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OPEN WOUNDS

Open Wounds

Your dog probably gets herself into all sorts of situations and can end up with a wide variety of wounds. The basic types of wounds are:

  • Abrasions
  • Avulsions
  • Lacerations
  • Punctures/bites
  • Degloving
  • Gunshot wounds

Causes include injury, dogfights, accidents and human malice.

If your dog has an open wound, she must be attended to promptly, regardless of whether the wound is bleeding. An open wound is, by definition, a contaminated wound, and it is likely to get infected unless your dog receives proper treatment: antibiotics, cleaning of the wound and stitches.

  • Abrasions. These do not break the skin, but they can be very painful. Most commonly, abrasion occurs when a dog gets hit by a car and thrown onto the road -- this type of wound is known as "road rash." Abrasions also result from dogfights, in which toenails and teeth may scrape the skin without breaking it. The worst abrasions occur when a dog is dragged by an automobile (by accident most of the time, but in some cases -- sadly -- on purpose). Abrasions may or may not bleed, but they should receive veterinary attention as soon as possible.
  • Avulsions. These are wounds in which a piece of tissue is torn away from the body. The most common types are avulsions of the dew claws or toes caused -- yet again -- by encounters with motor vehicles and dogfights. Although avulsions can bleed a lot, they generally are not life threatening.
  • Lacerations. These involve cutting or tearing of the skin. Lacerations can be any size-- from half an inch to a foot or longer. Common sites of lacerations are the paw pads and the trunk. Most lacerations result from dogfights, although other causes include encounters with sharp glass, jumping over or crawling under fences, running into barbed wire and running through plate glass windows. Lacerations usually bleed profusely and require immediate medical attention.
  • Punctures. These are wounds that penetrate the skin and often continue deeper into the underlying tissues -- without making a large hole. Most puncture wounds are so small that they can easily be overlooked, yet they can be more dangerous than an open laceration because they have a tendency to form pockets of pus (abscesses). The source of the puncture -- perhaps a nail, a thorn or a sharp canine tooth -- carries bacteria and a small plug of skin deep into your dogs tissues. Since the skin hole is small, it quickly closes over, sealing the bacteria and foreign material deep inside and setting up the conditions for a painful abscess. Your dog may run a fever, become anorexic and act lethargic until the abscess eventually ruptures and forms a large, bloody, pus-filled, smelly wound. During warm weather, ruptured abscesses quickly become infested with maggots. No dog ever deserves to be infested with maggots; if your dog has a small puncture wound, early treatment is crucial.
  • Bite wounds. These include punctures, lacerations and abrasions. The severity varies greatly -- from an inadvertent single puncture wound that occurs during normal dog play to very serious and life-threatening bite wounds obtained during a vicious attack or maul. Most of the latter cases involve large dogs attacking small dogs, adult dogs attacking pups or dogs trained to fight each other. All bite wounds -- even small ones -- can be serious and should be seen promptly by a veterinarian. If your dog has been mauled, she should be taken to an emergency hospital as soon as possible. Note: For bite wounds, your dog must receive a rabies booster vaccination -- even if her vaccines are current. If your dogs rabies vaccine is not up to date, she will have to be quarantined for six months.
  • Shearing wounds. These are fairly common but are seen almost exclusively in dogs hit by cars. The dog gets pinned under a spinning wheel, or is pushed or dragged under the car with a force that grinds through skin, soft tissues and eventually into the bone. Often, the legs, leg joints and paws are ground down, and the bone marrow cavity is exposed. This type of wound is both very painful and potentially life threatening since the bone is exposed and contaminated. It can take several days to clean the wound of all the gravel, dirt and road material that has been ground deep into the bone. If your dog has a shearing wound, an emergency veterinarian should see her as soon as possible.
  • Degloving wounds. These strip the skin off the body. They almost always involve the legs or the tail, both of which easily get caught under automobile wheels, in doors, in fences and in leg-hold traps. Degloving injuries, like shearing wounds, are serious. The skin barrier is gone, the soft tissues may be incalculably damaged, and the blood supply to the tip of the tail or the paws may be undermined.
  • Gunshot wounds. These are becoming more frequent -- surprising as that may seem. Often, as with puncture wounds, the entrance wound is quite small, and you may be unaware that your dog has been shot. The exit wound, if there is one, is larger. Tissue damage depends on the size and velocity of the bullet. Most gunshot wounds involve BB pellets or air rifle shots. BBs usually cause little damage, but air rifle shots can shatter bones, lacerate the lungs and penetrate the abdomen. If your dog has an entrance wound in the abdomen, she should receive exploratory surgery as soon as possible so that any holes in her gut can be repaired before massive abdominal infection (peritonitis) sets in.

Symptoms

  • Bleeding
  • Stiffness
  • Sore swollen area on body
  • Swelling and discharge from a small hole
  • Odor
  • Anorexia
  • Lethargy
  • Fever

Diagnosis

An open wound is diagnosed from a history of accident or injury and on the basis of a physical examination:

  • The veterinarian may have to clip your dogs hair to see the wound and any bruising of the skin around the wound.
  • X-rays are used to assess gas patterns under the skin, to examine the extent of shearing wounds and to look for bullets, shrapnel or fractures caused by a gunshot wounds. A gas pattern, which shows up black on an X ray, outlines the size of the wound and extent of air pocketing under the skin and into the deep tissues from an open wound.
  • In some cases, the veterinarian may inject dye into the hole and then X-ray your dog to see how deep the wound goes (this is called a contrast study).
  • Blood tests will screen for infection, as well as for any stress on your dogs organs if a wound is old or a deep abscess is suspected.

Treatment

The basic steps are to thoroughly clean the wound, to remove any dead or infected tissue (to debride) and to establish drainage so that an abscess will not form. More specifically:

  • The veterinarian may place a latex tube called a Penrose drain in your dogs wound -- one end goes deep inside the wound and the other end exits the skin. Penrose drains, which look like thick latex noodles, allow internal wounds to drain and set up healing from the inside out. They are used to treat all sorts of wounds, including lacerations, punctures and abscesses. Depending on your dogs wound, the drain may be left in place for three to seven days.
  • Your dog will receive systemic antibiotics.
  • Many veterinarians have also started treating severe wounds with Rimadyl to help reduce pain and swelling. (Rimadyl is in the same family of drugs as aspirin but, unlike aspirin, Rimadyl is safe for use in dogs.)
  • Your dogs wound should be cleaned at least once or twice a day.
  • For the first two to three days, warm compresses should be applied at least two to three times a day to encourage drainage and help reduce swelling.
  • For severe bite wounds, additional care includes intravenous fluids, blood fluid (plasma) transfusions and potent pain medication.
  • Shearing wounds are very dirty wounds and must heal over time -- often weeks to months.
  • If your dog has shearing wounds or degloving injuries, she will need several days of a treatment called "wet-to-dry bandages." The wound surface is cleaned as well as possible each day, and wet bandages are applied. As the bandages dry overnight, they adhere to the surface of the wound, and when they are taken off the next day, they act like tape picking up lint.
  • After several days of wet-to-dry bandages, the wound (and exposed bone surfaces) should appear clean. At this point, the veterinarian will apply a special dressing to the exposed area to promote the production of new scar tissue.
  • It will take several weeks to months of bandage changes and wound dressings before skin will cover the exposed area. Once your dogs exposed bones and joints are covered with tissue, the risk of life-threatening infection drops dramatically.
  • In the end, your dog may even need a skin graft.
  • A tail amputation is commonly performed when a degloving injury involves the tail.

The key to the fastest healing is early, aggressive debridement and wound care.

Prognosis

Depending on the type of wound, its severity and its duration, the prognosis is fair to excellent. Almost every wound will heal -- some just take a lot more time, bandage changes, wound cleansing and nursing than others.