My dogs recent surgery

Question
On Wed. my 9y/o peek-a-poo had bladder sugery and they removed 29 stones from the bladder.  We had to return to the vets office on Sat. for loss of appetite,unable to urinate, and distended abdomin.  The Vet stated that the skin around the sutures had necrosed and started leaking urine into the abdominal cavity.  They started a second surgery and removed the necrosed tissue and double stitched the incision.  Our dog seemed to be getting better, she started to eat and was not as lethargic as she was after the first surgery.  This afternoon the vets office called and said she was regressing.  They tapped the dogs abdomin and found urine in the cavity again.  A third surgery was performed this afternoon and the vet stated that she had never seen anything like this before and also the rest of the vets in the office, one with over 20 years of experience, could  not explain the problem.  Do you have any ideas as to what the problem could be?  The vet stated that the bladder this time did not look as healthy as it did on Sat.  Any help would be appreciated.

Answer
These surgeries are hard on the bladder. It isn't tough like other organs. It is fairly thin (when healthy) and can be thickened when it is full of stones and irritated. However, this also makes it friable, soft if you would, the tissues are raw and tender and don't stitch together well.
It's like trying to place sutures in a mango- same sort of texture. I am talking about the suture line and the edges of the incision, not the bladder itself.But the lining of the bladder is also very raw and irritated and that is one of the contributors to this.

So this makes it hard to maintain a good strong suture line on the bladder. I don't know why a vet with 20 yrs experience hasn't seen this before. So many things can cause it, but usually the bladder has been under assault for a while from the stones and that can really be irritating. Infection is another cause of it. Maybe some kind of bacteria is in there that is really attacking the tissues. We have seen bladders this raw before and really had a hard time with one once that had compartmentalized itself. But in the end the dog did well once we figured out which compartment was the main bladder.

There is never a real, hard explanation- like most things in medicine. Sometimes it's just rotten luck.

I really do hope she pulls through this. With real careful monitoring, antibiotics and lots of fluids she will do better. If they can just get her past the hump with the suture line closing better and stop the leaking she will do good.

At this point David, a whole lot of prayers might help. I will be adding to them. Please let me know what happens to her. I will be sending prayers and healing thoughts her way.