Dodging the Bullet

So tonight I'm on call and I get a call about a Rottie who, the owner says, is the size of a small black bear, and who they think has been shot.

Oh, goodie. This could be fun. Not. A large, painful dog, possibly in shock, possibly (in view of these things) inclined to have toothy objections to being handled, and who will have to be hoiked onto the Xray table at minimum, and perhaps other places as well. Oh, well. Duty calls.

I cruise on in and meet the owners, who, it transpires, aren't exaggerating much about the size of their dog. It's a nice-tempered but painful 4 year old Rott, who indeed has what appears to be a gunshot wound on his right side. He is also tall and big-framed, and somewhat chubby. Okay, a little more than somewhat.

The physical exam fails to reveal an exit wound, nor does it tell me where the bullet travelled from the place it entered the dog, amidships on the right side of the abdomen. In that position it could have gone strait through, penetrating the belly (and if so very likely piercing gut, which would be bad), or it could have travelled forward or back or up or down. Fortunately, the dog is reassuringly pink in the gums and walked into the clinic under his own steam, although he is pretty willing to lay down the minute the opportunity presents itself. This doesn't rule out the possibility of Something Bad Inside, but at least the dog is stable for the moment.

The owners okay an Xray of the abdomen to localize the bullet. Somehow the male owner manages to heave the dog onto the Xray table (I estimate that the owner weighs perhaps 20# more than the dog, if that, since my patient is in the 150# neighborhood, and the owner is a lean, compact sort of guy). Between the owner, his wife and I, we manage to lay the dog down on his uninjured left side. This requires a certain amount of grunting and straining and breathless exhortations for him to please lay down, after about 3 minutes of which he finally succumbs to our will and allows himself to be stretched out on his side. I invent an Xray technique (since our technique chart only goes up to 24 cm, and this dog measures 28.5), truss myself up in various leaden garments, shoo the owners out of the room and shoot a film. My patient, meanwhile, having realized that the Xray table isn't really that uncomfortable (and also that in this position he can be conveniently petted by both owners), has relaxed and stretched out like a beached walrus, basking in the murmured endearments of his tearful owners, while their rather adorable little girl watches gravely from the doorway.

I develop the film - which is barely dark enough, despite my generous estimate of the necessary kVp - and discover that this dog has gotten lucky. The bullet (which looks like a .22) travelled up and back from the entry, lodging itself in the backstrap. In that position, and given the dog's general physical signs, there's about a two out of three chance that the abdomen has not been penetrated in any way that will cause problems. This is a Good Thing, since the owners cannot afford to open the dog up to make sure.

We elect to do what we can do, which is to treat to prevent infection and control pain. I clean the wound and the owner eases the dog onto the floor, grunting and huffing as he lowers him gently to the ground. I get to the computer and am entering charges and talking to the owners about aftercare and rechecks, explaining why it's better not to suture the entry wound, when I hear the beep that means that someone has come in the building. Eh? It's 9:30 p.m. We're after hours, locked down except for the back door where I've let the owners go out to get their checkbook, and the only people who should be here are me and my clients. I look over my shoulder and in walks Dave, my BF. Well. MY night just got better.

"Hey!" I say to him, pleased. "What are you doing here?"
"I was on my way home, saw your truck, figured it was Pet E.R. in here, thought I'd stop in and visit," he says. He looks at the Rottie, offering his knuckles to sniff, and (in his usual style) is soon schmoozing with the owners, inquiring about their dog, listening to their account of the events of the day (which they, venting their stress, are all too happy to relate, babbling slightly in their relief that their dog is likely to be reparable with nothing but medication and nursing care.) I invite them to go have a look at the Xray while I poke around on the computer, and hear one of the owners solemnly telling Dave that the bullet is magnified to ten times its actual size on the film. (EH? I did mention that there was a slight magnification effect, but I don't recall anything about "ten times actual size". Oh, well.)

I script out meds, make sure the client is clear on aftercare and what signs to watch for should things not be going as hoped. Dave walks them out, holding doors for them, and then comes and fills me in on his day as I'm shutting down the clinic. As is his habit, he asks me about my other emergency calls that day. I mention that this was my second GSW in a week; a bit odd, since I haven't seen one in well over a year.

"Both shot in the same area?" Dave asks.
"Yes, actually, although the other dog was shot on the left, not the right," I say.
"No, I mean, were they in the same area?" He says.
"Yes, both lumbar," I say.
"No," Dave says, laughing. "I mean, were both dogs shot while in the same neighborhood?"
"Oh," I say. (Duh.) "No, one was up in Peters Creek," I tell him.

I button down the clinic and we go out into the cool night, letting Pepper out to romp around and urinate on things. We load ourselves into our respective trucks and as I'm driving home I'm thinking that I'm due one more; it's weird how often these things really DO come in threes. I just hope that if I do get another one, it follows a similar pattern and (so to speak) dodges the bullet.