Original Question: "My 7-month-old kitten was spayed and after the procedure, she developed a swelling at the incision site and was x-rayed by the vet and prescribed a 7-day oral antibiotic. A week later we did a follow-up the swelling was much reduced and a second X-ray done. The vet got back to me with 3 options 1) do nothing 2) an ultrasound and 3) another surgery to see if there was a chance of a herniation of fat (as opposed to intestine which they did not think was probable based on the second x-ray. The kitten is fine and the sutures are healing well, no swelling, no redness and yet the vet wants to pursue the second surgery. Is this even remotely a best practice?" - Lucy
Congrats on your new addition! I am glad you are so invested in her care and welfare and decided to have her spayed. This will help avoid contributing to the pet overpopulation problem and also help to prevent your kitty from developing various types of cancer. While the vast majority of cats recover from this procedure without incident, there can on occasion be complications as you described.
Swelling of the incision can occur for several reasons. First, the incision can become infected with bacteria – this occurs if the incision is contaminated, and especially if the cat licks the incision, introducing nasty oral bacteria to the area. Another thing that can occur is something called a suture reaction. This happens when the body starts breaking down the sutures under the skin, causing a mild inflammatory reaction and swelling. This may occur days to weeks after the surgery, and some animals may experience an almost allergic reaction to the suture material as it breaks down.
Another possibility is a hernia. A hernia occurs when the abdominal wall separates at the incision site and allows abdominal contents (fat, organs) to exit through the opening that is created. Hernias are a concern because there is a risk of an organ becoming trapped in the opening and being damaged. They should be repaired surgically as soon as possible to prevent this from occurring. Hernias occur within the first few weeks after surgery, before the abdominal wall is healed entirely.
As you described, there are a variety of tests such as physical exam/palpation, x-ray and ultrasound to determine what the post-op swelling is. I am unable to tell you which it is, but I believe the options provided are reasonable based on the information you shared here. The decision should be based on your personal level of concern in conjunction with your vet's assessment of the cat and results of the tests performed.
Dr. Kim Hester
Disclaimer: healthcareforpets.com and its team of veterinarians does not endorse any products or services mentioned. Advice presented by our veterinarians is not meant to replace a regular physical exam and consultation with your primary veterinarian. We always encourage you to seek medical advice from your regular veterinarian.
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