SURGICAL MANAGEMENT OF TRAUMATIC INTESTINAL EVISCERATION DUE TO INDIAN BISON (GAUR) ATTACK IN A DOBERMAN

    It was Dr. Shruti Gogia's last day at WVS India, Ooty and we were having dinner at the lecture hall on 16th April, 2022. At around 9:30 pm, a 9 month old, female, Doberman named  Puppy was presented with a history of devastating trauma caused by Indian bison (gaur). Evisceration of intestines was apparent (Fig 1). Many of these patients cannot be saved due to massive devitalisation of the bowel, infection and secondary injuries, some of the cases can be treated with aggressive medical and surgical management. We left the dinner plates on the table to attend this emergency.

    The treatment plan included – 1. Emergency triage and stabilization of the patient 2. Wound decontamination 3. Surgical correction and 4. Post-operative management. An IV catheter was placed and the patient was stabilized with IV fluids, antibiotics (Amox-Clav and Metronidazole) and Pain medication (Buprenorphine and Ketamine). Intestinal loops were assessed for viability and perforation. Intestinal loops were bright red in colour, and there was presence of intestinal peristalsis. Arterial pulsations in the mesenteric arteries were noticed. Warm saline lavage was done to remove the dirt and the intestines were covered with wet pads. There were no abnormalities in the blood report and radiographs.

    The dog was stable and the vital parameters were within normal range. The dog was placed in the lateral recumbency and the skin around the eviscerated loop was prepared aseptically with chlorhexidine solution. Puppy was induced with Diazepam and Propofol, and the endotracheal intubation was performed. General anaesthesia was maintained using Isoflurane gas anesthesia by Dr. Mukesh. A Lignocaine + Ketamine CRI was also used during the surgery. The intestinal loops were reduced into the abdominal cavity. The muscle layer were closed using 1-0 polydioxanone (PDS) in a simple continuous manner (Fig 2). The subcutaneous layer was closed in a continuous manner. The skin was opposed by cruciate suture pattern with 2-0 Polyamide (Nylon). 

    Following the surgery, Puppy was put on a course of antibiotics (Amox-Clav and Metronidazole) and pain killers (Meloxicam and Buprenorphine). An Elizabethan collar was used to prevent Puppy from biting or licking her surgical site. Strict rest and short leash walks were recommended for 2 weeks. Puppy made an uneventful recovery and the skin sutures were removed after 10 days. 

    Bison, boar and leopard attack cases are not so uncommon in Nilgiris. The pet owners need to carefully supervise their dogs when left outside to prevent such incidence. Dr. Shruti's last day at work was nothing less of an adventure. We were all extremely happy that puppy survived that night and made a recovery without complications. It was one last time the trio consisting of Dr. Shruti, Dr. Mukesh and myself were involved in a Friday night emergency!

References

 

1. Gower, Sara B., Chick W. Weisse, and Dorothy C. Brown. "Major abdominal evisceration injuries in dogs and cats: 12 cases (1998-2008)."Journal of American Veterinary Medical Association 234.12(2009): 1566-1572.

2. Slatter, Douglas H., ed. Textbook of small animal surgery. Vol. 1 & 2. Elsevier health sciences, 2003.

3. Stanley, Bryden J. "Complications of Intestinal Surgery WSAVA/FECAVA/BSAVA World Congress 2012."