July 28th, 2006

Friday. After a long night with two dogs in my bed (Miss Brown has quickly assumed her role in my household) I’m here at work on my day off to make a zillion phone calls and deal with one of veterinary medicines occasional headaches: a surgical complication.

Earlier this week (Monday) I spayed a six-month-old Rottweiler pup. Since she’s an anxious dog I made the decision to perform a nerve block at the incision site so she’d experience less pain on recovery. It worked. She was calm and comfortable as could be when she awoke from the anesthesia.

Today, she’s back with a low-grade fever and a hot incision site. Infection at the incision is a common complication of dog surgeries because it’s hard to keep them in a really clean environment and because pups tend to lick at the area. Her owners had removed the collar that serves to keep her away from the area because it stressed her out. She wasn’t even interested in the area, they assured me. No licking. I believe them.

In this case, the likely source of her infection was a reaction to the local anesthetic I used to keep her comfortable. The incision now looks like it has a ring of pink swollen tissue right where I injected this liquid (bupivicaine).

The reality: taking extra care to prevent pain can lead to more complications. Bupivicaine, like the NSAIDs and the opiates we often use before, during, and after surgery can all result in complications—they are drugs, after all. Anything you put into the body by any means adds an additional layer of complexity to your care of an animal. Pain relievers are a common source of complication.

This Rottweiler`s owners are nice but they’re not happy she’s had to be hospitalized to care for a complication. They see this as my fault. They’re not wrong.

It see it as my responsibility to make sure she does well in all things related to the procedure. That includes the whole two weeks until her stitches come out as well as the rest of her life with respect to the loss of her uterus and ovaries. That’s a long time (I hope).

This pup will do very well. Her fever is down already and she feels pretty comfortable. Her incision already looks better. She’ll stay for a day to receive fluids and antibiotics. I won’t charge her parents anything. Most vets do, just as most human surgeons will charge you for any complication that may result from your care. I don’t because I believe the possibility of a complication is a given. As such, expenses for the treatment of these should be built into the price of any routine surgery.

To be sure, I feel terrible she’s had a complication. No doubt her owners are a little unhappy with me. I expect that will pass as she improves and they see that we are caring people willing to take responsibility for her infection. Regardless, I can be satisfied that I’ve done my work to the best of my ability. I’ll try not to stress about it for the rest of the day (but I probably will).