Preventing pressure sores in a pet that stays lying down

Pressure sores do not appear at random: they form where a bony prominence presses against the surface with little tissue to cushion it. Knowing these points tells you exactly where to look each day and where to concentrate padding. In a dog or cat lying on its side the classic areas are the hip, the shoulder, the elbow, the hock and the area above the eye if the head rests in one place for long.

• Hip and pelvis, the points that bear most weight when the animal is on its side.
• Elbow and shoulder, often the first to show thickened, hairless skin.
• Hock, the bony point at the back of the leg, which drags on the surface with every attempt to rise.
• Chest and breastbone in animals that rest belly down for long stretches.
• Any point kept damp by urine, because wet skin breaks down far faster.

Changing position at regular intervals is the single most effective measure, because it takes pressure off the suffering points before the damage sets in. The goal is not perfection but consistency: a turn actually done every few hours beats an ideal schedule that lapses overnight. Here is a sustainable routine to adapt to the animal's size and tolerance.

1. 1

   Set a realistic interval and put it in the diary

   For many fragile pets a change every 3-4 hours during the day is a good starting point. Set a reminder: turning almost always fails because it is forgotten, not because it is hard.

2. 2

   Alternate the sides and the belly down position

   Do not just roll from one side to the other. If the animal tolerates it, also alternate short spells lying on the breastbone with legs tucked, which relieve the hip and shoulder.

3. 3

   Support the joints as you turn

   Move the body as a single block, supporting pelvis and chest together. A sudden movement on an arthritic hip hurts and teaches the animal to dread the moment of the turn.

4. 4

   Arrange limbs and head in the new position

   After each turn reposition legs and neck naturally, and slip a small cushion between the knees if it stays on its side. A limb left twisted under the body creates a new pressure point.

5. 5

   Note the time and the side you left it on

   Recording the previous position stops you always returning it to the same side and lets whoever takes over know what to do without asking.

The surface an animal lies on can prevent a sore or speed it up. A hard floor, a collapsed bed or a thin blanket concentrate the pressure exactly where it should not be. The aim is to spread the weight over a wide surface and keep the area dry.

If the animal has episodes of incontinence, add an absorbent layer on top of the surface and change it as soon as it is wet. The combination of pressure and moisture is the most aggressive for skin, and a pad changed in time prevents more damage than any cream.

Prevention plays out on the skin every day, which is why it needs to be looked at and touched regularly. A good check takes a few minutes and lets you find redness while it is still reversible, that is before it becomes an open lesion needing weeks of care.

1. Once a day run your fingers over the risk points and look for areas that are red, warm, swollen or hairless.
2. Press gently on a reddened area: if the redness does not fade when you release the pressure, the skin is already suffering.
3. Keep the skin clean and dry, wiping away any contact with urine or faeces at once with a product your vet approves.
4. Do not massage or rub areas that are already red, because the trauma worsens the damage to the deeper tissue.
5. Photograph doubtful spots with a date, so you can compare them over the following days and show your vet.