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Recognize and Manage Post-Surgical Complications in Referred Patients

Recognize and Manage Post-Surgical Complications in Referred Patients

Best Practices

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Learn how to recognize and manage common post-surgical complications in referred pets with clear steps for follow-up, treatment, and communication

By 

Sustainable Vet Group

Updated on

April 22, 2025

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Why Referring Vets Play a Key Role in Post-Surgical Care

Referring veterinarians are vital to a pet’s smooth recovery after surgery. Once a specialist completes the procedure, it's often the referring vet who continues the day-to-day care. This includes managing medications, monitoring healing, and addressing owner concerns.

Common referrals include orthopedic surgeries like TPLO, soft tissue operations such as mass removals, or emergency procedures like splenectomies. In all these cases, the follow-up care matters just as much as the surgery itself.

Pet owners often return to their local vet first if they notice swelling, limping, or discharge. They expect clear instructions, reassurance, and timely updates. When referring vets stay closely involved, it builds trust and helps detect problems early. Good communication between the surgical team and primary vet ensures the pet receives seamless care from start to finish.

Most Common Post-Surgical Complications in Referred Cases

Referred patients may return with a range of complications after surgery. Recognizing these issues early helps prevent long-term problems and improves outcomes. The most common post-op complications include:

  • Surgical Site Infections (SSI): Redness, swelling, discharge, or odor around the incision. These may need antibiotics or culture-based treatment.
  • Seroma or Hematoma: Soft swelling under the skin, often near the incision. Seromas are usually harmless, but large ones may require drainage.
  • Wound Dehiscence: The surgical site reopens partially or completely. This may be due to poor healing, infection, or licking.
  • Post-op Bleeding or Bruising: Mild bruising is expected, but ongoing bleeding or large hematomas need attention.
  • Persistent Pain or Lameness: Ongoing discomfort beyond the expected recovery period can signal internal complications or implant issues.
  • Behavioral Changes: Hiding, aggression, vocalizing, or reluctance to move may reflect pain or anxiety.

Referring vets are often the first to see these signs. A thorough recheck, gentle handling, and clear documentation help guide decisions on whether to treat locally or consult the surgeon.

Clinical Signs to Watch for in Referred Patients

After surgery, referred patients may show signs that indicate healing problems, infection, or pain. Referring veterinarians should monitor both local and systemic signs closely during follow-up visits and owner calls.

Local signs near the incision:

  • Redness or warmth: May indicate early infection or inflammation.
  • Swelling or firm lumps: Could be a seroma, hematoma, or infection.
  • Discharge: Clear fluid may be normal early on, but yellow, green, or bloody discharge suggests infection.
  • Excessive licking or chewing: Increases the risk of wound dehiscence and delayed healing.

Systemic signs to monitor:

  • Fever: Suggests infection or internal inflammation.
  • Lethargy or weakness: Can signal pain, anemia, or more serious systemic issues.
  • Vomiting or diarrhea: May be medication-related or signs of surgical complications.
  • Inappetence: Often overlooked but can be an early warning sign, especially when paired with other symptoms.

Pain indicators include:

  • Limping or stiffness: May reflect post-op pain, implant issues, or delayed healing.
  • Whining, panting, or restlessness: Often seen in dogs with moderate to severe pain.
  • Guarding behavior: The pet resists touch or avoids movement, especially near the surgical site.

When to refer back or escalate care:

If multiple signs are present, especially systemic symptoms combined with local changes, the patient should be re-evaluated urgently. Early detection of complications allows for quicker treatment, reduces long-term effects, and improves surgical outcomes. Communication with the surgical team is key if concerns arise.

Initial Management Strategies for Identified Complications

When post-surgical complications are identified in referred patients, timely and appropriate initial care can make a significant difference. The first step is addressing visible issues like wound concerns and discomfort.

  • Local wound care includes gentle cleaning with antiseptic solutions, applying a protective barrier if needed, and using an Elizabethan collar to prevent licking or trauma. If swelling, discharge, or dehiscence is present, the wound may need light bandaging and regular monitoring.
  • Antibiotics may need to be adjusted based on the suspected pathogen or culture results. In mild cases, extending the original course is enough. For moderate signs, a new antibiotic may be started. NSAIDs can help manage inflammation and pain but should be used with caution in pets that are anorexic or showing signs of systemic illness.
  • Systemic support like fluid therapy, antiemetics, and appetite stimulants may be necessary for pets with fever, vomiting, or lethargy. Monitoring hydration and organ function becomes essential at this stage.
  • Knowing when to refer back is critical. If there’s deep infection, implant exposure, worsening systemic signs, or non-healing wounds, surgical re-evaluation is often required. Prompt communication with the surgical team helps coordinate the best next steps for the pet.

Working Closely With the Referral Surgeon or Team

Good communication between the referring vet and surgical team ensures the patient gets the best care during recovery. It also builds trust with pet owners and avoids confusion when complications arise.

What to review in the surgical report

The surgical report is your roadmap to managing recovery. Always review the following:

  • Procedure details – Understand exactly what was done, including approach, implants used, and any intraoperative findings.
  • Post-op instructions – Note medication protocols, bandage changes, exercise limits, and diet recommendations.
  • Expected recovery timeline – Helps you track if healing is on schedule.
  • Risks and warnings – Be aware of specific complications tied to the procedure.

If anything in the report is unclear, contact the surgical team early. A solid understanding of the surgery helps you confidently guide the client and detect issues quickly.

How and when to update the surgical team

Keeping the surgeon in the loop is key when recovery doesn’t go as planned. Update the surgical team when:

  • Unexpected signs appear, such as fever, discharge, or delayed wound healing
  • Post-op medications need adjusting, especially antibiotics or pain control
  • You’re considering further diagnostics, like radiographs or bloodwork
  • The client expresses concern or confusion about progress

Use email for non-urgent updates and phone calls for pressing issues. Photos of wounds or videos of gait can help the surgeon assess remotely. Document your updates clearly, and let owners know you’re working closely with the surgeon—it reassures them and strengthens the care plan.

Handling unclear cases or deviations from expected recovery

Sometimes recovery doesn’t go by the book. When signs are vague—like mild lameness, subtle swelling, or mood changes—it’s hard to know if it’s normal healing or early complication. In these cases:

  • Compare with the expected timeline from the surgical report
  • Repeat physical exams, checking for heat, joint stability, or discomfort
  • Monitor trends, not just single visits (e.g., is swelling worsening?)
  • Speak with the surgeon for insights—subtle signs may still need action

Avoid assuming everything is “normal” without evidence. If something feels off, it likely is. Prompt communication can prevent small issues from becoming serious ones.

Tips for smooth co-management between clinics

Working as a team with the surgical practice makes recovery safer and more efficient. Here’s how to streamline collaboration:

  • Agree on roles early—who handles rechecks, medications, rehab?
  • Share records quickly, including lab results and photos
  • Be clear with the client about who to contact and when
  • Keep language consistent—this avoids owner confusion

If the pet’s condition worsens or doesn’t improve, don’t hesitate to refer back. Clients appreciate when both clinics work together. Smooth co-management means fewer delays, better outcomes, and stronger professional relationships.

Educating the Pet Owner After Referral

Client education plays a vital role in post-surgical recovery. When owners understand what to do—and what to watch for—they’re more likely to follow through and catch problems early. Clear, consistent guidance helps prevent confusion and supports better outcomes.

Clarify post-op instructions (activity, meds, wound care)

After a referral, owners may feel overwhelmed with instructions. Your job is to simplify and reinforce what matters most:

  • Activity: Explain limits clearly—no stairs, jumping, or off-leash time unless approved.
  • Medications: Review names, doses, and timing. Use charts or handouts if needed.
  • Wound care: Show how the incision should look and what signs to report.

Ask them to repeat key points back to you. This ensures they truly understand. Written summaries help them stay on track once they’re home.

Set expectations: healing timelines, warning signs

Setting realistic expectations helps owners stay calm and committed during recovery. Let them know:

  • How long healing will take—from initial swelling to full function
  • What’s normal—like mild bruising or temporary appetite changes
  • What’s not normal—fever, pus, worsening lameness, or foul odor

Explain that recovery is gradual, not overnight. Use timelines (e.g., “you should see steady improvement by week 2”) and encourage regular updates. Managing expectations early prevents panic and builds trust if setbacks occur.

Empowering owners to observe and report early

Pet owners are your eyes at home. Teach them how to observe subtle changes that may signal a complication:

  • Behavior: hiding, restlessness, aggression, or crying
  • Movement: limping, stiffness, reluctance to walk
  • Incision: redness, swelling, discharge, or licking

Encourage daily checks and suggest using a log or photos to track changes. Make it easy for them to contact your clinic with updates—email or text can be helpful. Reinforce that reporting early is not overreacting; it’s being proactive. When owners feel confident and included, recovery tends to go smoother for everyone involved.

Supportive Measures to Improve Outcomes

Alongside surgery and follow-up care, supportive measures at home play a key role in healing. These small details can prevent complications and reduce stress for both the pet and the owner.

E-collar or recovery suit compliance

Preventing licking or chewing at the incision site is critical. E-collars or recovery suits protect the wound, reduce infection risk, and help avoid wound dehiscence.

  • E-collars: Ensure the collar is long enough to prevent reaching the surgical site.
  • Recovery suits: Often more comfortable, especially for anxious pets or those in crates.
  • Owner support: Explain why it’s essential and when it's safe to remove.

Recheck fit and comfort at follow-up visits. Stress the importance of full-time use unless directly supervised. Even brief licking can set healing back.

Environmental control: rest area, soft bedding

Controlling the pet’s home environment supports safe and smooth recovery.

  • Designate a quiet rest area away from stairs, furniture, or other pets.
  • Use soft, clean bedding to protect healing joints and skin.
  • Limit slipping by using rugs or mats on smooth floors.

Keep the area warm, well-lit, and close to where the owner spends time—this reduces anxiety. Remind clients to avoid carrying pets unnecessarily, especially after orthopedic procedures, and instead use ramps or support harnesses when needed.

Gradual reintroduction to activity

Reintroducing movement too soon can cause setbacks. Instead, follow a controlled plan:

  • Week-by-week goals: Start with leash walks and slowly increase time and distance.
  • Avoid off-leash time until cleared by the vet or surgeon.
  • Supervise all activity, including bathroom breaks.

Teach owners to watch for soreness or stiffness after each new level of activity. If the pet regresses, reduce exercise and inform the vet. A structured return to activity helps build strength without stressing healing tissues.

Use of calming aids or pain management plans

Pain and anxiety can both interfere with healing. Addressing both improves comfort and compliance.

  • Pain control: Use prescribed NSAIDs, gabapentin, or other meds consistently—not just when the pet seems uncomfortable.
  • Calming aids: Products like pheromone diffusers, supplements, or anxiety wraps can help reduce restlessness.
  • Routine and predictability: Feed, medicate, and exercise at the same times daily.

Owners should understand that signs of pain—like panting, pacing, or aggression—shouldn’t be ignored. Encourage open communication if pain or stress seems unmanageable. A calm, pain-free pet is more likely to heal well and avoid complications.

Documentation and Case Responsibility

Accurate, detailed documentation is essential in managing referred surgical cases. It ensures continuity of care, supports legal protection, and helps all veterinary teams stay on the same page.

Importance of clear recordkeeping on findings and treatment

In follow-up care, documentation should be detailed and timely. Include:

  • Daily findings: incision appearance, pain scores, activity level
  • Owner-reported signs: appetite, behavior, concerns
  • Medications given: doses, changes, response to treatment

This record creates a clear timeline and makes it easier to detect early changes. It also helps the surgical team assess whether progress is within the expected range. Proper notes protect both the pet and the clinic in case complications arise later.

When to document shared decision-making

When treatment choices involve multiple options—such as managing a complication locally or referring back—document any shared decisions.

  • Note the discussion: what was offered, risks explained, and client’s preference
  • Confirm understanding: that the owner accepted or declined options with full information
  • Include communication with the surgeon if a joint decision was made

This builds trust and avoids miscommunication. It also protects the referring vet from liability by showing that decisions were made thoughtfully and collaboratively.

Legal clarity on care limits and consent in referred cases

In referred cases, always clarify:

  • What care is your responsibility (e.g., wound care, pain control)
  • What falls under the surgeon’s role (e.g., implant failure, revision surgery)
  • What consent was given—and for which procedures

Get written confirmation when possible. Avoid performing any procedure outside your scope without checking with the surgeon or gaining specific consent from the owner. This keeps care consistent and legally safe while maintaining a strong working relationship between clinics.

FAQs

What are the most common complications seen after surgery in referred patients?

Common complications include surgical site infections, seromas or hematomas, wound dehiscence, post-op bleeding, and persistent pain or lameness. Behavioral changes like hiding or aggression can also signal discomfort. Early detection through careful monitoring helps avoid escalation and improves recovery outcomes. GP vets play a key role in spotting these issues during follow-up care.

How can I tell if a post-surgical complication needs referral back to the surgeon?

Refer back if there’s deep infection, implant exposure, non-healing wounds, or worsening systemic signs like fever or severe pain. If the complication is beyond local wound care or doesn’t respond to initial treatment, consult the surgical team. Timely referral prevents delays in advanced care and keeps outcomes favorable.

What should I do if a referred patient develops a wound infection?

Start with local wound care and assess the need for systemic antibiotics. Review the surgical report and ensure medication compatibility. If the infection is severe, spreading, or not improving within a few days, refer back to the surgeon. Document findings and communicate early with both the client and the surgical team.

How involved should I be as a GP vet in managing post-op issues from a referral surgery?

As the GP vet, you're essential in follow-up care—managing meds, monitoring healing, and guiding owners. Handle mild to moderate issues, but keep the surgeon updated on progress. Work within your comfort zone, and refer back when complications exceed your clinic’s scope or the owner’s expectations.

What key signs should pet owners watch for after surgical discharge?

Owners should monitor for redness, swelling, discharge, excessive licking, limping, changes in appetite, or signs of pain like whining or hiding. Fever, vomiting, or wound reopening are red flags. Teach them to report concerns early and provide written guidelines so they know when to seek help.

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