Second Opinion? Paw Injury

[QuillGordon]

My boy Creek received a puncture wound Sept. 17 to his front left paw. I pulled out a wood splinter & thought he would be fine. He was not. When we arrived home his paw swelled to twice the size & was limping so I ran him to the vet. Anti-biotics & steroid shot was administered. The next morning the paw still swollen with pus discharge so I took'em back in. They knocked him out to explore and flush the wound they also performed an x-ray. They found nothing inside the wound and over the course of last weekend the swelling went down. I noticed a dark spot next to the puncture wound slightly larger than a pea a day after they explored the wound. This dark spot ended up being dying skin or necrotic tissue & has left a small hole in his paw. He also still has the same amount of swelling he did as of last weekend. Big toe twice the size of the others with a yellow mark on the top inside side of the toe. Anyways the necrotic tissue hasn't changed and the swelling hasn't changed. So I went back to the vet yesterday they said at this point it's kind of a watch and see if any other abscess forms but did put him on a stronger anti-biotic which he started last night.They also want to leave the necrotic tissue in place to protect new tissue to form. There is no festering & Creek walks on it fine but I'm getting frustrated & thinking of getting a second opinion as I'm not really fond of these two vets I've been seeing. One of them is "Oh yeah he's doing great" and the other is "Boy, I dunno this is really weird & I'm afraid there is something more going on." The old vet who used to run the place has now passed.

What ya think am I a impatient SOB or should I go with the hunch of it's time to find somebody else?

[shags]

You want punctures to heal from the inside out, and that can take longer than a laceration or scrape that heals outside in.
If there was more splinter in there, it would probably fester and push itself out, so watch for that. Crud in there will cause longer healing time.
I would give the new abx a little time to work. If no improvement, tell the vet you want a culture and sensitivity done. Around here that's about $90 but it's worth every penny if you find out the wound is growing some kind of weird unusual bug that only responds to some weird unusual abx, because you'll save time, money, and aggravation in the end.

Good luck, hope it's all OK soon.

[dog dr]

Try soaking in Epsom salt and hot water solution, at least once a day. There may be some foreign material still in there, but it can be very hard to find and often you end up causing more damage digging around in there. If he's walking on it I would just be patient for now. Easy for me to say, I know.

[hettmoe]

Try soaking in Epsom salt and hot water solution, at least once a day. There may be some foreign material still in there, but it can be very hard to find and often you end up causing more damage digging around in there. If he's walking on it I would just be patient for now. Easy for me to say, I know.

This has pretty much been my approach with bird dogs and cattle dogs. Hopefully, Creek will let you know if things are getting worse/better.

[QuillGordon]

Thank you for replying.
We have been doing the Epsom salt soaks since day one. He is hesitant at first but then immediately loves it and falls asleep. The anti biotics he is currently on is Antirobe/clindamycin 150mg twice daily. Also Rimadyl 75mg twice daily. Two doses thus far of the current abx with no improvement. He is still showing no signs of injury other than swollen toe up into the wrist area and hole in the bottom of the paw where the necrotic tissue is. Matter of fact he is currently chasing around our Dachshund with no hesitation of using the paw... If no improvement I have a appt Monday with the current vet. I also have a tip from a friend of a bird hunting vet who is close by and I will most likey go get a second opinion there & request the culture test...

Have you had any experience in using CT scans to find foreign bodies, especially wood?

[cjhills]

Wondering about the Rymadyl it just masks any pain he would have...................Cj.

[QuillGordon]

Yep, I wonder about that myself.

Here's some pics of his paw after a Epsom salt warm soak

[QuillGordon]

[Sharon]

Very hard sometimes to tell the difference between an interdigital cyst and a puncture from a foreign object. My dog had severe swelling to the top of the leg once from an interdigital cyst. By bet's on a cyst.

[Sharon]

How's the paw doing? I always like to hear back for my own education.

[hettmoe]

Me, too

[QuillGordon]

Creek has been seen by a different vet. http://www.uvhdc.com Dr Zelnik. They also explored the wound, found nothing, took a culture & up'd his dose of clindamycin to 225mg every twelve hrs. Fast forward a week & we see a slight decrease in swelling in the toe with hole still open but pink in the bottom of the paw. Cultured showed three bacteria growing. One was one that can only grow if another bacteria is present. Another is e-coil and another is an aquatic based bacteria, so the vet asked if he was in water of any sort. He was in a high altitude lake, getting a drink on our return. He is now on enrofloxacin that shows in trials to kill all three bacteria. So far we are not seeing great gains with the new antibiotic, he's been on it since Monday.

Me, I'm having anxiety issues over the whole thing. My hound is wondering why we are not out there hunting..

[Pepper]

I can only say that cleaning the wound thoroughly twice every day will help. IMO I hope all goes well with your dog.

[hettmoe]

I feel for you both

[dog dr]

I say hunt the dog. Be good for both of you.

[QuillGordon]

I agree we are so close, a boot to cover combined with a quick run would be so extremely beneficial to the psychy of hound and owner. Just don't want to compromise the healing process...

[banknote]

I have been going through a very similar thing with my 20mo GRM the last 2.5 weeks. Because of no initially apparent wound, I spent the first week waiting for it to take care of itself, figuring a toe strain. When infection became apparent 1.5 weeks ago, I took him to vet and have had him on clavamox ever since, which has taken care of the infection. The vet also removed some necrotic tissue and we've been managing the resulting open wound along the edge of a toe pad since then. No foreign body was ever found via exploration or x-ray. Twice daily re-dressings and application of sugar into wound have made for good progress and he is probably about a week away from hunting. Today was the first day he's run around on it like nothing is wrong, but the wound isn't quite fully closed so I'm giving it more time. Best of luck with your pup.

[tyleetess]

If you are still looking for a vet I would highly recommend Dr. Mike Van Zomeren at hunter animal hospital. He is a great vet. He owns, hunts and field trials pointing dogs. I feel more comfortable having a vet that knows the rigors and demandthese dogs deal with in the chukar hills and hunting in general. They are located on 3500 south around 4800 west, a quick google search could tell you for sure

[QuillGordon]

Two and a half weeks on the antibiotic & six weeks in the hole finally has healed as of a week and a half ago.
Booted for extra protection I'm happy to say ole Creek is back in the game...

[Sharon]

Isn't that great. Fine pics.

[QuillGordon]

Thanks Sharon
Now we have to work on getting all his pads toughened back up after the hiatus. Last year we could hunt every other day with no pad probs. Now were lucky to get in a hunt a week without seeing a prob. Frustrating!!!