Pepper is a one year old playful Border Collie who loves playing with sticks.
She was seen by the team at Hollybank as a reasonably sized lump, about the size of a golf ball had appeared under her lower jaw over night. Pepper, being our ‘brave pet’ was still her happy self and did not appear to be in any discomfort at all. Pepper was sent home with some medications to help reduce the size of the swelling. However, we were keen to be kept up to date with Pepper’s progress.
Over the next 24 hours the swelling under Pepper’s jaw increased to the size of a Satsuma and she developed a very high temperature. Pepper was diagnosed with an abscess. This is the bodies way of ‘walling off’ an area of infection. We were worried that a fragment of stick, or another ‘foreign body’ may have worked its way from Pepper’s mouth into the tissues surrounding Pepper‘s jaw. Pepper really wasn’t herself and ‘intravenous fluid therapy’ (a drip) was now required to try and bring her temperature down. Pepper would likely need surgery to identify and remove any foreign material.
Pepper had to sit very still whilst a small catheter was placed into a vein in her leg. The catheter would allow her fluids to be given. Over the next 24 hours Pepper was closely monitored throughout the day and night, her fluids continued to be administered and her temperature was recorded. Pepper’s temperature steadily reduced down to normal however the swelling by her jaw continued to increase so much so that her entire face became very swollen!
With Pepper’s face now being so swollen, finding any foreign material would be very challenging for the Veterinary Surgeon. The following day Pepper was sent to a specialist centre for a CT scan. This scan would provide the Veterinary Surgeon with many cross sectional x-ray images of Pepper’s skull and surrounding tissues to hopefully identify the location of anything that required surgical removal. When Pepper arrived at the specialist centre the continually increasing size of her abscess caused an area of skin under her jaw to tear; this released a lot of infected material from the swollen area but left Pepper with a large wound.
Pepper continued to be prepared for her scan, the scanner looks like a large tube. Pepper had to be sedated as she needed to remain very still for useful images to be produced. The scan was completed and the image to the left, along with lots more were sent back to the Hollybank team. To our surprise, the scan did not reveal any ‘foreign body’ in the tissues around Pepper’s jaw.
Pepper returned to us at the practice that evening and we arranged for our visiting soft tissue surgeon, Catherine Sturgeon to join us the following day. With all her experience Catherine would know how to best manage the large area of infection and the resulting wound.
Pepper required a full general anaesthetic to allow the surgery to be performed. During surgery Catherine removed any areas of unhealthy tissue from the wound as unhealthy tissue would delay wound healing. The area would require regular dressing changes in a some what awkward area to apply a bandage, therefore, loops of suture material were placed around the wound edges to allow a dressing to be secured over the area. Peppers wound was very deep and was packed with gels and sterile dressings to help it heal. These were all secured in place using the carefully placed loops. The following day the dressings needed replacing, despite the very large deep wound as shown, Pepper lay very still and did not object at all to the procedure!
Gels were then used to keep the wound healthy without any overlying dressing; the gels were placed into the wound at home on frequent basis by a very dedicated owner! Pepper was seen back by the team at Hollybank frequently so that her progress could be monitored, with Pepper being very brave and well behaved at each visit.
It took lots of patience but Pepper’s progress was amazing and the wound was almost completely healed within 4 weeks.
