Hank is a 3 year old Staffordshire bull terrier who is affectionately doted by the clinic ‘Hank The Tank’. Hank’s story is one of sheer courage and the miraculous ability of the canine body’s propensity for healing.
Hank presented to the clinic after being run over by a car. He had suffered terrible injuries to his groin and abdomen and he was in shock. Of even greater concern was the fact that it was difficult to hear his heart with the stethoscope and he was having trouble breathing. Hank was immediately started on potent pain relief and high rate intravenous fluids to try to control his shock and keep his blood pressure up in order to keep blood flowing to his vital organs. An x-ray of his chest taken, showed air was in his chest cavity - a medical problem called pneumothorax.
The presence of this air impairs an animal’s ability to breathe and it must be drained immediately. 760ml of air was drained from Hank's chest using a special needle allowing him to breathe much easier.
An x-ray taken a little while later showed that more air had accumulated in Hank’s chest and repeat drainage was required. At that point a permanent chest drain was surgically inserted through his chest and stitched in place. By doing this we were able to continually drain the air from his chest to make it easier for Hank to breathe.
Because of the extensive wounds to the abdomen, we were also concerned about damage to Hank's bladder. If his bladder is full when excessive pressure is quickly placed on the abdomen, there is a chance of it rupturing. Think of it like stepping on an inflated balloon compared to one which is still lying around days after a party. Trauma can also cause damage to the nerves supplying to, and leaving, the bladder and impair the animal's ability to urinate. To stop fluid building up in Hank's body and allow the removal of nasty toxin, we placed a drainage tube (urinary catherter) into his bladder via his uretha.
Now that Hank was stable we had to treat the severe and deep abrasions to his abdomen, thighs, groin and tail. In the following days, Hank was placed under anaesthetic and his wounds extensively flushed and cleaned. Dead tissue was removed in a process called debridement. Unfortunately only a small portion of his wound could be closed with stitches. In situations like this we have to let the body heal by a process called secondary intention. This is very different to primary intention, where healthy edges are placed together and healing is very quick and there is minimal scaring. An example of this would be a desexing incision on your new puppy or kitten or perhaps an accidental knife wound whilst you’re chopping onions for that delicious Bolognese pasta you’re making. In secondary intention healing, we need to allow the wounds to scab over, or granulate, and then for new skin to grow, a phase termed epitheliazation. Infection is of huge concern in such large wounds healing in this way and Hank was on two antibiotics to reduce the risk. This is because no one antibiotic is effective against all bacteria and to get good antibiotic coverage we needed two that work synergistically to have a broad spectrum of cover. The void between his damaged tissue and healing tissue started filling up with fluid, require the placement of another drain.
From there it was a slow process. Hank was continued on fluids, nutritional support, pain relief and needed regular dressing changes. His drains were removed as his body healed and special bandages that promote wound healing were used. Initially this included a non-stick wax impregnated dressing with an absorbent non-stick soft pad over the top. Bandage changes were required daily.
Once the wounds had started to granulate, where the surface becomes gritty and irregular, a special zinc paste bandage that encourages epitheliazation and has antimicrobial properties was used. The bandage changes were done less frequently as gradually Hank's wounds healed. It was slow going and Hank was very patient. After 5 weeks his wounds were almost gone and because of his love to lay down with his legs splayed behind him, Hank was actively stretching his scar tissue and performing much needed physiotherapy. Rightfully so, Hank's sheer courage earned him his nickname and a long and happy life with his loving owners.