Hit-By-Car

I am the queen of trauma...if your dog/cat/whatever is hit by a car, send it my way...seems like that is all I have been seeing the past few days...and not just small accidents, huge trauma!! First HBC: 8 yo f/s Rottweiler - ran over by garbage truck, truck stopped on her back leg, then backed up real quick and degloved all the skin off the foot!!! Ouch!! Yeah!! She came in to me in shock of course...started her on fluids, administered pain meds and sedatives, ran some bloodwork, after stabilization took some rads of chest (to look for contusions-bruising in lungs), rads of left shoulder, rads of left leg...the story gets more complicated and sad for this dog - she has two different types of metastatic cancer - osteosarcoma (bone cancer in the left scapula) and mast cell tumor in the left hind limb (the one run over by the truck!!) Why does this confuse things? Because the wound on her back limb is so bad - down to the bone - tendons exposed - and ultimate treatment would be amputation...not an option in this girl because of the osteosarcoma in the front limb - she would not survive as a tripod - would probably end up with a pathologic fracture of that limb. Ok, more complications, dog is supposed to go through radiation therapy for the tumors at UW-Madison...not so much gonna happen now. Well, dad is a ER doc himself...has money...keeps saying no heroic measures for the dog...however thousands of dollars for an estimate and poor prognosis is ok!!! Moving on then...radiographs of chest show a possible nodule--even more negative strikes against this poor dog!! Luckily, amazingly - no fractures in any of the limbs, not even the one the truck was on. So, we get her stabilized and then bandage her limb, plan is to do dressings on the limb because I have to wait until all the tissue declares itself dead or alive before it can be fixed....this can be a long time...So, did honey bandages...actually placing honey on the wound (has antibacterial properties and also osmotic to help pull junk out of the wound)...Dog was doing well..sitting up, alert, actually walking on that limb (I also placed a hard splint outside the honey bandage just to give her more support in the limb)...dogs are amazing...you know that has to be painful...so she got an abdominal ultrasound yesterday because it was part of staging for the cancer---strike 3 -- masses in spleen...Dad visited, cried, going to euthanize today I think...amazing dog..made it through so much...so sad...I did one more bandage change last night and wound is actually granulating in very nicely...took some pics...scroll down after reading this blog to see the images...prepare yourselves!! so that was Lily dog...great sweet girl. My other HBC came in last night...8yo f/s Pug--laceration on top of head (down to skull...yes can see the bone...I mean the whole top of the head!!!..skin is pulled away!!), right eye was proptosed (popped out of the socket!!), dog can't use limbs, breathing horribly...so I go to talk to owner and find out.....she ran over the dogs head...oh my god...so I go through my schpeel...dog is very critical...head trauma..MRI/CT and wound surgery but not for couple days until stable...thousands of dollars..possibility of no dog after all this. Women has to run to bathroom....I do not know if she vomited or what,,,but then she came back and was able to place a small deposit for the first night,,,,but only for supportive care which means I didn't get any radiographs...Just lavaged wound on head and placed skin staples to hold it together so skull wasn't exposed, took minimal bloodwork, started pain medications and minimal fluids...monitored overnight...was doing ok but early in the morning began going into respiratory distresss.....last I heard the doc I rounded to was trying to get ahold of owners, they are a money case so I am afraid she may be euthanized....hey I tried...so her pics are below too. Ok, away from head trauma...you all saw the pics of the dog that ate the rocks..my first foreign body surgery...yay me..exciting even though I do not like surgery...dog did well and went home...phew, successful surgery!!! Last night was absolutely horribly busy...horrible...what did I see...a down dog with a disk lesion that transfered to another vet at 5:30am for back surgery to remove the disk; a couple vomiting dogs that just wanted outpatient treatment; saw a dog with a laceration on his metacarpal pad -- couldn't afford surgery so I cleaned and bandaged it and told him to see his vet for follow-up; some other lame dogs; euthanized a cat with feline aortic thromboembolism (heart disease and then throw clots to legs and basically poor prognosis). The other night, saw two Boston Terriers (Zoe and Milo) brother and sister who had eaten mom's ibuprofen supply!! This causes renal toxicity and GI ulceration in dogs...activated charcoal to vomit, IV fluid diuresis, pepcid, sucralfate (GI protectant)...continued to vomit through night...transferred to rDVM in am, hope they did ok,,,cute as heck...took pics of course...they are below on the blog also.... So now I finally have 3 days off...woke up early and got ready, met Talia and her boyfriend and then Andrea (a visiting vet from Italy) for lunch...that was fun..got some pics so see below as well. It has been storming like crazy here!!! Man oh man...lost power in the clinic one night a million times...not cool...That's about it...if I think of more interesting cases I saw the past four days I'll blog them later.