25 January 2012

bullet: dodged

Posted in Uncategorized at 11:08 am by ejh345

At some point between being busy with clients Monday morning and wringing my hands feeling wretched about the situation with the missed emergency call, that client called the clinic and asked for his dog to be seen. I had gone in early and was planning on leaving a bit early, and so the timing was perfect: whenever he could get her in, I’d be happy to see her. My receptionist took the call and said that he sounded fine on the phone.

When he arrived in the clinic 45 minutes later, happy, hyper lab with a bulging spay incision bouncing at his side, I cut right to the chase and told him how sorry I was about the situation.  He shook his head and told me not to worry, that he understood sometimes things just didn’t work as they should.  Relief poured over me, but was quickly dampened when I confirmed that my lovely incision had indeed herniated: soft bowel loops could be reduced back into the abdomen, but clearly the abdomenal wall was open. And had been since Friday night.

Have I ever mentioned that I hate big dog spays? The ovaries are generally deep in the abdomen and so I either spend too long trying to exteriorize them, or I am tying off the arteries without great visibility and it is just stressful for me. However, until now I had yet to have a single actual complication. And I thought that her spay had been one of the least stressful ones to date. Everything had gone smoothly. But, these things happen.

I took her straight back into surgery and found remarkably pink, healthy intestines, but a rather inflamed abdominal wall. I flushed, debrided, resutured, said a thousand Hail Mary’s, and woke the pup up.  And then spent the entire night sweating over whether it would heal properly. 

In the morning I was thrilled to see my patient wolf down her breakfast, pee and poop normally, and generally look like a happy, healthy dog with a closed abdomen. When the owner came to pick her up, he apologized for sounding short in his messages and disagreed when I assured him that he had every right to be frustrated and upset. I cautioned him about the chances of a recurrence and the importance of keeping the dog as quiet as possible for the next few weeks, and sent them home with a recheck appointment scheduled, my cell phone number, and instructions to call if there were any concerns at all.

Going forward, every surgery patient will have our emergency number printed on their invoice, and we’ll be doing away with the redundant, stupid answering system.  This situation could have gone wrong in so many ways, and I know the dog even now would have a better prognosis if I had been available Friday night. But for now I am deeply grateful for my wonderful clients, their friendly and forgiving nature, and the ability of a Lab to heal thyself, with a bit of help from her bone-headed vet.

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