Second in a series
My first instruction, with Charley Garcia still on the phone, was NOT to remove the stick from her dog Ruby’s chest. Leaks can kill. That grotty elm branch, with its abundance of dirt, bark, and bacteria of many varieties, may have been keeping her alive. A projectile that has impaled a body, whether an arrow, spear, or part of a tree, can temporarily plug the holes it caused in blood vessels and lungs. We soon came to learn how important that was for Ruby. It was a mighty good thing Charley followed my advice.
As soon as our train-chasing Doberman patient was stable and anesthetized, she was thoroughly prepped from her throat to her lower abdomen. I was trained to be objective and I wasn’t new to emergency medicine. I sucked in big breath. We wheeled her into surgery ASAP.
My first responsibility was prioritizing Ruby’s internal injuries. Her x-rays showed that a 2-foot-long stick had been driven from the base of her neck, through her chest, her diaphragm, and into her liver. On opening her chest I found, to my astonishment, only a small tear in one lung lobe. Her heart, beating happily without a care in the world, had been completely spared.
This was not a routine surgery. All open-chest procedures are delicate. We had a dedicated assistant using the anesthetic breathing bag to gently inflate Ruby’s lungs, each time at my specific instruction. I severed the branch with bone cutters, irrigated the chest cavity with warm saline, and painstakingly closed the lung wound with fine suture material. I was ready with preplaced sutures on the inside of the entry wound as nurse Amos, on cue, very slowly extracted the offending wood from the front of Ruby’s chest. More irrigation and suction.
Another miracle: the business end of the stick, its point lodged in Ruby’s liver, had inflicted only a minor wound. After removing this last piece of elm through the chest incision, a Gel Film patch was applied to seal her liver. The arduous task of decontamination and wound closure lay ahead. Next week: The locomotive had won the race but could the loser survive?
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Dr. Jeff Nichol is a residency-trained veterinary behaviorist. He provides consultations in-person and in groups by Zoom (505-792-5131). Each week he shares a blog and a Facebook Live video to help bring out the best in pets and their people. Sign up at no charge at drjeffnichol.com. Post pet behavioral or physical questions on facebook.com/drjeffnichol or by US Post to 4000 Montgomery Blvd. NE, Albuq, NM 87109.