Incision(s) Care:

Please monitor the incision for any excessive redness, swelling, discharge, or separation for the surgical site.

DO NOT, for any reason, allow your pet to lick, chew or groom the surgical site. An e-collar should be purchased and kept on your pet at all times to keep from damaging the surgical site.

• Unless otherwise directed, use ice compression for 5-10 minutes (as tolerated) 3-4 times a day for the first 24-48 hours.
• On days 3-5 after surgery, use warm compression 5-10 minutes (as tolerated) 3-4 times a day for 2-3 days until the swelling subsides.
• You should always use a towel or barrier against the skin to prevent thermal damage and always check the temperature on your skin first.
• NO BATHS throughout the recovery period or until approved by a veterinarian. We do not want your pet climbing in and out of the bath or slipping and falling while still in recovery.

NOTE:  Swelling under the skin incision (seroma), is common after FHO procedure.  The use of controlled activity and exercises with restrictions (see below) coupled with initial ice and heat therapy is meant to help limit swelling. 

It is not uncommon to see bruising and swelling dissipate around the ankle (lower joints) after surgery. Please see instructions for warm compression and Passive Range of Motion (PROM).

Exercise Restrictions:

While controlled leash walk and supervised rehabilitation exercises are encouraged throughout FHO recovery, please restrict your pet’s activity when unsupervised or when not on leash for the ENTIRE 8-week recovery unless otherwise directed.

Spontaneous uncontrolled activity is discouraged.  Your pet must NOT be allowed to run, jump, or play roughly during this time. He/she may be taken outdoors on a short leash (+/- sling) 2-3 times a day to urinate and defecate. Again, when not under your direct supervision, your pet should be confined to a crate or small room.

If applicable, a sling may be purchased for your pet. This is to help with hindend control, to slow movement during recovery, to add resistance strengthening, and to prevent him/her from slipping on  slick surfaces. It can be used throughout recovery, if needed. It is placed under the abdomen (belly).  A small lift up can be used, but also shift the sling BACK (towards your pet’s tail) for resistance.  Your pet’s hind limbs should be able to walk on the ground. 

Leash Walking:

For the first two weeks, limit leash walking to short breaks to go potty outside while the incision is healing.  After two weeks (or after suture removal), gradually increase your pet’s leash walks by 5 minutes each week. DO NOT increase his/her walking to more than 30 minutes by week 8.

If at any time your pet becomes increasingly lame or painful, please call a veterinarian for additional recommendations.

Immediate Post-operative at home rehabilitation:

Consider starting after 3-5 days when your pet’s comfort can be safely monitored

• Hip massage and stretch: 2-3 times daily (duration—as tolerated)

Your pet can be standing or laying down.  Gently stroke and knead the muscles around the hip joint and hip flexor (iliopsoas muscle origin—inner aspect of the hip or groin area). Massage or stretch for ~ 10 minutes in a comfortable posture.  This may be coupled with gentle heat or warm compression prior to manipulation

VIDEO

• Rear Limb weight shift: 3-4 times daily, 10-15 repetitions

Position yourself behind the pet with your hands placed on either side of the pelvis to support your pet.

With the limbs in a square standing position, gently sway/push/shift your pet’s weight on and off the affected limb in a slow, rhythm.  For an added challenge, your pet’s front paws may be elevated on a curb or stair to add weight shifting backwards. 

VIDEO

• Sit/Stand commands: 3-4 times daily, 10 repetitions

While on leash, command your pet to ‘sit’.  Before your pet’s bottom or tail touches the floor, ask him/her to stand and continue leash walk.  Repeat occasionally through leash walk or do as tolerated for approx. 10 repetitions.  Stay on non-slip surfaces and change surface texture intermittently through recovery (mulch, grass, concrete, pavers, carpet, rug, yoga mat, etc)

For added training, add ‘step up’ on an inclined surface (large cushion, mattress, or stair landing), ‘sit’, ‘stand’, and repeat.

VIDEO

10-14 days Post-operative at home rehabilitation:

• Slow hill incline climb (leashed): 2 times daily for 2-5 repetitions

Walk up a gradual incline (gentle hill or driveway) while on leash at a slow controlled pace to encourage weight bearing and pushing off on each of your pet’s four limbs.

VIDEO

• Walking upstairs (leashed) 1- 2 times daily for 2-5 repetitions

Walk your pet on a controlled short leash.  Be sure that the pace is brisk enough to encourage forward motion, but slow and controlled to ensure your pet is stepping and pushing off with each limb.  Do NOT allow skipping steps or bunny hopping. 

VIDEO

• 3-legged standing (rear leg) 10 sets twice daily hold 10-20 seconds

The non-surgical leg is lifted and your pet’s bodyweight is shifted back (away from the front of your pet) and towards the surgical limb.  This should result in your pet placing more weight on the surgical or post-operative leg. 

Passive Range of Motion (PROM):

This may be performed at any time in recovery and can be performed with your pet standing or laying down as tolerated. Please start at the toes and work up the leg performing bending and extending at each joint. 10-15 repetitions can be performed per joint as tolerated by your pet. Please go slowly and minimize stress.

Please refer to this demonstration by Purdue University:

Medications:

Your pet will be sent home with oral medications. Please discuss administration with your veterinarian at the time of discharge from the hospital. These medications are likely to include a pain medicine and/or anti-inflammatory medicine. Antibiotics may also be prescribed on an as-needed basis.

Recheck Visits:

Your pet will need a recheck appointment in 10-14 days for skin suture/staple removal and/or incision check.

At the end of 8 weeks, please schedule an appointment with your veterinarian, if needed, to evaluate limb use.  No additional x-rays are needed after FHO recovery.

Please schedule these appointments with your veterinarian. DVSC can be contacted for any surgical questions in the recovery period.

If there is adequate healing and limb use at this 8-week point and you have veterinary approval, slowly and gradually increase your pet’s activity over the next 2-3 weeks.  This increase in activity should be SUPERVISED and on a leash until full function is achieved.

Your pet may also benefit from professional water treadmill therapy and rehabilitation. Please contact DVSC or your veterinary team for recommendation on referral veterinary rehabilitation programs.

Occasionally your dog may be lame after increased activity. Please allow 24 hours of rest and then continue on your schedule.

If at any time you notice your pet becoming lethargic, uninterested in food, or unable to hold down food, please contact your veterinary office or local emergency room. If at any time your pet becomes increasingly lame or painful within this recovery period, please call your primary veterinarian or the DVSC.