Princess is a 5 year old spayed female dachshund mix dog who presented to REACH for major back trauma. Her wounds consisted of a smaller puncture wound over her forehead and a major degloving laceration stretching from her left flank over her dorsal spine to her right flank. Her owner was unaware of how she received the wounds, but judging from their appearance it seemed as though Princess may have been hit by a car. Her wounds were severe, requiring priority attention; therefore immediate stabilization was ordered by the doctor. Princess would endure numerous treatments and tests leading to the complete treatment of her pain and injuries.
Upon Princess’ initial presentation she was immediately given an injection of a pain killer. This brought relief to any discomfort she had as well as calming her nerves, allowing the staff to evaluate her wounds more thoroughly. In addition she received an IV (intravenous) catheter to allow any IV meds and/or fluids to be administered. She was placed on a continuous rate of IV fluids to aid in circulation and hydration; this also helped to additionally stabilize her so she’d be a better candidate for anesthesia when her wounds would be repaired. She was also started on IV antibiotics and acid reducers to control infection and settle her stomach respectively. Prior to surgery her laceration would be wrapped in a wet-to-dry bandage; this would keep the tissue moist and protected from any additional bacterial contamination, hence keeping the tissue viable. Of course before any repair could be performed various diagnostics were performed to adequately diagnosis her condition as well as verify that it would be safe to anesthetize her.
Prior to invasive treatment Princess had blood work and x-rays performed that would aid in a definitive diagnosis in addition to ruling out any unseen problems internally. Blood work results were mostly normal except for an elevated ALT, a liver enzyme. This elevation was most likely due to abdominal trauma, once again suggesting she was hit by a car. Her blood volume was normal, so it was apparent that no internal bleeding was occurring. Radiographs (or x-rays) verified this and showed no abnormalities other than the soft tissue trauma. Once she received a substantial amount of fluids and the appropriate medications, she was induced with anesthesia for her surgery.
When Princess was suitably anesthetized her wound was prepared for the surgery. At first the wound was stapled shut to protect the interior from further contamination while the hair was clipped. After the hair was appropriately clipped the staples were removed and the wound was lavaged with a bactericidal solution; additional debris and hair were removed from the fascia before the tissue could be re-attached to the body wall. Sutures were placed to eliminate any pockets of open space within the tissue; this open space can be a foundation for infection. In addition, drains were placed to allow any unwanted material such as fluid to be drawn out; this would also prevent any anaerobic infection from developing. When the wound was closed the subcutaneous layers were closed with sutures while the skin was closed completely with staples. A protective body wrap was placed over the site to keep it clean; the wrap was changed daily over the next 2-3 days.
When the procedure was completed Princess was recovered from anesthesia; she recovered quite well. However, her body temperature was low; this is common with anesthetic cases since anesthesia can lower the body’s temperature and blood pressure. To counteract this Princess was maintained on IV fluids and heat support during her procedure. Still, even with heat support and IV fluids, patients can become hypothermic, but it is usually not life threatening if the patient is stable going into anesthesia. In Princess’ case she recovered well enough from anesthesia to where her body temperature was brought up enough in the recovery phase to where she was normal shortly after. In fact it wasn’t long until she was alert in her recovery cage so she could receive her continued supportive care.
Following Princess’ surgery she was kept on fluids and administered antibiotics, pain medications, and acid reducers for her stomach. The very next day she was walking and eventually became VERY ALERT; although very sweet she never hesitated to express her opinion about when she wanted to go out for a walk. After discharging from REACH her owner reported that she slowly began to act like herself again and regained a ravenous appetite. She would eventually have her drains and the staples removed, and she is expected to make a full recovery.