Читать книгу Small Animal Surgical Emergencies - Группа авторов - Страница 229

Postoperative care can be intensive and particular attention should be given to fluid therapy to ensure adequate hydration, the administration of appropriate pain relief, and maintaining adequate nutrition. Hypovolaemia, if still present, should be treated aggressively and may occur from continued fluid loss from the gastrointestinal tract as well as into the peritoneal cavity. Parameters that should be monitored closely include mucous membrane color and capillary refill time, PCV and total solids, acid–base balance, and urine output. A continuous electrocardiogram is useful to evaluate for the presence of arrhythmias. Blood pressure monitoring (invasive or non‐invasive) is also useful, although non‐invasive blood pressure monitoring can be challenging in the presence of arrhythmias. Placing an indwelling urinary catheter will allow measurement of urine output to help monitor perfusion status and as many of these dogs are recumbent for a period following surgery, can help to keep them comfortable. Mobilization as soon as possible after surgery should be encouraged. As long as there are no contraindications to feeding, water should be offered as soon as the dog is awake and food shortly afterwards. Intravenous fluid therapy can then be weaned gradually, over the next 48–72 hours. Because of the concern regarding compromise to the gastric mucosa, histamine‐2 receptor antagonists (famotidine), proton‐pump inhibitors (omeprazole, pantoprazole) and coating agents (sucralfate) should be considered.