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.
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.