I take your point about the risk of the splint--but there's risk to not splinting, too, right? Josephine, would you just remove it?
- Little Jo Wheek
I talked to my sister about his behavior while she was watching him before the last splint change, and she believes (as I now do) that the last splint wore the hole in his skin/fur. The last splint had paper tape that stuck to his fur, and it was stiff enough to chafe. In looking at the degree of scabbing in 24 hours (no scab, just dried up a bit), the scab he picked off yesterday was at least 48 hours old. Possibly exacerbated when they removed the splint.
Since I swabbed it with colloidal silver last evening and cut the gussets, he hasn't touched the sore. So I now think the irritation was the scab getting itchy. I think he is feeling well enough to wait 24 hours for the exotics vet, and I have decided against taking him to the local vet today. I no longer have much confidence in the local vet!
Thanks for the input--I'll keep you posted...
1.Not all splints are created equal: be persistent in getting one that is just large/tight enough to align the bone and provide support but not too big/tight to cause harm/discomfort. Splinting is as much art as science, and there is no method that results in a perfect splint every time. Last week I took Satchmo back three days in a row for do-overs until we got a splint that was comfortable for him.
2.Don't mess with success: Last week, the vet decided she wanted to do a splint change and an x-ray on Monday (yesterday). When she saw how well he was doing with the current splint, she recommended leaving things alone for a few more days. I absolutely should have made this decision myself, so thank goodness she came to the right conclusion.
3.Relentlessly advocate for your pig: When the second splint wore a hole in his skin, I assumed the worst—that he was self-mutilating. I later found out the techs had noted the sore in his chart and realized the splint caused it, but they failed to inform me. They also recommended taking him off pain reliever too early. Since then, I read them the riot act about not telling me about the sore (it is healed), and I negotiated a regular low dose of metacam I dispense (.05 ml—two drops—daily).
4.Listen to your pig: Satchmo told me when the splints weren't right, but it took me a while to figure out what he was saying. Fortunately, I heard him when he got a comfortable one!
Satchmo is doing really well. He has gained 37g in five days. He is completely back to normal personality. Last night he was doing wheelies around his pet store cage, and he even managed to jump up on his inverted cuddle cup to use it as a hammock (yikes). I changed things so he can't do that again, but I was glad to see him be his active, playful self! I'll post another update at the four-week mark.
He is on one week of severely restricted movement, so I now have him in a little carrier that is about 12x16 inches. Even so, he is trying to move around some, and I keep hearing him squeal in pain when he tweaks the ankle. This is quite distressing, because the vet said to eliminate the metacam to keep him from feeling too good and using his leg. I had been giving him .05 ml (two drops) up until a couple of days ago when he didn't seem to need it anymore. I just gave him one drop of metacam, in an effort to balance between feeling too good and too miserable. I held him with all pressure off the leg (kind of on his back) for about an hour, which seemed to help. He fell asleep briefly, even tho he normally hates being held that way. I am also putting a hot rice bag near him. Tomorrow I am supposed to begin very passive and gentle therapy on the ankle and knee.
Any advice on walking the pain/activity line would be welcome.
The first day and a half, Satchmo was miserable and very confused about what to do with his leg. He was quiet the whole time and ate minimally. I did give him almost a full dose of metacam about 12 hours post-splint--he was just too miserable for words.
Last evening, he started chirping as much as usual, and he is moving about, expressing interest in escaping his confines. He now rests weight on the injured ankle. The first day I couldn't touch his knee or ankle without his protests. This morning in therapy (!), I worked the knee 20 times and the ankle 10. He did not cry out, although he was skeptical, especially about the ankle. I am more interested in the knee at this point, because that is above the injury and is only stiff because of the splint. His skin lesions are healing rapidly. Today he has not needed any metacam, and he is eating to make up for lost time. It is still too soon to tell how normally he will be able to use his leg. He sure is cheerful despite all he's been through!
We have gradually been working on restoring full range of motion in the following increments: 5 days post-splint in tiny carrier (no use); 4 additional days in pet store cage (little use); 5 days in C&C cage with no loft or impediments (regular use, but light impact). No floor time yet.
Since 48 or so hours post-splint, Satch has been very cheerful, very hungry, and very normal--no need for metacam. He hasn't seemed to be in pain at all since. At first, he had a marked limp/drag. It was as if he needed to re-learn how to use his leg. He was walking much as he did while he was wearing the splint. I attempted to work his joints, but he would often strong arm me, resisting bending altogether. But when I wasn't messing with him, he would sometimes "forget" the leg was injured, and I'd catch him using it almost normally. So when he's relaxed or excited, he's more inclined to use the leg normally, and when he's conscious, he is more inclined to limp. Odd, but that's what I observe. I don't think we will know exactly how this will resolve until more time has passed. He's getting more and more active, and last night he was doing wheelies in the cage. So even if he never regains normal range of motion, I am quite certain he is enjoying life a great deal. He has not quite reached 700g, but he's close.
In terms of his personality, he is more and more affectionate. He is full of kisses! In my own mind, I think it's because he's grateful for the care. He greets us first thing in the morning, whenever we come home from work, and he gets the most excited when both of us are home. All my other pigs have been much more aloof. I don't know if he would have been this closely bonded with us without the injury, but it's nice to speculate about a silver lining. Hope Satchmo's experience helps another injured piggy down the road--but then, we both wish for no accidents, ever!
I started Satchmo on floor time about nine weeks post injury I figured I err on the side of caution. He had begun to be rather restless in his quarters--that's a bit of an understatement. His leg still seemed rather stiff and worked at an odd angle. I tried giving him my own brand of therapy, but he objected. I gave up. The first time on the floor, he was so stunned that he just sat there. I don't think he really could take in his freedom for one thing, and I think he was just a bit overwhelmed by the idea that he could use his leg. After an hour, I picked him up without his having moved much. The second day was a different story. He was about 10 feet away before I ever really let him go! His gait is a little odd, but he hasn't stopped dancing since!