MEDICAL MAGGOT THERAPY. Aw C’mon now… if it works, why not?!: The maggots are happy and so is the wound!


Tuesday, October 21st, 2014 | Filed under Mama Tess




ORIGINALLY POSTED ALMOST A YEAR AGO – I AM POSTING AGAIN TODAY because WordPress (the program that lets me write the blogs) is broken.  So, since I was going to write about Team Maggot and their arrival today for MT, I figured reposting this post would be a good second choice.  And, I forgot to take pics today so there’s that as well…

Today, the selfless Founder Warrior drove the 5+ hours round trip to help Mama Tess again.

This time she brought the medical maggots.

Why?

Well, MT has so much necrotic (dead) and infected material in her left foot from the horrible founder, inflammations and infection/abscesses, we are afraid of an infection migrating to her coffin bone.

We need to get that old, dead tissue out of there so she can heal – instead of her body trying to expel all that by itself and continuing to deform her foot in the process.

Especially since there is less circulation in her hooves due to the founder (remember that awful venogram…).  Antibiotics do not reach this area well… and maggots are quicker and less stressful for the horse.

For me, I just want her to get better.  Fast.  I want the infection to be gone.

So, bring in the little buggers!

These particular maggots are grown in a sterile environment.  Their entire goal is to eat necrotic tissue.  All of it.  Eat, eat, eat.  That’s all they do.  Eat and grow.

 

The Founder Warrior had the Medical Maggots overnighted from Monarch Labs.  They are sterile and clean.

The Founder Warrior had the Medical Maggots overnighted from Monarch Labs. They are sterile and clean.

ABOUT MEDICAL MAGGOTS

The Founder Warrior bought these maggots from Monarch Labs.  They are the industry leader in medical maggots for use in humans and equines.

(Excerpt from the Monarch Lab website)

In maggot debridement therapy, germ-free (“disinfected”) larvae of therapeutic fly species (“medical grade maggots”) are used to treat and manage wounds in a procedure known as “maggot therapy.” The maggots are applied to the wound for 2 or 3 days within special dressings to keep the maggots from migrating. Since medicinal maggots can not dissolve or feed on healthy tissue, their natural instinct is to crawl elsewhere as soon as the wounds are clean, or the larvae are satiated.

The scientific literature identifies three primary actions of medical grade maggots on wounds:

  • They debride (clean) the wound by dissolving dead and infected tissue with their proteolytic, digestive enzymes;
  • They disinfect the wound (kill bacteria) by secreting antimicrobial molecules, by ingesting and killing microbes within their gut, and by dissolving biofilm;
  • They stimulate the growth of healthy tissue.
This was our batch of 1005 maggots.  (The maggot counter's name was on the container!)

This was our batch of 1005 maggots. (The maggot counter’s name was on the container!)

HOW TO APPLY MAGGOTS TO A HORSE HOOF

(Excerpt from the Monarch Lab website)

  • The maggots have good access to necrotic tissue – Usually we are doing some degree of debridement prior to application of the maggots. Depending on the case this can range from a small hole in the sole of the foot to debridement of the third Phalanx. In the case of severe infections that communicate with the distal interphalangeal joint or the navicular bursa, a surgical drain can be placed and the maggots/dressing are placed at the egress of the drain. If the horse has a cast placed over the site of infection, due to instability of the hoof or distal interphalangeal joint, a small access hole is cut in the cast so the maggots can be placed and the gauze can be changed. In cases where foot casts are employed the maggots do an excellent job at keeping infection inside the cast under control.
  • The maggots are not compressed or suffocated in the wound – Since we deal exclusively with hoof problems, we must ensure that if the maggots are placed in the bottom of the foot they are not compressed to tightly when the horse is weight bearing. Occasionally, the defect in the sole of the hoof is large enough that we can place the maggots, along with the dressing in the wound and apply a heavy foot wrap. Otherwise a shoe is applied that has a plate that offers wound protection and can be removed in order to change the gauze and monitor the progress of the maggots. We typically change the gauze and check the wound every other day. For us, the maggots mature in anywhere from 2 days to 8 days, depending on the severity of the infection.
  • The nature of the infection indicates the application of maggots – Cases that do not respond to maggot therapy are often infections in which proteus vulgaris is cultured from the site, especially when highly resistant strains of proteus are cultured. In these cases will often use topical disinfectants and/or systemic and regional antibiotic therapy in order to change to bacterial population in the wound prior to or in conjunction with maggot therapy.
  • Once a good environment has been established for the maggots they are place in the wound with the small gauze that comes with them in the vial, then cotton gauze is loosely placed over the maggots and the appropriate protection is applied. As stated above the gauze is changed every other day and maggot therapy is continued until the wound was stopped draining and looks healthy.

 


Example 2. Here is a set of images from Rood & Riddle Equine Hospital (Lexington, KY) illustrating penetrating hoof injuries, treated with maggot therapy.

 

MAGGOTS FOR MAMA TESS!

The Founder Warrior brought Mark, the local farrier who is studying under her, again to help with MT.

Mark had been telling his wife, Terry, all about Tess so she wanted to come along today.  And, thank goodness she did because we needed all hands on deck for this one!  (Horsegod bless these good humans for donating their time, energy and faith for MT…)

The FW instructed us on our duties while she was debriding MT’s hooves.  Luckily, the poultice wraps I had been applying continuously for the last several days in preparation did soften the soles and draw out much of the abscess.

The Founder Warrior and Mark studied her hoof.

The Founder Warrior and Mark studied her hoof.

The abscess holes are the places for the maggots to enter her hoof.

We wanted to make sure there were no chemicals of any kind left on her hoof that could kill the maggots.  So, we rinsed and soaked her hoof thoroughly.

The FW debrided the hoof while Mark held my very powerful headlamp on the scene.

The FW debrided the hoof while Mark held my very powerful headlamp on the scene.

Screen Shot 2013-11-19 at 7.39.12 PM

Mark soaked her hoof at least 3 times – to get any chemicals out of there so the maggots would thrive.

FW taught Mark how to prepare the boot she would wear for the next 48 hours.  They cut out the toe of the pad we inserted into the boot.  This cutout toe would be the ‘break room’ for the maggots when they needed to come out for air and water.  If the hole wasn’t there, the maggots would suffocate.

Here they are, preparing the boot insert pad with the cut-out 'maggot break room' where the maggots will go when they need air and water.

Here they are, preparing the boot insert pad with the cut-out ‘maggot break room’ where the maggots will go when they need air and water.

Screen Shot 2013-11-19 at 7.39.38 PM

Mark was putting on the finishing touches to the pad insert while Terry kept Tess occupied by giving her one pellet at a time. Tess would hold the pellets until she got a mouthful and then chew.

The pad was inserted into the boot.  We had saline soaked gauze at the ready to cover the maggot gauze that we were going to insert into the largest sole opening – then wrap the whole thing and stick her foot into the boot.

And that is exactly what we did!

We had 1000 maggots in our container.  (Actually, the container said it had 1005 maggots and had the name of the woman who counted them right on the container.  Now THAT would be a great job to discuss at dinner parties…)

This was the last shot I got of the process.  Here the FW is taking the maggot gauze out of the sterile container.  After that, it was a whirlwind of wrapping and sweating and a bit of teeth grinding.  But, we did it!

This was the last shot I got of the process. Here the FW is taking the maggot gauze out of the sterile container. After that, it was a whirlwind of wrapping and sweating and a bit of teeth grinding. But, we did it!

OLE!

Anyway, I didn’t take photos because we were so busy at this point.

Terry took the helm, feeding/distracting Tess – one pellet at a time…

The FW and Mark took the gauze full of fresh, baby maggots and inserted it into the clean abscess area.

My favorite part of this process was when the FW inserted her index finger into the maggot jar and scooped up the last of the maggots the way one would get frosting off of the cake bowl… Yum!  Then she boldly rubbed her finger’s contents onto the excess gauze and stuck it up in there.

Furiously, they wrapped the foot as MT was pushing to have her hoof back… ai ai yi, the stress!

But they did it!  Her foot was wrapped and inserted into the prepared boot!

We stepped back and were silent for a moment.  All of us, who have grown to love her so much, silently asked Horsegods and the Maggotgods to do their thing and save this very brave girl…

Shortly thereafter, this team of angels left us to brave the winter storm and head home.

CHEERLEADER FOR THE MAGGOT TEAM!

I snuck down to the barn a few hours later to check on MT.  She had been totally asleep when I arrived.

I looked at her boot and couldn’t help myself… “Go Maggots, Go!  E-A-T!  Eat!  EAT!  GET FAT, FAT, FAT!”

There were 1005 little, hungry warriors in there whose sole purpose was to get fat.

I wanted them to succeed.

And MT, well, she just wanted more shut-eye.

MT:  “Are you done?”

Me:  Yes, my girl, for tonight, we are done.  G’night maggots!  May you all survive to take pride in a job well done!

I ventured to the barn a few hours later.   Tess had been totally asleep.  But, the boot was still on and she looked very relaxed.  Go Team Maggot, Go!

newrule

BIG ‘25% OFF’ JEWELRY SALE to benefit Mama Tess (she needs Team Maggot this week).

All jewelry on the JWP page is 25% off with shipping included!!

Click to go to the SALE!

Click to go to the SALE!

25% OFF ALL PIECES!!  Benefits Team Maggot!

25% OFF ALL PIECES!! Benefits Team Maggot!



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4 comments have been posted...

  1. Joanie

    Praying this works! Keep us posted! You are doing everything you possibly can that’s for sure!!!!

  2. KD Huff

    I’m with Arliss………… EWWWW but cool too. I’m not grossed out by much, but maggots can do it. Go, go, go little maggots!

  3. Arliss

    Wow, ewww, that is intense! But good!!

    OK, little guys, do your thing! :-)

  4. Vickie Ann Stafford

    I lost a wonderful little Arabian mare about 15 years ago to laminitis. It was heartbreaking. She struggled with it for 6 years. I did everything we could do at the time except a hoof resection (I couldn’t put her through that). She started to slough off the hoof and I had to euthanize her. She was my soulmate in the horse world, my dream horse, my first horse when I was 38. I have never stopped missing her. I read your blogs with great interest and say prayers and shed tears for you and your little mare. There are so many advances since I lost my mare. So I pray that she will recover enough to have a comfortable and happy life. I admire you determination to help her as I know the expenses are horrendous, especially when there is no guarantee treatment will be successful. I did what I could for her, but there were so few options for treatment at that time. I credit my farrier for keeping her comfortable and even rideable sometimes. He did far more than the vet ever did for us. I will continue to watch your blog and pray for you and your girl!

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