OPINION: the luckiest unlucky girl

Out of hours (OOH) is often regarded as a law unto itself, bringing with it a wide range of weird and wonderful cases you might not normally see on your regular 9-5.

Even with this in mind, as a recent graduate in sole charge OOH, I was not expecting to admit such an astonishing case late one Saturday evening.

A young feline neutered dog presented to me in the back of her owner’s car after suffering a full penetrating injury from a metal rod that extended from her left hip to her right axilla.

Incredibly, almost 45 minutes following the initial incident, on presentation, the dog was fully conscious. She was alert and even quite bright- wagging her tail and looking up at me from her owner’s lap.

Initial triage, analgesia and stabilisation were all performed in the back of the owner’s car so as not to cause further traumatisation from movement before the full extent of injuries could be better assessed.

Apart from mild tachycardia and adventitious lung sounds auscultated over the right dorsal lung region, her clinical exam was remarkably unremarkable.

There was no active bleeding, her pulses were strong and steady, gums pink and moist and blood pressure within normal limits.

Following her clinical examination, placement of an IV and administration of analgesia and fluids the dog was transferred to another local practice with CT imaging capabilities and more extensive surgical resources. The owners were aware that her prognosis was guarded and that she might decompensate at any time.

Further imaging revealed that despite penetrating the diaphragm, the stomach was the only organ to be perforated.

During a thoracotomy and exploratory laparotomy, the metal foreign body was carefully removed, the stomach repaired, and a drain placed post-recovery.

The patient recovered well, was lead walking comfortably the following day and was discharged 48 hours following her admission.

I had the pleasure of visiting the patient on a home visit for check-up in her first week postop and was amazed to see her speed of recovery.

Her owner’s remarked that despite her strict indoor rest she was rearing to go as if nothing had ever happened, and indeed the wounds from her surgical sites seemed to be the only evidence of the near disaster she’d gotten herself into only a few days earlier.