When my colleague Geraldine
Young informed me that I was to perform a follow up
examination on a "crunchy" kitten that had sustained
its injuries from a dog I feared the worst. After allowing
me to peruse the many stainless steel orthopaedic implants
at my disposal to reconstruct this unfortunate patient I
was informed that indeed no bones had been broken. Instead
the peculiar "crunching" sensation with "Ziggy",
only 10 weeks old, which was all too evident was coming
from her skin!
On stroking "Ziggy" along her back a rather weird
sound and sensation became apparent. The noise and touch
was similar to that of scrunching a piece of dry brown wrapping
paper. Despite these bizarre clinical findings "Ziggy"
remained surprisingly bright and perky. This clinical finding
is typical of what we call "subcutaneous emphysema"
or air trapped under the skin. The exact cause of this problem
was unclear but had been noticed by her owner after the
family dog had been playing with "Ziggy", somewhat
over enthusiastically, in her mouth!
There were 2 possible explanations.
The bacteria from the dog's mouth had pierced
her coat and started to produce gas
which then was trapped under her skin. A major complication
of penetrating injuries is infection with abscess formation.
The most innocuous looking wound can develop into a much
more serious condition by providing certain bacteria the
opportunity to flourish in an environment which keeps them
moist, warm and full of nutrients.
The respiratory tract had become damaged (punctured lung)
and air was escaping and finding its way under the skin.
If this injury is very small the "puncture" will
eventually seal itself and the air will be reabsorbed. Treatment
is aimed primarily at keeping infection at bay until the
situation is resolved.
Fortunately for "Ziggy" that is
exactly what happened. Concerned readers will be pleased
to know that "Ziggy" has found a new home in Stoney
Stanton where there are no over exuberant playmates. No
doubt when "Ziggy" is older she will be quite
capable of doing some scrunching of her own!
Dunne BVMS, Cert SAO, MRCVS