Houndwoman Posted November 6, 2009 Report Share Posted November 6, 2009 Oh bless him, good job he is so patient and laid back I really hope they can find out what is causing the problem so that the healing process can be completed Link to comment Share on other sites More sharing options...
houndzrus Posted November 7, 2009 Report Share Posted November 7, 2009 Still thinking of the lovely Nog and hoping they get to the bottom of the problem. Link to comment Share on other sites More sharing options...
ranirottie Posted November 7, 2009 Report Share Posted November 7, 2009 from us and i hope they sort it out soon x Link to comment Share on other sites More sharing options...
Brindlebabe Posted November 7, 2009 Report Share Posted November 7, 2009 Great to read that Nog is slowly but surely healing . Link to comment Share on other sites More sharing options...
kats n greys Posted November 8, 2009 Report Share Posted November 8, 2009 Poor Nog hope everything starts going better for him. Link to comment Share on other sites More sharing options...
Rumpole Posted November 9, 2009 Report Share Posted November 9, 2009 how is the brave little soldier Link to comment Share on other sites More sharing options...
Laurel n Hardy Posted November 10, 2009 Report Share Posted November 10, 2009 bless him, wao a good boy still sending loads of good thoughts to him Link to comment Share on other sites More sharing options...
Laurel n Hardy Posted November 10, 2009 Report Share Posted November 10, 2009 aww bless wot a good boy still sending good thoughts for his recovery Link to comment Share on other sites More sharing options...
snow Posted November 10, 2009 Author Report Share Posted November 10, 2009 I'm probably not going to update this thread as often given todays vet visit - we now have a timescale and if Nog is to have more surgery to remove the plate it won't be for another 3 months! They want the bones to have had 6 months of healing before they take the plate out - and it's only been 3 months so far (blimey has it been 3 months already? ) we have to go back again Friday for a dressing change but if it's as they expect no change on the wound then we'll switch to once a week visits for dressing changes only. Nog will have to remain on antibiotics until the leg is healed after the plate removal so he'll be on them for at least another 4 months he's not on any pain medication as he doesn't need it anymore however I have a supply of tramadol here so that if he over does it or if the cold affects the leg and makes it ache I can give pain relief as and when its needed without needing to consult the vet, he will also have to have a dressing on the leg for the entire time. The pattern is very clear now, skin forms over the plate but is thinner than clingfilm, then the skin breaks down again before reforming - no granulation is taking place beneath the thin skin on top of the plate and is unlikely to now after all this time. He doesn't tend to bother the dressing so we'll only use the buster collar when we have to leave him or at night when he's downstairs alone. Nog is banned from all off lead exercise and isn't allowed contact with other dogs which could excite him and lead to excessive boinging this means MIL can't come here for Xmas as she would want to bring her dog and thats just not a good idea at the moment, similarily Nog won't be able to go to her house when we visit Wales so he'll have to stay at my mums whilst we go see MIL. He is still barred from using stairs or any heavy impact on the bad leg, however, the on lead walkies must continue at the moment he must do 15 mins a day using the bad leg, so walks can be longer provided that he only uses the leg for 15 mins at a time, this time will increase as the weeks go on and it's likely that this will build up his muscle tone and reduce the need for hydro after the plate is removed. Nog now walks on all 4 legs for much of the time, albeit that when he wants to go faster he will revert to using 3 legs, he's also a LOT brighter and happier and full of himself since we stopped the tramadol, he's even started playing with his toys and rawhide chews tho he has to be supervised as he has a tendancy to do a lot of toss and pounce games at the vets today he once again showed that they really really should not take him for granted by leaping up onto the treatment table before they could stop him and when the vet brought him back out he reared up onto his hind legs twice trying to drag her across the waiting room at this stage that kind of movement isn't quite as dangerous as it used to be although it's not to be encouraged. He did dive up on the sofa on the weekend only to dive back off when I shrieked OYYYYYYYY he did so without using the bad leg on landing so we may allow him on the sofa when supervised which will really please him. Since hopefully the weekly visits will only be for dressing changes it seems pointless updating the thread further when theres no real news. Reiki is still gratefully appreciated but now it's for strong bones and fast healing. Link to comment Share on other sites More sharing options...
Mrs Mop Posted November 10, 2009 Report Share Posted November 10, 2009 That is good news, Link to comment Share on other sites More sharing options...
houndzrus Posted November 10, 2009 Report Share Posted November 10, 2009 Glad Nog is still improving Link to comment Share on other sites More sharing options...
griff Posted November 10, 2009 Report Share Posted November 10, 2009 sorry if it has been mentioned but have you tried silver dressings??? and manuka honey (couldn't read through all of the posts due to my wonky laptop ) hope Nog continues to get better Link to comment Share on other sites More sharing options...
snow Posted November 10, 2009 Author Report Share Posted November 10, 2009 I've discussed manuka honey with several of the vets and with the surgeon himself, they are very familiar with it and regularly use it on their avian and reptile patients as well as dogs - in Nogs case they are concerned that as he has already proven to be hypoallergenic to even the most innocuous of substances- even those designed to be used by patients who are allergic - that by introducing the honey into what is a porous plate that it could in fact prove a breeding ground for bacteria or an irritant not easily flushed out if that proves to be the case, additionally Nogs wound does try to heal but "breaks down" manuka apparently wouldn't prevent that "breaking down" bit so it would be a bit of a pointless risk. Not sure about silver dressings I haven't specifically heard them mentioned but the surgeon did say that Nogs now exhausted every known type of dressing material some he's allergic to others he's fine with - none however can prevent the wound "break down" as thats all to do with how Nog's body reacts to the plate as a foreign object. ETA: having now googled silver dressings even though I'm not a vet I can say they wouldn't be needed - the wound isn't infected and there is no bacteria in the wound site - he's swabbed every time the dressing is changed and the wound is clean & non suppurating, it simply isn't healing strong enough over the plate and thats to do with how Nog's body works rather than any external reason such as bacteria - in fact it would be fanflippingtastic if it were an infection as those can be treated. Because the wounds are open Nog needs to remain on the AB's and the leg covered with a thick dressing to prevent any bacteria getting in and taking hold - thats also why it's swabbed and tested every dressing change. It's also why we have a hold on Nog's boosters as the amount of AB's in his bloodstream would probably kill off the vaccines Link to comment Share on other sites More sharing options...
Laurel n Hardy Posted November 11, 2009 Report Share Posted November 11, 2009 Loads more good thoughts and a on the snozz for him too Link to comment Share on other sites More sharing options...
snow Posted December 17, 2009 Author Report Share Posted December 17, 2009 Nog and I have had a very long consultation with the vets today, we have been given the option of having Nog's leg removed now or we can opt for further (expensive) surgery to continue efforts to save it. I've fully discussed both options and both the vets and I agree that if at all possible we would prefer for Nog to keep the leg, the vet said they believe Nog would very quickly adapt to 3 legs as he's pretty much been using 3 legs a lot of the time for the past 4 months and not having to carry the dangling weight of the leg would make things even easier for him however, they feel it is preferable when possible to retain the leg, especially given the fact that Nogs injured hock shattered with no warning, they said that it would be incredibly bad luck for the uninjured leg to also go but of course if it is the only leg more strain will go onto that hock and if it were to break at some point our options then would be very very limited indeed and would potentially mean pts. I wanted to be 100% sure that more surgery to save the leg would be in Nog's best interests rather than ours or the vets, so I discussed how he's been coping so far and what he'd be facing with the new surgery, again I was reassured by their candor, if Nog had not been coping so well with all the mucking about he has to contend with, the dressings, the pills, the repeated vet examinations etc and had they felt that we (me & hubby) were not following their advice and not helping Nog's recovery then they would not have proposed even more surgery as an option. They took photos of the leg during the dressing change today so that I could see for myself exactly how the leg looks - and most icky it is indeed, the plate is now fully visible and more areas of the wounds have broken down, they can no longer even staple the edges together as the wounds are too wide so surgery of one kind or another has to happen pretty soon and we are once again back to dressing changes twice a week even over Christmas. Nog is therefore booked in for surgery on 29th December, he will be admitted that day and have x rays and Hannes will make a decision on what type of surgery it's to be, the surgery itself will take place either on 29th or 30th, we won't know until the plate itself is removed whether or not the leg will require external fixation, but it is highly likely it will need it as when the plate & screws are removed it will naturally leave holes in the bones - essentially the bones will again be "broken" albeit in a slightly different place and way, and those bones will need to calcify to regain their weight bearing strength. If he has to have external fixation this will be a metal framework cage, a large one for 2 weeks then a smaller 1 for a further 4 weeks, then we start allllllllllll over again with the restricted exercise and gradual increase in walking. Theres a slim chance that the holes won't be that bad and the fixation won't be needed but I'm not getting my hopes up on that as they don't think it likely. In addition to the bone work needed, something has to be done about the open wounds, this will either be a special type of surgery involving the leg kinda being laced up with shallow cuts into the meaty part of the leg and then drawn over and across, or they may decide to go for skin grafts, again they won't know which one they can do until the plate goes out and the decision on fixation is made. Because the surgery is major Nog will need to stay in the hospital for about 5 or 6 days, especially if he has grafts as the dressing changes will be several times a day to begin with, again had there been any doubts about Nog's ability to cope with a long hospital stay then they wouldn't have even considered this option. As it is Nog is the most easy going laid back dog they have ever dealt with, he loves them, he adores going there and I know for a fact that he is spoilt rotten and adored by all the staff so I have zero concerns on that score. Cost is going to be over £3,000 thank goodness the new insurance year has kicked in so we have a new £7,000 available - M&S now has a customer for life I don't know what we'd have done without this level and type of cover. Long term it's expected that all being well Nog will be back leading a normal life off lead chasing rabbits and racing his doggy mates across the fields again in about 6 months - just in time for the summer but boyyyyyyyy will that seem like a long long time by the time we get there. Link to comment Share on other sites More sharing options...
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