Thursday, March 28, 2013

Burn history and progression

When I look at the photos of Suki a week after the fire and compare them to now, I feel like I watched a miracle happen.  The quality of care that she recieved in New Bolton Center's ICU ensured her survival, but there has always been so much more to Suki's recovery than the phenomenal medical care.  With her diva confidence and courage she displayed a will to survive from the start.  For the most part I never doubted that Suki would survive, but I also think that I was in shock for the first several weeks. 

The right side of Suki's body was burned worse than the left, so I will focus on that side in this post.  As of now, the manuscript has more detail, but this gives a bit of perspective regarding the healing process.  I will focus on the graft in a separate post next week.

The burns looked worse before they started to get better, because the charred skin needed to fall off.  Doctors at New Bolton, after much consultation had decided not to aggressively debride the skin so that it would remain protected.  Because there was such a large surface area that was burned, it was important to minimize the risk of infection.  Allowing the skin to fall away with minimal assistance was the best way to go.
Day 6 post-fire.  All of that charred skin would eventually come off.

Two weeks later more of the skin had sloughed away, and the diligent work of doctors, nurses, vet students and residents  was evident.  The "charred areas are still evident, and Suki still smelled like fire at this point.  I think the crinkiling of the skin annoyed her, because Suki has always been very flexible and likes to bend herself in half to scratch.  On several occasions I watched her attempt this and lose her balance.  I would then take over the scratching (gently of course).  She very obviously appreciated the assistance!


One month post fire.

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Healthy, new skin emerges after much care, topical SSD and prophylactic antibiotics.  The skin looks very sensitive, but impeccable pain management kept Suki comfortable.  This area was also slathered with SSD to aid in healing, prevent infection and keep the skin moist.

Near the end of August Suki left New Bolton and the safety net of ICU to go to a rehabilitation farm.  Kelly immersed herself in Suki's care, which initially was rather comprehensive.  In addition to tending to the burns, Suki was still receiving a number of systemic meds which required diligence and a variety of disguises of the meds to get Suki to eat them.  Kelly more than got the job done, and I will be forever grateful! 

Two months post fire

Look at all of that hair growth!  The top of Suki's back still had a stubborn bit of eschar that had not come off, but overall she was looking great.  By this point of recovery Suki was able to turn around and scratch her sides again, a sure sign that the skin was healing well. 


Left side two months post fire

Suki's left side was not burned as badly.  At two months post fire she exhibited good health....and dapples!  The white ointment across her topline is SSD: silver sulfadiazine, also used in people.  It was during this time period that I suddenly realized that Suki no longer smelled like fire.  I hugged her every time I saw her, so it was monumental to no longer smell charred skin!  Even her melted mane had begun to look normal again. 


Three months post fire



Close up, three months post fire

Looking great, but that stubborn spot right where the saddle sits continued to be a problem.  The area was not infected at all, but that dead skin was holding fast!  Kelly gently debrided it daily.  Now that it was October Suki was wearing light clothing again, complicating things.  We did not bandage at this point which probably would have helped.  It is a difficult area to bandage (as I would find out later) and no one advised us to bandage at this point.  I realize I am not giving a lot of detail here, but the book will have much more.  The goal of this post is just to demonstrate the healing process in outline, which is amazing on its own!!

The hair growth continued while Suki's topline continued to struggle with healing.  Rolling complicated matters, even with clothing.  In August 2010 Suki had a big roll that really ripped open that spot on Suki's back.  A visit from the veterinarian led to bandaging, antibiotics and an antihistamine.  Suki is notoriously difficult when it comes to oral meds, with the ability of a cat to eat her food around medication leaving a pile of powder in her feed tub!  By October 2010 we had three steps forward two steps back going on, and Dr. Fugaro began to mention the possibility of a skin graft.  Suki had been in a regular boarding situation for six months at this point and even with the difficulties the progress was astounding!



October 2010

Other than the daily wound maintenance Suki was living a normal life which included weekly lunging.  She was spending a lot of time outside which made her thrive.  Sharing a pasture with her new sister Nikki, I felt like she was finally a "normal" horse.  Suki's personality never faltered and her spirit inspired everyone who met her. 

As we continued through the winter, the battle continued with the bandaging of that stubborn wound.  There was never any infection and I remained confident that it would heal....well, some days I was confident!

Since I will be doing a separate post about the skin graft, these photos will focus on the rest of Suki's body.  The hair growth began to slow a bit and by August 2011 but Suki glowed with good health.  The focus at that point was the graft area.






August 2011
August 2011



December 2011

Other than the graft area Suki experienced hair growth and complete recovery.

In August 2012, a visit from one of Suki's FB fans, Julie, shows her in good weight, good health and a testament to what quality care and love can do....




Now if we can just stop haiving snow and mud! 

The recovery process has been long, but Suki has not had any pain or discomfort.  Every need has been met and precautions taken.  The graft area took a bit longer, but that will be for another post....


2 comments:

  1. Wow, Suki has come such a long ways! You take great care of her! Suki is one of the most adorable horses ever! Do you think you will ever be able to ride Suki again?

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    1. Thank you Tess! Suki has so much courage and her diva personality has carried her through. I used to say that I would never be able to ride her again. Because there is no hair on her back where the saddle would sit, as that is where the worst of the burns were located, the extra weight of saddle and rider may not work so well. I am looking into some low friction pads, and following a summer of longlining with a surcingle, perhaps I will be sitting on her again in autumn 2013. Fingers crossed!
      Thank you for reading my blog!

      Fran

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