It's an emergency! But whatever you do, don't anesthetize her!
If anyone “gets” anesthephobia, I do. I don’t like my dog to enter into a controlled form of unconsciousness any more than you do. It’s somehow very stressful at a very raw, animal level: it’s unnatural and bizarre, if you think about it for too long.
But faced with two alternatives: my dog will suffer forty minutes of avoidable pain or my dog will receive fifteen minutes of anesthesia, I’d vote for the latter. Yet Saturday’s client did not agree with my personal and professional recommendations. He flat-out refused to have his dog undergo an anesthetic procedure. Here’s the story:
The patient: A seven-year-old, medium sized female dog of indeterminate, long-haired breed provenance.
The emergency: Attack by stray dog resulting in multiple puncture wounds, generalized bruising and one large but shallow laceration on her back.
The negotiation: “She’s sore all over and the areas I’ll have to clean most thoroughly are especially painful. The laceration will require sutures for most effective closure and, in my opinion, local anesthesia will be more painful over that wide area than simply suturing with a small gauge needle. We’ll have to anesthetize her.”
The client’s answer: No dice. “She doesn’t need it. Remember—this was the dog that let you scale her teeth without anesthesia!” (He’s referring to a small amount of tartar I scaled off her canines once—not even at the gumline.)
The conclusion: There’s no arguing with certain people. I knew the battle was lost unless I absolutely demanded. Instead, I chose to warn him of the risks of inadequate wound cleansing and less-than-secure laceration repair. Some battles are not worth fighting. I decided to save up my energy for a disaster case.
Probable worst case scenario?: Monday I’d be anesthetizing her to clean and culture her wounds.
The procedure: A good all-over bath (she was most dirty) with special attention to the puncture wounds (mostly on her limbs and underside). A rough clipping over these areas of interest (multiple close shaves are out of the question without anesthesia), and the same over the laceration, leaving more length of hair for use in the repair. Copious flushing of the laceration site (“dilution is the solution to pollution”) and a gentle blow dry completed the ablutions.
The closure: Finally, repair of the site using two tiny, strategically placed sutures (for a four-inch length wound) and braiding of the hair over the wound to achieve closure. Next, a line of surgical glue to keep the braid in place and voilá—a tenuously repaired laceration. We’ll see if it holds.
The medication: Pain relievers (Rimadyl) and antibiotics (Penicillin) were administered at the outset, of course. More Rimadyl and some Clavamox were prescribed to go home with her. But none of those pesky medications with the word “anesthetic” in them were employed.
The price: Because it took more than twice as long to accomplish the task, the client was charged more than double what I might otherwise have charged with anesthesia (for what would have been a more effective procedure). At least this client had the good sense not to complain.