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Right back into it :-)

December 18, 2011

Medicine Cases, Surgery

I was pretty excited about going back to work. I really missed doing what I do best: ‘treating my sweet patients’. I was scheduled to do surgeries that morning and I did not have much on. I first had to desex ‘Milky‘.

She was found to be in season and her uterus was fairly enlarged and vascular.

Surgery went smoothly but then she developed very pale gums a few hours post operatively. Unfortunately, that un-nerved me and I felt compelled to go back into surgery to make sure non of my ligatures had slipped off. My colleague convinced me to apply an abdominal bandage on Milky instead. The tight bandage seems to always help in preventing further bleeding and allows for a stable clot to form. I called and informed Milky’s owner about our predicament and advised them she will be kept hostage for close monitoring overnight.

Milky was not all too baffled with the sticky situation she was in.

milky all eyes
Basically we always inform clients we do not want to desex their pets if they are in season. It is too risky and potential for post-operative bleeding is just very high.

We usually check over the patients and when we discover any signs indicating the patient is in season, we call off the surgery.

Anyhow back to my day, I then proceeded with collecting blood from our donor ‘Bella’. She was a hyper labrador and required a small sedative to allow for a successful collection. Oh, and I had brought in my cat, Lewi, in for blood testing, a grooming and vaccination. I doubt any of my pets are pleased with the fact I am a vet. One limp, one wink, one itch and I am all over them making sure they are okay.

Poor Lewi spooked me with his unusual and unkempt coat and I was concerned he may have underlying kidney disease. Thankfully his blood results came back normal and we didn’t need to sedate him for his quick grooming session. It is kinda ironic that I could not successfully collect blood from my own cat. I was the better holder of Lewi but my colleague Alana did the ace job of managing to get blood from my cheeky cat!

Here’s Lewi all trimmed and proper and keeping an eye on Punchkin’s movements.

lewi and punch
As for the afternoon, we were booked solid with consults and everything went smoothly.

I re-examined Milky and her gums were looking much pinker and she was heaps brighter.

Here she was imploring us to let out of her cage..

milky22

Tuesday morning came and I walked into the clinic and there was a mad rush. An emergency case had just been admitted (referral from another vet) that I had to simply dive into. Poor ‘Shani’ had a very distended abdomen and fever. Shani is one of the sweetest natured dogs I have ever met.

She snuggles up to you and looks intently into your eyes and will gently give you a kiss.

This is her below when we first admitted her. You can tell she was very unwell if you look at her facial expression!

Shani

We took radiographs and confirmed she had pyometra(pus filled uterus); a totally preventative life threatening condition if she were desexed! We had to perform the surgery immediately.

I opened up her abdomen and was relieved to see that her uterus had not ruptured.

Please stop eating right now and be prepared for the next two pictures. I ofcourse have to share photos of Shani’s enlarged uterus and show you what was inside of it!

shani's pyometra

pus filled uterus

I double checked all my pedicles(the ligatures placed on the ovarian and uterine stumps) and they were secure (not bleeding).

My biggest concern was her getting toxic/septic.

She was recovering slowly in her cage and then seemed to develop pale gums. Pale gums can be due to hypothermia (very low temperature) or blood loss or even pain. I made sure she was warmed up and given sufficient pain relief but her gums remained pale. Again I felt a huge knot in my tummy. I could not have done a better job than I did and was now seriously concerned. I had to monitor her CBC (complete blood count) to ensure she isn’t actively bleeding.

Needless to say, I had a sleepless night because I kept ducking in and out of the clinic making sure my little Shani was doing okay. I was very tempted to give her a blood transfusion but didn’t. I was worried that her body is already working really hard to fight against the infection in her blood stream and so a blood transfusion may ultimately lead to a transfusion reaction.

Thankfully Shani has pulled through after intensive monitoring and gone home and is currently being managed by her regular vet.

The rest of my Tuesday was packed with other routine surgeries and consultations…

Wednesday came and it was fairly quiet but then during our lunch break, we got a very distressed call. A client was bringing in his friend’s dog that he had just run over. Poor ‘Kellie’, a Rottweiler cross, was breathing rapidly and knuckling her left forepaw and had a few gashes here and there. I gave her immediate supportive care which included pain relief and iv fluids. She was not only in shock but also suffered from head trauma and multiple wounds.

In those situations, you must triage and treat the most critical symptoms first. My biggest concern was her rapid breathing. I had topped her up with so much pain relief and her breathing pattern was not changing. I decided to take chest x-rays at that stage. I found she had tension pneumothorax (too much air in her chest cavity preventing her from expanding her lungs properly).

I immediately proceeded with a thoracocentesis (put a catheter in her chest) and drained 36 ml of air.

Thankfully that did the trick. She seemed much more comfortable and was finally able to lay down and breathe better.

The next morning, ‘Kellie’ was ready to bolt out of her cage.

kellie

However, now that she was stable, we still had to reassess the rest of her wounds and determine the next treatment step. We started by taking x-rays of her left forelimb and ruled out any fractures or luxations. She had a huge haematoma (blood clot) in her axillary region which was compressing her radial nerve function and that is why she was dragging her left forepaw.

Unfortunately if our medical therapy + acupuncture sessions don’t help her re-gain full function of her left forelimb, she will need to have an amputation!

By Thursday, I was feeling pretty tired and looked like Punchkin below.

punch

We had a huge start to the week. Thankfully we didn’t have too much of a chaotic Thursday or Friday.

Now I must get ready for a whole new week packed with surprising cases and adorable patients and hopefully not too many critical cases.

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About Rayya

Hi I am Dr. Rayya. I created this site to take you on a journey of my life as a vet! I hope to inspire you, teach you, learn from you. Most importantly help pet owners and animals around the world by sharing pictures, videos and posts from my everyday experiences.

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21 Comments on “Right back into it :-)”

  1. nicole Says:

    “I was worried that her body is already working really hard to fight against the infection in her blood stream and so a blood transfusion may ultimately lead to a transfusion reaction.”

    rayya, this statement prompted my breathing to pause, allowing my brain to wrap around the power of your words. shani’s sweet little body was “working really hard to fight against infection,” something for which she didn’t cause or ask. this pure, sweet being is sick for no reason other than natural causes. it truly makes a person appreciate their life.

    when my little gwendolyn became sick in february of 2010, it sickened me that whilst i planned to hurt my body with bulimic acts, my baby was fighting for hers, at the purest level, at no fault of her own. more so, it sickened me that my brain had to think about not bingeing, that i couldn’t dedicate my undivided brain to my princess, who was hurting so badly, who was so traumatised.

    i am so grateful to dogs.

    and i hope that sweet Shani recovers quickly and happily. x

    Reply

    • Rayya The Vet Says:

      I totally understand where you are coming from, Nicole! These canines are so pure and they count on us. Routine desexing could have totally prevented ‘shani’ from going through her ordeal. She is still out of the woods. I will keep you posted on her progress…I am so glad gwendolyn recovered well and was your rock in your own healing 🙂

      Reply

  2. Dianda Says:

    Milky looks adorable!
    I quickly skipped the pictures from the insides. I have a weak stomach, sorry. 😦

    Reply

  3. magsx2 Says:

    Hi,
    I couldn’t think of anything worse than running over a friends pet, the people must be sick with worry over poor “Kellie”, I hope everything works out for her.

    Reply

  4. becomingcliche Says:

    Welcome back to the madness. Hope you’re taking good care of yourself. I am so happy to read a post from you again!

    Reply

  5. Rosie Scribblah Says:

    What a frantic few days. make sure you take care of yourself. I recommend a weekly therapeutic massage like reflexology or face / head massage. I’ve been having one for years and they keep me sane, de-stresseed and healthy. I love your blog and really appreciate the work you do for animals 🙂

    Reply

    • Rayya The Vet Says:

      Rosie I would love to get a therapeutic massage weekly but due to time constraints I don’t. I love reflexology and find it very helpful. I am glad your are still enjoying my blog…thank you so much for your kind words 🙂

      Reply

  6. Cowboy Says:

    Howdy Doc –

    Great shots of the Pyo uterus. Those are the kind of images people should see when they refuse to spay their dog. Kind of a shock treatment………

    Since your Thursday and Friday was somewhat quiet – you might pay for it with a busier than usual Monday and Tuesday.

    Take care……..

    Reply

  7. elizadolly Says:

    Your passion for your work is so inspiring.
    It’s reassuring to know there are passionate, devoted people out there.

    Reply

  8. Misty Shores Chesapeakes Says:

    Great pictures!

    Lewi looks so cute the way he is sitting 🙂

    I am so glad you were able to help those beautiful babies, keep us updated on their recovery, I sure hope the therapy/ acupuncture work for Kellie.

    Reply

  9. Animalcouriers Says:

    Wow, what a week! Poor old Shani, such avoidable suffering. You did well to get her through, not many are so lucky.

    Reply

  10. 2browndawgs Says:

    I did not know that it was not a good idea to de-sex a female when they are in season. Something I will file away in my brain. 🙂

    Reply

  11. Bassas Blog Says:

    I think your pets are very lucky that you are such a caring vet and so are all your patients!

    Reply

  12. autumnlists Says:

    Keep up the good work, Rayya! We animal lovers depend on good vets like you.

    Reply

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