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Worried swelling will tear open stitches
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27 July 2017 - 10:00 am
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Hi,

This is my first time posting. My dog Charlie was attacked by a pit bull two weeks ago and ever since it's been extremely rough and scary. His back leg was shredded, his knee had to be reconstructed and his muscle had to be reattached to his bone. He has constantly been in and out of the vet and nearly lost his leg twice (I hope it's okay that I'm posting here even though they ended up saving his leg, this site and community seem amazing and I didn't know where else to go). 

A week after his first surgery he had tremendous pain, swelling, redness and drainage coming through his stitches. His leg swelled to three times the normal size and he constantly cried, shifted around and had labored breathing. Each time we took him to the vet they just kept him for a night and gave him stronger pain medicine. As soon as the stronger meds wore off, he was back to crying and in tremendous pain.

Then a week ago in a matter of hours the stitches tore completely open and it seemed like we were right back where we started. He was rushed back to the vet to get the stitches redone and while they were cleaning his wound he began to have internal bleeding. He nearly lost his leg again and coded on the operating table, but the surgeon miraculously saved his life and his leg again. They weren't able to locate or repair the site of the bleed, but thankfully it stopped. Now it's been about a week since that surgery, he's been home recovering and seems to be doing a lot better. His pain has decreased substantially and the incision site no longer looks red and infected. Four days ago they removed his Jackson Pratt drain and ever since he has had quite a bit of fluid building up along the bottom of the stitches. There is a fluid pocket on the inner part of his leg about the size of a large marble and then on the back of his leg along his butt there is another much larger fluid pocket. When he moves around the fluid gushes out of his stitches.

 
 

We've been doing a lot of hot compresses, keeping him very still and blotting the stitches carefully to keep them dry. Now we are extremely worried that the swelling and constant moisture will cause his stitches to tear open again. I wasn't sure if the fluid pockets are normal swelling or seromas and what I can do to help decrease his swelling, ensure that the stitches remain in place and encourage his healing. I've been in constant contact with the vet (who is extremely busy and not the best at answering my questions), but after speaking with them and sending photos they said he looks okay, to monitor the area and bring him in if it looks infected or if the swelling increases. Sorry for such a long post, my family and I are so exhausted and don't know what to do. Charlie means the world to us, we can't lose him. 

If anyone has had a similar experience or knows what we can do to help Charlie heal we would appreciate it so much. Thank you!

All the best,

Avery

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27 July 2017 - 12:01 pm
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Welcome and best wishes for Charlie! So sorry to hear the trouble he's been having. Please keep us posted, your future forum posts will not require moderation.

A seroma is perfectly normal, as is some seepage, but it should never get so bad as to burst stitches. Click any seroma link for more information, photos, and tips for what to look for when a seroma goes bad. Please call your vet with any serious concerns. The seroma can be drained with a simple quick procedure, but consistent fluid build up, or any dark red fluid can be signs of trouble.

Note a warm compress will increase circulation, resulting in faster fluid build-up. A cold compress will help reduce swelling. Rotating hot/cold therapy can be beneficial, but always and with cold for acute injuries. Please follow your vet's discharge instructions regarding post-op wound care, or consider seeking another opinion.

While you wait for comments from others, use the Advanced Search above to refine your forum search results with specific phrases, and you're sure to find lots of helpful feedback. You can also search all blogs here. Or, consider downloading the Tripawds e-books for fast answers to common concerns and feel free to call the toll-free Tripawds Helpline anytime!

Virginia
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27 July 2017 - 12:22 pm
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Geez!  So sorry sweet Charlie is going through all this!  I know it's so scary and so frustrating ro see him in pain!

And btw.....welcome to the family..three or four legs...all warmly welcome!!!

Have you considered going to another Vet ro look at Charlie and give a second opinion? Especially if hpthe communication is not up to snuff.  Charlie is going through a lot and you are paying big bucks so they need to give you the support you need!!   As a second oopinio, an  Orthopedic Surgeon perhaps?

One thing I want to throw out as suggestion to discuss with an Orthopedic Surgeon.  It is POSSIBLE...may not happen...but possible that his quality can best be served with an amputation to get rid of that bum leg.  Often we see dogs who join here because of failed attempts to repair a severy damaged leg...infections... numerous surgeries.... more infections...pain...confinement...outrages expense....etc.   Amputation takes care kf all that and, after recovery, dogs get on with living @ife to the fullest!

Keep us updated and, as Admin suggested, try the cold compresses.  You can just use a bag of frozen veggies and wrap in a washcloth and put on the swelling.  Don't put the frozen package directly on the skin.

Cheering for you Charlie!   We're right here by your side, okay?

Hugs!

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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27 July 2017 - 2:39 pm
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Hi Sally and Admin,

Thank you so much for your suggestions and insight! I'm definitely going to try a cold compress to reduce the swelling. Charlie doesn't seem to be in pain anymore, but the swelling is definitely bothering him. He limps slightly and likes to press his swollen leg under himself while sitting or lying down. The stitches still have very slow seepage that gushes at times when he moves around. I wasn't sure if it's a good thing for the liquid to gush out thru the stitches so that it might relieve pressure, but just in case I've doing my best to keep him still and the stitches dry so there is no chance for them to tear again.  I'm most concerned with the small gap between his stitches in some areas. He had a huge gash so the surgeon had to stretch and pull his skin a lot when she put in the stitches. The gap seems to be in the area on his leg where the skin rubs the most and has been stretched the most. Luckily we have a check up appointment at the vet tomorrow morning. If our concerns are not addressed tomorrow, I definitely will try to get a second opinion.

As far as amputation so far his leg has done surprisingly well. When he had the JP Drain in and there was far less swelling, he seemed to be using it much better. If the issues and problems continue we will look more into it as a possibility. Thank you both so much for your help and kind words!

Best,

Avery 

Virginia
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27 July 2017 - 8:19 pm
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Let us knkw what the Vet says tomorrow about what you are seeing with the stitches, the fluid, etc. 

It's a real good sign that the pain seems to be less and less.  Hopefully sweet Charlie will continue to improve in every area!.

Cheering for you sweet Charlie!

And Avery, you're doing an EXCELLENT job of caring for Charlie! 🙂

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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30 July 2017 - 6:44 pm
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Thank you so much! The past few weeks have been extremely stressful, so all your comments and kind words are very much appreciated. 

The vet appointment went well, they said that the swelling and fluid was a normal part of healing, but just in case they scheduled another follow up appointment to see the surgeon later this week. 

A new problem developed yesterday, Charlie got extremely nauseous and was throwing up all day. He couldn't eat or keep any fluid down. We went to the vet and they said it might be from the mix of medications (but he's been on the same meds pretty much for the past two weeks with out any problems). They said it also could be that he ate something bad (he's typically an extremely picky eater so I would be very surprised) or he might have something caught in his esophagus (they offered to do an X-Ray but said most likely nothing would show up even if there is something in there). The vet hydrated Charlie, gave him anti nausea meds and sent him home. After the appointment he was doing a lot better, but now he seems pretty sick again so we are still very concerned about him.

I'm wondering if it could be related to him still healing. He does still have pretty large fluid pockets built up around his stitches. Could the vomiting be a sign of an infection or some kind of complication from his surgery? Has anyone had experience with this before?

Thank you again! This site has been amazingly helpful.  

Virginia
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30 July 2017 - 8:29 pm
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Awww Charlie.  Let's get that tummy of yours settled down, okay?

Just throwing some things out there:  Did the Vet do any blook work?   Any kid ey and kiver function tests? Any suggestions for bland diet?  What meds is Charlie on and do they require his tummy to be coated with food?   If Vet thought maybe bad food, did they test for pancreatitis?  When Charlie vomited food and water, was it almost right away, or was it hours later?

Have you been changing food brands?

A second opinion may definitely be in order. We're pretty big on those around nere.  Sometimes a new set of eyes sees things another Vet may have missed.

Hoping Charlie can sail through this lstest hurdle and get on with a FULL and FLAWLESS recocery!   Up date when yiu can, okay?  We're here for you!

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Sorry,  not much help!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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31 July 2017 - 9:34 am
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Hey sorry to hear about his upset tummy. What is he vomiting up? What does it look like?

That could be anything at all, and it does sound like something you want to call the vet about if he's still not better. I'm going to bet it's just that the medication making him nauseated (anti-biotics can do that) but better to know for sure.

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31 July 2017 - 12:32 pm
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Charlie's vomit looked most yellow and clear like stomach bile and threw up around 20 times. That day, he wouldn't eat and couldn't keep any water down. He was very uncomfortable and agitated. 

Since he was first attacked three weeks ago, he has been on pretty much the same meds (besides the stronger pain meds the vet would give him during surgery and the many times we had to take him in for his unbearable pain). The meds we have been giving him at home for the past three weeks are: Endrofloxacin, Tramadol, Rovera, Acepromazine, Gabapentin, and Clavamox. Because his pain had subsided in the past week, we haven't been giving him the tramadol, Acepromazine, or Gabapentin. Then, when we took him to the vet this two days ago for his vomiting, they prescribed him Sucralfate. 

The vet gave him a hydration shot and right after he was doing much better. During the past two days he's been able to eat and drink a little and hasn't been throwing up, but you can tell his stomach is really bothering him. He constantly wants to go out on our deck and bee-line for some weeds that he immediately gobbles up (when Charlie's well, he is the pickiest eater ever, so this is highly unusual). I was nervous that the weeds were bad for him so I took him to a grassy area and let him eat a little bit of the grass. Lately he has started heaving a few times, but hasn't actually vomited and he has no interest in food at all. He's very slow and constantly wants to sleep, but that might just be part of the recovery process. And before yesterday he hadn't pooped in about 3 or 4 days, but finally he went about 4 times in a short period of time, his stool looked very soft and slightly runny. 

I'm really hoping it might be a small stomach bug or maybe an adverse reaction to his meds. If it is his meds, I just don't understand why we haven't seen any problems until now. I wish there was something I could do to help him feel better.

Thanks again for everyone's support and assistance!

Virginia
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31 July 2017 - 1:07 pm
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Not familiar with all the meds, but, over time meds can certainly cause gastro upset.  Clearly wa ting to eat grass shows he has some sort of tummy upset ao ewhere, somehow going on.

Gastro upsets can take on many forms...some similar to what  Charlie is experiencing.

I  would DEFINITELY, DEFINITELY get a Vet...whether it's the same one, or another one...to run some of the bloodwork, pancreatitis test, etc and do whatever is necessary to check out his tummy thoroughly to make sure there isn't any partial blockage or even some undiscovered injury from the accident.  If for no other reason, for peace of mind that it is "just" a really awful gastro upset that needs special attention to get Charlie feeling better!!

How are his gums color wise?

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

Virginia
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31 July 2017 - 1:10 pm
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PS...Not sure if they've eliminated any bacterial infection...parasitic stuff...worms,etc....things completely unrelated to the surgery and injuries???

And whatever remaining meds Charlie is on...check out side effects thoroughly with a Vet and eliminate those as the culprit.

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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31 July 2017 - 2:38 pm
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charliesfamily said
Charlie's vomit looked most yellow and clear like stomach bile...

This is a common sign of adverse NSAID reactions, which can be very serious. You might consider asking your vet to try something other than the Rovera.

FYI: Jerry could not handle Rimadyl (aka Carprofen), it tore him up inside, yellow bile and all. But he handled Metacam fine for nearly two years. Other members have reported the exact opposite for their dogs.

The reaction may, however, just be to the incredible cocktail of meds charlie is currently ingesting. Regardless, that volume and type of vomit needs to stop.

DISCLAIMER: We are not vets, please consult carefully with yours.

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31 July 2017 - 3:00 pm
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Mosby had a severe stomach reaction to Cipro, which is a fluoroquinolone, like Endrofloxacin. It didn't start at once; it took a few weeks, and then escalated when the vet raised his dosage. He didn't vomit, just completely stopped eating and drinking, because he was so nauseated. At the end of the day it sounds like Charlie is on a lot of meds, and any one or combination could be part of the problem; I certainly think it's worth getting a second opinion or investigating further regardless. Sending positive thoughts your way!! 

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