Peculiar digit foreign body

RE: Peculiar digit foreign body

Liz Barton — Mon, 25 Feb 2019 22:14:42 GMT

[quote user="Moira Hamilton"] Sadly there was so miscommunication when the dog came in for x-ray, the area of inflammation was meant to have been surgically examined [/quote]

Don't beat yourself up too much. The outcome for the dog would probably have been the same... or possibly worse if nothing had been found. Managing owners is always tricky in these situations. They're living with a dog who they just want fixed and will take all their frustration out on you as they're having to live with it 24:7 not being right. Keep doing what you're doing; listen, understand and empathise with their frustration. Tell them you've contacted an online forum of vets and now have several opinions backing up your own so they know you're concerned and going the extra mile.

RE: Peculiar digit foreign body

Evelyn Barbour-Hill — Mon, 25 Feb 2019 21:44:43 GMT

[quote user="Moira Hamilton"]I got them to use magnesium sulphate from the chemists, do think it’s a shame that we there aren’t small animal versions on the market. [/quote]

At twenty times the price.......

RE: Peculiar digit foreign body

Moira Hamilton — Mon, 25 Feb 2019 21:43:57 GMT

Thanks for that, client unfortunately would like it fixed NOW despite being told since the first time they came in that could take a while to improve. Not sure why there is so much inflammation around the digit. Sadly there was so miscommunication when the dog came in for x-ray, the area of inflammation was meant to have been surgically examined but there must have been crossed wires when I spoke to the person who was doing the x-ray so have spent a lot of time trying to divert conversations so I don’t drop them in it despite saying it was probably my fault that the miscommunication occurred. Could never be a politian :-D

RE: Peculiar digit foreign body

Moira Hamilton — Mon, 25 Feb 2019 21:29:49 GMT

I got them to use magnesium sulphate from the chemists, do think it’s a shame that we there aren’t small animal versions on the market. The cytology came up with nothing other than some blood with no sign of inflammatory cells or any sign of neoplasia, and the culture came up with nothing.

RE: Peculiar digit foreign body

James Dunne — Mon, 25 Feb 2019 13:25:54 GMT

These cases can be extremely frustrating. Unfortunately, some of them can be opened surgically, explored, lavaged aggressively, treated with antibiotic, have no remaining visible foreign body and STILL recur days, weeks or months later! Patience is a virtue with these cases and continuing poultice treatment is laborious but seems to be as successful as anything else.

RE: Peculiar digit foreign body

Liz Barton — Sun, 24 Feb 2019 22:50:46 GMT

[quote user="Moira Hamilton"]why rest made things so much worse and why a lesion has now appeared on the opposite side of the digit[/quote]

As others have said, likely more foreign material tracking on the other side - just took longer to abscessate. Also, could be more lame due to e.g. penetration of a joint (though presumably you'd be able to palpate that), or proximity to nerve fibres. As we know, infection can become acutely painful when it builds.

I would caution the owners that these things can track despite our best efforts. I have seen two cases of grass seeds with their irritating one-way barbs tracking up limbs and even into the chest cavity from an original foot lesion... 6-9 months later before presentation. Quite spectacular stuff!

I wouldn't have done anything differently... although my most recent practice didn't stock poultices. So incredibly useful in equine practice, I wonder why we don't use them more in small animals. Did you use a commercial poultice, or just get the owners to wrap warm saline-soaked towel or similar?

RE: Peculiar digit foreign body

Niall Taylor — Fri, 22 Feb 2019 17:38:27 GMT

Wot Evelyn said. Some of these foreign bodies do like to go walkabout. I wouldn't guarantee just opening the lesion will encourage anything to come out either, you may yet have to go fishing for the offending object.

And it definitely wasn't the rest that made things worse. The reason you advised rest was obviously to give any remaining fragments time to make their presence known, after which they could be removed more easily and with less trauma - well done you!

Niall

RE: Peculiar digit foreign body

Evelyn Barbour-Hill — Wed, 20 Feb 2019 22:18:14 GMT

There's more foreign matter in there and it's worked across to the other side?

I don't suppose rest made it worse, I expect it was going to get worse anyway.