Something that really is an emergency in small animals is internal bleeding. Now.in dogs this often happens to be from the spleen as a result of a tumour of from a traumatic injury.
So this evening I was sitting there in the middle of dinner when I got a sms. 2 words which instil dread into a horse owner but for a vet student send.my adrenaline levels sky high – “colic surgery”. That was all, them 2 words and food was forgotten. It became a case of rushing back to.my room to grab my bag with.my scrubs and stethoscope before sprinting down to clinic to grab my large animal bag with wellies and waterproofs from my locker.
Now what many people don’t realise.is how wet colic surgery tends to be. If we open the colon we use water to clean this out. All exposed internal tissues of the intestines and organs have to kept wet to keep them from drying out. So after my first colic I decided not to make that mistake again and everything since has been done in wellies.
Arriving to clinic I find that I am among the first to arrive so start helping set up theatre. I pop my head into the stables to check the horse, asking for the colic I get asked which one… Seems there are 2 not one – though one at this point hopefully looks like it is medical. Finding the correct patient I go and take a quick look and find it is massive. Heading back into the anaesthesia team I find the weight is 600kg. This is one of the heaviest horses I have seen operated here.
Helping guide the horse onto the table we get the surgery prep done. Then the surgeons step up and the first incision is made. Blood comes pouring out. At that moment I realise that I am completely outta my depth and have no idea how to approach the bleeding abdomen.in equine patients. The first thing that I learnt was that it is possible to take a sample of this blood and work out if it is arterial or venous using the pcv and total protein which is pretty cool (and useful).
The colon here however is completely obstipated – around the size of a small child this is lifted out and the second surgeon opens the pelvic flexure to start removing the obstruction whilst the first surgeon starts to explore the abdomen.
Watching the surgeon use his entire arm to try and check the kidney region for the bleeding was a new experience. Whilst I would be comfortable with bleeding in a dogs abdomen the size of the equine abdomen basically makes it like rooting around in a suitcase for a hairband. It is one of those things that I will need to read up on to learn – and hopefully will find some useful technique somewhere.
Unfortunately this patient did not make it out of recovery. However I learnt many useful things that will help.me in my future.