Some days, I wish I could escape all the traumatic injuries that I see and treat in the clinic at Saga Humane Society. There are times that it can be overwhelming. Dogs that get loose or run free are at such high risk of injury here in San Pedro. The dog bites, the hit by golf cart (or taxi, or car), the unknown injuries. It never seems to end. Although sometimes difficult to enforce, it is actually illegal in Belize to let your dog run free off your own property. So many injuries that I see would be avoided if owners kept their dogs well secured in their yard, or in the house.
CAUTION GRAPHIC PHOTOS!
Recently the staff was called to go downtown to pick up a puppy that had been reportedly hit by a taxi, the driver did not stop. Noemy found him cowering in town with severe leg wounds. He was already waiting when I arrived for the day. We quickly assessed him, gave him sedation and fluids, and started cleaning and flushing the wounds.
Woopie When Found and His Wounds
They were full of dirt and sand, one still had a small vessel pumping blood when positioned in just the right way. There was enough tissue to close, but there was some tension and I worried about how things would turn out over the next week. I started him on antibiotics and anti-inflammatories, applied a light bandage to each front limb, and hoped.
By the next morning he was up and walking. As I suspected there was were no fractures involved. His feet were moderately swollen, which at first I attributed to his overnight bandages, but over the next day they did not improve. It became obvious that there was an issue, likely a combination of damage to the blood and lymphatic vessels along with the closure I had done were not allowing the fluids to get out of his feet and back to his body. I waited and watched, hopeful that little collateral vessels would begin to do a bigger job, and sure enough within days he had normal feet once again! He was a very happy dog.
Big Feet and Being Goofy
Each day we kept a close eye on his progress. Eight days later I was able to take out many of his stitches. In the coming week I should be able to finish the job. It’s challenging to get good photos when the puppy is licking your hair!
Woopie is looking forward to a full recovery.
Recently I was called to a Sunday night emergency, just after I had put on my pyjamas the call came for dog bite. I hopped on my bike and headed to work. This was a dog I had examined before. She had been bitten in the rear leg by a dog that runs loose in the neighborhood causing problems. The owner could tell that the leg looked broken. I took one look and winced. This dog is not friendly to strangers, but at that point she didn’t care. I gave her sedation to better assess the issue. Her left hind leg had a few puncture wounds. Her lower leg was moving in an abnormal direction, and when I felt it I could easily tell that both her tibia and fibula (the bones between your knee and ankle) where both broken about two thirds of the way down. This dog had no muscle coverage in the injured area, her leg was basically swivelling around. I knew that a splint would be an effort in frustration and failure. Her owner is a very intelligent woman and we talked frankly about what to do. I bandaged the leg for stability, administered antibiotics and pain meds, and we all went home to bed.
The next morning I arrived at Saga fresh from my workout on my day off. I was prepared for yet another amputation. Ingrid already had the dog clipped and prepped and ready for surgery. People often say that dogs are a three legged animal with a spare. Many dogs can do well on three legs and I knew that this would be the least painful most successful option in the long run. Although her fracture was low, it is always appropriate to amputate the leg up high through the femur bone.
Leg Amputation Due to Dog Bite
By the next day she was already up and around.
1 Day Post Surgery
Within forty-eight hours she was back at home with her family doing well.
My final recent trauma drama was a young mix breed dog. A typical local “potlicker” with the fat lips of a sharpei. This dog had come from the mainland and had seen a visiting veterinarian on a weekend that I was away. He had an old infected hind leg fracture with draining wounds on the skin. This was likely a hit by car. He was put on antibiotics and told he needed amputation. This dog had never before been to a vet.
My first time seeing this dog was the day he came for amputation, it had been weeks since he had been in. He looked happy and healthy but his leg immediately made me uncomfortable. It was stuck in a straight position and the bone was very thick and weird. He had some moist scabs high up near the hip. I could not perform this surgery without more information. I sent him to the human clinic for an x-ray. When I got it back I could see that his femur bone (between the hip and the knee) was broken then partially re-healed, but the fractured section was very thick with a irregular hazy appearance. The problem was quite high up. Close to the hip, the bone appeared normal.
In the afternoon I set about doing the hind limb amputation. Luckily one of the pieces of equipment that I donated to Saga from my gofundme (thank you again if you gave!) was a cautery machine. This came in very handy.
When amputating a hind leg there are quite a few annoying blood vessels. The femoral vein is very large and at times it is hard to tie it off well on the first try. This was one of those times. I found out very quickly that the vessel needed to be re-clamped and ligated again. This is a common minor complication that can be quickly corrected.
A Little Bleeder and Leg Suspended
Once I was down to the bone I used a gigli wire with a little handle at each end, pumping my arms back and forth, back and forth, to essentially saw through the bone with friction by hand. An assistant (Ingrid) provides counter traction. This was way too easy, I knew something was wrong. Upon further examination I could tell that the section I had cut through was dead. I could not just leave dead bone in this dog. I spent the next long while dissecting up and around this piece until I came to normal bone and then again, with difficulty, was able to use the gigli wire to cut through to a healthy section. I also found the splinter of bone that was causing the leaking wounds through the skin.
Section of Dead Bone
Finally I was able to flush the area, close the muscles over and eventually the skin. This was one of the most mentally and physically exhausting surgeries that I have performed in my career. Sometimes being the only vet is just plain hard.
Final Product Right Hind Leg Amputation
The next day the leg looked very good. The dog was already walking and was eating. He also had a little bit of bloody diarrhea. Blood in diarrhea is not uncommon to dogs and he had been through a lot of stress, we dewormed him and started some treatment. I was still more worried about whether I had gotten all the infected bone out of his leg. Within a few more days he was vomiting, lethargic, and not eating. We continued to be aggressive with our treatment.
A week after I literally had blood, sweat, and tears over this dog’s extremely challenging surgery I came into work to find he was dead. His amputation looked amazing, no signs of swelling or infection, I could not have asked for better. You see, this dog, as I said, had never been to a vet. Although he looked happy and healthy aside from his leg, within a day he was exhibiting the first early signs of the parvo. Parvo is a horrible virus that basically kills off the inner lining of the intestines. The death rate from it here and elsewhere is very high. Parvo is preventable by proper vaccination. The timeline from infection to symptoms can range from 3-14 days.
The ending to this story stung like a bee. There was no time to cry, just a waiting room full of more patients to see.