@Drache613
Just bought him home he’s not quite back to his usual self but he is lifting his head and looking at stuff but I am expecting him to be pretty sleepy and inactive for a time.
Here is a transcript of the post-op care the specialist has given me and also attached to this reply are some photos of him back home and some photos of the formula I’ve been given to make for him.
“
Discharge instructions for Spike
Spike underwent a general anaesthetic for surgical excision of a submandibular and intraoral chromatophoroma at Small Animal Special Hospital with the Exotics and Surgery departments. Overall the surgery went well with successful excision of the mass. However, due to invasion of the tumour into the oesophagus, in order to excise the mass, the oesophagus was cut into and as such did require a reconstruction. Additionally, Spike also had an esophageal feeding tube placed. This tube feeds directly into the stomach, bypassing the need to feed via the oral cavity, thus reducing the risk of post-surgical healing complications associated with the ceseophageal surgical reconstruction.
Spike has recovered well from the anaesthetic, and as such is being discharged today to continue with his post operative recovery at home. The following medications have been dispensed for Spike Please
READ THE LABEL CAREFULLY and ensure that all medication is administered as instructed. If you are experiencing any difficulty in dosing him please contact us for advice.
Medications:
05-09-2023
Meloxicam Pain relief
0.5mg/ml
Please give 0.22 ml via stomach tube once every second day until recheck (next dose due 7/9/2023 evening)
05-09-2023
Tramadol 100Mg/MI Pain relief
Drops
Please give 0.06 ml via stomach tube once every second day until recheck (next dose due 8/9/2023 morning)
05-09-2023
Ceftazidime 100Mg/MI
Antibiotic Injection
Please give one 0.11 ml injection into muscle of forelimb once every
third day until finished. Next dose 8/9/2023 evening. Keep frozen until use.
As discussed due to the nature of the tumour and the surgery, post operative complications may develop. These may include:
— break down of the oesophageal reconstruction. If this occurs, it will need to be assessed by SASH Surgery and Exotics. Pending reassesment, reconstruction may be required vs allowing it to heal by itself. May require reconstruction vs healing via secondary intention
- Bleeding - although this is less likely, it is possible that with aggressive head motions, it may cause damage to the large vessels of that were closely associated with tumour. If this occurs, please strong pressure into the bottom right of the oral cavity using a gauze swab and seek veterinary attention immediately
- Infection of the esophageal feeding tube entry site
- Regrowth of the tumour - due to local invasion of the tumour into the oeseophagus, in addition to the highly malignant nature of the tumour, recurrence remains a high possibility.
Diet:
Following Is oral surgery, including an esophageal repair, he is not allowed to have any sollid foods for at least the next month, pending his healing/recovery and veterinary reassessment. He will need to be fed exclusively through his esophageal tube for this period.
Make sure to flush the tube with 1-2 ml of water before and after each feed.
Initially he will require 3 ml of formula once a day until his first defecation. After that, this volume is then increased to 6 ml of formula once a day until his next. Following this, he will require 11 ml of formula once a day ongoing.
Formula Recipe: 1 small scoop of Omnivore + 1 small scoop of Carnivore + 14 ml of warm/hot water (50 degrees celcius). Mix well.
Disgard any unused formula. Make fresh each time
Additionally, approximately 2-3 times daily, gently drip 1 mI of water into the mouth to keep the oral cavity moist.
Oesophageal Tube Care:
Each day insect the entry of the tube site in the skin for anabnormalities such as discharge, change in colour, or a foul odour. If any of these symptoms are noted, please contact us as soon as possible.
Each day after feeding, clean the area around the entry site with the provided antiseptic scrub using gauze swabs; wait 10 mins then clean the area with plain saline using gauze swabs. Try keep the entire tube as clean as posisble make surethat food and debris do not build up on the stube, especially around the area that is next to the body wall.
Housing:
Ensure Spike is housed with an appropriate thermal gradient. They should have access to a basking area with a temperature appropriate for a bearded dragon and a cooler area. Heating must be provided at all times.
Wound care:
Remove all sand, straw, sawdust and dirt substrates. Newspaper and paper towel are best used and changed daily. Avoid
bathing and ensure all large water bowls have been removed. Please monitor the wound for redness, swelling and discharge. If any occur, please contact the hospital for advice. Sutures are designed to be removed in 6-8 weeks, but they can fall out earlier if he sheds.
He will be due for a recheck with your regular vet in 1 weeks' time, and then a recheck with SASH Exotics and Surgery departments in 2 weeks time. However, if there are any complications or concerns prior to then, he will need to be reassessed earlier.
Please feel free to contact us if you have any further questions or are worried in any way about his recovery.”
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