Everything’s going well with recovery until the moment you see or feel a bump at or around the incision. Let’s review some possibilities of what it might be, what you should do (if anything) and whether you should schedule an appointment with the vet. No matter what the questionable bump is, it’s wise to send some pics or a video to someone on your dog’s veterinary team.
Bump #1: This one is typically located at the very top of the incision. It feels like a small round circle that’s the size of a pea or smaller. This can be where an internal incision is knotted. Sometimes it becomes less palpable over time. Keep a close eye on it, lightly palpate it each day to check for changes in size or tenderness. If it gets larger, call the vet and send the doc a pic or two. Keep in mind that the very top and bottom of the incision are usually the last to heal, so sometimes bumps like this hang out underneath an unhealed section of the incision, but it doesn't necessarily mean there's anything wrong.
Bump #2: These usually exist toward the top or bottom of the incision where the skin gets folded. The area that’s sutured is tightly closed, and when your dog is in certain positions, their skin might fold over the top or bottom of the incision. Bumps like this are usually less visible when the dog is standing because their skin is stretched. In a sitting or lying position the bump becomes more visible.
Bump #3: This might be a puckered section of the incision. This is usually seen during the first couple weeks after surgery when the incision is still pink and healing. It happens in a small section from one sutured spot to the next, and from the images I’ve seen, these bumps tend to be toward the top or bottom parts of incisions. There typically isn’t any drainage or redness present. The incision should still be closed and not pulled open. If a bump like this was closed one day and then looks to be separating from left to right, carefully read the info about Bump #7.
Bump #4: Sometimes there are multiple layers of sutures, not just the ones you see at the surface of the skin. The outermost (visible layer) gets removed, but deeper suture material is made to be absorbed by your dog's body over time. Some dogs reject this material which triggers an inflammatory response and delayed healing. You might be able to palpate a suture reaction as a linear bump along the incision line. The doctor will evaluate whether to give your pet antibiotics or to surgically remove the offending closure material.
Bump #5: Does it look like a water balloon and feel jelly-like? This can be a seroma. These are usually not infected and are sterile, meaning there aren’t any bacteria or white blood cells in the fluid. This typically occurs in dogs who do too much activity too early in their recovery. Can the fluid be aspirated to check if there’s an infection? Yes, but many docs don’t do this because puncturing the skin can introduce bacteria into what was a previously sterile area and then cause an infection. Can you do warm compresses or massage? Yes, but ask the doctor first. Some recommend both while others recommend leaving seromas alone. Your dog’s body will resorb the fluid without any intervention whatsoever. Does it need medication to heal? In the case of a one that’s not infected, no. Seromas that don’t resolve need to be checked by the doctor and might require antibiotics just to be safe.
Bump #6: Do you feel a hard, immoveable object near the incision? It could actually be the implant or the hardware used to keep the implant in place (screws or pins). Once the incision is fully healed, the bump from the hardware isn't associated with skin color changes, heat emanating from the bump or drainage from it. Most times it's normal to be able to feel metal hardware, but if you feel a new bump and your dog is showing interest in licking it or if your dog has begun to limp again, it could be implant failure that requires a veterinary visit ASAP.
Bump #7: This can form in the early or much later stages of healing, and by later, I mean after the incision is fully healed and the dog is many months into recovery. Bumps like this come on slowly and can quickly worsen. It might look like an inconspicuous small, red or pink nodule, but some are large, mushy or water-ballon like. It can look dry one day and quickly turn angry and red and then worsen to the point of oozing, weeping or rupturing. Sometimes the fluid that comes out might be lightly blood tinged and STILL be infected, so don’t be mistaken into believing that if there’s no pus there’s no infection. If there’s pus, the infection has been brewing beneath the skin’s surface for some time and needs to be addressed by a doctor ASAP. Look for redness around the bump, warmth emanating from the area, oozing or drainage or a foul-smelling discharge. Note whether your dog is licking his/her leg. Does he/she seem lethargic? Is there a change in appetite? Has your dog begun to limp again? Get pics of the area day by day and send them to the vet. Chances are that your dog will need to be seen by the doctor because bumps like this are indicative of infection. A bacterial culture does two things: It identifies the specific type of bacteria present, and you'll get an antibiotic known to kills off that particular bacteria. A broad-spectrum antibiotic might be prescribed, and while these drugs kill many types of bacteria they don't destroy all of them; this is why culturing is so beneficial.
Monitor your dog's incision multiple times a day. And if your pup develops a bump get pictures and videos to send to a veterinary team member. Look for behavior changes in your pet. If you’re concerned, don’t wait. Schedule an appointment to have your dog seen by a professional.