After knee replacement, dog’s wound lick is too ick
Question: I had bilateral knee replacement two months ago, and I’m concerned about infections. My doctor wants me to take an antibiotic before any dental procedure, including cleaning, which I will do. I also have a dog that loves to lick any cuts, especially if there is some blood to lick. What are the chances of a prosthesis becoming infected? Can one’s immune system fight off any bacteria that gets into the bloodstream? — S.S.
Answer: I often have heard that dogs’ mouths are clean, but that is not the case. Bacteria from a dog’s mouth can indeed cause an infection in any kind of open wound, even a small cut or scratch. Our immune system is normally very good at fighting them off, and I rarely see significant infections caused by the germs in a dog’s mouth (cats, monkeys and humans tend to be much worse).
However, in an artificial joint, such as after a knee or hip replacement, the immune system can’t effectively fight off infection, which is why your doctor recommended the antibiotic before a dental cleaning. They often cause some bacteria to transiently enter the bloodstream. Bacteria can enter the blood through an infected wound as well.
The chances of a joint infection after a dental cleaning or a cut, with or without a dog, are small, but the event is devastating. Keep the dog away: Cleanse any wound thoroughly with mild soap and water — but no harsh disinfectants like peroxide, which do more harm than good. Apply some antibiotic ointment (such as triple antibiotic) and cover with a clean bandage.
Q: Would you give me information on blocked bowel movements? I had a colonoscopy two years ago, and they said they couldn’t complete the procedure because of bowel blockage. — H.I.
A: A bowel blockage or obstruction can be partial or complete. There are numerous causes of bowel obstructions.
Symptoms of a bowel obstruction include pain and abdominal fullness, and, paradoxically, can include diarrhea. A complete bowel obstruction is a surgical emergency, and there is a surgical maxim that “the sun never sets on a bowel obstruction” — i.e., immediate surgery is life-saving. Clearly, you did not have a complete bowel obstruction, and I am convinced that there was a miscommunication at the time of your colonoscopy two years ago.
It’s hard for me to guess what it is they meant. I wonder if the preparation they gave you for the colonoscopy wasn’t adequate to clean the bowel completely, and they had a hard time getting to the whole colon. I spoke with a gastroenterologist, Dr. Doug Weine, and he thought that you might have a stricture (narrowing in the colon) due to diverticular disease or tortuous, redundant colon (excess bends and a longer-than-average length).
Get back to the doctor who did the colonoscopy, and get a complete exam done.