Urgent: post-amputation care, advice needed/I thought I would spend my Saturday doing this...

[aart]

Yes, likely infection.
Stop using peroxide, OK for an initial disinfection of a wound, but it can damage healthy tissue. There are other cleansers probably listed back in this thread, but I don't have them in my notes.

Use saline if nothing else available.
This is the ratio I have:

Boil 2C of water for 15 minutes

Cool to room temp and add 1tsp of salt

Refridgerate for up to 24 hrs

 

[darlingdarla]

Yes, likely infection.
Stop using peroxide, OK for an initial disinfection of a wound, but it can damage healthy tissue. There are other cleansers probably listed back in this thread, but I don't have them in my notes.

Use saline if nothing else available.
This is the ratio I have:

Boil 2C of water for 15 minutes

Cool to room temp and add 1tsp of salt

Refridgerate for up to 24 hrs

Thank you, I only used peroxide because it is a "new wound."
Would another round of antibiotics be recommended? I've still got the penicillin or I could try to get something new.

 

[Wyorp Rock]

Part of her pressure sore scab pulled off while changing her bandage and with it came yellowish gunk like the plug in a bumblefoot infection. At the end of the gunk was a black "plug" type situation.
I don't know what to make of this, is it infection or just dead tissue? It left quite a hole behind her knee, I irritated it with peroxide and filled with veterycin as I am out of antibiotic ointment. I wrapped her whole leg except for the tip.
It took almost no effort for it to come out, I didn't mean to pull the scab off, it wasn't even stuck to the wrap it just came off.
So what is the verdict? Antibiotics again? Or continuing course of treatment?

Yes, likely infection.
Stop using peroxide, OK for an initial disinfection of a wound, but it can damage healthy tissue. There are other cleansers probably listed back in this thread, but I don't have them in my notes.

Use saline if nothing else available.
This is the ratio I have:

Boil 2C of water for 15 minutes

Cool to room temp and add 1tsp of salt

Refridgerate for up to 24 hrs

Saline is a good choice!
Hibiclens (Chlorhexidine) is very good to have on hand as well.

I would not go with another round of Penicillin.
If you feel she needs another round of antibiotics then use something like Cephalexin which is used for bone infections. You would have to order it online. It's found as Fish Flex

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Ideally Cephalexine would be a good choice, but likely you need to ask your vet or order it online.

 

[darlingdarla]

Saline is a good choice!
Hibiclens (Chlorhexidine) is very good to have on hand as well.

I would not go with another round of Penicillin.
If you feel she needs another round of antibiotics then use something like Cephalexin which is used for bone infections. You would have to order it online. It's found as Fish Flex

​

Alright. I don't feel she needs more antibiotics, just thought I'd ask. Except for whatever this is, everything looks good, the necrotic tissue is separating and there is a clear line where it is slowly flaking off.
I'm going to treat this new wound as I normally would, with daily irrigation and ointment. I'll also keep wrapping it for a while.
It sucks because I felt like she was finally looking good.

 

[darlingdarla]

Just wanted to update, though I don't have any new pictures.
She's doing pretty well, the sheet of necrotic tissue is separating now. The tip is still well attached since there is more to separate, but it is well on the way.
The infected pressure sore is looking better, less red. She's got a good but smaller, health looking scab covering it.
I am keeping her bandaged right now because of the pressure sore, which I am covering in ointment currently, and the rest of her leg is covered in veterycin.
She is very anxious to move, I let her hobble around for a minute yesterday just to see how she is using the stump and she is lowering the leg much more readily and flexing the joint better.
I think it's still possible her leg will separate at the knee at some point, but for now just the already blackened bits are breaking off.
I'll have more pics in a day or two, or when the necrosis separates.

 

[darlingdarla]

Photos from yesterday:

The inside of the leg. the necrotic skin is so close to being able to come off, we're just waiting for the center of the tip to finish.

the blister on the inside (still oozing, but liquid is less yellow and no smell, a bit of redness around the necrosis but that may just be the separation in progress).

and the pressure sore after I removed the scab again. There was a bit of the yellow plug under the scab, but it came out clean, and now she is bandaged with triple antibiotic ointment. It's red in the photo, but looking a bit better. I'm keeping an eye on it.

 

[darlingdarla]

Thoughts on her progression?

Alright, it's been over two weeks since my last update. I got a second job and have been dealing with a lot of family issues, I am exhausted. Rosie remained a priority of course, just a slightly rushed one.
She still lives with the bantams and has regained most of her mobility, except she struggles with turning around.

Anyway. Here are some pics from today, and today's developments.

Basically I went to change her bandage. She is still having some issues with the pressure sore, but it's nothing compared to before. It's been three days since her last bandage change, so there was some gunk to squeeze out of it, but it came out completely clean and bled afterwards and otherwise the area looks good. Most of the skin has healed and is not hot despite the small infection, I think with a bit more time and me getting back into my daily routine of bandage changes it'll be healed up within a week.
I had brought out a pair of cuticle nippers with me to snip off the necrotic skin that had already detached like I did with the initial break, but as I was pulling off the rest of the bandage I heard a quiet snap. I got the rest of the bandage off and the necrotic tip came with it, leaving a slightly bloody but healthy looking tip underneath.
I honestly was shocked, it just detached
She didn't flinch of cry out or anything, it was almost like she didn't notice it.
I irrigated the new wound, as well as the holes around the joint, and throughly sprayed with veterycin. I then smeared some Vaseline on a sterile surgical pad and wrapped a piece of it around the tip and a piece around the joint, just to give a little more padding and protection, and I wrapped up the leg completely, again leaving extra padding at the tip for her comfort.

The holes at the joint make me feel like she still may loose the leg up to her knee, also the coloring of her leg might be odd, but since she is an Easteregger who has always had oddly colored legs I'm not sure, time will tell. Right now, the visibly necrotic areas have completely detached and now it's all about caring for the open wounds and what I think is exposed bone at the end of her stump.

 

[Wyorp Rock]

Time will tell of course, but I think it looks pretty good.
I do wonder what they holes are, any ideas about those?

This thread is quite long by now and my memory isn't serving me well, what are you using to clean the wounds? Chlorhexidine? If no, then I recommend you source some when you have a chance, if yes, then please forgive my lapse in memory.

Overall, I still think you are on the right track. It's good that she's staying pretty mobile.

I'm sorry that you are having to deal with so much. Do take care of yourself too. You have done a great job taking care of Rosie and haven't given up on her.

 

[darlingdarla]

Time will tell of course, but I think it looks pretty good.
I do wonder what they holes are, any ideas about those?

This thread is quite long by now and my memory isn't serving me well, what are you using to clean the wounds? Chlorhexidine? If no, then I recommend you source some when you have a chance, if yes, then please forgive my lapse in memory.

Overall, I still think you are on the right track. It's good that she's staying pretty mobile.

I'm sorry that you are having to deal with so much. Do take care of yourself too. You have done a great job taking care of Rosie and haven't given up on her.

I think the holes go around the joint if that makes sense? Because she had two at the back (what I call the pressure sore) and two at the front under the necrosis. They seem to connect and go around the joint, which makes me think there's still a strong possibility of another detachment at the joint.
Otherwise, I have no idea. I'm just trying to keep them clean. One is completely healed on the back of her knee, and the other is the pressure sore which has had a slight infection but is under control now.

I know, this thread just keeps going on lol, and now I feel like we've started over with a fresh wound. I don't use Chlorhexidine, but if you think it would be best I'll get some. I've been using bactine max cleansing spray because it does a good job of washing out any open wounds, and when I'm just doing bandage changes I'll use a cotton swab with iodine to wipe the leg.

And thank you, I appreciate it. Just the fact that she's doing okay is such a relief.

 

[Wyorp Rock]

I think the holes go around the joint if that makes sense? Because she had two at the back (what I call the pressure sore) and two at the front under the necrosis. They seem to connect and go around the joint, which makes me think there's still a strong possibility of another detachment at the joint.
Otherwise, I have no idea. I'm just trying to keep them clean. One is completely healed on the back of her knee, and the other is the pressure sore which has had a slight infection but is under control now.

I know, this thread just keeps going on lol, and now I feel like we've started over with a fresh wound. I don't use Chlorhexidine, but if you think it would be best I'll get some. I've been using bactine max cleansing spray because it does a good job of washing out any open wounds, and when I'm just doing bandage changes I'll use a cotton swab with iodine to wipe the leg.

And thank you, I appreciate it. Just the fact that she's doing okay is such a relief.

I think what you are using will be fine. Keep it up