Ailments of the musculoskeletal systems

Symptoms of bone infection
The most obvious sign in dogs/cats is lameness.
Of course, if the bone was broken and the jagged end was peeping out through the skin, then that pretty clearly is a good sign as to the origin of the infection. Once the infection (bacteria) anchors itself, one can expect a fever (usually with temperatures exceeding 40°C/103°F). The tissue surrounding the area where the infection had its origin would be swollen and very painful. Usually, especially if there was a bite wound or some other perforation wound, there would be a discharge (pus) from the open wound. We could follow the connection between the open entrance to the wound and the infected bone by using a sterile probe. However, much cleansing/sanitizing activity must be implemented, before inserting the probe, otherwise, all you would be doing is carrying more germs deep into the lesion on to the bone. In this regard, I would want to suggest using the X-ray to establish whether there is connection (canal) between the broken skin and the bone. As you can recognize this really is the job of a skilled veterinarian. I mention the procedure just in case there is no possibility at all to acquire the services of a vet.

Further symptoms are depression and loss of appetite. Some blood work (white blood cell count; staining smear and looking for specific presence and numbers of certain white blood cells), might have to be done – again, under veterinary advice.

If infection spreads to a nearby joint, the latter may itself become swollen and tender. In long-standing (chronic) osteitis cases, you might notice the swelling increasing and decreasing in size over the weeks, especially if there is a fistula drainage canal connecting the deep wound area and the external environment.

Osteitis/osteomyelitis has to be one of the most difficult ailments to counteract. In my 43-year career, I have often had to fall back on the amputation of the leg, because the therapy instituted against the bone infection was getting nowhere. In the end, if the dog’s life is threatened with septicaemia, the vet has to take radical steps, after a long discussion with the patient’s owner.

I should say in passing that the failure of the therapeutic regime is often due to the unwillingness/inability of the owner to follow the strict guidelines dictated by the vet. For example, if the vet advises two antibiotic capsules every eight hours for 10 consecutive days, then such advice has to be adhered to in every minute detail. When treating a bone infection (any infection, for that matter) with antibiotics, one cannot just skip a day with double the treatment. It doesn’t work that way.

Anyway, let’s work through the treatment course. Firstly, it is important, imperative even, that we ascertain not only what the infectious agent is, but also which drug will work best against it. Having identified the organism if bacteria are involved, and a “sensitivity test” (a special laboratory procedure to ascertain which antibiotic the germ is most likely to succumb to) is carried out, the owner (via antibiotics suspensions/capsules/tablets) or the vet (via injections) must start the treatment. Now, unlike so many other infectious ailments which can be served with antibiotics within a week, the treatment of bone infections has to go on for many weeks, even up to two months.

Sometimes, this long-term therapy necessitates surgical intervention. We begin with the appropriate antibiotic (decided upon after the sensitivity test) for a few days, then (according to the vet’s judgement) the surgery is embarked upon. During the surgery, all the “junk” (that has been produced by the infection) will be cleared away from the infection site and the surrounding area. This includes pus and dead tissue. Actually, I scrape the bone and the surrounding flesh until blood comes. In this way, I know that I am dealing with fresh, living tissue. The surgical wound can be left open to drain, or we can place drainage tubes in the area.

A special type of fenestrated tubing can be implanted that allows the vet to flush the site with sterile saline and antibiotics. I don’t like the idea of closing up the wound too tightly, because it is difficult for the vet to be so meticulous as to eliminate all dead space as he/she closes the wound. For me, it is preferred to leave the wound open so that (i) I can visibly follow closely the healing of the wound, (ii) I can easily flush the entire site, and (iii) special bacteria, which flourish when there is no air, cannot easily lodge themselves at the site and in the surrounding tissue.

At intervals (2-3 weeks) during the instituted treatment regime, one can do some more sensitivity tests to see if the antibiotics are still doing their required job. We can also follow the healing progress by using X-ray pictures and by generally evaluating the patient’s behaviour (alertness, appetite, mobility, etc). I usually advise the taking of the pet’s temperature mornings and evenings, to ensure no fever (indication of an infection surge) is present.

Finally, I should mention that if the bone infection is in a toe, the best course of action is to amputate the toe. In all other cases, brace yourself for the long haul of daily treatment for many weeks.

Please implement disease preventative measures (vaccinations, routine dewormings, monthly anti-heartworm medication, etc) and adopt-a-pet from the GSPCA’s Animal Clinic and Shelter at Robb Street and Orange Walk, if you have the wherewithal to care well for the animals.  Do not stray your unwanted pets, take them to the GSPCA’s Clinic and Shelter instead. If you do not wish your pet to have puppies or kittens, you may exploit the GSPCA’s free spay and neutering programme. If you see anyone being cruel to an animal, or if you need any technical information, please get in touch with the Clinic and Shelter by calling 226-4237.