Advice On Dog Injury

[FrodofromAus]

Hi Everyone

I was hoping someone might be able to give me an opinion of the picture of the injured dog. I read the forums quite a bit although I dont usually post. The picture is suppose to be showing the repair to two puncture wounds. To me it looks like an awfully big repair. Also what is the normal course of treatment for puncture wounds?

The injury in the area of the ear is the removal of a wart I am told. Does anyone know how vets normally do this sort of surgery and is it done under anesthetic and stitched?

Thanks in advance for your opinions

[Earthdog]

That looks right. The drains need to be kept clean and clear of myck. Dog usually has antibiotics for a week. Drain comes out after a few days. The vet should have told you all this. The area looks large because of the shaving thatt's been done. Does th ear have stitiches? Hard to tell. Yes the use anaesthetic.

Edited June 20, 2010 by Earthdog

[Greytmate]

With puncture wounds, it isn't until the dog is on the table that vets sometimes discover muscle damage underneath that has to be repaired.

By the look of that photo, I wouldn't really describe the injury as just a couple of puncture wounds. Possibly there was a bit of ripping and tearing going on as well. Very typical dog bite injury.

On dogs' skin, the thick outer layer of skin can be split apart from the inner layer and muscle. It can just sit there though, and you don't know the extent of damage until the vet examines. Sometimes you can feel or hear the extent of damage, it can make a crackly sound. A small hole can have a lot of damage underneath, or a very large gash can have no underlying damage at all.

If small areas of poorly attached skin are left on the dog, the skin can go necrotic. So it looks like the vet may have cleaned up a larger area to get a nice clean closure with good blood supply. You would expect if there are two small holes near each other, the skin will have been pulled up in that area, and the skin between the holes needs to be cut away.

The repair on the ear looks normal, for that type of surgery, and it is good when vets think to do small cosmetic jobs like that when the dog is under anaesthetic for another reason.

Why do you ask? Is it your dog? Are you unhappy with the vet?

If you had shown us a 'before' photo, I could have given you some more unqualified opinion.

[OSoSwift]

As Greytmate mentioned it looks quite normal for a wound caused by a dog grabbing hold of the scruff and giving it a good shake or rip/tear.

A couple of puncture wounds can hide rather serious injuries underneath.

A small dog came into our clinic after being grabbed around the abdomen. She has one small tooth hole, then a slightly larger one underneath her tummy, but still didn't look too bad. It wasn't until she was anaesthetised and the wound opened up that it was found she had a 2 inch tear that went into her abdomen and she was just extremely lucky she didn't lose her abdominal contents.

As for the ear, yes that looks quite normal as well. A lump, even small, will be removed with a margin of healthy looking tissue around it and will be as oval shaped as possible to enable even closure of the wound. It would generally be done under a GA especially if something else was being done as well. I guess some make take small "lumps" off under a sedation and local, but I would guess most would be a GA.

The drain goes from the top to the bottom of the area where the skin had been torn away from the subcutaneous layers of your dogs neck. This enables any fluid that collects from the tissue damage to drain from the lowest point (gravity) so that you do not end up with a huge seroma on her neck. Also allows any bacteria to drain out so you don't end up with an abcess and antibiotics can kill any bugs in there. Anitbiotics can only go where bloody does, so if you have a collection of puss then the antibiotics can't get into the puss and kill the bugs. The drain allows the fluid to drain away and then the subcutaneous layers can tack back down and heal where they are supposed to.

Are you not happy with the vet work?

[FrodofromAus]

I am actually asking on behalf of my aunty who is almost 80. When I shpwed the photo to a couple of people in dog rescue they thought it didnt seem right judging by the size of the stitches. There was no tear just two puncture wounds she was told by the vet. I looked up treatment on some websites and they seem to indicate that with punctures they shouldnt be stitched but cleaned out with saline, bettadine put into them and left open so you can see whats going on and at most just antibiotics from the vet. I found another forum on here where were speaking of punctures and no one mentioned that they had stitching.

I asked about the wart and they told me that they normally freeze them and that the cut in the picture looked more like something other than a wart like what you would expect from say a lump. The vet bill for all this was about $850.00

[Teebs]

cant comment on the punchers

But my dog had a wart removed from his leg a while ago, it wasnt that big, but it was annoying Atlas so they removed it and took a fair bit out of his leg to do so:

[tdierikx]

If the job was done at an emergency or specialist vet, that would account for the fairly high cost... my girl's surgery for badly ripped and punctured front legs (from a fight with my other girl) plus a dental cost me $650 at my local vet in normal business hours.

My other girl had a sinus cyst removed and a drain inserted for just over $400 at the same vet - also during business hours.

The wound in your pic looks big, but there may be reasons for it, and the drain is evidence of more damage than would have been obvious to the naked eye prior to surgery.

T.

[~Anne~]

I wouldn't think that any Vet would willingly disfigure a dog to make a buck. The scale of surgery was obviously neccessary. $850 is not a high price either for the work that appears to have been done.

[Greytmate]

I am actually asking on behalf of my aunty who is almost 80. When I shpwed the photo to a couple of people in dog rescue they thought it didnt seem right judging by the size of the stitches. There was no tear just two puncture wounds she was told by the vet. I looked up treatment on some websites and they seem to indicate that with punctures they shouldnt be stitched but cleaned out with saline, bettadine put into them and left open so you can see whats going on and at most just antibiotics from the vet. I found another forum on here where were speaking of punctures and no one mentioned that they had stitching.

I asked about the wart and they told me that they normally freeze them and that the cut in the picture looked more like something other than a wart like what you would expect from say a lump. The vet bill for all this was about $850.00

Best you talk to the vet then, not 'rescue people.' Yes, small puncture wounds are better flushed than stitched. Large puncture wounds sometimes need to be stitched.

It is a pretty big accusation to make that your vet has done extensive surgery for no reason. Give him the benefit of the doubt and ask him to explain again because your auntie is confused.

Talk to the vet about the 'wart'. What was in the lump? Was a biopsy done?

In all of my experience, lumps are either surgically removed or just left. Never seen one frozen off. That would be painful for a dog.

Like I said before, the vet has saved you money by removing the lump during this surgery. He could have told you to come back and have it done later and he would have made more money.

Is there more to this? Is the owner of the dog that bit this dog this trying to dispute the cost? The price and surgery sound quite normal to me, exactly what you would expect from a dog fight.

[persephone]

If a drain was inserted like that- in all probabilty there was quite a decent injury under teh skin.

Small punctures are indeed best left open.... however, deep/bites with underlying tissue destruction are very likely to have pockets in which infection will quickly set up ...also they may not heal well.. damage possibly was'cleaned up', re attached and drained...

I would be asking the vet ... explain yiour aunt is old, and got a shock at seeing her dog.

[Snoopy21]

Could it have been that there was some infection in the wound so they opened it to clear it up? Looks a bit like an abscess repair to me.

[Dame Aussie]

Looks normal to me. Sometimes people are shocked at the size of a surgical site but as GM said, there would have been a reason for it that they probably discovered when the dog was on the table.

[OSoSwift]

The drain can only be inserted from one side of the dead space to the other, so I would then assume that there was a large area of dead space underneath the skin. If that is left without having a drain inserted it will fill with fluid and it will be a rather large pain in the bottom.

Small bite wounds that say the tip of your finger fits in to, would be left. To leave a bite would that left a large amount of dead space and no drain would be a disaster.

They may have also opened up the are to make sure there were no major tears in the muscles or bloody vessels. I have seen very similar from dog fight woulds. They look benign on the outside, the real truth lies underneath.

I have never heard of any lump, wart or otherwise being frozen off (apart from sarcoids in horses)

The amount sounds right for what appears to have happened. If you are unsure contact the vet and ask them what was done. I am sure they would be happy to discuss it with you.

[FrodofromAus]

Yes Greymate there is more to this. I posted the question so that I could get opinions on the surgery without all the other information. I am not quite sure what it is that doesnt add up here but something is not right it may be what the owner of the dog has said I dont know.

There was a dog fight. Both the owner and two witnesses checked both dogs out thouroughly. There was slobber much higher up towards the head the fur was all pulled apart looking for marks underneath. A slight graze in that area was found. No other marks anywhere on the dog which all three including the owner concluded. The owner continued on her walk Interestingly she now claims everyone saw blood at the time. Of course she didnt mention and it to the other parties didnt deter her from carrying on with the walk.

The dog was taken to the vet a couple of hours later and given antibiotics and rymadal. Next day it was operated on and the owner given this huge bill. My aunty new nothing of it at this point. On the Tuesday she dropped the bill off at my aunty. My aunty rang me and so I rang the owner. I asked a few questions and asked if she had any photos and pointed out what the three people had agreed on at the time of the incident. She told me she wanted to come around now and get the money. I told her I had to look into if and she said she needed the money now to pay the vet the next day. When I said she can deal through me instead of my aunty and I wanted to see the rest of the information etc she said she would not deal with me she would deal with the old people.

I spoke to the practice manager mainly in regards to the bill. They had done one bill for the owner which did not included any portion of anesthetic and one bill for my aunty. I do agree that you should do anything else whilst under anesthetic to save further stress to the animal. I thought some portion for each person would be more reasonable. She had called me from a number about an hours drive from the workplace at around 7.30pm at night. She said a couple of bizarre things whilst on the phone which were strange. I requested that I speak to the vet in terms of the medical to answer some queries.

Vet rings me next day and wasnt overly helpful and seemed to be very defensive when I asked questions I thought were reasonable in relation to the wound and the wart. Some he wouldnt answer and instead I got a tirade of bullying and agressive behaviour commenting on my ethics, morals etc. He also seemed rather familiar with the owner as he told me how she wouldnt lie etc. I know about all the info my vet would say about me is that I am a good owner give the reasons for the statement and say I pay on time. I have since emailed him in regards to this conversation confirming what he said and how I thought it was unprofessional.

In essence I can obviously see an injury. To me who has limited knowledge it seems a bit cut and stitches hence why I asked for opinions without elaborating. I dont know what happened to the dog when it went on its walk. I have no idea why the owner now claims there was blood at the time but continued on anyway. I dont know why I got a defensive reaction and a tirade of language. Why have the account for four days then lob to someone almost 80 and expect it to be paid now. There are a few other details which are unanswered questions which has got me thinking what is going on here. It is the sort of gut feeling we have all had when we know something is not right and people are chopping and changing their stories.

It now might make a bit more sense but I wanted opinion based on the photo not the rest of it. All I was able to find out on the net about punctures was that they are normally left open as outlined in my earlier post. Is there other types of surgery that would be consistant with a cut this size? A friend of mine in dog rescue who has had many females desexed when in her care said that the cut etc on those dogs was far smaller and less stitches than the photo I showed her.

If any of this is the responsibility of my aunty she will do the right thing and there is no question of that. I just cant help wondering (given the condition of the dog after the incident which all parties agreed with) in addition to the other things ithat have happened if there is not more to this. Demanding payment from anyone never mind an someone elderly at 5pm and wanting it there and then to pay the vet the next day is not reasonable when you have had the invoice for four days and have not told the other party.

Thankis for all the replies it has been most helpful and appreciated

[Earthdog]

Your aunty's dog was involved in a fight witht he dog pictured? Where are the other witnesses? Did the woman report the incident? Was the wart removal part of your aunt's bill?

It does seem very strange.

[Crisovar]

Nobody here can comment on a wound that they didn't see, before it was treated, drain like that are not uncommon after dog fight injuries.

Was there damage under the skin??

Who knows.

Take the dog to another vet for a second opinion.

[OSoSwift]

Ah okay all much more complicated than I thought.

I guess that the circumstances surrounding the fight will need to be considered also. Who was on/off lead etc.

They possibly also want to deal with your Aunt as they may think they can bully her into paying a large bill, they of course will not want to deal with you if that is their agenda as they cannot bully you.

Dog fight wounds can look small until investigated further and I do not believe a vet would open up a huge area on a dog for no good reason. Around the neck they can get woulds that look minor until investigation as the skin does move reasonably freely around the scruff so the external wounds can look small, but the underlying ones are not.

Apart from that many people can be hard to deal with and turn into bullies when money is involved. Trying to intimidate your Aunty is not excusable. If paying the bill is justified then so be it, bullying is not on!

[Greytmate]

Thanks for explaining. It sounds very complicated.

Who should pay the bill might depend on the circumstances of the fight.

If your auntie feels that her dog was completely to blame for the other dogs injuries, I would suggest that you offer them $750, taking into account that other surgery was done at the same time.

You may just have to accept that the other dog's injuries are genuine. They do look normal for a dog fight. It isn't the sort of thing that can be easily faked, and the vet's word would stand up in court anyway.

Desexing incisions are tiny and very cleanly cut with a scalpel. Where as dog's teeth cause jagged tears that can really make a big mess under the skin.

The real danger here is that your auntie's dog will probably be declared dangerous if it is reported, so it might just be easier to pay the bill to keep the other owner happy, and put it down to a bad learning experience. If you try to fight it, the costs may be a lot higher than $800.

[Dame Aussie]

I agree here. I would probably just pay the bill, unless of course her dog started the fight on your property or something!

It does sound a bit weird, but I also don't think a vet would open up a dog like that just to help the owner get some cash...well I would hope not anyway!

[redangel]

IMO (vet nurse) looking of the wound it is a standard dog bite treatment, as nearly alway damage extends much further than the site of the puncture wounds, in most cases the area shaved here would suffer total hairloss due to the trauma involved. The drains are always placed at the highest point and run below the wound exiting out of the lowest point of the trauma...thus allowing downward drainage of fluid/possible pus causing more damage and possible blood infection. Yes it looks a large area, but the bite wounds though small allow anaerobic bugs to thrive in the surrounding muscle, as they do not require oxygen to thrive...should the wound just close it is a prime condition for nasty abscess/infection to grow. By placing the drain it keeps the wound open-thus anaerobic bugs will not thrive. Once the antibiotics have kicked in the drain is removed some 7 days later and the wound will heal closed. The expense is most certainly higher due to being an emergency centre- Id imagine this repair would be about slightly cheaper at a day vet, but they did what was required for the best of the dog.