Don’t leave the bum till last-A Medicine Nurse’s perspective

urine and faecal scalding

Don’t leave the bum till last! This is what we’ve learnt from our experience of urine and faecal scalding in the veterinary hospital.

Having done some research on this topic there doesn’t seem to be a huge amount of information or literature available but, in my experience, this is a prevalent problem in veterinary patients. Often the most poorly patients have been unable to move around or groom themselves efficiently, leading to soiling. Before long for the skin around the anus, tail and perineum to becomes damaged by the acidic urine and faeces, resulting in extreme discomfort and pain.

So how can we help?

As an internal medicine nurse, I have dealt with my fair share of dirty bottoms! This is my tried and tested method for the treatment of scalding:

  • Clean the bottom ASAP! Urine and faeces should be removed from the skin in the least abrasive way possible. I personally avoid the use of shampoos or detergents as I think this further irritates the skin underneath. If the dirt can be removed by simply showering with warm water then this is usually better than wiping, if you do need to wipe, do so as gently as possible. Don’t neglect the surrounding area, often the soiling extends up the tail and even between the hind legs.
  • Often people like to clip away the hair around the affected area to make cleaning easier. I agree that this is helpful, however the already irritated skin is prone to clipper rash, which is disastrous. I prefer to clip away excess hair but leave it 1-2cm in length. This ensures that the skin is not irritated whilst making cleaning far easier.
  • Dry the skin, leaving it wet causes it to become chapped. Gently pat dry, never rub or wipe as this will irritate the skin further.
  • Apply lots of cream!! Which cream to use depends on the severity of the scalding. If there is minimal skin irritation then a barrier cream may be enough but be careful with which one you choose, many conventional barrier creams contain ingredients like perfume which irritate the skin and delay the healing process. Some even contain ingredients such as zinc which is toxic if ingested.
  • While researching this topic I found Cavilon ® and Sorbaderm ®, which are creams specially formulated to provide a barrier against urine and faecal scalding. I am really interested in trying these so if anyone has please do pop some feedback in the comments. If the skin is damaged then I usually find barrier cream isn’t enough, instead I like to use Flamazine ® cream as recommended by our in house dermatologist. This is a POM-V so must be prescribed by a vet. This cream helps to prevent infection of burns while providing a barrier from further damage and in my experience the skin is noticeably better after just 1 day of use.
  • Prevent further contact with urine. Veterinary bedding is specially designed to wick urine away from the patient, keeping them dry. Absorbent pads or towels underneath the veterinary bedding also help to soak up urine and keep it away from the skin. Regular changes of bedding are essential to prevent saturation.
  • Prevent patient interference. Excessive licking causes more damage and ingestion of topical creams can be toxic- you may need to apply a Buster Collar
  • Discuss analgesia with your vet, urine burns can be very painful.

The most important thing is to remember to check the bottom! Early detection of the problem and intervention is key.

If there is even a sniff of diarrhoea, I reach straight for the barrier cream – prevention is always better than cure!

For further reading then this website is a fab site of information:

 

Fran

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