Crushing Injury with Bite Wounds – a diary with a happy ending.

HerculesI've talked about crushing injuries before more than once.  They are a lot worse than cuts and punctures, and initially, it's pretty hard to tell just how bad they are.

Hercules here used to be able to take on all comers.  He's a farm dog and a pretty good kind of a guy.  While he roams over the farm during the day sometimes, you can usually find him around the shop or at the house.

On August 23, at 10:00 PM, his owners found him prostrate on the patio. He had a LOT of bite-wound punctures and he wasn't moving much, being in a deep state of shock.  We started him on antibiotics and I.V. fluids with a CRI (that's a Constant Rate Infusion) of pain medications, but he looked like he wouldn't live 30 minutes.

He's a tough monkey, and he was still with us on the morning of Day 2.  The next day, he lay all day on his side, breathing heavily.  His chest X-rays looked good, but his kidney function was lousy.  So, we kept up the I.V. fluids and antibiotics and pain meds, and rolled him over every so often.

On Day 3, he had rolled up on his chest and was looking at me with some recognition.  He was able to stand, but he couldn't go far.  There was a lot of bloody goo in the floor of his cage under the grating he lay on.  I couldn't really see where it was coming from (… yet).  More fluids and medication.

Day 4: he's drinking water today, getting around a little better, but no interest in food.  My right-hand man, Greg, hand-fed him two cans of A/D.  He threw it up in a couple of hours.

August 27 Day 5: He's drinking a lot of water on his own, eating a few bites of food without prompting and getting around better.  Now it's obvious where the ooey-gooey was coming from.  While his other wounds are healing rapidly, the underside of his chest is coming apart.

The bite wounds are opening, and you can see the dying black skin that was crushed between the puncturing teeth of his attackers.  This is not pretty, and it's going to get worse.   The crushed tissue will have to finish dying and being removed before things can get better.  Of course, he's still on antibiotics and pain medicine.  We start adding Capstar to his daily regimen, just in case any flies happen to get to him and lay eggs.  I don't think maggots will help.

Herc Aug 30 Day 9:  Now all the dead skin has sloughed off and there is a crater big enough to put my whole hand in and move it around.  I don't do that, though.  The wound is so big that our 5"x9" normal bandage pads are too small to cover it.  After some abortive attempts at conventional bandaging, we resort to disposable diapers taped over his trunk, and covered with a T-shirt.

Day 16:  The tissue is all looking pretty healthy now.  The infection is under control, and we start thinking about how to close the thing.  It's still a pretty big wound, but it's closing up a little already.  Considering his age (100 years old, about) and his kidney problems and his heart problems, we're not enthusiastic about a prolonged anesthetic and surgical procedure. 

After discussing it with the owner, we decide to just keep bandaging it and see how things go.

Sept 20, 2010 resize Day 28:  And they go pretty well.  Here we are closing up nicely.  Just a few more bandage changes and he'll be back out on the farm again.

 

  Sept 29 resize Day 35:  Okay, NOW it's just going to be a few more bandage changes.

October 13, 2010 Day 46:  So, I was a little optimistic, but we finally made it.  It only took seven and a half weeks.  Sure, he's got a scar, but it's on the bottom where you can't see it.  In the meantime, he got to stay indoors with the air-conditioning, eat like a prince, and wear cool T-shirts. 

 

 

5 thoughts on “Crushing Injury with Bite Wounds – a diary with a happy ending.

  1. KateH says:

    Jeepers! Was that damage done by another dog – like Cujo, or what? Major kudos to him, his owners, and you and your staff for his recovery!

  2. Doc says:

    Hello, Kate,

    While we do not know, our best guess is that he was attacked by a pack of dogs, possibly coyotes. I don’t believe one dog could have held him down and bitten him in so many places.

    Thanks for reading and writing.

  3. H says:

    I have a mini-pinscher/chihuahua who was just attacked by a coyote and has lots of crushing to his ribs along with extensive wounds to his chest (currently bandaged), and wounds to his abdomen (stitched, with a drain).

    Is it possible for a people nurse (RN) to do the dressing and take care of him at home for the rest, in your opinion? I am devoted to him, and my mother is a nurse who offered to help.

    The cost of hospitalization has become prohibitive, and it’s only been a few days…thinking this may take 7 weeks in a hospital makes me cry, because there is no way I can afford it…

  4. Doc says:

    Hello, H,

    It is certainly possible for a people nurse to perform dressing changes.

    Talk with your veterinarian about this. I think that your mom would need to visit with the doctors to observe what they are doing, and get instructions about what they are trying to do. They would also have to tell her what she should be looking for during the aftercare.

    The injuries have been severe (from your description)so it isn’t going to be simply a matter of taking gauze on and off.

    Talk with your veterinarian about this.

    Best wishes.

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