Thursday, December 1, 2011

753. SOP - Gangrene in an old dog's tail

The dog cut his tail spirally with a wound of 10 cm long. There was a lot of bleeding. Vet 1 stitched up and the dog went home after 4 days of being warded and cared for at Toa Payoh Vets. Gangrene developed lower down the tail. The dog had fever. The owner phoned me. What to do?

1. General examination
2. Complete blood test
3. At least 2 days of antibiotics and NSAID
4. Observe dog's appetite
5. Blood test before surgery is advised to check total WBC.
6. Isoflurane gas + O2 only at 1-2% intubated. IV drip.
7. Use electro-surgery
8. Amputate higher up to avoid gangrenous toxic tissues.
9. Post-op to stay in Toa Payoh Vets unless the owner insists on going home.

TIP. Many Singaporean dog owners have no time or are bitten when they try to clean the wound post-stitching. The e-collar worn did not prevent the dog from traumatising the tail due to pain. A long black area of the tail of more than 10 cm long developed. Gangrene. Dog had high total WBC when I admitted it. Best advice is to amputate the tail at the first instance as the owners just can't manage to nurse. Pain-killers with NSAID are not very effective in tail wound injuries for some reasons. So, I do advise tail amputation and have never received any unhappiness. In private practice, a good clinical outcome is what the owner wants. No repeat visits as this means spending more money at the vet.

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