Necrotising fasciitis?

Re: Necrotising fasciitis?

Andrew Kent — Thu, 05 Jun 2014 19:32:24 GMT

[quote user="Martin Atkinson"]

[quote user="Andrew Kent"]

C-reactive protein is a completely non-specific marker of inflammation so I'm not sure it would help with prognosis? But I can't say I deal with many wounds so may have missed something?

[/quote]I was under the impression that when it was first marketed it was promoted as a marker for severity of inflammation as a prognostic guide i.e if you have a very high level and an animal with really nasty fascitis it may help you make the decision if it was worth continuing with treatment. Or am I thinking of something completely different?

[/quote]

It doesn't directly relate to severity of inflammation and there can be marked variation between animals so what is very high for one dog may be less high for another. Certain types of inflammation (for example immune-mediated diseases) seem to cause a particularly marked elevation but again that doesn't related to prognosis or likely response to therapy. Probably its biggest use is monitoring an individual dog over time to see change rather than as a snapshot of inflammation at any one time point.

Re: Necrotising fasciitis?

Bob Russell — Thu, 05 Jun 2014 18:25:52 GMT

[quote user="chris J"]

dont want to be accused of being 'alternative' but could manuka honey be useful in this case? I've had some really good results with nasty infected wounds.

[/quote]

Please don't tell me using manuka honey is alternative. I would be forced to stop using it!

Other than discomfort on application, I have found it has been brilliant for sloughing wounds (dog bites especially).

Re: Necrotising fasciitis?

Anonymous — Thu, 05 Jun 2014 17:43:26 GMT

dont want to be accused of being 'alternative' but could manuka honey be useful in this case? I've had some really good results with nasty infected wounds.

Re: Necrotising fasciitis?

Martin Atkinson — Thu, 05 Jun 2014 17:36:10 GMT

[quote user="Andrew Kent"]

C-reactive protein is a completely non-specific marker of inflammation so I'm not sure it would help with prognosis? But I can't say I deal with many wounds so may have missed something?

Re: Necrotising fasciitis?

Andrew Kent — Thu, 05 Jun 2014 16:17:26 GMT

In answer to the OP, we have seen a couple of dogs with extensive wounds from necrolytic disorders. Other than continued debridement I would also keep swabbing regularly - they can develop multi-resistance, and keep an eye on the blood albumin - they often lose huge amounts and we have had to use albumin transfusions in a couple. And I would share the guarded prognosis, both because they can end up with enormous skin defects and develop significant metabolic complications of the disease.

Andy

Re: Necrotising fasciitis?

Andrew Kent — Thu, 05 Jun 2014 16:11:40 GMT

C-reactive protein is a completely non-specific marker of inflammation so I'm not sure it would help with prognosis? But I can't say I deal with many wounds so may have missed something?

Re: Necrotising fasciitis?

Martin Atkinson — Thu, 05 Jun 2014 10:49:33 GMT

This is the sort of case I'd refer given the choice! I can't see that there is much else you can do other than debride what you can and let nature take its course with a view to some pretty nifty skin grafting when/if it starts to heal but the prognosis must be guarded. However there is a test you can do for C-reactive protein (Idexx) which may give you a prognosis if it is hopeless or has a chance of recovery.