Cats – FAQ
Frequently Asked Questions After Surgery – General Information
Q: When should my cat have the first bowel movement after surgery?
Many cats will not have a bowel movement for the first 4 to 5 days after surgery
Reasons that a cat will not have regular bowel movements after surgery include:
The cat has been fasted prior to surgery
Cats do not eat well during the hospital stay
They frequently do not eat well when the go home
They are fed highly digestible food that produces little stool
Pain medication that contain narcotics (such as fentanyl patches, tramadol, morphine) can be constipating
If a pet does not have a bowel movement on the 5th day of being home a stool softener such as metamucil can be fed
Dose of metamucil 1/4 tsp per mixed in with each meal (canned cat food)
Q: My cat had surgery and will not eat. What can be done?
Offer smelly foods that contain fish such as tuna or smelly cat foods
Try Gerber strained meats for babies such as the chicken, beef, turkey or veal
Hand feeding; place a small amount of food in the mouth so that they get the flavor
Warm the food slightly in a microwave as the food will be more aromatic; remember to stir the food before feeding and test the temperature with your finger; it should be only luke-warm.
Some cats will only eat dry food, try kibble if your cat normally has been fed that food
Petting and stroking your cat frequently will help to stimulate appetite
Remember that most pets will not eat the first day or two after they get home from surgery
Appetite stimulants such as cyproheptadine may be helpful
If your cat refuses to eat anything for 7 days a stomach tube should be placed to provide nutrition so that a serious liver problem (hepatic lipidosis) does not develop
Q: My cat is vomiting now that he/she is at home. What can be done?
The first thing for you to discern is whether your pet is vomiting or regurgitating. Both will result in fluid or food being brought up. Vomiting always will have heaving or retching of the abdomen prior to expulsion of the vomitus. Regurgitation is not associated with heaving and the cat usually just opens the mouth and fluid or food will be expelled. Usually the regurgitant will be clear or brown colored fluid.
Next is to identify the cause of the vomiting or regurgitation.
Causes and treatment of vomiting after surgery
When some pets return home after a stay in the hospital they may drink excessive amounts of water at one time and then vomit; if this appears to be happening the water should be limited to frequent smaller amounts.
Medications such as antibiotics are a common cause of vomiting after surgery. In order to see which medication is causing the problem the administration of each drug should be separated 2 hours apart. Usually the pet will vomit or appear nauseated (drooling and sick look) within 1 hour of administration of the medication that they are sensitive to. The antibiotic in some cases may be changed to a different one, or may be discontinued.
Stomach upset from anesthesia is a potential cause of vomiting and will pass within a couple of days.
Unusual cause of vomiting after surgery is internal organ failure. Blood testing will confirm this problem. For this reason vomiting should not be ignored if it persists for more than 24 hours.
If your pet had surgery of the bowels or stomach, vomiting is always a concern, as it may indicate that infection of the abdominal cavity, called peritonitis, is present. Do not ignore this sign.
Symptomatic treatment of vomiting involves with holding food for 12 to 24 hours, then introducing small amounts of bland food such as rice and lean cooked hamburger, if your pet does not vomit after that then. In order to decrease the acidity of the stomach Pepcid AC 0.5 mg/kg given by mouth twice daily for 5 days can sooth an upset stomach. Metoclopramide is a good anti-vomiting medication for cats. You should always consult a veterinary healthcare professional before administering medication.
Causes and treatment of regurgitation after surgery
The most common cause of regurgitation is reflux of acid from the stomach into the esophagus while your pet is under anesthesia. Acidic fluid from the stomach can cause a chemical burn of the esophagus and result in a bad case of heart burn, which is called esophagitis. This results in poor motility of the esophagus so water and food will accumulate in this structure. In most cases esphagitis is self-eliminating and will resolve within two or three days.
Regurgitation also can be caused by a neuromuscular degeneration of the esophagus and this problem will persist. It is not associated with surgery, rather other underlying diseases.
If the esophagitis is severe the esophagus may develop one or more strictures. A stricture is a narrowing or stenosis of the esophagus, does not allow passage of food down the esophagus, thus the pet has persistent regurgitation. This problem should be brought to the attention of your doctor within the first two weeks so that it can be treated by ballooning the stricture (minimally invasive procedure as it is done with the aide of an endoscope). If an esophageal stricture is chronic surgery is needed.
Symptomatic treatment of regurgitation caused by esophagitis includes feeding bland food, and administering a coating agent such as sucralfate. You should consult a veterinary health care professional if the regurgitation continues for more than a couple of days.
Q: How do I know that my cat is in pain following surgery?
Pain is more difficult to assess in cats versus dogs as signs can be more subtle and they usually do not vocalize
Signs of pain in a cat include the following:
biting if you get near the surgical site
growling or deep cry
not wanting to eat
hiding and not wanting to be near owner (remember that this could also be caused by the cat just being upset about leaving home and coming back)
What can be done for pain at home for my cat?
Pain medication such as buprenorphine or a Duragesic (fentanyl) patch
Tylenol will kill a cat as they lack abundant glutathione enzyme in the liver
Anti-inflammatories can be used, but the dose is much less than dogs and they should be given only for a few days
Q: Is it okay for my cat to lick or scratch the incision?
If a cat licks the incision it will actually delay the healing process because they usually lick too much and traumatize the area.
Cats have a barbed tongue, therefore a lot of damage can be done in a short period of time
Licking can remove stitches and cause the incision to open
Licking can become a severe habit that is difficult to break
Licking can cause infection as the mouth has many bacteria
Cats will frequently lick the incision when the owner is not watching such as at night time; if the skin looks red or excoriated the most common cause is from licking.
To stop your pet from licking/scrtaching the following can be tried:
Elizabethan collar can be placed on the neck; this will not help stop your pet from scratching at the region
Cervical collar (bite not collar) is a less awkward device and can be effective at stopping a pet from licking the surgical site
If the incision is over the chest an infant tee shirt can be put on your pet and the waist of the shirt fastened in place with an ace bandage or duct tape.
If the incision is over the paw or lower limb a bandage or sock could be put on and kept up with tape.
Bitter apple can be applied around the incision; many dogs will continue to lick after application of this topical
Bitter Apple and Liquid HeetTM (obtain this from a drugstore…it is used for sore muscles) mixed in a 2:1 ratio can be applied around the skin incision
Antipsychotic medication in some cases is needed