Major Foot Issue

PiggyFlamingo

Post   » Thu Nov 01, 2018 2:59 pm


Hi Everyone!
Apologies as I had to create a new account.

So my 1.5yr intact boar, Gamba was a severe neglect case that was surrendered to our local rescue. He recently had eye removal surgery 2 weeks ago by a different vet that the rescue uses as he was a "foster" at the time. He kept scratching at his incision which eventually became infected and partially re-opened. This all happened this past Saturday. To get us through until our vet opened on Monday morning, I stupidly used Coban to wrap his back feet so that he could not scratch his face. I already feel guilty enough about this decision. Anyway, I decided after about 4 hours to remove the wrap to let his feet "breathe". The left foot was fine, but the right foot felt cool to the touch. I put him back in his cage and checked on him 20 minutes later and noticed that the foot had swollen up to 3x the size of the other foot. I immediately scooped him up and put a cool compress on his foot for the swelling. It did not seem to help and I noticed large fluid blisters forming in between his toes. Within another 20 minutes, he bit his foot which started bleeding profusely. It looked like he bit the flesh on top of the middle toe and also bit the middle toe nail, breaking it about half way down. After finally getting the bleeding to stop after several hours (styptic powder did not help), I did a very cool episom salt soak.

We stayed up with him so that he could not scratch the face or bite his swollen foot. Monday morning, got him to the vet ASAP who did not seem THAT concerned about the foot. The eye incision had to be cleaned out and they also put a special mesh boot on his back right foot to keep him from chewing on it. He also had cold laser therapy on it. He went back again today (Thursday) for a re-check of his surgical site and also the remove the boot and do another cold laser treatment. The foot is still extremely um "juicy" with clear fluid.

I was wondering if any one has had the unfortunate experience of a too tight foot bandage and what additional treatments can I do for him? I was going to try to do an episom salt soak with the boot on since it is a plastic mesh and of course rinse his foot when I am done. The tissue still is looking pink so far but I am so worried for him.

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Lynx
Celebrate!!!

Post   » Thu Nov 01, 2018 10:42 pm


Unfortunately, I do not know the best course of action. I would trust your vet to give you the best advice for its care.

We have a page on bandaging. There is a warning about not cutting off blood circulation.
www.guinealynx.info/bandaging.html

PiggyFlamingo

Post   » Fri Nov 02, 2018 10:26 pm


Thank you, Lynx

The special mesh boot the vet put on him caused a wound on his leg. Poor thing is a mess and I’m so worried for him.

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Lynx
Celebrate!!!

Post   » Fri Nov 02, 2018 10:29 pm


Read over the bandaging page. I used a Telfa pad (which won't stick to an open wound), gauze, and carefully applied Vetwrap that is not pulled too tight (too tight cuts off blood circulation). To keep it on, some bandaging tape around the ankle. Also, not too tight.

There might be a spray antiseptic or something your vet would suggest in this case, before wrapping.

PiggyFlamingo

Post   » Sat Nov 03, 2018 12:52 am


Yes, I have the vetwrap and the sterile gauze and the non-stick pads. I really appreciate the advice and we will be off to the vet in the morning. Unfortunately, the middle toe on the affected foot looks like it is becoming necrotic. Like this poor boy hasn’t been through enough. We are managing his pain and the vet has said we are doing all supportive care for him that we can. Ironically, the culture came back from his eye incision and he’s now on an oral anti fungal as well. This poor boy has been through so much, I just hope his little bottle has enough fight left in him.

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Lynx
Celebrate!!!

Post   » Sat Nov 03, 2018 9:20 am


For what it's worth, one of my guinea pigs had a toe die when a vet too aggressively debrided a supposed infection in the foot pad. She did fine without that toe.

PiggyFlamingo

Post   » Wed Nov 07, 2018 10:50 am


For anyone going through a foot issue, I wanted to post an update about Gamba. He did have to go through yet another eye surgery as his wound was re-opened. Putting a e-collar on a piggy was stressful for all of us but he has since adjusted fairly well and the wound hopefully is finally healing.

Now to the foot: It would appear that the cold laser therapy and bandage changes every 2 days has made a huge impact for him. The tissue is now healthy and pink minus the tip of the middle toe where the toe nail also fell off. The vet said she couldn't believe how much improved the foot was. The epsom salt soaks in the beginning made a huge difference along with the cold laser to bring down the swelling/inflammation. He is also having the cold laser treatment on his eye incision as well. I am crossing my fingers that our sweet boy finally will heal for good.

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Lynx
Celebrate!!!

Post   » Wed Nov 07, 2018 11:36 am


That is wonderful news about the foot! If you have any before and current pictures of the foot, I would be happy to add them to your topic. You can send them to:
Image

If you can provide any detail on how the cold laser therapy was done, how often you soaked the foot, and the bandaging, it could be very helpful to other readers.

PiggyFlamingo

Post   » Wed Nov 07, 2018 4:47 pm


Sure Lynx, I will send the pics I have so far. They are pretty gruesome.

Here was the emergency treatment that I followed when I removed the bandage and realized it had been too tight.

1. COOL compress for 5 minutes on, 5 minutes off for 20 minutes. I did this every 2-3 hours because of the swelling.
2. Epsom Salt Ice Bath and soaked the foot for 1 minute in, 2 minutes out and did this for 10 minutes making sure the foot didn't become too cold. Did this every few hours. This was for the swelling and the fluid blisters that had formed on the foot.
3. Gave him Metacam for the inflammation and the pain.

We continued on this regimen for 2 days as it was weekend and the vet was closed. Also, we did not leave him unattended as he would bite the foot wound. We stayed up with him to ensure he wouldn't bite it again.

The vet started him on a treatment schedule for the cold laser therapy, every 2 days. The foot was left un-wrapped due to all the fluid being released from it. After it continued to get worse, I started warm epsom salt soaks for the whole leg for 7-10 minutes, 3x/day.

The cold laser therapy is super helpful in reducing the healing time for wounds and reducing inflammation/swelling. The length of the session depends on the severity of the wound (Gamba's are 3-5 minutes usually) and so does the frequency of the treatments. Currently Gamba is on a treatment schedule of every other day. As he continues to heal, it will go to 2x/week then to 1x/week. Treatment plans can be purchased but generally they come out to around $30-$35 a session and they treat his foot/leg and his eye incision in the same treatment. I highly recommend them as I have seen a huge difference in the healing of his eye incision and the foot wound.

The vet started vet-wrapping the leg after the issue with the wound caused by the mesh boot. The wrap must go up to the hip or he would manage to come out of it. Originally a Telfa pad was used between his skin and the vet wrap. This actually kept the wound too moist and caused additional skin to slough off. Switched to a cotton based gauze to help keep the foot dry and then wrapped with vet wrap. The bandages are currently being changed every other day as they need to come off for the cold laser treatments.

We also put an e-collar (cone of shame) on him at night so he cannot scratch his face while we sleep. He was very dramatic about it the first day but then he got used to it and it was no problem.

The pictures look rough but the foot really is improving! He did lose another toenail but considering the vet thought he could lose the foot, some toenails and possible 1 toe tip is the best possible scenario.

**Our vet uses Elastikon wrap on the edges of the vet wrap. It stuck to his skin/fur and was impossible to get off initially. Our favorite vet tech showed us the product they use called Mill Pledge Eaze-Off Adhesive Bandage Tape Remover made specifically for veterinary use to remove the bandages. Purchased from Amazon. It was pricey at $39 but a little goes a long way and it makes removing any tape from fur or skin super easy.

Hope this information is useful.

bpatters
And got the T-shirt

Post   » Wed Nov 07, 2018 5:59 pm


Since you're using a cone, retrieve some of his cecal pellets daily and offer them to him (I believe they're usually more plentiful in the evening, but can't remember where I read that). That can keep him from developing digestive issues.

PiggyFlamingo

Post   » Wed Nov 07, 2018 7:52 pm


No worries, Bpatters. He can actually retrieve them no problem because we trimmed the cone so he couldn’t scratch the eye but could still get his ‘chocolate pellets’. It’s a soft material so it doesn’t restrict him from that. He still gets some poop soup from his brothers bi-weekly anyway due to his Baytril. I appreciate you pointing it out as I could imagine many people would forget how important they are!

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Lynx
Celebrate!!!

Post   » Wed Nov 07, 2018 7:55 pm


Thanks for the detailed description. When you say you needed to prevent his biting his foot after this initially happened, this is common. When a foot is severely swollen or compromised, there is no feeling and it almost doesn't seem like a part of their body so an animal may bite at it.

It appears the purpose of the mesh was to prevent him from biting at the foot, not a bandage. I can see his method of wrapping the footlater caused problems. The description I have on the bandaging page emphasizes the importance of the non-stick pad (if there is an open wound) and gauze which prevents the vet wrap from contacting the skin or hair. The non-stretchy bandage around the ankle is supposed to only contact the wrap, not the skin or hair. A vet friend of mine emphasized how important it is not to trap moisture under a bandage - the reason for having the foot dry, using gauze, and changing it once a day. Leaving the foot open to the air for a while in between bandaging is important too.

How did you keep the foot clean when you needed to leave it open because it was weeping?

Oh, and here are your pictures and description:
__________________________________________________________________________
The first 2 pics are from when I realized the bandage was too tight, removed them and the foot had swollen to 3x the size of the other foot. He bit the foot, that is where the blood was from







Pic 3 is the mesh boot




Pics 4-5 are when we removed the mesh boot and started soaking the foot in epsom salt 3x/day. You can very clearly see the wound on his thigh where the boot cut in.







6-7 are from today’s appointment. Swelling gone. Lots of skin sloughed off but besides the middle toe, the tissue is healthy. The skin is no longer oozing anymore.






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