some cases of old...

thought these might be fun to post until i start my new job and have new cases to talk about:)

A small mature dog came in having been hit by a car. He was quite shocky so we immediately started IV fluids and pain medications. Owners approved xrays right away and here's what we found.

It's a bit hard to see in this small picture, but at the tip of the arrow are several fractures of the hip bones.

When animals are hit by cars, they can go into shock for several reasons. This guy was incredibly painful b/c of the fractures--this and the trauma in general can cause shock. He needed to stay in the hospital on IV fluids to help get him out of shock and continued pain medications to make him more comfortable. Also, many problems don't arise until several hours or even a day after the trauma--things like lung bruising may not be evident on the xrays until the next day so it's VERY important to keep these guys in hospital for treatment AND continued monitoring. Eventually (once he's more stable-->either at the regular vet or a referral center) he might need surgery to repair some of these fractures.

After discussing all of this with the owners, they explained they had no money. They knew how much xrays would cost when they approved it, but couldn't really afford that. I gave the owners the option of euthanizing which they refused. So they took him home were going to try to find a low-cost clinic in the morning. I tried to give him as much pain medication before he left as possible, but there was a good chance he would die at home. very sad. and my hands were tied.

A 20 lb puppy came in for 'possibly' eating a bottle cap. The owner saw the bottle cap on the floor and a few minutes later, it was gone--no where to be found. The puppy was acting completely normal when it came in. We took some xrays...below...

Definitely a bottle cap in the stomach- and compared to the size of the puppy, it's pretty big! Would likely obstruct the small intestine if we let it stay there.

So I gave the owner two options: 1) induce vomiting--risks include the sharp edges of the bottle cap scraping the esophagus on the way up-->causing scar tissue when it heals--> causing a stricture--> causing swallowing problems-->causing aspiration pneumonia +/- death...a little extreme and not a huge risk, but it's happened before. OR 2) surgery--go into the abdomen, cut into the stomach and take it out, risks include normal surgical risks (death, bleeding, infection, pain, etc) and surgery is much much more expensive (we're talking ~$300 for vomiting and $2000 for sugery...). So the owner chose to induce vomiting and voila!

The bottle cap came up along with huge amounts of dog food she just ate. Since it came up coated in partially digested food, likely no scratching of the esophagus but I sent home a medication that would help an scratches heal if they did occur.

what i should have done is sat the owner down for a serious intervention about his choice in beer-Labatt's blue? c'mon! even illinois has some decent local brews.

pft.