Have you ever wondered why paralyzed dogs get pressure sores and hygromas? The simple answer is they sit too much. Sitting or lying in one position for too long on a hard surface causes trauma to the skin. It seems like an easy problem to solve, but for many paraplegic pets, pressure sores and hygromas are frustrating and sometime life-threatening conditions.
Before we jump into preventing and treating this problem, let me start with the basics.
What is a pressure sore (decubitus ulcers)?
Pressure sores are caused by chronic injury to the skin. This happens when a dog lies on a hard surface for an extended period of time without changing positions. The pressure from lying in one position decreases blood flow to the area. It slowly causes damage to the tissue. Eventually the skin breaks down to form an open wound. These wounds can form on the surface of the skin or they can grow deep into the bone.
Pressure sores are painful and typically develop over bony areas like the elbows, hips and hocks (lower joint of the leg).
Paralyzed dogs are prone to the problem for several reasons. They have trouble flipping their body from one position to another and their muscle mass and tissue padding atrophy from lack of use. This decrease in muscle mass exposes the bony areas to pressure, making them susceptible to damage.
How pressure sores are treated.
Walkin’ Pets at HandicappedPets.com has an excellent article about how to treat pressure sores and hygromas. It has information every owner of a paralyzed dog should read.
Here are the basic tips:
- Take pressure off the wound. – That might include the use of an orthopedic dog bed or the use a pillow. And inflatable donut works well for hips.
- Make an appointment with your veterinarian. – Your veterinarian will determine the best treatment plan. An open would will probably be treated with a “moist wound care” protocol. It has proven to be the best way to grow new healthy cells. Many veterinarians use Hydroactive® wound dressings and daily cleaning with an antiseptic solution.
- Test for a bacterial infection. – Your veterinarian should determine whether the pressure sore has an underlying infection. These are treated with antibiotics and topical antiseptics.
- Deep wounds may need surgery. – Pressure sores that go deep into the skin or bone might require your veterinarian to debride the wound. Dead or diseased tissue is removed so healthy tissue can grow.
- Be patient. – It takes 2-4 weeks before you will sign of the skin healing. As a pressure sore heals it gets smaller. New healthy tissue grows at the edges and slowly closes the wound.
Do not let your dog stay in one position for more than 2-3 hours.
What is a hygroma?
Hygromas begin in the same way as pressure sores, but instead of the skin breaking down and developing an open wound, the tissues around bony areas become inflamed and fill with fluid.
The swelling of a hygroma is not painful. If it is caught early your veterinarian can treat it by aspirating the area with a needle and pulling out the fluid.
Some hygromas are more serious and can become infected. They need more advanced drainage techniques and sometimes surgery.
When a hygroma grows very large or becomes infected drainage tubes are inserted into the area to decrease the fluid built up.
Other hygromas develop an abscess or sore on top. These require surgery to remove the bad skin and grafts to reconstruct the area with healthy skin. Untreated hygromas can be life-threatening.
Click here to read: Abscess The Dangerous Complication of Pressure Sores
The best ways to prevent pressure sores and hygromas:
- Change your dog’s position often – Be sure your dog doesn’t sit or lay in one position for a prolonged period of time. Help them turn to a new position or flip them over to the other side every 2-3 hours.
- Invest in an Orthopedic dog bed – Many manufacturers sell dog beds made of egg-crate foam that evenly distribute your dog’s weight across a mattress. An orthopedic bed is also a great way to treat a dog who is developing a pressure sore of hygroma.
- Do range of motion exercises – Basic physical therapy exercises will keep your paralyzed dog’s joints and muscles flexible and strong. Talk to your veterinarian about the proper way to perform daily range of motion techniques.
- Massage therapy – Learn how to use massage techniques for your paralyzed dog’s hips and limbs. It is a good way to keep blood flowing to the muscles and surrounding tissue.
Symptoms or pressure sores and hygromas:
- Patches of exposed fur; particularly on the hips, elbows and hocks.
- Discoloration to the skin or if the skin is becoming thicker or developing a callous.
- Your dog is licking a particular area of her skin.
Advanced warning signs that call for immediate veterinary care:
- The color of the exposed skin is red or purple.
- There is an open wound on the skin.
- The wound is seeping yellow or green fluid or pus.
- There is a foul smell coming from the wound.
- The wound is swollen, tender to the touch or warm.
- Your dog is in pain.
Thank you for the education. I never heard of a Hygroma. So many times we encounter an issue then, play catch up, and chase a solution. I can appreciate oening our minds to knowledge, to prepare for prevention.
When my German Shepherd dog, “Merrick” became paralyzed after a back surgery gone bad, he started to get sores where the boney parts are in the insides of his legs. I changed his position every 2-3 hours, and put a rolled fleece cloth in between his legs. Kept 2 orthopedic beds side by side to have the ease of transfer, and a clean bed. Problem solved!
I have a gel mattress topper from my bed that I am going to cut down to use under my current dog beds for comfort.
Another tip that has been extremely helpful is, I put a heavy garden plastic over entire bed, taped close with duct tape. Cover with a crib or twin sheet, depending on size of bed. When changing, I either spray with a diluted bleach, or diluted Distilled White vinegar solution, wipe dry, put clean sheet on. Works wonderfully!.
Victoria, I like your ideas about using the rolled fleece to take pressure off your dog’s legs and adding a gel mattress topper. Both sound like great ways to prevent pressure sores.
I didn’t think about heavy garden plastic. That is a good idea! My pup stays in a playpen during the day when we are not home & I ended up buying the waterproof baby mattress that fits the playpen. Then cover with a fitted crib sheet.
My dog has been paralyzed for 3 months and hasn’t had any pressure sores. Is it possible his thick double coat is good protection for his bony hips? He’s a pomeranian terrier cross.
Your dog’s thick coat might be helping to prevent pressure sores. It could also be his light weight. Larger, heavier dogs are more prone to the problem. And if your dog is able to scoot on his own and stay active, he is probably switching positions enough on his own. Good job to both of you.
Hi, I had a paralyzed pom cross too and he never developed pressure sores either. I also thought it was probably the double coat. Thank goodness, he had enough to deal with.
I need to ask a vet about this, but it makes sense that a thick coat adds a layer of protection against pressure sores.
Perhaps in some cases, but a thick boat will also hide pressure sores until they become so bad they bleed or worse. Check your furry ones very frequently even if nothing is obvious at a glance.
**thick coat
I had a springer who was paralyzed for about a year. She would whine every 3 – 4 hours and need to be rolled over. I kept her on an orthopedic bed with a second layer of cushioning underneath. Fortunately, she never developed pressure sores, although she always had calluses on her elbows, I think she had those long before she became paralyzed.A waterbed also helped keep her cool in the summer. Kaylee was not incontinent but had trouble with bowel movements, so I had her lay on a towel for easy cleanup.
Sandy, It sounds like you took great care of your dog. I like the idea of using a waterbed to keep your dog cool.
I have a 14 year old german shepherd who has been paralyzed in his back legs for about 16 months since diagnosis – diagnosis not clear as he’s heterozygous for the gene for DM but has all the symptoms and negative x-rays but it’s not really progressing much ( he’s incontinent ) and normally uses a wheelchair – walkin wheels that was fabulous – all was great – and then i screwed up in August as he had gotten so thin in his back that i bought a medium back harness for the chair – he immediately got two cuts in his thighs and since then it’s been one thing after another. I can’t get him back in his whellchair since he has oozing and some bleeding from his armpits and the area directly behind his penis and inner thighs ( not the wounds they healed months ago) . I can’t see how it can be pressure sores since both areas get no pressure ( but they are areas that don’t get much air – i do try to keep the area open the air a bit with towels and such – someone thought it had a yeasty smell so we are treating it with minoxidal ( sp? ) for human yeast infectioni
John, I’m sorry to hear about your dog’s problem. It sounds like your dog is having severe chaffing from where the harness touches his body. This is a common problem, especially when a dog looses muscle mass.
One suggestion is to add sheepskin for padding. Pet parents have recommended a company called Just Merino Sheepskin because they can make the pads in any size you need. I have other suggestion to keep the skin clean, but I am going to email it to you directly. I have an e-book that I put together of products for paralyzed pets. I hope it helps.
I think I have a similar issue- I’d love to hear your ideas if you are still monitoring this page.
Beth, If your dog has a similar problem with sores under the armpits like pet owner John described, I stand by the advice I gave before. I would add padding to make the area softer for your dog. Sadly, dogs with DM tend to lose muscle mass and weight as their disease progresses. It causes pressure sores and sores due to chafing. I’ve heard good things about Just Merino Sheepskin. I think you can find it on Amazon. You can order whatever size you need. Sheepskin is soothing to the skin and I like that it’s a natural product. Hope this answers your question.
I have a 70# 12 year old BC mix that has been found positive for the DM gene and paraplegic for about 2 yrs..did I say incontinent also? I work at home so I am able to be with him regularly. He is in good spirits but misses playing with the other 5 puppers.. I feed them in all “our office” together so he gets social interaction, and they all have to go by him to go potty outside ,again social interaction. His beds have been ….vinyl covered crib mattresses!! I change frequently and usually get for free off craigslist! crib sheets rotate almost daily..easy peasy..spray clean. I tried the storebot dog wraps ,but too expensive and too small and tight. Moved on to human disposable diapers and briefs( I modify with scissors and strong tape), again mostly free or cheap on craigslist. Now I have settled on Walmarts adult mens pads that are like large sanitary napkins but connect on hip..Assurance brand “belted shields”–30 for 9.88 +tax! I only use 3-4 a day-one overnite with a Costco puppy pad–100 for 15.00! With the help of this site, I am now a perfect pee expresser!! Sorry such a long post.Janelle
Janelle, It sounds like you have mastered (and should teach) how to live with a paralyzed dog. Your story sounds a lot like mine in that I also work from home and could keep Sophie by my side and that we had 3 other dogs at the time.
I’m glad my site helped you perfect your pee expressing technique. Keep up the good work. I know your dog appreciates it. Best wishes.
My 16 year old husky recently was diagnosed with a nasal tumor that had spread to his brain. He still eats, drinks, and has normal urination and poop but he has slowly progressed to partial paralysis on one side more than the other. This makes him favor laying on one of his sides rather than the other. Yesterday after a full week of him on one side, he developed a bad ulcer out of nowhere that went deep. I’ve followed advice about a donut, wet womb care, and bedding, but I’m having problems getting im to switch sides and stay there. He struggles to roll over back on the side of the sore, so much that I fear he’s making the sore worse. Is there a way I can get him to stay on the other side periodically while the other side heals.
Lauren, I am so very sorry to hear about your dog. I have a suggestion for you that sounds silly, but it works. It came from a pet owner who used it to keep her dog from getting pressure sores. Get a bean bag chair! Your dog will love how comfy it is and you’ll be able to prop him into any position you want. I hope this keeps you dog comfortable in his remaining days. Another idea to help him walk while he is favoring one leg is to get a support harness. You’ll be able to help him walk without falling over. The two companies I like are: Walkabout Harnesses and Gingerlead. Best wishes to you both.
Lauren- I learned a trick from the nurse who took care of my mom while she was alive. She rolled a towel into a bolster to put under an area to prop her into the position we needed her to stay in. It was easily washable and so many sizes of towels available to put in different places. Check with pet rescue mama if this is ok to do with dogs first. Also you can get used towels of all sizes almost free or inexpensively at Salvation army and Goodwill stores, and cut them up. Just check frequently and cut away stray strings that develop if you cut towels and blankets that may wind around a paw and make your dog uncomfortable.
Linda, I love your suggestion about rolling a towel to prop up a dog. Your comment about your mother’s nurse reminded that my mother’s nurse did the same thing when her Parkinson’s Disease made it hard to sit up on her own.
my sweet little girl has just lost the use of her back legs.She is a three year old mini dachshund. It has all been overwhelming for us both,but we are coming together!!!Learning to Express her bladder was so scary for me but I did it,and we have a good routine going.My biggest fear now is sores so was glad to fine this group with so many questions answerd.Thanks for being here!!
Debbie, You passed a big hurdle in taking care of your dog when you learned how to express her bladder. I’m glad our stories are helpful. Feel free to reach out whenever you have a question.
Just picked up our old (17yr) Weimaraner “Eva” from the veterinary hospital where they watched her for us (4 nights) while we were away on vacation. Dropping Eva off she was in good health, could walk, and barley see her ribs and could even still hop up on the couch and her chair. However the morning of the day we were returning home (today) we received a call that Eva may have suffered from an overnight stroke resulting in her being paralyzed and a huge gash on her lip. We got there the same day they told this information and sure enough all that was true but she looked extremely underweight (ribs very visible) and very thirsty, but fully aware of her surroundings and breathing normally. They even mentioned euthanizing her to us. We denied that right away and took her home. Eva ate a full dinner when we got home and drank a lot of water, we followed that up with an aspirin. She also started to move/twitch her legs and feet more and more on her own. My question…Upon placing her down on the couch when we got home I noticed 4-5 bed sores on her deep enough where skin had broken away. What is the range of time you would estimate for these sores to develop and get to the point where they open and/or cause hygroma to form? Not looking for an exact figure but an estimated avg. time range. All of this happened today and we will be calling her vet first thing tomorrow to inform her of all that happened and what Eva’s current status is like. Currently Eva is unable to stand on her own, but clearly has signs of movement across her body and can slightly lift her head for a period of time while laying down. Her tail is even now moving and becoming more active such as her leg movements. We’re optimistic but HIGHLY concerned! Any help/advice from you and or community is much appreciated. Thanks.
Jason, It sounds like your poor dog went through a terrible ordeal. I am not a veterinarian, but 4 days seems quick to develop severe pressure sores. Maybe at 17 her skin was already thin and therefore broke down easily. Was Eva able to turn herself around in the cage the veterinary hospital had her in? The good news is with proper treatment the sores will probably not turn into hygromas. But you don’t want them to get worse so immediate intervention is necessary. And if Eva suffered a FCE stroke, one of the best interventions for it and to heal pressure sores is Hyberbaric Oxygen Therapy (HBOT). Here’s a story about a dog who was healed using this treatment. Please talk with your vet about HBOT for healing both problems or at least starting Eva on treatment to heal the pressure sores and gentle rehab to keep her muscles strong while she improves from the stroke. https://lessonsfromaparalyzeddog.com/hyperbaric-chamber-for-dogs-heals-fce-stroke-survivor/
I am fostering a 4 month old black mouthed curr mix rescue pup with back leg weakness due to a suspected injury from her newborn days. She has padded bedding while resting, but she bounces and drags mostly on the same hip. She gets abrasions that are soaked and treated daily. We do warm hydrotherapy and she is plenty active, even taking some steps…though her hip flexors are still very weak. The quicker she grows the sooner she is back to square one.
She is currently on preventative antibiotics and anti inflammatory meds. She is under the care of the rescue’s veterinarian.
She refuses diapers and wrappings of any kind. She is teething. A drag bag was a no go.
She is developing what appears to be a hygroma on her bum from all the hopping and dragging. It is painful for me to watch when I take her out every day. She seems unphased and keeps on playing, but is there anything more I can do while we are waiting for the funds to come into the rescue for a wheelchair? Will she even tolerate the wheelchair when it comes? She is sweet, but ALL puppy through and through. She eats like crazy, growing faster every day and is happy as can be.
Trisha, Thank you and your group for rescuing this puppy. It sounds to me like this baby will be very happy when she gets a wheelchair. It will keep her from hurting herself and let her run as fast as she wants. I’m attaching a link to a post about How To Get A Donated Dog Wheelchair. It’s full of groups who can help. And if you haven’t already talked with the various dog wheelchair manufacturers, please reach out to them because they might be able to help with the cost. In the meantime, if you’re looking to cover the area she drags, try putting her in a baby onesie. They’re inexpensive and will cover her hip and legs. You can even use them to keep a diaper in place. You might be able to sew in extra padding where she bounces and hurts her hip most. Dogs seem to like onesies because it doesn’t restrict their movement. Some pet owners say it’s easier for their dog to wear them backwards. But you can decide for yourself. Here’s a link to a story that explains it better: https://lessonsfromaparalyzeddog.com/5-ways-baby-onesies-protect-paralyzed-dog-save-money/ Best wishes.
Oops, forgot the link to How To Get A Donated Dog Wheelchair: https://lessonsfromaparalyzeddog.com/how-to-get-a-donated-dog-wheelchair-for-your-paraplegic-pet/