would you operate?

Re: would you operate?

Emily Nightingale — Tue, 06 Nov 2012 22:10:20 GMT

That's what I thought- just checking. Thanks. =)

Re: would you operate?

Hannah Wynne Richards — Tue, 06 Nov 2012 17:47:41 GMT

That's the idea with little bits of glass which hopefully will then pass through-it's just these bones are so big I doubt that would happen

Wynne

Re: would you operate?

Emily Nightingale — Tue, 06 Nov 2012 16:36:42 GMT

[quote user="Hannah Wynne Richards"]

I'd operate Those bones look too big for a cotton wool sandwich

Wynne

[/quote]

Hi Wynne- I'm probably being a bit slow but would you suggest feeding the dog cotton wool to try and pad the sharp bits out preventing perforation??

Sorry- just had to ask as my sleep deprived addled brain is wondering.

(10m old baby not sleep more than 4hrs on trot in last 3 weeks.. ) sigh.

Re: would you operate?

Anthony Dennison — Tue, 30 Oct 2012 16:39:23 GMT

[quote user="alison howell"]Don't know how you could concentrate on the poem at a time like that! Was far too scared of approaching baddies to listen to a word she said![/quote]

SPOILER ALERT!! I haven't seen it yet...

Re: would you operate?

HMC — Tue, 30 Oct 2012 09:46:44 GMT

Thanks guys. It's a difference of opinion....

But day off today and tickets for Skyfall with hubby are already booked!

Re: would you operate?

vs0u — Mon, 29 Oct 2012 21:21:52 GMT

[quote user="Hannah Bose"]

It's amazing how you can go from feeling all chuffed with oneself to being given a blow. The blow is not related to this case, thankfully, and shall remain enigmatic- I just felt the need to vent.

[/quote]

Don't let them get to you.

Re: would you operate?

vs0u — Mon, 29 Oct 2012 21:20:58 GMT

[quote user="Rajat"]

Lord Tennyson's poem (which M quotes to the enquiry commitee..) which I enclose - stay strong (no smiley icon for a hug and a kiss seemed a bit forward!)

Though much is taken, much abides; and though
We are not now that strength which in old days
Moved earth and heaven; that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.

[/quote]

Don't know how you could concentrate on the poem at a time like that! Was far too scared of approaching baddies to listen to a word she said!

Re: would you operate?

Mark Hedberg — Mon, 29 Oct 2012 21:10:20 GMT

[quote user="Robin Grimmer"]

[quote user="alison howell"]

Also had 2 dogs both springers fed RMB diet, one with perforated intestine from a bone and the other with intestinal obstruction. That's just within the past 3 years.

[/quote]

This is surely conclusive evidence that RMB diet is harmful then. What do others think?

[/quote]

No, that's anecdotal evidence - let's not get into the RMB thing again! (I speak not as a proponent of diet, but as a proponent of what evidence is.)

Re: would you operate?

Rajat — Mon, 29 Oct 2012 19:53:16 GMT

Hannah

You did a fab job on the dog - and like you somethings are getting me down too recently, the weather being a major player no doubt. Saw skyfall on the weekend and was greatly heartened to be reminded by Lord Tennyson's poem (which M quotes to the enquiry commitee..) which I enclose - stay strong (no smiley icon for a hug and a kiss seemed a bit forward!)

Though much is taken, much abides; and though
We are not now that strength which in old days
Moved earth and heaven; that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.

Re: would you operate?

James Laidlaw — Mon, 29 Oct 2012 19:04:46 GMT

That's vet life for you though, hope the knock wasn't too big!

Re: would you operate?

Mark Rowland — Mon, 29 Oct 2012 19:02:58 GMT

Ha ha that too :-)

Re: would you operate?

Nigel Davies — Mon, 29 Oct 2012 19:01:55 GMT

"Just remember what Rocky said: "it's not about how hard you can hit, it's about how hard you can get hit and keep moving forward "... Works for me anyway"

Sometimes its about WHO you can hit

Re: would you operate?

Mark Rowland — Mon, 29 Oct 2012 18:56:02 GMT

[quote user="james herriot lied"]

[quote user="Hannah Bose"]

It's amazing how you can go from feeling all chuffed with oneself to being given a blow. The blow is not related to this case, thankfully, and shall remain enigmatic- I just felt the need to vent.

[/quote]

[/quote] Agreed what's up? Just remember what Rocky said: "it's not about how hard you can hit, it's about how hard you can get hit and keep moving forward "... Works for me anyway

Re: would you operate?

james herriot lied — Mon, 29 Oct 2012 18:50:37 GMT

[quote user="Hannah Bose"]

It's amazing how you can go from feeling all chuffed with oneself to being given a blow. The blow is not related to this case, thankfully, and shall remain enigmatic- I just felt the need to vent.

[/quote]

What's up, Hannah?

Re: would you operate?

Simon Neuhoff — Mon, 29 Oct 2012 17:33:40 GMT

Yup I've also seen bones cause issues - all vets will have. Thing is though the vast majority don't cause issues. Difficult call but if the rate of perofration was 1 in 100 that would actually in my mind be a contraindication for surgery as the rate of complications for a gastrotomy would be higher!

I have also seen one dog die from overeating dry food - and pretty sure I saved another by doing a gastrotomy.

Re: would you operate?

Robin Grimmer — Mon, 29 Oct 2012 17:15:46 GMT

[quote user="alison howell"]

Also had 2 dogs both springers fed RMB diet, one with perforated intestine from a bone and the other with intestinal obstruction. That's just within the past 3 years.

[/quote]

This is surely conclusive evidence that RMB diet is harmful then. What do others think?

Re: would you operate?

HMC — Mon, 29 Oct 2012 17:01:27 GMT

It's amazing how you can go from feeling all chuffed with oneself to being given a blow. The blow is not related to this case, thankfully, and shall remain enigmatic- I just felt the need to vent.

Re: would you operate?

Anthony Dennison — Mon, 29 Oct 2012 13:32:33 GMT

[quote user="Bob Russell"]

This was not a case of a foreign body. The contents were food, just a lot of it.

[/quote]

Playing Devil's Advocate here - the contents was a chicken carcass that the dog wasn't supposed to have eaten - isn't a foreign body anything a dog has eaten that it wasn't supposed to?

Re: would you operate?

Bob Russell — Mon, 29 Oct 2012 13:13:23 GMT

This was not a case of a foreign body. The contents were food, just a lot of it.

I am sure the majority of dogs recover from a gastrotomy under these circumstances but it is a procedure that should never be taken lightly. I can only comment in general because it is not my case, I don't have to make the choice or live with the consequences!

I would be a bit more relaxed about raw bones than cooked as they do tend to be a lot more 'elastic' in the uncooked state. Would bones cause perforation without any warning, I wonder?

I certainly would not criticise a colleague for making this decision either way.

Re: would you operate?

Mark Holmes — Mon, 29 Oct 2012 12:19:29 GMT

[quote user="alison howell"]Probably a good proportion of these dogs would be fine but how many is it worth taking the risk for by leaving them - If 1 in 100 ends up perforating, or 1 in 50 - that's the gamble we are taking by deciding not to operate[/quote]

But to save that one dog you need to operate on 100, and 99 experience painful unneccessary surgery. I suspect the odds on perforation are lower than 1 in 100.

Re: would you operate?

vs0u — Mon, 29 Oct 2012 11:44:46 GMT

I'm surprised the more experienced people here are so unconcerned about foreign bodies!

I operated on a labrador recently that had a perforated stomach as a result of a piece of plastic about 2-3 cm big, it was pointy but not razor sharp and had made a large hole in the stomach. It took 3 hours to flush all the debris from the abdomen - there was gritty stuff every where - nightmare op.

Also had 2 dogs both springers fed RMB diet, one with perforated intestine from a bone and the other with intestinal obstruction. That's just within the past 3 years.

None of these presented prior to the emergency situation but I would definitely be going for an early op given the choice. It's so difficult to get rid of all the abdominal contamination once something's ruptured - far easier to avoid that situation - I think gastrotomy is relatively low risk on a healthy dog anyway if done carefully.

Probably a good proportion of these dogs would be fine but how many is it worth taking the risk for by leaving them - If 1 in 100 ends up perforating, or 1 in 50 - that's the gamble we are taking by deciding not to operate. The problem is we don't know which dog will be the one that ends up dying due a perforated intestine. We neuter many dogs so that a small proportion won't end up with a pyo or tumour - this is similar in a way. People seem to think that this type of surgery would be a major problem for a 11 y.o. westie - but I bet many people would be willing to do something less beneficial - for example a splenectomy - when most dogs that have splenic tumours die of mets within months - or amputating a leg with osteosarcoma - again certain death in months. Whereas this dog would have a very good prognosis for complete cure with surgery to remove the bones, not totally risk free but nothing ever is.

Re: would you operate?

Anthony Todd — Mon, 29 Oct 2012 09:30:39 GMT

"Well... I operated and glad I did."

A big leap I know, but another one for a quick ex.lap and no "faffing".......

I had a genuine pyo with, by chance I found it, an intestinal polyp.....

Easy to have a good look round during an ex.lap.......

Re: would you operate?

Bob Russell — Mon, 29 Oct 2012 09:19:03 GMT

[quote user="james herriot lied"]

[quote user="Bob Russell"]

Nope, I would monitor the dog and only intervene if it was absolutely necessary. My first boxer raided a bag of dry food. Her abdomen was so full I was convinced she would burst.

She was kept quiet, digested the lot. No vomiting, no diarrhoea!

[/quote]

With respect, Bob, the comparison is a bit chalk and cheese. I wouldn't operate either, if it was just a pack of dried food in there. But these bones aren't going to digest that quickly, and there are going to be ongoing risks in that time; with a stomach impaction like this, the first signs of things going wrong are likely to involve stomach wall compromise - so waiting to see invites the possibility of putting the dog in a worse position.

As an aside, what do you think would be the effect of putting pancrex (other brands are available) down a dog's throat in such a situation - would it improve rate of digestion?

[/quote]

I agree, not the same thing at all but my point was that a dog with a massive stomach is not necessarily in trouble! Very full abdomens can look dramatic but if the animal is well there is no automatic need to intervene!

Re: would you operate?

Moira Hamilton — Sun, 28 Oct 2012 17:33:57 GMT

Sorry didn't read the whole post before replying, so glad the surgery went well and sounds like it was very good timing with the splenic tumour, would have been bad to have to wait till there were clinical symptoms, well done!

Re: would you operate?

Moira Hamilton — Sun, 28 Oct 2012 17:24:56 GMT

As long as the owner is aware that despite being in a stable condition, this is going to be a difficult recovery and a very big op, but I would go in and try, if you don't the dog has no chance at all. At least giving it the chance to survive makes it worth the risk. GOOD LUCK!!!!!!

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Though much is taken, much abides; and though We are not now that strength which in old days Moved earth and heaven; that which we are, we are; One equal temper of heroic hearts, Made weak by time and fate, but strong in will To strive, to seek, to find, and not to yield.

Re: would you operate?

Re: would you operate?

Though much is taken, much abides; and though We are not now that strength which in old days Moved earth and heaven; that which we are, we are; One equal temper of heroic hearts, Made weak by time and fate, but strong in will To strive, to seek, to find, and not to yield.

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Though much is taken, much abides; and though
We are not now that strength which in old days
Moved earth and heaven; that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.

Though much is taken, much abides; and though
We are not now that strength which in old days
Moved earth and heaven; that which we are, we are;
One equal temper of heroic hearts,
Made weak by time and fate, but strong in will
To strive, to seek, to find, and not to yield.