Case Report - Lucy

On a Thursday back in June, Lucy, an 18-month-old cattle dog, made a very bad decision. She decided to jump off the back of her owner's Ute! Because Lucy had been tied in the back with 2 other dogs, her owners did not immediately realise that she was missing. Lucy was dragged along the road by her collar, for an unknown distance, before her owners stopped. They were then greeted with a horrific sight.

Lucy was rushed to Ingleburn Veterinary Hospital where she was examined straight away. She was in extreme shock (as were her owners). Lucy had suffered severe grazing to her feet, thighs, groin and flanks. She was "lucky" in that she hadn't sustained any broken bones.

Lucy was immediately placed on a drip, given pain relief and high doses of antibiotics. We gently cleaned and dressed her wounds and placed her on a heat pad in hospital. We were amazed how quickly she started to come out of her shock. Within a few hours she could sit up and by evening she was standing!

Lucy - Day 2 (7K)

The next day Lucy was strong enough to be given a deep sedative so that we could assess the full extent of her injuries. The grisly statistics were: On all feet nearly every nail had been sloughed off. Her front feet suffered deep grazing to the tops of her paws and to the pads underneath. There were friction bums to all nipples, especially those at the back. She had very severe grazing to the tops of both hind paws. On the left hind paw it was so severe that her metatarsal bones were exposed. Her left thigh was severely grazed. Her left hock and flank were also grazed. Her right thigh had deep grazes and there was a laceration to her right hock.

Lucy - Right Front Foot - Day 2 (2K) Lucy - Right Hind Foot - Day 2 (5K)

In all there was a vast amount of missing or dying tissue. The only wound we could close was on her right hock. This was debrided (the dead edges cut away) and 3 surgical staples placed. For the other wounds we had a couple of options: second intention healing (i.e. like a grazed knee), delayed closure (stitch later when we have enough healthy loose tissue to bring together) or skin grafts. With all of these the first thing we needed was to produce nice pink healthy granulation tissue. To achieve this we needed to:

  1. Prevent Infection. As mentioned Lucy was placed on high dose antibiotics (nearly double the dose normally used). This is because dead and dying tissue has a very poor blood supply. It is therefore a lot harder for the antibiotics to penetrate to where they are needed. Sofratulle dressing sheets (a moist dressing impregnated with an antibiotic) were used to cover each wound. Her wounds were cleaned and fresh bandages applied daily.
  2. Remove dead tissue. Solosite Wound Hydrogel was applied to her wounds (under the Sofratulle dressing) at each bandage change. The gel gradually sloughs off all dead tissue without harming the healthy.
  3. Keep wounds moist. Deep grazes contract and heal better if kept moist. The wound edges stay softer and find it easier to shrink together. [Often with animals we find it necessary to leave wounds open. Bandages can often chafe, slip and cause sweating. It is also sometimes hard to convince animals to leave them in place! In Lucy's case we were able to bandage her feet but we had to leave her wounds on her thighs and abdomen open. This meant that her left thigh was going to be the slowest to heal.]

Lucy went home on the second night. She returned daily to Ingleburn Veterinary Hospital for dressing changes for the next 10 days. By then her owners felt up to changing the dressings daily at home, with our staff just checking her once or twice a week.

Lucy - Day 4 (4K)

After the first week her front feet and flanks had healed. We had trouble temporarily with a hard scab forming on her left thigh. This we dissolved using more of the Solosite, which we held on using an adherent Opsite dressing (like an artificial skin), so that we were left with only healthy granulation tissue.

Lucy - Right Hind Foot - Day 19 (1K) Lucy - Right Hind Foot - Day 25 (1K)
Lucy - Day 19 (3K) Lucy - Day 25 (3K) Lucy - Day 50 (2K)

After 25 days all bandages were able to be left off. Lucy's wounds were all healing by contraction. By day 50 the wound on her left thigh was a tenth of it's original size. We were delighted that skin grafts and delayed closure were not going to be necessary.

As you can see from the photos Lucy made a remarkable recovery. It took a lot of time and effort from our staff at Ingleburn Veterinary Hospital, her owners, and of course from Lucy herself! She is one of the most stoic dogs we have ever had at the hospital, only needing sedatives for the first 2 bandage changes. Her temperament was a big factor in assisting her recovery. A lot of animals would not have put up with all the pain, discomfort and intensive handling. A more highly-strung animal may have needed to be put down.

We would all like to thank Lucy and her owners for permission to tell you her story.