Do you ever wonder what your vet does on a daily basis? Of course, most of you know we do routine things like exams, vaccinations and treating sick pets, but we also handle emergencies. It seems like we have had quite a few emergencies at SPAH lately. On Thursday, Jan 23rd, I had a small mixed breed dog come into the hospital as an emergency. Blackie had been found by his owners lying on the porch in a puddle of blood and unable to move. They rushed him to us at SPAH. My experienced technicians quickly triaged him and realized that he was in critical condition and needed to see me asap.

Blackie was rushed back to our treatment area where I determined that he was in shock and was having a hard time breathing due to significant trauma to his chest. He had a small bite wound that was draining a large amount of blood in his armpit, but more importantly, he had what we call a flail Chest. Flail chest is a life threatening condition that happens when multiple ribs are broken in multiple places due to extreme trauma. This causes the broken area to move in the opposite direction as the rest of the chest wall. The little dog was also leaking precious air from his chest making it very hard for him to breathe. Blackie was in very bad shape. My technicians worked quickly to place an IV catheter and give him oxygen to help him breathe. I started him on IV fluids, antibiotics and pain medication. We placed Blackie in our oxygen cage - a special cage that is sealed while 100% oxygen is pumped in. Oxygen cages are life saving devices for pets that are having difficulty breathing. Even though this cute little guy was in critical condition, I knew that without emergency surgery, he would not make it - I had to fix the flail chest and stop the air leaking from around his lungs for him to have a chance.

Anesthesia is always a risk and even more so in critically ill or injured patients, but at SPAH we take every care to ensure our patient's safety. I quickly customized an anesthetic plan for Blackie while his blood pressure, heart rate, breathing, ECG and temperature were monitored closely by my technicians and our special monitors. Due to his extreme injury, Blackie had to be ventilated during surgery because his lungs were not working well enough for him to breathe on his own - my technicians are trained to help me during these difficult cases. Once Blackie was safely anesthetized, I made an incision over his rib cage to find 2 very large open holes into his chest. One hole was so large that a piece of his lung had escaped the chest and was impaled on a broken piece of rib. I could see into his chest and visualize his heart and lungs! This was one of the most severe injuries I had ever seen. I got to work realigning his ribs and suturing his muscle and tissue back together to re-assemble his chest wall - the whole time working just inches from his heart and lungs. Here is an amazing video of what I had to work with during surgery:

As I stitched and repaired his damaged body, I placed drain tubes into his chest to allow me to drain blood and remove the air around his lungs. The lungs can only work and inflate when the pressure surrounding them is negative, like a vacuum.  After closing his chest wounds, I was able to examine the rest of his skin closely and realized that he must have been attacked by another very large dog that bit his chest and crushed his ribs. Blackie ended up having 3 major surgical incisions,  many stitches and staples, 2 drain tubes in his chest and a splint fashioned to fit over his chest to protect his realigned ribs and keep his chest from collapsing back in. Our little guy did wonderfully during surgery!

Blackie woke up well after surgery but was obviously in a lot of pain. I was happy to have the ability to give him great pain medications and lots of TLC. After surgery, Blackie was able to breathe normally and rest, but he was still in very critical condition for several days as large amounts of blood and fluid drained from his devastated chest. I was also very worried about infection. Day by day, Blackie gradually improved. By Friday night, he was able to walk and was eating a little. By Saturday, he was giving me little tail wags and kisses. And by Monday morning, he was trotting around our yard enjoying the fresh air and sunshine! What an amazing little guy! Here is a picture of Blackie and me just before I removed his drain tubes to send him home:

What a rewarding experience for me as a veterinarian! I am truly blessed to be able to use my skills to do what I love to do - help sweet little dogs like Blackie! Blackie still has a journey to complete recovery. He has to be monitored very closely for the next few weeks for infection and to make sure his ribs and wounds are healing properly, but he has an amazing and tough spirit, and I know he will do well!

Dr. Becky Green
Associate Veterinarian
Sienna Plantation Animal Hospital
9212 Sienna Ranch Road
Missouri City, TX 77459
281-778-5244

Dr. Becky Green with Blackie