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Common Postoperative Medications

Common Postoperative Medications

Anti-Inflammatories, Analgesics, Sedatives, and Antibiotics

Nonsteriodal Anti-Inflammatory Drug (NSAIDS) are a common class of drugs used to reduce pain, swelling, and fever. Many are used in human medicine and are over-the-counter (Ibuprofen, Aspirin, Aleve, etc). It is important to note that cats process NSAIDS differently than humans or dogs and should NEVER be given any over-the-counter medications without consulting your veterinarian or surgeon.   NSAIDS work in three ways:

Analgesic – These medications have pain-relieving qualities, which is probably their most common use.  We generally use a post-surgical dose for analgesia and reduce the dose 7-14 days post surgery.

Anti-pyretic – NSAIDs reduce fever by interfering with a group of hormones (prostaglandins), which cause the body’s temperature to rise and result in a fever.

Anti-inflammatory –Prostaglandins also trigger inflammation or swelling. We use NSAIDs to reduce the painful swelling of a number of conditions and injuries.

Prostaglandins protect the lining of the GI tract. NSAIDS can interfere with that protective quality. The most common side effects we see involve the GI tract but kidney and liver complications are possible. If your pet is on an NSAID please monitor for the following:

  • Decrease in appetite
  • Vomiting
  • Change in stools (diarrhea, dark or bloody stools)
  • Changes in drinking or urinating
  • Yellowing of skin, eyes or gums (jaundice)

If your pet is experiencing any of these signs please discontinue the NSAID and contacts us, your regular veterinarian, or an emergency hospital immediately.

Most common NSAIDS used at VSCP:

  1. Carprofen (Rimadyl, Rovera, Vetprofen, Novox) is an oral tablet used every 12 to 24 hours.
  2. Metacam is a liquid medication dosed in a syringe based on weight. Metacam is given once every 24 hours.
  3. Meloxicam is an oral tablet (generic Metacam) and is given once every 24 hours.
  4. Onsior is an oral tablet for cats. It is given once every 24 hours for up to 3 days only.

We recommend that all NSAIDS are given with a small meal to decrease potential side effects. Many dogs use NSAIDS on-going for treatment of osteoarthritis. Your veterinarian may require bi-yearly bloodwork to monitor kidney and liver values. It is important to note that many medications used in humans are not safe in dogs and potentially lethal to cats. Please only use prescribed medications.  For more information please review the Rimadyl informational hand-out.

Opioids are synthetic drugs that produce a morphine-like response. These are narcotics that are closely monitored by the DEA. Used in combination with a NSAID, they provide powerful pain relief to the recovering patient. The most common side effects with opioid treatment are:

  • Decrease in appetite
  • Vomiting
  • Increased sleeping
  • Constipation

At VSCP we use codeine, tramadol, buprenorphine, and fentanyl for the first 3-7 days post surgery.

  1. Codeine is an oral tablet given every 8 to 12 hours
  2. Tramadol is a semi-synthetic opioid. It comes in an oral tablet or compounded into a liquid. Once widely used in veterinary medicine, recent research indicates that it may not be as readily absorbed in dogs as previously thought.
  3. Buprenorphine is our opioid of choice for cats. It is a liquid that is absorbed very effectively through the gums given by syringe every 8-12 hours.
  4. Fentanyl is dispensed in a transdermal patch. Please read the client handout on fentanyl patches for more information.

Fentanyl Patch

Constipation is the most common side effect we see with patients on opioids. It is NOT uncommon for a patient to go 48 hours without defecating after surgery. We may recommend that you add canned pumpkin to your pet’s food while on these drugs. Please let us know if your pet goes more than 2 days without a bowel movement.

Sedatives are essential for some pets during the healing process.  Many are confined for upwards of 6 weeks and do not tolerate the forced inactivity well.  It is important to note that pets that are currently on opioids may experience increased sedation when given a sedative.  You may find that you have to increase the sedative dose once the pet is off opioids.

Acepromazine is the most common sedative used in veterinary medicine. It has a wide dose range and the effects vary from dog to dog. Your prescription will likely have a large dose range like 1/2 to 2 tablets. We recommend that you start with a lower dose and work up until you find the dose that best suits your pet. Some breeds (collies, Australian shepherds, etc.)  show such a great sensitivity to this medication that it is not used. Acepromazine comes in an oral tablet and can be dosed every 8-12 hours. The most common side effects are sedation (our desired effect) and low heart rate. In rare instances it can cause penile prolapse in dogs.

Trazadone is used in human medicine as an anti-depressant (serotonin antagonist).  In dogs, we use it for treating anxiety and phobias. It is an oral tablet given up every 12 hours. The most common side effect is drowsiness/sedation (our desired effect), however, pets on trazadone and NSAIDS are more likely to experience GI bleeding.  Please monitor for any changes in appetite, vomiting, changes in stools.

Antiobiotics are NOT routinely dispensed with most surgical procedures. All surgeries are completed with an aseptic (sterile technique) to avoid the introduction of bacteria. In a world where bigger and badder “bugs” are showing more antibiotic resistance, in most cases, we are choosing to use antibiotics only when there are signs of infection. However, many dogs come to us with chronic skin issues and most of those patients will take home a small course of cefpodoxime, a 3rd generation cephalosporin. Cefpodoxime is an oral tablet given once every 24 hours for 5-21 days.  The most common side effect is GI upset so we always recommend giving it with a small meal.  With ALL antibiotics it is extremely important to finish the entire prescription.

The most common cause of infection is a patient licking or chewing at the incision. Most patients are sent home with 1-2 collars to keep them from the surgery site.  We ask all owners to monitor for signs of infection which including swelling, redness, discharge, and pain. If an infection is present it is likely that our surgeons will culture the site and submit a sample to the outside lab to identify the type(s) of bacteria present and the antibiotics they are susceptible to.