Peaches is a super cute min pin and is in remarkably good shape for someone who weighs 8 pounds and was at the recieving end of a car a coupla days ago. She’s bright and alert and sweet as long as you don’t touch that bad leg. Then she gets nervous. Heart and lungs sound good, no other obvious injuries, eating and drinking fine.
She’s scheduled for surgery tomorrow to amputate the leg. There’s no saving it. It was severely mangled in the accident and it’s currently infected.
Today we beefed up her antibiotic and pain control regimens. She came to us on Tramodol and Rimadyl (a narcotic-like drug and a non steroidal anti-inflammatory) and Amoxicillin (basic broad-spectrum antibiotic).
I just added Baytril to the mix (a bit better antibiotic for penetrating bone and getting to nasty gram negative bacteria). This is a little risky because there are a lot of bugs out there that are already resistant to it, or just need a little taste of it to become resistant, but it’s the best we can do at the moment.
I also put a Fentanyl patch on her. This is basically a sticker (kind of like those Nicotine patches) that delivers a potent morphine like drug directly into her bloodstream for the next 3 or 4 days. It takes a few hours for this to kick in so that by the time she goes into surgery she should feel pretty good. I also gave her an injection of a drug called Buprinex which is another morphine-like drug to bridge the gap between now and when the patch kicks in.
The more pain medication we have on board BEFORE she goes to surgery, the better her overall level of pain will be controlled when we actually start cranking around on that broken leg. Studies have shown that the more preemptive measures you take to control pain, the faster the recovery and the less stress to the patient post op.
Since this is a learning case, I’m probably going to try some newer pain control methods on her tomorrow if I can. Thinking about a ketamine constant rate infusion (ketamine is basically a hallucinogen, it’s one of the more popular reasons vet clinics get broken into. We use it as a sedative, but somebody discovered that at very tiny doses given constantly through an IV it does a really good job at modulating pain without adverse effects to the patient) and maybe a local nerve block (on top of our usual pain control techniques).
Should be interesting, then we can become more comfortable with new and improved ways to keep our patients as pain-free as possible.
I’ll keep ya posted…