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Patient Spotlight: Petey, Healing skin wounds in dogs

Aug 26, 2013

buckethead.jpgThis adorable guy, Petey, was abandoned in the middle of the hot July summer in Montgomery, Alabama.  Someone found him and brought him to the kind people at the Bell Road Animal Medical Center in Montgomery.  Dr. Eric Lewis began treating Petey’s wounds immediately on July 16, expecting at least two months or more of recovery time before they would be able to offer Petey up for adoption. Even with newer therapy technology like the therapy laser, the extent of Petey’s wounds warranted a delayed healing process, but he was shocked at the speed of healing using the Assisi ™Portable.

Dr. Lewis is the practice owner and primary care veterinarian at Bell Road Animal Medical Center.  After graduating veterinary school at Auburn University College of Veterinary Medicine in 1990 he began practicing at Bell Road, and became the primary DVM there in 1992.  After 23 years, he continues his practice there today, improving the clinic’s offerings with the latest in medical technology for animals. If you live near Montgomery and need medical care or boarding for your pet, check them out at www.bellroadamc.com

I’ll let Dr. Lewis tell the story of Petey:

Petey was found here in Montgomery.  When he was brought to us he had a wound on the side of his left forefoot that extended from the carpus on the lateral side, down to the proximal lateral digit.  It was deep enough to have exposed some of the tendons on the dorsolateral aspect of his metacarpals.  There was no bone exposed, but the lateral extensor tendon was clearly visible.  He also had a seroma (a fluid filled pocket) or hygroma type lesion on the dorsal aspect of his right carpus.

IMG_20130718_165045.jpgOur best guess is that Petey  was in a car or truck with an open window and jumped out. After doing so, he must have landed on his right carpus and caused the seroma to come up.  We believe the injury to his left foot may have occurred when the edge of a tire rolled over it, just pinching that tissue.  The skin covering that area was still attached to the foot, but it had been “degloved” from the side of the foot and had begun a process of decay and had dried out.

When Petey first arrived the wound appeared to be between 3 and 5 days old, based on the amount of granulation tissue we saw, and the fact that the loose skin tissue had already had time to desiccate.  We were able to debride that tissue with just a pair of scissors, without topical anesthetic, as the tissue had already died and he couldn’t feel any pain from it.

It was July 16th when we began treatment.  The individual who brought him in and dropped him off left phone numbers, but none of them were functional, so were unable to get back in touch. We were left with no acceptable alternative other than to take on his care ourselves.

Petey is a very sweet dog with a good disposition-a very adoptable dog.  He’s an intact male about 8 months old.  At that time he also had hookworms, and no history of vaccinations, so we started with core vaccines and deworming while we began wound care.  We put an e-collar on him so he wouldn’t chew the bandage off.

Our initial wound care was just cleaning it with a chlorhexidine solution and bandaging the wound with Silvadene cream on a non-stick type topical bandage and wrapping the foot in a light wrap of cotton padding and vet wrap.  Initially we changed the bandage daily because the wound itself was quite suppurative.  The bandage the next day would be soaked with all the fluids produced by the wound. We also put Petey on oral cephalexin during the first 4 weeks.

IMG_20130726_170043.jpgWe began using the therapy laser with the infected wound setting on the first day.  After two or three days into his therapy  we were starting to see really good healthy granulation tissue to start.  We had at that time what we considered a pretty decent blood supply to the new tissue established.  At that point, on the 20th, we started using the Assisi Loop Portable™ on the wound, which  was around the fourth day of care.

By July 20th the granulation tissue had spread out and reached the edges of the wound.  On the 23rd the granulation tissue started looking healthier so we started leaving the bandage off for a few hours at a time to let some oxygen get to the tissue, but we continued to keep the dressing on it overnight.  Around the 24th, the wound was starting to show some contraction.  Originally the  4 inch wide non-stick pad was not quite wide enough, the wound was maybe 3-5mm longer than the bandage would fit.  By the time 10-11 days had elapsed, it was already starting to shrink so the bandage would cover it.  At that point there was significantly less suppuration from it.  When we changed the bandages they would be wet but not soaked through like previously.

On July 26th , 10 days after initial presentation, we started leaving the bandage on for 2 or 3 days at a time, using the Assisi Loop treatment with the bandage on, and giving a laser treatment when the bandages were changed and the skin was exposed.  The Laser will not work with the bandages on, but that doesn’t prevent the Loop™ from working, providing us a method to encourage wound healing without having to continue daily bandage changes.

Now, by the 15th of August, after just 4 weeks of treatment,  the edges of the wound have completely epithelialized.  There’s now a space only about 3cm by 6cm that still has granulation tissue on it.  It’s getting progressively smaller every time we change the bandage.

IMG_20130812_163629.jpgThe Assisi Loop certainly seems to have sped up the process.  I was expecting this to take anywhere from 6-8 weeks to be completely healed.  It may take 8 weeks before we’re at a point where he doesn’t need any further treatment.  I would have thought it would take 6 to 8 weeks to get where we are now, and it’s only been 4 weeks.  It’s taken at least 30% less time to heal than I thought it would, and I expected it to go fast because I’ve certainly seen the laser make a difference, but it went faster because the Assisi Loop was involved.

I’ve had the laser for 3 or 4 years now, and we use it on many patients unless it’s contraindicated.  Until now I’ve only used the Assisi Loop™ on a few cases of arthritis or hip problems.  I’m looking forward to trying the Assisi Loop on some other conditions based on this experience.



Category: Dogs, Patient Stories

Sida Li

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