The Lucky Dog

D. E. Larsen, DVM

I was surprised at how light the pup was when I lifted him onto the exam table.

“Boy, this pup is skin and bones, Robert,” I said.

“Yes, that is why we are here,” Robert said. “He has been vomiting everything he eats for the last month. He was doing fine at first, just as lively as the other pups. But when we started feeding them some dog food, he started vomiting.”

“That’s a little unusual,” I said. “What does the vomitus look like?”

“Looks like dog vomit,” Robert said with a questioning look. “What do you mean.”

“I mean, does it happen an hour after he eats and the food is half-digested? Or is it shortly after he eats and the food looks like it hasn’t been in the stomach?”

“He always acts like he is starving. He gobbles the food faster than the other pups. Then he turns away from the dish and deposits it on the floor. It pretty much looks like it looks in the dish, now that I think about it.”

“Can you leave him with us for a few hours,” I asked? “I think we need to get some x-rays of his chest.”

“I guess so, but why will it take a few hours?”

“We are pretty busy this morning,” I said. “I need to get a plain picture of his chest, and then I probably will need to do a barium swallow. That will take a little time.”

“What are you thinking, Doc,” Robert asked?

“We see an abnormality in the dog where the aorta comes out of the heart and turns the wrong way. It is called a Persistent Right Aortic Arch. The normal aorta turns to the left.”

“What does that mean for the pup,” Robert asked?

“It doesn’t bother the heart, but the little vessel that runs from the aorta to the pulmonary artery traps the esophagus, so solid food doesn’t get through very well. Those pups do well when they are nursing but start having problems when they start eating solid food.”

“Can we fix it?”

“Sort of major Surgery for these hands, but yes, we can fix it. But it is rare. This might not be this pup’s problem at all. That is why we need to get some pictures. This causes a ballooning of the esophagus above that strap, called a mega-esophagus. That is why we need to do a barium swallow.”

“So what is a barium swallow? That sounds a little gruesome,” Robert said.

“We give a small amount of barium and then roll him a few times, so the barium coats the inside of the esophagus. This allows us to evaluate the esophagus, and if there is a mega-esophagus, it shows up well.”

“Okay, I will leave him for a few hours, but when will you do surgery if that is needed?”

“We need to have this guy on a liquid diet for a few weeks and get a little muscle on these bones before we put him through an open chest surgery. I will go over all of that when we have a diagnosis. And just for the record, have you put a name on this guy yet?”

Robert looked at the pup with a softening expression. “We were waiting to see if he was going to make it or not. I guess if he pulls through all of this, he will be a lucky dog. Let’s call him Lucky.”

Robert left Lucky with us for the afternoon. The x-rays showed a massive esophagus with ballooning in front of the heart that nearly filled the thorax’s front end.

***

“This is a classic picture of a persistent right aortic arch,” I said as I showed Robert the x-rays. “I have a recipe for you for a liquid diet. We need to feed Lucky this diet for 3 weeks. I will recheck him at that time. If he is gaining weight, we will schedule surgery.”

“Do we need to do anything else?” Robert asked.

“Lucky needs to eat in an elevated position, so it is easier for the liquid to flow into his stomach. Otherwise, it will settle into the bottom of this enlarged pocket in the esophagus. You need to rig up a platform for the food dish with a step for Lucky’s front feet, so he is standing almost straight up to eat and drink.”

***

“Has it been 3 weeks already?” I asked Robert. He was a different puppy. He was bright and alert and wagging his tail.

“Dixie says he has gained almost 5 pounds,” Robert said. 

“It is amazing what happens when they stop vomiting everything,” I said. “Do you want to schedule surgery now? You know that it will end up making this guy a valuable pup.”

“We understand that,” Robert said. “We discussed it and decided we couldn’t just put him to sleep. We need another dog around the house, so we will sell the rest of the litter, and that will help reduce the expense of this surgery.”

***

The surgery went well. It was very similar to a PDA surgery without the stress of possible rupture of the ductus. 

After collapsing a couple of lung lobes to all for an adequate working area, I ligated the ductus’ strap and severed it. I could see the esophagus expand at the point of the previous narrowing. Lucky was going to feel much better.

I placed a chest drain, and then, taking care to make sure the lungs were fully expanded, I closed the chest.

Following a couple of nerve blocks to control the pain in the chest wall, we recovered Lucky.

Lucky was up and around and not having any problems. There was no fluid in the chest drain. We should be able to pull it in the morning.

“Surgery went well, Robert. I would expect Lucky to improve every week. We’ll continue to feed him from an elevated position for the next six months, but with any kind of luck, he should be close to normal by then.”

“When can he go home?” Robert asked.

“He needs to stay until we pull his chest drain. Things are looking real good at this point, and that will likely happen in the morning. I would expect him to be ready to go home anytime tomorrow afternoon.”

***

“I pulled the drain this morning, and he is acting like a new puppy,” I said as I allowed Lucky out of the kennel.

Lucky was dancing around Robert and jumping up. He was ready to go home.

“Besides watching that incision, I want you to continue feeding Lucky from an elevated platform and using the liquid diet until we get the sutures out in two weeks. If he is doing well, we will start blending some canned food in with the liquid. I have it all written out for you. If things are going well, we will change to canned food in a couple of months.”

“When can we start feeding him dry dog food?” Robert asked.

“We will see, maybe never. Maybe after a year if Lucky has no vomiting with canned food. The trouble with dry food is these dogs eat it so fast. It may stress his esophagus too much.”

Lucky continued to grow and caught up with his litter mates in no time. Eventually, he returned to a standard diet that included some dry dog food. 

Lucky was indeed a lucky dog.

Photo by Josh Hild on Unsplash

The Daughter’s Horse

D. E. Larsen, DVM

I slowed the truck to a stop while I reread the directions. I was meeting a man at his horse pasture. It was not associated with a house, and we didn’t have a street number.

When I looked up from the notes, I could see the guy waving at me from a pasture a couple of hundred yards from the road. I took the next driveway and pulled through the gate he was holding open for me.

“I am glad you could come on such short notice, Doc,” Alex said. “This cut probably is a day old, but I don’t have much time to spend out here.”

“You called at just the right time,” I said. “I had a cancellation, so I have some time to use. Where is the horse?”

“I have her in the little barn over there,” Alex said, pointing to a small shed at the corner of this two-acre pasture. “It’s not much of a barn, I know, but it serves its purpose.”

“I’ll get my stuff out, and if you can lead her out here, it will give me more room and better light.”

I felt pretty lucky today. Friday evening wire cuts were the usual fare. Most of the cuts were several days old. But they would not spend any extra time with their horse until Friday evening or Saturday morning. Then they would be upset when I failed to feel that a three-day-old wire cut wasn’t an emergency.

“What a nice looking mare,” I said as Alex led the well-groomed bay mare up to the truck. Where is this laceration?”

“This is Misty, Doc. The wound is over here on her left hip,” Alex said, turning the horse so I could see the laceration. “I have no idea how this could happen. I have looked all over, and I can’t find anything sharp that could’ve done this to her.”

“This looks like more of a tear than a cut,” I said. “Maybe she ran into a nail or a corner going in or out of that barn. It looks like things could be cramped in for her if she was turning around in a hurry or something.”

“You know, Tuesday night, I didn’t get out here to feed her until late,” Alex said. “There are no lights in that little shed, and I surprised her when I opened the side door. She swung around and ran out. I was in a hurry and put her feed in the rack and left. I wonder if that is when this could have happened?”

I looked at the wound carefully. It looked like it was probably three days old. The tissues around the wound were only slightly swollen. It was about 3 inches long with a little corner flap at one end.

“This wound is old enough that it could have happened Tuesday,” I said. “I can clean it up and cut away a little bit of the dry skin edge, and it will close up pretty well. I have to tell you, though, it will heal fine if we just treat it as an open wound. The choice is yours. It is just dollars and cents.”

“Dollars and cents, don’t I know that,” Alex said. “This is my daughter’s horse. We bought Misty for her thirteenth birthday. Boy, was she ever happy! I rented this pasture, and she was on this horse every spare minute. She would even ride her bike out here after school to ride her horse.”

“That sounds great,” I said. “Gave her something to do and teaches responsibility at the same time.”

“Yes, it was all of that, Doc,” Alex said. “But you know Doc, sixteen happens. She turned sixteen, and the boys started hanging around, and this poor horse looked like a forgotten rag doll. She hasn’t been on this horse for over two years now.”

“That is sort of a sad story, but one that I have heard before,” I said. “Sometimes, they mature a little and remember the time they spent with the horse, and they come back.”

“That is what the wife said,” Alex said. “But in the meantime, I am the one who is out here every day, feeding and grooming this horse. I am the one out here to meet the farrier two or three times a year. I am the one who calls the vet and comes out here to hold the horse. No offense. Doc, but it gets a little old at times.”

“You could sell this horse in second,” I said.

“I know, we had talked about that. But the wife and the daughter end up in tears every time I bring up the subject. I think I’m stuck.”

“Does your daughter have a job,” I asked?

“Yes, she has a good job,” Alex said. “She saves her money. She has a boyfriend. And there is another guy who is hanging around all the time. Waiting, I guess.”

“So, let’s go ahead and clean this wound up and close it up,” I said. “I will give Misty a tetanus shot and some antibiotics. Then tonight, you hand your daughter the bill. Don’t say anything. Just put the ball in her court. If she is going to be paying her share of things, she will start riding again, or she will decide to sell this horse to another young girl who will ride it.”

“Are you sure all you do is work with animals?” Alex asked?

“Animals are owned by people, Alex. You can’t do this job in a vacuum. I hear a lot of kids say they want to be a veterinarian because they like animals. I tell them they had better like people, also.”

When I stopped by the pasture a few weeks later to take the sutures out of Misty. Alex’s daughter, Sharon, was waiting at the gate with Misty on a lead.

“This healed beautifully,” Sharon said. “When can start riding her?”

“Let me get those sutures out, and you can throw a saddle on her,” I said. “She is probably going to be ready for a little ride.”

“Yes, I have sort of ignored her for some time now,” Sharon said. “But I am going to start riding again. I have a couple of girlfriends who go up Quartsville Creek and ride some trails up there.”

“That sounds fun, but you want to work her into that sort of thing slowly. She hasn’t been doing much for a time now. It will take some riding to get her back into shape.”

“Yes, we will take it slow. I probably need that myself. And Doc, thanks for all you do.”

Photo by Marko Blažević on Unsplash

From the Archives, one year ago

Ralph

https://docsmemoirs.com/2020/03/23/ralph/