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The "Cone of Shame": A Necessary Evil

The figure of speech "going off to lick your wounds" is okay in the metaphorical sense, but not when we're talking about dogs and cats after surgery.

Veterinarians cringe when well-meaning owners proudly announce that Fido has been licking a surgical wound in order to heal it. Dog saliva may indeed contain compounds that numb the wound and neutralize some microorganisms. However, doggie drool and kitty spit also has potentially harmful bacteria in it, and the act of licking itself can ruin a good surgical closure.

Dogs and cats routinely create serious infection in their skin from over-licking an area due to allergies, injury or post-surgical discomfort. That's why veterinarians regularly dispense an Elizabethan collar (e.g., e-collar) following spays, neuters and other surgeries. The "cone of shame" prevents the dog or cat from licking the incision, allowing the wound to heal faster and without complication.

Sometimes, however, the e-collar is an inadequate deterrent. I have met Houdini-like dogs who escape from their e-collars no matter how they are fastened. Some dogs figure out a way to chew through the plastic rendering the cone useless, while others ram it into things until it cracks, bends or (especially in Wisconsin winters) shatters. Many dogs act so demoralized initially that sympathetic owners can't bear to keep the cone on them at all. Most recently, I had a canine patient whose long nose poked over the edge of her cone just far enough that she managed to lick her spay wound to the point of infection and dehiscence.

Dehiscence is a fancy medical word for the splitting open of a wound. A dehiscence may be minor, involving a tiny part of the skin incision and requiring no special treatment. Or maybe a few skin staples will be placed to hold the wound edges closer together for faster healing. The worst kind of dehiscence, the kind that keeps veterinary students up all night and biting their nails following their first spay, is an opening completely downthrough the abdominal wall so that the animal's abdominal fat or even intestines protrude through the wound. Dogs have been known to chew on their own insides when this happens! Yikes! Thankfully, this is exceedingly uncommon.

Maddie's abdominal skin dehiscence looked a lot like this
Even Maddie, the long-snouted Springer Spaniel who managed to ferociously lick outside the cone, presented with just a partial dehiscence. While I could peer down through her subcutaneous tissue and fat to the sutures holding her abdominal wall together, thankfully the abdominal closure remained intact and her guts stayed in. Maddie's dehiscence was so severe, however, that she required general anesthesia so the dead, infected wound edges could be trimmed away, or debrided. I resutured the wound, placed Maddie on a course of oral antibiotics and gave her a larger e-collar. I expect the wound to heal normally after this, but I won't be surprised if she develops a seroma, or pocket of fluid under the skin, from bouncing around too much before the area completely heals.

Don't assume if your pet isn't licking their incision immediately after surgery that they won't. Some animals leave their surgery site alone during the early phase of healing, but attack it just as the skin finally starts to mend. If you have ever experienced insanely itchy skin as a surgical incision or even a minor cut begins healing you'll understand why dogs and cats suddenly notice their surgical wound a week after the fact!

The "cone of shame" is obnoxious, humiliating and completely necessary in most cases. Even with the cone on, however, pets can develop complications in their surgical wounds that require follow-up care by their veterinarian. Please follow your veterinarian's post-op instructions closely regarding exercise restrictions, wound care and medications. And most of all, don't let Fido lick!
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