XL Equine vet Nancy Homewood, from Hook Norton Veterinary Group, tells us about one of her resident patients Biscuit.
It was another busy day today, routine calls in the morning and a few check ups. Then I returned to the surgery to say goodbye to one of our longstanding patients, Biscuit. He came to us three months ago after he had a nasty accident with a post and rail fence. He was brought straight to the surgery for treatment on the May Bank Holiday after he had sustained a very large stake wound to his right armpit (axilla) region.
Luckily, there was not a lot of tissue loss as the post has managed to do most of its damage in-between the muscle bellies. There was a huge cavity left on the inside of his elbow. Every time he moved, you could hear air being drawn into the wound, and I was concerned he may develop a condition called pneumo-thorax, where air is drawn into the pleural cavity surrounding the lungs, usually secondary to trauma.
Biscuit was cross-tied at the surgery for three weeks to restrict movement and allow the wound to start healing. Cross-tying is not without complications and I felt the risk of developing Pneumothorax outweighed the risks of cross tieing for the short term. The wound was packed with saline soaked swabs and Manuka honey and flushed with saline every day.
Biscuit is only five-years-old and he tolerated being cross-tied remarkably well. Most of his right side blew up with air underneath the skin and he looked rather bloated. Over time, this air became reabsorbed by the body. Biscuit was closely monitored for any signs of respiratory distress, and he had plenty of TLC whilst he was cross-tied. Our nurses did a fantastic job of keeping him entertained, giving him hot flannel baths, and making sure he was comfortable. He was also fed from the floor every four hours to reduce the risk of him developing aspiration pneumonia from having his head tied up for such a long period of time.
The body is amazing at healing, and I am pleased to say that Biscuit’s wound has healed remarkably well with relatively minimal intervention. Healthy wounds will want to heal and by providing an adequate healing environment, the wound is well on its way to becoming a very discrete scar.
We all came rather attached to Biscuit and it was a sad day to see him leave for home. The nurses spent many an hour giving him lots of TLC. However, it's one of the most satisfying feelings knowing that your patient has recovered from such a dramatic and potentially life-threatening injury, thanks to great team work and the body’s natural healing. We wish him all the best in his continued rehabilitation at home.