Vet Blog
07/07/09
 Hello. My two-year-old female dog was spayed four days ago. Immediately after surgery I noticed a rash about 1 inch above the incision (not touching the incision). Is this normal? How do you care for the wound and the area aound the wound? Can I use hydrogen peroxide?
Su
Miami, FL
I suspect that your dog is suffering from clipper burn–the equivalent of razor burn in people.
Surgical procedures must be performed in a sterile manner. That means that the surgeon and the surgical area of the patient must be prepared in a fashion that eliminates as many bacteria as possible. Hair, it turns out, harbors massive amounts of bacteria. Hair is the enemy of sterility in surgery.
Surgeons scrub their hands with antiseptic solution. They don masks to prevent breathing or sneezing bacteria into the surgical site. Surgeons also wear surgical caps to keep their bacteria-ridden hair from falling into the sterile area.
Surgical patients have their hair removed with clippers (or, rarely, razors) in order to create a sterile area. The skin is then scrubbed with antiseptic solution before an incision is made.
Some animals, like many people, are sensitive to clipping or shaving. In these individuals hair removal can lead to irritation of the skin. I suspect that is what is happening with your dog.
The worst clipper burns I have seen have occurred in male dogs after neutering. The procedure requires that the scrotum be clipped. Unsurprisingly, this area is very sensitive and highly prone to clipper burn.
Most cases of clipper burn subside after several days. It is important to keep your pet from licking the area–this can exacerbate the irritation. A dreaded cone collar may be necessary to protect the site.
I do not recommend using hydrogen peroxide because it can be irritating to the skin and make the problem worse. However, ointments containing cortisone often help to alleviate the pain, burning, and redness that accompany clipper burn.
I’d recommend that you have the vet who spayed your dog take a look at the site. He or she should be able to help with the problem.
Photo: no sign of clipper burn on Recy.
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05/09/09
The April 25, 2009 Economist’s science and technology section contained an article that discussed a promising technique to aid in treating cancers in all species.
A DIAGNOSIS of cancer is often followed by a prescription of surgery. Before chemotherapy, before radiation, the knife is frequently the oncologist’s first line of attack. If done early and well, it has the potential to stop the disease in its tracks. Even if it does not, it is the best way for the doctor to get a feel for what he is dealing with, how extensive it is, and what to do next. But, whereas therapies and diagnostics for cancer have been evolving steadily in response to new biochemical knowledge, surgical techniques have remained surprisingly primitive.
What happens at the moment is that a surgeon roots around inside a patient, removes as much tumour as he can find, and hopes he got it all. He then sends what he has excised to a laboratory, where pathologists sample all around the outside of the extracted mass to see if it is encapsulated by healthy tissue. If it is, the whole tumour has probably been removed. If not, the surgeon must go back in, and the time-consuming process starts again.
Roger Tsien and his colleagues at the University of California, San Diego (UCSD), are trying to halt this cycle by creating a luminous map for the surgeon to follow. Dr Tsien, who shared the 2008 Nobel prize in chemistry for his work on green fluorescent protein, has found a way to make cancer cells glow. That could help surgeons see precisely what to cut out and what to leave behind.
Tumor removal surgery definitely can be harrowing business. The mainstay of tumor excision is obtaining “wide margins”. This means that the capsule of healthy tissue surrounding the tumor should be as large as possible. But tumor tissue can only be definitively diffentiated from normal tissue when it is examined under a microscope.
The technique detailed in the Economist will do nothing to address the need for microscopic evaluation to definitively determine tumor margins. However, it definitely is a step in the right direction.
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01/27/09
 Dear Dr. Barchas,
My six-year-old Labrador had hip surgery
when he was two and on some days he has a hard time
getting up or just may be having a bad day pain
wise. Of the OTC pain remedies can you recommend
the best one? Do they really do any good?
David
Gilbert, Az.
There are a few reasons why two-year-old dogs undergo hip surgery. Developmental problems such as hip dysplasia sometimes require surgery at two years. Trauma to the hip may lead to broken bones in or near the joint. Dislocation of the hip may occur when dogs are injured, and may require corrective surgery.
All of the problems that can lead to hip surgery have one thing in common. In many cases they also lead to arthritis in the affected joint.
Arthritis of the hips can lead to limping, difficulty rising, and reluctance to walk, run or play. I suspect that your dog has a hard time getting up because of arthritis in his hip.
There are several treatments for canine arthritis. The simplest, and most effective, do no require medications. I recommend that you keep your pet thin, provide regular mild or moderate exercise, and perform basic physical therapy to maintain flexibility and strengthen the muscles in his legs. Talk to your vet for tips on physical therapy.
Dietary supplements containing glucosamine, chondroitin sulfate and omega-3 fatty acids may help ease the symptoms and progression of arthritis. These sorts of supplements are available over the counter.
Aspirin is the only canine arthritis medicine that is available over the counter. It belongs to a class of drugs called non-steroidal anti-inflammatories (NSAIDs). Although aspirin is very helpful for some dogs, you should be aware that all NSAIDs, including aspirin, can cause serious side effects. Prescription NSAIDs may be safer and more effective. Do not administer aspirin to your dog without first talking to your vet.
Finally, before you resort to medications, I recommend that you talk to your vet about advanced non-drug treatments for your dog. Such treatments include professional physical therapy (available through special facilities), extracorporeal shockwave therapy, therapeutic laser treatments and stem cell therapies. Your dog may not yet be a candidate for such cutting-edge protocols, but it never hurts to ask.
For more information on arthritis in dogs, check out my website:
http://drbarchas.com/canine_arthritis
Photo credit. Photo license.
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01/22/09
 Ever since my female cat went to be fixed, she
has had a cough. I was wondering if there is any
thing I can do to help her. Also, she has become
more aggressive since she has been fixed. Is
that normal?
Steph
Kansas City, KS
Cats and dogs often cough for several days after surgery or anesthesia for dental work. This occurs for two reasons. First, to safely perform anesthesia, a special breathing tube must be inserted in the throat. The tube ensures that animals are able to breathe properly. It also protects the lungs from foreign material during the procedure. However, it occasionally causes minor irritation to the windpipe that leads to coughing for several days.
Also, remember that all major medical procedures are stressful. Stress weakens the immune system and makes pets more susceptible to minor respiratory ailments.
In either case, the coughing should not be accompanied by symptoms such as lethargy, weakness, loss of appetite, or difficulty breathing. If you see these symptoms, or if the coughing persists for more than a few days, contact the vet who performed the surgery.
Pets that undergo spay or neuter surgeries before puberty should not experience permanent personality changes. In fact, one of the benefits of early spaying and neutering is the prevention of undesirable personality changes that occur at puberty.
Temporary personality changes can occur after surgery, especially if proper pain management isn’t utilized. Aggression can be a sign of pain in both cats and dogs. I strongly recommend that you talk to your vet as soon as possible about your cat’s new aggressive tendencies.
It should be noted that when pets are spayed after puberty personality changes are not uncommon. The most frequently encountered changes are decreased levels of aggression and decreased interest in sexual activity.
Photo: Zipper shows off the site of her spay surgery.
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01/17/09
 My cat was just neutered. I want to make sure that
I’m taking good care of him so that he can heal
properly. Could you give me some tips? For
example, should I feed him a special diet for
awhile? How long does it take for him to heal?
Also, how soon can he take a bath?
Nikki
Los Angeles
I realize that the title of this post is only tangentially related to Nikki’s questions. I will answer all of the questions in this post, but Nikki’s e-mail reminded me of an article that appeared in the November, 2008 NAVC Clinician’s Brief.
The article discussed the tendency of pets to gain wait after they are spayed or neutered. The authors of the article reached a conclusion that is relevant to Nikki and to anyone whose pet has recently been spayed or neutered: the key to preventing obesity in spayed and neutered pets appears to be keeping them slim in the time period immediately after surgery.
Nikki, your cat does not need a special diet as he is recovering from surgery. However, be careful not to over feed him for the next several months. Monitor his weight, and cut back his food if his body fat increases.
There are several other steps you can take to help prevent complications during your cat’s recovery. All pets should be kept quiet for at least a week after undergoing spay or neuter surgery (cats should be kept indoors and dogs should be kept on leash). Prevent your cat from licking the incision excessively–in some cases, an Elizabethan collar is necessary. Unless a pet is thoroughly soiled, it should not be bathed until the incision has completely healed. This can take up to two weeks.
Finally, be sure to follow any post-operative instructions that your veterinarian may have provided.
Photo: Tiger is looking sharp in her Elizabethan collar.
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12/30/08
 I have two kittens and they have been spayed about one
week now. I noticed that under the incision that
a lump the size of a quarter has formed. I have
touched it on both of them and it doesn’t seem to
hurt or bother them. What should I do?
Laura
NY
The lumps are probably a normal consequence of the surgeries.
Spaying a cat or dog involves surgically removing the uterus and ovaries. These organs are located inside the abdomen.
To access the abdomen, the surgeon must first cut through the skin on the animal’s underside. Beneath the skin is a layer of fatty tissue, which is cut through next. Finally, the surgeon makes an incision in the muscle that lies beneath the fatty tissue. At that point he or she is able to operate inside the abdominal cavity.
When the surgery is complete, the surgeon must close the openings in the three layers mentioned above (muscle, fatty tissue, and skin) with stitches. The most important layer is the muscle layer. If it comes open for any reason serious complications can occur.
Therefore most surgeons are very aggressive about suturing (stitching) the muscle layer. This may lead to bunching up of the muscle. The bunching is not painful and does not hurt the animal in any way, but it can cause a lump to develop underneath the incision.
I suspect that the lumps you have noticed are the result of normal postoperative tissue bunching. But there is only one way to be sure. I’d recommend that you have a vet take a look at the areas to confirm that nothing is wrong.
About the photo: Lillian shows off her spay incision.
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12/29/08
 Dr. Barchas, is it true that if you neuter a dog
who is already 2 years old, it will not help him
marking inside the house?
I just adopted a well behaved German Shepherd.
He just arrived a day ago, but his past owner says
he will mark the house and to leave him in the car
port. To me that’s cruel. The owner moved to a
condo and the dog had to stay in one room all day
(for 3 months). That’s why past owner gave him to
me. Please help.
Ana
Levittown, PR
If your new dog is not neutered, the surgery may help to reduce unwanted urine marking inside the house.
Neutering or castration involves removal of a the dog’s testicles. In adult dogs, testicles produce a hormone called testosterone. Testosterone helps to drive a number of behaviors in dogs including urine marking, aggression, sexual activity, and the desire to escape into the neighborhood in search of trysts.
If you have your new dog neutered there is a very real chance that his urine marking will stop. Neutering him is a very wise step in dealing with the problem.
However, I should warn you that neutering is not a cure-all. There is a chance that your dog’s previous owners never bothered to house train him properly. Or, he may have a medical condition, such as a urinary tract infection, that is causing him to soil the house.
I recommend that you have a veterinarian evaluate your dog for medical conditions that may be leading to house soiling. If he gets a clean bill of health, neutering him is the next step. If the problem still persists, you will have to implement a behavior modification (training) protocol to properly house train your new pet.
Photo: Freedom Star has no known record of house soiling.
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12/19/08
 I have written twice on this blog already that I do not perform cosmetic ear cropping or tail docking. You can click here or here for my reasons.
I, like all veterinarians, must carry professional liability insurance in order to practice. My insurance provider sends periodic newsletters that report on veterinary liability lawsuits and insurance claims. Below is an excerpt from the most recent newsletter.
Hunting Pups Left Standing with Short Tails After Miscommunication
Dr. A was presented a litter of ten pups for tail docking. The owner discussed the docking with the technician and asked if the tail dock was going to be one-third. Then, the owner made a hand gesture of space of about one inch. The technician left to confirm with Dr. A that yes, the docking would be “one-third” and then the technician relayed this information to the owner. Dr. A cropped the tails leaving one-third on each pup, which is the show or conformation standard for this breed; however, the owner only intended for one-third of the tail to be removed, which is the field trial standard. The difference of leaving a third of the tail versus only removing a third of the tail was the point of miscommunication. The owner alleged the pups decreased in value from $1200 to $300 each. The owner demanded more than $20,000 for the value of the pups, stud fees, and breeding expenses. Dr. A consented to settle the case and Dr. A’s insurance carrier is working to negotiate a settlement. (Source: AVMA Professional Liability Insurance Trust newsletter, fall 2008)
Tail docking per se wasn’t the cause of Dr. A’s problems in this case. Communication problems were the root source of the lawsuit. Nonetheless, I wonder if Dr. A has ever thought to himself that he could have avoided the misery of this lawsuit if only he didn’t dock tails.
About the photo: “9″, from Connecticut, will meet neither field trial nor show standards. I think he looks good.
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11/14/08
 Why aren’t animals given any pain relief after
operations? When I ask this I am referring to the
time when pets are allowed home after having
surgery. Humans are in pain for weeks after an
operation, what it would be like if we were given
no pain relief at all? Imagine what it’s like for
a cat or dog who has just had surgery and are sent
home with nothing to ease their pain. They must be
in complete and utter agony for weeks. Why is no
form of pain relief offered or given to an animal
when it is sent home?
Joanne
Warwickshire, United Kingdom
There was a time not that long ago (that is to say, within my lifetime) when legitimate scientists debated whether dogs and cats truly felt pain. Certainly, they were noted to respond unfavorably to adverse stimuli. But it couldn’t be proved that they feel pain in the same way as people do.
That debate, thankfully, has been put to rest. No reasonable scientist or veterinarian would now deny that every mammal perceives pain in basically the same manner as humans. And no reasonable person would deny that the sorts of injuries and disease processes that cause pain in people will cause similar pain in mammals. (Some people continue to debate whether “lower” animals truly feel pain. I, for one, believe that birds, reptiles, amphibians, and fish feel pain. I’m not 100% certain about insects, but I can say without hesitation that insects respond unfavorably to adverse stimuli . . .)
After it was agreed that all mammals feel pain, a new debate emerged among veterinarians. Some vets argued that pain was good for animals. Their argument was that the pain from a broken leg would keep a dog from walking on the leg. Similarly, the pain from a surgical incision would keep a cat from licking the incision.
The argument that pain is good turned out to be as poorly reasoned as it seems. Vigorous research has shown that pain is, in fact, bad.
Pain leads to physiological changes in the body that delay healing. Pain suppresses appetite, which in turn prevents animals from obtaining the nutrition they need to heal. Pain hurts. Pain management is now a standard part of care in veterinary medicine.
Joanne, I don’t have an answer for your question. Animals that undergo surgery are supposed to go home with pain medicine.
If you have a pet that did not receive pain medicine after a surgical procedure, it might have been an oversight. Or your vet may be one of the rare ones left who hasn’t adapted to modern practices. You may want to ask him or her why no analgesic (pain control) drugs were prescribed.
Most veterinarians now are proactive about pain control in their patients. Pain in animals is less common than it used to be. But it still happens. If you believe that your pet is in pain, do not hesitate to contact your vet to work out a solution to the problem. No veterinarian I know wants to see a patient in pain.
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10/10/08
 I do not know how to crop ears or dock tails. Both procedures are relatively straightforward for a qualified veterinarian. I could easily master them. But I have chosen not to.
I am not willing to perform surgical procedures that are not medically necessary. Most of the vets I know hold similar attitudes. Doberman Pinschers can lead perfectly healthy lives with long tails and floppy ears.
Ear cropping and tail docking are painful. The procedures may lead to infections, disfigurement and other complications. My decision not to perform these surgeries was straightforward.
Unfortunately, this attitude is coming into conflict with breed standards and the expectations of some pet owners.
As fewer veterinarians are willing to crop ears and dock tails, more breeders and owners are turning to unqualified individuals to perform the procedures. Many experts worry that this trend will lead to increased complication rates and inadequate pain control for animals subjected to cosmetic surgeries.
Some members of the veterinary community feel that vets should embrace the procedures. When a qualified veterinarian crops ears or docks a tail, he or she is able to use sterile technique and implement an appropriate pain management protocol.
However, a growing number of vets (including me) advocate a different solution. Change the breed standards. Eliminate cosmetic surgeries in animals. I predict that we will prevail.
Photo credit: jsmjr (Flickr)
Photo licensing information: CC.
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Hello. My two-year-old female dog was spayed four days ago. Immediately after surgery I noticed a rash about 1 inch above the incision (not touching the incision). Is this normal? How do you care for the wound and the area aound the wound? Can I use hydrogen peroxide?
You have questions. 