Friday, March 20, 2015

Wound Repair, Take Two. How To Treat Your Dog Fight Wounds.

Don't you agree that her wound doesn't look too bad?
That's a very common assumption, and unfortunately, its often wrong.

This is Whiskey, a rather rambunctious three year old spayed girl who is more likely to greet you with a loud, ferocious bark and fierce lunge forward to remind you to stand down, turn around, and visit someone else, than a offer a wag and a smile.

As fate will have it, if you yell angrily at enough other dogs one of them is going to meet your nasty bark with an arcade of teeth and leave you with a wound to your face and a subsequent needed visit to the vet.

Whiskey came in on a Sunday for a bite wound that she had received on Friday. Her family had thought that it was just a small scratch, and no one wanted to incur a vet bill, especially in light of Whiskey's poor attitude.

On Sunday's visit it was decided to try to take a conservative approach. Whiskey was acting normally, eating, drinking, breathing, ambulating were all normal, and finances were tight. We flushed the wound (muzzle necessary), and applied 4 staples to keep the edges together.  She was in and out of our door with the minimum treatment plan available. The cost for this visit, $75, (an exam and 4 staples).

The next day Whiskey's mom called to say that she was in need of some pain medication. She came by to pick up a prescription for an NSAID.

On Tuesday afternoon the staples were missing and the wound wasn't smelling so good.



Tuesday night we treated Whiskey's wound more aggressively. We clipped the wound, applied a numbing agent and tried to suture it closed. We could have sedated her but her wound was not deep and did not require a drain. It was also very difficult to suture so close to her eye so we decided instead to staple it closed (again). This time Whiskey went home with an e-collar to protect her face and prohibit her from rubbing or pawing at the wound.

Lidocaine jel applied to the wound to provide a topical anesthetic.

Here is a video of us exploring Whiskey's wound. Any wound that is deep or dirty should be explored under general anesthesia. General anesthesia also allows us to explore and identify pockets, embedded debris, compromised structures and remove damaged tissue to speed up healing. In some cases an old wound needs to be cultured to identify which bacteria is residing in it and help identify the best antibiotic to treat it.



After clipping the wound it was closed. We had a long discussion about how to best do this;

1. Allow it to close on its own. In some cases this is best. These include wounds that have already got a good bed of granulation tissue. Or wounds that are so large we cannot close them.

2. Close it with glue, sutures, a full closure of the wound. This is the fastest way to heal a wound, BUT, you need to be sure that you know what you are closing, and be darned sure you aren't closing infection IN.

3. Clean the wound with lots of flushing (we use a dilute surgical scrub, or diluted betadine if around the eyes), and then apply either a suture or a staple to keep the wound from opening up further. Motion on a wound prevents the new healing cells from being able to form a supportive structure to allow it to close.

Whiskey allowed me to place one suture (I prefer them because I can get larger pieces of tissue and hold the wound together better than a staple, which is shallow, will allow. Therefore, she has 1 very solid deep suture, and four staples. Because we did not sedate or anesthetize her I did not suture it closed from top to bottom.





Whiskey went home with;

1. Pain medication, 7 days worth, $30.

2. Antibiotics 10 days worth, about $40.

3. E-collar about $15.

Whiskey's bill at my clinic was $185, which included the above and lidocaine $15, repairing wound $25, and initial examination $60. 

I will recheck Whiskey in 1 week. She may need the staples removed then, or it may take almost 2 weeks.

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A Pawbly member asked about how to treat their pets bite wound at home. I hope that this blog helps to explain why bringing your pet to the vet after a wound is so important. If you have a pet question, or any kind of pet experience that you think would help others, please join us at Pawbly.com. It is free and open to all pet lovers.

Any injured pet in the Northern Maryland area can find me at the clinic, Jarrettsville Vet, in Jarrettsville Maryland. Or follow me on Twitter @FreePetAdvice.

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