Violet's medical thread

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Lynx
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Post   » Mon Jan 11, 2016 11:09 am


I don't think the saline comes out the other end of the drain but instead from around the drain. The drain is there to prevent that area from closing up. There should be space between the drain and flesh that you inject the fluid. I think the drain is a closed tube (you could check with your vet about this).

bpatters
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Post   » Mon Jan 11, 2016 11:34 am


I think you're right, Lynx. You inject the fluid around the drain, then gently push it toward the other hole.

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Zaphy

Post   » Mon Jan 11, 2016 7:07 pm


Okay. So the flow should be like the first picture, not the second picture, right?

Image

Image

Today's problem of the day is that Violet's been biting and scratching at the area around the incision. She's pulled some hair out and the skin on one side is now red and sensitive. I took a closer look and it seems she had some fluid from the wound crusted up into a couple of scabs that were stuck in the hair, so I flushed the area with water and gently combed out the fur around it to make sure nothing else was caught in it. I'm guessing this isn't that big of a deal unless it develops into another infection. Hopefully whatever it was that was bothering her was rinsed out, but would it be safe to use a small amount of fragrance free lotion, or maybe some aloe vera gel to try to calm the irritation around the area?

bpatters
And got the T-shirt

Post   » Mon Jan 11, 2016 7:59 pm


Theoretically, the first diagram is right. However, if the center heals up first, you may wind up with the second scenario.

The main thing is to get any remaining pus out, however the flushing solution flows.

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Lynx
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Post   » Mon Jan 11, 2016 8:49 pm


Ditto bpatters.

Your sketch is very cute. I wonder if Violet would approve (I imagine she would at least approve of the sentiment). Would you like these images added too?

If she worries and bites at the area severely, you might need to fashion some kind of cone shaped collar for her to keep her from biting it. I don't have a quick page to point you to - hopefully someone will add a link.

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Zaphy

Post   » Mon Jan 11, 2016 9:56 pm


Thank you, and sure!

Talishan has an example of a collar for guinea pigs in her post-op care links she posted earlier, my only concern is that the irritated area is right where the collar would be against the skin, so I'm worried that it might bother it further.

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Lynx
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Post   » Tue Jan 12, 2016 6:48 am


That is a legitimate concern. I was going to suggest bandaging but with that drain there, I don't know that you could do that either. Maybe your vet has something up their sleeve?

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Zaphy

Post   » Tue Jan 12, 2016 3:57 pm


So sounds like they're going to try putting her on a narcotic- the vet was in surgery when I called, so he's going to call me back I guess.

I think I haven't been flushing the drain often enough, or maybe just not well enough, it was stinky when I flushed it this morning. Also had some yellow pus discharge from the side that she's been biting and scratching at. Not sure if that's cause or effect. But it seems like the swelling has maybe gone down some, the tube kinda opened up (as opposed to being smushed flat) and I noticed I can see straight through it to the other side. Either that or she's been tugging at it so much it loosened up. <.<;;

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Zaphy

Post   » Tue Jan 12, 2016 5:21 pm


HAHAHA OKAY SHE JUST RIPPED HER DRAIN OUT

LITERALLY LESS THAN 15 MINUTES AFTER THE VET CALLED AND I TOLD HIM EVERYTHING WAS FINE (apart from the discharge)

Anyway, she's not bleeding or anything and in fact is sitting here with a very smug look on her face just eating her poop happy as a clam. What a brat. I called the vet's office back and they said as long as she's still not bleeding she should be fine till Thursday which is when her follow-up appointment had already been scheduled.

Vet said keep doing the massage thing (I just realized I never told them I was flushing it instead)... I can see some globs of junk in there. I mean, since it's pretty much the same wound as it was with the drain in it I should still be able to treat it the same, right? Flush it out with warm saline still? I swabbed some tweezers with alcohol and used them to pick out a couple globs that were close to the opening.

Oh, and she very nearly ate the drain, she literally had it halfway inside her mouth and was chewing it by the time I was able to grab it and get it away from her.

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Lynx
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Post   » Tue Jan 12, 2016 6:14 pm


It's possible an antihistamine might help with the itching.

Pretty funny (not) about pulling out the drain!

Perhaps your illustrations should have included a few exclamation points and some bad language after the "I hate this" :-)

Do the best you can to keep it open with flushing. The massaging (in my opinion) may hurt and prevent healing.

What a crazy little pig!

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Zaphy

Post   » Wed Jan 13, 2016 12:19 am


Urgh. Over the course of the evening it's like the incision area is, like, splitting/falling apart?? I'm guessing the ripping out of the drain didn't do the original sutures any favors. I'm having a tough time describing it so here is a photo:
Image

I can't tell if the flesh the sutures were in, like, died and just gave out? Cause it's not bleeding other than some slight ooze as you can tell. And is that pus behind the rips that hasn't been rinsed out? Or fat? Or something else? The area seems like it's swelled up again too, so... yaaaaaaay. And of course the skin is still super irritated. Is this like 'take her to an emergency vet' kind of bad? Or 'wait and call your vet in the morning when they're open again' kind of bad? Or possibly 'this will be fine till the morning after tomorrow when your appointment is already scheduled'?

Violet is now on buprenorphine as well as the Rimadyl and Chloramphenicol. The narcotic has definitely mellowed her out, she's not bugging the wound any more. Might be too late though, plenty of damage has been done. And she still freaks out whenever I touch it. She also did not stand on her hind legs for her pepper just now. Still ate it though. Hopefully she's just a little woozy from the buprenorphine and it'll clear up in a few hours. I'll definitely wait to see if she perks up before giving her more.

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Zaphy

Post   » Wed Jan 13, 2016 3:37 am


Kay... I think, since she doesn't appear to be in too much more pain, I'll wait to call the vet till morning. The little flap of tissue that was connecting it in the middle is now detached, and it's just kinda gaping open now. She is not laying down and totally relaxing with her feet out, but she's also not entirely hunched and puffed out- just kinda sitting in a neutral position. She's still munching some hay of her own accord, she was still excited to get lettuce though she still didn't stand up (though I didn't give her the opportunity to, didn't want to stress the wound more than it's already been). She also is still ducking under and eating almost all her poops... I'm guessing if it were hurting her too terribly she wouldn't bend her head so far down?

So, plan of action: I changed her towel, made sure to feed her CC and water, flushed the wound again, gave her the extra half again of Rimadyl to hopefully soothe the pain enough for her to get some rest till morning. I'll be waking up at least once during the night to check on her and feed her again, since I know buprenorphine can cause constipation so hopefully that'll help keep things moving a bit.

I'm kinda assuming that they're going to have to knock her out again tomorrow to possibly debride the wound and sew it up again. But I guess we'll see when I call them in the morning.

This has turned into a bit of a nightmare T-T

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Lynx
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Post   » Wed Jan 13, 2016 6:24 am


You might want to read gl/postop.html with particular attention to Talishan's advice on pain relief. It's important not to knock them out too much. There's a balance that needs to be reached (it might help you - I think there may also be a link on that page to more detailed info on pain management).

Difficult to tell from the photo if it is pus or what behind the sutures (certainly looks like it could be pus). The opening of the incision, what you see might be some granulation of the tissue (a good thing, generally, though you still don't want the infection locked in).

Let us know what the vet says.

p.s. how does he irritate it? Can she reach down with her teeth? Is she scratching with her claws? If the latter, it might be possible to wrap the feet to limit further injury. I think there is some info on the bandaging page about my wrapping my guinea pig's feet when she had pododermatitis. gl/bandaging.html

In all cases, one does not want to bandage and leave bandaged. Unwrapping the bandaged area to let dry in the air, preventing moisture accumulation by leaving open for a while every day is quite important. New kinds of bacteria grow in moist environments.

When you flushed the wound again, did you see pus?

I wish she was more cooperative! This little pig is definitely worth it. Sure hope it never happens again.

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Zaphy

Post   » Wed Jan 13, 2016 9:07 am


All right. I did not give her the full dose of buprenorphine, and haven't given it to her since because it doesn't look like she's scratching at the original place any more.

Yesterday pre-buprenorphine she was scratching at it with her claws so wrapping the feet might not be a bad idea at all... I'll definitely check that link out. Thank you! She cannot reach the wound with her teeth but has been trying to, she's got a few small areas all around it that she's been barbering the hair away.

Last night when I flushed it again I did not see pus- all that yellow stuff just kinda stayed there. However, just now I flushed it again aaaaaand it started coming out of the wound. So I'm guessing that it is indeed pus. Vet opens in just a couple hours.

Edit: It's also worth nothing that I could not flush all the yellow stuff out of it. There appears to be a significant amount stuck to the walls of the wound.

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Lynx
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Post   » Wed Jan 13, 2016 10:21 am


I believe it is the walls of the wound that produce the pus. With a successful surgery to remove an abscess in its entirety, the wall is also removed and the wound likely sutured shut without need of draining (all the infection is removed). I think it likely that it is difficult to remove the whole thing in some cases as there can be multiple infected chambers. So you are having to go the flushing, keep it open, let it heal from the inside out route.

I think.

By the way, it might be interesting to see if those covers that are put on cat's nails to stop scratching could be put on your pig's front nails to prevent scratching the injury. Good luck.

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Zaphy

Post   » Thu Jan 14, 2016 5:10 am


Update! So the vet had me bring her in yesterday instead of waiting till today. He said that considering everything that it's been through, the wound actually looks pretty good. We're going to try leaving it open to drain this way a few days. He says keep flushing several times a day and keep changing out the towels she's on of course, and we've been trying to work out a way to keep her from bugging the area and making it worse. And as I type this at my desk (which is where I do all the flushing etc) I notice that the last suture has been ripped out of the wound, I just found it.

Lynx, he liked your idea of wrapping the feet to keep her from scratching at it. He also gave me some different sizes of the fabric sleeves you put under casts to try putting around her head (to be changed out frequently of course). There is one size of that which she will tolerate, but she absolutely WILL NOT stand for any gauze to be placed on the wound under the sleeve. She chilled for a while with it on before I took it off to flush. She looked pretty comfortable all things considered.

I realized at 2:30 am that I completely forgot about her 8pm antibiotic, so I gave the full dose to her then. Would it be better to wait 12 hours from that time to give her the next dose (it's twice a day, so wait till 2:30 pm), or to revert to the original schedule and give her next dose at 8am like normal?

She was also down on her weight this evening when I weighed her, 925g from 950g. Hopefully it was mostly water weight or whatever. I fed her more CC and water, and will continue to do so.

Here's what the wound is looking like right now. She took a scab off the side of the incision so it's oozing blood again, but hopefully that's not TOO bad:
Image

Bonus shot of when I tried to use the large size of fabric sleeve to make a dressing. Despite everything she's been through during the last week, and everything I've had to do to her gaping wound on her throat, this is still by far the most "mother how could you" face she's given me this entire time:
Image

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Lynx
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Post   » Thu Jan 14, 2016 9:00 am


What antibiotic is she getting again? What dose? Antibiotics can affect appetite. gl/antibiotic_advice.html

If Baytril, I think maybe resume your normal time after 12 hours has passed.

The nails look pretty sharp. Any chance you could use a human nail file or a grinding Dremel tool to round them nicely so they would be less likely to be able to be used to scratch the area? If you watch closely, perhaps it is one leg she tends to scratch with and you can do that one first?

It does seem to be looking better!

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Zaphy

Post   » Thu Jan 14, 2016 11:08 am


She's on chloramphenicol, 30 mg/ml. 1.5 ml twice daily.

I can do that, yes! She also has not been scratching at it much any more so that's good. She'll still bend her head down to try to get to it, mainly licking it after I flush it, but progress, yay!

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Lynx
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Post   » Thu Jan 14, 2016 12:06 pm


Ah, chloramphenicol. The antibiotic advice still applies but it looks like she's doing pretty well.
Last edited by Lynx on Thu Jan 14, 2016 3:50 pm, edited 1 time in total.

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countrygirl49
Supporter in '13

Post   » Thu Jan 14, 2016 2:35 pm


Sorry to hear that you are having complications! Keep up the good work with her, you'll both make it through!

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