Monday, September 16, 2013

Texas Chili Update - Day 18 - GRAPHIC PICTURES

In case you don't remember, this is what Chili's leg looked like on August 29

Below are some updates that I sent to Chili's owner, along with some pictures.
August 31 - He is doing pretty good.  He'a wearing an ice pack right now and is kind of pissy.  But I don't really blame him.  He is eating well.  However, he isn't drinking as much as I think he should, so I'm going to add some salt to his mid-day meal.  I'll get pictures of the unwrap, rewrap process tonight.

September 2 -
Just rewrapped after airing out and icing.  As you can see, there is minimal swelling, which is great news.  I must be doing something right. *:D big grin
I wrapped a little different this time.  The dang this weeps and then the wrapping gets heavy and slides down.  The 4 inches of green on the bottom is a "base", so hopefully it will stay in place this time.  In the last picture, the front of the knee is to the left.  I put a BUNCH of gauze pads there, so hopefully that will absorb any weeping, yet stay in place.  I didn't use any gamgee padding this time - we'll see how it goes.

Mike and Chili relaxing while the ice pack does it's work.

September 3 - Mike reports that Chili is hanging out, eating good, and that the wrap on his leg is staying in place today.   Doesn't appear to be weeping much, wrapping is not soaking through. No swelling visible.  All good news. As of last wrapping, the stitches were holding.
September 4 - Rewrapped last night. Pretty saturated. I'm out of Elasticon...Mike will have to make do with vet wrap. Mike saw Chili lay down to rest, but stitches held.  The knee was a little swollen last night so I iced for twenty minutes. I didn't get picture because Chili had wiped the mush off his mouth, or at least attempt to, and only succeeded in smearing it all over his face, legs and belly. Now that I think about it, that would have been a funny picture... like giving a child a spoon for the first time.

September 5 - Iced and rewrapped Chili's leg.  Mike got some rolls of Elasticon tape from the vet.  It was our dog vet and the guy gave the rolls to us for cost after Mike showed him the wound.
Anyway, I took the ice pack off and while I was gathering the supplies to wrap his leg, the big hairy dork reached down and ripped one of the stitches out.  Luckily, it wasn't the end or the middle.  It was one stitch in.  The skin opened up but not the inside stitches.
I could have shot them both!  I'm not doing this so he can rip out stitches or Mike can sit there with his head up his butt!!  (end rant)
September 10 - AM - Chili is much the same...doing good, a great patient, etc. I did manage to piss him off in Sunday evening.  He rolled and broke open the scab where he had removed the stitch. It had bled then stuck to the gauze and when I pulled the wrap off, it took the scab with it. He stomped his displeasure but stood quietly while I rewrapped it. It bled pretty good. The rest looks really good.
PM - Tonight when I unwrapped Chili's leg, a little puss ran out.  At least it looked like puss.  He still has some clear drainage too but I'm not worried about that.    He is getting uniprim am and pm.  Also, it appears that he has a fluid pocket, below the bend.  I will try to get clear pictures tomorrow night when I wrap.
The place where he ripped the stitch out, and pulled the scab off looks really good.  No bleeding tonight.

September 11 - Pictures


September 12 - Another stitch has pulled loose.  Luckily, they are both on the outside and the furthest toward his hoof, so it will hopefully drain that way.  My concern is across the front and the inside, which seem to be holding.
He also did something  - either laid down again or rubbed the other knee with his muzzle, because it was open and weepy tonight.  I wrapped it lightly and I'm sure it will heal fine.  He also has an open sore on the side of his hock... that place where they get rubs from laying down.
And then I forgot to put the cast padding on before the gauze wrap and it rubbed a sore on the back of his knee.  BAD MOMMA!
Tonight after unwrapping, I scrubbed with 75/25 water/bedadine then blotted with a paper towel before I rewrapped it.  I feel so bad for the poor old guy.  I wonder if an E-collar would keep him from rubbing his messy mush on his knees...
The bulge below his knee is firm. No heat and no swelling.
September 13 - I've been putting T-Zone Wound Cream on the wound.   I have had fabulous luck with it over the past 4 or 5 years.  And it isn't an ointment or gooey. It also has anti-microbial, anti-inflammatory, and anti-fungal properties.  I really like using it and it also keeps the wound from sticking to the gauze.
I'm so afraid to remove the sutures... I'd hate to have to start all over.  This kid will probably wear a "bracelet" for the rest of his life... LOL!
September 14 - I stepped outside tonight to have one last smoke before going to bed and I heard a horse get up and clear it's nostrils several times in a row.  I happened to have a spotlight handy so I shined it out to the paddock to see if I could tell which one.  It was Chili... and he wasn't walking on his bad knee... AT ALL! 
So I grabbed my bag(which I LOVE by the way!-pictured above), cut off his old wrap, then sent Mike into the house for the icepack.  Chili was holding his foot out at an odd angle and inching forward, walking on his toe.  So I iced his leg for about 15 minutes, then put the T-Zone on the wound.  He has pulled loose several stitches now - at least the skin.  The flesh underneath seems to be holding and the sutures are still in place.  The open part that looks like it's open (with no scab) is actually sealed for the most part on the surface, meaning it is dry, not wet like an open wound.
Anyway, while his leg was icing, I felt his lower leg.  It felt cool and initially I was concerned that I'd gotten too vigorous with the wrapping and got it too tight.  There was warmth on the back of his hoof, just about the heel bulb.  I massaged his lower leg while it was icing and gave him some B-L Pellets.  It probably would have been more effective to dose him with bute, but I'm reluctant to do that.(We have been battling ulcers for years)
I wrapped looser, which means it will probably be down around his ankle by morning.  I put a couple pieces of gauze, wrapped as tight as I could with the cast padding (it'll pull apart if I wrap too tight), then covered it with vet wrap.  I stood and watched him for about 20 minutes and he was standing normally when I came back into the house.  I'll check on him one more time before I go to bed. (now that I'm awake...)
So... I don't know if his problem is because I wrapped too tight, or he hurt himself getting up.  He is locked in the barn for the night.  That is sure to piss him off!!  I did redirect the fan so he gets some airflow.

September 15 - Pictures from this morning.  We went through two ice packs.  The pictures are before icing.  When I walked him back to his stall, he walked pretty much normally.  I did a very thin, light wrap.  The wound/sutures still look good and the open area is actually dry and sealed. (Thanks to the T-Zone! LOVE this stuff!)  And actually, the knee itself doesn't look very swollen.  The swelling is above and below with minimal involvement of the knee itself.  I'll ice it again around noon.
September 16 - We had one heck of a thunderstorm go through last night and we were without water and power.  Poor Mike have having fits - water was off, power was off, he had to haul water from the troughs to soak feed for three horses, the dog kept tripping him, he knocked the last cup of coffee off the counter (no water to make more), he couldn't find the wrapping supplies, etc etc etc.  It was easier for me to just come home! 
I went to the store and bought 4 rolls of the elasticon tape - to secure the top of Chili's wrap.  I also bought some more Ace bandages for Icing.

Pic 1 - I soaked the two bandages in ice water, then wrapped.
Pic 2 - Put on ice pack #1, wrapped, then ice pack # 2
Pic 3 - Leg icing
Pic 4 - Chili says "Hi"
This method is the first time I've done it like this and it worked REALLY well!  I also remembered I have some support wraps for my barrel horse that I could put on to support the wrap.  Naturally, I just re-remembered it, so when I go out to ice his leg, I'll try to remember to put it on.
I honestly don't think that the swelling has anything to do with the knee.  The knee itself isn't really all that swollen. The majority of the swelling is on the lower forearm on the outside.  I think the lower leg is residual puffiness, and not bad today.  I believe the swelling is from whatever he did on Saturday night, NOT the knee injury.
The wound is actually in really good shape.  The sutures are holding, minimal weeping, the exposed flesh is pink and smooth, and there is a seal over it (not unlike a scab).
He is NOT moving around much at all.  He will walk, but drags his foot backward, rather than stepping back.  I took his cribbing collar off on Saturday night and he was find yesterday.  Today, he was cribbing like it was going out of style, so the collar is back on.
So that is it in a nutshell... Going along great, then a setback.  *sigh...

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