Oxygen Masks for Pets

The fire department and other first responders are often called upon to help out family pets, but oxygen masks developed specifically for animals are not standard equipment on their trucks.  We decided to get involved after we spoke with some first responders who rushed affected pets into our facility.

TVRH, along with the non-profit group Avalo, teamed up with the Durham veterinary community for this fund-raising project - almost every veterinary clinic in Durham participated!  As the result of the generosity of Durham residents, we were able to make these masks available to help save lives.

Triangle Veterinary Referral Hospital was thrilled to be able to present 30 sets of oxygen masks to the Durham Fire Department, more than enough to equip all 23 of their trucks. 

Meet Rocky the Raccoon

Rocky, an education animal, getting an exam due to inappetence

Sedated, intubated, shaved, and getting prepped for surgery

gas anesthesia, IV fluids, heated table, and multiparameter monitoring

Prepped for surgery

Dr Grafinger performing surgery

Dr Grafinger performing surgery.

That's a lot of instruments for a little guy

The cause of all of Rocky's problems - a glass pebble

Rocky waking up from his surgery

Triangle Veterinary Referral hospital is not able to take wildlife cases from the public because we don't have any licensed rehabilitators on staff; it's safer for the animals to go directly to a rehabber that can take care of them properly.  But that doesn't mean that we don't do what we can to help out!  Dr Grafinger, our surgeon, has an interest and experience in exotics and so he volunteers his expertise to several organizations that work with any number of fascinating animals.

One of those groups is CLAWS, Inc., a nonprofit organization that is dedicated to helping wild and exotic animals.  They rehabilitate animals with the goal of being able to release them back into the wild, and use non-releasable animals to educate the public about how to safely live in harmony with native wildlife.

Recently one of their resident animals, a charming raccoon by the name of Rocky, stopped eating and became suspiciously lethargic.  When we sedated Rocky and took some radiographs, Dr Grafinger identified a probable foreign body in Rocky's intestines. 

Rocky was immediately prepped for surgery; he was intubated and placed on inhalant anesthesia.  We then placed an intravenous catheter, started fluids, and his belly was shaved and cleaned.  Once in the operating room, Rocky was placed on a heated surgery table, hooked up to a monitor that tracked his heart rate, blood pressure, temperature, oxygen saturation, and pulse rate; once he underwent a surgical scrub, Dr Grafinger went to work.  After making an incision and exposing the abdominal cavity, Dr Grafinger gently palpated Rocky's stomach and the length of his intestines and quickly located the suspicious object.  After making an incision into the intestine, he was able to remove a glass pebble, the cause of all of Rocky's problems.  Dr Grafinger then sutured the intestine closed and injected sterile saline into the affected area of the bowel, gently squeezing to each side of the incision to create pressure with the saline, checking for any leakage.  The test was successful, so Rocky's incision was carefully sutured closed.  Wild animals don't tend to tolerate e-collars, so Dr Grafinger took extra care with Rocky's sutures, leaving no external sutures to irritate Rocky.

We're very happy to report that Rocky recovered well from his surgery and quickly bounced back to his happy, active self.  If you'd like to see some of the animals that CLAWS uses in programs, check out their website and FaceBook page for event announcements.  And if you'd like to help them out during this busy baby season, it's super easy to check out their Amazon.com wish list.

Meet Nichols

Here you can see the scar on Nichols' carapace and on her right flipper

Meet Nichols, the loggerhead turtle.  Loggerheads are just one of the endangered species of turtles treated at the Karen Beasley Sea Turtle Rescue and Rehabilitation Center in Topsail Island.  Nichols suffered a boat propeller injury to her carapace and had a crab pot line wrapped around her right front flipper.

In 2012, Nichols was transported to the North Carolina State University School of Veterinary Medicine where a team of surgeons worked to repair her injuries. (See previous blog/link)  The debris from her shell was cleaned out, allowing her collapsed lung to reinflate.  Dr Grafinger focused on her flipper, stabilizing the broken bones and repairing the massive laceration.

We're happy to announce that yesterday Dr Grafinger attended the release of Nichols back into the wild!  How rewarding to see the end result of all the time and work that was showered on Nichols and the other turtles, freedom and a chance to live out their lives where they belong, in the vast ocean.

Nichols

The team making their way to the water with Nichols

Nichols sees the water

Look at the crowd of well-wishers!

Nichols as her tank is emptied prior to transport

Nichols

Dr Grafinger watching Nichols heading out to sea

Headed for her freedom

Check out this WUNC article about Nichols!  

Meet Oscar

Oscar is looking great 2 ½ weeks after his surgery. I was ecstatic to see him recover so well after surgery.

Oscar, a 3 year old male Doberman Pinscher, was running in the back yard with the owners when suddenly he jumped on pile of wooden sticks. The owners were surprised and horrified to see a large wooden stick coming out of the right chest wall when he jumped out of the pile. The stick was sticking out of his right chest wall and for a small period of time Oscar was suspended in the air only supported by the stick when the stick broke. Oscar kept walking and shaking, when part of the stick that remained in his chest wall fell on the ground.  Immediately after the incident he became painful, lethargic and was reluctant to walk.

Oscar presented to our Emergency Service with a skin wound on the right side of the chest wall that had a small amount of blood, increased respiratory effort, but no signs of a foreign body. Radiographs (x-rays) of the chest revealed evidence of pneumothorax (medical word for pneumo =air; thorax= chest cavity; free air in the chest). Pneumothorax is evidence of communication of the chest cavity with the outside world or worse injury to the lungs. Dr. Duran set in motion the treatment plan, which included stabilization with intravenous fluids, pain medications and thoracocentesis (removal of the air in the chest cavity). The thoracocentesis yielded close to 1 Liter of air. We thought that we had removed all of the air in the chest. However, radiographs showed that air continued to enter the chest. After thorough evaluation, a surgical exploratory of the 1.5 cm skin wound and the chest was recommended to determine if there was any internal damage. During exploration of the chest there was evidence of a 1.5 cm defect in the intercostal muscles (muscles between the ribs). That defect was extended and a thoracotomy ( incision in between the ribs to access the thoracic cavity) was performed. The lungs did not show any evidence of damage due to trauma, but a 1cm defect was noted on the diaphragm. The defect on the diaphragm was extended and a limited abdominal explore was performed. To my surprise, the liver had no evidence of trauma, but I retrieved 2 wood splinters from the abdomen. This was evidence that the wooden stick that impaled the thorax continued into the abdomen and there may be more foreign bodies present in the abdomen. The limited abdominal explore continued, and to my surprise there was a large wooden stick palpable in the mid abdomen. At that point the decision was made to explore the abdomen thoroughly. The defect on the diaphragm was repaired as well as the skin wound. A chest tube was placed to help evacuate the air off the chest after surgery.

The large wooden stick went through the right side of the thorax, diaphragm and was found in the back musculature next to the aorta during abdominal surgery.

Oscar goes home after surgery with an Elizabethan collar to prevent him from licking the skin incisions.

 An abdominal exploratory was performed to determine which organs were damaged during the wooden stick’s pathway and it’s final destination in the abdominal cavity. Unbeknownst to me this would soon become one of the most interesting and emotionally rewarding surgeries of my career. The abdominal explore revealed that a wooden stick approximately 8 cm was lodged in the hypaxial musculature ( back muscles ) between the aorta and the caudal vena cava displacing the aorta. There was also evidence of a hematoma (collected blood outside a vessel) in the region of the left kidney). During palpation of the affected area, there was palpable blood flow turbulence on the segment of the aorta next to the entry site of the stick. A potential tear on the aorta was suspected at that site. In order to prevent acute bleeding when removing the stick, the segment of the aorta was isolated and temporarily occluded with one temporary Rummel tourniquet in front and one behind the stick.  The stick was isolated and removed from the muscle. The Rummel tourniquets were gradually loosened resulting in hemorrhage from the isolated segment, so tourniquets were tightened again. Upon close examination, a 0.3 cm tear was visualized and sutured. The Rummel tourniquets were loosened to determine if the repair was successful and there was no evidence of hemorrhage. We were surprised not to see any major evidence of damage in the rest of the abdominal organs. The abdomen was closed and Oscar successfully recovered from surgery and anesthesia. Oscar remained hospitalized for 3 days for intravenous supportive care, antibiotics and some TLC. We were all amazed on how well he recovered from an event that could have ended his life! The penetrating stick stopped millimeters away from a life threatening aortic penetration. I can’t describe how extremely proud we were to see him walk home 3 days after his near death experience. Thank you Oscar for being a fighter and reminding us why we chose to do this for a living. We are so glad to see you go back home to your family.

-Dr. Leo Baez, DVM, DACVS

Cold Weather

When it’s below freezing, being outside for long periods is dangerous for your pets.  Here are some tips to help keep them safe during the coming cold weather.

Small breed dogs, thin dogs (like a greyhound), and puppies should only go outside long enough to potty and then back inside!  These guys do not have enough muscle mass to produce the needed heat to keep them warm.  Likewise, dogs with short or no hair have little or no insulation, and should also be kept indoors except for potty breaks.  Consider purchasing a fleece or down jacket to help with insulation, just as you would for yourself.

If your pet spends all or most of it’s time outdoors, please find a way to bring him or her inside for the next couple of nights!  He doesn’t have to be welcomed in to your bed;  a bathroom, utility room or even a  garage in a pinch will do just fine as long as you pet proof the area, removing any harmful chemicals and other threats. The important thing is to keep him dry and out of the wind.  While your dog or cat does have a fur coat, remember this is the same fur coat she sports in the summer, with not much extra insulation for sub-freezing temperatures.  If he is in the garage, check in with him a couple times during the night, and make sure the temperature isn’t dropping below zero in the garage.  Provide a bed and blanket, fresh water and food.

Cats should be kept indoors in freezing weather.  They are more likely to wander and get lost when they are seeking a warm place to stay.  Cats will also crawl under the hood of a car seeking heat, which may cause lethal injuries if the car is started.

Consider purchasing some boots for your dog if you plan to take long walks on frozen ground.  If you are the crafty type, there are even sewing patterns online to make them yourself!  This will protect Fido’s bare foot pads from the elements.  If you and Fido don’t like the doggie boots, remember to limit the time spent outside, as his bare feet are in contact with the ice and can develop frostbite.  It’s important to remember that if your dog is having a good time outside, she may not show signs that her feet are too cold, so you, the human, have to be the bad guy and tell her it’s time to go inside.

Speaking of feet, the salt that is often spread on roads and sidewalks is also harmful for your pet.  Other winter hazards, like antifreeze, are also a concern.  Make sure and rinse off your pooch’s feet after a walk outside in cold weather to remove ice, snow or any toxins.

Be careful on those sidewalks!  Just as people may slip and fall on ice, causing knee, back or other injuries, so too can your dog.  If you see a patch of ice on your sidewalk, it’s best to avoid it if possible by walking in the frozen grass instead.