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Linda Simon
Linda Simon, Veterinarian
Category: Vet
Satisfied Customers: 3358
Experience:  MVB MRCVS
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My 1 year old Bedlington Terrier just returned from a liver

Customer Question

Hi, my 1 year old Bedlington Terrier just returned from a liver biopsy - his suturing looks poor to me and he has some watery diarrhea
JA: Hi there. I'll do all I can to help. When did the diarrhea start? Could the unknown-word terrier have eaten anything unusual?
Customer: No it started after surgery
JA: What's the unknown-word terrier's name?
Customer: Biggles
JA: Is there anything else the Vet should know?
Customer: He had a liver biopsy and the suturing looks poor
Submitted: 16 days ago.
Category: Vet
Customer: replied 16 days ago.
I have uploaded an image of the suturing. The biopsy was performed today, it was done to diagnose whether he had copper storage disease as although he is only 1 year old and showing no clinical signs - he tested positive for the COMMD1 mutation.
Customer: replied 16 days ago.
The surgery was performed as an outpatient - he did not stay overnight. The stools he has produced over the past couple of hours since he returned home have essentially been brown water. He is walking to go to the loo and has eaten a little food but he doesn't like to lie down and moans when he tries to.
Expert:  Linda Simon replied 16 days ago.
Hi there, you are through to Dr Linda, a UK based vet.
Hopefully I can help you today.
When exactly was the procedure?
Despite the diarrhoea, is he keen to eat?
Any other signs such as lethargy or vomiting?
Has he been trying to lick or rub at the wound?
Finally, is he on any medicine?
Customer: replied 16 days ago.
The procedure was done in the early afternoon today. He produced some bile (yellow vomit) when he got home. Hes tried to lick at it but he is wearing a cone so could not. He has been prescribed Carbprofen but the first dose is tommorow morning. He is tired but I suspect this is due to the anaesthetic
Customer: replied 16 days ago.
If you want to call I can select that option
Customer: replied 16 days ago.
biopsy was done via laparotomy
Customer: replied 16 days ago.
he has eaten a little food - we're giving him a little at a time
Customer: replied 16 days ago.
he seems keen to eat it
Expert:  Linda Simon replied 16 days ago.

Thank you for all of this information.

Diarrhoea the day of the procedure is not unexpected and can be due to the anaesthetic. We thus advise a very bland diet (such as chicken and rice) and you could also give a probiotic paste such as Protexin Prokolin.

Similarly, a small vomit can be within the realms of normal.

Do keep an eye though, ensuring his gums are pink and wet and he should be much better tomorrow.

No need for a call!

I'm just looking at that photo now...

Customer: replied 16 days ago.
I just wanted to get a second opinion on the suturing as well - as both he and I have had better looking sutures with tighter closure
Expert:  Linda Simon replied 16 days ago.

There is a small amount of skin eversion (whereby the skin puckers slightly out rather than being flush) where one suture is placed.

As it is just a very small incision, this would not be of concern to me and I would certainly not advise anything needs to be done.

This wound should heal quickly and with minimal scarring.

As with all wounds, it is important it is kept clean and that Biggles does not chew or lick at it.

The black bits are just dried blood and will go away in a few days.

Customer: replied 16 days ago.
Great! Thanks a bunch Linda - I work in Pharma quality assurance so I can be a bit neurotic - this put my mind at rest!
Expert:  Linda Simon replied 16 days ago.

Not neurotic at all, I completely understand your concern.

This window stays open for several more days so do feel welcome to update any further photos as it heals and to keep me updated.

Wishing your little man a speedy recovery and fingers crossed the biopsy is negative.

Customer: replied 16 days ago.
Hopefully it will be negative, but I've already done a huge literature trawl and my understanding is that copper storage disease when caught early is fairly manageable. Thanks again Linda, yes I will keep you updated.
Customer: replied 16 days ago.
thanks for the great service
Customer: replied 16 days ago.
informative replies
Expert:  Linda Simon replied 16 days ago.

Very happy to help! Take care.

Customer: replied 15 days ago.
Hi Linda, Biggles went back to the vets today as he was in pain at the suture site - they gave him what I think was a bupivacaine injection at 6pm. At home at 7.30pm his heart rate was 52 bpm with an irregular rhythm and a respiratory rate of about 10-11 breaths per minute. This has now increased at the time of writing to about 58 BPM and 13-14 breaths per minute. Is this link of cardiac/respiratory depression normal after this anesthetic? He's fully conscious
Customer: replied 15 days ago.
this kind of
Expert:  Linda Simon replied 15 days ago.
I'm sorry to hear this.
Bupivicaine is a local anaesthetic so it is unlikely this was given, unless perhaps at the site of the incision itself?
More than likely, they gave buperenorphine which is a moderate pain relief.
It typically takes 15 minutes to kick in and lasts roughly 6 hours.
Sleepiness is a common side effects while a lower heart rate would be a rare side effect.
10-14 breaths a minute is well within the normal range.
His heart rate is slow, though a rate of 60 can be normal when sleeping. If he is easily roused and acting normal I would monitor and would expect his vital parameters to return to normal within a few hours.
Customer: replied 15 days ago.
Hi. thanks Linda! He can be roused (I wouldn't say easily) and at the moment he's watching me move around the kitchen whilst he's lying down. I wouldn't say he's acting normal as he's usually a highly active lunatic. The rate was taken whilst he was semi-awake. I'll keep monitoring him for the next few hours and report back if you want.
Expert:  Linda Simon replied 15 days ago.
Perfect.
I do understand your concern but suspect he is resting after a restless day. If he has been in pain he likely hasn't been able to relax so hopefully he isnjust recharging.
Customer: replied 15 days ago.
Awesome. I suspect so as well. But it's good to have a expert at hand though - again it's the pharma background of mine I get used to making clear decisions based on data and define parameters.... if I can't do that I go and get a subject matter expert to educate me if the decision is a more qualitative one.....like tired sleepy doggies :) Thanks a bunch
Customer: replied 15 days ago.
definite parameters
Expert:  Linda Simon replied 15 days ago.

Very happy to help! I hope I've put your mind at rest and I'll be online for a while so send on an update whenever you like :)

Customer: replied 15 days ago.
Great! Cheers hahah.
Customer: replied 15 days ago.
Biggles heart rate hasn't changed - still around 55 but he seem a little more alert now.
Expert:  Linda Simon replied 15 days ago.
Hi there, how is Biggles doing today?