Monday, October 24, 2011

705. Post-op discharge 3 days after a breast tumour surgery

Yesterday, Oct 24, 2011, the lady owner brought her dog back as there was a "leakage" of reddish-brown fluid from the surgical wound. She had asked for advice over the phone but I told her that it would be hard to know what was happening. However the dog was eating.



"It is not possible for the dog to lick her wound," the lady said since her dog was wearing an E-collar post-operation. "I don't see my dog licking the wound when I am with her."

"I have seen cases where it has been done," I did now want to argue as most owners seem to think that the dog would lick the surgical wound in their presence. If not, then, the dog had not done it. Unless the e-collar is of a size so big, the dog can still lick its surgical wounds partly.

One of the stitches had a gap and post-op blood had leaked out. It was not serious. So, I hospitalised the dog for 3 days as she was walking at home. "Not much walking as she always lay down," the owner said.

"Any walking other than crate confinement will put tension on this long surgical wound," I said. "This is not a small 2-cm wound but more than 20-cm long. Good communication with the owner is important but sometimes it can test a vet's patience.

TIPS
In this case, I had not performed the surgery. However, I had discussed in my previous article that the "walk-in" sutures and horizontal mattress sutures on the skin would have given a tighter fit to control bleeding and prevent "leaking" of plasma. As each vet has his or her own skill and style in stitching up, it is difficult to say whether the subcutaneous stitching of the tissue and then simple interrupted skin sutures did permit "leakage" as there are many factors involved in a post-operation bleeding. In this case, the whole lower part of the dog's body was wet with the reddish brown plasma and blood. I asked Min to bathe the dog as her front leg skin and elbows had yellow flakes and this has nothing to do with the surgery. The dog had not been groomed.

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