Timeless Spirit LogoTALES OF A COUNTRY VET


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Volume 3 Issue 4 ISSN# 1708-3265
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Tales of a Country Vet
Cody's Appetite
with Dr. Bruce Burton DVM

It was inky black outside. The November rain was pelting down, driven hard against the kitchen windows by the surging, near-gale force winds as I held the phone in my hand. "Hello?" The mildly Germanic voice warbled feebly into the receiver. It was after midnight and I had just placed the call. "Mike?… Is that you?… Are you still asleep?" I asked, suppressing a sadistic chuckle. For once I was the one initiating, rather than receiving, the late night phone call. "You wanted me to contact you if I had an interesting emergency…… Mike?… you still there?… Hey!,… wake up!" I hollered. "Yes, I'm still here, is this Bruce?…" he said with growing alertness. I could sense his fuzzy dream world gradually being replaced by cold reality as my voice roused him from deep sleep. "Yes, it's me!… You said you wanted me to phone if I had an interesting case!" I could hear a long drawn out yawn. "&#133But its,&#133&#133it's after midnight&#133" he whined in protest. "Yes, that's right!" I said unapologetically. "Like I've told you before, that's when the most interesting cases often occur&#133&#133 I have a possible gastric torsion coming in. It's a Great Dane and she's coming from South Langley, so it should take them about as long to get here as it'll take you." I said with evil enthusiasm because I knew what was coming. Mike continued to mumble for another fifteen seconds or so, obviously wrestling with the conflicting urges to either remain in his soft, warm bed or to crawl out of bed, load up his jeep in the storm and drive forty minutes to attend a gory, possibly fatal, surgery. To me the choice was obvious, but I could tell by his tone creature comforts had easily defeated professional interest long before he answered. "&#133&#133&#133You know,&#133&#133 oh! by the way, thanks for phoning,&#133 I really mean it,&#133 but I think I already have a Gastric Torsion. So I think&#133&#133I just might pass on this one&#133but thanks again for phoning&#133&#133 and please, make sure to call me if you do get anything else interesting&#133&#133but, well,&#133 I feel bad, but, I had a long day, and, to be honest, I just don't think I could stay awake, so I just might take a miss on this one&#133&#133 but hey!&#133&#133 please call me tomorrow and let me know how the little doggie does.&#133 Good night, Bruce and thanks for phoning!" The line went dead. The wind howled even louder. <p>Not many people actually thank you for waking them up with an offer to ruin their night's sleep. But I expected nothing less. Mike is a cinematographer. Actually, an award-winning, documentary cinematographer. He was in the process of filming the second season of his television show, "Animal ER" and was once again on the trail of interesting animal emergency cases. I had met him the year before when Ken, a friend and colleague, had phoned me to put in a good word for Mike. Apparently Mike was having a devil of a time finding any veterinarians to agree to be filmed in the process of working on emergency cases. Most of us vets prefer to do our work in the privacy of our own clinics, away from the glare and scrutiny of a camera, which will record for all time any mistake in diagnosis or treatment, or misstatement, with the expressed purpose of exposing this lapse in judgment to one and all, and to continue repeating it in reruns ad nauseum. It is rather daunting to have to perform under the bright lights and the all-seeing eye, as well as in the pressure cooker situation which often accompanies each emergency. When Mike first contacted me requesting I call him if any interesting emergencies occurred I, and, it turned out, most of my veterinary colleagues, had turned him down cold. When Ken phoned to apply a little collegial persuasion, I reluctantly agreed to meet Mike, but I was still convinced I was not interesting in being filmed. <p>However, when he showed up, he was able to appeal to my more extroverted side and was successful in convincing me of his sincere interest in recording accurately and fairly what goes on with animal emergencies. I then saw some of his other work and finally agreed I would contact him if any interesting cases presented themselves. Since that time he has been a regular fixture at the clinic and has filmed a wide range of emergencies on dogs, cats, horses, llamas, birds, as well as several of the cases I attended at the zoo. But not that night. Aspec, the Great Dane, showed up with her owners twenty minutes later, bloated to beat the band. We did the surgery. Aspec survived and missed her one and only chance at stardom. <p>"How did the little doggie do last night?" Mike asked when he phoned the next morning. I decided to rub it in. "She seems to be doing alright, we still have her in the clinic on an IV. It was a classic! You should have been there! Her stomach was blown up like a balloon. I thought I was going to have to take out her spleen. It was great!" I goaded. I could hear him deflate a little. "Yah, I suppose I should have come,&#133 But it's so hard to know when it's going to be a good story. I went back and checked. Unfortunately, the other gastric torsion I had on film was put to sleep. I forgot about that. The owners didn't have the money for the surgery&#133 it was so sad&#133I hate it when the animals die&#133 If you get another bloat, be sure to call me! " He said, brightening up. I promised I would and he hung up. <p>Emergencies were a little slow over the following couple of weeks so when Rose told me I had a call from Mike I assumed he thought I was ticked off at him and purposefully not calling him. "Bruce, I have a little problem. Its Cody. I think he may have swallowed a tennis ball." Cody? Cody? Who in the world was Cody I thought to myself. "What makes you think that?" "Well Crystal saw him eat it." "How long ago?" "Just a few minutes ago, maybe fifteen minutes." I looked at the clock, it was already 5:30 and I still had a couple of things to do. He continued. "I phoned the emergency clinic in Coquitlam and they wanted me to rush him down right away. They said they would likely have to perform a surgery right away!" He continued in a panic. "Well, is he ill?" I asked. "No! He's just running around like normal! In fact he's begging for his dinner." "If he's happy and hungry, then it's not likely to be a serious situation, at least for the moment. He should be fine until tomorrow. So, I wouldn't rush into an expensive, and possibly unnecessary, surgery. Besides, he may throw it up on his own. Try to put some salt, about a tablespoon, on the back of his tongue and see it he vomits anything. Dogs often chew up and swallow tennis ball fragments. If you can get them to throw up the pieces, your problem is solved." I said. "Keep him quiet tonight and make sure you don't feed him! We can take a look at him tomorrow, maybe take an Xray to see if he actually did swallow the tennis ball. If we need to take it out, we can do it then. But, if he takes a turn for the worse, call me tonight! And remember, no food!" I ordered. "Okay, thanks! I'll see you tomorrow&#133 Say, around noon?" "Fine, see you then." <p>Morning appointments were over at twelve. Mike pulled up in his Suzuki convertible. Cody, who turned out to be a very large two year old Samoyed, bounded out of the vehicle and sniffed the entire driveway inhaling the exotic aromas of farming country and the many dogs and cats who had preceded him. Nothing appeared to be wrong with him, so I told Mike to bring him into the clinic. I examined him on the table. His abdomen seemed a little hard but there was no pain. "Were you able to get him to vomit last night?" I asked. "No, we tried a little salt on his tongue, like you said." "How much did you use?" I asked. "Well, he didn't like it so I put a pinch on his tongue." "I think I said a tablespoon&#133" Looking at him over the top of my now necessary reading glasses. "The fact he doesn't like it is precisely the point. We want his stomach to react to it so he will throw up&#133&#133 But, it doesn't matter." I said in a conciliatory tone. "He seems to be no worse for it. You didn't feed him last night did you?" "Oh no! Not a speck of food. That's why he's so hungry right now." He said as Cody scavenged the floor frantically for the slightest morsel of food. "So he hasn't had any food what-so-ever since last night?" "No! And we watched him like a hawk. We only let him into the back yard to do his business for a minute and then we brought him back into the house. So there's no possibility of him eating anything." <img src="images/brucead.jpg" align="right" width=265 height=380 border=1></a> <p>I noticed the almost crazed passion with which Cody scoured the room, looking for something to eat. "Has he ever done this before, I mean eaten something he shouldn't." Mike looked at the floor sheepishly. "Well, no more than normal I suppose. He does like to chew shoes. He has eaten several pairs of shoes and sandals we had in the house. Expensive ones, of course." He said with exasperation. "The sandals were over $150 a pair and he ate three pairs. And if we leave anything on the counters or the table, he'll wolf it down before we can stop him. So we have to put a line of mouse traps along the counters to stop him stealing food. He's eaten socks before, and plants. He chewed up a belt once, and some underwear. He's tried to eat through a cupboard one time. Occasionally he'll chew up any wood we leave lying around, two by four's, plywood, that sort of thing. I guess that's normal for a big dog like him. Otherwise he's a great guy." He ended defensively. As he spoke each sentence was slower and more thoughtful than the previous one. He looked towards the ceiling and silently counted off each incident on the fingers of his left hand. I decided Mike was mentally tallying the damage caused by Cody, as if he had never done so before. It was clear he was reassessing his affection for Cody against the previous economic destruction, adding in the potential cost of saving him now. I sensed the scales were beginning to tip in the direction opposite to Cody's best long term interests. <p>I interrupted his thoughts, "So, as far as you know, he hasn't eaten anything since the tennis ball?" "That's right." I had learned long ago never to trust the word of an owner. Not that Mike would intentionally mislead me. I had no suspicion of that. But many owners are notoriously bad at monitoring the eating habits of their pets. And an intelligent, food-mad dog like Cody would easily out-maneuver a trusting owner like Mike. So, before committing to a possibly unnecessary surgery, I needed an X-ray. "You know, maybe Cody didn't even eat the tennis ball. We need to be sure. So, lets take an X-ray and see if it's even in there. No sense in doing surgery if there's nothing in there to remove." I continued. "Surprisingly, tennis balls tend to show up on X-rays, even though they are not composed of radio-opaque material." Mike and I dragged Cody to the X-ray table. Then we fought with the rather muscular, ninety-five pound dog, first to get him on the table, then to get him to lay still enough to get a clear picture. After a prolonged battle, and some heavy-duty sedation, we eventually subdued him adequately to shoot the X-ray. When it was developed, I brought it out and we examined it together. I pointed to the lower aspect of the abdomen. "Well Mike, as you can see, Crystal was right, Cody did swallow a tennis ball." The fragmented outline of two halves of a tennis ball was unmistakable. "But I'm afraid he's also got into something else." I said paternalistically. "You see, here," I said as I outlined the huge mass which represented remainder of Cody's stomach "his stomach is full of food. What kind I don't know, but it is almost bursting with large chunks of some kind of food. At least I suspect it's food." "What in the world can that be?" Mike said in amazement. "I have no idea. With Cody's history, I expect it could be anything. But it looks like dozens of two-inch long chunks of something and we need to get it out of his stomach before we can consider performing surgery." <p>We took Cody outside and Rose placed a heaping tablespoon of salt on the back of his tongue. Within five minutes Cody had vomited three times. Each time he deposited a pile equal to a double hand-full of neatly dissected chunks of apple. Mike recoiled in horror. He repeated with each up-chuck "Oh, my God! Look at that. I can't believe it!" It was a lesson to both of us of what Cody was able to consume in the brief minute or two of backyard freedom. <p>After a few dry heaves, I spoke to Rose. "Okay, let's bring him back inside. He must be finished by now." I examined each pile closely. There wasn't a single trace of any part of a tennis ball in his vomit. Each pile consisted of nothing other than chunks of apple. So at least we knew the tennis ball was not coming out the way it went in. And from the X-ray, it clearly wasn't going to pass safely though the intestines. So surgery was the only option. But at least now his stomach was empty. The gastrotomy should be straight forward. <p>We gave Cody more tranquilizer and then anesthetized him. Mike set up his lights and camera. We shaved the dense hair from Cody's abdomen. The incision was going to be large. So, with Mike watching my every move through the lens of his camera, the surgery began. My left hand held the sterilized skin in place. My right hand held the scalpel. The pale, iodine-stained skin parted beneath the razor-sharp blade like firm, moist silt behind a plough, as I drew it firmly and steadily along Cody's midline. I then repeated the procedure through the fat until I had completely exposed the muscle layer. I picked up the fibrous center line and pierced it with the tip of the scalpel. Upon entering the abdomen, a rush of air sucked inside. I completed the opening of the abdomen with a pair of serrated scissors. The intestines looked fine. As did the rest of the abdominal contents. I searched for the now-deflated stomach. By sweeping away the fat-laced omentum I was able to identify it lying nestled at the base of the liver, deep in the abdominal cavity. I ran my hand around the slippery organ and tried to palpate any foreign structures. If I could determine exactly where the tennis ball was located I could make a short cut precisely over the tennis ball and minimize the size of the incision. However, I was surprised at being unable to feel any foreign objects. I referred back to the X-ray, which was on the view-box and determined the tennis ball was most likely lodged in the outlet of the stomach, the pyloris. So I gripped the stomach wall with the aid of a gauze sponge and using the scalpel, incised deeply through the fibrous outer and then inner layers of the stomach. With the scissors, I extended the incision far enough on either side to permit me be able to retrieve the expected pieces of tennis ball. The incision was about 3 inches long. I packed off the abdomen with large gauze laparotomy pads, to trap any spillage of stomach contents. I then looked through the incision into the gaping stomach, searching for any sign of the errant tennis ball but the light from the overhead surgical lamp wouldn't penetrate. In the absence of the apples, the stomach had shrunk down to about the size of a soft ball, so there was little room for the tennis ball to hide, or so I thought. I had expected to have the ball, or what remained of it, out and in the pan within a minute or so, and to have begun closing immediately afterwards. However, this was proving more difficult than I had anticipated. By using a pair of long-handled, smooth grasping forceps I reached through the incision and blindly swept around, trying to locate any foreign matter the consistency of a tennis ball. Nothing! I generally spend most my time in surgery muttering and cursing to myself. This isn't always the smartest thing when the camera is running. "Where's that #$%%^ ball?&#133&#133 How can something so %$#@@ large be so @#%$* difficult to #$%@ find?&#133 The #$%@ incision too$%#@ small!" The tactile abilities of the grasping forceps obviously had its limits so I tried to reach in with my fingers to see if I could feel anything. The latex gloves reduced my sensitivity only slightly. Mentally coaxing my fingers to stretch beyond their limit, my fingers flicked aimlessly around the open space of the inside of Cody's stomach, searching for the telltale firmness of a tennis ball. No luck. Then just as I was about to give up my middle finger brushed against something abnormal. Then it was gone again! "There the *&^%$$ thing is!" I announced proudly. "Uhmmm, I mean&#133 Lets rule that one again&#133 Okay, ready&#133&#133 I shifted to my more refined, commentator's voice. "Well, now when you enter the stomach, it can be deceptively difficult to find foreign objects." I announced professionally as I smiled through my mask at the camera. "Here we have the stomach and I have just found what we were looking for." I inserted the forceps through the incision and tried to extract the tennis ball dramatically for the camera. I located the object and grasped it firmly but it was too large for the size of the hole. "Umm&#133 It appears the incision is slightly too small&#133 so I'll just reach over and enlarge the hole just a bit. This will reduce the chance of tearing the stomach." I continued my lecture. I extended the incision another inch using the scissors. "Now&#133 let's see what we can find&#133" I grasped the object once again and, once again, it refused to exit on cue. I was getting exasperated. "Ha&#133Ha&#133 Just a little wider&#133" I extended the incision another inch or so. I now had a huge gaping wound, large enough for my entire hand to pass through. My offstage voice was shouting at me "Now just grab that little sucker and get this surgery done with.' I grabbed the tennis ball, but it didn't feel like a tennis ball. In fact it didn't feel recognizable at all. I trapped it between my two fingers and pulled very gently. It was a three inch by two inch piece of a red rubber chew -toy. "Well, it didn't show up on the X-ray." I ad-libbed. I reached back in. My middle finger hit something solid and I fished it out. "Pine-cone!" I observed triumphantly as I placed on the tray. Next I snagged a three by four inch piece of flat, white plastic. "Don't know what this is&#133 Mike&#133 can you identify what this is&#133?" I said holding it up. "Looks like some kind of a flat, white plastic." He replied seriously. This was starting to be fun. I felt like a magician, pulling endless streams of knickknacks from a hat. I swept my fingers around again, and this time hooked what felt like the elusive tennis ball, or at least one half of the tennis ball. It was, as I had suspected, lodged in the pyloris so I had quite a struggle to extract it. But, eventually I was able to dislodge it and then remove it. Then the other half was located and removed. "Anything else?" Mike asked in jest. "Yes,&#133 let's see,&#133 some bark&#133 a piece of cardboard,&#133what's this&#133?" I held up a piece of wood. "There can't be any more!" Mike pleaded. I looped my finger around the end of something and slowly extracted a large, plaid handkerchief. "Oh, my God&#133 That's my handkerchief&#133&#133 It's been missing for over a week&#133Oh my God&#133Cody&#133 you crazy mutt&#133" Mike muttered to his comatose dog. One final check produced some sponge rubber, part of a mop, and some fake fur. I half expected to see a tiny clown jump out at some point during the surgery. <p>"Well I can't feel anything else in there so I'm going to close up." I described for Mike and the camera what I was doing as I sutured the stomach, then the abdominal wall, the subcutaneous tissues and finally the skin. <p>After I placed the last stitch, Mike asked me "I just don't know about this dog&#133 He's impossible to control. What do you think we should do, I mean I don't want to put him to sleep, he's a part of the family, but I can't afford to keep doing surgeries on him every time he eats something. If I feed more dog food him he gets fat. Yet, if I cut back on his food, he just goes nuts and eats whatever he can find regardless of its digestibility&#133&#133 What can I do?" I thought about it as I removed my cap, gown, mask and gloves. "If Cody is dedicated to committing suicide in this rather unique and bizarre manner, and I'm sure he is, then nothing short of installing a zipper on his stomach or wiring his jaw shut, is likely to be successful in stopping him. In order to keep both him and your life savings, you're going to have to consider something drastic. Like a full face mask for when you're not around or keeping him confined in a cage. "But he's such a nice doggie! We can't keep him in a cage." "Well, its your choice." I responded. <p>Cody recovered uneventfully and returned to his Billy goat ways. <p>A few weeks later I received a frantic call from Mike. "Hey Bruce!&#133 How are you doing?&#133 How's Rose?&#133 Good,&#133good&#133&#133 Oh! By the way that goofy dog of mine got into a box of chocolate bars last night and ate the whole works, wrappers and all.&#133 I wonder&#133&#133 should we consider surgery or what?" "Yes,&#133but I've reconsidered the kind of surgery he needs. I think a lobotomy would be your best move." I said in earnest. <br><br><br> <p><FONT SIZE=-1 COLOR="#336600">Dr. Bruce Burton, DVM, B.Sc., M.Sc., works with the animals at The Greater Vancouver Zoo and with 'animal stars' in the local film industry. He has extensive expertise in domestic and wild animal biology, health care and nutrition, as well as fish and game-farming experience. In addition to his busy practice in Bradner, Dr. Burton teaches at The University of British Columbia, and is often called upon by the SPCA to help exotic animals in need. <P>He chooses to write down his experiences so they are not lost, but rather shared with others. He wants his children and grandchildren to be able to read them first hand. I hope you enjoy your own sneak peek into his daily routine!</font> </td> </tr> </tbody> </table> <p align="center"><img src="images/bar1.jpg" width="360" height="8" border="0"> <p align="center"><a href="mailto:timelessspirit@shaw.ca?subject=Feedback"><img src="images/3-4/thoughts.jpg" width="375" height="100" border="3"></a> <p align="center"><img src="images/bar1.jpg" width="360" height="8" border="0"> <!-- End Matters --> <p align="center"><a href="http://www.timelessspirit.com/akswebdesign.html" target="_blank"><img src="images/akstitle.gif" width=200 height=40 border=0></a> <p align="center"><FONT SIZE=-1>Copyright (c) 2006 by Timeless Spirit Magazine. All articles are the copyright of the particular writers and cannot be reprinted without their expressed permission. All rights reserved. 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