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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog
Satisfied Customers: 16919
Experience:  Over 20 years of experience as a veterinarian.
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My two year old golden retriever was neutered 8 days ago.

Resolved Question:

My two year old golden retriever was neutered 8 days ago. He has never bothered with the wound although has a head cone on. I've been away on business for past three days and when I arrived home this evening my brother had just returned from the vets with him for his routine appointment. To my horror the dogs scrotum is twice the size it was before his operation, the vet gave him two injections and then some tablets which start tomorrow afternoon, Metacam and nisamox. He is apyrexial but I think it's a haematoma and it is really tight and solid. The vet says take him back Sunday for review but I am getting worried now and think it needs inscising. His appetite is good, not drunk much and not had his bowels open since this morning. I'm certainly not prepared to wait until Sunday, Do you think it's safe to wait until the morning or should I call the emergency vet now it's 2242 hrs here
Submitted: 3 years ago.
Category: Dog
Expert:  Dr. Kara replied 3 years ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that poor Stanley has such a swollen scrotum and I understand that you are very, very concerned about him.

Hematomas generally form within the first day or two after surgery from bleeders that ooze and dead space at the surgery site. The swelling is soft and fluid feeling, not firm, and not so far out from the time of surgery.

When I see such extreme swelling this far out after surgery it is almost always secondary to an internal suture reaction. Suture material, though sterile, is foreign material. In most dogs the body sends in white blood cells and "clean up" type cells to break down and remove the absorbable suture material. This is a mild inflammatory process at the cellular level that we don't even notice in most cases. In dogs that over-react to suture material we can see a huge inflammatory process occur, with very firm tissue edema, redness, and significant swelling from the release of cellular break down products and large numbers of white blood cells. There truly isn't anything to drain as there isn't a pocket of accumulated fluid outside the cells. The swelling and inflammation is all intracelllar.

When this happens we can use anti-inflammatories to try and relieve inflammation and swelling and slow down the immune system's over-reaction to the suture material. We will often prescribe antibiotics too as this sort of swollen tissue is very fragile and can easily develop a secondary infection. I suspect the two injections were an anti-inflammatory and an antibiotic to get the medications immediately into his system and the oral medications are to continue them.

In some cases we do need to go back in and remove the suture material if we cannot relieve the inflammation and swelling with medications. I suspect that is why they want to watch him and see him back on Sunday to gauge his response to the medications prescribed. In very rare cases we may have so much inflammation and pressure that we see tissue death which necessitates removing some or all of the scrotum.

But your veterinarian is doing the best that can be done for him now with medications. Definitely leave on his collar as it natural for them to want to lick such a sore spot, but that will make things worse.

You can also try cool compresses on the area to help relieve some inflammation and swelling.

Please let me know if you have any further questions.
Customer: replied 3 years ago.

Thank you for your detailed explanation, I am concerned about necrosis but I also know that our vet is very very good, but I just needed a bit of reassurance because I was not at the consultation earlier this evening and didn't have the opportunity to ask questions about possibility of a haematoma. What you say makes perfect understandable sense so, once again, many thanks
Expert:  Dr. Kara replied 3 years ago.
You are very welcome.
I understand how upsetting it must have been to come home and see him this way and not have the ability to ask any questions. I think your veterinarian is doing the best that they can with a bad suture reaction. There's no way to know which dogs will have them, and which won't but it is worth recording on his record so in the future if he needs surgery different suture can be used. Please let me know how things go for your fellow, or if you have any further questions, thanks, ***** *****
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