Rula, dog with necrotizing fasciitis

BREED: crossbreed
SEX: female
AGE: 6 years old
NAME: Rula

Clinical case
Rula enters the emergency room for a septic shock. She has two very painful perforating wounds, located in the perineal region. The cause of these injuries is unknown.
In less than 24 hours the perineal areas and areas adjacent to the wounds are affected as well. The skin is greyish, with necrotic tissue, without bleeding, and exudes a malodourous fluid from the thickened subcutaneous tissue and from the deepest fascia.

A blood test is performed, which highlights leukopenia, thrombocytopenia, hypoalbuminemia, and increased liver enzymes, and a cytological examination of the exudate, where degenerate neutrophils and abundant coccoid bacteria are observed, most of them arranged in rows.
The ultrasound shows the presence of fluids and gases in the subcutaneous plane and between the fascial planes, with diffuse distribution. There are no abscesses nor foreign bodies.

The therapy consists in stabilizing the patient, administering broad-spectrum antibiotics, and pain management. At the same time, 10 MLS® Laser Therapy sessions are performed.
The patient is then discharged and continues the therapies by her own veterinarian.
Rula is subjected to an aggressive surgical debridement of infected necrotic tissues. This procedure is repeated 3 times, with intervals of 3 days.
Bandages with honey and Peru balsam and castor oil dressings are applied every 3-4 days until complete re-epithelialization.

The situation for the patient develops favourably and complete recovery is achieved in 45 days. The scarring is very good and the resulting scars are small and elastic.

Courtesy of Dr Elena Dieguez DVM, Anicura Abros Hospital Veterinary - Ourense, Spain

Read the clinical report here