Kitten spay incision check - pulled stitch?

WebDragon

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Hello all. My girl Nyx (and her little sister Luna) were spayed on Monday, it's now Thursday. The vet set their recovery time at 14 days. They've both been in separate dog crates, wearing cones. They come out a few times a day, and Nyx has been guilty of jumping up on the crate, etc. at least once every time she's out.

Checking her belly tonight, her incision looks like this (she's facing left here). She had a laser spay with dissolving stitches. It looks like she's been bleeding a little and the light colored part is newly-exposed flesh, like she pulled the scab or pulled a stitch? Would appreciate any thoughts...
IMG_0478.JPG

Here's what it looked like this morning (facing right here):
IMG_0475.JPG

It didn't look like it was bleeding this morning. There's a lumpy bit in the middle that I thought was a scab, but it could be a blood-stained piece of litter?

I'll send photos to my vet, but have to wait until they open in the morning. Should I be worried that she pulled a suture or has a foreign object stuck in there? Should I be crating her 24/7 to try and contain her better? Thanks for helping a nervous cat momma...
 

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WebDragon

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Another picture, this one is from yesterday (Wednesday), head pointing left.
 

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Mamanyt1953

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Do have him take a look, if only for your own piece of mind. Mostly, though, from the photos that looks like just dried serum, which is perfectly normal. Serum is the stuff that helps form scabs, it's part of the healing process. HOWEVER...my rule of thumb is, when in doubt, have the vet check it!
 
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WebDragon

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Thanks for your advice Mamanyt1953! This morning there was more fresh blood over a larger area of the incision. I emailed pictures over and called the vet first thing this morning, and they wanted to see her ASAP. Of course by the time she came out of the carrier, the bleeding had stopped and it wasn't clear exactly where along the incision it was coming from. But no bleeding is good, don't get me wrong!

The vet examined her and said that it seemed the two edges of the incision were likely moving against or past one another, and the rubbing was tearing what healing had started and causing the bleeding. There was a slight separation of the sides of the incision but not enough to glue or stitch closed again. She advised using a little antibiotic ointment on it twice a day, and of course keeping the collar on. Fortunately it doesn't seem to have set the overall recovery time back.

Nyx and Luna were also prescribed Gabapentin to help calm them down, since even in their crates they are pretty fussy and active - they want to get out and play! The vet suspected that activity, if not the root cause of the bleeding, would at least keep the incisions from healing as quickly as they could.

Soon after I got her home, Nyx started grooming, and I realized that even with the cone on she's figured out how to groom the inside of her legs. Not the incision itself, but close. She's a medium-haired cat and I wonder if the tugging tongue against her fur is what's creating the irritation of the incision? I have a recovery suit for her that I haven't tried on her yet, but it doesn't go down the legs and probably wouldn't prevent her from grooming that area...

Bonus pre-surgery pic of the ladies, because cut up bellies aren't anywhere near as fun to look at as the whole cat :D Nyx is the brown tabby, Luna is the lil' grey.
IMG_0395.JPG
 
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WebDragon

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Friday PM... the incision has been bleeding again. Aside from the vet visit, she's been in her crate practically all day. Starting to have a strong suspicion that her inner leg grooming is what's irritating the wound. Or, relatedly, the cone scraping up against and irritating the incision when she does go to groom her inner legs. She has two 50mg doses of Gabapentin and two applications of antibiotic ointment behind her.

Head facing right in this photo. She's looking worse, not better, right? You can see in the strands of fur right alongside the shaved area that she's been licking all around her belly. Maybe she can actually directly lick the incision even with a cone on?! I love this little sweetie and am hoping this won't set her recovery back behind that of her sister. Fortunately she's still eating like a champ. I was asked to give the vet a follow-up call tomorrow, so I'll have to wait until then to see what's next.
Nyx 4.29.22 PM.JPG
 

Mamanyt1953

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Have you tried her with an Elizabethan collar rather than a cone? They look like this: Heck with it. I'm giving you my search result URL.
elizabethan collar for cats - Bing images

As you can see, they come in a variety of styles, and most people find that their cats tolerate them better than a stiff cone. AND, the collar would be less likely to rub the edges of the incision.
 
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Update after a few days. The kitties had a rough weekend, going to the vet twice in two days. Nyx had indeed figured out a way to lick her incision even with the cone on - by putting her head between her haunches, using her knees to brace the front edge of the collar, and sliding it back on her neck enough to have her face protrude forward and get to her belly. The first vet visit resulted in a prescription for Gapabentin, and the recommendation to put storebought antibiotic ointment on the incision. BUT the ointment caused Nyx to lick even more and do even more damage. This was the point where I figured out how she was actually able to get at the wound, so I put Nyx in a recovery suit and it was back to the vet first thing the next morning. At the same time, her sister Luna started peeing globs of blood. So the second visit was for them both :(

I saw a different vet (the one I've used for almost a decade now) the second time, who prescribed antibiotics for Luna after finding she had a mild UTI. For Nyx, she cleaned all of the dried blood and scabs off of the incision and glued it closed again. She recommended they both continue wearing the ecollar vs. other types of collars, but was also a big fan of onesies or recovery suits.

Nyx has been doing much better since, with the incision looking nice and neat, dry and clean under the fabric. She hasn't been bothering it at all, not trying to groom around the area anymore, and doesn't mind the recovery suit. I should have put it on her on Day 1. Luna will be wearing one too to get used to it for the day their cones come off; I think I'll keep them in the suits for an extra week after the cones come off just in case they decide to play rough with one another. But for now, both of them are pretty much back to normal!

Lesson learned: The recovery suit is awesome. And if the incision is looking gunky, it may be worth asking the vet to give it a cleaning (or doing it yourself). I wasn't charged an exam fee for having them seen, as it was considered the same as a follow-up appointment I would have needed anyway to have their stitches removed, if they weren't the dissolving kind. PHEW.
 
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WebDragon

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A question: I went to change Nyx's recovery suit earlier tonight, an easy process because she was preoccupied with grooming her front legs while her cone was off for those few minutes. I was switching out one suit for another because I saw the fabric had some pink stains around the area of the incision, which I thought were from when she had been bleeding late last week.

But as I changed her the incision started weeping clear pink-tinted fluid from around the large scab in the middle. It isn't blood like she'd been bleeding earlier - is this plasma? What I've heard referred to elsewhere on TCS as serum? I'll be emailing these pictures to the vet in the morning but wanted to know if I should be concerned in the meantime.

Nyx 5.2.22.jpg

This was taken with her on her back, head end pointing right, before the incision had started weeping fluid.

Nyx 5.2.22 (2).jpg

And this is a few minutes later, now rolled over on her side with her head pointing left. I dabbed the area with a paper towel and the stain is shown in the photo. The scab seemed kind of loose, but no painful reaction. All the same I wasn't going to go tugging at it.

She's been eating well and toileting normally. She seems alert but not overly energetic or agitated, and hasn't been trying to lick at or get to the incision. Thanks in advance for any thoughts or advice!
 
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Yep. It's serum. It's expected. And healthy.
Thanks! I was worried about it leaking through the incision site, sent more photos to the vet, and she was back for another vet visit on Wednesday. The vet who saw her was the one who originally did her surgery, and he was puzzled as to why she wasn't healing up. But, he didn't recommend any action other than to keep the incision open to the air and "let the body heal itself". He said there was one remaining suture knot in the incision that hadn't healed over or dissolved yet, and that it was causing all the irritation. It sits right underneath the scabbed area. So he pulled the scab off, and what's underneath looks like a hole! I could see a tiny black line in there which I assume is the suture. The vet wasn't a fan of the recovery suit, and said I should discontinue use of the antibiotic ointment. He thought this didn't push back her 14-day recovery period from the initial surgery. While I don't dispute any of their advice, I'm a little confused about having seen three different vets in the same practice, and gotten three different sets of instructions...

My husband was the one to take her in for her latest vet visit, and on the way home she managed to get out of the recovery suit in her carrier. Hubby didn't put it back on, and again she started licking at the incision even with the cone on. UGH. Everything was licked raw and red by the time I got home from work, and she went back into the recovery suit right away at that point.

It's now Friday, and she looks like she still has a long way to go in healing. The "hole" has sort of scabbed over, but kind of looks like an "innie" belly button, and the scab doesn't seem to be attached to much. We've decided to keep her crated for another several days beyond her initial 14-day recovery time, and beyond that she'll continue to wear the suit and cone, and be isolated from her already-healed and boisterous sister for another several days at least. I honestly don't trust to let her run free until she's 100% healed up. I feel like one high jump or kick from her sister could send her right back to the beginning :(

Her sister's incision looks perfectly healed BTW. I have no idea why the two of them have had such different results in recovery. I'm going away for a work trip and while Hubby is going to do just fine in watching them, I'm still just so worried about Nyx. But at least she's eating, pooping, playing, everything normal. No sign of infection that I can see. I figure that if something starts to go wrong we'll see it.
 

Mamanyt1953

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Sounds to me as if you have common sense firmly on your side. As for the "what the heck, let her lick it raw" vet, there are times when I do not agree with a vet's "wisdom." This would be one of them.
 
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An update on Nyx's progress. It's been almost a month since her spay surgery. She went in to the vet hospital again last Wednesday because she still hadn't healed up, and was seen by the same vet who had done her surgery and had already seen her once before. They advised to leave the recovery suit on for another week, and otherwise could resume her normal routine. Happily, she and her sister tussling didn't seem to do any harm. The week passed and when I checked her out yesterday, it looked like the incision had healed completely, no scabs or anything. I breathed a big sigh of relief as you can imagine! She came out of the suit and didn't seem to be grooming her belly more than normal.

24 hours later, I've checked her belly again and there's a short red line along her incision, like she'd licked it until it bled again. Argh. She does not like me holding her to check the incision or touching around it. There's nothing open, looks like a bleeding paper cut or a scratch, so I won't take her back in unless it looks like she's really bleeding. But after all this time it's disappointing to see. Anyone out there had similar experiences where it looked like an incision had healed up, but really hadn't completely?
 
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