Although the summer season is coming to a close, it's likely that you and your patients are staying active outside in new ways. Here at DoveLewis, summer is our dog-fight, hiking-mishap, and BBQ-bone-eating season. These are all emergencies that come into our doors on a regular basis, and we’re ready to handle it. As a technician, we have to be creative in our nursing strategies. This means finding ways to get our patients to take their medications, getting the perfect bed to recover in, and, protecting their freshly treated wound from the most destructive thing—themselves.
The Elizabethan Collar (or E-Collar for short) is an integral part of the healing process. We’ve all had patients (and likely even our own pets) that can’t fight the urge to lick themselves raw. Bacteria in saliva leads to infections, and infections can lead to wound dehiscence or necrosis of the skin (skin dying and sloughing off) or even death. A dog’s mouth is not sterile, and is actually a warm and moist environment for germs to breed in.
So, you have a patient that needs an E-Collar. How can you set them up for a successful recovery?
First, assess your E-Collar selection. Our team has over 10 different sizes of plastic E-Collars to choose from. Additionally, we carry a wide selection of soft E-Collars as well. All of our E-Collar options are hung on a wall in the treatment area so we are able to easily find what a patient needs. Knowing what sizes you carry in your hospital and where to find them is going to make your team happier and more efficient. If you can’t find the right size, talk to your manager or inventory specialist about acquiring more sizes or finding the right place to store them.
Tips for fitting E-Collars. We can tell that an E-Collar fits when the length of the cone extends past the tip of the nose by at least one inch. This helps prevent tongues and noses from reaching their incision or wound. We also check for tightness by making sure it’s snug, but that two fingers are able to comfortably fit between the collar and the patients’ neck.
Second, know the different options. Veterinary nurses need to be creative, and that has contributed to some pretty amazing hacks for caring for our patients. While cones may be the obvious choice to create a protective barrier between the patient’s mouth and another body part, some patients will have a hard time adjusting to the hard plastic cone. We’ve all seen cats recovering from urinary obstructions that feel so much better, but are terrified to move due to their cone. Or puppies that can’t use the potty yard because they are too distracted with the cone over their ears. Lots of different materials can create an effective barrier instead of a cone, such as t-shirts, onesies, stockinette, and socks. If you think a patient may be better suited for a soft cone, talk with the veterinarian about what options your clinic has to make the patient more comfortable.
Tips for trying alternative methods. Not all patients can be trusted with a less restricted version of an E-Collar. If your patient is an avid chewer or licker, is rambunctious, or won’t leave the problem area alone, your patient might not be a great candidate for this option. If your patient can’t be trusted, you can always try an alternative method for a short duration under supervision, like during meal time or a trip to the potty yard.
Third, talk with owners about why the collar needs to stay on. We’ve all seen patients come back for a visit after chewing out their sutures, licking the wound raw, or slipping out of their cones. Emphasize to the owners that the collar is there for the animal’s safety, and educate them about the potential complications. Dealing with surgery-site infections can lead to additional procedures and hospital time. Removing the collar early and not following post-care instructions can cause harm, increased expenses, and additional recovery time.
Finally, remember not all patients who need E-Collars will be cats and dogs. Rabbits, mice, and birds can all go home with barrier-like objects if you are crafty enough. While there are kitten-sized E-Collars that are great to have on hand, you probably have a handful of supplies that would make an effective and protective cone. Dixie cups, empty fluid bags, and cardboard can be used to make tiny cones for our smaller patients. Just remember, the cone must extend past the tip of their nose so that they can’t get around it, and be snug enough so that the pet can’t remove it themselves.
Elizabethan collars have become a normal part of our everyday lives. We use them for all creatures big and small. And hope to spread the word on how cool the “Cone of Shame” actually is.