Post Radiation Burn Care - Appointment #1

It is 4 days after the completion of Stella's radiation treatments and her first appointment for burn care.  Below are photos we took before her appointment and after.  In the before pics you will see areas that look scaly like crocodile flesh.  As I've said before we have been  careful not to touch the treatment area, other than applying the Silver Sulfadiazine Cream (SSD), so we were unsure if this was just hair that matted down with the cream or flesh that would need to be removed.  It turned out to be both.  Please be forewarned that the after photos are a bit shocking especially given that Stella's arm has had very little change in appearance from each daily post.

The radiation therapist cleaned and debrided the area of the dead tissue using Lidocaine topical anesthetic instead of putting Stella to sleep.  This procedure took about 15-20 minutes.  The radiation therapist also explained that the appearance of Stella's arm is completely normal and confirmed that while the cream is aiding in healing the wounds the dead tissue becomes more prominent; we just didn't notice it because the cream had matted down the hair.

While we waited we met with the Oncologist for follow-up.  Dr. F. stated that Stella did remarkably well during her treatments and that she was surprised that the burns developed so late and are relatively mild compared to her other patients.  She confirmed what the radiation therapist told us the other day that the way they will "know" they got all the residual microscopic cancer cells will be with time along with the knowledge they have of treating dogs with MCT's (and Pugs specifically) and with the location and grade of the tumor.  Just as with our initial appointment with Dr. F. 5 weeks ago she stated again that radiation therapy has a 90% effective rate that the cancer will not return in this same location. 

Stella will return to the hospital in 3 days for additional burn treatment.  At that time they will determine if she will need yet another appointment.  After burn treatments are complete she will see Dr. F. a few weeks later for a check-up and routine blood tests; because Stella had 20 rounds of anesthesia and is on medications they just want to be sure her bloodwork comes back normal.  Dr. F. said she would then like to see Stella every 3 months (for one year) for a check-up at which time she will carefully check Stella's body for any lumps/bumps.  After one year they will do an abdominal ultrasound to check the internal organs again.  Dr. F. said ultrasound should probably be performed once every year.

The report for today states: "We cleaned Stella's treatment site with dilute nolvasan soaked gauze to help remove any dead tissue and dried SSD cream.  The site looks great!  We have applied SSD cream to aid in healing".

We are to continue with the SSD cream 2-3  times a day and continue giving Stella the oral pain meds (Gabapentin & Tramadol) as needed.  We feel Stella has a little pain now as the treatment site is "raw" and definitely more sensitive so we will give her the pain meds.

First 3 pics are before cleaning and debridement: