Do-it-yourself first aid

A. Treating a maggot-infested wound

Sorry, there are no pretty pictures in this section. The truth is, maggot-infested wounds are not pretty under any circumstances, but they are an unfortunate reality our dogs have to face. A horrifyingly huge number of dogs and cats die because of neglected maggot wounds. This is all the more tragic because they are surprisingly simple to cure, once you’ve learnt how. Except for very serious cases, the dog doesn’t even need to be hospitalized. WSD first aid volunteers have treated thousands of maggot-infested wounds on the road over the last ten years, without needing the intervention of a vet. With dedication, consistency and a complete absence of squeamishness, you can do the same. Just remember the dog has to be muzzled for every dressing, as he may bite because of the pain.

How does maggot infestation occur?

Thanks to exposed garbage, most Indian cities are literally buzzing with different kinds of flies. They lay eggs on rotting food, carcasses, excreta, and open wounds of any size. The screwworm fly is attracted to fresh wounds and this is the one which is so dangerous for dogs, cats and other animals. Due to itchy skin, fights and injuries (however small), animals often have little cuts on their body. Even a pinhead-sized wound is enough to attract a fly. Eggs are laid within minutes. A cluster of fly eggs looks like a tiny white scrap of paper, or flattened rice. In areas the animal can reach with his tongue, they are usually licked off. Danger areas are the ears, anywhere on the head and neck, and the anus. Old or weak dogs may not clean themselves regularly, or if a wound is too painful they may avoid licking it. They then become prime targets for screwworm flies.

In hot, humid weather, fly eggs could hatch within a few hours. The larvae, or maggots, feed on the animal’s flesh, in the process deepening and enlarging the wound. Maggots start off miniscule in size but can grow to a length of half an inch or a bit longer in a few days. That’s how even a tiny barely visible cut can become a huge, life-threatening wound in a very short span of time. The hardest to detect are the kind where the opening in the skin remains the size of a pinhole, and the maggots tunnel downwards, forming a huge invisible pocket.

How do maggots cause death?

In Mumbai, maggot-infested wounds are probably the most common cause of death in stray dogs. This can happen in various ways:

• Maggots tunnel very deep into the body and eventually eat into vital organs. In the case of deep head wounds, they can cause severe damage to the brain.

• Maggots cause a very high amount of infection in the body. (Blood samples taken from such cases usually show extremely high white blood cell counts).

• Blood loss leads to severe anaemia, which finally kills the animal.

• Wounds inside the mouth cause a lot of drooling and irritable behaviour in the dog, leading people to assume that he has rabies. Such dogs may be killed by the public.

How to treat a wound

1. A typical maggot-infested wound. From the size of the maggots and the depth of the wound, we can tell that the infestation started several days ago. This dog has become so weak she can’t even get up or raise her head. Most of the cases you treat will probably not have reached this state and will resist or try to bite, even if they are normally friendly and docile. Make sure you muzzle the dog before you start treatment. Muzzling is not easily taught through pictures and requires a lot of practice. It would be best to learn it from a veterinarian or an animal welfare NGO.

2. These are all the medicines you need to treat a wound. Himax and Acrilin are veterinary medicines. Chloroform, Iodine tincture, Nebasulf are available at general chemists.

3. You will need forceps like these, or else ordinary pincers which you can buy at any good chemist. Also keep clean cotton wool handy.

4. In wounds other than those on the head, pour about 10 – 15 drops of chloroform directly into the hole. Leave it for a while. This will kill the maggots. If you like, plug the wound with cotton wool so the maggots suffocate.

5. NEVER USE CHLOROFORM FOR HEAD WOUNDS WITHOUT VETERINARY ASSISTANCE. Good and safe substitutes for chloroform are neem oil or eucalyptus oil. Many people use turpentine instead of chloroform. Pour directly into the wounds. Make sure you get a vet to examine the wound though.

6. Chloroform causes a burning sensation, and this part of the treatment will cause pain to the dog, but for his own welfare it is necessary to use it. Please remember, the burning feeling will pass, but if unattended, the maggots will kill him.

7. Check the wound to see if the maggots show signs of life. If they do, you can pour a few more drops of chloroform and again plug with cotton wool for a few minutes. Once you think they are dead, wipe your forceps/pincers with spirit and start removing them.

8. Even when you think you have removed all the maggots, inspect the inside of the wound thoroughly with a torch. Maggots often create tiny tunnels leading from the main wound deeper into the body of the dog. You may not see the maggots in these tunnels. One giveaway is that the bloody fluid in the hole/holes will appear to be moving, literally “breathing,” if you watch carefully for a few minutes. A common error is not waiting long enough to observe this movement. As a precaution, even when you think you have removed all the maggots, spray the inside of the wound with the veterinary spray Topicure. The pungent eucalyptus oil smell will irritate the maggots and they will start emerging from the tunnel.

9. Now the wound is finally cleared of maggots, proceed to the next step. Pour Iodine tincture directly into the wound to disinfect it. You can use Betadine or Wokadine solution instead of the product shown here, whichever is readily available.

10. Let the Iodine drain out. Then apply lots of Nebasulf powder in the wound. This will help to dry it.

11. Next apply Acrilin or Lorexane cream. Fill up the hole with this.

12. The final, and perhaps most important layer, is the ayurvedic fly repellent cream Himax. This is heaven’s gift to the animal world and thousands of dogs owe their lives to this ointment. Smear it liberally on the surface: the strong smell will prevent other flies from laying eggs on the wound and re-infesting it all over again. However, remember the repellent effect will last only for half a day or at the most 24 hours.

13. This dog has a second deep wound, also maggot-infested. Stuff it with clean cotton wool.

14. Pour a little chloroform onto the cotton wool and leave it for a few minutes. This method will suffocate and kill maggots even deep inside. Then repeat steps 7,8,9,10,11,12.

15. Examine the wounds daily to make sure they haven’t got reinfested. Then repeat steps 9,10,11,12. Sometimes there may be pus in the wound. You should flush it out thoroughly with Iodine/Betadine/Wokadine before proceeding with the Nebasulf powder.

16. This dog is so weak, she has remained inert throughout the treatment. She is one of the serious wound cases who need to be admitted to the WSD centre.

17. If you are not confident about being able to handle or treat a dog properly, please admit it in an animal hospital without delay.

18. For very large wounds and when the animal is weakened, it is preferable to admit the dog in a hospital to prevent increased infection. The dog will benefit from antibiotics, vitamins, iron tonics and clean surroundings.

Prevention of maggot infestation

You may be lucky enough to spot a wound before a fly does. Dress it with Iodine, Nebasulf, Acrilin and Himax daily, as shown. If the dog has a caretaker, try leaving Himax with him (it is available in tube) and tell him to apply it a second time in the day.

B. Treating skin disease

At WSD, we make two mixtures for treating skin disease. They are both for external application only. Usually we do not give any oral medication to the dog. Dogs with diseased skin are hardly ever admitted to the kennel but are treated on site.

Do not apply these mixtures on cats.

Treatment 1. Mix Scabnil Oleo with an equal part of neem oil. Apply on the dog with a brush. Repeat every 4 days.
The main ingredient of Scabnil Oleo is karanj oil or….. which is a powerful anti-fungal agent. Neem oil is also strongly anti-fungal.
(Scabnil Oleo is manufactured by Goka …)

Treatment 2. Mix together equal parts of sulphur powder and camphor powder. Add a sufficient quantity of good quality coconut oil and mix it properly until there are no lumps. The final mixture should have the consistency shown in the picture. If it is too thick and lumpy, it will fall off. If it is too thin and runny, it will also not remain on the dog’s body.

Apply the paste backwards on the dog’s skin, so that it reaches the hair roots. Do not rub it in, just apply an adequate layer. Repeat every 4 days until the dog is healed.

Some general points:

• In general we have found Treatment 2 to be more effective in heat-related skin problems. This is because of the cooling properties of camphor. At the time of application this treatment may irritate the skin and make the dog restless, but this will pass off in an hour or two.

• Usually dogs do not try to lick these ointments because of the strong smell. However, to be on the safe side it might be a good idea to keep the dog muzzled during application.

• If the skin is oozing pus or has symptoms other than itching and hair loss, please seek professional help. These treatments will not be sufficient in case of any serious problem, though they work on almost all the cases normally encountered on the street.

• If one of these ointments doesn’t show results even after two or three weeks, switch to the other.