In July I shared the incredible tale of my dog, Roxy. This incredible dog continues to endure an unfair share of hardship, but after almost a year she is finally enjoying being more active and playing is a returned routine to her life.
Shortly after posting her story, Roxy developed a draining wound over one of the bone screws that secured the plate that kept her right carpus (wrist) upright. X-rays suggested that the screw was loose, contributing little to the stability of the bone plate, and the bone it was anchored in looked weak. She handled the anesthesia well and the screw was removed and the remaining screws were tightened. All seemed well until two-three weeks post-surgery, when she began to reluctantly use her right forelimb. She no longer eagerly jumped from the car and had to be help down from the seat. Once inside the hospital she would collapse to recover from the transition before walking to her familiar place at the reception area to "milk" hugs and petting (not to mention the treats) from the reception staff and clients.
Initially I assumed it was part of the recovery phase, until one morning her nemesis the draining tract recurred. Microbiological culturing confirmed that her old friend, MRSP (methicillin resistant Staph. pseudintermedius, AKA "fleshing eating" bacteria) was active. Drug sensitivity revealed we were down to only one antibiotic that could control it. I immediately started the antibiotic injections and made an appointment with an orthopedic specialist in my area.
Her doctor and I agreed that the plate had to go, as it and the screws were acting as a focus for the MRSP re-infection. X-rays also revealed that some of the screws had broken and the plate was able to move, acting as an irritant and probably the source of so much of Roxy’s pain. The plate was successfully removed and she recovered in a splint for two weeks. She clearly was in less pain and the distinct "clack" of her splint made it very easy to identify her whereabouts at the hospital.
As expected, without internal support her right wrist collapsed and matched the left, but she was quite active in the confines of home and hospital. I laid a couple of patches of sod in the backyard so she had a softer surface for nature’s calls. By one month post-surgery the MRSP infection was resolved and her activity continued and continues to increase. Unfortunately it is limited by her confirmation (see picture) but she is relatively pain free and much happier and eager to play fetch on the soft carpet of the living room.
Surgical repair of her confirmation is not an option. The optimum technique for her massive bone injuries requires stabilization pins that align the bones but protrude through the skin and are attached to exterior bars. These would have to be in place for 3-6 months while internal bone grafts bridged the bone destruction. This is possible for normal animals but not for a dog with MRSP as part of its natural skin bacteria. The wounds created by the pins would act as entry points for the bacteria. With only one bullet left (antibiotic), a mutation in the MRSP that made it resistant to that treatment would leave Rox hopelessly defenseless. The risk is higher than the possible reward and not an appropriate end for an incredible life.
The next step is prosthetics. I am going to have her fitted for custom prosthetic splints that will keep her wrists upright so that she may once again go for walks in the neighborhood and hopefully enjoy a more expansive game of fetch.
Getting out and about will also help regain some of the socialization skills she lost during her frightening and traumatic time isolated in the drainage ditch, and her limited social contact at the hospital for the last ten months. I will update you with her "new wrists."
Roxy, sitting pretty
Dr. Ken Tudor
Image: Roxy by Dr. Tudor