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Second Opinion: Magic Act
A Vet’s Perspective
Magic Act: Second Opinion

Every day in veterinary emergency rooms across the country, shocked, distraught and overwhelmed dog owners face tough decisions. In addition to medical complexities and ambiguities, they deal with guilt, fear, grief and, sadly, money. But for Kathy Noons and her seven-year-old Boston Terrier, Tessie, it was all about hope.

Although Ms. Noons had asked her dog-walker to keep Tessie leashed, the woman often let her run loose with other dogs, and Tessie clearly loved it. But then came the phone call: The dogwalker had lost Tessie. It was January. The little dog was found the next morning, miles away, lying in a cemetery.

When Tessie arrived at the Angell Animal Medical Center ER, she had a temperature of 86.7°F (normal is around 101°F), the bones of her pelvis were shattered and, as a result of spinal trauma, she was paralyzed and incontinent.

Barely responsive, Tessie was so cold that warming her up had to be done slowly over the course of several hours to avoid further shocking her system. Blood and urine were drawn and tested, she was X-rayed and an ultrasound was performed. Throughout it all, she received intravenous fluids and medications for pain.

Eventually, Ms. Noons was presented with a long list of negatives that, when added up, suggested that euthanasia would be the kindest course of action. As she retold it, “That’s when I said, ‘C’mon, throw me a bone (no pun intended),’ [and] one doctor told me what I needed to hear. She said there’s always a chance.”

It took a few days for Tessie to stabilize, and that’s when I got involved. Ms. Noons later told me her biggest fear was that I would refuse to operate … that I would tell her it was futile. To be honest, it crossed my mind. Despite surgery, the risk of permanent nerve damage, incontinence and an inability to stand, let alone walk, was significant. But sometimes, if you put everything back in place, screw it all together and take a leap of faith, tissue heals. Tessie’s injuries were really bad, but not hopeless.

Though the odds were slim at best, I believed surgery offered her at least the possibility of a cure. An uncertain prognosis can be like a bad trip to Vegas, a gamble in which the only way out is through — risky, all or nothing. But that’s the hand we were dealt, and it was the one we played.

My involvement in Tessie’s recovery, while important, was brief and, to be honest, secondary. I reconstructed her broken pelvis with plates and screws, but the critical-care doctors and attentive technicians gave her the chance Ms. Noons sought. Yes, it takes a team to heal a “humpty-dumpty” dog, but in the jigsaw puzzle of putting Tessie back together, I only did one or two of the corners. Tessie’s primary-care team did all the tricky, thankless stuff.

Once Tessie was released from the hospital, Ms. Noons was committed to giving her the best possible chance to recover. Diapers, pain meds, hydrotherapy, acupuncture: Whatever Tessie needed, Ms. Noons provided. Ultimately, this level of commitment, this steadfast conviction, paid off. Three months after surgery, Tessie was running around, chasing other dogs and fully continent. Why this dog made it and a dozen others with the exact same injuries would not, I can’t say. Maybe a dog who can survive being hit by a car and a cold January night in Boston has an extra helping of luck.

“She was always a source of pride,” says Ms. Noons. “People would stop me and want to play with her. When they saw her in a diaper, barely able to walk, I could tell they were thinking, Is it fair what you’ve done to your dog?”

“How’s it feel today,” I say, “when you meet these naysayers in the street?” “It’s nice to be smug; I’m not going to say it isn’t. I’m proud of her, being fresh, going after bigger dogs. My princess is back.”

Ms. Noons marvels at what we did for Tessie and, though I appreciate (and am humbled by) her gratitude, it’s far more than I deserve. Perhaps the hands-on nature of surgery, the physicality of mending broken bones, the instant gratification of postoperative X-rays, makes it look as though the doctor with the scalpel created the cure. Truth is, I’m as amazed as she is, and under no illusion; in this magic act, I was nothing more than a willing assistant.

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This article first appeared in The Bark,
Issue 71: Sep/Oct 2012
Nick Trout is a Diplomate of the American and European Colleges of Veterinary Surgeons and a staff surgeon at Angell Animal Medical Center in Boston. facebook.com/DrNickTrout

Photograph Patrick ORourke

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