Treatment and Prognosis of Pressure Sores in Dogs
It is imperative that dogs with pressure sores be provided with well-padded, thick, soft sleeping surfaces at all times, to prevent further trauma. This may be all that is needed to decrease the size of the pressure sores and prevent their progression. There are many commercially available dog beds, mattresses and fabric-covered foam pads that will take the pressure off of bony prominences when a dog is resting or sleeping. If a pressure sore is not infected, adding soft bedding to the dog’s living environment - and observing the dog when it is lying down or resting - are probably all that is necessary to manage the condition. The site of the pressure sore should be wrapped with a padded bandage to prevent further trauma to the area as it heals. Moisturizers, aloe lotions or antibiotic ointments or gels can be applied to the affected area to soften the rough skin and provide some relief from discomfort. The area should be bandaged after these substances are applied, to reduce the risk of secondary bacterial infections developing in the moist environment.
If pressure sores become infected, the veterinarian will need to inspect the site more carefully. He probably will take a sample of the oozing exudates on a cotton swab and submit it to a diagnostic laboratory for culture and sensitivity, to identify the precise microorganisms that are responsible for the infection. Long-term antibiotic treatment, both orally and topically, is usually recommended to treat infected pressure sores. A typical course of oral antibiotic treatment is 4 to 6 weeks, at a minimum.
Dogs with hygromas – fluid-filled sacs over areas of pressure, also called bursas – may be treated by draining and flushing the lesion. If caught early, this can be accomplished by needle aspiration, which basically involves inserting a needle into the hygroma and extracting its fluid contents into an attached syringe by pulling on the plunger. The fluid inside hygromas usually is clear or yellowish-to-red. The aspiration site should be well-padded and bandaged after this procedure. However, unless the underlying cause of the hygroma is resolved, most of them will return after being drained by a veterinarian.
Surgical excision (removal) of calluses or hygromas is usually not recommended. Laser therapy may be helpful for small pressure sores, although this treatment is not yet widely available. Pressure sores with extensive ulceration may require surgical skin grafts. Some authorities report that slathering the sores with raw honey or wound-healing creams may accelerate healing.
All pressure sores should be cleaned daily with an antiseptic solution, which the attending veterinarian can recommend. This often is a chlorhexidine solution.
Unfortunately, because of their location on areas where bone and skin are in close proximity and where constant friction is present, pressure sores can be difficult to treat. Most calluses can be controlled by consistently providing appropriate lofty bedding, although it can take a long time for calluses to go away once they have developed, despite well-padded bedding. Fluid-filled hygromas often require more invasive techniques, such as surgical drains, to resolve them.