The Veterinary Centre

Henley and Twyford

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Case Notes: Fred's Strange Injury
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Handsome ginger lad Fred was rushed to the surgery one Sunday morning with a gaping hole in the side of his chest. He looked, for all the world, like the victim of a shark attack! He was understandably shocked and distressed as were his poor owners.

After three hours on an iv drip, with powerful painkillers and antibiotics on board, Fred was surprisingly stable and even managing a purr when stroked so we decided to crack on with a general anaesthetic and surgery that very afternoon.

First we got a conscious x-ray of his chest and remarkably, although there was evidence of contusions and haemorrhage, there were no fractured ribs or collapsed lung lobes. Once he was safely anaesthetised and intubated we took further x-rays of his chest and foreleg and ascertained that he had a fractured scapula and also an extensive scatter of dense fragments contaminating the whole wound.

The first hour under anaesthetic was spent simply cleaning up and decontaminating the wound. This involved copious flushing with litre bags of sterile saline and painstakingly picking out bits of hair and vegetation and the hard, black, gritty fragments (which I took to be stone) and cutting away all bits of skin, muscle, tendon and bone which were damaged beyond healing. Then the fractured scapula had to be wired back together.

Orthopaedic repairs should not really be done in a contaminated wound as there is a high risk of the bone becoming infected around the metal implants. However, there was no way we could leave such an extensive wound open until all the risk of infection had been cleared. It was not possible to close the wound without pulling the two halves of the scapula back into apposition and thus bringing the attached muscles back across the gaping cavity, so we had to risk it. This done it was just a question of patiently closing the deficit with every available bit of surviving muscle and fat and fibrous tissue and a few hundred dissolving sutures. Finally we had the challenge of finding enough skin to cover the whole area.

Fred was under anaesthetic for more than three hours in total and coped with this remarkable well. He recovered gently and we kept him well topped up with opiate painkillers via his drip for the next 48 hours.

At first, all went well. Fred made a brilliant recovery and went home after only three days, on oral antibiotics and cage rest. Unfortunately, a week later the wound started to open up again and pus was seeping out of it.

Fred weathered another long anaesthetic to remove the, now infected, wire sutures from the scapula and to cut away infected areas of bone. We also had to pick out a further plethora of the hard fragments which had now worked their way up to the surface from deep in the muscles; in the process of migration they had become silvery rather than black and were obviously metal!

Fred went on to make a full recovery and was signed off as fully fit exactly one month after his original injury. We are mystified by how he came by his strange injury and where the shower of tiny jagged metal fragments came from.

Photo:
Fred
Photo:
Fred, displaying an impressive scar.
Photo:
"He looked, for all the world, like the victim of a shark attack!"

Photo:

Strange parallel marks.

 

 

 

   
Henley Vets and Twyford Vets
The Veterinary Centre: 271 Reading Road, Henley-on-Thames, RG9 1EL - Phone 01491 574490
Also at Twycombe Lodge, Loddon Hall Road, Twyford, RG10 9JA - Phone 0118 934 0259