Case Of the Month – March 2012

Marmite Robertson has been unlucky enough to win our bravest pet award this month. A very lively young Labrador cross she managed to run full speed onto a sharp stick.  The stick unfortunately pierced the skin over her shoulder and then impaled itself into her fore leg.  Thankfully the point was deflected towards the outside of the leg and not towards her chest otherwise things could have been much more serious.Marmite had been moving at such speed that the stick almost came out of the rear of her leg travelling a good 15cm through the muscle.  Amazingly it did not hit any major vessels or nerves. She was rushed straight to the surgery as an emergency.  Thankfully there was little blood loss and immediately after the injury was surprisingly bright.  However as the adrenalin wore off poor Marmite began to feel the extent of her injuries.  Two types of pain killer were given to help her and she was taken to surgery for a general anaesthetic. Photos for the unsqueamish can be seen below.  The biggest problem with stake injuries is the debris and bacterial contamination they leave behind.  Abscesses and tracking foreign bodies are our biggest post-operative complications with these cases. To minimise skin trauma the entry hole was enlarged and another small hole where the stick had nearly broken through the skin at the back were made.  This enabled a full assessment of the muscle and the cleaning to begin.  Despite the stick looking relatively clean on removal at the time of the injury it had forced a lot of hair and debris into the wound.  This was painstakingly removed and the area flushed repeatedly with sterile saline to minimise the risk of post-operative complications. After an injury like this the body naturally produces a lot of fluid to flush the area itself.  To allow this to drain a rubber Penrose Drain was placed to keep the area open.  In these cases we do not want fluid to build up as it increases the risk of abscesses. The drain was protected with a t-shirt to stop Marmite from licking (so much more comfortable than the dreaded lampshade collar!).  Antibiotics and further pain relief were given and Marmite made a good recovery from her anaesthetic. After two days of strict rest the drain was removed by taking out two small sutures and the wound was cleaned again.  Then thankfully lead exercise could start as Marmite was already raring to go! Due to the injury being over the shoulder which is a very mobile area – the sutures were left in place for two weeks to ensure the area was strong enough to cope when Marmite was allowed off the lead. She is back to her bouncy healthy self again now, having made a full recovery and despite everything still wants to come in for her gravy bones!