Sunday, March 22, 2009

this is termed in veterinary medicine as a "peek 'n shriek"

case study: 9yr old great dane (61kg) with vomiting of 5 days duration, inappetance, slight jaundice. she transferred from her regular dvm for an ultrasound. the ultrasound showed pronounced gas dilation in the bowels (liver appeared normal). bloodwork: elevated ALT, ALKP, TBili. coags were normal. WBC count was also normal.
we took her to surgery. i was the anesthesiologist.
out came the guts...

and the big-ass lower intestine...

...that was torsed but not necrotic. it untwisted and immediately began pouring yoo-hoo diarrhea all over the floor- with force that misted everything in a five-foot radius. the doppler was saturated; rivulets seeped underneath the surgery table. "more towels, please!" i yelled into the treatment room.

we all ran to get our cameras. with the colon out of the abdominal cavity, we were better able to view the completely fucked liver. the dark purply orb is the gallbladder- also abnormal. gallbladders are typically a lurid green, as if they've been filled with antifreeze. sludgy and black, not good. the right and left lobes of the liver were completely adhesed. "this is one solid mass" the doctor said. "there is no normal tissue here."

i got the owners on the speaker phone. they processed the findings for about ten minutes. "oh god" the man said, his voice cracking. "this is so hard." they finally decided to euthanize on the table. i gave the injection. i am always struck by the poignancy of euthanizing while an animal is still attached to monitors; the doppler slows and muffles. the ECG turns into a silent, solid line. there is always that moment of peace before the alarms start beeping. that moment, i think, is what death really is... silent, complete, a serene exhalation.
"the liver should never look like a cluster of grapes" the doctor said as he sewed the body up.
throughout, 'saturday night fever', four hours of horribly entertaining disco music (every week 8p-midnight) played on the radio. we turned it off whilst talking to the owners.

her name was loki.

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