Dog Stitches After Care
Types of Stitches Used in Dogs
Whether your dog was just spayed or had a recent laceration repair, he will be sent home with an incision closed with stitches or staples. Your vet may have provided you with a discharge paper instructing you on proper dog stitches after care, but you may want to learn more about everything so you can readily recognize signs of trouble and take the best care of your dog. Often, you aren't even given the opportunity to talk with your vet after the surgery as they may have limited time on hand or another dog to take care of promptly. The veterinary technician may have provided you with some basic guidelines, but you may have many questions unanswered. The questions likely aren't that important that you feel they warrant a call to your vet, but still, they leave you wondering.
One question you may have is what types of stitches did your dog get? Interestingly, there are different ways to close an incision in dogs. One of the most common ways to close the edges of tissue together is through sutures, commonly referred to as stitches. Just as you stitch together pieces of cloth, the dog's skin can be sutured together with needles and thread. The thread is usually made of synthetic material.
Nowadays, stitches can be absorbable or non-absorbable. In the case of absorbable stitches, the dog's body will naturally break down and absorb the suture material over time. Depending on the material, absorption time frames vary. The stitches last long enough to promote healing of the tissue. Absorbable stitches are commonly used to close up the dog's muscle and subcutaneous layers and organs, like the intestine. An advantage of these stitches is that your dog will be less likely to remove them by licking or scratching. Your dog likely got absorbable stitches if your vet told you that you don't need to come back to have them removed. However, if you are in doubt, it's good to give your vet a call to double check. In some cases, the dog's body may reject the stitches rather than absorb them, triggering inflammation.
Non-absorbable stitches, as the name implies, aren't absorbed by the dog's body and therefore will need to be removed. These strong stitches are often made of nylon, steel, or synthetic materials. If your dog has non-absorbable stitches, most likely your vet told you to come back in about 10 to 14 days to have them removed. Generally, less scarring takes place with non-absorbable stitches since the immune system is less involved.
An alternative to stitches are surgical staples. Stapling a wound is much faster than suturing manually with thread and needle and it's also more accurate. As the name implies, a stapler is used to close wounds using metal staples. Staples are often used to close an incision of the skin, but can also be used to close an incision of the intestine or stomach. As with non-absorbable stitches, staples will need to be removed as they don't dissolve. Staples are removed generally 10 to 14 days later using a specialized staple remover. However, at least in human medicine, now even synthetic absorbable staples are becoming available.
In some cases, your vet may use surgical adhesives to close the wound, however these have their limitations. For instance, they cannot be used near the eyes and are not suitable for oozing, contaminated wounds. Also, incisions closed with adhesives are more prone to opening up when compared to stitches. Generally, adhesives are used to close very small incisions. The surgical glue is gradually removed by the body after some time.
Depending on the type of incision, the stitches may be used to close just skin or several layers of tissue. For instance, in a simple laceration involving just a superficial skin tear, the edges of the skin are stitched together, but in the case of a surgery, the vet may need to stitch up muscles, the subcutaneous layer made of fat and connective tissue, and then finally skin, meaning there will be several rows of sutures in a single incision site. When a large mass is removed, not much tissue may remain to close to incision. In this case, there may be lots of tension which can ultimately cause the incision to open up despite being stitched. To prevent this, your vet may use a special tension-relieving pattern to stitch up the area or may invest in a skin suture, also known as a 'stent suture' according to VCA Animal Hospitals.
Dog Stitches After Care
Whether your dog got absorbable or non-absorbable stitches or staples, you will need to take good care of the area as it heals. Generally, according to Pet Education, within 7 to 10 days the dog's incision area is capable to withstand tension and stretching. The moment the injury takes place, the immune system activates the white blood cells which mobilize to the incision site. The skin will redden, bruise and swell, but over time, scar tissue will form. Veterinarian Dawn Ruben claims that permanent scars tend to develop about 14 to 21 days later.
Did you know? You may think the an incision heals from one end to another, when in reality it heals side-to-side. This means that a 3 inch incision will relatively heal at the same rate as a half inch incision. Following are some things to watch for that may impair healing.
- Avoid Licking
Your vet sent you home with an Elizabethan collar (also, known as the "cone" or more humorously "the collar of shame") for a good reason: to help protect the area from excessive licking. Excessive licking may cause your dog to pull out the stitches or even cause an infection. It's a myth hard to debunk that licking wounds helps dogs heal! To the contrary, licking may cause bacteria to enter the site. Depending on the location and type of incision, you can ask your vet about using a bandage to keep your dog from licking the area. If the incision is near the abdomen or shoulder area, you can try to discourage licking by letting your dog wear a t-shirt. Simply, have your dog's head and front legs go through the head and armholes of the shirt, explain Pet Place Veterinarians. If the problem area is the foot, you can ask your vet about placing a sock on the area. Of course, avoid doing so if you own a dog who would eat the sock or shirt and risk an intestinal obstruction!
- Avoid Scratching
Licking can cause damage but also can scratching. As the wound heals and the fur starts growing back, the area starts getting itchy The Elizabethan collar may not be helpful in this case, as it prevents licking, but won't do much for scratching. Monitor your dog closely for scratching, and if possible, find a way to discourage scratching by using a command such as "leave it" or a positive interrupter. Crating your dog when you are not around may be helpful if it's snug enough to discourage scratching. Depending on where the incision is, letting your dog wear a t-shirt may help discourage scratching. This can be good for incisions on the abdomen and shoulders. Ask your vet if this is a good option for your dog as some vets prefer the wound to air. Remember that dogs are capable of scratching their front legs with their back legs, so if your dog has an incision to the back of his front legs, he may cause significant damage by scratching!
- Limit Activity
Yes, those staples and stitches are strong, but if your dog moves in a way that puts tension and stretches the area excessively, this may impair healing and there are also risks that the sutures may come out and/or the incision may start bleeding. This is why your vet told you to restrict activity as the incision heals. So best to take your dog out on potty breaks always on the leash and discourage running around and jumping especially during the first days. Jumping up and down may cause swelling and pain. Also, avoid long walks and rough-housing with other dogs. Depending on the incision, your vet may recommend restricted activity for anywhere between 7 and 14 days or even longer. In some cases, your vet may recommend cage rest or keeping your dog in a small room.
- Keep the Area Dry
You may feel compelled to give a bath to your dog, but you may want to hold it off if your dog has an incision that has to heal up. This also means preventing your dog's incision from getting wet in the rain. Also, you should avoid applying any creams, ointments or disinfectants unless your vet told you to do so. In particular, never use hydrogen peroxide or alcohol-based products as these will impair healing since these products damage the cells recommends VCA animal hospital.
- Know What is Normal
Your dog doesn't have to deal with an incision every day, so it's normal to not know what a normal incision must look like. You ideally want to see an incision that is clean with the edges touching. It's normal for the skin to appear reddish/pink in color and it's normal for the color to intensify during the first days as the area heals. It's also normal to notice some bruising along the edges in pale skinned dogs as the area heals. According to veterinarian Dawn Ruben, it's normal for the incision to swell, bruise and become red the first days after surgery. The redness and swelling is caused by an accumulation of fluid and blood cells and should gradually reduce though as the days go by.
And what about discharge? A small amount of clear or blood-tinged discharge can be seen seeping intermittently in the first 24/72 hours. According to Pet Place veterinarians, such discharge is visible when a dry paper towel is applied to the incision. According to Assisi Animal Health, its' normal for a little blood mixed with plasma (a clear, yellowish fluid) to leak from the wound site. Normally, the discharge should have a light yellow tint (serous) or a pink tint (serosanginous) and it shouldn't have any odor.
- Monitor for Complications
It's a good practice to observe the incision at least twice a day. Taking pictures every day in the same light will help you monitor better. Know how many stitches or staples your dog has so you can keep track of them. A big threat to an incision is an infection. The infection prolongs healing time and the pus may put extra tension on the stitches making them more prone to come out. This is why your vet may prescribe antibiotics to prevent this complication especially if the area was already infected or you are dealing with a wound particularly prone to infection such as an animal bite.
Do your best to keep the area as clean and dry as possible. The most serious complication of an incision is protruding tissue. Stitches are meant to keep the dog's underlying tissues in place, and when the stitches come out, there's risk that the tissues protrude out which can trigger a serious and even potentially fatal infection. The following are signs that an infection or other complication may be brewing.
- Excessive swelling of the area
- Excessive redness
- Blood seeping for over 24 hours.
- Drainage dripping from the incision
- Foul odor
- A wide gap over ¼ inch
- Missing sutures with redness/swelling and discharge
- Edges of skin no longer together
- Protruding tissue (this is is medical emergency)
- A dog that is listless and not eating
At times, dogs may develop a seroma at the incision site. When small blood vessels are ruptured, a seroma, an accumulation of serum that develops as a pocket of tissue where there is extra space during the healing process, forms. The majority of these non-painful growths reabsorb on their own with time and the swelling will decrease. This collection of serum may occur because of excess "dead space" but the inflammation is also often seen in animals that were too active during the recovery process or who licked and chewed the incision site. Hot or warm compresses to the area may be helpful as these encourage blood flow, allowing the body to reabsorb the extra fluid faster.
Does the incision seem to take a long time to heal? Common causes for prolonged healing times are underlying medical conditions such as diabetes, kidney or liver failure, hormonal imbalances and cancer. Delayed healing may be triggered by certain medications such as corticosteroids and aspirin at high doses. Also, consider that senior dogs take more time to heal when compared to younger dogs. As seen, it's very important to keep an eye on your dog's incision. It's best if you are home during the day or have somebody watch over your pet. It's astounding the number of calls vets get from owners of dogs who rip open their incisions because they were unsupervised or allowed to engage in wild play!
Disclaimer: this article is of a general nature and should not to be used as a substitute for professional veterinary advice. If your dog's incision appears concerning, please consult with your vet.
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