Case of the month – Oct 14

Dotty Maynard is our brave case of the month with the battle to save her leg.  Strictly speaking Dotty started as a patient in September but her lengthy treatment course has taken her through October and into November so she definitely qualifies as our case of the month! Dotty is a three year old Siamese cat and quite a character. Having been out on some night time adventures Dotty returned one morning with a nasty laceration and puncture wound to her left hindlimb. The suspicion was that the injury was sustained from her coming up against a local fox. Quick attention from her owners meant that Dotty underwent surgery that same day to flush, clean and repair the wound as well as her receiving pain relief and antibiotic cover. MAYNARD DOTTY Se1 Im001 As you can see from her x-ray here the foot was already really swollen but thankfully there were no broken bones. Despite her injuries receiving early treatment Dotty developed a severe infection in her limb and her wound repair broke down. Sadly this is quite common with bite wounds – the force of the bite crushes the delicate soft tissues with bruising preventing oxygenation of damaged area.  This doesn’t sound that bad in itself but a crush injury combined with bacteria effectively injected into the mix by sharp canine teeth results in a disaster waiting to happen. The immune system struggles to access the area without adequate blood supply and infections can take hold very quickly wreaking havoc. Photos of her injury are found down below in the gallery section – for those who don’t have a strong stomach we’d recommend not looking!    As you can see from the images the first doesn’t look that bad but once all the damaged/infected tissue is removed there is an enormous deficit exposing delicate tendons and bone.   There was a very real risk at this point that Dotty could loose her leg with such severe damage. Dotty had repeat surgery to remove the damaged and infected tissue, some of which included the tendons on the underside of her foot. Her wound was flushed with sterile solutions and swabs were taken for bacterial culture. Dressings such as manuka honey were used to further remove damaged tissue and produce an environment in which it was difficult for bacterial infection to develop. Initially Dotty’s dressings were changed every 24-48 hours under sedation as it was so painful but over time this was extended and Dotty would allow us to re-bandage her leg without any sedation.  Three types of antibiotics were given to maximise our chances of success whilst we waited for the culture results to come back. Gradually much to all our relief the surrounding tissues became healthy again as the infection cleared. It was unknown whether Dotty’s wound would require further surgery for a skin graft but as time went on, and her wound was re-dressed, her rate of healing increased until the wound finally closed. This type of healing is called second intention healing and the scar tissue produced will hopefully help to stabilise Dotty’s foot. Dotty is now starting to use her leg without a bandage as is getting used to this sensation. It is hoped she will enjoy a good level of comfortable function now her wound has healed although her toes will not function completely normally again.  You can see a short video here of her first few steps without a dressing – if you look closely the left hind foot does not rest on the ground normally but is quite flat footed.  Having said that though she is comfortable and functional – no problem with jumping! As is the case with Dotty any wound, and especially bite wounds, should be treated as a matter of urgency as even with intensive management infection can still progress and cause further damage. Although fox bites in our pets are rare it is worth being cautious when thinking about encouraging foxes into your back gardens as territorial conflicts can occur.