Saturday, June 5, 2010

Lawnmower: 1, Dog: 0

A frantic owner called last week to tell us his dog's nose was bleeding badly, and he was bringing the dog in for care. I immediately started running through differentials in my head for epistaxis (bloody nose). Rat poison is always at the top of the list, as is a thrombocytopenia (low platelets) - which can be caused by any number of diseases: tick-borne disease (Rocky Mountain Spotted fever, Lyme disease, Ehrlichia), immune-mediated thrombocytopenia, cancer, etc. etc.

The owner somehow failed to mention on the phone WHY the dog's nose was bleeding.

20 minutes later, the door to our ICU bursts open and my burly, 6"4 tech runs in carrying a large mastiff mix. Blood is pouring from the dog's nose - but not the nostrils. No, it's pouring from the 6 inch laceration across the bridge of the nose. Pouring isn't even the right word. It was spurting directly into the air, a bright red frothy fountain that told me that an artery was severed.

My enterprising tech quickly wrapped a towel tightly around the (very docile) dog's muzzle to form a temporary tourniquet while the rest of us cast around for a brilliant way to staunch the arterial bleed rapidly. It wasn't as easy as knocking the dog out and sewing it up right then and there. By the pale color of his gums, the blood covering his front legs, his sky high heart rate, and generally very docile demeanor, it was evident he'd lost a great deal of blood and would need an IV catheter and some fluids (possibly a blood transfusion) before we anesthetized him. That left us with trying to rapidly find a way to stop the bleeding.

Binder clips, as it turns out, are excellent for these sorts of linear, gushing wounds. While my tech held the (still amazingly calm) dog's head, I secured a 2 inch binder clip across the straight wound, staunching the gush of blood. Necessity is the mother...and all that.

The owners elected to proceed with my proposed plan: IV fluids, pain medications, blood pressure monitoring, a PCV/TS, and then - when his heart rate and color improved - light sedation with Propofol (yes, the drug that killed MJ) for a wound cleaning and repair.

When we finally got him sedated and got a good look at what we were dealing with, I was so stunned that I sent my tech running for the camera (pics to come when I get back home). The dog had lacerated the major artery that runs across the bridge of the nose. It was completely sliced through. A half an hour's honest work, and the wound was fixed.

When I asked dad what happened, he said that the dog had run at his very large, specialized lawnmower, grabbed the wheel, and was flipped completely over and under the fender of the the tire - resulting in the very large slice on his nose. It was at least 2 inches deep and made quite a pocket under the left eye.

I had to work really hard to restrain the laughter that came bubbling up within me when I visualized this occurring.

The moral of the story : please be specific if you call with an emergency that you are bringing in. Example: my dog is bleeding from the nose BECAUSE HE SUSTAINED A LAWNMOWER INJURY TO THE FACE would have been a lot more helpful :)

Just something to think about (and pictures of the wound coming when I get back home).



LittleVet said...

When I had a call to say a collie was coming down to the surgery because it had 'run into a moving train head first.' My first response was 'Yeah right- they must be joking.'

..but she had run into a train head first and she is fine now in fact I vaccinated her yesterday, her nose still points South west but other than that she looks pretty normal!

The Homeless Parrot said...

OMG. I had a similar one! My tech came to the back to notify us that a hit by train was on the way. I was all "surely, surely you misheard that. SURELY."

Nope, it was a dog that had been hit - not once, but twice, by a train. Needless to say - the only thing left for me to do was administer the pink juice. He was missing a leg, all the skin on his head and neck, his tail, it was horrifying.

Nicki said...

Cool case!

Elizabeth said...

Thanks for the pics, I was wondering what you meant by binder clips.. hehe really was a great idea..

Angie in MN said...

Those binder clips come in just as handy as duct tape. They're good for all kinds of stuff. Love that picture!