The end of the week was pretty slow in ICU so, in my usual style, I hung out with the neuro crew. They had an itty bitty little Chihuahua who had been attacked by her housemate, a Boxer. She had puncture wounds on her neck and luxated cervical vertebrae (which is what lead to it being a neuro case). We did full spinal radiographs and a CT scan of her cervical spine. Throughout these procedures, we had to transfer her several times to and from the gurney. With an injury like hers, we had to be extremely careful in moving her. She only weighed about 7 pounds, but we had one person putting traction on her neck and supporting her head while another person moved her body. We easily could have caused further damage had we not been extremely careful about how we handled her. Fortunately, she was a sweetie pie and cooperated with us. As the CT tech put it after looking at the images of her cervical spine, it looked like "two miles of bad country roads" (that's an Alabama-ism if I ever heard one). It literally looked as if two trains had smashed into each other head on. Her C5 vertebrae was all wonky and the rest of her neck didn't look much better. We took the wee one to surgery where her vertebrae was basically manipulated back in to place while someone applied traction (i.e. pulled on her head to help stretch the area out). The surgeon then installed a plate on her spine and closed her up. Because the area is still very fragile, we wanted to make sure that she had very limited ability to move her head and neck. We kept her anesthetized while a customized thermoplastic splint was made for her. Thermowhowhat? Break it down people...thermo= heat/temperature, plastic= well, plastic...malleable plastic, splint=device designed to support or restrict the movement of a joint. Got it? This splint material is heated in hot water and molded to the dog's body to create a splint that prevented her from moving her head and neck. Velcro straps were applied so it could be adjusted slightly and cast padding and vet wrap were placed between the splint and her to prevent rubbing and general ouchiness. The poor thing looked SO pathetic the next day in the ICU. She was all propped up on her pillow looking out of her cage and all she could do was move her eyes to look at you. All the other dogs are definitely going to pick on her, but at least she won't be paralyzed!
On Friday, we had a prime example of why it's important to socialize animals. We get this Dachshund in that belongs to an elderly woman. The dog has not been socialized, never sees many other people or dogs and up until this week has lived it's happy little life in relative isolation with little need to develop the ability to play well with others. That's totally fine and dandy with me until it injures it's back (as Dachshunds so often do) and yours truly nearly gets her face ripped off when I open the cage door to get her prepped for surgery. Holy Toledo! I didn't even touch the thing and it tried to eat me! Thank goodness for e-collars because I had already been bitten once this week and I don't care to repeat it in the near future. So we had to get this dog out of the cage and give her the pre-meds ASAP so that she would calm down and not further injure herself. A little Dexmedetomidine and Hydromorphone helped to make her slightly more manageable but we still induced her with Propofol pretty quickly after the pre-meds were given. We did our usual diagnostic stuff and then went to surgery with her. During surgery, she was having some heart arrhythmias. In this case it was a 2nd degree AV block which I am not even going to explain because it requires a lot of background info on normal ECG traces and yahdee dah. Anyway, sometimes the inhalant anesthetic that we use can cause some arrhythmias (which is one of many reasons we try to use as little as possible) and other drugs can sometimes cause them as well. The dog was given Glycopyrrolate to try to increase the heart rate and get rid of the arrhythmia. It was successful and the rest of the anesthesia was relatively uneventful. Ok so then we have to wake this kid up. One person has the e-collar, one person has a second dose of Dexmedetomidine (sedative!), one person is at the ready to pull the ET tube and the other person is restraining the dog's hind end. We put the e-collar on before the dog is ready to be extubated, and not a moment later she wakes up in a hurry. Keep in mind this dog has just had BACK SURGERY so she can't be flailing around. We do our best to hold her down while she is given another dose of Dex but we have to continue restraining her in her cage after she tries to do some crazy ninja flipout move the second we let her go in there. Usually, a post-op patient like with this type of surgery is kept in ICU for at least 36-48 hours following surgery. This kid? Going home at 8:30 am the very next day to reduce her stress and avoid injury to the people working with her. Yikes!
Tomorrow I start my rotation at the Raptor Center. It's part of the Auburn University Animal Hospital but they work with wild birds that have been injured and brought in to them. I've gotten to see them here and there over the past few weeks, but I'm looking forward to really getting to work with them. I'll be sure to post pics and keep all my bird-loving blogateers updated on my adventures.
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