Not for the faint of heart

I was going through my photos today and saw this picture. It is a case that did not end so well.

An owner brought in her cat, roughly five years old, that was having trouble breathing. His gums were a pale pink and he was using his abdominal muscles to help him breathe. When I tried to listen to the heart, I could barely hear it. We took a radiograph of him laying on his side (he became a bit panicky when my AHTs, PJ and Kelly, tried to take a picture of him on his back). The radiograph showed so much fluid in the chest that I couldn't see the heart. As his prognosis was so guarded, his owners chose to humanely euthanize him.

In odd cases like this, that just don't seem to add up, I asked the owners to let me do a necropsy (autoposy on an animal). Fortunately, they also wanted to know why they had to loose him at such a young age.

I always start by looking in the abdomen and in this case, it was clean. The chest, on the other hand was surprising and amazing (more proof that I don't get out much). The fluid I could see on the radiograph was bloody. The reason he was having problems breathing was because the blood was basically squishing the lung lobes. There was no evidence of trauma, so I knew there was something pretty weird going on. Once I was able to remove the blood, I found the heart. It was huge because there was also blood in the pericardial sac (sac around the heart).

Blow the picture up (sure, it is a bit gross, but you have to admit it is cool too!!). Alright, the blue dashed lines outline the very thin layer that should be muscle. The arrow points to my thumbnail that you can actually see through the fibrous layer. The yellow line indicates how thick the muscle should be throughout the heart.

My hypothesis is this heart defect was something he was born with. Over time, the area became thinner and blood began to ooze into the pericardial sac. Since he was starting to have difficulty breathing, it cause increased stress on the lungs leading them to ooze bloody fluid. There is no way he could have survived.

A dog named Zipper

Well, this past week, they came by two again. This is a little story about a dog that I shall call Zipper. Over the years he has made a habit of eating things that aren't exactly what you would describe as edible. Last year I had to do an emergency exploratory to remove material that had become stuck. One incision was made into his stomach and two into his intestines.

His owners knew something was up when he started to vomit and wouldn't eat. He is a really great dog to work with but there are times when you just shake your head when you see his name on the appointment book. We were pretty busy with multiple surgeries so the girls had him dropped off with automatic radiographs.

When I got out of surgery the radiograph was ready for me. There it was, the classic pattern for a foreign body. All the gas built up in the intestines as well as an incredible amount of gas in the stomach. You can see the arrow where the foreign body was stuck. It was in the large colon so we proceeded with a few enemas. When that didn't produce the foreign body, we sedated him and were able to pull out a small grey sock with pink trim.

We were elated until we did a follow up radiograph just to make sure there wasn't anything else left lurking in his intestines. Now that the gas was moving, it showed up. Another one!!!! He got to stay the night for more enemas. We were so happy when the other one was produced. The daughter did not want the pair back.

Oh yeah, why I call him Zipper. It would be nice to just be able to open his stomach with a zipper to see what he's eaten this time.

Dog versus Horse

This week, I had a dog come in on emergency. It had darted in with the horses and had accidently been kicked. She was a little trooper during the exam; however, watching her walk was not pretty. It actually caused me to pick her up after three steps and get some strong pain medication for her.

Once it had kicked in, we did some radiographs. As you can see from the arrows, there are two fractures causing significant instability of the pelvis. I emailed the radiographs to a board certified surgeon in Calgary for their opinion. I was thrilled when I was told that surgery would not be required.

Given she is a very small dog and can easily be kept confined, her prognosis for recovery is good. She will be on pain medication for as long as she needs and will have to have restricted exercise for 8 weeks.