Friday, September 2, 2011

Intussusepction



Ella with our 7 week old puppy Luna

What is an intussusepction, you ask? Good question. It is a medical condition where one portion of the intestine is "swallowed" by the adjacent part, much like a collapsing telescope. So why am I blogging about this medical condition? Well, our 7 week old puppy had it occur about a week ago. It is very rare (I have now seen 3 cases in 10 years of practice) and it is a condition that is fatal if not treated.

It all started with our puppy (Luna) vomiting and showing signs of abdominal discomfort. When she didn't improve with conservative treatment, I did a thorough exam of her abdomen under mild sedation (she was too tense in her abdomen for an thorough exam without it). My heart sank when I felt a loop of intestines that was just too thick to be normal. I had to decide if our puppy needed immediate - major abdominal surgery at 10:00pm. I did not have the luxury of an ultrasound or x-ray confirmation. I discovered that the decision to operate was a harder decision than I thought it would be, in part because the type of anesthesia that I have available is not the safest for a 7 week old puppy that is weak and sick. We had our own emotions to deal with, but we were mostly worried about what the kids would think if they woke up to find that their puppy was dead...either because of or because of the lack of surgery.

Well, we said a prayer and went for it. Bethany was brave enough to be the anesthesiologist, surgical nurse, and surgical lamp holder (aka mini-Maglite). She is still not used to the sights and smells of surgery, but she didn't vomit or faint (she is an amazing wife!). Little Luna (all of 4 pounds) was cut stem to stern and all of her abdomen was examined. The suspected problem was found and corrected, and the intestines were pexy'd (sutured to themselves) to prevent recurrence. Bethany marveled to see all of her intestines laid out on the surgical drape, and then when they were put back in the abdomen, she marveled at the fact that I knew how to put them all back correctly. Sshhh, don't tell her that all you do is stuff them back in like putting a sleeping bag into a case...there is no wrong way to do it...it will be our secret.

Praise God, she has made a full recovery and is doing great. Just as I was closing up her abdomen (now at 11:30 pm) I asked Bethany to take some pictures, because this was a night that we will not soon forget.

Closing her up




Andrew and Luna doing Math (a week earlier)