Feeding a low-residue diet can reduce the quantity or frequency of passing faeces , which can improve hygiene and reduce stress for the patient . Further to this , a gastrointestinal or hypoallergenic diet can also help to reduce the risk of diarrhoea in these cases .
Nutrition
Adequate nutrition may require nursing intervention , due to the possibility of oesophageal and pharyngeal dysfunction in these patients . They may need assistance to feed , such as propping the head above the level of the stomach , hand-feeding and feeding small balls of wet food . Syringe-feeding is not recommended , due to the increased risk of aspiration pneumonia and food aversion ; feeding tubes would be more appropriate . Once the patient is ambulatory , providing elevated bowls for both food and water is helpful for these patients , including smaller dogs . Maintaining intravenous fluid therapy would be appropriate until the patient is consistently eating and drinking its full recommended nutritional and fluid intake . Fluid and nutritional requirements should be calculated and weight monitored daily [ 11 ] .
Regurgitation and subsequent aspiration pneumonia can occur in these patients [ 2 ] . Signs of regurgitation and aspiration in these patients can be subtle , including repeated swallowing , drooling and coughing after eating . If a patient is seen to be regurgitating frequently , it should be starved for 6 – 8 hours before trying a small meal . Megaoesophagus may also develop , and these patients would require positional feeding of balls of food from a height . A naso-oesophageal feeding tube can be used to remove the contents of the oesophagus every 2 – 6 hours to reduce the risk of aspiration .
Additional information relating to nutrition can be found in the article on perioperative patient nutrition , from page 38 .
Figure 7 . Using a Kong toy outside for mental stimulation .
Conclusions
Overall , the prognosis of recovery to the point of unassisted ambulation for these patients is good [ 13 , 14 ] , but the recovery process can be long in some cases . Postoperative ventral slot patients can be some of the most challenging but rewarding cases for VNs . A thorough understanding of the potential complications , treatment options and appropriate interventions will help the veterinary nursing team to successfully support these cases throughout their recovery .
REFERENCES
Mental stimulation
The mental status of these patients can deteriorate during hospitalisation , due to boredom , depression and stress . Where possible , patients should be offered increased interaction with the team and taken to different environments , such as outside , different rooms in the practice and the reception area [ 11 ] . Patients should also be monitored for stereotypic behaviours such as over-grooming and self-mutilation , which can be signs of boredom , stress , sensation deficits and pain [ 3 ] . If the patient is able to move at all and it is safe to do so , it should be offered puzzle feeders , lick mats and toys to provide mental stimulation ( Figure 7 ).
1 Steele AM . Mechanical ventilation . In : Battaglia AM , Steele AM . ( eds .) Small Animal Emergency and Critical Care for Veterinary Technicians . St . Louis : Elsevier ; 2021 . p . 100 – 106 .
2 Drum M , Werbe B , McLucas K , Millis D . Nursing care of the rehabilitation patient . In : Millis DL , Levine D . ( eds .) Canine Rehabilitation and Physical Therapy . 2nd ed . St . Louis : Elsevier ; 2014 . p . 277 – 304 .
3 Thomas WB , Olby N , Sharon L . Neurologic conditions and physical rehabilitation of the neurologic patient . In : Millis DL , Levine D . ( eds .) Canine Rehabilitation and Physical Therapy . 2nd ed . St . Louis : Elsevier ; 2014 . p . 609 – 627 .
4 Platt P , Freeman AC . Neck and back pain . In : Platt SR , Olby NJ . ( eds .) BSAVA Manual of Canine and Feline Neurology . 4th ed . Gloucester : British Small Animal Veterinary Association ; 2019 . p . 252 – 270 .
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