Tuesday, September 25, 2012

Kudos

"Do you have an internet survey?"  my client asks, after receiving my update on her pet this morning.

"Not a specific one, but we do have paper surveys in the clinic. Why?" I replied.

"Because you were fantastic!" She said. "And everyone should know you are terrific!"

Positive feedback is amazing!

~ERdoc

Monday, September 24, 2012

Ouch.

Clients rushed in the front door, carrying their 60#, 2 year old German shorthair pointer.  "He's been shot!"

I quickly assessed the patient, "Theo."  An entry gunshot wound was present on his flank, and an exit wound on the other side.  His mucous membranes were gray, and he was unable to stand.  Theo was suffering extreme shock, and likely bleeding internally from the gunshot wound.

His family immediately approved triage care, and an IV catheter was placed.  IV fluids were started, initial labs collected, and pain relief medication started.

"Do you know what happened?" I asked the family.

Through tears, the family explained what had occurred. "We let him out to pee..... We heard a gunshot and ran outside, and found out that he had jumped over the fence.  The neighbor shot him just because he could....." The story broke away as the clients sobbed and hugged each other.

I returned to assess Theo.  Therapy managed to improve his vitals, but he was still in a critical condition, likely due to internal injuries, bleeding and possible rupture of vital organs.  His abdomen was becoming visibly more distended by the minute.

The only option for Theo was an immediate abdominal exploratory surgery to assess and attempt to repair damage.  His family and I discussed risks and benefits of surgery, with ultimately no other way to try to save his life. It was surgery, or euthanasia.

The clients elected to proceed with surgery, with the clear instructions given to me that if it didn't look like a good chance at survival, then euthanasia would be their choice while Theo was under anesthesia.  As we prepared Theo for anesthesia, blood started to pour out of his gunshot wounds.  Pressure was applied, a unit of blood prepared for transfusion, and he was prepped for surgery.

Within minutes I was in his abdomen.  My assistant applied pressure to bleeding vessels and held the body wall out of my way while I quickly assessed for injuries.  One puncture to his bowel was found.  Then another. And another.  Ultimately, I located 9 perforations, 2 places were the intestines were nearly severed, and his major blood supply to the intestines was severed in multiple locations. Feces and tapeworms oozed out of the open intestines, and blood was everywhere.

I made the call.  There was nothing left to sew together, and, in reality, no chance for Theo to recover from this injury.  The clients and I made the difficult decision to let him go.

Theo's family returned to say goodbye.  I grieved with them, and they shared memories with me of his life.  The family thanked me for trying, and thanked me for being their in their time of need.

For the rest of the evening, my staff and I tried to understand the mentality of the person who shot at this kind, young, great looking dog.  I understand if the person's life, children, or pets had been in danger...... but out of spite? Because your neighbor's dog jumped the fence and *gasp* stepped on your property? I just can't understand.

I'll be thinking about that family and their loss for a long time.  I know we did everything we could - I just wish the injuries had been repairable.

~Erdoc