By Dr. I.Elizabeth Borgmann. This article will discuss traumatic tears to the skin that extend partially or completely through the skin as well as abrasions (road rash). We will not be dealing with the punctures that involve muscle or enter into the abdomen or chest in this article – we’ll be saving that discussion for another time! And we will not be discussing general skin conditions. (If you would like more information on general skin conditions, Dr. Borgmann has written a series of skin articles that are archived on the Abbotsford Today website: www.abbotsfordtoday.ca.
The skin of dogs and cats is very different from our own. Their skin is thicker and the layer under the skin, the subcutaneous, is not as tightly adhered to the underlying muscle. This is why you can grab your dog or cat and pull together a bunch of skin by the scruff. This difference in structure allows us to administer significant amounts of fluids or medications under the skin. Similarly, it also means a lot of infection can accumulate under that skin.
On certain parts of the body, the skin is more tightly adhered to the underlying layers (for example, on the lower limbs or on the face). Managing wounds in this area is more similar to managing wounds in people.
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Dog and cats, both, will frequently damage their skin. They run through bushes and brambles. They jump fences. They play or fight with other dogs, cats and wildlife. The damage to the skin may be as simple as a poke or a partial thickness tear or as extensive as a tear involving a huge flap of skin. My own dog (before vet school) was clipped by a car and had a skin tear from the flank by the hind leg all the way forward to the forelimb exposing the entire musculature of the side.
The best thing skin trauma to receive is a partial thickness tear to the skin. The underlying tissue is not exposed and the skin does not move apart and gape. This is easy is take care off and manage. Simple regular daily cleaning with a good antiseptic soap is usually adequate. Sometimes you need to add a bit of a topical antibiotic cream (as long as they don’t lick it off – it doesn’t help when it is in the stomach).
Pokes are another issue. These are more likely to become infected, especially if they are from sharp animal teeth. The skin heals quickly but bacteria have been injected into a nice warm moist damp environment. This is the perfect place to grow more bacteria! This is commonly seen in cats where their dense hair coat hides the punctures. You learn about it several days later when the punctures have healed but a huge abscess forms underneath the site and ruptures on you brand new couch leaving behind an undeniably putrid stench.
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If you know a puncture has occurred, clean the site with soap and water and make an appointment to see your veterinarian. If it has turned into an abscess but not yet ruptured, see your veterinarian. The location, severity, and nature of the pet will determine your vet’s course of action. Some abscesses simply need to be lanced, others will need surgery and placement of a drain.
Tears resulting in skin flaps look a lot worse than they really are. They look horrible because you can lift the skin and look quite a long way under the skin along the muscle layers. The fresher these are, the easier they are to deal with so try and get in to see your veterinarian as soon as possible. If these edges are left too long they need to be trimmed before suturing and that is a more involved procedure. These flaps, new or old, need to be closed surgically.
If there is a small flap, clean any debris out from under the flap. Rinse the area with saline. Keep the area covered and moist. If you have it handy, the old hockey injury trick of a simple drop of crazy glue will hold this area closed. Never use large amounts of crazy glue – it is irritating! Otherwise tape and creative bandaging works. If you have a patient pet and you have some first aid skills, a few tacking sutures with a simple needle and thread will work until you see your veterinarian. This last trick will apply more to those of you that are into wilderness outdoor activities where it will take a good hike out before you can even think of getting to a vet. The bottom line is not to let the underlying tissue dry out and protect it from further damage.
If there is a large flap, follow the same principles. Remove any visible debris, rinse with saline, tape the skin over into a normal position and wrap the site. If you are having trouble getting the skin to stay in place or you have to hike out this is where some sewing skills and a few well placed tacking sutures (with needle and thread) can help. Keep these to a minimum – your goal is just to keep the area protected until it can be assessed and treated. Large flaps are always more challenging to repair and not only will your vet suture the skin back in place after assessing the underlying tissue trauma, but they will probably have to place a drain.
Skin abrasions, or road rash, in spite of being superficial traumas are much more challenging to manage. There is a larger surface area of damage. You can’t just sew it back together. And they hurt! Think back to when you were a kid – remember that skinned knee hurt a lot more than that cut? And it took a lot longer to heal? Your vet will guide you through the management of this and expect it to take quite a bit more time to heal.
If your pet has a skin abrasion, rinse the site and pick out any debris. You can run the site under fresh water to flush it clean of small rocks and dirt. Cover the site with lightly moistened gauze (use saline)
and visit your veterinarian.
So what items do you need in your first aid kit to managing skin trauma?
Saline to rinse the wound or keep it moist
Antibiotic cream
Tape, gauze, bandage material
Possibly some needle and thread or tissue glue (if you are hiking up into more secluded areas)
A cell phone with your vet’s number on speed dial
We hope you never need to use your first aid kit! Next time, we will talk about those significant lameness issues where your dog or cat won’t or can’t bear weight on one of their limbs!
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Dr. Borgmann lives in Chilliwack and has been practicing in the Fraser Valley for over 13 years and can be reached at the Whatcom Road Veterinary Clinic