Sunday, September 6, 2009

Arrow Escapes

Well, the horse stories could go on forever - and I will doubtless trot out (as it were) the rest of them for you at some juncture - but I thought today maybe a little change of pace, in case the less horse-obsessed amongst us were getting bored.

It's moose-hunting season up here now. And beautiful weather for being out today, although my nurse M says her best hunting is usually on the wet and gloomy days. Fortunately for her that's what we had during bow season, which comes before the regular season. M bagged her moose on the last day of the bow season, filling her freezer against the winter to come. I have to say I admire the willingness to hunt an animal as large as a moose with just a bow, and respect the skill it takes to bring one down in that way. It seems fairer to me, in some way; the bow hunter has not such an enormous advantage over the prey as a gun provides. You don't have the range you can get with a rifle, so it's a little more of a level footing, at least in my imagination, and requires more skill of the hunter. M is a careful hunter, never taking a shot unless she's pretty sure she HAS a shot, not risking merely wounding an animal that will then wander around for days, suffering. She's been known to proxy-hunt as well - going out to hunt for someone otherwise eligible to hunt but who is too old or infirm to hunt for themselves; a generous thing to do, given the amount of work it is and that the meat goes to the person for whom she is hunting, not to herself. But not everyone is so meticulous in their ethics.

Not long after bow season was over, Fish and Game had to go trap a trumpeter swan that someone had shot with an arrow. Swans are a non-huntable bird in Alaska, so that in and of itself was wrong, and the kind of thing that completely infuriates me - and completely infuriates all responsible hunters, as well. Luckily for the swan, whoever shot it - and F&G thinks it was done deliberately - used a target arrow, not a hunting arrow. Target points are little bullet-shaped tips, a short cylindrical metal shape that is crowned by a conical point. Hunting tips, by contrast, come in a variety of shapes, depending on what you're hunting, but a lot of them are shaped more or less like the arrowheads made by Native hunters (which shape most of us would recognize.) Some people, in fact, still knap their own flint arrowheads and hunt with them. At any rate, a target arrow does much less harm than a hunting arrow would do, but it still enrages me that anyone would shoot a defenseless bird just to be shooting something - shoot it in a way that will cause it pain and harm, but not kill it outright. Wild swans up here are often semi-habituated; as they migrate, they travel from lake to lake, often spending a few days at their "usual" stops. Beautiful as they are, it's not uncommon for people to go down to the shore to watch them, and sometimes feed them. As a result, swans are often inclined to paddle peacefully over for a little gander at their admirers, and possibly a handout or two. After all, it's a long flight south, and a few extra calories aren't going to go amiss. But that means it would be extremely easy for some cruel, small-minded moron to shoot one of them with an arrow.

As it happens, Fish and Game managed to net the swan and examine it. This is not as easy as it sounds; apart from being strong and fairly fast swimmers, swans are strong and fairly sizey birds. They can beat you about the head with their powerful wings, and are not averse to biting if the need arises. Habituated though they might be, they aren't really interested in being caught. When you add to this the presence of a highly annoyed mate trying to goose you as you splash around in your waders with a net, you really have to give the F&G boys some credit. Eventually they did manage to corral the injured swan, however, and have a look at it. One of its wings was pinioned to its body by the arrow, but the arrow didn't penetrate deeply into the body wall. They were able to repair the injuries (with the assistance of the good offices of Wild Bird Rescue) and return the swan to its mate - and since the trumpeter swan mates for life, this is an important consideration. Well, all's well that ends well, in that case at least (although I would DEARLY love to see the shooter get what ought to be coming to them for their cruelty and their violation of the law.)

It's not the only time I've seen a non-huntable animal with an arrow injury, though.

Many years back, after I first came to Alaska, I was on call one day when some people paged me. They had found a dog that had been shot; it wasn't their dog, but they didn't want to see it suffering, so could they bring it in? Well, this is a sort of tricky situation; the clinic I work for is a small business, and they expect to collect fees, so that they can feed their families and stay open to help other animals. These people don't own this dog, and naturally enough don't really want to pay the emergency fees on an animal they don't own. And while it's true that even if I were independently wealthy I'd probably be willing to do this work for free, in fact it's not unreasonable for me to expect to be paid for going in to work on a weekend - or any other time, come to that. In those days Animal Control had no real facilities for handling this kind of thing, so... what to do?

Well, sometimes, you just have to go with your gut, so I told the callers to come on in. I just figured we'd work it out as we went along.

I had assumed, on hearing that the dog had been shot, that it had been a gunshot wound, by far the more common event up here. But no; when I reached the clinic, the good Samaritans were waiting anxiously by their car. I walked over to them and they said, "We were afraid to move him too much, since it's still in him."

Eh? That's not the usual thing people say with a gunshot dog. I look through the open door into the back seat, where they have ensconced the dog. He is laying across the entire length of the back bench seat, a long, rangy grey husky-mix sort of dog. The Samaritans, obviously being the planning type, have blanketed the seat for comfort and against messes, and have already muzzled the dog with a blue nylon muzzle ("We don't know anything about this dog and we thought he might want to bite," they explained.)

Well, I might want to bite, too. Protruding from his back, just to the right of his spine and just aft of his ribs, is the end of the arrow. It is embedded so deep that the fletchings are snugged up against his fur. In fact, if not for them, I believe the arrow would have gone all the way through the dog.

Yikes. I can't believe the dog arrived alive.

"Let's get him inside and see what we've got," I say. "Let me go get a stretcher."

We manage to slide the dog onto the stretcher and carry him into the hospital with a minimum of jostling. I have a look at the dog. He looks a bit disreputable, a little thin and unkempt, as if he has been on his own for a while. He is regarding me somewhat warily over his muzzle, but the muzzle is loose enough that he can breathe unimpeded. After a minute, when I've not done anything too alarming, he opens his jaw slightly to pant, and I can see that his color is excellent. He looks alert and oriented, as well - all of which is a bit of a shock, considering that I can feel the point of the arrow protruding between the ribs on the left side of his chest, tenting his furry hide but not penetrating through it. This means that the arrow has passed from his right upper lumbar area - just over the right kidney - across his midline through his diaphragm, and through his chest at a slightly downward angle. The tip is palpable about mid-thorax, maybe 4 inches above the point of the heart, but level with it. Somehow the arrow, while it most assuredly passed by them both, has not torn either the aorta or the vena cava, the two enormous vessels that travel down the body's midline: a laceration to either one would have caused the dog to bleed out in a matter of minutes. I can't rule out a nick in one or the other; sometimes the presence of the foreign body will plug the wound temporarily - until it is removed, and then the hole opens up and bleeds ferociously. I know that the arrow has passed by the stomach, the liver, the gall bladder and the esophagus, not to mention quite a stretch of lung tissue, but I have no idea what damage was done to which organ - although it's obvious that the diaphragm must have a hole in it, since the arrow goes through it. And, quite incidentally, the dog is also missing a small bit off the tip of one ear, and two toes on one of his hind feet. He's had an eventful life, this dog. But clearly the arrow is by far the biggest of these events, and the most life-threatening. I can imagine the path of the arrow through his body, and all the potential harm it might have done going in - or could do, coming out again.

Hm. This could be quite a disaster in the making.

I look at the good Samaritans.

"Ideally this would be something where I sedate him and Xray to see what we have, and then decide on a course of treatment, although in a situation like this the anesthesia itself might destabilize him and kill him," I tell them. "But that all incurs some significant expenses, and I'm not sure whether you intended to take responsibility for that...?" I ask, as delicately as possible. They look at each other, one of those marital glances that seems to carry within it an entire conversation.

"He's not our dog," the husband finally says. "We wanted to help him, and we'll pay the emergency fee, but beyond that..."

Well, okay. This is certainly reasonable enough. This is not their job. They've already done more than many people would, by carefully catching up the dog, muzzling him to prevent him from injuring them - or me, I might add with some gratitude - and volunteering to pay an emergency fee for an animal they do not own and have no responsibility to beyond that of common human decency.

Okay, the ball is back in my court. I can euthanize him, or I can try to treat. Euthanasia is tempting, given the frightening nature of the arrow path; but the dog is laying sternal, looking quiet but alert, breathing easily (and isn't THAT rather astonishing, under the circumstances), rotating his ears to catch our conversation. I call my boss to ask for guidance. He says I can do whatever I decide is best, but to try not to spend too much of the clinic's money, since we're not getting paid for it. I look at the dog. He looks at me. There is undeniable awareness in his clear golden eyes. Somehow I feel like I have to try something, at least.... and clearly I can't just leave him there with an arrow running through his body.

"Well," I say to the Samaritans. "Our choices are to put him down or to give it a try. I'm inclined to give it a try, but I have to warn you: I have no idea what kind of tip is on this arrow. I can feel the point of it just under the skin, but it's mainly embedded in the muscle of his chest wall between the ribs -so even though I think it's a target point, I might be wrong: it might be a hunting point, and if so, pulling it out will likely kill him on the spot. Even with a target point it's a risky endeavor: if it doesn't kill him outright from exsanguination, there are all sorts of possible consequences: he could get a pneumothorax and die from that, or it may have lacerated his esophagus, which would certainly kill him unless very extensive surgery is done. It might have nicked a loop of bowel or perforated his stomach, either of which could lead to peritonitis. That would kill him too, unless we do some major surgery. It could have lacerated his kidney, which would be another complete disaster, and I don't see how it can have missed hitting his liver. And of course there are infection risks along the entire arrow path; even if it somehow missed all his organs, it certainly wasn't sterile, and it's bound to have carried all kinds of bacteria in with it. He could get a massive infection in his chest or his abdomen as a result, which would naturally be a very serious problem."

They look at each other.

"None of the long-term consequences are your problem, of course, since he's not your dog," I add. "But usually when people bring in dogs like this, even if they don't decide to keep them, they want to find out how they did in the long run. I'm just letting you know he's got a lot of potential hazard to this. If you'd rather I put him down and not take the risks, it's okay to tell me so."

"Would it be... would it be okay to just pull out the arrow and see what happens?" asks the wife, tentatively.

"Yes," I say. "You don't have to stay," I add, knowing that the dog might crash on the spot and that that might be deeply distressing for these kindhearted people.

"No. We'll stay," says the husband, resolutely. He flexes his hand slightly, ready to step in. "What do you want me to do?"

"Just steady him and keep him from jumping off the table," I say. Carefully, I clip as best I can around the fletching of the arrow; if the dog doesn't die from the extraction of it, I'll need to suture that area, and I'd rather do it without hair on it. I gently prep around the shaft of the arrow and set a purse-string suture around it; if I'm quick, I can pull this tight as soon as the arrow is out, cinching the skin down to prevent air from entering the arrow path to minimize the chance of sucking air into the wound, and maybe encouraging a pneumothorax. I have no idea if this would in fact happen, but it's at least something I can try to prevent.

During all this the dog lies stoically, flicking an ear back at me, but barely twitching when I set my sutures.

I grasp the ends of my purse-string suture with mt left hand, bracing the heel of it against the dog's back. I grip the arrow's fletchings firmly in my right.

"Ready?" I ask them. The husband, hugging the dog around the neck, his mouth set, looks at me and gives me a nod.

I start to pull back on the arrow - pull back hard, because it doesn't want to move. But after a second it starts to shift. I feel a stuttering, grating vibration in the shaft as the point releases itself from the rib against which it was set, and then the arrow pulls out smooth and fast. I snatch my purse-string tight, tossing the arrow on the floor, and quickly tie down my suture.

I look up. Neither the dog nor the good Samaritan clinging to his neck has moved during the few seconds it took to pull the arrow. Slowly, the man straitens up, backing away from the dog as he might from a live hand grenade. All eyes are on the dog. Inside his blue muzzle, he opens his mouth and pants gently.

I watch him for a minute, two minutes. He doesn't appear to be bleeding out. I inject a large wad of antibiotics and enlist the help of the good Samaritans to lift him off the table.

"Let's get this muzzle off of him," I say, unclasping it and handing it back to its owners. The dog sniffs with interest at the nearest trash can.

"Well, okay," I tell the couple. "Let me take care of him through the weekend, see what he does." I ensconce the dog in a cage with a blanket and some water, which he drinks a little of. We handle some paperwork and I promise to call Monday with an update.

Monday the dog is seeming pretty chipper with his little hotel stay. He likes the room service, and has happily eaten everything offered, with no ill effects. He has no fever, no cough, no penumothorax, no abdominal effusions, no belly pain, no apparent ill effects whatsoever from being impaled by the arrow. The good Samaritans stop in and want to visit him.

"Sure," I say, leading them back to his run. "I've been calling him Archer," I add, since we had to call him something, and "That Dog That Got Shot With The Arrow" is a bit cumbersome. "He has no microchip or other ID, so Animal Control is going to come over and get him later today or tomorrow. I gave them a description, but they have no reports that he's gone missing from anyone," I add. He's not that hard to identify, after all, with his missing parts; I'm fairly certain if someone was looking for him it would easy for Animal Control to match him up with my description.

Leaving them to commune with the dog for a while, I go take an appointment. I go back to check on them. The wife is sitting on the floor in the front of the run, cuddling the newly-christened Archer. He's generally friendly enough in a slightly aloof, independandt sort of way, but seems happy enough to be getting his ears scratched by Mrs. Samaritan.

"We've decided we want to adopt him," Mr. Samaritan informs me.

"Oh," I say. "I'll call Animal Control and see if I can clear it with them." Animal Control takes information from me and the Samaritans, treating it as they would had someone called to report a stray, but been willing to house the stray (rather than take it to the shelter) while Animal Control seeks the owner. The Samaritans pay Archer's bill and take him home.

I never saw any of them again - Archer OR the Samaritans - so I can only hope it all ended well. I do know that no one ever showed up at Animal Control looking for Archer - and I also know that whoever shot him was never caught. I've seen many a strange thing in Veterinary medicine from that day to this, but there haven't been a lot of things stranger than having a full recovery from an injury like that solely on the strength of a single suture and a wad of antibiotics.

Since they weren't gunshot wounds, I suppose you can't really say that either that trumpeter swan or Archer dodged the bullet... in either case, it was more of an arrow escape.


Holly said...

"dad is john smiley"


amazing, just amazing. You, the incidents and the animals. Amazing.

MaskedMan said...

There are some sad, sick people out there.

There are some open-hearted angels, to offset the jerks.

Sometimes, miracles happen.

And sometimes, all three intersect in highly improbable ways.

How magical to have been there, at that intersection.

AKDD said...

You do get the chance to see the WEIRDEST things in vet med every so often. It's just completely surreal, sometimes.

Other times, it's just plain cool. :)

I can't help but think that, given the angle of the shot, Archer was shot intentionally - from behind. It seems an act of the most complete cowardice, but I try to bear in mind that it's possible he'd just been in someone's goat pen eating their best milker or something. It's more likely not... but one never knows. Certainly very few people would stand by and do nothing if something was attacking their livestock. I have hoped for years that having a home and people to care for him meant that Archer kept out of whatever scrapes cost him his toes, his ear tip and his brush with death-by-arrow.

The swan, certainly, was doing no one any harm, and probably paddled trustingly up to whatever b**tard shot it. THOSE are the people I'd like to string up by their ankles to await my wrath.

Dragon43 said...

These kinds of recovery stories make me smile ear to ear.

I need orange said...

Truly amazing.

I was expecting hours of surgery, etc, etc, etc.

I, too, hope Archer and his family had many happy years together.

EvenSong said...

You have a lovely way of recounting the good, bad, and ugly in both animals and, more often, people. It's obvious that the first quality is what inspires you to keep at it.

Altho, being a horse person, I love the equine stories, I also appreciate the saga of your veterinary practice. I might have gone that route at one point in my life, but at this point in my But I do enjoy it vicariously thru your recollections.

Shalom said...

Not being a surgeon, I may be totally talking out of my tuchus here, but I would be interested to learn, given that you could feel the tip against the chest wall, why it was safer to remove the arrow via its point of entry, rather than cutting another hole and pulling it the rest of the way through (maybe sawing or clipping off the end with the feathers first)? I can see that two holes in a dog are worse than one, but against this, you have to weigh the possibility that the wider end of the arrowhead would snag on something on the way back out, whereas the smooth shaft isn't likely to worsen existing damage if it keeps going in the direction it was already heading in.

(I'm a pharmacist by profession, so I have no training in surgery, or even much more than the basics of anatomy: we have to know in great detail what the organs do and how, but not necessarily where they are or what they look like. I seem to remember reading back when I was a kid that porcupine quills are pushed through rather than pulled back, and this would seem to be the same sort of thing.)

Oh, and I hope you saved the arrow, so that if you ever find its owner, you can return it to him. Preferably with your own bow at fairly close range.

AKDD said...

Glad you're all enjoying these stories... I sometimes can hardly believe the things we see. And don't worry about no more horse stories... as those who know me well can attest, it's nearly impossible to shut me up on the subject. :D

Shalom, good question (and excellent suggestion on what to do with the arrow, BTW, didn't think of that....!) >:D

As for pulling back VS pulling forward: There were several reasons I chose the path I did. One was that I was about 75% sure that what was there was a target point, based partly on my palpation and partly on the fact that the dog wasn't dead yet; though I am not myself a bow-hunter, I thought it likely, given the arrow's path, that a hunting point would have already killed the dog.

Second was that it was a fiberglass shaft, which would be difficult to cut without shattering it or introducing fiberglass dust into the wound (a highly irritating substace to the tissues.) Moreover, there was literally NO space between the fletchings and the skin in which to cut; the feathers were flush against the skin. I was also pretty sure that the vibrations from trying to saw through it would have been intensely unpleasant for the dog, and it's highly doubtful that I would have been able to accomplish that feat without anesthesia.

The next thing was that on the lumbar area I had about 3 to 4 inches of fletched shaft to grasp and pull; on the left thorax, I had maybe a half a centimeter, if that (if you'll pardon my mixing my measurements... or the units thereof.) It would also have required anesthesia to cut the skin, excavate enough arrow tip to grasp and then pull forward (even without the whole sawing-through-the-shaft thing) and we had no funds to cover that.

The last thing would be that the one thing that was keeping the dog from having a nice sucking chest wound (and therefore a pneumopthorax, a serious complication) on the left chest was the fact that the skin was not penetrated on that side. The chest wall was breached, but the skin was not. Even with a purse-string procedure like I did on the lumbar area, pneumothorax would have been hard to prevent, no matter how fast I was. At the lumbar site, I was at least reasonably hopeful that even if I was not completely perfect on my purse-stringing speed, the tissues would be falling together behind the arrow as I pulled it out, lessening the chance of a pneumothorax. Or so I hoped - and as it happened, that actually worked, to my moderate astonishment.

But that was an excellent question, and I probably should have made that more clear in the actual story.

As for porcupine quills, we pull them whichever way we can get them. You pretty much grab whatever end you can get, although if both front and back ends are sticking out, I usually DO pull forward, because it does cause the barbs to lay flat and they are usually a bit easier to pull that direction. However, many and many a time the point is aiming deep into thick heavy tissue or pointing at an important or vulnerable organ or butted up against bone, and trying to push them forward til you can make the tip come out is a losing proposition... and might in some cases cause grievous harm.

Unfortunately I've had TONS of experience with PPQs since I moved to AK. I've spent many an hour hunched over some poor dog, de-quilling. Only once have I had to de-quill an owner (via the easier, forward-direction pull), and according to him it was pretty painful. I can't even imagine what the dogs go through.

Flo said...

I hunt, and I'm not ashamed of it- clean kills are not anything to be apologetic for- but I am so sorry those animals had to suffer for some human's sick amusement. That's not hunting, that's torturing for entertainment, and it's disgusting. Target arrows and BB guns are usually the tools of young males with nothing better to do with their time.
I'm currently getting ready for blackpowder season for Whitetails here in Kansas. Modern rifles are wonderful for being absolutely sure that if you take the time to practice, whatever you put crosshairs on will go down, but I too feel that it's not a fair match. The Germans have a saying that "all is for naught if an angel pisses in your flashpan" regarding blackpowder, so it's a bit more of a gamble. I really respect hunters who are primarily archers, but my skill level is not good enough for me to be going out without maiming something. And if I can't be sure the shot will kill it, I'm not shooting. I wish more people respected weapons and didn't treat them as toys. I also wish more people respected life and weren't in such a rush to kill things.

AKDD said...

Flo, I'm with you. I don't hunt myself, but I have no objections to those who hunt for food - and do it legally and ethically. I DO have a problem with people who just shoot things for fun or out of boredom, especially those who injure animals and then leave them to suffer. Trophy hunting... that makes me uneasy, but if you're hunting to feed yourself and your family, I see no reason why you should not make use of the whole animal, and if that includes putting a mount on your wall, I am not offended by that. I just find it disrespectful of the animal's sacrifice to take the pretty horns (or skin, or what have you) and leave the rest, as if the life of the animal was of no value apart from decoration.