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| Jack Seven; Wound management | |
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| Topic Started: May 9 2009, 12:15 AM (62 Views) | |
| wild whippies | May 9 2009, 12:15 AM Post #1 |
Squeaker
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As requested and for those who may unfortunately encounter a similar dilemma here is the story so far about Jack Seven. This topic contains photos that may upset but are of relevance to the discussion. Jack is a non-ped racing whippet (1/4 GHD 3/4 Whippet) age 5 yrs. Jack ran at our organisations coveted championship event aprox 6 weeks ago now and succesfully won his Veteran Championship title. Shortly after this, Jack started to show a swelling in his neck. Anti-biotics were given and his teeth given a scaling (partner is a dentist and recognised this could be a source of infection) and the situation resolved for a week or so then started to return. He had no other symptoms other than the swelling, however I thought it prudent to have a good look down his throat (not the easiest of feats with a 40+lb muscled up racing dog with a long pointy nose!) Anyway I caught a glimpse of inflammation on the same side as his neck swelling and a noticed a pungent odour so decided to get him down to the vet for more investigations. Jack seen Paul Evans, a vet with noted experience in greyhounds. Even with much coaxing Paul struggled to see down his throat so we sedated him upon which examination revealed a sinus (an unnatural hole) in the back of his throat. Paul's initial suspicians at this point being that either a grass seed, piece of bone or stick had somehow penetrated his throat, infection set in and tracked through his throat to his neck. Diagram shows roughly were the hole was located. Posted Image The hole itself was heavily infected with dead tissue so Jack was put under a full anaesthetic. As the neck was prepared for possible exploration, it becamse apparent the lump was located in very close proximity to his jugular vein. (point 3 in anatomical view below, point 5 being the jugular vein) Posted Image For this reason, together with the fact that no defined lump could be identified (i.e. this was a diffuse mass going through various layers of tissue and structures within the neck as opposed to a lump that could be simply cut out and removed) it was felt best to approach this with open wound drainage and an extensive course of anti-biotics. A swab was taken (to check that the bacteria present were susceptible to the anti-biotics) the tract within his throat was cleared of dead tissue and Paul did a thorough examination of the tissue to try and find a culprit. Unfortunately nothing was found but it was feasible that the culprit could be so small that it would be expelled through the drain. A tube was passed through the mass containing perforations so that the infection could drain out, it was secured with a suture and we was given instructions to irrigate the drain with peroxide. These are pictures of Jack 1 day post-op Posted Image Posted Image The swelling under his jaw and to his chest was fluid accumulation from the surgery along with probably some fluid build up of the salivary gland due to surgical swelling impairing it's function. When he was brought home he was kept comfortable with pain relief meds, anti-inflammatories along with his much needed anti-biotics. All the blood is from the drain, the fluid very dark in colour due to the infection and it's break down of cellular tissue that was dying and sloughing away through the drain. As soon as he could tolerate, we kept this clean by gently bathing the area with hot water and hibiscrub. (I chose this because it's a good anti-microbial soap that will cleanse the area without adversly effecting his skins natural bacteria levels - the last thing you'd want is to create chapped irritated skin that could predispose him to further infections) he'd then be dried thoroughly and a dilute solution of hydrogen peroxide was flushed through the drain with a syringe. Peroxide being used to create further hositility to the bacteria. Problems encountered: first few days Jack had a heavy snore, gurgling and some difficulty with food being swallowed during eating. To be expected but kept a very close eye on to ensure his airway wasn't being impaired or further swelling wasn't occuring. Jack (thankfully has a voracious appetite and was totally unhindered from the inconvenience, he'd just cough or hack and then continue eating. While this may seem odd, we took advatage of this to feed Jack 4 large high protein meals per day (every 6 hours) this was not only to give all the tablets but to keep his body in what's known as an anabolic state. When a body is kept in this state, it uses all it's energy for growth and more importantly repair. 4 Days Post-op Posted Image Posted Image Post-operative swelling greatly diminished and swelling mainly localised to the mass, he's a lot more ammeniable to bathing but the drain's itching him because of the healing at the tube's entry points. Flushing it through becomes a bit awkward with him putting up a bit of a fight however I found by me distracting him by rubbing him gently during bathing diverted his senses to Tony simultaneously irrigating the drain, Tony had to have steady hands though! I have to say this sensory diversion technique ( we both use it with our human patients) works well with dogs too. The fluid draining now is more pinky red and finer, a good sign. Jack went back to vets on wednesday, bit of mixed emotions as Paul was pleased with how things were progressing and that the mass was depleting however because it is working so well, he felt it prudent to leave the drain in longer as it was still functioning and fluid still discharging from it. Whilst we're obviously happy it's working, I did hope he'd be able to have it removed as he has had to be isolated from his brother and missing his walks and his general routine which I always feel upsets dogs. This is probably more me than Jack though as he's bouncing about and thinks all the fuss and food is great. :rolleyes: Friday (today) Paul rings with microbiology results. Firstly we was forewarned by him that the microbiologists usually find lots of weird and wonderful types of bacteria and whilst the first course have killed all the usual suspects, he's unfortunately got a pretty nasty virulent type of bacteria growing in there that's pretty hardy to anti-biotics (it's been recorded in studies to live in betadine solution (iodine) for up to a year!) The particular bacteria is present in water, soil, decaying matter etc and is never usually an issue to either humans or animals with the body constantly fighting it and it never being an issue. However like all bacteria, when given the opportunity to breed in a nice warm body cavity where it is hardier than the other bacteria around it, it has managed to proliferate. Whilst this was the only culture grown that has resiliance to some anti-biotics, it is susceptible to some of the anti-biotics he's on and further more his body is healing. Treatment plan with both Paul and Tony on board, up the anti-biotics that have an effect and flush the drain as often as possible with saline solution to encourage his body to heal. The hibiscrub being 4% cholorohexidine gluconate solution is still to be used for bathing as it also has an effect on the bacteria. We go back to Paul's on Monday, I'll keep you updated :crossedfingers: |
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| Linda & Fred | May 9 2009, 07:57 AM Post #2 |
Chatterbox
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Oh poor Jack! I must admit those first post-op photos do look dreadful, so it's looking much better later on. Progress is being made, which is always a good thing. Is he having any 'complimentary' treatment as well? |
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| zandd | May 9 2009, 12:37 PM Post #3 |
Moderator
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:yikes: oh my word poor Jack,what an awful thing for him to have to go through :err: Hope he continues to recover and puts this behind him :crossedfingers: |
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| wild whippies | May 9 2009, 06:45 PM Post #4 |
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Squeaker
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In this situation, no. Really because I have no expertise in the area with this particular situation and with it being a potentially life threatening one, I prefer to go with evidence based medicine basically because I'm so familiar with it. I know our vet does use homeopathic products and has recently invested in a laser for low level laser therapy. I've had dogs treated with LLLT for ligament strains and had excellent results and I will probably discuss this treatment with Paul when we're further out the woods as it were. I do think it'll be worthwhile supplementing Jack with a probiotic though due to some of the anti-biotics being indiscriminatory in their bacterial culling. Whilst were on the subject, all the dogs do have regular attendences with vets and specialist practitioners for osteopathic treatment, physiotherapy, chiropractic treatments, hydrotherapy, magnotherapy, LLLT and electro-muscle stimulation in relation to racing injuries and I do tend to supplement them to boost their immunity when infections are doing the rounds in racing (e.g. kennel cough, stomach upsets etc) I can't proove the supplements are effective as I couldn't disproove that their own immunities have coped with exposure but I did find it interesting that neither mine or my friends dogs succumbed to kennel cough last year when other people's dogs where dropping down with it. But both myself and my friend was extremely OTT over hygiene during this period as well. In fairness as with any infection, if you can keep the amount of bacteria that your dogs exposed to an absolute minimum, it can greatly reduce the chance of them developing an infection. With regards to the racing injury treatments they've received, I do feel they've all massively benefitted the dogs providing they've been the right treatment for the particular situation, e.g. magnotherapy is particularly beneficial in fracture repairs because it works better with bone than soft tissue. |
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| roo roo | May 9 2009, 07:00 PM Post #5 |
Total Gas Bag!
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poor Jack screamed his head off barking at me and hubs last night when we called down!he didnt look ill to me! :woohoo: |
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| Linda & Fred | May 10 2009, 09:28 AM Post #6 |
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Chatterbox
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My dogs have probiotics because of my greyhound's dodgy stomach, and they seem to do well on that. I asked about complimentary treatments because a whippet customer of mine (I'm a dog walker) was attacked by a dog recently and now has 23 stitches. :( I always give my dogs homepathic arnica if they have an op or stitches but don't know enough about it to suggest it to the owners. |
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| roo roo | May 10 2009, 10:17 AM Post #7 |
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Total Gas Bag!
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whippets being so thin skinned bruise easily and whenever anyone on the whippet sites has had a dog bitten or injured people always tell them to give arnica for it. :ok: |
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| Linda & Fred | May 10 2009, 11:45 AM Post #8 |
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Chatterbox
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okay ta I will let the owners know. I've got to go and cuddle him for a couple of short sessions tomorrow as he can't be walked. |
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| wild whippies | May 10 2009, 01:49 PM Post #9 |
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Squeaker
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Arnica works by thinning the blood. It's action can be exascerbated with certain drugs. It's suitable for treating bruising but I wouldn't recommend it for dogs who have had surgery without a vet's agreement as it may cause bleeding to the site or adverse reactions with other medications being given. If it is allowed to be given though, it is supposed to be very good for hastening healing. Edited by wild whippies, May 10 2009, 01:55 PM.
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