Case Study: Toby Smith

 In Case Studies

Case Study - Toby the DogIn October 2016, Toby was hit by car. His regular veterinarian referred him to us at Animal Emergency & Specialty Center.

Toby was unstable when he arrived due to his traumatic injuries. He had a severely fractured pelvis, partial proptosis of his left eye, severe road rash, and inguinal bruising. Additionally, Toby had a very low temperature, pale gums, and anemia. Toby was in shock.

Our emergency clinician started Toby on pain medications and aggressive IV fluid therapy. Because Toby was unable to walk or urinate on his own, a urinary catheter and collection system was placed.

As the night progressed, Toby started to stabilize. For the next several days, Toby was closely monitored. He was nauseous and unable to eat so a veterinarian placed a nasogastric tube to help Toby get the nutrients and medication he needed.

Two days after the accident, Toby suddenly developed free fluid in his abdomen. Analysis proved it was urine. The critical care doctor took contrast radiographs to identify the defect and discovered a small tear in Toby’s bladder. The tear was medically managed by placing a drain in his abdomen, allowing the fluid to drain and the bladder to heal.

Case Study - Toby the DogToby required constant care and attention from the AESC critical care team but remained a non-stop fighter. Four days after the accident, Toby required a transfusion to address his anemia and stabilize him for surgery for his fractured pelvis.

Dr. Rudd, our board-certified surgeon, evaluated Toby’s severely fractured right iliac and operated. The fracture fragments were meticulously located and reduced. Two T-plates were stacked and contoured to the pelvis to provide stability and prevent plate failure. The three-hour procedure was followed by a smooth recovery without complication.

Toby continued to improve over the next several days, eating on his own and with reduced swelling and bruising. He stood soon after surgery and continued to gain strength and energy. Unfortunately, there was more to do before Toby could return home. The significant trauma to his left eye necessitated a second surgery to remove it. Toby recovered quickly and was discharged that night after eleven days in the hospital.

Case Study - Toby the DogTwo weeks later, Dr. Rudd saw Toby for his post-operative recheck exam. Toby showed significant signs of improvement. Even though his activities were restricted and he was still slightly limping, he was a happy boy.

Toby looked great at his six week recheck! We took radiographs to assess the fracture, and saw it had healed. Now Toby could walk around and start to return to normal activity.

Now, Toby is back to normal and enjoying vacation time on the beach with his doting family.