Decubital Ulcers

Decubital ulcers are defects in the skin resulting from continuous pressure on a particular area leading to tissue ischaemia and necrosis.

In the livestock export process, it occurs in downers and animals that struggle when they get their head or legs stuck. 

Ulceration may be accelerated by abrasive flooring, dirty skin, friction, skin maceration, urine scalding and loss of subcutaneous padding from undernutrition.

At sea, even minor skin sores and abrasions can quickly become infected and ulcerate.

Lesions are usually located over bony prominences.

The skin over fetlock, carpus, hock, elbow and stifle joints is most commonly affected. The skin is initially red to purple then oozes, becomes necrotic and ulcerates. The ulcers tend to deepen quickly, become infected and may be slow to heal even under optimal conditions.

The prognosis for animals with deep decubital ulcers at sea is very poor, especially if joints are involved. Even if time and resources are available for a high standard of treatment, there may be insufficient time for recovery before arrival at the destination.

Early treatment while the ulcer is superficial, is essential for survival. Relocate the affected animal to a hospital pen and provide a deep layer of dry absorbent sawdust. Sawdust provides padding, reduces friction and absorbs moisture and may help to prevent exacerbation of existing ulcers and development of new ones.

Treat ulcers similarly to any open wound - apply lavage, debridement and if on limbs, bandaging. The objectives are to keep pressure off the ulcer and allow healthy granulation tissue to rapidly fill in the ulcer.

Apply lavage using clean mildly salty water squirted under moderate pressure with a 35 mL syringe and 19g needle.

Apply debridement by cutting or scraping away necrotic tissue.

Apply topical antibiotic ointments or powders to help control surface infection, parenteral antibiotics (procaine penicillin, erythromycin, oxytetracycline, or tylosin) to control deep infection, and non-steroid anti-inflammatory drugs (flunixin meglumine, ketoprofen, meloxicam, or tolfenamic acid) to control pain and swelling.

Apply bandages that are close fitting, snug, long, firm and thick so they are like a cast. This can be achieved using rolls of gauze, cotton wool and elastic adhesive bandages. The objectives of bandaging are to stop bleeding, immobilise the area, prevent further trauma and contamination, keep the wound warm and prevent it drying out. Without bandaging, wound healing may be severely compromised.

An inexpensive, easily applied waterproof conforming bandage suitable for shipboard conditions can be made using rolls of plastic clingwrap, foam rubber and electrical or duct tape.

Encourage affected animals to stand as much as possible.

Direct measures toward preventing downers and cattle getting stuck for prolonged periods - and reducing pressure and friction on skin if they do go down or get stuck.

Develop and implement a system for early detection and treatment of diseases, conditions and misadventures especially at sea.