Friday, August 17, 2018

Emergency Exploratory Laparotomy

After a quiet day we went down to dinner at 8:30 and as we were walking past we noticed there was a case in the clinic so stopped to see what was going on. A young Rottweiler presented collapsed with acute abdomen screaming in pain; the owners said it started today...

We placed an IV to put him on fluids and do a clinical exam while the vets took a history in Tamil language. He is regularly fed chicken bones, was straining to pass feces and had vomited so due to the acute nature we suspected he had a foreign body or GDV.

X-rays were taken which didn’t really show anything (but useful as it ruled out a GDV) and an abdominal ultrasound was also unremarkable except for a small spleen. After strong IV pain relief he was still screaming in pain so the decision was to take him to surgery for an exploratory laparotomy.
The team rushed to get everything ready including kits and warm fluids but the ex lap showed he pathology on liver and spleen; both were pale and discoloured.
Vinay scrubbed out to speak to the owners and advice of a poor prognosis, especially given the limitations of being a low resource charity. The owners elected to close the abdomen and try medication but saw how much pain he was in after recovering from surgery, despite strong pain relief, and sadly he was euthanised.

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