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Ted’s Braveheart

Ted arrived at the surgery early one morning, at the end of October. His owners had been out walking him early before work, when he had run off chasing a deer. He had disappeared for over 30 minutes and when his owners found him he was collapsed and bleeding severely. They loaded him into their car and phoned the emergency service to say they were on their way.

Ted’s photos 

Upon their arrival Jonathan examined Ted in the back of their car before helping carry him into the surgery. Ted had been hit by a car and sustained severe injuries.

We immediately placed him onto shock rate intravenous fluids, we also placed him on some padded blankets and heat pads as he was cold due to the shock, and he was having difficulty breathing so we administered oxygen via a nasal prong. A full body survey was performed and revealed the following:

– A severe degloving injury to his left fore leg – he had basically had all the skin ripped off the back of his front left leg, from above his elbow to below his carpus (wrist.)

– Multiple thoracic contusions (bruises.)

– Some abrasions to his left hind leg.

Although the degloving injury was the most apparently shocking, we were most concerned by his breathing. We attached the pulse oximeter to him, this machine measures the oxygen saturation levels within the body. We would normally expect levels to be between 97-100% in a healthy animal, Ted’s oxygen saturation was varying from 93-98%, which indicated he was not getting a good level of oxygen around the body. We used the portable x-ray machine to x-ray his chest, which showed there were no fractures but severe lung contusions.

We placed him on high flow oxygen supplementation and administered high level pain relief. The degloving wounds to the front leg needed some attention however we could not do this conscious and he was to unwell to anaesthetise him, so a temporary dressing was placed over the whole leg and he was placed in a large padded kennel. His owners were warned he was in a critical condition and may not survive the day, we advised them we would contact them every couple of hours with updates. I sat with Ted and monitored his heart and respiratory rates, oxygen saturation, temperature and colour, every 30minutes. Over the course of the day his respiration improved slightly and his oxygen saturation levels improved. By late afternoon we were able to stop his oxygen supplementation and he was more responsive to my presence. He was kept on a Ketamine drip for pain relief and his owners were told he was more settled but was still not out of the woods and overnight would be the deciding time.

He remained in a critical condition for 48 hours, after this he had stabilised enough to allow us to anaesthetise him and properly assess the damage to his leg. He had not only lost all the skin on the back of his leg, but the muscles had been disrupted and the underlying bone was visible, with a chip off the elbow bone. We flushed the wound copiously removing as much dirt and gravel as possible, the hole leg was then coated with a special gel to clean and keep the wound moist, this was then covered with a silver dressing (silver has strong antibacterial properties) and a large padded bandage. He remained in hospital for another week on strong painkillers and antibiotics and being sedated every day to have the dressings changed and the wounds cleaned. At the end of this time he was allowed home, but had to return every other day for a month.

Over the month of November he was sedated and redressed every other day, and the tissues were looking healthier every time. The body’s natural reaction is to provide extra tissue and the wound heals via granulation, this basically involves healing both from the sides inwards but also from the bottom up.

By the start of December the leg was looking brilliant and all the tissues looked healthy by now, however the granulation process was slowing and although there was a healthy margin of new tyissue there was still a large deficit to be filled in. Ted was hospitalised for another 2 weeks, during which time he received 2 skin grafts to cover the area. The crucial point to a skin graft is minimal movement, he was covered in a large padded dressing to immobilise the leg and apart from 3 short toilet breaks outside he was kept restricted in his kennel. The lower skin graft was a huge success and was accepted and held really well, the graft covering the elbow did not take due to movement of the elbow and secondary infection. Ted was allowed home and returned every other day for redressing. This even involved coming in for sedation on Christmas eve! By Saturday 27th December the skin graft was firmly in place and hair was starting to grow from it, the wound on the elbow was healing well, and for the first time we were able to redress his leg conscious.

Ted’s leg is gradually healing, the elbow is a difficult place to heal due to movement and boney prominences, he is still receiving dressing changes every other day, for which he is the model patient. It is going to be slow process but he is on the road to recovery.

During his treatment Ted has been a very brave dog, he was scared of the vets initially and a bit worried about what was happening, but over time he has grown to love us all and greats us enthusiastically with a waggy tail and lots of kisses! For a dog with such serious and painful injuries we would have forgiven the occasional grumble, but the worst he did was chew his bandages hence his wearing a Jonathan Wood t-shirt!!!

We hope Ted remains happy to come and visit us, but most of all we hope he has learnt a very big lesson…..don’t run away chasing deer!