Welcome to Tripawds,

You are awesome to foster Maximus.  You should always call your vet with any concerns- that is what they are there for.

I hope you don't mind that I moved your post to Ask a Vet-  since so much of your post was about vet questions.

In my experience dogs need pain meds after a major surgery, it sounds 'old school' to me for a vet to say they don't need anything.  And while some dogs experience some side effects that is a necessary evil.  And there are more choices than tramadol.  Maggie was sent home after surgery with a fentanyl patch and tramadol.  Pain meds can cause constipation and for the dog to not be himself (again my experiences) but as I said there are several choices.  And dogs react differently- Maggie did not do well on tramadol, but my quad pug Obie had a sever eye injury and was on tramadol for two weeks.  He had no side effects and did not have any withdrawal symptoms.

I did not have drainage issues with Maggie's amp- but many here have experience- again call your vet if you are concerned.

An elevated temp can be a sign of infection- the guidance from my vet was to call them if Mag had an elevated temp.

Karen and the pugapalooza

hi just wanted to come back and update.  We have had a very very long day, but it has a good ending. *big relieved sigh* I'm tired! lol Today Max had his fourth surgery in the last 16 days.

This morning Max didn't seem well when I got up. He literally hadn't moved all night and there was significantly more blood that had soaked through his bandage. He had drunk no water despite all the pee in his blankets and wouldn't sit up or barely lift his head to drink more or eat. I took the bandage off as instructed and of course it started bleeding heavily because of the slight movement that required.  I didn't even roll him or anything to get the underside of the bandage  off, just cut the top piece and removed it very carefully so I didn't  pull on any stuck parts. There was a section of skin about 2 inches long and half inch wide that was black, not bruised. I've seen dead skin before and really had no doubts about it. It smelled bad. There was the section that was bleeding and looked to have loose stitches and the black section was oozing what looked like blood mixed with pus. I paged the vet when I couldn't get the bleeding to stop.  On the phone either I didn't give a good enough enough description of what was going on or he just figured I was over reacting or exaggerating. Made me mad but also made me second guess myself. "maybe I am overreacting". When I described it, he said to wait till my appointment monday. Said it didn't sound great but wasn't an emergency.  I asked him what I should watch for that would show it was taking a turn for the worse and I should rush him in and he said oh you shouldn't need to rush him in, I'll see you monday. I was actually pretty mad. I did almost all the things he suggested for the bleeding, cold pack, pressure. He suggested I give him one of the sedatives to lower the blood pressure to slow the bleeding that way and keep him still. He was already still tho. Too still, and his gums were pale. I really didn't think lower blood flow and sedation would be a good thing.

I called my shelter director and she was much more concerned which was reassuring in a way and her advice was the only thing that got the bleeding to stop! I caked it with flour. I know sounds messed up but it worked.   I'm adding a baggie of flour to my first aid kit now. She made a bunch of calls and got me in at a different vet that we work with. Then while I was on my way there, she was finally able to get a hold of the original vet and she must have told him "this girl doesn't exaggerate, this is bad" cuz he came straight in and I drove Max straight over to him after the first vet did a quick blood test to make sure he wasn't bleeding out. Red blood cells were low, but not "OMG he's dying low" thankfully. Once the 2nd vet of the day, the one who has done all the surgeries, saw how it looked he definitely realized I wasn't messing around.

He opened up the incision to see what was going on and causing thebleeding. Turned out two big pockets of blood, fluid and blood clots had started to get infected and the patch of skin I was concerned about on the surface was dead like I thought. The bleeding was coming from the biggest infected pocket through a couple stitches that pulled loose.  He totally opened it all up, cleaned it all out and trimmed away the dead area. He put in two drains/shunts, one for each pocket to try and prevent this from happening again. He stitched him back up with stainless steel sutures instead of fiber ones so there is that much less increased risk of infection. The vet took him home for the weekend so he could keep a close watch on him and flush the shunts frequently. I stayed to watch the surgery, fascinating stuff. I was very interested and I also just wanted to have all the details for once and leave knowing exactly what was going on with him. It's frustrating being the foster mom sometimes.  The first few operations the vet would call my director instead of me (logically) but then I'd get it second hand from her and she never seems to ask all the questions I want answered.  She's used this vet a lot so she just trusts him and doesn't stress over the details much.  Me, I'm a worry wort momma!  lol  But the vet seems to have figured out that I'm going to be the one pestering him so he better give me the details.  hehe   So to sum it up prognosis is still very good. Max definitely seems to be prone to infection and we really need his immune system to kick in and help the antibiotics fight things off to get him healed. We caught this infection early though and got the dead skin off before it could get any worse. Things would have been very bad if I'd waited till monday. Thank God for that intuition/6th sense He gives us when something is wrong! Thank you all so much for your prayers and support. Anyways, all in all, a good outcome for what started off as a terrifying day. I really was afraid he was going to die before I made it to the clinic.  I'm not usually a cryer but I was fighting back the tears all day.  I lost my princess, a border collie huskey mix named Whisper, in October and it's all way too fresh still to spend the whole morning and early afternoon thinking I'm going to watch another one die.  Whisper's death was very unexpected.  She had a massive tumor in her abdomen pressing on her spine, intestines and multiple other organs.  She was only 9.  Ok, I'm getting off topic and weepy!  Thank you all again and goodnight.