An infected neuter incision in dogs is something concerning that requires veterinary attention. The vet during surgery will take several steps to prevent infections. Once a dog is discharged from the veterinary hospital after being neutered, dog owners will need to take over the task and follow some careful post-surgery instructions at home. Part of these instructions include keeping the dog calm so to protect the incision area from getting dirty and contaminated from harmful bacteria. On top of that, it's important to avoid giving the dog a bath as moisture attracts bacteria and preventing the dog from licking the area. By closely monitoring the incision, you canquickly identify signs of an infected neuter incision in dogs.
Healing Process of Dog Neuter Incision
When your dog is neutered, the veterinarian will need to access your dog's reproductive tract to remove the testicles. This surgical procedure requires cutting through skin and muscles so to make an opening that allows the vet to remove the testicles.
When performing the surgery, the vet will take several steps to prevent infections. First of all, the surgery takes place in a sterile environment utilizing sterilized surgical tools. The surgery team will adhere to meticulous hand washing protocols. The dog's fur is then clipped off the skin and the surgical site is prepped with antibiotic soap. On top of that, the vet may administer a dose of prophylactic antibiotic (to prevent infections). Afterward, once the testicles are removed, the vet will stitch the area so the opening is closed.
Even though the area is neatly stitched up by the vet in sterile conditions, the dog's body realizes that there is an incision and does its best to heal it. In most cases, the healing process unfolds uneventfully. The incision heals up just fine and soon, the dog is back to normal. However, not always things may go as planned. Opportunistic bacteria are always a threat, and they can even establish in the cleanest environments.
A dog's neuter incision will go through several biological stages. Knowing what happens during these stages can be helpful in recognizing signs of trouble which may be indicative of an infection.
The Inflammatory Stage
During this first stage, which generally lasts up to 5 days, blood vessels will gather to the area for the purpose of forming clots to halt any bleeding. Once the blood has clotted, the immune system will activate.
Activation of the immune system means that several white blood cells will flock to the area to fight bacteria and protect the incision from infection. The white blood cells consist of neutrophils, which are the most common inflammatory white blood cells, and macrophages, which are very large white blood cells.
It's normal to see some extent of redness, bruising and swelling for the first few days during this stage. The swelling is usually considerably less significant by 3 days.
This redness and swelling can be quite painful, which is why many dogs will feel compelled to lick, but it's important to avoid this. A dog's mouth is rich in bacteria that can easily contaminate the area and cause an infected neuter incision in dogs.
Your vet should have provided the dog owner with an Elizabethan collar. Alternatively, as a short-term solution, you can let the dog wear a pair of small boxer shorts or a T-shirt to prevent access to the area. You my also be given nonsteroidal anti-inflammatory drugs to control pain and inflammation. Consult with your vet when you may give them as your vet may have already given your dog long-acting pain medications prior to his discharge from the hospital.
In the first days after surgery, dog owners may notice a clear or slightly blood-tinged fluid (exudate) draining from the incision (see picture on the right). This fluid may appear to be a sign of infection, but it's actually a normal process that helps clean the area.
" By 8-12 hours, the inflammation has produced an exudate consisting of plasma proteins (especially fibrinigen), polymorpho-nuclear leukocytes, (PMNs), red blood cells, and macrophages."~ Dr. M. Joseph Bojrab, veterinary surgeon
The Proliferative Stage
This stage may start around the fifth day after surgery. The term proliferative in the medical field means "to grow or multiply by rapidly producing new tissue." During this stage, indeed new tissue will be formed.
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Basically, as the days go by, collagen will be deposited and scabs will start to form around the stitches.
As the edges start pulling together, the incision area may be slightly itchy to the dog. Dog owners should continue monitoring to avoid the dog from licking and chewing the area.
By the time a week has passed, the edges of the incision will likely start to appear well sealed together. Generally, 10 to 14 days after surgery the vet may remove the stitches if they are of the non-absorbable type. By this time, enough collagen has been laid down and the skin will have assumed enough tensile strength (ability to stretch) as normal skin.
" I would say that in most cases, by 5 days post surgery, I would expect that the incision would be partly healed and not likely to open full wide, even if he licked a suture out. Usually if they are infected, there would be a cloudy or pus like discharge and odor. " ~Dr. Z
The Remodeling Stage
Finally, this is the stage where there will be tissue remodeling. In other words, once collagen has been deposited, the collagen fibers will be remodeled which leads to the formation of scar tissue. The process of scar formation may take weeks to months as the scar needs to contract and remodel to its permanent form. As time goes by, the scar tissue will become flatter, more pale and somewhat softer.
Signs of an Infected Neuter Incision in Dogs
Infection is the most common complication of a dog's neuter incision. An infection takes place when bacteria contaminate the incision.
This can happen, when bacteria from the dog's mouth are transferred to the incision, or bacteria around the home and yard invade the incision. Dogs with a weakened immune system may also be more predisposed to infected incisions.
Signs of trouble include pain that doesn't get better, a foul odor due to dead tissue, presence of thick green, white or yellow discharge seeping from the incision, the incision feeling hot to the touch, and as the infection progresses, presence of fever, lack of appetite and lethargy.
Another sign to watch for is lack f improvement. Usually, incisions swell or redden a bit initially, but then improve after several days. Worsening pain, swelling or redness should be reported to the vet. If your dog's scrotum area looks swollen, read this article about swollen testicles in dogs after neutering.
At the Vet's Office
Infections arising from an incision are referred to as surgical site infections (SSI). These infections may be superficial, affecting the area just under the skin or they can be deeper, affecting the muscles or tissues that surround the muscles.
The vet will likely look at the incision and determine whether there is the presence of an infection. The vet may clean the area and then prescribe a course of systemic antibiotics. The vet may sometimes wish to perform a culture and sensitivity test so to pinpoint the bacteria involved and ensure the right type of antibiotics are selected.
In complicated cases, an infected neuter incision in dogs may require another surgery to cut away the infected skin and close up with new stitches.
"Purulent material indicates infection and if it is coming from inside the incision, then there most likely is more infection deeper in the tissues of that area. Cleaning the area, starting oral antibiotics and possibly draining the area if there is a pocket of infection may be needed."~Dr. Bruce.
- Johnston, D.E.: The process in wound healing. J. Am. Animal Hospital Association. 13:186, 1977
- DVM360: Wound healing (Proceedings)