Florence was a 5 month old female Sprocker Spaniel who was referred to Hamilton’s following a road traffic accident, following diagnosis of diaphragmatic rupture and multiple pelvic/hind limb fractures at her first opinion vet.
She was initially stabilised with methadone, fluids and oxygen therapy by the triage team before being taken to ultrasound to assess the internal damage.
Ultrasound showed a diaphragmatic rupture with displacement of liver gallbladder and stomach into chest, and a marked left retroperitoneal haemorrhage.
Failure to achieve cardiovascular and respiratory stabilisation lead to the decision to perform emergency surgery. Soft issue surgeon, Dr Karla Lee, performed a standard ventral midline laparotomy, where she found a prepubic tendon rupture with extension along the left lateral body wall. The diaphragmatic radial tear was very large, extending from the central tendon towards the sternum and the majority of the liver and stomach were displaced into the thorax. The liver had multiple surface tears with blood present within the thoracic cavity. Karla replaced the stomach and liver back into the abdomen and 60ml of blood was collected from the thorax and then autotransfused. Karla sutured the diaphragm and placed a thoracic drain.
The prepubic tendon rupture was repaired by drilling 3 holes through the available pubis, recognising this was fractured, and passing 2-0 PDS sutures through these holes and the prepubic tendon. The left lateral body wall rupture was sutured to the left inguinal ring and available muscles with 3-0 PDS SI sutures.
Surgery went well and the prognosis for her soft tissue injuries was very good. Florence was subsequently transferred to the orthopaedics team two days later and placed under the care of Dr Tim Easter.
Pre-op pelvis and femur
Florence had sustained a right distal femoral fracture and a capital physeal fracture to the left hip. Tim stabilised the fractures with metal implants and Florence was able to return home within two days of her second surgery.
Femur post-op with pins and femur with pins removed
Florence was discharged via our rehabilitation department where the owners were given a full home care plan and guide to recovery aids. Florence’s owners kept in regular contact with the team; sending wound updates and videos of Florence’s progress.
Florence has come on literally in leaps and bounds! Watch the video below to see her progress.