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Vet Talk

Bailey the Gutless Wonder and the Cone of Shame
October 1, 2018 (published)

You know the day is not going to start well when, on your first day back from vacation (a Monday), the vet tech greets you at the door with a panicked look.

“You have to come with me,” she said. “Last night, Dr. Smith admitted Bailey, who had been spayed on Thursday. She had been licking at her sutures and some skin sutures had broken. He told the clients he would close the small gap in the skin in the morning.” This is a reasonable option: late on a Sunday evening, you don’t want to be anesthetizing or sedating a boisterous young Labrador to fix a couple of broken stitches. In those days, we did not have a nearby emergency service to which we could turf a case like this. We had to handle it ourselves as best we could. Therefore, Dr. Smith thought, a night in the slammer is just fine for Bailey.

Except when it isn’t.

I walked into the ward. There was Bailey, a six-month-old yellow Labrador, sitting in her cage looking at me and wagging her tail. “And the problem is?” I wondered for a moment. Then I saw the plastic bag in the cage beside her. In the plastic bag were Bailey’s intestines. Bailey’s abdomen was wide open. It was like something from a Peckinpah movie, only instead of a chainsaw Bailey had been eviscerated by a surgical scalpel and her own teeth.

During the night, Bailey had proceeded to chew at her stitches until her belly broke open. Not satisfied with this degree of self-mutilation and being a good Labrador (and therefore, not one to waste a good meal), she proceeded to bite through her own jejunum. And step on it. And roll on it. Amazingly, she seemed none the worse for wear that morning.

E-collars were not routinely in use 30 years ago.

“I have the surgery all prepped and the surgical kit ready for you,” said my rather pallid technician. We promptly carried Bailey and her plastic bag of viscera into the operating theater, anesthetized her, and began the reconstruction. Two ends of intestine that should be together? I sewed them together. The dirt and foot prints? Liters and liters of saline were poured into the abdominal cavity and aspirated back out after sloshing about a bit; an abdominal version of the dentist’s “rinse and spit.” Finally, after about an hour, Bailey was closed back up and ready to be awakened.

But as I pulled her endotracheal tube (ET tube) out of her mouth, I saw specks of blood on it. “Hmmm, that’s strange,” I thought. Why would there be blood on the ET tube? I looked in her mouth and in the back of her throat, I saw a mass. I grabbed it with hemostats and pulled. And pulled. And pulled. Out came 18 inches of Bailey’s intestine, which had lodged itself in her esophagus! Not only had she bitten through her intestines, she had actually engaged in autophagy. She was literally eating herself. Yeah, I know. Gross!!!!!

Suddenly, I realized that I had just taken the two loose ends of her intestine and sewed them together. What if there were more “ends” that I had not seen? I cursed for not checking the entire GI tract from stomach to rectum (no professor of surgery ever taught us about a dog eating herself!) So, back under she went and I undid all those sutures I had just placed, and I proceeded to check the intestinal tract along its entire length. Through dumb luck, I had actually sewn the only two bits that were torn (bitten through). The 18-inch piece that had ended up in the back of Bailey’s throat was disposed of. I closed her back up, and she proceeded to recover in her cage uneventfully.

At discharge, we modified her “at home” recovery plan. It’s critical that pet owners follow these post-op instructions carefully after any surgery. First, we provided a heavy sedative. Second, we had her don the cone of shame. “She has to wear this until we remove her sutures in two weeks,” I told the client. Bailey never looked back. She didn’t even really care about her cone of shame. I wonder if she was disappointed that her canine andouillette was taken away from her.

Surprisingly, when I recounted this story to colleagues decades later, several reported having seen the same thing – a dog (not always a Labrador) breaking its midline incision and eating its own intestines. I thought I had a one off. Apparently not.

So what’s the moral of this story, other than to just gross you out? Well, our pets are often much more resilient than we might imagine, especially if they are young and otherwise healthy. More importantly, when your veterinarian puts a cone of shame on your pet, it’s for a good reason. It’s not humiliating (not to the dog, anyway). Uncomfortable? Yes. But it’s also a necessary evil that stops the Bailey scenario from playing out on a weekly basis. 

1 Comment


Robyn Limberg-Child
October 31, 2018

We have had this discussion in the clinic from time to time, with pyometra dogs that are persistently licking up their vaginal discharge. And same question would be true for a 'autophagous' dog--is it considered 'fasted' if the stomach contents are actually a part of the same animal??




 
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