Post-Operative and Post-Procedural Care

General policy

Adequate and appropriate post-operative/post-procedural care must be provided to all experimental animals used in protocols involving major and minor surgical procedures at the institution. Provision of post-operative care is the responsibility of the Principal Investigator (PI) through his or her designated personnel listed in the approved protocol. The veterinarian is responsible for monitoring post-operative care to ensure proper procedures and practices are followed to minimize pain and distress, and also to ensure that only procedures approved in the protocol are employed. Animal care staff may provide emergency veterinary care when the Attending Veterinarian or his or her designee determines that immediate intervention is needed to save the animals life or relieve pain, and neither the PI nor his or her research staff members are available or cannot be contacted within a reasonable time (determined by the nature of the veterinary emergency).

The above stated interventions by animal care staff are not intended to compromise research results; however, unless specifically described in the protocol and approved by the IACUC, unrelieved pain associated with surgical procedures will not be permitted. The same assigned responsibilities and actions also apply to potentially painful procedures in non-surgical protocols.

Procedures

After surgery is completed, large animals (e.g., rabbit, cat, dog, ferret, sheep, goat, swine, non-human primate):

  1. Should be transferred to a designated recovery room or their pens/cages and monitored continuously. A post-operative recovery sheet is to be kept with the animal throughout the entire post-operative period, defined as the time until the animal can maintain sternal recumbancy (quadrupeds) or sit upright (non-human primates). Prior to exhibiting that level of recovery, an animal should be turned from one side to its other no less frequently than every thirty minutes. Post-operative recovery forms are available at a website.
  2. Vital signs (temperature, heart rate, respiratory rate, mucous membrane (gums) color and capillary refill time) should be documented on the post-operative recovery form at least every fifteen minutes. If mucous membrane color is not pink/red or capillary refill time is longer than 3 seconds, intravenous fluids, oxygen, and stimulatory drugs may be indicated.
  3. Once the animal is deemed stable and able to swallow, the endotracheal tube (if applicable) is removed. If the animal is under the effect of an anesthetic or paralytic that suppresses the gag reflex, even greater attention may be necessary to avoid removing the endotracheal tube prematurely so aspiration of vomitus does not occur.
  4. If the animals body temperature is below 99F (35 C), the animal should be covered with a thermal retention blanket, placed on a water-circulating heating pad, and receive warmed intravenous solutions. Hot water bottles may also be used if they are not in direct contact with the animals skin and placed beside, not under, the animal.
  5. Post-procedural analgesics will be administered as stated in the approved protocol. If an animal continues to demonstrate obvious pain or discomfort, the Attending Veterinarian or his or her designee will determine if additional or different analgesic therapy is indicated, after consultation with the PI or his or her designee.
  6. The PI and Attending Veterinarian, or their designees, should be notified immediately if post-procedural complications are noted; these may include, but are not limited to, bleeding, difficulty breathing, seizures, vomiting, and the incision site dehiscence. During evenings, weekends, and holidays, a staff veterinarian may be paged by calling the switchboard and asking for the emergency after-hours veterinary beeper. In addition to the after-hours beeper, each staff veterinarian carries a personal pager whose number is also posted in each facility.
  7. Post-operative and post-procedural monitoring should continue as listed in the IACUC-approved protocol. This usually involves at least daily observation by the PI or his or her designee. However, more frequent monitoring may be required for animals deemed physiologically unstable or not fully recuperated from the procedure. Skin sutures and wound clips must be removed in a timely fashion (usually 10-14 days after surgery). All observations, procedures, and treatments must be noted in the animals individual health record (see IACUC Policy on Observation and Record Keeping).
  8. Post-operative care and monitoring of small animals should be performed as stated in the approved protocol.