Chest abscess lumpectomyspay suture reaction and infection
Question: I had my kitten (5 months) go thru surgery last Monday, July 16, for a lumpectomy (abscess on chest) and spay. 2 days later (July 18) the lumpectomy started oozing so I took her to the vet & they put her on a different antibiotic, clavamox. Then on July 23 at 2:00 a.m., Keary (my kitten) woke up screaming in pain & attacking the spay area. So we rushed her to an emergency clinic to be worked on. The lumpectomy stitches had been torn open also. The hospital worked on her & bandaged the top part so it could heal open & it's doing well. I visited her Wednesday, July 25, & she still seemed very sensitive & sore in the spay area. So on the 26th, the surgeon put her under & checked out the spay area. He removed her stitches & said it could have been a reaction to the stitches & also her licking both the abscess wound & the spay wound so now the spay wound is infected. They found a few pockets of pus & they cleaned her up. They said they checked all the internal walls to see if the infection had gotten in & it had not. And she doesn't have a fever and is eating great. They left the wound open & tried to bandage it but Keary kept attacking the bandage. So now they have her in an e-collar to prevent that. The spay wound is still super sensitive today & they say it's too early to tell if it's going to heal up since the operation to remove the stitches & pus was yesterday. And they say the top wound -- lumpectomy -- is healing great. I don't want to get my hopes up but we really love this kitten. Is it normal for the spay area to be so sensitive -- the spay was 2 weeks ago but the area was working on yesterday. She is now on a new antibiotic, cephalexine. Have you ever seen this before? She's been tested for feline leukemia & FIV 3 times w/strong negatives each time. Can this just be a chronic infection that we're struggling to deal w/? I'm hoping it's not life threatening. They also cultured both areas Wednesday (7/25) but we don't have the results yet. Thank you for any advice. Lisa
Answer: Lisa-
I can't recall a patient who had an abscess at the time of a spay surgery and ended up with an infection in both areas but I can see where this might happen in that case. We have seen a couple of patients with pretty severe suture reactions and they do go on for some time. The last patient we saw that seemed to have this problem had been spayed about 6 weeks previously at another veterinary hospital and still seemed to be reacting to the subcutaneous suture material. I am not sure what the suture material used was in this case, though. Removal of the suture remnants seemed to calm the problem down but I think it took about 2 weeks after we removed the sutures before the dog (this patient was a dog) finally was willing to leave the area alone.
Most surgical sites can be allowed to heal by second intention (to heal without sutures by scarring in on their own). So far, this has worked most of the time for us when it seemed necessary. Hopefully, that will be your experience, too.
I do think it is a good idea to have culture and sensitivity results on the bacterial infections when that is possible. It helps in identifying the antibiotics most likely to work and given the length of time you have been dealing with this that could still be very useful information. If the cultures are negative it might be worth thinking about l-form bacteria. These are odd organisms that seem to respond to tetracyclines better than other antibiotics. Usually, doxycycline is used in cats for this problem.
It is frustrating to wait these problems out but it usually does work. I hope that holds true for your cat, too.
Mike Richards, DVM 832001
Last edited 09/23/02
Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...