Jasper and the Pot of Water
We all fear accidents – all we can’t do is take reasonable precations. But our pets sometimes outwit us and late last night Jasper flew into a pot of boiling water. When I saw him the next day I explained to the owner that even though the legs looked pretty good, the true extent of the damage might not show up for several days.
The owner was not surprised since, as a cook, he was familiar with burn first aid care. Jasper was bathed in warm (not cold) water initially and repeatedly. Warm water helps stimulate blood flow which leads to long term improvements in healing.
Within 24 hours you can see the swelling starting already:
Initial swelling on the left leg
Irritation and swelling
Regardless of the presentation, we treated for the possibility of very bad burns by starting Jasper on pain medication, antibiotics and topical treatments. Sometimes wrapping a burn can be helpful but it depends on the location and the patient. Jasper did well on his treatments and recovered fully. He was lucky – many of our patients lose toes or worse. It can be very hard to keep their pain under control and to medicate them frequently until the burns are healed.
Take a look at some of the changes to Jasper’s legs over the following weeks:
3 days later the skin is sloughing.
Improvements 11 days after the burn
But now a thick scab is present
The scab is trimmed to prevent a constriction
All healed after 1 full month of care
What is Evidence Based Medicine (EBM)?
It is an applied aspect of clinical epidemiology…??? What that means is that the practice of medicine should be based on valid, clinically relevant research data whenever possible.
The way I like to think of EBM, and why I think it is relevant to my veterinary practice, is that it is a tool to improve my medicine. There is a variety of information “out there” and we need to rank its usefulness. Basically, as Dr. McKenzie described it, EMB creates a pyramid of data with super-duper extensive reviews of all the data on the planet at the top…and what is affectionately known as “In My Experience” at the bottom.
Great! That Makes Everything Easier Right?
Human medicine has oodles of data and studies and reviews of studies and compilations of reviews of studies available to sort through. Veterinary medicine has not so much.
Exotic veterinary medicine has way less.
Well, How Does EBM Help Then?
Data has to come from somewhere. It may well start with an “In My Experience” which turns into a case report or a case series. Then someone tries to get more information through a study (double blinded is the best!).
Eventually we’ll have enough studies to be able to summarize the data in a great big review.
But until then, EMB reminds us to critically evaluate where our information comes from, not to discard the lower levels but understand they are incomplete.
For more information, check out the Evidence Based Veterinary Medical Association.
Pickle is one lucky little rat. She came in a few days after getting her foot stuck in a vent. Based on the injuries, it looked like a steam burn. A very bad steam burn. The photos are not nice so they won’t be posted.
All of Pickle’s toes ended up falling off, but the foot (and the attached ratty) healed. This was due to a number of factors, but the owner’s dedication was definitely an important one.
What Happened Here?
At Bay Area Bird Hospital we see animals that get better without tons of invasive treatments as well as ones that don’t make it despite everything we tried. We work hard to treat correctly – just enough and not too much but it’s rough not knowing that if we just do treatments x, y and z then each pet will thrive.
Different factors play a role in how and why healing occurs.
- Age – Youngsters, just like human kids, are healing machines while seniors tend to have delayed responses.
- Nutrition – better diets mean the body has better building blocks to repair itself, better resistance to damage or disease and a better immune system.
- Care – How well an owner can respond to their pet’s needs by modifying the environment, paying close attention to changes and treating as recommended can make a significant effect on the overall response.
In the end, prevention is the best medicine.