Toby’s Bullet Wound

 D. E. Larsen, DVM

Ann rushed in the door with Toby clutched to her chest. After five, we were technically closed, but Ann had an emergency, plus she was a friend, a neighbor, and a long-time client.

“Toby has a broken leg,” Ann said to Sandy as she stopped at the front counter. “I think he has been shot.”

“Dave is in the back finishing up some treatments,” Sandy said. “Let’s get Toby in an exam room and see if Dave can get a look at him.”

Sandy got Ann and Toby settled into the exam room and came looking for Ruth and me.

“Ann is upfront with Toby,” Sandy said. “She thinks he has been shot, and his leg is broken.”

We had just finished treating a pup and quickly returned him to his kennel.

Ann was almost in tears when I entered the exam room. Toby was laid out on the exam table, curled up in Ann’s coat, and seemed as comfortable as he could be with a fractured femur. Toby was purring.

I carefully examined Toby, trying to leave him curled up in Ann’s coat.

“The leg is broken for sure,” I said. “It looks like a bullet wound, probably a twenty-two, based on the size of the hole. This leg seems a little limp to me, and I am a little concerned that there be some nerve injury.”

“Can he be fixed?” Ann asked.

“Oh, yes, he can be fixed,” I said. “There is an exit wound on the leg, so it doesn’t look like the bullet hit anything else. If there is a nerve that was damaged, that might not be fixable.”

Ann had been a nurse, and she knew what that meant.

“You are saying that he might lose his leg,” I said.

“We might not know that until surgery,” I said. “We will get an x-ray and prepare to repair the fracture. If I find significant nerve damage when we get to surgery, I will amputate the leg.”

“When are you going to do this?” Ann asked.

“There is no reason for Toby to wait until morning,” I said. “He is uncomfortable, even if he seems okay. I will do this right now.”

“Can I wait here?” Ann asked.

“Whatever you would like,” I said. “You can wait here, or you can check back in an hour or so. I guess Toby will recover pretty rapidly following surgery. He could probably go home with you tonight if I could recheck him in the morning.”

“That would be good,” Ann said. “Maybe I will just stay and bother Sandy if she isn’t too busy. You are generally pretty fast with your surgeries.”

Toby’s x-ray showed a bullet path through the leg with some lead fragments scattered in the tissues after the bullet struck the bone. There was a mid-shaft fracture of the femur, and the bone was broken up pretty bad. I couldn’t see any nerves on the x-ray, of course, but I was pretty sure there was significant damage to the nerves in this leg. 

I stepped out front and spoke with Ann before starting surgery.

“There is a nasty fracture of the femur,” I said. “It looks like the bullet went right through the bone. There is lead scattered in tissues, so it was definitely a bullet wound. The bone is repairable, but I think there is major nerve damage to this leg. I will look before doing anything, but I think we are going to have to amputate this leg.”

“There are no other options?” Ann asked.

“Based on the responses in the lower leg, I am guessing that the sciatic nerve is injured, maybe severed,” I said. “If that is the case, there is no other option other than amputation.”

“Okay, I guess he will do okay on three legs,” Ann said.

“A cat with three legs is not slowed down a bit,” I said.

Returning to the surgery room, Ruth was waiting with everything set out.

“Let’s not open the bone pack until I get a look at the inside of this leg,” I said.

After draping the hind leg for surgery, I opened the thigh on the lateral surface and dissected down to the femur by separating muscles. This was a fracture with many pieces of bone, and it would be a difficult repair. 

I explored the wound, looking for the sciatic nerve. There it was. The sciatic nerve was completely severed by the bullet. It made the decision easy. This leg had to come off.

“We go home early tonight,” I said to Ruth. “Finishing this amputation won’t take long. You can put all that bone stuff away. That bullet did half the job of amputating this leg. I will be done shortly.”

I ligated the vessels and trimmed up the jagged end on the bone with a rongeur. Then I sutured the muscles over the end of the bone to form a nice stump and closed the skin in two layers.

Toby recovered quickly, and Ann was happy to take him home for the night.

“Plan to bring him by in the morning and leave him for the day,” I said. “That way, we can make sure we have his pain under control and that the incisions will be okay.”

“Will he have to wear one of those collars?” Ann asked.

“I rarely use one,” I said. “If I use a half dozen of them a year, that is exceptional. Good tissue handling during surgery is the key to rapid and infection-free healing. Besides, the animals hate them, and so do their owners.”

“Okay, we will see you in the morning,” Ann said. “I am sure that Toby will enjoy the night at home other than in your hotel.”

•••

Toby looked great when Ann dropped him off at the clinic the following morning. It took him a few days to figure things out, but by the time we took his sutures out two weeks later, you couldn’t tell he only had three legs.

“I hate to think that there are people out there that get their jollies by shooting at cats,” Ann said. “And people worry about coyotes and the cougars getting their cats. I think people are probably the bigger problem.”

“Yes, it’s too bad that we will never know who was responsible,” I said. 

Photo by Oswald Yaw Elsaboath from Pexels.