Right foreleg amputation and laser therapy of the wound in a dog

On 1 May, Albert, a 6-year-old male neutered whippet, presented after a road traffic accident, with a degloving injury to the medial right metacarpus and lameness of the right foreleg (Figure 1). The patient was triaged by the registered veterinary nurse on duty. This assessment found no severe detriment to the airways, raised respiration rate and normal function of circulatory system, although an obvious leg wound had the potential to cause haemorrhage if managed incorrectly. Further assessment of the major body systems found no neurological or mentation deficits or deviations from normothermia, although gait was severely affected by the injured forelimb. Once this limb was radiographed conscious, it was determined by the on duty veterinary surgeon to have a fracture of the radius and digit 1 metacarpus. Owing to the location of the island clinic and availability of sea or air transport to a veterinary surgeon for theatre time, a Robert Jones bandage was applied over a hydrogel non-medicated wound gel (Intrasite) and hydrocellular conforming dressing with moisture retaining properties (Allevyn). This dressing type was chosen as the decision of limb salvage versus amputation surgery had not been made at this stage. Pain relief was given using buprenorphine at a dose of 0.02 mg/kg intramuscularly, meloxicam at a dose of 0.2 mg/kg subcutaneously and Synulox at a dose of 8.75 mg/kg subcutaneously. Air transport to the closest clinic with a veterinary surgeon was arranged for the following day, with amputation surgery scheduled 2 days post-road traffic accident. Pain relief was scheduled immediately before transport so Albert would have sufficient analgesia until admission at the receiving clinic.