The Post-Op Recovery Guide For Osteochondritis Dissecans
Incision: Surgical incisions need to remain dry to prevent infection. If the incision becomes dirty, gently clean it with hand soap and water, and pat dry with paper towel. Otherwise, leave it alone. Keep checking the incision frequently until it is completely healed. Look for swelling, oozing, pus, redness, heat, bad odor, and loose or missing staples or stitches. Excessive licking can irritate an incision and cause infection or drainage. A normal amount of drainage is none to just a few drops. The incision may be slightly puckered at first but it should improve to normal smooth skin as it heals.
Medication: Follow the medication schedule exactly and give prescribed medications for the length of time indicated. NSAIDs should always be given with a meal to prevent stomach upset. Give the entire course of medications. If you miss a dose, do not double up the next dose. Simply resume the dosage schedule with the next treatment and keep giving the medication until it’s gone.
Feeding, Potty time and bathing: A decreased appetite usually isn’t a concern for the first day after surgery. If your pet is not eating or drinking 24-36 hours after going home though, notify your veterinarian. Fresh water should always be available. Many pets will not have a bowel movement for 1 to 3 days after coming home. This timeframe is normally not a concern. If your pet does not produce any stool by 72 hours after returning home contact your veterinarian. Do not bath your pet until sutures or staples are removed at 14 days post op.
E-collar / “The Cone”: Lampshade-like cones, also called Elizabethan collars or e-collars, go around your pet’s neck. These devices help prevent your pet from irritating the incision, creating an infection, and pulling out stitches or staples Some e-collars are made of fabric or may be inflatable which may or may not work depending on where your pet’s incision is located. Ask your veterinary team for recommendations. Eating can be complicated and messy while wearing an e-collar. If it is removed the pet must be supervised until the collar is replaced. It takes only seconds for a pet to get to an incision and cause infection, which can be catastrophic.
Activity Restriction: Limit the pet to leash walks only with no running for 2 full months. See Below for Rehabilitative Details.
Weeks 1 and 2 post-op: strict rest with leash walking to go to the bathroom only. Twice-daily passive range of motion exercises, accompanied by icing and massage of the quadriceps muscles, if tolerated. Ice the joint (frozen veggies) three times daily for 10 to 15 minutes for the first week, and after exercise as needed in the next 8 weeks. Warm packing the joint prior to walking or motion exercises can also be very helpful.
Weeks 3 through 6 post-op: moderate rest, allowing the patient to walk about the inside of the home, with toe touching on the surgical leg. No playing or jumping. On leash outdoors. Start swimming in a pool or lagoon, +/- using an underwater treadmill. “Ladder walking” also known as cavaletti pole exercises are very useful. Walks should increase in length / duration. Use of a professional rehabilitative therapy service may begin at 4 weeks post-op.
Weeks 7 and 8 post-op: long daily walks, up and down stairs on leash to promote strength. Continue swimming and/or treadmill therapy.
Appropriate dietary management is prudent, as over-conditioned patients (pudgy, plump, etc) have an increased risk of re-injury.
There are several places in the county, which offer rehabilitative therapy, including swim therapy, underwater treadmill, acupuncture, acupressure and massage. Use of these services can greatly increase the percentage return to original function which may be achieved post-surgery, and the speed with which this may happen.
Veterinary rechecks at 2 weeks for suture/staple removal, and 8 weeks for off leash approval are standard.
