Sunday, December 4, 2011

I'll take testicles with that

Here's a novelty; I'm going to write a vet related post, something I've not done in a while. Soon, I'll post the case of the draino burn puppy but not until we've reached full resolution and I can include all the cool photos.

My boss has a horrible habit of handing me cases to do the surgery and saying, "Oh, this one should be really easy!" I love surgery so being handed the cases is usually not a source of irritation. The being easy comment is because inevitably when he says that it turns out to be way more complicated than he expects. Then he gets antsy because it takes longer than he thinks it should. Then he gets guilty for dumping it on me and tries to help, thus only getting in the way. It's all so predictable I could choreograph a movie beforehand.

The most recent of these was a bilateral perineal hernia on a 12 year old Chihuahua with horrible dental disease, mild azotemia, and a single descended testicle. The azotemia resolved with 24 hours of fluid therapy and I then took him to surgery. My boss said that the hernias were small and only contained a little fat so they should be no problem to repair. As an aside, with my aggressive dental techniques (at least that's how my boss and staff view them), the dog had one lonely tooth left at the end of the day. Tell me what I should have done differently? The teeth were abscessed with horrible periodontal disease and most of them fell out in my hands not even qualifying as true extractions in my book...

When I opened the herniated areas, the dog's guts were hanging out his rear through the incisions I created. There was also another, initially unidentified object encased in fascia and not directly connected to the intestines on the right side. The intestines appeared healthy with no evidence of damage therefore I reduced the left side and closed the hernia then moved to the right. I reduced the intestinal loops then began to carefully explore the unknown mass in an effort to identify it. If it wasn't a testicle, I really don't know what it was. The anatomy was perfect for a retained testicle although the "testicle" itself was inflamed and engorged as if it had been strangulated. I ligated the blood supply and removed the presumed testicle then finished repairing the hernia. I then proceeded to castrate the dog only to discover that he had a descended testicle and a subcutaneous testicle.

OK. I can still do routine math. One plus one plus one equals three. Wait a second!!! Three??? Three testicles? There are only supposed to be two. I'm thoroughly confused now. I dissected the "mass" and still came to the conclusion that it was a testicle. I did a touch prep that was totally useless with its ambiguity.

Yes, I have submitted it for histopath. I'll let you know what I find out..... Three?????

1 comment:

Elizabeth said...

hmm what could you have done differently, lets see take out the last tooth.. hehe no more dentals.. seems so funny to bother leaving one tooth.