Sunday, June 5, 2011

B is for BONES

The last several days at work have been jam-packed with the best of the ER.  I've been too busy at work to blog, and too tired when home to write - I'll spend the next few days catching up on the action.

The first two cases I've grouped because they have a similar theme: B is for bones.

Tina, a 4 year old pit mix, presented to us early Monday with a primary complaint of "painful."  Tina's owner, Sally, was a 30-something, friendly, level headed person.  Upon arrival she noted that an acquaintance had given Tina rib bones, despite multiple pleas NOT to feed this to her dog.  This, unfortunately, had happened before, and I had been the veterinarian to see her, so Sally was relieved to see me, a familiar face.

Tina had been vomiting bones, and was straining to defecate.  She was painful.  Physical exam revealed a fairly stable patient, with normal vital signs.  Rectal exam, however was very abnormal.  Shards of bone were present in the colon, easily within reach  Tina had been straining to pass these splinters and fragments of bone, but the pain was too great for her.     We administered a strong pain medication and sedative, and I removed these bones.  Tina was 100% more comfortable, and radiographs revealed that no further bones remained.  I sent her home with a zip-lock bag full of the bones I removed, and a letter to her friend, written in a professional tone, but with the gist being: STOP FEEDING BONES TO YOUR FRIEND'S DOG!

Chet, a 5 year old Cairn terrier, presented for abdominal pain.  He was previously healthy, and had developed vomiting over the last 24 hours.  His owner, David, revealed that his aunt had given Chet a knuckle bone 2 days ago.

Radiographs revealed bone shards throughout the intestinal tract, from the stomach all the way to the colon.  Medical therapy was started, including IV fluids and pain control.   Less than an hour after presentation, ultrasound revealed a perforation and immediate exploratory surgery was performed.

Exploratory surgery revealed a perforation at the distal ileum due to sharp fragments of bone.  Surgery was difficult, and the bone was removed and the perforation repaired.  Broad spectrum antibiotics, nutritional support, fluid therapy, and pain control were adjusted as needed over 3 days.

Chet discharged several days ago and is doing well.  Needless to say, neither of these families will EVER feed bones to their dog(s) again!

No comments:

Post a Comment