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internal sutures and surgical glue vs. external sutures

Posted by newhomeseeker (My Page) on
Tue, Mar 16, 10 at 9:28

I took my two 7 month old kittens to my vet to be spayed yesterday. I made the appt about a month ago and when I did I asked if the vet would use internal sutures and surgical glue because I preferred it. I had a cat spayed about a year ago and they used the external sutures and it was horrible. I couldnt' use an e-collar (plastic or cloth) on her because she went nuts and ran into things and was so active she almost tore her stiches. So they suggested buying a newborn sized onesie and putting her in that so she couldn't lick the stiches. I tried that and while it was hiliarious trying to get a 7 lb cat into a onesie (with modifications made to it) the cat did not find this amusing and therefore it did not work.

I am gone about 10 hours per day so I couldnt' keep any eye on her and on day three she started chewing her stiches out. I had to take her back to the vet to have some of the sutures redone! And then when we got home she chewed those out as soon as she could as well. Even though it had to hurt! The vet really scared me because he told me she could bleed to death if she removed the stiches. (even though they use internal sutures as well) We kept her in our bedroom for two weeks to keep an eye on her.
A few months ago one of my foster kitties was spayed through the shelter. THey used internal sutures and surgical glue and I had NO problems. She licked the area a little bit but never had any trouble with the incision and it was so easy and less stressful to the cat. She was fine in about two days. So I asked the shelter vet why she prefers this method and she said for one there are no sutures to remove (no return visits) and the animals don't bother the incision site as much (as with external sutures).

So when I made my appt. I asked if one of the vets preferred this method and the girl told me that today most vets do this and I asked her to check (there are six vets there) because last year they did not use this method. She had already scheduled an appt. for me but said she would call me back. She checked with the vets and called me back and said they only had ONE vet that used this method (a new vet) and she had to change my appt. so the surgery could be performed by this specific vet. She gave me a new later appt. date and yesterday I brought my cats in for surgery.

Before i left I asked (just to make sure) which dr. was performing the surgery and they gave me the name of a vet I've seen before but not the one I was orginally told was doing the surgery. I advised that I'd specifically asked for a certain vet because I wanted the cats to have internal sutures and surgical glue. They looked in the computer and there WAS a note stating this. I advised the receptionist (vet tech) that if the vet was not comfortable doing this to please call me and I'd pick my cats up and take them elswhere or reschedule the appt. I left my cell number.
Never heard from the vet so I thought everthing was fine. Went to pick my cats up last night and the vet tech was going over the after-care instructions and said the cats would need to come back in 10-14 days for suture removal. I said "wait a minute, they have external sutures?" and she said yes, why and I told her that I'd left instructions that they were to have surgical glue and she just looked at me and rudely said "well that's not what happened" SHe went to talk to the vet and I was seething mad and she came back and told me that they did have internal sutures and surgical glue "BUT that is not SAFE, that is not the proper way to close an incision and the doctor did not feel comfortable doing that" She also told me that I'd have to watch the cats very closely as "just a few licks of the surgical glue and they can split the incision right open"

Does this make any sense? i thought the surgical glue and internal sutures were safer or sturdier than the external sutures? Aside from my vet's office being incompentent and irritating as normal do I need to worry that they will rip open their incisions?


Follow-Up Postings:

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RE: internal sutures and surgical glue vs. external sutures

I like internal sutures;
they don't have to be removed, & I never have known a cat to lick or split them.

You're a grown-up lady & can make your own decisions of course, but my advice is...

drop the jerks & look for a nicer class of vet.

I wish you the best.


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RE: internal sutures and surgical glue vs. external sutures

I would be SEETHING mad.

IF they didn't think the internal stitches and glue weren't safe, they should have told you that BEFORE the surgery, giving you the option to take your business elsewhere. It sounds like you were VERY specific about what you wanted.

I would never go back to that vet again, simply for the lack of communication. And I would make sure that all my friends knew about how mad they had made you.

I can't remember how long its been since any of my dogs had the old-fashioned stitches. My vet has been using the glue for years.


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RE: internal sutures and surgical glue vs. external sutures

I can count on 1 hand the number of routine surgeries where I place external sutures. I very rarely have any complications. I can count them on 1 hand too. And I do over 20 routine surgeries a week (usually closer to 30). I've gotten to the point where I rarely use glue either- my dermal sutures are just that good. That comes with *lots* of practice.

You have a right to request surgeries done the way you want them, assuming that is within best practices. Not using external sutures is certainly well within your rights.

Not only was there a serious lack of communication, but the tech/receptionist flat-out LIED to you. That's a deal-breaker for me.


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RE: internal sutures and surgical glue vs. external sutures

My cat was just spay. She was closed with surgical glue. She was licking it and I was looking up if it was dangerous for cats to ingest. The vet said it wasn't. I want through Alley Cat Rescue for the cost with a local animal hospital that honors their prices. I cannot find anywhere that comments on the ingestion question. Can anyone tell me? Also I read about surgical glue and it is supposed to be placed on the incision cut only. My cat had this silver stuff all over her belly area. I asked the doctor what it was and he said it was powder. I called the office and asked what the powder was called and the person said it was surgical glue that was sprinkled on the incision and got off the mark. I would think this is sloppy work. If the cat is asleep how could he miss the mark? She said it was not harmful if licked. I read up on glues and there are transparent film adhesive and hydrocolloid glue in powder form but this stuff was silver in color. Can anyone tell me about this glue?


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RE: internal sutures and surgical glue vs. external sutures

Meg,

What is the difference between external sutures, internal sutures, and dermal sutures? I've never heard the term "dermal sutures" before and am not sure what it refers to.

I actually prefer external sutures to glue. Each time one of my animals has had an incision closed with glue, the incision site has become inflamed. I haven't seen that inflammatory response to external sutures in any of my animals.

Laurie


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RE: internal sutures and surgical glue vs. external sutures

The vet used internal sutures on the feral I trapped so that it would be easier in that trapping her a second time to remove the external sutures may not have been an option. I saw no problem whatsoever. The fur had been shaved in that area but days later I could barely tell there had been an incision except for a small pink spot. She seemed to breeze right through the surgery.


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RE: internal sutures and surgical glue vs. external sutures

I worked for a rescue group for years and never used external sutures even once and no problems (spayed literally thousands of animals). But I learned years before at a regular practice not to use external sutures, particularly in dog neuters, as the pets never bothered the surgical site if there were no external sutures, but almost always did if they were there.

Where I work now they like external sutures because they like to see the pets back to be sure all went well (internal sutures mean pets never have to return and sometimes you wonder if there were any problems or not, I guess). Still, all the vets here can close without external sutures if asked, or if the pet is particularly grumpy.

I agree with being upset even though I understand some places policies... still, if they said they were going to do things one way, they should agree to stick to that. I don't really understand why they didn't.

By the way, the glue used is usually only to make things look nice, not to keep the incision from flying apart... 95% of the time glue is not needed with only internal sutures, unless one was sloppy or the tissues were exceptionally tight. I use glue in many cases to neaten things up and I have to say I have never had any irritation (but then I don't put glue INSIDE the incision, just on the outside). I do use glue when closing rat and rabbit incisions as the primary closure method, but I sort of have to as these animals will chew any suture they get ahold of (same when I do primate surgeries). Rabbit and rat skin though is so thin that internal sutures are nearly impossible to place... but thankfully that super thin skin holds the glue very well and not had a problem with skin coming apart afterwards. Reptile skin, on the other hand, could not easily be closed without external sutures, so there are exceptions.

Not sure why all vets don't use this method. I noticed that most surgical specialists prefer not to use external sutures, at least on their abdominal incisions (extremities are much harder to close without skin sutures).


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RE: internal sutures and surgical glue vs. external sutures

We just got our puppy spayed a couple of weeks ago. The vet service we went to was a lower cost foundation run by several vets to support an animal rescue. They do 15,000 surgeries a year on family pets and ferals and always use the glue & interior sutures. I was really nervous about taking our new puppy there, but the price between them (120 including micro chipping and a rabies shot) and our normal vet (450 for the same) was huge and really made me wonder why our Vet charges so much.

Anyway, this place was amazing. Though very busy, it was clean, well maintained and run like a tight ship. I dropped of our puppy in the morning and picked her up that night. She was given 36 hours worth of pain medication at the time of the surgery so I had to do nothing but keep an eye on the tiny incision. By the second day she seemed normal, just less active. Within a couple of weeks she healed perfectly but if there had been a problem, the clinic offered free follow up care to ensure a perfect heal.

I'm not a Vet, but I think that if a service with that kind of volume uses glue and internal sutures, it's safe to say it's a good and accepted practice. I know for my pet it worked like a charm and this was the best experience we've had when spaying/neutering one of our animals.

I agree that it may be time for you to find another Vet. Although your Vets people skills are obviously lacking, the bigger problem I see is that they don't seem to be up to date with the new methods being used today. That concerns me and makes me question the quality of care your pets are receiving.


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