Soft Tissue Surgery case of the week

RE: Soft Tissue Surgery case of the week

Anthony Dennison — Fri, 20 Dec 2019 11:10:58 GMT

Thanks for all the replies - so a bit more information.

Cat was brought in by an RSPCA inspector after the owner requested help for treatment then just signed the cat over. Had been an issue for approximately 3 weeks already. Wound had not been clipped or cleaned, it was infected and smelly. The puncture wounds on the shoulder and surrounding fur were all clagged up with what I assumed was sudocreme.

[quote user="George Cooper"] I completely detest Buster collars and anything of that ilk, believing them to be the Devil's own Invention!! I have found that I rarely (= vanishingly small numbers) need to enforce this!![/quote]

It was necessary in this case. Cat was licking it constantly - it might be that after proper wound management it wouldn't be required but the cat just wasn't leaving it alone.

Interesting to see pretty much 100% agreement on case management on this one! My concern was the pocketing between the elbow and shoulder wounds, especially around the elbow. Bit like a collar wound, difficult to heal potentially. Would anyone consider omentalising this wound as part of a repair if healing by 2nd intention wasn't working?

Cat has gone to RSPCA GMAH, so not sure what's happened to it now. Inspector said sometimes with these they just amputate the limb for quickest resolution. Bit extreme!

RE: Soft Tissue Surgery case of the week

Evelyn Barbour-Hill — Fri, 20 Dec 2019 01:10:55 GMT

[quote user="Kate Richardson"]I can see what your saying, slight clue in the OP though.[quote user="Anthony Dennison"]brought in with puncture wounds on shoulder [/quote] I'll let you all off though as it's Christmas [/quote]

RE: Soft Tissue Surgery case of the week

Kate Richardson — Thu, 19 Dec 2019 15:43:31 GMT

[quote user="Lucy Fleming"]

[quote user="Kate Richardson"]

[quote user="Lucy Fleming"]I don't think so, I had to take a second look before I worked it out. Maybe it's because the head's not in the picture?[/quote]

Yes it is It's got a buster collar on

[/quote]

I was thinking more of the first pic, where you can only see the edge of the buster collar, and the edges of the clip make the shoulder look a bit like a thigh

[/quote]

I can see what your saying, slight clue in the OP though.[quote user="Anthony Dennison"]brought in with puncture wounds on shoulder [/quote] I'll let you all off though as it's Christmas

RE: Soft Tissue Surgery case of the week

Lucy Fleming — Thu, 19 Dec 2019 11:54:44 GMT

[quote user="Kate Richardson"]

[quote user="Lucy Fleming"]I don't think so, I had to take a second look before I worked it out. Maybe it's because the head's not in the picture?[/quote]

Yes it is It's got a buster collar on

[/quote]

I was thinking more of the first pic, where you can only see the edge of the buster collar, and the edges of the clip make the shoulder look a bit like a thigh

RE: Soft Tissue Surgery case of the week

Kate Richardson — Thu, 19 Dec 2019 11:50:55 GMT

[quote user="Lucy Fleming"]I don't think so, I had to take a second look before I worked it out. Maybe it's because the head's not in the picture?[/quote]

Yes it is It's got a buster collar on

RE: Soft Tissue Surgery case of the week

Lucy Fleming — Thu, 19 Dec 2019 11:45:13 GMT

[quote user="Bob Russell"]

I have to admit I spent so little time examining the leg before judging the wound that my brain had registered a back leg!!

Is it an age thing??

[/quote]

I don't think so, I had to take a second look before I worked it out. Maybe it's because the head's not in the picture?

Possibly not on this one as it looks like there's not an awful lot of necrotic tissue left to break down, but anyone use Dermisol on these types of wounds?

RE: Soft Tissue Surgery case of the week

Bob Russell — Thu, 19 Dec 2019 10:34:08 GMT

I have to admit I spent so little time examining the leg before judging the wound that my brain had registered a back leg!!

Is it an age thing??

RE: Soft Tissue Surgery case of the week

Kate Richardson — Thu, 19 Dec 2019 09:27:31 GMT

[quote user="Evelyn Barbour-Hill"]The tibial wound[/quote]

methinks you need to refresh your anatomy

RE: Soft Tissue Surgery case of the week

Evelyn Barbour-Hill — Thu, 19 Dec 2019 01:59:14 GMT

Antibiotic at first, say five days. Metacam for considerably longer. Lampshade on head only if it proves essential (which is very unlikely).

The owner may care to irrigate gently with salted water. May help, won't do harm.

The tibial wound might be dressable, but the others are not, so no point in dressing anything.

I can't tell for sure from the photos, but it might have been possible to use a few sutures to reduce the size of the exposed areas a bit.

Re-examine frequently, of course.

RE: Soft Tissue Surgery case of the week

George Cooper — Wed, 18 Dec 2019 23:44:30 GMT

Apologies for any irritation that arises from my "Disagree" button pressed. I completely detest Buster collars and anything of that ilk, believing them to be the Devil's own Invention!! I have found that I rarely (= vanishingly small numbers) need to enforce this!!

If the wound/contusion/ abscess etc etc etc is addressed "properly" it doesn't require an HMV plastic megaphonic wallpaper-stripper wrapped around ANY animal's neck! Just my opinion and experience and observation!.

RE: Soft Tissue Surgery case of the week

Gillian Mostyn — Wed, 18 Dec 2019 20:48:19 GMT

I personally think any attempt at dressing this wound would be a mistake. Difficult to achieve in this location anyway, and likely to cause more problems than it solves.

RE: Soft Tissue Surgery case of the week

Joyce Whitehead — Wed, 18 Dec 2019 20:32:29 GMT

I’d be another in the antibiotic, nsaid and wait and see camp. I’d definitely want to see it in a few days, so I’d probably give Betamax LA as repeating the injection is a good chance to cast my eye over. Keep indoors, maybe in a crate even, and collar on.

RE: Soft Tissue Surgery case of the week

Rob Loxley — Wed, 18 Dec 2019 14:03:20 GMT

Agree, but one thought would be whether surgical intervention before a non-healing wound develops makes life easier than having to deal with the odd obstinately non-healing wound at a later date.
In the OP I would like to know how long it's already been going on? I suspect long enough to want to be cautious about any primary closure at this stage.
I'd probably clean, debride, dress and reassess, but consider delayed surgical closure if not progressing as expected. As you mentioned finances, sometimes surgery can be more cost effective than repeated rebandaging and frequent rechecks.

RE: Soft Tissue Surgery case of the week

Julie Innes — Wed, 18 Dec 2019 08:38:11 GMT

I'm another in the "it's amazing what heals!" camp! Antibiotics, NSAIDs and a buster collar. I would check it every few days to watch progress (also satisfying!), especially if the owner is a bit unreliable

RE: Soft Tissue Surgery case of the week

Gillian Mostyn — Wed, 18 Dec 2019 07:52:55 GMT

Looking at how bruised and angry the surrounding skin is I'd also put the cat on antibiotics and NSAIDS and reassess in 1 week. Buster collar on at all times.

I suspect this wound will dry up and heal without surgery but would make the decision about surgery after a week.

At this point it would make no difference to the plan whether money was an issue or not.

RE: Soft Tissue Surgery case of the week

Beats — Tue, 17 Dec 2019 18:35:07 GMT

betamox LA, betamox palatable drops home. Keep inside.

Infinite funds: back weekly to assess progress and plan

Limited funds: continue amoxicillin for 2 weeks and see back in a month

RE: Soft Tissue Surgery case of the week

Bob Russell — Tue, 17 Dec 2019 17:46:23 GMT

With proper wound management these can do very well. Clip, clean, debride and protect the wound and it is amazing how well these do. Antibiotics probably do a limited amount of good but I would use them. Loxicom or similar because this will hurt.

Some degree of closure of the wound will speed things but you don't want excessive tension.

Cats are amazing healers!

Using mobile as all phones and Internet are down in the village. Don't like it!!

RE: Soft Tissue Surgery case of the week

Sarah Keir — Tue, 17 Dec 2019 17:39:05 GMT

I've seen wounds worse than that in cats heal by secondary intention.

RE: Soft Tissue Surgery case of the week

Anthony Dennison — Tue, 17 Dec 2019 14:37:09 GMT

Just to add - the wound on the lateral aspect of the elbow communicates with the puncture wounds on the shoulder. No boney damage, joints are all OK.