Suturing, antifreeze, and a necrotic tail

WOW! This was certainly one of the most exciting nights so far! It was also very sad, which is unfortunate. I felt that I learned a lot, though, and gained more experience for sure...

Suturing When I came, there was a dog who was very sick, lethargic, and not having any bowel movements. So, of course, the owners were worried and brought her in. For the longest time she was a mystery case, and we didn't know what was going on. All kinds of tests were going on, and the blood work was coming back with strange results. Namely, the white blood cell count didn't even register, and the plasma was yellow and foamy after being spun out and separated from the red blood cells. Hmm. Also, the glucose was super super high in the urine. Anyways, people started suspecting antifreeze, so they did an antifreeze test, and it came back negative. Finally, the dog started really crashing, so they had to put her to sleep. It was sad. So, afterwards, Dr. G. opened up the dog to do a necropsy within the abdomen, and began looking around to see what could have been the cause of death. She allowed me to don gloves and poke around, and I was really excited to do that. I haven't done it often, except once and now will be twice on a pig. This is amazing. So, I poked around, and she noted that the spleen looked odd. It was kind of patchy-looking in color, so even I saw it looked funny. The kidneys were fine she said, but there was a lot of free blood in the abdomen. It's supposed to belong somewhere, like, oh, let's just randomly say.... within the circulatory system! Hmm. So, Dr. G. looked further, and she saw that the intestine had been perforated, it looked like. On closer inspection, or, from about 2 feet away, she could see that there was a huge, 1.5" abscess attached to the abdominal wall and the vena cava. It was enormous! She cut it open, and it was full of white stuff, infection. So, this was an obvious issue. Dr. G. suspects that the dog ate something sharp a while back, it poked through her intestine, which caused an abscess, and then it was like a GI blockage. So, she concluded that the dog most likely died from a mixture of sepsis (infection in the blood) and GI obstruction. This is totally supported by the lab findings, because the white frothy plasma of blood was basically mostly white blood cells and fragments of other lysing (or dying/being eaten up) cells that were destroyed. That's also why the spleen was messed-up, because it filters the blood. So, the filter got clogged, and the blood wasn't working as it should have.

Hold on, it gets better. THEN, after the necropsy, the doctor said that someone had to suture closed the incision in the abdomen. Both night nurses jumped at the offer, but they had to go do rooms, since clients were still coming. In my head, I was like, "OOH OOH! Me, me me me!" I didn't dare to say anything, though, because I didn't think it could happen. But, behold, I was chosen! Dr. G. handed me the instruments, a suture, and showed me how to begin. First I sewed up the inner layer of the abdomen, with the muscle and fascia, and then I closed up the outer, skin part. After I was done, Dr. M. came by to look, and she and everyone else there said I did a really good job. I was so excited! All those sewing lessons came in handy.

Antifreeze This was like a game of "Guess-who". So, I guess everyone was determined to have at least one pet come in poisoned by antifreeze. So, first we suspected that the dog in the above story had antifreeze poisoning, but she came out clean (of ethylene glycol, anyways). But then, as two of the doctors said their good-byes that very same evening, they quickly came back with someone that was left on our doorstep... a poor old little jack russel terrier in a carrier. We were indignant, as the little guy was shivering in about 45 degee temperatures. As the nurses quickly got started taking care of him, the receptionist came by, and looked surprised. We asked why, and she said that a lady had brought him up front earlier and had said that he was abandoned in the park. The receptionist told her to take him to Dove Lewis, the emergency hospital, so the lady left. However, she apparently just left the dog by the back door. How rude! I hate when people do something horrible like this. Anyways, that poor dog was just not looking good. They pumped IV fluids into him like no other, and did blood tests and such on him as well. He started out with a rectal temperature of 92, which is DEFINITELY close to death. With heating blankets and the heated pod, we managed to get it up to 96 shortly. But later, the doctor suspected something and had him tested for antifreeze. Sadly, it came up very positive. This dog was poisoned by ethylene glycol. This is sad, because they rarely survive this poisoning. So, the doctor tried an interesting treatment: strong vodka. Apparently this can somehow counteract the effects of antifreeze when given to the dog, but it also has some bad side effects. They gave the alcohol to the dog, and Dr. M. took him home with her. Sadly, he died overnight. It's terrible that he had to die, but at least he was loved by all of us in his last hours. It was an interesting treatment, though, that I've never heard of.

Necrotic Tail Well, poor little Carson the Chessie came in again (after coming numerous times lately) to have his tail looked at. A couple of weeks back, the tail was wounded, and had to be partially amputated. As it was healing, however, something bad happened so that it became necrotic (dead flesh). So, a week later, they did another surgery to amputate a bit more of the tail. When the doctor looked below the bandages for the recheck, she was shocked and dismayed to find that the flesh was necrotic again. It was blackish at the tip, and looked like a big scab. The doctors all collaborated, and decided to do a final amputation, this time all the way up the healthy tissue, to make a little stump like boxers have. It would look good on the dog, and this way they can make sure to be at the healthy tissue so that any leftover infected parts don't spread and make the rest of the tail worse. Poor dog. This hurts a lot, but he'll feel better soon.