The Wild Wild West

It started on a quiet Saturday night.  I attended a dinner with the staff to say goodbye to one of our own.  We enjoyed food, drinks, and laughs.  I went home smiling and soon put on my PJ’s and headed to bed.  I awoke at 1:30 am and I was already on the phone.  Somehow I had answered while still asleep.  I quickly recognised those most familiar words, “Doctora, you have an emergency.”  It of course, was Ingrid.  She sounded far too chipper, and I soon found out that she was still awake, having not yet been to bed.  Within five minutes she was at my door, picking me up in the golf cart to drive me to work.  Biking around in the middle of the night would not likely be perceived as “safe”, even by me.

As we arrived I immediately recognized the male owner.  He is a well known local that makes one of my favorite unique island drinks.  He and his wife had returned home from a late night shift to find their small friendly dog having difficulty using its hind legs.  After a thorough exam, I gave an injection as well as some medications and home care instructions and we were all headed home once again.  By 2:30 am I was putting my head back on my pillow, having difficulty falling asleep after all of the excitement.

CAUTION: Some bite wound photos.

At 6:20 am the phone was ringing again, this time I looked at the screen before I answered, a number was listed with no name that my phone recognized.  As I said hello, the voice at the other end sounded panicked.  I knew her right away.  She quickly explained that her neighbor’s dog had been attacked by another larger dog.  I instructed her to send them to the clinic and rolled out of bed.  Pulling a scrub top over my head and exercising my self imposed special right to wear flip flops after hours, I hopped sleepily onto my bike and headed to town.  The owner met me minutes later with a small fluffy dog having bite wounds on both sides of her abdomen.  All I knew was that the dog who bit her dog was not her own.  I quickly realized that I would need help, and so as I sent the owner home, I called for assistance.  The dog was soon under anesthesia in order to clean and better assess her wounds.

Bite Wounds on Right Side

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When it comes to bite wounds there is often more than meets the eye.  On both sides although it appeared like small punctures, they connected to each other with extensive damage to the underlying tissues.  This needed to be opened up and flushed out before being sutured closed.  After a few hours we had everything squared away.  The dog was resting quietly in a cage and I was heading home by 10 am.

Closed Wounds on Left Side

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I stopped on the way to pick up a few groceries, and as I stood in front of the freezer trying to find affordable bacon, the phone began to ring.  I searched my bag and glanced at the screen, Ingrid.  Sigh.  I answered jokingly, wondering what could possibly be wrong now.  “Gunshot”, she explained sounding concerned, “The other dog involved in this morning’s dog bite has been shot.”  I quickly paid my bill and headed back to the clinic.

I arrived back at Saga to evaluate this large dog.  By all reports from all peoples I met, the shooter was yet a third party, but of course that was for the police to sort out, not me. Unfortunately, many hours had passed since she had been injured and no one had noticed until now.  She had been given an injection for pain and we now started emergency IV fluids.  Her heart was racing and she was covered in blood.  We began washing her down to find the location of her wound and soon found a single bullet hole entering her abdomen from the side.

Bullet Hole into Abdomen

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This was obviously not an ideal situation even in the most advanced of clinics.  This was a dog who desperately needed a blood transfusion and surgery and  was not likely stable enough for anesthesia.  We got her to a point where we thought it was best to open her up and explore her wounds.  As I cut her belly open from the midline I was greeted by a sea of blood.  Not having any suction here we began to use sterile towels and gauze to find the source.  Quickly I identified a dramatic hole in her small intestine, but could still hear air escaping and smell a foul odor.  Eventually I found a second area with multiple holes where the small intestine meets the colon at the area of the cecum (a small organ that dogs don’t have much use for now through evolution, but animals like horses and rabbits need for digestion).  This meant that mixed in with the blood in her abdomen was feces.  I took a moment to evaluate the entire situation in my mind.  I took off my gloves and asked for the phone.  I explained to her owner the extent of her injuries and my recommendation for euthanasia.  As he agreed with me to go ahead and let her go, sadly, she died on her own.  Although my decision was vindicated, I felt saddened at what she had been through.  What we had all been through.

Finally I arrived back home after 2 pm and put myself back to bed.  Over the next week the fluffy dog with the bites returned to the clinic for a recheck and although her right side was healing perfectly her left side was forming a draining abscess due to the bacteria in the dog’s mouth that bit her.  Despite antibiotics right from the start there was infection and some of the skin was dying.  We decided to hospitalize her for care, using additional antibiotics and honey bandages as well as removing dead tissues as we went along.

Healed on right, Infected on Left

I continued this type of treatment for a week until I felt that I could again make an effort to close the wound.  Soon we went back to surgery and I opened up any remaining pocket, placed a drain to allow the fluid to escape, and closed her up again.

Wound Closed Again, Now With Drain

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After five more days of maintaining the drain we were able to remove it.  Eventually her stitches were also taken out, but frustratingly a small area in the middle of the wound was open. I started honey bandages yet again to encourage it to heal in on it’s own.  It had been three weeks since the bite happened.

Wound Almost Healed

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Finally She Can Go Home!

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In the end, two dogs survived that day of emergencies, one did not.  As I conferred later on with one of the ladies involved on that fateful morning, she said to me in reference to the day’s events, “It’s like the wild west.”  Indeed.

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