Izzy's Leg: Week 1

Warning: gross photos below.

I am probably going to lose track of which week I am on, but for this count, I know he has been home for a week.

When I took the bandages off on Friday afternoon, I got a little worried. The bandages smelled really bad, like they have every time, and the wound had changed in character. It was still as wide and as long, but it was starting to puff out. It also looked more like hamburger than the inside a chicken leg.

Gross images of raw meat:

Raw chicken - what the wound used to look like.

Raw hamburger - what it looks like now.

While I am a very good cook and have a fair amount of experience with different cuts of meat, I do not want to see a wound on my horse that resembles something from the butcher's window. 

When Dr. Tolley examined the wound last Saturday, I was so shocked by the hugeness of the gash that I was more focused on the treatment protocol - how to apply the five bandage layers correctly, than on asking too many questions. The one thing that I always ask when dealing with an injury or illness, which I completely forgot to do, is what should I expect over the next two weeks?

Even though I knew Dr. Tolley wasn't going be in the office on Saturday, I called anyway knowing that I could at least speak to Dr. Gonzalez, BVH's newest doctor. Sure enough, the receptionist put him on the phone almost immediately. Fortunately, I had caught him just before he headed out for a field call.

I always take my horses in for treatment, but given the severity of this wound, I hadn't wanted to put Izzy back in the trailer, unwrapped, for yet another road trip. Instead, I opted to pay the ranch call and have Dr. Tolley bring the hospital to me. Because of that, Dr. Gonzalez hadn't yet seen the wound.

I described Izzy's injury and tried to explain what it now looked like. He assured me that it sounded as though it was healing well, but asked if I could send some photos for him to exam. Photos? Oh, yeah ... I have lots of photos.

I sent the following two photos (warning - grossness follows) and was relieved at his quick response.
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Day 5 - raw chicken

Day 11 - raw hamburger

Hi Karen:
The wound looks like it is healing nicely. I dont see any issues that warrant immediate veterinary attention on our part. Continue the therapy protocol as outlined by Dr. Tolley. Clean the edges like you mentioned previously and continue to apply your bandages. I have forwarded the images to him and I am expecting his feedback. I will let you know his opinion ASAP. Thanks for sending the images.
Best,

Dr. Gonzalez 

The therapy protocol recommend by Dr. Tolley was this:

• Soak a clean piece of the used cotton roll with Betadine and gently swab the wound to remove dirt or other debris that might have slipped in under the bandage.
• Cover a Telfa pad with a thick glob of Biozide gel. 
• Place the Telfa pad over the wound, pressing it gently so that it sticks.
• Wrap the wound once or twice with brown gauze to ensure the Telfa pad doesn't move.
• Wrap the leg snugly with a long sheet of cotton roll.
• Use an entire roll of brown gauze to apply a pressure bandage to the wound. I am to pull the gauze as tightly as I can while I wrap the wound. He said I'll know I am pulling hard enough when the gauze starts to sound as though it is ripping. I haven't been able to pull that hard yet.
• Making sure to leave some of the cotton roll sticking out of the top and bottom of the wrap, I am to finish off the wrap with a roll of Vet Wrap (I actually use a cheaper brand).

When I am finished it looks like this.

By the second day, it's looking a bit rough, but I love a fresh bandage job - purrrrrty!

We have our first follow-up appointment on Saturday where Dr. Tolley will probably need to debride the wound. Proud flesh will likely become an issue. At the appointment, he will decide whether to change out the Biozide gel for something to inhibit the development of proud flesh. While he hasn't said so, I am assuming, and budgeting for, every other week visits for the month of February. With a wound this large and open, I would rather have someone with a degree monitor the condition of the wound rather than simply trust my own judgement.

I paid for Dr. Tolley's first visit over the phone, so I hadn't seen his write up. His medical notes finally arrived over the weekend, here is what it said:

What does it need to look like to be something other than a SUPERFICIAL laceration?!

I feel lucky to have access to such a knowledgeable and friendly staff of doctors. Not every vet hospital will put the vet on the phone and let you chat with him (or her). While Dr. Tolley is my regular vet, it's nice to have finally worked with Dr. Gonzalez. I would definitely feel comfortable having him treat my boys in the future.