More Trouble

(Note: Pictures slightly graphic.)

Popeye's left stump this past weekend:







Today:





I sent these pictures to the orthopedic surgeon, who thinks a seroma has probably formed in the left stump.

(Taken from: http://www.datasci.com/pdf/technotes/392-0027-002.pdf)

What is a seroma?
A seroma is defined as a sterile accumulation of serum in a circumscribed location in the tissue. The difference between a seroma and an abscess is that an abscess involves the presence of white blood cells, bacteria, and the breakdown products of both. In other words, an abscess is defined as an infection. A seroma, on the other hand, is just fluid, serum that has accumulated in a dead space in the tissue. It is the result of tissue insult and the product of tissue inflammation and the body's defense mechanisms.

Why does a seroma form?
First, be assured that it is a perfectly normal response. The body is simply reacting to the presence of a dead space within the tissue that was previously attached to something. When we remove a large mass, or create a defect (such as making the subcutaneous pocket needed for the DSI transmitter body), we damage the very small vessels that previously ran from the underlying tissue (i.e., muscle, connective tissue) to the overlying tissue (i.e., skin, muscle).

Although these vessels do not cause significant blood loss, they do allow escape of serum into the area. There is also the resulting tissue damage that occurs regardless of how carefully we dissect. This tissue damage results in cellular death. The body's reaction is an inflammatory one. Because of the inflammation, cell death, and increased vascular permeability, fluid can accumulate in the newly created space. This process will generally resolve over time if there is some form of natural drainage, if there is not continued irritation to the area, if circulation to the area is sufficient, and if the animal is in good health.

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In Popeye's case, he was probably too active too soon after the surgery, hopping about on his stumps and exacerbating the inflammation. The surgeon said you don't generally expect dogs who just underwent amputation to be so active, but Popeye is of course a unique case.

For now I am just putting a warm compress on it throughout the day to hopefully reduce the swelling naturally. Worse case scenario would be he'd have to go to the vet to get it drained. But inserting a needle would open the wound up to infection, whereas right now, it is completely sterile and has no risk of infection at all. Plus, there is a likely possibility that the seroma would just fill up again.

We're also still waiting for that damn bandage to come out. He's still eating and pooping normally, but no large bandage has been seen (and believe me, I am intimately familiar with his poop).

I keep dreaming of the day, far far into the future, when Popeye will be at a point where there won't be anything I have to worry over.