Wednesday, January 30, 2013
Every veterinarian that works on small animals is aware of the classic battle. Small dog versus big dog. Now I know many of you will say to yourself, "I know so and so's little dog and it is so tough it puts all those big dogs in their place". That might be fine and good for so and so's dog but I am talking about the battle where big dog is not intimidated by small dog and as proof picks up small dog in its mouth. The resultant injuries can vary from mild to severe and this case was one of the worst. Shortly after the call came in a small ball of blood covered fur with legs, teeth, and ears was carried in by a very distraught owner. The dog was in shock and was bleeding from multiple wounds. After shaving the dog we found severe bite wounds on both sides of the abdomen with one side of the dog bulging out oddly. A look with the light through the small tooth hole confirmed my suspicion that the bulging was caused by intestines under the skin with no evidence of a body wall to hold anything in. I personally think the worst part of being a veterinarian is having to deliver bad news. I discussed with the owner how grave the situation was with her dog. I told her what things we could offer at our clinic and what could be done elsewhere. Of course we discussed the necessity of surgery and potential for the dog expiring at any minute. She implored us to do everything we could to save the dog but she was not interested in going elsewhere. We immediately started the dog on intravenous fluids to stabilize it and prepared to go into surgery. The owner was too emotional to stay at the clinic and said to call her on her cell phone if we needed anything. Once we got into surgery things went from bad to worse. As soon as I opened the incision through the skin I know we were in big trouble. The only way I can explain without posting a very graphic photo is to say that the inside of the dog looked like hamburger and sausage. The entire side of the abdomen (the muscle) was the hamburger torn open with the intestines (the sausage) coming out with multiple areas of damaged and bleeding blood vessels interspersed. I immediately had my technician call the owner and put her on speaker phone while I stayed in the sterile surgery. By the way, if the vet is calling you on speaker phone from surgery, they are usually not calling to wish you a happy birthday. Avoiding the hamburger and sausage analogy I explained that the dog had a very very poor chance of A: having me get it all back together in a semblance of a whole piece and B: having all of those stitches stay in and C: not dying during surgery and D: even if it survived surgery not dying from infection in the meantime. I once again, this time very strongly, recommended euthanasia. She essentially ignored my recommendation and instead said do whatever you can in surgery to save the dog. Then she said, "Just promise me that everything is going to be ok. Promise me that my baby is going to be just fine." Again I re-iterated that the dog's injuries were extremely severe and likely life threatening with a good chance of not making it through the surgery. Her response, "Just promise me that he is going to be okay and be just fine". On occasion, rare occasion, I am tempted to reach through the phone, grab the client by the shoulders, look them straight in the eye, shake them just a little, and say, "Are you listening to a word that I am saying?" By some miracle, and a lot of creative suture work, I was able to get all the insides back inside and the hamburger wall to be one piece. By another miracle the dog was alive at the end of the surgery. Sadly this fluffy little dog had used up all of its miracles. It appeared to be waking up shortly after surgery, but then returned to comatose and after about 4 hours passed away. During those four hours I had been on the phone multiple times with the owner letting her know the progression of events and unlikelihood of survival. Finally after the dog passed away I got to make my least favorite phone call and share the bad news. She expressed her gratitude for all the work we had done for her dog and calmly said she wouldn't be able to come in and pick up the body till in the morning. She was very quiet and gracious and though I was surprised at how she handled things I figured that would be the end of the story. The middle of the next morning I was out in the large animal section of the clinic when I suddenly heard what I thought was a siren of some sort followed by some pounding noises. Confused I listened more carefully to try and figure out what was going on. Once the cow I was working on in the chute stopped banging around I could very clearly hear this. (Keep in mind the siren type sound) WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAH MY BABY!!! WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAH pound pound pound pound etc. MY BABY!!!! WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAH. Followed by the loudest screaming sobbing I have ever heard. Realize I can hear all of this through one concrete wall and two interior walls. Then it would quiet down for about 2 minutes and the cycle would repeat itself. WAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAH MY BABY!!!! I think you get the idea. This cycle repeated itself for a solid 15 minutes with mild variations. My technicians and receptionists described the scene to me after the fact. The explanation to the noise was of course the owner of the fluffy dead dog. She went in to see her dead dog which was located in our kennels at the back of the clinic. She walked quietly up to the front reception area then suddenly her blood curdling screaming began and she sprinted back to sob beside her dead dog. The gentlemen with her would get her calmed down and begin walking her out of the building only to have a repeat performance every time she reached the reception area. For a few minutes my staff thought they were going to have to call the authorities to have her removed. I always chuckle inwardly when people make the comment along the lines of I bet you went into veterinary medicine so that you just have to deal with animals and not people. Without a doubt some of our most rewarding and most challenging times are dealing with people and the emotions attached to their animals.