The morning sun flashes into the kitchen window, a reflection off the windshield of the returning school bus. Perplexed, coffee mugs are set aside; confused glances exchanged. Only 5 minutes has passed since the bus left the farm drive for school. It is strangely quiet… where is the dog?
The door flies open and a young, anxious voice provides the answer, “Simba got hit by the bus!”
It takes a brush with loss, to be reminded this desire to stay close is a two-way street. Often unexpectedly, dogs become life constants; our emotional connections quietly tied to each other. Equally unexpected may be the physical similarities and differences held within a furry frame of fidelity. It is during times of urgency this knowledge comes forward whether one is ready for it, or not. Simba’s accident is one of those times.
Simba, an over-sized short-haired border collie, had been pulled onto the bus by his young owner immediately after the accident. His black and white figure, now spotted with red, won’t move from under the bus’s front seat.
Amidst a bus load of crying children, he is coaxed half-way into the aisle. It is just far enough so he may be pulled out and assisted shakily down the bus stairs. He resists attempts to be lifted. With great effort, he makes his way across the lawn and onto the front porch. There, his legs give out and this time no amount of persuasion will move him.
An old blanket is frantically teased under his panting body. Lifting each blanket corner, he is gently placed into a plastic ice-fishing sled. His spine may be injured and this will keep him from moving too much – or at least that is the hope. Immediately, the make-shift gurney is placed in the back seat of the car. Simba’s vet, Dr. Cariann Turbeville, is called. There is relief hearing a voice on the other end of the line; Verona Veterinary Service is already open.
It will take nearly 30 minutes to reach the Vet’s office. Simba’s injuries are assessed enroute. The skin is torn along his jaw, halfway to his ear, and must be held in place to slow the bleeding. There are gravel filled lacerations of varying sizes across his left side. Blood leaks from somewhere underneath him too. As the trees whiz by, his eyes begin to close and his whimpering wanes.
“You foolish dog,” is repeated softly. A free hand strokes the intact side of his muzzle. The tip of Simba’s tail feebly wags. Questions dart around the car. Would it be better to go to the veterinary hospital? How much longer will that take? After four years on the farm why did he start chasing the bus now? Then there is the question no one is supposed to ask: How much can we afford? It is a relief to halt these wretched thoughts when the car reaches the Vet’s Office. Simba briefly lifts his head as he is gurneyed into the office. Otherwise he doesn’t move.
“Springtime is the worse time for these accidents, “explains Dr. Turbeville. Unfortunately, Dr. Turbeville doesn’t think Simba’s behavior will change with the passing of spring. “Once they [dogs] start, they don’t stop.”There is some research on animal behavior that may explain Simba’s behavior, according to the Vet. She knows of several studies on the natural breeding cycles of canines. Even though she is not aware of conclusive findings, some researchers and vets speculate a male dog can sense a female “in heat,” or receptive to breeding, up to 5 miles away. Female dogs typically go into heat twice each year; in Autumn and again in Spring. Even neutered dogs, like Simba, may adapt uncharacteristic behaviors – such as chasing vehicles – if the scent of a female reaches their sensitive sniffers.
Verona Veterinary Service is not an emergency animal clinic, but staff there know Simba and are ready for him. Sympathetic coos come from the waiting area as Simba is ushered into an examination room. Just as clinics do for humans in crisis, there are multiple hands at work. The vet, along with an intern, begins by checking Simba’s heart rate. An intravenous (IV) solution is started, by a veterinary technician, to keep the dog hydrated. This also allows pain medication to be delivered. His blood pressure is checked. Visible injuries are cleansed, stitched and stapled.
“His skin looks very pale. He must have lost quite a bit of blood,” assesses Dr. Turbeville. Despite the amount of visible blood loss, Dr. Turbeville doesn’t feel it fully explains Simba’s pale skin color. Attention is turning to the trauma that cannot be outwardly seen. Blood tests confirm Simba is anemic; a sign he is bleeding internally. X-rays are required to check for broken bones, and to investigate the sources of the internal blood-loss. But the vet first has a more immediate concern; shock.
Dr. Turbeville explains that shock can be fatal. In cases of traumatic injury, shock describes conditions that interfere with the heart’s ability to receive and pump oxygen-carrying blood throughout the body. The risk of shock may be reduced by keeping the injured calm, warm and hydrated; regardless if human or canine. The blanket helps; so does the IV.
IV’s are given to both humans and animals to prevent shock. The IV solution keeps fluids levels stable, which in turn helps keep blood pressure up, says Dr. Turbeville. She explains a decrease in blood pressure may restrict the flow of blood and fluids to the kidneys. Without that flow, it only takes a few minutes and the kidneys will shut down. Once the kidneys cease cleansing body fluids, toxins begin to build up. Then other organs, such as the liver and heart, begin to fail. Unlike humans, dogs and other animals cannot easily communicate where they feel pain. This makes it more challenging to pin-point the location of injuries. Simba must be given anesthetic and his entire body X-rayed while he sleeps. The vet cautions, if he goes into shock while sleeping, there is a risk he won’t wake up.
In general, dogs have a circulatory advantage over humans that reduces the impacts of injury and shock according to Dr. Turbeville. There are four main arteries carrying blood to a dog’s heart, compared to only one, the aorta, in humans. In dogs, if any of the main arteries are damaged, the others can easily take over. “Don’t easily believe someone who says a dog has had a heart attack,” cautions Dr. Turbeville. “It’s not likely.”
Dr. Turbeville explains further; if the dog is too stressed, such as after a traumatic injury like Simba’s, their circulatory advantage won’t matter. Dogs typically want to move around when nervous and the movement may further damage existing internal injuries, causing them to bleed more. Keeping him still is a priority. As the initial dose of pain medication takes effect, Simba rallies. The presence of his care-takers is not calming but instead exciting to the confused dog. His glassy stare follows every move. He squirms and seems to plead to be taken home. Recognizing the urgent need to keep him calm, Simba is left in the hands of Dr. Turbeville and her staff.
Several hours later, amidst the glow of a wall-mounted light box, the X-rays reveal amazing and troubling things. Surprisingly, Simba has only a single hair-line fracture on the left front leg and no other broken bones. While a few of his joints appear slightly out of alignment, it is amazing to learn no surgery or casts will be needed. These injuries will heal with rest over time.
Equally remarkable, is that his bladder is unscathed. Dr. Turbeville says this is very lucky; most dogs require surgery to repair ruptures to the bladder after colliding with vehicles. She feels the bus must have been traveling slowly. Less surprising and more ominous are the dark spots over many of his organs. Dr. Turbeville explains each dark spot on the X-ray indicates a collection of blood. The largest of these shadows is over his left lung, but her examination indicates Simba is breathing fine.
The most troubling revelation is the darkest mass, just a bit lower than the lung, above his stomach. It could just be tumor; not uncommon for a seven-year-old dog like Simba. Under the circumstances however, the vet worries it may be a hematoma on the spleen. “The next 48 hours will be critical,” consoles Dr. Turbeville. She is both tender and direct. “He will either make it, or he won’t.”
Simba’s vet explains a hematoma is just a fancy word for bruise or a collection of broken blood vessels. If the broken blood vessels on Simba’s spleen have stopped bleeding, then with rest his body will reabsorb the blood in a few days. The same will happen for the less serious internal injuries, too. If however the bleeding continues or the spleen ruptures, Simba will quickly bleed to death. Surgery is possible to repair or remove Simba’s spleen but it is very expensive – she estimates over $8000.00. It is possible to live without a spleen, Dr. Turbeville continues. The spleen contains white blood cells and helps the body fight infection. If removed, other organs, such as the liver, typically take over some of the spleen’s functions. After removing the spleen, the immune system may be compromised but it isn’t eliminated.
Unfortunately, according to Dr. Turbeville, the surgery required to repair or remove the spleen is risky. Simba will need to be transported to a veterinary hospital and the spleen could rupture from this activity. It is also possible that surgery itself might cause an unrepairable rupture. In Simba’s case, she feels surgery has less than a 50% chance of success. Simba’s youngest care-taker shakes his head and blurts out, “I don’t think we should do it.”
The room is quick to agree. Simba will remain at the Vet overnight. He will be kept calm and as pain-free as safely possible. Blood work will be done again to see if the internal bleeding has stopped. If all goes well, he may be home the following evening to recuperate. If it goes poorly overnight, he may die alone. Reluctantly, after short pats on the head to say good bye, Simba is left to sleep off his anesthetic.
To be continued…. Torque Writer (TM) This work is protected by US Copyright law, and may not be reproduced (wholly or partially) without the written consent and signature of the author, Rebecca L. Olson.
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