Dog's wound won't heal

Naydy

My mam's dog is 12, big lab cross. He had surgery on his leg back in January and the wound just won't heal. Vet now thinks that he has proud flesh. My mam has bathed his leg and changed bandages every day since the surgery but it keeps reopening. It's not infected. He has had numerous antibiotic shots. They've said they can't restitch it. Vet has suggested numerous things which we've tried, everything from supplements to Vetricyn spray to manuka honey. Nothing is working. Dog is not in pain that we can tell, mam says the most trouble she has changing his bandages is when she uses the honey he tries to eat it :P. We're at wits end at this stage tho as it's not getting better and coming up on 5 months. Vet is out if ideas too she says keep doing what we're doing, that his healing is not what it should be because of his age. Anyone out there any experience of proud flesh in dogs or ideas of what to try? Thanks in advance.

Choc Chip

I've only seen proud flesh in horses (years ago!)... if I remember rightly the advice was to restrict movement (along with bandaging etc). Is he being exercised..?

If it is proud flesh, there's a product called equaide that I've seen used in horses- maybe ask your vet if it's suitable for dogs?

As a last resort, you might ask your vet about cutting it back. BUT... Disclaimer: I've only seen it in horses and that was a good while ago so not sure how feasible that is in dogs and what current views are on it, esp with his age! If you google it in horses I'm sure there are loads more ideas. It's fairly common with them.

Naydy

Choc Chip wrote: »

I've only seen proud flesh in horses (years ago!)... if I remember rightly the advice was to restrict movement (along with bandaging etc). Is he being exercised..?

If it is proud flesh, there's a product called equaide that I've seen used in horses- maybe ask your vet if it's suitable for dogs?

As a last resort, you might ask your vet about cutting it back. BUT... Disclaimer: I've only seen it in horses and that was a good while ago so not sure how feasible that is in dogs and what current views are on it, esp with his age! If you google it in horses I'm sure there are loads more ideas. It's fairly common with them.

Thank you for your reply. He has to wear the bandage very tight and to be honest his exercise is at a minimum as we're concerned about the leg and his joints are very stiff. We haven't tried equaide, I will look into that. It's funny you say that about horses, I had to contact equine supply companies to get some of the sprays the vet recommended. Vet actually suggested cutting it back but the surgeon in the hospital took one look at it and said he wouldn't do it, was too risky for him as he'd need more anesthesia and it could be too much shock to system . Thank you again, much appreciated, will follow up with the equaide

maggiepip

The only advice I would have is you mentioned your mother was bathing it daily too, I've always found washing a wound in water sets it back, and my own vet always says not to wash. Change the dressings, and re bandage but maybe hold off on washing it for awhile and see if that helps.

My dog has recently had a wound to heal , and vet used manuka honey to speed healing , but bandages weren't changed daily, and the wound was never washed during healing.

Eta: is it possible to leave it open? Or is it too raw? 5 months is a long time covered up, maybe letting air at it could help, an antiseptic powder could help dry it up too.

Naydy

maggiepip wrote: »

The only advice I would have is you mentioned your mother was bathing it daily too, I've always found washing a wound in water sets it back, and my own vet always says not to wash. Change the dressings, and re bandage but maybe hold off on washing it for awhile and see if that helps.

My dog has recently had a wound to heal , and vet used manuka honey to speed healing , but bandages weren't changed daily, and the wound was never washed during healing.

Eta: is it possible to leave it open? Or is it too raw? 5 months is a long time covered up, maybe letting air at it could help, an antiseptic powder could help dry it up too.

We need to wet the bandages when removing to avoid hurting him, as there is a fair bit of fluid on the wound and the bandages stick to him but I will talk to her about holding off the washing and see what we can do, thanks. Unfortunately it's too raw so we can't leave it open for more than short periods when we can watch him. Also the proud flesh is spreading and the bandage has to be on tight to slow that down we've been told.
I contacted an equaide supplier as our vet wasn't familiar and they said its fine for large dogs, so that will be the next thing we try.

CelticRambler

Sounds to me like you've been given a lot of strange advice by your vet(s).

What strikes me most is in your last message, saying "the bandages stick to him". That means you're using the wrong dressings for the type of wound, so I suspect it's the changing of the bandages that's causing a lot of the problem.

"Proud flesh" - don't get it in dogs. It'd be nice to see a photo, but if I had to guess, I'd say you're looking at granulation tissue, which is perfectly normal (and necessary for the healing process of open wounds)

As for "he'd need more anesthesia and it could be too much shock to system" ... Yeah, maybe - if the dog has loads of other problems, or the vet's protocols are really out-of-date. A few weeks ago, I shared in the care of a cat who burnt his whole side in an engine. He had fifteen anaesthetics in two weeks for dressing changes and was right as rain after each one.

Where exactly on the leg is the wound, and how did he get it in the first place?

maggiepip

Agree with everything CelticRambler says OP. If the bandages are sticking you're constantly disrupting healing. You need to use non stick dressings, Melolin do a dressing with a shiny side that shouldnt stick to the wound. Honey dressings shouldn't stick either if you use a decent amount of honey and change appropriately.

Naydy

CelticRambler wrote: »

Sounds to me like you've been given a lot of strange advice by your vet(s).

What strikes me most is in your last message, saying "the bandages stick to him". That means you're using the wrong dressings for the type of wound, so I suspect it's the changing of the bandages that's causing a lot of the problem.

"Proud flesh" - don't get it in dogs. It'd be nice to see a photo, but if I had to guess, I'd say you're looking at granulation tissue, which is perfectly normal (and necessary for the healing process of open wounds)

As for "he'd need more anesthesia and it could be too much shock to system" ... Yeah, maybe - if the dog has loads of other problems, or the vet's protocols are really out-of-date. A few weeks ago, I shared in the care of a cat who burnt his whole side in an engine. He had fifteen anaesthetics in two weeks for dressing changes and was right as rain after each one.

Where exactly on the leg is the wound, and how did he get it in the first place?

It was a benign tumor on his back leg that had to be surgically removed. We were told even before the first surgery that the anesthesia was a risk due to his size and age, and I have heard plenty of cases of vets trying to avoid surgery in older dogs if it's at all possible so I don't know why you think that's so strange?
I agree proud flesh is rare but it's not unheard of in dogs, I've been doing research the past little while, so I don't know how you can dismiss that right out either. Thank you for your input about the bandages, we are using what has been recommended by the vet and unfortunately there is fluid on the wound which can make them stick a little bit (hence we dampen then a little so they peel right off) but they are the best of all we've used so far.

Ms Doubtfire1

Would agree, strange advice. My mare came up a year ago with a gloved front leg- flesh was stripped off to the bone it was a deep and nasty wound. It didn't fully heal until the 'flap' was removed (the dead flesh).After that the wound was treated with Vulketan twice a day. Vulketan is an ointment. Would presume you need soemthing like that for your dog - ask another vet maybe? But dead(proud) flesh needs to be cut away first. Don't cover up the wound at all. Get doggie a cone of shame..;-)

Naydy

maggiepip wrote: »

Agree with everything CelticRambler says OP. If the bandages are sticking you're constantly disrupting healing. You need to use non stick dressings, Melolin do a dressing with a shiny side that shouldnt stick to the wound. Honey dressings shouldn't stick either if you use a decent amount of honey and change appropriately.

We are using melolin ATM. Before that it was I think neoprene or neopore? Which was similar. The bandages have to be very tight as I said which means even these non stick ones end up sticking a bit

maggiepip

Naydy wrote: »

We are using melolin ATM. Before that it was I think neoprene or neopore? Which was similar. The bandages have to be very tight as I said which means even these non stick ones end up sticking a bit

Why do the bandages have to be very tight? The fact that you have to dampen off the bandages with water will definitely be causing a big problem for healing.

Naydy

Ms Doubtfire1 wrote: »

Would agree, strange advice. My mare came up a year ago with a gloved front leg- flesh was stripped off to the bone it was a deep and nasty wound. It didn't fully heal until the 'flap' was removed (the dead flesh).After that the wound was treated with Vulketan twice a day. Vulketan is an ointment. Would presume you need soemthing like that for your dog - ask another vet maybe? But dead(proud) flesh needs to be cut away first. Don't cover up the wound at all. Get doggie a cone of shame..;-)

Maybe another discussion with the vet surgeon needed so. We won't look forward to another few weeks of the cone if that's the case, he was not a happy camper with it, poor thing. Thanks for all advice everyone, hearts broken with him, we'd do anything to make him better

CelticRambler

Naydy wrote: »

It was a benign tumor on his back leg that had to be surgically removed.

Where on the leg, exactly, though? And did you have the tumour analysed (if so, what was it?)

Naydy wrote: »

We were told even before the first surgery that the anesthesia was a risk due to his size and age, and I have heard plenty of cases of vets trying to avoid surgery in older dogs if it's at all possible so I don't know why you think that's so strange?

Because I've heard those kind of stories too, and unless there's a very good reason (other serious underlying problems), modern anaesthetic protocols administered by competent vets and nurses are perfectly fine.

Ms Doubtfire1

Naydy wrote: »

Maybe another discussion with the vet surgeon needed so. We won't look forward to another few weeks of the cone if that's the case, he was not a happy camper with it, poor thing. Thanks for all advice everyone, hearts broken with him, we'd do anything to make him better

Nayde - proud flesh can be cut away with local only - there's no nerves in it he won't need to be sedated.
Do not bandage tightly - don't bandage at all.A tight bandage will impair the blood flow and an impaired blood flow will delay wound healing.rest, yes, no bandage

Naydy

CelticRambler wrote: »

Where on the leg, exactly, though? And did you have the tumour analysed (if so, what was it?)



Because I've heard those kind of stories too, and unless there's a very good reason (other serious underlying problems), modern anaesthetic protocols administered by competent vets and nurses are perfectly fine.

Sorry, thought I answered the first part. On the inside of the hock on his hind leg. So any movement affects it. It's very hard to keep him still, we've actually stopped people using the doorbell cause it makes him jump up quickly. Yeah, we paid a few hundred to have it sent off to lab for tests as there was a small chance it could be cancerous. When results came back all they could say was it was benign.
He's a very large dog, almost 13 and the vet seems to think he's at high risk. We could look for a second opinion, but it's the most reputable clinic where my mother lives

andreac

Sorry but i would get a 2nd opinion. That is going on way too long. No bandage of any sort should be that tight. It's probably doing more harm than good to be honest.
Where are you based? Maybe we can recommend someone for you.

Naydy

Thank you for all advice and opinions, we are going to try the equaide and reducing the bandaging for now and look into a second opinion on having the wound cut back.

CelticRambler

Naydy wrote: »

Yeah, we paid a few hundred to have it sent off to lab for tests as there was a small chance it could be cancerous. When results came back all they could say was it was benign.

That's not right. Even if the lab couldn't give it a precise name, they should at least have been able to say whether or not the whole thing had been removed (the report should include the phrase "tumour free margins" - seen or not seen - or else "well encapsulated"). If the edges of the wound weren't tumour-free (because the vet didn't take enough skin away) then even a benign tumour can re-grow and stop the wound from healing. For that very reason, you'd normally get a biopsy done on a lump in this location before surgery, and if it was benign, then leave it alone.

I'd be looking for a second opinion too. There's an awful lot in what you've said that makes me think that that vet was not really geared up for this kind of case. Even if the dog had needed a skin graft to close the hole, it should all have been fully healed months ago.

Choc Chip

I'm so sorry for ya OP. I hope he gets better soon. Are you comfortable enough to run through any suggestions with your vet? We're all just guessing on an internet forum, whereas your vet can see the wound - make sure you check with them before you change anything/ use anything new (I'm sure you know that already).

And this is probably a silly question, but when you say the bandage is sticking, I'm assuming you mean the melolin pad (shiny side down) underneath the bandage? Just checking!

Naydy

Choc Chip wrote: »

I'm so sorry for ya OP. I hope he gets better soon. Are you comfortable enough to run through any suggestions with your vet? We're all just guessing on an internet forum, whereas your vet can see the wound - make sure you check with them before you change anything/ use anything new (I'm sure you know that already).

And this is probably a silly question, but when you say the bandage is sticking, I'm assuming you mean the melolin pad (shiny side down) underneath the bandage? Just checking!

Yes I mean the melolin pad . I'm getting some of this information second hand because I don't live with my mam and work two counties away so I'm not around for a lot of the vet visits but I will be home for the next one so I'll be putting a lot of this to her.

Naydy

CelticRambler wrote: »

That's not right. Even if the lab couldn't give it a precise name, they should at least have been able to say whether or not the whole thing had been removed (the report should include the phrase "tumour free margins" - seen or not seen - or else "well encapsulated"). If the edges of the wound weren't tumour-free (because the vet didn't take enough skin away) then even a benign tumour can re-grow and stop the wound from healing. For that very reason, you'd normally get a biopsy done on a lump in this location before surgery, and if it was benign, then leave it alone.

I'd be looking for a second opinion too. There's an awful lot in what you've said that makes me think that that vet was not really geared up for this kind of case. Even if the dog had needed a skin graft to close the hole, it should all have been fully healed months ago.

It said grade 1 soft tissue sarcoma. And when we asked the surgeon he said that meant it was benign. But he couldn't say if it would come back or what caused it.

CelticRambler

Naydy wrote: »

It said grade 1 soft tissue sarcoma. And when we asked the surgeon he said that meant it was benign.

You (your mother) needs a new vet. Sarcomas are malignant, even Grade 1. Definitely sounds now like the excision wasn't aggressive enough, i.e. they probably only removed the obvious lump and didn't take enough "healthy" tissue, so what you're seeing now is the tumour growing back, not proud flesh.

This link includes a pictures of what I suspect your dog's lump looked like before surgery, and one of what it should have looked like afterwards (skin graft).

DBB

Ooohhh... That's worrying Celtic Rambler
Op, it does seem to me on a number of levels that a 2nd opinion would be the way to go, or at least a thorough Q+A session with the current vet.
If it turns out to be a straightforward wound and not cancerous growth, then I will tell you that I was in an identical situation to you about 4 yrs ago... Dog the same age, wound not healing.. Though her wound was caused by a compound tibial fracture. Her tibia was plated, and one day shortly after her surgery I stupidly left her for a short time with no buster collar, and she licked the surgical wound down to the plate... Gross.
It took months to heal as we hit many problems on the way, but it never actually got infected. Many of the problems were caused by me over-fussing over the wound.
Just to reiterate what others have said... Daily washing of the wound is a disaster zone. It is disturbing healing and it has to stop. Honestly... I'd rather leave the dressing stuck to the wound and let it become part of the scab... I made the same mistakes as your mam, and mistakes they are!
What eventually worked was... Someone might be able to tell me the name, and maybe it's been mentioned already under a brand name I don't recognise... Is it hydro-gel? Or dermo-gel? It's a clear gel that's used on surgical wounds that supports cellular growth and healing?
So... That, with a light melonin (shiny surface against the wound) taped lightly on, then put a babygro on the dog... Pyjama bottoms work with bigger dogs... To help keep the pad in place and to stop rooting (you can creatively cut holes for peeing and pooping so that the clothing doesn't have to be removed). Tight bandaging doesn't sound right at all, at all.
And you need to be stringent about keeping the buster collar on... He just can't be allowed to root at it.
If you have to put him in a crate to stop him charging to the door, so be it.

All of the above is really only if your dog's wound is just that... A straightforward wound. However, the fact that it's not healing, and the wound is cancer-induced, and given what Celtic Rambler has warned... I'd want to rule anything more sinister out at this stage.

alroley

A few months ago my dog has a wound on his hind leg that was slow to heal. Washing definitely slowed down the healing process - once I stopped it started to heal much faster! Because of where the wound was - I restricted his movement a lot - no walks and confined to a pen or up on the couch with me most of the time.

boomerang

DBB wrote: »

Someone might be able to tell me the name, and maybe it's been mentioned already under a brand name I don't recognise... Is it hydro-gel? Or dermo-gel? It's a clear gel that's used on surgical wounds that supports cellular growth and healing?

Intrasite gel?

DBB

boomerang wrote: »

Intrasite gel?

That's the one