Merlin’s been a great dog so far, but despite that, there’s no need to propagate his genes. So, Monday was the big day… neuter time! As expected, since returning home he’s been feeling sorry for himself, but otherwise so far, so good.
Being someone who deals exclusively with infectious diseases and does surgical site infection (SSI) research, I have to think about his risk of developing an infection and how to prevent that.
Infection rates after neuters are very low. Actually, I can’t say that with confidence since we don’t have good data to back it up. We just finished one of the largest surgical site infection surveillance studies in dogs and cats, but being based at a tertiary care referral hospital, we didn’t get any data on neuters. I’m not aware of any private-practice-based studies that have assessed SSIs in dogs and cats, so my initial statement is just based on the fact that I don’t hear much about SSIs after neuters, and when I talk to people in primary care practices, they don’t report many of these infections. They occur, but they probably are truly rare.
However, rare doesn’t mean it will never happen, so pet owners need to be aware of what they can do to reduce the risk of post-operative infections (and then actually do it).
It’s been said in human medicine that the most critical time for preventing (or causing) SSIs begins and ends in the operating room. I think that’s true for animals as well, so there’s not much that the pet owner can do about that part except choose a good veterinarian, and not be afraid to ask pointed questions about the clinic’s infection control measures. The pet owner’s major role is taking care of the animal after surgery. Here are a few things that I need to do for Merlin:
- Restrict his exercise for a few days. Trauma to the incision site will increase inflammation and the chance of an opportunistic infection developing.
- Keep him from swimming (or more accurately, wallowing in the swampy areas and ponds around home). Keeping the incision dry is important for good wound healing.
- Keep him from licking the wound. This a huge factor and one that people often mess up. Yes, he hates his Elizabethan collar (i.e. the head cone). However, it’s important that he wears it to keep him from damaging the incision site and seeding it with bacteria from his mouth. It’s a matter of short-term pain (annoyance, actually) for long-term gain.
- Keep an eye on the incision. A little inflammation (e.g. redness, swelling) is normal. If it increases or any discharge develops, that might indicate a developing infection. If that occurs, getting him re-evaluated ASAP is important.
- Make sure he goes in for his recheck, and that it’s done on time. This is important to detect problems in a timely fashion and to remove his sutures. (Merlin will presumably get his "recheck" at home, since the two DVM degrees Heather and I have hopefully give us the collective ability to remove a few stitches ourselves and determine if the incision is healing okay.)
None of this guarantees Merlin won’t get an infection, but these measures are all important. There is a non-preventable fraction of infections – meaning some will occur despite everything you do. However, a large percentage of SSIs are preventable and these basic practices can help.