First aid for street dogs: How to treat wounds

Two years ago I took a series of photographs showing a maggot-infested wound being treated. It was for a first-aid tutorial I wrote for the website of the NGO Welfare of Stray Dogs (WSD). Their website is currently being upgraded so I am posting the guidelines here, as they may be useful for those interested in helping street animals.

Maggot-infestation (myiasis) is one of the most common causes of death in street dogs at least in Mumbai. Dogs frequently get wounds due to fights with other dogs, accidents, mistreatment by humans, tick bites or even just from skin problems due to prolonged scratching. Flies are abundant in Indian cities thanks to our poor public hygiene. The screwworm fly is the most dangerous for animals because it lays eggs in fresh wounds. Even a pinhead-sized wound can attract flies. In hot, humid weather the eggs can hatch within a few hours. The larvae, or maggots, feed on the host's flesh causing a lot of pain and damage.

Dogs and cats often prevent egg-laying and cure their own wounds by constant licking. Maggot infestations usually occur in wounds which the dog can't reach by licking (commonly on the head and neck), also in extremely painful wounds which the dog doesn't want to touch, and also in old lethargic dogs.

Such wounds if untreated will lead to the animal's death either through blood loss, high infection or damage to vital organs. Neglected wounds can also get sepsis or gangrene.

You don't need a medical degree to treat such cases; in fact several NGOs train dog lovers (including students) in basic first-aid, thus saving the lives of thousands of dogs and cats who would otherwise die from lack of treatment.

By now I'm sure our more squeamish readers have left us! Those who are still on this page, please click on the link below for the step-by-step illustrated guide.

WARNING:

(1) The visuals are unpleasant (which is why I'm posting them in the form of an album instead of directly on this blog)

(2) DOGS HAVE TO BE PROPERLY MUZZLED AND RESTRAINED before treatment as they will almost always try to bite because of the pain. Muzzling has to be done very rapidly and cannot be safely taught through pictures, so please learn it from a local veterinarian or animal welfare NGO.

The link:

http://picasaweb.google.co.in/indog09/TreatmentOfMaggotInfestedWounds#

The procedure in detail (refer to the pictures):

Treatment is based on removing the maggots, drying and healing the wound, and preventing re-infestation.

1. These are the medicines commonly used to treat maggot-infested wounds: Iodine solution (Betadine, Wokadine or any similar product will do); chloroform, Acrilin or any other veterinary antiseptic ointment, Nebasulf powder, and the Ayurvedic fly repellent cream Himax. Chloroform may not be easily available as it is highly toxic, so ask an animal welfare NGO to help you get some and store it out of the reach of children/animals. Options to chloroform: Neem oil, eucalyptus oil, any veterinary anti-maggot spray or application (ask your vet to recommend one).

2. The dog in the picture had a large wound on the back, very large and with several openings. She had a smaller one near the anus. She was hardly able to move due to pain and weakness from blood loss, but she was muzzled anyway as dogs will almost always react aggressively when they are in pain.

3. The first step is to kill the maggots. The pictures show one way of applying chloroform. This is demonstrated on the dog's second wound, a narrow deep one. First plug the wound with clean cotton wool.

4. Pour a few drops of chloroform on to the cotton. This will kill the maggots but it is a very toxic product and must be used with caution. It will also cause a temporary burning sensation so please make sure the dog is properly restrained. To prevent pain you can first pour in liquid Xylocaine (a local anaesthetic) and then put the chloroform. NEVER use chloroform on a head wound until you have learned how to from a trained vet assistant/welfare worker. For head wounds you can pour in neem oil or eucalyptus oil, this will help as a first-aid measure until you can get the dog professionally checked. One dog lover recommends sprinkling a crushed and powdered Ivermectin tablet into maggot-infested wounds instead of chloroform. (Ivermectin is a veterinary antiparasitic medicine). I haven't tried this myself but she got good results.

5. After some minutes the maggots will die. Now start removing them with clean, sterilized forceps/pincers. Wipe the instrument with spirit before use.

6. The back wound was severely infested. It took almost an hour to remove the maggots. Maggots often tunnel deep into the flesh and many can't be manually reached or removed. You can flush the wound with Hydrogen Peroxide at this point as it will bring dirt and dead maggots to the surface. Some wounds are wide and shallow and relatively easy to treat. Others are narrow at the opening, tunnel-like and full of bloody fluid. In wounds of this type maggots are difficult to detect. Even experienced workers may overlook maggots in such cases. Watch the surface of the wound for some minutes, preferably using a torch: if you observe movement in the fluid that's a sure sign there are maggots inside. You could also use a eucalyptus spray like the veterinary product Topicure. If maggots are present, they will emerge.

7. Flush the wound with Betadine/Wokadine/any other Iodine solution. This will disinfect the wound and flush out dead maggots. If there is pus it will reduce gradually with daily cleaning and dressing.

8. After the Iodine solution has flushed out, sprinkle Nebasulf powder or any similar product, to dry the wound.

9. Now apply an antiseptic ointment. Mumbai vets and NGOs often use Acrilin, a veterinary product which works very well in healing deep wounds.

10. As the topmost layer apply Himax, a near-miraculous product which performs the critically important function of repelling flies and preventing re-infestation. Apply liberally at least once if not twice a day. Repeat the whole process (from application of Iodine to Himax) once a day until the wound is healed. Always check the wound thoroughly to ensure that flies have not laid eggs in it again. If you see eggs, remove them with forceps. The dog may resist as eggs stick tightly to the surface and removal may be a bit painful.

11. Most wounds can be treated on the street but if they are very severe or the patient is very weak, hospitalization is best. The dog in the pictures was barely able to move when admitted. Notice the inflammation around the back wound. Animals with large wounds should be kept in clean surroundings, as dirt entering the wound can cause infection or sepsis. Smaller or less serious wounds can be treated on site, but they must be checked and dressed daily.

12. It may help to give the dog a short course of antibiotics, as maggots usually cause a high level of infection in the body. Ask a vet to prescribe a suitable one. Some vets give a single injected dose of a long-acting antibiotic like Penidur (penicillin).

Note: The model for these photographs was an elderly street dog named "Aunty." The person treating her was Pooja Mishra, WSD's field manager. The location was the WSD kennel in Mahalaxmi, Mumbai.