Like everyone else, I have moments when I wish I could turn back
the clock. Ah, to be young again, eh? But you and I know it won’t
happen.
Like everyone else, I have moments when I wish I could turn back the clock. Ah, to be young again, eh? But you and I know it won’t happen. Our only consolation is that with age and experience we presumably become wiser. Veterinarians practice their profession and presumably learn from their experience. And just the other day, I realized how time and experience have helped me make better decisions.
Jessie, a beautiful black labrador was a victim of those nasty thunderstorms a few weeks back. The loud thunder hit so close to home that with an adrenaline surge rivaling Superdog, she bolted from her back yard enclosure. Jessie ran almost two miles until she got out onto the freeway and was struck by a car. Her injuries were life threatening, but thanks to the fast response of emergency personnel, she was quickly treated at an emergency veterinary hospital where she rebounded within 24 hours.
Her owner called me to talk about all her injuries including a nasty compound fracture of her hind leg. There was lots of dirt and debris that needed to be cleaned out, and her fracture would require surgical fixation. Her owner, already facing an expensive emergency clinic bill, wanted to know if I could do the surgery. He had been given the estimated costs of surgery performed by a board-certified specialist. But he hoped I could do a simpler procedure for less money. And here’s where experience of practice comes in.
Many years ago, I would have probably taken on this case and surgically cleaned the wound (a procedure called debridement). Then, to stabilize the fragments, I would place a stainless steel rod in the bone to hold the fragments in alignment. Wrapping up the smaller fragments with some small cerclage wire, I would finish, telling the owner that forced rest and confinement would be essential to this dog’s recovery. A dog like Jessie would go home with some antibiotics and pain meds, and we’d see her back in about 8 weeks for a followup x-ray. Case closed, right? No. Sometimes it wasn’t quite so simple.
Jessie’s wound was contaminated and there were several fragments. Aligning all these pieces with a rod and wires couldn’t hold everything together snug enough for good healing. Fractured bones must have rigid stabilization to heal properly. Only a stainless steel plate across the fracture line could do all this. And only a specialist in the use of plating materials could do a satisfactory job.
Years ago, if the owner asked, I might have taken the risk and done the less expensive procedure, saving the owner some $1,500. And many times, my surgery would work just fine. But several times over the years, something went bad. In one instance, the owner just couldn’t (or wouldn’t) keep his pet confined. His dog ran all over the backyard during her recovery and her lower leg twisted out, rotating on the steel rod. Eventually the leg healed nicely but it was improperly aligned. This poor dog had a back leg that pointed almost 90 degrees to the side! She needed corrective surgery so she could walk normally again.
In another case, the pin stayed in place, but once again, the dog was allowed to run and jump. This excessive activity prevented her leg from healing, a condition called non-union. In both these cases, the followup treatment and second corrective surgery led to expenses greater than the cost of plating the bone. And these dogs had to endure a second surgery. Penny-wise and pound-foolish, we were.
A few years have gone by since the last time I let someone persuade me to try an inferior treatment to save some money. And this time, during my followup visit with Jessie, I found out that a small fragment was, indeed, missing when her leg was plated. Her bone plate will hold the bone pieces rigid, so she should heal anyway. But if I had used a rod and cerclage wire, she would most likely have had a non-union. And this happy lab wouldn’t have been able to go home to her family where five people love her so much.
Sure, her flight onto the freeway cost a lot of money. But as her “mom” told me, they were just glad to have her back home in one piece again. “We weren’t ready to lose her just yet.” And I could tell by the wag of her tail, Jessie wasn’t ready either.
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Remember in our last column we talked about why some cows are given a magnet that stays in their stomach? The magnet gathers nails, tacks and wire, preventing them from penetrating the stomach wall and causing a fatal infection. It’s safe and inexpensive protection for range cattle.
Here’s the question. Let’s say a farmer buys a cow at an auction. How can he or she determine if that cow already has a magnet in its stomach?
I hope all you Girl Scouts and Boy Scouts figured this one out. All you need is your handy compass. If you hold a compass to the side of her, the needle should point right to her stomach where the magnet is located. And if you move your compass left and right, the needle should continue to point to the same area and move accordingly.
It’s a simple trick that can save some time and money, and maybe a cow’s life.
