anesthesia machine
anesthesia machine


                                                                                                               "My dog has been hit by a car, doc!  I think she's pretty bad off. She can't stand, her right rear leg is all twisted up. Please help her."

Like many emergencies this one occurred at the end of a long day. It was immediately apparent to me that the pitbull's right rear leg would require amputation. Nothing but skin maintained its attachment to her body.  She was pale and her breathing rapid and shallow.  I looked at Sonja and asked, "Will you stay?" She shrugged her shoulders, silently saying, "Of course, don't I always?" Then I looked at her owner and began the standard veterinary emergency question and information patter. 

"She's in shock. She is going to need to be treated quickly and aggressively. Her right rear leg will have to be amputated. I don't know what else is wrong. In about a half hour we will have spent at least $500 and I can't guarantee she will live. Do you want A dog, or do you want THIS dog?"  It is a harsh question but it puts the issue of cost in stark relief. 

"I don't care what it costs, fix her."   This is a problematic  statement for veterinarians.  Experience tells us there is an unspoken second line many times. It is, "Because I'm not going to pay you, anyway." However, I knew Sheba's owners pretty well and I trusted them.  I turnned to Sonja, my technician.

"Let's get an 18 gauge catheter in each front leg and run LRS full bore. We don't have time for a presurgical panel but get an hematocrit. Give her a tenth of a cc of acepromazine and let's mask her down for intubation and maintanance anesthesia. Prep for amputation. I'll be in as soon as I can."

I turned to her owners. "She'll be fine with the amputation. You will barely notice it after a month. You made the right choice. We'lll do our best to keep her alive. I'll call you if we run into complications or if she doesn't make it through the surgery."  There were nods all around, message understood.

The amputation was far easier than most.  One snip with a scissor and the leg was gone. It took some time to locate all the torn blood vessels and ligate them to control the bleeding.  Lacerations were sutured. She was going to look like a fighting dog with all the scars. Finally it was time to wake her up.  I said, "let's turn her over to help her wake up."  As we did so the left rear leg flopped off the table. There was a fracture in the leg somewhere and it could not provide support for the lower limb. It  hung loosely off the edge of the table.

I had made a classic error. I was so absorbed by the need to deal with the right leg that I had not examined the left one. Now I was faced with a patient whose right leg I had just amputated and whose left leg was going to need a cast and a small miracle. I could and did handlle setting the leg and applying a cast. She would have to provide the miracle. This time the waking up went uneventfully and I went to talk with her owners.

I explained the mistake I had made and the consequences. "Keep her as quiet as you can and maybe the left leg will be able to heal," Her owners looked a little skeptical. "What does barking have to do with healing?  She likes to look out the window and bark."  I couldn't help myself, I started to laugh,  The skepitcal looks increased. "I meant keep her confined and still."

Ten days later Sheba walked into our office on all threes. The cast was in tatters but holding. We replaced it. "When this cast gets that worn, we'll take it off and she'll be good to go."  And she was. It was a huge relief that my mistake had not been costly to her or anyone,  It was a lesson I never forgot.  Almost never, anyway.

Unlike some patients, Sheba never seemed to blame me for the loss of her leg, the pain while recovering or any of it. She was happy to come to the office and she always greeted me enthusiastically.  Her house was on my running route and I saw her frequently. 

One day I was approaching her house on my almost daily run and I noticed a moving van in the neighbor's yard. New folks moving in. I noticed a dog crate among the boxes on the lawn. I was celebrating potential new customers when I noticed the dog. It was coming at me full speed. Red long hair, white bared teeth, no barking. A ChowChow missle coming in fast. No sweat, I thought,  I am confidant I can handle one dog in hand to paw combat. Then the second one appeared. It was coming from a different direction in a well coordinated attack. The dogs were obviously used to working together. I accelerated even though I knew I was not going to be able to outrun the dogs. 

Suddenly a brown blur came out between two houses. It hit the first Chow mid chest and she rolled over three or four times from the impact. Without hesitation the brown blur changed direction and went for the second Chow.  It took off running. the blur stuck with it until it was clear it wasn't coming back. The the blur took off for me. I was concerned. It could obviously fight. As it got close I realized that my high speed saviour was Sheba. She jumped up on me and gave me a look that clearly said, "We're even now, Doc."