Today
was a very busy day! We were packed with
technician appointments, and we also had a couple of emergencies. The first emergency was a transfer Shepard
mix, named Mack, who had GDV (Gastric Dilatation and Volvulus—
basically, stomach bloat and twist). As
I said on day 6, stomach bloat and
twist (GDV) is when the stomach bloats and twists 180-degrees. Since the stomachs of dogs hang down, this
can happen quite easily, especially with medium-sized and larger dogs. It is
really harmful to the dog because it releases toxins and doesn’t allow anything
to enter or leave the stomach, which prevents the dog from getting nutrition
and from releasing digested food, and causes the stomach to bloat even further.
Because the blood supply is being cut off to and from the stomach, the stomach
tissue begins to die. This can result in death, so the dog needs to be taken to
the hospital right away when this happens so that he/she can receive the
surgical procedure that will fix his/her stomach. Mack was found with the GDV yesterday, at the
kennel in which he was boarding at.
However, the vet who concluded that he had GDV didn’t perform surgery,
nor did they send him over to our hospital until the next day! I couldn’t
believe my ears when I heard that. Mack
was in so much pain, and the person who looked at him at the kennel, being a
Veterinarian, knows that he is in a lot of pain and could die within a day or
two. I couldn’t believe it and didn’t
understand at all what was going through that Veterinarian’s mind when he/she
was looking at him. But anyway, Mack
made it to our hospital and made it through the surgery! Getting him prepared for the surgery was
difficult, because we were giving him anesthetics and hooking him up to the anesthesia
machine, giving him fluids, and were also trying to get a tube into his stomach
(through the twisted part) to get anything and everything out of his
stomach. That took a while because we
couldn’t get the tube through, but once we did all sorts of thick, bloody fluid
came rushing out and continued to come out for a couple of minutes. And since the blood and fluid had been
sitting in the stomach for a while, it smelled awful. Once the fluid stopped coming out, we moved
him to the surgery room and Pat got him ready for the surgery while Dr. Todd
prepared for the surgery. The surgery
took a while (about an hour and a half or so [including the time it took to
tube/drain the stomach before taking Mack into the surgery room]), because in
addition to draining the stomach, blood kept needing to be drained from the
surgical sight (so Dr. Todd could work properly) once the surgery was
underway, he had to check the spleen to make sure it wasn’t damaged (the blood
supply can also be cut off to the spleen when twist occurs—in such a case, the
spleen would have to be removed), and Dr. Todd had to make sure the stomach
was still relatively okay as well. Part
of the stomach was, of course, blackened (dead), but Dr. Todd said the dog
would be okay. He made a small incision
in the dog’s body wall, and then sutured the stomach to the body wall. This prevents the stomach from twisting
again; however, the stomach can still bloat again, which is still an emergency situation,
but not life-threatening like the stomach twisting. No one
knows for sure why the stomach bloats and/or twists, but the possibilities are
that the dog could have poor motility, a tumor, a foreign body, drinking and/or
eating too much too fast and then exercising and/or having a large air intake. After Dr. Todd sutured the stomach to the
body wall, he re-checked the innards to make sure everything looked okay and
then sutured Mack up. He was moved to
the recovery room, and since he is staying the night to be observed, he was
still in there when I left at the end of the day. Even though he’s sleepy, dazed, and in pain
from the surgery right now, he (much logically) seems to be feeling much better
than he was this morning when he came in.
He was, of course, receiving antibiotics, pain medication, and fluids, and
he should be feeling even better tomorrow!
Mack when he first came into the hospital.
His bloated stomach.
Placing the long tube down his esophagus, fighting to get it through the twisted part (this took a while), and finally getting it into his stomach to drain anything and everything that has been stuck in there.
Getting the tube in place to drain the stomach contents into the bucket.
The contents draining.
Massaging the stomach (and moving/flipping the dog over a few times) to help the contents get out.
Mack being prepared for surgery.
Blood clots began to drain from his stomach once the surgery began.
Making the incisions and starting to look around the area in the abdomen.
Moving organs around to get to the stomach.
The stomach; it can't be seen as clearly in this picture because of the lighting, but the darker parts of the stomach are completely black (the black parts are the dead tissue of the stomach).
The spleen; it was being checked to make sure it was okay and healthy too (which it was, thankfully).
Getting tubing ready to drain all the blood and fluid around/in the abdomen area.
Draining the blood and fluid out of the area.
The container on the side where the blood and fluid was draining to.
Making the incision in the body wall and suturing the stomach to the body wall, to prevent it from twisting again.
The finalized suturing and stapling.
Later
in the day, we had another transfer patient (a boxer named Ippy), who had
pyometra. Pyometra is a disease of the
uterus caused by hormone fluctuations, where the uterus fills with pus. This is another emergency case that causes
serious pain for the animal, and can cause death if not treated quickly. When pyometra occurs, the uterus has to be
removed; so essentially, the animal has to be spayed. Note: pyometra can be avoided by spaying your
animal when they are young. This is just one of the many reasons why you
should spay or neuter your animal when they are young; many, many problems can
arise if your animal isn’t spayed or neutered. Jen, Nancy, and I first took x-rays to see
how big the uterus was (it was huge), and then we injected her with an
anesthetic, hooked her up to the anesthesia and oxygen machine, and took her
into the surgery room and prepared her for surgery. Dr. Amanda performed the surgery, and had a
bit of a difficult time for a while because a) the uterus was huge, b) it kept
getting caught on/tangled with other organs, and c) the uterus was so huge,
even the littlest amount of force could cause the uterus to burst (which, of
course, would cause the pus to get all over us, in addition complicating the
surgery all together); so, Dr. Amanda was being extremely careful. When she was finally able to get the uterus
out, tie off the stump, and cut off the uterus, Stephanie and Jen weighed it
and it weighed about seven pounds! As I
said, it was huge. After Dr. Amanda
stitched her up, Jen and I moved her to the recovery room. I’m sure she felt so much better (besides the
pain caused by having surgery) when she woke up!
Ippy, right when she arrived, right before x-rays. She felt miserable.
The entire light grey area under her spine is her uterus.
Ippy's enlarged vulva, which was also dripping with the pus from her uterus.
Carefully retracting the uterus out of the body.
The whole 7-lb uterus once it was all out of the body.
Another view of the uterus.
Cutting the cuterus out after tying off the uterine stump.
The finalized suturing and stapling.
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