Anesthesia and Pain
Quick Action and Teamwork Lead to Happy Ending
When Oliver, a 4-1/2-month-old golden retriever puppy arrived at Foster Hospital for Small Animals at Cummings School of Veterinary Medical Center at Tufts University, he had been vomiting for two days after breaking into the trash can. “You could tell he wanted to lie down, but couldn’t; he was stretching out his neck looking very uncomfortable,” owner Carrie Alward recalled. She knew something was not right and brought Oliver to a local emergency clinic. The x-ray was inconclusive, but they suspected he had acquired a gastrointestinal infection, and sent Oliver home that evening. After 36 hours with no improvement, Carrie brought him to Foster Hospital in search of a second medical opinion and was hopeful that specialists from Tufts would collaborate to diagnose and ultimately treat her Oliver. Emergency room veterinarian, Dr. Tiffany Jagodich was immediately concerned with the seriousness of Oliver’s illness. She started him on intravenous fluids and medications (pain relief, antacids, and anti-vomiting medications) and transitioned him to the ICU for ongoing treatment and further diagnostic tests, where he was placed in the care of Dr. Scott Taylor.
“Oliver was in extreme pain and unable to rest, remaining standing in a hunched position. He was one very sad puppy,” recalls Dr. Taylor. Standard imaging techniques, including x-rays and ultrasound were again inconclusive. Foster Hospital’s ICU staff, however, recommended and discussed additional diagnostic options with Carrie Alward. Ultimately, the doctors and Alward family decided to pursue a CT scan for Oliver, which would require anesthesia. This more advanced diagnostic test revealed a bamboo skewer (teriyaki stick) vertically piercing from Oliver’s stomach through his esophagus and into the muscles under his spine. It’s no wonder that Oliver was so uncomfortable. Carrie received a call from Dr. Taylor who described the dire situation — one that would require surgery. Although the doctors were hopeful that they could successfully remove the skewer and repair the internal damage that it had done, the Alward family was also prepared for the worst.
Oliver’s case is a true testament to the teamwork and collaboration that happen every day at Foster Hospital for Small Animals. Drs. John Berg and Harpreet Singh, soft tissue surgery specialists, in conjunction with radiologists Drs. Dominique Pennink, Trisha Oura and Josh Hobbs, and board-certified anesthesiologist Dr. Lois Wetmore were consulted by the ICU team to discuss the best approach and management for this very precarious injury. In the end, it was the collaboration and joint care of the entire team of veterinary specialists under one roof that would ultimately save Oliver’s life.
Multiple procedures were required — first abdominal surgery, followed by thoracic surgery and then incision repair to both his stomach and esophagus. A portion of his lung was also removed and a specialized feeding tube placed in his stomach to bypass the esophagus during his recovery. This was a very complicated procedure, one that required the skilled expertise of veterinary specialists with advanced training in surgery and anesthesia. . In spite of the potential risk of complications, Oliver had an excellent recovery while being intensively managed by Dr. Kristina DePaula during this ICU stay. Nutritionist Dr. Lily Johnson was also consulted during the recovery period to ensure Oliver’s nutrient requirements were met.
Oliver was discharged on a Sunday, four days after his surgery, and continued to receive stomach tube feedings. When the tube was removed 15 days later, Dr. Johnson instructed Carrie on how to transition to regular feedings and the best foods to provide a growing puppy. This was not Carrie’s first encounter with Foster Hospital. The team had previously cared for another of Carrie’s doggie’s, who had suffered with bone cancer and she speaks of how wonderful they were then. This time was no different. “The Tufts team of doctors and staff held my hand through the entire process. Dr. Depaula, in particular, was there for me and for Oliver, explaining everything so that I understood exactly what to expect” recalled Carrie. “It’s frustrating that they didn’t do more thorough diagnostic testing when I brought Oliver to the local emergency clinic for the initial evaluation,” said Carrie, disappointed that she hadn’t first taken him to Tufts.
Not only does she sing the praises of the Foster Hospital’s team of veterinarians and staff who provided such compassionate care for her sweet Oliver and saved his life, but she will also shout from the rooftops the importance of keeping barbecue skewers out of the trash. Now two months later, “Oliver is thriving, growing and doing everything he should be doing…just like his brothers and sisters are,” according to Carrie.
- Cummings School