"Happy Tail" Injury (Traumatic Tail Injury)
by Zoe Shepard, RN, BSN, COCN
Ellis the IW is so very happy, make that elated, to see his people after a weekend away. He is standing in the frame of his doghouse, his kennel, his run and excitedly beating his whip-like tail against the uprights, causing tissue loss and bleeding at the contact site(s). These injuries can be very serious and challenging, leading to tissue or bone infection, delayed healing, even amputation.
Primary response, of course, is to interrupt the trauma, stop any bleeding, gently cleanse the wound and cover it to prevent infection and further damage. A trip to the veterinarian may be urgent or not, but vigilance is needed to ensure proper healing and avoid complications.
Many vets will prefer systemic antibiotics and conservative wound healing protocols depending on the degree and location of damage. My discussion will focus on wound healing measures used today for humans that are equally suitable for use in dogs. These products may hasten healing time, protect from further trauma and lessen the need for continued antibiotics.
- It has been clinically proven for years now that keeping a wound clean and moist (not dry) will accelerate healing. Debris, dead tissue, hair must be removed for optimal healing. This may need to be accomplished surgically or by gentle repeated cleansing with saline or a medical wound cleanser (Restore, Hollister Woundcare/SAFClens®, Convatec). Wound cleansers have ingredients to remove bacteria and debris under a clinically acceptable pressure: a power wash for the wound, so to speak.
- It is preferable that the wound does not dry out. If the wound is moist, a wet saline dressing and an ointment may suffice. Never remove a dressing that is adhered to the wound bed without wetting it first to release it from the site. It will remove newly healed cells as well as old debris. A dry wound bed will need moisture added in by way of a “hydrophilic” gel (Solosite®, Smith-Nephew, multiple manufacturers) applied in a thin layer and covered with petroleum gauze or a medical grade foam (Copa™, Covidien or Kendall™ AMD Antimicrobial Foam Dressing) and a generous application of Vetwrap™.
- Covering the wound with a moisture retentive dressing that is almost air tight will hold in the body’s own magic potion for cleansing and protection. A hydrocolloid dressing (DuoDERM®, Convatec) can act as an artificial skin, protecting the wound bed while holding in healing fluids. Since this dressing choice is almost airtight, not letting much air reach the wound, the vet may opt to continue antibiotics to guard against bacteria that thrive in oxygen starved environments. The hydrocolloid sheet can be cut to fit the wounded area and is self-adhering. It is imperative to leave a 1 to 1.5 inch margin around the wound for attaching to healthy skin. The hair may need to be shaved or clipped to promote adherence. If the wound is 0.5 by 1 inch, one would need a dressing cut 1.5 to 2 inches by 2.5 inches or so for optimal wear time which is 3 to 5 days. Change the dressing if leakage of fluid occurs. These dressings produce a “goo” or gel which looks like pus as they combine with the wound’s fluids. This “goo” is normal, healing, and to be expected. It washes away easily with saline or wound cleanser at the dressing change. A generous application of Vetwrap/elastic tape will be needed to cover this dressing as well.
- Some tail injuries will be slow to heal, especially those farthest from the body. Other new options for care in difficult to heal wounds involve antimicrobial dressings which decrease the bacterial “load” in a slow to heal injury. These are basically contact sheets, a film or thin gauze of silver (Restore Ag contact layer, Hollister Woundcare) or other antimicrobial (Hydrofera Blue®, Hollister Woundcare), which are laid in the wound and left 3-5 days to deliver their medication slowly. Follow package directions for application options. Since these layers can be left for several days they are an excellent though somewhat expensive option when one gets a dressing “to stay in place” on an ever moving appendage. The usual Vetwrap/elastic tape over gauze/foam would be an appropriate secondary dressing cover.
The most wonderful “state of the art” dressing is of no consequence if it is sailing across the room like a projectile or lying in a slobbery heap having been dutifully removed by a most helpful hound. The following are some suggestions for securing any type of dressing combination to a long thin branch of a tail.
- Elastic stretch tape (Tensoplast®, BSN Medical) used directly over the dressing and onto the skin. This will stick to some length of hair but trimming the area will increase the tack. As always, be generous. Wrap on either side of the injury and up the tail as necessary. Be careful not to wrap this elastic/adhesive bandage so tightly that it could impede circulation.
- Vetwrap can be used over any dressing as well. Does not stick to the skin but will stick to itself and adds a bit of compression to the area. Has a 30-50% stretch. Be careful not to stretch too much and wrap too tight.
- Unna boot (DermaScience, multiple manufacturers) is a semi-hard cast like wrap that firms up as it dries forming, a fairly strong barrier again tooth or claw. In humans it is used to heal leg ulcers and exerts a bit of compression like a support stocking. Its use here is primarily as a barrier layer that aids in protecting the dressing of choice as well as helping keep it in place. It is available in 3 or 4 inch widths and is cut into strips and laid over or wrapped around the dressing to be secured. It can be used directly over an open wound or over a contact layer. The dressing contains zinc oxide and calamine and can be quite soothing. It is very important to maintain a smooth application, avoiding any wrinkling of the material, as it is laid or wrapped since it contracts as it dries. Vetwrap (Coban™, 3M) is applied over the area for a slow set up and to ensure it stays in place. Wrap generously above and below the area, but take care not to stretch the wrap too tightly.
- Some determined canines may need the “beloved” E-collar to deter their single-minded intentions. There are also new wide soft collars on the market to prevent turning of the head/neck to reach the tail area. I’ve had success with a wide soft cervical collar (human) on a Bassett Hound, short legged but long in body, tail and perseverance.
These product suggestions are available from medical supply houses or online. Some vets will be more comfortable than others with their use. Antibiotic coverage remains a decision for the attending vet, based on the health of the animal and the appearance of the wound. It is preferable these days to reduce antibiotic use if able.
This page was last updated 03/27/2014.