VET’S DIARY: Horrific injury, happy ending

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WHEN my sister and I were about 10 or 11 years old we shared a bedroom, writes Dominic Plumley,

Mum and dad had moved us all into a derelict farmhouse and were in the process of renovating it. Our room had no wallpaper – or paint for that matter – and to cover the dusty old lime plaster we had pinned up a number of posters featuring the cartoon character Snoopy.

I can only really remember one of these, with Snoopy prostrate on his kennel and the very American caption – Mondays are the sand traps on the golf course of life! At that age, Charles Schulz’s philosophy was somewhat lost on me – this week – I fully understood the sentiment.

Actually, Monday at our Morpeth hospital had been progressing well until about 5pm – quite a busy day but things pretty much under control – then things went pear shaped. Within the space of about half an hour animals arrived from all directions and in all conditions. Howling lame dogs, vomiting cats, fitting dogs – you name it – it all happened.

In the middle of all of this mayhem and by far the most dramatic was the arrival of Tip, a 10-year-old whippet-cross-lurcher. Chasing a rabbit in the park in Morpeth,Tip had nipped into the park keepers garden. Hopping out of the garden – like she often does – she managed to impale herself on the wrought iron railings – the spike passing through her right thigh and groin! Her owner bravely lifted her off – being bitten by the terrified dog in the process and transported her straight to us – blood everywhere.

There are times when words fail me to describe how well our team of vets and nurses respond to such situations. Already stretched, everyone just clicked into another gear, almost subconsciously operating together.

Vet, Jo Mouat, made a quick assessment of Tip’s circulation; she hadn’t been in the building for more than a couple of hundred seconds before she was on intravenous fluids and being anaesthetized to examine the traumatised tissue that was simultaneously having pressure applied to it to staunch the haemorrhage by nurses Fiona Garrard and Rebecca Watts. In the mean time, Lindsay Smith, rapidly drafted in from the Equine Clinic – responded to hastily barked instructions – delivering everything that was required as the three clinicians battled to save their patient’s life.

As soon as Tip was asleep, Jo examined the huge wound, blood pumping from the severed femoral artery and vein. These vessels were clamped, with no chance of repair because of the extent of the damage. At this point, probably less than 10 minutes after Tip’s arrival, everyone could relax a little, the patient was under control and Jo could concentrate on putting her leg back together.

Several hours later, with countless internal and external sutures in place, Tip started the process of recovery from her anaesthetic – her colour good, her breathing stable and most importantly – alive! Remarkably, after a night of mild sedation for pain relief as much as anything, she was on her feet this morning.

Obviously, with the major artery and vein supplying the leg no longer intact we have concerns about the circulation in the affected limb. As long as enough tissue is undamaged, generally other collateral blood vessels will make up the difference. Thankfully, the early signs are that Tip’s foot is warm and has some blood supply. As you might expect, she is reluctant to put any weight on it – but that will hopefully come over the next few days.

It is always difficult to predict the ‘what if’ scenario – but there is little doubt that in Tip’s case – with the haemorrhage from her femoral artery – the difference between death and survival can only have been a matter of minutes.

I think that counts as a chip out of the bunker straight into the hole!