Returning to Sport Post-Abdominal Surgery Series

​For as long as anyone remembers veterinarians have said a dog post-op spay or abdominal surgery can return to normal activity in 10-14 days. But what is normal activity - walks, jumping on furniture, wrestling with dog friends, jogging, fetch, running at top speed on an agility course with tight turns, running a fast line with jumps and a rebound in fly ball, pushing off a dock at high speed and landing in water with their back hyperextended as they reach for a toy in dock diving? It’s extremely important to understand WHAT a dog’s activity is when the phrase ‘they can return to normal activity’ is spoken post surgically.

Photo Credit Great Dane Images

​Over the next 12 weeks I will create a blog series that incorporates weekly progress updates of my 4-year-old mini schnauzer Rainey, as she recovers from the worst kind of spay procedure - an emergency spay due to pyometra, a life threatening uterine infection. To make this series more than your average fitness story I will also include how recovering from an abdominal surgery fits into the spectrum of Traditional Chinese Veterinary Medicine (TCVM). TCVM looks at the whole patient, and as such it contains 5 Branches - acupuncture, Tui-na massage, nutrition or Food Therapy, herbal medications, and physical activity. 

Photo Credit Great Dane Images

​To begin this series, we must understand what Rainey’s normal activity was. Rainey is an athletic mini schnauzer who is very active in agility and scent work. Rainey attends agility class one evening per week. In class she usually gets 4 runs. She will perform a predetermined numbered course that presents different challenges for dog and handler (that’s me). These challenges range from dog going from full extension to collection for a tight turn, technical challenges where dog must wrap their body tightly to a jump stanchion and turn back the direction she just came from, or collect herself from high speed to enter 12 weave poles where she controls her body to literally weave at speed. ​​As you can imagine, a lot ​of muscles are

needed. Then 2-3 days a week for 5 to 10 minutes she receives fitness/conditioning training where we focus on different muscle groups and proprioception, as well as continuing to build the propulsive force for driving off her back end. She also performs cardio High Intensity Interval Training (HIIT) on the land treadmill for 10 minutes 1-2 days per week. Then 2-3 weekends per month, before COVID, and 1 weekend a month or less now, we participate in agility trials. There she would run 4 to 6 runs a day for 2 to 3 days in a row. She would receive off days before and after competition. Then there’s scent work training, which only occurs 1-4 times per month. That doesn’t seem physically demanding, but it can be. Rainey is just over 12.5 inches tall. Some of her searches have her jumping on/off tables, standing on her back legs, or crawling under things. Also, the mental demand of scent work is extremely high. The dog must think, while smelling and following an odor as it fades in and out of existence, until finally they hit the cone of scent and drive to the source. We will typically perform 6 searches in a short time frame. As you can see, this little dog is very busy and on January 11th this all came to a screeching halt as Rainey was rushed to emergency surgery.

Next, to understand the reason why an abdominal surgery should allow far more time than 10-14 days for recovery we must revisit our anatomy.  The structure that is typically cut when entering the abdomen is the linea alba, which is a fibrous seam composed of the aponeuroses where the right and left abdominal oblique and transverse abdominal muscles come together.   An aponeurosis has the same consistency as a tendon (a dense, regularly arranged fibrous connective tissue that attaches muscle to bone) but instead of being organized into a small, well-defined bundle, an aponeurosis is arranged like a thin sheet of tissue.  A ligament on the other hand is a dense fibrous connective tissue that connects bones.  The linea alba extends from the xiphoid process of the sternum to the pubis, and includes the umbilicus, which is roughly at the level of the third lumbar vertebrae.  Therefore, one could argue that the linea alba mimics both the functions of a tendon and a ligament through its various boney attachments and muscle involvements, although to my knowledge this has not been formerly researched.  If we compare the healing time for a tendon, conservative activity and light weight bearing are not recommended 

Rainey's incision 2 days post-surgery

until week 6 post-operatively.  Granted, these injuries typically occur on a weight bearing limb.  When we discuss the linea alba we are not necessarily weight bearing, but we are bearing the weight of the abdomen.  And in the case of Rainey, she has a 1.75-inch incision in her 8-inch xiphoid to pubis linea alba, therefore the incision encompasses 21.8% of her total linea alba.  It’s a well-known fact that an animal and humans’ core is their driving force for speed, and a strong core aids in a strong back.  If an animal has a strong core, they will inherently have a strong back, which will aid in their overall comfort, speed, and injury prevention.  Therefore, it can be assumed that if the time and steps are not taken to secure proper healing of the linea alba the patient will suffer with a weaker core, therefore potentially weaker back, slower ground speed, and possibly increased susceptibility to injury, including iliopsoas strains.  However, to my knowledge no actual data supports this hypothesis, but my clinical studies of anatomy and physiology, as well my experiences with canine and human athletics do.  As this series unfolds, we will discuss further how the canine core supports this hypothesis and why a strong core is so important.

The final integration of this blog series will explain how TCVM fits into the picture of canine sports medicine and recovery from an abdominal surgery.  While I am focusing on Rainey’s first 2 weeks of recovery, I have been directing my energy heavily toward her diet, herbals, acupuncture, and Tui-na.  We have not been focusing on her activity, aside from preventing jumping, running, and stairs.  However, I have taken time to interact with her one-on-one and provide mental stimulation in the form of hand target games.  Next week we will dive further into the mystical world that is TCVM and why this is so important for our recovering patients.  We will also discuss the use of other modalities such as the Assisi Loop and Laser Therapy.
 
I hope you join me on this journey as I bring Rainey back to health through the use of TCVM and canine fitness!
 
Take care,
Dr. Shantel Julius, DVM, CCRP, CVA, fCoAC, CVSMT, CVFT, CVTP, CVCH, CTCVMP
 
References:
Evans, H.E., deLahunta, A. Guide to the Dissection of the Dog, 6th Edition. Saunders. 2004.
Dyce, K.M., Sack, W.O., Wensing, C.J.G.  Textbook of Veterinary Anatomy, 4th Edition. Saunders. 2010.
Millis, D., Levine, D. Canine Rehabilitation and Physical Therapy, 2nd Edition. Elsevier. 2014.