Wound is not closing - feedback please
 

I posted back on October 7 when Deuce had a Lump under his right eye that appeared to be fluid filled. As it turned out we went to the vet two times, did two rounds of different antibiotics and the infection cleared up ( I thought we were done with this) but now it appears that the opening in the skin is not closing. It gets a scab but just gets larger and larger. It is not fluid filled and when the scab comes off (like in a bath) it is just still open about an 1/8"long. It is not inflamed but just not closing.

On the last visit to the vet when we did a second round of oral antibiotics, she told me to clean the wound three times a day and not let a scab form. In addition she had me apply a topical antibiotic to the wound for a week then let it scab. Wound has not closed.

Her suggestions at the last visit if it does not heal was that it may be a resistant bacteria of some sort, there may be a foreign object in there, or it still may be a back tooth problem (have not taken xray yet).

Course of action includes putting him under to clean out wound and see if something is in there and clean teeth while he is under and remove a baby tooth that appears to still be in the front. His teeth are not bad but I would think he will need a cleaning in another few years if I don't do it now and stay on an oral care program.

I hate putting him under but will do what I have to do to get this resolved. He is not in pain or any discomfort. Chews fine. Any other thoughts about this? Thanks.

I personally would get another opinion from another vet. I probably would speak to a vet at a vet with a wound care center, but not all vet hospitals have this. Or I might go to a board certified dentist to assess this. You might want to PM ladyjane, she just had a rescue named summer who had extensive wound care and knows a lot on this topic.

Poor Deuce. Sorry to hear that he is still battling this wound. If I I recall correctly, someone on your previous thread posted about a similar wound that turned out to have a microscopic foreign object lodged in it. The object was prevented the wound from healing.

A dental problem is another potential cause for the wound.

I agree with Cathy's advice to see another doc, a specialist of some kind.

Sending prayers that you can get this resolved once and for all.

I would definitely see a wound care specialist.....my foster, Summer, was treated at Texas A&M in the soft tissue surgery department. That is the department that deals with wound care.

If you have a vet school close to you, that might be a good place to start! I do think that your pup will more than likely need to be anesthetized so that they can get a really good look at what is going on inside this wound.

Hope this helps. :)

I've been looking for a Vet Hospital that has wound care. It looks like there is an REgional Emergency Care Clinic locally that has several kinds of departments. Would that be the kind of Wound Care you are talking about? I googled it in Northern VA but did not come up with any other than the Regional clinic.

Usually large universities have tem. As an example, take a look at Tufts or Texas A&M vet hospitals to see what Linda and I were referring to.

You might want to call them and ask.

Sending prayers for answers in what's needed to get Deuce on the road to his recovery. Hugs))) to you and the little guy.

Virginia Tech and University of Maryland are the two big Vet Schools in the area. UMD and VA Tech have a regional center in Blacksburg, VA. That's about 6 hours from here. I'm still looking in surrounding states, but will call the Emerg Care Clinic tomorrow regarding wound care. At this point with the holiday looming I'm in research mode until Monday unless this scab takes a turn. I am still applying antibiotic 3 X's p/d and it is NOT bleeding, no fluid, no swelling. That is better than previously.

Just wondering how does a dog's skin heal with all this hair? A tummy is rather sparse but a face has lots.:confused:

For a non-healing wound, the hair should have been trimmed or shaved a bit (1/2 - 1 inch all around the wound) to help in keeping the wound clean. If this has been open for a while, the wound edges may have to be surgically refreshed for healing to complete.

I would see another Vet as the wound is not the problem. It is not healing because there is an abcess related to the upper teeth on that side causing the problem. It is opening that wound up again as it is weak there, to drain. Which is lucky. If it had no where to drain the abcess or infection would build up somewhere behind the eye. I have seen this situation many many times before with different Yorkies and grooming client yorkies. And seen it once where an abcess was enclosed and was pushing the eye out of the socket. He would have lost his eye if he had not been rushed into the Vet who knew what he was looking at. He went in through the roof of the mouth and made an opening for the abcess to drain.
This can occur after a dental and teeth extracted if the abcesses didn't have time to drain before it healed over OR it can occur with an abcessed or infected tooth. It can also occur is a foreign body has gotten up into the sinuses and worked its way forward. I had this exact thing happen with my first Yorkie who swallowed a bit of spear grass, tried to cough it back up but it went up his sinuses and I didn't know, I thought he had coughed whatever it was he swallowed, back out. Caused no end of trouble but in the end it was resolved.
You need to find a Vet ASAP that knows what they are looking at.

Definitely agree... possible Carnasal tooth abcesses present as you described. I would be concerned about infection, both local and systemic, can be very serious. She really needs to be seen ASAP.

Update - Scheduled for Monday
 

Deuce is scheduled to have the lump/wound addressed on Monday. It is still draining. Will do Xrays first and examine the tooth. If that's the culprit they will remove if not they will look in other areas of the mouth and for foreign bodies in the wound. I will ask about the sinuses. Hoping we find the source of the problem quickly.

Good luck! Sending prayers and best wishes for Deuce....

Good luck! I hope they get to the bottom of it and Deuce is healing soon! Please keep us posted.

I hope things go well and they are able to correctly diagnose and treat him. Good luck!!!

Sending prayers for Deuce for tomorrow that all goes well and that the docs can get figured out and taken care of for him once and for all. Keep us updated.

Update on Surgery
 

Dental Xrays were taken from various angles and teeth were carefully checked. There isn't an abscess or cracked tooth that would cause the problem. The surgeon checked all around the mouth and explored the wound to see if there was something in there - nothing found. We will continue the irrigation procedure on the wound at home along with antibiotics to see if it responds and begins the healing process. I almost wished it was the tooth to get this problem resolved for him.

At least you know what it isn't. :) I think the irrigation will help it. Before it was closing over and that is not good ... it needs to heal on the inside. Hopefully it will be better soon. :)

Did they do a C&S (culture and sensitivity) on the wound? I'll keep him in my prayers...

Boy, you have really had a time with this. I am so sorry. Has your vet checked the wound for parasites? It sounds like everything else has been mentioned. I know it seems unlikely given the time of year though.

Very happy to hear all went well today. I agree with LJ that it is good to know that Deuce's teeth are all good and that there isn't anything in the wound. Sending prayers that the irrigation will do the trick and that the sore will finally heal.

He's resting comfortably
 

The poor little guy is not smiling but he's resting comfortably. He's been very clingy since he's been home. He ate a little and has had some water. Most of the hair is shaved on the right side of his face so it will be a bit easier to keep clean and keep track of. Time will tell.

Poor baby. I hope he feels better soon.

Praying he heals up quickly!

I had a cat with a large open wound on his side from a drained abcess. At the vet's advice, we kept it clean, used Polysporin and it eventually started to grow new skin around the edges and closed. Then he grew the hair back in that spot.
Now that you have ruled out teeth, etc I suppose it is a matter of perseverence.Good luck!

Update on Wound
 

Well, we've been taking care of the wound as prescribed and it looks good. Healing from inside out. He is also on oral antibiotics. Deuce is a wild man as usual, eating well and has no ill effects. Will have a vet visit early next week. I'm thinking time (2-3 weeks) will tell after we finish the oral antibiotics to see if the infection comes back. I'm not a pessimist just cautious.

Glad to hear Deuce is feeling good and that the wound is heading in the right direction. Praying it closes for good soon.

Thank you for updating! I am happy to hear that things are going well. :)

Wound still leaking
 

I am sorry to say the problem has not been solved. The wound began to leak again and fill up with white fluid. He is still on antibiotics (the third course) Taking Deuce to a Dental Specialist to recheck mouth. Hoping for a solution for my baby boy!!!