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
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.