Healing is not a word that we use very often in mainstream medicine, although I don’t know why.  After all, it’s the goal we all aim for.  Seems it’s distinct from “recovery” that feels more mechanical, a bit like a “satisfactory outcome” while to heal has an emotional element. Some would say spiritual.  Possibly that’s why alternative and complimentary medicine appears to be more focused on the patient’s mind as well as the body. Now that seems a very human perspective so can it be relevant to animals? I think yes. Animals that are not in pain, have a stress-free, comfortable environment in which to recover, “heal” more quickly.  Maybe they put their energies into getting better rather than fretting about their condition, as we humans are prone to.

The most common use of the verb “to heal” in veterinary medicine probably relates to a wound of some type. Maybe a cut through skin and muscle or a broken bone.  Free-ranging dogs frequently become the victims of injuries caused by barbed wire or a sharp stick. When moving at speed, even blunt objects can inflict serious damage. 

Our pet’s loose and relatively elastic skin is a mixed blessing. It moves over the muscle underneath with ease, often allowing a bite to be skin-deep, as teeth skid over deeper tissues.  The down side? Any underlying damage rarely coincides with the skin wound and this hidden damage can be easily overlooked. Unless a significant blood vessel is broken, there may be minimal bleeding. With a dark hairy coat, many wounds initially go unnoticed by owners.  Some might heal on their own but contamination from the penetrating object and hair means an infection often becomes established a day or two later, trapped under the skin by hair matted with blood and serum over the wound.

However, if you do manage to find a fresh wound, provide some pain relief with a licensed product (meloxicam if you have it) and gently bathe it in dilute povidone-iodine solution (water based so it doesn’t sting) and prevent licking.  Do not use TCP or Dettol, they are too irritant for animals’ skin.  Keep exposed tissue moist with Savlon and small skin-deep, non-infected lacerations might heal by “second intention”. This means a scab forms and new skin develops underneath.  Eventually the scab (a band-aid of fibrin) falls off, revealing a layer of fragile and hairless skin. This will toughen up with time, but may leave a scar. Non-infected wounds also display an amazing capacity to contract, shrinking the skin deficit so the area to heal is minimal.  Lack of pain, minimal swelling, no discharge and a contracting wound are all good signs that healing is on the right track.

Unfortunately, most wounds we see are already showing signs of infection, characterised by heat, pain and swelling. Loosely attached skin allows a pocket of pus to collect underneath or it may migrate south under gravity.  It’s all too late for topical washes and Savlon, the pus-pocket needs draining, flushing and any dead tissue removed.  Traumatised tissue loses its blood supply, dies and becomes a focus for infection.  Removal is essential for optimum healing, using a procedure we call “debridement”. We debride wounds under anaesthetic – essential for patient welfare and surgeon’s safety! Don’t really want to test the healing powers of nurses and vets after a good bite from a painful and justifiably cross patient.

The most dramatic example of debridement I saw involved a very fat pet pig called Porter.  Poor “Porty”(so called by his doting owner) suffered a wound on the back of his neck that became infected and attracted swarms of flies. The resulting “fly strike” was so extensive I sent the pig not to market (heaven forbid) but to surgery.  The surgical resident at the time must have removed several kilos of tissue, leaving a scarily impressive wound that I did my best to conceal from the owner.  This all necessitated a lengthy stay at the clinic for daily dressing changes. Not a process to rush, we decided, as the owner brought in a wonderful food hamper for Porter daily.  We residents dined well for a few weeks, Porter healed nicely and lost a necessary amount of weight.  Three out of three!

With all this talk of wounds, infections and healing, you might ask what about antibiotics?  Surely we can fix everything by giving these magic bullets? Yes and no. These days we have strict guidelines for giving antibiotics as the medical professions strive to minimise their use. This is primarily to limit resistance and prolong their effectiveness in both animals and humans. We should remember infected wounds and abscesses were treated successfully before antibiotics were discovered, using the old-fashioned poultice and promoting tissue drainage. These principles are possibly more important today as bacterial resistance grows, underlining the need to appreciate how our actions influence the environment around us.