Tucker Weintraub or
“Why Bones are Bad”
He got into the garbage almost two weeks before we met him.
It was not intentional (on his owner’s part, anyway). The garbage bag was sitting next to the front
door; closed and ready to be taken outside. Tucker, an extremely sweet, fluffy,
grey yorkiepoo very quietly nosed his way into the bag and ate his delectable
find, including the chicken bones that would cause him so much trouble.
He vomited right after his feast and over the next couple of
days, his energy and appetite waned. He began trembling as if he was
uncomfortable. He was examined by his
veterinarian (Dr. David Handel). He knew that something was not right but none
of the examination findings nor lab tests gave him any clues as to the reason. Two days later, Tucker was worse and went
back to see Dr. Handel. This time, he had a fever and was dehydrated. When Dr. Handel took x-rays of Tucker’s
chest, he identified a small volume of fluid around the lungs. He immediately
started antibiotic therapy and transferred him to VCA Veterinary Referral
Associates because he knew that Tucker required further diagnostics and round
the clock care.
At VRA, Dr. Prantil was able to collect a small sample of
the fluid that was around his lungs and diagnosed a bacterial infection in his
chest (pyothorax). This is a very serious
infection and most animals who have it are even more sick than Tucker was.
These patients usually have so much fluid in the chest that they have trouble
breathing and require tubes to be placed in their chests to allow drainage of
the infection. Tucker was not following the “rules”. There was not enough fluid in his chest to
drain so we treated him with intravenous fluids and antibiotics. His fever resolved
and he was feeling so well that he went home after three days in the
hospital. Our only concern was that he
was not eating. We all know that some
dogs just don’t like to be in the hospital so, when we sent him home, it was
with the caveat that if he did not start eating well, he would need to come
back for a recheck.
And fortunately, the Weintraubs were very attuned to their
little dog. They really must have had a
sixth sense about him because even though he finally started eating on the
third day after leaving the hospital, they brought him back in for a recheck.
The main problem I could see when I examined him was that his breathing was
just a little labored. We took x-rays of his chest and saw that there was still
a little bit of fluid around his lungs and now, there was a small abnormality
visible in his lungs as well: a spot that was a smidge too grey in an area that
should have been black. So the treatment
we were using was not working; Tucker seemed to be getting worse. Our next step
was to go to surgery and explore the chest for the cause of the infection. And
it was lucky we did.
During surgery, Dr. Snakard (surgeon) found that a small
portion of the esophagus felt abnormal: very firm and irregular. Because of its
location (way down in the chest beneath the constantly beating heart and the
always moving lungs), she couldn’t really get a good look at it so we decided
to look at it from another perspective. Dr.
Conway (internist) came in and “scoped” him.
Passing an endoscope down through Tucker’s mouth and into his esophagus,
she was able to see that there was a piece of a chicken bone sitting right in
the esophagus. Actually, it was sitting
both in and out of the esophagus
because on its way down, the bone had torn right through the wall. This was the source of the pyothorax and
without fixing it, Tucker would never get better. One of the amazing things
about this, and the main reason no one had been able to diagnose it sooner, was
that the bone – a fairly large piece of bone - was too thin (only a millimeter
or 2 in width) to show up on x-rays. Bones normally show up very well on
x-rays. Poor Tucker! No wonder his
appetite had been poor! Dr. Snakard went to work. She removed the bone,
repaired the esophagus and removed a piece of the lung that had been terribly
infected because it was sitting against the esophageal wound.
Tucker recovered slowly from surgery and ten days later
(almost 3 weeks after getting into the garbage), he left the hospital with his
tail held high.
Having a bone lacerate the esophagus is bad enough but,
unfortunately, it might not be the end of Tucker’s problems. As the esophagus heals, there is a danger
that it will scar down and stricture, resulting in a passage that is too narrow
for food to pass. If this happens,
Tucker will have a lot of trouble holding food down and will have to undergo
additional medical procedures to dilate the stricture. There is no preventative
measure that we can take or medication that we can give; we just have to see
what Tucker’s body does as it heals. He
is doing well now and I very much hope he stays that way!
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