Daisy – Life threatening injuries
Daisy was only a one and half year old cat when she was hit by a car. She received emergency treatments from her local veterinary surgery and was then referred immediately to Northwest Surgeons. Daisy had incurred multiple injuries. She had fractured her pelvis and ruptured both her body wall and bladder – urine was leaking into the abdomen and seeping into her muscles, fat and the skin of her tummy region. Left unchecked this would lead to a painful death for her. Rupture of Daisy’s bladder was confirmed by injection of a water soluble contrast agent into her urethra via a urinary catheter. The contrast dye, which shows up white on xray was seen leaking into the surrounding tissues.
The bladder and pelvis were repaired surgically, but there was already some evidence that the fat and skin infused abnormally with urine would start to die away as a result of the damage caused by the urine leakage. Approximately 10 days after surgery, a clear line of demarcation had formed between the normal skin of the belly and the dead and dying skin and fat. The latter was removed, leaving a very large open wound – the entire surface area of Daisy’s belly region was no longer present. The large wound was managed by tie-over dressings which allow a number of dressing products to be applied to a wound and tied underneath surgical swabs – in a parcel-like effect. This enabled Daisy to walk around without having her entire body wrapped beneath dressings whilst the body slowly started to fill in the wound cavity.
Six weeks later, the wound had progressively healed but had reached a static point and we had to use a skin grafting technique to fill the remaining wound bed. Daisy’s progress was hampered by a number of clinical set-backs resulting from the horrific nature of her original injuries. She developed acute kidney failure and became critically ill. As a result of her weakened state, the skin graft failed and the wound bed became infected with a resistant bacterium that took advantage of her debilitation. At Northwest Surgeons, the importance of infection control is taken very seriously and it was the routine monitoring that takes place as part of our infection control procedures that detected this problem early. Daisy was moved immediately into our isolation facility and strictly barrier nursed to prevent contamination of other patients and staff. Within two weeks of appropriate treatment and topical silver preparations (which have activity against bacteria), the infection was quickly controlled. However, the open wound took a number of combined medical treatments before it would support further wound healing. In total, Daisy stayed over 3 months in isolation, but she remained a bright, active and happy cat despite her continued isolation status for infection control. This was largely because part of Daisy’s treatment incorporated designated playtimes which she adored. She also became expert and mischievous in buster collar avoidance skills!
Three and a half months later, the wound bed was again ready for surgery and this time, much to everyone’s relief, the flank fold skin flap healed 100%. Finally, 6 months after beginning her emergency treatment at Northwest Surgeons, Daisy went home to her devoted owner and we are delighted to report that she now leads an active and normal life style.