Meter Reader Mishap, From the Archives

D. E. Larsen, DVM

“Dale is waiting on the phone for you,” Judy said. “He is the manager of PP&L.”

I knew Dale from the Rotary Club, but I wasn’t aware that he had any animals. I put the little pup back in the kennel. Dale was lucky. Another few minutes, and we would have had the puppy sedated, and he would have had to call back.

I picked up the phone, “Dale, what can I do for you today,” I said?

“Doc, one of my meter readers, ran over a duck this morning,” Dale said. “The owner says it has a broken leg. I was hoping you could get a look at it for me. We will be paying the bill.”

“Dale, if it is a duck with a broken leg, you should maybe be talking with them about buying the duck.”

“I tried that, Doc,” Dale said. “This is some sort of special duck. She called it a Khaki Campbell. Does that mean anything to you?”

“I am not much of a bird person, Dale,” I said. “I do see farm birds once in a while. Chickens mostly, but I have treated a few geese and a duck or two. I would have to look up the breed.”

“We are between the old rock and a hard place,” Dale said. “Our truck ran over the duck in their driveway. We are obligated to fix it. And this old gal is so mad she is spitting nails.”

“Send her in, and I will see if there is anything I can do for the bird,” I said. “Do you want to approve any estimate on repair cost?”

“It is only a duck, Doc,” Dale said. “I would hope the cost would be in line with the value of the bird.”

“Dale, I would be broke if I based my fees on the value of the animal,” I said. “You will be paying for my time and expenses. You should understand that.”

“I know, and judging from what this gal says, the duck is worth a bundle,” Dale said. “When I told her to put it out of its misery, and we would send her a check for a hundred dollars, you should have heard the explosion.”

“Send her in, and we will do what we can,” I said.

Leah was visiting the clinic that day on a sixth grade career day visitation. She was full of information on the Khaki Campbell domestic duck. Apparently, it was a breed developed in England, and it was famous for its egg-laying and raising ducklings.

When Grace came in with the duck, she was still red in the face from her conversation with Dale.

“This is the best duck I have ever owned,” Grace started. “And he wanted me to wring her neck or something.”

“Let’s get her in the exam room and let the doctor get a look at her,” Judy said as she ushered her into the exam room.

“This is Waddles,” Grace said as soon as I came into the exam room. “She is the best duck I have ever had. She is a Khaki Campbell. Do you know anything about that breed?”

“I have been learning a lot about it in the last hour,” I said. “Our visiting student, Leah, is very knowledgeable about the breed. They a quite the egg layers, I am told.”

“I am impressed, Doctor,” Grace said. “If the power company had been the least bit concerned, you would have thought they would have at least tried to look her up.”

“Let’s look at this leg,” I said as I rolled Waddles over.

Waddles had a fractured tibia on her left leg. It felt like a pretty clean fracture without a lot of bone fragments.

“We might get lucky here,” I said. “I think I can pin this fracture without even opening the fracture site. We will need to get a set of x-rays, and I think we can get this done and send Waddles home this evening.”

“I don’t want you to leave a stone unturned,” Grace said. “I want this to be the biggest bill you can make. I want that guy at PP&L to spit out his coffee when he hears the fee.”

“I think Dale has come to understand your attachment to Waddles,” I said. “He said, “I am prepared to pay the bill”. But, my guess is he will choke a little when he gets it.”

The tibia in a duck is the bone we call the drumstick in a chicken or turkey. X-rays showed a simple fracture, and the surgery went very well. I was able to thread a steel pin down the bone from the stifle joint and get an excellent reduction of the fracture.

“This will heal really well,” I told Leah when I had finished.

“Do you leave the pin in the bone,” Leah asked?

“No, we will take it out in 6 weeks. Maybe we could bring your entire class down to watch that surgery.”

“Yeah, they would like that,” Leah said.

Waddles woke up from anesthesia and walked on the leg with no problem. We called Grace so she could pick her up.

“I want you to make sure she stays out of the water until this is healed,” I said. “It would probably be best to keep her in a cage until we take this pin out.”

“When is going to happen,” Grace asked?

“We will make an appointment to take sutures out and recheck her in 2 weeks. Then we will take that pin out in 6 weeks.”

When Waddles came in for her pin removal, you could see a slight limp when she walked.

“That will clear up as soon as we get this pin out of there,” I assured Grace.

We had Leah’s entire class in the clinic to watch the surgery. We lined them up against the wall in the surgery room where everyone could see. As was typical in these events, several kids tried to stay and watch, but as we got closer to the actual surgery, they had to go out front.

I don’t think any of the kids really knew what to expect. Pin removal is not much of a surgery, just a small incision over the pin’s head, grasp the pin with forceps, and pull it out of the bone. 

The real surprise comes when I pull the three-inch steel pin out of the tiny incision. It is sort of like the magician pulling the rabbit out of the hat. There were several gasps.

Waddles was happy after she woke up. And she enjoyed all the attention from the kids gathered around her kennel.

Dale was very quiet on the phone as I gave him the bill’s information for Waddles’ fracture repair.

“If she was a goose, I would expect her to be laying golden eggs,” Dale said.

Photo by Magdalena Smolnkcka on Unsplash

The Kid Doesn’t Stand a Chance 

D. E. Larsen, DVM

Ruth hung up the phone and took a deep breath. She looked at me from across the room.

“Your favorite client is on her way with Rambo,” Ruth said. “He has a laceration on his foot. And the worse part, she is bringing her kid.”

“Great, I wonder how we will be able to look at his foot,” I said. “The last time he was here, we couldn’t get through the exam room door.”

“She said she had a muzzle on him,” Ruth said. “That might help a little. But with the boy along, it will be total chaos. Maybe we could handle Rambo better if we had Sue wait in the reception area with her son.”

“That’s a thought, but she usually wants to be involved,” I said. “And here she comes now.”

Sue was a petite gal. She couldn’t weigh more than a hundred and ten pounds soaking wet. Rambo was a large, unruly Rottweiler who weighed at least a hundred and forty pounds. Jamie, a five-year-old holy terror with bright red, almost orange hair, never listened to anybody, especially his mother.

Rambo led the procession through the door. He was on a leash, or maybe it was Sue who was on the leash. Rambo went where he wanted, and Sue was drug along, thinking she had some semblance of control. Jamie followed but was looking for things to get into when he came through the door.

“You find a chair out here and wait for us,” Sue instructed Jamie.

“No, I want to watch,” Jamie said defiantly!

Rambo was squishing blood out of a wound on the side of his foot with every step. Sue managed to bring Rambo to a stop as she grabbed Jamie by the arm and wrestled him into a chair in the reception area.

“Now, you stay put!” Sue said sternly.

Rambo continued to bleed as he turned circles in the reception area. Ruth tried to direct Sue and Rambo into an exam room. Jamie slipped out of his chair a made a dash for the door. Sandy came around the counter and followed Jamie out the door, hoping to keep him out of the parking lot.

“Jamie just ran outside,” Ruth told Sue. “Maybe you should keep track of him while we look at Rambo.”

“That kid, I don’t know what I’m going to do with him,” Sue said as she handed Ruth the leash and followed Sandy out the door.

Ruth looked at Rambo. He sat and seemed to instantly calm when Sue left the room. Ruth patted him on the head, and he licked at her hand through his muzzle.

I came into the room with a dose of tranquilizer and a wet towel.

“He is fine now that Sue is outside,” Ruth said.

I rubbed Rambo on the top of his head, and he pushed back against my hand. I picked up his foot and used the wet towel to clean the blood and debris from the wound. It was a small laceration on the side of his small toe. It had lacerated a vessel, which accounted for all the blood. Now that he was quiet, the bleeding had slowed.

“Let’s get him back to treatment, and I can get a couple of sutures in this before they catch Jamie,” I said.

Rambo followed us with no problem. I bent down, and with both arms under him, I lifted him onto the treatment table. I washed the area and shaved the wound. Rambo was acting like a typical large-breed dog now. Confident in his situation, I think I could have sutured this wound without anesthesia, and he wouldn’t flinch. But I injected a dose of lidocaine around the base of the toe.

We could hear Sandy and Sue coming in the front door.

“Ruth, go out and make sure Sue doesn’t come back here,” I said. “Tell her Rambo is doing so well, we don’t want to upset him. I will be done here in a few minutes.”

I closed the wound with three interrupted sutures of nylon. At any other time, I would have used absorbable sutures on Rambo. But now, we know the secret, separate him from Sue, and he is fine.

I could hear the commotion out front. Sue was scolding Jamie and trying to get him seated. He was having none of it. 

I put a light wrap on Rambo’s foot and motioned him to jump down. He jumped down, and we walked out front. Rambo stopped before we got to the reception area as if he didn’t want to rejoin the chaos.

Jamie came running when he saw Rambo. Sue was right behind him, trying to get a grip on his arm again. She stopped and looked at Rambo.

“Boy, that was fast,” Sue said. “An he looks like he likes you.”

“Yes, it was a small cut,” I said. “The blood made it look worse than it was. In the future, we will have you wait out here when we treat Rambo. He is a different dog when he is by himself.”

Sue stood at the counter and settled the account with Sandy while Jamie hung around Rambo’s neck, pulling his ears from time to time. Finally finished, Sue took the leash, Jamie pushed the door open, and Rambo pulled Sue out the door. 

We stood and watched as she loaded Rambo into the back seat and then raced to grab Jamie by the arm, pull him back to the car, and into the back seat with Rambo.

I looked at Sandy and Ruth and shook my head.

“The kid doesn’t stand a chance,” I said. “If I have seen it once, I have seen it a hundred times. People with unruly dogs always seem to have unruly kids.”

Photo by Pramod Tiwari on Pexels.

Nick’s Ankle 

D. E. Larsen, DVM

Sandy was standing behind the counter with her hands on her hips when I returned to the clinic from a morning farm call.

“Skip is on his way here with Ted’s dog,” Sandy said. “They found him in the river, and Skip said he has a broken leg.”

I glanced over my shoulder and saw Skip pulling up to the clinic with a couple of boys in the back of his pickup.

“Looks like I need to wash up,” I said. “You guys can get them settled in an exam room, and I will be right there.”

When I returned to the exam room, Nick, Ted’s old black Lab, was on the table, soaking wet but waging his tail. The boys, both the younger sons of Skip and Ted, were also soaked. They must have been the rescuers.

“Looks like you guys have been swimming,” I said. 

“Nick was way out in the river,” Matt said. “We don’t know how he broke his leg.”

Nick’s leg was a mess. His hock joint was completely disarticulated, with all the tissue on the lateral side of the hock gone. All the lateral soft tissues were gone, including blood vessels. There was river sand in all the tissues. I even flicked a few small rocks out of the wound as I examined it.

“This is pretty bad, Skip,” I said. “Where is Ted?”

“Ted is out of town,” Skip said. “He won’t be home for several days.”

“I don’t know if this is repairable,” I said. “It would be best to have Dr. Slocum in Eugene look at it.”

“I don’t think Nick is going to Eugene for surgery,” Skip said. “What do you think you can do for him?”

“My first impression is this leg needs to come off,” I said. “I don’t know if there will be enough circulation in this foot to heal.”

“I guess you could try to fix it,” Skip said. “You could always take the leg off later. I don’t want to make a decision for Ted that is so final as an amputation if there is a possibility of fixing it.”

“Well, you’re right about the leg,” I said. “We can take it off later if things don’t work. But I want to be clear, repairing this leg is over the head of this clinic. Fusing this hock joint is the only real chance of healing this leg. That is best done with a bone plate. That kind of surgery is available in Eugene, but not here.”

“Doc, you do what you can,” Skip said. “We will give it the old college try. If it doesn’t work, we can deal with that at the time.”

With that said, Skip and his crew patted Nick on his head and left him with me.

“Where do we start with this mess?” Dixie asked.

“We start in the tub,” I said. “We have a lot of sand to wash out of this wound.”

We sedated Nick and sort of pressure-washed the exposed bone and joint. Sand seemed to be everywhere, but with several scrubs of the entire leg, we were at a point where we moved to the surgery room for the final prep.

Once the wound was scrubbed and draped, I started to put things back together. 

The first and probably most challenging task was removing the cartilage from the joint surfaces to get a boney fusion to hold the foot in place.

Once that was done, I positioned the hock in a functional position. I drove a pin from the underside of the hock through the joint and into the tibia. The stability surprised me a bit.

“This looks pretty good,” I said. “It might even work.”

“How are you going to close this wound?” Dixie asked.

“I will do what is called a pedicle skin graft,” I said. “I will take a strip of skin from the upper leg, turn it around and suture it over this wound. By leaving it attached above, hopefully, the skin will survive.”

After closing the wound, I placed the leg in a Thomas Splint.

“I usually don’t use a splint when I use internal fixation, but if Nick were to walk on this leg, he would likely break the pin,” I said. “This way, we can get some boney fusion and remove the pin before he walks on the foot.”

“Do you think it will work?” Dixie asked.

“There is not a book written that would say this will work,” I said. “It is so contaminated, the whole thing might just blow up on us. Couple that with the loss of significant blood flow to the foot, our chances of this working are slim.”

I called Skip to tell him I would keep Nick at the clinic until Ted got home. That way, we could monitor the wound healing and keep Nick on pain medication. I think Skip was relieved that he didn’t have to take care of Nick for a couple of days.

***

To everyone’s surprise, including mine, Nick went on to heal well. The joint fused nicely, and we removed the pin with a brief procedure. The skin graft survived. It added a little character with the hair growing in the wrong direction.

Nick’s leg was never normal, and it looked somewhat fragile. But it served him well for the remainder of his life.

Photo by Mali Maeder on Pexels.