Behind the Scenes: Lucy's FHO

**Warning: this post is graphic. If you're squeamish and don't want to see surgery photos, just know that Lucy had her surgery and did very well.**

Lucy's x-ray showing pelvic and FH fractures

Today was an exciting, long, tiring, major day for me and Lucy. Our little lady beagle went in for her FHO surgery this morning! Brief refresher: Lucy got hit by a car and fractured the ball joint (femoral head) of her hip. FHO is where they remove the ball joint entirely, leaving behind a smooth-edged free-floating femur. San Jose Animal Care Center (the shelter where Lucy's from and where I volunteer) has a great partnership with a local veterinary specialty center called SAGE. The shelter arranged for a SAGE specialist to perform Lucy's FHO in-house at SJACC and I got to watch. How cool is that?! For those of you who may be wondering, the shelter has a special medical fund set aside for SAGE procedures that covers specialty surgeries like Lucy's. This reserve is funded by the City, by private donations, and by a special resource called Maddie's Fund (http://www.maddiesfund.org/). What does this mean? St. Francis covers Lucy's post-op care. The surgery and all associated costs are taken care of. That is huge for rescue, just huge. I am so impressed by SJACC's resources and the smart decisions they make with their funding. It's absolutely amazing. These people are going to get tired of hearing my broken record spiel about how awesome they are, I'm sure, but I can't help it. I have truly landed on a different planet. Confused? Check out my blog post from a couple weeks ago: http://ohfortheloveofdogs.blogspot.com/2014/03/san-jose-animal-care-center-breath-of_20.html

All scrubbed up for FHO!

Although I spent a preliminary observation day in the vet clinic last week, today was my first day officially volunteering back there. I saw SO much stuff last week, it blew my mind. In a mere four hours, I watched 14 spays/neuters, an enucleation, ear tippings on feral cats, dental cleanings and extractions, a punch biopsy, removal of a surprise dead kidney during a routine spay, dental x-rays, and all kinds of other stuff. I'd never seen a surgery before, so this was a huge deal for me. I got lightheaded briefly during the first two spays, but was totally fine after that. It was weird to have a physiological response despite not feeling squeamish or bothered by any of it. Today was more hands-on for me. I drew rabies / bordatella / DHPP vaccinations, assisted with health check paperwork for dogs waiting in stray hold, learned how to set up and test all the tubing for the anesthesia/respiration machines, applied eye lubricant and clipped nails when dogs and cats went under, and of course observed Lucy's surgery. I had a freaking BLAST.

I brought Lucy in at 8AM. I took a few photos of the team prepping her for surgery (shown right). By noon, she was under for her spay with Dr. Tyson. Meanwhile, Dr. Scherrer and his RVT arrived from SAGE for the FHO. At 1:05, Dr. Scherrer made the first incision and it was go time. I had so much fun watching this procedure. Lucy did great. Fortunately, everything went smoothly as a straightforward FHO should. There are a few different techniques for removing the femoral head during FHO. One is to use a bone saw, another is to use a burr, and another yet is to use something called gigli wire (like a garrote). Dr. Scherrer opted to use the Stryker burr to remove Lucy's femoral head. The Stryker is basically a drill type instrument that has different attachments (think drill bits) on the end. You can also see the cauterizing tool he used to control the bleeding. In the video below, you can even see a decent sized puff emerge from the site. That's the cauterizer at work. Dr. Scherrer's RVT monitored Lucy very closely during the entire surgery (just shy of 2 hours!) and made sure she remained comfortable. She did great! Check out the removed femoral head (shown bottom right).

Lucy will stay overnight with Dr. Tyson tonight to be sure she gets through the critical part of her recovery. She's on a serious cocktail of drugs called an mlk drip: morphine, lidocaine, and ketamine. These are administered via IV drip before, during, and after surgery. She's also got a fentanyl pain management patch on her leg that will continue to keep her comfortable for the next few days once she's no longer on the mlk drip. On top of that, Lucy received a post-op metacam injection to control inflammation. Did I mention she got a hydromorphone injection before all of this? The girl is straight chillin, so don't worry! She's being kept as comfortable as possible.

All that fuss for one tiny bone

Lucy waking up post-op

Our lady beagle will come home tomorrow, take it easy, and in a few days begin some basic physical therapy exercises with me. In two short weeks, she'll be ready to use that leg like normal. The pelvic fracture will eventually heal on its own. Then miss Lucy will be ready for adoption! Huge thanks to St. Francis for sponsoring Lucy's rescue, to SJACC for allocating the resources to bring in SAGE, to Dr. Tyson and everyone at the shelter for spaying Lucy and keeping her comfortable, and of course to Dr. Scherrer and Liza for their mobile surgery skills today (and for letting me crash the OR with my camera!). All of these people are genuinely amazing and so devoted to what they do. It has been an absolute privilege to volunteer in the vet clinic and get to know such a wonderful team of people. Shelter medicine is definitely its own thing and it's totally what I want to do. I feel like a sponge; I'm learning so much and having so much fun along the way. Stay tuned for pupdates on Lucy's recovery and for more volunteer adventure in the vet clinic next Tuesday!