Meet Sox, an adorable, spunky 6 month old miniature dauschund. 6 weeks ago Sox presented to our hospital after being hit by a car. He was having difficulty breathing, he was pale, he had a very low blood pressure and he was very painful. He was given some pain medications and radiographs were quickly taken to identify the reasons for his distress. He had a diaphragmatic hernia and a fracture of his femur. The diaphragmatic hernia had allowed his abdominal organs, like his liver and stomach, to move into his chest cavity making it so he could not expand his lungs normally. He needed emergency surgery to fix that. He was quickly stabilized and taken into the operating room.
In surgery we put Sox on a respiratory ventilator because he was not able to breathe well on his own. We then made a long incision on his abdomen through the skin and tissues so that we could evaluate his abdominal cavity. We found that his diaphragm, a muscle which normally separates the abdominal cavity from the chest cavity and helps with breathing, was completely torn away from its normal attachments. This meant that all of his liver, his stomach and his spleen had moved from his abdominal cavity into his chest cavity. It also meant that he could not create the normal pressure changes in his chest cavity which are essential to breathing. We gently manipulated the abdominal organs back into their appropriate locations in the abdomen. We then sutured the diaphragm back to its original location and closed our initial incision. Sox recovered from anesthesia and was able to breathe without the help of the ventilator, but he still needed extra oxygen supplementation for the next several hours.
Sox spent the next 2 days in our hospital receiving supportive care while allowing his lungs and body to recover from the trauma. On the third day he was breathing well on his own and his blood pressures were normal.
We then took him back into the operating room to fix his femur fracture. He had broken his bone at the growth plate, a weak spot in the bone of a young, growing dog. The surgery went well and his fracture was stabilized with some pins. He recovered from anesthesia without any complications.
Sox went home the next day. He needed to be kept in a crate or small room for four weeks to allow his fracture to heal. This turned out to be a hard task because as soon as he started to feel better he wanted to play and run around. The family did an excellent job of taking care of him and helping him recovery.
We took radiographs of the femur 4 weeks after surgery and it was healing very well. All of his incisions were healed and his shaved skin was already covered with new hair! He had a slow return to normal activity over the next 2 weeks.
Sox is fully recovered now and running around at home as if nothing ever happened.