UT-VMC emergency room tails:Overboard

UTVMC ER TAILSBy Dr. Amanda Rainey

Working in emergency medicine has its way of keeping you on your toes.  The day can be going along with little excitement, and in an instance become something entirely different depending on what comes through the receiving doors.  I was reminded of this very recently during one of my Saturday shifts at the UTVMC.  The intern on duty had just admitted an older Golden Retriever that was very ill, but it was our only case at the moment and we were going through the nuances of the animal’s presentation with our two students, in order to help them learn how to work through such a situation.

“Emergency to the front STAT!!!”  The call over our intercom system shattered the quiet contemplation of our discussion and our ER technician along with one of the students on duty bolted from the ICU, sprinting to retrieve the unknown critical new arrival.  Moments later I could hear a gurney rolling quickly down the hallway, and what I saw as it was wheeled into the room caused me to gulp.  Tucker had been out on the boat with his owner fishing, and somehow lost his balance when standing on the edge of the craft.  He had fallen overboard, and been injured by the propeller as he fell.  I quickly assessed his wounds as our skilled ICU technicians placed an intravenous catheter and obtained his vitals.  Miraculously, his values indicated he was quite stable despite what he had just endured.  Tucker had a long and deep laceration just above his tail base, another large wound slightly below his rectum, and a traumatic tail amputation.  Blood slowly dripped from his now short tail, and after determining his stability we immediately created a makeshift bandage to cover and protect the wounds.

As I spoke with Tucker’s owners, I could see how shocked and overcome they were with the situation.  Committed to helping him, they gave his permission to begin caring for him and to do whatever we deemed necessary.  Tucker was given intravenous pain medication and started on fluid therapy to support his cardiovascular system as he had lost blood.  We heavily sedated him to perform radiographs of his chest and abdomen to search for any internal trauma.  Thankfully, nothing appeared injured and we proceeded to addressing his wounds with our on call surgery team.  Due to the severity of the injuries, Tucker was completely anesthetized to being exploring and correcting the defects.  The laceration above his tail base reached to his spine, and we could visualize his vertebrae, but none were damaged.  Similarly, the wound below his rectum was also very serious, but amazingly missed any vital anatomy such as his urethra or colon.  These were sutured closed after the placement of closed suction drains to prevent infection or fluid buildup.  His tail had been neatly severed between the vertebrae, and our surgeon was able to complete this amputation and close the wound.  Several hours after we started, Tucker rolled back into ICU to recover.

The next morning I arrived for my shift and went straight to check on Tucker.  He saw me coming and I couldn’t help but grin when I saw him trying to wag his new little nub of a tail in greeting.  Tucker had to stay in the hospital for several days to manage his drains and ensure his wounds healed appropriately, as well as for pain management, but was incredibly lucky to survive such an incident.  He was a great patient, and it was an incident that many of us will never forget.  

           

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