Case of the Month: Wound Management

Bella’s story*

Bella is an active and enthusiastic young Labrador mix. She hikes and hunts regularly with her human mom. When Bella was about a year and a half old, she injured a toenail on her right front foot while hiking.  The toe became painful and inflamed and Bella was taken to the family veterinarian, where the broken toenail was treated, and a bandage was applied. Two weeks later, Bella deeply lacerated the paw pad on her right hind foot while scrambling on some sharp-edged stones.  Again, Bella needed to go to the vet to be anesthetized and have the wound treated and sutured.  At this visit, it was discovered that the toenail she had injured earlier wasn’t healing well, and had become infected.  Now Bella needed bandages on her front and back feet on the right side. More importantly to Bella and her family, this bouncy dog would need to have her activity severely restricted while she healed.

Unfortunately, the healing process was very slow.  Bella suffered multiple setbacks in the form of poor healing, and persistent infections in her affected feet.  She needed to be sedated  many times to treat her wounds. At one point, amputation of one of the affected toes was even considered.  The healing process took more than four months from the date of her original injury, and many, many trips to the vet.

About the Condition: Wound Management

Traumatic wounds, especially those affecting the legs and feet, can be difficult to manage. These are highly mobile areas, without a lot of extra skin nearby to allow for surgical repair.  While broken toenails are common, it’s important to remember that toenails are directly connected to the most distal bone of the toe, meaning that infections in this area can become very serious if they spread to the boney structures.  Additionally, lacerations of paw pads are difficult to heal, both because of the regular body weight that must be borne on the wound, and also because stiches are often unsuccessful at apposing wound edges for long enough for healing to occur.

Bandages are an important tool for keeping dirt and debris out of foot wounds.  They also prevent the licking or chewing that pets tend to want to do when they have a wound. Unfortunately, bandages can also hide problems, like infection or poor healing, and if they become displaced, wet, or soiled, they can encourage infection or impair blood flow to the healing area.  That’s why they need to be checked and replaced every 2-3 days throughout the healing period.

Treatment

Bella needed more than 16 bandage changes, multiple rounds of sedation and anesthesia for wound care, three different types of antibiotics, several laboratory tests, and pain management to help her heal from what was initially a fairly minor trauma.

Claim Outcome

Bella’s veterinary care for her broken nail and paw pad lacerations ended up costing more than $4600 during just three months of the necessary care. Her Pets Plus Us Accident and Illness Max plan reimbursed her mom more than $3500 of those fees.**