Maneka Gandhi
Some weeks ago, I made a WhatsApp group for People for Animals unit heads. There are about 200 of them. Now I see their work every day. They rescue the most-wounded, terrified creatures. Animals that have huge cancerous growth on their horns, legs run over by cars, heads and throats eaten by maggots. PFA teams pick them up fearlessly, climb trees and go down wells, go into collapsed buildings to pick up cages of lovebirds and into swamps to rescue stranded cattle. I am full of admiration for these selfless amazing heroes.
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During this time, the maximum number of rescues that PFA is doing is of maggot cases. Mainly dogs; but also a lot of donkeys and cows. This is common in the warm summer months when flies are laying their eggs and are more prominent in hot, humid environments. Dogs with festering wounds, skin problems, or mobility impairment issues are more likely to develop this disease. Those who live on this hard unforgiving, hostile road, or who are weak and debilitated, are particularly susceptible. Any type of wound, or moist coat soaked with faeces or urine, can become the perfect spot for flies to lay their eggs. Within a few hours the eggs hatch into tiny pale worms called maggots that start eating the flesh. At first, the maggots will feed on dead skin or debris. But when that food source runs out, they release an enzyme in their saliva that starts digesting healthy skin. The enzyme causes small holes in the skin, and then the maggots burrow underneath the skin. They will eat the animal alive.
The maggots release toxins that can make the animal sick very quickly, leading to fever, lethargy and shock. Blood samples taken from such cases usually show extremely high white blood cell counts. Blood loss leads to severe anaemia. The dog will develop a foul, decaying smell as the maggots secrete an enzyme that necrotizes healthy skin tissues. This is the most potent indicator. The animal is in such pain that he starts behaving erratically, drooling, leading people to believe that he has rabies. So, they stone or hit him till he dies. Many years ago I had to pick up a dog who was being chased by people like this shouting ‘paagal paagal’. His head had been half eaten. I put him in my car. We treated him that night, took out hundreds of wriggly creatures. He lived in my house for two years before he died peacefully.
The screwworm fly is the most dangerous. It is attracted to fresh wounds. Due to itchy skin, fights and injuries, animals often have little cuts on their body. Even a pinhead-sized wound is enough to attract a fly. Eggs are laid within minutes. A cluster of fly eggs looks like a tiny white scrap of paper, or flattened rice. In areas the animal can reach with his tongue, they are usually licked off. What remains are the ears, anywhere on the head and neck, eyes and mouth and the anus. The maggots deepen and enlarge the wound. A tiny barely visible cut becomes a huge, life-threatening wound in a very short span of time. The hardest to detect are when the opening in the skin remains the size of a pinhole, merely showing a lump on the skin. The maggots tunnel downwards, forming a huge invisible pocket.
However, maggots are surprisingly simple to get rid of, once you’ve learnt how. Except for very serious cases, the dog doesn’t even need to be hospitalised. Even first aid volunteers can do it without needing the intervention of a vet.
If you are an animal carer/feeder this is what you need to have in your first aid box. I am taking everything written below from Welfare of Stray Animals run by Abodh Aras who has been doing a wonderful job in Mumbai for many years. A muzzle; forceps; Himax; Acrilin or Lorexane; chloroform; iodine tincture; Nebasulf; clean cotton wool; turpentine; neem oil; Topicure spray; Betadine. The dog must be muzzled for every dressing, as he may bite because of the pain. If you can, cut the hair away from the area around the wound. The hair contains bacteria and can keep on re-infecting the wound. In wounds, other than those on the head, pour about 10 – 15 drops of chloroform directly into the hole. Leave it for a while. This will kill the maggots. Plug the wound with cotton wool so the maggots suffocate. The chloroform will cause pain to the dog so make sure he is tied, or he will run.
Do not use chloroform on head wounds. Good substitutes are medicinal turpentine oil, neem oil. Do NOT use painters turpentine oil, kerosene, petrol, phenyl or hydrogen peroxide. These will kill the animal. Check the wound to see if maggots show signs of life. If they do, you can pour a few more drops of chloroform and again plug with cotton wool for a few minutes. Once you think they are dead, wipe your forceps/tweezers with Dettol or Savlon and start removing them. If the wound is deep seated and the only thing you see is a hole outside, then take turpentine oil into an empty plastic syringe (without needle) and push it into the ‘hole’. Let it act over next 6-8 hours. As medicine takes effect, you will either see the maggots popping out of the wound on the floor or large chunks of glued insects/dissolved and held together like blobs of pus coming out of the wound.
Inspect the inside of the wound thoroughly with a torch. Maggots often create tiny tunnels leading from the main wound deeper into the body of the dog. One giveaway is that the bloody fluid in the hole/holes will appear to be moving, literally “breathing,” if you watch carefully for a few minutes. A common error is not waiting long enough to observe this movement. As a precaution, even when you think you have removed all the maggots, spray the inside of the wound with the veterinary spray Topicure. The pungent eucalyptus oil smell will irritate the maggots and they will start emerging from the tunnel. Once the wound is cleared of maggots, pour iodine tincture directly into the wound to disinfect it. You can use Betadine or Wokadine solution. Let the iodine drain out. Then apply lots of Nebasulf, Negasunt or Gotbac powder in the wound. This will help to dry it.
Apply Acrilin or Lorexane cream. Fill up the hole with this. The final and most important layer is the ayurvedic fly repellent cream Himax. Smear it liberally on the surface: the strong smell will prevent other flies from laying eggs on the wound and re-infesting it all over again. However, the effect will last only for a day. Examine the wounds daily to make sure they haven’t been reinfested. Sometimes there may be pus in the wound. Flush it out thoroughly with Iodine/Betadine/Wokadine before proceeding with the Nebasulf powder. If the dog is so weak that she can hardly move, do not leave her on the road. Make sure she gets shelter or is in your house. She is going to need antibiotics (Augmentin 625, vitamins, iron tonic and good food). Check the dog for the next few days in case any remaining larvae mature.
Even simpler is to pour some oil (coconut oil, neem oil) on maggots. This deprives them of oxygen, and they will come running out. Then pick them off using tweezers, tissue or gauze. Then flush the affected area with water, which will help to remove any unhatched eggs. Then you can put some turmeric on the affected area. Or you can use an antibiotic cream/ointment. Some people apply a pyrethrin- or pyrethroid-containing spray (dogs only) to lesions to kill remaining maggots. This should only be done under veterinary advice as it could kill a debilitated animal. Alternatively, ivermectin 0.2 to 0.4 mg/kg SC once is effective against maggots. You can apply two drops of ivomec+tt oil and few drops of pyodyne. The maggots will die within 15 minutes. Prevention is better than cure. If you see that your neighbourhood street dog/cat/cow/donkey has an open wound, clean the wound site with cotton dipped in weak tincture iodine solution or Betadine, Cipladine or Wokadine. Put Nebasulf or Neosporin powder on the wound site. To prevent flies from sitting and laying eggs on this wound site, put Lorexane and then paste a layer of Himax, an ayurvedic veterinary fly/insect repellent, on top of the wound. Other veterinary powders with wound healing and maggoticidal properties are Gotbac powder or Negasunt powder that can be directly applied on an animal/dog’s open wound. Get these sprays D-Mag spray or Topicure spray, both of which help kill maggots as well as promote wound healing.
In a few days, fresh skin will start appearing. Your effort and investment have saved a life. Maggot infestations don’t go away or cure or heal on their own, human intervention is essential. Remember to keep repeating the above steps with a periodicity of 12-24 hours at the start of the treatment and then every other day till the wound heals and seals itself.
To join the animal welfare movement contact gandhim@nic.in, www.peopleforanimalsindia.org
