Alteplase is used.
When and for how long is my dog at high-risk for blot clotting?
Days 1-4 after the surgery are the most critical days for developing blot clotting, and up to the 7th day specifically for Cavalier King Charles Spaniels. After this period, the risk significantly reduces, but the dogs are kept on blood thinners (Plavix) for 3 months post-operatively or more just to be safe.
What are some post-surgical options for avoiding infection at the surgical site?
Tshirt or onesie, surgical suit, harness (e.g., Easy Walk) are some suggestions. If the harness hits right at the incision site, you can temporarily use a collar instead. Additionally, a cone can help keep your dog from biting or licking the incision site.
When are surgical stitches removed?
Provided there are no complications, 12-14 days after surgery.
Post-surgery, why might the heart murmur still be high?
Each dog is different, and heart murmurs that change rapidly are always a cause for concern. However, post-mitral valve repair surgery, there is turbulence in the heart due to the suture in the valve and the additional heart chords. It is more important for the echocardiogram to show a low level of regurgitation rather than having a quiet murmur grade. It's also natural after surgery as the heart remodels to see a little adjustments over time.
Post surgery, how do I know if my dog has a blood clot?
Signs of a blood clot are limping or paralysis with signs of pain. The risk beyond the 2-week post-surgery period is very low. Any unusual behavior or pain should be immediately addressed by a veterinarian. We have only seen this a few times and it was managed successfully.
Post surgery, I noticed two bruise-like marks on my dog, which were not there earlier in the day. Could they be blood clots? Should I take her to the veterinarian immediately?
Most likely, the cause of skin discoloration is a hematoma, which is a common side effect of of Plavix (blood thinners). However, if the bruising is growing or changing rapidly, or causing the dog discomfort, it should always be checked out by a veterinarian just in case. Any discoloration on the skin, or just beneath the skin is not a blood clot. Signs of a blood clot are limping or paralysis with signs of pain. The risk beyond the 2-week post-surgery period is very low.
Does Plavix (blood thinner) interact negatively with other drugs or supplements?
You should always consult with your veterinarian when adding any additional prescription medications or supplements. Vitamin E or Tumeric is a known blood thinner, and should never be taken in conjunction with Plavix.
Why must my dog not run or jump for up to three months post-surgery?
The surgical stitches in the heart are healing during this time. For their efficacy to remain intact and for the heart to completely heal, the dog’s activity level needs to be safely limited, leash walked at all times outside to prevent them from suddenly running. Please read the additional guidance for post-operative activity here.
Post-surgery I was given instructions to walk my dog 15 minutes a day, 4 times per day. This is more exercise than my dog typically gets, do I increase activity to this level?
No, the guideline of 15 minutes, 4 times per day is an absolute maximum for the most active dogs. Dogs should be walked about 4 times per day to keep blood circulating well for recovery, but the amount of time should be much lower than the dog’s regular activity level. Throughout the 3-month recovery period, the amount of time spent walking should slowly increase.
I have observed my dog coughing after surgery. Should I be concerned?
Some residual coughing persists after surgery because the intubation from cardio-pulmonary bypass through the trachea can cause irritation to the wind pipe. This is especially apparent in dogs where there is some (even minor) tracheal collapse already. In general, you should always seek a professional medical opinion from your veterinarian if coughing persists and concerns you. Soft foods are better on the throat.