Case of the Week: Osteomyelitis

Sheba is a 3 year old female German Shepherd.  When she was 7 months old she was attack by another dog and suffered from severe bite wounds to her left front leg.  Her parents took her to a veterinarian where she received treatment for her bite wounds.  Several months later she developed draining tract wounds in the area of the bites.  Multiple antibiotics had been administered over the last 3 years without resolution of the draining wound.


On presentation to our hospital, we found Sheba to be bright and alert with no abnormalities on physical examination with the exception of her left front leg.  She was toe touching lame.  Sheba's leg was swollen at the end of her humerus, just before the bend of her elbow, tender to touch and had two draining tract wounds within the swollen area.  Keep in mind this was an injury that was a little over 2 years old.


Radiographs were taken (left).  In doctor terms, there is bone lysis and sclerosis with loss of cortical bone and bone sequestra.  In other words, loss of bone along the margins of the bone and reactive bone with a piece of the original bone separated from it's origin.  


These findings in addition to the draining tracts and soft tissue swelling makes our diagnosis Osteomyelitis.  


Osteomyelitis is an infection the bone. Infection of the bone, called osteomyelitis can be acute or chronic. Acute infection show up quickly, while those that are chronic spread slowly and symptoms can take months to develop.  In Sheba's case, chronic.


The most common causes of bone infection in both people and dogs are staphylococcal bacteria, followed by streptococcal bacteria, and, more rarely, other bacterial and fungal organisms. Bone infections can arise from infections in other areas of the body carried to the bone by the bloodstream.


The more common causes of the bone infections in dogs are from outside of the body via bite wounds, other puncture wounds, compound fractures, and bone surgeries. Severe dental disease can lead to infection of the bones of the jaws.


Osteomyelitis can also be acquired secondarily to other brain injuries, most commonly brain infections, traumas, brain tumors and poisonings.


The initial signs are pain, swelling, fever, and if a limb is involved, lameness. These signs are usually accompanied by depression and loss of appetite. In time the infection usually breaks through the skin, and a blood-tinged or pus discharge occurs.


Diagnosis is made by the history, clinical signs, confirmed by blood tests and x-rays. It is advisable to have the discharge cultured in order to identify the organisms that are causing the infection and also to run a sensitivity test to determine which antibiotic will be effective in treatment. Although these tests are extra cost, bone infections can be difficult to clear up and a hit-or-miss use of antibiotics can make the condition worse.


In most cases it will be necessary to drain the wound surgically and remove all dead and infected tissues from the bone. Vigorous and often long-term antibiotic treatment will be essential, both systematically (by injection or mouth) and locally (into the wound). The wound will either be left open or closed with a tube inserted for drainage. Although most bone infections clear up with adequate treatment, some do not respond and require more extensive surgery and long-term treatment.


Sheba was referred to an orthopedic specialist for surgical debridement of the bone.  Other potentials could include amputation of the limb. 


We are wishing Sheba full recovery for her long term infectious condition.

My cat: Claws

I rarely share personal pictures of my own pets, of which I have several.  I have two house cats: Otis (named by my husband, because she "sits on the dock by the bay") and Claws (because when she was little she liked to use them).

I adopted Claws as a kitten from a client of mine (go figure).  She was a fiesty little thing and still is.  When I brought her home, Hannah (10 year old Jack Russell), truly believed that I had brought her her own personal play toy.  Those two wrestled and chewed on each other for hours.  Claws would sit at the top of her 6' cat tower and fly off to land right in the middle of Hannah's back and the chase and chew game would begin.  They were certainly good for hours of laughter.

Otis was not real thrilled with the arrival of Claws into her domain.  Otis had had the house to herself, except for Hannah (and Cookie in the old days) Being at least 12 years old, Otis found Claws to be a real nuisance.  Otis doesn't play and having a rambunctious kitten attack her in play was not her idea of a good time.  Even now, with Claws being almost 3 years old, Otis barely tolerates Claws.

The picture above was taken of Claws attacking Meade, when Meade was just a pup.  Claws has no boundaries and has no fear!

Claws has this addiction to crinkly bags or sacks.  Nothing is sacred or too daunting for her.  She has carried up from our basement a 3# sack of opened potting soil (leaving a trail of dirt in her wake), to deposit the dirt load in the floor and take off with the sack for play.  Bread, marshmallows, throat lounges, zip lock bags (hamburger left in sink for thawing) have all been found on the floor with missing bags.  She doesn't eat the contents (however the dogs appreciate her contribution to their food cravings), she simply wants the bags.  Meade and Hannah has been known (from a dead sleep) to suddenly burst out of the living room towards the kitchen with the sound of her paws striking the floor from a leap and dash from the kitchen counter.  Another favorite for her are silk flower arrangements; they are toast in her presence (reminder don't spend $100 on a floral arrangement).

She has taken control of man and beast.  I have learned a great deal about cat behavioral modification!  Mostly Claws has taught me how to rearrange my habits to fit her persistent antics.  All bread is kept in a cabinet (marshmallows too).  All items that are contained in a bag are in a closet, on top of the refrigerator, under a cabinet, etc.  I did try a Scat Mat which has helped but in general she finds away around it.  Mouse traps set around all floral arrangements are effective, but not always attractive when company arrives (Meade found them interesting as well).

She is obnoxiously affectionate, often demanding attention and petting when it is the least convenient for me.  I love how she keeps my lap warm and the calming effect I get in petting her.  This is however not convenient when you are trying to knit or crochet.  You can put her down on the floor a dozen times, but she is not discouraged, she just tries again.....and again...etc.  Until I just get up and leave.

Claws sleeps with my husband and me.  She prefers to start her nightly routine in preparation for sleep on my husband's chest, inching her way slowly up to his face, when she will be promptly deposited to the floor.  Not being ignored, she will return and start working on me, inching her way from my side to my face.  My answer to her is to hide my head under the covers.  She will rub against me there for a few seconds then move on because she isn't getting what she wants.  Finally she will settle herself in close to your side and go to sleep.

I wouldn't trade Claws for anything, but I don't want two of her kind in the house at the same time.  My husband and I would have to move out! LOL  In closing this last picture is one Bruce took of her sunning herself on our couch, one of the rare moments that she is actually stationary.