Wound Assessment Basics: to manage at home or get the vet STAT?
Homestead Vet Cache Series, Issue 2
Despite their emergent, initially scary, oh-my-goodness-lots-of-blood presentation, wounds really are one of the most rewarding problems to treat. If there was a need for an animal “wound clinic” - I would start one, that’s how much I love treating wounds.
They usually happen to otherwise healthy animals and aren’t the result of a disease - which means that you’re able to employ the miraculous power of a fully functioning immune system, the animal’s cellular healing apparatus operating at maximum capacity, to facilitate healing of that defect. And with every bandage change, you are privileged to witness divine design programmed into each stage of wound healing.
The likelihood of one of your animals winding up with a wound at some point in time is fairly high, a virtual guarantee if you’re at this homesteading gig long enough. However, the probability of them scheduling their injury during your veterinarian’s normal business hours is slim. I mean, what’s the fun in cutting your paw on the neighbor’s lawn edging at 9am Tuesday morning, if you can get it done chasing a raccoon across their front yard at 10pm Saturday night? Pretty sure that came straight from the “How to be a Livestock Guardian Dog 101” textbook.
And farm dogs aren’t alone in the untimely injury club. Unwelcome canids love to tear hide off sheep’s hindquarters under the cover of darkness, cattle love a good weekend tangle with barbed wire, and rabbits are notorious for their morning chore-time reveals of fight wounds they inflicted on one another during tight.
Minor, superficial wounds can be managed at home, while the more serious sort need immediate veterinary care and monitoring. And still others will fall somewhere in the murky middle, where you can get by with first aid techniques until your veterinarian is available to provide assistance. But how do you know the difference?
A quick detour
Real life, real cases, real situations are the best way to learn. But since I don’t have the pleasure of having you here for some hands-on experience, the second best option (for the time being) is interacting with you via our very own Substack Chat.
I can share things there that I’d just never, nope-not-ever post on social media. In the chat, you’re going to find pictures, details, & personal interactions that are complimentary to articles, but just don’t fit in this format. And even better, I can hear directly from you in there, and you can talk with one another! We can, you know, chat about things.
(Don’t worry, I won’t spam you with a gazillion posts, and you can turn off notifications if they’re annoying ;)
This week, the plan is to share some real wound cases and I how I treated them - gnarly photos and all. My hope is to give you a good smattering of examples so you have some familiar frames of reference the next time you encounter something similar.
See you there.
[** Speaking of gnarly photos, there are a few beyond this point. Consider yourself warned ;) **]
Wound Assessment Basics
So how do you decide between wounds you can manage at home, versus what you can bandaid until you see a vet, versus what needs veterinary attention NOW?
The annoying, but true answer is, “It depends.” It depends on the wound, on the animal, on your Homestead Vet Cache supply, and on your own comfort level with handling it.
Nevertheless, here are some guidelines for when to just wrap a towel around the wound and book it to the nearest veterinarian ASAP:
Unstable vitals
Do you know your animals’ normal temperature, heart rate, and respiratory rates? If not, here’s a free printable for you to hang on the barn door or stick to the lid of your critter first aid kit.
Even if external wounds don’t seem severe, if your animal’s vital signs are haywire, they won’t get up or walk, if you see/hear breathing difficulty, if they’re obtunded (mentally dull/poorly responsive), or if the animal otherwise looks ill, there could be more severe problems present than what meets the eye.
In situations like these, non-hemorrhaging wounds become secondary considerations. Stabilizing the animal systemically is paramount. Seek veterinary help.
Uncontrollable hemorrhage
Pumping, pulsating streams of blood = arterial hemorrhage, which can lead to excessive blood loss. High pressure, artery plumbing is far more challenging to stop up than that of floppy, low pressure veins. Most hemorrhage from arteries will require ligation, a literal tying off of the vessel with suture.
Thankfully, arteries live deeper in the tissues, while veins are more superficial & closer to the skin. So superficial lacerations, the most common type you’ll encounter, will have a greater likelihood of bleeding from veins than from arteries.
Regardless of the type of wound bleeding, grab a stack of clean gauze if you have it (a clean rag or towel if you don’t), and apply steady pressure without removing that first layer you just applied. If blood soaks through, just add more absorbent material on top.
A fragile accumulation of platelets and clotting factors will start to adhere to the surface of the wound, but will also stick to the bandage. If you remove the bandage too soon, the clot will rip away too, and you’ll be starting over from scratch. 15-20 minutes, without blood soaking through my top layer (closest to my hand), is my general wait time before I’ll ever so gently lift that base layer (against the wound), and peek to see if the bleeding has ceased.
If consistent pressure applied directly to the wound is not noticeably slowing the bleeding in the first 5 minutes, it’s time to jump in the truck and head to the closest veterinary emergency service.
Vital structure involvement
If you have any inkling that the wound may extend into a body cavity, such as the chest or abdomen, or that it’s in close proximity to a vital structure (like the jugular vein in the neck, femoral artery, facial structures, etc.), don’t mess with it. Protect the area as best you can, and get a vet’s eyeballs on it.
Severe pain and/or she’s gonna’ eat you
Pain is challenging to detect in animals, especially our herbivorous beasts and poultry. But if the wound is painful enough that the animal won’t allow you to address it without a fight, then it’s painful enough to seek help. Remember, pain = stress, and stress is not conducive to efficient healing.
With omnivores & carnivores (pigs, dogs, cats), pain is often mistaken for aggression, where the animal will deploy its sharp accessories in your general direction in response to pain. Don’t take it personally. Recruit your vet’s help, get her some pain relief, and don’t get eaten in the meantime.
Deep punctures
Puncture wounds, like those from bites, wire fencing, gunshots, and penetrating objects/stab wounds, are at particular risk of dangerous infections. They can inoculate bacteria deep into tissues, where the pathogens then throw a party. Deep punctures are particularly challenging to clean, and often need special bandaging or drains to facilitate decontamination.
Here’s an example that might be familiar to you. Ever heard your barn cat get into a midnight squabble, find a little blood on his face the next morning, then have him seemingly return to normal? That is, until the side of his face blows up like a water balloon 3 days later? You know what’s in that stinky little swelling…pus. His skin sealed up the bite wound from the fight 3 nights ago, and an abscess started brewing beneath.
While healing from the inside out is important for all wounds, it’s particularly vital for puncture wounds. The body has to be able to kick all the infection and contaminants out of the wound prior to the wound sealing on the outside (skin), or an abscess will result. Furthermore, anaerobic microorganisms can set up shop in deep punctures and wreak all kinds of systemic havoc.
Cats and ruminants especially love to cook up abscesses, but all critters are risk with puncture wounds present.
Multiple wounds
Dog fights, predator attacks, hit-by-car trauma’s and the like, often result in multiple and widespread wounds, putting the animal at risk of shock, multiple organ dysfunction, and sepsis (bacteria in the blood). In these cases, get thee to the vet or get the vet to thee.
Severe contamination
Old wounds (like when your cat drags himself home after a mystery trauma 3 days prior) and really dirty, contaminated wounds need intensive decontamination to get the healing process off on the right foot. Sharp debridement (literally a cutting away of dead, contaminated tissue) or special decontaminating bandages, may be used by your veterinarian to address these types of wounds.
You cry, or gag, just looking at it
For real. There are a couple animals of my own for whom I’ve made a terrible vet, for no other reason than the fact that I’ve been too emotionally wrapped up in their well being. I’m not objective. If you lose objectivity, wise decision making is tossed to the wind. So, if the situation induces too much emotion, or if your primary focus has to be on keeping lunch down in its proper compartment, do yourself a favor and let your vet help you out.
This list is most certainly not exhaustive. But you’re common sense folk, I think you can extrapolate from here. If ever in doubt, call your veterinarian.
Next week we’ll tackle the most common sort of wound you’ll see around the homestead - superficial skin wounds. And that’s where we’ll jump into the nuts, bolts, gauze & tape of bandaging. We’ll go step by step through the 6 C’s of Wound Management, with links to handy supplies to keep your Homestead Vet Cache well prepared.
I look forward to seeing you then, and in the chat next week. Cheers friend!