Deep Ulcer Between Beth's Toes

[PrairieProf]

Thanks for the vote of confidence. I am very intelligent (and the daughter of two human physicians), but what do I know about air vs. no air in wound healing? But I do think if I had this wound on my foot and my shoe rubbed it when I walked it would be covered!

Edited May 17, 2011 by PrairieProf

[Batmom]

See? Smart. Whatever you decide to do, you'll know in a couple days if it's getting worse rather than better and can adjust your protocol accordingly.

[BauersMom]

Ditto everything Batmom said... and wound healing like this is not a "one size fits all" fix. While your vet may feel that one way is the best way, it still may not be the best way for you and Beth. Same goes for the suggestions in this thread. A lot of this is trial and error - working? Keep at it. Not working? Try something different.

 

With the splinted and casted dogs that I've dealt with and all the resulting sores, it's always been somewhat a trial-and-error thing. Some of them I have been able to leave open, some needed to be wrapped, some needed a staple or a stitch, etc.

 

The only real keys is the wound needs to be kept clean and kept from getting bigger. There are different ways of getting to that goal.

 

Good luck

[Guest bethac]

Checking in to see how Beth is doing and what your vet had to say. Hoping today is a better day ...

[PrairieProf]

Just back from vet. He wasn't mad at me and is OK with wrapping the foot, though he still swears that moist wound healing is best for dry wounds only. He gave me the SSD ointment, and put her on a new antibiotic, Clindamycin. The ulcer is so deep that her ligament is exposed, and what he's worried about is the possibility of osteomyelitis (bone infection), which Clindamycin is supposed to be the best for. He wants me to change the bandage twice a day.

 

At least with the bandage, whatever the implications for healing intrinsically, she won't lick the foot and I'll be able to leave the house with less anxiety. She's never shown inclination to bite off bandages or anything, just that occasional licking when she gets bored or drawn to a wound.

 

He did say that it didn't look worse today than yesterday -- I guess I just hadn't seen the really bad part before. I realized too that when Beth gets ouchy as we walk more than a block and a half, it's probably not the torn ligament that's starting to hurt her, but the wound rubbing.

 

I am still so distraught. I don't see how the deep deep ulcer is ever going to heal since she reirritates it every time she takes a step....

[Batmom]

One last tip: You don't need to clean it every time you change the bandage. Just put a new blob of SSD in between her toes (or on your gauze pad in there), wrap it up, and go. Of course you'd want to clean if she stepped in a mud puddle or something but she's not liable to do that.

 

It will heal. Give it a couple days and see how it looks then.

[PrairieProf]

Thanks Batmom, he didn't actually tell me clean it, just put on new SSD. I think with the ooze going into the gauze and a Pawz boot on when we go outside, it won't really get dirty.

 

Fortunately the vet's wrapping technique looked pretty much what like my former tech neighbor did last night -- "not tight" seems to be the main point.

[racindog]

I run and have discovered that the original green canned Bag Balm is one of the best thngs in the whole world to prevent rubbing friction. I can run 15 miles or more and never ever get a blister as long as I slather it on my toes. Greyhound experience has taught me the necessity of putting cotton between their toes when their foot has to be wrapped. So you can see where I'm going- some cotton soaked with bag balm between the toes would help prevent the friction and also help heal I believe. Thats what I'd do. Hope she feels better soon! A sore paw isn't any fun!

Edited May 17, 2011 by racindog

[Kestrel]

Poor Beth, and poor you! What an ordeal. Sending lots of healing thoughts since I don't have any advice to offer!

[DesiRayMom]

What a miserable spring this has been for both you & Beth.

 

Hugs to both of you & hope her icky toe gets better right away quick.

[PrairieProf]

Well, I've now changed the wrap twice by myself, and it's not as scary as it seemed. Poor Beth is getting so many pills at the moment (Deramaxx, Tramadol, and two different antibiotics) that I had to post a schedule on my refrigerator to remind myself what times of day I'm giving which. So far her GI system is handling it all, which I'm thankful for.

 

Her walking does seem improved. She even tries to trot a little (I know, I know, I mostly restrain her, but the trot is also her finding-a-poop-spot ritual). The best thing is that she only sat down once on the walk this morning (the big sign that her foot hurts) even though we went several blocks so she could poop. And that was when we were passing schoolboys showing each other fart noises, which she found profoundly intriguing and wanted to keep watching.

 

When I changed the dressing today, it seemed to me the ulceration might be a tiny bit improved, but it's hard to tell. It is still so gruesome looking with the white ligament showing through. At least I confirmed that the ulcer is on the originally injured toe -- I was thinking it was on the adjoining one. So if we ever needed to amputate that toe (a possibility I am trying to stay prepared for) it would solve both problems.

Edited May 18, 2011 by PrairieProf

[Cully]

[Batmom]

[PrairieProf]

Oh god, I thought it was getting a bit better when I posted last but now I think it's getting worse. She's sitting down a lot when walking, and when I changed the wrap this morning there's more ligament showing than there was initially. No sign of infection at least.

 

I have a call in to my vet (and an appointment tomorrow morning).

 

I am beginning to think that amputation may turn into the most feasible option ... so scared. It's a weight-bearing toe. I've read all the GT archive posts that most greyhounds do well, but it would be so awful if she was left with a limp or couldn't run. And what if she developed another problem with that foot (or the other) down the road? She's only five, she's got a lot of years left to hurt herself....

[Batmom]

Hmmm. May want to take a good look at how the foot is wrapped and see if you can devise a way to pad it so that there's a smidge of space between the toes and they are immobilized so as not to rub when she walks on the foot. In wrapping Zema's dislocated foot, I was at my wit's end until GreysAndMoreGreys suggested support from underneath. In your case, that plus a little extra padding between the toes might do the trick.

 

Keeping fingers crossed.

[BauersMom]

My 13 year old lost a weight bearing toe and had no issues. If it comes to that, don't worry - she'll be fine.

[Guest CampWhippet]

I've dealt with this quite a bit.

 

I clean up the area between the toes very well. I pour hydrogen perxoide right in to the hole and let it bubble until it is clear. (Keep pouring more if it is not clear and clean at first try.) I let it dry a bit then gauze folled by vet wrap. I haven't used anything between the toes and it heals quickly. Never heals if I don't wrap it.

 

One last tip: You don't need to clean it every time you change the bandage. Just put a new blob of SSD in between her toes (or on your gauze pad in there), wrap it up, and go. Of course you'd want to clean if she stepped in a mud puddle or something but she's not liable to do that.

 

It will heal. Give it a couple days and see how it looks then.

Exactlty my experience as well. Change wrap every 2-3 days. Fact is it will be gone by day -5-64.

Edited May 19, 2011 by CampWhippet

[PrairieProf]

Here are the best pictures I can get of the wound (have to try to spread her toes with one hand and hold the camera with the other). They're pretty gory, so I'm posting links rather than direct photos.

 

http://i511.photobucket.com/albums/s357/PrairieProf/downsized_0519011126.jpg

 

The white you see in the center of the crater is exposed ligament -- even more would show if I could get the full view: http://i511.photobucket.com/albums/s357/PrairieProf/downsized_0519011127.jpg

[Guest Cara_Lea]

I have no advice.. just sending good thoughts for Beth and for you. *HUGS*

[Guest bethac]

No advice - just sending positive energy your way and praying that Beth starts to show some improvement soon. Hugs for you too, Ann.

[RaineysMom]

oh poor girl :( sending healing hugs Beth's way.

[BootsyCollins]

My Argos got these more than once. I would clean it with peroxide or diluted betadine, then use neosporin on a piece of gauze, stuff it in there, and wrap his foot for a day or two. Change the pad about once a day, more often if it got wet. Once, he did go on antibiotics for it, but otherwise, they always healed up just fine.

[Guest Shermanator]

My bridge boy Patton had a weight bearing toe amputated for a corn. First we tried to cut it out, whch left us with a massive wound on the toe, which took weeks to heal. (I too became the queen of feet wrapping!)

Since that failed, we amputated, and it was easy. Best thing we ever did for him. He was bearing weight on the foot the day after surgery, and after 2 weeks, he was back to being my crazy boy, barreling through the house like it was his personal racetrack. It was no where near as scary as what I thought it would be.

[PrairieProf]

Saw the vet this morning ... he thought the wound looked OK, no sign of infection and at least some slight signs of granulation tissue at the edges. Basically he wants me to keep doing what I'm doing -- said that ulcers like this can take several months to heal. My next appointment is Tuesday though he said I should come in Monday if I need to.

 

What's pretty gross and upsetting is how the toe itself flops to one side now that there's no ligament supporting it there. And evidently it will probably heal that way too. I can't believe that's not going to cause problems, though again he basically said we need to wait and see. He pointed out that we can always amputate, but you can't undo an amputation once you've done it, so .... I know he's right, but I find living with the uncertainty very debilitating.

 

It's only been eight days since the original injury, and it feels like a month. Being all alone with an injured dog is awful. And now our (very short) walks are the most anxious element of my day, rather than the best part.

Edited May 20, 2011 by PrairieProf

[racindog]

My Slim had a similar situation with both his front feet. Due to injury the ligaments/tendons etc. just shriveled up and disappeared. That is how my board certifed vet treating him put it into laymens terms for me. Amputation was not an option for Slim because it was multiple toes on both front feet. However if did ALWAYS cause him problems. He had to wear Ther-a-paws at all times he went out and still soemtimes his toes would tear open. With no support his toes would just tear open sometimes-you could see the bone even and nothing else inside them. It really looked like there wasn't anyhting holding them on but the skin. The vet joked about calling it Slims Syndrome. The only other thing that helped was Tuf-Foot.(www.tuffoot.com) I squirted some Tuf Foot on every night and it did toughen them up a little and help protect it some. You'll get soemthing worked out where ya'll can walk as far as you want and have fun again. They're just toes so theres ways to cope -it could have been so much worse.

Edited May 20, 2011 by racindog