The Severely Abused Chihuahua-Pom
This was Honey’s day, with all the anesthesia and surgical planning completed; and alternative plans prepared depending on how complicated the fracture repair would be due to the type of injuries and with the age of the left femoral fracture. I had blocked off the majority of the day for her, as it was difficult to predict how long her procedures would take. Everything was well-planned for in advance, including her post-operative CRIs (continuous rate infusions) of pain medications. The unknown was what I would find once I could visualize her broken bones, as small cracks and fissures are often difficult to see on standard radiographs.
What I found was as bad and complicated as I could have imagined. Large pockets of blood displaced the tissue surrounding her right femoral fracture, a result of a recent kick or hit with a blunt object. Multiple cracks and fissures ran up and down the length of the bones with two larger fragments and several smaller fragments embedded in her damaged muscles. I was able to align the bones back to proper reduction using a multitude of cerclage bands and several IM (intramedulary) pins. The IM pins run the length of the femur inside the medulary canal, while the bands hold the pieces of bones together similar to the metal rings used to hold wooden wine barrels together.
Her left femoral fracture was much worse. The ends of the bones were displaced as far apart as they could get from what had to be the result of a very serious blow to her leg. The medulary canals were completely closed over with new bone growth giving the appearance of a piece of cauliflower stuck on the end of a chicken bone. Her muscles, once torn and separated from the injury were now healed and scarred down in the most grotesque way. I had to carefully cut and dissect the muscles free from their scars to allow adequate exposure to her bones. Once I was able to free the tissue, and reposition the ends of her bones to their proper alignment, I had to carefully remove the excessive bony callous (bone laid down as the body tried to heal itself) and drill a new medulary canal to allow the insertion of the IM pins. This fracture was also complicated with multiple fragments, some which were embedded and hidden deep in her muscles and were already beginning to be reabsorbed. I suspect that this fracture had occurred approximately seven to eight weeks prior to the fracture of her right femur. This precious little girl was essentially crippled on her left leg and in constant agony when she was beaten again, this time fracturing her right femur and causing the bleeding of her right eye.
Surgery and post-op radiographs were completed and anesthesia went as planned - without any unexpected events. Her blood pressure, blood gases, body and respiratory temperatures, ECG, respiratory depth and rate were maintained perfectly throughout her nearly five hour procedure. She quietly woke up in our incubator with oxygen, heat, fluid and pain medication on board, along with continuous vital monitoring by our staff. This marked the beginning of a very long road to recovery for Honey.
To be continued…
William T. Carlisle, DVM