Houstons old wound has been well on the way to getting all healed up. Here is a picture from his previous owners, and I'm going to assume this was taken fairly close to when we first got him a little over 2 months ago:
The picture of him in front of the fireplace shows him about 4 weeks later:
And then on December 29th, Jim left for work and before leaving, he checked on Houston, who was nice and curled up tight right next to me in bed (without his cone on). I have no idea how long that lasted, but I woke up to a really weird noise coming from the living room. I flew in there and found Houston all stretched out in the middle of the living room floor, chewing his wound. This was the first and only time we've actually caught him doing anything other than licking it. I don't think he had much time alone with it, but he did some damage, as you can see in this next picture:
I shared the news with Jim, and we both agreed this could have happened to either one of us on watch for Houston. We had gotten too comfy with him and needed to up our attention level to him again (disappointing for sure, because it had gotten so close to being fully healed up). So we were put back somewhat on the healing process, but I didn't get too concerned until a few days later, I had just applied some healing balm to some dry areas of his wound, and then needed to go take care of some things outside with the cats and chickens (so Houston couldn't go with me). I left him in the front room with his cone on. I came back about 10 minutes later and found that Houston had gotten a portion of his cone so wet from licking that he'd made it more pliable, and was actually able to squish it down enough so he could get to his wound and lick. Srsly, you remember what his cone looks like, right?
I tucked this note in the back of my mind, until the very next day, we basically went through the same routine, and I came back in the house and found he was laid out on the bed (cone on), and was working around the cone to lick. At this point, I started thinking about the fact we left him with water at floor level every day when we went to work (because he could squish the cone down and get to the water), and we'd given him a bone to chew on with his cone on (again, he could squish it down to pick stuff up). Okay, so he's got this newly chewed open wound now, and I've put some balm on it and then stuck the cone on his head and left him alone in places where he could get all sprawled out. Noted. I was a little nervous though, since the cone that could not be gotten around, had just been compromised twice. I quit putting the balm on right before he needed the cone on and left alone. We went back to only leaving him in the front room (with a bed, just not as nice as he has in the house), and no water left out for him (not gone super long stretches and he's well hydrated all other times). This was working, but just to touch base with the rescue, I emailed Jackie and Denise about what happened, and we all started looking into what deterrents had been already tried (cone-wise), and what might still be left to try, along with looking into more of the potential behavioral aspect of his wound licking. Here he is a week after he chewed on it:
Jackie turned up some recommendations in his past that had not been pursued (combo of drugs for pain and behavioral recommendations) and so, we got an appt for him at the Bargersville Vet Hospital in Franklin, IN. We also all agreed on a cone that hadn't been tried for him and put that purchase request in a the same time.
The vet we were trying to see is pretty booked, but due to a well timed cancellation, we were able to get Houston to see Dr. Baker on Monday, January 9th, 2017. Here is the writeup from the Rescue coordinator, Jackie, who met us there. We're still waiting for the bigger writeup from Dr. Baker (she's srsly a busy lady!).
"Houston was able to see Dr. Baker several weeks early due to a cancellation. His weight = 84.1, which is heavy for him. Lauren will cut back on food, increase exercise, and watch the treats.
Lauren brought a chip for him, but when scanned first, it was found that he was already chipped? The previous owners said they didn't think he was chipped, but he is.
Houston has a delightful and friendly personality. You can tell something is up with his rear end when he stands. He turns his right back hock in a bit and frequently takes weight off of that leg when he stands. His rump does not give the appearance of a strong bird dog able to power through a field all day.
Dr. Baker got a couple xrays of Houston with him on his side, but he would not lay on his back and let his hips be manipulated for the xrays she really needed, therefore, we had to do a light sedation. No one was prepared for this, but it had to be done. He has a fractured femur that has healed incorrectly with some remodeling present. The spaces between his vertebra on the lateral view all looked ok, so it seems there was no compression damage in the car accident he suffered 5 years ago. The staff took measurements of his thighs to compare as his progress goes along. His right one is noticeably smaller. His right leg is also 2 cm shorter than his left, also from the incorrectly healed fracture. This imbalance in his rear causes him lumbral-sacral discomfort. Dr. Baker was unable to fully extend his hips behind him, and he had visible reaction to being palpated in that area. His hip is not subluxated, but not totally seated properly either. He also had one piece of buckshot in his left hip.
Lauren has noted that when he does downward dog, he does not go into it all the way, only part way. He also sits with his right leg out to the side. He likely has chronic pain in his right leg. Not all dogs react to that, but he reacts to it by licking to get relief. There could be a deep infection in the soft tissue. Did he impinge nerves during healing? Does he get endorphin release from licking?
The course of action is:
#1 - to do laser treatments on the leg and lumbral-sacral area between now and the 30th, which is when he sees Dr. Baker again for a review and acupuncture. He has laser appointments set up for 9, 12, 16, 19, 23, and 30 January. This will be somewhere around $25/appointment because it is a tech appointment, not a vet appointment, It could be less than that, but I don't think more.
#2 - Start him on gabapentin (300 mg 2x/day) and amitriptyline (=Elavil, 50 mg 2x/day). This combination is used for chronic lickers of granulomas and flank suckers. It is a pain/nerve med plus a behavioral altering med.
#3 - Apply silver sulfadine topically to right thigh 2 times a day. Lydocaine topical is a possibility in the future as well.
Dr. Baker encourages him to play with the other dogs as he has been doing, and for Lauren to get him to downward dog stretches often. He also got a free nail job and teeth scraping while down.
The Gaba, elavil and silver sulfadine are reasonably priced, so we got lucky there.
If this course of action doesn't seem to be helping him by the 30th, we will look into seeing if there might be a chronic infection deep in the tissues. Dr. Baker didn't see anything like that on the xrays and Theresa Crabtree did not feel like he had that either (and she called the femoral break before the xrays were done).
Lauren did contact the previous owner to see if she had contact info for the vet Houston went to during the accident and the owner's name at the time. Vet was Scott Nieves, Beaumont Vet, 859-608-2884. I called and left a vm for Scott, told him what I needed (vet records for Houston at the time) but have not gotten a return call yet.
Houston does have a double ear infection - yeast and bacteria. He got some entederm ointment to be applied 2 times a day and massaged in."
Here's our boy at the vet that day getting laser therapy (he was still a little groggy from the partial sedation):
And back home that night:
As of today, he's had another round of the laser therapy and been on his meds since last Monday night. The new cone came in but we're not thinking it's going to be any better (and maybe worse) than his current one. Not wide enough as is to cover the wound when he turns around and the method of attachment needs better securing. We examined his current cone and are going to try putting additional reinforcement in a few more areas on the outer edge to see if that helps. We had an appointment for this coming Monday for laser, but luck IS on our side (sometimes:) and Dr. Baker had another cancellation that morning and Houston will be able to get acupuncture and laser that day (god bless makeup snow days at school too)! Another laser appointment for next Thursday and then we'll have a solid 4 treatments and almost 2 weeks of meds under our belt to give some more updates hopefully. Because this guy deserves it. And he says he deserves his own bone at all time. He even sleeps with it:)
