Stop the bleeding!!

January 23, 2012

As a Vet, you can never be sure what will happen from one minute to the next; emergency cases can suddenly turn a routine surgery on its head.

Last Monday morning, surgery was suddenly interrupted when a collapsed German Shepherd Dog called Ziggy was rushed in.

Ziggy is a fine looking breeding bitch and had suffered complications in labour over the weekend, when a pup became stuck. A routine caesarean operation had been performed and when awake from the anaesthetic, Ziggy and her new pups were discharged.

When Ziggy was brought in on Monday, she was very ill. Her gums were very pale and her temperature was below normal. She was unable to stand and her breathing was very fast and shallow. It was clear that unless we acted quickly, Ziggy was not strong enough to hold on much longer.

I admitted Ziggy and the nursing team and I quickly started her treatment. Firstly, we inserted an intravenous catheter and set up a drip. We used a special fluid called a plasma volume expander to help to support her circulation. I also took a blood sample from her. The sample was rushed to our in-house laboratory and tested using the biochemistry and haematology analysers. Results were processed within 6 minutes. The test confirmed that Ziggy was extremely anaemic. An ultrasound scan was performed on her abdomen where we could see free fluid. Ziggy was then prepared for a procedure called abdominocentesis which involves a sampling needle being passed into her abdomen and we were able to confirm that the fluid in her abdomen was blood.

German Shepherd dogs can have a defect in their blood clotting mechanism which reduces their ability to form blood clots, in a similar way to people with haemophilia. Samples were taken to investigate her clotting ability and they confirmed that Ziggy did indeed have a clotting defect. The blood supply to the womb of a pregnant bitch is enormous to support the growing pups and I was suspicious that there was continued blood loss from the womb because her blood would not clot properly.

The difficulty was how to deal with the problem. Ziggy was too weak to anaesthetise and attempting further surgery would be likely to disturb any fragile clots that had formed. After discussion with the owner, we made the difficult decision not to undertake further surgery, but to manage Ziggy’s circulation with a blood transfusion and further I.V fluids.

Slowly, over a period of days, Ziggy has gradually improved. Fortunately, while still reduced, she does have some clotting ability and at the end of the week, she was able to go home. She will, of course, have to avoid further surgery where possible in the future, and special precautions will need to be taken if this necessity arises.


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