The Face of a Burn Patient: Sadie's Story
*Contains Graphic images*
(Knoxville, TN. December 5, 2013) Late November, Sadie, a loving dog, was burned in a house fire in east Tennessee. The family lost everything in the fire. Sadie was found two days later, hiding in the rubble and suffering major burns. She was taken to Dr. Kate Zimmerman at Tri-County Veterinary Hospital. Dr. Zimmerman has worked tirelessly to raise funds to pay for the extensive medical treatment necessary for Sadie. She has detailed the journey through the Tri-County Veterinary Hospital's FaceBook page. The response has been overwhelming from what Dr. Zimmerman calls the SOS (Save Our Sadie) Family, and WCYB-TV aired Sadie's story. As the medical bills continue to mount, Dr. Zimmerman has requested donations be made to the Veterinary Care Foundation. To donate to the foundation for Sadie's care, visit the site, select Tennessee and then choose Tri-County Veterinary Hospital.
Sadie has been at the University of Tennessee Veterinary Medical Center (UTVMC) since Monday, December 2. Click here to view a news story WTNZ/WBIR ran December 5 about Sadie.
For those of you wondering what goes on with a patient like Sadie at the UT Veterinary Medical Center, I'll describe Sadie's first few days here at UT.
When we first examined Sadie on Monday (December 2) , our biggest concerns were her eyes and what was hiding under the hair and crusts on her skin. She also had vaginal discharge, which could have been a sign that her pregnancy was terminating or she was getting a uterine infection. We first checked her blood work for signs of infection and gathered our teams of specialists together to discuss her care. Our nutritionist made recommendations for her calorie needs: dogs with burns need twice as many calories as healthy dogs, so feeding is critical. Our ophthalmologists examined her eyes, cleaned and flushed the areas, obtained cultures of her ulcer and swollen inner eyelids, and stained her eyes with fluorescein to evaluate the ulcer. Although it was deep, the ulcer looked like it might heal with some intensive treatment with cleansing and frequent medications, including a product made from blood. Under a microscope, our reproductive specialist examined drainage from her reproductive tract to look for evidence of infection. She also performed an ultrasound: at this point, there was no evidence of severe infection; however, a recheck examination is scheduled to make sure there is no problem before her release. She then underwent a hyperbaric oxygen treatment while we prepared for the next step of her treatment.
Our anesthesiology team- a resident, anesthesiologist, student, and technician- developed an anesthesia plan for Sadie so that she could undergo wound cleansing. Because Sadie had lost a lot of proteins and had lung damage with the fire, we had to be cautious about anesthetics and fluids. At the same time, Sadie was in terrible pain, so we needed to make sure she was comfortable during and after the procedure. Once she was under anesthesia, the surgery team jumped in full force. A surgeon, resident, intern, 5 students, and a board certified surgery technician all worked on Sadie to get her cleaned up as quickly as possible. Though the room was crowded, we were able to have 4 sets of clippers going at once.
We shaved around the wounds and used special flushing solutions to soak off the drainage and debris that had built up in her hair and on her skin. After thorough cleansing and bathing, we evaluated and photographed all the wounds. We then used topical medications to sooth the burned areas and kill any bacteria on the wounds. Removing all this crust allowed the wounds to air and dry. Sadie was then moved into the intensive care unit, where we worked with our criticalists, technicians, and nursing staff to set up a plan for her care, which included treatments of her skin and eyes every 6 hours, along with continuous monitoring. All told, Sadie received care and input from over 20 veterinarians, technicians, students, and assistants over the first 12 hours of her stay.
On her second day in the hospital, Sadie had had enough of receiving medications and completely refused food. She also had some swelling around her feet from the burns and poor circulation, and the skin on her belly looked slightly worse. Because she had not eaten well for 4 days, she was in danger of infection or even organ damage. We therefore decided a feeding tube was in order- a tube that would allow her to be fed and given medications. Once again we gathered together our teams of specialists to anesthetize her, place a feeding tube, and bathe her wounds. Our ophthalmologists were not able to get a good look at her eyes but were pleased she was more comfortable and the swelling and discharge had decreased. The feeding tube went in easily, and a follow-up chest x-ray allowed us to take a look at her lungs.
After she recovered, she underwent another hyperbaric treatment and low level laser therapy.
Wednesday, December 4: Today Sadie's had a wonderful day, with great strides in all areas. She is eating well, although she prefers to be hand-fed her meals. The E tube is allowing us to get all her medications in her, and she is now very comfortable and relaxed.
As you can see in the photo, her face is healing and will probably not need any grafts. She is no longer squinting and has much less discharge from her eyes. She is scheduled for a recheck eye exam by our ophthalmologists and uterine ultrasound by our theriogenologist (reproductive specialist). The swelling in her feet has decreased. Her belly skin needs the most attention right now; it will take some time to determine whether any surgical intervention is needed. She may need eye and skin treatments four times a day for a few more days, so arranging nursing care will be very critical.
All in all, however, she's doing incredibly well and is ready to be with her people.
Thursday, December 5: Sadie is out of ICU! When Dr. Tobias greeted her, Sadie wagged her tail like nobody's business. She's barking and is ready to go! She may be going home this weekend! Her pain is well managed with oral medications; the tricky thing is that she doesn't like to eat after receiving her meds. Her tear production is back to normal, and the ulcer in her eye is less deep. However, the burns around her eyes have affected her eyelid function, and she can't blink properly. Her wounds are gradually improving. Dr. Tobias thinks Sadie is making tremendous progress. She has stolen many hearts at UT!
UPDATE: Sadie was able to go back to her family Friday, December 6. Click here to watch the story WCYB TV aired on her release. Below is Sadie with her boy before leaving UTVMC.
Posted: 12-05-13 Viewed: 24895 times
Media RelationsSandra Harbison
College of Veterinary Medicine
University of Tennessee
2407 River Drive
Knoxville, TN 37996