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Mumbai, India
I am an animal lover. I own two lovely dogs and two gorgeous cats. I work with the wildlife conservation NGO Satpuda Foundation in the tiger reserves of central India. Before that I worked for 14 years with the street dogs of Mumbai. I created and manage the INDog Project www.indog.co.in and the INDog Club.

This blog is for aboriginal breed enthusiasts and for the INDog/Indian Pariah Dog Club. It is part of the INDog Project www.indog.co.in. Membership of the Club is restricted to Pariah Dogs and mongrels (mix-breeds) only. The two are NOT the same, do please read the text on the right to understand the difference. Our aim: to create awareness about the primitive natural breed cynologists call the Indian Pariah Dog/INDog. The Club is an informal group with over 200 members.

Friday, March 6, 2009

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.

16 comments:

Anonymous said...

Hey rajashree, thank you, very informative. I visit your blog quite often and love it when there is a new post.
Not sure if its material that suits your blog profile- but I would love some information on society/ building/ municipal rules for owning dogs in India/ Mumbai.

June said...

oops- that was me, June

Rajashree Khalap said...

Hi June, yes it's a relevant topic and I'll ask one of our member dog-owners who is a lawyer. You could also ask In Defence of Animals (IDA), one of their officers Fizzah Shah knows a lot about this kind of topic. Their website is http://www.idaindia.org/index.htm
Best,
Rajashree

charu shah said...

its better to use ivermectin in powder form on maggot wounds. i have tried chloroform, and it burn a lot. the dog cries n howls in pain!
on the other hand, crushed ivermectin tablet powder, when filled on the maggot wound, will kill all maggots, but not harm the dog or pup at all! i have used this powder on a month old pups, and they had no problems at all! the maggots died the next day, and pups were hale n hearty!
i wud suggest ivermectin to chloroform anytime!

Rajashree Khalap said...

Thanks Charu. You'd made this suggestion earlier and I've included it in the post. Agreed the dog shouldn't have to go through extra pain. Btw, we sometimes used to put zylocaine (local anaesthetic) before the chloroform so the dog didn't feel any pain.

elli said...

hi m from pune...i jus came across your blog when i was looking for some way to help this stray tat i feed...he is around 4-5 months old..n he has severe scratching problem....almost 90% of his fur is gone n his body is pink from all the scratching...i was wondering is there any medicine i can mix in his food that can heal him ....plz mail me wit any answers at...scooch@rediffmail.com....i'll be very grateful...thank u :)

doggylove said...

i agree with charu, instead of the tablet, we use 'hitek' oral solution, its oral liquid form of ivermectin. we fill it in syringe and flush it in maggot wounds, quantity depends on the depth of the wound.2 ml is enough for fairly medium wound anywhere on body of the dog, apply any ointment over it.again repeat the procedure alternate days, its been discussed with vet that ivermectin not only kills maggots it also helps in wound healing later on, so application of cream etc doesnt matter, especially in dogs who dont allow to touch them.we had treated a huge wound on side of a female dog, her flesh eaten away and internal organs in a state where they could pop out any time, stinking , large wound.daily putting oral ivermectin, while somebody offered her food(extremely timid dog,, doesnt like anyone even stare at her), gave her neomac tab(the one charu said) orally internally, and 5 day course of 1\2 meriquin daily once, healed her completely, a small fibrotic scar reminds of her past wound.ivermectin is a boon to stray dog! some say it harms liver in long run, so use cautiously in older dogs.

Rajashree Khalap said...

I agree ivemectin is a wonder drug, but I am cautious about injecting or feeding it because it is toxic to the kidneys. I use it only for a dog that can't be caught for regular dressing, like my building dog Kajol. I gave her oral ivemec mixed in her food and that kept her maggot-free for one and a half months, until she could be caught and taken to an NGO. But there are large and complex wounds with many tiny "tunnels" that can't be accessed with liquid medication and definitely not with powders. That's where chloroform is the best medication, because you can put just a few drops and it evaporates and the fumes draw out and/or kill the maggots in those deep holes. When dogs have developed such deep wounds they are usually put in animal hospitals, so it is unlikely that the lay person would have experience of treating such a wound. The danger of not reaching the maggots in the "tunnels" is that they could eat their way in further and reach vital organs and kill the dog. Animal lovers sometimes report that even after treatment, new maggots appear in the wound on the second or third day - these are the ones that hatch deep inside almost invisible pinholes in the flesh. Very dangerous if you don't reach and kill them ASAP.

Re antibiotics, I hope anyone using them is also giving a vit B supplement. I know you are a doctor and always use medicines responsibly, but I am rather disturbed by all the animal lovers going around freely dosing street animals with prescription drugs like antibiotics and even steroids! Recently I heard of a woman who was planning to give Wysolone to a tiny kitten. This kind of thing is a malpractice in my opinion. Just because these are street animals and we are not accountable to anyone for what happens to them, doesn't mean they should be quacked - but I think that happens sometimes.

Madhura said...

Ivermectin injection [Hitek] mixed with sterile water in 1:2 ratio can be poured directly on the wounds. It will kill maggot fairly fast, though not instanteneously like chloroform. Also using NS saline and/or metrogyl IV to clean the wound [i use a 50ml syringe and inject streams of the fluids in the wound and then dry the area with sterilised gauze before putting on betadine] also helps in keeping it clean and returning blood flow. Streams of water also flushes out the maggots from deep wounds without need of forceps. Feeding ivermectin [neomec/ivermectol] tablets is also recommended, especially if the dog is running away and can't be caught.

Madhura said...

'Animal lovers sometimes report that even after treatment, new maggots appear in the wound on the second or third day - these are the ones that hatch deep inside almost invisible pinholes in the flesh."

That's why oral ivermectin [1mg/kg of body weight] is recommended. Ivermectin does not affect kidneys but liver. So a liver tonic can be given as an additional appetite booster. Overdoses of ivermectin must be dosage that exceeds actual osage by 10 times or more and results in ivermectin going to the brain and therefore leads to dilated pupil, uncordinated movements etc. Except in acue cases, ivermectin breaks down within 36 hours and the dog is back to normal.

While I appreciate your concerns about well wishers who are not vets you must appreciate that many areas [like Kolkata] have practically no help for strays: no ambulances, often really bad and harmful shelters where dogs catch other infections and mostly extremely incompetent and unscrupulous vets. One gave a puppy with worm infestation steroids and claimed it had jaundice! Good veterinary facilities can also be extremely expensive: I recently got two cats at my home spayed for 12000 rupees. I don't have a car and taxis refuse to take maggot wounded dogs: it's often impossible for me to take dogs to a good veterinary practice.
The best I can do is call vets I know and ask them to prescribe drugs for a condition i can describe. And often it works wonders.

Kunal Pashine said...

my dog got irritation,wounds,infections,itching after biting by street dogs...what I have to do...help me

Rajashree Khalap said...

Kunal, you should consult a vet about that, not ask people on a blog

gspal said...

On Oct 17, 2013 we found a senior abandoned male German Spitz of less than 10 kg weight with maggot infested wound of about 2" in diameter on its hip. At a vet clinic all its hair were first shaved, given it a bath and then it was dried. For five days the wound was cleaned with pouring (with a needless syringe) liquid hydrogen peroxide that killed maggots and were removed every day, and then liquid Betadine was applied. After that a yellowish cream by the name of Lorexane was applied liberally to the wound. For 5 days daily it was given four injections of Moxipil (antibiotic), Malonex (pain killer), Vetalgin (fever), and Ivermectin (for maggots). After 5 days of the above treatment, the vet has told us to carryout the treatment at home for another three days by giving orally Moxipil 250 gm pill twice a day, and Prednisone 5 mg 1/2 tab twice a day. The dressing is to be carried out preferably twice a day as explained above. My query is that would not the antibiotic Moxipil 250 gm twice a day be too much for a less than 10 kg ill German Spitz? Is there need to give antibiotics for so long, i.e. 8 days? We are now doing the dressing at home.

Monicaa Singh said...

thank you for the information...there is a street dog in my area who is wounded badly on his neck. he used to come regularly to have food in the morning but since his injury he comes once in 2-3 days..i tired to sprinkle some betadine on his wound but he manages to get away. it is not possible to tame or catch him. i want to ask if there is any oral medicine that i could mix in his food.

Rajashree Khalap said...

GS Pal and Monicaa Singh, you must ask a vet about oral medications. You should ask for a second medical opinion about those antibiotics. It's not safe to ask such questions online. Monicaa, there is oral ivermectin but you MUST ask a good vet about dosage as it depends strictly on body weight. My own dog had a strange reaction to ivermectin (he is not a sheepdog breed but pure Pariah dog). I would advise people to look at other options when possible.

Vatsal Doshi said...

M a well trained volunteer with an ngo called bird helpline..my personal experince and research states that crushed neptalin balls can showered on maggots after an hour all maggots will come out of wounds so even maggots wont die and wound is also safe then apply neem oil so that maggots inside the body comes out of wound u can use forcep nd cotton remove maggots and apply kailash jeevan which is easily available in all medical store after a day repeat it and aplly himax arround wound. After wounds get dry make paste of peru and its leaves turmeric and coconut oil and apply on wound for 2-3 days