HomeNewsCase Contest Honorable Mention: Lake Forest Animal Hospital

Case Contest Honorable Mention: Lake Forest Animal Hospital

Patient Information

Patient Name: Maggie
Patient Age & Gender:  11 years, Female/Spayed
Species and Breed:  Feline, Domestic Short Hair
Patient’s Symptoms:  Wound.  Deep laceration down to muscle layer, Right Ventral Thorax
Initial Diagnosis:  Wound, left side, unknown cause

Treatment Information

Laser Make & Model:  CTS-12
Frequency of Treatment:  Initially twice weekly, three days between treatments
Protocol Used:  Operation Mode
Mode:  CW
Power:  9W
Treatment Time:  30 seconds on wound, 1 minute each side of spine due to Maggie being hyperesthetic
Total Energy Delivered:  810 Joules
Areas Treated:  Left ventral thorax and spine
Approximate Size of Area Treated:  7 x 6 cm
Other Treatment Details:  Large non contact head held approximately 2″ from wound

Click here to download PDF of medical charts and supporting test results

Results

Maggie Cook undoubtedly was the most challenging wound case I have ever had.  For the first 6 years of her life, she was an outwardly healthy Humane Society adoptee.  Then, In April 2008, she presented to us for a wound on her left side of an unknown cause…dog bite, wild life fight?  She was treated relatively routinely and conservatively, wound debridement, sutures, drains, pain meds, and antibiotics.  At her suture removal, however, we had our first glimpse that Maggie was not at all a routine cat.  Her skin had not healed and she had more necrotic tissue.  Perhaps she was having a tissue reaction?  So this time nylon suture was used and her antibiotics were changed.  Two weeks later, the same problem – a non-healing wound.  Almost 2 weeks later still, nodules were forming near the incisions.  Surgery was scheduled again.  This time aerobic and anaerobic cultures were taken as well as a biopsy of the wound.  It was noticed that Maggie was unusually slow to recover from anesthesia.  I should also mention that Maggie’s brother, George, was seen during this time on emergency.  His entire subcutaneous space was an abscess which ruptured shortly after the owner brought him in.  Needless to say, George did not survive this horrific event.  I have never seen anything like it before or since.

We adjusted Maggie’s meds based on her C&S.  Her wound biopsy indicated that she did not have any primary skin issues which would delay her healing.  A month later another egg sized mass showed up, this one in her axilla – more cultures, more debridement.  One week later, no more debridement and drains.  This time we submitted a feline immunodeficiency panel.  She had been tested for FeLv/FIV previously, but this included FIP.  She remained negative for FeLv/FIV but tested positive for FIP at 1:400.  She was started on Alpha Interferon and antibiotics.

So ultimately we had an FIP positive cat who was amazingly happy and resilient but who also had a nasty wound that would drain on her owner’s new leather sofa.  This client, gratefully, tolerated Maggie’s wound.  When I heard Laser Les give his sales pitch, honestly Maggie was the first case I thought of.  Her owner was very happy to accommodate my curiosity; and so the goggles were donned and her chronic, oozing open wound decreased dramatically in the first 2 weeks and we saw a pink, wet wound as expected while laser stimulation increased blood flow.  Over the course of 5 months, we did film tracings of the wound which clearly demonstrate the benefits of the laser.  At one point, we debrided and sutured the wound, while part of the wound dehisced, some actually healed which helped decrease the size faster.  Additionally, the wound seemed to contract faster.

Today, Maggie clinically is a “normal” geriatric cat who has a side which no longer oozes and has even regrown hair.  Amazingly, she has only a small scar which hints to her complicated past!

From what I understand, the laser was likely multi modal in its benefits.  It decreased pain and infection, stimulated blood flow and collagen.  I believe these contributed to strengthening her tissues which finally allowed her to heal.  She gained back the 2+ pounds she lost, indicating what a strain the wound was on her body (as you can appreciate from her pictures).

We saw Maggie just a few weeks ago.  She was doing great; she was simply in for her yearly checkup!  Her owner opted to run vaccine titers vs. automatic vaccination in order to minimize the stress on Maggie’s immune system.  The site of her wound looks very “quiet”.  Now we just need to conquer her carsickness!

 

Maggie