Case Study: Hedgehog with a large contaminated Wound
(23.04.2012) On January 23 (2012) a hedgehog was presented at the clinic with a large contaminated wound in the right abdominal wall. The animal was probably tracked down and nibbled by rats while in hibernation.
Mag. Helene Widmann ([email protected])
Hedgehogs are usually deep asleep and hide in safe places at this time of the year. The animal only weighed 390 grams and was moderately dehydrated.
23-01-2012
The massive skin defect did not seem to limit its mobility or cause any pain.
Method
After stabilisation with heated Ringer‘s solution 5% glucose - and a mix of Vitasol AD3EC, VanavitTM B complex and CatosalTM. The wound was covered with meloxicam (MetacamTM) and an antibiotic layer with enroflaxine (BaytrilTM) 2.5%.
26-01-2012
After 20 minutes in a quiet protected place, the wound was treated under isoflurane inhalational anesthesia.
After thorough surgical debridement and intensive irrigation with a mixture of Calendula tincture and NaCl, the wound was covered with honey gel (LMesitran Soft).
Thereafter the Tulle (cut to the appropriate size) was placed on top of the wound bed. The dressing was covered with a compress and fixated with self adhering bandages.
27-01-2012
When applying protective bandages, it is important to make sure that is not as tight as a pressure bandage, as this could lead to breathing problems. A fixation on the shoulders and across between the forelimbs ensures that the bandage remains in place.
29-01-2012
Until 05/02/2012 (two weeks) the wound was treated daily alternating between 1)bathing the wound with malvaceae (mallow) tea and anaerobic organisms microorganisms (EM), and 2) application of the honey gel and honey tulle covered with a protective bandage.
31-01-2012
The antibiotic treatment was maintained for five days. Meloxicam reduced pain and inflammation during one week. In addition, the patient received up to 31/01/2012 daily infusion to support detoxification and immune system.
31-01-2012
In addition the woundhealing was promoted from 01/02 until 06/02 with a wound laser. As of 07/02/2012 the wound was no longer covered due to the continuous wound closure and the increasing mobility of the animal. The wound was cleaned on a daily basis with effective microorganisms and the honey gel.
4-2-2012
From 17/02 until 21/02 the wound was only treated with L-Mesitran wound gel, since a dry crust remained, under which the scar tissue was formed. The final inspection took place on 21/02, again under isoflurane anesthesia. At this time, the entire skin defect was completely closed with little scar tissue.
Discussion
The western European hedgehog is a common pan-European free-ranging animal protected by wildlife conservation laws, which is generally not kept as a pet (Ulrich, 2010). The major causes of mortality are probably road casualties and hypothermia during the winter months.
21-2-2012
In this case the hedgehog was woken up during hibernation because other animals were eating it alive. Practicing wound management on exotic patients can be challenging due to their small size, unusual anatomy, difficult behaviors, and tendency for developing secondary stress-related health problems (hernandez, 2004).
The osmotic action of the honey gel caused an effective cleaning of the wound area, the necrotic tissue was autolytical debrided. The Tulle product prevented the new granulation tissue of adhering to the dressing, which resulted in a fast uncomplicated wound closure, indicating that no secondary stress-related health problems manifested. The animal was therefore released into the wild again.
References
- Hernandez-Divers S (2004) Principles of wound management of small mammals: hedgehogs, prairie dogs, and sugar gliders. Vet Clin North Am Exot Anim Pract. 7(1):1-18, v.
- Keymer I et al. (1991) Zoonoses and other findings in hedgehogs (Erinaceus europaeus): a survey of mortality and review of the literature. Vet Rec. 1991 16;128(11):245-9
- Ulrich R et al. (2010) Desmoplastic ganglioglioma of the spinal cord in a Western European hedgehog (Erinaceus Europaeus). VET Diagn Invest 22: 978-983
