Traumatic Wounds – treated with Hyperbaric Oxygen Therapy.

Shadow was very unsettled after moving house in 2007. She kept running away – back to her old house and went missing for 6 weeks, early in 2009. A previous neighbour found her outside on his deck. He noticed Shadow had a massive wound on the underside of the belly and down between the back legs. So he got on the phone and called the 24/7 team at Town and Country Vet.

Shadow was admitted to the McGlashen Ave clinic on 22nd February 2009 – it was Dr Llyn Powell’s day on hospital cases. He thoroughly checked out poor old Shadow (8 years old at the time). She was very weak, could barely walk and her life was obviously in the balance. Fortunately she still had some appetite. The wound was badly contaminated with dirt and had the nasty look and smell of gangrene. All the abdominal muscles were intact but the subcutaneous fat and skin in the area had been shredded. Shadow was put on an IV drip and given a general anaesthetic. The necrotic tissue was removed and the wound cleaned and flushed with antibiotics. The wound was closed as much as possible with several Penrose drains put in place. She was maintained on intravenous fluids and given broad spectrum antibiotics overnight.

Hyperbaric Oxygen Therapy (HBOT) Dr Powell was aware that there had been good reports of success managing big infected wounds in people using. After surgery Shadow recovered well and while still sleepy Dr Powell elected to give her a session in the HBOT chamber. Annette, Town and Country’s Head Nurse laid Shadow down on a blanket in the warm chamber and the black cat snored off into a deep slumber. One hour later, when it was over, Shadow emerged bright, alert, full of life giving oxygen and unbelievably perky – and hungry! We were all impressed.

Shadow stayed in the hospital overnight. The following day she spiked a temperature, was off her food and the swab of the wound from the previous day showed a positive for both aerobic and anaerobic bacteria. Not the best of news but not unexpected – so it was back into the chamber for 2 HBOT sessions that day and continuing on with fluids and antibiotics. This pattern of twice daily HBOT continued for the next 10 days or so and Annette noted that after each oxygen therapy session Shadow’s appetite seemed to imporve for a few hours.

By day 3 the suture line that had tacked the wound was beginning to break down. The blood supply to the remaining skin was badly damaged and large areas were just shrivelling up. On day 5, Dr Powell performed a second surgery – basically to clean up the wound again. After the 2nd clean up so much skin was lost that the wound could not be closed. Shadow was wrapped in a large dressing which extended from her waist and all the down both hind legs.

Over the next week Shadow’s dressing was changed daily, antibiotic maintained and she continued with her Hyperbaric Oxygen treatments. The vets noticed that the wound was healing very quickly and forming an excellent bed of granulation tissue. Shadow was sent home at night and brought in each day for her dressings to be changed. She became quite used to her car journeys and happily hopped in and out of the oxygen chamber.

There was still a major skin deficit and towards the end of March Dr Powell performed a skin graft to further speed up the healing process, all the while continuing with the oxygen therapy. Despite the fact the graft went on over a moving joint (the stifle) the take was brilliant – the new skin just stuck on and Shadow was getting a new lease on life. Our vets believe the extra oxygen was critical in supporting the graft through the early days when blood supply is not properly reformed.

Oxygen therapy continued throughout April. Bandaging stopped, mid-April, after a good bed of granulation tissue and skin completely coverd the wound. Of course the now rapidly healing open wound was itchy. Shadow got to like the nice Manuka Honey used to cover the raw tissue and would quickly lick it all off the itchy wound. So it was on with a Buster collar. Even though all this is terribly undignified for a cat, Shadow proved to have an amazing temperament, calm, tolerant and took it all in her stride. She even got quite used to coming to the vets and being fussed over and our Nurses were able to eventually do the re-bandaging without sedation.

At this stage the wound looked great and had reduced to 1/10th its original size and the skin graft had taken well. Shadow was now being cared for at home with her family and visiting for HBOT. She had 40 sessions in the chamber in total!!!

Shadow went back at home – completely recovered. And the lesson from this story of massive skin trauma?? We all know wounds of this type often fail to heal or take months and months – and now we also know that Hyperbaric Oxygen Therapy can make the difference between life and death.