Deep Ulcer Between Beth's Toes

[PrairieProf]

Well, confusingly positive update -- just getting back from the vet where Beth is day boarding in ICU again. He said the foot looked good!?! -- that it had already opened some yesterday when they sent her home and now it's closed up. I made him show me the foot so I could point things out even though he'd already examined it and I even drew a picture of what had happened, because I couldn't believe the raw meat and exposed subcuticular sutures I looked at all through the night aren't a huge problem. But basically he thinks it will heal as is. It will be unwrapped when she's in the crate so it gets air and no pressure on her toes, then wrapped for trips outside. The ugly lump on the top of her foot is just edema from yesterday's wrap.

 

The wonderful news is that one of the techs will take Beth home and babysit her for the weekend after the hospital closes Saturday at noon -- she apparently does this from time to time. She has a crate and can care for the foot and have direct contact with the vets if a problem develops. I will miss my baby girl sooo much but I think everyone at the hospital recognizes that I need a break from anxiety or I'm going to lose it. I was wondering whether we could send her to a 24/7 intensive care hospital, but this is much better. Fortunately Beth is very adaptable to new places and loves everybody, so I don't think this will be too stressful for her.

Edited June 3, 2011 by PrairieProf

[Batmom]

Really hope this weekend gets her past the worst part for you. It *is* stressful to have an injured dog, and the vet and techs can tell more easily whether things are progressing infinitesimally or backsliding.

[DesiRayMom]

You ladies just canNOT catch a break. Well, maybe you did, even if just for this weekend.

Hope you can get some rest & not worry too much.

When you see her next week, maybe your refreshed eyes will see improvement & give you strength.

Thinking of you both......

[PrairieProf]

Beth is home for the night now -- the tech was quite willing to take her but I didn't want to be separated from her for that long if she was doing OK. And she is -- even I could see significant progress in the foot now. The wound is granulating -- it's dark red and dry rather than pink and moist.

 

I also got clarified that she did not, thank God, rip out her subcuticular sutures -- they're still there doing their job. The rip was more superficial, and revealed the top knots of the sutures. But it will granulate. So the deal is no bandage in the crate, bandage just to take her outside, which is quite a pain but is the fastest way for the foot to heal and not develop more sores.

 

One of the techs commented how funny Beth looked roaching, so I'm happy to know she's not finding her time at the hospital too stressful. What a good girl I have.

 

Oh, and also, the vet said that the day he agreed we should go ahead and amputate the original ulceration was so deep that bone was exposed. So we really didn't have much choice -- good to know as the impulse to second-guess that decision has inevitably crept in with all the stress.

Edited June 3, 2011 by PrairieProf

[Guest bethac]

Well, it sounds like Beth is making progress. You'll probably be happier having her with you, despite all the gyrations you have to endure to get her wrapped up and outside, then back in again and unwrapped. Just remember - you could be doing this in January but you're not - small blessings.

 

Hope you get some rest tonight.

[PrairieProf]

Well, I'm still going to have the tech take her Saturday and Sunday -- I will feel awful about not having her hom, like I've abandoned her, but I desperately need a couple of days to get my life back. And not be stuck worrying about her in isolation from the vet for over a day and half. But I'm relieved there's progress -- if it just keeps moving ahead without more setbacks, which I can hardly believe at this point.

[Meandmy]

I can "hear" the stress in your posts, so give yourself Saturday and Sunday to relax - guilt free! She's well taken care of and obviously adaptable. She'll be fine.

 

I went through a major leg surgery with my Shadow once (removal of a hemangiopericytoma) and they had to remove such a huge portion of his leg muscle right around his knee. It took forever to heal, we had to keep in open to air, it didn't stay closed well due to being so close to his joint, he wouldn't stop licking it, etc. etc. I know just how you feel. I was ready to tear my hair out. But eventually it healed up and was worth all the time it took. He was happy, healthy, and good as new. He even forgave me for making him wear one-legged sweatpants all summer

[PrairieProf]

I can "hear" the stress in your posts, so give yourself Saturday and Sunday to relax - guilt free! She's well taken care of and obviously adaptable. She'll be fine.

 

I went through a major leg surgery with my Shadow once (removal of a hemangiopericytoma) and they had to remove such a huge portion of his leg muscle right around his knee. It took forever to heal, we had to keep in open to air, it didn't stay closed well due to being so close to his joint, he wouldn't stop licking it, etc. etc. I know just how you feel. I was ready to tear my hair out. But eventually it healed up and was worth all the time it took. He was happy, healthy, and good as new. He even forgave me for making him wear one-legged sweatpants all summer

 

Thanks, this is very helpful to hear right now (both parts). Things seem OK this morning -- the wound opened a bit on our last outing last night, but not as much as the night before, so I didn't panic; the vet says it looks good this morning. The lump of edema on her foot came back, but the vet doesn't seem worried about it so I'm trying not to be.

 

It feels very weird to have a dogless weekend -- I'm trying to appreciate the freedom of that as well as the break from stress. Tomorrow I may go to an arts festival in a nearby city I like to enjoy a day I probably couldn't if Beth were at home, even healthy. And I'll cuddle my cat even more that usual.

[PrairieProf]

Jess the vet tech sent me a picture of Beth at her house -- guess she's not missing her mom too badly! I'm sure this cat's friendliness made her very happy. (Jess assured me Beth went into her crate with her muzzle on shortly after -- she'd just had a potty break and a snack before this was taken.)

 

 

I myself would not let Beth have immediate unleashed/unmuzzled access to an unfamiliar cat, but Jess said her cats are very dog-savvy. Nice to see Beth really truly is cat safe.

 

Edited to add a pic from Sunday morning, just returned from a potty outing. She looks so happy -- she hardly smiles like that at my house. Jess says she's doing great and her foot looks great -- hope she's right about the latter!

 

Edited June 5, 2011 by PrairieProf

[krissn333]

That kitty looks just like my parents' kitty Ellie!

[Guest Liz_in_PA]

 

She looks so happy -- she hardly smiles like that at my house. Jess says she's doing great and her foot looks great -- hope she's right about the latter!

 

 

 

My kids happily do housework when they visit their friends. They still want to come home at night. Beth is enjoying her slumber party and you should enjoy your time without the kid. (Go to the art festival!)

[PrairieProf]

 

 

My kids happily do housework when they visit their friends. They still want to come home at night. Beth is enjoying her slumber party and you should enjoy your time without the kid. (Go to the art festival!)

 

Thanks, I'm going to go! Though even after an epic sleep last night, I still feel like I could sleep all day. I guess it's nice for Beth to have the mental stimulation of a new place when she can't have physical activity.

[NancyB]

I hope Beth continues to improve

[Remolacha]

I know this has been so stressful for you! Luckily, it doesn't seem to phase Beth at all. What a great dog she is! It seems like it has been going on forever, but in a few weeks (really not long at all!) you will be past all this stress

[Guest FullMetalFrank]

Glad you got some rest, and Beth looks happy to be having a "sleepover" with some new friends. Take that as a compliment to raising a confident dog! I really hope she heals quickly.

[Guest LindsaySF]

Coming in late to this...

 

I'm glad the tech is able to watch her for you, to give you a bit of a break. I didn't read the whole thread so I apologize if I repeat something.

 

I haven't dealt with the exact issue you're facing, but I've dealt with my share of wounds, including a minor leg wound on a foster that grew into a huge ordeal as a result of the dog licking it open and essentially tearing the skin off most of her leg. Fun times.... There literally was no skin to stitch back together, it was just... open. But amazingly it did granulate and heal.

 

After tons of trial and error, here's what worked to get it healed:

 

1. Muzzle with stool guard almost 24/7 for over a month. She could get the muzzle off, so I looped it through a Yorkie-sized tag collar right behind her ears (a "muzzle keeper" strap would be ideal).

2. Granulex. I swear by this stuff. It stains fabrics, beware.

3. Bactine spray. I alternated this with the Granulex, and continued it once the Rx Granulex bottle ran out. It cleans wounds well and helps to dry them out.

4. I left the wound open, no wrap, and I stayed away from creams and lotions and Neosporin ointment. The wound stayed too "wet" and wouldn't granulate or scab when I tried wraps or ointments.

5. The foster started rubbing the muzzle on the open wound, she tore the beautiful scab off (twice), so I ended up having to wrap it to prevent that rubbing. The key was to make sure everything was 100% dry before wrapping, and then I changed it twice a day (and applied Granulex or Bactine twice a day). Once it healed a bit more, I fashioned a shirt sleeve over the leg, and left that on instead of the wrap as it was more breathable (still muzzled).

 

It seems in your case that some wrap and padding is needed for walks so the toes don't spread and tear the skin. The plan of wrapping only for walks, then unwrapping for rest time, is what I would suggest. The area between the toes is a high moisture area, it needs to breathe as much as possible. I have wrapped some wounds before (most recently Chase's pressure sore on her rump), but most wounds I like to leave open to the air if at all possible.

 

It's frustrating because you need to walk Beth to potty, but I would limit her walking as much as possible. If she really needs to potty, she'll tell you. If she gets whiny at times when she doesn't normally go potty, ignore her. Keep her on a set potty schedule, only bring her out at those times, have lots of crate time in the interim to keep her off the foot. It's a tough love approach, and it will be hard (she will whine a lot and rub the muzzle pathetically), but worth it in the end.

 

I hope things continue to improve.

 

 

 

~Lindsay~

[XTRAWLD]

Sounds like things are coming around. I think the break you had from Beth likely did you some good, and I might take a guess that it did for Beth too? She was able to go to a new place, new things, change gears. Changes in even mental attitude helps a great deal with healing, in people, likely dogs too? Laughter is the best medicine? She looks happy in the pic the tech took. I hope she is doing well when you get her back home.

[PrairieProf]

Coming in late to this...

 

I'm glad the tech is able to watch her for you, to give you a bit of a break. I didn't read the whole thread so I apologize if I repeat something.

 

I haven't dealt with the exact issue you're facing, but I've dealt with my share of wounds, including a minor leg wound on a foster that grew into a huge ordeal as a result of the dog licking it open and essentially tearing the skin off most of her leg. Fun times.... There literally was no skin to stitch back together, it was just... open. But amazingly it did granulate and heal.

 

After tons of trial and error, here's what worked to get it healed:

 

1. Muzzle with stool guard almost 24/7 for over a month. She could get the muzzle off, so I looped it through a Yorkie-sized tag collar right behind her ears (a "muzzle keeper" strap would be ideal).

2. Granulex. I swear by this stuff. It stains fabrics, beware.

3. Bactine spray. I alternated this with the Granulex, and continued it once the Rx Granulex bottle ran out. It cleans wounds well and helps to dry them out.

4. I left the wound open, no wrap, and I stayed away from creams and lotions and Neosporin ointment. The wound stayed too "wet" and wouldn't granulate or scab when I tried wraps or ointments.

5. The foster started rubbing the muzzle on the open wound, she tore the beautiful scab off (twice), so I ended up having to wrap it to prevent that rubbing. The key was to make sure everything was 100% dry before wrapping, and then I changed it twice a day (and applied Granulex or Bactine twice a day). Once it healed a bit more, I fashioned a shirt sleeve over the leg, and left that on instead of the wrap as it was more breathable (still muzzled).

 

It seems in your case that some wrap and padding is needed for walks so the toes don't spread and tear the skin. The plan of wrapping only for walks, then unwrapping for rest time, is what I would suggest. The area between the toes is a high moisture area, it needs to breathe as much as possible. I have wrapped some wounds before (most recently Chase's pressure sore on her rump), but most wounds I like to leave open to the air if at all possible.

 

It's frustrating because you need to walk Beth to potty, but I would limit her walking as much as possible. If she really needs to potty, she'll tell you. If she gets whiny at times when she doesn't normally go potty, ignore her. Keep her on a set potty schedule, only bring her out at those times, have lots of crate time in the interim to keep her off the foot. It's a tough love approach, and it will be hard (she will whine a lot and rub the muzzle pathetically), but worth it in the end.

 

I hope things continue to improve.

 

 

~Lindsay~

 

Thanks Lindsay. What you suggest is pretty much exactly what we're doing, so that's encouraging -- wrapped only for the briefest possible walks and crate rest with no wrap and a muzzle with stool guard (we have it tied around her throat with a strip of gauze) the remainder of the time. The wrap seems to create pressure or rub sores like crazy now (though it didn't all the time we were wrapping the original toe injury) so that's another reason we can't leave it on. Fortunately she can't really rub the muzzle between her toes, and she's tolerating wearing it much better than I expected. I mentioned the Granulex to my vet(s) and it wasn't something they'd used, but I have Bactine at home and may try it if you say it helps dry the wound.

 

Wrapping and unwrapping the foot so many times a day is really exhausting and emotionally draining for me. It helps to day board her in the vet hospital so the techs can take responsibility for the foot and for keeping an eye on her with the muzzle for that part of the time. The open area is not that large in absolute terms so I hope hope hope it won't take that long to heal, but even minimal walking seems to pull it open -- hopefully less and less. It seems so far away right now that my dog will ever be able to take a normal walk again with an unwrapped foot, but the tech reports her foot looks "great" so we'll see what that actually means when I pick her up tomorrow.

Edited June 6, 2011 by PrairieProf

[Xan]

Whew! Just catching up to all this. What an ordeal! I'm glad to come into this when things are starting to look better, and you've gotten a bit of a break.

 

[Guest Liz_in_PA]

Was Beth happy to see you this morning? And how is her toe?

[PrairieProf]

Got her home just now -- I left her at the hospital until 5 p.m. The foot does look a bit better -- drier, healthy in general, though there's still a pretty good pit in the area where the deepest tear was, and the top of the remaining middle knuckle is still irritated (and worse after the wrap to get her home). I see the lump of edema on top of the foot is still there too, whether or not it was at the hospital. I hate how it looks worse when we get home than five minutes earlier when we were there with the vet -- kind of juicy and more open -- stresses me out so much!

 

The vet said he took out some stitches and they cleaned it up. He is full of praise for what a great, relaxed dog she is and how much they enjoy having her in the hospital -- much commentary on her roaching!

 

We'll be continuing the day-boarding at the hospital this week; I need nine hours a day to have a life and not feel I have to constantly keep an eye on her.

Edited June 6, 2011 by PrairieProf

[Batmom]

FWIW, edema and seroma in lower limbs / feet can take quite awhile to go away -- working against gravity.

 

Glad your girl is home and improving, however slowly.

 

Hugs to you and scritchies to the lovely sweet Beth!

[krissn333]

Could you maybe put a little bit of bag balm on the knuckle that's a little bit owie-looking? That stuff is magical for things like that sometimes

 

Glad she's generally doing well. Just sounds like it's going to be a very slow battle.

 

And when you wrap the foot, could you put a cotton ball on the top of the knuckle so that it's not getting irritated by the wrap?

[PrairieProf]

Back home from another day of vet boarding -- at least Beth gets to be in two different places to do her crate rest, so it's not quite as boring for her, and she has lots of different people to interact with there, which is what she likes best!

 

Things look pretty much the same from my perspective. It's frustrating to look at the foot; I'd like to see more signs of healing. But I had a good chat with the very experienced tech who explained that the shrinking of the most visible wound (where the stitches ripped on the inside of the remaining middle toe) would be the last thing I'd see, only after all the granulation underneath has taken place. And I can see that area is still sort of concave. But she said that in the "apex" between the toes (the main amp site) where the stitches also ripped and it had to be left open, there is granulation and signs of filling in from underneath, and she thinks the healing is on track. And I guess every day that passes makes it less likely there are going to be further complications or skin tearing, right? So it's just going to be a lot of patience. The knuckle abrasion is getting better, and the foot as a whole is starting to regrow hair so it doesn't look as plucked-chicken-like.

 

At least Beth is happy, eating well, and being a cooperative patient.

Edited June 8, 2011 by PrairieProf

[Remolacha]

I think this is much harder on you than it is on Beth glad to hear the experts think everything is going well, I know how hard it is to be patient!